Mitochondrial toxicity of aluminium nanoparticles in comparison to its ionic form on isolated rat brain mitochondria.

OBJECTIVES: The aim of this study was to evaluate the toxic effect of AlNPs on rat brain mitochondria and compare it with that of aluminium's ionic form. METHODS: Mitochondria were isolated from rat brain. Isolated mitochondria were treated with normal saline (Control) and different concentrations of aluminium ions (AlIs) and AlNPs (50, 100 and 200 µM). Then, the effect of AlNPs on electron transport chain complexes as well as various endpoints such as mitochondrial oxidative damage (reactive oxygen species, lipid peroxidation, glutathione, and protein carbonyl) and mitochondrial function were assessed. Also, apoptosis was evaluated by cytochrome c release, mitochondrial membrane potential and swelling. RESULTS: When compared to the control group, the exposure to AlNPs showed a marked elevation in oxidative stress markers and inhibition of complex III which was accompanied by disturbance in mitochondrial function. Also, AlNPs induced a significant collapse of mitochondrial membrane potential, mitochondrial swelling, and cytochrome c release. CONCLUSIONS: The comparison of mitochondrial toxicity markers between both forms of aluminium revealed that the toxic effect of AlNPs on isolated brain mitochondria was substantially greater than that that caused by AlIs, which can probably be ascribed to its higher reactivity (Tab. 1, Fig. 8, Ref. 45).

Report of the clinical donor case workshop of the European Association of Tissue Banks annual meeting 2014.

The European Association of Tissue Banks (EATB) donor case workshop is a forum held within the program of the EATB annual congress. The workshop offers an opportunity to discuss and evaluate possible approaches taken to challenging situations regarding donor selection. Donor case workshops actively engage participants with diverging background and experience in an informal, secure and enjoyable setting. The resulting discussion with peers promotes consensus development in deciding tissue donor acceptability, especially when donor health issues are not conclusively addressed in standards and regulations. Finally the workshop serves to strengthen the professional tissue banking networks across Europe and beyond. This report reflects some of the discussion at the workshop during the annual congress in Lund, Sweden, in 2014. The cases presented demonstrate that the implications of various donor illnesses, physical findings and behaviours on the safety of tissue transplantation, may be interpreted in a different way by medical directors and other professionals of different tissue facilities. This will also result in diverging preventive measures and decisions taken by the tissue facilities. Some of the donor cases illustrate varied responses from participants and demonstrate that operating procedures, regulations and standards cannot comprehensively cover all tissue donor illnesses, medical histories and circumstances surrounding the cause of death. For many of the issues raised, there is a lack of published scientific evidence. In those cases, tissue bank medical director judgement is critical to guarantee transplantation safety. This judgement should be based on a proper and documented risk assessment case by case. Conditions or parameters taken into account for risk assessment are amongst others, the type of tissue, the type of processing, the characteristics of the final product, and the availability of an adequate sterilisation methodology. By publishing these difficult donor suitability cases, and the resulting discussions, we provide information for future similar cases and we identify needs for future literature review and scientific research. In this way the donor case workshops play a role in optimizing the quality and security of tissue donation.

Predictive risk score for isolated brain metastasis in non-small cell lung cancer.

Background: Brain metastasis is common with non-small cell lung cancer (NSCLC). Patients with some early-stage cancers don't benefit from routine brain imaging. Currently clinical stage alone is used to justify additional brain imaging. Other clinical and demographic characteristics may be associated with isolated brain metastasis (IBM). We aimed to define the most salient clinical features associated with synchronous IBM, hypothesizing that clinical and demographic factors could be used to determine the risk of brain metastasis. Methods: The National Cancer Database was used to identify patients with NSCLC from 2016-2020. Primary outcome was the presence of IBM relative to patients without evidence of any metastasis. Cohorts were divided into test and validation. The test cohort was used to identify risk factors for IBM using multivariable logistic regression. Using the regression, a scoring system was created to estimate the rate of synchronous IBM. The accuracy of the scoring system was evaluated with receiver operating characteristic (ROC) analysis using the validation cohort. Results: Study population consisted of 396,113 patients: 25,907 IBM and 370,206 without metastatic disease. IBM was associated with age, clinical T stage, clinical N stage, Charlson/Deyo comorbidity score, histology, and grade. A scoring system using these factors showed excellent accuracy in the test and validation cohort in ROC analysis (0.806 and 0.805, respectively). Conclusions: Clinical and demographic characteristics can be used to stratify the risk of IBM among patients with NSCLC and provide an evidence-based method to identify patients who require dedicated brain imaging in the absence of other metastatic disease.

