1
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Yuan J, Xu L, Chien CY, Yang Y, Yue Y, Fadera S, Stark AH, Schwetye KE, Nazeri A, Desai R, Athiraman U, Chaudhuri AA, Chen H, Leuthardt EC. First-in-human prospective trial of sonobiopsy in high-grade glioma patients using neuronavigation-guided focused ultrasound. NPJ Precis Oncol 2023; 7:92. [PMID: 37717084 PMCID: PMC10505140 DOI: 10.1038/s41698-023-00448-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023] Open
Abstract
Sonobiopsy is an emerging technology that combines focused ultrasound (FUS) with microbubbles to enrich circulating brain disease-specific biomarkers for noninvasive molecular diagnosis of brain diseases. Here, we report the first-in-human prospective trial of sonobiopsy in high-grade glioma patients to evaluate its feasibility and safety in enriching plasma circulating tumor biomarkers. A nimble FUS device integrated with a clinical neuronavigation system was used to perform sonobiopsy following an established clinical workflow for neuronavigation. Analysis of blood samples collected before and after FUS sonication showed that sonobiopsy enriched plasma circulating tumor DNA (ctDNA), including a maximum increase of 1.6-fold for the mononucleosome cell-free DNA (cfDNA) fragments (120-280 bp), 1.9-fold for the patient-specific tumor variant ctDNA level, and 5.6-fold for the TERT mutation ctDNA level. Histological analysis of surgically resected tumors confirmed the safety of the procedure. Transcriptome analysis of sonicated and nonsonicated tumor tissues found that FUS sonication modulated cell physical structure-related genes. Only 2 out of 17,982 total detected genes related to the immune pathways were upregulated. These feasibility and safety data support the continued investigation of sonobiopsy for noninvasive molecular diagnosis of brain diseases.
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Affiliation(s)
- Jinyun Yuan
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
| | - Lu Xu
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
| | - Chih-Yen Chien
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
| | - Yaoheng Yang
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
| | - Yimei Yue
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
| | - Siaka Fadera
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
| | - Andrew H Stark
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
| | - Katherine E Schwetye
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Arash Nazeri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Rupen Desai
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Umeshkumar Athiraman
- Department of Anesthesia, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Aadel A Chaudhuri
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO, 63108, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Computer Science and Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Hong Chen
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA.
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Division of Neurotechnology, Department of Neurosurgery, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
| | - Eric C Leuthardt
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, 63130, USA.
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, 63110, USA.
- Division of Neurotechnology, Department of Neurosurgery, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
- Department of Neuroscience, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
- Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, Saint Louis, MO, 63130, USA.
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2
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Dickson A, Geerling E, Stone ET, Hassert M, Steffen TL, Makkena T, Smither M, Schwetye KE, Zhang J, Georges B, Roberts MS, Suschak JJ, Pinto AK, Brien JD. The role of vaccination route with an adenovirus-vectored vaccine in protection, viral control, and transmission in the SARS-CoV-2/K18-hACE2 mouse infection model. Front Immunol 2023; 14:1188392. [PMID: 37662899 PMCID: PMC10469340 DOI: 10.3389/fimmu.2023.1188392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/22/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Vaccination is the most effective mechanism to prevent severe COVID-19. However, breakthrough infections and subsequent transmission of SARS-CoV-2 remain a significant problem. Intranasal vaccination has the potential to be more effective in preventing disease and limiting transmission between individuals as it induces potent responses at mucosal sites. Methods Utilizing a replication-deficient adenovirus serotype 5-vectored vaccine expressing the SARS-CoV-2 RBD (AdCOVID) in homozygous and heterozygous transgenic K18-hACE2, we investigated the impact of the route of administration on vaccine immunogenicity, SARS-CoV-2 transmission, and survival. Results Mice vaccinated with AdCOVID via the intramuscular or intranasal route and subsequently challenged with SARS-CoV-2 showed that animals vaccinated intranasally had improved cellular and mucosal antibody responses. Additionally, intranasally vaccinated animals had significantly better viremic control, and protection from lethal infection compared to intramuscularly vaccinated animals. Notably, in a novel transmission model, intranasal vaccination reduced viral transmission to naïve co-housed mice compared to intramuscular vaccination. Discussion Our data provide convincing evidence for the use of intranasal vaccination in protecting against SARS-CoV-2 infection and transmission.
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Affiliation(s)
- Alexandria Dickson
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Elizabeth Geerling
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - E. Taylor Stone
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Mariah Hassert
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Tara L. Steffen
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Taneesh Makkena
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Madeleine Smither
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - Katherine E. Schwetye
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | | | | | | | | | - Amelia K. Pinto
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
| | - James D. Brien
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, MO, United States
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3
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Yuan J, Xu L, Chien CY, Yang Y, Yue Y, Fadera S, Stark AH, Schwetye KE, Nazeri A, Desai R, Athiraman U, Chaudhuri AA, Chen H, Leuthardt EC. First-in-human prospective trial of sonobiopsy in glioblastoma patients using neuronavigation-guided focused ultrasound. medRxiv 2023:2023.03.17.23287378. [PMID: 36993173 PMCID: PMC10055591 DOI: 10.1101/2023.03.17.23287378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Sonobiopsy is an emerging technology that combines focused ultrasound (FUS) with microbubbles to enrich circulating brain disease-specific biomarkers for noninvasive molecular diagnosis of brain diseases. Here, we report the first-in-human prospective trial of sonobiopsy in glioblastoma patients to evaluate its feasibility and safety in enriching circulating tumor biomarkers. A nimble FUS device integrated with a clinical neuronavigation system was used to perform sonobiopsy following an established clinical workflow for neuronavigation. Analysis of blood samples collected before and after FUS sonication showed enhanced plasma circulating tumor biomarker levels. Histological analysis of surgically resected tumors confirmed the safety of the procedure. Transcriptome analysis of sonicated and unsonicated tumor tissues found that FUS sonication modulated cell physical structure-related genes but evoked minimal inflammatory response. These feasibility and safety data support the continued investigation of sonobiopsy for noninvasive molecular diagnosis of brain diseases.
