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Nickl V, Fakler J, Ziebolz D, Rumpel C, Stabenow L, Bernhagen J, Rampeltshammer E, Ernestus RI, Löhr M, Gugel I, Matthies C, Monoranu CM, Hagemann C, Breun M. Development of a vestibular schwannoma tumor slice model for pharmacological testing. J Neurosci Methods 2024; 405:110082. [PMID: 38387803 DOI: 10.1016/j.jneumeth.2024.110082] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/16/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Our goal was to develop a 3D tumor slice model, replicating the individual tumor microenvironment and for individual pharmaceutical testing in vestibular schwannomas with and without relation to NF2. METHODS Tissue samples from 16 VS patients (14 sporadic, 2 NF2-related) were prospectively analyzed. Slices of 350 µm thickness were cultured in vitro, and the 3D tumor slice model underwent thorough evaluation for culturing time, microenvironment characteristics, morphology, apoptosis, and proliferation rates. Common drugs - Lapatinib (10 µM), Nilotinib (20 µM), and Bevacizumab (10 µg/ml) - known for their responses in VS were used for treatment. Treatment responses were assessed using CC3 as an apoptosis marker and Ki67 as a proliferation marker. Standard 2D cell culture models of the same tumors served as controls. RESULTS The 3D tumor slice model accurately mimicked VS ex vivo, maintaining stability for three months. Cell count within the model was approximately tenfold higher than in standard cell culture, and the tumor microenvironment remained stable for 46 days. Pharmacological testing was feasible for up to three weeks, revealing interindividual differences in treatment response to Lapatinib and intraindividual variability in response to Lapatinib and Nilotinib. The observed effects were less pronounced in tumor slices than in standard cell culture, indicating the model's proximity to in vivo tumor biology and enhanced realism. Bevacizumab had limited impact in both models. CONCLUSION This study introduces a 3D tumor slice model for sporadic and NF2-related VS, demonstrating stability for up to 3 months, replication of the schwannoma microenvironment, and utility for individualized pharmacological testing.
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Affiliation(s)
- Vera Nickl
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany.
| | - Jonathan Fakler
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - David Ziebolz
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Charlotte Rumpel
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Linus Stabenow
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Johanna Bernhagen
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Eva Rampeltshammer
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Ralf-Ingo Ernestus
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Mario Löhr
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Isabel Gugel
- Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany; Centre of Neurofibromatosis and Rare Diseases, University Hospital Tübingen, Tübingen, Germany
| | - Cordula Matthies
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Camelia M Monoranu
- Institute of Pathology, Department of Neuropathology, University of Würzburg, Würzburg, Germany
| | - Carsten Hagemann
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Maria Breun
- Department of Neurosurgery, Section Experimental Neurosurgery, University Hospital Würzburg, Würzburg, Germany
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2
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Alsalkini M, Cibulková V, Breun M, Kessler AF, Schulz T, Cattaneo A, Wipplinger C, Hübner J, Ernestus RI, Nerreter T, Monoranu CM, Hagemann C, Löhr M, Nickl V. Cultivating Ex Vivo Patient-Derived Glioma Organoids Using a Tissue Chopper. J Vis Exp 2024. [PMID: 38314829 DOI: 10.3791/65952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Glioblastoma, IDH-wild type, CNS WHO grade 4 (GBM) is a primary brain tumor associated with poor patient survival despite aggressive treatment. Developing realistic ex vivo models remain challenging. Patient-derived 3-dimensional organoid (PDO) models offer innovative platforms that capture the phenotypic and molecular heterogeneity of GBM, while preserving key characteristics of the original tumors. However, manual dissection for PDO generation is time-consuming, expensive and can result in a number of irregular and unevenly sized PDOs. This study presents an innovative method for PDO production using an automated tissue chopper. Tumor samples from four GBM and one astrocytoma, IDH-mutant, CNS WHO grade 2 patients were processed manually as well as using the tissue chopper. In the manual approach, the tumor material was dissected using scalpels under microscopic control, while the tissue chopper was employed at three different angles. Following culture on an orbital shaker at 37 °C, morphological changes were evaluated using bright field microscopy, while proliferation (Ki67) and apoptosis (CC3) were assessed by immunofluorescence after 6 weeks. The tissue chopper method reduced almost 70% of the manufacturing time and resulted in a significantly higher PDOs mean count compared to the manually processed tissue from the second week onwards (week 2: 801 vs. 601, P = 0.018; week 3: 1105 vs. 771, P = 0.032; and week 4:1195 vs. 784, P < 0.01). Quality assessment revealed similar rates of tumor-cell apoptosis and proliferation for both manufacturing methods. Therefore, the automated tissue chopper method offers a more efficient approach in terms of time and PDO yield. This method holds promise for drug- or immunotherapy-screening of GBM patients.
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Affiliation(s)
- Marah Alsalkini
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg
| | - Veronika Cibulková
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg
| | - Maria Breun
- Department of Neurosurgery, University Hospital Würzburg
| | | | - Tim Schulz
- Department of Neurosurgery, University Hospital Würzburg
| | | | | | - Julian Hübner
- Department of Hematology, University Hospital Würzburg
| | | | | | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University Hospital Würzburg
| | - Carsten Hagemann
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg
| | - Vera Nickl
- Department of Neurosurgery, University Hospital Würzburg;
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3
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Breun M, Flock K, Feldheim J, Nattmann A, Monoranu CM, Herrmann P, Ernestus RI, Löhr M, Hagemann C, Stein U. Metastasis Associated in Colorectal Cancer 1 (MACC1) mRNA Expression Is Enhanced in Sporadic Vestibular Schwannoma and Correlates to Deafness. Cancers (Basel) 2023; 15:4089. [PMID: 37627117 PMCID: PMC10452285 DOI: 10.3390/cancers15164089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Vestibular schwannoma (VS) are benign cranial nerve sheath tumors of the vestibulocochlear nerve. Their incidence is mostly sporadic, but they can also be associated with NF2-related schwannomatosis (NF2), a hereditary tumor syndrome. Metastasis associated in colon cancer 1 (MACC1) is known to contribute to angiogenesis, cell growth, invasiveness, cell motility and metastasis of solid malignant cancers. In addition, MACC1 may be associated with nonsyndromic hearing impairment. Therefore, we evaluated whether MACC1 may be involved in the pathogenesis of VS. Sporadic VS, recurrent sporadic VS, NF2-associated VS, recurrent NF2-associated VS and healthy vestibular nerves were analyzed for MACC1 mRNA and protein expression by quantitative polymerase chain reaction and immunohistochemistry. MACC1 expression levels were correlated with the patients' clinical course and symptoms. MACC1 mRNA expression was significantly higher in sporadic VS compared to NF2-associated VS (p < 0.001). The latter expressed similar MACC1 concentrations as healthy vestibular nerves. Recurrent tumors resembled the MACC1 expression of the primary tumors. MACC1 mRNA expression was significantly correlated with deafness in sporadic VS patients (p = 0.034). Therefore, MACC1 might be a new molecular marker involved in VS pathogenesis.
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Affiliation(s)
- Maria Breun
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany (A.N.)
| | - Katharina Flock
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany (A.N.)
| | - Jonas Feldheim
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany (A.N.)
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, 45147 Essen, Germany
| | - Anja Nattmann
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany (A.N.)
- Department of Ophthalmology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Camelia M. Monoranu
- Institute of Pathology, Department of Neuropathology, University of Würzburg, 97080 Würzburg, Germany
| | - Pia Herrmann
- Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany
| | - Ralf-Ingo Ernestus
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany (A.N.)
| | - Mario Löhr
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany (A.N.)
| | - Carsten Hagemann
- Section Experimental Neurosurgery, Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany (A.N.)
| | - Ulrike Stein
- Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany
- German Cancer Consortium (DKTK), 69120 Heidelberg, Germany
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4
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Feldheim J, Kessler AF, Feldheim JJ, Schmitt D, Oster C, Lazaridis L, Glas M, Ernestus RI, Monoranu CM, Löhr M, Hagemann C. BRMS1 in Gliomas-An Expression Analysis. Cancers (Basel) 2023; 15:cancers15112907. [PMID: 37296870 DOI: 10.3390/cancers15112907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
The metastatic suppressor BRMS1 interacts with critical steps of the metastatic cascade in many cancer entities. As gliomas rarely metastasize, BRMS1 has mainly been neglected in glioma research. However, its interaction partners, such as NFκB, VEGF, or MMPs, are old acquaintances in neurooncology. The steps regulated by BRMS1, such as invasion, migration, and apoptosis, are commonly dysregulated in gliomas. Therefore, BRMS1 shows potential as a regulator of glioma behavior. By bioinformatic analysis, in addition to our cohort of 118 specimens, we determined BRMS1 mRNA and protein expression as well as its correlation with the clinical course in astrocytomas IDH mutant, CNS WHO grade 2/3, and glioblastoma IDH wild-type, CNS WHO grade 4. Interestingly, we found BRMS1 protein expression to be significantly decreased in the aforementioned gliomas, while BRMS1 mRNA appeared to be overexpressed throughout. This dysregulation was independent of patients' characteristics or survival. The protein and mRNA expression differences cannot be finally explained at this stage. However, they suggest a post-transcriptional dysregulation that has been previously described in other cancer entities. Our analyses present the first data on BRMS1 expression in gliomas that can provide a starting point for further investigations.
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Affiliation(s)
- Jonas Feldheim
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45131 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Hufelandstraße 55, 45131 Essen, Germany
| | - Almuth F Kessler
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Julia J Feldheim
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
- Department of Neurosurgery, University Hospital Essen, Hufelandstraße 55, 45131 Essen, Germany
| | - Dominik Schmitt
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
- Department of Nuclear Medicine, University of Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Christoph Oster
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45131 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Hufelandstraße 55, 45131 Essen, Germany
| | - Lazaros Lazaridis
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45131 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Hufelandstraße 55, 45131 Essen, Germany
| | - Martin Glas
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45131 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Hufelandstraße 55, 45131 Essen, Germany
| | - Ralf-Ingo Ernestus
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
| | - Mario Löhr
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Carsten Hagemann
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
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5
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Nickl V, Schulz E, Salvador E, Trautmann L, Diener L, Kessler AF, Monoranu CM, Ernestus RI, Löhr M, Hagemann C. Abstract 4573: Evaluation of tumor treating fields (TTFields) effects at 200 kHz on a glioblastoma, an anaplastic ependymoma and an oligodendroglioma sample in a patient-derived ex vivo organoid model. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4573] [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: 04/07/2023]
Abstract
Abstract
TTFields are alternating electric fields of low intensity (1-3 V/cm) and intermediate frequency (100-500 kHz), which are effective and approved for the treatment of glioblastoma (GBM) using 200 kHz frequency. However, there is a lack of ex vivo models to evaluate effects on patients’ tumor biology or to screen patients for treatment efficacy. Therefore, we adapted patient-derived three-dimensional GBM tissue culture models to be compatible with TTFields application and recently published the feasibility of such an approach (Nickl, et al., 2022, doi: 10.3390/cancers14215177). Here, we applied one of those models, i.e. tumor-organoids cultured as microtumors on murine organotypic hippocampal slice cultures (OHSCs), to additional brain tumor entities, namely a sample of an anaplastic ependymoma (AE) patient and an oligodendroglioma patient. Organoids were generated from fresh intra-operatively obtained tumor tissue and cultured for 2 weeks. OHSCs were prepared by slicing the brains of mice 5-8 days postpartum to sections with a thickness of 350 µm using a vibratome, and culturing them for 2 weeks as well. Subsequently, organoids were placed onto the OHSCs. The inovitro™ laboratory research system was used for TTFields administration at 200 kHz and 1.5 V/cm for 72 h. Microtumor growth was evaluated on fluorescence images. Viable organoids formed from the GBM, AE and oligodendroglioma sample and grew to microtumors when placed onto OHSCs. Application of TTFields at 200 kHz led to a significant decrease of microtumor size of the GBM and AE (both p<0.0001), but not the oligodendroglioma sample. This proof-of-principle investigation proved that the application of patient-derived organoids cultured on OHSCs is feasible to investigate the effects of TTFields on different kinds of brain tumors. To our knowledge, this is the first evaluation of TTFields efficacy on patient derived AE and oligodendroglioma tissue cultures. While TTFields at 200 kHz led to a decrease in the microtumor size of the AE sample, the non-responsiveness of the oligodendroglioma sample may be due to different inter-patient sensitivity to TTFields or a suboptimal TTFields frequency.
Citation Format: Vera Nickl, Ellina Schulz, Ellaine Salvador, Laureen Trautmann, Leopold Diener, Almuth F. Kessler, Camelia M. Monoranu, Ralf-Ingo Ernestus, Mario Löhr, Carsten Hagemann. Evaluation of tumor treating fields (TTFields) effects at 200 kHz on a glioblastoma, an anaplastic ependymoma and an oligodendroglioma sample in a patient-derived ex vivo organoid model. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4573.
