Targeting Glioblastoma Cancer Stem Cells With A Novel Connexin43 Mimetic Peptide

Glioblastoma (GBM) is a highly malignant and lethal cancer of the central nervous system. Despite intensive research efforts, there has been limited progress in improving patient outcome. The current therapy for GBM patients includes surgical resection, radiotherapy and cytotoxic chemotherapy with temozolomide (TMZ), conferring a median survival time of only 14.6 months. Failure to generate more effective treatment strategies is due in part to the cellular heterogeneity within GBM tumors, which comprise a sub-population of GBM cancer stem cells (GSCs) characterized by self-renewal characteristics and resistance to TMZ. Recent work, including our own, has demonstrated that levels of the gap junction protein Connexin43 (Cx43) correlate with GBM TMZ resistance. Increased Cx43 levels occur in GSCs compared to parental GBM cells, and patients with high levels of Cx43 mRNA and low levels of MGMT, an enzyme that repairs TMZ-induced DNA lesions, have a significantly shorter life span. In contrast, Cx43 has also been associated with anti-proliferative effects in glioma and reduced levels of Cx43 protein are reported in high-grade gliomas. In addition to forming gap junctions, Cx43 can regulate cell proliferation, migration, and apoptosis, through distinct channel-independent mechanisms. Therefore, altering the localization and/or activity of Cx43 rather than Cx43 expression alone may represent a more targeted strategy in GBM treatment. Using super-resolution microscopy, we find intracellular Cx43 decorating microtubules in GSCs demonstrating for the first time such clustering in situ. Regulation of Cx43 function is primarily associated with multiple sites for post-translational modification and protein-protein interaction within the Cx43 carboxy-terminus (CT) which includes a tubulin binding domain. We have developed a peptide named JM2 (juxtamembrane 2) composed of the Cx43 CT amino acids encompassing the microtubule-binding sequence fused to an antennapedia cell penetration domain for cellular uptake. Super-resolution microscopy and biochemical analysis confirm JM2 specific interaction with microtubules concomitantly with a loss of Cx43 interaction with microtubules in GSCs derived from patient tumors. In addition, we observe that JM2 decreases Cx43 gap junction plaque formation and cell-cell communication in GSCs and limits microtubule dynamics. Importantly, JM2 decreases cell survival in TMZ-resistant GSCs and GSC neurosphere formation in vitro, and GSC-derived tumor growth in vivo. Our current research includes the development of JM2-loaded biodegradable nanoparticles for sustained JM2 delivery in preparation for future clinical trials. In conclusion, we have developed a Cx43 mimetic peptide that significantly decreases the tumorigenic potential of GSCs and represents a novel and potent therapeutic opportunity to alter Cx43 activity in targeting chemoresistant GSCs for GBM treatment. Citation Format: Samy Lamouille, James W. Smyth, Laurie O9Rourke, Pratik Kanabur, Sujuan Guo, Jane Jourdan, Zhi Sheng, Robert G. Gourdie. Targeting glioblastoma cancer stem cells with a novel Connexin43 mimetic peptide [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4765. doi:10.1158/1538-7445.AM2017-4765