Abstract
Brain tumor-associated cerebral edema arises because tumor capillaries lack normal blood-brain barrier function; vascular permeability factor (VPF, also known as vascular endothelial growth factor, VEGF) is a likely mediator of this phenomenon. Clinically, dexamethasone reduces brain tumor-associated vascular permeability through poorly understood mechanisms. Our goals were to determine if suppression of permeability by dexamethasone might involve inhibition of VPF action or expression, and if dexamethasone effects in this setting are mediated by the glucocorticoid receptor (GR). In two rat models of permeability (peripheral vascular permeability induced by intradermal injection of 9L glioma cell-conditioned medium or purified VPF, and intracerebral vascular permeability induced by implanted 9L glioma), dexamethasone suppressed permeability in a dose-dependent manner. Since 80% of the permeability-inducing activity in 9L-conditioned medium was removed by anti-VPF antibodies, we examined dexamethasone effects of VPF expression in 9L cells. Dexamethasone inhibited FCS- and PDGF-dependent induction of VPF expression. At all levels (intradermal, intracranial, and cell culture), dexamethasone effects were reversed by the GR antagonist mifepristone (RU486). Dexamethasone may decrease brain tumor-associated vascular permeability by two GR-dependent mechanisms: reduction of the response of the vasculature to tumor-derived permeability factors (including VPF), and reduction of VPF expression by tumor cells.
Full Text
The Full Text of this article is available as a PDF (266.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aaslid R., Gröger U., Patlak C. S., Fenstermacher J. D., Huber P., Reulen H. J. Fluid flow rates in human peritumoural oedema. Acta Neurochir Suppl (Wien) 1990;51:152–154. doi: 10.1007/978-3-7091-9115-6_51. [DOI] [PubMed] [Google Scholar]
- Alexander J. T., Saris S. C., Oldfield E. H. The effect of interleukin-2 on the blood-brain barrier in the 9L gliosarcoma rat model. J Neurosurg. 1989 Jan;70(1):92–96. doi: 10.3171/jns.1989.70.1.0092. [DOI] [PubMed] [Google Scholar]
- Arbit E., Rubinstein A., DiResta G., Lee J., Ali F., Galicich J. H. The effect of the aminosteroid U-78517G on peritumoural brain oedema. Acta Neurochir Suppl (Wien) 1990;51:158–159. doi: 10.1007/978-3-7091-9115-6_53. [DOI] [PubMed] [Google Scholar]
- Audus K. L., Guillot F. L., Braughler J. M. Evidence for 21-aminosteroid association with the hydrophobic domains of brain microvessel endothelial cells. Free Radic Biol Med. 1991;11(4):361–371. doi: 10.1016/0891-5849(91)90152-s. [DOI] [PubMed] [Google Scholar]
- Bacic M., Edwards N. A., Merrill M. J. Differential expression of vascular endothelial growth factor (vascular permeability factor) forms in rat tissues. Growth Factors. 1995;12(1):11–15. doi: 10.3109/08977199509003209. [DOI] [PubMed] [Google Scholar]
- Berkman R. A., Merrill M. J., Reinhold W. C., Monacci W. T., Saxena A., Clark W. C., Robertson J. T., Ali I. U., Oldfield E. H. Expression of the vascular permeability factor/vascular endothelial growth factor gene in central nervous system neoplasms. J Clin Invest. 1993 Jan;91(1):153–159. doi: 10.1172/JCI116165. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bingham W. G., Jr, Paul S. E., Sastry K. S. Effect of steroid on enzyme response to cold injury in rat brain. Neurology. 1971 Feb;21(2):111–121. doi: 10.1212/wnl.21.2.111. [DOI] [PubMed] [Google Scholar]
