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Monday, August 4, 2014

What You Should Know About Glioblastoma Multiforme

By Annabelle Holman


Primary brain tumors, those that originate in the brain, are more frequent in children and older adults. One feature that sets brain tumors apart from those arising from other tissues in the body is their inability to exit the brain to form secondary, or metastatic, tumors in other organs. They do, however, have a tendency to invade the surrounding brain to establish new tumors within the cranium. The most serious type of intrinsic brain tumor is called glioblastoma multiforme, or GBM.

In men and women less than 20 years old, brain cancer is, after leukemia, the next most prevalent cause of cancer deaths. Apart from leukemia, intracranial-derived tumors are the next leading cause of fatality in men between the ages of 20 and 30. In females between 20 and 39 years old, brain tumors are the fifth most prevalent cause of cancer deaths.

Luckily, GBM is infrequent; there are no more than two or three new cases per 100,000 individuals and account for only 20% of all intracranial neoplasms. Their propensity to invade the surrounding brain tissue means that it is not possible for them to be completely eradicated by surgical means. Try scraping off every bit of butter from a slice of toast.

GBM arises from cells in the brain called glial cells. Neurons, which are generally post-mitotic, meaning they lose the ability to divide once they have achieved terminal differentiation. Glial cells, on the other hand, may continue to divide and replicate throughout life. There is evidence from in vivo and in vitro studies to suggest that some, if not all, astrocytomas arise in utero.

There are three different types of glial cells in the brain, each with different functions. These are astrocytes, microglia and oligodendrocytes. Astrocytes are the most common neural cell type found in brain tumors. These are called astrocytomas. GBM is the most malignant of the astrocytomas, with median survival time of less than five months without treatment.

Astrocytes are star-shaped glial cells found in the brain and spinal cord. The provide support to the endothelial cells that form the blood brain barrier, provide nutrients to nervous tissue and form a part of the repair process following trauma to the central nervous system. There is evidence to suggest that astrocytes communicate with nerve cells by releasing a neurotransmitter called glutamate.

Oligodendrocytes have fewer spiny processes than astrocytes. Their main function is to produce the myelin sheath that surrounds nerve cell axons to insulate them and speed up nerve impulse transmission. A single oligodendrocyte can service as many as 50 different nerve cells. It is the myelin sheath that is attacked by the immune system in the autoimmune condition known as multiple sclerosis (MS).

Microglia are the smallest members of the glial cell team. Their main function is to provide a rapid response to invading foreign bodies and prepare them for slaughter by T-cells. They do this by engulfing foreign matter in a process called phagocytosis. Resting microglia are the prettiest, and look like tiny astrocytes. Activated microglial cells look more bulbous with the processes less prominent.




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