371 Activated PPARβ/QKI Signaling in Macrophage/Microglia Sensitizes Glioblastoma to Immunotherapy

Abstract

INTRODUCTION: Glioblastomas (GBMs) share overwhelmingly immunosuppressive tumor microenvironments that are enriched in glioblastoma-associated macrophages and microglia (GAMs). Notably, GAMs have distinctive reshuffling of lipid composition and dysfunctional lipid metabolism. The peroxisome proliferator-activated receptor (PPAR) family members are master regulators of lipid metabolism in macrophages. One of the PPARs, PPARβ is a pivotal modulator of lipid metabolism in macrophages that orchestrates timely disposal of GBM cells. METHODS: Co-immunoprecipitation using an anti-Qki antibody was followed by detecting PPARβ. PPARβ and QKI levels were compared between GAMs inside GBMs and paired macrophages/microglia outside GBMs, as well as human low-grade versus high-grade gliomas. Survival was collected from CX3CR1-CreERT2; PpardL/L/Qki+/+ mice (PPARβ KO) (Ppard is the gene name for PPARβ), CX3CR1-CreERT2; Ppard+/+/QkiL/L mice (QKI KO) and control CX3CR1-CreERT2; Ppard+/+/Qki+/+ (Ctrl) mice given tamoxifen when implanted with GL261 cells. Survival was collected for GBM bearing mice given PPARβ agonist, KD3010 and/or anti-PD-1 therapy. RESULTS: PPARβ co-activates the QKI-mediated complex, which is an essential mediator of phagocytosis in macrophage/microglia. Moreover, PPARβ/QKI signaling is markedly decreased in GAMs relative to paired macrophages/microglia within boundary brain parenchyma (P < 0.001). Myeloid cell–specific PPARβ; or QKI knockout shorten overall survival of GBM–bearing mice (P < 0.05), and inhibited PPARβ/QKI signaling in GAMs correlates with grade progression in human gliomas (P < 0.01) and worse prognosis for GBM (P = 0.0034). Therapeutically, PPARβ agonist plus anti-PD-1 greatly prolongs survival of mice GBMs relative to anti-PD-1 monotherapy (P < 0.05). CONCLUSIONS: We characterize dysfunctional lipid metabolism in GAMs and elucidates the mechanism underlying immunosuppression of GAMs caused by PPARβ/QKI loss. The study supports for therapeutic options for restoring PPARβ/QKI-mediated lipid metabolism in GAMs and development of novel strategies to sensitize GBM to immunotherapy.