MicroRNAs are considered as potential regulators in various biological pathways and contribute to the diagnosis and prognosis of cancers. MicroRNA-214-3p (miR-214-3p) was proved to be correlated with various cancers in recent studies. However, the biological functions of miR-214-3p in hepatocellular carcinoma (HCC) and its association with the prognosis of HCC after liver transplantation are still unevaluated. Here we intended to elucidate the functional implication of miR-214-3p in regulation of cell proliferation and apoptosis and its potential prediction of clinical prognosis of HCC patients.
Methods
Expressions of miR-214-3p in 98 HCC patients and three HCC cell lines were detected by quantitative reverse transcription PCR (qRT-PCR) to explore the association of miR-214-3p expression and clinicopathological characteristics. The effects of miR-214-3p on cell proliferation and apoptosis were examined by proliferation and flow cytometry assay, respectively. The direct target gene of miR-214-3p was also detected by luciferase reporter assay.
Results
The effects of miR-214-3p on cell proliferation and apoptosis were examined by proliferation and flow cytometry assay, respectively. The direct target gene of miR-214-3p was also detected by luciferase reporter assay. The results showed that miR-214-3p expression was downregulated in primary HCC samples compared with normal liver tissues, and was decreased in HCC recurrence species compared with non-recurrence controls (P = 0.001). Low miR-214-3p level was associated with poor overall survival (OS) (Log rank P = 0.003) and recurrence-free survival (RFS) (Log rank P = 0.007). Moreover, miR-214-3p precursor transfection resulted in decreased cell proliferation, cell cycle arrest at G1 phase, and enhanced cell apoptosis in HepG2 and HUH-7 cells. Further investigation showed that miR-214-3p could regulate its target gene maternal embryonic leucine zipper kinase (MELK) by directly binding to MELK-3′-UTR.
Conclusions
miR-214-3p suppresses HCC progression by directly down-regulating MELK expression, indicating a potential therapeutic target for the treatment and prognosis of HCC patients.
Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide with poor survival and unsatisfied prognosis [1‐3]. Over decades, the incidence of HCC has been dramatically increased especially in hepatitis B or C virus (HBV or HCV) infection induced phenotype [4]. Until now, surgical hepatic resection and liver transplantation are still the main curative treatment for HCC patients. Although great advances have been made in treatment and diagnosis, the prognosis of HCC remains limited, with its survival rates under 20% at 5 years [5]. Therefore, it’s an urgent need to understand the molecular mechanisms responsible for the pathogenesis of HCC and to identify effective treatment strategies. However, tumor recurrence rates remain a major concern for the exhibition of active hepatitis or cirrhosis in surrounding non-tumor liver tissues, even in patients who have received curative treatments [6, 7]. A better understanding of the molecular mechanisms that can distinguish progressive from non-progressive HCC is indispensable for exploring novel prognostic markers and therapeutic targets which may guide the surveillance after liver transplantation.
Recent evidences support that microRNAs (miRNAs) serve as potential indicators for diagnosis and prognosis of cancers [8]. miRNAs are small noncoding RNAs, which contain 20 ~ 23 nucleotides, processed from pri-miRNAs and contribute to post-transcriptional regulation of target gene expression through binding directly to the specific sequences of target genes’ 3′-UTRs [8]. Researches show that miRNAs have effects on cell proliferation, migration, and apoptosis via making a difference in the stability or translation of target mRNA. Additionally, miRNAs are considered as crucial participators in tumor progression through influencing multiple biological functions and pathways [9]. Previous study has demonstrated that miR-214-3p is correlated with tumor onset and progression [10]. It has been reported that miR-214-3p is downregulated in HCC tissues and closely related to fibrotic stages [11, 12]; however, the biological functions of miR-214-3p in HCC and its position in HCC prognosis after transplantation remain unclear.
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In our current study, the expression of miR-214-3p in the formalin-fixed paraffin-embedded (FFPE) tumor tissues from HCC patients was detected, and the correlation of miR-214-3p expression with lymph node metastasis, recurrence, pathological T stage, and age was analyzed as well. Moreover, a further insight into the function of miR-214-3p in regulating HCC cell proliferation, cell cycle, and apoptosis was gained by overexpressing miR-214-3p in human HCC cells.