Evolution of air-borne vocalization: Insights from neural studies in the archeobatrachian species Bombina orientalis.

Vocalization of tetrapods evolved as an air-driven mechanism. Thus, it is conceivable that the underlaying neural network might have evolved from more ancient respiratory circuits and be made up of homologous components that generate breathing rhythms across vertebrates. In this context, the extant species of stem anurans provide an opportunity to analyze the connection of the neural circuits of lung ventilation and vocalization. Here, we analyzed the fictive lung ventilation and vocalization behavior of isolated brains of the Chinese fire-bellied toad Bombina orientalis during their mating season by nerve root recordings. We discovered significant differences in durations of activation of male brains after stimulation of the statoacoustic nerve or vocalization-relevant forebrain structures in comparison to female brains. The increased durations of motor nerve activities in male brains can be interpreted as fictive calling, as male's advertisement calls in vivo had the same general pattern compared to lung ventilation, but longer duration periods. Female brains react to the corresponding stimulations with the same shorter activity pattern that occurred spontaneously in both female and male brains and thus can be interpreted as fictive lung ventilations. These results support the hypothesis that vocal circuits evolved from ancient respiration networks in the anuran caudal hindbrain. Moreover, we could show that the terrestrial stem archeobatrachian Bombina spec. is an appropriate model to study the function and evolution of the shared network of lung ventilation and vocal generation.

Prognostic Factors and Impact of Therapeutic Intervention in Patients With Brain Metastases at the Initial Presentation.

Background Studies investigating the normative characteristics and prognosis of patients diagnosed with brain metastases (BMs) at the onset of cancer are scarce. Therefore, we analyzed real-world treatment options. Methodology This retrospective study enrolled 112 patients newly diagnosed with BM between May 2006 and October 2021. The variables examined included patients' age, sex, recurrence split analysis, Glasgow prognostic score (GPS), number of lesions, tumor size, peripheral brain tumor edema, targeted therapy, supportive care, chemotherapy, and date of onset. Prognostic factors were assessed using recursive partitioning analysis (RPA), graded prognostic assessment (GPA) scores, and GPS scoring, with magnetic resonance imaging (MRI) and computed tomography (CT) studies. Primary treatment comprised whole-brain radiotherapy (WBRT), with regular follow-up. Results Data from 112 survivors were analyzed, revealing a median overall survival time (MST) of 7.7 months, with some patients surviving beyond 24 months post-WBRT. Univariate analysis revealed associations between MST and RPA class, GPS, and treatment modalities (including targeted therapy and chemotherapy). RPA class 2, GPS of 0, and targeted therapy were identified as predictors of better prognosis in the multivariate analysis. In the subgroup not receiving chemotherapy, no significant difference in prognosis was seen between groups with or without WBRT. Conclusions Alongside RPA, scores indicating chronic inflammatory changes, including GPS, were confirmed as crucial prognostic factors. Moreover, treatment with molecularly targeted drugs correlated with favorable prognoses. The treatment-naïve group exhibited poorer prognoses, and WBRT was not deemed a significant prognostic factor in the chemotherapy group.

Advances in Brain Metastases Diagnosis: Non-coding RNAs As Potential Biomarkers.

