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Cancer Treatment and Research... 2021No large-scale study evaluating the usefulness of tamoxifen after meningioma surgery has been undertaken.
BACKGROUND
No large-scale study evaluating the usefulness of tamoxifen after meningioma surgery has been undertaken.
METHODS
We processed the French Système National des Données de Santé (SNDS) database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve cases of meningiomas operated between 2007 and 2017. Survival analyses were performed using a matched cohort study.
RESULTS
251 patients treated by tamoxifen were extracted from a nationwide population-based cohort of 28 924 patients operated on for a meningioma over a 10-year period. 94% were female and median age at meningioma first surgery was 57 years IQR[47-67]. Tamoxifen treatment median duration was 1.4 years IQR[0.4-3.2]. Tamoxifen treatment median cumulative given dose was 11.4 gs, IQR[3.6-24.9]. There was a strong positive correlation between treatment duration and cumulative dose (τ=0.81, p<0.001). 6% of the patient had to be reoperated for a meningioma recurrence and 26.3% had radiotherapy. OS rates at 5 and 10 years were: 92.3%, CI[90.3-94.3] and 81.3%, CI[75.2-88] respectively. These 251 patients were matched by gender, age at surgery and grade with the same number of subjects within the nationwide cohort. Nor overall (HR=1.46, CI[0.86- 2.49], p=0.163) or progression-free survival (HR=1.2, CI[0.89- 1.62], p=0.239) were significantly improved by the tamoxifen treatment.
CONCLUSION
Using this unique database, in the setting of breast cancer, we could not conclude on a favourable effect of tamoxifen to prevent recurrence after meningioma surgery or to increase meningioma-related survival even in case of prolonged treatment duration or high cumulative given dose.
Topics: Aged; Chemoradiotherapy, Adjuvant; Chemotherapy, Adjuvant; Databases, Factual; Dose-Response Relationship, Drug; Female; France; Humans; Male; Meningeal Neoplasms; Meninges; Meningioma; Middle Aged; Neoplasm Recurrence, Local; Progression-Free Survival; Retrospective Studies; Survival Analysis; Tamoxifen; Time Factors
PubMed: 33647870
DOI: 10.1016/j.ctarc.2021.100343 -
AJNR. American Journal of Neuroradiology Feb 2022The arachnoid membranes are projections of connective tissue in the subarachnoid space that connect the arachnoid mater to the pia mater. These are underappreciated and... (Review)
Review
The arachnoid membranes are projections of connective tissue in the subarachnoid space that connect the arachnoid mater to the pia mater. These are underappreciated and largely unrecognized by most neuroradiologists despite being found to be increasingly important in the pathogenesis, imaging, and treatment of communicating hydrocephalus. This review aims to provide neuroradiologists with an overview of the history, embryology, histology, anatomy, and normal imaging appearance of these membranes, as well as some examples of their clinical importance.
Topics: Arachnoid; Consciousness; Humans; Pia Mater; Radiology; Subarachnoid Space
PubMed: 34711549
DOI: 10.3174/ajnr.A7309 -
Molecular Psychiatry Apr 2021The potential existence and roles of the meningeal lymphatic system in normal and pathological brain function have been a long-standing enigma. Recent evidence suggests... (Review)
Review
The potential existence and roles of the meningeal lymphatic system in normal and pathological brain function have been a long-standing enigma. Recent evidence suggests that meningeal lymphatic vessels are present in both the mouse and human brain; in mice, they seem to play a role in clearing toxic amyloid-beta peptides, which have been connected with Alzheimer disease (AD). Here, we review the evidence linking the meningeal lymphatic system with human AD. Novel findings suggest that the recently described meningeal lymphatic vessels could be linked to, and possibly drain, the efferent paravascular glial lymphatic (glymphatic) system carrying cerebrospinal fluid, after solute and immune cell exchange with brain interstitial fluid. In so doing, the glymphatic system could contribute to the export of toxic solutes and immune cells from the brain (an exported fluid we wish to describe as glymph, similarly to lymph) to the meningeal lymphatic system; the latter, by being connected with downstream anatomic regions, carries the glymph to the conventional cervical lymphatic vessels and nodes. Thus, abnormal function in the meningeal lymphatic system could, in theory, lead to the accumulation, in the brain, of amyloid-beta, cellular debris, and inflammatory mediators, as well as immune cells, resulting in damage of the brain parenchyma and, in turn, cognitive and other neurologic dysfunctions. In addition, we provide novel insights into APOE4-the leading genetic risk factor for AD-and its relation to the meningeal lymphatic system. In this regard, we have reanalyzed previously published RNA-Seq data to show that induced pluripotent stem cells (iPSCs) carrying the APOE4 allele (either as APOE4 knock-in or stemming from APOE4 patients) express lower levels of (a) genes associated with lymphatic markers, and (b) genes for which well-characterized missense mutations have been linked to peripheral lymphedema. Taking into account this evidence, we propose a new conceptual framework, according to which APOE4 could play a novel role in the premature shrinkage of meningeal lymphatic vessels (meningeal lymphosclerosis), leading to abnormal meningeal lymphatic functions (meningeal lymphedema), and, in turn, reduction in the clearance of amyloid-beta and other macromolecules and inflammatory mediators, as well as immune cells, from the brain, exacerbation of AD manifestations, and progression of the disease. Altogether, these findings and their potential interpretations may herald novel diagnostic tools and therapeutic approaches in patients with AD.
