Neuroinflammatory changes of the normal brain tissue in cured mice following combined radiation and anti-PD-1 blockade therapy for glioma

Sci Rep. 2021 Mar 3;11(1):5057. doi: 10.1038/s41598-021-84600-3.

Abstract

The efficacy of combining radiation therapy with immune checkpoint inhibitor blockade to treat brain tumors is currently the subject of multiple investigations and holds significant therapeutic promise. However, the long-term effects of this combination therapy on the normal brain tissue are unknown. Here, we examined mice that were intracranially implanted with murine glioma cell line and became long-term survivors after treatment with a combination of 10 Gy cranial irradiation (RT) and anti-PD-1 checkpoint blockade (aPD-1). Post-mortem analysis of the cerebral hemisphere contralateral to tumor implantation showed complete abolishment of hippocampal neurogenesis, but neural stem cells were well preserved in subventricular zone. In addition, we observed a drastic reduction in the number of mature oligodendrocytes in the subcortical white matter. Importantly, this observation was evident specifically in the combined (RT + aPD-1) treatment group but not in the single treatment arm of either RT alone or aPD-1 alone. Elimination of microglia with a small molecule inhibitor of colony stimulated factor-1 receptor (PLX5622) prevented the loss of mature oligodendrocytes. These results identify for the first time a unique pattern of normal tissue changes in the brain secondary to combination treatment with radiotherapy and immunotherapy. The results also suggest a role for microglia as key mediators of the adverse treatment effect.

MeSH terms

  • Animals
  • Antibodies / administration & dosage*
  • Brain / metabolism
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / radiotherapy*
  • Cell Line, Tumor
  • Combined Modality Therapy / methods
  • Cranial Irradiation / methods*
  • Disease Models, Animal
  • Glioma / metabolism
  • Glioma / mortality*
  • Glioma / pathology
  • Glioma / radiotherapy*
  • Immune Checkpoint Inhibitors / administration & dosage*
  • Immunocompromised Host
  • Immunotherapy / methods*
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Microglia / drug effects
  • Microglia / metabolism
  • Organic Chemicals / administration & dosage
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • Programmed Cell Death 1 Receptor / immunology
  • Programmed Cell Death 1 Receptor / metabolism
  • Protein Kinase Inhibitors / administration & dosage
  • Random Allocation
  • Survival Rate
  • Treatment Outcome

Substances

  • Antibodies
  • Immune Checkpoint Inhibitors
  • Organic Chemicals
  • PLX5622
  • Pdcd1 protein, mouse
  • Programmed Cell Death 1 Receptor
  • Protein Kinase Inhibitors