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4
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Nelson PT, Lee EB, Cykowski MD, Alafuzoff I, Arfanakis K, Attems J, Brayne C, Corrada MM, Dugger BN, Flanagan ME, Ghetti B, Grinberg LT, Grossman M, Grothe MJ, Halliday GM, Hasegawa M, Hokkanen SRK, Hunter S, Jellinger K, Kawas CH, Keene CD, Kouri N, Kovacs GG, Leverenz JB, Latimer CS, Mackenzie IR, Mao Q, McAleese KE, Merrick R, Montine TJ, Murray ME, Myllykangas L, Nag S, Neltner JH, Newell KL, Rissman RA, Saito Y, Sajjadi SA, Schwetye KE, Teich AF, Thal DR, Tomé SO, Troncoso JC, Wang SHJ, White CL, Wisniewski T, Yang HS, Schneider JA, Dickson DW, Neumann M. LATE-NC staging in routine neuropathologic diagnosis: an update. Acta Neuropathol 2023; 145:159-173. [PMID: 36512061 PMCID: PMC9849315 DOI: 10.1007/s00401-022-02524-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
An international consensus report in 2019 recommended a classification system for limbic-predominant age-related TDP-43 encephalopathy neuropathologic changes (LATE-NC). The suggested neuropathologic staging system and nomenclature have proven useful for autopsy practice and dementia research. However, some issues remain unresolved, such as cases with unusual features that do not fit with current diagnostic categories. The goal of this report is to update the neuropathologic criteria for the diagnosis and staging of LATE-NC, based primarily on published data. We provide practical suggestions about how to integrate available genetic information and comorbid pathologies [e.g., Alzheimer's disease neuropathologic changes (ADNC) and Lewy body disease]. We also describe recent research findings that have enabled more precise guidance on how to differentiate LATE-NC from other subtypes of TDP-43 pathology [e.g., frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS)], and how to render diagnoses in unusual situations in which TDP-43 pathology does not follow the staging scheme proposed in 2019. Specific recommendations are also made on when not to apply this diagnostic term based on current knowledge. Neuroanatomical regions of interest in LATE-NC are described in detail and the implications for TDP-43 immunohistochemical results are specified more precisely. We also highlight questions that remain unresolved and areas needing additional study. In summary, the current work lays out a number of recommendations to improve the precision of LATE-NC staging based on published reports and diagnostic experience.
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Affiliation(s)
- Peter T Nelson
- University of Kentucky, Rm 575 Todd Building, Lexington, KY, USA.
| | - Edward B Lee
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Konstantinos Arfanakis
- Rush University Medical Center, Chicago, IL, USA
- Illinois Institute of Technology, Chicago, IL, USA
| | | | | | | | | | | | | | | | | | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología Y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | | | - Masato Hasegawa
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | | | | | | | | | | | | | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Canada
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Qinwen Mao
- University of Utah, Salt Lake City, UT, USA
| | | | | | | | | | - Liisa Myllykangas
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sukriti Nag
- Rush University Medical Center, Chicago, IL, USA
| | - Janna H Neltner
- University of Kentucky, Rm 575 Todd Building, Lexington, KY, USA
| | | | | | - Yuko Saito
- Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, Tokyo, Japan
| | | | | | | | - Dietmar R Thal
- Laboratory for Neuropathology, Department of Imaging and Pathoogy, and Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Sandra O Tomé
- Laboratory for Neuropathology, Department of Imaging and Pathoogy, and Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | | | | | - Charles L White
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Hyun-Sik Yang
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, BostonBoston, MAMA, USA
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5
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Geerling E, Carpenter DH, Schwetye KE, DeBosch B, Pinto A. Metabolic syndrome enhances viral disease severity and reduces vaccine efficacy in mice. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.125.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Metabolic syndrome (MetS) is a cluster of conditions linked by chronic inflammation that increase the risk for comorbidities. Currently, 1/3 of United States adults have MetS. Globally, obesity rates have tripled since 1975, which is notable since it is a criterium used to diagnose MetS. MetS patients show higher mortality post-SARS-CoV-2 infection and poor vaccination outcomes following influenza virus vaccination when compared to metabolically healthy humans. However, the mechanisms driving MetS-induced immune dysfunction are unknown. Based on previously published work, we hypothesize that MetS-associated chronic inflammation alters programming of adaptive immune cells critical for viral control, thus enhancing disease severity and reducing vaccine efficacy. To challenge this, we use West Nile virus and SARS-CoV-2 in MetS murine models. By infecting or vaccinating chow fed wild type (WT) and high fat diet induced MetS mice, we compared immune responses over time. Our results indicate that MetS mice have higher mortality post infection, heightened viral titers, severe organ pathology, dysfunctional T and B cell responses and reduced neutralizing antibody efficacy when compared to WT mice. Further, MetS alters antibody and T cell responses post-vaccination, rendering vaccination insufficient for protecting against severe viral disease. Our results imply that MetS enhances viral disease severity and reduces vaccine efficacy. Ongoing studies in our lab are focused on determining the mechanism by which MetS alters adaptive immune cell function, with our data implicating chronic inflammation as an inducer of immune cell epigenetic changes that alter their differentiation landscapes and consequently effector functions.
Supported by grants from NIH (R01 12781495) and DoD (USAMRDCPR192269).
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Affiliation(s)
| | | | - Katherine E Schwetye
- 3Department of Pathology and Immunology, Washington Univ. in St. Louis Sch. of Med
| | - Brian DeBosch
- 4Diabetes Research Center, Washington Univ. in St. Louis Sch. of Med
| | - Amelia Pinto
- 1Molecular Microbiology and Immunology, St. Louis Univ., Sch. of Med
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6
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McNulty SN, Schwetye KE, Ferguson C, Storer CE, Ansstas G, Kim AH, Gutmann DH, Rubin JB, Head RD, Dahiya S. BRAF mutations may identify a clinically distinct subset of glioblastoma. Sci Rep 2021; 11:19999. [PMID: 34625582 PMCID: PMC8501013 DOI: 10.1038/s41598-021-99278-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022] Open
Abstract
Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Prior studies examining the mutational landscape of GBM revealed recurrent alterations in genes that regulate the same growth control pathways. To this regard, ~ 40% of GBM harbor EGFR alterations, whereas BRAF variants are rare. Existing data suggests that gain-of-function mutations in these genes are mutually exclusive. This study was designed to explore the clinical, pathological, and molecular differences between EGFR- and BRAF-mutated GBM. We reviewed retrospective clinical data from 89 GBM patients referred for molecular testing between November 2012 and December 2015. Differences in tumor mutational profile, location, histology, and survival outcomes were compared in patients with EGFR- versus BRAF-mutated tumors, and microarray data from The Cancer Genome Atlas was used to assess differential gene expression between the groups. Individuals with BRAF-mutant tumors were typically younger and survived longer relative to those with EGFR-mutant tumors, even in the absence of targeted treatments. BRAF-mutant tumors lacked distinct histomorphology but exhibited unique localization in the brain, typically arising adjacent to the lateral ventricles. Compared to EGFR- and IDH1-mutant tumors, BRAF-mutant tumors showed increased expression of genes related to a trophoblast-like phenotype, specifically HLA-G and pregnancy specific glycoproteins, that have been implicated in invasion and immune evasion. Taken together, these observations suggest a distinct clinical presentation, brain location, and gene expression profile for BRAF-mutant tumors. Pending further study, this may prove useful in the stratification and management of GBM.