Topics: Alzheimer Disease; Amyloid beta-Peptides; Animals; Apolipoprotein E3; Apolipoprotein E4; Brain; Humans; Lymphatic System; Lymphatic Vessels; Meninges; Mice
PubMed: 32355332
DOI: 10.1038/s41380-020-0731-7 -
Scientific Reports Feb 2022In this paper, we have considered a deterministic mathematical model to analyze effective interventions for meningitis and pneumonia coinfection as well as to make a...
In this paper, we have considered a deterministic mathematical model to analyze effective interventions for meningitis and pneumonia coinfection as well as to make a rational recommendation to public healthy, policy or decision makers and programs implementers. We have introduced the epidemiology of infectious diseases, the epidemiology of meningitis, the epidemiology of pneumonia, and the epidemiology of infection of meningitis and pneumonia. The positivity and boundedness of the sated model was shown. Our model elucidate that, the disease free equilibrium points of each model are locally asymptotically stable if the corresponding reproduction numbers are less than one and globally asymptotically stable if the corresponding reproduction numbers are greater than one. Additionally, we have analyzed the existence and uniqueness of the endemic equilibrium point of each sub models, local stability and global stability of the endemic equilibrium points for each model. By using standard values of parameters we have obtained from different studies, we found that the effective reproduction numbers of meningitis [Formula: see text] and effective reproduction numbers of pneumonia [Formula: see text] that lead us to the effective reproduction number of the meningitis and pneumonia co-infected model is [Formula: see text]. Applying sensitivity analysis, we identified the most influential parameters that can change the behavior of the solution of the meningitis pneumonia coinfection dynamical system are [Formula: see text] and [Formula: see text]. Biologically, decrease in [Formula: see text] and increasing in [Formula: see text] is a possible intervention strategy to reduce the infectious from communities. Finally, our numerical simulation has shown that vaccination against those diseases, reducing contact with infectious persons and treatment have the great effect on reduction of these silent killer diseases from the communities.
Topics: Basic Reproduction Number; Coinfection; Computer Simulation; Humans; Meningitis; Models, Theoretical; Pneumonia; Public Health
PubMed: 35173209
DOI: 10.1038/s41598-022-06253-0 -
The Neuroscientist : a Review Journal... Oct 2021Emerging evidence highlights the several roles that meninges play in relevant brain functions as they are a protective membrane for the brain, produce and release... (Review)
Review
Emerging evidence highlights the several roles that meninges play in relevant brain functions as they are a protective membrane for the brain, produce and release several trophic factors important for neural cell migration and survival, control cerebrospinal fluid dynamics, and embrace numerous immune interactions affecting neural parenchymal functions. Furthermore, different groups have identified subsets of neural progenitors residing in the meninges during development and in the adulthood in different mammalian species, including humans. Interestingly, these immature neural cells are able to migrate from the meninges to the neural parenchyma and differentiate into functional cortical neurons or oligodendrocytes. Immature neural cells residing in the meninges promptly react to brain disease. Injury-induced expansion and migration of meningeal neural progenitors have been observed following experimental demyelination, traumatic spinal cord and brain injury, amygdala lesion, stroke, and progressive ataxia. In this review, we summarize data on the function of meninges as stem cell niche and on the presence of immature neural cells in the meninges, and discuss their roles in brain health and disease. Furthermore, we consider the potential exploitation of meningeal neural progenitors for the regenerative medicine to treat neurological disorders.
Topics: Adult; Animals; Brain; Cell Differentiation; Humans; Meninges; Neural Stem Cells; Neurogenesis
PubMed: 32935634
DOI: 10.1177/1073858420954826 -
Neurobiology of Disease Dec 2023Cerebral small vessel disease (CSVD) causes 20%-25% of stroke and contributes to 45% of dementia cases worldwide. However, since its early symptoms are inconclusive in... (Review)
Review
Cerebral small vessel disease (CSVD) causes 20%-25% of stroke and contributes to 45% of dementia cases worldwide. However, since its early symptoms are inconclusive in addition to the complexity of the pathological basis, there is a rather limited effective therapies and interventions. Recently, accumulating evidence suggested that various brain-waste-clearance dysfunctions are closely related to the pathogenesis and prognosis of CSVD, and after a comprehensive and systematic review we classified them into two broad categories: trans-barrier transport and lymphatic drainage. The former includes blood brain barrier and blood-cerebrospinal fluid barrier, and the latter, glymphatic-meningeal lymphatic system and intramural periarterial drainage pathway. We summarized the concepts and potential mechanisms of these clearance systems, proposing a relatively complete framework for elucidating their interactions with CSVD. In addition, we also discussed recent advances in therapeutic strategies targeting clearance dysfunction, which may be an important area for future CSVD research.
