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Maita KC, Avila FR, Torres-Guzman RA, Sarabia-Estrada R, Zubair AC, Quinones-Hinojosa A, Forte AJ. In Vitro Enhanced Osteogenic Potential of Human Mesenchymal Stem Cells Seeded in a Poly (Lactic- co-Glycolic) Acid Scaffold: A Systematic Review. Craniomaxillofac Trauma Reconstr 2024; 17:61-73. [PMID: 38371215 PMCID: PMC10874209 DOI: 10.1177/19433875231157454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Study Design Human bone marrow stem cells (hBMSCs) and human adipose-derived stem cells (hADSCs) have demonstrated the capability to regenerate bone once they have differentiated into osteoblasts. Objective This systematic review aimed to evaluate the in vitro osteogenic differentiation potential of these cells when seeded in a poly (lactic-co-glycolic) acid (PLGA) scaffold. Methods A literature search of 4 databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted in January 2021 for studies evaluating the osteogenic differentiation potential of hBMSCs and hADSCs seeded in a PLGA scaffold. Only in vitro models were included. Studies in languages other than English were excluded. Results A total of 257 studies were identified after the removal of duplicates. Seven articles fulfilled our inclusion and exclusion criteria. Four of these reviews used hADSCs and three used hBMSCs in the scaffold. Upregulation in osteogenic gene expression was seen in all the cells seeded in a 3-dimensional scaffold compared with 2-dimensional films. High angiogenic gene expression was found in hADSCs. Addition of inorganic material to the scaffold material affected cell performance. Conclusions Viability, proliferation, and differentiation of cells strongly depend on the environment where they grow. There are several factors that can enhance the differentiation capacity of stem cells. A PLGA scaffold proved to be a biocompatible material capable of boosting the osteogenic differentiation potential and mineralization capacity in hBMSCs and hADSCs.
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Affiliation(s)
- Karla C. Maita
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | | | | | | - Abba C. Zubair
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
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2
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Akinduro OO, Suarez-Meade P, Roberts M, Tzeng SY, Sarabia-Estrada R, Schiapparelli P, Norton ES, Gokaslan ZL, Anastasiadis PZ, Guerrero-Cázares H, Green JJ, Quiñones-Hinojosa A. Verteporfin-loaded microparticles for radiosensitization of preclinical lung and breast metastatic spine cancer. J Neurosurg Spine 2022; 38:481-493. [PMID: 36585863 DOI: 10.3171/2022.11.spine22867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/30/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The vertebral column is the most common site for skeletal metastasis, often leading to debilitating pain and weakness. Metastatic cancer has unique genetic drivers that potentiate tumorigenicity. There is an unmet need for novel targeted therapy in patients with spinal metastatic disease. METHODS The authors assessed the effect of verteporfin-induced yes-associated protein (YAP) inhibition on spine metastatic cell tumorigenicity and radiation sensitivity in vitro. Animal studies used a subcutaneous xenograft mouse model to assess the use of systemic intraperitoneal verteporfin (IP-VP) and intratumoral verteporfin microparticles (IT-VP) to inhibit the tumorigenicity of lung and breast spinal metastatic tumors from primary patient-derived tissue. RESULTS Verteporfin led to a dose-dependent decrease in migration, clonogenicity, and cell viability via inhibition of YAP and downstream effectors cyclin D1, CTGF, TOP2A, ANDRD1, MCL-1, FOSL2, KIF14, and KIF23. This was confirmed with knockdown of YAP. Verteporfin has an additive response when combined with radiation, and knockdown of YAP rendered cells more sensitive to radiation. The addition of verteporfin to YAP knockdown cells did not significantly alter migration, clonogenicity, or cell viability. IP-VP and IT-VP led to diminished tumor growth (p < 0.0001), especially when combined with radiation (p < 0.0001). Tissue analysis revealed diminished expression of YAP (p < 0.0001), MCL-1 (p < 0.0001), and Ki-67 (p < 0.0001) in tissue from verteporfin-treated tumors compared with vehicle-treated tumors. CONCLUSIONS This is the first study to demonstrate that verteporfin-mediated inhibition of YAP leads to diminished tumorigenicity in lung and breast spinal metastatic cancer cells. Targeting of YAP with verteporfin offers promising results that could be translated to human clinical trials.
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Affiliation(s)
| | | | | | - Stephany Y Tzeng
- 2Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Emily S Norton
- Departments of1Neurosurgery and.,3Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Jacksonville, Florida; and
| | - Ziya L Gokaslan
- 4Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | - Jordan J Green
- 2Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
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Capilla-González V, Herranz-Pérez V, Sarabia-Estrada R, Kadri N, Moll G. Editorial: Mesenchymal Stromal Cell Therapy for Regenerative Medicine. Front Cell Neurosci 2022; 16:932281. [PMID: 35693887 PMCID: PMC9179645 DOI: 10.3389/fncel.2022.932281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Vivian Capilla-González
- Department of Regeneration and Cell Therapy, Andalusian Center of Molecular Biology and Regenerative Medicine (CABIMER)-University of Pablo de Olavide-University of Seville-CSIC, Seville, Spain
- *Correspondence: Vivian Capilla-González
| | - Vicente Herranz-Pérez
- Department of Cell Biology, Functional Biology and Physical Anthropology, School of Biological Sciences, University of Valencia, Valencia, Spain
| | | | - Nadir Kadri
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Science for Life Laboratory (SciLife), Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Guido Moll
- BIH Center for Regenerative Therapies (BCRT) and Berlin-Brandenburg School for Regenerative Therapies (BSRT), Berlin Institute of Health (BIH) at the Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Guido Moll
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Avila FR, Torres-Guzman RA, Huayllani MT, Guliyeva G, Zubair AC, Quiñones-Hinojosa A, Forte AJ, Sarabia-Estrada R. Human stem cells prevent flap necrosis in preclinical animal models: A systematic review. J Clin Transl Res 2022; 8:110-124. [PMID: 35382131 PMCID: PMC8977210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/06/2022] [Accepted: 02/10/2022] [Indexed: 10/27/2022] Open
Abstract
Background and Aim Adipose-derived mesenchymal stem cells (ADSCs) have been proven effective to prevent distal skin flap necrosis in preclinical models. However, to appropriately translate these findings to clinical trials, the effect of ADSC of human origin (hADSC) needs to be evaluated. We hypothesize that hADSC treatment is as effective as animal ADSC treatment at preventing distal skin flap necrosis in animal flap models. Methods Three databases were inquired on August 17, 2020, to evaluate the necrotic flap area after using hADSCs in animal models of ischemic flaps. No publication status or dates were considered. Studies were included if they used hADSCs, measured the surviving or necrotic skin area of flaps, used animal models, and were in English. Studies were excluded if they did not use cells of human origin. The flap survival or necrotic area, perfusion, capillary density, vascular endothelial growth factor secretion and HIF-1α expression were extracted. Results Ten studies met inclusion criteria. The mean absolute risk reduction (ARR) in necrotic skin area was 22.37% (95% confidence interval [CI] 16.98-27.76%, P<0.05) for flaps treated with animal ADSCs and 18.04% (95% CI 2.74-33.33%, P<0.05) for flaps treated with hADSCs. The difference between mean ARRs was not statistically significant (4.33%, 95% CI - 34.47-43.13%, P>0.05). Conclusion Human ADSCs prevent skin flap necrosis to the same degree as animal ADSCs in rodent and rabbit flap models. Relevance for Patients This review found that adipose-derived stem cells of human origin are equally effective at reducing the risk of surgical flap necrosis in preclinical models of small animals as autologous animal cells. The findings in this review should encourage researchers to use human adipose-derived stem cells in animal models of ischemic flaps to accelerate their translation into clinical trials and, eventually, surgical practice. The low immunogenicity of these cells should be leveraged to gain insight into the effects of the products that will be ultimately administered to patients. Furthermore, human adipose-derived stem cells' pro-angiogenic mechanism of action sets this therapy as a promising preventive measure for flap necrosis.
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Affiliation(s)
- Francisco R. Avila
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | | | - María T. Huayllani
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Gunel Guliyeva
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Abba C. Zubair
- 2Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, United States
| | | | - Antonio J. Forte
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States,3Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, United States,Corresponding author: Antonio J. Forte Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, Florida 32224, United States Tel: 904-953-2073
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5
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Garcia JP, Avila FR, Torres RA, Maita KC, Eldaly AS, Rinker BD, Zubair AC, Forte AJ, Sarabia-Estrada R. Hypoxia-preconditioning of human adipose-derived stem cells enhances cellular proliferation and angiogenesis: A systematic review. J Clin Transl Res 2022; 8:61-70. [PMID: 35187291 PMCID: PMC8848748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Human adipose-derived stem cells (hADSCs) have gained attention lately because of their ease of harvesting and ability to be substantially multiplied in laboratory cultures. Stem cells are usually cultured under atmospheric conditions; however, preconditioning stem cells under hypoxic conditions seems beneficial. AIM This systematic review aims to investigate the effect of hypoxia preconditioning and its impact on the proliferation and angiogenic capacity of the hADSCs. METHODS We performed a systematic review by searching PubMed, Scopus, Embase, and Google Scholar databases from all years through March 22, 2021, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Medical Subject Headings terms "adipose-derived stem cell," "Hypoxia," "cell proliferation," and "angiogenesis" guided our search. Only articles written in English using experimental models comparing a preconditioned group against a control group of hADSCs with data on proliferation and angiogenic capacity were included. RESULTS Our search yielded a total of 321 articles. 11 articles met our inclusion criteria and were ultimately included in this review. Two studies induced hypoxia using hypoxia-inducible factor-1 alpha stabilizing agents, while nine reached hypoxia by changing oxygen tension conditions around the cells. Four articles conducted in-vivo studies to correlate their in-vitro findings, which proved to be consistent. Although 1 article indicated cell proliferation inhibition with hypoxia preconditioning, the remaining 10 found enhanced proliferation in preconditioned groups compared to controls. All articles showed an enhanced angiogenic capacity of hADSCs after hypoxia preconditioning. CONCLUSION In this review, we found evidence to support hypoxia preconditioning of hADSCs before implantation. Benefits include enhanced cell proliferation with a faster population doubling rate and increased secretion of multiple angiogenic growth factors, enhancing angiogenesis capacity. RELEVANCE FOR PATIENTS Although regenerative therapy is a promising field of study and treatment in medicine, much is still unknown. The potential for angiogenic therapeutics with stem cells is high, but more so, if we discover ways to enhance their natural angiogenic properties. Procedures and pathologies alike require the assistance of angiogenic treatments to improve outcome, such is the case with skin grafts, muscle flaps, skin flaps, or myocardial infarction to mention a few. Enhanced angiogenic properties of stem cells may pave the way for better outcomes and results for patients.
