gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Protoporphyrin IX in serum of glioblastoma patients after 5-ALA administration – a potential biomarker?

Protoporphyrin IX im Serum von Glioblastom Patienten nach Administration von 5-ALA – ein potentieller Biomarker?

Meeting Abstract

  • Anna Walke - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland; Core Unit Proteomics, Interdisciplinary Center for Clinical Research, Münster, Deutschland
  • Christopher Krone - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Sönke Hellwig - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Michael Müther - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Walter Stummer - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Simone König - Core Unit Proteomics, Interdisciplinary Center for Clinical Research, Münster, Deutschland
  • presenting/speaker Eric Suero-Molina - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV002

doi: 10.3205/22dgnc002, urn:nbn:de:0183-22dgnc0020

Veröffentlicht: 25. Mai 2022

© 2022 Walke et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: 5-Aminolevulinic acid (5-ALA)-mediated fluorescence-guided resection (FGR) maximizes tumor resection in high-grade glioma surgery, improving progression-free survival. Hereby, tumor tissue is identified by the pink color resulting from protoporphyrin IX (PPIX), which, induced by 5-ALA, accumulates selectively in malignant glioma cells. Tumor cells can produce porphyrins naturally or after administration of their prodrug 5-ALA, which is reflected in elevated plasma levels of cancer patients as shown for colorectal adenocarcinoma, bladder and prostate cancer. The aim of this work was to evaluate if PPIX could serve as a blood biomarker for the tumor burden in glioma patients.

Methods: Liquid chromatography coupled to mass spectrometry (LC-MS) was applied for quantification of PPIX in serum. PPIX levels in patients with primarily diagnosed glioblastoma undergoing FGR were evaluated. Blood was collected from 11 patients before, during and after FGR and from 3 healthy volunteers after 5-ALA administration. PPIX was extracted from serum using liquid-liquid extraction followed by an anionic exchange and measured with target LC-MS with mesoporphyrin IX as internal standard. The project was approved by the local ethics committee.

Results: Healthy volunteers exhibited average PPIX serum levels ranging from 16 to 774 pmol/ml after 5-ALA administration. In the patient group, the PPIX serum level was 2.4-fold higher and peaked at later time points (8.0 h vs. 3.8 h). The time curve of the PPIX level in patients and healthy volunteers was first similar, but started spreading around 4.5 h after 5-ALA administration (Figure 1 [Fig. 1]). Even 48 h after 5-ALA administration the PPIX serum levels were third as high in patients than in healthy probands demonstrating a longer elimination time.

Conclusion: PPIX serum levels following 5-ALA administration increased both in patients and healthy volunteers, but they were higher and peaked later in the former. The time point of the maximal serum PPIX level was in agreement with the time of the highest measured fluorescence in glioma tissue (7-8 h after 5-ALA administration). LC-MS-based analysis is a valuable means of monitoring PPIX ex vivo. Further effort is required to elucidate if PPIX is a blood biomarker for the tumor burden in glioma patients.