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Affiliation(s)
- Samantha N McNulty
- Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Katherine E Schwetye
- Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Cole Ferguson
- Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Chad E Storer
- Department of Genetics, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - George Ansstas
- Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA.,Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Albert H Kim
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - David H Gutmann
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Joshua B Rubin
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.,Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA
| | - Richard D Head
- Department of Genetics, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO, 63110, USA.
| | - Sonika Dahiya
- Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid Ave, St. Louis, MO, 63110, USA. .,Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
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Abstract
Sellar region lesions include a broad range of benign and malignant neoplastic as well as non-neoplastic entities, many of which are newly described or have recently revised nomenclature. In contrast to other intracranial sites, imaging features are relatively less specific, and the need for histopathological diagnosis is of paramount importance. This review will describe pituitary adenomas, inflammatory lesions, and tumors unique to the region (craniopharyngioma) as well as tumors which may occur in but are not exclusively localized to the sellar location (schwannoma, metastasis, etc.).
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Affiliation(s)
- Katherine E Schwetye
- Department of Pathology, Saint Louis University, 1402 South Grand Boulevard, St Louis, MO 63104, USA
| | - Sonika M Dahiya
- Department of Pathology and Immunology, Washington University in St. Louis, 660 South Euclid Avenue, St Louis, MO 63110, USA.
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8
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Griffin S, Witt MC, El Tecle N, Prim M, Hockman J, Schwetye KE, Pierson MJ. Intracranial metastasis from a malignant peripheral nerve sheath tumor in a patient with neurofibromatosis type 1: A case study and literature review. Clin Neurol Neurosurg 2021; 203:106540. [PMID: 33607580 DOI: 10.1016/j.clineuro.2021.106540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Malignant Peripheral Nerve Sheath Tumors (MPNSTs) are a rare type of soft tissue sarcoma. While these tumors often metastasize, intracranial metastases of MPNSTs have only been rarely noted. METHODS Using Pubmed, Google Scholar, and Science Direct we conducted a systematic review of the literature to identify all reported cases of MPNSTs with metastases to the brain since the inception of these databases through January 2020. Data were extracted and data analysis was completed using python statistical packages. RESULTS Only 26 cases (including present study) of MPNSTs resulting in intracranial metastases have been reported in the literature. Eight of these 26 cases occurred in patients who were previously diagnosed with Neurofibromatosis Type 1 (NF1). Additionally, one patient had been previously diagnosed with Neurofibromatosis Type 2 (NF2). The average reported time from diagnosis of a MPNST to the time of diagnosis with intracranial metastasis was 36 months, with a median time of 14 months. The average reported survival time for patients after being diagnosed with intracranial metastasis was 5.9 months. The cases that utilized a combination of therapeutic intervention including surgical resection, radiotherapy and chemotherapy saw the greatest improvement of survival times. CONCLUSION MPNSTs with brain metastases are extremely rare and have a poor prognosis with a 6 months median survival after metastasis. While combination therapy is indicated, further studies on treatment are needed to determine survival benefits. Early and effective initial diagnosis of MPNST before brain metastases occurs is likely to give the best chance of increased overall survival.
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Affiliation(s)
- Samuel Griffin
- Saint Louis University School of Medicine, 1402 S Grand Blvd, Saint Louis, MO 63104, United States.
| | - M Cassandra Witt
- Saint Louis University School of Medicine, 1402 S Grand Blvd, Saint Louis, MO 63104, United States.
| | - Najib El Tecle
- Saint Louis University Department of Neurological Surgery, 1008 S Spring Ave, 3rd Floor, Saint Louis, MO 63110, United States.
| | - Michael Prim
- Saint Louis University Department of Neurological Surgery, 1008 S Spring Ave, 3rd Floor, Saint Louis, MO 63110, United States.
| | - Jakob Hockman
- Saint Louis University Department of Pathology, 1402 S Grand Blvd, Saint Louis, MO 63104, United States.
| | - Katherine E Schwetye
- Saint Louis University Department of Pathology, 1402 S Grand Blvd, Saint Louis, MO 63104, United States.
| | - Matthew J Pierson
- Midwest Neurosurgery Associates, 2330 E Meyer Blvd, Ste 411, Kansas City, MO 64132, United States.
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9
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Hassert M, Wolf KJ, Schwetye KE, DiPaolo RJ, Brien JD, Pinto AK. CD4+T cells mediate protection against Zika associated severe disease in a mouse model of infection. PLoS Pathog 2018; 14:e1007237. [PMID: 30212537 PMCID: PMC6136803 DOI: 10.1371/journal.ppat.1007237] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 07/23/2018] [Indexed: 12/12/2022] Open
Abstract
Zika virus (ZIKV) has gained worldwide attention since it emerged, and a global effort is underway to understand the correlates of protection and develop diagnostics to identify rates of infection. As new therapeutics and vaccine approaches are evaluated in clinical trials, additional effort is focused on identifying the adaptive immune correlates of protection against ZIKV disease. To aid in this endeavor we have begun to dissect the role of CD4+T cells in the protection against neuroinvasive ZIKV disease. We have identified an important role for CD4+T cells in protection, demonstrating that in the absence of CD4+T cells mice have more severe neurological sequela and significant increases in viral titers in the central nervous system (CNS). The transfer of CD4+T cells from ZIKV immune mice protect type I interferon receptor deficient animals from a lethal challenge; showing that the CD4+T cell response is necessary and sufficient for control of ZIKV disease. Using a peptide library spanning the complete ZIKV polyprotein, we identified both ZIKV-encoded CD4+T cell epitopes that initiate immune responses, and ZIKV specific CD4+T cell receptors that recognize these epitopes. Within the ZIKV antigen-specific TCRβ repertoire, we uncovered a high degree of diversity both in response to a single epitope and among different mice responding to a CD4+T cell epitope. Overall this study identifies a novel role for polyfunctional and polyclonal CD4+T cells in providing protection against ZIKV infection and highlights the need for vaccines to develop robust CD4+T cell responses to prevent ZIKV neuroinvasion and limit replication within the CNS.
