Abstract

BackgroundSp1, an important transcription factor, is involved in the progression of various cancers. Our previous studies have indicated that Sp1 levels are increased in the early stage of lung cancer progression but decrease during the late stage, leading to poor prognosis. In addition, estrogen has been shown to be involved in lung cancer progression. According to previous studies, Sp1 can interact with the estrogen receptor (ER) to coregulate gene expression. The role of interaction between Sp1 and ER in lung cancer progression is still unknown and will be clarified in this study.MethodsThe clinical relevance between Sp1 levels and survival rates in young women with lung cancer was studied by immunohistochemistry. We validated the sex dependence of lung cancer progression in EGFRL858R-induced lung cancer mice. Wound healing assays, chamber assays and sphere formation assays in A549 cells, Taxol-induced drug-resistant A549 (A549-T24) and estradiol (E2)-treated A549 (E2-A549) cells were performed to investigate the roles of Taxol and E2 in lung cancer progression. Luciferase reporter assays, immunoblot and q-PCR were performed to evaluate the interaction between Sp1, microRNAs and CD44. Tail vein-injected xenograft experiments were performed to study lung metastasis. Samples obtained from lung cancer patients were used to study the mRNA level of CD44 by q-PCR and the protein levels of Sp1 and CD44 by immunoblot and immunohistochemistry.ResultsIn this study, we found that Sp1 expression was decreased in premenopausal women with late-stage lung cancer, resulting in a poor prognosis. Tumor formation was more substantial in female EGFRL858R mice than in male mice and ovariectomized female mice, indicating that E2 might be involved in the poor prognosis of lung cancer. We herein report that Sp1 negatively regulates metastasis and cancer stemness in E2-A549 and A549-T24 cells. Furthermore, E2 increases the mRNA and protein levels of RING finger protein 4 (RNF4), which is the E3-ligase of Sp1, and thereby decreases Sp1 levels by promoting Sp1 degradation. Sp1 can be recruited to the promoter of miR-3194-5p, and positively regulate its expression. Furthermore, there was a strong inverse correlation between Sp1 and CD44 levels in clinical lung cancer specimens. Sp1 inhibited CD44 expression by increasing the expression of miR-3194-5p, miR-218-5p, miR-193-5p, miR-182-5p and miR-135-5p, ultimately resulting in lung cancer malignancy.ConclusionPremenopausal women with lung cancer and decreased Sp1 levels have a poor prognosis. E2 increases RNF4 expression to repress Sp1 levels in premenopausal women with lung cancer, thus decreasing the expression of several miRNAs that can target CD44 and ultimately leading to cancer malignancy.

Highlights

  • Sp1, an important transcription factor, is involved in the progression of various cancers

  • We investigated the relationship among the Sp1 level, sex and survival rate of 331 lung cancer cohorts, including 185 male and 146 female cohorts by Kaplan–Meier survival curves and hazard ratio (HR) (Figs. 1, 2 and Additional file 7: Table S2)

  • When we studied the relationship between the Sp1 level and survival rate in a sex-dependent manner, we found that women with late-stage lung cancer and low Sp1 levels had a worse prognosis (HR = 3.897) than men with late-stage lung cancer and low Sp1 levels (HR = 0.985) (Fig. 1C, middle and lower panels), indicating that Sp1 is involved in lung cancer progression in a sex-dependent manner

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Summary

Introduction

Sp1, an important transcription factor, is involved in the progression of various cancers. Our previous studies have indicated that Sp1 levels are increased in the early stage of lung cancer progression but decrease during the late stage, leading to poor prognosis. Previous studies have indicated that when female patients are analyzed based on hormonal status, premenopausal women have a worse prognosis than both men and postmenopausal women, suggesting that estrogen promotes lung cancer malignancy in premenopausal women [6]. Recent studies have indicated that some Asian women with lung cancer have a poor prognosis [7, 8], and this is a very difficult and complicated issue because it is related to many possible factors such as race and gender. Lung cancer is recognized as a different disease in women and men [10]. A detail understanding of why lung cancer in women leads to poor outcomes is very important and will be beneficial for the prevention of lung cancer in women [11]

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