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Affiliation(s)
- John P. Garcia
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida
| | | | | | - Karla C. Maita
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida
| | | | - Brian D. Rinker
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida
| | - Abba C. Zubair
- 2Transfusion Medicines and Stem Cell Therapy, Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, USA
| | - Antonio J. Forte
- 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida,Corresponding author: Antonio J. Forte Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224. Phone: 904-953-2073 Fax: 904-953-7368
| | - Rachel Sarabia-Estrada
- 3Departments of Neurosurgery; Neuroscience; and, Cancer Biology, Mayo Clinic, Jacksonville, Florida
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Huayllani MT, Ruiz-Garcia H, Boczar D, Avila FR, Lu X, Rinker BD, Moran SL, Sarabia-Estrada R, Quiñones-Hinojosa A, Forte AJ. Adipose-Derived Stem Cells Therapy for Radiation-Induced Skin Injury. Ann Plast Surg 2021; 87:639-649. [PMID: 34724441 DOI: 10.1097/sap.0000000000003039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Radiation-induced skin injuries have been treated with different medical therapies and have shown diverse outcomes. We aim to evaluate the effect of adipose-derived stem cells (ADSCs) therapy on radiation-induced skin injury. METHODS We performed a review by querying PubMed, Ovid MEDLINE, and EMBASE databases from inception to April 2020 following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The MeSH terms "adipose-derived stem cells," "wound healing," "radiation," and synonyms in combinations determined our search strategy. Experimental peer-reviewed articles describing the protocol and comparing the results with controls were included. Non-English studies were excluded. RESULTS Our search recorded a total of 137 articles. Only 8 studies met our inclusion criteria and were included in this review. Five studies evaluated the use of ADSC alone, whereas the others evaluated the efficacy of ADSC seeded in scaffolds. Adipose-derived stem cell-based therapies, either alone or seeded in scaffolds, were shown to improve wound healing in most studies when compared with controls. CONCLUSIONS There is evidence supporting the positive benefits from ADSC-based therapies in radiation-induced skin injury. However, further studies are needed to standardize the method of ADSC extraction, radiation-induced skin injury experimental model, and increase the time of follow-up to evaluate the results accurately.
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Affiliation(s)
| | | | | | | | - Xiaona Lu
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
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Garcia CA, Bhargav AG, Brooks M, Suárez-Meade P, Mondal SK, Zarco N, ReFaey K, Jentoft M, Middlebrooks EH, Snuderl M, Carrano A, Guerrero-Cazares H, Schiapparelli P, Sarabia-Estrada R, Quiñones-Hinojosa A. Functional Characterization of Brain Tumor-Initiating Cells and Establishment of GBM Preclinical Models that Incorporate Heterogeneity, Therapy, and Sex Differences. Mol Cancer Ther 2021; 20:2585-2597. [PMID: 34465594 PMCID: PMC8687628 DOI: 10.1158/1535-7163.mct-20-0547] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 03/09/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
Glioblastoma (GBM) is the most common primary brain cancer in adults where tumor cell heterogeneity and sex differences influence clinical outcomes. Here, we functionally characterize three male and three female patient-derived GBM cell lines, identify protumorigenic BTICs, and create novel male and female preclinical models of GBM. Cell lines were evaluated on the following features: proliferation, stemness, migration, tumorigenesis, clinical characteristics, and sensitivity to radiation, TMZ, rhTNFSF10 (rhTRAIL), and rhBMP4 All cell lines were classified as GBM according to epigenetic subtyping, were heterogenous and functionally distinct from one another, and re-capitulated features of the original patient tumor. In establishing male and female preclinical models, it was found that two male-derived GBM cell lines (QNS108 and QNS120) and one female-derived GBM cell line (QNS315) grew at a faster rate in female mice brains. One male-derived GBM cell line (QNS108) decreased survival in female mice in comparison with male mice. However, no survival differences were observed for mice injected with a female-derived cell line (QNS315). In summary, a panel of six GBM patient-derived cell lines were functionally characterized, and it was shown that BTIC lines can be used to construct sex-specific models with differential phenotypes for additional studies.
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Affiliation(s)
- Cesar A Garcia
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Adip G Bhargav
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mieu Brooks
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Paola Suárez-Meade
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Sujan K Mondal
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Natanael Zarco
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Neurogenesis and Brain Tumors Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Karim ReFaey
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
| | - Mark Jentoft
- Department of Pathology, Mayo Clinic, Jacksonville, Florida
| | - Erik H Middlebrooks
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health, New York, New York
| | - Anna Carrano
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Neurogenesis and Brain Tumors Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Hugo Guerrero-Cazares
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Neurogenesis and Brain Tumors Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Paula Schiapparelli
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Rachel Sarabia-Estrada
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
| | - Alfredo Quiñones-Hinojosa
- Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida.
- Brain Tumor Stem Cell Laboratory, Mayo Clinic, Jacksonville, Florida
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Akinduro OO, Suarez-Meade P, Garcia D, Brown DA, Sarabia-Estrada R, Attia S, Gokaslan ZL, Quiñones-Hinojosa A. Targeted Therapy for Chordoma: Key Molecular Signaling Pathways and the Role of Multimodal Therapy. Target Oncol 2021; 16:325-337. [PMID: 33893940 DOI: 10.1007/s11523-021-00814-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chordoma is a rare but devastating tumor that arises in the cranial skull base or spine. There are currently no US Food and Drug Administration-approved targeted therapies for chordoma, and little understanding of whether using more than one therapy has benefit over monotherapy. OBJECTIVE The objective of this study was to systematically review the current status of clinical trials completed for patients with chordoma to determine if multimodal therapy offers a benefit in progression-free survival over monomodal therapy. METHODS We performed a systematic review of the literature according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to review the available clinical trials of targeted therapy for chordoma. We compiled the clinical data to determine if there is a benefit of multimodal therapy over monotherapy. RESULTS Our search resulted in 11 clinical trials including 270 patients with advanced chordoma who were treated with targeted therapies. The most commonly employed targeted therapies acted within the following pathways: platelet-derived growth factor receptor (187 patients), vascular endothelial growth factor (66 patients), and mammalian target of rapamycin (43 patients). Reported progression-free survival for included studies ranged from 2.5 to 58 months, with the longest progression-free survival in a trial that included a platelet-derived growth factor receptor inhibitor, nilotinib, and concurrent radiotherapy (58.2 months). There was a higher range of progression-free survival for trials treating patients with multimodal therapy (10.2-14 months vs 2.5-9.2 months, except for a monotherapy trial published in 2020 with a progression-free survival of 18 months), and those published in 2018 or later (14-58.2 months vs 2.5-10.2 months). Only 23% of patients with chordoma in published clinical trials have been treated with multimodal therapy. CONCLUSIONS Progression-free survival may be enhanced by the use of targeted therapy with concurrent radiotherapy, use of multimodal therapy, and use of newer targeted therapy. Future clinical trials should consider use of concurrent radiotherapy and multimodal therapy for patients with advanced chordoma.
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Affiliation(s)
- Oluwaseun O Akinduro
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | - Paola Suarez-Meade
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | - Diogo Garcia
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | | | - Rachel Sarabia-Estrada
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | - Steven Attia
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Ziya L Gokaslan
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Alfredo Quiñones-Hinojosa
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA.
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Fernandez-Gil BI, Vazquez-Ramos C, Bechtle A, Suarez-Meade P, Qosja N, Schiapparelli P, Sarabia-Estrada R, Escames G, Quinones-Hinojosa A. DDRE-33. MELATONIN AS A MASTER METABOLIC SWITCH FOR GLIOBLASTOMA. Neurooncol Adv 2021. [PMCID: PMC7992251 DOI: 10.1093/noajnl/vdab024.055] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Glioblastoma (GBM) is the most common form of malignant primary brain cancer in adults with a median survival of only 15 months. Therefore, new therapies to suppress malignant brain cancer are needed. Brain Tumor Initiating Cells (BTICs) are a GBM subpopulation of cells with a highly glycolytic profile that are thought to be responsible of the resistance of GBM to treatments. Metabolic reprogramming allows tumor cells to survive in unsupportive microenvironments. Manipulating tumor metabolism to counteract GBM resistance arises as a powerful approach with minimum effects in normal counterparts. At pharmacological concentrations, melatonin displays oncostatic properties. This is thought to be due to an increase in mitochondrial oxidative phosphorylation through the effects of melatonin in mitochondria, key organelle in metabolic homeostasis. We hypothesize that melatonin could alter BTIC metabolism, by inducing an anti-Warburg effect and as consequence, melatonin will decrease the viability of GBM cells and tumor growth. We found that treatment of GBM cell lines with 3mM melatonin significantly altered tumor cell metabolism. We observed that melatonin downregulated the lactate symporter MCT4 (p<0.002), inducing a significant intracellular accumulation of lactate (p<0.002) while decreasing it in the extracellular media (p<0.001). This was followed by a decrease in the internal pH (p<0.002). These effects were compensated by an increase in the oxygen consumption rate (OCR) followed by decay that leaded to an increase in ROS production (p<0.001). All these changes result in a depletion of cellular ATP (p<0.001) and eventually drove to a decrease in the proliferation (p<0.001) and cell death (p<0.001). When applied in vivo we observed a significant reduction in the tumor growth (p<0.001), volume (p<0.002) and weight (p<0.002), as well as a drop in the proliferation marker ki67 (p<0.001) and a fibrosis increase in treated tumors. These results position melatonin as a strong therapeutic candidate for GBM therapy.
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Affiliation(s)
| | | | | | | | | | | | | | - Germaine Escames
- Biomedical Research Center (CIBM). University of Granada, Granada, Granada, Spain
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Ávila FR, Huayllani MT, Boczar D, Ciudad P, Sarabia-Estrada R, Quiñones-Hinojosa A, Forte AJ. Materiales sensibles a biomarcadores y apósitos inteligentes: revisión sistemática. J Wound Care 2020; 29:13-22. [PMID: 33251960 DOI: 10.12968/jowc.2020.29.latam_sup_3.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Evaluate a number of biomarkers that can objectively measure the wound healing process, and identify the materials that could replicate this in smart wound dressings. METHOD A systematic review was conducted to establish the use of materials sensitive to biomarkers. Publications in English were included. Review articles and abstracts presented at conferences were excluded. RESULTS A total of 296 studies were identified, of which 19 were included. All of these were experimental studies. The articles evaluated pH, temperature, blood pressure, uric acid, and glucose. The materials used were hydrogels, fibres and conductive inks. CONCLUSION The most cited biomarker was pH. Materials that evaluate biomarkers via colorimetric methods could be the most suitable to incorporate into smart wound dressings.
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Affiliation(s)
- Francisco R Ávila
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, Estados Unidos
| | - Maria T Huayllani
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, Estados Unidos
| | - Daniel Boczar
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, Estados Unidos
| | - Pedro Ciudad
- Departmento de Cirugía Plástica, Reconstructiva y Quemaduras, Hospital Nacional Arzobispo Loayza, Lima, Perú
| | | | | | - Antonio J Forte
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, Estados Unidos
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11
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Angom RS, Mondal SK, Wang F, Madamsetty VS, Wang E, Dutta SK, Gulani Y, Sarabia-Estrada R, Sarkaria JN, Quiñones-Hinojosa A, Mukhopadhyay D. Ablation of neuropilin-1 improves the therapeutic response in conventional drug-resistant glioblastoma multiforme. Oncogene 2020; 39:7114-7126. [PMID: 33005016 DOI: 10.1038/s41388-020-01462-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/25/2020] [Accepted: 09/10/2020] [Indexed: 12/18/2022]
Abstract
Glioblastoma multiforme (GBM) is a highly proliferative and locally invasive cancer with poor prognosis and a high recurrence rate. Although anti-VEGF (vascular endothelial growth factor) therapy offers short-term benefit to GBM patients, this approach fails as the tumor develops into a more invasive and drug-resistant phenotype and ultimately recurs. Recently, both glioma stemlike cells (GSCs) and brain tumor-initiating cells (BTICs) have been implicated in GBM recurrence and its resistance to therapy. We observed that patient-derived GBM cells expressing shRNAs of VEGF or neuropilin-1 (NRP-1) attenuate cancer stem cell markers, inhibit the tumor-initiating cell's neurosphere-forming capacity, and migration. Furthermore, both VEGF and NRP-1 knockdown inhibit the growth of patient-derived GBM xenografts in both zebrafish and mouse models. Interestingly, NRP-1-depleted patient-derived GBM xenografts substantially prolonged survival in mice compared to that of VEGF depletion. Our results also demonstrate that NRP-1 ablation of patient-derived GBM cells improves the sensitivity of TMZ and enhances the overall survival of the respective tumor-bearing mice. This improved outcome may provide insight into the inhibition of GBM progression and effective treatment strategies by targeting NRP-1 in addition to chemotherapy and radiotherapy.
