Abstract Mitochondrial transfer in the central nervous system occurs from astrocytes to neurons in stroke. Mitochondrial exchange has also been reported among tumor cells in glioblastoma (GBM), the most common primary brain tumor. However, the role of mitochondrial transfer from non-neoplastic cells in the surrounding microenvironment to GBM remains poorly understood. We hypothesized that mitochondrial transfer from these non-neoplastic to GBM cells supports tumor metabolism and growth. Using transgenic mice expressing fluorophore-tagged mitochondria, we found that ~50% of orthotopically-implanted mouse GBM cells acquire host mitochondria. Brain-resident cells, mainly astrocytes, but not infiltrating immune cells were the primary mitochondrial donors in vivo and in vitro. Mitochondrial transfer also occurred from immortalized human astrocytes to a broad array of patient-derived xenograft (PDX) models of GBM in vitro at rates of 15-35%. GBM cells that acquired mitochondria expressed higher levels of the ATP-synthase subunit ATP5A and produced more ATP, while metabolomics revealed upregulated amino acid metabolism in recipient cells. In vivo, mouse GBM cells that acquired mitochondria were more likely to be in G2/M proliferative cell cycle phases. We observed a similar effect in PDX that acquired astrocyte mitochondria from co-cultures in vitro. To mechanistically link increased proliferation specifically to mitochondrial transfer, we isolated astrocyte mitochondria by differential centrifugation and found that addition and uptake of cell-free mitochondria in human GBM cells recapitulated the increased proliferation. Using sorted mouse and human GBM cells with/without astrocyte mitochondrial acquisition, we further found that mitochondrial transfer promoted in vitro self-renewal and in vivo tumorigenicity, leading to significant reduction in survival and increased penetrance in orthotopic GBM models. Transfer in mouse and human systems was contact-dependent and was abrogated by physical separation of donor and recipient cells by transwell inserts. We visualized contact-dependent transfer across actin-based intercellular connections consistent with previously reported microtubes. We confirmed the critical role of actin and the actin-associated protein, growth-associated protein 43 (GAP43) in facilitating mitochondrial transfer by showing that pharmacologic inhibition and genetic knockdown (respectively) significantly decreased the rate of mitochondrial transfer. Taken together, mitochondrial transfer comprises a fundamental, protumorigenic mechanism of GBM, enhancing metabolic activity and driving tumor cell proliferation. Further elucidating the molecular machinery regulating astrocyte mitochondrial transfer and its downstream protumorigenic effects will lead to therapeutic opportunities targeting this understudied tumor microenvironment interaction. Citation Format: Dionysios C. Watson, Defne Bayik, Simon Storevik, Shannon S. Moreino, Samuel S. Sprowls, Gauravi Deshpande, Palavalasa Sravya, Costas A. Lyssiotis, Daniel R. Wahl, Hrvoje Miletic, Justin D. Lathia. Mitochondrial transfer from astrocytes drives glioblastoma tumorigenicity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 331.
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