Chaperons moleculae in brain tumors-CHAMOBRAT TRIAL: HSP60 and microRNAs related levels in tissue and circulating exosomes in human brain tumors before and after ablative surgery

Current regimen for high-grade gliomas is maximal safe surgical resection followed by external beam radiotherapy with concurrent temozolamide. Maximal tumor resection, however, must be balanced with preservation of the patient’s neurological function. A crucial prognostic factor in oncological neurosurgery is the extent of resection. Several studies have addressed the importance of extent of resection in gliomas surgery. Despite development in the fields of pre operative and intraoperative neuroimaging and neuromonitoring have ameliorated the survival rate and the quality of life for patients affected by high grade gliomas, the clinical outcome of patients with such gliomas remains extremely poor. Among molecular proteins implied in the brain cancerogenesis, Heat Shock Proteins (HSPs) or chaperones, and miRNAs associated with HSP genes may represent a novel and important research field. The aim of the current project is to research the presence, levels, expression and distribution of HSP60 and some miRNAs involved in their regulation, in pathological tissues and in exosomes isolated by blood samples, obtained from patients with gliomas and atypical meningiomas, before and after ablative surgery. Our preliminary results show that exosomal HSP60 and its regulators can be considered tools for improving diagnostic procedures for diagnosis, patient stratification and/or prognosis of disease outcome. We suggest to start to look at the brain tumors through the Chaperone Eye, so to speak, and consider at least some of these tumors to be chaperonopathies by mistake or collaborationism. Looking at tumors through the Chaperone Eye implies that patient examination should include qualitative and quantitative analyses of Hsps, including those in exosomes, before and after surgery and other treatments for monitoring disease evolution and response to treatment. This conduct will provide new insights on brain tumors that will enhance progress in clinical applications of chaperones and exosomes, including their use as novel biomarkers or, in future, therapeutic agents.