CSIG-27. FLUID SHEAR STRESS ACTIVATES A MECHANO-METASTATIC CASCADE TO PROMOTE MEDULLOBLASTOMA METASTASIS

Abstract

Abstract Medulloblastoma (MB) is the most common malignant pediatric brain tumor. Dissemination of MB cells into cerebrospinal fluid (CSF) and blood initiates metastasis in the central nervous system, which significantly worsens patient prognosis. Disseminated MB cells survive the nutrient-deprived CSF environment and are subjected to fluid shear stress (FSS) by CSF flow. Whether and how FSS contributes to MB metastasis is completely unknown. We computationally simulated FSS dynamics in MB patients using MRI-informed CSF flow models. Based on CSF flow rates and force magnitudes in patients, we engineered two FSS application systems: (1) an orbital shaker system that applies FSS to large populations of cells, and (2) a microfluidic system compatible with live-cell and high-resolution imaging. By applying physiologically relevant FSS to MB cells, we discovered that FSS-treated MB cells metastasize more frequently and form larger metastatic tumors along the spinal cords of mice. Mechanistically, FSS induces actomyosin contraction, which promotes cell clustering, glucose transporter 1 (GLUT1) localization at the cell surface, and GLUT1-dependent glucose uptake. FSS elevates intracellular calcium through mechanosensitive ion channel PIEZO2, which is required for FSS-induced actomyosin contraction, cell clustering, and GLUT1 activity. Genetically perturbing PIEZO2 or pharmacologically inhibiting GLUT1 robustly suppresses MB metastasis in mice. Collectively, we discover that MB cells perceive FSS, define an FSS-activated mechano-metastatic cascade, and demonstrate that this cascade is clinically targetable to mitigate MB metastasis.