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Erschienen in: Experimental Hematology & Oncology 1/2023

Open Access 01.12.2023 | Review

New insight into circRNAs: characterization, strategies, and biomedical applications

verfasst von: Xin-Yi Feng, Shun-Xin Zhu, Ke-Jia Pu, Heng-Jing Huang, Yue-Qin Chen, Wen-Tao Wang

Erschienen in: Experimental Hematology & Oncology | Ausgabe 1/2023

Abstract

Circular RNAs (circRNAs) are a class of covalently closed, endogenous ncRNAs. Most circRNAs are derived from exonic or intronic sequences by precursor RNA back-splicing. Advanced high-throughput RNA sequencing and experimental technologies have enabled the extensive identification and characterization of circRNAs, such as novel types of biogenesis, tissue-specific and cell-specific expression patterns, epigenetic regulation, translation potential, localization and metabolism. Increasing evidence has revealed that circRNAs participate in diverse cellular processes, and their dysregulation is involved in the pathogenesis of various diseases, particularly cancer. In this review, we systematically discuss the characterization of circRNAs, databases, challenges for circRNA discovery, new insight into strategies used in circRNA studies and biomedical applications. Although recent studies have advanced the understanding of circRNAs, advanced knowledge and approaches for circRNA annotation, functional characterization and biomedical applications are continuously needed to provide new insights into circRNAs. The emergence of circRNA-based protein translation strategy will be a promising direction in the field of biomedicine.
Hinweise
Xin-Yi Feng and Shun-Xin Zhu contributed equally to this work.

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Abkürzungen
circRNAs
Circular RNAs
ncRNAs
Non-coding RNAs
mRNA
Messenger RNA
lncRNA
Long noncoding RNA
snoRNA
Small nucleolar RNA
miRNA
MicroRNA
ssRNAs
Single-stranded RNAs
tRNAs
Transfer RNAs
pre-mRNA
Precursor mRNA
BSJ
Back-splicing junction site
ICSs
Intronic complementary sequences
RBPs
RNA-binding proteins
RNase R
Ribonuclease R
m6A
N(6)-Methyladenosine
COVID-19
Corona Virus Disease 2019
snRNAs
Small nuclear RNAs
rRNAs
Ribosomal RNAs
RNA-seq
RNA sequencing
UTRs
Untranslated regions
ciRNAs
Intronic circRNAs
EIciRNAs
Exon‒intron circRNAs
ecircRNAs
Exonic circRNAs
circR-loops
CircRNA:DNA hybrids
IRS2
Insulin receptor substrate 2
EGFR
Epidermal growth factor receptor
PABPN1
Nuclear poly (A) binding protein 1
HuR
Human antigen R
dsRNA
Double-stranded RNA
PKR
Double-stranded RNA-activated protein kinase
DRIP-seq
DNA:RNA immunoprecipitation sequencing
R-loop
DNA:RNA hybrids
SARS-CoV-2
Severe Acute Respiratory Syndrome Coronavirus 2
gRNAs
Guide RNAs
ADARs
Adenosine Deaminase
IRES
Internal ribosome entry
elF4
Eukaryotic translation initiation factor 4
elF4G
Eukaryotic translation initiation factor 4G
elF3
Eukaryotic translation initiation factor 3
elF4G38
Eukaryotic translation initiation factor 4G38
eIF4E
Eukaryotic translation initiation factor 4E
Ago2
Argonaute 2
DBR1
Debranching RNA Lariats 1
RNase H1
Ribonuclease H1
SLE
Systemic lupus erythematosus
RNase L
Ribonuclease L
f-circRNAs
Fusion circular RNAs
ceRNA
Competing endogenous RNA
RT
Reverse transcription
PCR
Polymerase Chain Reaction
qPCR
Quantitative PCR
ddPCR
Droplet digital PCR
CCD
Charge-coupled device camera
ISH
In situ hybridization
siRNA
Small interfering RNA
shRNA
Short hairpin RNA
ASO
Antisense oligonucleotides
CRISPR
Clustered Regularly Interspaced Short Palindromic Repeats
GCN1
GCN1 Activator Of EIF2AK4
sgRNAs
Small guide RNAs
td
T4 thymidylate synthase
RIG-I
Retinoic-acid-inducible gene I
SUZ12
SUZ12 polycomb repressive complex 2 subunit
MYBL2
V-Myb avian myeloblastosis viral oncogene homolog-like 2
CLIP-seq
Crosslinking immunoprecipitation-high-throughput-sequencing
RIP
RNA immunoprecipitation
MFNNs
Matrix factorization and neural networks
dRNH1
Human RNase H1
DRIP-seq
DNA:RNA hybrid immunoprecipitation and sequencing
SMARCA5
SWI/SNF Related, Matrix Associated, Actin Dependent Regulator of Chromatin, Subfamily A, Member 5
DSBs
Double-strand DNA breaks
XPO4
Exportin 4
AML
Acute Myelocytic Leukemia
ALL
Acute Lymphocytic Leukemia
CLL
Chronic Lymphocytic Leukemia
CML
Chronic Myeloid Leukemia
MM
Multiple Myeloma
CRC
Colorectal Carcinoma
HCC
Hepatocellular Carcinoma
GC
Gastric Carcinoma
BC
Bladder Cancer
PC
Pancreatic Cancer
OSCC
Oral Squamous Cell Carcinoma
ESCC
Esophageal Squamous Cell Carcinoma
EC
Esophagus Cancer
LC
Lung Cancer
RC
Renal Carcinoma
GM
Glioma Malignancy
OC
Ovarian Cancer
TC
Thyroid Cancer
CC
Cervical Cancer
CEA
Carcinoembryonic antigen
LAA
Large-artery atherosclerosis
TNBC
Triple-negative breast cancer
PDX
Patient-Derived Xenograft
ASOs
Antisense oligonucleotides
TOP1
DNA topoisomerase I
CPT
Camptothecin
FLT3
FMS-like tyrosine kinase 3
ITD
Internal tandem duplication
YBX1
Y-box binding protein 1
PRP19
Pre-mRNA processing factor 19
METTL3
Methyltransferase Like 3
NSCLC
Non-Small Cell Lung Carcinoma
DDP
Cisplatin
GRB7
Growth factor receptor bound protein 7
FAK
Focal Adhesion Kinase
AKT
Protein Kinase B, PKB
ERK
Extracellular regulated protein kinases
HER2
Human epidermal growth factor receptor 2
PTBP1
Polypyrimidine tract-binding protein 1
HACE1
HECT domain and ankyrin-repeat-containing E3 ubiquitin-protein ligase 1
SGs
Stress granules
RACK1
Receptor for Activated C kinase1
MTK1
Mitogen-activated protein kinase kinase kinase 4
RNAi
RNA interference
ORF
Open reading frame
PDK1
3-Phosphoinositide-dependent protein kinase 1
NF-κB
Nuclear factor kappa-B
RPS3
Ribosomal protein S3
HSP
Heat Shock Proteins
PABP
Poly A binding protein
HBA1
Hemoglobin Subunit Alpha 1

Background

CircRNA was originally regarded as incorrect RNA cleavage products in viroids [1]. With the development of high-throughput sequencing technologies, an increasing number of circRNAs have been discovered and have received much attention [2, 3]. Unlike other well-known classes of linear RNAs, such as messenger RNA (mRNA), long noncoding RNA (lncRNA), small nucleolar RNA (snoRNA), microRNA (miRNA), etc., circular RNAs are covalently closed single-stranded RNAs (ssRNAs) that have recently become a widespread class of RNA species [38]. Although there is still a challenge to identify and annotate novel emerging circRNAs, advances in bioinformatics algorithms, detection methods, and molecular biological techniques have provided new opportunities to accelerate the understanding of circRNAs.
In recent years, several key characterizations of circRNAs have been identified [5, 9]. Although a few circRNAs were first identified during intron self-splicing from ribosomal RNAs, mitochondrial RNAs, and tRNAs, most annotated circRNAs are generated from pre-mRNA back-splicing [4, 5, 10, 11]. In this uncommon pre-mRNA splicing, a downstream 5′ splice site is joined to an upstream 3′ splice site to form circular RNAs with a 3′,5′-phosphodiester bond at the back-splicing junction site (BSJ) [4]. Many regulators have been revealed to improve circRNA biogenesis, including intronic complementary sequences (ICSs) in flanking introns of circle-forming exons, Alu elements and RNA-binding proteins (RBPs) [4, 10, 1214]. Due to the lower efficiency of back-splicing than that of canonical splicing, the examined cells and tissues usually showed a generally low abundance of circRNAs. Once produced, the unique covalently closed conformation of circRNAs endows them with considerable stability and more resistance to RNase R than linear RNAs [15], which enables them to regulate cellular processes with a small number of molecules. Interestingly, there are some insights into circRNA clearance, including circRNA degradation by RNase H1 in circRNA:DNA hybrids [16, 17], endonuclease RNase L during innate immune response activation [18], and the RNaseP/MRP complex in m6A modification [19]. circRNA levels can also be reduced in cancer cells with a rapid proliferation rate [9, 20].
In the past few years, circRNAs have been regarded as competing endogenous RNAs that sponge miRNAs that silence their target genes [4, 10, 21, 22]. Recent studies have revealed that circRNAs perform cellular functions via several novel regulatory mechanisms, including circRNA-RBP [23], circRNA:DNA hybrids [16, 17], m6A modification [19, 2426], guiding A-to-I editing [27, 28], and translation potential [2932]. These features illustrated that circRNAs may comprehensively play important roles in pathological and physiological processes. Increasing evidence indicates that circRNAs are closely associated with proliferation, metastasis, DNA damage, drug resistance and other life activities of cancer cells [20, 3335].
Given that circRNAs have structural stability advantages and that the negative effect of intron-derived circRNAs on triggering the immune response is smaller than that of other RNAs, the development of RNA drugs based on circRNAs has important application prospects [5, 9, 36]. circRNAs can be relatively stable in biological fluids and may serve as good biomarkers for early diagnosis and prognosis [36, 37]. Several tissue-specific circRNAs have been suggested to be used as targets for cancer treatment, even in therapy resistance and targeted drug development [3843]. Of note, RNA circle-based translation technologies have emerged as a promising strategy in biomedicine [9, 30, 44, 45]. For example, the circRNA-RBD-Delta vaccine was designed to resist the COVID-19 pandemic [44].
In this review, we collected the recent progress in the biogenesis, degradation and biology of circRNAs and describe novel technologies for the identification, accurate quantification, and functional characterization of circRNAs. Based upon our findings, we also discuss the current challenges of circRNA analysis and new insight into strategies to determine circRNA functions and the biomedical implications of circRNA.

