N-acetylcysteine remodels the tumor microenvironment of primary and recurrent mouse glioblastoma

J Neurooncol. 2025 May;173(1):131-145. doi: 10.1007/s11060-025-04971-9. Epub 2025 Feb 15.

Abstract

Purpose: Glioblastoma (GBM) exhibits a high ROS character, giving rise to an immunosuppressive microenvironment and tumor vascular abnormality. This study investigated the potential effect of N-acetylcysteine (NAC), an antioxidant, on primary and recurrent mouse brain tumors.

Methods: We measured reactive oxygen species (ROS)/ glutathione (GSH) levels in human GBM. Additionally, we conducted NAC trials on primary mouse brain tumor models (GL261-Luc, CT2A-Luc) and a recurrent mouse GBM model (GL261-iCasp9-Luc). After brain tumor inoculation, mice received a daily 100 mg/kg NAC treatment, and the tumor volume was monitored via IVIS imaging. The efficacy of NAC was evaluated through survival time, tumor volume, ROS/GSH levels, M1/M2 macrophages, immune cells infiltration, and tumor vascularization.

Results: Human GBM suffered from significant oxidative stress. With NAC treatment, mouse brain tumors exhibited a lower ROS level, more M1-like tumor-associated macrophages/microglia (TAMs), more CD8 + T cell infiltration, and a normalized vascular character. NAC inhibited tumor growth and suppressed recurrence in mouse brain tumor models.

Conclusion: NAC is a promising adjunctive drug to remodel the brain tumors microenvironment.

Keywords: Glioblastoma; N-acetylcysteine; Oxidative stress; Tumor microenvironment.

MeSH terms

  • Acetylcysteine* / pharmacology
  • Acetylcysteine* / therapeutic use
  • Animals
  • Brain Neoplasms* / drug therapy
  • Brain Neoplasms* / metabolism
  • Brain Neoplasms* / pathology
  • Disease Models, Animal
  • Female
  • Glioblastoma* / drug therapy
  • Glioblastoma* / metabolism
  • Glioblastoma* / pathology
  • Glutathione / metabolism
  • Humans
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Neoplasm Recurrence, Local* / drug therapy
  • Neoplasm Recurrence, Local* / metabolism
  • Neoplasm Recurrence, Local* / pathology
  • Oxidative Stress / drug effects
  • Reactive Oxygen Species / metabolism
  • Tumor Microenvironment* / drug effects

Substances

  • Acetylcysteine
  • Reactive Oxygen Species
  • Glutathione