Glycosaminoglycans (GAGs) in human cerebral tumors. Part 1. Biochemical findings

The Networking Brain: How Extracellular Matrix, Cellular Networks, and Vasculature Shape the In Vivo Mechanical Properties of the Brain

Mechanically, the brain is characterized by both solid and fluid properties. The resulting unique material behavior fosters proliferation, differentiation, and repair of cellular and vascular networks, and optimally protects them from damaging shear forces. Magnetic resonance elastography (MRE) is a noninvasive imaging technique that maps the mechanical properties of the brain in vivo. MRE studies have shown that abnormal processes such as neuronal degeneration, demyelination, inflammation, and vascular leakage lead to tissue softening. In contrast, neuronal proliferation, cellular network formation, and higher vascular pressure result in brain stiffening. In addition, brain viscosity has been reported to change with normal blood perfusion variability and brain maturation as well as disease conditions such as tumor invasion. In this article, the contributions of the neuronal, glial, extracellular, and vascular networks are discussed to the coarse-grained parameters determined by MRE. This reductionist multi-network model of brain mechanics helps to explain many MRE observations in terms of microanatomical changes and suggests that cerebral viscoelasticity is a suitable imaging marker for brain disease.

Magnetic Resonance Elastography in Intracranial Neoplasms: A Scoping Review

BACKGROUND

Magnetic resonance elastography (MRE) allows noninvasive assessment of intracranial tumor mechanics and may thus be predictive of intraoperative conditions. Variations in the use of technical terms complicate reading of current literature, and there is need of a review using consolidated nomenclature.

OBJECTIVES

We present an overview of current literature on MRE relating to human intracranial neoplasms using standardized nomenclature suggested by the MRE guidelines committee. We then discuss the implications of the findings, and suggest approaches for future research.

METHOD

We performed a systematic literature search in PubMed, Embase, and Web of Science; the articles were screened for relevance and then subjected to full text review. Technical terms were consolidated.

RESULTS

We identified 12 studies on MRE in patients with intracranial tumors, including meningiomas, glial tumors including glioblastomas, vestibular schwannomas, hemangiopericytoma, central nervous system lymphoma, pituitary macroadenomas, and brain metastases. The studies had varying objectives that included prediction of intraoperative consistency, histological separation, prediction of adhesiveness, and exploration of the mechanobiology of tumor invasiveness and malignancy. The technical terms were translated using standardized nomenclature. The literature was highly heterogeneous in terms of image acquisition techniques, post-processing, and study design and was generally limited by small and variable cohorts.

CONCLUSIONS

MRE shows potential in predicting tumor consistency, adhesion, and mechanical homogeneity. Furthermore, MRE provides insight into malignant tumor behavior and its relation to tissue mechanics. MRE is still at a preclinical stage, but technical advances, improved understanding of soft tissue rheological impact, and larger samples are likely to enable future clinical introduction.

The scrambled story between hyaluronan and glioblastoma

Advances in cancer biology are revealing the importance of the cancer cell microenvironment on tumorigenesis and cancer progression. Hyaluronan (HA), the main glycosaminoglycan in the extracellular matrix, has been associated with the progression of glioblastoma (GBM), the most frequent and lethal primary tumor in the central nervous system, for several decades. However, the mechanisms by which HA impacts GBM properties and processes have been difficult to elucidate. In this review, we provide a comprehensive assessment of the current knowledge on HA's effects on GBM biology, introducing its primary receptors CD44 and RHAMM and the plethora of relevant downstream signaling pathways that can scramble efforts to directly link HA activity to biological outcomes. We consider the complexities of studying an extracellular polymer and the different strategies used to try to capture its function, including 2D and 3D in vitro studies, patient samples, and in vivo models. Given that HA affects not only migration and invasion, but also cell proliferation, adherence, and chemoresistance, we highlight the potential role of HA as a therapeutic target. Finally, we review the different existing approaches to diminish its protumor effects, such as the use of 4-methylumbelliferone, HA oligomers, and hyaluronidases and encourage further research along these lines in order to improve the survival and quality of life of GBM patients.

