FTL is a Novel Prognostic Predictor Associated with M2-TAMs and N2-TANs in Low-grade Glioma

Glioma patients have a certain risk of recurrence after treatment with surgery, radiation, or even chemotherapy. Therefore, it is necessary to identify more efficient prognostic predictors. Ferritin light chain (FTL) is implicated in the alteration of the tumor immune microenvironment (TIM) and is believed to negatively impact the prognosis of glioma patients. The study aimed to investigate the potential of FTL as a prognostic predictor for low-grade gliomas (LGGs) and to elucidate the underlying mechanisms. In the bioinformatic analysis, gene expression and clinical data of gliomas from the TCGA and CGGA databases were obtained. Western blot and RT-PCR were used to explore FTL expression in gliomas and to validate the results of the bioinformatical analysis. Serum FTL levels were detected and analyzed to assess the potential of FTL as a prognostic predictor for gliomas. FTL was found to be highly expressed in gliomas and may contribute to short survival in LGG patients. Additionally, serum FTL levels were significantly elevated in glioma patients and correlated with disease control status. M2-tumor-associated macrophages (M2-TAMs) and N2-tumor-associated neutrophils (N2-TANs) were positively associated with FTL expression and together influenced the overall survival of LGG patients. Importantly, FTL expression was closely related to molecules and downstream pathways associated with M2-TAM and N2-TAN polarization. This study reveals that the high FTL expression is associated with a poor prognosis in LGG patients, and the mechanism is related to the immune suppression within the TIM, mediated by M2-TAMs and N2-TANs.