Publications by authors named "David Gutmann"

This multi-institutional, descriptive study of 19 children with neurofibromatosis 1 examines the link between optic pathway gliomas (OPGs) and central precocious puberty (CPP). We report that CPP can arise without OPG chiasmal involvement and that prior OPG chemotherapy does not prevent the development of CPP.

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  • * Research using single-cell RNA sequencing shows that pediatric low-grade gliomas (LGGs) have more exhausted CD8 T cells compared to high-grade gliomas in both children and adults.
  • * Preclinical studies reveal that in LGGs, exhausted CD8 T cells are mainly found in tumor tissue and play a role in promoting tumor growth, and ICI treatments can reduce tumor proliferation through specific cytokine suppression rather than direct T cell killing.
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There are few centers with combined pediatric and adult neurofibromatosis 1 practices and transition of care programming. Using an electronic health records-based approach, we found an early death peak in the fourth decade of life largely owing to malignancy, underscoring the need for integrated neurological training and practice across the lifespan.

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Cancer neuroscience is a rapidly growing multidisciplinary field that conceptualizes tumors as tissues fully integrated into the nervous system. Recognizing the complexity and challenges in this field is of fundamental importance to achieving the goal of translational impact for cancer patients. Our commentary highlights key scientific priorities, optimal training settings, and roadblocks to translating scientific findings to the clinic in this emerging field, aiming to formulate a transformative and cohesive path forward.

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  • - A new approach to cancer treatment is emerging, focusing on developing therapies throughout all stages of cancer, using various preclinical models to test these treatments.
  • - The research emphasizes the complexity of cancer, which includes genetic mutations and changes in cell behavior, and involves collaborations among experts at the National Cancer Institute to share insights on preclinical modeling.
  • - The authors outline the strengths and weaknesses of different cancer models, proposing a roadmap and initial suggestions for using advanced preclinical models to improve strategies for cancer prevention and treatment.
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Background: Pediatric low-grade glioma incidence has been rising in the United States, mirroring the rising rates of pediatric and maternal obesity. Recently, children of obese mothers were demonstrated to develop brain tumors at higher rates. Importantly, obesity in the United States is largely driven by diet, given the prevalence of high-fat and high-sugar (HFHS) food choices.

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Brain tumors are the leading cause of cancer-related death in children, where low-grade gliomas (LGGs) predominate. One common hereditary cause for LGGs involves neurofibromatosis-1 (NF1) gene mutation, as seen in individuals with the NF1 cancer predisposition syndrome. As such, children with NF1 are at increased risk of developing LGGs of the optic pathway, brainstem, cerebellum, and midline brain structures.

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Neurogenetic disorders, such as neurofibromatosis type 1 (NF1), can cause cognitive and motor impairments, traditionally attributed to intrinsic neuronal defects such as disruption of synaptic function. Activity-regulated oligodendroglial plasticity also contributes to cognitive and motor functions by tuning neural circuit dynamics. However, the relevance of oligodendroglial plasticity to neurological dysfunction in NF1 is unclear.

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Pediatric low-grade glioma (pLGG) is the most common childhood brain tumor group. The natural history, when curative resection is not possible, is one of a chronic disease with periods of tumor stability and episodes of tumor progression. While there is a high overall survival rate, many patients experience significant and potentially lifelong morbidities.

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  • * Traditional treatments for NF1-LGG have included chemotherapy and surgery, but some kids don’t respond well and may continue to struggle or see their condition worsen.
  • * New research is focusing on targeted therapies that aim to provide better treatment options, with ongoing studies looking into these innovative approaches and how to effectively manage and monitor NF1-LGG in children.
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Importance: Autism spectrum disorder (ASD) is a neurodevelopmental disorder more prevalent in males than in females. The cause of ASD is largely genetic, but the association of genetics with the skewed sex ratio is not yet understood. To our knowledge, no large population-based study has provided estimates of heritability by sex.

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Background: With the recognition that noncancerous cells function as critical regulators of brain tumor growth, we recently demonstrated that neurons drive low-grade glioma initiation and progression. Using mouse models of neurofibromatosis type 1 (NF1)-associated optic pathway glioma (OPG), we showed that Nf1 mutation induces neuronal hyperexcitability and midkine expression, which activates an immune axis to support tumor growth, such that high-dose lamotrigine treatment reduces Nf1-OPG proliferation. Herein, we execute a series of complementary experiments to address several key knowledge gaps relevant to future clinical translation.

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The field of cancer neuroscience has begun to define the contributions of nerves to cancer initiation and progression; here, we highlight the future directions of basic and translational cancer neuroscience for malignancies arising outside of the central nervous system.

