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Genetic Signaling in GBM 815 outside of the CNS (Zhang and Lippard, 2003). In fact, despite the synthesis of thousands of compounds over the last decade only very few novel neurotoxic MBADs have successfully reached the clinical development stage in brain cancer chemotherapy (Zhang and Lippard, 2003; Heffeter et al., 2008). Anti-miRNA therapeutic strategies remain attractive in that single miRNAs may interact with the expression of a relatively large number of dysregulated pathogenic genes in neurological disease processes (Corsten et al., 2007; Lukiw et al., 2009). For example miRNA-21 levels have been reported to be elevated in glioma and their knock-down is associated with increased apoptotic activity. The use of anti-miRNA-21 oligonucleotides in vitro shows that suppression of miRNA-21 leads to a synergistic increase in caspase-3 activity and decreased cell viability (Corsten et al., 2007). Similar effects on the use of miRNA-based therapies on the stem-cell-like characteristics of glioma have been suggested to have considerable therapeutic potential (Godlewski et al., 2008; Hide et al., 2008). The development of advanced combinatorial therapies involving surgery, radiotherapy, antiangiogenics, MBADs, miRNA antisense strategies, and chemotherapeutics remain as attractive and evolving strategies in the future clinical management of glioma and GBM. 9 Summary Glioma and glioblastoma multiforme constitute highly complex, progressive, and insidious neoplastic disorders of the human CNS. Those treated with optimal therapy, including surgical resection, radiation therapy, and chemotherapy, have a median survival of approximately 12 months, with fewer than 25% of patients sur- viving up to two years and fewer than 10% of patients surviving up to five years. Whether the prognosis of patients with secondary glioblastoma is better than, or similar to, those patients with primary glioblastoma remains controversial. Glioma and GBM each exhibit significantly heterogeneous gene expression profiles, and spontaneous, dysregulated, and highly proliferative invasive cell growth. Although individual genetic signaling patterns are variable, increases in the expression of glioma and GBM markers, such as beta-amyloid precursor protein, caspase-3, pentraxin-2, and vascular endothelial growth factor, indicate upregulated expres- sion of cell–cell contact, cell cycle, vascular proliferation, and apoptotic–necrotic markers at the level of gene expression in virtually all brain tumors examined. The heterogeneous genotypic and phenotypic nature of human brain neoplasms further confounds their molecular and genetic signature as well as pharmacological and therapeutic treatment strategies. Surgical resection followed by aggressive radiotherapy and chemotherapy using genomic methylating agents, such as temozolomide (TMZ), and tailored to each individual case, currently represents the best treatment options available. Surgical and multimodal radiotherapeutic approaches combined with chemotherapeutic agents, each with independent and sometimes synergistic mechanisms of action, are currently providing the greatest clinical benefit with improved quality of life in many 816 W.J. Lukiw and F. Culicchia cases. Recent discoveries on the regulation of miRNA-124, miRNA-125b, miRNA- 137 and miRNA-221 expression are uncovering another layer of genetic control in neoplastic brain cells, and should provide yet another therapeutic approach, and treatment opportunity, for advanced clinical intervention. The design and applica- tion of novel micro-RNA-based therapeutic strategies are highly attractive because a single miRNA may be able to quench the expression of entire families of interre- lated neoplastic or oncogenic genes. Several of these novel approaches have been proven to be effective in vitro, however, miRNA and drug delivery systems in vivo remain an imposing biophysical, medical, and clinical research challenge. In the future, combinatorial s urgical, radiotherapeutic, and pharmacological strategies, employing several genomic structure and function modifiers simultaneously, appear to hold the most promise for advancing the clinical management of brain cancer and improvement in the prognosis for both the glioma and GBM patient. Acknowledgments The work in this manuscript was supported by a Translational Research Initiative (TRI) Grant entitled “Gene expression patterns in glioblastoma multiforme (GBM)”by the Louisiana State University Board of Regents. 