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Affiliation(s)
- Ramcharan Singh Angom
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Sujan Kumar Mondal
- Department of Neurosurgery, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA.,Department of Pathology, University of Pittsburgh Medical Center, UPMC Hillman Center, Pittsburgh, PA, USA
| | - Fei Wang
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA.,Department of Neurosurgery, Inner Mongolia Medical University Affiliated Hospital, 010050, Inner Mongolia, China
| | - Vijay Sagar Madamsetty
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Enfeng Wang
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Shamit K Dutta
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Yash Gulani
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Rachel Sarabia-Estrada
- Department of Neurosurgery, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Jann N Sarkaria
- Department of Radiation Oncology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | | | - Debabrata Mukhopadhyay
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA.
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12
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Lara-Velazquez M, Alkharboosh R, Norton ES, Ramirez-Loera C, Freeman WD, Guerrero-Cazares H, Forte AJ, Quiñones-Hinojosa A, Sarabia-Estrada R. Chitosan-Based Non-viral Gene and Drug Delivery Systems for Brain Cancer. Front Neurol 2020; 11:740. [PMID: 32849207 PMCID: PMC7406673 DOI: 10.3389/fneur.2020.00740] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 01/22/2020] [Accepted: 06/16/2020] [Indexed: 12/17/2022] Open
Abstract
Central nervous system (CNS) tumors are a leading source of morbidity and mortality worldwide. Today, different strategies have been developed to allow targeted and controlled drug delivery into the brain. Gene therapy is a system based on the modification of patient's cells through the introduction of genetic material to exert a specific action. Administration of the foreign genetic material can be done through viral-mediated delivery or non-viral delivery via physical or mechanical systems. For brain cancer specifically, gene therapy can overcome the actual challenge of blood brain barrier penetration, the main reason for therapeutic failure. Chitosan (CS), a natural based biodegradable polymer obtained from the exoskeleton of crustaceans such as crab, shrimp, and lobster, has been used as a delivery vehicle in several non-viral modification strategies. This cationic polysaccharide is highly suitable for gene delivery mainly due to its chemical properties, its non-toxic nature, its capacity to protect nucleic acids through the formation of complexes with the genetic material, and its ease of degradation in organic environments. Recent evidence supports the use of CS as an alternative gene delivery system for cancer treatment. This review will describe multiple studies highlighting the advantages and challenges of CS-based delivery structures for the treatment of brain tumors. Furthermore, this review will provide insight on the translational potential of various CS based-strategies in current clinical cancer studies. Specifically, CS-based nanostructures including nanocapsules, nanospheres, solid-gel formulations, and nanoemulsions, also microshperes and micelles will be evaluated.
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Affiliation(s)
- Montserrat Lara-Velazquez
- Mayo Clinic Florida, Department of Neurosurgery, Jacksonville, FL, United States
- Plan of Combined Studies in Medicine (PECEM), UNAM, Mexico City, Mexico
| | - Rawan Alkharboosh
- Mayo Clinic Florida, Department of Neurosurgery, Jacksonville, FL, United States
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States
- Regenerative Sciences Training Program, Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Emily S. Norton
- Mayo Clinic Florida, Department of Neurosurgery, Jacksonville, FL, United States
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States
- Regenerative Sciences Training Program, Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - William D. Freeman
- Mayo Clinic Florida, Department of Neurosurgery, Jacksonville, FL, United States
| | | | - Antonio J. Forte
- Mayo Clinic Florida, Department of Neurosurgery, Jacksonville, FL, United States
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, United States
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13
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Huayllani MT, Sarabia-Estrada R, Restrepo DJ, Boczar D, Sisti A, Nguyen JH, Rinker BD, Moran SL, Quiñones-Hinojosa A, Forte AJ. Adipose-derived stem cells in wound healing of full-thickness skin defects: a review of the literature . J Plast Surg Hand Surg 2020; 54:263-279. [PMID: 32427016 DOI: 10.1080/2000656x.2020.1767116] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 12/16/2022]
Abstract
The complex process of wound healing can be delayed in circumstances when the natural niche is extremely altered. Adipose-derived stem cells (ADSC) seem to be a promising therapy for these type of wounds. We aim to describe the studies that used ADSC for wound healing after a full-thickness skin defect, the ADSC mechanisms of action, and the outcomes of the different ADSC therapies applied to date. We performed a review by querying PubMed database for studies that evaluated the use of ADSC for wound healing. The Mesh terms, adipose stem cells AND (skin injury OR wound healing) and synonyms were used for the search. Our search recorded 312 articles. A total of 30 articles met the inclusion criteria. All were experimental in nature. ADSC was applied directly (5 [16.7%]), in sheets (2 [6.7%]), scaffolds (14 [46.7%]), skin grafts (3 [10%]), skin flaps (1 [3.3%]), as microvesicles or exosomes (4 [13.3%]), with adhesives for wound closure (1 [3.3%]), and in a concentrated conditioned hypoxia-preconditioned medium (1 [3.3%]). Most of the studies reported a benefit of ADSC and improvement of wound healing with all types of ADSC therapy. ADSC applied along with extracellular matrix, stromal cell-derived factor (SDF-1) or keratinocytes, or ADSC seeded in scaffolds showed better outcomes in wound healing than ADSC alone. ADSC have shown to promote angiogenesis, fibroblast migration, and up-regulation of macrophages chemotaxis to enhance the wound healing process. Further studies should be conducted to assure the efficacy and safety of the different ADSC therapies.
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Affiliation(s)
| | | | | | - Daniel Boczar
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Andrea Sisti
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Justin H Nguyen
- Department of Transplantation Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Brian D Rinker
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Steven L Moran
- Division of Plastic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Antonio J Forte
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL, USA
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14
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Yuan W, Chen D, Sarabia-Estrada R, Guerrero-Cázares H, Li D, Quiñones-Hinojosa A, Li X. Theranostic OCT microneedle for fast ultrahigh-resolution deep-brain imaging and efficient laser ablation in vivo. Sci Adv 2020; 6:eaaz9664. [PMID: 32300661 PMCID: PMC7148106 DOI: 10.1126/sciadv.aaz9664] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/15/2020] [Indexed: 05/21/2023]
Abstract
Current minimally invasive optical techniques for in vivo deep-brain imaging provide a limited resolution, field of view, and speed. These limitations prohibit direct assessment of detailed histomorphology of various deep-seated brain diseases at their native state and therefore hinder the potential clinical utilities of those techniques. Here, we report an ultracompact (580 μm in outer diameter) theranostic deep-brain microneedle combining 800-nm optical coherence tomography imaging with laser ablation. Its performance was demonstrated by in vivo ultrahigh-resolution (1.7 μm axial and 5.7 μm transverse), high-speed (20 frames per second) volumetric imaging of mouse brain microstructures and optical attenuation coefficients. Its translational potential was further demonstrated by in vivo cancer visualization (with an imaging depth of 1.23 mm) and efficient tissue ablation (with a 1448-nm continuous-wave laser at a 350-mW power) in a deep mouse brain (with an ablation depth of about 600 μm).
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Affiliation(s)
- Wu Yuan
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Defu Chen
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | | | | | - Dawei Li
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
| | | | - Xingde Li
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
- Corresponding author.
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15
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Huayllani MT, Sisti A, Boczar D, Restrepo DJ, Parker AS, Sarabia-Estrada R, Rinker BD, Forte AJ. Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii : A Clinical Case and Systematic Review of Literature. Indian J Plast Surg 2020; 53:25-35. [PMID: 32367915 PMCID: PMC7192657 DOI: 10.1055/s-0040-1709377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Chronic tenosynovitis of the upper extremities caused by Mycobacterium kansasii ( M. kansasii ) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment can lead to disfiguration of structures and rupture of tendons, resulting in worse cosmetic outcomes after reconstruction. Methods We present a clinical case and literature review of M. kansasii in patients with chronic tenosynovitis of upper extremities. PubMed was queried for cases of upper extremities tenosynovitis caused by M. kansasii . The keywords " M. kansasii ," "tenosynovitis" and synonyms were used for search in different combinations. Manuscripts, with no specific data or another condition, where the infection was not located in the upper extremities, were reviews, or not in English, were excluded from the study. Results We described 23 reported cases of tenosynovitis of the upper extremity caused by M. kansasii . An immunosuppressed state was present in eight (34.8%) cases, and 12 (52.2%) patients received immunosuppressive treatment. A long-time period between the first appearance of symptoms and the definitive diagnosis was identified (median: 7 months, interquartile range: 9). The most frequent symptoms were local swelling (65.2%), pain (56.5%), mass effect (26%), and stiffness (13%). Tendon rupture was found in three (13%) patients as a complication of the disease. Moreover, seven (30.4%) patients underwent previous surgeries to try to relieve the symptoms before definitive diagnosis was achieved. Conclusion M. kansasii is an important differential causal pathogen for tenosynovitis of the upper extremities. Although rare, raising awareness about this infectious disease is imperative to avoid inadequate management and hazardous aesthetic sequelae.
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Affiliation(s)
- Maria T. Huayllani
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Andrea Sisti
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Daniel Boczar
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - David J. Restrepo
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Alexander S. Parker
- University of Florida, College of Medicine, Jacksonville, Florida, United States
| | | | - Brian D. Rinker
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
| | - Antonio Jorge Forte
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United States
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16
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Huayllani MT, Restrepo DJ, Boczar D, Sisti A, Spaulding AC, Parker AS, Sarabia-Estrada R, Guerrero-Cazares H, Moran SL, Forte AJ. Osteosarcoma of the Upper Extremities: A National Analysis of the US Population. Anticancer Res 2019; 39:5663-5668. [PMID: 31570464 DOI: 10.21873/anticanres.13763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/09/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Osteosarcoma of the upper extremities is rare, and characteristics in this location have not been described before. We aimed to analyze the characteristics and survival rate of osteosarcoma of the upper extremities. MATERIALS AND METHODS A retrospective cohort study was performed by querying the National Cancer Database. Statistical analysis was performed using a multivariate logistic regression model and Kaplan-Meier log-rank tests for survival. RESULTS A total of 991 patients were diagnosed with osteosarcoma of the upper extremities. Most tumors were osteogenic and osteoblastic (66.8%), larger than 8 cm (47.9%), high grade (64.3%), lymph node-negative (7.9%), and without metastasis to lungs (39.0%). Osteosarcomas of the hand and wrist were less likely to be high-grade when compared to osteosarcomas of the forearm, arm, and shoulder. CONCLUSION The results of this study help us to approach patients promptly and avoid total amputation, increasing functionality and prognosis of the disease.
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Affiliation(s)
- Maria T Huayllani
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, U.S.A
| | - David J Restrepo
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, U.S.A
| | - Daniel Boczar
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, U.S.A
| | - Andrea Sisti
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, U.S.A
| | - Aaron C Spaulding
- Department of Health Science Research, Mayo Clinic, Jacksonville, FL, U.S.A
| | | | | | | | - Steven L Moran
- Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, U.S.A
| | - Antonio J Forte
- Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, U.S.A.
