Abstract Disclosure: E.I. Ramos: None. B. Yang: None. M. Sedano: None. V. Reid: None. K. Diwa: None. A. Hidalgo: None. A. Beard: None. J. Patel: None. S.S. Gadad: None. Studies show that genes transcribed from chromosome X play critical roles in several biological processes. X-linked genes are tightly regulated and expressed in tissues protected from immune surveillance. However, several of them get dysregulated in diseases such as cancer. Intriguingly, genome-wide analyses showed their presence in the previously considered gene deserts in the human genome. Their direct role in estrogen transcription in tamoxifen-resistant breast cancer and biological outcomes are still unknown. To this end, we leveraged the power of functional genomics, including RNA with 4-thiouridine (4sU) coupled with RNA-sequencing and CRISPR-based genetic screening, to identify X-linked genes with a potential role in tamoxifen-directed estrogen-regulated transcription. Through a series of phenotypic assays, we selected a poorly studied transcript, “H19X,” with limited protein-coding potential; RNA-In-Situ-Hybridization revealed its localization to the nucleus. In the current study, we have identified the H19X-controlled estrogen-dependent gene regulatory mechanisms in tamoxifen-resistant estrogen receptor-positive (ER+) breast cancer cells. We manipulated the levels of H19X in tamoxifen-resistant ER+ breast cancer cells to generate a comprehensive list of direct transcripts using 4sU-RNA-seq. Interestingly, H19X regulates the expression of estrogen-driven intergenic, divergent, and antisense transcripts whose promoters are bound by ER-alpha (ERα) binding sites. Mechanistically, ‘Assay for Transposase-Accessible Chromatin using sequencing (ATAC-seq)’ revealed that H19X modulates chromatin structure at target regions to control gene expression. In addition, ‘chromatin immunoprecipitation (ChIP) with massively parallel DNA sequencing ChIP-seq’ (H3K27ac, H3K27me3) identified a critical role for H19X in controlling the epigenetic landscape in tamoxifen-resistant ER+ breast cancer cells. Collectively, our study sheds light on the molecular functions of X-linked genes and allows us to identify new diagnostic and therapeutic targets in tamoxifen-resistant ER+ breast cancer.S.S.G. is supported by grants from a) The Cancer Prevention and Research Institute of Texas (CPRIT; RR170020); b) Lizanell and Colbert Coldwell foundation; c) The Edward N. and Margaret G. Marsh Foundation; d) The American Cancer Society Presentation: Saturday, June 17, 2023
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