Home circNFATC3 facilitated the progression of oral squamous cell carcinoma via the miR-520h/LDHA axis
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circNFATC3 facilitated the progression of oral squamous cell carcinoma via the miR-520h/LDHA axis

  • Hongguo Xie and Xiaopeng Lu EMAIL logo
Published/Copyright: June 27, 2023

Abstract

The aim of this study was to verify the effects of circular RNA nuclear factor of activated T-cells, cytoplasmic 3 (circNFATC3), in oral squamous cell carcinoma (OSCC) development. The levels of circNFATC3, microRNA-520h (miR-520h), and lactate dehydrogenase A (LDHA) were measured by qRT-PCR and western blot analysis. The cellular functions were assessed by using commercial kits, MTT assay, EdU assay, flow cytometry analysis, and transwell assay. The interactions between miR-520h and circNFATC3 or LDHA were confirmed by dual-luciferase reporter assay. Finally, the mice test was enforced to evaluate the character of circNFATC3. We observed that the contents of circNFATC3 and LDHA were upregulated and miR-520h levels were downregulated in OSCC tissues compared with those in paracancerous tissues. For functional analysis, circNFATC3 knockdown repressed the cell glycolysis metabolism, cell proliferation, migration, and invasion, although it improved cell apoptosis in OSCC cells. LDHA could regulate the development of OSCC. circNFATC3 acted as a miR-520h sponge to modulate LDHA expression. In addition, the absence of circNFATC3 subdued tumor growth in vivo. In conclusion, circNFATC3 promoted the advancement of OSCC by adjusting the miR-520h/LDHA axis.

1 Introduction

Oral squamous cell carcinoma (OSCC) is a severe problem globally because of its most serious influence on the life quality of patients [1,2,3]. The survival rate of OSCC patients is merely 40–50% [4]. Although clinical treatment methods like surgical methods and chemoradiotherapy have been improved in decades, the treatment consequence is still unsatisfactory. Consequently, it is urgently indispensable to discover new therapies, especially targeting accurate pathogenesis. In recent years, molecular targeted therapy has developed gradually, but it is not mature. The specific mechanism also needs further study.

Circular RNAs (circRNAs) are a kind of regulatory RNAs, which are categorized by forming closed-loop structures through a covalent bond and could be stably present in organisms [5]. It has been reported that numerous circRNAs are specifically expressed in various tissues in humans and diversely expressed in cancer versus normal tissues, insinuating that they have specific functions in these cells [6,7,8,9,10]. For instance, the data indicate that circPVT1 is aberrantly upregulated and might increase the cell growth in OSCC [11]. Besides, circUHRF1 promotes the carcinomatous malevolent performance of OSCC cells [12]. Of note, a recent study suggested that the regulation of hsa_circ_0005615 (circNFATC3) in human cancer cells might alter proliferation and migration in vitro [13]. Some reports verified that the dysregulation of circNFATC3 was closely associated with cell malignant behaviors in hepatocellular carcinoma and gastric cancer [14,15]. Meanwhile, the upregulation of circNFATC3 was able to promote cervical cancer tumor development [16]. Nevertheless, the detailed supervisory effect and mechanism of circNFATC3 on OSCC are not clear, which needs further study.

In recent years, increasing research studies have been focused on the regulatory mechanism of circRNA-miRNA-mRNA in tumor progression [17]. The mechanism proposed is that circRNA might function as the competing endogenous RNAs (ceRNAs) to sequester miRNAs away from target mRNAs [18]. Furthermore, miRNAs are a kind of RNA that regulate cellular processes [19,20]. Some miRNAs of the miR-520 family have been testified in human tumors. For example, miR-520d-5p represses gastric cancer growth and miR-520h plays a vital role in breast cancer progression [21,22]. Besides, miR-520h has been verified to inhibit lung cancer cell malignant behaviors [23]. It has been reported that miR-520h was significantly under-expressed in oral tumors [24] but its precise role in OSCC development remains unclear.

Lactate dehydrogenase A (LDHA) is one of the key enzymes involved in glycolysis, which might convert pyruvate to lactate [25]. In the glycolytic pathway, the key role of LDHA is irrevocably changing pyruvate to lactate and converting NADH to NAD+. Of note, LDHA is highly expressed in many types of cancers [26,27]. As a crucial carcinogen, LDHA is particularly closely related to angiogenesis, tumor growth, and epithelial–mesenchymal transition in various tumors [28,29], containing OSCC [30]. In addition, it has been confirmed that overexpression of LDHA might boost OSCC cell proliferation, migration, and drug resistance [31,32].

Using bioinformatics software, it was shown that miR-520h has some binding sites with circNFATC3 or LDHA. Accordingly, we aimed to explore whether circNFATC3 was implicated in OSCC progression via the miR-520h/LDHA axis.

2 Materials and methods

2.1 Clinical tissue

Forty-six pairs of OSCC and paracancerous tissues were collected from patients who had undergone surgery at Jingmen No.1 People’s Hospital. None of the patients received any treatment before surgery (Table 1).