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17
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Garcia CA, Bhargav AG, Mondal SK, ReFaey K, Zarco N, Schiapparelli P, Sarabia-Estrada R, Guerrero-Cazares H, Quiñones-Hinojosa A. Functional Characterization of Brain Tumor-Initiating Cells: Implications for Preclinical Models and Drug Development. Neurosurgery 2019. [DOI: 10.1093/neuros/nyz310_807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Gil BIF, Vazquez-Ramos CA, Schiapparelli P, Sarabia-Estrada R, Escames G, Quinones-Hinoja A. Melatonin Disrupts Glioblastoma Metabolism and Enhances Temozolomide Cytotoxic Effects. Neurosurgery 2019. [DOI: 10.1093/neuros/nyz310_644] [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: 11/13/2022] Open
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19
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Gil BF, Rodriguez K, Schiapparelli P, Ramos CV, Escames G, Quinones-Hinojosa A, Sarabia-Estrada R. BSCI-27. MELATONIN REDUCES MALIGNANCY OF BREAST CANCER BRAIN METASTATIC CELLS. Neurooncol Adv 2019. [PMCID: PMC7213190 DOI: 10.1093/noajnl/vdz014.023] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Around fifteen to thirty percent of stage IV breast cancer metastasizes to the brain, severely decreasing the quality of life of these patients by causing neurological decline and eventually death. In metastatic cancers there is a small subset of cells in the primary tumor bulk called Metastatic Tumor Initiating Cells (MTICs) which are able to escape and produce a niche establishment at distal sites where they can quickly become resistant to surgery and radiation. Melatonin has shown an inhibitory role in the viability and invasiveness of breast cancer and in modulating the expression of proteins related to Breast Cancer Stem Cells (BCSCs). These findings suggest its potential anti-metastatic role in different breast cancer cell lines. In this study we aimed to evaluate the effects of melatonin treatment in vitro for breast cancer brain metastasis. The cell line MDA-BT was originally obtained from MDA-MB-231, passed through the rat’s heart and then isolated once engrafted as a tumor in the brain. After a dose response assay, cells were treated with melatonin at doses of 1500 and 3000 µM for 48hrs. Clonogenic assay, MTT, as well as a stem cell signature through RT-qPCR, including CD44, CD24 and ALDH1 markers, were performed to evaluate the malignancy of the MTICs. The results showed that melatonin at high doses impacts morphology, declines viability, reduces colony formation ability, and decreases stemness in MDA-BT cells. Therefore, our findings highlight melatonin as a relevant therapeutic candidate to target breast cancer brain metastases.
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Alvarado-Estrada KN, Marenco-Hillembrand L, Mampre D, Quinones-Hinojosa A, Sarabia-Estrada R, Zhang YS, Maharjan S, Chaichana K. BSCI-16. HEMODYNAMIC SHEAR STRESS SELECTS A SUBPOPULATION OF LUNG ADENOCARCINOMA CELLS WITH HIGHER METASTATIC CAPACITY. Neurooncol Adv 2019. [PMCID: PMC7213184 DOI: 10.1093/noajnl/vdz014.014] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Patients with primary cancers often develop delayed brain metastases. One of the most common cancer types and sources of brain metastasis is lung cancer. For metastasis from lung cancer the 3-year survival is < 5%. Cancer cells in circulation are responsible for metastatic spread. The mechanical microenvironment plays an important role in cancer cells behavior. When cancer cells reach the bloodstream they are exposed to hemodynamic shear stress. It has been shown that most of the circulating tumor cells die once they reach the bloodstream, but the biology of the survival cells is poorly understood. We designed a microfluidics system that simulated the mechanical stress in the human circulating system such as turbulence, change in pressure (0.4-15dyn/cm2) and flow rate (1.06–106.1mm/s). Lung adenocarcinoma cells (A549) were put into circulation and collected after 72 hours. It was found that, 1.4±0.3% of the cells survived, and viability was evaluated by LDH and calcein. CD133, SOX2, and NANOG were downregulated and EMT genes were upregulated in the circulating cancer cells (CCCs) compared with cells in static-suspension or 2D. After re-seeding in 2D, CCCs overexpressed CD133. Female athymic nude rats (6-8weeks,n=16) received intracardiac injections of CCCs or 2D cells (GFP-LUC lentivirus traduced). Bioluminescence imaging was performed every week; the survival in of the CCCs group was lower than the 2D group. One-way ANOVA test was used to analyze survival and gene expression. Survival data was plotted on a Kaplan-Meier curve and compared using the Mantel-Cox logrank test, p=< 0.05. We have isolated a cellular subpopulation of lung adenocarcinoma with high resistance to hemodynamic shear stress that shows a higher metastatic capacity and genetic plasticity compared with cells growing in suspension or 2D. Targeting these cells would potentially allow us to develop personalized treatments to help to stop metastatic spread and improve actual therapeutical strategies.
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Affiliation(s)
| | | | | | | | | | - Yu Shrike Zhang
- Department of Medicine, Harvard Medical School; Division of Engineering in Medicine, Brigham and Women’s Hospital, Cambridge, MA, USA
| | - Sushila Maharjan
- Brigham and Women’s Hospital at Harvard Medical School, Cambridge, MA, USA
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Page CD, Sarabia-Estrada R, Hoffman RJ, Lo CP, Gades NM. Lack of Absorption of a Sustained-release Buprenorphine Formulation Administered Subcutaneously to Athymic Nude Rats. J Am Assoc Lab Anim Sci 2019; 58:597-600. [PMID: 31362805 DOI: 10.30802/aalas-jaalas-19-000013] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Female athymic nude rats (Rattus norvegicus; n = 45; age, 6 wk) were used in an IACUC-approved protocol to investigate mechanisms and potential treatments associated with brain, spine, and spinal cord metastases from triple negative breast cancer. The analgesic plan included the use of buprenorphine SR LAB (0.6 mg/kg; 0.11 mL/rat) subcutaneously and an oral NSAID delivered via the water. Thirty-seven rats reached the experimental end point at 3 mo after xenotransplantation and were euthanized for tissue harvest. Grossly, all 37 rats had nodules in the subcutis over the shoulders; these were identified as small, cystic structures (diameter, approximately 0.25 cm). The cysts and haired skin were submitted for LC-MS/MS (liquid chromatography-tandem mass spectrometry) and histopathology. Histologically, the cysts were lined by fibrous connective tissue mildly infiltrated by macrophages, lymphocytes, and plasma cells. Adjacent blood vessels were rimmed by a mild infiltrate of lymphocytes and plasma cells. The cysts contained variable accumulations of a light pink, proteinaceous fluid. The cause for the cysts could not be determined histologically; there was no evidence of neoplasia. LC-MS/MS analysis revealed that the cysts contained buprenorphine. We hypothesize that the lack of T cells and a cell-mediated immune response in these rats prevented the dissolution of the vehicle and absorption of the buprenorphine. The manufacturer provides a cautionary statement regarding the use of this formulation in nude mice due to skin reactions, but to our knowledge, this report is the first description of an apparent lack of absorption of the drug in immunodeficient animals.
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Affiliation(s)
- C Douglas Page
- Departments of Comparative Medicine, College of Medicine, Mayo Clinic, Jacksonville, Florida;,
| | | | - R Jay Hoffman
- Veterinary Medical Diagnostic Laboratory, Texas A&M University, College Station, Texas
| | - Chih-Ping Lo
- Veterinary Medical Diagnostic Laboratory, Texas A&M University, College Station, Texas
| | - Naomi M Gades
- Department of Comparative Medicine, Mayo Clinic, Scottsdale, Arizona
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22
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Mampre D, Ehresman J, Alvarado-Estrada K, Wijesekera O, Sarabia-Estrada R, Quinones-Hinojosa A, Chaichana KL. Propensity for different vascular distributions and cerebral edema of intraparenchymal brain metastases from different primary cancers. J Neurooncol 2019; 143:115-122. [PMID: 30835021 DOI: 10.1007/s11060-019-03142-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 01/28/2019] [Accepted: 03/01/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE This study seeks to ascertain whether different primary tumor types have a propensity for brain metastases (BMs) in different cerebral vascular territories and cerebral edema. METHODS Consecutive adult patients who underwent surgical resection of a BM at a tertiary care institution between 2001 and 2011 were retrospectively reviewed. Only patients with the most common primary cancers (lung, breast, skin-melanoma, colon, and kidney) were included. Preoperative MRIs were reviewed to classify all tumors by cerebral vascular territory (anterior cerebral artery-ACA, lenticulostriate, middle cerebral artery-MCA, posterior cerebral artery-PCA, posterior fossa, and watershed), and T2-weighted FLAIR widths were measured. Chi square analyses were performed to determine differences in cerebral vascular distribution by primary tumor type, and one-way ANOVA analyses were performed to determine FLAIR signal differences. RESULTS 669 tumors from 388 patients were classified from lung (n = 316 BMs), breast (n = 144), melanoma (n = 119), renal (n = 47), and colon (n = 43). BMs from breast cancer were less likely to be located in PCA territory (n = 18 [13%]; χ2 = 6.10, p = 0.01). BMs from melanoma were less likely to be located in cerebellar territory (n = 11 [9%]; χ2 = 14.1, p < 0.001), and more likely to be located in lateral (n = 5 [4%]; χ2 = 4.56, p = 0.03) and medial lenticulostriate territories (n = 2 [2%]; χ2 = 6.93, p = 0.009). BMs from breast and melanoma had shorter T2-FLAIR widths, with an average [IQR] of 47.2 [19.6-69.2] mm (p = 0.01) and 41.2 [14.4-62.7] mm (p = 0.002) respectively. Conversely, BMs from renal cancer had longer T2-FLAIR widths (64.2 [43.6-80.8] mm, p = 0.002). CONCLUSIONS These findings suggest that different primary tumor types could have propensities for different cerebral vascular territories and cerebral edema.
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Affiliation(s)
- David Mampre
- Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Jeff Ehresman
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Keila Alvarado-Estrada
- Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Olindi Wijesekera
- Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Rachel Sarabia-Estrada
- Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Kaisorn L Chaichana
- Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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Abstract
Ninety percent of deaths from solid tumors have been ascribed to the invasion and metastatic dissemination of cancer cells. One of the most fundamental prerequisites of brain tumor stem cell invasion is their ability to penetrate and traverse through the basement membrane and stromal compartments displacing from their original point of origin and repopulating at a distant site and adjacent tissue. In order to propose a successful clinical strategy, the investigation of the molecular determinants of invasion must factor in measurements and predictors of the complexity of brain tumor invasion potential accounting for the physiological scenarios encountered in the tumor niche. This chapter will highlight some laboratory approaches such as: spot assay, 3D chemogradient chambers, Fluoroblok™ tumor invasion, organotypics, and 3D tumor spheroid assays that could help mitigate the investigation of a tumor stem cell's invasion capacity through restrictive 3D environments otherwise seen in vivo.