Characterization of circRNAs

Biogenesis of circRNAs

In general, circular RNA is usually derived from back-splicing of pre-mRNA to form a closed RNA transcript [3, 5, 10, 11]. Additionally, circular RNA can intermediately originate from small nuclear RNAs (snRNAs), mitochondrial RNAs, ribosomal RNAs (rRNAs), and transfer RNAs (tRNAs) during intron self-splicing [5, 42, 4648]. Advancing RNA sequencing (RNA-seq) technologies and computational pipelines for circular RNA annotation, recent studies have found that circRNAs can be derived from exons, introns, 5' untranslated regions (UTRs), 3' UTRs or antisense sequences and can be classified into four main categories, intronic circRNAs (ciRNAs), exon‒intron circRNAs (EIciRNAs), exonic circRNAs (ecircRNAs), and others, detected in a variety of organisms, including viruses, archaea, plants, parasites, and most mammals [4, 5, 10, 11, 49, 50] (Fig. 1a). Evidence has shown that back-splicing of pre-mRNA is the predominant process for circRNA generation [3, 50]. In this back-splicing process of pre-mRNA, a splice donor that is downstream of the 5’ splice site is joined to a splice acceptor that is upstream of the 3’ splice site, producing a circular format with a 3’-5’ phosphodiester bond at the back-splicing junction site (BSJ) [3]. In addition, RBPs, special sequences of introns, etc., may assist in the production of circRNA [3, 12, 15]. Circularized RBPs can shorten the distance between the upstream and downstream of the circular exon by connecting related intron sequences, promote splicing, and induce the formation of circular RNA [11, 23, 51]. If the intron has a unique inverted repeat sequence (such as Alu) [12, 52], after base pairing occurs, the splicing donor is brought close to the splicing acceptor, which promotes nucleophilic attack and splicing and can also promote the production of circRNA. However, the biochemical environment and regulatory factors required for the occurrence of circRNA are not yet clear. It is still worth noting that one gene can generate different circRNAs, which can be affected by the competition of RNA pairing across the flanking introns [3, 11].

Function mechanisms of circRNAs

To date, studies using the application of emerging approaches have elucidated various regulatory mechanisms of circRNAs, which highlight many aspects of gene expression, DNA damage, RNA editing and immunity. We will focus on the representative epigenetic regulation of circRNAs (Fig. 1b–g), including circRNA-miRNA sponges, circRNA:DNA hybrids (circR-loops), guiding A-to-I editing, circRNA-protein interactions, and translation [16, 22, 2729, 32].
A majority of studies have shown that circRNA can act as miRNA sponges in a manner similar to that of mRNA [22]. Circular RNA exists in the cytoplasm and has multiple miRNA binding sites. It can sponge miRNA to inhibit the regulatory function of miRNA. For example, miR-7 [53, 54] has been identified as a tumor-inducing factor or tumor suppressor in the process of tumorigenesis. Circular RNA (ciRS-7; also known as CDR1as) can specifically sponge miR-7, thereby inhibiting the function of miR-7 and upregulating the expression of IRS2, EGFR and other related genes [22, 55] (Fig. 1b). Another well-known epigenetic regulatory mechanism of circRNAs is their interaction with RNA-binding proteins [23, 56] (Fig. 1c). circRNA interactions with RBPs could function as protein antagonists or as inhibitors of protein activity [10, 57, 58]. For example, circ-Foxo3 interacts with cell cycle-related proteins (including p21 and p27), thereby blocking the role of these proteins in the cancer cell cycle [57]. CircPABPN1 binds to HuR, suppresses the interaction of HuR with PABPN1 mRNA and reduces its translation [58]. Besides, endogenous circRNAs tend to form 16–26 bp duplexes and interact with double-stranded RNA (dsRNA)-activated protein kinase (PKR), which blocks innate immunity [18, 40] (Fig. 1d). CircRNAs have an extensive ability to regulate cellular processes, which may explain the epigenetic differences between cells in the same organism.
In recent years, some emerging epigenetic regulatory mechanisms of circRNAs have been illuminated. DNA: RNA immunoprecipitation sequencing (DRIP-seq) data have also shown that circRNAs frequently form R-loop structures and tend to regulate DNA damage and genome instability [16, 59] (Fig. 1e). Some circRNAs can act as stable antisense RNAs to bind with RNAs to modulate RNA stability, structure, and activity [27, 60, 61] (Fig. 1f). For example, artificial antisense sequences in a circular RNA backbone can significantly reduce the proliferation of the SARS-CoV-2 virus [60]. Circular guide (g)RNAs were engineered to execute A-to-I editing on mRNAs by recruiting endogenous ADARs, which may realize the aim of treatment without disturbing genes [27].

Translation potential of circRNAs

As mentioned above, circRNAs are a class of noncoding RNAs, but recent scientific research has shown that some circRNAs also have certain coding capabilities [32]. The 5' cap and 3' poly(A) tail are necessary structures for the linear translation of mRNA [25]. Unlike ordinary mRNA, circRNA lacks a similar translational molecular structure, but it can utilize the N6-adenosine methylation (m6A) modification or internal ribosome entry site (IRES) translation to promote the direct binding of the initiation factors to the cyclic RNA [25, 32, 6264] (Fig. 1g). The translation of linear mRNA is initiated by the elF4E complex [65, 66]. First, elF4F binds to the 5' cap end of the mRNA, and then elF4G serves as a protein binding scaffold to assemble the initiation complex [66]. Then, the combination of elF3 and elF4G recruits ribosomes to the mRNA and initiates translation [66]. For circRNA, a special eIF4G protein (eIF4G2) directly recognizes IRES and initiates eIF4 complex assembly without eIF4E in a 5' cap-independent manner, providing circRNA with translation ability [29, 67]. m6A modification can also regulate the protein-coding potential of circRNAs [25, 68, 69]. For example, a high m6A methylation level was found in circZNF609, which promotes internal ribosome entry site (IRES)-activated protein coding [25, 68]. Yang et al. also examined the coding landscape of the human transcriptome and found that many circRNAs contain m6A motifs with translational potential and that high m6A levels in circRNAs have the ability to improve the efficiency of translation [25]. Interestingly, according to mass spectrometry, 50% of translatable endogenous circRNAs undergo rolling ring translation [32, 63, 67]. Given that circRNA lacks the general translational elements, a large number of products translated from circular RNAs are short in length and lower efficiency than that from mRNAs. Moreover, there are still issues that need to be further answered, such as which factors regulate the translation of circRNA, and what is the relationship between the translation product of circRNA and that of its corresponding linear transcript?

CircRNA degradation

Due to the special structural characteristics of circRNA, it cannot be degraded by RNase H, which is conventionally used to eliminate linear RNA [15]. The specific degradation mechanism of circRNA is currently unclear. Several studies have found that miRNA can regulate the degradation of circRNA [22, 70]. For example, CDR1as can be degraded via sponging by miR-671 through Argonaute 2 (Ago2)-mediated degradation [55]. Circular intronic RNAs (ciRNAs) escape from DBR1 debranching of intron lariats and are cotranscriptionally produced from pre-mRNA splicing, but their turnover and mechanism of action have remained elusive [59]. Li et al. reported that RNase H1 degrades a subgroup of circular intronic RNAs (ciRNAs), which have high GC% and often form R-loops [16, 59] (Fig. 1h). For example, ci-ankrd52 facilitates R-loop formation, a process that allows the release of ankrd52 pre-mRNA from R-loops by ci-ankrd52 replacement and subsequent ciRNA removal via RNase H1-mediated degradation [59]. This RNase H1/R-loop-dependent ciRNA degradation likely limits ciRNA accumulation and resolves R-loops at some GC-rich ciRNA-producing loci. In the autoimmune disease systemic lupus erythematosus (SLE), endogenous circRNAs bind to PKR via forming 16–26 bp imperfect RNA duplexes [18]. Upon viral infection, PKR is activated by phosphorylation in early cellular innate immune responses, resulting in the release of circRNAs and global degradation by RNase L [18] (Fig. 1i). This study suggests that the structure of circRNAs is important in innate immunity and its degradation. Studies have also found that m6A RNA modification can promote the recruitment of endonucleases to degrade circRNA [9, 19] (Fig. 1j).
In addition to intracellular degradation, circRNA can also be transported out of the cell in the form of exosomes and into body fluids [36, 71, 72]. However, the reason why cells form exosomes is still unclear. Is it merely a tool for the exchange of information between cells? Alternatively, it may reduce the toxicity caused by excessive accumulation of circRNA in the cell and actively transport circRNA out of the cell. The degradation of exosomes may release the circRNA outside; but there is no conclusive mechanism yet [73]. Although there are some endeavors to understand the mechanism of circRNA decay in certain contexts, further studies are still needed to fully understand the common circRNA degradation mechanisms under different physiological conditions.