- Bodsch W., Rommel T., Ophoff B. G., Menzel J. Factors responsible for the retention of fluid in human tumor edema and the effect of dexamethasone. J Neurosurg. 1987 Aug;67(2):250–257. doi: 10.3171/jns.1987.67.2.0250. [DOI] [PubMed] [Google Scholar]
- Bruce J. N., Criscuolo G. R., Merrill M. J., Moquin R. R., Blacklock J. B., Oldfield E. H. Vascular permeability induced by protein product of malignant brain tumors: inhibition by dexamethasone. J Neurosurg. 1987 Dec;67(6):880–884. doi: 10.3171/jns.1987.67.6.0880. [DOI] [PubMed] [Google Scholar]
- Chomczynski P., Sacchi N. Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem. 1987 Apr;162(1):156–159. doi: 10.1006/abio.1987.9999. [DOI] [PubMed] [Google Scholar]
- Conn G., Bayne M. L., Soderman D. D., Kwok P. W., Sullivan K. A., Palisi T. M., Hope D. A., Thomas K. A. Amino acid and cDNA sequences of a vascular endothelial cell mitogen that is homologous to platelet-derived growth factor. Proc Natl Acad Sci U S A. 1990 Apr;87(7):2628–2632. doi: 10.1073/pnas.87.7.2628. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Criscuolo G. R., Lelkes P. I., Rotrosen D., Oldfield E. H. Cytosolic calcium changes in endothelial cells induced by a protein product of human gliomas containing vascular permeability factor activity. J Neurosurg. 1989 Dec;71(6):884–891. doi: 10.3171/jns.1989.71.6.0884. [DOI] [PubMed] [Google Scholar]
- Dolecki G. J., Connolly D. T. Effects of a variety of cytokines and inducing agents on vascular permeability factor mRNA levels in U937 cells. Biochem Biophys Res Commun. 1991 Oct 31;180(2):572–578. doi: 10.1016/s0006-291x(05)81103-9. [DOI] [PubMed] [Google Scholar]
- Dvorak H. F., Sioussat T. M., Brown L. F., Berse B., Nagy J. A., Sotrel A., Manseau E. J., Van de Water L., Senger D. R. Distribution of vascular permeability factor (vascular endothelial growth factor) in tumors: concentration in tumor blood vessels. J Exp Med. 1991 Nov 1;174(5):1275–1278. doi: 10.1084/jem.174.5.1275. [DOI] [PMC free article] [PubMed] [Google Scholar]
- FRENCH L. A., GALICICH J. H. THE USE OF STEROIDS FOR CONTROL OF CEREBRAL EDEMA. Clin Neurosurg. 1964;10:212–223. doi: 10.1093/neurosurgery/10.cn_suppl_1.212. [DOI] [PubMed] [Google Scholar]
- Finkenzeller G., Technau A., Marmé D. Hypoxia-induced transcription of the vascular endothelial growth factor gene is independent of functional AP-1 transcription factor. Biochem Biophys Res Commun. 1995 Mar 8;208(1):432–439. doi: 10.1006/bbrc.1995.1356. [DOI] [PubMed] [Google Scholar]
- Gerber A. M., Savolaine E. R. Modification of tumor enhancement and brain edema in computerized tomography by corticosteroids: case report. Neurosurgery. 1980 Mar;6(3):282–284. doi: 10.1227/00006123-198003000-00010. [DOI] [PubMed] [Google Scholar]
- Goldberg M. A., Schneider T. J. Similarities between the oxygen-sensing mechanisms regulating the expression of vascular endothelial growth factor and erythropoietin. J Biol Chem. 1994 Feb 11;269(6):4355–4359. [PubMed] [Google Scholar]
