Tumor-associated astrocytes augment cholesterol synthesis to support glioblastoma growth through alternatively spliced Quaking (QKI) isoforms

Neuro Oncol. 2026 Feb 17:noag030. doi: 10.1093/neuonc/noag030. Online ahead of print.

Abstract

Background: Glioblastoma (GBM) is a highly aggressive brain tumor with limited treatment options. Tumor-associated astrocytes (TAAs) are crucial components of the GBM microenvironment, yet the contribution of alternative splicing (AS) in TAAs to tumor progression remains unclear.

Methods: Transcriptomic and molecular analyses of GBM-associated astrocytes revealed a GBM-induced isoform switch in the RNA-binding protein Quaking (QKI) from the QKI-6 isoform to QKI-5 isoform. The biological role of QKI-5 was examined through gain- and loss-of-function approaches in human astrocytes and co-culture systems with patient-derived glioma stem-like cells (GSCs). In vitro proliferation and sphere-formation assays, along with in vivo orthotopic xenograft models, were used to evaluate tumor growth. Immunoprecipitation and AlphaFold3 structural prediction were performed to investigate the mechanistic interaction between QKI-5 and sterol regulatory element-binding protein 2 (SREBP2).

Results: GBM-induced QKI-5 interacts with SREBP2 to transcriptionally activate cholesterol metabolic enzymes, enhancing astrocyte-derived cholesterol production and promoting GBM growth. Knockdown of QKI-5 or inhibitors for SREBP2-driven signaling suppressed astrocyte-mediated tumor-supportive effects in vitro and in vivo.

Conclusion: QKI-5 drives astrocytic metabolic reprogramming via the QKI-5-SREBP2 axis, fostering a cholesterol-rich tumor microenvironment that supports GBM progression. Targeting this pathway offers a potential therapeutic strategy.

Keywords: Alternative splicing; Cholesterol metabolism; Glioblastoma; Quaking (QKI); Tumor-associated astrocyte.