Cnsc-41. does ischemic stroke drive brain tumor progression?

Abstract Glioblastoma multiforme is the most common and lethal primary brain tumor, with a 5-year survival rate of less than 5%. Its complex pathophysiology, highlighted by massive inflammatory responses, enhances tumor progression and impedes therapeutic interventions, leading to its dismal prognosis. Inflammatory responses are also a cardinal feature of brain injury and remarkably, clinical evidence from large-scale patient cohort studies indicates a link between glioma and cerebral ischemic stroke, where approximately 10% of ischemic stroke patients develop glioma. This observation suggests that brain injury may be a risk factor for the development of brain tumors; however, whether and how stroke occurrence promotes brain tumor progression is unknown. To address this knowledge gap, we employed a photothrombotic stroke mouse model in conjunction with established glioma models. In these models, we observed a significant increase in tumor cell proliferation and infiltration towards the infarct region and blood-brain barrier disruption. Intriguingly, spatial transcriptomic analysis in stroke-glioma models highlighted altered pH regulation in the microenvironment at the leading edge of tumor cells near stroke lesions. Further analysis revealed that the astrocytic pH regulator, Slc4a4, is significantly downregulated in the infiltrating tumor cells near infarct lesions, and that Slc4a4 inhibits tumor progression in our glioma models. Based on patient cohort studies that link glioma occurrence with cerebral ischemia and our new mouse model results, our data demonstrates that exposure to cortical ischemia-induced-hypoxia during tumorigenesis, promotes malignant glioma progression by altering the brain microenvironment via pH modulation. These conceptually innovative studies will integrate our new stroke-glioma models and advanced methodologies to investigate the stroke-glioma interaction via hypoxia and pH modulation, potentially identifying new therapy targets.