Transcriptional landscape of neuronal and cancer stem cells

Tumor mass is composed by heterogeneous cell population including a subset of “cancer stem cells” (CSC). Oncogenic signals foster CSC by transforming tissue stem cells or by reprogramming progenitor/differentiated cells towards stemness. Thus, CSC share features with cancer and stem cells (e.g. self-renewal, hierarchical developmental program leading to differentiated cells, epithelial/mesenchimal transition) and these latter are maintained by the constitutive activation of stemness-promoting signals. CSC could trigger tumor formation, drive to resistance to conventional therapeutics and underlie patients’ relapse. Indeed, stem cell signatures have been associated with poor prognosis in various. This background makes the identification of CSC molecular features mandatory to highlight the survival inner working and to design novel CSC specific therapeutic strategies. Medulloblastoma (MB) is the most common childhood malignant brain tumor and a leading cause of cancerrelated morbidity and mortality. Current multimodal therapies are effective in about 50% of patients but often cause long-term side effects, i.e. developmental, neurological, neuroendocrine and psychosocial deficits (Northcott PA Nature Rev cancer 2012). For many years, MB treated as a single tumor entity despite the divergent tumor histology, patients’ outcome and drug sensitivity, and also by the diversity of the stem cell of origin. Very recently the scenario of human MB has dramatically changed since its heterogeneous biology has been addressed by high-throughput gene expression analysis (oligonucleotide microarrays) or by the powerful genomic next-generation sequencing. These led to the identification of four tumor subgroups (WNT, SHH, Group 3 and Group 4) uncovering the existence of a highly diverse mutational spectra and gene expression. However a quantitative approach has not yet been applied to the transcriptional landscape of Medulloblastoma stem cells (MbSC) through RNA Next Generation Sequencing (RNA-Seq) technology. This is a relevant issue, since RNA-Seq is able to interrogate the genome wide global transcriptome including new transcripts, alternative spliced isoforms and non-coding RNAs. Lower rhombic lip progenitors of the dorsal brainstem are considered the trigger cells in WNT tumors; in SHH subgroup initiation cells are Prominin1+ CD15+ stem cells from the subventricular zone requiring the commitment to Math1+ granule cell progenitors [GCP] of the external granule cell layer [EGL]; while Math1+ or Math1- EGL-GCP or Prominin1+/lineage-negative stem cells sustain the MYC driven Group 3. MbSC derived from SHH tumors and postnatal normal cerebellar stem cells (NcSC) have been reported to share several features. A key signal for both of them is Hedgehog. Furthermore, both NcSC and MbSC display up-regulation of stemness genes (e.g Sox2, Nestin, Nanog, Prom1). Finally, constitutive activation of the Shh pathway by conditional deletion of Ptch1 inhibitory receptor in NcSC, promote medulloblastoma in vivo, producing a mouse model of the human SHH tumor. Acquisition of stemness features may therefore represent the first step of oncogenic conversion. Cooperation with additional oncogenic signals is however needed to enhance MbSC tumorigenicity. In order to understand the MbSCs transcriptional programs, we analyze by RNA-Seq, MbSC derived from Ptch1+/- tumors (Ptch1+/- MbSC). This choice, of a genetically determined model of MB, has allowed us to work with Ptch1+/- MbSC together with appropriate NcSC counterpart, and to analyze biological replicates doing statistical analysis. We identify a number of transcripts, annotated ones, novel isoforms, and long non-coding RNAs, characterizing MbSC and/or NcSC. Some of these genes control stemness or are cancer related and conserved in human medulloblastomas. Interestingly a subset of them, belonging to cell stress response, are of prognostic relevance being significantly related to clinical outcome. Correlation of genes expression characterizing MbSC with survival information from our human medulloblastomas database further demonstrates the significance of these findings. Our data suggest that the modulation of normal and cancer stem cell functions observed in vitro is effective in dissecting the transcriptional programs underlying the in vivo behavior of human medulloblastomas

Acrocyanosis, digital ischemia and acronecrosis as first manifestations of endometrial adenocarcinoma: case presentation and literature review

The association between digital ischemia and cancer is rarely reported in literature and the exact mechanism of this occurrence has not been completely understood. We report here a case of a 73 yearold woman who presented digital ischemia as first manifestation of endometrial adenocarcinoma. Reporting this rare clinical case and with a brief literature review, we recommend to consider an intensive search for primary and metastatic cancer in all patients who experience a digital ischemia, with the aim to early detect and treat the disease

