Abstract
Malignant gliomas are largely resistant to current chemotherapeutic strategies often displaying a multidrug-resistant phenotype. Mechanisms involved in drug resistance are reduced cellular drug accumulation through membrane efflux pumps, drug detoxification as well as alterations in drug target specificity. In 27 primary and 17 secondary glioblastomas and their astrocytic precursor tumors, we studied the immunohistochemical expression profile of P-glycoprotein (P-gp), multidrug resistance-associated protein (MRP), lung resistance-related protein (LRP), metallothionein, and topoisomerase II α. Glial tumor cells in all glioblastomas showed constant up-regulation of LRP, MRP, and topoisomerase II α. P-gp was found in 90% of the primary and 60% of the secondary glioblastomas. In precursor tumors, these drug resistance-related factors were expressed in varying proportions. Metallothionein, also found in normal and activated astrocytes, was retained in all neoplastic phenotypes. Furthermore, metallothionein, P-gp, LRP, and topoisomerase II α were strongly expressed by normal and neoplastic vessels which may confer to impaired penetration of therapeutic agents through the blood–brain and blood–tumor barrier. However, the expression profiles of drug resistance-related proteins neither differed between primary and secondary glioblastomas nor revealed any correlation to precursor or recurrent tumors. Nevertheless, inhibition of these factors may be promising approaches to the management of malignant gliomas.
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Kleihues P, Burger PC, Plate KH, Ohgaki H, Cavenee WK: Glioblastoma. In: Kleihues P, Cavenee WK (eds) Pathology and genetics. Tumours of the nervous system. International Agency for Research on Cancer, Lyon, 1997, pp 16-24
Endicott JA, Ling V: The biochemistry of P-glycoproteinmediated multidrug resistance. Annu Rev Biochem 58: 137-171, 1989
Scheffer GL, Wijngaard PLJ, Flens MJ, lzquierdo MA, Slovak ML, Pinedo HM, Meijer CJ, Clevers HC, Scheper RJ: The drug resistance related protein LRP is a major vault protein. Nat Med 1: 578-582, 1995
Zaman GLR, Flens MJ, van Leusden MR, de Haas M, Mulder HS, Lankelman J, Pinedo HM, Scheper RJ, Baas F, Broxterman HJ: The human multidrug resistance-associated protein (MRP) is a plasma membrane drug efflux pump. Proc Natl Acad Sci USA 91: 8822-8826, 1994
Ebadi M, Iversen PL: Metallothionein in carcinogenesis and cancer chemotherapy. Gen Pharmacol 25: 1297-1310, 1994
Kägi JHR: Overview of metallothionein. Methods Enzymol 205: 613-626, 1991
Takano H, Kohno K, Matsuo K, Matsuda T, Kuwano M: DNA topoisomerase-argeting antitumor agents and drug resistance. Anticancer Drugs 3: 323-330, 1992
Gomi A, Shinoda S, Masuzawa T, Ishikawa T, Kuo MT: Transient induction of the MRP/GS-X pump and-glutamylcysteine synthetase by 1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2-chloroethyl)-3-nitrosourea in human glioma cells. Cancer Res 57: 5292-5299, 1997
Harford C, Sarkar B: Studies of induction of metallothionein in Jar (human choriocarcinoma) cells by cis and trans isomers of diaminedichloroplatinum (II) and their hydrolyzed species. Mol Toxicol 2: 67-74, 1989
Abe T, Hasegawa S, Taniguchi K, Yokomizo A, Kuwano T, Ono M, Mori T, Hori S, Kohno K, Kuwano M: Possible involvement of multidrug-resistance-associated protein (MDR) gene expression in spontaneous drug resistance to 236 vincristine, etoposide and adriamycin in human glioma cells. Int J Cancer 58: 860-864, 1994
Izumu I, Mineura K, Watanabe K, Kowada M: Characterization and chemosensitivity of two cell lines derived from human glioblastomas. J Neuro-Oncol 17: 111-121, 1993
Matsumoto T, Tani E, Kaba K, Shindo H, Miyaji K: Expression of P-glycoprotein in human glioma cell lines and surgical glioma specimens. J Neurosurg 74: 460-466, 1991
Abe T, Mori T, Wakabayashi Y, Nakagawa M, Cole SP, Koike K, Kuwano M, Hori S: Expression of multidrug resistance protein gene in patients with glioma after chemotherapy. J Neuro-Oncol 40: 11-18, 1998
Tews DS: Cell death and oxidative stress in gliomas. Neuropathol App Neurobiol 25: 272-284, 1999