Table 1

Correlation between circNFATC3 expression and clinicopathological parameters of patients with OSCC

Clinical feature circNFATC3
n High (n = 23) Low (n = 23) P-Value
Age (years) 0.234
 ≥60 20 12 8
 <60 26 11 15
Gender 0.536
 Male 30 16 14
 Female 16 7 9
Tumor size 0.139
 <3 cm 21 8 13
 ≥3 cm 25 15 10
TNM stage 0.036*
 III–IV 27 17 10
 I–II 19 6 13
Differentiation 0.238
 Well/moderate 24 10 14
 Poor 22 13 9
Lymph node metastasis 0.017*
 Negative 20 6 14
 Positive 26 17 9

* P < 0.05.

  1. Ethics approval and consent to participate: The present study was approved by the ethical review committee of Jingmen No. 1 People’s Hospital. Written informed consent was obtained from all enrolled patients.

2.2 Cell lines

Human OSCC cell lines SCC25, HSC3, and SCC15 were used in this study. In addition, the human normal oral keratinocyte cell lines (HOK) were used as a control. SCC25 and SCC15 cells were acquired from American type culture collection (ATCC, Manassas, VA, USA). HSC3 and HOK cells were purchased from Cell Bank, Chinese Academy of Sciences (CAS, Shanghai, China). According to the instructions, SCC25 and SCC15 were cultured in the complete growth medium with 10% fetal bovine serum (FBS; Sigma-Aldrich, St. Louis, MO, USA). All cells were cultured with 5% CO2.

2.3 qRT-PCR

RNA was extracted with the Trizol reagent (Sigma). Then, the entire RNA of circNFATC3 and LDHA was reverse-transcribed to cDNA using the Prime Script RT reagent kit (Sigma). Meanwhile, miR-520h was reverse transcribed using the miRNA First-Strand Synthesis kit (Sigma). Next, cDNA was used for qRT-PCR with an SYBR Green kit (Sigma). GAPDH and RNU6 (U6) were used as endogenous controls. The primers were as follows: circNFATC3, F: 5′- ACCCTTTACCTGGAGCAAACC-3′ and R: 5′-TGTGGTAAGCAAAGTGGTGT-3′; NFATC3, F: 5′-TCCACCTCCATCTACTTTAACCA-3′ and R: 5′-TTGGGACCACCTAATGGGCT-3′; LDHA, F: 5′-GAGTGGAATGAATGTTGCTGGTGTC-3′ and R: 5′-CCAGGATGTGTAGCCTTTGAGTTTG-3′; miR-520h, F: 5′-TCGCGACAAAGTGCTTCCCT-3′ and R: 5′-GTGCAGGGTCCGAGGT-3′; GAPDH, F: 5′-TCCCATCACCATCTTCCAGG-3′ and R: 5′-GATGACCCTTTTGGCTCCC-3′; U6, F: 5′-CTCGCTTCGGCAGCACATATACT-3′ and R: 5′-ACGCTTCACGAATTTGCGTGTC-3′. Relative expression was processed using the 2−△△Ct method.

2.4 RNase R and actinomycin D assay

The SCC25 and HSC3 RNAs and cells were inactivated with RNase R (Sigma) or Act D (Sigma) according to the manufacturer’s instructions. Afterward, the RNA was used to reverse transcribe into cDNA, and the abundances of circNFATC3 and NFATC3 mRNA were examined by using qRT-PCR.

2.5 Western blot

Western blot analysis was performed as given by Shang et al. [33]. The antibodies were applied as follows: anti-LDHA (1:1,000; Santa Cruz Biotechnology, Santa Cruz, CA, USA), anti-MMP2 (1:1,000; Cell Signaling Technology), anti-Slug (1:1,000; Cell Signaling Technology), and anti-β-actin (1:5,000; Sigma).

2.6 Cell transfection

circNFATC3 expression was stably inhibited by lentiviral with shRNA. Lentivirus sh-circNFATC3 targeting circNFATC3 (sh-circNFATC3-1, sh-circNFATC3-2), and a non-specific control shRNA (sh-NC), miR-520h mimics (miR-520h), anti-miR-520h, controls, oe-LDHA, and vector were constructed by Sangon Biotech (Shanghai, China). These plasmids or oligonucleotides were transferred into SCC25 and HSC3 cells by using Lipofectamine 3000 (Sangon).

2.7 Glycolysis metabolism assay

SCC25 and HSC3 cells were planted into 6-well plates. After 24 h cultivation, the concentrations of glucose and lactate were detected by using Glucose Assay Kit and L-Lactate Assay Kit (Sigma), respectively, according to the manufacturer’s instructions.

2.8 Cell proliferation assay

SCC25 and HSC3 cells with diverse transfection were planted in 96-well plates. Cell proliferation was measured at 0, 1, 2, and 3 days using an MTT assay (Sigma). The absorbance was detected at 490 nm. Besides, the EdU Apollo Imaging Kit (Sigma) was used following the manufacturer’s instructions.

