Ostrowski Robert P, Acewicz Albert, He Zhaohui, Pucko Emanuela B, Godlewski Jakub
Department of Neurooncology, Mossakowski Medical Research Institute, Polish Academy of Sciences (MMRI-PAS), 02-106 Warsaw, Poland.
Department of Neuropathology, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland.
Int J Mol Sci. 2025 Aug 1;26(15):7425. doi: 10.3390/ijms26157425.
Progress in establishing environmental risk factors and, consequently, prophylactic measures for glial tumors, particularly for glioblastomas, is of utmost importance, considering the dismal prognosis and limited treatment options. This report surveyed updates on established and recently identified factors that can predispose a patient to glioma formation while highlighting possible mechanistic links and further research directions. In addition to established factors that increase the risk of glioma, i.e., brain irradiation and several genetic syndromes, another group consists of likely factors contributing to such risks, such as the use of tobacco and those yielding ambiguous results (e.g., UV exposure). Oxidative stress is a common denominator for several types of exposure, and a mechanistic background for other factors remains elusive. Nevertheless, the analysis of clinical and basic research strongly suggests that, apart from the effect of environmental stressors on DNA alterations and mutation burden, the impact of modifying the tumor microenvironment should be considered. Identifying the involvement of environmental hazards in gliomagenesis and glial tumor progression would lower overall risk by modifying clinical practice, patient management, and lifestyle choices. Further verifying the environmental hazards in glioma formation and progression would have far-reaching implications for neurologists, neurosurgeons, and patients.
鉴于胶质肿瘤，尤其是胶质母细胞瘤的预后不佳且治疗选择有限，确定其环境风险因素并因此制定预防措施至关重要。本报告调查了已确定的和最近发现的可能使患者易患胶质瘤的因素的最新情况，同时强调了可能的机制联系和进一步的研究方向。除了已确定的增加胶质瘤风险的因素，即脑部放疗和几种遗传综合征外，另一组因素包括可能导致此类风险的因素，如吸烟以及那些结果不明确的因素（如紫外线暴露）。氧化应激是几种类型暴露的共同特征，而其他因素的机制背景仍不清楚。然而，临床和基础研究分析强烈表明，除了环境应激源对DNA改变和突变负担的影响外，还应考虑改变肿瘤微环境的影响。确定环境危害在胶质瘤发生和胶质肿瘤进展中的作用，将通过改变临床实践、患者管理和生活方式选择来降低总体风险。进一步验证环境危害在胶质瘤形成和进展中的作用，将对神经科医生、神经外科医生和患者产生深远影响。
