High-grade glioma is the most common primary brain cancer type and is characterized by invasive and fast growth. In a previous issue of Cancer Research, Simone and colleagues show that the two isoforms of the aquaporin-4 (AQP4) water channel may determine the fate of gliomas. Glioma cell lines expressing the M23-AQP4 isoform, which forms large aggregates of orthogonal arrays of particles, shrink and undergo apoptosis, whereas cell lines expressing the tetramer-forming M1-AQP4 isoform display higher activity of matrix metalloproteinases, making them more invasive. This study provides new insight on the role of AQP4 isoforms in the biology of gliomas.See related article by Simone and colleagues; Cancer Res 79(9): 2182-94.Glioma is a relatively common type of tumor in the central nervous system and comprises tumors that differ in malignancy and cellular origin. Glioblastoma multiforme (GBM) is a glioma subtype originating in astrocytes. It is the most common type of brain cancer in adults and is characterized by diffuse and invasive growth, which in combination with high frequency of recurrence make the prognosis very poor (1). Most patients die within 8-18 months of diagnosis and the 2-year survival rate is about 3%. Thus, GBM represents a significant burden on the society and novel therapies are urgently needed.The study by Simone and colleagues addresses the role of different isoforms of the water channel aquaporin-4 (AQP4) in the pathogenicity of gliomas (2). AQP4 is the predominant brain water channel protein. It is mainly expressed by astrocytes, where it is distributed in a highly polarized manner. The astrocytic foot processes abutting brain microvessels display about 10-fold higher AQP4 density than the astrocyte membrane domains facing the neuropil (3). The dystrophin-associated protein (DAP) complex is responsible for the polarized distribution of AQP4 as it connects intracellular actin cytoskeleton to extracellular matrix molecules present in the perivascular basal lamina. More specifically, the endfoot AQP4 molecules are tethered to the membrane by isoforms of syntrophin, which are PDZ domain-containing members of the DAP complex that interact with the intracellular tail of AQP4 (4).AQP4 is expressed as two major isoforms that differ in regard to methionine (M) starting codon. The shorter and more abundant form is called M23 and the longer and less abundant form is called M1. The two AQP4 isoforms form heterotetramers, which in turn aggregate into higher order structures called orthogonal arrays of particles (OAP). The two AQP4 isoforms display the same water permeability, with the main established difference between them being their ability to aggregate into OAPs. The shorter M23 isoform forms large OAPs, whereas the longer M1 isoform forms very small or no OAPs (5). The functional significance of the OAPs has not yet been established, but in vitro data indicate that the M23 isoform may function as adhesion molecules, whereas the M1 isoform is mobile in the plasma membrane and is more involved in cell ...