Departments of Pathology and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
Mol Neurobiol. 2019 Sep;56(9):6645-6653. doi: 10.1007/s12035-019-1561-y. Epub 2019 Mar 26.
For normal functioning, the brain requires an adequate supply of blood. The components of normal brain vasculature are collectively referred to as the neurovascular unit. When the brain develops pathology, the structural and functional components of brain vasculature become compromised. This is evidenced in the case of neoplasia where the integrity of the vasculature is co-opted to further the neoplastic processes that require exponential blood resupply in order to facilitate the diffusion radius of tumor growth. Glioblastoma changes the brain vasculature in such a way that advances the tumor's progress while making it more resistant to standard modes of treatment. While the brain vasculature is changed as a result of glioblastoma growth and progression, it is also changed to advance the invasiveness of the tumor. The diagnostic criteria for glioblastoma is correlated with advanced neovascularization processes that change the previously existing vasculature into that which is morphologically atypical and in a dysfunctional state. Advancing therapies to treat glioblastoma must understand normal brain vasculature and how it is changed as a result of tumor growth.
为了正常运作,大脑需要充足的血液供应。正常脑脉管系统的组成部分统称为神经血管单元。当大脑发生病变时,脑脉管系统的结构和功能成分就会受到损害。在肿瘤发生的情况下就是如此,脉管系统的完整性被利用来促进需要指数级血液供应的肿瘤进程,以促进肿瘤生长的扩散半径。胶质母细胞瘤以一种使肿瘤进展更具侵袭性的方式改变大脑脉管系统,同时使其对标准治疗模式更具抵抗力。虽然脑脉管系统因胶质母细胞瘤的生长和进展而发生改变,但它也会发生改变以促进肿瘤的侵袭性。胶质母细胞瘤的诊断标准与先进的新生血管过程相关,这些过程将先前存在的脉管系统改变为形态异常和功能失调的状态。为了治疗胶质母细胞瘤而推进的治疗方法必须了解正常的大脑血管系统以及肿瘤生长如何导致其发生变化。