Name: a unified methodological framework for vestibular schwannoma research
Uploaded: 2017-06-20T13:00:00
Description: Watch this Scientific Journal Video about A Unified Methodological Framework for Vestibular Schwannoma Research at JoVE.com

This work was supported by the National Institute of Deafness and Other Communication Disorders grants R01DC015824 (K.M.S.) and T32DC00038 (supporting J.E.S and S.D.), the Department of Defense grant W81XWH-14-1-0091 (K.M.S.), the Bertarelli Foundation (K.M.S.), the Nancy Sayles Day Foundation (K.M.S.), the Lauer Tinnitus Research Center (K.M.S.), and the Barnes Foundation (K.M.S.).

Written informed consent for the collection of all samples was obtained prior to surgery, and the experiments were carried out according to the Code of Ethics of the World Medical Association (Declaration of Helsinki). All sections of the study protocol were approved by the Institutional Review Board of Massachusetts Eye and Ear and Massachusetts General Hospital.
NOTE: Sections 1-7 below are designed to be performed sequentially upon the receipt of a primary human VS or GAN sample from the op...

<ol>
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E., Caye-Thomasen, P., Tos, T., Thomsen, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+the+real+incidence+of+vestibular+schwannoma?.">What is the real incidence of vestibular schwannoma?.</a> Arch Otolaryngol Head Neck Surg. 130 (2), 216-220 (2004).</li><li>Stangerup, S. E., Caye-Thomasen, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epidemiology+and+natural+history+of+vestibular+schwannomas.">Epidemiology and natural history of vestibular schwannomas.</a> Otolaryngol Clin North Am. 45 (2), 257-268 (2012).</li><li>Mahaley, M. S., Mettlin, C., Natarajan, N., Laws, E. R., Peace, B. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+patterns+of+care+of+brain+tumor+patients+in+the+United+States:+a+study+of+the+Brain+Tumor+Section+of+the+AANS+and+the+CNS+and+the+Commission+on+Cancer+of+the+ACS.">Analysis of patterns of care of brain tumor patients in the United States: a study of the Brain Tumor Section of the AANS and the CNS and the Commission on Cancer of the ACS.</a> Clin Neurosurg. 36, 347-352 (1990).</li><li>Carlson, M. L., Link, M. J., Wanna, G. B., Driscoll, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Management+of+sporadic+vestibular+schwannoma.">Management of sporadic vestibular schwannoma.</a> Otolaryngol Clin North Am. 48 (3), 407-422 (2015).</li><li>Dilwali, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sporadic+vestibular+schwannomas+associated+with+good+hearing+secrete+higher+levels+of+fibroblast+growth+factor+2+than+those+associated+with+poor+hearing+irrespective+of+tumor+size.">Sporadic vestibular schwannomas associated with good hearing secrete higher levels of fibroblast growth factor 2 than those associated with poor hearing irrespective of tumor size.</a> Otol Neurotol. 34 (4), 748-754 (2013).</li><li>Caye-Thomasen, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=VEGF+and+VEGF+receptor-1+concentration+in+vestibular+schwannoma+homogenates+correlates+to+tumor+growth+rate.">VEGF and VEGF receptor-1 concentration in vestibular schwannoma homogenates correlates to tumor growth rate.</a> Otol Neurotol. 26 (1), 98-101 (2005).</li><li>Koutsimpelas, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+VEGF/VEGF-R+axis+in+sporadic+vestibular+schwannomas+correlates+with+irradiation+and+disease+recurrence.">The VEGF/VEGF-R axis in sporadic vestibular schwannomas correlates with irradiation and disease recurrence.</a> ORL J Otorhinolaryngol Relat Spec. 74 (6), 330-338 (2012).</li><li>Dilwali, S., Roberts, D., Stankovic, K. 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M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Secreted+Factors+from+Human+Vestibular+Schwannomas+Can+Cause+Cochlear+Damage.">Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage.</a> Sci Rep. 5, 18599 (2015).</li><li>Blakeley, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+drug+treatments+for+neurofibromatosis+type+2-associated+vestibular+schwannoma.">Development of drug treatments for neurofibromatosis type 2-associated vestibular schwannoma.</a> Curr Opin Otolaryngol Head Neck Surg. 20 (5), 372-379 (2012).</li><li>Schroeder, R. D., Angelo, L. S., Kurzrock, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=NF2/merlin+in+hereditary+neurofibromatosis+2+versus+cancer:+biologic+mechanisms+and+clinical+associations.">NF2/merlin in hereditary neurofibromatosis 2 versus cancer: biologic mechanisms and clinical associations.</a> Oncotarget. 5 (1), 67-77 (2014).</li><li>Schularick, N. M., Clark, J. J., Hansen, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Primary+culture+of+human+vestibular+schwannomas.">Primary culture of human vestibular schwannomas.</a> J Vis Exp. 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This manuscript describes a unified methodological framework for VS research, outlining the simultaneous processing of human VS and GAN specimens for downstream research applications. As VS research enters the age of precision medicine, preparing the same sample in forms capable of answering numerous research questions will enable the discovery of molecular, cellular, genetic, and proteomic insights specific to individual patients.
The purity of human Schwann cell and VS cultures were thorough...

