Summary: Introducing VEGF-C into the cerebrospinal fluid of mouse models of glioblastoma, researchers noted increased levels of T cell response to the cancerous tumors. When combined with immune system checkpoint inhibitors, the VEGF-C treatment significantly extended the life span of the mice with glioblastoma brain cancer.
The brain is a sort of fortress, equipped with barriers designed to keep out dangerous pathogens. But protection comes at a cost: These barriers interfere with the immune system when faced with dire threats such glioblastoma, a deadly brain tumor for which there are few effective treatments.
Yale researchers have found a novel way to circumvent the brain’s natural defenses when they’re counterproductive by slipping immune system rescuers through the fortresses’ drainage system, they report Jan. 15 in the journal Nature.
“People had thought there was very little the immune system could do to combat brain tumors,” said senior corresponding author Akiko Iwasaki. “There has been no way for glioblastoma patients to benefit from immunotherapy.”
Iwasaki is the Waldemar Von Zedtwitz Professor of Immunobiology and professor of molecular, cellular, and developmental biology and an investigator for the Howard Hughes Medical Institute.
While the brain itself has no direct way for disposing of cellular waste, tiny vessels lining the interior of the skull collect tissue waste and dispose of it through the body’s lymphatic system, which filters toxins and waste from the body. It is this disposal system that researchers exploited in the new study.
These vessels form shortly after birth, spurred in part by the gene known as vascular endothelial growth factor C, or VEGF-C.
Yale’s Jean-Leon Thomas, associate professor of neurology at Yale and senior co-corresponding author of the paper, wondered whether VEGF-C might increase immune response if lymphatic drainage was increased. And lead author Eric Song, a student working in Iwasaki’s lab, wanted to see if VEGF-C could specifically be used to increase the immune system’s surveillance of glioblastoma tumors. Together, the team investigated whether introducing VEGF-C through this drainage system would specifically target brain tumors.
The team introduced VEGF C into the cerebrospinal fluid of mice with glioblastoma and observed an increased level of T cell response to tumors in the brain. When combined with immune system checkpoint inhibitors commonly used in immunotherapy, the VEGF-C treatment significantly extended survival of the mice. In other words, the introduction of VEGF-C, in conjunction with cancer immunotherapy drugs, was apparently sufficient to target brain tumors.
“These results are remarkable,” Iwasaki said.
“We would like to bring this treatment to glioblastoma patients. The prognosis with current therapies of surgery and chemotherapy is still so bleak.”
Funding: The study was primarily funded by the Howard Hughes Medical Institute and the National Institutes of Health.
VEGF-C-driven lymphatic drainage enables immunosurveillance of brain tumours
Immune surveillance against pathogens and tumours in the central nervous system is thought to be limited owing to the lack of lymphatic drainage. However, the characterization of the meningeal lymphatic network has shed light on previously unappreciated ways that an immune response can be elicited to antigens that are expressed in the brain. Despite progress in our understanding of the development and structure of the meningeal lymphatic system, the contribution of this network in evoking a protective antigen-specific immune response in the brain remains unclear. Here, using a mouse model of glioblastoma, we show that the meningeal lymphatic vasculature can be manipulated to mount better immune responses against brain tumours. The immunity that is mediated by CD8 T cells to the glioblastoma antigen is very limited when the tumour is confined to the central nervous system, resulting in uncontrolled tumour growth. However, ectopic expression of vascular endothelial growth factor C (VEGF-C) promotes enhanced priming of CD8 T cells in the draining deep cervical lymph nodes, migration of CD8 T cells into the tumour, rapid clearance of the glioblastoma and a long-lasting antitumour memory response. Furthermore, transfection of an mRNA construct that expresses VEGF-C works synergistically with checkpoint blockade therapy to eradicate existing glioblastoma. These results reveal the capacity of VEGF-C to promote immune surveillance of tumours, and suggest a new therapeutic approach to treat brain tumours.