Abstract

BackgroundOverexpression of erythropoietin (EPO) and EPO receptor (EPO-R) is associated with poor prognosis in non-small-cell lung carcinoma (NSCLC). Hypoxia, a potent EPO inducer, is a major stimulating factor in the growth of solid tumors. However, how EPO-R expression is regulated under hypoxia is largely unknown.MethodsThe role of EPO-R in NSCLC cell proliferation was assessed by RNA interference in vitro. Luciferase reporter assays were performed to map the promoter elements involved in the EPO-R mRNA transcription. Nuclear co-immunoprecipitation and chromatin immunoprecipitation were performed to assess the interaction among transcription factors HIF1α, SP1, and EGR1 in the regulation of EPO-R under hypoxia. The expression of key EPO-R transcription factors in clinical specimens were determined by immunohistochemistry.ResultsHypoxia induced a dosage and time dependent EPO-R mRNA expression in NSCLC cells. Knockdown of EPO-R reduced NSCLC cell growth under hypoxia (P < 0.05). Mechanistically, a SP1-EGR1 overlapped DNA binding sequence was essential to the hypoxia induced EPO-R transcription. In the early phase of hypoxia, HIF1α interacted with EGR1 that negatively regulated EPO-R. With the exit of EGR1 in late phase, HIF1α positively regulated EPO-R expression through additive interaction with SP1. In clinical NSCLC specimen, SP1 was positively while EGR1 was negatively associated with active EPO-R expression (P < 0.05).ConclusionsHIF1α, SP1 and EGR1 mediated EPO-R expression played an essential role in hypoxia-induced NSCLC cell proliferation. Our study presents a novel mechanism of EPO-R regulation in the tumor cells, which may provide information support for NSCLC diagnosis and treatment.Graphical abstract

Highlights

  • Overexpression of erythropoietin (EPO) and EPO receptor (EPO-R) is associated with poor prognosis in non-small-cell lung carcinoma (NSCLC)

  • Hypoxia-induced EPO-R is essential to NSCLC cell growth The upregulation of EPO-R reported in various solid tumors has raised safety concerns for the use of EPO or erythropoiesisstimulating agents (ESAs) to treat anemia in cancer patients

  • EPO-R was significantly overexpressed in NSCLC cell lines as compared with those of Human bronchial epithelial cell (HBEC) lines (Additional file 3: Figure S1A and S1B)

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Summary

Introduction

Overexpression of erythropoietin (EPO) and EPO receptor (EPO-R) is associated with poor prognosis in non-small-cell lung carcinoma (NSCLC). A potent EPO inducer, is a major stimulating factor in the growth of solid tumors. How EPO-R expression is regulated under hypoxia is largely unknown. Su et al Cell Communication and Signaling (2019) 17:152 including erythropoietin (EPO), which provide tumor cells with the device to maintain vigorous growth and expansion in a hypoxic microenvironment [6]. Recombinant EPO or erythropoiesisstimulating agents (ESAs) can accidentally stimulate the growth of EPO-R-positive tumors when used for treating tumor-related anemia suggesting the universality and importance of tumor-associated EPO-R expression [11,12,13,14,15]. The enhanced EPO signaling is found within hypoxic tumor regions with highest levels of EPO-R expression [16]. Unlike EPO, the mechanism of hypoxia-mediated EPO-R expression is not delineated

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