GABAergic Circuit Activation Induces a Therapeutically Responsive State for anti-PD-L1 Immunotherapy in Glioblastoma
Scalera, M.; De Santis, E.; Rossi, F.; Meneghetti, N.; Nemati Fard, L. A.; Miglionico, P.; Raimondi, F.; Flori, A.; Pasqualetti, M.; Menichetti, L.; Sengupta, S.; Vannini, E.; Costa, M.
Show 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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