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Affiliation(s)
- Vera Nickl
- 1University Hospital Wuerzburg, Wuerzburg, Germany
| | | | | | | | | | | | | | | | - Mario Löhr
- 1University Hospital Wuerzburg, Wuerzburg, Germany
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6
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Nickl V, Schulz E, Salvador E, Trautmann L, Diener L, Kessler AF, Monoranu CM, Dehghani F, Ernestus RI, Löhr M, Hagemann C. Glioblastoma-Derived Three-Dimensional Ex Vivo Models to Evaluate Effects and Efficacy of Tumor Treating Fields (TTFields). Cancers (Basel) 2022; 14:5177. [PMID: 36358594 PMCID: PMC9658171 DOI: 10.3390/cancers14215177] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 10/02/2023] Open
Abstract
Glioblastoma (GBM) displays a wide range of inter- and intra-tumoral heterogeneity contributing to therapeutic resistance and relapse. Although Tumor Treating Fields (TTFields) are effective for the treatment of GBM, there is a lack of ex vivo models to evaluate effects on patients' tumor biology or to screen patients for treatment efficacy. Thus, we adapted patient-derived three-dimensional tissue culture models to be compatible with TTFields application to tissue culture. Patient-derived primary cells (PDPC) were seeded onto murine organotypic hippocampal slice cultures (OHSC), and microtumor development with and without TTFields at 200 kHz was observed. In addition, organoids were generated from acute material cultured on OHSC and treated with TTFields. Lastly, the effect of TTFields on expression of the Ki67 proliferation marker was evaluated on cultured GBM slices. Microtumors exhibited increased sensitivity towards TTFields compared to monolayer cell cultures. TTFields affected tumor growth and viability, as the size of microtumors and the percentage of Ki67-positive cells decreased after treatment. Nevertheless, variability in the extent of the response was preserved between different patient samples. Therefore, these pre-clinical GBM models could provide snapshots of the tumor to simulate patient treatment response and to investigate molecular mechanisms of response and resistance.
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Affiliation(s)
- Vera Nickl
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Ellina Schulz
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Ellaine Salvador
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Laureen Trautmann
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Leopold Diener
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Almuth F. Kessler
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Camelia M. Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany
| | - Faramarz Dehghani
- Department of Anatomy and Cell Biology, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Ralf-Ingo Ernestus
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Mario Löhr
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Carsten Hagemann
- Section Experimental Neurosurgery, Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
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7
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Bockmayr M, Harnisch K, Pohl LC, Schweizer L, Mohme T, Körner M, Alawi M, Suwala AK, Dorostkar MM, Monoranu CM, Hasselblatt M, Wefers AK, Capper D, Hench J, Frank S, Richardson TE, Tran I, Liu E, Snuderl M, Engertsberger L, Benesch M, von Deimling A, Obrecht D, Mynarek M, Rutkowski S, Glatzel M, Neumann JE, Schüller U. Comprehensive profiling of myxopapillary ependymomas identifies a distinct molecular subtype with relapsing disease. Neuro Oncol 2022; 24:1689-1699. [PMID: 35380708 PMCID: PMC9527524 DOI: 10.1093/neuonc/noac088] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 11/13/2022] Open
Abstract
BACKGROUND Myxopapillary ependymoma (MPE) is a heterogeneous disease regarding histopathology and outcome. The underlying molecular biology is poorly understood, and markers that reliably predict the patients' clinical course are unknown. METHODS We assembled a cohort of 185 tumors classified as MPE based on DNA methylation. Methylation patterns, copy number profiles, and MGMT promoter methylation were analyzed for all tumors, 106 tumors were evaluated histomorphologically, and RNA sequencing was performed for 37 cases. Based on methylation profiling, we defined two subtypes MPE-A and MPEB, and explored associations with epidemiological, clinical, pathological, and molecular characteristics of these tumors. RESULTS MPE-A occurred at a median age of 27 years and were enriched with tumors demonstrating papillary morphology and MGMT promoter hypermethylation. Half of these tumors could not be totally resected, and 85% relapsed within 10 years. Copy number alterations were more common in MPE-A. RNA sequencing revealed an enrichment for extracellular matrix and immune system-related signatures in MPE-A. MPE-B occurred at a median age of 45 years and included many tumors with a histological diagnosis of WHO grade II and tanycytic morphology. Patients within this subtype had a significantly better outcome with a relapse rate of 33% in 10 years (p=3.4e-06). CONCLUSIONS We unraveled the morphological and clinical heterogeneity of MPE by identifying two molecularly distinct subtypes. These subtypes significantly differed in progression-free survival and will likely need different protocols for surveillance and treatment.
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Affiliation(s)
- Michael Bockmayr
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany.,Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - Kim Harnisch
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute for Neuropathology, University Hospital of Zurich, Switzerland
| | - Lara C Pohl
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - Leonille Schweizer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Theresa Mohme
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Meik Körner
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - Malik Alawi
- Bioinformatics Core, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Abigail K Suwala
- Department of Neuropathology, Institute of Pathology, University of Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Neurological Surgery, UCSF, San Francisco, CA, USA
| | - Mario M Dorostkar
- Center for Neuropathology, Ludwig-Maximilians-University, Munich, Germany German Center for Neurodegenerative Diseases, Munich, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Martin Hasselblatt
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Annika K Wefers
- Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - David Capper
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jürgen Hench
- Division of Neuropathology, Institute of Medical Genetics and Pathology, University of Basel, Basel, Switzerland
| | - Stephan Frank
- Division of Neuropathology, Institute of Medical Genetics and Pathology, University of Basel, Basel, Switzerland
| | - Timothy E Richardson
- Department of Pathology and Laboratory Medicine, Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, TX, USA
| | - Ivy Tran
- Department of Pathology, NYU Langone Health, New York City, NY, USA
| | - Elisa Liu
- Department of Pathology, NYU Langone Health, New York City, NY, USA
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health, New York City, NY, USA
| | - Lara Engertsberger
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Austria
| | - Martin Benesch
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Austria
| | - Andreas von Deimling
- Department of Neuropathology, Institute of Pathology, University of Heidelberg, Germany
| | - Denise Obrecht
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Mynarek
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Glatzel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia E Neumann
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Molecular Neurobiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrich Schüller
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany.,Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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8
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Suwala AK, Stichel D, Schrimpf D, Kloor M, Wefers AK, Reinhardt A, Maas SLN, Kratz CP, Schweizer L, Hasselblatt M, Snuderl M, Abedalthagafi MSJ, Abdullaev Z, Monoranu CM, Bergmann M, Pekrun A, Freyschlag C, Aronica E, Kramm CM, Hinz F, Sievers P, Korshunov A, Kool M, Pfister SM, Sturm D, Jones DTW, Wick W, Unterberg A, Hartmann C, Dodgshun A, Tabori U, Wesseling P, Sahm F, von Deimling A, Reuss DE. Primary mismatch repair deficient IDH-mutant astrocytoma (PMMRDIA) is a distinct type with a poor prognosis. Acta Neuropathol 2021; 141:85-100. [PMID: 33216206 PMCID: PMC7785563 DOI: 10.1007/s00401-020-02243-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 01/05/2023]
Abstract
Diffuse IDH-mutant astrocytoma mostly occurs in adults and carries a favorable prognosis compared to IDH-wildtype malignant gliomas. Acquired mismatch repair deficiency is known to occur in recurrent IDH-mutant gliomas as resistance mechanism towards alkylating chemotherapy. In this multi-institutional study, we report a novel epigenetic group of 32 IDH-mutant gliomas with proven or suspected hereditary mismatch repair deficiency. None of the tumors exhibited a combined 1p/19q deletion. These primary mismatch repair-deficient IDH-mutant astrocytomas (PMMRDIA) were histologically high-grade and were mainly found in children, adolescents and young adults (median age 14 years). Mismatch repair deficiency syndromes (Lynch or Constitutional Mismatch Repair Deficiency Syndrom (CMMRD)) were clinically diagnosed and/or germline mutations in DNA mismatch repair genes (MLH1, MSH6, MSH2) were found in all cases, except one case with a family and personal history of colon cancer and another case with MSH6-deficiency available only as recurrent tumor. Loss of at least one of the mismatch repair proteins was detected via immunohistochemistry in all, but one case analyzed. Tumors displayed a hypermutant genotype and microsatellite instability was present in more than half of the sequenced cases. Integrated somatic mutational and chromosomal copy number analyses showed frequent inactivation of TP53, RB1 and activation of RTK/PI3K/AKT pathways. In contrast to the majority of IDH-mutant gliomas, more than 60% of the samples in our cohort presented with an unmethylated MGMT promoter. While the rate of immuno-histochemical ATRX loss was reduced, variants of unknown significance were more frequently detected possibly indicating a higher frequency of ATRX inactivation by protein malfunction. Compared to reference cohorts of other IDH-mutant gliomas, primary mismatch repair-deficient IDH-mutant astrocytomas have by far the worst clinical outcome with a median survival of only 15 months irrespective of histological or molecular features. The findings reveal a so far unknown entity of IDH-mutant astrocytoma with high prognostic relevance. Diagnosis can be established by aligning with the characteristic DNA methylation profile, by DNA-sequencing-based proof of mismatch repair deficiency or immunohistochemically demonstrating loss-of-mismatch repair proteins.
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Affiliation(s)
- Abigail K Suwala
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Damian Stichel
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Daniel Schrimpf
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Matthias Kloor
- Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), University Hospital Heidelberg, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Annika K Wefers
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Annekathrin Reinhardt
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Sybren L N Maas
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Christian P Kratz
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Leonille Schweizer
- Department of Neuropathology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Matija Snuderl
- Division of Neuropathology, NYU Langone Health, New York, USA
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, USA
- Division of Molecular Pathology and Diagnostics, NYU Langone Health, New York, USA
| | - Malak Sameer J Abedalthagafi
- Pathology Department, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Zied Abdullaev
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Camelia M Monoranu
- Institute of Pathology, Julius-Maximilians-University, Würzburg, Germany
| | - Markus Bergmann
- Institute of Clinical Neuropathology, Bremen-Mitte Medical Center, Bremen, Germany
| | - Arnulf Pekrun
- Professor Hess Children's Hospital, Klinikum Bremen-Mitte, Bremen, Germany
| | | | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Christof M Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen, Goettingen, Germany
| | - Felix Hinz
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Philipp Sievers
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Andrey Korshunov
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Marcel Kool
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Stefan M Pfister
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dominik Sturm
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- Pediatric Glioma Research Group, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neurooncology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Unterberg
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Hartmann
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Andrew Dodgshun
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
- Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand
| | - Uri Tabori
- The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Canada
- Division of Haematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Pieter Wesseling
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pathology, Amsterdam University Medical Centers/VUmc and Brain Tumor Center Amsterdam, Amsterdam, The Netherlands
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - David E Reuss
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany.
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9
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Nattmann A, Breun M, Monoranu CM, Matthies C, Ernestus RI, Löhr M, Hagemann C. Analysis of ADAM9 regulation and function in vestibular schwannoma primary cells. BMC Res Notes 2020; 13:528. [PMID: 33176868 PMCID: PMC7659081 DOI: 10.1186/s13104-020-05378-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/07/2020] [Accepted: 11/05/2020] [Indexed: 11/16/2022] Open
Abstract
Objective Recently, we described a disintegrin and metalloproteinase 9 (ADAM9) overexpression by Schwann cells of vestibular schwannoma (VS) and suggested that it might be a marker for VS tumor growth and invasiveness. This research note provides additional data utilizing a small cohort of VS primary cultures and tissue samples. We examined whether reconstitution of Merlin expression in VS cells regulates ADAM9 protein expression and performed lentiviral ADAM9 knock down to investigate possible effects on VS cells numbers. Moreover, the co-localization of ADAM9 and Integrins α6 and α2β1, respectively, was examined by immunofluorescence double staining. Results ADAM9 expression was not regulated by Merlin in VS. However, ADAM9 knock down led to 58% reduction in cell numbers in VS primary cell cultures (p < 0.0001). While ADAM9 and Integrin α2β1 were co-localized in only 22% (2 of 9) of VS, ADAM9 and Integrin α6 were co-localized in 91% (10 of 11) of VS. Therefore, we provide first observations on possible regulatory functions of ADAM9 expression in VS.
