The miR-145-MMP1 axis is a critical regulator for imiquimod-induced cancer stemness and chemoresistance.

Cancer stemness, chemoresistance, and metastasis are related biological events. However, whether they have common molecular mechanisms remains to be determined. Here, we report that imiquimod (IMQ) facilitates the acquisition of stem-cell-like properties and chemoresistance via the upregulation of matrix metalloproteinase 1 (MMP1) and downregulation of microRNA-145 (miR-145). MiR-145-5p was found to suppress MMP1 expression through direct binding, and miR-145-mediated downregulation of MMP1 reversed the effects of IMQ. In addition, IMQ downregulated miR-145 by promoting DNA methylation at its promoter. DNA methyltransferase inhibitors limited IMQ-induced MMP1 expression, stemness, and chemoresistance. Collectively, our results highlight the miR-145-MMP1 axis as a potential coordinator of cancer stemness and chemoresistance. Given the role of MMP1 in the initiation of metastasis, the miR-145-MMP1 axis serves as a promising therapeutic target for improved cancer treatment.

Gliomas in the sellar turcica region: a retrospective study including adult cases and comparison with craniopharyngioma.

PURPOSE: Previous studies of sellar gliomas have been confined to pediatric optic pilocytic gliomas. The present study aimed to analyze the features of sellar gliomas involving both pediatric and adult patients with various pathologies and to compare them with craniopharyngiomas to better differentiate the diagnosis. METHODS: Twenty-seven sellar gliomas were retrospectively examined regarding their demographics, pathologies, clinical and imaging presentations, surgeries and postoperative complications. Thirty craniopharyngiomas from the same period and 880 gliomas of the most common pathologies from 2008-2014 were included for comparisons. RESULTS: In total, 55.6% of the sellar gliomas were adult cases. The pathology included pilocytic astrocytoma, ganglioglioma, diffuse astrocytoma, pilomyxoid astrocytoma, oligoastrocytoma, and glioblastoma. Compared with craniopharygiomas, sellar gliomas presented with a significantly lower ratio of visual disturbances, growth hormone deficiencies, lesion cystic changes, and calcification. Sellar gliomas had significantly greater effects on the patients' mentality and anatomical brain stem involvement. Total resections were achieved in 11 patients, which were significantly lower compared with craniopharyngiomas. CONCLUSIONS: Sellar gliomas affect both pediatric and adult patients with pathological changes extending beyond pilocytic astrocytomas. They have diverse clinical manifestations and imaging presentations. Differences exist regarding several aspects between sellar gliomas and craniopharyngiomas, which may facilitate a differential diagnosis.

Anatomic Study of Posterior Communicating Artery in Computed Tomographic Image.

PURPOSE: This study aims to provide an anatomic data of posterior communicating artery (PComA) and its anatomic relationship to the adjacent structures, so as to guide surgeons in the surgery of internal carotid artery-posterior communicating artery aneurysm clipping and sellar tumors resection without injuring the PComA. METHODS: Computer topographic angiography images of 123 individuals were reviewed, and the measurements were done on coronal, sagittal, axial, and other user-defined planes after multiplanar reconstruction. Posterior communicating artery was classified in the reconstructed three-dimensional image, measured in proper planes, and located by the structures such as anterior clinoid process (ACP), posterior clinoid process (PCP), and sagittal midline. RESULTS: Six types of PComA were identified in this study based on its existence and origin. The initial part of PComA can be located by ACP, PCP, and sagittal midline based on some particular angles and distances. CONCLUSIONS: Posterior communicating artery varies in different individuals, and the radiologic study of it is an optimal way to analyze the variances. The anatomic relations between PComA and basic skull structures such as the ACP and PCP are especially important for neurosurgeons.

Fast identification of the BmNPV infected silkworms by portable NIR spectroscopy and chemometrics.

A convenient, low-cost, and rapid detection of BmNPV-infected silkworms is of great significance for the safety of the sericulture industry. In this study, a portable NIR system was used to collect the spectra of normal silkworms and the infected silkworms induced by the administration of Bombyx mori nuclear polyhedrosis virus (BmNPV). Different spectral pretreatment methods were applied, then principal component analysis (PCA), linear discriminant analysis (LDA), and partial least squares discriminant analysis (PLSDA) were used for the classification analysis. The results showed that PCA and LDA were unable to achieve the purpose. For the PLSDA calibration, after the pretreatment of SNV combining 2nd derivative, it had a high identification performance, and obtained low classification errors of 0.023, 0.033, and 0.030 for the calibration set, cross-validation set, and test set, respectively, with higher sensitivity and specificity. Therefore, the BmNPV-infected silkworms can be identified by portable NIR spectroscopy, which will effectively reduce losses for the sericulture industry.