Vestibular schwannomas (VSs) are the most common neoplasms of the cerebellopontine angle, diagnosed in 1 in every 100,000 individuals. Though non-metastatic, these tumors severely affect a patient&#39;s quality of life1,2,3,4,5,6. Affected individuals commonly live with hearing loss, tinnitus, and a feeling of aural fullness. Symptoms become increasingly debilitating as the tumor grows, causing balance problems, facial paralysis, and impairment of other cranial nerve functions. Life-threatening complications due to brainstem compression may also ensue7.
Management options for VS are essentially limited to watchful waiting for static tumors and stereotactic radiation therapy or surgical resection for growing tumors8. The surgical removal of these tumors in research-affiliated hospitals presents the opportunity to acquire and analyze fresh tumor tissue collected during patient surgeries. One specific surgical approach to VS, the translabyrinthine resection, can even offer access to valuable human sensory epithelium from the inner ear and perilymph.
Because VSs arise from a peripheral sensory nerve (i.e., the vestibular nerve), it is important to compare VS-associated observations with those derived from an appropriate control nerve, such as the human great auricular nerve (GAN). Healthy GANs are regularly sacrificed during parotidectomies or neck dissections and can be used as robust models for healthy Schwann cell physiology9.
Because there are no FDA-approved drugs for the treatment or prevention of sporadic VS, it is imperative that researchers elucidate the underlying molecular mechanisms of the disease to identify therapeutic targets. Proteins that have been shown to play a role in VS pathogenesis include merlin, vascular endothelial growth factor (VEGF), cyclooxygenase 2 (COX-2), nuclear factor kappa B (NF-&#954;B), tumor necrosis factor alpha (TNF-alpha), epidermal growth factor receptor (EGFR), and related signaling molecules10,11,12,13,14,15,16,17.
Recent advances have expanded and improved protocols for the collection, processing, culture, and downstream investigation of primary human vestibular schwannomas and healthy nerve tissues18,19. However, most existing protocols are designed to accommodate the preparation of such tissues for a single downstream research application (i.e., cell culture alone). This article presents a unified methodological framework for the simultaneous processing of a single primary human VS or GAN sample for multiple downstream applications: cell type-specific culture, protein extraction, RNA preservation, tumor secretion collection, and tissue fixation. This work also details the surgical collection and processing of human cerebrospinal fluid (CSF) and perilymph during translabyrinthine VS resection, as these closely related tissues may serve as important sources of biomarkers for VS. Finally, this protocol presents steps for the viral transduction of primary human VS cells in culture as a novel application of this tissue for use in gene therapy.