Brain metastasis is considered the most common brain tumor. They arise from different primary cancers. The most common primary tumors giving brain metastases include breast, colorectal, lung, melanoma, and renal cancer. Depending only on history, physical examination, and conventional imaging modalities makes brain tumors diagnosis difficult. Rapid and non-invasive promising modalities could diagnose and differentiate between different brain metastases without exposing the patients to unnecessary brain surgeries for biopsies. One of these promising modalities is non-coding RNAs (ncRNAs). NcRNAs can determine brain metastases' prognosis, chemoresistance, and radioresistance. It also helps us to understand the pathophysiology of brain metastases development. Additionally, ncRNAs may work as potential therapeutic targets for brain metastases treatment and prevention. Herein, we present deregulated ncRNAs in different brain metastases, including microRNAs and long non-coding RNAs (lncRNAs), such as gastric adenocarcinoma, colorectal, breast, melanoma, lung, and prostate cancer. Additionally, we focus on serum and cerebrospinal fluid (CSF) expression of these ncRNAs in patients with brain metastases compared to patients with primary tumors. Moreover, we discuss the role of ncRNAs in modulating the immune response in the brain microenvironment. More clinical studies are encouraged to assess the specificity and sensitivity of these ncRNAs.

Metastatic Urothelial Cell Carcinoma Presenting as an Isolated Malignancy to the Posterior Fossa: A Case Report and Review on the Literature.

Urothelial cell carcinoma (UCC) of the bladder infrequently metastasizes to the central nervous system (CNS). The incidence worldwide is approximately 1%. The cerebral hemispheres of the anterior and middle cranial fossa are the most common sites of CNS spread, and usually, multiple metastatic lesions are present. Infrequently, metastasis presents as a single solitary metastatic malignancy to the posterior fossa. Here, we present the case of a patient with bladder UCC who presented with a single solitary metastatic malignancy to the cerebellum. The authors discuss the signs, symptoms, mechanism of metastatic spread to the CNS, diagnosis, management, and prognosis of isolated posterior fossa metastasis originating from bladder UCC. We also performed an extensive literature search to identify all cases of metastatic bladder UCC presenting as an isolated malignancy to the posterior fossa in the past 20 years.

Urothelial Carcinoma of the Bladder With Primary Metastasis to the Brain: A Case Report and Literature Review.

Brain metastases are the most common type of brain tumor in adults, commonly arising from primary tumor sites of the lung, breast, skin (melanoma), colon, and kidney. Isolated central nervous system (CNS) metastasis arising from urothelial carcinoma (UC) is a rare presentation yielding a poor prognosis. A 71-year-old male patient with a history of urothelial carcinoma, treated one year prior with partial cystectomy and adjuvant gemcitabine and cisplatin (GC) therapy, presented with worsening neurological symptoms, including progressively worsening dizziness, shuffling gait, drifting, expressive aphasia, and confusion. MRI revealed a left frontal 4.0 x 3.6 cm brightly contrast-enhancing tumor with possible hemorrhage, extensive vasogenic edema, and moderate mass effect. An additional smaller right cerebellar lesion was also noted. Outpatient CT of his chest, abdomen, and pelvis revealed no evidence of other malignant sites. He ultimately underwent a left craniotomy with a total resection of his left frontal mass. Pathological examination revealed a urothelial primary. Post-operative MRI revealed complete resection of the left frontal mass and the patient was discharged with no neurologic deficits on exam. In many cases, brain metastases may present years later following initial therapy of UC as the CNS may act as a sanctuary site during systemic chemotherapy. Chemotherapeutics such as gemcitabine with better penetration of the blood-brain barrier may be beneficial in delaying the onset of these metastases.

Rotenone Decreases Ischemia-Induced Injury by Inhibiting Mitochondrial Permeability Transition: A Study in Brain.