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MESH Headings
- Adoptive Transfer
- Amino Acid Sequence
- Animals
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- CD4-Positive T-Lymphocytes/immunology
- Central Nervous System/immunology
- Central Nervous System/virology
- Disease Models, Animal
- Epitopes, T-Lymphocyte/genetics
- Epitopes, T-Lymphocyte/immunology
- Genes, T-Cell Receptor beta
- Humans
- Immunity, Cellular
- Liver/immunology
- Liver/virology
- Lymphocyte Depletion
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Receptor, Interferon alpha-beta/deficiency
- Receptor, Interferon alpha-beta/genetics
- Receptor, Interferon alpha-beta/immunology
- Viral Vaccines/immunology
- Virus Replication/immunology
- Zika Virus/genetics
- Zika Virus/immunology
- Zika Virus/pathogenicity
- Zika Virus Infection/genetics
- Zika Virus Infection/immunology
- Zika Virus Infection/prevention & control
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Affiliation(s)
- Mariah Hassert
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, United States of America
| | - Kyle J. Wolf
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, United States of America
| | - Katherine E. Schwetye
- Department of Pathology, Saint Louis University, St. Louis, Missouri, United States of America
| | - Richard J. DiPaolo
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, United States of America
| | - James D. Brien
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, United States of America
| | - Amelia K. Pinto
- Department of Molecular Microbiology and Immunology, Saint Louis University, St Louis, Missouri, United States of America
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10
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Schwetye KE, Rodriguez D, Schmidt RE, Dahiya S. A 60-Year-Old Woman with Multifocal Subcortical Infarcts. Brain Pathol 2017; 28:131-132. [PMID: 29265630 DOI: 10.1111/bpa.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Katherine E Schwetye
- Department of Pathology and Immunology, Division of Neuropathology, Washington University School of Medicine, St. Louis, MO
| | - David Rodriguez
- Mallinckrodt Institute of Radiology, Department of Neuroradiology, Washington University School of Medicine, St. Louis, MO
| | - Robert E Schmidt
- Department of Pathology and Immunology, Division of Neuropathology, Washington University School of Medicine, St. Louis, MO
| | - Sonika Dahiya
- Department of Pathology and Immunology, Division of Neuropathology, Washington University School of Medicine, St. Louis, MO
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Schwetye KE, Gauvain K, Rodriguez D, Cottrell C, Limbrick DD, Schmidt RE, Dahiya S. An 8-Year-Old Girl with A Supratentorial Mass. Brain Pathol 2017; 28:125-126. [PMID: 29265627 DOI: 10.1111/bpa.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Katherine E Schwetye
- Department of Pathology and Immunology, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - Karen Gauvain
- Department of Pediatrics, Division of Hematology-Oncology, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - David Rodriguez
- Department of Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - Catherine Cottrell
- Department of Pathology and Immunology, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - David D Limbrick
- Department of Neurological Surgery Washington University School of Medicine, St. Louis, MO
| | - Robert E Schmidt
- Department of Pathology and Immunology, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - Sonika Dahiya
- Department of Pathology and Immunology, Mallinckrodt Institute of Radiology, St. Louis, MO
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Sur S, Steele R, Aurora R, Varvares M, Schwetye KE, Ray RB. Bitter Melon Prevents the Development of 4-NQO-Induced Oral Squamous Cell Carcinoma in an Immunocompetent Mouse Model by Modulating Immune Signaling. Cancer Prev Res (Phila) 2017; 11:191-202. [PMID: 29061560 DOI: 10.1158/1940-6207.capr-17-0237] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 09/06/2017] [Accepted: 10/12/2017] [Indexed: 01/07/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, and tobacco is one of the most common factors for HNSCC of the oral cavity. We have previously observed that bitter melon (Momordica charantia) extract (BME) exerts antiproliferative activity against several cancers including HNSCC. In this study, we investigated the preventive role of BME in 4-nitroquinoline 1-oxide (4-NQO) carcinogen-induced HNSCC. We observed that BME feeding significantly reduced the incidence of 4-NQO-induced oral cancer in a mouse model. Histologic analysis suggested control 4-NQO-treated mouse tongues showed neoplastic changes ranging from moderate dysplasia to invasive squamous cell carcinoma, whereas no significant dysplasia was observed in the BME-fed mouse tongues. We also examined the global transcriptome changes in normal versus carcinogen-induced tongue cancer tissues, and following BME feeding. Gene ontology and pathway analyses revealed a signature of biological processes including "immune system process" that is significantly dysregulated in 4-NQO-induced oral cancer. We identified elevated expression of proinflammatory genes, s100a9, IL23a, IL1β and immune checkpoint gene PDCD1/PD1, during oral cancer development. Interestingly, BME treatment significantly reduced their expression. Enhancement of MMP9 ("ossification" pathway) was noted during carcinogenesis, which was reduced in BME-fed mouse tongue tissues. Our study demonstrates the preventive effect of BME in 4-NQO-induced carcinogenesis. Identification of pathways involved in carcinogen-induced oral cancer provides useful information for prevention strategies. Together, our data strongly suggest the potential clinical benefits of BME as a chemopreventive agent in the control or delay of carcinogen-induced HNSCC development and progression. Cancer Prev Res; 11(4); 191-202. ©2017 AACRSee related editorial by Rao, p. 185.
