ABSTRACT
INTRODUCTION: The study of brain tumors has shown that microRNAs can act as both oncogenes and tumor suppressors and, consequently, can be used as biomarkers for the diagnosis and prognosis of such tumors. Thus, big interest arises in the role of microRNA and its part in oncogenesis in the human brain to find key molecules that can act as tumor markers for diagnostic and prognostic purposes, as well as potential therapeutic agents. STUDY AIM: The sim of this study was to assess histological, molecular, and genetic metrics in patients with supratentorial gliomas, and indicate diagnostic and prognostic abilities of microRNA usage as biomarkers of the grade of malignancy of the tumor. MATERIALS AND METHODS: Clinical and genetic studies were performed in 107 operated patients with supratentorial gliomas of different malignancies. The expression levels of 10 microRNAs (-16, -21¸ -31, -124, - 125b, -181b, -191, -221, -223, and -451) were analyzed using real-time polymerase chain reaction (PCR). The results were analyzed statistically using Statistica 12.0 (Statistica, Hamburg, Germany) and GraphPad Prism 9 software (GraphPad Software Inc., Boston, Massachusetts, United States). RESULTS: Based on a comprehensive statistical analysis involving the database of the clinical results of treatment of all 107 patients (combined treatment methods, quality of life, and survival) and microRNA expression levels, specific profiles of microRNA expression typical of different histotypes of gliomas of different malignancy were identified, the prognostic significance of the studied microRNAs as potential predictors of survival in patients with brain gliomas was determined, and microRNAs with the highest prognostic value were identified among them.
ABSTRACT
The understanding of anti-NMDA (N-methyl-D-aspartate) receptor encephalitis, recognized by Dalmau and colleagues in 2007, has come a long way in helping clinicians to recognize the significance of rapidly progressive psychiatric symptoms in patients who are actually suffering from autoimmune disease. This subtype of autoimmune encephalitis manifests from antibodies that target the NR1 and/or NR2 subunits of NMDA receptors in serum or cerebrospinal fluid. Since gaining notoriety among neurologists, it has shown an etiologic predilection for children, adolescents, and young adult females, often associated with ovarian teratomas. Conversely, it affects young males as well, though it is rarer to find co-occurring tumors. It is a multistage disorder, initially presenting with psychiatric symptoms that progress in varying fashion, including headache, fever, nuchal rigidity, emesis, seizure, autonomic instability, auditory and visual hallucinations, delusional ideation, agitation, altered sensorium, and motor disturbances (i.e. dyskinesia, catatonia, etc.). Early diagnosis is critical due to the relatively high (25%) mortality rate. In this case, we present the case of a 30-year-old male who presented to our institution's Comprehensive Psychiatric Emergency Program (CPEP) exhibiting bizarre behavior and visual hallucinations, and was later confirmed to have anti-NMDA receptor encephalitis. The case report highlights the risk factors, disease course, and treatment modalities of anti-NMDA receptor encephalitis with special emphasis on the subsect of patients who may not respond to first-line therapies.
