1
|
Attia M, Mirkin Y, Hershcovitch R, Cohen Z, Zibly Z, Zauberman J, Wohl A, Harnof S, Spiegelmann R, Hadani M, Furman O, Zach L. NCOG-50. CHARACTERIZING MENINGIOMA IN YOUNG PATIENTS UNDER 40. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.639] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Meningiomas are the most common primary CNS tumor in adults, with a median age at diagnosis of 65 years. Younger patients usually have a genetic background or history of prior radiation exposure. Population-level studies suggest 80-85% of meningiomas are WHO grade I (benign), 15-18% grade II (atypical), and 1-3% grade III (anaplastic). This case series describes a single center experience of meningiomas in patients under 40.
METHODS
We reviewed the Sheba Medical Center Neurosurgery and radiotherapy databases containing patients operated on for meningioma between 2011-2020. Digital medical records were retrieved, including pathology reports, surgical reports, clinical and radiological data, and use of radiotherapy or medical treatments.
RESULTS
Of 600 patients in the database, 47 patients under 40 (7.8%) were identified and 54 tumors were reviewed (five patients had multiple operation). 32 patients were female (68%) ; 2 were under 20 years old, 17 were age 20-30 and 28 were age 31-39 at first presentation. Seven patients had received prior radiation therapy for a childhood malignancy. 28 meningiomas were histology confirmed grade I (52%), 22 were grade II (41%), 2 were grade III (4%), and 2 (4%) were grade undetermined. 22 tumors were located in the skull base (41%) and 32 (59%) in the brain convexity. 16 skull base tumors were grade I, five were grade II, and one was grade III. 12 convexity tumors were grade I, 16 were grade II, and two were grade III. Median follow-up was 35 months (range 1 - 98 months).
CONCLUSION
Our experience with meningioma patients under 40 revealed a different grade segregation than the older population, with younger patients showing a higher incidence of grade II tumors. These tumors are generally more aggressive, and require careful resection and consideration for post-surgical radiotherapy. Further validation with population based databases is required.
Collapse
Affiliation(s)
| | | | | | - Zvi Cohen
- Sheba Medical Center, Ramat Gan, Israel
| | | | | | | | | | | | | | | | - Leor Zach
- Sheba Medical Center, Ramat Gan, Israel
| |
Collapse
|
2
|
Attia M, Mirkin Y, Hershkovitch R, Cohen ZR, Zibly Z, Zauberman J, Wohl A, Harnof S, Spiegelmann R, Hadani M, Furman O, Zach L. P14.36 Characterising Meningiomas in young patients under 40. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.156] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Meningiomas are the most common primary CNS tumor in adults, with a median age at diagnosis of 65 years and a female to male ratio of 2–3:1 (except in grade II, III meningiomas). Younger patients usually have a genetic background or history of prior radiation exposure. Based on population-level studies, approximately 80–85% of meningiomas are WHO grade I (benign), 15–18% grade II (atypical), and 1–3% grade III (anaplastic). This case series describes a single center experience of the presentation and pathology of meningiomas in patients under the age of 40.
MATERIALS AND METHODS
We reviewed the Sheba Medical Center Neurosurgery and radiotherapy databases containing patients who were operated on for meningioma between the years 2011–2020. Patients under 40 were selected and information from digital medical records was gathered on these patients, including pathology reports, surgical reports, clinical and radiological data, and the use of radiotherapy or medical treatments.
RESULTS
Of 600 patients in the database, 49 patients under 40 (8.3%) were identified and 54 tumors were reviewed (five patients were operated on for multiple meningiomas). 31 patients were female (63%); 2 were under 20 years old, 15 were age 20–29 and 32 were age 30–39 at first presentation. Seven patients had received prior radiation therapy for a childhood malignancy. 28 meningiomas were histology confirmed grade I (52%), 22 were grade II (41%), 2 were grade III (4%), and 2 (4%) were grade undetermined. 22 tumors were located in the skull base (41%) and 32 (59%) in the brain convexity. Of the skull base tumors, 16 were grade I, 5 were grade II, and one was grade III. Of the convexity tumors, 12 were grade I, 16 were grade II, and 2 were grade III. Median follow-up was 35 months, and longest follow-up time was 98 months. Six patients were treated with additional radiotherapy after surgery.
CONCLUSION
Our experience with meningioma patients under 40 revealed a different grade segregation than the older population, with younger patients showing a higher incidence of grade II tumors. These tumors are generally more aggressive, and require careful resection and consideration for post-surgical radiotherapy. Further validation with population based databases is required.
