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FC > 2                          FC > 2
                                        MB vs. CTR                       common
                                          (CSF)                          enriched
                                                             5
                                          n = 22                            CM
                                                                          n = 128


                           HSID     Nam         ID         FC        FC          FC        FC
                                                           FC
                                                                     FC
                                                ID
                                                                                 FC
                                                                                           FC
                                    Namee
                           HSID
                                                       CM vsC (D283) CM vsC (D341)vsC (D283) CM vsC (D341)  CMvsC (DAOY)vsC (DAOY)  MB
                                                       CM
                                                                                        MB vsCTRvsCTR
                                                                            CM
                                                          6.7878
                                            MIMAT0004762MIMAT0004762  6.  18.4618.46  10.7810.78  2.012.01
                          hs_1346hs_1346 hsa-miR-486-3p
                          hs_1517hs_1517 hsa-miR-572  MIMAT0003237MIMAT0003237  6.  8.768.76  3.4747  2.532.53
                                                                                3.
                                                          6.1010
                          hs_0978hs_0978 hsa-miR-4476  MIMAT0019003MIMAT0019003  5.0404  4.734.73  2.7979  2.542.54
                                                                                2.
                                                          5.
                          hs_1566hs_1566 hsa-miR-615-5p  MIMAT0004804MIMAT0004804  2.9292  4.254.25  2.1616  2.042.04
                                                          2.
                                                                                2.
                                                                                2.5151
                          hs_0775hs_0775 hsa-miR-3918  MIMAT0018192MIMAT0018192  2.  2.662.66  2.  2.112.11
                                                          2.0808
                         a
                                                                            FC > 2
                                           FC > 2
                                                                         MR vs. non-
                                        MB vs. CTR
                                                             4
                                                                             MR
                                           (CSF)
                                                                            (CM)
                                           n = 22
                                                                            n = 38
                                                                               FC
                                                             ID
                                               Name
                                                                      FC
                                     HSI       Name          ID       FC       FC
                                     HSIDD
                                                                           MB vs CTRvs CTR
                                                                    A      MB
                                                                    A vs NAvs NA
                                    h
                                                                     10.58
                                                        MI
                                                                               2.63
                                           h
                                    hs_0152s_0152  hsa-miR-1290sa-miR-1290  MIMAT0005880MAT0005880  10.58  2.63
                                                                     2.57
                                                                               2.08
                                           hsa-miR-125a-3p-miR-125a-3p
                                    hs_0103
                                                        MI
                                    hs_0103  hsa        MIMAT0004602MAT0004602  2.57  2.08
                                                                               2.15
                                                                     2.57
                                    h hs_0160s_0160  h hsa-miR-1298sa-miR-1298  MIMAT0005800MAT0005800  2.57  2.15
                                                        MI
                         b          h hs_0106s_0106  hsa-miR-125b-1*sa-miR-125b-1*  MIMAT0004592IMAT0004592  2.33  2.18
                                           h
                                                        M
                                                                     2.33
                                                                               2.18
            Figure 5: MiRNAs commonly enriched in CM of MB cell lines,  and in CSF sample. (a) Venn diagram and table presenting 5 miRNAs commonly upregulated
            in CM of 3 MB cell lines and in CSF from MB patients compared to CTR; (b) Venn diagram and table representing 4 miRNAs commonly upregulated in CSF
            samples from MB patients  and over-represented in CM of the MR cell lines D341, D283. CM: Culture-medium; MB: Medulloblastoma; CSF: Cerebral spinal
            fl uid; MR: Metastasis related; FC: Fold change; CTR: Control; MiRNAs: MicroRNA
            used in most diagnostic labs). Importantly, we could   spectra in CM and those expressed intracellularly was
            detect ex-miRNAs by qRT-PCR in CM of as few as    observed. Since deregulated miRNA expression is an
            100-500 MB cells [Figure 8b], recommending qRT-PCR   early event in tumorigenesis, measuring miRNA levels
            for the development of non-invasive detection of   in CSF may also be useful for early detection, which
            metastasis-predicting markers for MB.             can contribute greatly to the success of treatment. [28]
                                                              Therefore, in order to use ex-miRNAs as biomarkers
            Discussion                                        for MB, it is important to establish a signature capable
            Aberrant expression of ex-miRNA circulating in    of differentiating disease from healthy states. Our
            CSF of certain brain tumor patients has recently   pilot microarray screening identifi ed 86 miRNAs
            been reported to be cancer biomarkers and potential   exclusively detected in CSF of MB patients but not
            regulators of the disease. [7,8]  However, the existence and   in control CSF from patients with no brain tumor. We
            role of ex-miRNAs in MB extracellular environment   also identifi ed 268 miRNAs that are over-represented
            are unknown.  Therefore, better understanding of   and interestingly, only 6 miRNAs under-represented in
            ex-miRNA secretion and function in MB seems crucial   MB-CSF compared with control CSF.  These  fi ndings
            for the development of novel insights for its diagnosis   could be of great signifi cance, providing the correlation
            and prognosis.  This study aimed to identify key   between expression levels of these miRNAs in CSF of
            miRNAs in culture medium of 3 cell lines, representing   MB patients and their disease states can be established
            different MB subtypes. Our results identifi ed  a   in future studies.
            signifi cant number (1,347) of hitherto unrecognized   Tumor cell-derived ex-miRNAs are reported to be
            new miRNAs commonly expressed in CM of the 3      pro-tumorigenic. [29]  Ex-miRNAs can transfer their
            cell lines.  A signifi cant concordance of ex-miRNA   oncogenic activity to recipient target cells to infl uence
            72                                      Journal of Cancer Metastasis and Treatment  ¦  Volume 1 ¦ Issue 2 ¦ July 15, 2015 ¦
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