Osuka S(1)(2), Zhu D(2), Zhang Z(2), Li C(1), Stackhouse CT(1)(3), Sampetrean O(4), Olson JJ(2), Gillespie GY(1), Saya H(4), Willey CD(3), Van Meir EG(1)(2). Author information:
(1)Department of Neurosurgery, School of Medicine and O'Neal Comprehensive
Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.
(2)Laboratory of Molecular Neuro-Oncology, Department of Neurosurgery, School of
Medicine and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
(3)Department of Radiation Oncology, University of Alabama at Birmingham,
(4)Division of Gene Regulation, Institute for Advanced Medical Research, Keio
University School of Medicine, Tokyo, Japan.
Glioblastoma (GBM) is composed of heterogeneous tumor cell populations, including those with stem cell properties, termed glioma stem cells (GSCs). GSCs are innately less radiation sensitive than the tumor bulk and are believed to drive GBM formation and recurrence after repeated irradiation. However, it is unclear how GSCs adapt to escape the toxicity of repeated irradiation used in clinical practice. To identify important mediators of adaptive radioresistance in GBM, we generated radioresistant human and mouse GSCs by exposing them to repeat cycles of irradiation. Surviving subpopulations acquired strong radioresistance in vivo, which was accompanied by a reduction in cell proliferation and an increase in cell-cell adhesion and N-cadherin expression. Increasing N-cadherin expression rendered parental GSCs radioresistant, reduced their proliferation, and increased their stemness and intercellular adhesive properties. Conversely, radioresistant GSCs lost their acquired phenotypes upon CRISPR/Cas9-mediated knockout of N-cadherin. Mechanistically, elevated N-cadherin expression resulted in the accumulation of β-catenin at the cell surface, which suppressed Wnt/β-catenin proliferative signaling, reduced neural differentiation, and protected against apoptosis through Clusterin secretion. N-cadherin upregulation was induced by radiation-induced IGF1 secretion, and the radiation resistance phenotype could be reverted with picropodophyllin, a clinically applicable blood-brain-barrier permeable IGF1 receptor inhibitor, supporting clinical translation.
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