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Yu S, Chen C, Chen M, Liang J, Jiang K, Lou B, Lu J, Zhu X, Zhou D. MAGOH promotes gastric cancer progression via hnRNPA1 expression inhibition-mediated RONΔ160/PI3K/AKT signaling pathway activation. J Exp Clin Cancer Res 2024; 43:32. [PMID: 38268030 PMCID: PMC10809607 DOI: 10.1186/s13046-024-02946-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Gastric cancer (GC) is associated with high mortality and heterogeneity and poses a great threat to humans. Gene therapies for the receptor tyrosine kinase RON and its spliceosomes are attracting increasing amounts of attention due to their unique characteristics. However, little is known about the mechanism involved in the formation of the RON mRNA alternative spliceosome RONΔ160. METHODS Fourteen human GC tissue samples and six normal gastric tissue samples were subjected to label-free relative quantitative proteomics analysis, and MAGOH was identified as a candidate protein for subsequent studies. The expression of MAGOH in clinical specimens was verified by quantitative real-time PCR and western blotting. We then determined the biological function of MAGOH in GC through in vitro and in vivo experiments. RNA pulldown, RNA sequencing and RNA immunoprecipitation (RIP) were subsequently conducted to uncover the underlying mechanism by which MAGOH regulated the formation of RONΔ160. RESULTS Proteomic analysis revealed that MAGOH, which is located at key nodes and participates in RNA processing and mRNA splicing, was upregulated in GC tissue and GC cell lines and was associated with poor prognosis. Functional analysis showed that MAGOH promoted the proliferation, migration and invasion of GC cells in vitro and in vivo. Mechanistically, MAGOH inhibited the expression of hnRNPA1 and reduced the binding of hnRNPA1 to RON mRNA, thereby promoting the formation of RONΔ160 to activate the PI3K/AKT signaling pathway and consequently facilitating GC progression. CONCLUSIONS Our study revealed that MAGOH could promote the formation of RONΔ160 and activate the PI3K/AKT signaling pathway through the inhibition of hnRNPA1 expression. We elucidate a novel mechanism and potential therapeutic targets for the growth and metastasis of GC based on the MAGOH-RONΔ160 axis, and these findings have important guiding significance and clinical value for the future development of effective therapeutic strategies for GC.
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Affiliation(s)
- Shanshan Yu
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Chen
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ming Chen
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinxiao Liang
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kecheng Jiang
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Bin Lou
- Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun Lu
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaohua Zhu
- Department of Oncology, Shaoxing People's Hospital, Shaoxing, China
| | - Donghui Zhou
- Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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2
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Ding RB, Chen P, Rajendran BK, Lyu X, Wang H, Bao J, Zeng J, Hao W, Sun H, Wong AHH, Valecha MV, Yang EJ, Su SM, Choi TK, Liu S, Chan KI, Yang LL, Wu J, Miao K, Chen Q, Shim JS, Xu X, Deng CX. Molecular landscape and subtype-specific therapeutic response of nasopharyngeal carcinoma revealed by integrative pharmacogenomics. Nat Commun 2021; 12:3046. [PMID: 34031426 PMCID: PMC8144567 DOI: 10.1038/s41467-021-23379-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/16/2021] [Indexed: 02/04/2023] Open
Abstract
Nasopharyngeal carcinoma (NPC) is a malignant head and neck cancer type with high morbidity in Southeast Asia, however the pathogenic mechanism of this disease is poorly understood. Using integrative pharmacogenomics, we find that NPC subtypes maintain distinct molecular features, drug responsiveness, and graded radiation sensitivity. The epithelial carcinoma (EC) subtype is characterized by activations of microtubule polymerization and defective mitotic spindle checkpoint related genes, whereas sarcomatoid carcinoma (SC) and mixed sarcomatoid-epithelial carcinoma (MSEC) subtypes exhibit enriched epithelial-mesenchymal transition (EMT) and invasion promoting genes, which are well correlated with their morphological features. Furthermore, patient-derived organoid (PDO)-based drug test identifies potential subtype-specific treatment regimens, in that SC and MSEC subtypes are sensitive to microtubule inhibitors, whereas EC subtype is more responsive to EGFR inhibitors, which is synergistically enhanced by combining with radiotherapy. Through combinational chemoradiotherapy (CRT) screening, effective CRT regimens are also suggested for patients showing less sensitivity to radiation. Altogether, our study provides an example of applying integrative pharmacogenomics to establish a personalized precision oncology for NPC subtype-guided therapies.