2.9 Flow cytometry assay

SCC25 and HSC3 cells were plated on the 6-well plates. Then, the cell apoptotic was assessed by using an Annexin V-FITC/PI kit (Sigma) following the manufacturer’s instructions.

2.10 Wound-healing assay

SCC25 and HSC3 cells were plated on 6-well plates. In simple terms, the cells were scratched with a germ-free pipette tip and then treated with FBS-free media for 24 h. The distance between two cell boundaries were measured.

2.11 Transwell assay

Transwell assay was used to investigate the influence of circNFATC3 deletion on cell invasion [34]. The invasive cells were counted under a microscope.

2.12 Dual-luciferase reporter assay

The combinative sites between miR-520h with circNFATC3 or LDHA 3′-UTR were analyzed by Starbase. The circNFATC3 or LDHA 3′UTR wild and mutant were manufactured by Sangon (WT-circNFATC3, WT-LDHA 3′UTR or MUT-circNFATC3, MUT-LDHA 3′UTR). The luciferase activity was examined using the Dual-Luciferase Reporter Assay Kit (Promega, Madison, WI, USA).

2.13 RIP assay

SCC25 and HSC3 cells were assayed using the Magna RIP kit (Sigma) following the manufacturer’s instructions. Finally, the circNFATC3 and miR-520h were quantified.

2.14 Xenograft models

All mice test processes were performed following the guidelines of the Animal Care and Use Committee of the Jingmen No.1 People’s Hospital. SCC25 cells (5 × 106) with sh-circNFATC3 or sh-NC were injected hypodermically into two groups of 4-week-old nude mice (n = 6 mice/group, Beijing Vital River Laboratory Animal Technology Co., Ltd., Beijing, China), respectively. The tumor volumes were observed every day and measured every 4 days: volume = (length × width2)/2. After 6 weeks, all mice were killed, and tumor nodes were resected for further examination.

2.15 IHC assay

The Ki67 (ab92742; 1:1,000; Abcam), Vimentin (ab92547; 1:1,000; Abcam), and c-caspase 3 (ab32351; 1:1,000; Abcam) abundances in the tumor were quantified by using the IHC assay. The explicit examination technique was in accordance with Ma et al. [35]. The sections were observed.

2.16 Statistical analysis

All statistics results were from three independent replications and were investigated using SPSS 23.0. Pearson’s correlation analysis was used to quantify the correlation. Shapiro–Wilk test was used to check for normality, and all data conformed to normal distribution. Student’s t-test and ANOVA were used to compare the statistical differences. P < 0.05 was significant.

3 Results

3.1 circNFATC3 was markedly augmented in OSCC

Initially, circNFATC3 is located at chr16:68155889-68157024 (Figure 1a). We addressed whether the abundance of circNFATC3 was abnormal in OSCC. circNFATC3 was significantly augmented in OSCC tumor tissues (n = 46) and cell lines (SCC25, HSC3, and SCC15) (Figure 1b and c). Based on the median of circNFATC3 expression in OSCC tissues, the patients were divided into high level of circNFATC3 group and low level of circNFATC3 group, and the high level of circNFATC3 was correlated with lower overall survival (Figure A1a). Furthermore, we found that circNFATC3 only enlarged in cDNA through divergent primers but not in gDNA (Figure 1d). Hence, to further explore the structure of circNFATC3, RNase R and Act D enzyme assay was performed to measure the structures of circNFATC3 and NFATC3 mRNA in OSCC cell lines (SCC25 and HSC3). In general, RNase R and Act D do not absorb circRNAs but absorb only linear RNAs [36]. As displayed in Figure 1e–g, NFATC3 mRNA was significantly decreased after digestion by RNase R and Act D when compared with circNFATC3. The results confirmed the cyclic structure of circNFATC3. These outcomes suggested that the circNFATC3 contents were augmented in OSCC and might take effect in OSCC. Besides, the circNFATC3 structure pattern was circRNAs.

Figure 1 
                  circNFATC3 was enhanced in OSCC. (a) The structure of circNFATC3. (b) The expression of circNFATC3 was detected. (c) The content of circNFATC3 in HOK, SCC25, HSC3, and SCC15 cells was examined. (d) The amplification of circNFATC3 and GAPDH. (e) The relative levels of circNFATC3 and NFATC3 mRNA were determined. (f and g) The circNFATC3 and NFATC3 mRNA levels were measured. **P < 0.01, ***P < 0.001.
Figure 1

circNFATC3 was enhanced in OSCC. (a) The structure of circNFATC3. (b) The expression of circNFATC3 was detected. (c) The content of circNFATC3 in HOK, SCC25, HSC3, and SCC15 cells was examined. (d) The amplification of circNFATC3 and GAPDH. (e) The relative levels of circNFATC3 and NFATC3 mRNA were determined. (f and g) The circNFATC3 and NFATC3 mRNA levels were measured. **P < 0.01, ***P < 0.001.