Comparison of Dynamic Contrast-Enhancement Parameters between Gadobutrol and Gadoterate Meglumine in Posttreatment Glioma: A Prospective Intraindividual Study

BACKGROUND AND PURPOSE

Differences in molecular properties between one-molar and half-molar gadolinium-based contrast agents are thought to affect parameters obtained from dynamic contrast-enhanced imaging. The aim of our study was to investigate differences in dynamic contrast-enhanced parameters between one-molar nonionic gadobutrol and half-molar ionic gadoterate meglumine in patients with posttreatment glioma.

MATERIALS AND METHODS

This prospective study enrolled 32 patients who underwent 2 20-minute dynamic contrast-enhanced examinations, one with gadobutrol and one with gadoterate meglumine. The model-free parameter of area under the signal intensity curve from 30 to 1100 seconds and the Tofts model-based pharmacokinetic parameters were calculated and compared intraindividually using paired t tests. Patients were further divided into progression (n = 12) and stable (n = 20) groups, which were compared using Student t tests.

RESULTS

Gadobutrol and gadoterate meglumine did not show any significant differences in the area under the signal intensity curve or pharmacokinetic parameters of K ^trans, V_e, V_p, or K_ep (all P > .05). Gadobutrol showed a significantly higher mean wash-in rate (0.83 ± 0.64 versus 0.29 ± 0.63, P = .013) and a significantly lower mean washout rate (0.001 ± 0.0001 versus 0.002 ± 0.002, P = .02) than gadoterate meglumine. Trends toward higher area under the curve, K ^trans, V_e, V_p, wash-in, and washout rates and lower K_ep were observed in the progression group in comparison with the treatment-related-change group, regardless of the contrast agent used.

CONCLUSIONS

Model-free and pharmacokinetic parameters did not show any significant differences between the 2 gadolinium-based contrast agents, except for a higher wash-in rate with gadobutrol and a higher washout rate with gadoterate meglumine, supporting the interchangeable use of gadolinium-based contrast agents for dynamic contrast-enhanced imaging in patients with posttreatment glioma.

How tissue fluidity influences brain tumor progression

Mechanical properties of biological tissues and, above all, their solid or fluid behavior influence the spread of malignant tumors. While it is known that solid tumors tend to have higher mechanical rigidity, allowing them to aggressively invade and spread in solid surrounding healthy tissue, it is unknown how softer tumors can grow within a more rigid environment such as the brain. Here, we use in vivo magnetic resonance elastography (MRE) to elucidate the role of anomalous fluidity for the invasive growth of soft brain tumors, showing that aggressive glioblastomas (GBMs) have higher water content while behaving like solids. Conversely, our data show that benign meningiomas (MENs), which contain less water than brain tissue, are characterized by fluid-like behavior. The fact that the 2 tumor entities do not differ in their soft properties suggests that fluidity plays an important role for a tumor's aggressiveness and infiltrative potential. Using tissue-mimicking phantoms, we show that the anomalous fluidity of neurotumors physically enables GBMs to penetrate surrounding tissue, a phenomenon similar to Saffman-Taylor viscous-fingering instabilities, which occur at moving interfaces between fluids of different viscosity. Thus, targeting tissue fluidity of malignant tumors might open horizons for the diagnosis and treatment of cancer.

Tumoral invasion in the central nervous system

During growth, migration and differentiation, cells closely interact with the extracellular matrix (ECM). The harmony between cells and their environment is a key factor that maintains the normal architecture of tissues. Loss of growth control is not the only characteristic of oncogenesis, loss of control by the ECM is an important event that allows malignant cells to further progress toward invasion and metastasis. Changes in cell adhesion, proteolytic degradation of the ECM and cell migration have all been described during invasion of most tissues by tumor cells. However little is known of these changes in tumors of the central nervous system (CNS). Although brain tumor cells may share some of the invasive characteristics of tumors that arise outside the CNS, the particular structure and composition of the brain ECM suggest the existence of unique invasive mechanisms in these tumors. Furthermore, the interaction between brain tumor cells and their ECM may explain the intriguing observation that despite their highly invasive behavior, these cells remain poorly metastatic. This review focuses on biochemical mechanisms essential for tumor invasion and how they relate to invasion of tumors that arise in the CNS.