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Affiliation(s)
- Rawan Al-Kharboosh
- Department of Neurosurgery, Mayo Clinic Florida, Jacksonville, FL, USA.,Mayo Clinic Graduate School, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Montserrat Lara-Velazquez
- Department of Neurosurgery, Mayo Clinic Florida, Jacksonville, FL, USA.,Plan of Combined Studies in Medicine. Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Luis Prieto
- Mayo Clinic Graduate School, Mayo Clinic College of Medicine, Rochester, MN, USA
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Ruiz-Garcia H, Sarabia-Estrada R, Harrell A, Sujan M, Alvarado-Estrada K, Quinones-Hinojosa A, Trifiletti D. STEM-08. MODULATION OF RADIATION-INDUCED MESENCHYMAL STEM CELL MIGRATION IN GLIOBLASTOMA. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.1015] [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
Affiliation(s)
- Henry Ruiz-Garcia
- Radiation Oncology, Mayo Clinic-Jacksonville., Jacksonville, FL, USA
| | | | - Anna Harrell
- Clinical Research, Mayo Clinic, Jacksonville, FL, USA
| | - Mondal Sujan
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA
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25
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Sarabia-Estrada R, Ruiz-Valls A, Guerrero-Cazares H, Ampuero AM, Jimenez-Estrada I, De Silva S, Bernhardt LJ, Goodwin CR, Ahmed AK, Li Y, Phillips NA, Gokaslan ZL, Quiñones-Hinojosa A, Sciubba DM. Metastatic human breast cancer to the spine produces mechanical hyperalgesia and gait deficits in rodents. Spine J 2017; 17:1325-1334. [PMID: 28412561 PMCID: PMC5628502 DOI: 10.1016/j.spinee.2017.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/10/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Metastases to the spine are a common source of severe pain in cancer patients. The secondary effects of spinal metastases include pain, bone fractures, hypercalcemia, and neurological deficits. As the disease progresses, pain severity can increase until it becomes refractory to medical treatments and leads to a decreased quality of life for patients. A key obstacle in the study of pain-induced spinal cancer is the lack of reliable and reproducible spine cancer animal models. In the present study, we developed a reproducible and reliable rat model of spinal cancer using human-derived tumor tissue to evaluate neurological decline using imaging and behavioral techniques. PURPOSE The present study outlines the development and characterization of an orthotopic model of human breast cancer to the spine in immunocompromised rats. STUDY DESIGN/SETTING This is a basic science study. METHODS Female immunocompromised rats were randomized into three groups: tumor (n=8), RBC3 mammary adenocarcinoma tissue engrafted in the L5 vertebra body; sham (n=6), surgery performed but not tumor engrafted; and control (n=6), naive rats, no surgery performed. To evaluate the neurological impairment due to tumor invasion, functional assessment was done in all rodents at day 40 after tumor engraftment using locomotion gait analysis and pain response to a mechanical stimulus (Randall-Selitto test). Bioluminescence (BLI) was used to evaluate tumor growth in vivo and cone beam computed tomography (CBCT) was performed to evaluate bone changes due to tumor invasion. The animals were euthanized at day 45 and their spines were harvested and processed for hematoxylin and eosin (H&E) staining. RESULTS Tumor growth in the spine was confirmed by BLI imaging and corroborated by histological analysis. Cone beam computed tomography images were characterized by a decrease in the bone intensity in the lumbar spine consistent with tumor location on BLI. On H&E staining of tumor-engrafted animals, there was a near-complete ablation of the ventral and posterior elements of the L5 vertebra with severe tumor invasion in the bony components displacing the spinal cord. Locomotion gait analysis of tumor-engrafted rats showed a disruption in the normal gait pattern with asignificant reduction in length (p=.02), duration (p=.002), and velocity (p=.002) of right leg strides and only in duration (p=.0006) and velocity (p=.001) of left leg strides, as compared with control and sham rats. Tumor-engrafted animals were hypersensitive to pain stimulus shown as a significantly reduced response in time (p=.02) and pressure (p=.01) applied when compared with control groups. CONCLUSIONS We developed a system for the quantitative analysis of pain and locomotion in an animal model of metastatic human breast cancer of the spine. Tumor-engrafted animals showed locomotor and sensory deficits that are in accordance with clinical manifestation in patients with spine metastasis. Pain response and locomotion gait analysis were performed during follow-up. The Randall-Selitto test was a sensitive method to evaluate pain in the rat's spine. We present a model for the study of bone-associated cancer pain secondary to cancer metastasis to the spine, as well as for the study of new therapies and treatments to lessen pain from metastatic cancer to the neuroaxis.
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Affiliation(s)
| | - Alejandro Ruiz-Valls
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Ana M. Ampuero
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ismael Jimenez-Estrada
- Physiology, Biophysics and Neurosciences, Research Center and Advanced Studies, IPN, Mexico City, MEXICO
| | - Samantha De Silva
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lydia J. Bernhardt
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - C. Rory Goodwin
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A. Karim Ahmed
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yuxin Li
- Department of Neurosurgery, Jinan General Hospital of PLA, Jinan, 250031, CHINA
| | - Neil A. Phillips
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ziya L. Gokaslan
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University Providence, Rhode Island, USA
| | | | - Daniel M. Sciubba
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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26
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Sarabia-Estrada R, Ruiz-Valls A, Shah SR, Ahmed AK, Ordonez AA, Rodriguez FJ, Guerrero-Cazares H, Jimenez-Estrada I, Velarde E, Tyler B, Li Y, Phillips NA, Goodwin CR, Petteys RJ, Jain SK, Gallia GL, Gokaslan ZL, Quinones-Hinojosa A, Sciubba DM. Effects of primary and recurrent sacral chordoma on the motor and nociceptive function of hindlimbs in rats: an orthotopic spine model. J Neurosurg Spine 2017; 27:215-226. [PMID: 28598292 DOI: 10.3171/2016.12.spine16917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 11/06/2022]
Abstract
OBJECTIVE Chordoma is a slow-growing, locally aggressive cancer that is minimally responsive to conventional chemotherapy and radiotherapy and has high local recurrence rates after resection. Currently, there are no rodent models of spinal chordoma. In the present study, the authors sought to develop and characterize an orthotopic model of human chordoma in an immunocompromised rat. METHODS Thirty-four immunocompromised rats were randomly allocated to 4 study groups; 22 of the 34 rats were engrafted in the lumbar spine with human chordoma. The groups were as follows: UCH1 tumor-engrafted (n = 11), JHC7 tumor-engrafted (n = 11), sham surgery (n = 6), and intact control (n = 6) rats. Neurological impairment of rats due to tumor growth was evaluated using open field and locomotion gait analysis; pain response was evaluated using mechanical or thermal paw stimulation. Cone beam CT (CBCT), MRI, and nanoScan PET/CT were performed to evaluate bony changes due to tumor growth. On Day 550, rats were killed and spines were processed for H & E-based histological examination and immunohistochemistry for brachyury, S100β, and cytokeratin. RESULTS The spine tumors displayed typical chordoma morphology, that is, physaliferous cells filled with vacuolated cytoplasm of mucoid matrix. Brachyury immunoreactivity was confirmed by immunostaining, in which samples from tumor-engrafted rats showed a strong nuclear signal. Sclerotic lesions in the vertebral body of rats in the UCH1 and JHC7 groups were observed on CBCT. Tumor growth was confirmed using contrast-enhanced MRI. In UCH1 rats, large tumors were observed growing from the vertebral body. JHC7 chordoma-engrafted rats showed smaller tumors confined to the bone periphery compared with UCH1 chordoma-engrafted rats. Locomotion analysis showed a disruption in the normal gait pattern, with an increase in the step length and duration of the gait in tumor-engrafted rats. The distance traveled and the speed of rats in the open field test was significantly reduced in the UCH1 and JHC7 tumor-engrafted rats compared with controls. Nociceptive response to a mechanical stimulus showed a significant (p < 0.001) increase in the paw withdrawal threshold (mechanical hypalgesia). In contrast, the paw withdrawal response to a thermal stimulus decreased significantly (p < 0.05) in tumor-engrafted rats. CONCLUSIONS The authors developed an orthotopic human chordoma model in rats. Rats were followed for 550 days using imaging techniques, including MRI, CBCT, and nanoScan PET/CT, to evaluate lesion progression and bony integrity. Nociceptive evaluations and locomotion analysis were performed during follow-up. This model reproduces cardinal signs, such as locomotor and sensory deficits, similar to those observed clinically in human patients. To the authors' knowledge, this is the first spine rodent model of human chordoma. Its use and further study will be essential for pathophysiology research and the development of new therapeutic strategies.
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Affiliation(s)
| | | | - Sagar R Shah
- Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida.,Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Alvaro A Ordonez
- Pediatrics, Center for Infection and Inflammation Imaging Research
| | | | | | - Ismael Jimenez-Estrada
- Department of Physiology, Biophysics, and Neurosciences, Research Center for Advanced Studies IPN, Mexico City, Mexico
| | | | | | - Yuxin Li
- Department of Neurosurgery, Jinan General Hospital of PLA, Jinan, China
| | | | | | | | - Sanjay K Jain
- Pediatrics, Center for Infection and Inflammation Imaging Research
| | | | - Ziya L Gokaslan
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; and
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Petteys RJ, Spitz SM, Syed H, Rice RA, Sarabia-Estrada R, Goodwin CR, Sciubba DM, Freedman BA. Design and testing of a controlled electromagnetic spinal cord impactor for use in large animal models of acute traumatic spinal cord injury. J Clin Neurosci 2017; 43:229-234. [PMID: 28539210 DOI: 10.1016/j.jocn.2017.04.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/24/2017] [Accepted: 04/22/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Spinal cord injury (SCI) causes debilitating neurological dysfunction and has been observed in warfighters injured in IED blasts. Clinical benefit of SCI treatment remains elusive and better large animal models are needed to assess treatment options. Here, we describe a controlled electromagnetic spinal cord impactor for use in large animal models of SCI. METHODS A custom spinal cord impactor and platform were fabricated for large animals (e.g., pig, sheep, dog, etc.). Impacts were generated by a voice coil actuator; force and displacement were measured with a load cell and potentiometer respectively. Labview (National Instruments, Austin, TX) software was used to control the impact cycle and import force and displacement data. Software finite impulse response (FIR) filtering was employed for all input data. Silicon tubing was used a surrogate for spinal cord in order to test the device; repeated impacts were performed at 15, 25, and 40 Newtons. RESULTS Repeated impacts demonstrated predictable results at each target force. The average duration of impact was 71.2 ±6.1ms. At a target force of 40N, the output force was 41.5 ±0.7N. With a target of 25N, the output force was 23.5 ±0.6N; a target of 15Newtons revealed an output force of 15.2 ±1.4N. The calculated acceleration range was 12.5-21.2m/s2. CONCLUSIONS This custom spinal cord impactor reliably delivers precise impacts to the spinal cord and will be utilized in future research to study acute traumatic SCI in a large animal.
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Affiliation(s)
- Rory J Petteys
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Neurosurgery, William Beaumont Army Medical Center, El Paso, TX, USA.
| | - Steven M Spitz
- Department of Neurosurgery, Georgetown University Hospital, Washington, DC, USA
| | - Hasan Syed
- Department of Neurosurgery, Georgetown University Hospital, Washington, DC, USA
| | - R Andrew Rice
- Department of Neurosurgery, Georgetown University Hospital, Washington, DC, USA
| | - Rachel Sarabia-Estrada
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - C Rory Goodwin
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brett A Freedman
- Department of Orthopedic Surgery, Mayo Clinic School of Medicine, Rochester, MN, USA
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Cowan A, Sarabia-Estrada R, Wilkerson G, McKnight P, Guarnieri M. Lack of adverse effects during a target animal safety trial of extended-release buprenorphine in Fischer 344 rats. Lab Anim (NY) 2017; 45:28-34. [PMID: 26684956 PMCID: PMC7092016 DOI: 10.1038/laban.745] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 02/24/2015] [Indexed: 11/17/2022]
Abstract
Extended-release buprenorphine is an effective analgesic in laboratory animals, and its safety has been established in mice but not in rats. The authors used a target animal safety trial to evaluate the safety of extended-release buprenorphine in rats. Fischer 344 rats received post-surgical subcutaneous injections of 1.3 mg, 3.9 mg or 6.5 mg buprenorphine per kg body weight (two times, six times or ten times the intended dose, respectively), and their body weight, clinical signs and symptoms, clinical pathology and histopathology were monitored for 4 d. Body weight was not significantly different in rats that received buprenorphine compared with control rats. Signs of nausea-related behavior were observed in 25% of the rats treated with buprenorphine. Clinical pathology results for all rats were normal, and gross and microscopic histopathology examinations identified no substantial abnormalities, suggesting that this behavior was of minor consequence. Other adverse events previously reported to occur with opiate therapy, including weight loss and dermal lesions at drug injection sites, were not observed in this study. The results of this study show that post-surgical administration of an extended-release buprenorphine product is safe in Fischer 344 rats and does not necessarily cause substantial adverse effects, confirming that opiate therapy is a viable choice in laboratory animal medicine.
