Hyaluronic Acid Binding Protein is a Biomarker of Increased Stiffness in Vestibular Schwannoma
Can the biomolecular and biophysical properties of the vestibular schwannoma extracellular matrix and microenvironment influence tumor stiffness and, therefore, affect clinical outcomes? Researchers in the Department of Otorhinolaryngology at McGovern Medical School at UTHealth Houston and the Department of Otolaryngology at The Ohio State University College of Medicine examined this question and presented their results at the national American Neurotology Society meeting in 2024.
“Stiffer tumors have increased mass effect, leading to cranial nerve and brainstem compression and are thought to cause greater hearing deficits,” says Vivian Kaul, MD, a neurotologist and assistant professor at McGovern Medical School. “In the OR, they are more difficult to remove, requiring higher ultrasonic aspirator settings and increased time manipulating the tumor-brain interface, which can increase postsurgical morbidity. Our goal in the study was to uncover the molecular determinants of tumor stiffness in vestibular schwannoma to improve patient outcomes.”
The investigators enrolled 16 adult patients undergoing microsurgical resection in the prospective, double-blinded study. “We performed magnetic resonance elastography before surgery to characterize tumor stiffness by jiggling the structure to determine the amount of stiffness,” Dr. Kaul says. “We also looked at various biomarkers, all of which correlated with tumor stiffness. Ultimately, we ended up demonstrating a dose-dependent upregulation of hyaluronan synthetases from stimulation with TNFα, a pro-inflammatory cytokine known to be expressed in the vestibular schwannoma microenvironment.”
Bailey Duhon, a second-year medical student, presented the results of the study at the meeting.