Methods
Patients and tissue samples
A cohort of 98 patients undergoing liver transplantation for HCC was obtained with their follow-up data from the Nanfang Hospital of Southern Medical University from January 2006 to November 2011. All the patients were followed until December 2011. The median recurrence-free period was 12 months for patients with HCC recurrence compared to 65 months for patients without HCC recurrence. All of these 98 patients enrolled in this study met the transplantation criteria for HCC [13]. HCC samples were from the paraffin embedded archival tissue blocks and the normal liver tissues were from the liver hemangioma resection. The clinicopathological parameters of patients with HCC were summarized in Table 1. Informed consents from all patients were provided according to the protocols approved by the Institutional Review Boards of the Nanfang Hospital of Southern Medical University.
Table 1
Clinicopathology parameters in 98 HCC patients according to high- or low miR-214-3p expression level
Parameter
n
Low miR-214-3p expression
High miR-214-3p expression
P
Age
98
56.60 ± 6.14
54.06 ± 8.73
0.327*
Gender
Male
83
44
39
0.742#
Female
15
6
9
Liver disease
HBV
93
46
47
1.000∆
Others
5
3
2
Cirrhosis
Positive
94
46
48
1.000∆
Negative
4
2
2
Tumor stage
I + II
65
32
33
0.791#
III
33
18
15
Histologic grade
Differentiated
87
41
46
0.068∆
Undifferentiated
11
8
3
Milan criteria
In
53
23
30
0.163#
Out
45
26
19
Tumor size (cm)
≤ 4.5
59
24
35
0.016#
> 4.5
39
25
14
Multinodular
Positive
43
25
18
0.044#
Negative
55
24
31
Vascular invasion
Positive
22
16
6
0.025#
Negative
77
33
43
Serum AFP (ng/ml)
≤ 400
62
29
33
1.000#
> 400
36
19
17
Overall survival
41/98
11/49
30/49
HCC recurrence
57/98
37/49
20/49
AFP alpha-fetoprotein
* Unpaired student t-test; #Chi square test; ∆Fisher’s exact test
Cell culture and transfection
HepG2, HUH-7, SNU398 and L-O2 cell lines used in this study were purchased from the ATCC (Manassas, VA). All cells then were cultured in EMEM and supplemented with 10% (v/v) heat-inactivated fetal bovine serum (FBS, Gemini Bio-Products, Sacramento, CA) and antibiotics (98 U/ml penicillin and 98 μg/ml streptomycin) at 37 °C in a humidified atmosphere of 5% CO2. Double-stranded RNAs that mimic endogenous precursor miR-214-3p (Invitrogen-Life Technologies, Carlsbad, CA) as well as negative oligonucleotide control was transfected into cells using Oligofectamine (Thermo Scientific, Waltham, MA) according to the manufacturer’s instruction.
RNA isolation and Taqman real-time PCR
Total RNA was isolated and then reverse transcribed to cDNA with the stem-loop RT primer for miR-214-3p. miR-214-3p expression was normalized and quantificated using U6 small RNA as an internal control. For miR-214-3p analysis, primers were 5′-GCATCCTGCCTCCACATGCAT-3′ and 5′-GCGCTGAGGAATAATAG AGTATGTAT-3′. PCR primers for the internal control U6 were 5′-TGACTTCCAAG TACCATCGCCA-3′ and 5′-TTGTAGAGGTAGGTGTGCAGCAT-3′. The relative expression levels were calculated using the 2−ΔΔCt method. All the experiments were run in triplicate.
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Cell proliferation assay
Cell proliferation assay was carried out using cell Titer 96 Aqueous one Solution Cell Proliferation Assay (Promega, Madison, WI) follow in the manufacturer’s protocol. Three independent experiments were done.
Cell cycle analysis
HepG2 and HUH-7 cells were collected in the log phase of growth and incubated for 24 h. Then the cells were trypsinized, washed with PBS twice, and fixed overnight in cold 75% ethanol at 4 °C. After that, the fixed cells were stained with propidium iodide, follow by examination using flow cytometer (BD Biosciences, San Jose, CA). Finally, DNA histograms were analyzed with modified software. Three independent experiments were done.