Collapse
Affiliation(s)
- M Attia
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Mirkin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Hershkovitch
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
| | - Z R Cohen
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Z Zibly
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J Zauberman
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Wohl
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Harnof
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Spiegelmann
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Hadani
- Neurosurgery Department, Sheba Medical Center, Ramat Gan, Israel
| | - O Furman
- Neuro-Oncology Unit, Sheba Medical Center, Ramat Gan, Israel
| | - L Zach
- Neuro-Oncology Unit, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
3
|
Ungar L, Nachum O, Zibly Z, Wohl A, Harel R, Attia M, Spiegelmann R, Zaubermann J, Feldman Z, Knoller N, Cohen ZR. Comparison of Frame-Based Versus Frameless Image-Guided Intracranial Stereotactic Brain Biopsy: A Retrospective Analysis of Safety and Efficacy. World Neurosurg 2021; 164:e1-e7. [PMID: 34332151 DOI: 10.1016/j.wneu.2021.07.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND A definitive diagnosis of brain lesions not amenable to surgery is mainly made by stereotactic needle biopsy. The diagnostic yield and safety of the frameless vs frame-based image-guided stereotactic techniques is unclear. OBJECTIVE To evaluate the safety and accuracy of frameless vs frame-based stereotactic brain biopsy techniques. METHODS A total of 278 patients (153 men, mean age 65.5 years) with intra-axial brain lesions underwent frame-based (n=148) or frameless image-guided stereotactic brain biopsy (n=130) using a minimally invasive twist drill technique during 2010-2016 at Sheba Medical Center. Demographic, imaging, and clinical data were retrospectively analyzed. RESULTS The diagnostic yield (>90%) did not differ significantly between groups. Overall morbidity (6.8% vs 8.5%), incidence of permanent neurologic deficits (2.1% vs 1.6%), mortality rate (0.7% vs 0.8%), and postoperative computed tomography-detected asymptomatic (14.2% vs 16.1%) and symptomatic (2.0% vs 1.6%) bleeding also did not differ significantly between the frame-based and frameless cohorts, respectively. The diagnostic yield and complication rates related to the biopsy technique were not significantly associated with sex; age; entry angle to the skull and skull thickness; lesion location or depth, or radiologic characteristics. Diagnostic yield was significantly associated with the mean lesion volume. Smaller lesions were less diagnostic than larger lesions in both techniques (p=0.043 frame-based and p=0.048 frameless). CONCLUSION The frameless biopsy technique is as efficient as the frame-based brain biopsy technique with a low complication rate. Lesion volume was the only predictive factor of diagnostic yield. The minimally invasive twist drill technique is safe and efficient.
Collapse
Affiliation(s)
- Lior Ungar
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Ortal Nachum
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Zion Zibly
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Anton Wohl
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Ran Harel
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Moshe Attia
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | | | - Jacob Zaubermann
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Zeev Feldman
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Nachshon Knoller
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Zvi R Cohen
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.
| |
Collapse
|
4
|
Ungar L, Zibly Z, Wohl A, Harel R, Hadani M, Attia M, Spiegelmann R, Feldman Z, Zaubermann J, Knoller N, Cohen ZR. Utility of the Polestar N30 low-field MRI system for resecting non-enhancing intra-axial brain lesions. Neurol Neurochir Pol 2021; 55:202-211. [PMID: 33559873 DOI: 10.5603/pjnns.a2021.0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/17/2020] [Revised: 11/26/2020] [Accepted: 12/15/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND To determine the utility of an intraoperative magnetic resonance imaging (iMRI) system, the Polestar N30, for enhancing the resection control of non-enhancing intra-axial brain lesions. MATERIALS AND METHODS Seventy-three patients (60 males [83.3%], mean age 37 years) with intra-axial brain lesions underwent resection at Sheba Medical Centre using the Polestar between February 2012 and the end of August 2018. Demographic and imaging data were retrospectively analysed. Thirty-five patients had a non-enhancing lesion (48%). RESULTS Complete resection was planned for 60/73 cases after preoperative imaging. Complete resection was achieved in 59/60 (98.3%) cases. After iMRI, additional resection was performed in 24/73 (32.8%) cases, and complete resection was performed in 17/60 (28.8%) cases in which a complete resection was intended. In 6/13 (46%) patients for whom incomplete resection was intended, further resection was performed. The extent of resection was extended mainly for non-enhancing lesions: 16/35 (46%) as opposed to only 8/38 (21%) for enhancing lesions. Further resection was not significantly associated with sex, age, intended resection, recurrence, or affected side. Univariate analysis revealed non-eloquent area, intended complete resection, and enhancing lesions to be predictive factors for complete resection, and non-enhancing lesions and scan time to be predictive factors for an extended resection. Non-enhancement was the only independent factor for extended resection. CONCLUSIONS The Polestar N30 is useful for evaluating residual non-enhancing intra-axial brain lesions and achieving maximal resection.
Collapse
Affiliation(s)
- Lior Ungar
- Sackler School of Medicine, Tel Aviv University, Israel
| | - Zion Zibly
- Sackler School of Medicine, Tel Aviv University, Israel
| | - Anton Wohl
- Sackler School of Medicine, Tel Aviv University, Israel
| | - Ran Harel
- Sackler School of Medicine, Tel Aviv University, Israel
| | - Moshe Hadani
- Sackler School of Medicine, Tel Aviv University, Israel
| | - Moshe Attia
- Sackler School of Medicine, Tel Aviv University, Israel
| | | | - Zeev Feldman
- Sackler School of Medicine, Tel Aviv University, Israel
| | | | | | - Zvi R Cohen
- Sackler School of Medicine, Tel Aviv University, Israel.