Bright luminescent Zn2GeO4:Mn NP/MXene hydrogel-based ECL biosensor for glioblastoma diagnosis.

In this work, miRNA-10b in the glioblastoma (GBM) tumor tissues has been detected by a novel electrochemiluminescence (ECL) biosensor. Firstly, a new kind of bright luminescent Zn2GeO4:Mn NPs were prepared as ECL nanoprobe, which possessed high fluorescence quantum yield and ECL quantum efficiency. Secondly, Ti3C2 MXene hydrogel (MXG) have been developed as the sensing interface. The MXG retained the inherent biocompatibility and mechanical features of hydrogel. Furthermore, the uniform distribution of metallic Ti3C2 MXene in the hydrogel microstructure provided the good conductivity and multiple binding sites for biomolecules. MXene also can promote the separation of the electrons and holes to accelerate the electron-transfer rate and improve ECL efficiency. Due to these synergistic effects, the screen printed electrode was successfully modified with MXG as sensing platform to enhance the ECL intensity of Zn2GeO4:Mn NP, which greatly improved the detection efficiency and facilitated the high-throughput analysis. Finally, the toehold mediated strand displacement (TMSD) strategy was employed with then biosensor to detect miRNA-10b with the range of 10 fM to 1 nM. The limit of detection was 5 fM. This ECL biosensor has been used to analyze miRNA-10b expression in GBM tumor tissues, which possessed the great potential value for clinical diagnosis.

Symptomatic secondary spinal arachnoid cysts: a systematic review.

BACKGROUND CONTEXT: Secondary spinal arachnoid cysts have rarely been reported but present significant challenges for management. These cysts could be anteriorly located with long rostral-caudal extensions and many are related to arachnoiditis, leading to difficult-to-treat disorders. Thus far, due to the scarcity of reports, the features of the disease and the optimal therapeutic strategies remain unclear. PURPOSE: To investigate clinical features and the optimal treatment modalities of secondary spinal arachnoid cysts compared with primary spinal arachnoid cysts. STUDY DESIGN: Systematic review. PATIENT SAMPLE: Systematic review identified 103 secondary cases from 80 studies and reports. OUTCOME MEASURES: Condition of symptom relief and duration of treatment response were analyzed. METHODS: An electronic literature search of the PubMed database was conducted for studies on secondary spinal arachnoid cysts between 1990 and 2022. Non-English publications, nonhuman studies, reports of a primary cyst, studies not including case details, and studies of nonsymptomatic cases were excluded. RESULTS: This systematic review included 103 secondary cases. The most commonly reported etiologies were iatrogenic factors, trauma, and subarachnoid hemorrhage, accounting for 88 intradural extramedullary, 11 extradural, one intradural/extradural, one interdural, and one intramedullary spinal arachnoid cyst after a median duration of 30, 12, and 9 months, respectively. Extradural cysts were more prone to occur at dorsal locations and affect thoracic segments (mean cyst length: 3.4 segments). Intradural cysts showed a relatively higher ventral/dorsal ratio (1:1.09, 1.75:1, and 3.50:1 for cysts occurring from iatrogenic factors, trauma, and subarachnoid hemorrhage, respectively) and thoracic distribution, with a mean cyst length of 4.3 segments (5.1 for ventral and 3.5 for dorsal cysts). For intradural cysts, recurrence risk was lower after surgical resection than after fenestration/marsupialization (12-month recurrence risk: 21.43% vs 50.72%, log-rank test: p=.0248, Gehan-Breslow-Wilcoxon test: p=.0126). In cases treated with shunting, one recurrence (1/8 cases) was noted after external shunting and two recurrences (2/5 cases) after internal shunting at a median follow up of 12 months. CONCLUSIONS: Secondary spinal arachnoid cysts, particularly intradural cysts, are rarer and more challenging to treat than primary spinal cysts. Although fenestration/marsupialization is the commonly adopted treatment, the recurrence rate is high. For unresectable cysts, shunting procedures, particularly shunting into a body cavity (eg, pleural or peritoneal cavity) away from the subarachnoid space, could be a therapeutic alternative besides fenestration/marupialization, yet its efficacy requires confirmation by more data.