Principles and challenges for circRNA discovery and annotation

CircRNA constitutes a large amount of cell contents of unknown function [5, 9]. Accurate identification and annotation of novel emerging circRNAs are still urgently needed in this rapidly expanding research field. Recent advances in high-throughput RNA sequencing and related bioinformatics tools have accelerated research (Table 1). Since 2012, increasing numbers of bioinformatics tools have been developed to discover and annotate circRNAs. In 2013, find-circ became the first publicly available pipeline for identifying circRNAs from sequencing data [49]. Even today, many explorations of circRNAs still commence with RNA-seq data [7477]. While RNase R-treated sequencing is considered easier and more accurate for circRNA detection, most circRNA detection tools can identify back-splice junction (BSJ) reads with high confidence from conventional RNA-seq datasets [2, 49, 78]. Nevertheless, achieving both sensitivity and specificity in circRNA discovery remains a challenge, particularly in the context of identifying and annotating novel emerging circRNAs.
Table 1
Bioinformatic tools for circRNAs discovery
Software
Seq type
Language
Latest update
Download link
Characteristic
Refs.
MapSplice
II
C++ 
2016
/
[74]
PcircRNA_finder
II
Python, Perl
2016
Predict circRNAs in plants with frequently used circRNA detect tools
[75]
PredcircRNATool
II
Python
2016
Identification of circular RNAs based on conformational and thermodynamic properties in the flanking introns
[108]
CircPro
II
Perl
2017
Identify the protein-coding potential circRNAs
[198]
CIRI
II
Perl
2017
De novo assemble novel circRNA with variable sequencing data
[82]
ACFS
II
Perl, Shell
2017
Discovery and annotate circRNA from single-end RNA-seq
[91]
find_circ
II
Python
2017
De novo assemble novel circRNA transcripts and widely used in circbase
[49]
circseq-cup
II
Python
2017
Identify full-length sequence of circRNAs
[207]
KNIFE
II
Python, Shell, Perl
2017
Detect and quantify circRNAs from junctional alignments
[208]
PredcircRNA
II
Python
2017
Distinguish circRNA from other lncRNAs using multiple kernel learning
[76]
CPSS
II
PHP, Perl, R
2017
For small RNA sequencing data analysis
[209]
miARma-seq
II
Perl, Python, R
2018
Integration of mRNA, miRNA and circRNA analysis
[210]
CIRI-AS
II
Perl
2018
Identify circRNA internal components and alternative splicing events de novo
[211]
hppRNA
II
Perl, R
2018
Analysis circRNA with different core-workflows from a large number of samples
[212]
segemehl
II
C +  + 
2018
Detect back-splice reads and gene fusion
[83]
STARChip
II
Perl, Shell
2018
Output the chimeric reads and discovery fusions circRNAs
[89]
UROBORUS
II
Perl
2018
Suggest detecting circRNAs with low expression levels in RNA-seq
[133]
WebCircRNA
II
Python
2018
Using machine-learning based method to predict stem cell specific circRNAs
[213]
circRNA_finder
II
Perl, Awk, Shell
2019
/
[81]
CircRNAFisher
II
Perl
2019
Identify circRNA de novo
[214]
PRAPI
III
Python
2019
One-stop solution of post-transcriptional regulation analysis for Iso-seq, suitable for third generation sequencing
[101]
CircRNAWrap
II
Shell, R
2019
Integrate multiple circRNA-detect tools to discovery confidence circRNAs
[85]
RAISE
II
Shell, Perl
2019
Integrating detection, quantification and prediction of internal structure
[84]
DeepCirCode
II
Python, R
2019
Using machine-learning model to predict back-splice sites of circRNA
[77]
ROP
II
Shell, Python
2019
Discover the source of all reads with Python2, but it is no longer maintained
[215]
ACValidator
II
Python, Shell
2020
Assemble circRNA from pseudo-reference file
[216]
CircDBG
II
C +  + 
2020
Detect circRNA by de Brujin graph
[217]
CircMarker
II
C +  + . Java
2020
/
[218]
AutoCirc
II
Perl
2020
Identify back-splice junctions of potential circRNAs from RNA-seq de novo quickly
[24]
Pcirc
II
Python
2020
Identify plant circRNA with random forest methods
[110]
cirRNAPL
II
Java
2020
Identification of circRNAs based on extreme learning machine
[109]
circDeep
II
Python
2020
Identification of circRNAs with deep learning
[111]
CLEAR
II
Python
2020
Combine with ribo-seq & RNA-seq as input, and quantify the expression of circRNAs
[219]
NCLcomparator
II
Roff
2020
Detect circRNAs by combined several non-co-linear transcript
[220]
CIRCexplorer
II
Python
2021
De novo assemble novel circRNA with supporting many common aligners
[13]
CIRI-full
II
Perl
2021
Reconstruct and quantify full-length circular RNAs from RNA-seq data sets
[134]
CIRI-long
III
Perl
2021
Identify circRNA from long-reads sequencing data
[102]
CIRIquant
II
Perl
2021
Quantify circRNA expression from RNA-seq data
[221]
CirCompara2
II
Python, R
2021
Integrate multiple circRNA-detect tools to discovery confidence circRNAs
[86]
circAST
II
Python
2021
Assemble full-length circRNAs and quantification using RNA-Seq data with the back-spliced events
[222]
DCC and CircTest
II
Python
2022
Detect and quantify circRNAs from chimeric reads
[78]
Ularcirc
II
R
2022
Analysis and visualize the canonical and back-splice junctions, annotate circRNA with overlapping gene information
[80]
NCLscan
II
C +  + , Python
2022
Identify both intragenic and intergenic non-co-linear transcript
[205]
circall
II
C +  + , R
2022
Discovery circRNAs from paired-end RNA-seq
[223]
CYCLeR
II
R
2022
Reconstruct and quantify circRNAs from RNA-seq datasets accurately
[224]
stackCirRNAPred
II
Python
2022
Identification of circRNAs based on stacking strategy
[107]
circtools
II
Python, R
2023
Integrate the cumbersome circRNA analysis process of analysis
[225]
circfull
III
Python
2023
Detect and quantify full-length circRNA isoforms from circFL-seq
[105]
isocirc
III
Python, R
2023
Integrated pipeline to characterize full-length circRNA isoforms using rolling circle amplification
[104]

Canonical BSJ-based circRNA identification

Many tools identify circRNAs by searching for specific BSJ sequences and performing different kinds of mapping (Fig. 2a). Most of the algorithms embedded in the tool are based on the segmentation of reads, while some other tools are based on predefined BSJ and circRNA flanking sequences. Examples include Find-circ [49], CIRI [79], CIRIexplorer [12, 13], Ularcirc [80], and circRNA-finder [81]. They all have their own merits or characteristics. Find_circ was the first circRNA prediction tool using the identification of back-spliced sequencing reads in RNA-Seq. CIRI, CIRI2 and CIRCexplorer2 [13, 79, 82] all scan through sequence data first to identify junction reads in backspliced exons, intron lariats, and alternative splicing sites and then implements multiple filtration strategies to remove false-positives. Other identification of BSJ reads is based on splicing, such as MapSplice [74] and segemehl [83]. MapSplice improves the quality and diversity of read alignments of a given splice to increase accuracy and can be used for both short (< 75 bp) and long reads (≥ 75 bp) to detect novel canonical as well as noncanonical splices [74].
Although circRNA library preparation of RNA-seq by rRNA deletion and RNase R treatment followed by many circRNA identification tools is a better method, there exist some RNase R-sensitive circRNAs, such as circ_CDR1as, which leads to the problem that these RNase R-sensitive circRNAs will be missing when only using RNase R-treated library preparation-based tools [15, 49, 82] (Fig. 2b, c). To improve circRNA identification efficiency and reduce the false-positive rate, some researchers integrate current prediction algorithms to make an ensemble tool (Table 1). For example, RAISE [84], CircRNAwrap [85], and PcircRNA_finder [75] that was used in the study of plants. Different integrated identification pipelines satisfy the different research purposes for users. Recently, Gaffo et al. developed CirComPara2 [86], which has been set to simultaneously use seven circRNA detection methods (integrated C2BW, C2SE, C2ST, C2TH, CIRI2 [82], DCC [78] and find_circ [49]) and identify the real circRNAs shared between at least two of these methods. The new trends of circRNA detection development are integrating variable tools because they can outperform single state-of-the-art circRNA identification tools and consistently achieve high recall rates without losing precision.

