TMIC-39. PERIVASCULAR CONTAINMENT OF T CELLS IN IDH-MUTANT ASTROCYTOMA ASSOCIATES WITH HIGH ABUNDANCE OF GEMISTOCYTIC TUMOR CELLS AND IMMUNE STIMULATORY MICROGLIA

Abstract

Abstract Isocitrate dehydrogenase mutant (IDHmt) astrocytoma is considered a T cell-deficient tumor, yet little is known regarding the underlying mechanism that drives T cell exclusion. To this end, we have systematically characterized the IDHmt astrocytoma immune microenvironment. We used multiplex immunofluorescence stainings (n=75; 1293 regions), bulk (n=152) and single nucleus RNA-sequencing (snRNAseq) (n=8) alongside spatial proteomics and RNA sequencing (n=12; 72 regions of interest) on samples from one patient cohort from the Erasmus Medical Center in the Netherlands, enabling integrative spatially resolved multi-omics analysis. We identified three spatially distinct T cell distributions in IDHmt astrocytoma: perivascular accumulation of T cells (T cell cuffs); presence of T cells in the tumor stroma; and absence of T cells. T cells were most frequently present in cuffs. Notably, T cell cuffs were characterized by a high abundance of a histologically distinct tumor cell type called gemistocytes. Conversely, we find gemistocyte high regions to be enriched for T cell cuffs, B cells and tumor associated macrophages (TAMs). Gemistocyte high tumors have an increased expression of immune cell migration and activation programs. SnRNAseq demonstrates that these programs originate from TAMs and T cells. Interestingly, we find that gemistocytic tumor cells form a transcriptionally distinct tumor cell sub-cluster of the astrocyte-like tumor cell state that expresses CD44. Spatial transcriptomics consequently confirmed that gemistocytes co-occurred with a population of immune stimulatory microglia that expresses the CD44-ligand Secreted Phosphoprotein 1 (SPP1), the chemo-attractants CCL3, CCL4 and CCL4L2, and markers for reactive microglia. In summary, we systematically uncovered a previously unrecognized cellular network between T cells, gemistocytic tumor cells and a subpopulation of immune-stimulatory microglia. This spatially confined population of TAMs, together with gemistocytic tumor cells, harbors signatures associated with astrogliosis, a CNS-specific mechanism of T cell exclusion, and thus may explain the perivascular confinement of T cells.