Mitochondria participate in many physiological and pathological processes in the cells, including cellular energy supply, regulation of calcium homeostasis, apoptosis, and ROS generation. Alterations of mitochondrial functions, especially the opening of mitochondrial permeability transition pore (mPTP) are the main mechanisms responsible for the ischemic brain damage. Recently, the inhibitors of the Complex I of mitochondrial respiratory chain emerged as promising suppressors of mitochondrial ROS generation and mPTP opening. Here we describe the assay that can be implemented easily to evaluate the protective effects of rotenone or other potential inhibitors of the Complex I of mitochondrial respiratory chain against acute ischemia-induced injuries in brain.

A Rare Case of Metastatic Esophageal Adenocarcinoma Presenting as an Isolated Cerebellar Lesion 5 Years After Treatment.

Isolated brain metastasis (IBM) as a recurrence of primary esophageal adenocarcinoma (AC) has rarely been reported in the literature and typically manifests within a short period of time after diagnosing the primary lesion. We present here an unusual case of an IBM presenting nearly 5 years after neoadjuvant chemoradiation therapy and surgical resection of a primary distal esophageal tumor with no interval evidence of recurrence. A 53-year-old man presented to our gastroenterology clinic with progressive dysphagia and weight loss. On upper endoscopy, the patient was found to have a large obstructing distal esophageal mass with biopsies reported as moderately differentiated AC. Subsequent computed tomography (CT) chest/abdomen/pelvis (C/A/P) and magnetic resource imaging (MRI) brain were negative for any distant metastases. The patient received preoperative chemotherapy and radiation therapy, followed by distal esophagectomy with findings of stage IIIB disease. He did well after surgery and was monitored closely by his oncologist with no evidence of recurrence on interval imaging or follow-up endoscopy. Several years after his diagnosis, however, the patient developed new neurologic symptoms, and an MRI brain revealed a solitary cerebellar lesion with surrounding edema concerning for metastatic disease. Positron emission tomography and CT C/A/P were negative for any other new lesions. The tumor was resected, and pathology was confirmed as metastatic AC of esophageal origin. To our knowledge, this is the first case of recurrent esophageal AC presenting as an isolated cerebellar lesion 5 years after treatment of the primary tumor.

Prolonged perfusion of rat brain with a high oxygen tension solution, without oxygen carriers and with an external normal barometric pressure.

BACKGROUND: Isolated brain of experimental animals is a useful model to study transport of substances, including drugs, across the blood-brain barrier, mechanisms of convulsive activity, ischemic and reperfusion brain injury. Normal functioning of neurons, especially cortical, in the central nervous system requires adequate supply of oxygen. Therefore oxygen carriers or fluorocarbon substances with high oxygen capacity are often used in animal brain perfusion experiments. NEW METHOD: In the present study of the in situ rat brain perfusion oxygen carriers were not used. The optimum oxygen capacity of the perfusion media (adequate to the arterio-venous difference) was achieved by a high oxygen tension (2400-2600 mm Hg) in the solution under normal barometric pressure. Perfusate was depressurized and delivered at normal rat systemic hydrostatic pressure to the brain via a cannula inserted transcardially into the ascending aorta, with both subclavian arteries ligated. Perfusate was delivered using normal hydrostatic pressure. RESULTS: In these experimental conditions of the brain perfusion the pattern of electrocorticogram has been stable in the course of 5 h and more. The release of lactic acid in the perfusion solution was 3 times less than in perfusion under partial oxygen tension of 900 mm Hg; excessive activation of the lipid peroxidation process in the brain tissue was not observed. CONCLUSION: The presented new model of the isolated brain perfusion may be used in experiments with other isolated organs and in studies of toxic effects of oxygen.

Isolated Central Nervous System Metastasis From Neuroendocrine Carcinoma of the Cervix Without Pulmonary Metastasis.

