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Lin C, Wang N, Xu C. Glioma-associated microglia/macrophages (GAMs) in glioblastoma: Immune function in the tumor microenvironment and implications for immunotherapy. Front Immunol 2023; 14:1123853. [PMID: 36969167 PMCID: PMC10034134 DOI: 10.3389/fimmu.2023.1123853] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/28/2023] [Indexed: 03/11/2023] Open
Abstract
Glioma is a mixed solid tumor composed of neoplastic and non-neoplastic components. Glioma-associated macrophages and microglia (GAMs) are crucial elements of the glioma tumor microenvironment (TME), regulating tumor growth, invasion, and recurrence. GAMs are also profoundly influenced by glioma cells. Recent studies have revealed the intricate relationship between TME and GAMs. In this updated review, we provide an overview of the interaction between glioma TME and GAMs based on previous studies. We also summarize a series of immunotherapies targeting GAMs, including clinical trials and preclinical studies. Specifically, we discuss the origin of microglia in the central nervous system and the recruitment of GAMs in the glioma background. We also cover the mechanisms through which GAMs regulate various processes associated with glioma development, such as invasiveness, angiogenesis, immunosuppression, recurrence, etc. Overall, GAMs play a significant role in the tumor biology of glioma, and a better understanding of the interaction between GAMs and glioma could catalyze the development of new and effective immunotherapies for this deadly malignancy.
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Zhao W, Li J, Yang G, Ren G, Zhang L, Wang T. Non-typical anti-GBM disease with intraglomerular granulomatous reaction and anti-PLA2R-negative membranous nephropathy in the context of IgM/κ paraproteinemia. Int Urol Nephrol 2022; 55:1389-1391. [PMID: 36456884 DOI: 10.1007/s11255-022-03424-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/18/2022] [Indexed: 12/02/2022]
Affiliation(s)
- WenTing Zhao
- Department of Nephrology, The First Hospital of HeBei Medical University, No. 89 East DongGang Road, ShiJiaZhuang, 050030, People's Republic of China
| | - Jing Li
- Department of Nephrology, The First Hospital of HeBei Medical University, No. 89 East DongGang Road, ShiJiaZhuang, 050030, People's Republic of China
| | - Guang Yang
- TaiYuan KingMed Center for Clinical Laboratory, No. 2 LongSheng Street, TaiYuan, 030000, People's Republic of China
| | - GuangWei Ren
- Department of Nephrology, The First Hospital of HeBei Medical University, No. 89 East DongGang Road, ShiJiaZhuang, 050030, People's Republic of China
| | - LiHong Zhang
- Department of Nephrology, The First Hospital of HeBei Medical University, No. 89 East DongGang Road, ShiJiaZhuang, 050030, People's Republic of China
| | - Tao Wang
- Department of Nephrology, The First Hospital of HeBei Medical University, No. 89 East DongGang Road, ShiJiaZhuang, 050030, People's Republic of China.
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Matsui K, Kamata W, Mochida Y, Ishioka K, Moriya H, Hidaka S, Ohtake T, Tamai Y, Kobayashi S. Acquired aplastic anemia complicated with anti-glomerular basement membrane disease successfully treated with immunosuppressive therapy: a case report. BMC Nephrol 2022; 23:136. [PMID: 35392836 PMCID: PMC8991481 DOI: 10.1186/s12882-022-02772-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aplastic anemia (AA) is a rare but fatal disorder characterized by pancytopenia due to bone marrow hypoplasia. Anti-glomerular basement membrane disease (anti-GBM disease) is an immune complex small-vessel vasculitis that presents as rapidly progressive glomerulonephritis and/or pulmonary hemorrhage. Although both involve autoreactive T cells that are partially triggered by human leukocyte antigen (HLA)-DR15, there have been no reports of their co-existence and the treatment strategy is not well understood. CASE PRESENTATION A 67-year-old woman presented with fever, malaise, and acute kidney injury with proteinuria and hematuria requiring hemodialysis. She was diagnosed with anti-GBM antibody disease based on high serum anti-GBM antibody titer and crescentic glomerulonephritis on a renal biopsy. Pulse administration of methylprednisolone (MP), oral prednisolone (PSL), and plasmapheresis were performed. Only 2 weeks after the diagnosis of anti-GBM disease, the patient developed pancytopenia requiring frequent blood transfusions. The blood cell count did not recover even 1 month after discontinuing the drugs that could cause pancytopenia. Bone marrow examination showed hypocellularity without abnormal infiltrates or fibrosis, which led to the diagnosis of severe acquired AA. Further HLA phenotyping revealed that she had HLA-DR15. Increased dose of PSL with the secondary MP pulse and the addition of cyclosporine improved pancytopenia. Although she remained dialysis-dependent, anti-GBM disease and pancytopenia did not recur for more than 2 years. CONCLUSIONS We report the first case of acquired AA complicated with anti-GBM disease in an elderly woman with HLA-DR15, which was successfully treated with immunosuppressive therapy (IST). This report is valuable not only because it shows they may co-occur, but also because it provides a therapeutic option for this complex condition. It was also suggested that pancytopenia in patients with anti-GBM disease recalls serious hematologic diseases including AA that require immediate treatment based on bone marrow examination.
