STIMULATION OF THE MIDKINE/ALK AXIS RENDERS GLIOMA CELLS RESISTANT TO CANNABINOID ANTI-TUMORAL ACTION

Identifying the molecular mechanisms responsible for the resistance of gliomas to anti-cancer treatments is an issue of great therapeutic interest. Δ9-Tetrahydrocannabinol (THC), the major active ingredient of marijuana, and other cannabinoids inhibit tumor growth in animal models of cancer, including glioma, an effect that relies, at least in part, on the stimulation of autophagy-mediated apoptosis in tumor cells. Here, by analyzing the gene expression profile of a large series of human glioma cells with different sensitivity to cannabinoid action, we have identified a subset of genes specifically associated to THC resistance. One of these genes, namely that encoding the growth factor midkine (Mdk), is directly involved in the resistance of glioma cells to cannabinoid treatment. We also show that Mdk mediates its protective effect via the anaplasic lymphoma kinase receptor (ALK) and that Mdk signaling through ALK interferes with cannabinoid-induced autophagic cell death. Furthermore, in vivo Mdk silencing or ALK pharmacological inhibition sensitizes cannabinod-resistant tumors to THC anti-tumoral action. Altogether, our findings identify Mdk as a pivotal factor involved in the resistance of glioma cells to THC pro-autophagic and anti-tumoral action, and suggest that selective targeting of the Mdk/ALK axis could help to improve the efficacy of anti-tumoral therapies for gliomas.