Abstract:Objective Explore the molecular mechanisms of M2 phenotype bone marrow-derived macrophages’ exosomes in promoting immune escape of glioma and resistance to PD-1 inhibitors. Methods Co-culture systems of M0, M1 and M2 type tumor-associated macrophages (TAMs) with glioma cells (GL261 cells or K-Luc cells) were established. Cell experiment groups-1: GL261 cells-M0 type, M1 type, and M2 type groups, as well as K-Luc cells-M0 type, M1 type, and M2 type groups. Extracted the exosomes from the culture supernatants of M0 type, M1 type and M2 type TAMs, and used them to treat GL261 cells or K-Luc cells, respectively. Cell experiment groups-2: GL261 cells-M0-Exo group, M1-Exo group, M2-Exo groups, and the K-Luc cells-M0-Exo group, M1-Exo group, M2-Exo groups. ELISA was used to determine the levels of IFN-γ, IL-8 and IL-12 in M0-Exo group, M1-Exo group and M2-Exo group of the two types of brain tumor cells. Lentivirus-mediated knockdown/overexpression of IFN-γ were conducted. In vivo brain xenograft mice model was established by using C57BL/6J mice. Different pre-treated GL261 cells were stereotactically injected into the mice" brains. Ninety six C57BL/6J mice were randomly divided into 6 groups, with 16 mice in each group: Doxycycline-IgG antibody-Vector control group, Doxycycline-IgG antibody- Lenti-IFN-γ-OE group, and Doxycycline-IgG antibody-Lenti-IFN-γ shRNA group; as well as Doxycycline-PD-1 antibody-Vector control group, Doxycycline-PD-1 antibody-Lenti-IFN-γ-OE group, and Doxycycline-PD-1 antibody-Lenti-IFN-γ shRNA group. After euthanizing the mice, the brain tumors were removed and the volume of the tumors were measured using drainage volume method. Flow cytometry was employed to determine the percentage (%) of infiltrating CD8+ PD-1+ T cells infiltrated in the tumor. Results Compared with M0 type TAMs and M1 type TAMs, the proliferation ability of GL261 cells and K-Luc cells co-cultured with M2 type TAMs was enhanced (P<0.05). Compared with the cells treated with M0-type TAMs-derived exosomes and M1-type TAMs-derived exosomes, the proliferation ability of GL261 cells and K-Luc cells treated with M2-type TAMs-derived exosomes was enhanced (P<0.05). For GL261 cells and K-Luc cells, compared with the M0-Exo group, in the M1-Exo group and the M2-Exo group, the levels of IL-8 increased (P<0.05), and the levels of IL-12 decreased (P<0.05). Compared with the M0-Exo group, the levels of IFN-γ in the M1-Exo group and the M2-Exo group increased (P<0.05); particularly, compared with the M1-Exo group, the level of IFN-γ in the M2-Exo group increased (P<0.05). Compared with the Doxycycline-IgG antibody-Vector control group, in the Doxycycline-IgG antibody-Lenti-IFN-γ-OE group the tumor volume increased (P<0.05), while in the Doxycycline-IgG antibody-Lenti-IFN-γ shRNA group the tumor volume decreased (P<0.05). Compared with the Doxycycline-PD-1 antibody-Vector control group, the tumor volume in the Doxycycline-PD-1 antibody-Lenti-IFN-γ-OE group increased (P<0.05), and the proportion of infiltrating CD8+ PD-1+ T cells in the tumor increased (P<0.05); the tumor volume in the Doxycycline-PD-1 antibody-Lenti-IFN-γ shRNA group decreased (P<0.05), and the proportion of infiltrating CD8+ PD-1+ T cells in the tumor decreased (P<0.05). Conclusion The high level of IFN-γ in M2 phenotype bone marrow-derived macrophages’ exosomes could promote the infiltration of CD8+ PD-1+ T cells in glioma to form an immunosuppressive microenvironment, and to acquire resistance to PD-1 inhibitors.