Schulz Alexander, Büttner Robert, Hagel Christian, Baader Stephan L, Kluwe Lan, Salamon Johannes, Mautner Victor-Felix, Mindos Thomas, Parkinson David B, Gehlhausen Jeffrey R, Clapp D Wade, Morrison Helen
Leibniz Institute on Aging, Fritz Lipmann Institute, Beutenbergstrasse 11, 07745, Jena, Germany.
Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
Acta Neuropathol. 2016 Aug;132(2):289-307. doi: 10.1007/s00401-016-1583-8. Epub 2016 May 28.
Schwannomas are predominantly benign nerve sheath neoplasms caused by Nf2 gene inactivation. Presently, treatment options are mainly limited to surgical tumor resection due to the lack of effective pharmacological drugs. Although the mechanistic understanding of Nf2 gene function has advanced, it has so far been primarily restricted to Schwann cell-intrinsic events. Extracellular cues determining Schwann cell behavior with regard to schwannoma development remain unknown. Here we show pro-tumourigenic microenvironmental effects on Schwann cells where an altered axonal microenvironment in cooperation with injury signals contribute to a persistent regenerative Schwann cell response promoting schwannoma development. Specifically in genetically engineered mice following crush injuries on sciatic nerves, we found macroscopic nerve swellings in mice with homozygous nf2 gene deletion in Schwann cells and in animals with heterozygous nf2 knockout in both Schwann cells and axons. However, patient-mimicking schwannomas could only be provoked in animals with combined heterozygous nf2 knockout in Schwann cells and axons. We identified a severe re-myelination defect and sustained macrophage presence in the tumor tissue as major abnormalities. Strikingly, treatment of tumor-developing mice after nerve crush injury with medium-dose aspirin significantly decreased schwannoma progression in this disease model. Our results suggest a multifactorial concept for schwannoma formation-emphasizing axonal factors and mechanical nerve irritation as predilection site for schwannoma development. Furthermore, we provide evidence supporting the potential efficacy of anti-inflammatory drugs in the treatment of schwannomas.
施万细胞瘤主要是由Nf2基因失活引起的良性神经鞘瘤。目前,由于缺乏有效的药物,治疗选择主要限于手术切除肿瘤。尽管对Nf2基因功能的机制理解有所进展,但迄今为止主要局限于施万细胞内在事件。决定施万细胞在施万细胞瘤发生过程中行为的细胞外信号仍然未知。在这里,我们展示了促肿瘤微环境对施万细胞的影响,其中改变的轴突微环境与损伤信号协同作用,导致持续的再生施万细胞反应,促进施万细胞瘤的发展。具体而言,在对坐骨神经进行挤压损伤的基因工程小鼠中,我们在施万细胞中纯合nf2基因缺失的小鼠以及施万细胞和轴突中杂合nf2基因敲除的动物中发现了宏观神经肿胀。然而,只有在施万细胞和轴突中联合杂合nf2基因敲除的动物中才能诱发类似患者的施万细胞瘤。我们确定肿瘤组织中严重的重新髓鞘化缺陷和持续的巨噬细胞存在是主要异常。令人惊讶的是,在这个疾病模型中,用中等剂量阿司匹林治疗神经挤压损伤后正在发生肿瘤的小鼠,可显著降低施万细胞瘤的进展。我们的结果提出了一个施万细胞瘤形成的多因素概念,强调轴突因素和机械性神经刺激是施万细胞瘤发展的偏好部位。此外,我们提供了支持抗炎药物在治疗施万细胞瘤方面潜在疗效的证据。
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