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Introduction: Neurofibromatosis type 1 (NF1) is a rare neurogenetic disorder characterized by multiple organ system involvement and a predisposition to benign and malignant tumor development. With revised NF1 clinical criteria and the availability of germline genetic testing, there is now an opportunity to render an early diagnosis, expedite medical surveillance, and initiate treatment in a prompt and targeted manner.

Areas Covered: The authors review the spectrum of medical problems associated with NF1, focusing specifically on children and young adults.

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  • Nervous system tumors, especially brain tumors, are the most common in children and very deadly for adults, yet effective treatments remain limited despite extensive research.
  • Human stem cell engineering, using embryonic or induced pluripotent stem cells, offers a new approach by allowing researchers to introduce genetic changes related to these cancers and create 3D brain models (cerebral organoids) that mimic human brain development.
  • This article reviews the current progress in using human stem cell models for studying nervous system tumors, outlining their benefits and drawbacks while making suggestions for future research directions.
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  • Tissue injury and tumor development share similar immune responses and inflammatory factors, suggesting that brain injuries might create conditions favorable for tumors.
  • Research using mouse models of Neurofibromatosis type 1 (NF1) shows that both optic nerve crush and traumatic brain injury can lead to the formation of optic gliomas in mice with Nf1-deficient cells.
  • The study reveals that released glutamate from damaged neurons triggers IL-1β production in oligodendrocytes, leading to microglia expressing Ccl5, which is key for glioma development; blocking this process can stop tumor growth.
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Reactive astrogliosis is a common pathological hallmark of CNS injury, infection, and neurodegeneration, where reactive astrocytes can be protective or detrimental to normal brain functions. Currently, the mechanisms regulating neuroprotective astrocytes and the extent of neuroprotection are poorly understood. Here, we report that conditional deletion of serum response factor (SRF) in adult astrocytes causes reactive-like hypertrophic astrocytes throughout the mouse brain.

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  • Optic pathway gliomas (OPGs) in children with neurofibromatosis type 1 (NF1) lead to retinal ganglion cell (RGC) problems and vision loss, more often seen in girls.
  • Research shows that estrogen plays a role in this difference, and female Nf1 mice have higher levels of the neurotoxic protein interleukin-1β (IL-1β) affecting RGCs.
  • Neutralizing IL-1β and suppressing estrogen can reduce IL-1β levels and improve RGC function, suggesting new protective treatments for vision loss caused by NF1-OPGs.
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Neurofibromatosis type 1 (NF1) is an autosomal dominant condition caused by germline mutations in the neurofibromin 1 (NF1) gene. Children with NF1 are prone to the development of multiple nervous system abnormalities, including autism and brain tumors, which could reflect the effect of NF1 mutation on microglia function. Using heterozygous Nf1-mutant mice, we previously demonstrated that impaired purinergic signaling underlies deficits in microglia process extension and phagocytosis in situ.

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  • * pLGG is viewed as a chronic condition, emphasizing the significance of quality of life and functional outcomes, along with advancements in understanding its biological mechanisms for developing targeted therapies.
  • * The International Pediatric Low-Grade Glioma Coalition (iPLGGc) reviews the latest information on pLGG, including its epidemiology, treatment options, and ongoing challenges, while introducing additional research papers on preclinical models, clinical trial frameworks, and tumor resistance issues.
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Pediatric low-grade gliomas (pLGGs) are the most common brain tumor in young children. While they are typically associated with good overall survival, children with these central nervous system tumors often experience chronic tumor- and therapy-related morbidities. Moreover, individuals with unresectable tumors frequently have multiple recurrences and persistent neurological symptoms.

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Monocytes and monocyte-derived macrophages (MDMs) from blood circulation infiltrate glioblastoma (GBM) and promote growth. Here, we show that PDGFB-driven GBM cells induce the expression of the potent proinflammatory cytokine IL-1β in MDM, which engages IL-1R1 in tumor cells, activates the NF-κB pathway, and subsequently leads to induction of monocyte chemoattractant proteins (MCPs). Thus, a feedforward paracrine circuit of IL-1β/IL-1R1 between tumors and MDM creates an interdependence driving PDGFB-driven GBM progression.

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  • Single nucleotide variants, like the CRLF3L389P variant in the CRLF3 gene, are common but often overlooked in their potential clinical implications, particularly in conditions like Neurofibromatosis type 1 (NF1).
  • Research shows that this specific variant is linked to increased autism symptoms in children with NF1 and significantly affects neuronal maturation and dendrite development in both human stem cell models and genetically engineered mice.
  • Findings indicate that while CRLF3L389P does not alter protein expression or general brain structure, it does impair neuronal function, making it a potential factor in neurodevelopmental disorders.
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