- Goldman C. K., Kim J., Wong W. L., King V., Brock T., Gillespie G. Y. Epidermal growth factor stimulates vascular endothelial growth factor production by human malignant glioma cells: a model of glioblastoma multiforme pathophysiology. Mol Biol Cell. 1993 Jan;4(1):121–133. doi: 10.1091/mbc.4.1.121. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Green S. B., Byar D. P., Walker M. D., Pistenmaa D. A., Alexander E., Jr, Batzdorf U., Brooks W. H., Hunt W. E., Mealey J., Jr, Odom G. L. Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma. Cancer Treat Rep. 1983 Feb;67(2):121–132. [PubMed] [Google Scholar]
- Groothuis D. R., Fischer J. M., Lapin G., Bigner D. D., Vick N. A. Permeability of different experimental brain tumor models to horseradish peroxidase. J Neuropathol Exp Neurol. 1982 Mar;41(2):164–185. doi: 10.1097/00005072-198203000-00006. [DOI] [PubMed] [Google Scholar]
- Groothuis D. R., Fischer J. M., Vick N. A., Bigner D. D. Comparative permeability of different glioma models to horseradish peroxidase. Cancer Treat Rep. 1981;65 (Suppl 2):13–18. [PubMed] [Google Scholar]
- Guerin C., Wolff J. E., Laterra J., Drewes L. R., Brem H., Goldstein G. W. Vascular differentiation and glucose transporter expression in rat gliomas: effects of steroids. Ann Neurol. 1992 May;31(5):481–487. doi: 10.1002/ana.410310504. [DOI] [PubMed] [Google Scholar]
- Hall E. D., McCall J. M., Chase R. L., Yonkers P. A., Braughler J. M. A nonglucocorticoid steroid analog of methylprednisolone duplicates its high-dose pharmacology in models of central nervous system trauma and neuronal membrane damage. J Pharmacol Exp Ther. 1987 Jul;242(1):137–142. [PubMed] [Google Scholar]
- Hall E. D., Travis M. A. Inhibition of arachidonic acid-induced vasogenic brain edema by the non-glucocorticoid 21-aminosteroid U74006F. Brain Res. 1988 Jun 7;451(1-2):350–352. doi: 10.1016/0006-8993(88)90782-2. [DOI] [PubMed] [Google Scholar]
- Hermanson M., Funa K., Hartman M., Claesson-Welsh L., Heldin C. H., Westermark B., Nistér M. Platelet-derived growth factor and its receptors in human glioma tissue: expression of messenger RNA and protein suggests the presence of autocrine and paracrine loops. Cancer Res. 1992 Jun 1;52(11):3213–3219. [PubMed] [Google Scholar]
- Hiesiger E. M., Voorhies R. M., Basler G. A., Lipschutz L. E., Posner J. B., Shapiro W. R. Opening the blood-brain and blood-tumor barriers in experimental rat brain tumors: the effect of intracarotid hyperosmolar mannitol on capillary permeability and blood flow. Ann Neurol. 1986 Jan;19(1):50–59. doi: 10.1002/ana.410190110. [DOI] [PubMed] [Google Scholar]
- Iijima K., Yoshikawa N., Connolly D. T., Nakamura H. Human mesangial cells and peripheral blood mononuclear cells produce vascular permeability factor. Kidney Int. 1993 Nov;44(5):959–966. doi: 10.1038/ki.1993.337. [DOI] [PubMed] [Google Scholar]
- Ikeda E., Achen M. G., Breier G., Risau W. Hypoxia-induced transcriptional activation and increased mRNA stability of vascular endothelial growth factor in C6 glioma cells. J Biol Chem. 1995 Aug 25;270(34):19761–19766. doi: 10.1074/jbc.270.34.19761. [DOI] [PubMed] [Google Scholar]
