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Peer-reviewedCC BY 4.0Frontiers in Immunology

Glioblastoma stem cell–immune microenvironment crosstalk: molecular mechanisms and therapeutic opportunities

  1. 1Department of Pathology, Yancheng Clinical Medical College of Jiangsu University, The First People’s Hospital of Yancheng
  2. 2Department of Translational Medicine Centre, The Fourth Affiliated Hospital of Nantong University
  3. 3School of Life Science, Nantong Laboratory of Development and Diseases, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Centre of Neuroregeneration, Nantong University

Abstract

Glioblastoma (GBM) remains one of the most aggressive and treatment-resistant primary brain malignancies, with limited improvement in long-term survival despite advances in multimodal therapy. Glioblastoma stem cells (GSCs) are central to tumour initiation, recurrence and therapeutic resistance, but their malignant properties are not determined by intrinsic programmes alone. Increasing evidence indicates that reciprocal interactions between GSCs and the tumour immune microenvironment (TIME) establish a dynamic ecosystem that promotes stemness, immune escape and treatment resistance. In this review, we summarise the molecular and cellular mechanisms underlying GSC – TIME crosstalk, with emphasis on tumour-associated macrophages, myeloid-derived suppressor cells, T cells, regulatory T cells, natural killer cells, B cells, plasma cells and neutrophils. We highlight major signalling and metabolic networks, including B2M/TGF-β1, IL8/CXCR2, IFI35/NF-κB, lactate/lactylation, IgG/FcγRIIA and m6A/LOXL2 signalling, as well as extracellular vesicle-mediated communication. We further discuss how these interactions sustain GSC stemness, facilitate metabolic adaptation, promote immune escape and contribute to resistance to radiotherapy, temozolomide and targeted therapies. Emerging therapeutic approaches—including tumour-associated macrophage/myeloid-derived suppressor cell (TAM/MDSC) reprogramming, metabolic and epigenetic intervention, immune checkpoint blockade, bispecific antibodies, chimeric antigen receptor T/natural killer (CAR-T/NK) cell therapy and extracellular vesicle-based delivery—are also evaluated. Finally, we discuss the importance of spatial heterogeneity, blood-brain barrier limitations and rational combination strategies. Understanding GSC-TIME crosstalk may provide a framework for developing more effective and biologically informed precision therapies for GBM.

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BibTeX
@article{xu2026glioblastoma,
  title = {{Glioblastoma stem cell–immune microenvironment crosstalk: molecular mechanisms and therapeutic opportunities}},
  author = {Chuanhai Xu and Linlin Chai and Wei Yuan},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1972420},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1972420/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Glioblastoma stem cell–immune microenvironment crosstalk: molecular mechanisms and therapeutic opportunities
AU  - Chuanhai Xu
AU  - Linlin Chai
AU  - Wei Yuan
PY  - 2026
DA  - 2026/10/09
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1972420
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1972420/full
AB  - Glioblastoma (GBM) remains one of the most aggressive and treatment-resistant primary brain malignancies, with limited improvement in long-term survival despite advances in multimodal therapy. Glioblastoma stem cells (GSCs) are central to tumour initiation, recurrence and therapeutic resistance, but their malignant properties are not determined by intrinsic programmes alone. Increasing evidence indicates that reciprocal interactions between GSCs and the tumour immune microenvironment (TIME) establish a dynamic ecosystem that promotes stemness, immune escape and treatment resistance. In this review, we summarise the molecular and cellular mechanisms underlying GSC – TIME crosstalk, with emphasis on tumour-associated macrophages, myeloid-derived suppressor cells, T cells, regulatory T cells, natural killer cells, B cells, plasma cells and neutrophils. We highlight major signalling and metabolic networks, including B2M/TGF-β1, IL8/CXCR2, IFI35/NF-κB, lactate/lactylation, IgG/FcγRIIA and m6A/LOXL2 signalling, as well as extracellular vesicle-mediated communication. We further discuss how these interactions sustain GSC stemness, facilitate metabolic adaptation, promote immune escape and contribute to resistance to radiotherapy, temozolomide and targeted therapies. Emerging therapeutic approaches—including tumour-associated macrophage/myeloid-derived suppressor cell (TAM/MDSC) reprogramming, metabolic and epigenetic intervention, immune checkpoint blockade, bispecific antibodies, chimeric antigen receptor T/natural killer (CAR-T/NK) cell therapy and extracellular vesicle-based delivery—are also evaluated. Finally, we discuss the importance of spatial heterogeneity, blood-brain barrier limitations and rational combination strategies. Understanding GSC-TIME crosstalk may provide a framework for developing more effective and biologically informed precision therapies for GBM.
SN  - 1664-3224
ER  -