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Affiliation(s)
- Anja Nattmann
- Department of Neurosurgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Maria Breun
- Department of Neurosurgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, 97080, Würzburg, Germany
| | - Cordula Matthies
- Department of Neurosurgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Ralf-Ingo Ernestus
- Department of Neurosurgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Carsten Hagemann
- Department of Neurosurgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
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10
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Feldheim J, Kessler AF, Schmitt D, Salvador E, Monoranu CM, Feldheim JJ, Ernestus RI, Löhr M, Hagemann C. Ribosomal Protein S27/Metallopanstimulin-1 (RPS27) in Glioma-A New Disease Biomarker? Cancers (Basel) 2020; 12:cancers12051085. [PMID: 32349320 PMCID: PMC7281545 DOI: 10.3390/cancers12051085] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 04/13/2020] [Revised: 04/23/2020] [Accepted: 04/25/2020] [Indexed: 12/20/2022] Open
Abstract
Despite its significant overexpression in several malignant neoplasms, the expression of RPS27 in the central nervous system (CNS) is widely unknown. We identified the cell types expressing RPS27 in the CNS under normal and disease conditions. We acquired specimens of healthy brain (NB), adult pilocytic astrocytoma (PA) World Health Organization (WHO) grade I, anaplastic PA WHO grade III, gliomas WHO grade II/III with or without isocitrate dehydrogenase (IDH) mutation, and glioblastoma multiforme (GBM). RPS27 protein expression was examined by immunohistochemistry and double-fluorescence staining and its mRNA expression quantified by RT-PCR. Patients’ clinical and tumor characteristics were collected retrospectively. RPS27 protein was specifically expressed in tumor cells and neurons, but not in healthy astrocytes. In tumor tissue, most macrophages were positive, while this was rarely the case in inflamed tissue. Compared to NB, RPS27 mRNA was in mean 6.2- and 8.8-fold enhanced in gliomas WHO grade II/III with (p < 0.01) and without IDH mutation (p = 0.01), respectively. GBM displayed a 4.6-fold increased mean expression (p = 0.02). Although RPS27 expression levels did not affect the patients’ survival, their association with tumor cells and tumor-associated macrophages provides a rationale for a future investigation of a potential function during gliomagenesis and tumor immune response.
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Affiliation(s)
- Jonas Feldheim
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
| | - Almuth F. Kessler
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
| | - Dominik Schmitt
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
| | - Ellaine Salvador
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
| | - Camelia M. Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany;
| | - Julia J. Feldheim
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
| | - Ralf-Ingo Ernestus
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
| | - Mario Löhr
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
| | - Carsten Hagemann
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (D.S.); (E.S.); (J.J.F.); (R.-I.E.); (M.L.)
- Correspondence: ; Tel.: +49-931-201-24644
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11
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Bell L, Lenhart A, Rosenwald A, Monoranu CM, Berberich-Siebelt F. Lymphoid Aggregates in the CNS of Progressive Multiple Sclerosis Patients Lack Regulatory T Cells. Front Immunol 2020; 10:3090. [PMID: 32010141 PMCID: PMC6974514 DOI: 10.3389/fimmu.2019.03090] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 08/21/2019] [Accepted: 12/17/2019] [Indexed: 12/27/2022] Open
Abstract
In gray matter pathology of multiple sclerosis, neurodegeneration associates with a high degree of meningeal inflammatory activity. Importantly, ectopic lymphoid follicles (eLFs) were identified at the inflamed meninges of patients with progressive multiple sclerosis. Besides T lymphocytes, they comprise B cells and might elicit germinal center (GC)-like reactions. GC reactions are controlled by FOXP3+ T-follicular regulatory cells (TFR), but it is unknown if they participate in autoantibody production in eLFs. Receiving human post-mortem material, gathered from autopsies of progressive multiple sclerosis patients, indeed, distinct inflammatory infiltrates enriched with B cells could be detected in perivascular areas and deep sulci. CD35+ cells, parafollicular CD138+ plasma cells, and abundant expression of the homing receptor for GCs, CXCR5, on lymphocytes defined some of them as eLFs. However, they resembled GCs only in varying extent, as T cells did not express PD-1, only few cells were positive for the key transcriptional regulator BCL-6 and ongoing proliferation, whereas a substantial number of T cells expressed high NFATc1 like GC-follicular T cells. Then again, predominant cytoplasmic NFATc1 and an enrichment with CD3+CD27+ memory and CD4+CD69+ tissue-resident cells implied a chronic state, very much in line with PD-1 and BCL-6 downregulation. Intriguingly, FOXP3+ cells were almost absent in the whole brain sections and CD3+FOXP3+ TFRs were never found in the lymphoid aggregates. This also points to less controlled humoral immune responses in those lymphoid aggregates possibly enabling the occurrence of CNS-specific autoantibodies in multiple sclerosis patients.
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Affiliation(s)
- Luisa Bell
- Institute of Pathology, Julius-Maximilian University of Wuerzburg, Wuerzburg, Germany
| | - Alexander Lenhart
- Institute of Pathology, Julius-Maximilian University of Wuerzburg, Wuerzburg, Germany
| | - Andreas Rosenwald
- Institute of Pathology, Julius-Maximilian University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Cancer Center Mainfranken, Julius-Maximilian University of Wuerzburg, Wuerzburg, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, Julius-Maximilian University of Wuerzburg, Wuerzburg, Germany
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12
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Breun M, Schwerdtfeger A, Martellotta DD, Kessler AF, Monoranu CM, Matthies C, Löhr M, Hagemann C. ADAM9: A novel player in vestibular schwannoma pathogenesis. Oncol Lett 2020; 19:1856-1864. [PMID: 32194680 PMCID: PMC7039135 DOI: 10.3892/ol.2020.11299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/27/2019] [Accepted: 10/02/2019] [Indexed: 01/02/2023] Open
Abstract
A disintegrin and metalloproteinase 9 (ADAM9) is a member of the transmembrane ADAM family. It is expressed in different types of solid cancer and promotes tumor invasiveness. To the best of our knowledge, the present study was the first to examine ADAM9 expression in vestibular schwannomas (VS) from patients with and without neurofibromatosis type 2 (NF2) and to associate the data with clinical parameters of the patients. The aim of the present study was to evaluate if ADAM9 could be used as prognostic marker or therapeutic target. ADAM9 mRNA and protein levels were measured in VS samples (n=60). A total of 30 of them were from patients with neurofibromatosis. Healthy peripheral nerves from autopsies (n=10) served as controls. ADAM9 mRNA levels were measured by PCR, and protein levels were determined by immunohistochemistry (IHC) and western blotting (WB). The Hannover Classification was used to categorize tumor extension and hearing loss. ADAM9 mRNA levels were 8.8-fold higher in VS compared with in controls. The levels were 5.6-fold higher in patients with NF2 and 12-fold higher in patients with sporadic VS. WB revealed two mature isoforms of the protein, and according to IHC ADAM9 was mainly expressed by S100-positive Schwann cells. There was a strong correlation between ADAM9 mRNA expression and the level of functional impairment (r~1, p=0.01). Particularly, the secreted isoform of ADAM9 was expressed in patients with higher hearing impairment. ADAM9 mRNA was overexpressed in the tumor samples relative to healthy vestibular nerves, and there was an association between higher ADAM9 expression levels and greater hearing impairment. Therefore, ADAM9 may be a prognostic marker for VS, and ADAM9 inhibition might have the potential as a systemic approach for the treatment of VS.
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Affiliation(s)
- Maria Breun
- Department of Neurosurgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | | | | | - Almuth F Kessler
- Department of Neurosurgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, D-97080 Würzburg, Germany
| | - Cordula Matthies
- Department of Neurosurgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Carsten Hagemann
- Department of Neurosurgery, University Hospital Würzburg, D-97080 Würzburg, Germany
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13
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Devraj G, Guérit S, Seele J, Spitzer D, Macas J, Khel MI, Heidemann R, Braczynski AK, Ballhorn W, Günther S, Ogunshola OO, Mittelbronn M, Ködel U, Monoranu CM, Plate KH, Hammerschmidt S, Nau R, Devraj K, Kempf VAJ. HIF-1α is involved in blood-brain barrier dysfunction and paracellular migration of bacteria in pneumococcal meningitis. Acta Neuropathol 2020; 140:183-208. [PMID: 32529267 PMCID: PMC7360668 DOI: 10.1007/s00401-020-02174-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
Bacterial meningitis is a deadly disease most commonly caused by Streptococcus pneumoniae, leading to severe neurological sequelae including cerebral edema, seizures, stroke, and mortality when untreated. Meningitis is initiated by the transfer of S. pneumoniae from blood to the brain across the blood-cerebrospinal fluid barrier or the blood-brain barrier (BBB). The underlying mechanisms are still poorly understood. Current treatment strategies include adjuvant dexamethasone for inflammation and cerebral edema, followed by antibiotics. The success of dexamethasone is however inconclusive, necessitating new therapies for controlling edema, the primary reason for neurological complications. Since we have previously shown a general activation of hypoxia inducible factor (HIF-1α) in bacterial infections, we hypothesized that HIF-1α, via induction of vascular endothelial growth factor (VEGF) is involved in transmigration of pathogens across the BBB. In human, murine meningitis brain samples, HIF-1α activation was observed by immunohistochemistry. S. pneumoniae infection in brain endothelial cells (EC) resulted in in vitro upregulation of HIF-1α/VEGF (Western blotting/qRT-PCR) associated with increased paracellular permeability (fluorometry, impedance measurements). This was supported by bacterial localization at cell-cell junctions in vitro and in vivo in brain ECs from mouse and humans (confocal, super-resolution, electron microscopy, live-cell imaging). Hematogenously infected mice showed increased permeability, S. pneumoniae deposition in the brain, along with upregulation of genes in the HIF-1α/VEGF pathway (RNA sequencing of brain microvessels). Inhibition of HIF-1α with echinomycin, siRNA in bEnd5 cells or using primary brain ECs from HIF-1α knock-out mice revealed reduced endothelial permeability and transmigration of S. pneumoniae. Therapeutic rescue using the HIF-1α inhibitor echinomycin resulted in increased survival and improvement of BBB function in S. pneumoniae-infected mice. We thus demonstrate paracellular migration of bacteria across BBB and a critical role for HIF-1α/VEGF therein and hence propose targeting this pathway to prevent BBB dysfunction and ensuing brain damage in infections.
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Affiliation(s)
- Gayatri Devraj
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
| | - Sylvaine Guérit
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Jana Seele
- Institute of Neuropathology, University Medical Center, Göttingen, Germany ,Department of Geriatrics, Evangelisches Krankenhaus, Göttingen-Weende, Germany
| | - Daniel Spitzer
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Jadranka Macas
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Maryam I. Khel
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany
| | - Roxana Heidemann
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Anne K. Braczynski
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Department of Neurology, Technische Hochschule University Hospital, Aachen, Germany
| | - Wibke Ballhorn
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
| | - Stefan Günther
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | | | - Michel Mittelbronn
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg ,Laboratoire National de Santé (LNS), Dudelange, Luxembourg ,Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg, Luxembourg ,NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
| | - Uwe Ködel
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany
| | - Camelia M. Monoranu
- Department of Neuropathology, Institute of Pathology, Julius Maximilians University, Würzburg, Germany
| | - Karl H. Plate
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany ,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Roland Nau
- Institute of Neuropathology, University Medical Center, Göttingen, Germany
| | - Kavi Devraj
- Edinger Institute/Neurological Institute, Goethe University, Frankfurt am Main, Germany. .,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany.
| | - Volkhard A. J. Kempf
- Institute for Medical Microbiology and Infection Control, Goethe University, Frankfurt am Main, Germany
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14
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Feldheim J, Kessler AF, Monoranu CM, Ernestus RI, Löhr M, Hagemann C. Changes of O 6-Methylguanine DNA Methyltransferase (MGMT) Promoter Methylation in Glioblastoma Relapse-A Meta-Analysis Type Literature Review. Cancers (Basel) 2019; 11:cancers11121837. [PMID: 31766430 PMCID: PMC6966671 DOI: 10.3390/cancers11121837] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/11/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023] Open
Abstract
Methylation of the O6-methylguanine DNA methyltransferase (MGMT) promoter has emerged as strong prognostic factor in the therapy of glioblastoma multiforme. It is associated with an improved response to chemotherapy with temozolomide and longer overall survival. MGMT promoter methylation has implications for the clinical course of patients. In recent years, there have been observations of patients changing their MGMT promoter methylation from primary tumor to relapse. Still, data on this topic are scarce. Studies often consist of only few patients and provide rather contrasting results, making it hard to draw a clear conclusion on clinical implications. Here, we summarize the previous publications on this topic, add new cases of changing MGMT status in relapse and finally combine all reports of more than ten patients in a statistical analysis based on the Wilson score interval. MGMT promoter methylation changes are seen in 115 of 476 analyzed patients (24%; CI: 0.21–0.28). We discuss potential reasons like technical issues, intratumoral heterogeneity and selective pressure of therapy. The clinical implications are still ambiguous and do not yet support a change in clinical practice. However, retesting MGMT methylation might be useful for future treatment decisions and we encourage clinical studies to address this topic.
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Affiliation(s)
- Jonas Feldheim
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (R.-I.E.); (M.L.)
| | - Almuth F. Kessler
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (R.-I.E.); (M.L.)
| | - Camelia M. Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany;
| | - Ralf-Ingo Ernestus
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (R.-I.E.); (M.L.)
| | - Mario Löhr
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (R.-I.E.); (M.L.)
| | - Carsten Hagemann
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany; (J.F.); (A.F.K.); (R.-I.E.); (M.L.)