- Ikeda Y., Long D. M. Oxygen free radicals in the genesis of peritumoural brain oedema in experimental malignant brain tumours. Acta Neurochir Suppl (Wien) 1990;51:142–144. doi: 10.1007/978-3-7091-9115-6_48. [DOI] [PubMed] [Google Scholar]
- Ito U., Reulen H. J., Tomita H., Ikeda J., Saito J., Maehara T. A computed tomography study on formation, propagation, and resolution of edema fluid in metastatic brain tumors. Adv Neurol. 1990;52:459–468. [PubMed] [Google Scholar]
- Ito U., Tomita H., Tone O., Shishido T., Hayashi H. Formation and resolution of white matter oedema in various types of brain tumours. Acta Neurochir Suppl (Wien) 1990;51:149–151. doi: 10.1007/978-3-7091-9115-6_50. [DOI] [PubMed] [Google Scholar]
- Jarden J. O., Dhawan V., Moeller J. R., Strother S. C., Rottenberg D. A. The time course of steroid action on blood-to-brain and blood-to-tumor transport of 82Rb: a positron emission tomographic study. Ann Neurol. 1989 Mar;25(3):239–245. doi: 10.1002/ana.410250306. [DOI] [PubMed] [Google Scholar]
- Jarden J. O., Dhawan V., Poltorak A., Posner J. B., Rottenberg D. A. Positron emission tomographic measurement of blood-to-brain and blood-to-tumor transport of 82Rb: the effect of dexamethasone and whole-brain radiation therapy. Ann Neurol. 1985 Dec;18(6):636–646. doi: 10.1002/ana.410180603. [DOI] [PubMed] [Google Scholar]
- Jonat C., Rahmsdorf H. J., Park K. K., Cato A. C., Gebel S., Ponta H., Herrlich P. Antitumor promotion and antiinflammation: down-modulation of AP-1 (Fos/Jun) activity by glucocorticoid hormone. Cell. 1990 Sep 21;62(6):1189–1204. doi: 10.1016/0092-8674(90)90395-u. [DOI] [PubMed] [Google Scholar]
- King W. A., Black K. L., Ikezaki K., Conklin S., Becker D. P. Tumor-associated neurological dysfunction prevented by lazaroids in rats. J Neurosurg. 1991 Jan;74(1):112–115. doi: 10.3171/jns.1991.74.1.0112. [DOI] [PubMed] [Google Scholar]
- Laue L., Kawai S., Brandon D. D., Brightwell D., Barnes K., Knazek R. A., Loriaux D. L., Chrousos G. P. Receptor-mediated effects of glucocorticoids on inflammation: enhancement of the inflammatory response with a glucocorticoid antagonist. J Steroid Biochem. 1988 Jun;29(6):591–598. doi: 10.1016/0022-4731(88)90156-2. [DOI] [PubMed] [Google Scholar]
- Linas S. L., Marzec-Calvert R., Ullian M. E., O'Brien R. F. Mechanism of the antihypertensive effect of K depletion in the spontaneously hypertensive rat. Kidney Int. 1988 Jul;34(1):18–25. doi: 10.1038/ki.1988.140. [DOI] [PubMed] [Google Scholar]
- Long D. M. Capillary ultrastructure and the blood-brain barrier in human malignant brain tumors. J Neurosurg. 1970 Feb;32(2):127–144. doi: 10.3171/jns.1970.32.2.0127. [DOI] [PubMed] [Google Scholar]
- McIntosh T. K., Banbury M., Smith D., Thomas M. The novel 21-aminosteroid U-74006F attenuates cerebral oedema and improves survival after brain injury in the rat. Acta Neurochir Suppl (Wien) 1990;51:329–330. doi: 10.1007/978-3-7091-9115-6_111. [DOI] [PubMed] [Google Scholar]
- Megyesi J. F., Farrell C. L., Del Maestro R. F. Investigation of an inhibitor of lipid peroxidation U74006F on tumor growth and protein extravasation in the C6 astrocytoma spheroid implantation glioma model. J Neurooncol. 1990 Apr;8(2):133–137. doi: 10.1007/BF00177835. [DOI] [PubMed] [Google Scholar]
