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Vascular
Apoptosis and Involution in Gliomas Precede Neovascularization: A Novel
Concept for Glioma Growth and Angiogenesis
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David Zagzag,
Ramin Amirnovin, M. Alba Greco, Herman Yee, Jocelyn Holash, Stanley J. Wiegand,
Stephanie Zabski, George D. Yancopoulos, and Martin Grumet
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Microvascular
and Molecular Neurooncology Laboratory (DZ, RA); Department of Pathology,
Division of Neuropathology (DZ), Division of Surgical Pathology (HY), and
Division of Pediatric Pathology (MAG), Department of Neurosurgery (DZ),
Department of Pharmacology (MG); Kaplan Cancer Center (DZ, MAG, HY, MG),
New York University Medical Center, New York, New York; and Regeneron Pharmaceuticals
(JH, SJW, SZ, GDY), Tarrytown, New York
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SUMMARY:
Vascular changes in gliomas were analyzed by implanting fluorescent-labeled
glioma 261 cells in the brains of 28 mice. Seven animals were killed each
week for 4 weeks. We investigated the expression of angiopoietin-2 (Ang-2)
by in situ hybridization and compared it with the distribution of apoptotic
cells identified by DNA strand breaks (using the terminal deoxynucleotidyl
transferase-mediated biotinylated deoxyuridine triphosphate nick end labeling
[TUNEL] method) and transmission electron microscopy (TEM). As early as
1 week after implantation, tumor cells accumulated around vessels, which
expressed Ang-2 and were TUNEL negative. TEM showed tumor cells adjacent
to the vascular cells "lifting up" the normal astrocytic feet
processes away from the endothelial cells and disrupting normal pericytic
cuffing. After 2 weeks the number of perivascular glioma cells had increased.
No increase in the number of blood vessels was detected at this time.
Vascular cells remained positive for Ang-2 and rare ones were TUNEL positive.
TEM showed closely packed proliferating perivascular tumor cells. After
3 weeks, there was vascular involution with scant zones of tumor necrosis.
Ang-2 was still detected in vascular cells, but now numerous vascular
cells were TUNEL positive. In addition, TEM showed apoptotic vascular
cells. After 4 weeks, there were extensive areas of tumor necrosis with
pseudopalisading and adjacent angiogenesis. Ang-2 was detected in vascular
cells at the edge of the tumors in the invaded brain and in vessels surrounded
by tumor cells. At both 3 and 4 weeks, most of the TUNEL-positive tumor
cells lacked morphological features characteristic of apoptosis and displayed
features consistent with necrotic cell death as determined by TEM. Only
rare tumor cells appeared truly apoptotic. In contrast, the TUNEL-positive
endothelial cells and pericytes were round and shrunken, with condensed
nuclear chromatin by TEM, suggesting that vascular cells were undergoing
an apoptotic cell death. These results suggest that vascular cell apoptosis
and involution preceded tumor necrosis and that angiogenesis is a later
event in tumor progression in experimental gliomas. Moreover, Ang-2 is
detected prior to the onset of apoptosis in vascular cells and could be
linked to vascular involution.
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