Abstract

BackgroundAlthough gemcitabine-based chemotherapy has been established as a core multimodal therapy for non-small cell lung cancer (NSCLC) treatment, its clinical efficacy remains limited by the development of acquired resistance following tumor metastasis and relapse. In this study, we investigated how gemcitabine-resistant (GR) cells contribute to the development of NSCLC tumor malignancy via exosome-mediated transfer of microRNAs.MethodsWe first studied the mechanism of exosome internalization via PKH-67 staining and an immunofluorescence assay, then confirmed our finding by transmission electron microscopy and western blot analysis. Candidate miRNAs were identified through microarray analysis. Thereafter, RT-PCR, MTS, Transwell and soft agar assays were performed to assess the role of exosomic miR-222-3p in vitro. A 3’ untranslated region reporter assay was applied to identify the target of miR-222-3p. A lung metastasis mouse model was constructed to evaluate tumor growth and metastasis in vivo. Finally, clinical samples were used for correlation analysis between exosomic miR-222-3p levels and patients’ response to gemcitabine.ResultsA549-GR–derived exosomes were internalized by receipt cells via caveolin- and lipid raft-dependent endocytosis, which allowed the transfer of miR-222-3p. Exosomic miR-222-3p enhanced the proliferation, gemcitabine resistance, migration, invasion, and anti-anoikis of parental sensitive cells by directly targeting the promoter of SOCS3. In addition, a higher level of exosomic miR-222-3p in sera usually predicted worse prognosis in NSCLC patients.ConclusionOur data demonstrate that exosomic-miR-222-3p functions as a principal regulator of gemcitabine resistance and malignant characteristics by targeting SOCS3. The exosomic miR-222-3p level in sera may be a potential prognostic biomarker for predicting gemcitabine sensitivity in NSCLC patients.

Highlights

  • Gemcitabine-based chemotherapy has been established as a core multimodal therapy for non-small cell lung cancer (NSCLC) treatment, its clinical efficacy remains limited by the development of acquired resistance following tumor metastasis and relapse

  • A549-GR cell-derived exosome (GR-Exo) internalization is mediated through caveolin- and lipid raft-dependent endocytosis To identify the differences in characteristics between A549-GR and A549-P cells, we first measured the cell viability of each line after exposure to different concentrations of gemcitabine

  • Our results demonstrated that platinum has no influence on miR-222-3p expression with or without gemcitabine treatment in advance, which excludes the potential disturbance of platinum, indicating that NSCLC patients with a higher level of circulating exosomic miR-222-3p might experience worse tumor metastasis (P = 0.001)

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Summary

Introduction

Gemcitabine-based chemotherapy has been established as a core multimodal therapy for non-small cell lung cancer (NSCLC) treatment, its clinical efficacy remains limited by the development of acquired resistance following tumor metastasis and relapse. Gemcitabine-based chemotherapy is an established multimodal therapy for NSCLC treatment. Its clinical efficacy remains limited by the development of acquired resistance following tumor metastasis and relapse. MiR-21 was found to induce epithelial– mesenchymal transition (EMT) and gemcitabine resistance through activation of the PTEN/AKT pathway [2]. A recent study found that downregulation of miR-130a-3p can induce the EMT and malignancy of hepatocellular carcinoma cells via inhibition of Smad4 [3]. MiR-101-3p reverses gemcitabine resistance by inhibiting ribonucleotide reductase M1 in pancreatic cancer [4]

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