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Affiliation(s)
- Alan Cowan
- Temple University School of Medicine, Department of Pharmacology, Philadelphia, PA
| | | | | | | | - Michael Guarnieri
- Johns Hopkins School of Medicine, Department of Neurological Surgery, Baltimore, MD
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29
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Sarabia-Estrada R, Ruiz-Valls A, R Sha S, Guerrero-Cazares H, Jimenez-Estrada I, Tyler B, Gallia G, Gokaslan Z, Quinones-Hinojosa A, Sciubba D. TMOD-35. PRIMARY AND RECURRENT SACRAL CHORDOMA AFFECTS THE HIND LIMBS MOTOR AND NOCICEPTIVE FUNCTION IN RATS: AN ORTHOTOPIC SPINE MODEL. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Mangraviti A, Tzeng SY, Gullotti D, Kozielski KL, Kim JE, Seng M, Abbadi S, Schiapparelli P, Sarabia-Estrada R, Vescovi A, Brem H, Olivi A, Tyler B, Green JJ, Quinones-Hinojosa A. Non-virally engineered human adipose mesenchymal stem cells produce BMP4, target brain tumors, and extend survival. Biomaterials 2016; 100:53-66. [PMID: 27240162 DOI: 10.1016/j.biomaterials.2016.05.025] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/16/2016] [Accepted: 05/18/2016] [Indexed: 12/27/2022]
Abstract
There is a need for enabling non-viral nanobiotechnology to allow safe and effective gene therapy and cell therapy, which can be utilized to treat devastating diseases such as brain cancer. Human adipose-derived mesenchymal stem cells (hAMSCs) display high anti-glioma tropism and represent a promising delivery vehicle for targeted brain tumor therapy. In this study, we demonstrate that non-viral, biodegradable polymeric nanoparticles (NPs) can be used to engineer hAMSCs with higher efficacy (75% of cells) than leading commercially available reagents and high cell viability. To accomplish this, we engineered a poly(beta-amino ester) (PBAE) polymer structure to transfect hAMSCs with significantly higher efficacy than Lipofectamine™ 2000. We then assessed the ability of NP-engineered hAMSCs to deliver bone morphogenetic protein 4 (BMP4), which has been shown to have a novel therapeutic effect by targeting human brain tumor initiating cells (BTIC), a source of cancer recurrence, in a human primary malignant glioma model. We demonstrated that hAMSCs genetically engineered with polymeric nanoparticles containing BMP4 plasmid DNA (BMP4/NP-hAMSCs) secrete BMP4 growth factor while maintaining their multipotency and preserving their migration and invasion capacities. We also showed that this approach can overcome a central challenge for brain therapeutics, overcoming the blood brain barrier, by demonstrating that NP-engineered hAMSCs can migrate to the brain and penetrate the brain tumor after both intranasal and systemic intravenous administration. Critically, athymic rats bearing human primary BTIC-derived tumors and treated intranasally with BMP4/NP-hAMSCs showed significantly improved survival compared to those treated with control GFP/NP-hAMCSs. This study demonstrates that synthetic polymeric nanoparticles are a safe and effective approach for stem cell-based cancer-targeting therapies.
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Affiliation(s)
- Antonella Mangraviti
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephany Y Tzeng
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - David Gullotti
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristen L Kozielski
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jennifer E Kim
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Seng
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sara Abbadi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Paula Schiapparelli
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rachel Sarabia-Estrada
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Angelo Vescovi
- IRCSS Casa Sollievo della Sofferenza, Opera di San Pio da Pietrelcina, viale dei Cappuccini, 1, 71013 S. Giovanni Rotondo, Italy
| | - Henry Brem
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alessandro Olivi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Betty Tyler
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Jordan J Green
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Alfredo Quinones-Hinojosa
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Goodwin CR, Abu-Bonsrah N, Boone C, Ruiz-Valls A, Sankey EW, Sarabia-Estrada R, Elder BD, Kosztowski T, Sciubba DM. Non-hepatocellular carcinoma spinal metastases. J Clin Neurosci 2016; 27:22-7. [DOI: 10.1016/j.jocn.2015.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 11/13/2015] [Indexed: 12/15/2022]
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32
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Goodwin CR, Xu R, Iyer R, Sankey EW, Liu A, Abu-Bonsrah N, Sarabia-Estrada R, Frazier JL, Sciubba DM, Jallo GI. Local delivery methods of therapeutic agents in the treatment of diffuse intrinsic brainstem gliomas. Clin Neurol Neurosurg 2016; 142:120-127. [PMID: 26849840 DOI: 10.1016/j.clineuro.2016.01.007] [Citation(s) in RCA: 16] [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: 12/10/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Abstract
Brainstem gliomas comprise 10-20% of all pediatric central nervous system (CNS) tumors and diffuse intrinsic pontine gliomas (DIPGs) account for the majority of these lesions. DIPG is a rapidly progressive disease with almost universally fatal outcomes and a median survival less than 12 months. Current standard-of-care treatment for DIPG includes radiation therapy, but its long-term survival effects are still under debate. Clinical trials investigating the efficacy of systemic administration of various therapeutic agents have been associated with disappointing outcomes. Recent efforts have focused on improvements in chemotherapeutic agents employed and in methods of localized and targeted drug delivery. This review provides an update on current preclinical and clinical studies investigating treatment options for brainstem gliomas.
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Affiliation(s)
- C Rory Goodwin
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - Risheng Xu
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - Rajiv Iyer
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - Eric W Sankey
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - Ann Liu
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - Nancy Abu-Bonsrah
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - Rachel Sarabia-Estrada
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - James L Frazier
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - Daniel M Sciubba
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA
| | - George I Jallo
- The Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA.
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Mangraviti A, Tzeng S, Gullotti D, Kozielski K, Kim J, Seng M, Abbadi S, Schiapparelli P, Sarabia-Estrada R, Brem H, Tyler B, Olivi A, Green J, Quinones-Hinojosa A. ATPS-90EFFICACY OF NON-VIRAL ENGINEERED ADIPOSE MESENCHYMAL STEM CELLS FOR BRAIN TUMOR THERAPY. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov204.90] [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: 11/13/2022] Open
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Goodwin CR, Khattab MH, Sankey EW, Elder BD, Kosztowski TA, Sarabia-Estrada R, Bydon A, Witham TF, Wolinsky JP, Gokaslan ZL, Sciubba DM. Factors Associated with Life Expectancy in Patients with Metastatic Spine Disease from Adenocarcinoma of the Lung. Global Spine J 2015; 5:417-24. [PMID: 26430597 PMCID: PMC4577314 DOI: 10.1055/s-0035-1554778] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 03/16/2015] [Indexed: 01/15/2023] Open
Abstract
Study Design Retrospective study. Objective Our objective was to identify preoperative prognostic factors associated with survival in patients with spinal metastasis from lung carcinoma. Methods A retrospective analysis of 26 patients diagnosed with lung carcinoma metastatic to the spinal column was performed to determine factors associated with survival. We used 3 months survival as the clinical cutoff for whether surgical intervention should be performed. We analyzed patients who survived less than 3 months compared with those who survived more than 3 months. Demographic, preoperative, operative, and postoperative factors including functional scores were collected for analysis. Results The median survival for all patients in our study was 3.5 months. We found a statistically significant difference between the group that survived less than 3 months and the group that survived greater than 3 months in terms of extrathoracic metastasis, visceral metastasis, and average postoperative modified Rankin score. Conclusion Determining which patients with lung cancer spinal metastases will benefit from surgical intervention is often dictated by the patient's predicted life expectancy. Factors associated with poorer prognosis include age, functional status, visceral metastases, and extrathoracic metastases. Although the prognosis for patients with lung cancer spinal metastases is poor, some patients may experience long-term benefit from surgical intervention.
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Affiliation(s)
- C. Rory Goodwin
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Mohamed H. Khattab
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Eric W. Sankey
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Benjamin D. Elder
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Thomas A. Kosztowski
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Rachel Sarabia-Estrada
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Ali Bydon
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Timothy F. Witham
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Jean-Paul Wolinsky
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Ziya L. Gokaslan
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States
| | - Daniel M. Sciubba
- Department of Neurosurgery, The Johns Hopkins University, Baltimore, Maryland, United States,Address for correspondence Daniel M. Sciubba, MD Department of Neurosurgery, Johns Hopkins University School of Medicine600 North Wolfe Street, Meyer 7-109, Baltimore, MD 21287United States
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Sarabia-Estrada R, Ruiz-Valls A, Goodwin CR, Sha S, Quiñones-Hinojosa A, Gokaslan ZL, Sciubba DM. Abstract 5149: An orthotopic model of human chordoma in rats. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-5149] [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: 11/16/2022]
Abstract
Abstract
Introduction. Chordoma (CHO) is a relatively rare, slow-growing, malignant, locally aggressive cancer that constitutes 1% to 4% of all primary bone tumors. It arises from notochordal remnants along the neuraxis at developmentally active sites. CHO causes significant damage through local bone destruction and compromise of surrounding neurologic and neurovascular structures. CHO in the lumbar spine results in devastating effects that include pain, paralysis, bowel/bladder dysfunction, and decreased ambulation. These effects are minimally responsive to conventional chemotherapy and radiotherapy and as such, surgical resection is the mainstay of treatment. Pre-clinical models that better recapitulate the clinical symptoms observed in patients diagnosed with CHO are needed to increase the understanding of this disease and to develop strategies to develop new therapeutic strategies. Here we developed the first orthotopic animal model of human CHO in the lumbar spine of immunocompromised rats.
Methods. 11 immunocompromised rats were implanted in the lumbar spine with human CHO tumor tissue. A group of 6 sham rats (surgical approach without tumor implantation) and another with 6 intact rats were used as control groups. This tumor was obtained from a donor rat that was previously injected with UCH1CHO cells in the flank. Nociceptive response was conducted every week after the first neurological deficits were present using Randal-Sellito. Locomotion gait analysis was used to evaluate gait impairment. Rats were clinically observed for neurological impairment in the lumbar spine and/or hind limbs. Spines were collected after euthanasia, and inspected for signs of spinal cord compression followed by H&E staining to evaluate the histology.
Results. In CHO-implanted rats, the threshold for a mechanic nociceptive response was significantly reduced in time and pressure applied. Locomotion gait analysis showed a disruption in the normal pattern of the rats’ gait. At D25-35 after tumor implantation rats showed impairment in the flexion and extension of the knees, ankles, and toes. At the gross morphology level, the spinal cord showed signs of compression at upper and lower levels related with the implanted CHO tumor. Histology revealed tumor invasion in the spinal canal that was related with deficit in the flexion and extension of the toes. The tumor showed typical CHO morphology: physaliferous cells filled with vacuolated cytoplasm of mucoid matrix.
Conclusions. We have developed a novel orthotopic human CHO model in rats. This model reproduces cardinal clinical signs such as locomotor and sensory deficits present in human patients. To our knowledge, this is the first orthotopic animal model of human CHO. Its use and further study will be essential for pathophysiology research and the development of new therapeutic strategies.