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			<td height="42" style="height:42px;width:419px;">BioCoat Poly-D-Lysine/Laminin 12mm #1 German Glass Coverslip</td>
			<td style="width:159px;">Corning</td>
			<td style="width:159px;">354087</td>
			<td style="width:683px;">Or prepare coverslips with Corning Laminin (CB-40232) and Cultrex Poly-L-Lysine (3438-100-01)</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">CELLSTAR 15 ml Centrifuge Tubes, Conical bottom, Graduation, Sterile</td>
			<td style="width:159px;">Greiner Bio-One</td>
			<td style="width:159px;">188161</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">CELLSTAR 50 ml Centrifuge Tubes, Conical bottom, Graduation, Sterile</td>
			<td style="width:159px;">Greiner Bio-One</td>
			<td style="width:159px;">227261</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">CELLSTAR Cell Culture Dish, 60 mm</td>
			<td style="width:159px;">Greiner Bio-One</td>
			<td style="width:159px;">628160</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Collagenase from Clostridium histolyticum, Sterile-filtered</td>
			<td style="width:159px;">Sigma-Aldrich</td>
			<td style="width:159px;">C1639</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Costar 24 Well Clear TC-Treated Multiple Well Plates, Sterile</td>
			<td style="width:159px;">Corning</td>
			<td style="width:159px;">3526</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;">DAPI (4&#39;,6-Diamidino-2-Phenylindole, Dihydrochloride)</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">D1306</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">DMEM, high glucose, pyruvate, no glutamine, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">10313-039</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">DMEM/F-12, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">11320-033</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Dumont #3 Forceps, Dumoxel</td>
			<td style="width:159px;">Fine Science Tools</td>
			<td style="width:159px;">11231-30</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Dumont #5 Forceps, Standard tip, Inox</td>
			<td style="width:159px;">Fine Science Tools</td>
			<td style="width:159px;">11251-20</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Fetal Bovine Serum, qualified, USDA-approved regions, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">10437-028&#160;</td>
			<td>Aliquot in 50 ml tubes and store in -20&#176;C freezer</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Hyaluronidase from Bovine Testes, Type I-S, Lyophilized Powder</td>
			<td style="width:159px;">Sigma-Aldrich</td>
			<td style="width:159px;">H3506</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Millex-GP Syringe Filter Unit, 0.22 &#181;m, polyethersulfone, 33 mm, sterile</td>
			<td style="width:159px;">EMD Millipore</td>
			<td style="width:159px;">SLGP033RS</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Paraformaldehyde, Reagent Grade, Crystalline</td>
			<td style="width:159px;">Sigma-Aldrich</td>
			<td style="width:159px;">P6148</td>
			<td>Prior to use: Establish Standard Operating Procedures based on protocols available online</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">PBS, pH 7.4, 500 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">10010-023&#160;</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Penicillin-Streptomycin (10,000 U/ml), 100 ml</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">15140-122</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">PhosSTOP Phosphatase Inhibitor Tablets</td>
			<td style="width:159px;">Roche</td>
			<td style="width:159px;">04906845001</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">Pierce Protease Inhibitor Tablets</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">88666</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Pipettes and pipette tips, 5/10/25 ml</td>
			<td style="width:159px;">Variable</td>
			<td style="width:159px;">Variable</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Plastic Homogenization Pestle for 1.5/2.0ml Microtubes</td>
			<td style="width:159px;">E&#38;K Scientific</td>
			<td style="width:159px;">EK-10539</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">PrecisionGlide Needles, 27 G x 1 1/2 in&#160;</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">301629</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">RIPA Buffer</td>
			<td style="width:159px;">Boston BioProducts</td>
			<td style="width:159px;">BP-115</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:419px;">RNAlater (RNA stabilization solution)</td>
			<td style="width:159px;">Thermo Fisher Scientific</td>
			<td style="width:159px;">AM7021</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Safe-Lock Microcentrifuge Tubes, Polypropylene, 0.5 ml</td>
			<td style="width:159px;">Eppendorf</td>
			<td style="width:159px;">022363719</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Safe-Lock Microcentrifuge Tubes, Polypropylene, 1.5 ml</td>
			<td style="width:159px;">Eppendorf</td>
			<td style="width:159px;">022363204</td>
			<td>Autoclave prior to use</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Saline - 0.9% Sodium Chloride Injection, bacteriostatic, 20 ml</td>
			<td style="width:159px;">Hospira</td>
			<td style="width:159px;">0409-1966-05</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Scalpel Blades - #15</td>
			<td style="width:159px;">Fine Science Tools</td>
			<td style="width:159px;">10015-00</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Schuknecht Suction Tube 24 gauge</td>
			<td style="width:159px;">Bausch + Lomb</td>
			<td style="width:159px;">N1698 42</td>
			<td>Useful for the surgical approach (in addition to common otologic surgical instruments) and e.g. a blue surgical marker</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Specimen Container, OR sterile, 4OZ&#160;</td>
			<td style="width:159px;">Medline</td>
			<td style="width:159px;">DYND30331H</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Stemi 2000-C Stereo Microscope</td>
			<td style="width:159px;">Zeiss</td>
			<td style="width:159px;">000000-1106-133</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Syringe/Needle Combination, Luer-Lok Tip, 5 ml, 22 G x 1 in.</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">309630</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Tuberculin Syringe Only, Slip tip, 1 ml</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">309659</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Tuberculin Syringe Only, Slip tip, 3 ml</td>
			<td style="width:159px;">BD</td>
			<td style="width:159px;">309656</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:419px;">Ultrasonic homogenizer, 4710 Series, CV18 probe</td>
			<td style="width:159px;">Cole-Parmer</td>
			<td style="width:159px;">CP25013</td>
			<td></td>
		</tr>
	</tbody>
</table>