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Affiliation(s)
- Subhayan Sur
- Department of Pathology, Saint Louis University, St. Louis, Missouri
| | - Robert Steele
- Department of Pathology, Saint Louis University, St. Louis, Missouri
| | - Rajeev Aurora
- Department of Molecular Microbiology & Immunology, Saint Louis University, St. Louis, Missouri
| | - Mark Varvares
- Cancer Center, Saint Louis University, St. Louis, Missouri
| | | | - Ratna B Ray
- Department of Pathology, Saint Louis University, St. Louis, Missouri. .,Cancer Center, Saint Louis University, St. Louis, Missouri
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13
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Day GS, Gordon BA, Perrin RJ, Cairns NJ, Schwetye KE, Ferguson CJ, Sinha N, Ponisio MR, Vincent BD, Beaumont H, Bucelli RC, Ghoshal N, Musiek ES, Morris JC, Benzinger TL, Ances BM. [O3–03–01]: FLORTAUCIPIR TAU‐PET SPECIFICITY IS MAINTAINED IN PATIENTS WITH PATHOLOGICALLY CONFIRMED CREUTZFELDT‐JAKOB DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Gregory S. Day
- Knight Alzheimer Disease Research CenterSt. LouisMOUSA
- Washington University in St. LouisSt. LouisMOUSA
- Knight Alzheimer's Disease Research CenterSt. LouisMOUSA
- Knight Alzheimer's Disease Research CenterSaint LouisMOUSA
- Washington University in St. Louis School of MedicineSt. LouisMOUSA
| | | | | | | | | | | | - Namita Sinha
- Knight Alzheimer Disease Research CenterSt. LouisMOUSA
| | | | | | | | | | - Nupur Ghoshal
- Knight Alzheimer Disease Research CenterSt. LouisMOUSA
| | - Erik S. Musiek
- Knight Alzheimer Disease Research CenterSt. LouisMOUSA
- Washington University School of MedicineSt. LouisMOUSA
| | | | - Tammie L.S. Benzinger
- Knight Alzheimer Disease Research CenterSt. LouisMOUSA
- Washington University School of MedicineSt. LouisMOUSA
| | - Beau M. Ances
- Knight Alzheimer Disease Research CenterSt. LouisMOUSA
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Schwetye KE, Kansagra AP, McEachern J, Schmidt RE, Gauvain K, Dahiya S. Unusual high-grade features in pediatric diffuse leptomeningeal glioneuronal tumor: comparison with a typical low-grade example. Hum Pathol 2017; 70:105-112. [PMID: 28652147 DOI: 10.1016/j.humpath.2017.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/05/2017] [Accepted: 06/16/2017] [Indexed: 11/27/2022]
Abstract
Diffuse leptomeningeal glioneuronal tumor, a recent addition to the World Health Organization classification system, typically presents in the pediatric population with signs and symptoms related to elevated intracranial pressure and imaging characteristics that may mimic infectious etiologies. The tumor is usually low grade and tends to harbor BRAF rearrangement/duplication in up to 75% of cases, BRAF V600E mutation in a smaller subset of cases, and loss of chromosomal arm 1p in approximately 50%-60% of cases, with ~20% of those showing loss of both 1p and 19q (codeletion). We report here 2 contrasting cases of diffuse leptomeningeal glioneuronal tumors, one with typical low-grade features and an indolent, although not benign, course, in which the disease is currently successfully managed by chemotherapy, and a second case with unusually high-grade features on initial presentation, including frank anaplasia and elevated mitotic index, in which the disease showed an initial response to chemoradiation but ultimately was fatal.
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Affiliation(s)
- Katherine E Schwetye
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Akash P Kansagra
- Mallinckrodt Institute of Radiology, Department of Neuroradiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - James McEachern
- Mallinckrodt Institute of Radiology, Department of Neuroradiology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Robert E Schmidt
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Karen Gauvain
- Department of Pediatrics, Division of Hematology-Oncology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Sonika Dahiya
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, USA.
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Guzmán Pérez-Carrillo GJ, Owen C, Schwetye KE, McFarlane S, Vellimana AK, Mar S, Miller-Thomas MM, Shimony JS, Smyth MD, Benzinger TLS. The use of hippocampal volumetric measurements to improve diagnostic accuracy in pediatric patients with mesial temporal sclerosis. J Neurosurg Pediatr 2017; 19:720-728. [PMID: 28338446 DOI: 10.3171/2016.12.peds16335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Many patients with medically intractable epilepsy have mesial temporal sclerosis (MTS), which significantly affects their quality of life. The surgical excision of MTS lesions can result in marked improvement or even complete resolution of the epileptic episodes. Reliable radiological diagnosis of MTS is a clinical challenge. The purpose of this study was to evaluate the utility of volumetric mapping of the hippocampi for the identification of MTS in a case-controlled series of pediatric patients who underwent resection for medically refractory epilepsy, using pathology as a gold standard. METHODS A cohort of 57 pediatric patients who underwent resection for medically intractable epilepsy between 2005 and 2015 was evaluated. On pathological investigation, this group included 24 patients with MTS and 33 patients with non-MTS findings. Retrospective quantitative volumetric measurements of the hippocampi were acquired for 37 of these 57 patients. Two neuroradiologists with more than 10 years of experience who were blinded to the patients' MTS status performed the retrospective review of MR images. To produce the volumetric data, MR scans were parcellated and segmented using the FreeSurfer software suite. Hippocampal regions of interest were compared against an age-weighted local regression curve generated with data from the pediatric normal cohort. Standard deviations and percentiles of specific subjects were calculated. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined for the original clinical read and the expert readers. Receiver operating characteristic curves were generated for the methods of classification to compare results from the readers with the authors' results, and an optimal threshold was determined. From that threshold the sensitivity, specificity, PPV, and NPV were calculated for the volumetric analysis. RESULTS With the use of quantitative volumetry, a sensitivity of 72%, a specificity of 95%, a PPV of 93%, an NPV of 78%, and an area under the curve of 0.84 were obtained using a percentage difference of normalized hippocampal volume. The resulting specificity (95%) and PPV (93%) are superior to the original clinical read and to Reader A and Reader B's findings (range for specificity 74%-86% and for PPV 64%-71%). The sensitivity (72%) and NPV (78%) are comparable to Reader A's findings (73% and 81%, respectively) and are better than those of the original clinical read and of Reader B (sensitivity 45% and 63% and NPV 71% and 70%, respectively). CONCLUSIONS Volumetric measurement of the hippocampi outperforms expert readers in specificity and PPV, and it demonstrates comparable to superior sensitivity and NPV. Volumetric measurements can complement anatomical imaging for the identification of MTS, much like a computer-aided detection tool would. The implementation of this approach in the daily clinical workflow could significantly improve diagnostic accuracy.