Citation Format: Rachel Sarabia-Estrada, Alejandro Ruiz-Valls, Courtney R. Goodwin, Sagar Sha, Alfredo Quiñones-Hinojosa, Ziya L. Gokaslan, Daniel M. Sciubba. An orthotopic model of human chordoma in rats. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5149. doi:10.1158/1538-7445.AM2015-5149
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Affiliation(s)
| | | | | | - Sagar Sha
- Johns Hopkins University, Baltimore, MD
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Abstract
Study Design Case report. Objective Merkel cell carcinoma is an aggressive neuroendocrine carcinoma with a poor prognosis. Metastatic epidural spinal cord compression (MESCC) is a debilitating disease causing neurologic deficits. The surgical management for MESCC depends on pathology. Methods We report a case of Merkel cell carcinoma of the spine and evaluate the treatment paradigms utilized in the prior reports. Result A 76-year-old man with a history of Merkel cell carcinoma presented with 2-week history of progressive difficulty ambulating and a solitary T5 epidural mass encasing the spinal cord. The patient underwent a T5 corpectomy with cage placement and T3 to T7 posterior fusion with postoperative neurologic improvement and a return to ambulation. Three weeks postoperatively, the patient re-presented with new-onset weakness and widespread metastatic spinal disease with epidural compression at the T8 level. Six weeks postoperatively, he was placed in hospice care. Conclusion Prior reports in the literature demonstrated a poor prognosis for Merkel cell carcinoma metastasis to the spine with survival ranging from 1 to 9 months after diagnosis. Although neurologic decline necessitates a surgical intervention, the assessment of operative benefit should take into account the prognosis associated with the primary tumor subtype.
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Affiliation(s)
- C. Rory Goodwin
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Ankit I. Mehta
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Owoicho Adogwa
- Division of Neurosurgery, Department of Surgery, Duke University, Durham, North Carolina, United States
| | - Rachel Sarabia-Estrada
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Daniel M. Sciubba
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States,Address for correspondence Daniel M. Sciubba, MD Department of Neurosurgery, The Johns Hopkins University600 North Wolfe Street, Meyer 7-109, Baltimore, MD 21287United States
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Sarabia-Estrada R, Bañuelos-Pineda J, Osuna Carrasco LP, Jiménez-Vallejo S, Jiménez-Estrada I, Rivas-Celis E, Dueñas-Jiménez JM, Dueñas-Jiménez SH. Aberrant gastrocnemius muscle innervation by tibial nerve afferents after implantation of chitosan tubes impregnated with progesterone favored locomotion recovery in rats with transected sciatic nerve. J Neurosurg 2015; 123:270-82. [DOI: 10.3171/2014.12.jns132519] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
Transection of peripheral nerves produces loss of sensory and/or motor function. After complete nerve cutting, the distal and proximal segment ends retract, but if both ends are bridged with unaltered chitosan, progesterone-impregnated chitosan, or silicone tubes, an axonal repair process begins. Progesterone promotes nerve repair and has neuroprotective effects thwarting regulation of neuron survival, inflammation, and edema. It also modulates aberrant axonal sprouting and demyelination. The authors compared the efficacy of nerve recovery after implantation of progesterone-loaded chitosan, unaltered chitosan, or silicone tubes after sciatic nerve transection in rats.
METHODS
After surgical removal of a 5-mm segment of the proximal sciatic nerve, rats were implanted with progesterone-loaded chitosan, unaltered chitosan, or silicone tubes in the transected nerve for evaluating progesterone and chitosan effects on sciatic nerve repair and ipsilateral hindlimb kinematic function, as well as on gastrocnemius electro-myographic responses. In some experiments, tube implantation was performed 90 minutes after nerve transection.
RESULTS
At 90 days after sciatic nerve transection and tube implantation, rats with progesterone-loaded chitosan tubes showed knee angular displacement recovery and better outcomes for step length, velocity of locomotion, and normal hindlimb raising above the ground. In contrast, rats with chitosan-only tubes showed reduced normal raising and pendulum-like hindlimb movements. Aberrant fibers coming from the tibial nerve innervated the gastrocnemius muscle, producing electromyographic responses. Electrical responses in the gastrocnemius muscle produced by sciatic nerve stimulation occurred only when the distal nerve segment was stimulated; they were absent when the proximal or intratubular segment was stimulated. A clear sciatic nerve morphology with some myelinated fiber fascicles appeared in the tube section in rats with progesterone-impregnated chitosan tubes. Some gastrocnemius efferent fibers were partially repaired 90 days after nerve resection. The better outcome in knee angle displacement may be partially attributable to the aberrant neuromuscular synaptic effects, since nerve conduction in the gastrocnemius muscle could be blocked in the progesterone-impregnated chitosan tubes. In addition, in the region of the gap produced by the nerve resection, the number of axons and amount of myelination were reduced in the sciatic nerve implanted with chitosan, progesterone-loaded chitosan, and silicone tubes. At 180 days after sciatic nerve sectioning, the knee kinematic function recovered to a level observed in control rats of a similar age. In rats with progesterone-loaded chitosan tubes, stimulation of the proximal and intratubular sciatic nerve segments produced an electromyographic response. The axon morphology of the proximal and intratubular segments of the sciatic nerve resembled that of the contralateral nontransected nerve.
CONCLUSIONS
Progesterone-impregnated chitosan tubes produced aberrant innervation of the gastrocnemius muscle, which allowed partial recovery of gait locomotion and could be adequate for reinnervating synergistic denervated muscles while a parent innervation is reestablished. Hindlimb kinematic parameters differed between younger (those at 90 days) and older (those at 180 days) rats.
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Affiliation(s)
| | | | | | | | - Ismael Jiménez-Estrada
- 3Department of Physiology, Biophysics and Neurosciences, CINVESTAV, IPN, México City D.F., México
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Petteys RJ, Spitz SM, Rhee J, Rory Goodwin C, Zadnik PL, Sarabia-Estrada R, Groves ML, Bydon A, Witham TF, Wolinsky JP, Gokaslan ZL, Sciubba DM. Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases. Eur Spine J 2015; 24:2142-9. [DOI: 10.1007/s00586-015-3862-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 11/30/2022]
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Mangraviti A, Tzeng S, Seng M, Abbadi S, Kozielski K, Schiapparelli P, Wijesekera O, Sarabia-Estrada R, Brem H, Tyler B, Olivi A, Green J, Quinones-Hinojosa A. SC-17 * BMP4-SECRETING hAdMSCs ENGINEERED WITH NANOPARTICLES: A NON-VIRAL MSC-BASED THERAPY FOR GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou275.17] [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: 11/14/2022] Open
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Traul KA, Romero JB, Brayton C, DeTolla L, Forbes-McBean N, Halquist MS, Karnes HT, Sarabia-Estrada R, Tomlinson MJ, Tyler BM, Ye X, Zadnik P, Guarnieri M. Safety studies of post-surgical buprenorphine therapy for mice. Lab Anim 2014; 49:100-10. [PMID: 25305141 DOI: 10.1177/0023677214554216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of appropriate analgesia in laboratory mice may be suboptimal because of concerns about adverse events (AE). Target Animal Safety trials were conducted to determine the safety of an extended-release suspension of buprenorphine. Drug or control suspensions were injected subcutaneously in surgically-treated BALB/c mice anesthetized with ketamine-xylazine to mimic post-operative conditions in which the compound might commonly be administered. Single and repeat five-fold (5×) excesses of the 3.25 mg/kg intended dose were used to provoke potential AE. Trials included prospective measurements of weight changes, blood chemistry, hematology, and histopathology. Clinical and histopathology findings were similar in drug-treated and control mice in a four-day trial using a single 16.25 mg/kg, 5× overdose of the drug. In a 12-day trial, which used a total buprenorphine dose of 48.75 mg/kg, clinical and histopathology values were also similar in control and drug-treated female mice. In the male arm of the repeat-overdose trial, two of eight mice died on the morning of day 12, three days following the third 16.25 mg/kg overdose administration. Histopathology did not reveal a cause of death. In a 14-month trial using a single 3.25 mg/kg dose of the drug, no significant findings identified potential AE. These findings indicate a high tolerance to an extended-release buprenorphine suspension administered post-operatively in mice with appropriate husbandry.
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Affiliation(s)
- Karl A Traul
- Pharmaceutical Consulting, Lawrenceville, NJ, USA
| | - Jennell B Romero
- Johns Hopkins School of Medicine, Department of Molecular and Comparative Pathobiology, Baltimore, MD, USA
| | - Cory Brayton
- Johns Hopkins School of Medicine, Department of Molecular and Comparative Pathobiology, Baltimore, MD, USA
| | - Louis DeTolla
- University of Maryland, School of Medicine, Departments of Pathology, Medicine, Division of Infectious Diseases and Public Health, and the Program of Comparative Medicine, Baltimore, MD, USA
| | - Nadine Forbes-McBean
- Johns Hopkins School of Medicine, Department of Molecular and Comparative Pathobiology, Baltimore, MD, USA
| | - Matthew S Halquist
- Virginia Commonwealth University School of Pharmacy, Department of Pharmaceutics, Richmond, VA, USA
| | - H Thomas Karnes
- Virginia Commonwealth University School of Pharmacy, Department of Pharmaceutics, Richmond, VA, USA
| | - Rachel Sarabia-Estrada
- Johns Hopkins School of Medicine, Department of Neurological Surgery, Baltimore, MD, USA
| | | | - Betty M Tyler
- Johns Hopkins School of Medicine, Department of Neurological Surgery, Baltimore, MD, USA
| | - Xiaobu Ye
- Johns Hopkins School of Medicine, Department of Neurological Surgery, Baltimore, MD, USA
| | - Patricia Zadnik
- Johns Hopkins School of Medicine, Department of Neurological Surgery, Baltimore, MD, USA
| | - Michael Guarnieri
- Johns Hopkins School of Medicine, Department of Neurological Surgery, Baltimore, MD, USA
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Zadnik PL, Molina CA, Sarabia-Estrada R, Groves ML, Wabler M, Mihalic J, McCarthy EF, Gokaslan ZL, Ivkov R, Sciubba D. Characterization of intratumor magnetic nanoparticle distribution and heating in a rat model of metastatic spine disease. J Neurosurg Spine 2014; 20:740-50. [DOI: 10.3171/2014.2.spine13142] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The goal of this study was to optimize local delivery of magnetic nanoparticles in a rat model of metastatic breast cancer in the spine for tumor hyperthermia while minimizing systemic exposure.
Methods
A syngeneic mammary adenocarcinoma was implanted into the L-6 vertebral body of 69 female Fischer rats. Suspensions of 100-nm starch-coated iron oxide magnetic nanoparticles (micromod Partikeltechnologie GmbH) were injected into tumors 9 or 13 days after implantation. For nanoparticle distribution studies, tissues were harvested from a cohort of 36 rats, and inductively coupled plasma mass spectrometry and histopathological studies with Prussian blue staining were used to analyze the samples. Intratumor heating was tested in 4 anesthetized animals with a 20-minute exposure to an alternating magnetic field (AMF) at a frequency of 150 kHz and an amplitude of 48 kA/m or 63.3 kA/m. Intratumor and rectal temperatures were measured, and functional assessments of AMF-exposed animals and histopathological studies of heated tumor samples were examined. Rectal temperatures alone were tested in a cohort of 29 rats during AMF exposure with or without nanoparticle administration. Animal studies were completed in accordance with the protocols of the University Animal Care and Use Committee.
Results
Nanoparticles remained within the tumor mass within 3 hours of injection and migrated into the bone at 6, 12, and 24 hours. Subarachnoid accumulation of nanoparticles was noted at 48 hours. No evidence of lymphoreticular nanoparticle exposure was found on histological investigation or via inductively coupled plasma mass spectrometry. The mean intratumor temperatures were 43.2°C and 40.6°C on exposure to 63.3 kA/m and 48 kA/m, respectively, with histological evidence of necrosis. All animals were ambulatory at 24 hours after treatment with no evidence of neurological dysfunction.
Conclusions
Locally delivered magnetic nanoparticles activated by an AMF can generate hyperthermia in spinal tumors without accumulating in the lymphoreticular system and without damaging the spinal cord, thereby limiting neurological dysfunction and minimizing systemic exposure. Magnetic nanoparticle hyperthermia may be a viable option for palliative therapy of spinal tumors.