a unified methodological framework for vestibular schwannoma research

Vestibular schwannomas are the most common neoplasms of the cerebellopontine angle, making up 6-8% percent of all intracranial growths. Though these tumors cause sensorineural hearing loss in up to 95% of affected individuals, the molecular mechanisms underlying this hearing loss remain elusive. This article outlines the steps established in our laboratory to facilitate the collection and processing of various primary human tissue samples for downstream research applications integral to the study of vestibular schwannomas. Specifically, this work describes a unified methodological framework for the collection, processing, and culture of Schwann and schwannoma cells from surgical samples. This is integrated with parallel processing steps now considered essential for current research: the collection of tumor and nerve secretions, the preservation of RNA and the extraction of protein from collected tissues, the fixation of tissue for the preparation of sections, and the exposure of primary human cells to adeno-associated viruses for application to gene therapy. Additionally, this work highlights the translabyrinthine surgical approach to collect this tumor as a unique opportunity to obtain human sensory epithelium from the inner ear and perilymph. Tips to improve experimental quality are provided and common pitfalls highlighted.

Primary human VS cells in culture, as established in section 5, can be treated as informative models for disease-associated processes in many downstream research applications (Figure 1). Healthy Schwann cells cultured in section 6 provide a direct and instructive point of comparison. As outlined below, extensive data from VSs and GANs processed according to this unified methodological framework are available in multiple articles previously published<sup class...

Watch this Scientific Journal Video about A Unified Methodological Framework for Vestibular Schwannoma Research at JoVE.com

A Unified Methodological Framework for Vestibular Schwannoma Research

The goal of this protocol is to outline the collection and processing of human surgical samples for multiple downstream applications in vestibular schwannoma and Schwann cell research.

Vestibular schwannomas are the most common neoplasms of the cerebellopontine angle, making up 6-8% percent of all intracranial growths. Though these ...

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