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Affiliation(s)
| | - Christopher Owen
- Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University
| | | | - Spencer McFarlane
- Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University
| | - Ananth K Vellimana
- Department of Neurosurgery, Pediatric Division, St. Louis Children's Hospital/Washington University; and
| | - Soe Mar
- Department of Neurology, Division of Pediatric Neurology, Washington University School of Medicine, St. Louis, Missouri
| | | | - Joshua S Shimony
- Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University
| | - Matthew D Smyth
- Department of Neurosurgery, Pediatric Division, St. Louis Children's Hospital/Washington University; and
| | - Tammie L S Benzinger
- Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University
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Miller-Thomas MM, Sipe AL, Benzinger TLS, McConathy J, Connolly S, Schwetye KE. Multimodality Review of Amyloid-related Diseases of the Central Nervous System. Radiographics 2017; 36:1147-63. [PMID: 27399239 DOI: 10.1148/rg.2016150172] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Amyloid-β (Aβ) is ubiquitous in the central nervous system (CNS), but pathologic accumulation of Aβ results in four distinct neurologic disorders that affect middle-aged and elderly adults, with diverse clinical presentations ranging from chronic debilitating dementia to acute life-threatening intracranial hemorrhage. The characteristic imaging patterns of Aβ-related CNS diseases reflect the pathophysiology of Aβ deposition in the CNS. Aβ is recognized as a key component in the neuronal damage that characterizes the pathophysiology of Alzheimer disease, the most common form of dementia. Targeted molecular imaging shows pathologic accumulation of Aβ and tau protein, and fluorine 18 fluorodeoxyglucose positron emission tomography and anatomic imaging allow differentiation of typical patterns of neuronal dysfunction and loss in patients with Alzheimer disease from those seen in patients with other types of dementia. Cerebral amyloid angiopathy (CAA) is an important cause of cognitive impairment and spontaneous intracerebral hemorrhage in the elderly. Hemorrhage and white matter injury seen at imaging reflect vascular damage caused by the accumulation of Aβ in vessel walls. The rare forms of inflammatory angiopathy attributed to Aβ, Aβ-related angiitis and CAA-related inflammation, cause debilitating neurologic symptoms that improve with corticosteroid therapy. Imaging shows marked subcortical and cortical inflammation due to perivascular inflammation, which is incited by vascular Aβ accumulation. In the rarest of the four disorders, cerebral amyloidoma, the macroscopic accumulation of Aβ mimics the imaging appearance of tumors. Knowledge of the imaging patterns and pathophysiology is essential for accurate diagnosis of Aβ-related diseases of the CNS. (©)RSNA, 2016.
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Affiliation(s)
- Michelle M Miller-Thomas
- From the Mallinckrodt Institute of Radiology (M.M.M.T., A.L.S., T.L.S.B., J.M., S.C.) and Department of Pathology and Immunology (K.E.S.), Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Adam L Sipe
- From the Mallinckrodt Institute of Radiology (M.M.M.T., A.L.S., T.L.S.B., J.M., S.C.) and Department of Pathology and Immunology (K.E.S.), Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Tammie L S Benzinger
- From the Mallinckrodt Institute of Radiology (M.M.M.T., A.L.S., T.L.S.B., J.M., S.C.) and Department of Pathology and Immunology (K.E.S.), Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Jonathan McConathy
- From the Mallinckrodt Institute of Radiology (M.M.M.T., A.L.S., T.L.S.B., J.M., S.C.) and Department of Pathology and Immunology (K.E.S.), Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Sarah Connolly
- From the Mallinckrodt Institute of Radiology (M.M.M.T., A.L.S., T.L.S.B., J.M., S.C.) and Department of Pathology and Immunology (K.E.S.), Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Katherine E Schwetye
- From the Mallinckrodt Institute of Radiology (M.M.M.T., A.L.S., T.L.S.B., J.M., S.C.) and Department of Pathology and Immunology (K.E.S.), Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
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17
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Soleimani-Meigooni DN, Schwetye KE, Angeles MR, Ryschkewitsch CF, Major EO, Dang X, Koralnik IJ, Schmidt RE, Clifford DB, Kuhlmann FM, Bucelli RC. JC virus granule cell neuronopathy in the setting of chronic lymphopenia treated with recombinant interleukin-7. J Neurovirol 2016; 23:141-146. [PMID: 27421731 DOI: 10.1007/s13365-016-0465-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/25/2016] [Accepted: 06/10/2016] [Indexed: 11/25/2022]
Abstract
JC virus (JCV) is a human polyomavirus that infects the central nervous system (CNS) of immunocompromised patients. JCV granule cell neuronopathy (JCV-GCN) is caused by infection of cerebellar granule cells, causing ataxia. A 77-year-old man with iatrogenic lymphopenia presented with severe ataxia and was diagnosed with JCV-GCN. His ataxia and cerebrospinal fluid (CSF) improved with intravenous immunoglobulin, high-dose intravenous methylprednisolone, mirtazapine, and mefloquine. Interleukin-7 (IL-7) therapy reconstituted his lymphocytes and reduced his CSF JCV load. One month after IL-7 therapy, he developed worsening ataxia and CSF inflammation, which raised suspicion for immune reconstitution inflammatory syndrome. Steroids were restarted and his ataxia stabilized.
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Affiliation(s)
- David N Soleimani-Meigooni
- Department of Neurology, Washington University School of Medicine, Campus Box 8111. 660 South Euclid Ave., St. Louis, MO, 63110, USA
| | - Katherine E Schwetye
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
| | - Maria Reyes Angeles
- Department of Infectious Diseases, Washington University, St. Louis, MO, USA
| | - Caroline F Ryschkewitsch
- Laboratory of Molecular Medicine and Neuroscience, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Eugene O Major
- Laboratory of Molecular Medicine and Neuroscience, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Xin Dang
- Department of Neurology, Division of Neuro-Immunology and Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Igor J Koralnik
- Department of Neurology, Division of Neuro-Immunology and Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Robert E Schmidt
- Department of Pathology and Immunology, Washington University, St. Louis, MO, USA
| | - David B Clifford
- Department of Neurology, Washington University School of Medicine, Campus Box 8111. 660 South Euclid Ave., St. Louis, MO, 63110, USA
| | - F Matthew Kuhlmann
- Department of Infectious Diseases, Washington University, St. Louis, MO, USA
| | - Robert C Bucelli
- Department of Neurology, Washington University School of Medicine, Campus Box 8111. 660 South Euclid Ave., St. Louis, MO, 63110, USA.