- Correspondence: ; Tel.: +49-931-20124644
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15
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Weigand I, Knobloch L, Flitsch J, Saeger W, Monoranu CM, Höfner K, Herterich S, Rotermund R, Ronchi CL, Buchfelder M, Glatzel M, Hagel C, Fassnacht M, Deutschbein T, Sbiera S. Impact of USP8 Gene Mutations on Protein Deregulation in Cushing Disease. J Clin Endocrinol Metab 2019; 104:2535-2546. [PMID: 30844069 DOI: 10.1210/jc.2018-02564] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/01/2019] [Indexed: 02/01/2023]
Abstract
CONTEXT Cushing disease (CD) is a rare disorder with severe sequels and incompletely understood pathogenesis. The underlying corticotroph adenomas harbor frequently somatic mutations in the ubiquitin-specific peptidase 8 (USP8) gene. These mutations render USP8 hyperactive and prevent client proteins from degradation. OBJECTIVE To investigate the impact of USP8 mutations on proteins deregulated in CD. DESIGN One hundred eight pituitary adenomas (75 corticotroph [58 USP8 wild type (WT) and 17 USP8 mutated], 14 somatotroph, and 19 nonfunctioning) were investigated by immunohistochemistry. All evaluated proteins [USP8, arginine vasopressin receptor 1b and 2, corticotropin-releasing hormone receptor, cAMP response element-binding protein (CREB), p27/kip1, cyclin E, heat shock protein 90 (HSP90), orphan nuclear receptor 4, epidermal growth factor receptor, histone deacetylase 2, glucocorticoid receptor, cyclin-dependent kinase 5 and Abelson murine leukemia viral oncogene homolog 1 enzyme substrate 1] were known to be deregulated in CD. Furthermore, AtT20 cells were transfected with USP8 to investigate the expression of possible downstream proteins by immunoblot. RESULTS Whereas most of the investigated proteins were not differentially expressed, the cell-cycle inhibitor p27 was significantly reduced in USP8 mutated corticotroph adenoma (H-score 2.0 ± 1.0 vs 1.1 ± 1.1 in WT adenomas; P = 0.004). In contrast, the chaperone HSP90 was expressed higher (0.5 ± 0.4 vs 0.2 ± 0.4; P = 0.29), and the phosphorylation of the transcription factor CREB was increased in USP8 mutated adenomas (1.30.5 ± 0.40.9 vs 0.70.5 ± 0.40.7; P = 0.014). Accordingly, AtT20 cells transfected with the USP8 P720R mutant had higher phosphorylated CREB (pCREB) levels than WT transfected cells (1.3 ± 0.14 vs 1 ± 0.23; P = 0.13). CONCLUSIONS We could demonstrate that USP8 mutations are associated with deregulation of p27/kip1, HSP90, and pCREB. These findings suggest that these proteins are direct or indirect clients of USP8 and could therefore be potential targets for therapeutic approaches in patients with CD.
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Affiliation(s)
- Isabel Weigand
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Lisanne Knobloch
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Jörg Flitsch
- Department of Neurosurgery, University Hospital of Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Saeger
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Wuerzburg, Wuerzburg, Germany
| | - Kerstin Höfner
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Sabine Herterich
- Central Laboratory, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Roman Rotermund
- Department of Neurosurgery, University Hospital of Hamburg-Eppendorf, Hamburg, Germany
| | - Cristina L Ronchi
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
- Institute of Metabolism and System Research, University of Birmingham, Birmingham, United Kingdom
| | - Michael Buchfelder
- Department of Neurosurgery, University of Erlangen-Nuernberg, Erlangen, Germany
| | - Markus Glatzel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Hagel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Fassnacht
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
- Central Laboratory, University Hospital Wuerzburg, Wuerzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
| | - Timo Deutschbein
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Silviu Sbiera
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
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16
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Hagemann C, Neuhaus N, Dahlmann M, Kessler AF, Kobelt D, Herrmann P, Eyrich M, Freitag B, Linsenmann T, Monoranu CM, Ernestus RI, Löhr M, Stein U. Circulating MACC1 Transcripts in Glioblastoma Patients Predict Prognosis and Treatment Response. Cancers (Basel) 2019; 11:cancers11060825. [PMID: 31200581 PMCID: PMC6627447 DOI: 10.3390/cancers11060825] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 02/06/2023] Open
Abstract
Glioblastoma multiforme is the most aggressive primary brain tumor of adults, but lacks reliable and liquid biomarkers. We evaluated circulating plasma transcripts of metastasis-associated in colon cancer-1 (MACC1), a prognostic biomarker for solid cancer entities, for prediction of clinical outcome and therapy response in glioblastomas. MACC1 transcripts were significantly higher in patients compared to controls. Low MACC1 levels clustered together with other prognostically favorable markers. It was associated with patients’ prognosis in conjunction with the isocitrate dehydrogenase (IDH) mutation status: IDH1 R132H mutation and low MACC1 was most favorable (median overall survival (OS) not yet reached), IDH1 wildtype and high MACC1 was worst (median OS 8.1 months), while IDH1 wildtype and low MACC1 was intermediate (median OS 9.1 months). No patients displayed IDH1 R132H mutation and high MACC1. Patients with low MACC1 levels receiving standard therapy survived longer (median OS 22.6 months) than patients with high MACC1 levels (median OS 8.1 months). Patients not receiving the standard regimen showed the worst prognosis, independent of MACC1 levels (low: 6.8 months, high: 4.4 months). Addition of circulating MACC1 transcript levels to the existing prognostic workup may improve the accuracy of outcome prediction and help define more precise risk categories of glioblastoma patients.
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Affiliation(s)
- Carsten Hagemann
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany.
| | - Nikolas Neuhaus
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany.
| | - Mathias Dahlmann
- Experimental and Clinical Research Center, Charité Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Robert-Rössle-Straße 10, D-13125 Berlin, Germany.
- German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany.
| | - Almuth F Kessler
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany.
| | - Dennis Kobelt
- Experimental and Clinical Research Center, Charité Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Robert-Rössle-Straße 10, D-13125 Berlin, Germany.
- German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany.
| | - Pia Herrmann
- Experimental and Clinical Research Center, Charité Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Robert-Rössle-Straße 10, D-13125 Berlin, Germany.
| | - Matthias Eyrich
- Department of Pediatric Hematology/Oncology, University Children's Hospital, University of Würzburg, D-97080 Würzburg, Germany.
| | - Benjamin Freitag
- Department of Pediatric Hematology/Oncology, University Children's Hospital, University of Würzburg, D-97080 Würzburg, Germany.
| | - Thomas Linsenmann
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany.
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany.
| | - Ralf-Ingo Ernestus
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany.
| | - Mario Löhr
- Tumorbiology Laboratory, Department of Neurosurgery, University of Würzburg, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany.
| | - Ulrike Stein
- Experimental and Clinical Research Center, Charité Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Robert-Rössle-Straße 10, D-13125 Berlin, Germany.
- German Cancer Consortium (DKTK), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany.
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17
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Breun M, Monoranu CM, Kessler AF, Matthies C, Löhr M, Hagemann C, Schirbel A, Rowe SP, Pomper MG, Buck AK, Wester HJ, Ernestus RI, Lapa C. [ 68Ga]-Pentixafor PET/CT for CXCR4-Mediated Imaging of Vestibular Schwannomas. Front Oncol 2019; 9:503. [PMID: 31245296 PMCID: PMC6581743 DOI: 10.3389/fonc.2019.00503] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/28/2019] [Indexed: 12/25/2022] Open
Abstract
We have recently demonstrated CXCR4 overexpression in vestibular schwannomas (VS). This study investigated the feasibility of CXCR4-directed positron emission tomography/computed tomography (PET/CT) imaging of VS using the radiolabeled chemokine ligand [68Ga]Pentixafor. Methods: 4 patients with 6 primarily diagnosed or pre-treated/observed VS were enrolled. All subjects underwent [68Ga]Pentixafor PET/CT prior to surgical resection. Images were analyzed visually and semi-quantitatively for CXCR4 expression including calculation of tumor-to-background ratios (TBR). Immunohistochemistry served as standard of reference in three patients. Results: [68Ga]Pentixafor PET/CT was visually positive in all cases. SUVmean and SUVmax were 3.0 ± 0.3 and 3.8 ± 0.4 and TBRmean and TBRmax were 4.0 ± 1.4 and 5.0 ± 1.7, respectively. Histological analysis confirmed CXCR4 expression in tumors. Conclusion: Non-invasive imaging of CXCR4 expression using [68Ga]Pentixafor PET/CT of VS is feasible and could prove useful for in vivo assessment of CXCR4 expression.
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Affiliation(s)
- Maria Breun
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, University of Würzburg, Institute of Pathology, Würzburg, Germany.,Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany
| | - Almuth F Kessler
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Cordula Matthies
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Carsten Hagemann
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Schirbel
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Steven P Rowe
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Martin G Pomper
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Andreas K Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Hans-Jürgen Wester
- Pharmaceutical Radiochemistry, Technische Universität München, Munich, Germany
| | - Ralf-Ingo Ernestus
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Constantin Lapa
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
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18
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Linsenmann T, Monoranu CM, Alkonyi B, Westermaier T, Hagemann C, Kessler AF, Ernestus RI, Löhr M. Cerebellar liponeurocytoma - molecular signature of a rare entity and the importance of an accurate diagnosis. Interdisciplinary Neurosurgery 2019. [DOI: 10.1016/j.inat.2018.10.017] [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: 11/16/2022] Open
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19
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Feldheim J, Kessler AF, Schmitt D, Wilczek L, Linsenmann T, Dahlmann M, Monoranu CM, Ernestus RI, Hagemann C, Löhr M. Expression of activating transcription factor 5 (ATF5) is increased in astrocytomas of different WHO grades and correlates with survival of glioblastoma patients. Onco Targets Ther 2018; 11:8673-8684. [PMID: 30584325 PMCID: PMC6287669 DOI: 10.2147/ott.s176549] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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] [Indexed: 01/04/2023] Open
Abstract
Background ATF5 suppresses differentiation of neuroprogenitor cells and is overexpressed in glioblastoma (GBM). A reduction of its expression leads to apoptotic GBM cell death. Data on ATF5 expression in astrocytoma WHO grade II (low-grade astrocytoma [LGA]) are scarce and lacking on recurrent GBM. Patients and methods ATF5 mRNA was extracted from frozen samples of patients’ GBM (n=79), LGA (n=40), and normal brain (NB, n=10), quantified by duplex qPCR and correlated with retrospectively collected clinical data. ATF5 protein expression was evaluated by measuring staining intensity on immunohistochemistry. Results ATF5 mRNA was overexpressed in LGA (sevenfold, P<0.001) and GBM (tenfold, P<0.001) compared to NB, which was confirmed on protein level. Although ATF5 mRNA expression in GBM showed a considerable fluctuation range, groups of varying biological behavior, that is, local/multifocal growth or primary tumor/relapse and the tumor localization at diagnosis, were not significantly different. ATF5 mRNA correlated with the patients’ age (r=0.339, P=0.028) and inversely with Ki67-staining (r=−0.421, P=0.007). GBM patients were allocated to a low and a high ATF5 expression group by the median ATF5 overexpression compared to NB. Kaplan–Meier analysis and Cox regression indicated that ATF5 mRNA expression significantly correlated with short-term survival (t,12 months, median survival 18 vs 13 months, P=0.022, HR 2.827) and progression-free survival (PFS) (12 vs 6 months, P=0.024). This advantage vanished after 24 months (P=0.084). Conclusion ATF5 mRNA expression could be identified as an additional, though not independent factor correlating with overall survival and PFS. Since its inhibition might lead to the selective death of glioma cells, it might serve as a potential ubiquitous therapeutic target in astrocytic tumors.
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Affiliation(s)
- Jonas Feldheim
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
| | - Almuth F Kessler
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
| | - Dominik Schmitt
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
| | - Lara Wilczek
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
| | - Thomas Linsenmann
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
| | - Mathias Dahlmann
- Experimental and Clinical Research Center, Charité Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Ralf-Ingo Ernestus
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
| | - Carsten Hagemann
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
| | - Mario Löhr
- Department of Neurosurgery, Tumorbiology Laboratory, University of Würzburg, Würzburg, Germany,
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20
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Hagemann C, Neuhaus N, Dahlmann M, Kessler AF, Kobelt D, Herrmann P, Eyrich M, Freitag B, Freitag B, Linsenmann T, Monoranu CM, Ernestus R, Löhr M, Stein U. P01.050 Circulating MACC1 transcript plasma levels in glioblastoma patients segregate together with prognostic markers and treatment response. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.092] [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)
- C Hagemann
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - N Neuhaus
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - M Dahlmann
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
| | - A F Kessler
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - D Kobelt
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
| | - P Herrmann
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
| | - M Eyrich
- University of Würzburg, Department of Pediatric Hematology/Oncology, Würzburg, Germany
| | - B Freitag
- University of Würzburg, Department of Pediatric Hematology/Oncology, Würzburg, Germany
| | - B Freitag
- University of Würzburg, Department of Pediatric Hematology/Oncology, Würzburg, Germany
| | - T Linsenmann
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - C M Monoranu
- University of Würzburg, Department of Neuropathology, Würzburg, Germany
| | - R Ernestus
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - M Löhr
- University of Würzburg, Department of Neurosurgery, Tumorbiology Laboratory, Würzburg, Germany
| | - U Stein
- Experimental and Clinical Research Center, Charite Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine in the Helmholtz-Association, Berlin, Germany
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21
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Capper D, Engel NW, Stichel D, Lechner M, Glöss S, Schmid S, Kölsche C, Schrimpf D, Niesen J, Wefers AK, Jones DTW, Sill M, Weigert O, Ligon KL, Olar A, Koch A, Forster M, Moran S, Tirado OM, Sáinz-Jaspeado M, Mora J, Esteller M, Alonso J, Del Muro XG, Paulus W, Felsberg J, Reifenberger G, Glatzel M, Frank S, Monoranu CM, Lund VJ, von Deimling A, Pfister S, Buslei R, Ribbat-Idel J, Perner S, Gudziol V, Meinhardt M, Schüller U. Correction to: DNA methylation-based reclassification of olfactory neuroblastoma. Acta Neuropathol 2018; 136:505. [PMID: 30094618 DOI: 10.1007/s00401-018-1887-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the original publication, the second name of the twentieth author was incorrect. It should read as 'Miguel Sáinz-Jaspeado'. The original publication of the article has been updated to reflect the change. This correction was authored by Ulrich Schüller on behalf of all authors of the original publication.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ulrich Schüller
- Center for Neuropathology, Ludwig-Maximilians-University, Munich, Germany.