Albumin-bound formulation of paclitaxel (Abraxane® ABI-007) in the treatment of breast cancer

Breast cancer is the most common type of malignancy diagnosed in women. In the metastatic setting this disease is still uncurable. Taxanes represent an important class of antitumor agents which have proven to be fundamental in the treatment of advanced and early-stage breast cancer, but the clinical advances of taxanes have been limited by their highly hydrophobic molecular status. To overcome this poor water solubility, lipid-based solvents have been used as a vehicle, and new systemic formulations have been developed, mostly for paclitaxel, which are Cremophor-free and increase the circulation time of the drug. ABI-007 is a novel, albumin-bound, 130-nm particle formulation of paclitaxel, free from any kind of solvent. It has been demonstrated to be superior to an equitoxic dose of standard paclitaxel with a significantly lower incidence of toxicities in a large, international, randomized phase III trial. The availability of new drugs, such as Abraxane®, in association with other traditional and non-traditional drugs (new antineoplastic agents and targeted molecules), will give the oncologist many different effective treatment options for patients in this setting

Anomalous vascularization in a Wnt medulloblastoma: A case report

BACKGROUND: Medulloblastoma is the most common malignant brain tumor in children. To date only few cases of medulloblastoma with hemorrhages have been reported in the literature. Although some studies speculate on the pathogenesis of this anomalous increased vascularization in medulloblastoma, the specific mechanism is still far from clearly understood. A correlation between molecular medulloblastoma subgroups and hemorrhagic features has not been reported, although recent preliminary studies described that WNT-subtype tumors display increased vascularization and hemorrhaging. CASE PRESENTATION: Herein, we describe a child with a Wnt-medulloblastoma presenting as cerebellar-vermian hemorrhagic lesion. Brain magnetic resonance imaging (MRI) showed the presence of a midline posterior fossa mass with a cystic hemorrhagic component. The differential diagnosis based on imaging included cavernous hemangioma, arteriovenous malformation and traumatic lesion. At surgery, the tumor appeared richly vascularized as documented by the preoperative angiography. CONCLUSIONS: The case we present showed that Wnt medulloblastoma may be associated with anomalous vascularization. Further studies are needed to elucidate if there is a link between the hypervascularization and the Wnt/β-catenin signaling activation and if this abnormal vasculature might influence drug penetration contributing to good prognosis of this medulloblastoma subgroup

MicroRNAs-Proteomic Networks Characterizing Human Medulloblastoma-SLCs

Medulloblastoma (MB) is the most common malignant brain tumor of pediatric age and is characterized by cells expressing stem, astroglial, and neuronal markers. Among them, stem-like cells (hMB-SLCs) represent a fraction of the tumor cell population with the potential of self-renewal and proliferation and have been associated with tumor poor prognosis. In this context, microRNAs have been described as playing a pivotal role in stem cells differentiation. In our paper, we analyze microRNAs profile and genes expression of hMB-SLCs before and after Retinoic Acid- (RA-) induced differentiation. We aimed to identify pivotal players of specific pathways sustaining stemness and/or tumor development and progression and integrate the results of our recent proteomic study. Our results uncovered 22 differentially expressed microRNAs that were used as input together with deregulated genes and proteins in the Genomatix Pathway System (GePS) analysis revealing 3 subnetworks that could be interestingly involved in the maintenance of hMB-SLCs proliferation. Taken together, our findings highlight microRNAs, genes, and proteins that are significantly modulated in hMB-SLCs with respect to their RA-differentiated counterparts and could open new perspectives for prognostic and therapeutic intervention on MB

Numb Isoforms Deregulation in Medulloblastoma and Role of p66 Isoform in Cancer and Neural Stem Cells

Numb is an intracellular protein with multiple functions. The two prevalent isoforms, Numb p66 and Numb p72, are regulators of differentiation and proliferation in neuronal development. Additionally, Numb functions as cell fate determinant of stem cells and cancer stem cells and its abnormal expression has been described in several types of cancer. Involvement of deregulated Numb expression has been described in the malignant childhood brain tumor medulloblastoma, while Numb isoforms in these tumors and in cancer stem-like cells derived from them, have not been studied to date. Here we show that medulloblastoma stem-like cells and cerebellar neuronal stem cells (NSCs) express Numb p66 where its expression tampers stemness features. Furthermore, medulloblastoma samples evaluated in this study express decreased levels of Numb p66 while overexpressed Numb p72 compared with normal tissues. Our results uncover different roles for the two major Numb isoforms examined in medulloblastoma and a critical role for Numb p66 in regulating stem-like cells and NSCs maintenance