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Schwetye KE, Joseph NM, Al-Kateb H, Rich KM, Schmidt RE, Perry A, Gutmann DH, Dahiya S. Gliosarcomas lackBRAFV600Emutation, but a subset exhibit β-catenin nuclear localization. Neuropathology 2016; 36:448-455. [DOI: 10.1111/neup.12293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Katherine E. Schwetye
- Department of Pathology and Immunology; Washington University School of Medicine; St. Louis MO USA
| | - Nancy M. Joseph
- Department of Pathology; University of California-San Francisco; San Francisco CA USA
| | - Hussam Al-Kateb
- Department of Pathology and Immunology; Washington University School of Medicine; St. Louis MO USA
| | - Keith M. Rich
- Department of Neurosurgery; Washington University School of Medicine; St. Louis MO USA
| | - Robert E. Schmidt
- Department of Pathology and Immunology; Washington University School of Medicine; St. Louis MO USA
| | - Arie Perry
- Department of Pathology; University of California-San Francisco; San Francisco CA USA
| | - David H. Gutmann
- Department of Neurology; Washington University School of Medicine; St. Louis MO USA
| | - Sonika Dahiya
- Department of Pathology and Immunology; Washington University School of Medicine; St. Louis MO USA
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Abstract
Cognitive and behavioral disorders affect nearly 80% of all children with the neurofibromatosis type 1 inherited cancer syndrome, and are among the most significant clinical manifestations for patients and their families. One of the barriers to successful therapeutic intervention is the wide spectrum of clinical phenotypic expression, ranging from visuospatial learning problems to social perceptual deficits (autism). Leveraging numerous small-animal models of neurofibromatosis type 1, several promising targets have been identified to treat the learning, attention, and autism spectrum phenotypes in this at-risk population. In this review, we provide an up-to-date summary of our current understanding of these disorders in NF1, and propose future research directions aimed at designing more effective therapeutic approaches and clinical trials.
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Affiliation(s)
- Katherine E Schwetye
- Department of Pathology, Division of Neuropathology, Washington University School of Medicine, Box 8111, 660 S. Euclid Avenue, St. Louis MO 63110, USA
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20
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Schwetye KE, Pfeifer JD, Duncavage EJ. MED12 exon 2 mutations in uterine and extrauterine smooth muscle tumors. Hum Pathol 2013; 45:65-70. [PMID: 24196187 DOI: 10.1016/j.humpath.2013.08.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/08/2013] [Accepted: 08/09/2013] [Indexed: 11/19/2022]
Abstract
Mutations in exon 2 of the MED12 gene have been reported in 50% to 70% of uterine leiomyomas. To determine the frequency of MED12 mutations in various types of smooth muscle tumors as well as normal uterine myometrium adjacent to a leiomyoma, we selected a total of 143 cases for analysis of MED12 exon 2 mutations by polymerase chain reaction and Sanger sequencing. MED12 mutations were detected in 54% of classical uterine leiomyomas (15/28) and in 15% of cases in myometrium adjacent to leiomyomas (2/13); 34% of leiomyoma/leiomyomatosis in pelvic/retroperitoneal sites (10/29); 0% of extrauterine leiomyomas (0/29); 8% of smooth muscle tumor of uncertain malignant potential (1/12); 30% of uterine leiomyosarcomas (6/20); and 4% of extrauterine leiomyosarcomas (1/25). Mutations were clustered around codons 44, 40, 41, and 36, and consisted primarily of single nucleotide substitutions and small in-frame deletions. Our results confirm the findings of similar recent studies and further show that pelvic and retroperitoneal leiomyomas harbor an increased frequency of MED12 mutations (34%) as compared with other extrauterine sites (0%; P = 0.0006), and that histologically unremarkable adjacent myometrium can harbor similar MED12 mutations. These findings suggest that smooth muscle tumors in pelvic/retroperitoneal sites are subject to the same mutational changes as those of uterine myometrium, and that these mutations may precede the gross or histological development of a leiomyoma.
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Affiliation(s)
- Katherine E Schwetye
- Department of Pathology, Washington University School of Medicine, St. Louis, MO 63110, USA
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21
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Willie JT, Lim MM, Bennett RE, Azarion AA, Schwetye KE, Brody DL. Controlled cortical impact traumatic brain injury acutely disrupts wakefulness and extracellular orexin dynamics as determined by intracerebral microdialysis in mice. J Neurotrauma 2013; 29:1908-21. [PMID: 22607167 DOI: 10.1089/neu.2012.2404] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Among other deficits, traumatic brain injury (TBI) causes impaired arousal and cognitive dysfunction. Hypothalamic orexin neuropeptides (also called hypocretins) regulate levels of arousal, and cerebrospinal fluid orexin levels are reportedly low in TBI patients. We hypothesized that TBI acutely impairs the dynamics of orexin release into brain interstitial fluid, and that these extracellular orexin levels correlate with wakefulness and motor activity. To test this in mice, we combined an electromagnetic controlled cortical impact (CCI) model of experimental TBI with dual intracerebral microdialysis using one catheter in the hypothalamus and one catheter in the hippocampus, plus electroencephalography/electromyography (EEG/EMG), and motor activity monitoring. Baseline data were continuously collected in tethered but relatively freely moving mice for 2 days. Then, ipsilateral CCI or sham surgery was performed, and data collection was continued for 3 additional days. At baseline, extracellular orexin levels in the hypothalamus showed a circadian rhythm, with peak levels during the dark (wake) phase, and a nadir during the light (rest) phase. Following CCI but not sham surgery, orexin levels were depressed in both the hypothalamus and hippocampus, and diurnal fluctuation amplitudes were blunted in the hypothalamus. At baseline, correlations of orexin with wakefulness and motor activity were positive and highly significant. Following CCI but not sham surgery, the mice exhibited reduced wakefulness and motor activity, and correlations between orexin and these measures were diminished. These abnormal orexin dynamics were associated with hypothalamic astrogliosis, but not acute loss of orexin neurons, as assessed by immunohistochemistry 3 days after injury. Future studies involving experimental manipulations of the orexin system will be required to determine its contribution to neurological outcomes following injury.