Fusion circRNA identification

Previous studies have shown that fusion genes can transcribe into not only linear but also chimeric fusion circular RNAs (f-circRNAs), which are functional in gene expression regulation and implicated in malignant transformation [8790]. Currently, even though it remains a challenge to identify fusion circRNAs owing to their general sparsity, low abundance in cells, heavy background noise in RNA-seq and perhaps imperfect computational methods, researchers have endeavored to develop bioinformatics approaches to systematically identify fusion transcripts, specifically detecting f-circRNAs in cancer cells (Table 1). ACFS has the ability to detect fusion events and recognize f-circRNAs from RNA-Seq data accurately [91]. However, f-circRNA detectors may suffer from a high false-positive rate and a significant increase in the computational burden owing to the detection algorithm performance. Identification of f-circRNAs requires detection of the BSJ site within the gene fusion events. STAR Chimeric Post (STARChip) is an open-source software based on the STAR aligner that can simplify filter high-quality chimeric alignments and improve f-circRNA identification to annotate f-circRNA in a rapid, efficient and scalable manner [89]. Cai et al. developed a comprehensive Python-based workflow called “Fcirc” to identify linear and circular RNA transcripts from known fusion events in RNA-Seq datasets [92]. It requires already known gene fusions as a reference to build the bipartite graph of gene pairs, which is different from fusion detection tools such as ChimeraScan [88], FusionCatcher [93], JAFFA [94], TrinityFusion [95] and STAR-Fusion [95]. Therefore, Fcirc can detect f-circRNAs from known fusion events with higher specificity, a lower false-positive rate and shorter computing times [92]. Usefully, Fcirc is an open-friendly comprehensive pipeline that can allow users to add their own fusion gene pairs of interest at their convenience and regularly update newly emerging fusion genes from common multiple databases (COSMIC, FusionCancer, ChimerDB, FARE-CAFE, and TicDB) [93, 9699].

circRNA identification using long-read sequencing data

The circRNA discovery tools above are mostly compatible with the reads of next-generation RNA-seq [2, 100]. Due to the short reads in RNA-seq, these alignment-based algorithms have difficulty distinguishing circular reads from the exonic regions that overlap the corresponding linear transcripts. In recent years, with emerging long-read sequencing technologies, including PacBio and Oxford Nanopore, reconstruction of transcript isoforms has become much easier [101104]. Thus, the application of long-read sequencing technologies will lead to a novel generation of circRNA discovery tools that have the ability to achieve high-throughput detection of full-length circRNAs and improve sensitivity and specificity. circNick-LRS [103] (Fig. 2d) is the first reliable method to use long-read nanopore sequencing to detect circRNAs in both humans and mice.
Of note, due to circNick-LRS and circPanel-LRS eliminating the need for prior circRNA enrichment, a large number of nonconical splicing events in the global genome have been found to produce various types of circRNAs, including novel exons, intron retention and microexons. Both circFL-seq [105] and isoCirc [104] identify full-length circRNA isoforms using rolling circle amplification followed by nanopore long-read sequencing (Fig. 2e). Significantly, the low abundance circRNA reads could be enriched and identified using rolling circles and long-read sequencing. Zhao’s team developed an algorithm called the circRNA identifier using long-read sequencing data (CIRI-long) (Fig. 2e) to reconstruct the sequence of circRNAs [102, 106]. CIRI-long not only enables unbiased reconstruction of full-length circRNA sequences but also identifies mitochondria-derived circRNAs, transcriptional read-through circRNAs, and noncanonical AG/GT splicing circRNAs, which other methods to detect. Interestingly, CIRI-long identified a novel type of intronic self-ligated circRNA with a different incompletely characterized internal GT/AG splice signal rather than the flanking AG/GT signal in most exonic and intronic-exonic circRNAs [102]. With the development of sequencing technology, circRNA discovery tools provide insights into circRNA complexity that will further advance this rapidly expanding research field.

circRNA identification using machine learning

Because the above methods always require RNA-seq data as input, circRNA signals with low abundance are usually missed [78, 100]. It is necessary for us to develop a novel tool to identify circRNAs at low levels. Machine learning algorithms establish some mapping rules based on the knowledge and characteristics of the real known circRNAs (Table 1). For example, PredcircRNA [76] and StackCirRNAPred [107] predict whether an unknown RNA sequence possibly comes from circRNA by some common reliable features, such as ALU repeats, structural motifs and sequence motifs [15, 76]. Other machine learning circRNA prediction tools based on the characteristics of nucleotide sequences are PredicircRNATool [108], DeepCirCode [77], CirRNAPL [109], PCirc [110], circDeep [111], etc. CirRNAPL is a user-friendly web server that extracts the structural features and pseudo-ribonucleic acid composition of circRNA to optimize the extreme learning machine based on the particle swarm optimization algorithm, which achieves identification accuracy in three public datasets [109]. Further improvements in the sensitivity and specificity of classifying circRNA from other lncRNAs can be found in circDeep, which is an end-to-end deep learning framework [111]. Considering the growing number of circRNA sequences and their splicing complexity, advanced parallel technology is highly recommended in circRNA discovery.

Database for circRNA annotation and functional study

With the development of bioinformatic tools for circRNAs, an increasing number of public circRNA databases have emerged [20, 100, 112114]. The most well-known and comprehensive database is circBase, which encompasses over 90,000 circRNAs along with their genomic coordinates, strands, annotations, and other relevant information [113]. These circRNA databases have become widely utilized in annotation pipelines, facilitating the research and analysis of circRNAs [100, 113]. Furthermore, several databases have been developed to gather diverse attributes of circRNAs beyond basic sequence information, offering unique features for research purposes [2, 64, 100, 115]. Notably, riboCIRC and TransCirc are comprehensive databases that specifically focus on potential translatable circRNAs [64, 116]. They provide predictions of circRNA-derived open reading frames (cORFs) and annotations of cORF-encoded peptides, supported by evidence of translation.
In recent years, the clinical significance of circRNAs has gained substantial attention, with increasing evidence showing their potential as clinical biomarkers and therapeutic targets [67, 114, 117, 118]. Specialized databases such as MiOncoCirc focus on providing information on the association between circRNAs and cancer [20]. Lnc2Cancer 3.0 has been updated to include circRNA-cancer associations and presents information on regulatory mechanisms, biological functions, and clinical applications of circRNAs in cancer [115]. Another comprehensive database, CircR2Disease v2.0 [119], provides experimentally validated relationships between circRNAs and various diseases. ExoRBase 2.0 concentrates on RNAs found in extracellular vesicles, encompassing circRNAs [120]. This database sheds light on the alterations of circRNAs in extracellular vesicles under both physiological and pathological conditions. At the same time, functional circRNA has emerged as a prominent research focus within the field of noncoding RNA. Several databases, including CircFunBase [112], deepBase [121], and circBank [122], provide valuable information on the interactions of circRNAs with various types of RNAs and proteins.
Despite progress in circRNA detection and annotation, the lack of standardized naming conventions remains a pressing issue in this field. The diverse naming methods used across different databases and articles have created a significant barrier for research, leading to information duplication and errors. Some databases use a 'circ_' prefix followed by a numeric ID or the parental gene symbol to name circRNAs [49, 113]. However, this inconsistent and arbitrary naming approach hampers the establishment of an integrated circRNA database. To address this issue, Chen et al. proposed a clear naming system for circRNAs. According to this system, a new circRNA can be named 'circ + ' followed by the parental gene name (separated by '::' in the case of fusion genes), the number of its exon, and 'RI' if it remains in an intron or 'S' if it exhibits different internal splicing patterns [50]. We strongly encourage researchers to embrace these clear naming rules to promote consistency and facilitate data integration.

New insight into strategies to determine circRNA functions

Several methods have been developed to study the functions of circRNAs [9, 46]. We systematically summarized current strategies used to explore circRNAs, including ceRNA prediction [22], knockdown or out of functional circRNAs, overexpression of functional circRNAs [123131], and circRNA-RBP prediction [132]. The advantages and disadvantages of these methods have also been discussed. Some new insights may help improve the strategies of circRNA research and applications of therapeutic potential.

Strategies for circRNA detection

CircRNA sequencing of rRNA-depleted and RNase R-treated cells is the method used to discover novel circRNAs and was also used in all early circRNA profiling studies [20, 82, 133]. Based on the BSJ feature of circRNAs, candidate circRNAs were further identified and quantified. In recent years, many common detection techniques for various types of RNAs have also been applied in circRNA studies [78, 85, 105, 134]. Due to the lack of clarity regarding circRNA production or splicing, these detection methods have specific advantages and disadvantages (Fig. 3).
Northern blotting is the gold standard method for validating all kinds of RNAs, including circRNAs [9, 18, 123, 128]. Antisense probes are designed complementary to the sequences spanning the BSJ point in the circRNAs of interest, which are loaded on a denatured agarose gel containing formaldehyde, and hybridization is performed [18, 128] (Fig. 3a). This technique can precisely identify and quantify targeted circRNAs distinguished from linear RNAs transcribed from the same gene. However, the disadvantage of northern blotting is also obvious. This method requires a large amount of RNA, involves multiple steps, has a high background and often uses radioactively labeled probes [18]. This method generally requires many skills and is also time-consuming. Generally, candidate circRNAs are further validated and quantified by reverse transcription (RT) and quantitative PCR (qPCR) assays [2, 125, 135] (Fig. 3b). Although RT‒PCR is a timesaving and effective technique by means of a real-time PCR machine, the designed primer often cannot precisely distinguish the circular from the linear transcript during the fast PCR process with many copies of the amplified products [2]. The formation of concatemers by rolling circle amplification during the RT step is also a challenge that may hamper the accurate quantification of circRNAs.
Interestingly, droplet digital PCR (ddPCR) can overcome this shortcoming brought by RT‒qPCR [2, 33]. ddPCR is a novel technology that can determine the absolute quantification of a candidate circRNA using the ratio of positive to negative droplets, which exhibits a higher sensitivity even in plasma that has a very low amount of circRNA [33, 136] (Fig. 3c). However, the reagents for ddPCR assays are always expensive compared to other methods. If circRNAs can be quantified via high-throughput techniques, NanoString Technology is a good choice [4, 127] (Fig. 3d). The BSJ flanking sequences are captured by a biotinylated probe and a reporter probe loaded with fluorescent barcodes, and the circRNA-based barcodes on the reporter probes can finally be counted by a high-resolution charge-coupled device camera (CCD) and digitization. This enzyme-free technique also works well to detect paraffin-embedded RNA [4]. In situ hybridization (ISH) is another technique used to visualize and quantify circRNAs of interest [4, 125] (Fig. 3e). This technique designs an oligonucleotide probe, spanned to the BSJ site of circRNA, coupled to fluorescent dyes, to visualize a circRNA of interest in fixed and permeabilized cells using confocal microscopy. The value of fluorescent signals can reflect the quantity of circRNA to some extent. However, the ISH approach always requires the use of multiple probes covering the unique BSJ region, which may result in poor efficiency and a high false-positive rate. Interestingly, the dCas13a-EGFP system can be used to image and track specific circRNAs [137139]. The special BSJ sequences could be a limit of guide RNA design in this approach.