3.2 Silencing circNFATC3 induced cell apoptosis, while subdued glycolysis metabolism, cell proliferation, migration, and invasion in OSCC cells

SCC25 and HSC3 were transfected with sh-circNFATC3 (sh-circNFATC3-1, sh-circNFATC3-2), with sh-NC as the control. The transfection efficiency of sh-circNFATC3 was quantified by qRT-PCR. The results showed that circNFATC3 was significantly decreased in SCC25 and HSC3 cells by sh-circNFATC3 (Figure 2a). In addition, the knockdown of circNFATC3 significantly repressed glycolysis metabolism in SCC25 and HSC3 cells (Figure 2b and c). Next, circNFATC3 reduction notably decreased cell proliferation (Figure 2d–f). Besides, the absence of circNFATC3 encouraged cell apoptosis in SCC25 and HSC3 cells (Figure 2g and h). Subsequently, the absence of circNFATC3 subdued migration and invasion of SCC25 and HSC3 cells (Figure 2i–k). MMP2 and Slug were linked with the migration and invasion of OSCC cells [37,38]. Here, we identified that sh-circNFATC3 transfection conspicuously abridged the MMP2 and Slug levels in SCC25 and HSC3 cells (Figure 2l). Our results indicated that deficiency of circNFATC3 induced cell apoptosis, and suppressed cell glycolysis metabolism, cell proliferation, migration, and invasion of OSCC cells.

Figure 2 
                  The absence of circNFATC3 lack inhibited OSCC. (a) The silencing efficacy of circNFATC3 was assessed. (b and c) The levels of glycolysis metabolism were examined. (d–f) The impact of circNFATC3 deletion on the proliferation of SCC25 and HSC3 cells was illustrated. (g and h) Flow cytometry assay was carried out to explain the effects of circNFATC3 knockdown on the apoptosis of SCC25 and HSC3 cells. (i) The rate of wound healing was illustrated by the wound healing assay. (j and k) Transwell assay was enforced to investigate the influences of circNFATC3 deletion on cell invasion. (l) The levels of MMP2 and Slug were examined. **P < 0.01, ***P < 0.001.
Figure 2

The absence of circNFATC3 lack inhibited OSCC. (a) The silencing efficacy of circNFATC3 was assessed. (b and c) The levels of glycolysis metabolism were examined. (d–f) The impact of circNFATC3 deletion on the proliferation of SCC25 and HSC3 cells was illustrated. (g and h) Flow cytometry assay was carried out to explain the effects of circNFATC3 knockdown on the apoptosis of SCC25 and HSC3 cells. (i) The rate of wound healing was illustrated by the wound healing assay. (j and k) Transwell assay was enforced to investigate the influences of circNFATC3 deletion on cell invasion. (l) The levels of MMP2 and Slug were examined. **P < 0.01, ***P < 0.001.

3.3 MiR-520h targeted circNFATC3 in OSCC cells

Starbase and Circinteractome were used to forecast the miRNAs of circNFATC3 (among the 8 miRNAs with an intersection, two miRNAs differentially expressed in OSCC were reported: miR-520h and miR-149-5p) (Figure 3a). Then, the relative levels of miR-520h and miR-149-5p in SCC25 and HSC3 after transfection with sh-circNFATC3 and sh-NC were determined by qRT-PCR. Expression analysis showed that the expressions of the two miRNA were notably impaired, and the expression of miR-520h was significantly increased. Therefore, miR-520h was used in the following experiments (Figure 3b). We addressed whether the expression of miR-520h was abnormal in OSCC tissues. The qRT-PCR results indicated that miR-520h was significantly lesser in OSCC tumor tissues (n = 46) than that in paracancer tissues (n = 46) (Figure 3c). In addition, Pearson’s correlation analysis indicated that miR-520h was negatively correlated with circNFATC3 in OSCC tissues (Figure 3d), and its expression displayed a low expression in OSCC cells relative to their respective controls (Figure 3e). As shown in Figure 3f, there were some combinative sites between circNFATC3 and miR-520h, which were subsequently confirmed by using dual-luciferase reporter assay. Consequences revealed that miR-520h notably increased the abundances of miR-520h in OSCC cells (Figure 3g). In addition, results revealed that the luciferase activity was decreased in OSCC cells co-transfected with WT-circNFATC3 and miR-520h. However, there was no change in luciferase activity after co-transfection with MUT-circNFATC3 and miR-NC (Figure 3h and i). RIP assays further confirmed the targeted relationship of miR-520h and circNFATC3 (Figure 3j and k). The above experimental results showed that there was a clear targeting relationship between miR-520h and circNFATC3. In a word, the results revealed that circNFATC3 served as a miR-520h sponge in OSCC, and it could play a crucial role in OSCC growth.

