Department of Neurological Surgery, Nippon Medical School.
Department of Neurosurgery for Community Health, Nippon Medical School Graduate School.
J Nippon Med Sch. 2021 Jan 8;87(6):310-317. doi: 10.1272/jnms.JNMS.2020_87-601. Epub 2020 Mar 31.
5-Aminolevulinic Acid (5-ALA) photodiagnosis (PD) is an effective method to detect residual tumors during glioma surgery. However, fluorescence strength differs in malignant gliomas, and false-negative fluorescence may result in tumor residue. We investigated the effect of ultrasound on the intracellular level of protoporphyrin IX (PpIX) and expression level of ATP-binding cassette transporter 2 (ABCG2), which is thought to act as a membrane efflux pump of PpIX from cytosol.
The malignant glioma cell lines SNB19, U87MG, and T98G were used for in vitro experiments. Cultured cells underwent ultrasound irradiation (1 MHz, 3 W/cm, duty cycle 10%) after administration of 5-ALA, and morphological changes in tumor cells were observed. PpIX levels and ABCG2 expression were evaluated.
The glioma tumor cells showed transient morphological changes and detachment from the culture dish; however, most cells survived and reverted to their original morphology within 6 hours. PpIX expression levels increased in glioma cells after ultrasound irradiation, and the increase was earlier and greater than that for 5-ALA alone. ABCG2 expressions increased after 5-ALA administration but were lower in ultrasound-irradiated glioma cells.
Ultrasound irradiation of malignant gliomas contributes to stronger 5-ALA-induced fluorescence by elevating intracellular PpIX levels. Suppression of ABCG2 expression by ultrasound may contribute to PpIX accumulation in glioma cells.
5-氨基酮戊酸(5-ALA)光诊断(PD)是一种在胶质瘤手术中检测残留肿瘤的有效方法。然而,恶性胶质瘤的荧光强度不同,假阴性荧光可能导致肿瘤残留。我们研究了超声对原卟啉 IX(PpIX)细胞内水平和三磷酸腺苷结合盒转运蛋白 2(ABCG2)表达水平的影响,ABCG2 被认为是 PpIX 从细胞质中膜外排泵。
采用体外实验的方法,使用恶性神经胶质瘤细胞系 SNB19、U87MG 和 T98G。给予 5-ALA 后,对培养的肿瘤细胞进行超声照射(1 MHz,3 W/cm,占空比 10%),观察肿瘤细胞的形态变化。评估 PpIX 水平和 ABCG2 表达。
胶质瘤肿瘤细胞表现出短暂的形态变化,并从培养皿中脱落;然而,大多数细胞在 6 小时内存活并恢复到原来的形态。超声照射后,胶质瘤细胞中 PpIX 的表达水平增加,且增加早于且大于单独使用 5-ALA 的情况。5-ALA 给药后 ABCG2 表达增加,但超声照射的胶质瘤细胞中 ABCG2 表达降低。
恶性胶质瘤的超声照射通过提高细胞内 PpIX 水平促进更强的 5-ALA 诱导荧光。超声抑制 ABCG2 表达可能有助于 PpIX 在胶质瘤细胞中的积累。