- Institute of Neuropathology, University Medical Center Hamburg, Hamburg, Germany.
- Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf, Germany.
- Research Institute Children's Cancer Center Hamburg, Hamburg, Germany.
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22
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Waszak SM, Northcott PA, Buchhalter I, Robinson GW, Sutter C, Groebner S, Grund KB, Brugières L, Jones DTW, Pajtler KW, Morrissy AS, Kool M, Sturm D, Chavez L, Ernst A, Brabetz S, Hain M, Zichner T, Segura-Wang M, Weischenfeldt J, Rausch T, Mardin BR, Zhou X, Baciu C, Lawerenz C, Chan JA, Varlet P, Guerrini-Rousseau L, Fults DW, Grajkowska W, Hauser P, Jabado N, Ra YS, Zitterbart K, Shringarpure SS, De La Vega FM, Bustamante CD, Ng HK, Perry A, MacDonald TJ, Hernáiz Driever P, Bendel AE, Bowers DC, McCowage G, Chintagumpala MM, Cohn R, Hassall T, Fleischhack G, Eggen T, Wesenberg F, Feychting M, Lannering B, Schüz J, Johansen C, Andersen TV, Röösli M, Kuehni CE, Grotzer M, Kjaerheim K, Monoranu CM, Archer TC, Duke E, Pomeroy SL, Shelagh R, Frank S, Sumerauer D, Scheurlen W, Ryzhova MV, Milde T, Kratz CP, Samuel D, Zhang J, Solomon DA, Marra M, Eils R, Bartram CR, von Hoff K, Rutkowski S, Ramaswamy V, Gilbertson RJ, Korshunov A, Taylor MD, Lichter P, Malkin D, Gajjar A, Korbel JO, Pfister SM. Spectrum and prevalence of genetic predisposition in medulloblastoma: a retrospective genetic study and prospective validation in a clinical trial cohort. Lancet Oncol 2018; 19:785-798. [PMID: 29753700 PMCID: PMC5984248 DOI: 10.1016/s1470-2045(18)30242-0] [Citation(s) in RCA: 222] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Medulloblastoma is associated with rare hereditary cancer predisposition syndromes; however, consensus medulloblastoma predisposition genes have not been defined and screening guidelines for genetic counselling and testing for paediatric patients are not available. We aimed to assess and define these genes to provide evidence for future screening guidelines. METHODS In this international, multicentre study, we analysed patients with medulloblastoma from retrospective cohorts (International Cancer Genome Consortium [ICGC] PedBrain, Medulloblastoma Advanced Genomics International Consortium [MAGIC], and the CEFALO series) and from prospective cohorts from four clinical studies (SJMB03, SJMB12, SJYC07, and I-HIT-MED). Whole-genome sequences and exome sequences from blood and tumour samples were analysed for rare damaging germline mutations in cancer predisposition genes. DNA methylation profiling was done to determine consensus molecular subgroups: WNT (MBWNT), SHH (MBSHH), group 3 (MBGroup3), and group 4 (MBGroup4). Medulloblastoma predisposition genes were predicted on the basis of rare variant burden tests against controls without a cancer diagnosis from the Exome Aggregation Consortium (ExAC). Previously defined somatic mutational signatures were used to further classify medulloblastoma genomes into two groups, a clock-like group (signatures 1 and 5) and a homologous recombination repair deficiency-like group (signatures 3 and 8), and chromothripsis was investigated using previously established criteria. Progression-free survival and overall survival were modelled for patients with a genetic predisposition to medulloblastoma. FINDINGS We included a total of 1022 patients with medulloblastoma from the retrospective cohorts (n=673) and the four prospective studies (n=349), from whom blood samples (n=1022) and tumour samples (n=800) were analysed for germline mutations in 110 cancer predisposition genes. In our rare variant burden analysis, we compared these against 53 105 sequenced controls from ExAC and identified APC, BRCA2, PALB2, PTCH1, SUFU, and TP53 as consensus medulloblastoma predisposition genes according to our rare variant burden analysis and estimated that germline mutations accounted for 6% of medulloblastoma diagnoses in the retrospective cohort. The prevalence of genetic predispositions differed between molecular subgroups in the retrospective cohort and was highest for patients in the MBSHH subgroup (20% in the retrospective cohort). These estimates were replicated in the prospective clinical cohort (germline mutations accounted for 5% of medulloblastoma diagnoses, with the highest prevalence [14%] in the MBSHH subgroup). Patients with germline APC mutations developed MBWNT and accounted for most (five [71%] of seven) cases of MBWNT that had no somatic CTNNB1 exon 3 mutations. Patients with germline mutations in SUFU and PTCH1 mostly developed infant MBSHH. Germline TP53 mutations presented only in childhood patients in the MBSHH subgroup and explained more than half (eight [57%] of 14) of all chromothripsis events in this subgroup. Germline mutations in PALB2 and BRCA2 were observed across the MBSHH, MBGroup3, and MBGroup4 molecular subgroups and were associated with mutational signatures typical of homologous recombination repair deficiency. In patients with a genetic predisposition to medulloblastoma, 5-year progression-free survival was 52% (95% CI 40-69) and 5-year overall survival was 65% (95% CI 52-81); these survival estimates differed significantly across patients with germline mutations in different medulloblastoma predisposition genes. INTERPRETATION Genetic counselling and testing should be used as a standard-of-care procedure in patients with MBWNT and MBSHH because these patients have the highest prevalence of damaging germline mutations in known cancer predisposition genes. We propose criteria for routine genetic screening for patients with medulloblastoma based on clinical and molecular tumour characteristics. FUNDING German Cancer Aid; German Federal Ministry of Education and Research; German Childhood Cancer Foundation (Deutsche Kinderkrebsstiftung); European Research Council; National Institutes of Health; Canadian Institutes for Health Research; German Cancer Research Center; St Jude Comprehensive Cancer Center; American Lebanese Syrian Associated Charities; Swiss National Science Foundation; European Molecular Biology Organization; Cancer Research UK; Hertie Foundation; Alexander and Margaret Stewart Trust; V Foundation for Cancer Research; Sontag Foundation; Musicians Against Childhood Cancer; BC Cancer Foundation; Swedish Council for Health, Working Life and Welfare; Swedish Research Council; Swedish Cancer Society; the Swedish Radiation Protection Authority; Danish Strategic Research Council; Swiss Federal Office of Public Health; Swiss Research Foundation on Mobile Communication; Masaryk University; Ministry of Health of the Czech Republic; Research Council of Norway; Genome Canada; Genome BC; Terry Fox Research Institute; Ontario Institute for Cancer Research; Pediatric Oncology Group of Ontario; The Family of Kathleen Lorette and the Clark H Smith Brain Tumour Centre; Montreal Children's Hospital Foundation; The Hospital for Sick Children: Sonia and Arthur Labatt Brain Tumour Research Centre, Chief of Research Fund, Cancer Genetics Program, Garron Family Cancer Centre, MDT's Garron Family Endowment; BC Childhood Cancer Parents Association; Cure Search Foundation; Pediatric Brain Tumor Foundation; Brainchild; and the Government of Ontario.
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Affiliation(s)
- Sebastian M Waszak
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Paul A Northcott
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Ivo Buchhalter
- Division of Theoretical Bioinformatics, German Cancer Research Center, Heidelberg, Germany; Division of Applied Bioinformatics, German Cancer Research Center, Heidelberg, Germany
| | - Giles W Robinson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Christian Sutter
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Susanne Groebner
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kerstin B Grund
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - David T W Jones
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center at the NCT Heidelberg, Heidelberg, Germany
| | - Kristian W Pajtler
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center at the NCT Heidelberg, Heidelberg, Germany
| | - A Sorana Morrissy
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Marcel Kool
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center at the NCT Heidelberg, Heidelberg, Germany
| | - Dominik Sturm
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center at the NCT Heidelberg, Heidelberg, Germany
| | - Lukas Chavez
- Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Aurelie Ernst
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
| | - Sebastian Brabetz
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center at the NCT Heidelberg, Heidelberg, Germany
| | - Michael Hain
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
| | - Thomas Zichner
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Maia Segura-Wang
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Joachim Weischenfeldt
- Biotech Research and Innovation Centre, Copenhagen, Denmark; Finsen Laboratory, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Tobias Rausch
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Balca R Mardin
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Xin Zhou
- Department of Computational Biology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Cristina Baciu
- University Health Network-Toronto General Hospital, Toronto, ON, Canada
| | - Christian Lawerenz
- Data Management Facility, German Cancer Research Center, Heidelberg, Germany
| | - Jennifer A Chan
- Department of Pathology and Laboratory Medicine, Department of Oncology, and Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Pascale Varlet
- Department of Neuropathology, Sainte-Anne Hospital, Paris, France
| | - Lea Guerrini-Rousseau
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Daniel W Fults
- Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Wiesława Grajkowska
- Department of Pathology, Children's Memorial Health Institute, Warsaw, Poland
| | - Peter Hauser
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Nada Jabado
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - Young-Shin Ra
- Department of Neurosurgery, Asan Medical Center, Seoul, South Korea
| | - Karel Zitterbart
- Department of Paediatric Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic; Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Suyash S Shringarpure
- Departments of Genetics and Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Francisco M De La Vega
- Departments of Genetics and Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Carlos D Bustamante
- Departments of Genetics and Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Ho-Keung Ng
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Arie Perry
- Division of Neuropathology, Department of Pathology and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Tobey J MacDonald
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Pablo Hernáiz Driever
- Klinik für Pädiatrie mS Onkologie und Hämatologie, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Anne E Bendel
- Department of Pediatric Hematology and Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Daniel C Bowers
- Division of Pediatric Hematology-Oncology, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Geoffrey McCowage
- Department of Paediatric Oncology, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Murali M Chintagumpala
- Department of Pediatric Hematology and Oncology, Texas Children's Hospital, Houston, TX, USA
| | - Richard Cohn
- Department of Paediatric Oncology, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Timothy Hassall
- Department of Paediatric Oncology, Lady Cilento Children's Hospital, South Brisbane, QLD, Australia
| | - Gudrun Fleischhack
- Pediatric Oncology and Hematology, Pediatrics III, University Hospital of Essen, Essen, Germany
| | | | - Finn Wesenberg
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Cancer Registry of Norway, Oslo, Norway
| | - Maria Feychting
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Lannering
- Department of Pediatrics, University of Gothenburg, The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Christoffer Johansen
- Oncology Clinic, Finsen Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Unit of Survivorship, Copenhagen, Denmark
| | | | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Claudia E Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Michael Grotzer
- Department of Pediatric Oncology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Camelia M Monoranu
- Comprehensive Cancer Center Mainfranken, Würzburg, Germany; Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Tenley C Archer
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth Duke
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Scott L Pomeroy
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Redmond Shelagh
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Stephan Frank
- Institute of Neuropathology, University Hospital Basel, Basel, Switzerland
| | - David Sumerauer
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | | | - Marina V Ryzhova
- Department of Neuropathology, Burdenko Neurosurgical Institute, Moscow, Russia
| | - Till Milde
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Clinical Cooperation Unit Pediatric Oncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center at the NCT Heidelberg, Heidelberg, Germany
| | - Christian P Kratz
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | | | - Jinghui Zhang
- Department of Computational Biology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - David A Solomon
- Division of Neuropathology, Department of Pathology and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Marco Marra
- Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC, Canada
| | - Roland Eils
- Division of Theoretical Bioinformatics, German Cancer Research Center, Heidelberg, Germany
| | - Claus R Bartram
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Katja von Hoff
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Klinik für Pädiatrie mS Onkologie und Hämatologie, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vijay Ramaswamy
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Richard J Gilbertson
- Department of Oncology and Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Andrey Korshunov
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany; Clinical Cooperation Unit Neuropathology, German Cancer Research Center, Heidelberg, Germany
| | - Michael D Taylor
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David Malkin
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Amar Gajjar
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Jan O Korbel
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany
| | - Stefan M Pfister
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Division of Pediatric Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp Children's Cancer Center at the NCT Heidelberg, Heidelberg, Germany.