Three-dimensional conductive network constructed by in-situ preparation of sea urchin-like NiFe2O4 in expanded graphite for efficient microwave absorption.

Expanded graphite (EG) is a modified conductive lamellar carbon that has been widely studied in the field of electromagnetic wave absorption due to its low density, good electrical conductivity, and unique structure. However, its application is limited because the interlayer gap cannot match microwave wavelength, and its single composition has less microwave loss. In this study, sea urchin-like NiFe2O4/EG composites are prepared in situ between expanded graphite layers by microwave treatment. The sea urchin-like NiFe2O4 grows between the expanded graphite to form a three-dimensional conductive network structure, which enhances conductive loss of composites and further increases the interlayer distance of EG. The extended interlayer distance promotes multiple reflections and scattering of electromagnetic waves in composites and improves dielectric properties. In addition, EG with a large specific surface area provides many active sites, further promoting interface and dipole polarization. Benefiting from synergistic effect of NiFe2O4 and EG, magnetic loss and dielectric loss of NiFe2O4/EG composites have been improved and impedance matching is further enhanced. The results indicate that the minimal reflection loss of NiFe2O4/EG-4 reaches -53.47 dB at 2.69 mm, and the effective absorption bandwidth reaches 2.97 GHz. In addition, based on the computer simulation technology results, NiFe2O4/EG can attenuate microwave energy under experimental conditions. This work provides a strategy for synthesizing carbon matrix composites with adjustable dielectric parameters and electromagnetic wave properties.

Case report of a patient with Erdheim-Chester disease presenting with neuro-endocrine symptoms and negative for BRAF mutation.

RATIONALE: Erdheim-Chester disease (ECD) is a rare progressive disease affecting multiple systems. It has recently been recognized as a neoplastic disease following the discovery of activating mutations in the MAPK pathway. There are several striking signs of ECD, such as the long bone involvement, as well as the hairy kidney appearance on computed tomography scan. It is rare for ECD to manifest neurological symptoms. Central nervous system involvement is a strong prognostic factor and independent predictor of death. ECD is characterized by the overproduction and accumulation of foamy histiocytes and Touton's giant cells in various tissues and organs. ECD is a multisystem disorder in which any organ may be affected. PATIENT CONCERNS: This case report describes a 57-year-old woman with headaches and ataxia as the first clinical manifestation, without characteristic bone pain, but with delayed enuresis. In addition to the renal involvement, this patient had rarer splenic involvement. DIAGNOSES: The imaging presentation of this patient was similar to that of a "multiple meningiomas". A combination of clinical, imaging and pathology for the diagnosis of ECD. INTERVENTIONS: Patients were given INF-α therapy. OUTCOMES: Fortunately, the patient responded well to INF-α treatment. LESSONS: ECD patient with neuro-endocrine symptoms.

"Big Data" Approaches for Prevention of the Metabolic Syndrome.

Metabolic syndrome (MetS) is characterized by the concurrence of multiple metabolic disorders resulting in the increased risk of a variety of diseases related to disrupted metabolism homeostasis. The prevalence of MetS has reached a pandemic level worldwide. In recent years, extensive amount of data have been generated throughout the research targeted or related to the condition with techniques including high-throughput screening and artificial intelligence, and with these "big data", the prevention of MetS could be pushed to an earlier stage with different data source, data mining tools and analytic tools at different levels. In this review we briefly summarize the recent advances in the study of "big data" applications in the three-level disease prevention for MetS, and illustrate how these technologies could contribute tobetter preventive strategies.

Malignant Transformation and Metastatic Spread of Dumbbell-Shaped Meningeal Melanocytoma of the Cervical Spine: A Case Report and Literature Review.

Background: Meningeal melanocytoma is a rare disease that originates from leptomeningeal melanocytes in the central nervous system. Meningeal melanocytoma is generally considered benign, and has a good prognosis following complete surgical resection. Reports of the malignant transformation and spread of these tumors are scarce. Case Presentation: A 19 year old female presented with headache, progressive limb weakness, and dyspnea. Magnetic resonance imaging showed a dumbbell-shaped lesion at C1-C2 that was hyperintense on T1 weighted images and showed strong contrast enhancement. Total resection was achieved using a posterior midline approach. Post-operative pathology showed meningeal melanocytoma. The tumor recurred 9 months later with intracranial spread. Resection of the lesion revealed malignant transformation to meningeal melanoma. Conclusion: Meningeal melanocytoma harbors malignant potential even with total resection. Radiotherapy could be considered to prevent disease recurrence and progression.