Apoptosis analysis
A total of 5 × 105 cells were harvested and centrifuged for apoptotic evaluation. Propidium iodide (BD Bioscience) and the fluorescein isothiocyanate-conjugated (FITC) anti-human Annexin V Apoptosis Detection Kit I (BD Pharmingen) was used to characterize cells according to the manufacturer’s instructions. Labeled cells were detected using the fluorescence activated cell sorting (FACS) Aria II Cell Sorter System (BD Biosciences), followed by data analysis using the Diva program (BD Biosciences). Three independent experiments were done.
Luciferase activity assay
For luciferase reporter assay, HEK293T cells were cultured in 48-well plates and then cotransfected with 10 ng pGL3 cm-MELK-3′ UTR-Wt or pGL3 cm-MELK-3′ UTR-Mut, 30 pmol of miR-214-3p precursor or NC oligonucleotides, and 2 ng of pRL-TK (Ruibo, Guangzhou, China). After transfection for 72 h, cells were collected separately and then analyzed following the Dual-Luciferase Reporter Assay protocol (Promega, Madison, WI). The data were presented as relative luciferase activity. Three independent experiments were done.
Immunohistochemical (IHC) staining
Briefly, before antigen retrieval in citrate buffer, tissue sections were dewaxed and subsequently rehydrated in graded series of ethanols. After that, the sections were incubated overnight with antibody against MELK (Epitomics, Burlingame, USA; 1:200) at 4 °C, followed by incubation with an HRP-conjugated secondary antibody and DAB (Dako, Carpenteria, CA). DAB was used for color development, compared with dark brown staining was considered positive.
Western blot analysis
Cells were harvested and lysed in lysis buffer supplemented with proteinase inhibitor cocktail on ice for 20 min. Cell lysates were resolved by SDS-PAGE and transferred to PVDF membranes (Millipore). The membranes were blocked for 1 h in 5% non-fat dry milk and incubated with primary MELK (Epitomics, Burlingame, USA or GAPDH (Cell signaling technology, Danvers, USA) antibodies at 4 °C overnight. Then the membranes were incubated with HRP-conjugated secondary antibodies and detected with ECL Plus (Millipore).
Statistical analysis
The SPSS version 17.0 (SPSS Inc. Chicago, IL) was used for statistical analysis in this study. Comparisons between two groups were performed using Student’s t test. Correlations between clinicopathologic characteristics and immunohistochemical variables were analyzed using Chi square test or Fisher’s exact test. The Kaplan–Meier method was selected to graph survival curves. Log-rank statistic was applied to calculate the differences between the groups. The impact of prognostic factors on RFS and OS were analyzed by Cox proportional hazard models. A two-sided P value less than 0.05 was considered statistically significant.
Results
Downregulation of miR-214-3p in primary HCC tissues
We first determined miR-214-3p expression in HCC cell lines (HepG2, HUH-7 and SNU398) and a normal hepatic cell line (L-O2). Our results showed that miR-214-3p exhibited decreased expressions in HCC cell lines compared with L-O2 cells (Fig. 1a). To explore the clinical significance of miR-214-3p in HCC, the expression of miR-214-3p was examined in HCC tissues. The results showed that miR-214-3p expression in HCC tissues (n = 98) was dramatically lower in tumor recurrence patients than in non-recurrence patients (P = 0.020; Fig. 1b). Similarly, a significant reduction of miR-214-3p expression was observed in liver transplant recipients who died compared with that in the survived patients (P = 0.003; Fig. 1c).
Fig. 1
MiR-214-3p expression in HCC tissues and cell lines. a Expression of miR-214-3p in 98 HCC species, normal liver tissues, LO2, HUH-7, and SNU398 cell lines detected by qRT-PCR; b Expression of miR-214-3p in HCC samples of patients with or without tumor recurrence; c Expression of miR-214-3p in HCC samples of patients dead and survival
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Association of miR-214-3p expression with clinicopathological variables
In this study, we found that the decreased expression of miR-214-3p in HCC was closely link to various pathologic parameters, including tumor size (P = 0.016), multinodular HCC (P = 0.044), and vascular invasion (P = 0.025, Table 1).
