GABAergic Circuit Activation Induces a Therapeutically Responsive State for anti-PD-L1 Immunotherapy in Glioblastoma
M ScaleraiD, Elisa De SantisiD, Filippo RossiiD, Nicolò MeneghettiiD, Lorenzo Amir Nemati FardiD, Pasquale MiglionicoiD, Francesco RaimondiiD, Alessandra FloriiD, Massimo PasqualettiiD, Luca MenichettiiD, Soma SenguptaiD, Eleonora VanniniiD, Mario CostaiD
Abstract
Glioblastoma (GBM) disrupts cortical excitatory-inhibitory balance and establishes an immunosuppressive microenvironment that limits therapeutic efficacy. Whether restoring inhibitory signaling can restrain glioma progression and improve responsiveness to immune checkpoint blockade remains unknown. Peritumoral parvalbumin-positive (PV+) interneurons were bidirectionally manipulated by chemogenetics in orthotopic GL261 gliomas to assess tumor growth and neurological function. GABAB signaling was pharmacologically activated with baclofen in GL261 and CT-2A models and combined with anti-PD-L1 blockade in GL261. Therapeutic response, survival, tumor rechallenge, and early myeloid remodeling were evaluated. Human GBM single-cell transcriptomic data were analyzed to examine the relationship between GABAergic and PD-L1 intercellular signaling. PV activation transiently restrained glioma growth, reduced tumor proliferation and preserved cortical function, whereas PV+ silencing increased seizure susceptibility and neurological impairment without accelerating tumor growth. Baclofen monotherapy did not affect survival, whereas its combination with anti-PD-L1 immunotherapy induced complete tumor eradication in 66% of GL261-bearing mice, prolonged survival, and conferred durable protection against tumor rechallenge. Combination therapy also altered the proportions of Arg1+ and CD11c+ cells within the intratumoral F4/80+ compartment. Human single-cell analysis revealed a shared myeloid-centered communication axis linking GABAB and PD-L1 signaling. These findings identify GABAergic signaling as a modulator of GBM progression and demonstrate that combining baclofen with anti-PD-L1 induces durable tumor regression, and prolongs survival in the GL261 model, supporting a neuro-immune framework for combining GABAergic modulation with immunotherapy.
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