| |
Collapse
|
5
|
Itsekson-Hayosh Z, Tsarfaty G, Greenberg G, Sharon M, Bakon M, Wohl A, Chapman J, Orion D. Early Fluid Attenuation Inversion Recovery Sulcal Contrast Enhancement Correlates with Severity of Reversible Cerebral Vasoconstriction Syndrome. J Stroke 2021; 23:146. [PMID: 33600715 PMCID: PMC7900390 DOI: 10.5853/jos.2020.01004.e1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Ze'ev Itsekson-Hayosh
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, The Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Galia Tsarfaty
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Gahl Greenberg
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Michal Sharon
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Mati Bakon
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Anton Wohl
- Department of Neurosurgery, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Joab Chapman
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, The Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel.,Robert and Martha Harden Chair in Mental and Neurological Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Orion
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, The Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| |
Collapse
|
6
|
Itsekson-Hayosh Z, Tsarfati G, Greenberg G, Sharon M, Bakon M, Wohl A, Chapman J, Orion D. Early Fluid Attenuation Inversion Recovery Sulcal Contrast Enhancement Correlates with Severity of Reversible Cerebral Vasoconstriction Syndrome. J Stroke 2020; 22:400-402. [PMID: 33053955 PMCID: PMC7568979 DOI: 10.5853/jos.2020.01004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/26/2020] [Indexed: 12/01/2022] Open
Affiliation(s)
- Ze'ev Itsekson-Hayosh
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, The Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Galia Tsarfati
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Gahl Greenberg
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Michal Sharon
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Mati Bakon
- Institute of Medical Imaging, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Anton Wohl
- Department of Neurosurgery, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Joab Chapman
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, The Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel.,Robert and Martha Harden Chair in Mental and Neurological Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Orion
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, The Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Neurology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| |
Collapse
|
7
|
Wohl A, Kimchi G, Korach J, Perri T, Zach L, Zibly Z, Harel R, Nissim U, Spiegelmann R, Nass D, Cohen ZR. Brain Metastases from Ovarian Carcinoma: An Evaluation of Prognostic Factors and Treatment. Neurol India 2020; 67:1431-1436. [PMID: 31857529 DOI: 10.4103/0028-3886.273627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims and Objectives To review a series of patients with brain metastases from ovarian cancer at a single institution. To describe treatment modalities, their outcomes and to determine prognostic factors. Patients and Methods Between January 1995 and December 2014, 25 patients with ovarian cancer brain metastases were treated at The Sheba Medical Center. The medical records were retrospectively reviewed to collect demographic, clinical, and imaging data as well as the information on the treatment modalities used and their outcomes. Results Mean patient age at the time of brain metastasis diagnosis was 62.7 years. The median interval between the diagnosis of primary cancer and brain metastasis was 42.3 months. Neurologic deficits, headache, and seizure were the most common symptoms. The brain was the only site of metastasis in 20% of the patients. Active ovarian cancer at the time of diagnosis of brain metastasis was observed in half of the patients with systemic disease. Multiple brain metastases were observed in 25% of the patients. We treated 11 patients with surgery plus radiation therapy protocols in various orders: surgery followed by complementary whole-brain radiation therapy (WBRT), surgery followed by stereotactic radiosurgery (SRS), and surgery followed by WBRT and then by adjuvant SRS. Five patients underwent surgery alone and nine patients were treated with radiation alone (WBRT, SRS, or both). Univariate analysis for predictors of survival demonstrated that age above 62.7 years at the time of central nervous system involvement was a significant risk factor and leptomeningeal disease was a poor prognostic factor in reference to supra-tentorial lesions. Multivariate analysis for predictors of survival, however, showed that multiple brain lesions (>4) were a poor prognostic factor, and multivariate analysis of the time to progression revealed that combined treatments of surgery and radiation resulted in longer median periods of progression-free survival than each modality alone. Conclusion We conclude that the only significant predictors of survival or progression-free survival in our cohort were the number of brain metastases and the treatment modality.
Collapse
Affiliation(s)
- Anton Wohl
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Gil Kimchi
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Jacob Korach
- Department of Gynecology, Sheba Medical Center, Ramat Gan, Israel
| | - Tamar Perri
- Department of Gynecology, Sheba Medical Center, Ramat Gan, Israel
| | - Leor Zach
- Department of Oncology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv, Israel
| | - Zion Zibly
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Ran Harel
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Uzi Nissim
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | | | - Dvora Nass
- Department of Pathology, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv, Israel
| | - Zvi R Cohen
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| |
Collapse
|
8
|
Abstract
OBJECTIVE One of the most serious complications following subarachnoid hemorrhage (SAH) is delayed cerebral ischemia (DCI) secondary to symptomatic vasospasm. An animal model mimicking post SAH vasospasm is essential for enabling the translation of newer technologies from the conceptual phase to animal studies, and eventually to clinical trials. Various animal models of DCI following SAH have been reported, with canine models being the most common. Due to the similarity of the swine cardiovascular system and its dimensions to the human's system, the main objective of this study was to establish a consistent and quantitatively representative model of SAH-induced vasospasm in swine. MATERIALS AND METHODS Twelve female swines (57 ± 3 kg) were injected twice (with a 2-day interval between injections) with autologous blood into the subarachnoid space at the level of C2-3 vertebrae. Different volumes were injected to identify clinical and radiological changes. The effect of volume variations on hematoma size and vasospasm intensity in the circle of Willis arteries were studied 7-14 days after the first injection using ascending pharyngeal angiographic measurements of vessel diameter. Neurological outcome using a modified scoring table based on clinical parameters (e.g., appetite, behavior, walking, posture, and eye movement) was recorded. RESULTS Our results demonstrate that between volume combinations, intrathecal injection of 12 ml followed by 15 ml, with a 2-day interval in between, resulted in the most extensive angiographically-assessed vasospasm 12 ± 2 days following the first injection. The degree of vasospasm in the intracranial internal carotid artery was 22% and 16% for the left and right sides, respectively. Vasoconstriction of the anterior cerebral artery was 34% and 27% for the left and right sides, respectively. The vasoconstriction was not associated with either overt clinical signs or clinical outcome, which is indicative of an ischemic event. CONCLUSIONS The relative scarcity of swine models for SAH-induced vasospasm motivated us to develop and quantify a straightforward protocol for producing consistent mild-to-moderate vasospasm following SAH. As swine is commonly used in translational cardiovascular research, we believe that this study constitutes an important phase in the study of SAH and in developing pharmacological agents and medical devices for interventions.