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Affiliation(s)
- Kenji Matsui
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura, Kanawaga, 247-8533, Japan.
| | - Wataru Kamata
- Division of Hematology, Shonan Kamakura General Hospital, Kamakura, Kanawaga, Japan
| | - Yasuhiro Mochida
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura, Kanawaga, 247-8533, Japan
| | - Kunihiro Ishioka
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura, Kanawaga, 247-8533, Japan
| | - Hidekazu Moriya
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura, Kanawaga, 247-8533, Japan
| | - Sumi Hidaka
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura, Kanawaga, 247-8533, Japan
| | - Takayasu Ohtake
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura, Kanawaga, 247-8533, Japan
| | - Yotaro Tamai
- Division of Hematology, Shonan Kamakura General Hospital, Kamakura, Kanawaga, Japan
| | - Shuzo Kobayashi
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, 1370-1, Okamoto, Kamakura, Kanawaga, 247-8533, Japan
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Gnanavelu H, Narasimhan V, Manayath N, Korula C. Retroperitoneal Mass—Castleman Disease. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02639-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abe K, Shimamura Y, Nishizawa K, Maeda T, Yane K, Shinohara T, Ogawa Y, Takizawa H. A case of relapsed anti-glomerular basement membrane glomerulonephritis complicated by IgG4-related disease. Nefrologia 2021; 41:352-354. [PMID: 36165342 DOI: 10.1016/j.nefroe.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/20/2020] [Indexed: 06/16/2023] Open
Affiliation(s)
- Koki Abe
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan.
| | | | - Keitaro Nishizawa
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Takuto Maeda
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Kei Yane
- Department of Gastroenterology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Toshiya Shinohara
- Department of Pathology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Yayoi Ogawa
- Hokkaido Renal Pathology Center, Sapporo, Japan
| | - Hideki Takizawa
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan
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Abe K, Shimamura Y, Nishizawa K, Maeda T, Yane K, Shinohara T, Ogawa Y, Takizawa H. A case of relapsed anti-glomerular basement membrane glomerulonephritis complicated by IgG4-related disease. Nefrologia 2020; 41:352-354. [PMID: 32807580 DOI: 10.1016/j.nefro.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/20/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Koki Abe
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan.