Construction of heterointerfaces and honeycomb-like structure for ultrabroad microwave absorption.

Heterointerface design is an effective strategy to improve the effective absorption bandwidth in electromagnetic wave EMW absorbing materials. In this paper, honeycomb-like Fe-doped tremella carbide composites (FCT) with a large number of heterogeneous interfaces were obtained by in-situ construction of multiphase composite particles (Fe3C, Fe3O4, and a-Fe) during the carbonization process. The effects of Fe doping on the phase, structure, morphology, and absorption properties of FCT were investigated. The results show that the porous structure and the heterogeneous interface can significantly improve the electromagnetic wave absorption performance of FCT. Iron doping introduces a heterogeneous multiphase structure into FCT, which increases the interfacial loss and magnetic loss of the material, thereby improving the overall impedance matching of the material. FCT-4 composite exhibited excellent microwave attenuation capability with a reflection loss of -34.6 dB. Simultaneously, the widest effective absorption bandwidth is up to 8.84 GHz (9.16-18 GHz) with a matching thickness of 2.8 mm, which covers almost the entire X (8-12 GHz) and Ku (12-18 GHz) bands. Thus, this paper provides an effective strategy for the preparation of excellent electromagnetic wave absorbing materials by in situ construction of heterointerfaces.

Lateral ventricle pleomorphic xanthoastrocytoma concurrent with Dandy-Walker complex: A case report.

INTRODUCTION: Dandy-Walker complex and pleomorphic xanthoastrocytomas are both rare disease entities that typically manifest early in life and are associated with congenital etiological factors. Dandy-Walker complex is a cerebellar malformation associated with a series of anatomical changes. The disease onset is usually at birth or during infancy. Late onset in adulthood is uncommon. Pleomorphic xanthoastrocytoma is a rare WHO grade II astrocytic tumor affecting mainly young adults. Concomitant occurrence of Dandy-Walker complex and pleomorphic xanthoastrocytoma has not been previously reported. PATIENT CONCERNS AND DIAGNOSIS: A 30-year-old woman with a previous history of unconfirmed resected lateral ventricle meningioma presented with severe headache for 1 day. Imaging examination revealed a mass in the right lateral ventricle with heterogeneous signal patterns, changes in the posterior fossa corresponding to a Dandy-Walker variant, and mild hydrocephalus. INTERVENTIONS AND OUTCOMES: Surgical complete resection of the mass was achieved. postoperative histopathological examination confirmed WHO grade II pleomorphic xanthoastrocytoma. Three years postsurgery, ventriculoperitoneal shunt was performed due to worsening of hydrocephalus. The patient has since remained symptom-free. CONCLUSION: This is the first report of concomitant occurrence of Dandy-Walker complex and pleomorphic xanthoastrocytoma. The association of neurological congenital malformation with intracranial neoplasms may be multifactorial, with underlying role of genetic mutations or chromosome alterations.

GDF15 promotes glioma stem cell-like phenotype via regulation of ERK1/2-c-Fos-LIF signaling.

Growth differentiation factor 15 (GDF15), a member of the transforming growth factor ß family, is associated with tumor progression, metastasis, and cell apoptosis. However, controversy persists regarding the role of GDF15 in different tumor types, and its function in glioma stem cells (GSCs) remains unknown. Here, we report that GDF15 promotes the GSC-like phenotype in GSC-like cells (GSCLCs) through the activation of leukemia inhibitor factor (LIF)-STAT3 signaling. Mechanistically, GDF15 was found to upregulate expression of the transcription factor c-Fos, which binds to the LIF promoter, leading to enhanced transcription of LIF in GSCLCs. Furthermore, GDF15 may activate the ERK1/2 signaling pathway in GSCLCs, and the upregulation of LIF expression and the GSC-like phenotype was dependent on ERK1/2 signaling. In addition, the small immunomodulator imiquimod induced GDF15 expression, which in turn activated the LIF-STAT3 pathway and subsequently promoted the GSC-like phenotype in GSCLCs. Thus, our results demonstrate that GDF15 can act as a proliferative and pro-stemness factor for GSCs, and therefore, it may represent a potential therapeutic target in glioma treatment.

Cerebral pleomorphic xanthoastrocytoma mimicking inflammatory granuloma: Two case reports.