Collapse
Affiliation(s)
- Zion Zibly
- Department of Neurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Lory Fein
- Department of Neurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Mayur Sharma
- Rose-Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio, 44195, USA
| | - Yaron Assaf
- Department of Neurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Anton Wohl
- Department of Neurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Sagi Harnof
- Department of Neurosurgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| |
Collapse
|
9
|
Peshes-Yeloz N, Ungar L, Wohl A, Jacoby E, Fisher T, Leitner M, Nass D, Rubinek T, Wolf I, Cohen ZR. Role of Klotho Protein in Tumor Genesis, Cancer Progression, and Prognosis in Patients with High-Grade Glioma. World Neurosurg 2019; 130:e324-e332. [PMID: 31228703 DOI: 10.1016/j.wneu.2019.06.082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 10/17/2018] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Klotho, a single-pass transmembrane protein associated with premature aging, acts as a tumor suppressor gene by inhibiting insulin/insulin-like growth factor-1 and fibroblast growth factor pathways. Downregulated Klotho expression is reported in melanoma, mesothelioma, bladder, breast, gastric, cervix, lung, and kidney cancers and is associated with a poor prognosis. Klotho expression and Klotho promoter hypermethylation are predictive factors for patient prognosis. METHODS To investigate the potential role of Klotho in glioblastoma-multiforme (GBM), 22 GBM samples were collected from the Sheba Tumor Bank and examined. RESULTS We found that increased Klotho messenger ribonucleic acid (RNA) expression predicted longer survival (P = 0.03) of GBM patients. Methylation analysis was performed on bisulfite-treated deoxyribonucleic acid from the GBM patient samples using ionization time-of-flight mass spectrometry according to the Sequenom EpiTYPER protocols. Klotho promoter hypermethylation was detected in 65% of the GBM samples and correlated significantly with improved survival (P < 0.04). We found 3 major Klotho promotor hypermethylation sites located 585-579 bp, 540-533 bp, and 537-534 bp upstream of the transcription start site. Methylated deoxyribonucleic acid immunoprecipitation studies confirmed these results. Notably, the messenger RNA expression in these GBM samples revealed an unexpected linear correlation with methylation of these 3 hypermethylation sites identified in the Klotho promotor. Thus Klotho expression and methylation could predict prognosis in patients with GBM. CONCLUSIONS Epigenetic regulation in GBM appears to be complicated. Specific CpG islands affect genes or micro RNAs that interact to control Klotho expression. The diverse effects of these islands may be due to unique factors of GBM.
Collapse
Affiliation(s)
- Naama Peshes-Yeloz
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Lior Ungar
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Anton Wohl
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Elad Jacoby
- Cancer Research Center, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Tamar Fisher
- Cancer Research Center, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Moshe Leitner
- Cancer Research Center, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Dvora Nass
- Institute of Pathology, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Tamar Rubinek
- Institute of Oncology, Tel-Aviv Medical Center, Tel-Aviv; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Ido Wolf
- Institute of Oncology, Tel-Aviv Medical Center, Tel-Aviv; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel
| | - Zvi R Cohen
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan; Affiliated with the Sackler School of Medicine, Tel Aviv, Israel.