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Affiliation(s)
- Jon T Willie
- Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA, USA
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22
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Brody DL, Mac Donald C, Kessens CC, Yuede C, Parsadanian M, Spinner M, Kim E, Schwetye KE, Holtzman DM, Bayly PV. Electromagnetic controlled cortical impact device for precise, graded experimental traumatic brain injury. J Neurotrauma 2007; 24:657-73. [PMID: 17439349 PMCID: PMC2435168 DOI: 10.1089/neu.2006.0011] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Genetically modified mice represent useful tools for traumatic brain injury (TBI) research and attractive preclinical models for the development of novel therapeutics. Experimental methods that minimize the number of mice needed may increase the pace of discovery. With this in mind, we developed and characterized a prototype electromagnetic (EM) controlled cortical impact device along with refined surgical and behavioral testing techniques. By varying the depth of impact between 1.0 and 3.0 mm, we found that the EM device was capable of producing a broad range of injury severities. Histologically, 2.0-mm impact depth injuries produced by the EM device were similar to 1.0-mm impact depth injuries produced by a commercially available pneumatic device. Behaviorally, 2.0-, 2.5-, and 3.0-mm impacts impaired hidden platform and probe trial water maze performance, whereas 1.5-mm impacts did not. Rotorod and visible platform water maze deficits were also found following 2.5- and 3.0-mm impacts. No impairment of conditioned fear performance was detected. No differences were found between sexes of mice. Inter-operator reliability was very good. Behaviorally, we found that we could statistically distinguish between injury depths differing by 0.5 mm using 12 mice per group and between injury depths differing by 1.0 mm with 7-8 mice per group. Thus, the EM impactor and refined surgical and behavioral testing techniques may offer a reliable and convenient framework for preclinical TBI research involving mice.
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Affiliation(s)
- David L Brody
- Department of Neurology, Hope Center for Neurological Disorders, Washington University, St. Louis, Missouri, USA.
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Jong YJI, Schwetye KE, O'Malley KL. Nuclear localization of functional metabotropic glutamate receptor mGlu1 in HEK293 cells and cortical neurons: role in nuclear calcium mobilization and development. J Neurochem 2007; 101:458-69. [PMID: 17250682 DOI: 10.1111/j.1471-4159.2006.04382.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Group I metabotropic glutamate receptor (mGlu1) plays an important role in neuromodulation, development, and synaptic plasticity. Using immunocytochemistry, subcellular fractionation, and western blot analysis, the present study shows that mGlu1a receptors are present on nuclear membranes in stably transfected human embryonic kidney 293 (HEK293) cells as well as being endogenously expressed on rat cortical nuclei. Both glutamate and the group I agonist, quisqualate, directly activate nuclear mGlu1 receptors leading to a characteristic oscillatory pattern of calcium flux in isolated HEK nuclei and a slow rise to plateau in isolated cortical nuclei. In either case calcium responses could be terminated upon application of the mGlu1-selective antagonist, 7-(hydroxyamino)cyclopropa[b]chromen-1a-carboxylate ethyl ester. Responses could also be blocked by ryanodine and inositol 1,4,5-triphosphate receptor inhibitors, demonstrating the involvement of these calcium channels. Agonist activation of intracellular receptors was driven by Na(+)-dependent and -independent processes in nuclei isolated from either HEK or cortical neurons. Finally, mGlu1 nuclear receptors were dramatically up-regulated in the course of post-natal development. Therefore, like the other Group I receptor, mGlu5, mGlu1 can function as an intracellular receptor, suggesting a more encompassing role for nuclear G protein-coupled receptors and downstream signaling elements in the regulation of nuclear events.
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Affiliation(s)
- Yuh-Jiin I Jong
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St Louis, Missouri 63110, USA
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Hartman RE, Shah A, Fagan AM, Schwetye KE, Parsadanian M, Schulman RN, Finn MB, Holtzman DM. Pomegranate juice decreases amyloid load and improves behavior in a mouse model of Alzheimer's disease. Neurobiol Dis 2006; 24:506-15. [PMID: 17010630 DOI: 10.1016/j.nbd.2006.08.006] [Citation(s) in RCA: 239] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Revised: 08/03/2006] [Accepted: 08/15/2006] [Indexed: 02/05/2023] Open
Abstract
Although there are no proven ways to delay onset or slow progression of Alzheimer's disease (AD), studies suggest that diet can affect risk. Pomegranates contain very high levels of antioxidant polyphenolic substances as compared to other fruits and vegetables. Polyphenols have been shown to be neuroprotective in different model systems. We asked whether dietary supplementation with pomegranate juice (PJ) would influence behavior and AD-like pathology in a transgenic mouse model. Transgenic mice (APP(sw)/Tg2576) received either PJ or sugar water control from 6 to 12.5 months of age. PJ-treated mice learned water maze tasks more quickly and swam faster than controls. Mice treated with PJ had significantly less (approximately 50%) accumulation of soluble Abeta42 and amyloid deposition in the hippocampus as compared to control mice. These results suggest that further studies to validate and determine the mechanism of these effects, as well as whether substances in PJ may be useful in AD, should be considered.
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Affiliation(s)
- Richard E Hartman
- Department of Psychology, Loma Linda University, Loma Linda, CA 92354, USA.
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25
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Keune JD, Brenner MJ, Schwetye KE, Yu JW, Fox IK, Hunter DA, Mackinnon SE. Temporal factors in peripheral nerve reconstruction with suture scaffolds: an experimental study in rodents. Restor Neurol Neurosci 2006; 24:181-90. [PMID: 16873973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
PURPOSE This study investigated nerve regeneration following nerve repair with longitudinally oriented sutures, with emphasis on timing. Prior work in rodents has shown that suture scaffolds are comparable to nerve grafting when assessments are made at late time points. However, rodents have exceptional regenerative capacity, making it difficult to detect key differences at late time points. This study therefore investigated regeneration across suture scaffolds both at early (4 week) and late (12 week) endpoints. METHODS Rodents were randomized to nerve gap, transection and repair, nerve grafting, and suture scaffold groups. Nerve regeneration was evaluated at 4 and 12 weeks. Histomorphometry parameters were evaluated using binary image analysis of toluidine blue-stained nerve cross sections. RESULTS Compared to nerve grafts, suture scaffolds were associated with significantly decreased neural density (4208 +/- 3546 vs. 193 +/- 416, fibers/mm;2, p<0.05) and fiber width (1.92 +/- 1.21 vs. 0.75+/- 1.16, microm, p<0.05). At 12 weeks, differences between groups were no longer detectable. CONCLUSION When evaluated at optimal time points for rodents, suture scaffolds fail to support regeneration comparable to the existing gold standard of nerve grafting. This finding raises significant concerns regarding the clinical application of suture scaffolds.
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Affiliation(s)
- Jason D Keune
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, Saint Louis, MO 63110, USA
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Abstract
Currently, the literature lacks a solid body of research on decision and cost-effectiveness analysis of imaging strategies for adults and children suspected of having a brain neoplasm. This article describes the epidemiology and clinical presentation of brain neoplasms, reviews current diagnostic strategies, highlights gaps in the literature on decision and cost-effectiveness analysis, and suggests directions for future research.
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Affiliation(s)
- Alf Hutter
- Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO 63110, USA
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