Bossanyi von P, Diete S, Dietzmann K, Warich-Kirches M, Kirches E: Immunohistochemical expression of P-glycoprotein and glutathione S-transferase in cerebral gliomas and response to chemotherapy. Acta Neuropathol 94: 605-611, 1997
Kirches E, Oda Y, von Bossanyi P, Diete S, Schneider T, Warich-Kirches M, Dietzmann K: Mdr1 mRNA expression differs between grade III astrocytoma and glioblastomas. Clin Neuropathol 16: 34-36, 1997
Maier H, Jones C, Jasani B, Ofner D, Zelger B, Schmid KW, Budka H: Metallothionein overexpression in human brain tumors. Acta Neuropathol 94: 599-604, 1997
Hiura T, Khalid H, Yamashita H, Tokunaga Y, Yasunaga A, Shibata S: Immunohistochemical analysis of metallothionein in astrocytic tumors in relation to tumor grade, proliferative potential, and survival. Cancer 83: 2361-2369, 1998
Childs S, Ling V: The MDR superfamily of genes and its biological implications. In: DeVita VT, Hellman S, Rosenberg SA (eds) Important advances in oncology. Lippincott Co, Philadelphia 1994, pp 21-36
Müller M, Meijer C, Zaman GJR, Borst P, Scheper RJ, Mulder NH, de Vries EG, Jansen PL: Overexpression of the gene encoding the multidrug resistance-associated protein results in increased ATP-dependent glutathione S-conjugate transport. Proc Natl Acad Sci USA 91: 13033-13037, 1994
Henson JW, Cordon-Cardo C, Posner JB: P-Glycoprotein expression in brain tumors. J Neuro-Oncol 14: 37-43, 1992
Cordon-Cardo C, O'Brien JP, Boccia J, Casals D, Bertino JR, Melamed MR: Expression of the multidrug resistance gene product (P-glycoprotein) in human normal and tumor tissues. J Histochem Cytochem 38: 1277-1287, 1990
Tanaka Y, Abe Y, Tsugu A, Takamiya Y, Akatsuka A, Tsuruo T, Yamazaki H, Ueyama Y, Sato O, Tamaoki N, Nakamura M: Ultrastructural localization of P-glycoprotein on capillary endothelial cells in human gliomas. Virchows Arch 425: 133-138, 1994
Becker I, Becker K-F, Meyermann R, Höllt V: The multidrug-resistance gene MDR1 is expressed in human glial tumors. Acta Neuropathol 82: 516-519, 1991
Nabors MW, Griffin CA, Zehnbauer BA, Hruban RH, Phillips PC, Grossman SA, Brem H, Colvin OM: Multidrug resistance gene (MDR1) expression in human brain tumors. J Neurosurg 75: 941-946, 1991
Toth K, Vaughan MM, Peress NS, Slocum HK, Rustum YM: MDR 1 P-glycoprotein is expressed by endothelial cells of newly formed capillaries in human gliomas but is not expressed in the neovasculature of other primary tumors. Am J Pathol 149: 853-858, 1996
Mousseau M, Chauvin C, Nissou M-F, Chaffanet M, Plantaz D, Pasquier B, Schaerer R, Benabid A: A study of the expression four chemoresistance-related genes in human primary and metastatic brain tumours. Eur J Cancer 29A: 753-759, 1993
Biernat W, Kleihues P, Yonekawa Y, Ohgaki H: Amplification and overexpression of MDM2 in primary (de novo) glioblastomas. J Neuropathol Exp Neurol 56: 180-185, 1997
Kondo S, Kondo Y, Hara H, Kaakaji R, Peterson JW, Morimura T, Takeuchi J, Barnett GH: mdm2 gene mediates the expression of the mdrl gene and P-glycoprotein in a human glioblastoma cell line. Br J Cancer 74: 1263-1268, 1996
Flens MJ, Zaman GJR, van der Valk P, Izquierdo MA, Slovak ML, Pinedo HM, Meijer CJ, Clevers HC, Scheper RJ: Tissue distribution of the multidrug resistance protein. Am J Pathol 148: 1237-1247, 1996
Sugawara I, Akiyama S, Scheper RJ, Itoyama S: Lung resistance protein (LRP) expression in normal human tissues in comparison with that of MDR1 and MRP. Cancer Lett 112: 23-31, 1997
Huai-Yun H, Secrest DT, Mark KS, Carney D, Brandquist C, Elmquist WF, Miller DW: Expression of multidrug resistance-associated protein (MRP) in brain microvessel endothelial cells. Biochem Biophys Res Comm 243: 816-820, 1998
Stride BD, Valdimarsson G, Gerlach JH, Wilson GM, Cole SPC, Deeley RG: Structure and expression of the messanger RNA encoding murine multidrug resistance protein, an ATP-binding cassette transporter. Mol Pharmacol 49: 962-971, 1996
Izquierdo MA, Scheffer GL, Flens MJ, Giaccone G, Broxterman HJ, Meijer CJ, van der Valk P, Scheper RJ: Broad distribution of the multidrug resistance-related vault lung resistance protein in normal human tissues and tumors. Am J Pathol 148: 877-887, 1996
Chugani DC, Kedersha NL, Rome LH: Vault immuno-fluorescence in the brain: new insights regarding the origin of microglia. J Neurosci 11: 256-268, 1991