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Affiliation(s)
- Ren-Bo Ding
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Ping Chen
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.488387.8Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan China
| | - Barani Kumar Rajendran
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Xueying Lyu
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Haitao Wang
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Jiaolin Bao
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Jianming Zeng
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Wenhui Hao
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Heng Sun
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Ada Hang-Heng Wong
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Monica Vishnu Valecha
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Eun Ju Yang
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Sek Man Su
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Tak Kan Choi
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Shuiming Liu
- grid.507998.a0000 0004 0639 5728Kiang Wu Hospital, Macau SAR, China
| | - Kin Iong Chan
- grid.507998.a0000 0004 0639 5728Kiang Wu Hospital, Macau SAR, China
| | - Ling-Lin Yang
- grid.488387.8Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan China
| | - Jingbo Wu
- grid.488387.8Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan China
| | - Kai Miao
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Qiang Chen
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Joong Sup Shim
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Xiaoling Xu
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Chu-Xia Deng
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
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3
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Balmaña M, Diniz F, Feijão T, Barrias CC, Mereiter S, Reis CA. Analysis of the Effect of Increased α2,3-Sialylation on RTK Activation in MKN45 Gastric Cancer Spheroids Treated with Crizotinib. Int J Mol Sci 2020; 21:ijms21030722. [PMID: 31979110 PMCID: PMC7037121 DOI: 10.3390/ijms21030722] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/26/2022] Open
Abstract
In the scenario of personalized medicine, targeted therapies are currently the focus of cancer drug development. These drugs can block the growth and spread of tumor cells by interfering with key molecules involved in malignancy, such as receptor tyrosine kinases (RTKs). MET and Recepteur d'Origine Nantais (RON), which are RTKs frequently overactivated in gastric cancer, are glycoprotein receptors whose activation have been shown to be modulated by the cellular glycosylation. In this work, we address the role of sialylation in gastric cancer therapy using an innovative 3D high-throughput cell culture methodology that mimics better the in vivo tumor features. We evaluate the response to targeted treatment of glycoengineered gastric cancer cell models overexpressing the sialyltransferases ST3GAL4 or ST3GAL6 by subjecting 3D spheroids to the tyrosine kinase inhibitor crizotinib. We show here that 3D spheroids of ST3GAL4 or ST3GAL6 overexpressing MKN45 gastric cancer cells are less affected by the inhibitor. In addition, we disclose a potential compensatory pathway via activation of the Insulin Receptor upon crizotinib treatment. Our results suggest that cell sialylation, in addition of being involved in tumor progression, could play a critical role in the response to tyrosine kinase inhibitors in gastric cancer.
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Affiliation(s)
- Meritxell Balmaña
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- IPATIMUP—Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Francisca Diniz
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- IPATIMUP—Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
- Institute of Biomedical Sciences of Abel Salazar—ICBAS, University of Porto, 4050-313 Porto, Portugal
| | - Tália Feijão
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, University of Porto, 4200-135 Porto, Portugal
| | - Cristina C. Barrias
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- Institute of Biomedical Sciences of Abel Salazar—ICBAS, University of Porto, 4050-313 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, University of Porto, 4200-135 Porto, Portugal
| | - Stefan Mereiter
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- IPATIMUP—Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
| | - Celso A. Reis
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- IPATIMUP—Institute of Molecular Pathology and Immunology, University of Porto, 4200-135 Porto, Portugal
- Institute of Biomedical Sciences of Abel Salazar—ICBAS, University of Porto, 4050-313 Porto, Portugal
- Medical Faculty, University of Porto, 4200-319 Porto, Portugal
- Correspondence: ; Tel.: +351-22-040-88-00 (ext. 6068)
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4
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Khoi PN, Li S, Thuan UT, Sah DK, Kang TW, Nguyen TT, Lian S, Xia Y, Jung YD. Lysophosphatidic Acid Upregulates Recepteur D'origine Nantais Expression and Cell Invasion via Egr-1, AP-1, and NF-κB Signaling in Bladder Carcinoma Cells. Int J Mol Sci 2020; 21:ijms21010304. [PMID: 31906413 PMCID: PMC6981588 DOI: 10.3390/ijms21010304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/05/2019] [Accepted: 12/29/2019] [Indexed: 12/12/2022] Open
Abstract
Muscle invasive bladder carcinoma is a highly malignant cancer with a high mortality rate, due to its tendency to metastasize. The tyrosine kinase recepteur d’origine nantais (RON) promotes bladder carcinoma metastasis. Lysophosphatidic acid (LPA) is a phospholipid derivative, which acts as a signaling molecule to activate three high affinity G-protein coupled receptors, LPA1, LPA2, and LPA3. This in turn leads to cell proliferation and contributes to oncogenesis. However, little is known about the effects of LPA on invasive bladder cancer (IBC). In this study, we discovered that LPA upregulated RON expression, which in turn promoted cell invasion in bladder cancer T24 cells. As expected, we found that the LPA receptor was essential for the LPA induced increase in RON expression. More interestingly, we discovered that LPA induced RON expression via the MAPK (ERK1/2, JNK1/2), Egr-1, AP-1, and NF-κB signaling axes. These results provide experimental evidence and novel insights regarding bladder malignancy metastasis, which could be helpful for developing new therapeutic strategies for IBC treatment.
