Implications of immune-associated genes and immune cells in glioblastoma.
Background: Glioblastoma is the most common and lethal primary brain tumor in adults. Epidemiological studies have revealed that a history of allergies is a protective factor, thereby underlining the likely impact of the immune system on GBM. A number of transcriptomic studies have also identified immune signatures more or less associated with patient survival. Methods: In order to clarify and identify which immune-associated (IA) genes were the most involved in GBM, we studied the expression of 791 immune genes in GBM and normal brains samples. Interactions between IA genes were studied through an analysis of co-expression network. We then searched for a link between IA genes and patient survival according to 3 statistical methods, before defining a mathematical risk model based on different data sets. Finally, we studied the infiltrative immune population of 73 GBM by cytometry. Results: A significantly different profile of IA genes expression between healthy brains and GBM was consistently defined, but not among GBM. The analysis of co-expression network revealed 6 modules, 5 of which were enriched by genes associated with patient survival. 108 IA genes have a significant association with patient survival and the 6-IA gene risk predictor allowed us to distinguish two groups of patients according to their survival, including patients whose tumor had a methylated MGMT gene promoter and in the subset of proneural GBM. Finally, in every analyzed GBM sample, we have shown that there was a leukocyte infiltration by macrophages/microglial cells and sometimes by lymphocytes or granulocytes. Only the lymphocytes infiltration was significantly associated with the survival in our group of patients. Conclusion: IA genes that are involved in various immune functions are expressed differentially between healthy brains and GBM and amongst GBM. A robust 6-IA gene risk predictor was defined: it divides patients into two low and high risk groups, including those who have a good prognosis. Finally, we revealed an infiltration of immune cells in a series of GBM, only the lymphocytic infiltration was positively associated with patient survival.