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Affiliation(s)
| | | | | | | | | | - Jana Mihalic
- 3Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Sarabia-Estrada R, Zadnik PL, Molina CA, Jimenez-Estrada I, Groves ML, Gokaslan ZL, Bydon A, Witham TF, Wolinsky JP, Sciubba DM. A rat model of metastatic spinal cord compression using human prostate adenocarcinoma: histopathological and functional analysis. Spine J 2013; 13:1597-606. [PMID: 23810458 DOI: 10.1016/j.spinee.2013.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 09/28/2012] [Accepted: 05/04/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Cancer is a major global public health problem responsible for one in every four deaths in the United States. Prostate cancer alone accounts for 29% of all cancers in men and is the sixth leading cause of death in men. It is estimated that up to 30% of patients with cancer will develop metastatic disease, the spine being one of the most frequently affected sites in patients with prostate cancer. PURPOSE To study this condition in a preclinical setting, we have created a novel animal model of human metastatic prostate cancer to the spine and have characterized it histologically, functionally, and via bioluminescence imaging. STUDY DESIGN Translational science investigation of animal model of human prostate cancer in the spine. METHODS Luciferase-positive human prostate tumor cells PC3 (PC3-Luc) were injected in the flank of athymic male rats. PC3-Luc tumor samples were then implanted into the L5 vertebral body of male athymic rats (5 weeks old). Thirty-two rats were randomized into three surgical groups: experimental, control, and sham. Tumor growth was assessed qualitatively and noninvasively via bioluminescence emission, upon luciferin injection. To determine the functional impact of tumor growth in the spine, rats were evaluated for gait abnormalities during gait locomotion using video-assisted gait analysis. Rats were euthanized 22 days after tumor implantation, and spines were subjected to histopathological analyses. RESULTS Twenty days after tumor implantation, the tumor-implanted rats showed distinct signs of gait disturbances: dragging tail, right- or left-hind limb uncoordination, and absence of toe clearance during forward limb movement. At 20 days, all rats experienced tumor growth, evidenced by bioluminescent signal. Locomotion parameters negatively affected in tumor-implanted rats included stride length, velocity, and duration. At necropsy, all spines showed evidence of tumor growth, and the histological analysis found spinal cord compression and peritumoral osteoblastic reaction characteristic of bony prostate tumors. None of the rats in the sham or control groups demonstrated any evidence of bioluminescence signal or signs of gait disturbances. CONCLUSIONS In this project, we have developed a novel animal model of metastatic spine cancer using human prostate cancer cells. Tumor growth, evaluated via bioluminescence and corroborated by histopathological analyses, affected hind limb locomotion in ways that mimic motor deficits present in humans afflicted with metastatic spine disease. Our model represents a reliable method to evaluate the experimental therapeutic approaches of human tumors of the spine in animals. Gait locomotion and bioluminescence analyses can be used as surrogate noninvasive methods to evaluate tumor growth in this model.
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Affiliation(s)
- Rachel Sarabia-Estrada
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Meyer 7-109, Baltimore, MD 21287, USA
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Guarnieri M, Brayton C, DeTolla L, Forbes-McBean N, Sarabia-Estrada R, Zadnik P. Safety and efficacy of buprenorphine for analgesia in laboratory mice and rats. Lab Anim (NY) 2013; 41:337-43. [PMID: 23079917 DOI: 10.1038/laban.152] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 06/08/2012] [Indexed: 11/09/2022]
Abstract
Buprenorphine is a long-acting opiate with a high therapeutic index. The authors review the pharmacology, toxicity, analgesic effects and delivery of buprenorphine for use in laboratory mice and rats. Buprenorphine-based analgesic therapy has a substantial record of safety, and there is growing evidence of its effectiveness for treating post-operative pain. Nonetheless, more research is needed to determine optimal delivery systems and analgesic regimens for pain therapy in laboratory animals.
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Zadnik P, Sarabia-Estrada R, Groves ML, Molina C, Jackson C, McCarthy E, Gokaslan ZL, Bydon A, Wolinsky JP, Witham TF, Sciubba DM. A novel animal model of human breast cancer metastasis to the spine: a pilot study using intracardiac injection and luciferase-expressing cells. J Neurosurg Spine 2012; 18:217-25. [PMID: 23259542 DOI: 10.3171/2012.11.spine12325] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Metastatic spine disease is prevalent in cancer victims; 10%-30% of the 1.2 million new patients diagnosed with cancer in the US exhibit spinal metastases. Unfortunately, treatments are limited for these patients, as disseminated disease is often refractory to chemotherapy and is difficult to treat with surgical intervention alone. New animal models that accurately recapitulate the human disease process are needed to study the behavior of metastases in real time. METHODS In this study the authors report on a cell line that reliably generates bony metastases following intracardiac injection and can be tracked in real time using optical bioluminescence imaging. This line, RBC3, was derived from a metastatic breast adenocarcinoma lesion arising in the osseous spine of a rat following intracardiac injection of MDA-231 human breast cancer cells. RESULTS Upon culture and reinjection of RBC3, a statistically significantly increased systemic burden of metastatic tumor was noted. The resultant spine lesions were osteolytic, as demonstrated by small animal CT scanning. CONCLUSIONS This cell line generates spinal metastases that can be tracked in real time and may serve as a useful tool in the study of metastatic disease in the spine.
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Affiliation(s)
- Patricia Zadnik
- Departments of Neurosurgery, The Johns Hopkins University School of MedicineBaltimore, Maryland, USA
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Molina CA, Sarabia-Estrada R, Gokaslan ZL, Witham TF, Bydon A, Wolinsky JP, Sciubba DM. Delayed onset of paralysis and slowed tumor growth following in situ placement of recombinant human bone morphogenetic protein 2 within spine tumors in a rat model of metastatic breast cancer. J Neurosurg Spine 2012; 16:365-72. [DOI: 10.3171/2011.12.spine11496] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ObjectRecombinant human bone morphogenetic proteins (rhBMPs) are FDA-approved for specific spinal fusion procedures, but their use is contraindicated in spine tumor resection beds because of an unclear interaction between tumor tissue and such growth factors. Interestingly, a number of studies have suggested that BMPs may slow the growth of adenocarcinomas in vitro, and these lesions represent the majority of bony spine tumors. In this study, the authors hypothesized that rhBMP-2 placed in an intraosseous spine tumor in the rat could suppress tumor and delay the onset of paresis in such animals.MethodsTwenty-six female nude athymic rats were randomized into an experimental group (Group 1) or a positive control group (Group 2). Group 1 (tumor + 15 μg rhBMP-2 sponge,13 rats) underwent transperitoneal exposure and implantation of breast adenocarcinoma (CRL-1666) into the L-6 spine segment, followed by the implantation of a bovine collagen sponge impregnated with 15 μg of rhBMP-2. Group 2 (tumor + 0.9% NaCl sponge, 13 rats) underwent transperitoneal exposure and tumor implantation in the lumbar spine but no local treatment with rhBMP-2. An additional 8 animals were randomized into 2 negative control groups (Groups 3 and 4). Group 3 (15 μg rhBMP-2 sponge, 4 rats) and Group 4 (0.9% NaCl sponge, 4 rats) underwent transperitoneal exposure of the lumbar spine along with the implantation of rhBMP-2– and saline-impregnated bovine collagen sponges, respectively. Neither of the negative control groups was implanted with tumor. The Basso-Beattie-Bresnahan (BBB) scale was used to monitor daily motor function regression and the time to paresis (BBB score ≤ 7).ResultsIn comparison with the positive control animals (Group 2), the experimental animals (Group 1) had statistically significant longer mean (25.8 ± 12.2 vs 13 ± 1.4 days, p ≤ 0.001) and median (20 vs 13 days) times to paresis. In addition, the median survival time was significantly longer in the experimental animals (20 vs 13.5 days, p ≤ 0.0001). Histopathological analysis demonstrated bone growth and tumor inhibition in the experimental animals, whereas bone destruction and cord compression were observed in the positive control animals. Neither of the negative control groups (Groups 3 and 4) demonstrated any evidence of neurological deterioration, morbidity, or cord compromise on either gross or histological analysis.ConclusionsThis study shows that the local administration of rhBMP-2 (15 μg, 10 μl of 1.5-mg/ml solution) in a rat spine tumor model of breast cancer not only fails to stimulate local tumor growth, but also decreases local tumor growth and delays the onset of paresis in rats. This preclinical experiment is the first to show that the local placement of rhBMP-2 in a spine tumor bed may slow tumor progression and delay associated neurological decline.
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Keir ST, Reardon DA, Friedman HS, Bigner DD, Lee DY, Kaul A, Pong WW, Gianino SM, White CR, Emnett RJ, Gutmann DH, Robinson JP, VanBrocklin M, Jydstrup-McKinney A, Saxena L, Holmen SL, Price RL, Song J, Bingmer K, Zimmerman P, Rivera A, Oglesbee M, Yi JY, Kaur B, Cook C, Kwon CH, Chiocca EA, Hu Y, Chaturbedi A, Nelson J, Linskey ME, Zhou YH, Sarabia-Estrada R, Molina CA, Jimenez-Estrada I, Gokaslan ZL, Witham TF, Wolinsky JP, Bydon A, Sciubba DM, Luchman A, Stechishin O, Weljie A, Blough M, Kelly J, Nguyen S, Hassam R, Livingstone D, Cseh O, Hoc HD, Cairncross JG, Weiss S, Monje M, Mitra SS, Freret ME, Edwards MS, Weissman IL, Beachy PA, Ozawa T, Charles NA, Huse JT, Helmy K, Squatrito M, Holland EC, Kennedy BC, Sonabend A, Lei L, Guarnieri P, Leung R, Soderquist C, Yun J, Bruce J, Canoll P, Castelli M, Lei L, Sonabend A, Kennedy B, Guarnieri P, Rosenfeld S, Bruce J, Canoll P, Balvers RK, Kloezeman JJ, Heijsman D, Kremer A, French PJ, Dirven CM, Leenstra S, Lamfers ML, Lazovic J, Soto H, Piccioni D, Chou A, Li S, Prins R, Liau L, Cloughesy T, Lai A, Pope W, Johns TG, Day B, Wilding A, Stringer B, Boyd AW, Li P, Mcellin B, Maddie M, Wohlfeld B, Kernie S, Kim R, Maher EA, Bachoo R. TUMOR MODELS (IN VIVO/IN VITRO). Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor165] [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: 11/13/2022] Open
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Rosales-Cortés M, Peregrina-Sandoval J, Bañuelos-Pineda J, Sarabia-Estrada R, Gómez-Rodiles CC, Albarrán-Rodríguez E, Zaitseva GP, Pita-López ML. Immunological study of a chitosan prosthesis in the sciatic nerve regeneration of the axotomized dog. J Biomater Appl 2003; 18:15-23. [PMID: 12873072 DOI: 10.1177/0885328203018001002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study demonstrated that when the regeneration of the axotomized sciatic nerve is induced through tubulization with chitosan, this biomaterial does not induce immunostimulation or immunodepression in the dog. Canine females were distributed among three groups: an intact control group which was only isolated, an axotomized control group, and an axotomized group which was tubulized with 3% chitosan prostheses. In vitro culture and phagocytosis tests, as well as IgG and IgM serum concentrations, were determined in peripheral blood on days 0, 15, 30 and 60. The results showed that chitosan implants did not importantly affect the immune response.
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Affiliation(s)
- M Rosales-Cortés
- Div. Medicina Veterinaria, Dpto. Neuromorfología, C.U.C.B.A. UdeG, Mexico.
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