Figure 3 
                  circNFATC3 as a miR-520h sponge. (a) The targeted binding of circNFATC3 and miRNAs was forecast by Starbase and Circinteractome. (b) The effects of knockdown circNFATC3 and miR-520h expression in OSCC cells. (c) The abundance of miR-520h in OSCC tumor tissues (n = 46) and paracancerous tissues (n = 46) was measured. (d) Pearson’s correlation analysis showed that circNFATC3 was negatively associated with miR-520h in OSCC tumor tissues (R = −0.729). (e) The content of miR-520h in OSCC cells was examined. (f) The binding sequence between circNFATC3 and miR-520h was predicted by Targetscan 7.0. (g) The overexpression efficiency of miR-520h in OSCC cells was examined by qRT-PCR. (h  and i) Dual-luciferase reporter assay was used to reveal the relationship between circNFATC3 and miR-520h. (j and k) RIP analysis proved that circNFATC3 was abundantly pulled down by anti-Ago2 antibodies when transfected with miR-520h mimics in OSCC cells versus the miR-520h NC and the IgG group. *P < 0.05, ***P < 0.001.
Figure 3

circNFATC3 as a miR-520h sponge. (a) The targeted binding of circNFATC3 and miRNAs was forecast by Starbase and Circinteractome. (b) The effects of knockdown circNFATC3 and miR-520h expression in OSCC cells. (c) The abundance of miR-520h in OSCC tumor tissues (n = 46) and paracancerous tissues (n = 46) was measured. (d) Pearson’s correlation analysis showed that circNFATC3 was negatively associated with miR-520h in OSCC tumor tissues (R = −0.729). (e) The content of miR-520h in OSCC cells was examined. (f) The binding sequence between circNFATC3 and miR-520h was predicted by Targetscan 7.0. (g) The overexpression efficiency of miR-520h in OSCC cells was examined by qRT-PCR. (h and i) Dual-luciferase reporter assay was used to reveal the relationship between circNFATC3 and miR-520h. (j and k) RIP analysis proved that circNFATC3 was abundantly pulled down by anti-Ago2 antibodies when transfected with miR-520h mimics in OSCC cells versus the miR-520h NC and the IgG group. *P < 0.05, ***P < 0.001.

3.4 circNFATC3 contributed to OSCC via miR-520h

To further study the effects of circNFATC3 and miR-520h on OSCC progression, we first identified the interfering efficiency of miR-520h inhibitors. Primarily, qRT-PCR indicated that the abundances of miR-520h were diminished by miR-520h inhibitors in SCC25 and HSC3 cells (Figure 4a). Meanwhile, we found that circNFATC3 knockdown increased the expression of miR-520h in SCC25 and HSC3 cells, while this influence was diminished by miR-520h inhibitor (Figure 4b). Afterward, circNFATC3 silencing significantly repressed glycolysis metabolism in SCC25 and HSC3 cells, but this impact was partially attenuated by miR-520h knockdown (Figure 4c and d). Subsequently, miR-520h knockdown decreased the inhibition effects of circNFATC3 silencing on cell proliferation in SCC25 and HSC3 cells (Figure 4e–g). On the other hand, the miR-520h inhibitor sectionally restored the promotion effect of circNFATC3 inhibition on cell apoptosis (Figure 4h). Consistent with these observations, miR-520h inhibitors restrained the suppression impacts of circNFATC3 silencing on cell migration and invasion in SCC25 and HSC3 cells (Figure 4i–k). We further performed Western blot assay, which showed that miR-520h inhibitors restrained the repression impacts of circNFATC3 silencing on the expression of MMP2 and Slug in SCC25 and HSC3 cells (Figure 4l).

Figure 4 
                  circNFATC3 expedited OSCC via miR-520h. (a) The interfering efficiency of miR-520h was determined in SCC25 and HSC3 cells. (b) The miR-520h expression was examined in SCC25 and HSC3 cells. (c and d) The levels of glycolysis metabolism, (e–g) the level of cell proliferation, (h) the apoptosis, (i) the rate of wound healing, (j and k) the number of invaded cells, and (l) the protein level of MMP2 and Slug were examined. *P < 0.05, **P < 0.01, ***P < 0.001.
Figure 4

circNFATC3 expedited OSCC via miR-520h. (a) The interfering efficiency of miR-520h was determined in SCC25 and HSC3 cells. (b) The miR-520h expression was examined in SCC25 and HSC3 cells. (c and d) The levels of glycolysis metabolism, (e–g) the level of cell proliferation, (h) the apoptosis, (i) the rate of wound healing, (j and k) the number of invaded cells, and (l) the protein level of MMP2 and Slug were examined. *P < 0.05, **P < 0.01, ***P < 0.001.