New insight into the knockdown/out of functional circRNAs

Downregulating the expression of circRNAs is a popular strategy to explore their cellular functions [4, 5, 9]. Most circRNA knockdown methods are based on the complementary base pairing of seed sequences to BSJ junction sites, including siRNA, shRNA, ASO, or CRISPR/Cas series systems (Fig. 4a–c).
Introducing siRNA corresponding to circRNA specifically targeting BSJ into transfected cells is a convenient and effective method to inhibit the expression of circRNA in cancer cells [46, 125]. The cells can also be transfected with lentivirus carrying shRNA according to the siRNA sequence to achieve stable knockdown [46, 125] (Fig. 4a). However, the siRNA method executes the knockdown based on the complementary base pairing of seed sequences, which only has 6–8 bases sponged to the BSJ junction site, which may produce an off-target effect on the linear lncRNA or mRNA. The CRISPR/Cas13d system is a useful tool for efficiently degrading circRNAs and reducing false targeting [124, 129] (Fig. 4b). Efficient Cas13d knockdown requires 28–30 nt long spacers and is intolerant to mismatches in spacers [129, 140, 141]. For example, Li et al. constructed a CRISPR–RfxCas13d system and found that gRNA spacers with the BSJ in the center (–7 to 7 nucleotides spanning the BSJ site) exhibited high knockdown efficiencies without affecting linear cognate RNAs [124]. Because circular and linear RNA have distinct biogenesis efficiencies, conformations and turnover rates, RfxCas13d-based RNA interference specifically suppresses circular but not linear RNA [124]. Another advantage is that CRISPR/Cas13-based gRNA, which carry a spacer sequence specifically targeting and spanning the BSJ site within a relatively long sequence, should have the capability to distinguish between circular and linear RNAs and thereby reduce off-target effects on linear lncRNA or mRNA. The combination of lentiviral vehicle and CRISPR/Cas13d can help in investigating the function of circRNA specificity in a xenotransplantation model and drug sensitivity screening.
In recent years, CRISPR/Cas9, which is a highly specific and efficient tool to edit the genome, has also been used in circRNA knockout [123, 142]. In general, the CRISPR/Cas9 system knocks out special circRNAs by deleting intronic complementary sequences neighboring circularized exons in circRNA biogenesis [5, 46, 143145] (Fig. 4c). For example, sgRNA specifically targeting the inverted complementary sequence in the intron of GCN1L1 can knock circGCN1L1 out but not disturb the corresponding linear mRNA [145]. Similarly, CRISPR/Cas9 removal of the downstream inverted repeat ALU element can prevent circHIPK3 formation [144]. However, due to the complexity of circRNA biogenesis, it is difficult to determine which intronic sequences are targeted by sgRNAs in the CRISPR/Cas9 system. Apart from targeting intronic sequences, another challenge of circRNA knockout using the CRISPR/Cas9 system is that many circRNAs are produced from alternative splicing between exons and introns in the genome. Alternative splicing-based circRNA cannot directly target the sequence by sgRNAs, which may interfere with linear mRNA production [146].
Therefore, it is still necessary to gain insight into circRNA knockdown-based strategies, which should be considered with many different factors involved in circRNA production.

Overexpression of functional circRNAs

Several methods based on chemical synthesis and enzymatic ligation have been used to generate circRNAs in vitro; however, circRNA production in vivo has only recently been delineated [47, 128, 147, 148]. There is a circRNA-expressing vector that splices intron-containing tRNAs to produce circRNAs in cells [47, 148] (Fig. 4d). Construction of the tRNA-derived intronic-circRNA with a fluorescence-based RNA reporter allows us to characterize the expression of and visually localize circRNA. Because tRNA is constitutively expressed in all cells, tRNA-derived intronic circRNAs are theoretically expressed at high-copy and stable levels [47, 148]. Due to the feature of tRNA biogenesis by the processivity of pol III, this method have a circRNA size limitation (generally < 250 nt) [47]. Another in vivo circularized RNA was generated by the Group I intron of the phage T4 thymidylate synthase (td) gene transfected into cultured mammalian cells [62, 149]. However, both tRNA- and td gene-based RNA circles induced some extra sequences that tended to form 16–26 bp imperfect dsRNA regions, which generally activated remarkable immune responses via recognition by the pattern recognition receptor retinoic-acid-inducible gene I (RIG-I) or PKR [62, 128, 149]. We previously constructed a universal circRNA expression vector containing flanking introns from SUZ12 that ensured correct splicing to express circRNA without extra sequences [125] (Fig. 4e). We added a sequence that is the reverse complement repeat of the first 100 bp of the 5’ intron component into the vector following the 3’ intron to promote the interaction between the flanking introns, facilitating circRNA production. For example, the sequence of exons 8–9 of MYBL2 was inserted into the vector, and circMYBL2 was highly expressed, i.e., approximately 100-fold, in 293 T cells [125].
Considering the complexity of circRNA biogenesis, suitable strategies are needed for studying the different structural and functional features of circular RNA occurring in cells [5].
The replacement of stronger enhancers including ICSs, Alu elements, other RNA pairing structures and adding BSJ associated RBPs may be strategies to improve circRNA overexpression [5, 12, 150]. In contrast, Chen’s laboratory introduced in vitro synthesized RNA circles produced by T4 RNA ligase without extraneous fragments that present minimized immunogenicity, suggesting a useful method for the future synthesis of circular RNAs [128] (Fig. 4f).

ceRNA prediction

When circRNAs enter the cytoplasm, some of them become competitive endogenous RNAs (ceRNAs) [22, 100]. CircRNA can bind miRNA to prevent it from binding to target genes and changing the regulatory ability of target gene mRNA. Bioinformatics algorithms can be used to predict whether circRNAs have matching miRNAs [151153] (Fig. 5a). The AGO2 protein was identified by analyzing the experimental data for CLIP-seq and functional genomic annotations, and the communication between miRNA and targeted circRNA was predicted after analysis and processing [151].

circRNA-RBP prediction

Although circRNA-miRNA sponging is the most well-known function, increasing evidence has also shown that circRNAs can interact with RBPs to exert widespread regulatory effects [56, 132]. For example, circPABPN1 can bind to HuR and prevent HuR from binding to PABPN1 mRNA, thereby reducing the translation of PABPN1 [154]. Some databases have summarized the interactions between circRNAs and RBPs. For example, CircInteractome provides miRNA and RBP binding sites on circRNA [132]. starBase also concentrated and systematically identified RNA‒RNA and protein‒RNA interaction networks [151].
To date, experimental research on circRNA-RBP interactions has mainly been conducted through RNA pulldown assays or RNA immunoprecipitation (RIP) for experimental analysis [56, 155] (Fig. 5b and c). Although these methods have been popularly used in many important discoveries, they still face many difficulties such as high costs, large tasks, and time consumption. Therefore, some programs that can predict the interaction of circRNA and RBP have been developed to compensate for the defects of classic experiments [56, 156]. Wang's team used matrix factorization and neural networks (MFNNs) to construct a prediction framework based only on interaction matrices, which has a high prediction accuracy and is an effective prediction method [156]. CirRBP, a stacked operation ensemble deep learning model, can fuse binding sites from multiple databases via a localization algorithm and compensates for the defect that most previous prediction methods only identify circRNA-RBP binding sites based on a single data resource [56]. However, CirRBP cannot provide accurate binding sites but only provides probability values of sequence fragments. Then, CirRBP was developed into an open-source web application called CRWS, which can allow users to change the codes in their own needs. CRWS is a useful online tool to use multi-source data to train models and predict precise binding sites [56]. Therefore, highly efficient and convenient circRNA-RBP prediction strategies will undoubtedly be useful for the study of circRNA functions.