| |
Collapse
|
10
|
Welby JP, Kaptzan T, Wohl A, Peterson TE, Raghunathan A, Brown DA, Gupta SK, Zhang L, Daniels DJ. Current Murine Models and New Developments in H3K27M Diffuse Midline Gliomas. Front Oncol 2019; 9:92. [PMID: 30873381 PMCID: PMC6400847 DOI: 10.3389/fonc.2019.00092] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/31/2019] [Indexed: 01/24/2023] Open
Abstract
Diffuse Midline Gliomas with Histone 3-Lysine-27-Methionine (H3K27M) mutation constitute the majority of Diffuse Intrinsic Pontine Glioma (DIPG), which is the most aggressive form of pediatric glioma with a dire prognosis. DIPG are lethal tumors found in younger children with a median survival <1 year from diagnosis. Discovery of the characteristic H3K27M mutations offers opportunity and hope for development of targeted therapies for this deadly disease. The H3K27M mutation, likely through epigenetic alterations in specific H3 lysine trimethylation levels and subsequent gene expression, plays a significant role in pathogenesis of DIPG. Animal models accurately depicting molecular characteristics of H3K27M DIPG are important to elucidate underlying pathologic events and for preclinical drug evaluation. Here we review the past and present DIPG models and describe our efforts developing patient derived cell lines and xenografts from pretreated surgical specimens. Pre-treated surgical samples retain the characteristic genomic and phenotypic hallmarks of DIPG and establish orthotopic tumors in the mouse brainstem that recapitulate radiographic and morphological features of the original human DIPG tumor. These models that contain the H3K27M mutation constitute a valuable tool to further study this devastating disease and ultimately may uncover novel therapeutic vulnerabilities.
Collapse
Affiliation(s)
- John P Welby
- Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Tatiana Kaptzan
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Anton Wohl
- Department of Neurosurgery, Chaim Sheba Medical Center, Tel-HaShomer, Ramat-Gan, Israel
| | | | - Aditya Raghunathan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Desmond A Brown
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - Shiv K Gupta
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States
| | - Liang Zhang
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - David J Daniels
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
11
|
Shavit-Stein E, Sheinberg E, Golderman V, Sharabi S, Wohl A, Gofrit SG, Zivli Z, Shelestovich N, Last D, Guez D, Daniels D, Gera O, Feingold K, Itsekson-Hayosh Z, Rosenberg N, Tamarin I, Dori A, Maggio N, Mardor Y, Chapman J, Harnof S. A Novel Compound Targeting Protease Receptor 1 Activators for the Treatment of Glioblastoma. Front Neurol 2018; 9:1087. [PMID: 30619047 PMCID: PMC6304418 DOI: 10.3389/fneur.2018.01087] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 11/28/2018] [Indexed: 01/27/2023] Open
Abstract
Data from human biopsies, in-vitro and in-vivo models, strongly supports the role of thrombin, and its protease-activated receptor (PAR1) in the pathology and progression of glioblastoma (GBM), a high-grade glial tumor. Activation of PAR1 by thrombin stimulates vasogenic edema, tumor adhesion and tumor growth. We here present a novel six amino acid chloromethyl-ketone compound (SIXAC) which specifically inhibits PAR1 proteolytic activation and counteracts the over-activation of PAR1 by tumor generated thrombin. SIXAC effects were demonstrated in-vitro utilizing 3 cell-lines, including the highly malignant CNS-1 cell-line which was also used as a model for GBM in-vivo. The in-vitro effects of SIXAC on proliferation rate, invasion and thrombin activity were measured by XTT, wound healing, colony formation and fluorescent assays, respectively. The effect of SIXAC on GBM in-vivo was assessed by measuring tumor and edema size as quantified by MRI imaging, by survival follow-up and brain histopathology. SIXAC was found in-vitro to inhibit thrombin-activity generated by CNS-1 cells (IC50 = 5 × 10-11M) and significantly decrease proliferation rate (p < 0.03) invasion (p = 0.02) and colony formation (p = 0.03) of these cells. In the CNS-1 GBM rat animal model SIXAC was found to reduce edema volume ratio (8.8 ± 1.9 vs. 4.9 ± 1, p < 0.04) and increase median survival (16 vs. 18.5 days, p < 0.02 by Log rank Mental-Cox test). These results strengthen the important role of thrombin/PAR1 pathway in glioblastoma progression and suggest SIXAC as a novel therapeutic tool for this fatal disease.
Collapse
Affiliation(s)
- Efrat Shavit-Stein
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Ehud Sheinberg
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
- Department of Neurosurgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Valery Golderman
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Shirley Sharabi
- The Advanced Technology Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Anton Wohl
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Shany Guly Gofrit
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Zion Zivli
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | | | - David Last
- The Advanced Technology Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - David Guez
- The Advanced Technology Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Dianne Daniels
- The Advanced Technology Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Orna Gera
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Kate Feingold
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Zeev Itsekson-Hayosh
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Nurit Rosenberg
- Institute of Thrombosis and Heamostasis, Coagulation Laboratory, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ilia Tamarin
- Institute of Thrombosis and Heamostasis, Coagulation Laboratory, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Amir Dori
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Nicola Maggio
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Yael Mardor
- The Advanced Technology Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Joab Chapman
- Department of Neurology and Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
- Robert and Martha Harden Chair in Mental and Neurological Diseases, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Sagi Harnof
- Department of Neurosurgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| |
Collapse
|
12
|
Naylor RM, Wohl A, Raghunathan A, Eckel LJ, Keating GF, Daniels DJ. Novel suprasellar location of desmoplastic infantile astrocytoma and ganglioglioma: a single institution's experience. J Neurosurg Pediatr 2018; 22:397-403. [PMID: 29979130 PMCID: PMC6261346 DOI: 10.3171/2018.4.peds17638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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 The aim of this study was to describe the clinical presentation, imaging appearance, and differential outcomes based on tumor location in 7 patients with desmoplastic infantile astrocytoma and desmoplastic infantile gangliogliomas (DIA/DIG). METHODS Data of 7 patients with histopathology-proven DIA/DIGs and preoperative imaging were retrospectively reviewed, and age, sex, clinical presentation, imaging characteristics, tumor location, surgical procedure, postoperative morbidity, and overall mortality were recorded. RESULTS Two subgroups of patients with DIA/DIGs were found to exist based on whether their tumor was located in the cerebral hemispheres or suprasellar region. Nearly all patients presented with rapidly enlarging head circumference regardless of tumor location. However, ocular abnormalities, including nystagmus and preference for downward gaze, were specific for patients with suprasellar disease. These patients experienced significant postoperative complications and had poor long-term outcomes. In contrast, patients with hemispheric tumors underwent more extensive resection than patients with suprasellar tumors, had uneventful postoperative courses, and had no documented long-term comorbidities. CONCLUSIONS Postoperative course and long-term outcome for patients with DIA/DIGs were correlated to the anatomical location and radiographic appearance of their tumor at presentation, despite having histologically and molecularly indistinguishable, WHO grade I tumors.