Hyaluronan and hyaluronectin in the extracellular matrix of human brain tumour stroma

Hyaluronan (HA) and the hyaluronan-binding glycoprotein hyaluronectin (HN) were measured in 23 gliomas and 8 meningiomas and their location was revisited in 35 tumours. A clear-cut difference was found in the HN/HA ratio values of glioblastomas (below 0.5) and that of astrocytomas (above 0.5 P < 0.001). Besides their location in the intercellular part of gliomas, HA and HN displayed a perivascular location in 1/3 astrocytomas, 17/24 glioblastomas, and 3/7 meningiomas, suggesting they could be produced also by the vascular stroma of tumours and that they would characterise the neoangiogenesis. All cultivated glioma cells tested produced HA in vitro, whereas only 1/11 cell lines produced HN, at a low level. The results obtained suggest that glioma HA and HN are produced by both cancer cells and vascular stroma cells, which contribute to the edification of the extracellular matrix. In meningiomas only the stroma would be responsible for HA and HN production.

Establishment and characterisation of a human glioma cell line

A new cell line, CB109, has been established from a human glioblastoma multiforme. The cytoskeleton was positive for glial fibrillary acidic protein, vimentin and fibronectin. Hyaluronan (HA) and the HA-binding protein hyaluronectin (HN) were expressed in the cell cytoplasm and in the extracellular matrix of spheroids and plated cells. Hyaluronidase did not prevent spheroid formation suggesting that HA was not involved in the cell-cell adhesion. HA precoating prevented cell adherence to the plates and favoured spheroid formation. HA was secreted in relatively large amounts into the culture medium. High performance liquid chromatography demonstrated that HA was in the high molecular weight form. The rate of HN secretion by cells was very low. Basic fibroblast growth factor significantly increased the proliferation in vitro and tumour growth after grafting into nude mice. The epidermal growth factor receptor was not expressed on cultivated CB109 cells. Cytogenetic analysis showed polysomy 7, structural rearrangement of chromosome 10 short arm and a translocation 13q13-q14 without detectable alteration of the RB gene.

Immunocytochemical study of macrophages and microglial cells and extracellular matrix components in human CNS disease. 1. Gliomas

We have used an immunocytochemical approach to investigate the inter-relationships between astrocytes, macrophages and microglia and the extracellular matrix components fibronectin and laminin, in 27 gliomas. Using recently available markers to macrophages and microglia (monoclonals Mac387, KP1 and the lectin RCA-1) and antisera to GFAP, fibronectin and laminin, we have described the reactions of these cells and the extracellular matrix. We found RCA-1 to be the superior marker for detecting most macrophages and microglia. There were more macrophages and microglia in high-grade gliomas than in low-grade. RCA-1 also reacted with endothelial cells in normal and reactive brain but showed markedly less affinity for endothelium in an close to gliomas. A possible role for the extracellular matrix in the astrocyte, macrophage and microglial reactions is discussed in the broader context of their role in the immune response.

Glycosaminoglycans in cortical autopsy samples from Alzheimer brain

Each of the known classes of mammalian glycosaminoglycans, with the exception of keratan sulphate, was found in cerebral cortex samples from patients with Alzheimer-type dementia and age-matched controls. These molecules were quantitated, after electrophoresis and staining with Alcian Blue dye, by scanning densitometry. No significant differences were found between the mean levels of each of the above glycosaminoglycans in frontal cortex from patients with dementia compared with controls. An increase (26%; p less than 0.05) in the mean level of hyaluronate, but not of other glycosaminoglycans, was found in temporal cortex samples. On the other hand, the uronic acid content of hyaluronate degradation products following Streptomyces hyaluronidase treatment of brain glycosaminoglycans did not reveal any statistically significant changes in Alzheimer's disease. HPLC of disaccharide products from Arthrobacter chondroitinase AC digests did not reveal any significant changes in sulphate substitution of chondroitin sulphate in Alzheimer brain.

Developmental and age-related changes in rat brain glycosaminoglycans

The quantities of each major class of glycosaminoglycan were determined in rat cerebrum from postnatal day 5 to 30 months of age. Chondroitin sulphate, dermatan sulphate, heparan sulphate, heparin, and hyaluronate were found, but no keratan sulphate was detected. Large and rapid changes in glycosaminoglycan content were observed during the period of brain maturation, and thereafter relatively steady levels were maintained until after the age of 12 months. The most remarkable change in the aged rat cerebrum was the ratio by weight of hyaluronate to chondroitin sulphate, which was approximately 1:1 from postnatal day 10 to 18 months but increased to 2.6:1 by the age of 30 months. In immature rats, the proportion of nonsulphated and 6-sulphated disaccharides derived from chondroitinase AC digests of brain glycosaminoglycans was much greater than in adults. In mature rats, chondroitin sulphate was composed almost entirely of 4-sulphated disaccharide subunits. The possibility that these changes could affect the permeability properties of the cerebral extracellular space and ionic equilibria in the brain is discussed.

