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Intrathecal IgM response in disseminated cerebrospinal metastasis from malignant melanoma

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Summary

Neurological complications are a major cause of morbidity and mortality in patients with disseminated malignant melanoma. We have studied and correlated clinical and cerebrospinal fluid (CSF) findings in 20 patients with central nervous system metastases from malignant melanoma including 8 patients with metastatic meningeal melanomatosis (MMM) and 12 patients with solid cerebral metastases (SCM). The putative CSF tumor markers, fibronectin and β2-microglobulin, were elevated significantly in MMM but not in SCM patients. A prominent increase in the IgM index, which reflects intrathecal B-cell stimulation, and a rise of IgG index, interleukin-6, and tumor necrosis factor-α in MMM patients provide preliminary evidence for a local intrathecal immune response triggered by melanoma cell invasion of the subarachnoid space.

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References

  1. Wasserstrom WR, Glass JP, Posner JB: Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients. Cancer 49: 759–772, 1982

    Google Scholar 

  2. Mendez IM, Del Maestro RF: Cerebral metastases from malignant melanoma. Can J Neurol Sci 15: 119–123, 1988

    Google Scholar 

  3. Byrne TN, Cascino TL, Posner JB: Brain metastasis from melanoma. J Neuro-Oncol 1: 313–317, 1983

    Google Scholar 

  4. Brega K, Robinson WA, Winston K, Wittenberg W: Surgical treatment of brain metastases in malignant melanoma. Cancer 66: 2105–2110, 1990

    Google Scholar 

  5. Weller M, Stevens A, Sommer N, Schabet M, Wiethölter H: Tumor cell dissemination triggers an intrathecal immune response in neoplastic meningitis. Cancer 69: 1475–1480, 1992

    Google Scholar 

  6. Weller M, Stevens A, Sommer N, Wiethölter H: Tumor necrosis factor-α in malignant melanomatous meningitis. J Neurol Neurosurg Psychiatry 55: 74, 1992

    Google Scholar 

  7. Bjerrum OW, Birgens HS: Measurement of beta-2-microglobulin in serum and plasma by an enzyme-linked immunosorbent assay (ELISA). Clin Chim Acta 155: 69–76, 1986

    Google Scholar 

  8. Weller M, Sommer N, Stevens A, Wiethölter H: Increased intrathecal fibronectin synthesis in bacterial and carcinomatous meningitis. Acta Neurol Scand 82: 138–142, 1990

    Google Scholar 

  9. Weller M, Stevens A, Sommer N, Melms A, Dichgans J, Wiethölter H: A comparative analysis of cytokine patterns in immunological, infectious, and oncological neurological disorders. J Neurol Sci 104: 215–221, 1991

    Google Scholar 

  10. Weller M, Stevens A, Sommer N, Wiethölter H, Dichgans J: CSF interleukins, immunoglobulins, and fibronectin in neuroborreliosis. Arch Neurol 48: 837–841, 1991

    Google Scholar 

  11. Reiber H, Felgenhauer K: Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system. Clin Chim Acta 163: 319–328, 1987

    Google Scholar 

  12. Patel JK, Didolkar MS, Pickren JW, Moore RH: Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg 135: 807–810, 1978

    Google Scholar 

  13. Merimsky O, Inbar M, Reider-Groswasser I, Chaitchik S: Brain metastases of malignant melanoma in interferon complete responders: clinical and radiological observations. J Neuro-Oncol 12: 137–140, 1992

    Google Scholar 

  14. Fitzpatrick TB, Sober AJ, Mihm MC: Malignant melanoma of the skin. In: Braun Wald E, Isselbacher KJ, Petersdorf RG, Wilson JD, Martin JB, Fauci AS (eds) Principles of Internal Medicine. McGraw Hill, New York, 1987, pp 1595–1597

    Google Scholar 

  15. Koh HK: Cutaneous melanoma. N Engl J Med 325: 171–182, 1991

    Google Scholar 

  16. Vassalli P: The pathophysiology of tumor necrosis factors. Annu Rev Immunol 10: 411–452, 1992

    Google Scholar 

  17. Sawada M, Kondo N, Suzumura A, Marunouchi T: Production of tumor necrosis factor-alpha by microglia and astrocytes in culture. Brain Research 491: 394–397, 1989

    Google Scholar 

  18. Chung IY, Benveniste EN: Tumor necrosis factor-α production by astrocytes. Induction by lipopolysaccharide, IFNγ, and IL-1β. J Immunol 144: 2999–3007, 1990

    Google Scholar 

  19. Lugassy C, Escande JP: Immunolocation of TNF-Alpha/cachectin in human melanoma cells: studies on co-cultivated malignant melanoma. J Invest Dermatol 96: 238–242, 1991

    Google Scholar 

  20. Zouboulis CC, Schröder K, Garbe C, Krasagakis K, Krüger S, Orfanos CE: Cytostatic and cytotoxic effects of recombinant tumor necrosis factor-α on sensitive human melanoma cellsin vitro may result in selection of cells with enhanced markers of malignancy. J Invest Dermatol 95: 223S-230S, 1990

    Google Scholar 

  21. Engelberts I, Stephens S, Francot GJM, Van der Linden CJ, Buurman WA: Evidence for different effects of soluble TNF-receptors on various TNF measurements in human biological fluids. Lancet 338: 515–516, 1991

    Google Scholar 

  22. Aderka D, Engelmann H, Maor Y, Brakebusch C, Wallach D: Stabilization of the bioactivity of tumor necrosis factor by its soluble receptors. J Exp Med 175: 323–329, 1992

    Google Scholar 

  23. Møller B, Mogensen SC, Wendelboe C, Bendtzen K, Petersen CM: Bioactive and inactive forms of tumor necrosis factor-α in spinal fluid from patients with meningitis. J Infect Dis 163: 886–889, 1991

    Google Scholar 

  24. Weller M, Stevens A, Sommer N, Schabet M, Wiethölter H: Humoral CSF parameters in the differential diagnosis of hematologic CNS neoplasia. Acta Neurol Scand 86: 129–133, 1992

    Google Scholar 

  25. Schipper HI, Bardosi A, Jacobi C, Felgenhauer K: Meningeal carcinomatosis: origin of local IgG production in the CSF. Neurology 38: 413–416, 1988

    Google Scholar 

  26. Sharief MK, Keir G, Thompson EJ: Glutaraldehyde-enhanced immunofixation: a sensitive new method for detecting oligoclonal IgM. J Neuroimmunol 23: 149–156, 1989

    Google Scholar 

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Weller, M., Stevens, A., Sommer, N. et al. Intrathecal IgM response in disseminated cerebrospinal metastasis from malignant melanoma. J Neuro-Oncol 16, 55–59 (1993). https://doi.org/10.1007/BF01324835

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