RATIONALE: Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade glial neoplasm of the central nervous system, which is difficult to distinguish from other neoplastic and non-neoplastic entities. Herein, we report 2 cases of PXA that had been misdiagnosed as an inflammatory granuloma. PATIENT CONCERNS: The first case was a 22-year-old man who originally presented with a generalized seizure 7 years previously. Magnetic resonance imaging (MRI) revealed a lesion in the right parietal lobe, leading to a diagnosis of inflammatory granuloma. The second case was a 43-year-old man who presented with repeated generalized seizures. MRI revealed a nodular lesion in the left temporal lobe. The magnetic resonance spectrum showed elevated Cho and NAA peaks and a decreased Cr peak. An inflammatory granuloma was suspected. DIAGNOSIS: After surgical treatment, histopathological examination revealed PXA. INTERVENTIONS: In the first case, after 10 months of anti-inflammatory treatment, the lesion was significantly reduced in size. During the following 7 years, the patient experienced generalized seizures 3 to 4 times annually. To control intractable epilepsy, the lesion was resected. In the second case, conservative treatment provided no benefit, and then the lesion was resected. OUTCOMES: In the first case, during a follow-up period of 14 months, the patient was seizure-free with no tumor recurrence. In the second case, after a 6 months of follow-up, the patient remained seizure-free with no tumor recurrence. LESSONS: The preoperative differential diagnosis of PXA is challenging due to the nonspecific symptoms and imaging manifestations. Considering the potential risk of malignant transformation of PXA, early surgery should be highlighted, and gross total resection is associated with a favorable prognosis.

Human Cancer Cells Sense Cytosolic Nucleic Acids Through the RIG-I-MAVS Pathway and cGAS-STING Pathway.

Pattern recognition receptors (PRRs) are germline-encoded host sensors of the innate immune system. Some human cancer cells have been reported to express PRRs. However, nucleic acid sensors in human cancers have not been studied in detail. Therefore, we systematically analyzed the expression, molecular cascade, and functions of TLR3, RIG-I, MDA5, LGP2, cGAS, and STING in human cancer cells. TLR3, TRIF, RIG-I, MDA5, LGP2, and MAVS were expressed in 22 cell lines. The majority of cell lines responded to only RIG-I ligands 5'-ppp-dsRNA, Poly(I:C)-HMW, Poly(I:C)-LMW, and/or Poly(dA:dT), as revealed by IRF3 phosphorylation and IFN-ß secretion. IFN-ß secretion was inhibited by RIG-I and MAVS knockdown. cGAS and STING were co-expressed in 10 of 22 cell lines, but IFN-ß secretion was not induced by STING ligands ISD, HSV60, VACV70, Poly(dG:dC), and 3'3'-cGAMP in cGAS and STING intact cell lines. Further experiments revealed that the cGAS-STING pathway was activated, as revealed by TBK1 and IRF3 phosphorylation and IFN-ß and ISG mRNA expression. These results suggest that human epithelial cancer cells respond to cytosolic RNA through the RIG-I-MAVS pathway but only sense cytosolic DNA through the cGAS-STING pathway. These findings are relevant for cancer immunotherapy approaches based on targeting nucleic acid receptors.

Bilateral Internal Auditory Canal Metastasis of Colon Carcinoma Mimicking Neurofibromatosis Type II: A Case Report and Literature Review.

BACKGROUND: The vast majority of cerebellopontine angle tumors are benign with a favorable prognosis. Metastatic tumors occurring in the cerebellopontine angle are extremely rare. Herein, we report a case of colon carcinoma metastasis to the bilateral internal auditory canals. CASE DESCRIPTION: A 59-year-old man presented with a 2-week history of binaural hearing loss. One year before admission, he was diagnosed with colon carcinoma and underwent surgical resection combined with chemotherapy. Physical examination showed complete hearing loss in bilateral ears and bilateral facial palsy. Magnetic resonance imaging of the brain revealed nodules in the bilateral internal auditory canals. Middle-ear computed tomography demonstrated soft-tissue masses extending into the bilateral internal auditory canals. A diagnosis of neurofibromatosis type II was suspected. A unilateral surgical resection of the cerebellopontine angle tumor was performed. Postoperatively, the hearing loss and facial palsy remained unchanged. Pathologic examination showed metastatic, poorly differentiated carcinoma. The patient was diagnosed with metastatic colon carcinoma in the bilateral internal auditory canals. The patient refused radiotherapy and chemotherapy. The tumor progressed rapidly, and the patient developed dysphagia and choking 1 month later. The patient died of respiratory and circulatory failure 2 months after the surgery. CONCLUSIONS: Clinicians should be aware of metastatic tumors in the internal auditory canals. Comprehensive clinicoradiologic evaluation should be highlighted. A history of malignancy and rapidly progressive hearing loss and facial palsy may suggest the diagnosis of metastasis to the internal auditory canal. The definitive diagnosis still depends on histopathologic examination.

