Abstract

A hallmark of cellular transformation is the evasion of contact-dependent inhibition of growth. To find new therapeutic targets for glioblastoma, we looked for pathways that are inhibited by high cell density in astrocytes but not in glioma cells. Here we report that glioma cells have disabled the normal controls on cholesterol synthesis. At high cell density, astrocytes turn off cholesterol synthesis genes and have low cholesterol levels, but glioma cells keep this pathway on and maintain high cholesterol. Correspondingly, cholesterol pathway upregulation is associated with poor prognosis in glioblastoma patients. Densely-plated glioma cells increase oxygen consumption, aerobic glycolysis, and the pentose phosphate pathway to synthesize cholesterol, resulting in a decrease in reactive oxygen species, TCA cycle intermediates, and ATP. This constitutive cholesterol synthesis is controlled by the cell cycle, as it can be turned off by cyclin-dependent kinase inhibitors and it correlates with disabled cell cycle control though loss of p53 and RB. Finally, glioma cells, but not astrocytes, are sensitive to cholesterol synthesis inhibition downstream of the mevalonate pathway, suggesting that specifically targeting cholesterol synthesis might be an effective treatment for glioblastoma.

Highlights

  • Malignant gliomas are highly lethal adult brain tumors with glial features, likely derived from neural stem cells, glial progenitors, or astrocytes [1,2,3]

  • In an effort to characterize density-dependent differences between normal astrocytes and patientderived glioblastoma cells, we found that tumor cells have dysregulated the normal controls on cholesterol synthesis

  • Tumor cells plated at high density increase oxygen consumption and keep cholesterol synthesis gene expression on in order to maintain cholesterol levels, while normal astrocytes maintain consistent oxygen consumption at all densities, but turn off genes in the mevalonate pathway and reduce cholesterol when dense

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Summary

Introduction

Malignant gliomas are highly lethal adult brain tumors with glial features, likely derived from neural stem cells, glial progenitors, or astrocytes [1,2,3]. The most common and lethal malignant glioma is WHO grade IV glioblastoma, or GBM, which has a median survival of 15 months with current standard-of-care therapy consisting of surgery, radiation, and temozolomide [4]. While the bulk of these tumors can be removed surgically, total resection is impossible due to the highly invasive and infiltrative nature of the tumor cells These tumors are highly resistant to cytotoxic therapies: adjuvant treatment with temozolomide only improves survival 2.5 months beyond radiation and surgery alone [4]. The RTK/ PI3K/MAPK axis is the most targetable with state-ofthe-art therapeutics, yet these drugs have not significantly improved patient survival beyond that of the current standard-of-care [4, 6, 7]. There is reason to be optimistic that new drug targets will be discovered

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