The extracellular matrix of the central and peripheral nervous systems: structure and function

The extracellular matrix (ECM) is the naturally occurring substrate upon which cells migrate, proliferate, and differentiate. The ECM functions as a biological adhesive that maintains the normal cytoarchitecture of different tissues and defines the key spatial relationships among dissimilar cell types. A loss of coordination and an alteration in the interactions between mesenchymal cells and epithelial cells separated by an ECM are thought to be fundamental steps in the development and progression of cancer. Although a substantial body of knowledge has been accumulated concerning the role of the ECM in most other tissues, much less is known of the structure and function of the ECM in the nervous system. Recent experiments in mammalian systems have shown that an increased knowledge of the ECM in the nervous system can lead to a better understanding of complex neurobiological processes under developmental, normal, and pathological conditions. This review focuses on the structure and function of the ECM in the peripheral and central nervous systems and on the importance of ECM macromolecules in axonal regeneration, cerebral edema, and cerebral neoplasia.

Glycosaminoglycan changes in human gliomas. A biochemical study

Glycosaminoglycans (GAGs) were isolated, separated by electrophoresis and quantified in 36 neurosurgical specimens of human gliomas and in 8 samples of normal white and gray matter. Gliomas of various degrees of malignancy exhibited different GAG patterns. Total GAG concentration was three times higher in low grade gliomas than in normal white matter. The mean percentage of single GAG classes was usually similar in both tissues, although in certain tumor samples a higher percentage of hyaluronate was found. GAG patterns in anaplastic astrocytomas, however, more closely resembled normal white and gray matter, both quantitatively and qualitatively. Glioblastomas, on the other hand, showed high GAG concentrations, in particular of heparan sulfate and dermatan sulfate. This finding could be secondary to the abundant vessels and mesodermal material associated with this oncotype. The hyaluronate/sulfated GAGs ratio was lower in oligodendrogliomas than in low grade astrocytomas. This biochemical feature may be correlated with the alcianophilia found in the honey-comb degeneration of oligodendrogliomas. The significance of these findings as they relate to tumor histology and biology have been discussed.

Immunohistochemical study of chondroitin sulfate in human gliomas

A polyclonal rabbit antiserum was utilized to localize chondroitin sulfate in human gliomas. Tissue sections were digested with chondroitinase ABC to create the antigenic determinant on the chondroitin sulfate proteoglycan molecule. Normal CNS tissue showed a positive immunohistochemical staining both in white and gray matter, sparing the cytoplasm of glial and neuronal cells. Differentiated astrocytomas presented the same pattern as the normal CNS. Anaplastic astrocytomas and glioblastomas showed progressive reduction of parenchymal positivity as anaplasia increased. These data suggest that chondroitin sulfate is a character expressed by differentiated CNS cells and that it is lost with dedifferentiation. Vascular structures presented positive material in the adventitia in all the oncotypes. A discontinuous positivity was observed in the basal membrane zone of the vessels.

Biochemical and histochemical evaluation of glycosaminoglycans in brain tumors induced in rats by nitrosourea derivatives

The occurrence, distribution and concentration of GAGs in ENU and MNU experimental brain tumors induced in the rat are reported. GAGs have been histochemically studied by Alcian Blue methods; they have been quantified and qualitatively evaluated by electrophoresis of brain extracts. The pattern of GAGs in normal rats is consistent with the data of the literature. No GAG accumulation precedes the tumor development. Early neoplastic proliferations, oligodendroglial and mixed glial microtumors are strongly alcian-positive; the alcianophilia spares clusters of cells developing a cytoplasm. In large tumors, GAGs are histochemically demonstrable in the honey-comb areas of oligodendrogliomas and in peripheral infiltration areas of polymorphic gliomas. The role of the normal nervous tissue and oligodendroglial cells in the accumulation of the GAGs is discussed. The accumulated GAGs seem to rise from the nervous tissue included in the tumors, rather than from the metabolism of tumor cells.