The novel ruthenium-gamma-linolenic complex [Ru(2)(aGLA)(4)Cl] inhibits C6 rat glioma cell proliferation and induces changes in mitochondrial membrane potential, increased reactive oxygen species generation and apoptosis in vitro

The present study reports the synthesis of a novel compound with the formula [Ru(2)(aGLA)(4)Cl] according to elemental analyses data, referred to as Ru(2)GLA. The electronic spectra of Ru(2)GLA is typical of a mixed valent diruthenium(II,III) carboxylate. Ru(2)GLA was synthesized with the aim of combining and possibly improving the anti-tumour properties of the two active components ruthenium and gamma-linolenic acid (GLA). The properties of Ru(2)GLA were tested in C6 rat glioma cells by analysing cell number, viability, lipid droplet formation, apoptosis, cell cycle distribution, mitochondrial membrane potential and reactive oxygen species. Ru(2)GLA inhibited cell proliferation in a time and concentration dependent manner. Nile Red staining suggested that Ru(2)GLA enters the cells and ICP-AES elemental analysis found all increase in ruthenium from <0.02 to 425 mg/Kg in treated cells. The sub-G1 apoptotic cell population was increased by Ru(2)GLA (22 +/- 5.2%) when analysed by FACS and this was confirmed by Hoechst staining of nuclei. Mitochondrial membrane potential was decreased in the presence of Ru(2)GLA (44 +/- 2.3%). In contrast, the cells which maintained a high mitochondrial membrane potential had an increase (18 +/- 1.5%) in reactive oxygen species generation. Both decreased mitochondrial membrane potential and increased reactive oxygen species generation may be involved in triggering apoptosis in Ru(2)GLA exposed cells. The EC(50) for Ru(2)GLA decreased with increasing time of exposure from 285 mu M at 24h, 211 mu M at 48 h to 81 mu M at 72 h. In conclusion, Ru(2)GLA is a novel drug with anti proliferative properties in C6 glioma cells and is a potential candidate for novel therapies in gliomas. Copyright (C) 2009 John Wiley & Sons, Ltd.

Gamma-linolenic acid inhibits both tumour cell cycle progression and angiogenesis in the orthotopic C6 glioma model through changes in VEGF, Flt1, ERK1/2, MMP2, cyclin D1, pRb, p53 and p27 protein expression

Background: Gamma-linolenic acid is a known inhibitor of tumour cell proliferation and migration in both in vitro and in vivo conditions. The aim of the present study was to determine the mechanisms by which gamma-linolenic acid (GLA) osmotic pump infusion alters glioma cell proliferation, and whether it affects cell cycle control and angiogenesis in the C6 glioma in vivo. Methods: Established C6 rat gliomas were treated for 14 days with 5 mM GLA in CSF or CSF alone. Tumour size was estimated, microvessel density (MVD) counted and protein and mRNA expression measured by immunohistochemistry, western blotting and RT-PCR. Results: GLA caused a significant decrease in tumour size (75 +/- 8.8%) and reduced MVD by 44 +/- 5.4%. These changes were associated with reduced expression of vascular endothelial growth factor (VEGF) (71 +/- 16%) and the VEGF receptor Flt1 (57 +/- 5.8%) but not Flk1. Expression of ERK1/2 was also reduced by 27 +/- 7.7% and 31 +/- 8.7% respectively. mRNA expression of matrix metalloproteinase-2 (MMP2) was reduced by 35 +/- 6.8% and zymography showed MMP2 proteolytic activity was reduced by 32 +/- 8.5%. GLA altered the expression of several proteins involved in cell cycle control. pRb protein expression was decreased (62 +/- 18%) while E2F1 remained unchanged. Cyclin D1 protein expression was increased by 42 +/- 12% in the presence of GLA. The cyclin dependent kinase inhibitors p21 and p27 responded differently to GLA, p27 expression was increased (27 +/- 7.3%) while p21 remained unchanged. The expression of p53 was increased (44 +/- 16%) by GLA. Finally, the BrdU incorporation studies found a significant inhibition (32 +/- 11%) of BrdU incorporation into the tumour in vivo. Conclusion: Overall the findings reported in the present study lend further support to the potential of GLA as an inhibitor of glioma cell proliferation in vivo and show it has direct effects upon cell cycle control and angiogenesis. These effects involve changes in protein expression of VEGF, Flt1, ERK1, ERK2, MMP2, Cyclin D1, pRb, p53 and p27. Combination therapy using drugs with other, complementary targets and GLA could lead to gains in treatment efficacy in this notoriously difficult to treat tumour.

