ABSTRACT: Abstract OBJECTIVE Glioblastoma (GBM) patients with high intratumoral IDO1 mRNA levels have an associated decrease in survival (Zhai et al., 2017; CCR). IDO1 is an immunosuppressive mediator that metabolizes tryptophan (Trp), and through its associated enzyme activity, has long been recognized to increase immunosuppressive CD4+CD25+FoxP3+ Tregs. Accordingly, we previously showed that the genetic knockdown of IDO1 in murine glioma cells, suppresses intratumoral Treg recruitment and increases animal subject survival. Unexpectedly, however, IDO1 knockdown has no effect on intratumoral Trp metabolism (Zhai et al., 2017; BBI). Further surprisingly, we recently demonstrated that, although IDO1 overexpression increases Treg levels in brain tumors, the pharmacological inhibition of IDO1 metabolism has no effect on Treg accumulation (Ladomersky et al., 2018; CCR). These novel data led us to question the requirement for IDO1 enzyme activity to regulate Tregs in malignant glioma. METHODS Lentiviral vectors encoding: (i) vector control-, (ii) wild-type (WT)-, or (iii) enzyme-null-IDO1, were created by site-directed mutagenesis in a plasmid containing WT, murine, IDO1-GFP cDNA. IDO1-deficient glioma cells from transgenic mice [(ERT2)GFAP?Cre;pTENfl/fl;p53fl/fl;Rbfl/fl;IDO1-/-] were transduced with the modified plasmids. RT-PCR, Western blotting and HPLC confirmed IDO1 expression and enzyme activity, in vitro. Syngeneic IDO1-/- mice were intracranially-engrafted with 2 × 105 modified glioma cells and studied for intratumoral Treg levels. RESULTS The substitution of IDO1 histidine 350, to an alanine (H350A), decreases IDO1 enzyme activity by 90%. Syngeneic mice with intracranial, IDO1 enzyme null (H350A) glioma, have similar intratumoral Treg levels as IDO1 WT glioma, at 25% and 26%, respectively, and is significantly increased as compared to the 5.8% Tregs in vector control glioma (P=0.015). CONCLUSIONS Our data challenge current dogma explaining how IDO1 causes Treg accumulation, and are in-line with the recent IDO1 enzyme inhibitor-focused Phase III clinical trial failure [NCT02752074]. We are now focused on revealing the mechanism underlying IDO1-mediated immunosuppression in malignant glioma.
