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Ambion, Life  Technology), which was used as
                                                              spike-in by adding it during the lysis step of miRNAs
                                                              extraction.
                                                              Results
                                                              Detection of ex-miRNAs in cultured medium of
                                                              MB cell lines by microarray analysis
                                                              Given that some human cancer cells secrete miRNAs
                                                              into their extracellular environment and body fl uids, [24-26]
                                                              it was hypothesized that MB cell lines may secrete
                                                              miRNAs into their spent culture medium.  To test this
                                                              hypothesis, 3 cell lines representing MB subtypes D341
                                                              and D283 (metastasis-related group 3 and group 4 MB
                                                              subtypes)  and DAOY (sonic hedgehog-related) were
                                                                      [27]
            Figure 2: PCA graph showing microRNA spectra in CSF of MB patient vs.   cultured individually for 72 h in vitro  and miRNAs
            control CSFs. TB0021_CTR1: CSF from patient with no brain tumor control   expression was analyzed in the lysates of each MB
            1; TB0012_CTR2: CSF from patient with no brain tumor control 2; TB0011_  cell line and in their corresponding culture media.  We
            MB: CSF of MB patient. MB: Medulloblastoma; CSF: cerebral spinal fl uid;
            PCA: Principal component analysis                 identifi ed 1,662, 1,615, and 1,199 secreted miRNAs
                                                              in the culture-medium (CM) of MB cell lines D283,
            MicroRNA isolation for reverse transcription      D341 and DAOY, respectively, among them 1,083
            polymerase chain reaction analysis                miRNAs that were common in the CM of the 3 cell
                                                              lines. In cell lysates of D283, D341 and DAOY, on the
            For precipitation of nucleic acids, the monovalent   other hand, we detected 1,787, 1,394 and 1,761 miRNA
            cation concentration of the solution was adjusted
            to 0.5 mol/L sodium acetate. Glycogen (AM9510,    respectively, with 1,347 miRNAs found common to
            Ambion, Life Technology, NY, USA) was added to a   all 3 cell lines [Figure 4a]. Interestingly, 950 miRNAs
            final concentration of 100  μg/mL.  The solution was   were commonly identifi ed in CM of both groups and in
            then mixed with 1 volume of isopropanol. The mixture   lysates of the 3 cell lines tested, indicating that the level
            was chilled for 20 min at -20 °C, then centrifuged   of ex-miRNAs may well refl ect the expression level of
            for 20 min at 13,000 rpm. The supernatant fluid was   tumor miRNAs. Using a fold-change > 2, we identifi ed a
            removed, and the nucleic acid resuspended in lysis   group of 156 miRNAs that are commonly enriched in CM
            buffer. Final purification of RNA enriched for small   derived from the 3 cell lines compared to their respective
            RNAs from 600  μL of conditioned media and CSF    cell lysates [Figure 4b] and [Supplementary  Table 1]
            samples was obtained using the mirVanaTM miRNA    and 57 miRNAs that were spec ifi c to the CM of D341
            Isolation Kit (Ambion, Life  Technology) according   and D283, which represented the 2 metastasis-related
                                                                                                           [27]
            to manufacturer’s instructions for “Enrichment    group 3 and group 4 MB subtypes, respectively
            Procedure for Small RNAs.” Using this approach    compared to DAOY-derived CM [Figure 4b] and
            consisting of two sequential filtrations with different   [Supplementary  Table 2].  We found 2 additional groups
            ethanol concentrations, an RNA fraction highly    of miRNAs to be differentially enriched in CM of D341
            enriched in RNA species ≤ 200 nt was obtained. First   and D283, represented by 60 miRNAs overrepresented
            strand synthesis of mature miRNAs was followed by   and 52 underrepresented compared to DAOY-derived
            quantitative reverse transcription polymerase chain   CM [Supplementary Tables 3 and   4]. Overall, the results
            reaction (qRT-PCR) using miRNA-specific  TaqMan   of this experiment demonstrate that MB cell lines secrete
            MGB probes (Applied Biosystems, Life Technology).   miRNAs into the CM and that certain ex-miRNAs retain
            For the qRT-PCR reaction, the Gene Expression     different enrichment levels in the CM-derived from the 2
            Master Mix   was used and the protocol was optimized   cell lines representing the metastasis-related group 3 and
            for the  ABI7900HT reader (Applied Biosystems).   group 4 MB subtypes
            Probe-primer solutions specific for the following   Detection of ex-miRNAs in CSF of MB patients
            miRNAs were used: miR-1290 (002863), miR-125a-    by microarray analysis
            3p (002199), miR-1298 (002861), miR-125b-1*
            (002378), miR-486-3p (002093), miR-572 (001614),   We next asked whether ex-miRNAs could be detected
            miR-4476 (464702_mat), miR-615-5p (002353),       in CSF of MB patients, to test whether it would be
            and miR-3918 (464506_mat) (Applied Biosystems,    technically possible to use the CSF as a source for
            Life  Technology).  The relative gene expression   diagnostic miRNA testing. Using microarray analysis,
            was calculated for each gene of interest using the   we screened cell-free CSF from a patient with MB and
            ΔΔCT method, where cycle threshold values were    compared the results to controls (CSF from two different
            normalized to the level of cel-miR-39-3p (4464066,   leukemia patients with no cerebral manifestation or

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