Ixolaris, a tissue factor inhibitor, blocks primary tumor growth and angiogenesis in a glioblastoma model

Background: The expression levels of the clotting initiator protein Tissue Factor (TF) correlate with vessel density and the histological malignancy grade of glioma patients. Increased procoagulant tonus in high grade tumors (glioblastomas) also indicates a potential role for TF in progression of this disease, and suggests that anticoagulants could be used as adjuvants for its treatment. Objectives: We hypothesized that blocking of TF activity with the tick anticoagulant Ixolaris might interfere with glioblastoma progression. Methods and results: TF was identified in U87-MG cells by flow-cytometric and functional assays (extrinsic tenase). In addition, flow-cytometric analysis demonstrated the exposure of phosphatidylserine in the surface of U87-MG cells, which supported the assembly of intrinsic tenase (FIXa/FVIIIa/FX) and prothrombinase (FVa/FXa/prothrombin) complexes, accounting for the production of FXa and thrombin, respectively. Ixolaris effectively blocked the in vitro TF-dependent procoagulant activity of the U87-MG human glioblastoma cell line and attenuated multimolecular coagulation complexes assembly. Notably, Ixolaris inhibited the in vivo tumorigenic potential of U87-MG cells in nude mice, without observable bleeding. This inhibitory effect of Ixolaris on tumor growth was associated with downregulation of VEGF and reduced tumor vascularization. Conclusion: Our results suggest that Ixolaris might be a promising agent for anti-tumor therapy in humans.

Perspectives for Novel Mixed Diruthenium-Organic Drugs as Metallopharmaceuticals in Cancer Therapy

Ruthenium compounds have been actively studied as metallodrugs for cancer therapy. Representatives of ruthenium-based antitumor drugs are the classes of ruthenium(III)-chlorido-(N-ligand)complexes, including the drugs namely NAMI-A and KP1019 in clinical trials, and ruthenium(II)-arene organometallics, with some compounds currently undergoing advanced preclinical testing. An alternative approach for tumor-inhibiting metallodrugs is the coordination of metal ions to organic pharmaceuticals. The combination of antitumor-active ruthenium ion with biologically-active pro-ligands in single compounds can result in the enhancement of activity, for example through synergistic effects. In the present article, some developments in the ruthenium-based antitumor drugs field are briefly highlighted and recent studies on mixed diruthenium-organic drugs as metallopharmaceuticals in cancer therapy are described. Novel organic pharmaceuticals-containing diruthenium(II, III)complexes have shown promising antitumor activity for C6 rat glioma - a model for glioblastoma multiforme (GBA).

Bevacizumab for the treatment of high-grade glioma

Introduction: Gliomas are highly vascular and rich in vascular endothelial growth factor (VEGF) that promotes angiogenesis. Bevacizumab is a monoclonal antibody against VEGF inhibiting angiogenesis by preventing receptor activation. Phase II clinical trials using bevacizumab in both newly diagnosed and recurrent high-grade glioma (HGG) showed promising results.

Areas covered: This is a review of clinical trials investigating bevacizumab in newly diagnosed and recurrent HGGs with a focus on outcome results. A future perspective about the expected role of bevacizumab is given. Bevacizumab efficacy, safety and tolerability, the combination of radiation and bevacizumab as well as the use of bevacizumab to treat pseudoprogression are discussed. Further criteria of response evaluation needed to be adjusted in the age of anti-angiogenic therapy and this will be discussed.

Expert opinion: Bevacizumab has been shown to be safe and tolerable in HGG. In the recurrent disease setting, bevacizumab alone might be sufficient for a clinical benefit and is currently approved as a single agent for this indication. While clinical trials demonstrate a prolonged progression-free survival in bevacizumab-treated HGG, a benefit on OS has not been demonstrated yet. Bevacizumab has also been introduced into other settings in neuro-oncology including concurrent administration with re-irradiation for recurrent HGG.

Neuro-oncology : late neurocognitive decline after radiotherapy for low-grade glioma

Radiotherapy is administered to most patients with low-grade glioma. A well-designed, retrospective study assessed neurocognitive function in patients who had received radiotherapy for low-grade gliomas versus those who had not. Cognitive function did not differ markedly between groups after 6 years, but by 12 years this feature was worse in the group that received radiotherapy.