Topics: Humans; Blood-Brain Barrier; Glymphatic System; Stroke; Cerebral Small Vessel Diseases; Meninges; Brain
PubMed: 37951367
DOI: 10.1016/j.nbd.2023.106347 -
Cell Reports Mar 2023Tuberculous meningitis (TBM) is the most severe and deadly manifestation of tuberculosis. Neurological complications are observed in up to 50% of patients affected....
Tuberculous meningitis (TBM) is the most severe and deadly manifestation of tuberculosis. Neurological complications are observed in up to 50% of patients affected. Here, attenuated Mycobacterium bovis are injected into the cerebellum of mice, and histopathological images and cultured colonies confirm successful brain infection. Then, whole-brain tissue is dissected for 10X Genomics single-cell sequencing, and we acquire 15 cell types. Transcriptional changes of inflammation processes are found in multiple cell types. Specifically, Stat1 and IRF1 are shown to mediate inflammation in macrophages and microglia. For neurons, decreased oxidative phosphorylation activity in neurons is observed, which corresponds to TBM clinical symptoms of neurodegeneration. Finally, ependymal cells present prominent transcriptional changes, and decreased FERM domain containing 4A (Frmd4a) may contribute to TBM clinical symptoms of hydrocephalus and neurodegeneration. This study shows a single-cell transcriptome of M. bovis infection in mice and improves the understanding of brain infection and neurological complications in TBM.
Topics: Animals; Mice; Tuberculosis, Meningeal; BCG Vaccine; Brain; Inflammation; Single-Cell Analysis; Mycobacterium tuberculosis
PubMed: 36862557
DOI: 10.1016/j.celrep.2023.112177 -
The Journal of Experimental Medicine Apr 2024Leptomeningeal metastasis (LM), or spread of cancer to the cerebrospinal fluid (CSF)-filled space surrounding the central nervous system, is a fatal complication of... (Review)
Review
Leptomeningeal metastasis (LM), or spread of cancer to the cerebrospinal fluid (CSF)-filled space surrounding the central nervous system, is a fatal complication of cancer. Entry into this space poses an anatomical challenge for cancer cells; movement of cells between the blood and CSF is tightly regulated by the blood-CSF barriers. Anatomical understanding of the leptomeninges provides a roadmap of corridors for cancer entry. This Review describes the anatomy of the leptomeninges and routes of cancer spread to the CSF. Granular understanding of LM by route of entry may inform strategies for novel diagnostic and preventive strategies as well as therapies.
Topics: Meninges; Central Nervous System
PubMed: 38451255
DOI: 10.1084/jem.20212121 -
Saudi Medical Journal Jun 2020Immunoglobulin G4-related disease (IgG4-RD) is rare disease entity and has recently been recognized as an inflammatory disorder with the tendency to affect multiple...
Immunoglobulin G4-related disease (IgG4-RD) is rare disease entity and has recently been recognized as an inflammatory disorder with the tendency to affect multiple organs. Pachymeningitis of spine caused by IgG4-related disease is extremely rare. Neck pain and spinal cord compression symptoms consist of usual presentation of IgG4-related spinal pachymeningitis; however, polyarthritis is an unusual presentation of this disease, and it was reported in only one case that mimicked psoriatic arthritis. In this report, we describe a case of IgG4-related spinal pachymeningitis in a middle-age male who presented initially with neck pain and rheumatoid arthritis-like symptoms and later on developed both right upper and lower limb weakness. He was found to had pachymeningeal thickening on a cervical magnetic resonance image (MRI) and elevated serum IgG4 levels. He was treated with glucocorticoids and rituximab, which led to a significantly positive radiological response.
Topics: Adult; Arthritis, Rheumatoid; Biomarkers; Cervical Vertebrae; Extremities; Glucocorticoids; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease; Magnetic Resonance Imaging; Male; Meningitis; Muscle Weakness; Neck Pain; Rituximab; Spinal Cord Compression; Treatment Outcome
PubMed: 32518934
DOI: 10.15537/smj.2020.6.25086 -
Indian Journal of Pediatrics Jun 2021
Topics: Flavobacteriaceae; Flavobacteriaceae Infections; Humans; Infant, Newborn; Meningitis; Meningitis, Bacterial; Neonatal Sepsis; Sepsis
PubMed: 33825133
DOI: 10.1007/s12098-021-03737-1