Collapse
Affiliation(s)
- Ryan M. Naylor
- Mayo Medical School, Mayo Clinic, Rochester, Minnesota,Mayo Graduate School, Mayo Clinic, Rochester, Minnesota,Mayo Medical Scientist Training Program, Mayo Clinic, Rochester, Minnesota
| | - Anton Wohl
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Aditya Raghunathan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | | | - David J. Daniels
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
13
|
Nesvick C, Naylor R, Wohl A, Raghunathan A, Eckel L, Keating G, Daniels D. CRAN-38. CLINICOPATHOLOGIC FEATURES OF SUPRASELLAR AND LATERAL CEREBRAL DESMOPLASTIC INFANTILE ASTROCYTOMA AND GANGLIOGLIOMA. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.073] [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: 11/13/2022] Open
|
14
|
Bushi D, Chapman J, Wohl A, Stein ES, Feingold E, Tanne D. Apixaban decreases brain thrombin activity in a male mouse model of acute ischemic stroke. J Neurosci Res 2018; 96:1406-1411. [PMID: 29761540 DOI: 10.1002/jnr.24253] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 11/19/2017] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 12/31/2022]
Abstract
Factor Xa (FXa) plays a critical role in the coagulation cascade by generation of thrombin. During focal ischemia thrombin levels increase in the brain tissue and cause neural damage. This study examined the hypothesis that administration of the FXa inhibitor, apixaban, following focal ischemic stroke may have therapeutic potential by decreasing brain thrombin activity and infarct volume. Male mice were divided into a treated groups that received different doses of apixaban (2, 20, 100 mg/kg administered I.P.) or saline (controls) immediately after blocking the middle cerebral artery (MCA). Thrombin activity was measured by a fluorescence assay on fresh coronal slices taken from the mice brains 24 hr following the MCA occlusion. Infarct volume was assessed using triphenyltetrazolium chloride staining. A high dose of apixaban (100 mg/kg) significantly decreased thrombin activity levels in the ipsilateral hemisphere compared to the control group (Slice#5, p = .016; Slice#6, p = .016; Slice#7, p = .016; Slice#8, p = .036; by the nonparametric Mann-Whitney test). In addition, treatment with apixaban doses of both 100 mg/kg (32 ± 8% vs. 76 ± 7% in the treatment vs. control groups respectively; p = .005 by the nonparametric Mann-Whitney test) and 20 mg/kg (43 ± 7% vs. 76 ± 7% in the treatment vs. control groups respectively; p = .019 by the nonparametric Mann-Whitney test) decreased infarct volumes in areas surrounding the ischemic core (Slices #3 and #8). No brain hemorrhages were observed either in the treated or control groups. In summary, I.P. administration of high dose of apixaban immediately after MCA occlusion decreases brain thrombin activity and reduces infarct size.