Neuroendocrine carcinoma of the cervix (NECC) accounts for 2% of all cervical cancers. Brain metastasis is rare, with few cases described in the literature, and is usually associated with preceding pulmonary metastasis. We describe an additional case of isolated brain metastasis without pulmonary metastasis from NECC and reflect on unique management. A 37-year-old woman with a history of NECC presented with severe headache post-total hysterectomy with pelvic lymph node dissection. The computed tomography (CT) scan demonstrated obstructive hydrocephalus with several intra-axial lesions located in the pineal region, left cerebellar hemisphere, and left frontal operculum. A right frontal ventriculostomy was initially placed to relieve the hydrocephalus. CSF was sent for cytology but was unrevealing. Due to the degree of brainstem compression and the need to obtain a pathologic diagnosis, a posterior fossa craniotomy for the removal of the lesion was performed. Histopathology demonstrated small blue cell tumors positive for neuroendocrine markers consistent with neuroendocrine carcinoma of the cervix. Resection of additional metastasis was not recommended. An endoscopic third ventriculostomy (ETV) was then performed in order to remove the ventriculostomy with success. The patient was then referred to radiation oncology and received whole-brain radiotherapy (WBRT) for a total of 30 Grays (3000 cGy) over 10 fractions. Interval imaging demonstrated complete resolution of the pineal and left frontal lesions. The patient was symptom-free for approximately three months. She then presented with paraplegia consistent with follow-up imaging of her neuraxis, demonstrating drop metastasis in her cervical, thoracic, and lumbar spine. Spinal radiation was given with partial recovery in upper extremity function, however, lower extremity function did not recover. The patient was then transferred to palliative care. There are no guidelines on NECC brain metastasis management. Brain metastasis is associated with reduced longevity. NECC has a propensity for early dissemination and treatment failure. ETV is preferred over ventriculoperitoneal shunting in cases with obstructive hydrocephalus, as it may reduce the risk of tumor seeding. Retrospectively, our patient may have benefitted from upfront craniospinal radiation.

Neurosarcoidosis presenting with isolated intracranial mass lesion and communicating hydrocephalus.

Isolated neurosarcoidosis is a very rare disease, which makes up 5-15% of sarcoidosis cases. Hydrocephalus is a rare clinical feature with a prevalence of 6% among these patients. Considering neurosarcoidosis in the differential diagnosis of a unique parenquimal mass lesion could help in the early identification of this disease. We report the case of a 27-year-old African man who developed with a sole intracranial mass lesion mimicking radiologically a glioma, which finally came out as an isolated neurosarcoidosis. There is a difficulty in diagnosis when isolated neurosarcoidosis appears. In addition, the low prevalence of the disease entails a not standardized medical treatment. Natural outcome is poor even when hydrocephalus is resolved. Multimodal treatments including complete pharmacological treatment do not seem to assure a better outcome in these patients until date.

Differential expression of receptors mediating receptor-mediated transcytosis (RMT) in brain microvessels, brain parenchyma and peripheral tissues of the mouse and the human.

Receptor-mediated transcytosis (RMT) is a principal pathway for transport of macromolecules essential for brain function across the blood-brain barrier (BBB). Antibodies or peptide ligands which bind RMT receptors are often co-opted for brain delivery of biotherapeutics. Constitutively recycling transferrin receptor (TfR) is a prototype receptor utilized to shuttle therapeutic cargos across the BBB. Several other BBB-expressed receptors have been shown to mediate transcytosis of antibodies or protein ligands including insulin receptor (INSR) and insulin-like growth factor-1 receptor (IGF1R), lipid transporters LRP1, LDLR, LRP8 and TMEM30A, solute carrier family transporter SLC3A2/CD98hc and leptin receptor (LEPR). In this study, we analyzed expression patterns of genes encoding RMT receptors in isolated brain microvessels, brain parenchyma and peripheral organs of the mouse and the human using RNA-seq approach. IGF1R, INSR and LRP8 were highly enriched in mouse brain microvessels compared to peripheral tissues. In human brain microvessels only INSR was enriched compared to either the brain or the lung. The expression levels of SLC2A1, LRP1, IGF1R, LRP8 and TFRC were significantly higher in the mouse compared to human brain microvessels. The protein expression of these receptors analyzed by Western blot and immunofluorescent staining of the brain microvessels correlated with their transcript abundance. This study provides a molecular transcriptomics map of key RMT receptors in mouse and human brain microvessels and peripheral tissues, important to translational studies of biodistribution, efficacy and safety of antibodies developed against these receptors.