The long noncoding RNA linc-NeD125 controls the expression of medulloblastoma driver genes by microRNA sponge activity

Long noncoding RNAs (lncRNAs) are major regulators of physiological and disease-related gene expression, particularly in the central nervous system. Dysregulated lncRNA expression has been documented in several human cancers, and their tissue-specificity makes them attractive candidates as diagnostic/prognostic biomarkers and/or therapeutic agents. Here we show that linc-NeD125, which we previously characterized as a neuronal-induced lncRNA, is significantly overexpressed in Group 4 medulloblastomas (G4 MBs), the largest and least well characterized molecular MB subgroup. Mechanistically, linc-NeD125 is able to recruit the miRNA-induced silencing complex (miRISC) and to directly bind the microRNAs miR-19a-3p, miR-19b-3p and miR-106a-5p. Functionally, linc-NeD125 acts as a competing endogenous RNA (ceRNA) that, sequestering the three miRNAs, leads to de-repression of their targets CDK6, MYCN, SNCAIP, and KDM6A, which are major driver genes of G4 MB. Accordingly, linc-NeD125 downregulation reduces G4 cell proliferation. Moreover, we also provide evidence that linc-NeD125 ectopic expression in the aggressive Group 3 MB cells attenuates their proliferation, migration and invasion. This study unveils the first lncRNA-based ceRNA network in central nervous system tumours and provides a novel molecular circuit underlying the enigmatic Group 4 medulloblastoma

Metastatic Group 3 Medulloblastoma in a Patient With Tuberous Sclerosis Complex: Case Description and Molecular Characterization of the Tumor

Medulloblastoma is the most common pediatric brain tumor. We describe a child with tuberous sclerosis complex that developed a Group 3, myc overexpressed, metastatic medulloblastoma (MB). Considering the high risk of treatment-induced malignancies, a tailored therapy, omitting radiation, was given. Based on the evidence of mammalian target of rapamycin mTORC, mTOR Complex; RAS, Rat sarcoma; RAF, rapidly accelerated fibrosarcoma (mTOR) pathway activation in the tumor, targeted therapy was applied resulting in complete remission of disease. Although the PI3K/AKT/mTOR signaling pathway plays a role in MB, we did not find TSC1/TSC2 (TSC, tuberous sclerosis complex) mutation in our patient. We speculate that a different pathway resulting in mTOR activation is the basis of both TSC and MB in this child; H&E, haematoxilin and eosin; Gd, gadolinium

Consequences of simulated microgravity in neural stem cells: biological effects and metabolic response.

Objective: Microgravity was often shown to cause cell damage and impair cell cycle in a variety of biological systems. Since the effects on the neural system were poorly investigated, we aimed to gain insight into how biological processes such as cell cycle, cell damage, stemness features and metabolic status are involved in neural stem cells (NSC) when they experience simulated microgravity. We also wished to investigate whether these modulations were transient or permanent once cells were returned to normal gravity. Methods: NSC were isolated from mouse cerebella and cultured in the Rotary Cell Culture System (RCCS) to model microgravity. We analyzed cell cycle, stress and apoptotic response. We also performed a 1H NMR-based metabolomic analysis and evaluation of stemness features of NSC in simulated microgravity and once in the returned to normogravity cell culture. Results: Biological processes and metabolic status were modulated by simulated microgravity. Cells were arrested in S-phase together with enhanced apoptosis. Metabolic changes occurred in NSC after simulated microgravity. Interestingly, these modulations were transient. Indeed, stemness features and metabolic footprint returned to basal levels after few days of culture in normal conditions. Moreover NSC clonogenic ability was not impaired. Conclusions: Our data suggest that simulated microgravity impacts on NSC biological processes, including cell cycle and apoptosis. However, NSC does not suffer from permanent damage

Positron Emission Tomography (PET) radiotracers in oncology – utility of 18F-Fluoro-deoxy-glucose (FDG)-PET in the management of patients with non-small-cell lung cancer (NSCLC)

PET (Positron Emission Tomography) is a nuclear medicine imaging method, frequently used in oncology during the last years. It is a non-invasive technique that provides quantitative in vivo assessment of physiological and biological phenomena. PET has found its application in common practice for the management of various cancers