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Mol Neurobiol 34:181–192 Index A Aberrant caspase activity, 342–343 Acetylcholine (ACh), 389, 422 class I, 422–425 Acetylcholinesterase, 266–267 inhibitors, 618 Acetyl-L-carnitine (ALC) treatment for AD, 620 ACh, see Acetylcholine (ACh) Acute heat pain latency, 484 test, 475, 483 N-Acylphosphatidyl-ethanolamine (NAPE), 471 Addiction alcoholism, 181–182 psychostimulant, 180–181 Adenosine, 268–269, 438–439, 570 molecular role of, 268 Adherent junctions PECAM-1, 128, 131 VE-cadherin, 128, 131 Adhesion, 567 ADNFLE, see Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) Adrenomyeloneuropathy (AMN), 564 Aging, 259 advanced, 270 conversion to MCI, 272–273 default network, 271 disconnection hypothesis, 270–271 MCI/AD diagnosis, 271 Agmatine (AGM), 432 Alcohol pellagra, 115 thiamine deficiency, 110 Wernicke’s encephalopathy (WE), 110 Alcoholism role of DAT promoter hypermethylation in, 181 –182 Alexander disease (AxD), 565 Alpha-synuclein, 281 aggregation, 661 Alzheimer disease (AD), 245, 411, 588 amyloid-β peptide, 612–614 Aβ-injected rodent, 64–65 Aβ1-42 oligomer, 613 AβPP, 611 APOE ε allele of gene, 611 gene, 701 gene function and expression, 710–712 gene location and structure, 710 genetic variation, 712 inheritance and clinical features, 710 structure and single nucleotide polymorphisms, 711 APP structure and mutations, 703 autosomal dominant, genes associated with gene function and expression, 703–704 gene location and structure, 703 genetic variation, 704–705 inheritance and clinical features, 702–703 behavioral and cognitive decline, 610–611 case report, 269–270 clinical diagnosis DSM-IV, 699 MMSE and CADASIL, 699 clinical features, 651–652 clinical symptoms early-onset AD (EOAD), 698 and late-onset AD (LOAD), 698 treatment of, 699 defined, 610 diagnosis, 273–274 diet in, 274 J.P. Blass (ed.), Neurochemical Mechanisms in Disease, Advances in Neurobiology 1, DOI 10.1007/978-1-4419-7104-3, C  Springer Science+Business Media, LLC 2011 823 824 Index Alzheimer disease (AD) (cont.) early-onset familial AD (EOFAD) genetics of, 701 EOFAD, 701 genetic influence in, 611 human diagnosis, 52–53 familial AD (FAD), 52 neuropathological hallmarks, 52 sporadically (SAD), 52 imaging, 274–276 integrated approach, 276 invertebrate models advantages, 62 APP and APPL, 62 C. elegans, 62–63 sea lamprey, 62 model of disconnected neuron, 280 nAChRs altered expression, 763–764 with β amyloid, interaction of, 764–765 neurochemistry and neurobiology cell cycle re-entry hypothesis, 656–657 genomic instability model, 657 interaction of ApoE and Tau, 656 neurobiology of NFT, 654–656 tau hyperphosphorylation, 652–654 neuropathological diagnosis amyloid plaques, 699 APP cleavage, 700 Congo red-positive fibrillar, 699 EOAD, 701 neurons, 701 neuropathology, 652 oxidative DNA damage, 611 oxidative stress associated with, 610 and Parkinson’s disease genes, 702 pharmacological treatments for antiglutamatergic treatment, 618 antioxidants, 620 antioxidant therapies, 618 Aβ channel blockers, 618 Aβ immunotherapy, 618 cholesterol-lowering drugs, 618 cholinesterase inhibitors, 618 epidemiological data, 619 hormonal replacement therapy, 618 nonsteroidal anti-inflammatory drugs, 618 Phase II trial, 619 rivastigmine and galactine, 618 β-andγ-secretase inhibitors, 618 tacrine and donepezil, 618 presenilin 1, 705 gene function and expression, 706–707 gene location and structure, 706 genetic variation, 707–708 inheritance and clinical features, 705–706 structure and mutations, 707 presenilin 2 gene function and expression, 708–709 gene location and structure, 708 genetic variation, 709 inheritance and clinical features, 708 structure and mutations, 709 presenilin 1 gene (PSEN1), 701 mutations, 269–270 prevalence and incidence early-onset AD (EOAD), 698 and late-onset AD (LOAD), 698 primate model, approaches lesioning, 63–64 pharmacological, 64 spontaneous, 63 risk factors for, 673 diabetes and hyperlipidemia, 674 elevated plasma homocysteine, 674 head injury, 674 hypertension and heart disease, 674 low educational attainment, 674 low linguistic ability early in life, 674 obesity, 674 smoking, 674 rodent models pharmacological, 53 transgenic mouse, 53–60 transgenic rat, 60–62 synaptic dysfunction, 279 imaging data, 281 neuropathological studies, 279 role of tau, 281 tau protein, 614 abnormal phosphorylation and, 615 gene mutations, 611 isoforms in, 657–658 American Type Tissue Collection (ATCC), 812 2-Aminoethanesulfonic acid, 436 AMP-activated protein kinase (AMPK), 794 Amyloid-β peptide (Aβ), 612 in oxidative stress, 588–590 and tau interaction, 278–279 Amyloid precursor protein (APP), 270, 273, 276–277, 376, 589, 597–598 amyloidogenic mouse models, 277 mutations, 673 . 273–274 diet in, 274 J.P. Blass (ed.), Neurochemical Mechanisms in Disease, Advances in Neurobiology 1, DOI 10.1007/978-1-4419-7104-3, C  Springer Science+Business Media, LLC 2011 823 824 Index Alzheimer. combinatorial therapies involving surgery, radiotherapy, antiangiogenics, MBADs, miRNA antisense strategies, and chemotherapeutics remain as attractive and evolving strategies in the future clinical. systems in vivo remain an imposing biophysical, medical, and clinical research challenge. In the future, combinatorial s urgical, radiotherapeutic, and pharmacological strategies, employing several

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