Consensus statement on microglial and macrophage functions in gliomas
This international consensus statement synthesizes key findings on the complex roles of microglia and macrophages (tumor-associated microglia/macrophages or TAMs) in glioma progression and therapeutic resistance. Recent advances have highlighted the cellular, spatial, and temporal heterogeneity of TAMs, their functional plasticity, and the intricate interactions between TAMs, glioma stem cells, and the neuronal microenvironment, challenging the M1/M2 classification paradigm for TAMs in gliomas and other misconceptions. The statement emphasizes that glioma cells manipulate TAMs to suppress anti-tumor functions, while microglia-mediated modulation of neuron-glioma cell interactions promotes tumor progression. Furthermore, glioblastoma-derived extracellular vesicles (EVs) reprogram microglia to support tumor progression, offering novel therapeutic targets. To advance research and develop more effective treatments, the statement advocates for precision therapies targeting specific TAM subsets or functions, the use of bioengineered EVs as a therapeutic approach, and a shift away from simplistic terminology like "M1/M2" and "neuroinflammation". Ultimately, this new understanding can support innovative strategies to modulate the tumor microenvironment, turning immunosuppression into immunostimulation and improving outcomes for patients with glioblastoma and other types of gliomas.
Authors
- Kaspar Matiasek (ORCID: https://orcid.org/0000-0001-5021-3280)
- Roman Sankowski (ORCID: https://orcid.org/0000-0001-9215-8021)
- Marc‐André Mouthon (ORCID: https://orcid.org/0000-0003-2633-9179)
- Michael Weller (ORCID: https://orcid.org/0000-0002-1748-174X)
- Christian M. Schürch (ORCID: https://orcid.org/0000-0002-1792-1768)
- Bjarne Winther Kristensen (ORCID: https://orcid.org/0000-0002-6352-0826)
- Christian Mawrin (ORCID: https://orcid.org/0000-0002-6677-3124)
- Anna Golebiewska (ORCID: https://orcid.org/0000-0002-4160-2521)
- Alessandro Michelucci (ORCID: https://orcid.org/0000-0003-1230-061X)
- Bożena Kamińska (ORCID: https://orcid.org/0000-0002-2642-4616)
- Lara Barazzuol (ORCID: https://orcid.org/0000-0002-6538-2383)
- Tibor Hortobágyi (ORCID: https://orcid.org/0000-0001-5732-7942)
- Daniel S. Kirschenbaum (ORCID: https://orcid.org/0000-0002-0609-8788)
- Marius Schwabenland (ORCID: https://orcid.org/0000-0003-2205-5427)
- Mariano S. Viapiano (ORCID: https://orcid.org/0000-0002-8756-388X)
- Karl Frontzek (ORCID: https://orcid.org/0000-0002-0945-8857)
- Émilie Le Rhun (ORCID: https://orcid.org/0000-0002-9408-3278)
- Islam Alzoubi (ORCID: https://orcid.org/0000-0002-1711-7745)
- Yuqi Zheng (ORCID: https://orcid.org/0000-0003-3859-3609)
- Nicola Montemurro (ORCID: https://orcid.org/0000-0002-3686-8907)
- Atul Anand (ORCID: https://orcid.org/0000-0001-7474-5433)
- Azzam Ismail (ORCID: https://orcid.org/0000-0002-9019-6881)
- Michael Schulz (ORCID: https://orcid.org/0000-0001-6731-9188)
- Gerard H. Jansen (ORCID: https://orcid.org/0000-0002-5647-8893)
- Alejandro Schcolnik-Cabrera
- Manuel B. Graeber
- Indrė Valiulytė-Simaitė
- Regina Reimann
- Quan Liu
- Mario Dorostkar
- Aurélie Tchoghandjian
- Tobias Weiss
- Kevin S. Lee
- Max Wintermark
- Q. Richard Lu
- Yoshihiro Komohara
- Costas G. Hadjipanayis
Institutions
- University of Pisa (IT)
- University of Copenhagen (DK)
- Cincinnati Children's Hospital Medical Center (US)
- Centre National de la Recherche Scientifique (FR)
- The University of Sydney (AU)
- Lithuanian University of Health Sciences (LT)
- University Medical Center Groningen (NL)
- The University of Texas MD Anderson Cancer Center (US)
- University of Alberta (CA)
- Inserm (FR)
- University of Freiburg (DE)
- University of Groningen (NL)
- German Cancer Research Center (DE)
- University of Zurich (CH)
- SUNY Upstate Medical University (US)
- Université Paris Cité (FR)
- Heidelberg University (DE)
- Université Paris-Saclay (FR)
- Ottawa Hospital (CA)
- University Medical Center Freiburg (DE)
- Copenhagen University Hospital (DK)
- Rigshospitalet (DK)
- CEA Paris-Saclay - Etablissement de Fontenay-aux-roses (FR)
- MIND Research Institute (US)
- Institut de Neurophysiopathologie (FR)
- University Hospital of Zurich (CH)
- Luxembourg Institute of Health (LU)
- Universitätsklinikum St. Pölten (AT)
- UPMC Presbyterian (US)
- Fourth Affiliated Hospital of Guangxi Medical University (CN)
- National Hospital for Neurology and Neurosurgery (GB)
- Instytut Biologii Doświadczalnej im. Marcelego Nenckiego (PL)
- Azienda Ospedaliera Universitaria Pisana (IT)
- University College London (GB)
- University of Virginia (US)
- University of Tübingen (DE)
- Ludwig-Maximilians-Universität München (DE)
- Leeds Beckett University (GB)
- Otto-von-Guericke-Universität Magdeburg (DE)
- Kumamoto University (JP)
Publication Details
- Journal
- Acta Neuropathologica
- Published
- 2026-04-16
- DOI
- https://doi.org/10.1007/s00401-026-02999-3
- Primary Topic
- Immune cells in cancer
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Pfizer
- Novocure
- Les Laboratories Pierre Fabre
- Seagen
- University of Sydney
- Servier
- H. Lundbeck A/S
- Medac
- LEO Pharma