Correlation of miR-214-3p in HCC with tumor recurrence and poor prognosis
Kaplan–Meier analysis showed that decreased miR-214-3p expression was connected with shorter OS (median survival 27 vs. 63 months, P = 0.003) and RFS (median survival 32 vs. 53 months P = 0.007) of liver transplant recipients (Fig. 2a and b). In multivariate analysis using a continuous variable Cox proportional hazards model, miR-214-3p expression was found to be predictive of outcomes independent of gender, age, and tumor stages (OS, P = 0.004; RFS, P = 0.018).
Fig. 2
Kaplan-Meier analyses of OS and RFS in 98 patients with HCC in high and low expression levels of miR-214-3p. a OS; b RFS. HCC patients were divided into miR-214-3p high and low expression groups based on the median fold-change values
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Effects of Pre214-3p transfection on cell proliferation
To uncover whether overexpression of miR-214-3p had an effect on cell proliferation, HepG2 and HUH-7 cells were transfected with miR-214-3p precursor (Pre214-3p) (Fig. 3a and b). Cell proliferation assay showed that the proliferation rate was decreased in HepG2 and HUH-7 cells with the inhibitory efficiencies were 42.5 and 36.2% after Pre214-3p transfection, respectively (Fig. 3c). Cell cycle analysis showed that compared with the control group, the percentages of G1-phase cells were increased in Pre214-3p-transfected HepG2 (P = 0.005) and HUH-7 cells (P = 0.012), while the percentages of S-phase cells were decreased both cell lines (P = 0.007 and P = 0.018) (Fig. 3d and e). Nevertheless, no statistical significance was found in the percentages of G2/M phase cells in HepG2 or HUH-7 cells compared with the control group (Fig. 3d and e). These results suggested that overexpression of miR-214-3p blocks cell cycle progression by inducing cell cycle arrest at G1 phase.
Fig. 3
MiR-214-3p overexpression inhibits cell proliferation and cell cycle progression in HUH-7 and HepG2 cells. a MiR-214-3p level in HUH-7 cell line; b MiR-214-3p level in HUH-7 cell line; c Proliferation assay of HCC cell lines after miR-214-3p overexpression. D: Influence of miR-214-3p on cell cycle progression of HUH-7 cell lines; e, d Influence of miR-214-3p on cell cycle progression of HepG2 cell lines (*P < 0.05; Student’s t-test)
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Effects of Pre214-3p transfection on apoptosis
Flow cytometry analysis was conducted to investigate whether miR-214-3p could induce apoptosis of HCC cells. Increasing apoptotic rates were observed in Pre214-3p-transfected HUH-7 (P = 0.012) and HepG cells (P = 0.008), compared with the control group (Fig. 4 a and b).
Fig. 4
MiR-214-3p overexpression induces apoptosis in HUH-7 and HepG2 cells analyzed by flow cytometry. a HUH-7 cells; b HepG2 cells (*P < 0.05; Student’s t-test)
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MiR-214-3p downregulates MELK expression by directly targeting its 3′-UTR
Moreover, potential targeted genes of miR-214-3p were predicted using online databases, i.e. TargetScan, PicTar, and miRanda. MELK was chosen for further experimental validation due to its frequent overexpression detected by the three databases and its unknown anti-apoptotic function. Dual-luciferase reporter analysis showed that enforced expression of miR-214-3p remarkably reduced the luciferase activity of the reporter gene with the WT construct rather than with the mutant MELK 3′-UTR construct (Fig. 5a and b). Moreover, overexpression of miR-214-3p in HepG2 and HUH-7 resulted in a reduced MELK expression (Fig. 5c). Similarly, HCC sample with decreased miR-214-3p showed higher MELK expression (Fig. 5d). Together, these results suggest that miR-214-3p downregulates MELK expression by targeting MELK 3′-UTR.