Collapse
Affiliation(s)
- Doron Bushi
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joab Chapman
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Robert and Martha Harden Chair in Mental and Neurological Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anton Wohl
- Department of Neurosurgery, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
| | - Efrat Shavit Stein
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ekaterina Feingold
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Tanne
- Comprehensive Stroke Center, Department of Neurology and The J. Sagol Neuroscience Center, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.,Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
15
|
Wohl A. Untersuchungen über die Zustandsgleichung. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1921-9917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
16
|
|
17
|
Wohl A. Untersuchungen über die Zustandsgleichung. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1921-9916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
18
|
Kimchi G, Stlylianou P, Wohl A, Hadani M, Cohen ZR, Zauberman J, Feldman Z, Spiegelmann R, Nissim O, Zivly Z, Penn M, Harnof S. Predicting and reducing cranioplasty infections by clinical, radiographic and operative parameters – A historical cohort study. J Clin Neurosci 2016; 34:182-186. [DOI: 10.1016/j.jocn.2016.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 06/25/2016] [Indexed: 10/21/2022]
|
19
|
Marcu-Malina V, Garelick D, Peshes-Yeloz N, Wohl A, Zach L, Nagar M, Amariglio N, Besser MJ, Cohen ZR, Bank I. Peripheral blood-derived, γ9δ2 t cell-enriched cell lines from glioblastoma multiforme patients exert anti-tumoral effects in vitro. J BIOL REG HOMEOS AG 2016; 30:17-30. [PMID: 27049073] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal of this work was to assess the potential of T cells expressing Vγ9Vδ2+ T cell receptors (TCR, γ9δ2T cells) present in peripheral blood (PB) m ononuclear cells (MC, PBMC) of glioblastoma multiforme (GBM) patients to act as anti-tumoral agents. We found that γ9δ2T cell levels were decreased in patients' PB relative to a cohort of healthy donors (HD) (respectively 0.52±0.55%, n=16, vs 1.12±0.6%, n=14, p=0.008) but did not significantly correlate with postoperative survival (R=0.6, p=0.063). Importantly, however, the γ9δ2T cells could be expanded in vitro to consist 51±23% of the cultured lymphocytes (98% CD3+). This was achieved after 14 days of culture in medium containing the amino-bisphosphonate (ABP) Zoledronate (Zol) and interleukin (IL)-2, resulting in γ9δ2T cell-enriched lines (gdTCEL) similar to those of HD derived gdTCEL (54±19%). Moreover, gdTCEL from patients and HD mediated cytotoxicity to GBM-derived cell lines (GBMDCL), which was abrogated by immune-magnetic removal of the γ9δ2T cells. Furthermore, low level interferon (IFN) γ secretion was induced by gdTCEL briefly co-cultured with GBMDCL or autologous - tumor-derived cells, which was greatly amplified in the presence of Zol. Importantly, IFNγ secretion was inhibited by mevastatin but enhanced by cross-linking of butyrophilin 3A1 (CD277) on a CD277+ GBMDCL (U251MG) or by pretreatment of GBMDCL with temozolomide (TMZ). Taken together, these data suggest that γ9δ2T cells in PB of GBM patients can give rise to gdTCEL that mediate anti-tumoral activities.
Collapse
Affiliation(s)
- V Marcu-Malina
- Laboratory for Immunoregulation, Sheba Medical Center, Tel Hashomer, Israel; Institute of Hematology, Sheba Medical Center, Tel Hashomer, Israel
| | - D Garelick
- Department of Medicine F, Sheba Medical Center, Tel Hashomer, Israel
| | - N Peshes-Yeloz
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel
| | - A Wohl
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel
| | - L Zach
- Institute of Oncology and Radiotherapy, Sheba Medical Center, Tel Hashomer, Israel
| | - M Nagar
- Institute of Hematology, Sheba Medical Center, Tel Hashomer, Israel
| | - N Amariglio
- Cancer Research Center, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - M J Besser
- Sackler School of Medicine, Tel Aviv University, Israel; Ella Institute for Melanoma, Sheba Medical Center, Tel Hashomer, Israel
| | - Z R Cohen
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel
| | - I Bank
- Laboratory for Immunoregulation, Sheba Medical Center, Tel Hashomer, Israel; Department of Medicine F, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| |
Collapse
|
20
|
Cohen ZR, Ramishetti S, Peshes-Yaloz N, Goldsmith M, Wohl A, Zibly Z, Peer D. Localized RNAi therapeutics of chemoresistant grade IV glioma using hyaluronan-grafted lipid-based nanoparticles. ACS Nano 2015; 9:1581-91. [PMID: 25558928 DOI: 10.1021/nn506248s] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Glioblastoma multiforme (GBM) is one of the most infiltrating, aggressive, and poorly treated brain tumors. Progress in genomics and proteomics has paved the way for identifying potential therapeutic targets for treating GBM, yet the vast majority of these leading drug candidates for the treatment of GBM are ineffective, mainly due to restricted passages across the blood-brain barrier. Nanoparticles have been emerged as a promising platform to treat different types of tumors due to their ability to transport drugs to target sites while minimizing adverse effects. Herein, we devised a localized strategy to deliver RNA interference (RNAi) directly to the GBM site using hyaluronan (HA)-grafted lipid-based nanoparticles (LNPs). These LNPs having an ionized lipid were previously shown to be highly effective in delivering small interfering RNAs (siRNAs) into various cell types. LNP's surface was functionalized with hyaluronan (HA), a naturally occurring glycosaminoglycan that specifically binds the CD44 receptor expressed on GBM cells. We found that HA-LNPs can successfully bind to GBM cell lines and primary neurosphers of GBM patients. HA-LNPs loaded with Polo-Like Kinase 1 (PLK1) siRNAs (siPLK1) dramatically reduced the expression of PLK1 mRNA and cumulated in cell death even under shear flow that simulate the flow of the cerebrospinal fluid compared with control groups. Next, a human GBM U87MG orthotopic xenograft model was established by intracranial injection of U87MG cells into nude mice. Convection of Cy3-siRNA entrapped in HA-LNPs was performed, and specific Cy3 uptake was observed in U87MG cells. Moreover, convection of siPLK1 entrapped in HA-LNPs reduced mRNA levels by more than 80% and significantly prolonged survival of treated mice in the orthotopic model. Taken together, our results suggest that RNAi therapeutics could effectively be delivered in a localized manner with HA-coated LNPs and ultimately may become a therapeutic modality for GBM.