| | | | - Keitaro Nishizawa
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Takuto Maeda
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Kei Yane
- Department of Gastroenterology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Toshiya Shinohara
- Department of Pathology, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Yayoi Ogawa
- Hokkaido Renal Pathology Center, Sapporo, Japan
| | - Hideki Takizawa
- Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan
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Zhang M, Guan N, Zhu P, Chen T, Liu S, Hao C, Xue J. Recurrent anti-GBM disease with T-cell large granular lymphocytic leukemia: A case report. Medicine (Baltimore) 2019; 98:e16649. [PMID: 31374037 PMCID: PMC6708844 DOI: 10.1097/md.0000000000016649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Anti-glomerular basement membrane disease (anti-GBM disease) is a rare small vessel vasculitis caused by autoantibodies directed against the glomerular and alveolar basement membranes. Anti-GBM disease is usually a monophasic illness and relapse is rare after effective treatment. This article reports a case of coexistence of recurrent anti-GBM disease and T-cell large granular lymphocytic (T-LGL) leukemia. PATIENT CONCERNS A 37-year-old man presented with hematuria, edema, and acute kidney injury for 2 months. DIAGNOSIS Anti-GBM disease was diagnosed by renal biopsy, in which crescentic glomerulonephritis was observed with light microscopy, strong linear immunofluorescent staining for immunoglobulin G on the GBM and positive serum anti-GBM antibody. Given this diagnosis, the patient was treated with plasmapheresis, steroids, and cyclophosphamide for 4 months. The anti-GBM antibody titer was maintained to negative level but the patient remained dialysis-dependent. One year later, the patient suffered with a relapse of anti-GBM disease, after an extensive examination, he was further diagnosed T-LGL leukemia by accident. INTERVENTIONS The patient received cyclosporine A therapy for T-LGL leukemia. OUTCOMES After treatment with cyclosporine A, serum anti-GBM antibody became undetectable. During the 16 months follow-up, anti-GBM titer remained normal and abnormal T-lymphocytes in the bone marrow and peripheral blood were also decreased. LESSONS T-LGL leukemia is an indolent lymphoproliferative disorder that represents a monoclonal expansion of cytotoxic T cells, which has been reported to be accompanied by some autoimmune diseases. This is the first report of coincidence of T-LGL leukemia and anti-GBM disease, and suggests there are some relationships between these 2 diseases. Clinical physicians should exclude hematological tumors when faced with recurrent anti-GBM disease.
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Affiliation(s)
| | | | - Ping Zhu
- Division of Hematology, Huashan Hospital, Fudan University, Shanghai, China
| | - Tong Chen
- Division of Hematology, Huashan Hospital, Fudan University, Shanghai, China
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Li X, Hao Y, Xue R, Qi X, Ma Z. Dual anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane antibody-positive crescent glomerulonephritis in a patient with monoclonal gammopathy of undetermined significance: A case report. Medicine (Baltimore) 2019; 98:e14557. [PMID: 30762802 PMCID: PMC6408057 DOI: 10.1097/md.0000000000014557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and anti-glomerular basement membrane (GBM) antibody disease are both rare autoimmune diseases. Monoclonal gammopathy of undetermined significance (MGUS) is one of the most common causes of plasma cell dyscrasias (PCD). The three entities can cause renal lesions via different mechanisms and, however, they have not been reported in a single patient with renal lesion. PATIENT CONCERNS Here, we describe a patient with half-year fatigue and 40-day nausea and vomiting. Laboratory workup displayed increased serum creatinine, proteinuria, and mild microscopic hematuria. Serological tests were positive for anti-nuclear antibody (titer 1:100), anti-GBM antibodies (not quantified), and myeloperoxidase (MPO)-ANCA (228 RU/ml). Serum immunofixation electrophoresis found monoclonal immunoglobulin (MIg) G κ-light chain in the serum. Renal biopsy displayed crescentic formation in glomerule by microscopy and staining for liner IgG (+), sparse C3 (+-) and light chain (κ and λ) (+-) by immunofluorescence. The bone marrow examination indicated basically normal myelogram and sporadic plasma cells positive for CD38, CD138 staining, and κ light-chain restriction. DIAGNOSIS Crescentic glomerulonephritis and MGUS. INTERVENTIONS The patient was treated with plasmapheresis, pulse methylprednisolone therapy in combination with cyclophosphamide. OUTCOMES The patient still became hemodialysis-dependent. LESSONS The present study discusses, to the best of our knowledge, first case of crescentic glomerulonephritis seropositive for ANCA anti-GBM antibody in MGUS. The rare concurrence highlights it as a clinical concern.
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Affiliation(s)
| | - Yunfei Hao
- Cerebrovascular Disease Center, Gansu Provincial Hospital, Lanzhou, Gansu Province, China
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