Imaging Gliomas with Nanoparticle-Labeled Stem Cells.

OBJECTIVE:: Gliomas are the most common neoplasm of the central nervous system (CNS); however, traditional imaging techniques do not show the boundaries of tumors well. Some researchers have found a new therapeutic mode to combine nanoparticles, which are nanosized particles with various properties for specific therapeutic purposes, and stem cells for tracing gliomas. This review provides an introduction of the basic understanding and clinical applications of the combination of stem cells and nanoparticles as a contrast agent for glioma imaging. DATA SOURCES: Studies published in English up to and including 2017 were extracted from the PubMed database with the selected key words of "stem cell," "glioma," "nanoparticles," "MRI," "nuclear imaging," and "Fluorescence imaging." STUDY SELECTION:: The selection of studies focused on both preclinical studies and basic studies of tracking glioma with nanoparticle-labeled stem cells. RESULTS:: Studies have demonstrated successful labeling of stem cells with multiple types of nanoparticles. These labeled stem cells efficiently migrated to gliomas of varies models and produced signals sensitively captured by different imaging modalities. CONCLUSION: The use of nanoparticle-labeled stem cells is a promising imaging platform for the tracking and treatment of gliomas.

Small Cell Glioblastoma of the Sella Turcica Region: Case Report and Review of the Literature.

BACKGROUND: Glioblastomas in the sellar region are very rare; in most cases, the tumor originates from the optic nerve or optic chiasm. Only 4 cases of sellar glioblastoma with a nonoptic origin have been reported. We present such a case with detailed clinical, imaging, and histopathologic information. We also review similar published cases. CASE DESCRIPTION: A 42-year-old woman presented with endocrinologic abnormalities, including amenorrhea and lactation, symptoms of diabetes insipidus, and signs of elevated intracranial pressure. Magnetic resonance imaging showed a giant, heterogeneously enhancing lesion involving the intrasellar, parasellar, and suprasellar regions, with hypercellularity and signs of infiltration of adjacent structures. Intraoperative examination revealed the tumor to be independent from the optic pathways, but it showed infiltration of the hypothalamic region. Histopathologic examination demonstrated uniformly packed small cells and negative staining for glial fibrillary acidic protein, which was consistent with a diagnosis of small cell glioblastoma. CONCLUSIONS: This is the first report of a small cell glioblastoma in the sella turcica region. Glioblastomas in the sellar region with no clear evidence of an optic origin should be viewed as an independent disease entity. The typical characteristics of this tumor indicate it should be considered a rare subtype of glioblastoma. Further accumulation of experience is needed to better differentiate these cases and to offer optimal treatment.

Recent advances in the role of toll-like receptors and TLR agonists in immunotherapy for human glioma.

Gliomas are extremely aggressive brain tumors with a very poor prognosis. One of the more promising strategies for the treatment of human gliomas is targeted immunotherapy where antigens that are unique to the tumors are exploited to generate vaccines. The approach, however, is complicated by the fact that human gliomas escape immune surveillance by creating an immune suppressed microenvironment. In order to oppose the glioma imposed immune suppression, molecules and pathways involved in immune cell maturation, expansion, and migration are under intensive clinical investigation as adjuvant therapy. Toll-like receptors (TLRs) mediate many of these functions in immune cell types, and TLR agonists, thus, are currently primary candidate molecules to be used as important adjuvants in a variety of cancers. In animal models for glioma, TLR agonists have exhibited antitumor properties by facilitating antigen presentation and stimulating innate and adaptive immunity. In clinical trials, several TLR agonists have achieved survival benefit, and many more trials are recruiting or ongoing. However, a second complicating factor is that TLRs are also expressed on cancer cells where they can participate instead in a variety of tumor promoting activities including cell growth, proliferation, invasion, migration, and even stem cell maintenance. TLR agonists can, therefore, possibly play dual roles in tumor biology. Here, how TLRs and TLR agonists function in glioma biology and in anti-glioma therapies is summarized in an effort to provide a current picture of the sophisticated relationship of glioma with the immune system and the implications for immunotherapy.