Collapse
Affiliation(s)
- Zvi R Cohen
- Department of Neurosurgery, Sheba Medical Center , Ramat Gan, Israel
| | | | | | | | | | | | | |
Collapse
|
21
|
Priel E, Wohl A, Teperberg M, Nass D, Cohen ZR. Human cytomegalovirus viral load in tumor and peripheral blood samples of patients with malignant gliomas. J Clin Neurosci 2014; 22:326-30. [PMID: 25443081 DOI: 10.1016/j.jocn.2014.06.099] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 06/09/2014] [Accepted: 06/12/2014] [Indexed: 11/16/2022]
Abstract
Malignant gliomas are the most common primary brain tumors in adults. The disease has no known etiology, progresses rapidly, and is fatal despite current therapies. Human cytomegalovirus (HCMV) is a beta herpes virus that is trophic for glial cells and infects 50% to 90% of the adult human population. HCMV-mediated disease in immunosuppressed patients has highlighted the possible role of this virus in the development of other diseases, particularly inflammatory diseases such as vascular diseases, autoimmune diseases, and certain malignancies. Sensitive detection of viral DNA, mRNA, and antigens in tumor tissues, as well as seroepidemiologic evidence, suggest a link between HCMV and several human malignancies. HCMV gene products are proposed to dysregulate multiple cellular pathways involved in oncogenesis, such as cell cycle regulation, apoptosis, migration, and angiogenesis. These theories, currently being researched, suggest that HCMV acts as an oncomodulator in malignancies. We investigated the association between HCMV infection and reactivation, and malignant gliomas. An open, matched case-control, parallel group pilot study was performed in a tertiary referral center. The HCMV viral load in peripheral blood and tumor samples of 19 patients newly diagnosed with glioblastoma multiforme was compared with a matched control cohort comprising 19 patients newly diagnosed with non-malignant brain tumors. There was no significant correlation between peripheral blood and tumor tissue HCMV viral load in patients with glioblastoma multiforme compared to the control cohort. The findings of the present study did not support an oncomodulatory role for HCMV in malignant gliomas.
Collapse
Affiliation(s)
- Eldar Priel
- Department of Internal Medicine E, Sheba Medical Center, Tel Hashomer, Israel
| | - Anton Wohl
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, 52621, Israel
| | - Michal Teperberg
- National Department of Virology, Sheba Medical Center, Tel Hashomer, Israel
| | - Dvora Nass
- Department of Pathology, Sheba Medical Center, Tel Hashomer, Israel
| | - Zvi R Cohen
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, 52621, Israel.
| |
Collapse
|
22
|
Affiliation(s)
- A. Wohl
- II. chem. Institut der Universität, Berlin
| |
Collapse
|
23
|
|
24
|
|
25
|
Wohl A, Frank F. Ueber das Acetal des Crotonaldehyds und die Ueberführung desselben in Methyltriose (Methylglycerinaldehyd). ACTA ACUST UNITED AC 2006. [DOI: 10.1002/cber.190203502130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
26
|
|
27
|
Affiliation(s)
- A. Wohl
- Organ.‐chem. Laborat. der Techn. Hochschule Danzig
| | - Franz Koch
- Organ.‐chem. Laborat. der Techn. Hochschule Danzig
| |
Collapse
|
28
|
|
29
|
|
30
|
|
31
|
|
32
|
|
33
|
|
34
|
Wohl A, Kadmon H, Barak O. ‘Secrets and Surprises’: A Program for Learning to Read Hebrew Braille. Journal of Visual Impairment & Blindness 1991. [DOI: 10.1177/0145482x9108500112] [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: 11/17/2022]
Affiliation(s)
- A. Wohl
- Centre for Educational Technology, 16 Klausner Street, Ramat Aviv, Tel Aviv 61394, Israel
| | - H. Kadmon
- Israeli Ministry of Education, 18 Shoken Street, Tel Aviv 6556, Israel
| | - O. Barak
- Centre for Educational Technology, 16 Klausner Street, Ramat Aviv, Tel Aviv 61394, Israel
| |
Collapse
|
35
|
Korduba CA, Veals J, Wohl A, Symchowicz S, Tabachnick II. SCH 10595, an effective dopamine- -hydroxylase inhibitor and a hypotensive agent. J Pharmacol Exp Ther 1973; 184:671-7. [PMID: 4687230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
|
36
|
Wohl A. Versammlungsberichte. Angew Chem Int Ed Engl 1933. [DOI: 10.1002/ange.19330461204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
37
|
|
38
|
Wohl A, Claassen H, Wohl A. Bemerkung zur Arbeit von Dr. H. Claassen auf Seite 80. Angew Chem Int Ed Engl 1932. [DOI: 10.1002/ange.19320450405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
39
|
|
40
|
|
41
|
|
42
|
Wohl A. Untersuchungen über die Zustandsgleichung. Z PHYS CHEM 1921. [DOI: 10.1515/zpch-1921-0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
43
|
|
44
|
|
45
|
|
46
|
|
47
|
|
48
|
|
49
|
|
50
|
|