3.5 MiR-520h targeted LDHA in SCC25 and HSC3 cells

First, the expression of some predicted target mRNAs of miR-520h was detected, and LDHA was the most significantly downregulated by miR-520h (Figure A1b). Besides, LDHA levels were significantly increased in OSCC tissues compared to paracancer tissues (Figure 5a and b). Besides, Pearson’s correlation analysis showed that miR-520h was negatively correlated with the LDHA, but circNFATC3 was positively correlated with the LDHA (Figure 5c and d). Furthermore, LDHA abundances were significantly enhanced in OSCC cells (Figure 5e). The target gene of miR-520h was confirmed in this part. StarBase v2.0 online database was used to envisage the combinative sites of miR-520h in LDHA 3′-UTR (Figure 5f). Dual-luciferase reporter assay indicated that the luciferase activity in the WT-LDHA 3′-UTR group was significantly reduced by miR-520h. Yet the luciferase activity of the MUT-LDHA 3′-UTR group was not dramatically altered by miR-520h (Figure 5g and h). RIP assay results confirmed the interaction between miR-520h and LDHA (Figure 5i and j). The above experimental results showed that there was a clear targeting relationship between miR-520h and LDHA. Western blot assay was used to reveal that the protein expression of LDHA was memorably upregulated due to LDHA overexpression (Figure 5k). We further performed a Western blot assay, which showed that LDHA reversed the inhibition influences of miR-520h mimics or reduced the abundances of LDHA in SCC25 and HSC3 cells (Figure 5l). At the same time, we found that miR-520h inhibitor attenuated the suppression impacts of sh-circNFATC3 or abridged the contents of LDHA in SCC25 and HSC3 cells (Figure 5m).

Figure 5 
                  miR-520h targets LDHA in SCC25 and HSC3 cells. (a) The contents of LDHA in OSCC tumor tissues (n = 46) and paracancerous tissues (n = 46) were quantified. (b) The abundances of LDHA in OSCC tumor tissues and paracancerous tissues were measured. (c) Pearson’s correlation analysis showed that miR-520h was negatively linked with LDHA in OSCC tumor tissues (R = −0.625). (d) Pearson’s correlation analysis showed that circNFATC3 was positively linked with LDHA in OSCC tumor tissues (R = 0.687). (e) The level of LDHA in OSCC cells was measured. (f) The connective site between miR-520h and LDHA. (g and h) The association of miR-520h and LDHA. (i and j) RIP analysis proved the relationship between miR-520h and LDHA. (k) The effectiveness of LDHA overexpression was ensured by Western blot analysis. (l and m) The content of LDHA was distinguished. **P < 0.01, ***P < 0.001.
Figure 5

miR-520h targets LDHA in SCC25 and HSC3 cells. (a) The contents of LDHA in OSCC tumor tissues (n = 46) and paracancerous tissues (n = 46) were quantified. (b) The abundances of LDHA in OSCC tumor tissues and paracancerous tissues were measured. (c) Pearson’s correlation analysis showed that miR-520h was negatively linked with LDHA in OSCC tumor tissues (R = −0.625). (d) Pearson’s correlation analysis showed that circNFATC3 was positively linked with LDHA in OSCC tumor tissues (R = 0.687). (e) The level of LDHA in OSCC cells was measured. (f) The connective site between miR-520h and LDHA. (g and h) The association of miR-520h and LDHA. (i and j) RIP analysis proved the relationship between miR-520h and LDHA. (k) The effectiveness of LDHA overexpression was ensured by Western blot analysis. (l and m) The content of LDHA was distinguished. **P < 0.01, ***P < 0.001.

3.6 MiR-520h curbed the OSCC via LDHA

To further explore whether miR-520h inhibited the progression of OSCC cells by targeting LDHA, we transfected the miR-520h mimic, NC mimic, miR-520h mimic + pcDNA, and miR-520h mimic + LDHA in SCC25 and HSC3 cells. Afterward, the miR-520h mimic significantly repressed glycolysis metabolism in SCC25 and HSC3 cells, whereas this influence was partially decreased by LDHA (Figure 6a and b). MiR-520h reduced the proliferation of SCC25 and HSC3 cells, but there was a positive conclusion of LDHA (Figure 6c–e). Moreover, by flow cytometry analysis, we established that miR-520h mimics expedited cell apoptosis in SCC25 and HSC3 cells, and this influence was inhibited by LDHA (Figure 6f). In addition, the migration and invasion of SCC25 and HSC3 cells were suppressed by the miR-520h mimic; however, LDHA overexpression could partially abolish these impacts. (Figure 6g and h). We further performed the Western blot assay, which showed that the expression of MMP2 and Slug in SCC25 and HSC3 cells were diminished by miR-520h mimic, whereas LDHA overexpression could partly decrease these influences (Figure 6i). In brief, all these results demonstrated that miR-520h adjusted the cell glycolysis metabolism, viability, colony formation, cell migration, and apoptosis of OSCC cells via LDHA.

Figure 6 
                  miR-520h adjusted OSCC via LDHA. (a and b) The levels of glycolysis metabolism, (c–e) cell proliferation, (f) apoptosis, (g) the rate of wound healing, (h) the invaded cells, and (i) the protein level of MMP2 and Slug were examined. **P < 0.01, ***P < 0.001.
Figure 6

miR-520h adjusted OSCC via LDHA. (a and b) The levels of glycolysis metabolism, (c–e) cell proliferation, (f) apoptosis, (g) the rate of wound healing, (h) the invaded cells, and (i) the protein level of MMP2 and Slug were examined. **P < 0.01, ***P < 0.001.