Phase II trial of continuous low-dose temozolomide for patients with recurrent malignant glioma

Background In this phase II trial, we investigated the efficacy of a metronomic temozolomide schedule in the treatment of recurrent malignant gliomas (MGs).

Methods Eligible patients received daily temozolomide (50 mg/m2) continuously until progression. The primary endpoint was progression-free survival rate at 6 months in the glioblastoma cohort (N = 37). In an exploratory analysis, 10 additional recurrent grade III MG patients were enrolled. Correlative studies included evaluation of 76 frequent mutations in glioblastoma (iPLEX assay, Sequenom) aiming at establishing the frequency of potentially “drugable” mutations in patients entering recurrent MG clinical trials.

Results Among glioblastoma patients, median age was 56 y; median Karnofsky Performance Score (KPS) was 80; 62% of patients had been treated for ≥2 recurrences, including 49% of patients having failed bevacizumab. Treatment was well tolerated; clinical benefit (complete response + partial response + stable disease) was seen in 10 (36%) patients. Progression-free survival rate at 6 months was 19% and median overall survival was 7 months. Patients with previous bevacizumab exposure survived significantly less than bevacizumab-naive patients (median overall survival: 4.3 mo vs 13 mo; hazard ratio = 3.2; P = .001), but those patients had lower KPS (P = .04) and higher number of recurrences (P < .0001). Mutations were found in 13 of the 38 MGs tested, including mutations of EGFR (N = 10), IDH1 (N = 5), and ERBB2 (N = 1).

Conclusions In spite of a heavily pretreated population, including nearly half of patients having failed bevacizumab, the primary endpoint was met, suggesting that this regimen deserves further investigation. Results in bevacizumab-naive patients seemed particularly favorable, while results in bevacizumab-failing patients highlight the need to develop further treatment strategies for advanced MG.

Bevacizumab for the treatment of high-grade glioma: an update after phase III trials.

Gliomas are highly vascular and rich in VEGF, which promotes angiogenesis. Bevacizumab is a monoclonal antibody against VEGF, inhibiting angiogenesis by preventing receptor activation. Early Phase II clinical trials using bevacizumab in both newly diagnosed and recurrent high-grade gliomas (HGG) showed promising results, but these have not been confirmed in recent Phase III trials. This review is an update including recently reported Phase II and III study results.

Quercetina : efeitos sobre parâmetros proliferativos e sobre a ecto-5'-nucleotidase em linhagem de glioma humano U138MG

Gliomas são os mais comuns e devastadores tumores primários do sistema nervoso central. Os nucleotídeos da adenina são moléculas sinalizadoras no meio extracelular, envolvidas em importantes condições fisiológicas e patológicas. O ATP, neurotransmissor excitatório, e a adenosina, neuromoduladora, entre outros efeitos, podem induzir proliferação celular em linhagens de gliomas. Os eventos induzidos pelos nucleotídeos extracelulares são controlados pela ação das E-NTPDases, que hidrolisam o ATP até adenosina extracelularmente. Recentes estudos epidemiológicos têm sugerido que os flavonóides derivados da dieta, em particular a quercetina, apresentam um papel benéfico em prevenir ou inibir a tumorigênese. Assim, primeiramente nós avaliamos o efeito antiproliferativo da quercetina em linhagem de glioma humano U138MG. O estudo demonstrou que este flavonóide induziu em cultura de gliomas: (1) diminuição da proliferação e da viabilidade celular; (2) morte celular via necrose e apoptose; (3) parada no ciclo celular na fase G2 e (4) diminuição do índice mitótico. Além disso, nós demonstramos que a quercetina, enquanto promoveu regressão tumoral, protegeu culturas organotípicas hipocampais do dano isquêmico. Em conjunto, esses dados sugerem que a quercetina exibe efeitos antiproliferativos direcionados para as células tumorais e reduzida citotoxicidade para células normais, características altamente desejáveis na quimioterapia. Dados do nosso laboratório demonstram que o metabolismo extracelular das purinas encontra-se alterado em linhagens de gliomas com relação a culturas de astrócitos, sugerindo que mudanças no sistema purinérgico podem ser uma característica dos gliomas que potencialmente podem contribuir para o seu fenótipo de malignidade. Assim, o passo seguinte desse trabalho foi investigar o perfil de secreção dos derivados da adenina, o metabolismo extracelular do AMP e a ação da quercetina sobre o sistema purinérgico. As culturas de glioma apresentaram secreção de ATP, o qual foi detectado em maiores níveis com relação as outras moléculas avaliadas, ADP, AMP, adenosina e inosina. O AMP extracelular foi eficientemente metabolizado pelos gliomas, demonstrando uma ecto-5’-NT/CD73 muito ativa. Adicionalmente, quercetina interagiu com o sistema purinérgico, inibindo não-competitivamente a atividade da ecto-5’-NT/CD73 e modulando negativamente a sua expressão. Nós sugerimos que a inibição da atividade da ecto-5’-NT/CD73 pode resultar em um decréscimo na disponibilidade de adenosina extracelular, uma promotora tumoral. Tal efeito pode estar correlacionado com a inibição da proliferação promovida pela quercetina nessa linhagem de glioma. Nossos dados sugerem que a quercetina pode ter uma função importante na inibição da proliferação dos gliomas, atuando em diferentes vias de sinalização, incluindo o sistema purinérgico. Assim, esse estudo abre novas perspectivas para as potenciais aplicações dos flavonóides na prevenção e tratamento de tumores cerebrais.