circR-loops: circRNA:DNA hybrids

R-loops are widespread structures that are often formed co-transcriptionally [59, 157159]. The genome-wide R-loop signature was generally identified by immunoprecipitation with the R loop-specific S9.6 antibody or catalytically inactive human RNase H1 (dRNH1) coupled with high-throughput sequencing of the resident DNA and RNA [59, 158, 160]. Apart from nascent mRNAs, DRIP-seq data have also shown that lncRNAs and circRNAs frequently form R-loop structures [17, 161] (Fig. 5d). These pervasive formations of circR-loops regulate diverse types of biological processes, including gene expression and DNA damage in cells [16, 17, 161163]. For example, circSEP3 can form an R-loop by binding strongly to its cognate DNA locus, leading to SEPALLATA3 transcriptional pausing and coinciding with alternative splicing [163]. Overexpression of circSMARCA5 can generate a circR-loop at its parent gene locus, which results in transcriptional pausing at exon 15 of SMARCA5 and is sufficient to improve sensitivity to cytotoxic drugs in breast cancer [162]. Interestingly, a recent study showed that a set of circRNAs are enriched within the breakpoint cluster region (bcr) of MLL and can form circR-loops at their cognate loci [17]. These circR-loops promote transcriptional pausing, proteasome inhibition, chromatin reorganization, and double-strand DNA breaks (DSBs). Overexpressing circMLL (9,10) can trigger the de novo generation of clinically relevant chromosomal translocations mimicking the MLL recombinome in mouse leukemia xenograft models [17]. These studies suggest that nuclear circRNAs may form circR-loops and play both physiological and pathological roles in cells. Abnormalities in circRNA export from the nucleus can lead to diseases. Chen et al. identified that conserved exportin 4 (XPO4) can modulate circRNA nuclear export [16]. They observed that knockdown of XPO4 can improve circRNA nuclear retention, circR loop formation and DNA damage [16].
Recent studies may suggest that many circRNAs in circR-loops regulate the cognate DNA locus or mRNA transcription in a cis manner [16, 17]. It is still unclear whether these circRNAs in circR-loops can play roles in trans. There is still an interesting question that whether circR-loops interact with special RBPs to mediate chromatin marks, chromatin accessibility or active chromatin landscape.

New insights into biomedical application of cancer-related circRNA

Because circRNA has tissue- and cancer-specific expression and stability in body fluids, it can be used as a rapid, accurate, and noninvasive biomarker for early diagnosis and prognosis [20, 37, 114, 130, 164]. Several circRNAs are reported to play important roles in tumorigenesis and progression, as well as in chemotherapeutic resistance, and are potential promising targets in cancer treatment [66, 115, 130].

CircRNA is a promising biomarker in cancer

Cancer cells present aberrant expression of circRNAs, which are usually related to some clinical characteristics, such as tumor type, tumor size, histological grade, tumor invasion and metastasis (Table 2). For example, in non-small cell lung cancer, low expression of hsa_circ_0001073 may distinguish adenocarcinoma from squamous cell carcinoma [165]. In breast cancer, circRNA expression profiles may distinguish between estrogen receptor-positive, HER2-positive, and triple-negative breast cancer [166]. In tissue samples, the upregulation of hsa_circ_0003823, circPUM1, circCYP24A1, and circCNOT6L presented diagnostic performance with considerable sensitivity and specificity values, which exhibited relatively higher recurrence of esophageal squamous cell carcinoma (ESCC) [167170]. In the plasma samples, Hu et al., found that highly concentration of plasma circGSK3β and CEA can indicate the recurrence/metastasis of ESCC [171]. CircRNA also showed the ability to distinguish different nontumor diseases [172]. The hsa_circRNA_0001599 was highly expressed in large-artery atherosclerosis (LAA)-stroke patients, revealing its potential as a biomarker of LAA-stroke diagnosis [172]. The plasma concentration of CircBRAP can be a predictor of preeclampsia [173]. CircRNA can be quite stable in biological fluids, and detection of circulating circRNA may be an excellent noninvasive biopsy that is likely to become a new method for cancer detection in the future.
Table 2
Cancer-related circRNAs
Cancer
Name
Up/down
Characteristic
Refs.
Hematologic malignancies
AML
Circ_0009910
Up
Silencing Circ_0009910 can significantly inhibit proliferation, sphere formation and promote apoptosis
[226]
AML
Circ-SFMBT2
Up
Silencing Circ-SFMBT2 can inhibit the proliferation, migration, invasion and glycolysis of AML cells and induce apoptosis
[227]
AML
circ_0040823
Down
Overexpression of circ_0040823 inhibited the proliferation of AML cells and induced apoptosis and cell cycle arrest
[184]
AML
hsa_circ_0079480
Up
Associated with overall survival and relapse-free survival of AML
[228]
AML
circ_0004277
Down
Overexpression of circ 0004277 inhibited the migration and invasion of AML cells
[183]
ALL
Circ_0000745
Up
Knockdown of Circ_0000745 inhibits cell cycle progression and glycolysis, and induces apoptosis and iron death
[229]
ALL
circ_0008012
Up
related to proliferation and apoptosis of ALL cells
[230]
CLL
circ-CBFB
Up
Knockdown of circ-CBFB inhibited the proliferation of CLL cells, stopped the cell cycle and induced apoptosis
[231]
CLL
hsa_circ_0132266
Down
Inhibition of CLL cell apoptosis and impaired proliferation
[232]
CLL
Hsa_circ_0064574
Up
highly expressed in the plasma of CLL patients
[233]
CLL
circZNF91
Up
Silencing circZNF91 can inhibit CLL cell proliferation, induce apoptosis and block cell cycle
[234]
CML
Hsa_circ_0058493
Up
Increase the resistance of CML cells to imatinib
[235]
CML
circ_0080145
Up
Increase the resistance of CML cells to imatinib
[236]
CML
circ_0051886
Up
Increase the resistance of CML cells to imatinib
[236]
MM
Circ_0000190
Down
Inhibiting the viability, proliferation and inducing apoptosis
[237]
MM
hsa_circ_0007841
Up
Associated with drug resistance and chromosome aberration
[38]
MM
circITCH
Down
Related to the resistance of MM cells to bortezomib (BTZ)
[238]
Digestive system malignancy
 
CRC
Hsa_circ_0082182
Up
Associated with tumor proliferation and lymph node metastasis
[239]
CRC
Hsa_circ_0000370
Up
Associated with tumor proliferation and lymph node metastasis
[239]
CRC
hsa_circ_0004585
Up
Positively correlated with tumor size
[240]
CRC
hsa_circ_0000567
Down
Negatively correlated with tumor size, lymph node metastasis, remote metastasis, and TNM staging
[241]
CRC
hsa_circ_0004771
Up
Upregulated in tumor cell-derived plasma exosomes
[242]
HCC
circIPO11
Up
Drives self-renewal of liver cancer
[123]
HCC
hsa_circ_0000798
Up
High expression in liver cancer tissues was negatively correlated with the overall survival cycle of patients
[243]
HCC
hsa_circ_0027089
Up
Distinguishing cirrhosis
[244]
HCC
hsa_circ_0058124
Up
Associated with invasive characteristics, also regulates the resistance of liver cancer cells to sorafenib
[245]
HCC
hsa_circSMARCA5
Down
Related to proliferation, invasion and metastasis
[246]
HCC
hsa_circ_0068669
Down
Related to tumor microvascular invasion and TNM staging
[247]
HCC
hsa_circ_0028502
Down
associated with lymph node metastasis and TNM stage
[248]
HCC
hsa_circ_0076251
Down
Associated with Barcelona Clinic Liver Cancer (BCLC) stage
[248]
HCC
circUBAP2
Up
Negatively correlated with aggressive clinical characteristics
[249]
HCC
circRNA-YBX1
Down
Mediate phase separation suppresses the metastasis
 