Blaauwgeers HG, Sillevis-Smitt PA, De-Jong JM, Troost D: Distribution of metallothionein in the human central nervous system. Glia 8: 62-70, 1993
Ebadi M, Iversen PL, Hao R, Cerutis DR, Rojas P, Happe HK, Murrin LC, Pfeiffer RF: Expression and regulation of brain metallothionein. Neurochem Int 27: 1-22, 1995
Suzuki K, Nakajima K, Kawaharada U: Metallothionein in the human brain. Acta Histochem Cytochem 25: 617-622, 1992
Suzuki K, Nakajima K, Otaki N, Kimura M, Kawaharada U, Uehara K, Hara F, NakazatoY, Takatama M: Localization of metallothionein in aged human brain. Pathol Int 44: 20-26, 1994
Neal JW, Singhrao SK, Jasani B, Newman GR: Immunocytochemically detectable metallothionein is expressed by 237 astrocytes in the ischaemic human brain. Neuropathol App Neurobiol 22: 243-247, 1996
Thornalley PJ, Vasak M: Possible role for metallothionein in protection against radiation-induced oxidative stress. Kinetics and mechanisms of its reaction with superoxide and hydroxyl radicals. Biochim BiophysActa 827: 36-44, 1995
Montaudon D, Pourquier P, Denois F, de Tinguy-Moreaud E, Lagarde P, Robert J: Differential stabilization of topoisomerase-II-DNA cleavable complexes by doxorubicin and etoposide in doxorubicin-resistant rat glioblastoma cells. Eur J Biochem 245: 307-315, 1997
Ali-Osman F, Berger MS, Rajagopal S, Spence A, Livingston RB: Topoisomerase II inhibition and altered kinetics of formation and repair of nitrosourea and cisplatininduced DNA interstrand cross-links and cytotoxicity in human glioblastoma cells. Cancer Res 53: 5663-5668, 1993
Taki T, Arita N, Hayakawa T, Ohnishi T, Izumoto S, Yamamoto H, Mogami H: T98G glioma cells have nicks in DNA in quiescent phase. Exp Cell Res 190: 212-217, 1990
Tan KB, Mattern MR, Boyce RA, Schein PS: Elevated DNA topoisomerase activity in nitrogen mustard-resistant human cells. Proc Natl Acad Sci USA 84: 7668-7671, 1987
Taki T, Ohnishi T, Arita N, Hiraga S, Hayakawa T: In vivo etoposide-resistant C6 glioma cell line: significance of altered DNA topoisomerase activity in multi-drug resistance. J Neuro-Oncol 36: 41-53, 1998
Beauchesne P, Bertrand S, N'guyen MJ, Christianson T, Dore JF, Mornex F, Bonner JA: Etoposide sensitivity of radioresistant human glioma cell lines. Cancer Chemother Pharmacol 41: 93-97, 1998
Sullivan DM, Glisson BS, Hodges PK, Smallwood-Kentro S, Ross WE: Proliferation dependence of topoisomerase II mediated drug action. Biochemistry 25: 2248-2256, 1986
Hegmann EJ, Bauer HC, Kerbel RS: Expression and functional activity of P-glycoprotein in cultured cerebral capillary endothelial cells. Cancer Res 52: 6969-6975, 1992
Takamiya Y, Abe Y, Tanaka Y, Tsugu A, Kazuno M, Oshika Y, Maruo K, Ohnishi Y, Sato O, Yamazaki H, Kijima H, Ueyama Y, Tamaoki N, Nakamura M: Murine P-glycoprotein on stromal vessels mediates multidrug resistance in intracerebral human glioma xenografts. Br J Cancer 76: 445-450, 1997
Schinkel AH, Smit JJM, van Tellingen O, Beijnen JH, Wagenaar E, van Deemter L, Mol CA, van der Valk MA, Robanus-Maandag EC, te Riele HP: Disruption of the mouse mdr1a P-glycoprotein gene leads to a deficiency in the blood-brain-barrier and to increased sensitivity to drugs. Cell 77: 491-502, 1994
Tsuji A: P-glycoprotein-mediated efflux transport of anticancer drugs at the blood-brain barrier. Ther Drug Monit 20: 588-590, 1998
Balmaceda C: Advances in brain tumor chemosensitivity. Curr Opin Oncol 10: 194-200, 1998
Leweke F, Damian MS, Schindler C, Schachenmayr W: Multidrug resistance in glioblastoma. Chemosensitivity testing and immunohistochemical demonstration of P-glycoprotein. Pathol Res Pract 194: 149-155, 1998
Iwadate Y Tagawa M, Fujimoto S, Hirose M, Namba H, Sueyoshi K, Sakiyama S, Yamaura A: Mutations of the p53 gene in human astrocytic tumours correlates with increase resistance to DNA-damaging agents but not to antimicrotubule anti-cancer agents. Br J Cancer 77: 547-551, 1998
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Tews, D.S., Nissen, A., Külgen, C. et al. Drug Resistance-associated Factors in Primary and Secondary Glioblastomas and their Precursor Tumors. J Neurooncol 50, 227–237 (2000). https://doi.org/10.1023/A:1006491405010
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DOI: https://doi.org/10.1023/A:1006491405010