Deciphering the potential of a novel cytostatic autophagy modulator for the treatment of brain cancer along with reduction in brain inflammation
Authors: Agrawal Manas Yogendra , Srivastava Sanjay 
Published: May 2024

Background and Purpose: Glioblastoma multiforme (GBM) is the most aggressive form of brain tumor, with significant failure of current treatment options, with the five-year survival rate of GBM being less than 7%. Temozolomide (TMZ), the standard chemotherapy, leads to severe toxicity, whereas radiation therapy leads to necrosis. Moreover, GBM leads to severe neuroinflammation, leading to severe fatalities and, thus, poor quality of life in patients. Therefore, owing to the pressing need for safer treatment alternatives, we repurposed a novel FDA-approved acetamide, BRZ, which not only exhibited a significant curbing of GBM progression but also reduced neuroinflammation. Thus, our study provides a treatment option that can also lead to better quality of life in GBM patients. Methods: Sulfarhodamine B cytotoxicity assay was performed on human (SF268, SF295, SF188) and murine (CT2A-LUC) GBM cell lines for both BRZ and TMZ. In the quest for figuring out the mode of cell-growth suppression, we performed annexin and acridine orange flow cytometry assays along with b-galactosidase cellular senescence staining assay. Cellular staining was also confirmed using confocal microscopy. Oncogenic modulation due to BRZ was studied by performing western blotting. In order to study the effect of BRZ on neuroinflammation, we examined the modulation of different neuroinflammatory genes on LPS-stimulated human and murine microglia using RT-qPCR and western blotting. We corroborated our in vitro findings by investigating the tumor progression in intracranially-injected GBM tumors in C57/BL6 mice. Mice weight and organ weights were recorded for both vehicle and BRZ-treated mice to assess toxicity profiles. Results: BRZ exhibited ~300 times more cytotoxicity in GBM cells as compared to TMZ, making it a more potent treatment option. BRZ lead to an increase in acridine orange in a concentration-dependent manner, hinting towards autophagic cell death. b-galactosidase staining assay and confocal microscopy exhibited a dose-dependent increase in b-galactosidase, showcasing a probable cytostatic effect. Expression of autophagic markers such as Atg5, Atg101, LC3A/B, and senescence markers b-galactosidase, p16, and p21 were increased due to BRZ confirming a cytostatic autophagic modulation in GBM cells. Immunoblotting revealed oncogenic modulation due to BRZ wherein Notch-1, Gli-1, Akt, and p-STAT3 were significantly downregulated, as observed in western blotting. Neuroinflammatory genes such as CXCL10, IL6, and ISG15 were downregulated in LPS-stimulated microglia using BRZ in a concentration-dependent manner, hinting towards the potential of BRZ in brain inflammation. BRZ significantly reduced the progression of orthotopic GBM tumors in C57/BL6 mice. There was no significant difference observed in body and organ weights in the vehicle and BRZ-treated mice, hinting toward the safety profile of BRZ. Conclusions and future direction: Our study provides a novel and safer treatment option for GBM in the form of a cytostatic autophagy modulator, BRZ, which also reduces neuroinflammation with the potential to increase patient’s quality of life. In the future, we aim to perform ex vivo analyses of mice brain tumors and perform the neuroinflammation study in GBM mice. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.