- Miller A. H., Spencer R. L., Pulera M., Kang S., McEwen B. S., Stein M. Adrenal steroid receptor activation in rat brain and pituitary following dexamethasone: implications for the dexamethasone suppression test. Biol Psychiatry. 1992 Nov 15;32(10):850–869. doi: 10.1016/0006-3223(92)90175-y. [DOI] [PubMed] [Google Scholar]
- Monacci W. T., Merrill M. J., Oldfield E. H. Expression of vascular permeability factor/vascular endothelial growth factor in normal rat tissues. Am J Physiol. 1993 Apr;264(4 Pt 1):C995–1002. doi: 10.1152/ajpcell.1993.264.4.C995. [DOI] [PubMed] [Google Scholar]
- Plate K. H., Breier G., Millauer B., Ullrich A., Risau W. Up-regulation of vascular endothelial growth factor and its cognate receptors in a rat glioma model of tumor angiogenesis. Cancer Res. 1993 Dec 1;53(23):5822–5827. [PubMed] [Google Scholar]
- Plate K. H., Breier G., Weich H. A., Mennel H. D., Risau W. Vascular endothelial growth factor and glioma angiogenesis: coordinate induction of VEGF receptors, distribution of VEGF protein and possible in vivo regulatory mechanisms. Int J Cancer. 1994 Nov 15;59(4):520–529. doi: 10.1002/ijc.2910590415. [DOI] [PubMed] [Google Scholar]
- Plate K. H., Breier G., Weich H. A., Risau W. Vascular endothelial growth factor is a potential tumour angiogenesis factor in human gliomas in vivo. Nature. 1992 Oct 29;359(6398):845–848. doi: 10.1038/359845a0. [DOI] [PubMed] [Google Scholar]
- RUDERMAN N. B., HALL T. C. USE OF GLUCOCORTICOIDS IN THE PALLIATIVE TREATMENT OF METASTATIC BRAIN TUMORS. Cancer. 1965 Mar;18:298–306. doi: 10.1002/1097-0142(196503)18:3<298::aid-cncr2820180306>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
- Rajan S. S., Rosa L., Francisco J., Muraki A., Carvlin M., Tuturea E. MRI characterization of 9L-glioma in rat brain at 4.7 Tesla. Magn Reson Imaging. 1990;8(2):185–190. doi: 10.1016/0730-725x(90)90252-w. [DOI] [PubMed] [Google Scholar]
- Reivich M., Jehle J., Sokoloff L., Kety S. S. Measurement of regional cerebral blood flow with antipyrine-14C in awake cats. J Appl Physiol. 1969 Aug;27(2):296–300. doi: 10.1152/jappl.1969.27.2.296. [DOI] [PubMed] [Google Scholar]
- Ross R., Raines E. W., Bowen-Pope D. F. The biology of platelet-derived growth factor. Cell. 1986 Jul 18;46(2):155–169. doi: 10.1016/0092-8674(86)90733-6. [DOI] [PubMed] [Google Scholar]
- Schüle R., Rangarajan P., Kliewer S., Ransone L. J., Bolado J., Yang N., Verma I. M., Evans R. M. Functional antagonism between oncoprotein c-Jun and the glucocorticoid receptor. Cell. 1990 Sep 21;62(6):1217–1226. doi: 10.1016/0092-8674(90)90397-w. [DOI] [PubMed] [Google Scholar]
- Senger D. R., Galli S. J., Dvorak A. M., Perruzzi C. A., Harvey V. S., Dvorak H. F. Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. Science. 1983 Feb 25;219(4587):983–985. doi: 10.1126/science.6823562. [DOI] [PubMed] [Google Scholar]
- Shima D. T., Deutsch U., D'Amore P. A. Hypoxic induction of vascular endothelial growth factor (VEGF) in human epithelial cells is mediated by increases in mRNA stability. FEBS Lett. 1995 Aug 21;370(3):203–208. doi: 10.1016/0014-5793(95)00831-s. [DOI] [PubMed] [Google Scholar]