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23
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Breun M, Schwerdtfeger A, Martellotta DD, Kessler AF, Perez JM, Monoranu CM, Ernestus RI, Matthies C, Löhr M, Hagemann C. CXCR4: A new player in vestibular schwannoma pathogenesis. Oncotarget 2018; 9:9940-9950. [PMID: 29515781 PMCID: PMC5839412 DOI: 10.18632/oncotarget.24119] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 07/12/2017] [Accepted: 12/03/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND CXCR4 is a chemokine receptor that recruits blood stem cells and increases tumor cell growth and invasiveness. We examined CXCR4 expression in vestibular schwannomas (VS) from patients with and without neurofibromatosis type 2 (NF2) and correlated the levels with the patients' clinical characteristics. The aim was to determine whether CXCR4 can be used as a prognostic marker and as a target for systemic therapy. RESULTS Overall, CXCR4 mRNA levels were 4.6-fold higher in VS versus control; the levels were 4.9-fold higher in NF2 patients and 4.2-fold higher in sporadic VS patients. IHC and WB showed heterogeneous protein expression, and CXCR4 was expressed mainly in S100-positive Schwann cells. There was no correlation between the CXCR4 protein levels and tumor extension. However, there was a trend towards correlation between higher expression levels and greater hearing loss. MATERIALS AND METHODS CXCR4 mRNA and protein levels were determined in VS samples (n = 60); of these, 30 samples were from patients with NF2. Healthy nerves from autopsies served as controls. CXCR4 mRNA levels were measured by PCR, and protein levels were measured by immunohistochemistry (IHC) and Western blotting (WB). Tumor extension and hearing loss were categorized according to the Hannover Classification as clinical parameters. CONCLUSIONS CXCR4 mRNA was overexpressed in VS relative to healthy vestibular nerves, and there was a trend towards higher CXCR4 expression levels being correlated with greater functional impairment. Thus, CXCR4 may be a prognostic marker of VS, and CXCR4 inhibition has potential as a systemic approach for the treatment of VS.
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Affiliation(s)
- Maria Breun
- Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany
| | | | | | - Almuth F. Kessler
- Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Jose M. Perez
- Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, University of Würzburg, Institute of Pathology, 97080 Würzburg, Germany
- Comprehensive Cancer Center (CCC), Mainfranken, Würzburg
| | - Ralf-Ingo Ernestus
- Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Cordula Matthies
- Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Carsten Hagemann
- Department of Neurosurgery, University Hospital Würzburg, 97080 Würzburg, Germany
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24
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Heß K, Purrucker J, Hegenbart U, Brokinkel B, Berndt R, Keyvani K, Monoranu CM, Löhr M, Reifenberger G, Munoz-Bendix C, Kalla J, Groß J, Schick U, Kollmer J, Klapper W, Röcken C, Hasselblatt M, Paulus W. Cerebral amyloidoma is characterized by B-cell clonality and a stable clinical course. Brain Pathol 2017; 28:234-239. [PMID: 28160367 DOI: 10.1111/bpa.12493] [Citation(s) in RCA: 14] [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: 08/14/2016] [Accepted: 01/31/2017] [Indexed: 11/29/2022] Open
Abstract
Amyloidomas are rare amyloid-containing lesions, which may also occur in the central nervous system. Etiology, pathogenesis and clinical course are poorly understood. To gain more insight into the biology of cerebral amyloidoma, they aimed to characterize its histopathological, molecular and clinical features in a retrospective series of seven patients. FFPE tissue specimens were examined using immunohistochemistry, chromogenic in situ hybridization (CISH) for light chains kappa and lambda as well as an IgH gene clonality analysis. Follow-up information was gathered by reviewing patient records and imaging results. Median age of the three males and four females was 50 years (range: 35-53 years). All cerebral amyloidomas were located supratentorially and were classified as lambda light chain amyloidosis (AL-λ; n = 6) and kappa light chain amyloidosis (AL-κ; n = 1) on immunohistochemistry and CISH. B-cell clonality was confirmed by IgH gene clonality assay in all cases examined. After a median follow-up of 21 months, all patients were alive and showed stable disease. No progression to systemic disease was observed. In conclusion, their data suggest that cerebral amyloidoma is a local disease characterized by B-cell clonality and associated with a stable clinical course.
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Affiliation(s)
- Katharina Heß
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Jan Purrucker
- Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany.,Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ute Hegenbart
- Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Benjamin Brokinkel
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Rouven Berndt
- Clinic of Cardiovascular Surgery, Vascular Inflammatory Research, Christian-Albrechts University Kiel, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Kathy Keyvani
- Institute of Neuropathology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Camelia M Monoranu
- Department of Neuropathology, Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Guido Reifenberger
- Institute of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Jörg Kalla
- Institute of Pathology, Hospital Schwarzwald-Baar, Villingen-Schwenningen, Germany
| | - Justus Groß
- Clinic of Cardiovascular Surgery, Vascular Inflammatory Research, Christian-Albrechts University Kiel, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Uta Schick
- Department of Neurosurgery, Clemenshospital, Münster, Germany
| | - Jennifer Kollmer
- Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany.,Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section, Christian-Albrechts University Kiel, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Christoph Röcken
- Department of Pathology, Christian-Albrechts University Kiel University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
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25
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Rivera B, Gayden T, Zhang J, Nadaf J, Boshari T, Faury D, Zeinieh M, Blanc R, Burk D, Fahiminiya S, Bareke E, Schueller U, Monoranu CM, Sträter R, Kerl K, Niederstadt T, Kurlemann G, Ellezam B, Michalak Z, Thom M, Lockhart P, Leventer R, Ohm M, McGregor D, Jones D, Karamchandani J, Greenwood C, Berghuis A, Bens S, Siebert R, Zakrzewska M, Liberski P, Zakrzewski K, Sisodiya S, Paulus W, Albrecht S, Hasselblatt M, Jabado N, Foulkes WD, Majewski J. Abstract LB-019: FGFR1 abnormalities in seizure-associated familial and sporadic dysembryoplastic neuroepithelial tumors. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-lb-019] [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
Background: Dysembryoplastic neuroepithelial tumors (DNETs) are benign developmental brain tumors associated with intractable, drug-resistant epilepsy. Distinguishing this entity from other low-grade ganglioneuronal tumors is challenging for neuro-pathologists. We set out to identify the genetic causes of DNETs and to clarify the molecular mechanisms underlying this condition.
Experimental procedures: We collected a family with three individuals with seizures and multinodular DNETs together with 100 sporadic tumors from 96 persons referred to us as DNETs. Whole-exome sequencing was performed on 46 tumours and targeted sequencing for hotspot FGFR1 mutations and BRAFp.V600E was used on the remaining samples. Blind neuropathology review and molecular characterization were performed. FISH, Copy Number Variation assays and Sanger sequencing were used to validate the findings. Supporting evidence for functional defects was obtained by in silico modelling of novel FGFR1p.R661P variant. Functional impact of this and other FGFR1 mutations were assessed using Flow Cytometry and β-galactosidase staining in HEK293 cells.
Results: We identified a novel germline FGFR1 mutation, p.R661P, in a father and his two children with DNETs. Somatic activating FGFR1 mutations (p.N546K or p.K656E) were observed in cis in the tumors with the germline mutation. Pathology review distinguished DNETs (WHO grade I) (45%) from DNET-like tumors (55%). FGFR1 alterations, mainly intragenic tyrosine kinase FGFR1 duplication and multiple mutants in cis, characterized DNETs (25/43;58.1%) whereas FGFR1 mutations (10/53;19%) (p < 0.0001) and hotspot BRAFp.V600E (12/53;22.6%) (p < 0.001) were identified in DNET-like tumors. Phospho-ERK overexpression in FGFR1p.R661P and p.N546K mutant cells support enhanced MAPK/ERK activation in this condition.
Conclusions: This study identifies constitutional and somatic FGFR1 alterations and hotspot BRAFV600E as key events in DNETs and DNET-like tumors respectively. The final common effect of these alterations appears to be a balanced level of signalling that results in benign rather than malignant tumors. The integrated pathology and molecular characterization performed here reveals the key role of the MAP-Kinase pathway in these epileptogenic low-grade glioneuronal tumors, pointing the way towards existing targeted therapies.
Citation Format: Barbara Rivera, Tenzin Gayden, Jian Zhang, Javad Nadaf, Talia Boshari, Damien Faury, Michele Zeinieh, Romeo Blanc, David Burk, Somayyeh Fahiminiya, Eric Bareke, Ulrich Schueller, Camelia M. Monoranu, Ronald Sträter, Kornelius Kerl, Thomas Niederstadt, Gerhard Kurlemann, Benjamin Ellezam, Zuzanna Michalak, Maria Thom, Paul Lockhart, Richard Leventer, Milou Ohm, Duncan McGregor, David Jones, Jason Karamchandani, Celia Greenwood, Albert Berghuis, Susanne Bens, Reiner Siebert, Magdalena Zakrzewska, Pawel Liberski, Krzysztof Zakrzewski, Sanjay Sisodiya, Werner Paulus, Steffen Albrecht, Martin Hasselblatt, Nada Jabado, William D. Foulkes, Jacek Majewski. FGFR1 abnormalities in seizure-associated familial and sporadic dysembryoplastic neuroepithelial tumors. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-019.
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Affiliation(s)
| | | | - Jian Zhang
- 1McGill University, Montreal, Quebec, Canada
| | - Javad Nadaf
- 1McGill University, Montreal, Quebec, Canada
| | | | | | | | - Romeo Blanc
- 1McGill University, Montreal, Quebec, Canada
| | - David Burk
- 1McGill University, Montreal, Quebec, Canada
| | | | - Eric Bareke
- 1McGill University, Montreal, Quebec, Canada
| | | | | | | | - Kornelius Kerl
- 5University Children's Hospital Münster, Münster, Germany
| | | | | | | | | | - Maria Thom
- 8UCL Institute of Neurology, London, United Kingdom
| | | | | | - Milou Ohm
- 10VUMC School of Medical Sciences, Amsterdam, Netherlands
| | | | - David Jones
- 12German Cancer Research Center, Heidelberg, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Nada Jabado
- 1McGill University, Montreal, Quebec, Canada
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Rivera B, Gayden T, Carrot-Zhang J, Nadaf J, Boshari T, Faury D, Zeinieh M, Blanc R, Burk D, Fahiminiya S, Bareke E, Schüller U, Monoranu CM, Sträter R, Kerl K, Niederstadt T, Kurlemann G, Ellezam B, Michalak Z, Thom M, Lockhart P, Leventer R, Ohm M, MacGregor D, Jones D, Karamchandani J, Greenwood CM, Berghuis A, Bens S, Siebert R, Zakrzewska M, Liberski PP, Zakrzewski K, Sisodiya S, Paulus W, Albrecht S, Hasselblatt M, Jabado N, Foulkes WD, Majewski J. LG-26GERMLINE AND SOMATIC FGFR1 ABNORMALITIES IN DYSEMBRYOPLASTIC NEUROEPITHELIAL TUMORS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now075.26] [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: 11/12/2022] Open
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Rivera B, Gayden T, Carrot-Zhang J, Nadaf J, Boshari T, Faury D, Zeinieh M, Blanc R, Burk DL, Fahiminiya S, Bareke E, Schüller U, Monoranu CM, Sträter R, Kerl K, Niederstadt T, Kurlemann G, Ellezam B, Michalak Z, Thom M, Lockhart PJ, Leventer RJ, Ohm M, MacGregor D, Jones D, Karamchandani J, Greenwood CMT, Berghuis AM, Bens S, Siebert R, Zakrzewska M, Liberski PP, Zakrzewski K, Sisodiya SM, Paulus W, Albrecht S, Hasselblatt M, Jabado N, Foulkes WD, Majewski J. Germline and somatic FGFR1 abnormalities in dysembryoplastic neuroepithelial tumors. Acta Neuropathol 2016; 131:847-63. [PMID: 26920151 PMCID: PMC5039033 DOI: 10.1007/s00401-016-1549-x] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 12/12/2022]
Abstract
Dysembryoplastic neuroepithelial tumor (DNET) is a benign brain tumor associated with intractable drug-resistant epilepsy. In order to identify underlying genetic alterations and molecular mechanisms, we examined three family members affected by multinodular DNETs as well as 100 sporadic tumors from 96 patients, which had been referred to us as DNETs. We performed whole-exome sequencing on 46 tumors and targeted sequencing for hotspot FGFR1 mutations and BRAF p.V600E was used on the remaining samples. FISH, copy number variation assays and Sanger sequencing were used to validate the findings. By whole-exome sequencing of the familial cases, we identified a novel germline FGFR1 mutation, p.R661P. Somatic activating FGFR1 mutations (p.N546K or p.K656E) were observed in the tumor samples and further evidence for functional relevance was obtained by in silico modeling. The FGFR1 p.K656E mutation was confirmed to be in cis with the germline p.R661P variant. In 43 sporadic cases, in which the diagnosis of DNET could be confirmed on central blinded neuropathology review, FGFR1 alterations were also frequent and mainly comprised intragenic tyrosine kinase FGFR1 duplication and multiple mutants in cis (25/43; 58.1 %) while BRAF p.V600E alterations were absent (0/43). In contrast, in 53 cases, in which the diagnosis of DNET was not confirmed, FGFR1 alterations were less common (10/53; 19 %; p < 0.0001) and hotspot BRAF p.V600E (12/53; 22.6 %) (p < 0.001) prevailed. We observed overexpression of phospho-ERK in FGFR1 p.R661P and p.N546K mutant expressing HEK293 cells as well as FGFR1 mutated tumor samples, supporting enhanced MAP kinase pathway activation under these conditions. In conclusion, constitutional and somatic FGFR1 alterations and MAP kinase pathway activation are key events in the pathogenesis of DNET. These findings point the way towards existing targeted therapies.