Oligodendroglioma cístico e positividade das reações para cisticercose relato de caso

São poucos os estudos sobre gliomas «low-grade». Os oligodendrogliomas representam de 1,3 a 10% dos tumores intracerebrais. A neurocisticercose é uma das mais graves parasitoses do SNC, com evidente polimorfismo clínico e laboratorial. O objetivo deste estudo é relatar o caso de um doente com cefaléia, perda progressiva da visão, alteração do comportamento e, provas imunológicas positivas para cisticercose no líquido cístico e cefalorra-queano. Após tentativas para tratamento da neurocisticercose, sem muito sucesso, foi submetido a craniotomia frontal para exérese de tumor cístico, que revelou tratar-se de oligodendroglioma. Discutem-se aspectos relacionados aos possíveis mecanismos para associação de neurocisticercose e oligodendroglioma.

RECK-Mediated Inhibition of Glioma Migration and Invasion

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

High frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis in Brazilian patients with neurofibromatosis type 1

A clinical study of Brazilian patients with neurofibromatosis type 1 (NF1) was performed in a multidisciplinary Neurofibromatosis Program called CEPAN (Center of Research and Service in Neurofibromatosis). Among 55 patients (60% females, 40% males) who met the NIH criteria for the diagnosis of NF1, 98% had more than six café-au-lait patches, 94.5% had axillary freckling, 45% had inguinal freckling, and 87.5% had Lisch nodules. Cutaneous neurofibromas were observed in 96%, and 40% presented plexiform neurofibromas. A positive family history of NF1 was found in 60%, and mental retardation occurred in 35%. Some degree of scoliosis was noted in 49%, 51% had macrocephaly, 40% had short stature, 76% had learning difficulties, and 2% had optic gliomas. Unexpectedly high frequencies of plexiform neurofibromas, mental retardation, learning difficulties, and scoliosis were observed, probably reflecting the detailed clinical analysis methods adopted by the Neurofibromatosis Program. These same patients were screened for mutations in the GAP-related domain/GRD (exons 20-27a) by single-strand conformation polymorphism. Four different mutations (Q1189X, 3525-3526delAA, E1356G, c.4111-1G>A) and four polymorphisms (c.3315-27G>A, V1146I, V1317A, c.4514+11C>G) were identified. These data were recently published.

DO GLIOMA-CELLS EXPRESS CYTOKERATIN

There have been several recent reports of cytokeratin immunoreactivity in glial cells and tumors. We wanted to further test these tissues for cytokeratin immunoreactivity, and to determine whether antibody positivity corresponded to true cytokeratin expression. In the first set of experiments, a series of 10 formalin-fixed, frozen sections of glial tissue were employed; positive immunostaining with a cocktail of monoclonal anti-cytokeratin antibodies was seen only when a pepsin predigestion step was included in the immunostaining procedure. In the second set of experiments, 30 cases of malignant glioma fixed in both methacarn and formalin fixation were employed. Using a panel of three different anti-cytokeratin monoclonal antibodies (35 beta H11, 34 beta E12, CAM5.2), no positive immunostaining was observed in any of the methacarn-fixed tissues; positive immunostaining in the corresponding formalin-fixed tissue was frequently found, but only using the antibodies (35 beta H11, 34 beta E12) requiring enzyme predigestion. In the third set of experiments, immunoblots were performed on cytoskeletal extracts of human gliomas; no bands corresponding to known cytokeratins were observed in any cases. It is concluded that glial tissues and tumors do not, in fact, truly express cytokeratins, despite the fact that it is possible to obtain positive immunostaining of glial tumors and tissues using certain anti-cytokeratin antibodies under certain laboratory conditions.

