Hansen Marlan R, Clark J Jason, Gantz Bruce J, Goswami Prabhat C
Department of Otolaryngology-Head and Neck, University of Iowa, Iowa City, Iowa 52242, USA.
Laryngoscope. 2008 Jun;118(6):1023-30. doi: 10.1097/MLG.0b013e318163f920.
For vestibular schwannomas (VSs) that require treatment, options are limited to microsurgery or irradiation (IR). Development of alternative therapies that augment or replace microsurgery or IR would benefit patients not suitable for current therapies. This study explored the ability of ErbB2 inhibitors to modulate the effects of IR on VS cells.
Prospective study using primary cultures derived from human VSs.
Primary cultures of VS cells were derived from acutely resected tumors. Cultures received single escalating doses (15-40 Gy) of gamma-irradiation from a Cs gamma-irradiation source. Cell proliferation was determined by BrdU uptake and apoptosis by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). Trastuzumab (Herceptin) and PD158780 were independently used to inhibit ErbB2 signaling while neuregulin-1beta (NRG-1) was used to activate ErbB2.
IR induces VS cell cycle arrest and apoptosis in doses greater than 20 Gy, demonstrating that VS cells are relatively radioresistant. This radioresistance likely arises from their low proliferative capacity as a sublethal dose of IR (10 Gy) strongly induces deoxyribonucleic acid (DNA) damage evidenced by histone H2AX phosphorylation. Inhibition of ErbB2, which decreases VS cell proliferation, protects VS cells from radiation-induced apoptosis, while NRG-1, an ErbB2 ligand and VS cell mitogen, increases radiation-induced VS cell apoptosis.
Compared with many neoplastic conditions, VS cells are relatively radioresistant. The radio-protective effect of ErbB2 inhibitors implies that the sensitivity of VS cells to IR depends on their proliferative capacity. These results hold important implications for current and future treatment strategies.
对于需要治疗的前庭神经鞘瘤(VS),治疗选择仅限于显微手术或放射治疗(IR)。开发增强或替代显微手术或IR的替代疗法将使不适合当前疗法的患者受益。本研究探讨了表皮生长因子受体2(ErbB2)抑制剂调节IR对VS细胞作用的能力。
使用源自人类VS的原代培养物进行前瞻性研究。
VS细胞的原代培养物取自急性切除的肿瘤。培养物接受来自铯γ射线源的单剂量递增(15 - 40 Gy)γ射线照射。通过5-溴脱氧尿嘧啶核苷(BrdU)摄取测定细胞增殖,通过末端脱氧核苷酸转移酶介导的dUTP缺口末端标记法(TUNEL)测定细胞凋亡。曲妥珠单抗(赫赛汀)和PD158780分别用于抑制ErbB2信号传导,而神经调节蛋白-1β(NRG-1)用于激活ErbB2。
剂量大于20 Gy时,IR诱导VS细胞周期停滞和凋亡,表明VS细胞具有相对放射抗性。这种放射抗性可能源于其低增殖能力,因为亚致死剂量的IR(10 Gy)强烈诱导组蛋白H2AX磷酸化所证明的脱氧核糖核酸(DNA)损伤。抑制ErbB2可降低VS细胞增殖,保护VS细胞免受辐射诱导的凋亡,而ErbB2配体和VS细胞有丝分裂原NRG-1则增加辐射诱导的VS细胞凋亡。
与许多肿瘤情况相比,VS细胞具有相对放射抗性。ErbB2抑制剂的放射保护作用意味着VS细胞对IR的敏感性取决于其增殖能力。这些结果对当前和未来的治疗策略具有重要意义。