3.7 circNFATC3 contributed to OSCC by regulating LDHA

Primarily, qRT-PCR indicated that the LDHA level was diminished by the absence of circNFATC3 but increased by LDHA (Figure 7a). Afterward, circNFATC3 silencing significantly repressed glycolysis metabolism in SCC25 and HSC3 cells, but this impact was partially attenuated by enhanced LDHA (Figure 7b and c). Subsequently, the enhanced LDHA decreased the inhibition effects of circNFATC3 silencing on cell proliferation (Figure 7d–f). On the other hand, LDHA sectionally restored the promotion effect of circNFATC3 inhibition on cell apoptosis (Figure 7g). Consistent with these observations, LDHA restrained the suppression impacts of circNFATC3 silencing on cell migration and invasion in SCC25 and HSC3 cells (Figure 7h–k). We further performed the Western blot assay, which showed that LDHA restrained the inhibition impacts of circNFATC3 silencing on the expression of MMP2 and Slug in SCC25 and HSC3 cells (Figure 7l).

Figure 7 
                  circNFATC3 contributed to OSCC by regulating LDHA. (a) The LDHA expression was examined in SCC25 and HSC3 cells. (b and c) The levels of glycolysis metabolism, (d–f) the level of cell proliferation, (g) apoptosis, (h and i) the rate of wound healing, (j and k) the number of invaded cells, and (l) the protein levels of MMP2 and Slug were examined. *P < 0.05, **P < 0.01, ***P < 0.001.
Figure 7

circNFATC3 contributed to OSCC by regulating LDHA. (a) The LDHA expression was examined in SCC25 and HSC3 cells. (b and c) The levels of glycolysis metabolism, (d–f) the level of cell proliferation, (g) apoptosis, (h and i) the rate of wound healing, (j and k) the number of invaded cells, and (l) the protein levels of MMP2 and Slug were examined. *P < 0.05, **P < 0.01, ***P < 0.001.

3.8 The absence of circNFATC3 harmed tumor growth in vivo

As presented in Figure 8a and b, the SCC25 cells with sh-circNFATC3 or negative control (sh-NC) were hypodermically injected into athymic nude mice, respectively. Subsequently, we established that intratumoral injection of sh-circNFATC3 blocked tumor volume and weight. Additionally, circNFATC3 and LDHA contents were abridged, although miR-520h was amplified in the sh-circNFATC3 group (Figure 8c and d). The outcomes of IHC revealed that the Ki67 and Vimentin abundances were lesser, but c-caspase 3 contents were higher in the sh-circNFATC3 group, which indicated that the absence of circNFATC3 subdued tumor growth and invasiveness but promoted apoptosis in vivo (Figure 8e). These results indicate the absence of circNFATC3 subdued xenograft tumor growth via the miR-520h/LDHA axis.

Figure 8 
                  circNFATC3 knockdown restricted tumor growth. (a and b) Tumor volumes and weight was measured. (c) The contents of circNFATC3 and miR-520h were measured. (d) The LDHA level was quantified. (e) IHC analysis was applied to measure Ki67, Vimentin, and c-caspase 3 contents. *P < 0.05.
Figure 8

circNFATC3 knockdown restricted tumor growth. (a and b) Tumor volumes and weight was measured. (c) The contents of circNFATC3 and miR-520h were measured. (d) The LDHA level was quantified. (e) IHC analysis was applied to measure Ki67, Vimentin, and c-caspase 3 contents. *P < 0.05.

4 Discussion

Herein, we aimed to clarify the function and mechanism of circNFATC3 in OSCC malignancy. In the current research, circNFATC3 might act as an oncogene in OSCC via the miR-520h/LDHA axis.

OSCC is a type of cancer that accounts for about 90% of all oral malignancies and comprises cancers in the mouth and oropharynx [39]. Worldwide, the incidence ranks OSCC among the top three of all cancers in some Asia-Pacific countries [40]. Although the OSCC is frequently identified at an advanced stage, the 5-year overall survival rate of OSCC cases is appraised to be 50–60% [41]. Consequently, it is of great significance to study the molecular mechanism of the pathogenesis of OSCC in this article. This research clarified that circNFATC3 facilitated OSCC progression via the miR-520h/LDHA axis. By competitively binding to miR-520h, circNFATC3 could relieve the latter’s transcriptional inhibition of LDHA protein and improve the transcription and protein expression of LDHA, thus promoting the development of OSCC cells.