GC
circNRIP1
 
Inhibit the growth of gastric cancer
[179]
GC
hsa_circ_0003159
Down
Negative correlation between tumor metastasis and TNM stage
[250]
GC
hsa_circ_0000096
Down
Affects the growth and migration of GC cells
[251]
GC
hsa_circ_002059
Down
Associated with distal metastasis of tumor cells and TNM staging
[252]
GC
hsa_circ_0000190
Down
Related to tumor diameter, lymphoid metastasis, distal metastasis and TNM stage
[253]
GC
hsa_circ_0000181
Down
Associated with tumor diameter, lymphoid metastasis
[254]
GC
hsa_circ_0000467
Up
Closely related to TNM staging
[255]
GC
hsa_circ_0001895
Down
Down-regulated in GC tissue and precancerous stage of GC
[256]
GC
hsa_circ_0017728
Up
Associated with short overall survival, poor pathological differentiation, higher TNM stage and lymph node metastasis
[257]
GC
circPDIA4
Up
Accelerate the invasion of cancer cells in vitro, promote the progression of GC and indicate poor prognosis
[258]
BC
Hsa_circ_0001136
Up
Associated with tumor grade, tumor stage, lymph node invasion and distal metastasis
[259]
BC
hsa_circ_0137439
Up
Related to tumor grade, tumor stage, lymph node invasion, also can distinguish between MIBC and NMIBC
[260]
BC
hsa_circ_0001361
Up
Promoted the invasion and metastasis of bladder cancer cells and was positively correlated with pathological grade
[261]
BC
circSLC8A1
Down
Overexpression inhibits the migration, invasion and proliferation of tumor cells
[262]
PC
circANAPC7
Down
Inhibits Tumor Growth and Muscle Wasting
[180]
PC
Circ-MBOAT2
Up
Regulates cell proliferation, migration, invasion and glutamine catabolism
[181]
PC
circRNA IARS
Up
Positively correlated with hepatic metastasis, vascular infiltration and TNM stage of pancreatic ductal adenocarcinoma (PDAC), and negatively correlated with postoperative survival time
[263]
PC
hsa_circRNA_001859
Down
Inhibit the proliferation, invasion and EMT of pancreatic cancer
[264]
OSCC
Hsa_circ_0001971
Up
Related to TNM stage of tumor
[265]
OSCC
Hsa_circ_0001874
Up
Related to tumor grade and TNM stage
[265]
OSCC
Hsa_circ_0003829
Down
Negatively correlated with lymph node metastasis and TNM stage
[266]
OSCC
Circ_0109291
Up
Silencing circ_0109291 can improve tumor sensitivity to DDP
[267]
ESCC
Hsa_circ_0003823
Up
Promotes the Tumor Progression, Metastasis and Apatinib Resistance
[167]
ESCC
circPUM1
Up
Regulates oxidative phosphorylation
[168]
ESCC
circCYP24A1
Up
Facilitates esophageal squamous cell carcinoma progression
[169]
ESCC
circCNOT6L
Up
Regulates cell development
[170]
ESCC
circGSK3β
Up
Promotes metastasis
[171]
EC
circ-VIM
Up
Silencing circ-VIM in vitro can inhibit immune escape and multiple carcinogenic activities of EC cells, as well as inhibit internal xenograft growth and lung metastasis
[182]
Lung cancer
LC
Hsa_circ_0001715
Up
Related to TNM stage and distant metastasis of lung adenocarcinoma, and inversely proportional to overall survival
[268]
LC
Hsa_circ_0005962
Up
Promote the proliferation of lung adenocarcinoma cells (LUAD)
[269]
LC
Hsa_circ_0086414
Down
Plasma hsa_circ_0086414 was related to EGFR mutations
[269]
LC
Hsa_circ_002178
Up
Promotes the expression of PDL1/PD1 in lung adenocarcinoma cells and is also present in exosomes
[270]
LC
Hsa_circ_0037515
Down
Significantly down-regulated in non-small cell lung cancer (NSCLC)
[271]
LC
Hsa_circ_0037516
Down
significantly down-regulated in non-small cell lung cancer
[271]
LC
hsa_circ_0001073
Down
Indicates the lung adenocarcinoma (LUAD) subtype in non-small cell lung cancer
[165]
LC
hsa_circ_0001495
Up
Indicates the squamous cell carcinoma (LUSC) subtype in non-small cell lung cancer
[165]
Others
RC
circHIAT1
Down
Overexpression inhibits the malignant progression of clear cell renal cell carcinoma
[272]
RC
hsa_circ_001895
Up
Promotes ccRCC cell proliferation, invasion and migration and is associated with poor prognosis
[273]
GM
circRNA-104718
Up
Indicates a poor prognosis and promotes invasion and migration of tumor cells
[274]
GM
circ-GLIS3
Up
Related to the resistance of temozolomide (TMZ) and promotes the proliferation, invasion and migration of glioma cells
[275]
GM
Circ_0047688
Up
Promote malignant behavior of glioma cells
[276]
GM
Circ_0001982
Up
Promote the proliferation, migration and invasion of glioma cells
[277]
GM
has-circ-0072688
Up
Promote the proliferation of glioblastoma and inhibit apoptosis
[278]
GM
hsa_circ_0030018
Up
Promote proliferation and inhibit apoptosis of glioma cells
[279]
Breast cancer
hsa_circ_0008673
Up
Related to tumor size and distal metastasis
[280]
Breast cancer
Circ-LARP4
Down
High expression indicates good prognosis and is negatively correlated with tumor size
[175]
Breast cancer
circRNA-CREIT
Down
Increases drug resistance in triple negative breast cancer (TNBC) and is associated with poor prognosis
[40]
OC
circBNC2
Down
associated with advanced cancer and lymph node metastasis in epithelial ovarian cancer (EOC)
[281]
TC
Hsa_circ_0137287
Down
related to tumor size, lymph node metastasis and TNM stage
[282]
CC
Circ_0000745
Up
Knockdown Circ_0000745 inhibited proliferation, migration, invasion and glycolysis of cervical cancer cells
[283]
AML: Acute Myelocytic Leukemia; ALL: Acute Lymphocytic Leukemia; CLL: Chronic Lymphocytic Leukemia; CML: Chronic Myeloid Leukemia; MM: Multiple Myeloma; CRC: Colorectal Carcinoma; HCC: Hepatocellular Carcinoma; GC: Gastric Carcinoma; BC: Bladder Cancer; PC: Pancreatic Cancer; OSCC: Oral Squamous Cell Carcinoma; ESCC: Esophageal Squamous Cell Carcinoma; EC: Esophagus Cancer; RC: Renal Carcinoma; GM: Glioma Malignancy; OC: Ovarian Cancer; TC: Thyroid Cancer; CC: Cervical Cancer; LC: Lung Cancer
CircRNAs can not only distinguish different tumor subtypes but also indicate different prognostic levels in the body [130, 174, 175]. For example, CIRS-7 is associated with poor prognosis in most cancers [174]; circUBAP2 has also been identified as an oncogenic factor associated with poor prognosis [174], while circLARP4 is a tumor suppressor associated with good prognosis in several cancers [176]. circRNA-CREIT was also recently found to be abnormally downregulated in doxorubicin-resistant triple-negative breast cancer (TNBC) cells and associated with poor prognosis [40].

CircRNAs are promising therapeutic targets

In recent years, numerous dysregulated circRNAs have been found to affect the proliferation, apoptosis, metastasis, DNA damage and other life activities of cancer cells [3, 10, 99, 130]. Therefore, similar to miRNAs and lncRNAs, circRNAs can also be used as therapeutic targets for cancer treatment [54, 130, 177, 178] (Table 2). For example, intratumoral injection of circNRIP1 siRNA could significantly inhibit the growth of gastric cancer in PDX mouse models, suggesting that oncogenic circNRIP1 may be a promising target for gastric cancer treatment [179]. Antisense oligonucleotides (ASOs) against circIPO11 combined with the TOP1 inhibitor camptothecin (CPT) exert synergistic effects and can significantly suppress liver cell self-renewal and HCC propagation [123]. The knockdown of circMYBL2 in vitro and in vivo by siRNA and shRNA significantly inhibited the FLT3-ITD protein level and inhibited the proliferation of FLT3-ITD AML cells but had no effect on normal cells [125]. circIPO11 knockout using CRISPR/Cas9 technology suppresses the progression of chemically induced liver cancer development [123]. Notably, several circRNAs act as suppressors in cancer progression, indicating their antitumor effects [154, 180184]. circANAPC7, newly discovered tumor suppressors, can significantly inhibit tumor growth and muscle atrophy in pancreatic cancer [180]. In vivo delivery of these kinds of tumor suppressor circRNAs may be a promising approach for anticancer therapy.

CircRNA regulates therapy resistance and targeted drug development

In the current clinical treatment of cancer, various chemotherapeutic drugs have been developed to inhibit the growth of cancer cells and have achieved good clinical effects [185187]. However, with the prolonged time of medication at any time, the drug resistance of cancer cells gradually increases, resulting in the gradual weakening of the therapeutic effect, which is a major problem that has to be solved in clinical treatment [187, 188]. Recent studies show that circRNAs play a role in the resistance of cancer cells to anticancer agents [33, 189, 190]. They found that circRNA-SORE (also known as circRNA_104,797 and circ_0087293) was upregulated in sorafenib-resistant HCC cells, acting as ceRNA to isolate miR-103a-2-5p and miR-660-3p and competitively activate the Wnt/β-catenin pathway to promote sorafenib resistance [191] (Fig. 6a). Interestingly, this team also reported that circRNA-SORE binds YBX1 and blocks PRP19-mediated YBX1 degradation. They found that silencing circRNA-SORE by injection of siRNA in vivo could substantially overcome sorafenib resistance [41] (Fig. 6a). CircVMP1 could upregulate the expression of methyltransferase 3, N6-adenosine-methyltransferase complex catalytic subunit (METTL3) and SOX2 by acting as a sponge of miR-524-5p, thereby promoting the progression of NSCLC and cisplatin (DDP) resistance [192]. These studies put forward a new idea for solving chemotherapeutic drug resistance by knocking down specific circRNAs to inhibit their function of promoting drug resistance.
CircRNAs can also interact with oncoproteins to help cancer cells establish drug resistance [33, 189, 193, 194]. For example, circCDYL2 enhances the interaction between GRB7 and FAK by inhibiting the ubiquitination degradation of GRB7, thereby maintaining the activation of downstream AKT and ERK1/2 signaling pathways and leading to trastuzumab resistance in breast cancer [193] (Fig. 6b). Circ-HER2 encodes the small protein HER2-103, which promotes homo/heterodimerization of epidermal growth factor receptor (EGFR)/HER3 and activates AKT phosphorylation and malignant phenotypes [194]. Pertuzumab inhibits the tumorigenicity of circ-HER2/HER2-103-expressing TNBC cells but not circ-HER2/HER2-103-negative TNBC cells in vivo [194]. These studies suggest that both knockdown of circCDYL2 and overexpression of circ-HER2/HER2-103 together can improve the outcome of drug therapy targeting HER2 signaling in TNBC. We previously also showed that circMYBL2 is more highly expressed in AML patients with FLT3-ITD mutations [125] (Fig. 6c). Relapse of FLT3_ITD AML has been observed due to acquired resistance with secondary mutations in FLT3. shRNA-mediated circMYBL2 knockdown specifically inhibited FLT3-ITD translation by preventing the binding of polypyrimidine tract-binding protein 1 (PTBP1) from FLT3 messenger RNA and impaired the cytoactivity of inhibitor-resistant FLT3-ITD AML, suggesting that circMYBL2 knockdown was effective against FLT3-ITD AML with quizartinib resistance [125]. Notably, circRNAs can regulate the assembly of membraneless organelles to overcome drug resistance [40, 189]. For example, circRNA-CREIT facilitates the interaction between PKR and the E3 ligase HACE1 to promote proteasomal degradation of PKR, which attenuates the assembly of stress granules (SGs) to activate the RACK1/MTK1 apoptosis signaling pathway and overcome doxorubicin resistance in TNBC [40] (Fig. 6d).
Drug resistance is an urgent problem to be solved in current tumor therapy treatments. Recent studies have shown that circRNAs can regulate drug tolerance pathways by interacting with miRNAs, proteins and translated proteins in tumor cells [33, 130, 189]. Targeting drug resistance-related circRNAs may improve the efficiency of chemotherapeutics in cancers.