- Shweiki D., Itin A., Soffer D., Keshet E. Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis. Nature. 1992 Oct 29;359(6398):843–845. doi: 10.1038/359843a0. [DOI] [PubMed] [Google Scholar]
- Stewart P. A., Wiley M. J. Developing nervous tissue induces formation of blood-brain barrier characteristics in invading endothelial cells: a study using quail--chick transplantation chimeras. Dev Biol. 1981 May;84(1):183–192. doi: 10.1016/0012-1606(81)90382-1. [DOI] [PubMed] [Google Scholar]
- Tamargo R. J., Leong K. W., Brem H. Growth inhibition of the 9L glioma using polymers to release heparin and cortisone acetate. J Neurooncol. 1990 Oct;9(2):131–138. doi: 10.1007/BF02427833. [DOI] [PubMed] [Google Scholar]
- Tamargo R. J., Sills A. K., Jr, Reinhard C. S., Pinn M. L., Long D. M., Brem H. Interstitial delivery of dexamethasone in the brain for the reduction of peritumoral edema. J Neurosurg. 1991 Jun;74(6):956–961. doi: 10.3171/jns.1991.74.6.0956. [DOI] [PubMed] [Google Scholar]
- Tischer E., Mitchell R., Hartman T., Silva M., Gospodarowicz D., Fiddes J. C., Abraham J. A. The human gene for vascular endothelial growth factor. Multiple protein forms are encoded through alternative exon splicing. J Biol Chem. 1991 Jun 25;266(18):11947–11954. [PubMed] [Google Scholar]
- Udaka K., Takeuchi Y., Movat H. Z. Simple method for quantitation of enhanced vascular permeability. Proc Soc Exp Biol Med. 1970 Apr;133(4):1384–1387. doi: 10.3181/00379727-133-34695. [DOI] [PubMed] [Google Scholar]
- Vecht C. J., Hovestadt A., Verbiest H. B., van Vliet J. J., van Putten W. L. Dose-effect relationship of dexamethasone on Karnofsky performance in metastatic brain tumors: a randomized study of doses of 4, 8, and 16 mg per day. Neurology. 1994 Apr;44(4):675–680. doi: 10.1212/wnl.44.4.675. [DOI] [PubMed] [Google Scholar]
- Weissman D. E., Dufer D., Vogel V., Abeloff M. D. Corticosteroid toxicity in neuro-oncology patients. J Neurooncol. 1987;5(2):125–128. doi: 10.1007/BF02571300. [DOI] [PubMed] [Google Scholar]
- Weissman D. E., Grossman S. A. A model for quantitation of peritumoral brain edema. J Neurosci Methods. 1988 Apr;23(3):207–210. doi: 10.1016/0165-0270(88)90004-0. [DOI] [PubMed] [Google Scholar]
- Weissmann G., Sessa G., Weissmann S. The action of steroids and triton X-100 upon phospholipid/cholesterol structures. Biochem Pharmacol. 1966 Oct;15(10):1537–1551. doi: 10.1016/0006-2952(66)90198-5. [DOI] [PubMed] [Google Scholar]
- Weizsaecker M., Deen D. F., Rosenblum M. L., Hoshino T., Gutin P. H., Barker M. The 9L rat brain tumor: description and application of an animal model. J Neurol. 1981;224(3):183–192. doi: 10.1007/BF00313280. [DOI] [PubMed] [Google Scholar]
- Westermark B., Heldin C. H., Nistér M. Platelet-derived growth factor in human glioma. Glia. 1995 Nov;15(3):257–263. doi: 10.1002/glia.440150307. [DOI] [PubMed] [Google Scholar]
- Wolff J. E., Laterra J., Goldstein G. W. Steroid inhibition of neural microvessel morphogenesis in vitro: receptor mediation and astroglial dependence. J Neurochem. 1992 Mar;58(3):1023–1032. doi: 10.1111/j.1471-4159.1992.tb09357.x. [DOI] [PubMed] [Google Scholar]
