Molecular Pathogenesis of Low-Grade Glioma

Neurosurg Clin N Am. 2019 Jan;30(1):17-25. doi: 10.1016/


Advances in genome sequencing have elucidated the genetics of low-grade glioma. Available evidence indicates a neomorphic mutation in isocitrate dehydrogenase (IDH) initiates gliomagenesis. Mutant IDH produces the oncometabolite 2-hydroxyglutarate, which inhibits enzymes that demethylate genomic DNA and histones. Recent findings by the authors and others suggest the ensuing hypermethylation alters chromatin conformation and the transcription factor landscape in brain progenitor cells, leading to a block in differentiation and tumor initiation. Work in preclinical models has identified selective metabolic and molecular vulnerabilities of low-grade glioma. These new concepts will trigger a wave of innovative clinical trials in the near future.

Keywords: Astrocytoma; Low-grade glioma; Mutant IDH; Oligodendroglioma.

Publication types

  • Review

MeSH terms

  • Brain Neoplasms / genetics*
  • Brain Neoplasms / pathology
  • Cell Differentiation / genetics*
  • DNA Methylation / genetics
  • Glioma / genetics*
  • Glioma / pathology
  • Humans
  • Isocitrate Dehydrogenase / genetics*
  • Mutation / genetics*


  • Isocitrate Dehydrogenase