Challenges of circRNAs as therapeutic targets

Although recent studies have suggested that circRNAs are promising therapeutic targets in many diseases, there are still some challenges [67, 99, 130]. Currently, two targeted therapies are commonly used: gene editing systems and RNAi [123, 141143, 146]. The gene editing method uses the CRISPR‒Cas9 system to specifically delete the Alu sequence, which is important for circRNA formation [4, 10, 15, 143]. Such an operation does not affect the mRNA content of the corresponding linear product of the gene but only affects the formation of circRNA, thus regulating the life activities of the cell. However, this method often leads to the occurrence of unpredictable selective shearing events, and DNA editing is an irreversible operation with potential ethical problems. On the contrary, RNAi technology is relatively safe to change cellular RNA levels for it will not cause gene changes [67, 125, 141, 195197]. It induces circRNA cleavage by delivering small interfering RNA or short hairpin RNA to cells and reduces the content of circRNA. In addition, the CRISPR‒Cas13 system is increasingly being utilized to effectively target circRNA without affecting mRNA and has been shown to have an overall advantage in the efficiency and specificity of circRNA knockdown [124, 126, 141]. However, the efficiency of introducing gRNA and Cas13 enzymes into target cells is not high, and there is a certain off-target effect. For CRISPR‒Cas13 technology to be truly applied to clinical practice, these problems still need to be further solved.

Therapeutic potential based on circular RNA translation

Recent studies have found that some circRNAs can also be directly translated into small peptides and play a role in cells [9, 65, 198]. Interestingly, a number of circRNAs can encode carcinogenic or cancer-inhibiting protein products [199201] (Fig. 7). For example, circAKT3 has a predicted ORF and encodes a small 174-amino acid peptide, AKT3-174aa, which competitively binds p-PDK1 to inhibit downstream targets of p-PDK1, suppressing glioblastoma tumorigenicity [199] (Fig. 7a). MAPK1-109aa, encoded by circMAPK1, can inhibit the proliferation and migration of gastric cancer cells [200] (Fig. 7b). circPLCE1-411 promotes the ubiquitin-dependent degradation of the critical NF-κB regulator RPS3 by directly binding the HSP90α/RPS3 complex to inhibit the NF-κB signaling pathway in colorectal carcinoma (CRC) [201] (Fig. 7c). In vivo experiments showed that circular LINC-PINT and vSP27 could inhibit the growth of cancer and had no adverse effects on mice [202, 203] (Fig. 7d).
Given that circRNAs have the perfect characteristics of stable conformation, high stability, and special immunogenicity, RNA circle-based technologies were developed [9, 18, 67]. Recently, circRNAs harboring the translational capability of SARS-CoV-2 receptors were used to generate mRNA vaccines, such as the circRNA-RBD-Delta vaccine, which was used to protect against the COVID-19 pandemic [44] (Fig. 7e). However, few studies have investigated circRNAs with mRNA-based therapeutics in cancer treatment. It is a promising strategy to synthesize translational circRNAs with antineoplastic genes in cancer therapy. Similar to small antisense oligonucleotides, efficient introduction of circRNA into target cells is key to clinical implementation. To improve the delivery efficiency of circRNA delivery boxes, vectors can be replaced with lentiviruses or adeno-associated viruses [28, 54, 190, 196]. circRNA expression boxes in target cells may produce a large number of linear products in addition to target circRNA, which may adversely affect cells. We may directly introduce circRNA, which has been synthesized in vitro, into the target cells and deliver it with nonviral nanoparticles [45, 130, 192, 204]. However, in vitro circularized RNAs generally induce extra coding genes or sequences and often activate remarkable immune responses and other unknown side effects. Therefore, future studies may develop specific and effective approaches to improve circular RNA-based therapeutics.

Conclusions and perspectives

With advances in bioinformatics and biotechnologies, circRNA research has become an increasingly popular and important field [2, 5, 9, 10, 50, 99, 130]. There are many new insights into aspects of circRNA studies, including biogenesis, epigenetic regulation and degradation [4, 5, 9, 10, 67]. Increasing evidence has revealed that circRNAs have dysregulated expression patterns and diverse regulatory mechanisms underlying cellular processes and are always related to the pathogenesis of various diseases, including cancer [20, 130]. However, the study of the regulation, functions and biomedical application of these molecules is still at an early stage, and the complexity of circRNA already appears. For example, diverse biogenesis mechanisms of circRNAs are still emerging. Most annotated circRNAs are produced by back-splicing of pre-mRNA or intron self-splicing of small RNAs [5, 13, 148, 149]. With advances in deep sequencing, especially the development of long-read sequencing, a majority of novel circRNAs are generated by unknown splicing and differential locations on chromatin, such as from incomplete introns or exons with splicing complexity [100, 102, 127]. Some circRNAs were derived from intergenic sequences [50, 205]. The factors regulating these unknown production mechanisms of circRNA should be further delineated. In addition, although many significant advances in identification tools of circRNAs have appeared, it is still difficult to precisely define their length, location, and expression, which are always different from those in experimental validations. This is an important and challenging task in this field, which requires scientists to work together. Advanced parallel technologies will be helpful for circRNA discovery. Some open friendly comprehensive pipelines, such as Fcirc, may offer platforms for users to optimize the discovery tools of circRNAs [64, 89, 92].
The sequence overlaps of circRNAs with their cognate linear RNA sequences usually restrict the determination of circRNA functions [5, 11]. Although recent progress in biotechnologies for knockdown and knockout has been made, uncertain efficiency and off-targeting in si/shRNA or CRISPR/Cas series systems always occur. A recent design based on CRISPR‒Cas13 systems can improve the specificity of targeting BSJ sites [124, 129, 140, 141]. However, the efficiency of expression of Cas13 and sgRNA together is low in cells, especially in cells in suspension, which may restrict their widespread application. Importing some extra sequences and immunogenicity are two difficulties in circRNA overexpression in cells, which affect the application of circRNAs in biomedicine [18, 149]. Novel strategies for circRNA overexpression are urgently needed. In vitro synthesized circRNAs via T4 RNA ligase without extraneous fragments that present minimized immunogenicity may be developed to be a useful method to meet the sufficient quantity of circRNAs in biomedical applications [128].Kindly check and confirm the section headings are correct.Yes, we check and confirm the section headings are correct.
Considering the structural stability advantages, cancer-specific expression, and drug resistance exhibited by circRNAs, they hold significant promise as noninvasive biomarkers for cancer and as targets in cancer treatment [20, 67, 99, 130]. Nonetheless, in clinical practice, the challenge lies in determining the extraction and processing methods for test substances, hindering the quest to establish circRNA as the quickest and most precise biopsy marker for clinical assessments. Additionally, achieving precise in vivo delivery of si/shRNA-based knockdown or tumor suppressor circRNAs in anticancer therapy should be continually optimized. We hope that these issues can be addressed in future research.
The discovery of circRNA translation not only brings exciting new perspectives for translation machines but also brings novel design concepts for the treatment of major diseases based on circRNA translation [32, 62, 206]. The considerable intra- and extracellular stability of circRNA seems to make it a more ideal tool than other ncRNAs in many aspects of biomedical applications [62, 67]. A novel SARS-CoV-2 vaccine based on circRNA-RBD translation was able to produce a higher and longer-lasting antigen and induce a higher proportion of neutralizing antibodies than an mRNA vaccine [44]. However, circRNA-based protein translation strategies are still in the exploratory stage. Many problems remain unresolved. The most important problem is that the translation efficiency of circRNA based on IRES is low. Therefore, the common translational elements of circRNA need to be further optimized. For example, a team found that five elements upstream of the IRES topology, the 5′ PABP spacer, the HBA1 3′ UTR and the HRV-B3 IRES with proximal loop Apt-eIF4G insertion, can considerably improve the translational efficiency of circRNA in vivo [30]. In addition, the search for candidate proteins suitable for circRNA translation strategies should also be continued. A precision medicine approach based on personalized circRNA construction-candidate target-host may be possible in the future. The emergence of circRNA-based protein translation strategies has brought new directions to the field of biomedicine.

Acknowledgements

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Declarations

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Competing interests

The authors declare that they have no competing interests.
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Metadaten
Titel
New insight into circRNAs: characterization, strategies, and biomedical applications
verfasst von
Xin-Yi Feng
Shun-Xin Zhu
Ke-Jia Pu
Heng-Jing Huang
Yue-Qin Chen
Wen-Tao Wang
Publikationsdatum
01.12.2023
Verlag
BioMed Central
Erschienen in
Experimental Hematology & Oncology / Ausgabe 1/2023
Elektronische ISSN: 2162-3619
DOI
https://doi.org/10.1186/s40164-023-00451-w

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