Glioma-derived extracellular vesicles as drivers of immunotherapeutic ...
www.frontiersin.org
June 7, 2026, 12:34 p.m.
Gliomas, particularly glioblastoma, secrete extracellular vesicles that serve as critical mediators of immune suppression within the tumor microenvironment. These vesicles carry bioactive molecules including immune checkpoint proteins, non-coding RNAs, and metabolic regulators, enabling communication across the blood-brain barrier and linking local to systemic immune responses. This review examines how glioma-derived extracellular vesicles drive immunotherapeutic resistance through multiple mechanisms. Specifically, vesicle-associated PD-L1 engages T-cell PD-1 receptors more effectively than membrane-bound variants, promoting broader immunosuppression. Additionally, these vesicles expand myeloid-derived suppressor cells, polarize macrophages and microglia toward immunosuppressive states, and impair dendritic cell function, collectively driving T-cell dysfunction. Non-coding RNAs enriched in vesicles further regulate critical signaling pathways. Understanding these mechanisms offers potential therapeutic targets for metabolic and immune interventions to overcome treatment resistance.