Fig. 5
MiR-214-3p down-regulates MELK expression. a WT and MUT of putative miR-214-3p target sequences of MELK 3′-UTR; b WT and MUT miR-214-3p target sequences were cotransfected with miR-214-3p precursor into HEK293T cells.; c Effects of miR-214-3p overexpression on the expression level of MELK in HepG2 and HUH-7 cells transfected with miR-214-3p by Western blot; d Expression of MELK and miR-214-3p in HCC tissues detected. Protein expression of MELK in HCC samples 1 and 2 was detected by IHC (× 200) while expression of miR-214-3p was determined using real-time PCR. 1, 2 refer to HCC sample 1 and 2. (*P < 0.05; Student’s t-test)
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Discussion
In recent decades, miRNAs have been considered as contributive regulators involved in transcriptional regulation, cell differentiation, tumorigenesis, and other biological processes [14]. Globally aberrant miRNA expression profiles of tumors have provided valuable insights into the molecular pathways of oncogenesis [15]. Nowadays, more than 2000 human miRNAs have been reported as regulational factors in cell proliferation, migration, and invasion of tumors [16]. Newly papers indicated that upregulation of miR-214-3p was found in breast cancer patients with osteolytic bone metastasis, and a knock-in miR-214-3p remarkably increased bone resorption by straightly targeting Traf3 to promote osteoclast activity and bone-resorbing activity [17, 18]. However, other studies demonstrated that miR-214-3p was significantly downregulated in two esophageal squamous cancer cell lines compared with esophageal epithelial cells [19]. Further investigations pointed out that downregulation of miR-214-3p suppressed chemoresistance in esophageal cancer cells by targeting both survivin and CUG-BP1 [20]. The anti-apoptotic Bcl-2 family member MELK/A1 is one of these PRDI-BF1/Blimp-1 target genes. MELK as a target of miR-214-3p provides a novel perspective on the mechanisms underlying HCC proliferation and resistance to apoptosis [21]. Abundant MELK expression was detected in the bone marrow as well as in some other tissues [22, 23]. Specifically, a connection was found in clinical samples between the MELK expression and the progression of stomach carcinoma [24].
Our studies showed that miR-214-3p expression was decreased in both HCC tissues and HCC cell lines, which were consistent with previous results [11]. It has been reported that miR-214-3p expression is strongly related to with fibrotic stages [12]. Interestingly, in this study, we found that miR-214-3p expression is also closely associated with recurrence and living status of liver transplant patients. Moreover, downregulation of miR-214-3p was associated with poor survival and tumor recurrence in HCC patients. Moreover, miR-214-3p restoration inhibited cell cycle progression and accelerated apoptosis in vitro. To our best knowledge, this is the first study showing that miR-214-3p regulates cellular proliferation in HCC cells and links to the prognosis of HCC. In all, this study shown that miR-214-3p was decreased in HCC tissues and the expression level of miR-214-3p might be a significant prognostic marker for HCC patients. Based on gain-of-function approach, it is suggested that miR-214-3p could remarkably block HCC cell proliferation and induce apoptosis in vitro by directly targeting MELK 3′-UTR.
Conclusions
Collectively, our data not only demonstrates novel insights regarding miR-214-3p function and the potential mechanisms of HCC cell proliferation, but also indicates a possible regulation pathway for MELK and a potential therapeutic strategy for HCC treatment.
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Authors’ contributions
LY carried out the experiments, and also revised the manuscript. LY and CY carried out the experiments and drafted the manuscript. XQ, DNN, DH and GYJ carried out the experiments. LCH participated in the design of the study and performed the statistical analysis. WSH conceived of the study, and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.
Acknowledgements
The authors thank statistical assistance provided by the Department of Laboratory Medicine, The Second Hospital of Hebei Medical University.
Competing interests
The authors declare that they have no competing interests.
Availability of data and materials
Please contact author for data requests.
Consent for publication
Informed consent was obtained from all individual participants included in the study.
Ethics approval and consent to participate
Ethical approval for this study was obtained from the institutional review board of the Nanfang Hospital of Southern Medical University.
Funding
This study was supported by the National Natural Science Foundation of China (No. 81201663) and the National Natural Science Foundation of China (No. 81360324).
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