Downregulation of the RECK-tumor and metastasis suppressor gene in glioma invasiveness

Invasive behavior is the pathological hallmark of malignant gliomas, being responsible for the failure of surgery, radiation, and chemotherapy. Matrix metalloproteinases (MMPs) are essential for proper ECM remodeling and invasion. The tumor and metastasis suppressor RECK protein regulates at least three members of the MMPs family: MMP-2, MMP-9, and MT1-MMP. In order to mimic the in vivo invasion process, A172 and T98G, respectively, non-invasive and invasive human glioblastoma cell lines, were cultured onto uncoated (control) or type I collagen gel-coated surface, and maintained for up to 7 days to allow establishment of the invasive process. We show that the collagen substrate causes decreased growth rates and morphological alterations correlated with the invasive phenotype. Electronic transmission microscopy of T98G cells revealed membrane invaginations resembling podosomes, which are typically found in cells in the process of crossing tissue boundaries, since they constitute sites of ECM degradation. Real time PCR revealed higher RECK mRNA expression in A172 cells, when compared to T98G cells and, also, in samples obtained from cultures where the invasive process was fully established. Interestingly, the collagen substrate increases RECK expression in A172 cells and the same tendency is displayed by T98G cells. MMPs-2 and -9 displayed higher levels of expression and activity in T98G cells, and their activities are also upregulated by collagen. Therefore, we suggest that: (1) RECK down regulation is critical for the invasiveness process displayed by T98G cells; (2) type 1 collagen could be employed to modulate RECK expression in glioblastoma cell lines. Since a positive correlation between RECK expression and patients survival has been noted in several types of tumors, our results may contribute to elucidate the complex mechanisms of malignant gliomas invasiveness.

Análises moleculares da região controle do DNA mitocondrial de astrocitomas na população paraense

O câncer do sistema nervoso central representa 2% de todas as neoplasias malignas na população mundial e 23% dos casos de câncer infantil. No Brasil, estimam-se 4.820 casos deste câncer em homens e 4.450 em mulheres para o ano de 2012. Os gliomas são tumores do sistema nervoso central formados a partir de células da glia e somam mais de 70% do tumores cerebrais. A propriedade mais importante dos gliomas é sua capacidade de evasão imunológica. Idade, etnia, gênero e ocupação podem ser considerados fatores de risco para o surgimento de gliomas, e são duas vezes mais frequentes em afro-americanos. O astrocitoma é o tumor glial mais frequente, constituindo cerca de 75% dos casos de gliomas. Estes tumores são classificados em quatro graus, de acordo com a Organização Mundial de Saúde. O DNA mitocondrial está relacionado com o desenvolvimento e a progressão de vários tipos de tumores. A mitocôndria é responsável pelo balanço energético celular e está envolvida no disparo da apoptose em resposta ao estresse oxidativo. Mutações na D-LOOP podem alterar a taxa de replicação do DNA e aumentar o risco do desenvolvimento do câncer. Neste estudo foram analisadas 29 amostras de astrocitoma classificados de acordo com a OMS. Nossos dados sugerem que os astrocitomas de baixo grau podem estar relacionados à herança genética, tornando portadores de alguns polimorfismos ou mutações específicas, mais suscetíveis ao risco de desenvolver a doença, e os de alto grau podem estar relacionados à exposição prolongada aos agentes carginógenos. Foram identificados polimorfismos e mutações onde alguns apresentaram relação com o risco do desenvolvimento de astrocitomas e com a progressão da doença. A inserção de dois ou mais nucleotídeos nas regiões de microssatélites pode causar sua instabilidade e contribuir com o surgimento do câncer. A deleção no sítio 16132 pode ser um marcador para astrocitoma de alto grau, assim como a inserção de duas ou mais citosinas no sítio 16190 pode ser um marcador específico para astrocitomas. As mutações heteroplásmicas podem ser determinantes para o surgimento e/ou progressão de astrocitomas de alto grau.