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Dietl S, Schwinn S, Dietl S, Riedel S, Deinlein F, Rutkowski S, von Bueren AO, Krauss J, Schweitzer T, Vince GH, Picard D, Eyrich M, Rosenwald A, Ramaswamy V, Taylor MD, Remke M, Monoranu CM, Beilhack A, Schlegel PG, Wölfl M. MB3W1 is an orthotopic xenograft model for anaplastic medulloblastoma displaying cancer stem cell- and Group 3-properties. BMC Cancer 2016; 16:115. [PMID: 26883117 PMCID: PMC4756501 DOI: 10.1186/s12885-016-2170-z] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 02/14/2016] [Indexed: 11/18/2022] Open
Abstract
Background Medulloblastoma is the most common malignant brain tumor in children and can be divided in different molecular subgroups. Patients whose tumor is classified as a Group 3 tumor have a dismal prognosis. However only very few tumor models are available for this subgroup. Methods We established a robust orthotopic xenograft model with a cell line derived from the malignant pleural effusions of a child suffering from a Group 3 medulloblastoma. Results Besides classical characteristics of this tumor subgroup, the cells display cancer stem cell characteristics including neurosphere formation, multilineage differentiation, CD133/CD15 expression, high ALDH-activity and high tumorigenicity in immunocompromised mice with xenografts exactly recapitulating the original tumor architecture. Conclusions This model using unmanipulated, human medulloblastoma cells will enable translational research, specifically focused on Group 3 medulloblastoma. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2170-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sebastian Dietl
- University Children's Hospital, Pediatric Oncology, Hematology and Stem Cell Transplantation, University of Würzburg, Würzburg, Germany
| | - Stefanie Schwinn
- University Children's Hospital, Pediatric Oncology, Hematology and Stem Cell Transplantation, University of Würzburg, Würzburg, Germany
| | - Susanne Dietl
- Department of Surgery II, University of Würzburg, Würzburg, Germany
| | - Simone Riedel
- Interdisciplinary Center for Clinical Research Laboratory (IZKF Würzburg), Department of Internal Medicine II, University of Würzburg, Würzburg, Germany
| | - Frank Deinlein
- University Children's Hospital, Pediatric Oncology, Hematology and Stem Cell Transplantation, University of Würzburg, Würzburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andre O von Bueren
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University Hospital of Geneva, Geneva, Switzerland
| | - Jürgen Krauss
- Department of Neurosurgery, University of Würzburg, Würzburg, Germany
| | | | - Giles H Vince
- Department of Neurosurgery, University of Würzburg, Würzburg, Germany
| | - Daniel Picard
- Department of Pediatric Oncology, Hematology and Clinical Immunology / Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany
| | - Matthias Eyrich
- University Children's Hospital, Pediatric Oncology, Hematology and Stem Cell Transplantation, University of Würzburg, Würzburg, Germany
| | | | - Vijay Ramaswamy
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, Canada
| | - Michael D Taylor
- Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, Canada
| | - Marc Remke
- Department of Pediatric Oncology, Hematology and Clinical Immunology / Department of Neuropathology, Heinrich Heine University, Düsseldorf, Germany.,Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, Canada
| | | | - Andreas Beilhack
- Interdisciplinary Center for Clinical Research Laboratory (IZKF Würzburg), Department of Internal Medicine II, University of Würzburg, Würzburg, Germany
| | - Paul G Schlegel
- University Children's Hospital, Pediatric Oncology, Hematology and Stem Cell Transplantation, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Matthias Wölfl
- University Children's Hospital, Pediatric Oncology, Hematology and Stem Cell Transplantation, University of Würzburg, Würzburg, Germany.
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Thomas C, Sill M, Ruland V, Witten A, Hartung S, Kordes U, Jeibmann A, Beschorner R, Keyvani K, Bergmann M, Mittelbronn M, Pietsch T, Felsberg J, Monoranu CM, Varlet P, Hauser P, Olar A, Grundy RG, Wolff JE, Korshunov A, Jones DT, Bewerunge-Hudler M, Hovestadt V, von Deimling A, Pfister SM, Paulus W, Capper D, Hasselblatt M. Methylation profiling of choroid plexus tumors reveals 3 clinically distinct subgroups. Neuro Oncol 2016; 18:790-6. [PMID: 26826203 DOI: 10.1093/neuonc/nov322] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 12/15/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Choroid plexus tumors are intraventricular neoplasms derived from the choroid plexus epithelium. A better knowledge of molecular factors involved in choroid plexus tumor biology may aid in identifying patients at risk for recurrence. METHODS Methylation profiles were examined in 29 choroid plexus papillomas (CPPs, WHO grade I), 32 atypical choroid plexus papillomas (aCPPs, WHO grade II), and 31 choroid plexus carcinomas (CPCs, WHO grade III) by Illumina Infinium HumanMethylation450 Bead Chip Array. RESULTS Unsupervised hierarchical clustering identified 3 subgroups: methylation cluster 1 (pediatric CPP and aCPP of mainly supratentorial location), methylation cluster 2 (adult CPP and aCPP of mainly infratentorial location), and methylation cluster 3 (pediatric CPP, aCPP, and CPC of supratentorial location). In methylation cluster 3, progression-free survival (PFS) accounted for a mean of 72 months (CI, 55-89 mo), whereas only 1 of 42 tumors of methylation clusters 1 and 2 progressed (P< .001). On stratification of outcome data according to WHO grade, all CPCs clustered within cluster 3 and were associated with shorter overall survival (mean, 105 mo [CI, 81-128 mo]) and PFS (mean, 55 mo [CI, 36-73 mo]). The aCPP of methylation cluster 3 also progressed frequently (mean, 69 mo [CI, 44-93 mo]), whereas no tumor progression was observed in aCPP of methylation clusters 1 and 2 (P< .05). Only 1 of 29 CPPs recurred. CONCLUSIONS Methylation profiling of choroid plexus tumors reveals 3 distinct subgroups (ie, pediatric low-risk choroid plexus tumors [cluster 1], adult low-risk choroid plexus tumors [cluster 2], and pediatric high-risk choroid plexus tumors [cluster 3]) and may provide useful prognostic information in addition to histopathology.
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Affiliation(s)
- Christian Thomas
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Martin Sill
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Vincent Ruland
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Anika Witten
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Stefan Hartung
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Uwe Kordes
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Astrid Jeibmann
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Rudi Beschorner
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Kathy Keyvani
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Markus Bergmann
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Michel Mittelbronn
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Torsten Pietsch
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Jörg Felsberg
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Camelia M Monoranu
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Pascale Varlet
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Peter Hauser
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Adriana Olar
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Richard G Grundy
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Johannes E Wolff
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Andrey Korshunov
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - David T Jones
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Melanie Bewerunge-Hudler
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Volker Hovestadt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Andreas von Deimling
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Stefan M Pfister
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - David Capper
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany (C.T., V.R., A.J., W.P., M.H.); Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany (M.S.); Core Facility Genomics of the Medical Faculty Münster, Münster, Germany (A.W.); Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (S.H., U.K.); Department of Neuropathology, Institute for Pathology and Neuropathology, University of Tübingen, Tübingen, Germany (R.B.); Faculty of Medicine, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany (K.K.); Department of Neuropathology, Klinikum Bremen-Mitte, Bremen, Germany (M.B.); Institute of Neurology (Edinger Institute), Goethe University, Frankfurt, Germany (M.M.); Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany (T.P.); Department of Neuropathology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (J.F.); Department of Neuropathology, Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken (CCCM), Würzburg, Germany (C.M.M.); Department of Neuropathology, Sainte-Anne Hospital, Paris, France (P.V.); 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary (P.H.); Department of Hematopathology, Molecular Diagnostic Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas (A.O.); Children's Brain Tumour Research Centre, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK (R.G.G.); Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio (J.E.W.); Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany (A.K., A.v.D., D.C.); Clinical Cooperation Unit Neuropathology, German Research Center (DKFZ), Heidelberg, Germany (A.K., A.v.D., D.C.); German Cancer Consortium (DKTK), German Cancer Research Ce
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Linsenmann T, Monoranu CM, Vince GH, Westermaier T, Hagemann C, Kessler AF, Ernestus RI, Löhr M. Long-term tumor control of spinal dissemination of cerebellar glioblastoma multiforme by combined adjuvant bevacizumab antibody therapy: a case report. BMC Res Notes 2014; 7:496. [PMID: 25099491 PMCID: PMC4267424 DOI: 10.1186/1756-0500-7-496] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 07/28/2014] [Indexed: 01/26/2023] Open
Abstract
Background Glioblastoma multiforme located in the posterior fossa is extremely rare with a frequency up to 3.4%. Compared with glioblastoma of the hemispheres the prognosis of infratentorial glioblastoma seems to be slightly better. Absence of brainstem invasion and low expression rates of epidermal growth factor receptor are described as factors for long-time survival due to the higher radiosensitivity of these tumors. Case presentation In this case study, we report a German female patient with an exophytic glioblastoma multiforme arising from the cerebellar tonsil and a secondary spinal manifestation. Furthermore, the tumor showed no O (6)-Methylguanine-DNA methyltransferase promotor-hypermethylation and no isocitrate dehydrogenase 1 mutations. All these signs are accompanied by significantly shorter median overall survival. A long-term tumor control of the spinal metastases was achieved by a combined temozolomide/bevacizumab and irradiation therapy, as part of a standard care administered by the treating physician team. Conclusion To our knowledge this is the first published case of a combined cerebellar exophytic glioblastoma with a subsequent solid spinal manifestation. Furthermore this case demonstrates a benefit undergoing this special adjuvant therapy regime in terms of overall survival. Due to the limited overall prognosis of the disease, spinal manifestations of glioma are rarely clinically relevant. The results of our instructive case, however, with a positive effect on both life quality and survival warrant treating future patients in the frame of a prospective clinical study.
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Affiliation(s)
- Thomas Linsenmann
- Department of Neurosurgery, Julius-Maximilians-University, 97080 Wuerzburg, Germany.
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Gerschütz A, Heinsen H, Grünblatt E, Wagner AK, Bartl J, Meissner C, Fallgatter AJ, Al-Sarraj S, Troakes C, Ferrer I, Arzberger T, Deckert J, Riederer P, Fischer M, Tatschner T, Monoranu CM. Neuron-specific mitochondrial DNA deletion levels in sporadic Alzheimer's disease. Curr Alzheimer Res 2014; 10:1041-6. [PMID: 24156256 DOI: 10.2174/15672050113106660166] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 07/29/2013] [Accepted: 08/01/2013] [Indexed: 11/22/2022]
Abstract
Oxidative stress is implicated in the pathogenesis of neurodegenerative diseases, including sporadic Alzheimer´s disease (AD). Mitochondrial DNA (mtDNA) deletions are markers of oxidative damage and increase with age. To unravel the impact of mtDNA damage on AD development, we analyzed mtDNA deletion levels in diverse neuronal cell types of four brain regions (hippocampal CA1 and CA2 regions, nucleus tractus spinalis nervi trigemini, and the cerebellum) that exhibit differing levels of vulnerability to AD related changes at progressive Braak stages compared with age-matched controls. Neurons from these four brain regions were collected using laser microdissection, and analyzed using quantitative polymerase chain reaction (qPCR). Although, no correlation between mtDNA deletion levels and AD progression were found, the data revealed regional and cell type specific selective vulnerability towards mtDNA deletion levels. In conclusion, unexpected results were obtained as granule cells from the cerebellum and neurons from the nucleus tractus spinalis nervi trigemini of the brain stem displayed significant higher mtDNA deletion levels than pyramidal cells from hippocampal CA1 and CA2 region in age and AD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Camelia M Monoranu
- University of Wuerzburg, Department of Neuropathology, Institute of Pathology, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
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Linsenmann T, Monoranu CM, Kessler AF, Ernestus RI, Westermaier T. Bone chips, fibrin glue, and osteogeneration following lateral suboccipital craniectomy: a case report. BMC Res Notes 2013; 6:523. [PMID: 24321093 PMCID: PMC4029092 DOI: 10.1186/1756-0500-6-523] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/26/2013] [Indexed: 11/29/2022] Open
Abstract
Background Suboccipital craniectomy is a conventional approach for exploring cerebellopontine angle lesions. A variety of techniques have been successfully employed to reconstruct a craniectomy. This is the first report about the histological findings after performing a cranioplasty by using a mixture of autologous bone chips and human allogenic fibrin glue. Case presentation A 53-year-old German woman underwent left lateral suboccipital retrosigmoidal craniectomy for treatment of trigeminal neuralgia in 2008. Cranioplasty was perfomed by using a mixture of autologous bone chips and human allogenic fibrin glue. Due to recurrent neuralgia, a second left lateral suboccipital craniectomy was performed in 2012. The intraoperative findings revealed a complete ossification of the former craniotomy including widely mature trabecular bone tissue in the histological examination. Conclusion A mixture of autologous bone chips and human allogenic fibrin glue seems to provide sufficient bone-regeneration revealed by histological and neuroradiological examinations.
