Tumor Microenvironment in Gliomas: A Treatment Hurdle or an Opportunity to Grab?

GNB4 Silencing Promotes Pyroptosis to Inhibit the Development of Glioma by Activating cGAS-STING Pathway

The induction of immunogenic cell death is a promising therapeutic option for gliomas. Pyroptosis is a type of programmed immunogenic cell death and its role in gliomas remains unclear. Differentially expressed genes (DEGs) were obtained from GSE4290 and GSE31262 datasets. Hub genes were screened from protein-protein interaction networks and assessed using principal component analysis and receiver operating characteristic curves. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to measure the mRNA expression of hub genes. Pyroptosis and pathway-related proteins were assessed using western blotting. Inflammatory factor levels were determined using enzyme-linked immunosorbent assay. The effect of guanine nucleotide-binding protein-4 (GNB4) on proliferation, migration, and invasion was evaluated using a cell viability test kit and wound-healing and transwell assays. In total, 202 DEGs were identified. Among them, F2R, GNG4, GNG3, PRKCB, and GNB4 were identified as hub genes in gliomas after comprehensive bioinformatics analysis. GNB4 was significantly upregulated in glioma cells compared to normal brain glial cells. Silencing GNB4 significantly inhibited proliferation, invasion, and migration of glioma cells. The expression of pyroptosis-related proteins increased after GNB4 silencing, with elevated levels of inflammatory factors. Pyroptosis inhibitors reversed the inhibitory effects of GNB4 silencing on cell proliferation, migration, and invasion. Additionally, GNB4 silencing activated the cGAS-STING pathway. Treatment with a cGAS-STING pathway inhibitor reversed the inhibition of proliferation, migration, and invasion while downregulating the expression of pyroptosis-related proteins. Silencing GNB4 promotes pyroptosis and thus inhibits the proliferation, migration, and invasion of glioma cells by activating the cGAS-STING pathway, which is a promising biomarker and therapeutic target for glioma.

Tumor-associated microenvironment, PD-L1 expression and their relationship with immunotherapy in glioblastoma, IDH-wild type: A comprehensive review with emphasis on the implications for neuropathologists

Although novel knowledge has been acquired on the molecular landscape of glioblastoma (GBM), a relatively few steps forward have been made regarding its therapy. With the increasing use of novel immunotherapeutic drugs capable of stimulating the antitumor inflammatory response, in the last decades numerous studies aimed to characterize the tumor-associated microenvironment (TME) and its relationship with the immunogenicity of GBM. In this regard, although the tumor-associated microglia and macrophages (TAMs) and PD-L1/PD-1 axis have been emerged as one of the most relevant components of the GBM TME and one of the potential molecular pathways targetable with immunotherapy, respectively. It has been supposed that TAMs may acquire different phenotypes, switching from M1 to M2 phenotypes, with tumor-suppressive and tumor-stimulating role depending on the different surrounding conditions. PD-L1 is a type 1 transmembrane protein ligand expressed by T-cells, B-cells and antigen-presenting cells, with a main inhibitory checkpoint role on tumor immune regulation. While PD-L1 immunohistochemical expression has been extensively investigated in many cancers, its usefulness in the evaluation of GBM response rates to immunotherapy and its standardized evaluation by immunohistochemistry are still debated. The present review paper focuses on the current "state of the art" about the relationship between TME, PD-L1/PD-1 pathway and immunotherapy in GBM, also providing neuropathologists with an updated guide about the clinical trials conducted with PD-L1 and PD-1 inhibitors.

The Biological and Clinical Role of the Telomerase Reverse Transcriptase Gene in Glioblastoma: A Potential Therapeutic Target?

Glioblastoma IDH-wildtype represents the most lethal and frequent primary tumor of the central nervous system. Thanks to important scientific efforts, we can now investigate its deep genomic assessment, elucidating mutated genes and altered biological mechanisms in addition to its clinical aggressiveness. The telomerase reverse transcriptase gene (TERT) is the most frequently altered gene in solid tumors, including brain tumors and GBM IDH-wildtype. In particular, it can be observed in approximately 80-90% of GBM IDH-wildtype cases. Its clonal distribution on almost all cancer cells makes this gene an optimal target. However, the research of effective TERT inhibitors is complicated by several biological and clinical obstacles which can be only partially surmounted. Very recently, novel immunological approaches leading to TERT inhibition have been investigated, offering the potential to develop an effective target for this altered protein. Here, we perform a narrative review investigating the biological role of TERT alterations on glioblastoma and the principal obstacles associated with TERT inhibitions in this population. Moreover, we discuss possible combination treatment strategies to overcome these limitations.