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Affiliation(s)
- Pham Ngoc Khoi
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Korea; (P.N.K.); (S.L.); (U.T.T.); (D.K.S.); (T.W.K.); (T.T.N.)
| | - Shinan Li
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Korea; (P.N.K.); (S.L.); (U.T.T.); (D.K.S.); (T.W.K.); (T.T.N.)
| | - Ung Trong Thuan
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Korea; (P.N.K.); (S.L.); (U.T.T.); (D.K.S.); (T.W.K.); (T.T.N.)
| | - Dhiraj Kumar Sah
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Korea; (P.N.K.); (S.L.); (U.T.T.); (D.K.S.); (T.W.K.); (T.T.N.)
| | - Taek Won Kang
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Korea; (P.N.K.); (S.L.); (U.T.T.); (D.K.S.); (T.W.K.); (T.T.N.)
| | - Thi Thinh Nguyen
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Korea; (P.N.K.); (S.L.); (U.T.T.); (D.K.S.); (T.W.K.); (T.T.N.)
| | - Sen Lian
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China;
| | - Yong Xia
- Institute of Precision Medicine, Jining Medical University, Jining 272067, China
- Correspondence: (Y.X.); (Y.D.J.); Tel.: +86-537-3616565 (Y.X.); +82-62220-4105 (Y.D.J.)
| | - Young Do Jung
- Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju 501-190, Korea; (P.N.K.); (S.L.); (U.T.T.); (D.K.S.); (T.W.K.); (T.T.N.)
- Correspondence: (Y.X.); (Y.D.J.); Tel.: +86-537-3616565 (Y.X.); +82-62220-4105 (Y.D.J.)
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5
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An C, Li H, Zhang X, Wang J, Qiang Y, Ye X, Li Q, Guan Q, Zhou Y. Silencing of COPB2 inhibits the proliferation of gastric cancer cells and induces apoptosis via suppression of the RTK signaling pathway. Int J Oncol 2019; 54:1195-1208. [PMID: 30968146 PMCID: PMC6411345 DOI: 10.3892/ijo.2019.4717] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/07/2019] [Indexed: 12/26/2022] Open
Abstract
Emerging studies have reported that coatomer protein complex subunit β2 (COPB2) is overexpressed in several types of malignant tumor; however, to the best of our knowledge, no studies regarding COPB2 in gastric cancer have been published thus far. Therefore, the present study aimed to determine the significance and function of COPB2 in gastric cancer. COPB2 expression in gastric cancer cell lines was measured using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis. In addition, lentivirus-short hairpin RNA (shRNA) COPB2 (Lv-shCOPB2) was generated and used to infect BGC-823 cells to analyze the effects of COPB2 on the cancerous phenotype. The effects of shRNA-mediated COPB2 knockdown on cell proliferation were detected using MTT, 5-bromo-2-deoxyuridine and colony formation assays. In addition, the effects of COPB2 knockdown on apoptosis were analyzed by flow cytometry. Nude mice and fluorescence imaging were used to characterize the regulation of tumor growth in vivo, and qPCR and immunohistochemistry were subsequently conducted to analyze COPB2 expression in xenograft tumor tissues. Furthermore, a receptor tyrosine kinase (RTK) signaling pathway antibody array was used to explore the relevant molecular mechanisms underlying the effects of COPB2 knockdown. The results revealed that COPB2 mRNA was abundantly overexpressed in gastric cancer cell lines, whereas knockdown of COPB2 significantly inhibited cell growth and colony formation ability, and led to increased cell apoptosis in vitro. The tumorigenicity assay revealed that knockdown of COPB2 reduced tumor growth in nude mice, and fluorescence imaging indicated that the total radiant efficiency of mice in the Lv-shCOPB2-infected group was markedly reduced compared with the mice in the Lv-shRNA control-infected group in vivo. The antibody array assay revealed that the levels of phosphorylation in 23 target RTKs were significantly reduced: In conclusion, COPB2 was highly expressed in gastric cancer cell lines, and knockdown suppressed colony formation and promoted cell apoptosis via inhibiting the RTK signaling and its downstream signaling cascade molecules. Therefore, COPB2 may present a valuable target for gene silencing strategy in gastric cancer.
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Affiliation(s)
- Caixia An
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Hailong Li
- Department of Clinical Laboratory Diagnosis, School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu 730000, P.R. China
| | - Xueyan Zhang
- Department of Clinical Laboratory Diagnosis, School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu 730000, P.R. China
| | - Jing Wang
- Department of Clinical Laboratory Diagnosis, School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu 730000, P.R. China
| | - Yi Qiang
- Division of Cardiac Surgery, Gansu Provincial Maternal and Child Health Hospital, Lanzhou, Gansu 730050, P.R. China
| | - Xinhua Ye
- Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Qiang Li
- Division of Neurosurgery, Second Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Quanlin Guan
- Department of Surgical Oncology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
| | - Yongning Zhou
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P.R. China
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