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Affiliation(s)
- Thomas Linsenmann
- Departments of Neurosurgery, University of Würzburg, Josef-Schneider-Str, 11, Würzburg D-97080, Germany.
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Hagemann C, Fuchs S, Monoranu CM, Herrmann P, Smith J, Hohmann T, Grabiec U, Kessler AF, Dehghani F, Löhr M, Ernestus RI, Vince GH, Stein U. Impact of MACC1 on human malignant glioma progression and patients' unfavorable prognosis. Neuro Oncol 2013; 15:1696-709. [PMID: 24220141 DOI: 10.1093/neuonc/not136] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [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: 01/19/2023] Open
Abstract
BACKGROUND Metastasis-associated in colon cancer 1 (MACC1) has been established as an independent prognostic indicator of metastasis formation and metastasis-free survival for patients with colon cancer and other solid tumors. However, no data are available concerning MACC1 expression in human astrocytic tumors. Glioblastoma multiforme (GBM) is the most prevalent primary brain tumor of adulthood, and due to its invasive and rapid growth, patients have unfavorable prognoses. Although these tumors rarely metastasize, their invasive and migratory behavior is similar to those of metastatic cells of tumors of different origin. Thus, we hypothesized that MACC1 may be involved in progression of human gliomas. METHODS We performed real-time measurements of proliferation and migration in MACC1-transfected GBM cell lines (U138, U251) and evaluated tumor formation in organotypic hippocampal slice cultures of mice. Semiquantitative and quantitative real-time reverse transcription PCR analyses were performed for MACC1 and for its transcriptional target c-Met in human astrocytoma of World Health Organization grade II (low-grade astrocytoma) and GBM biopsies. Data were validated by MACC1 immunohistochemistry in independent matched samples of low-grade astrocytoma and GBM. RESULTS MACC1 increases the proliferative, migratory, and tumor-formation abilities of GBM cells. The c-Met inhibitor crizotinib reduced MACC1-induced migration and tumor formation in organotypic hippocampal slice cultures of mice. Analyzing patients' biopsies, MACC1 expression increased concomitantly with increasing World Health Organization grade. Moreover, MACC1 expression levels allowed discrimination of dormant and recurrent low-grade astrocytomas and of primary and secondary GBM. Strong MACC1 expression correlated with reduced patient survival. CONCLUSIONS MACC1 may represent a promising biomarker for prognostication and a new target for treatment of human gliomas.
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Affiliation(s)
- Carsten Hagemann
- Corresponding Author: Ulrike Stein, PhD, Experimental and Clinical Research Center, Charité University Medicine Berlin and the Max-Delbrück-Center for Molecular Medicine, Robert-Rössle-Straße 10, 13125 Berlin, Germany.
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Stein US, Fuchs S, Monoranu CM, Herrmann P, Smith J, Ernestus RI, Vince GH, Hagemann C. Abstract 444: MACC1 as biomarker for progression and prognosis of human malignant glioma. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-444] [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
Metastasis-associated in colon cancer-1 (MACC1) is a prognostic indicator for metastasis formation and metastasis-free survival of colon cancer patients. Patients with low MACC1 expressing primary tumors had a 5-year-survival of 80%, whereas subjects with high MACC1 expressing tumors had a 5-year-survival of only 15%. Correlations of MACC1 expression levels with tumor progression, recurrence and metastasis have meanwhile been reported for e.g. gastric, lung and hepatocellular cancer. However, no data are available concerning MACC1 expression in human astrocytic tumors. Glioblastoma multiforme (GBM) are the most prevalent brain tumors of adults either developing de novo without known precursor-lesion (primary GBM), or progressing from low grade astrocytomas (secondary GBM). Patients suffering from GBM have a very disadvantageous prognosis. Although these tumors rarely metastasize, they are characterized by rapid growth, and their invasive and migratory behavior is similar to those of metastatic cells of tumors with different origin. Therefore we tested our hypothesis on MACC1 involvement in progression of human gliomas. MACC1 mRNA expression increased concomitantly with increasing WHO grading, as demonstrated by semi-quantitative and quantitative RT-PCR of biopsies from human low grade astrocytomas and GBM. MACC1 protein expression allowed discrimination of dormant and recurrent LGA and of primary and secondary GBM, as shown by immunohistochemistry of an independent patients’ cohort. Furthermore, strong MACC1 expression was associated with reduced median patients’ survival. Finally, we performed real-time measurements of migration and proliferation in the MACC1-transfected GBM cell line U138/MACC1 and found promoted proliferation and migration. Therefore, MACC1 may be a new biomarker for progression and for prognosis of human malignant gliomas and might represent a new potential therapeutic target for inhibition of their proliferation and migration.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 444. doi:1538-7445.AM2012-444
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Affiliation(s)
| | | | | | | | - Janice Smith
- 1Max Delbrück Ctr. for Molecular Medicine, Berlin, Germany
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Schwab N, Ulzheimer JC, Fox RJ, Schneider-Hohendorf T, Kieseier BC, Monoranu CM, Staugaitis SM, Welch W, Jilek S, Du Pasquier RA, Brück W, Toyka KV, Ransohoff RM, Wiendl H. Fatal PML associated with efalizumab therapy: insights into integrin αLβ2 in JC virus control. Neurology 2012; 78:458-67; discussion 465. [PMID: 22302546 DOI: 10.1212/wnl.0b013e3182478d4b] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Progressive multifocal leukoencephalopathy (PML) has become much more common with monoclonal antibody treatment for multiple sclerosis and other immune-mediated disorders. METHODS We report 2 patients with severe psoriasis and fatal PML treated for ≥3 years with efalizumab, a neutralizing antibody to αLβ2-leukointegrin (LFA-1). In one patient, we conducted serial studies of peripheral blood and CSF including analyses of leukocyte phenotypes, migration ex vivo, and CDR3 spectratypes with controls coming from HIV-infected patients with PML. Extensive pathologic and histologic analysis was done on autopsy CNS tissue of both patients. RESULTS Both patients developed progressive cognitive and motor deficits, and JC virus was identified in CSF. Despite treatment including plasma exchange (PE) and signs of immune reconstitution, both died of PML 2 and 6 months after disease onset. Neuropathologic examination confirmed PML. Efalizumab treatment was associated with reduced transendothelial migration by peripheral T cells in vitro. As expression levels of LFA-1 on peripheral T cells gradually rose after PE, in vitro migration increased. Peripheral and CSF T-cell spectratyping showed CD8+ T-cell clonal expansion but blunted activation, which was restored after PE. CONCLUSIONS From these data we propose that inhibition of peripheral and intrathecal T-cell activation and suppression of CNS effector-phase migration both characterize efalizumab-associated PML. LFA-1 may be a crucial factor in homeostatic JC virus control.
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Affiliation(s)
- N Schwab
- Department of Neurology–Department of Inflammatory Diseases of the Nervous System and Neurooncology,University of Mu¨nster, Germany
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Monoranu CM, Apfelbacher M, Grünblatt E, Puppe B, Alafuzoff I, Ferrer I, Al-Saraj S, Keyvani K, Schmitt A, Falkai P, Schittenhelm J, Halliday G, Kril J, Harper C, McLean C, Riederer P, Roggendorf W. pH measurement as quality control on human post mortem brain tissue: a study of the BrainNet Europe consortium. Neuropathol Appl Neurobiol 2009; 35:329-337. [PMID: 19473297 DOI: 10.1111/j.1365-2990.2008.01003a.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Most brain diseases are complex entities. Although animal models or cell culture experiments mimic some disease aspects, human post mortem brain tissue remains essential to advance our understanding of brain diseases using biochemical and molecular techniques. Post mortem artefacts must be properly understood, standardized, and either eliminated or factored into such experiments. Here we examine the influence of several premortem and post mortem factors on pH, and discuss the role of pH as a biochemical marker for brain tissue quality. METHODS We assessed brain tissue pH in 339 samples from 116 brains provided by 8 different European and 2 Australian brain bank centres. We correlated brain pH with tissue source, post mortem delay, age, gender, freezing method, storage duration, agonal state and brain ischaemia. RESULTS Our results revealed that only prolonged agonal state and ischaemic brain damage influenced brain tissue pH next to repeated freeze/thaw cycles. CONCLUSIONS pH measurement in brain tissue is a good indicator of premortem events in brain tissue and it signals limitations for post mortem investigations.
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Affiliation(s)
- C M Monoranu
- Department of Neuropathology, Institute of Pathology, Würzburg
| | - M Apfelbacher
- Department of Neuropathology, Institute of Pathology, Würzburg.,Clinical Neurochemistry (National Parkinson Foundation Centre of Excellence Research Laboratory), Clinic and Policlinic for Psychiatry, Psychosomatic and Psychotherapy, University of Würzburg, Würzburg
| | - E Grünblatt
- Clinical Neurochemistry (National Parkinson Foundation Centre of Excellence Research Laboratory), Clinic and Policlinic for Psychiatry, Psychosomatic and Psychotherapy, University of Würzburg, Würzburg
| | - B Puppe
- Department of Neuropathology, Institute of Pathology, Würzburg
| | - I Alafuzoff
- Department of Clinical Medicine, Kuopio University, Kuopio, Finland
| | - I Ferrer
- Institut de Neuropatologia, Universitat de Barcelona, Barcelona, Spain
| | - S Al-Saraj
- Department of Clinical Neuropathology, London Institute of Psychiatry, London, UK
| | - K Keyvani
- Institute of Neuropathology, University Hospital, Münster
| | - A Schmitt
- Clinic of Psychiatry and Psychotherapy, Georg-August-University, Göttingen
| | - P Falkai
- Clinic of Psychiatry and Psychotherapy, Georg-August-University, Göttingen
| | - J Schittenhelm
- Institute of Brain Research Neuropathology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - G Halliday
- Prince of Wales Medical Research Institute and University of New South Wales, Sydney
| | - J Kril
- Department of Pathology, University of Sydney, Syndney
| | - C Harper
- Department of Pathology, University of Sydney, Syndney
| | - C McLean
- Department of Anatomical Pathology, Monash University, The Alfred Hospital, Prahran, Victoria, Australia
| | - P Riederer
- Clinical Neurochemistry (National Parkinson Foundation Centre of Excellence Research Laboratory), Clinic and Policlinic for Psychiatry, Psychosomatic and Psychotherapy, University of Würzburg, Würzburg
| | - W Roggendorf
- Department of Neuropathology, Institute of Pathology, Würzburg
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Mackenzie IRA, Bigio EH, Ince PG, Geser F, Neumann M, Cairns NJ, Kwong LK, Forman MS, Ravits J, Stewart H, Eisen A, McClusky L, Kretzschmar HA, Monoranu CM, Highley JR, Kirby J, Siddique T, Shaw PJ, Lee VMY, Trojanowski JQ. Pathological TDP-43 distinguishes sporadic amyotrophic lateral sclerosis from amyotrophic lateral sclerosis with SOD1 mutations. Ann Neurol 2007; 61:427-34. [PMID: 17469116 DOI: 10.1002/ana.21147] [Citation(s) in RCA: 704] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Amyotrophic lateral sclerosis (ALS) is a common, fatal motor neuron disorder with no effective treatment. Approximately 10% of cases are familial ALS (FALS), and the most common genetic abnormality is superoxide dismutase-1 (SOD1) mutations. Most ALS research in the past decade has focused on the neurotoxicity of mutant SOD1, and this knowledge has directed therapeutic strategies. We recently identified TDP-43 as the major pathological protein in sporadic ALS. In this study, we investigated TDP-43 in a larger series of ALS cases (n = 111), including familial cases with and without SOD1 mutations. METHODS Ubiquitin and TDP-43 immunohistochemistry was performed on postmortem tissue from sporadic ALS (n = 59), ALS with SOD1 mutations (n = 15), SOD-1-negative FALS (n = 11), and ALS with dementia (n = 26). Biochemical analysis was performed on representative cases from each group. RESULTS All cases of sporadic ALS, ALS with dementia, and SOD1-negative FALS had neuronal and glial inclusions that were immunoreactive for both ubiquitin and TDP-43. Cases with SOD1 mutations had ubiquitin-positive neuronal inclusions; however, no cases were immunoreactive for TDP-43. Biochemical analysis of postmortem tissue from sporadic ALS and SOD1-negative FALS demonstrated pathological forms of TDP-43 that were absent in cases with SOD1 mutations. INTERPRETATION These findings implicate pathological TDP-43 in the pathogenesis of sporadic ALS. In contrast, the absence of pathological TDP-43 in cases with SOD1 mutations implies that motor neuron degeneration in these cases may result from a different mechanism, and that cases with SOD1 mutations may not be the familial counterpart of sporadic ALS.
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Affiliation(s)
- Ian R A Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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