Isolated Murine Brain Model for Large-Scale Optoacoustic Calcium Imaging.

Real-time visualization of large-scale neural dynamics in whole mammalian brains is hindered with existing neuroimaging methods having limited capacity when it comes to imaging large tissue volumes at high speeds. Optoacoustic imaging has been shown to be capable of real-time three-dimensional imaging of multiple cerebral hemodynamic parameters in rodents. However, optoacoustic imaging of calcium activity deep within the mammalian brain is hampered by strong blood absorption in the visible light spectrum as well as a lack of activity labels excitable in the near-infrared window. We have developed and validated an isolated whole mouse brain preparation labeled with genetically encoded calcium indicator GCaMP6f, which can closely resemble in vivo conditions. An optoacoustic imaging system coupled to a superfusion system was further designed and used for rapid volumetric monitoring of stimulus-evoked calcium dynamics in the brain. These new imaging setup and isolated preparation's protocols and characteristics are described here in detail. Our new technique captures calcium fluxes as true three-dimensional information across the entire brain with temporal resolution of 10 ms and spatial resolution of 150 µm, thus enabling large-scale neural recording at penetration depths and spatio-temporal resolution scales not covered with any existing neuroimaging techniques.

Isolation of Rodent Brain Vessels.

The prevalence of neurodegenerative diseases is increasing worldwide. Cerebrovascular disorders and/or conditions known to affect brain vasculature, such as diabetes, are well-known risk factors for neurodegenerative diseases. Thus, the evaluation of the brain vasculature is of great importance to better understand the mechanisms underlying brain damage. We established a protocol for the isolation of brain vessels from rodents. This is a simple, non-enzymatic isolation protocol that allows us to perform comparative studies in different animal models of disease, helping understand the impact of several pathological conditions on brain vasculature and how those alterations predispose to neurodegenerative conditions.

Long-term Survival after Lapatinib Rechallenge in Isolated Brain Metastasis of HER2-positive Breast Cancer.

Lapatinib is an effective drug in HER2-positive breast cancer. We present a case with successful treatment of lapatinib in brain metastasis of HER2+ breast cancer. Forty-eight years old woman was admitted our clinic with early breast cancer. In third years after adjuvant chemotherapy and trastuzumab, isolated and multiple brain metastasis were detected. After whole brain RT, lapatinib (with capecitabine for 10 months and with letrozole for 3 months) has been used. Volumetric reduction of lesions was achieved and symptoms disappeared. When lapatinib discontinued, brain metastasis relapses. Lapatinib plus capecitabine reinduction has been started. Totally, longer survival than 45 months was achieved after first brain metastasis detection. Because both combinations of lapatinib with capecitabine and letrozole were effective and reinduction treatment was successful, presented case has strongly supported activity of lapatinib treatment in brain metastasis of HER2+ breast cancer.

Brain metastasis as an isolated late recurrence in small-cell lung cancer.

The brain is one of the most common sites of metastasis of small-cell lung cancer (SCLC). In this study, we reported 6 cases with isolated brain relapse of SCLC ≥1 year after the completion of the initial treatment for SCLC. Of the 6 patients, 2 had a solitary brain metastasis and 4 had ≥2 brain metastatic sites. The metastases were identified during a regular check-up computed tomography (CT) scan and were successfully treated. The median interval from the initial diagnosis to the development of brain metastasis was 16 months (range, 13-30 months). All patients received whole-brain irradiation and achieved a complete response. Only one patient developed disturbances of the higher cerebral function. The median interval from whole-brain irradiation to death or last follow-up was 33 months (range, 8-90 months). To the best of our knowledge, these are the first reported cases with isolated brain relapse of SCLC. Although a rare finding, clinicians should be alert on the possibility of such recurrence, particularly in patients who refused prophylactic cranial irradiation.