Researchers solve mystery of how ALL enters the central nervous system
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IMAGE: This is cancer’s hidden pathway to the central nervous system. view more 

Credit: Alisa Weigandt for Duke Health

DURHAM, N.C. – A deadly feature of acute lymphoblastic leukemia (ALL) is its invasion of the central nervous system.

ALL in the central nervous system is very difficult to treat, because most drugs are blocked from the organ system due to a “blood-brain barrier” designed to protect the brain. How cancer cells enter the central nervous system has been an unanswered question for researchers and clinicians for decades.

Now, a research team led by Duke Cancer Institute scientists has found that this blood cancer infiltrates the central nervous system not by breaching the blood-brain barrier, but by evading the barrier altogether.

Publishing in the journal Nature, the researchers describe how the cancer cells are uniquely equipped with receptors that can grasp scaffolding proteins on the outside of blood vessels like fire poles, riding them down from the bone marrow through membranes into the space filled with cerebral-spinal fluid.

“It’s a very unexpected way for cells to travel into the central nervous system,” said Dorothy Sipkins, M.D., Ph.D., associate professor in Duke’s division of Hematologic Malignancies and Cellular Therapy. Sipkins is

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