Abstract 5521: Nicotine promotes perineural brain metastasis of lung cancer by activating GABAergic neurons

Abstract Tobacco smoking significantly increases the incidence of brain metastasis. However, the pathological mechanism by which smoking promotes brain metastasis through modulating brain microenvironment is yet poorly understood. We previously showed that the incidence of brain metastasis is associated with nicotine intake. Nicotine enhanced polarization of M2 pro-tumor microglia, which promoted brain metastasis. In addition to the immune surveillance role, microglial cells also control neuronal synapse formation. Microglial cells promote neuron synapse formation in the developing brain, whereas microglia depletion suppresses synapse density. Furthermore, microglia-secreted microRNAs (miRNAs) have been shown to promote synaptic formation by targeting synapse-related genes of the DKK-Wnt family. Neurons are one of the most abundant cell types in the brain, and they are highly specialized for cell-to-cell signal activation. However, little is known about the roles of neurons in brain metastasis of lung cancer. We hypothesize that nicotine stimulates microglia to secrete exosomal miR-32-3p, which promotes brain metastasis by augmenting GABAergic synaptic formation and hence releasing GABA that serves as a metabolic substrate to fuel tumor cell growth. We also hypothesize that inhibiting the GABA transporter of tumor cells suppresses brain metastasis by blocking the GABA shunt. We found that lung cancer patients with a smoking history had significantly higher synaptic formation and the expression of GABA transporter in brain metastasis. To investigate the effect of smoking and nicotine intake on brain metastasis in vivo, mice were intracardially transplanted with lung cancer brain metastasis cells (H2030BrM and PC9BrM) followed by administration of nicotine or cigarette smoke exposure in a smoking chamber. We found that smoking and nicotine increased M2 microglia polarization, synaptic formation, and the expression of GABA in mouse brain metastasis. Furthermore, nicotine increased the secretion of miR-32-3p from nicotine-pretreated microglia, which promoted GABA release from GABAergic neurons. Treating H2030BrM and PC9BrM cells with conditioned medium (CM) obtained from neurons exposed to CM derived from nicotine-treated microglia exosomes resulted in increased tumor growth through the activation of the GABA shunt pathway. Blocking GABA transporter 1 (GAT1) by CRISPR/Cas9 or a small molecule of GAT1 inhibitor suppressed the GABAergic neuron-induced tumor progression. Our results indicate that nicotine-activated microglia enhanced GABA release from neurons followed by the promotion of GABA shunt in tumor cells and that a GAT inhibitor serves as a promising therapeutic tool for the treatment of lung cancer patients with brain metastasis. Citation Format: Shih-Ying Wu, Abhishek Tyagi, Ravindra Pramod Deshpande, Kerui Wu, Eleanor Cecile Smith, Kounosuke Watabe. Nicotine promotes perineural brain metastasis of lung cancer by activating GABAergic neurons [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5521.