Neuroblastoma is a cancer of nerve cells that reside outside of the brain, and occurs when malignant cancer cells form in the specialised nerve cells of the sympathetic nerves involved in the development of the nervous system and other tissues.
Neuroblastoma most commonly occurs in one of the adrenal glands situated in the tummy or in the chest, neck, abdomen, pelvis or the nerve tissue that runs alongside the spinal cord. The adrenal glands are specialised glands that release hormones that help the body respond to stress and maintain blood pressure.
Neuroblastoma may be present at birth, but generally presents in early childhood, before the age of 5 years. In most cases, by the time it is diagnosed the cancer has usually already spread to areas outside of the original site, often to the lymph nodes, bones, bone marrow, liver, and skin.
It’s the second most common type of childhood cancer and has a disproportionately high mortality rate, compared to other childhood cancers.
Treatment usually involves surgery, chemotherapy or radiation, high-dose chemotherapy with stem cell support, or a combination in high-risk cases. Unfortunately, in some cases, none of the treatments work.

One day last year, Dr Kenneth Alexander, Division of Infectious Diseases chief at Nemours Children’s Hospital, Orlando, Florida, was driving home when he thought “What if the Zika virus could be used to kill a childhood cancer called neuroblastoma?”
The Zika outbreak was in its third year and scientists had learned that the virus damages the nervous systems of unborn babies by destroying the developing nerve cells that also make up neuroblastomas.
Dr Alexander brainstormed with a surgical colleague and then brought Dr Griffith Parks, a University of Central Florida scientist who has been studying Zika, on board.
Around a year later, the team published preliminary results of their first study in PLOS One, showing that neuroblastoma cells that were exposed to the Zika virus in the laboratory died 10 days after being infected, making the virus a potential treatment for the cancer.
This is like all good ideas. It’s early and there may be a fly in the ointment,” Dr Alexander said in an interview. “But at this point, things are looking promisingThe path ahead is there and we hope to get lots of other people interested in this research.”
Study co-author Dr Tamarah Westmoreland, a paediatric general and thoracic surgeon, said:
There’s a lot of research on neuroblastoma, but we wanted to take a different approach (to finding a treatment; I think Zika is holding great promise. In looking at these results, we think it can be used (along with) current therapies. However, we’re very early in this research.”
Several other groups, including one in Brazil and one in the US, have shown in preliminary studies that Zika infection killed glioblastoma cells in the adult brain, potentially opening new doors for treating this common, aggressive type of brain cancer.
Another Brazilian group reported in June that a Zika virus strain killed aggressive cancerous tumours of the central nervous system.
Dr Alexander said what’s unique about his team’s research is identification of a surface protein called CD24. The protein makes cancer cells susceptible to being killed by the Zika virus. Cancer cells that didn’t have the CD24 protein didn’t respond to Zika, his team found in their laboratory research.
So with these findings, we can ask what other cancers express CD24,” said Dr Alexander. “Now we’re beginning to look at other cancer cells that express CD24 to see if we can kill them as well.”
Scientists don’t fully know how the virus enters and destroys the cells. There may be proteins in addition to CD24 that make a cell susceptible to Zika.
But at least we’ve gotten part of the story,” said Dr Alexander.
This is not the first time a virus has been used to treat cancer, the history of which dates back to the 1940s. More recently, a modified form of herpes virus has been used to treat melanoma.
Dr Alexander said that, based on his team’s preliminary findings, the Zika virus won’t have to be modified from its natural form, because fully grown nerve cells are immune to the virus.
We’ve got this fortuitous situation, where the virus can make a subset of people really sick. But for the majority of us, it’s a non-serious infection,” he said.
Most children and adults who are infected with the virus don’t develop any symptoms or have a mild cold-like reaction.
Dr Alexander said the potential therapy could be an injection, much like how mosquitoes infect humans. Or an injection to the site of an excised tumour to prevent the return of the cancer.
The team is now taking the research out of Petri dishes and into rodents.
Dr Alexander and Dr Parks, interim associate dean of research and director of Burnett School of Biomedical Sciences, Orlando, are also planning to study how the CD24 interacts with the Zika virus. – The Orlando Sentinel/Tribune News Service

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