Previous studies discovered that some circRNAs served as an imperative part in the advancement of OSCC. Liu et al. uncovered that circIGHG promoted OSCC by tempting epithelial-to-mesenchymal changeover [42]. Su et al. reported that circPHIP supported OSCC by adjusting PHIP and ACTN4 expression, which was related to tumor metastasis and the TNM stage [43]. Additionally, circBICD2 knockdown suppressed OSCC cell proliferation, glycolysis, migration, and invasion but facilitated apoptosis [44]. In this study, we found that circNFATC3 acted as a tumor promoter and its deficiency might induce OSCC cell apoptosis and subdue cell glycolysis metabolism, cell proliferation, migration, and invasion. In addition, our study on mice further discovered that knockdown circNFATC3 attenuated tumor growth. CircRNAs might impact protein-coding genes, which are competitive sponging for miRNAs. For example, circIGHG, circBICD2, and circPHIP could promote OSCC by sponging miR-142-5p [42,43,44]. In this study, circNFATC3 was exposed to elevate OSCC via miR-520h.

MiR-520h facilitated protein kinase 2 (DAPK2), which was associated with cell death [22]. Moreover, miR-520h affected the progression of lung cancer [23]. Furthermore, miR-520h also adjusted metastasis in cervical cancer [45]. These conclusions uncovered that miR-520h played a key role in the progression of human cancers. In this experiment, we proved that miR-520h regulated the advancement of OSCC. We also revealed the suppressive character of miR-520h in glycolysis metabolism, proliferation, and cell migration by targeting LDHA. The results indicated that miR-520h might link with the progress of OSCC, in agreement with C. M. Su et al.’s findings.

It was previously reported that LDHA promoted tumor growth and enhanced cancer cell metabolism [46]. LDHA silencing exposed a connection between glycolysis and tumor preservation [47]. Knockdown of LDHA also restrained metastasis of hepatocellular carcinoma cells and tumor growth [48]. In this study, LDHA contents were significantly increased in OSCC compared to that in paracancerous tissues and cells. In addition, we found that miR-520h repressed cell glycolysis metabolism, proliferation, cell migration, and invasion, and these influences were weakened by LDHA overexpression. We revealed that the absence of miR-520h alleviated the inhibitory conclusion of the absence of circNFATC3 on LDHA contents in OSCC cells. These results further supported the regulatory role of circNFATC3/miR-520h/LDHA in OSCC cells. This study had some insightful findings though it still had some limitations. For instance, the results and conclusions obtained from commercial cell lines are not fully representative of the actual conditions, which also lacks clinical statistical support. In the next step, we will further verify the role of circNFATC3 in clinical application.

In summary, the results indicated that circNFATC3 and LDHA levels increased while miR-520h content decreased in OSCC. Besides, our research first demonstrated that the absence of circNFATC3 suppressed OSCC cell glycolysis metabolism, proliferation, cell migration, and invasion by regulating the miR-520h/LDHA axis. This mode should be further confirmed by clinical research in the future. We trust that this information might deliver a new contrivance for improving OSCC treatments.


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Acknowledgement

Not applicable

  1. Funding information: No funding was received.

  2. Conflict of interest: The authors declare that they have no competing interest.

  3. Data availability statement: The analyzed data sets generated during the present study are available from the corresponding author on reasonable request.

Appendix

Figure A1 
                  High level of circNFATC3 was correlated with lower overall survival, and the reasons for the introduction of LDHA. (a) The correlation between circNFATC3 expression and overall survival was analyzed. (b) The expression of predicted target mRNAs of miR-520h was detected in SCC25 cells transfected with NC mimic or miR-520h mimic.
Figure A1

High level of circNFATC3 was correlated with lower overall survival, and the reasons for the introduction of LDHA. (a) The correlation between circNFATC3 expression and overall survival was analyzed. (b) The expression of predicted target mRNAs of miR-520h was detected in SCC25 cells transfected with NC mimic or miR-520h mimic.

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Received: 2022-08-12
Revised: 2022-11-16
Accepted: 2023-01-05
Published Online: 2023-06-27

© 2023 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  86. Midazolam impedes lung carcinoma cell proliferation and migration via EGFR/MEK/ERK signaling pathway
  87. Network pharmacology combined with molecular docking and experimental validation to reveal the pharmacological mechanism of naringin against renal fibrosis
  88. PTPN12 down-regulated by miR-146b-3p gene affects the malignant progression of laryngeal squamous cell carcinoma
  89. miR-141-3p accelerates ovarian cancer progression and promotes M2-like macrophage polarization by targeting the Keap1-Nrf2 pathway
  90. lncRNA OIP5-AS1 attenuates the osteoarthritis progression in IL-1β-stimulated chondrocytes
  91. Overexpression of LINC00607 inhibits cell growth and aggressiveness by regulating the miR-1289/EFNA5 axis in non-small-cell lung cancer
  92. Subjective well-being in informal caregivers during the COVID-19 pandemic
  93. Nrf2 protects against myocardial ischemia-reperfusion injury in diabetic rats by inhibiting Drp1-mediated mitochondrial fission
  94. Unfolded protein response inhibits KAT2B/MLKL-mediated necroptosis of hepatocytes by promoting BMI1 level to ubiquitinate KAT2B
  95. Bladder cancer screening: The new selection and prediction model
  96. circNFATC3 facilitated the progression of oral squamous cell carcinoma via the miR-520h/LDHA axis
  97. Prone position effect in intensive care patients with SARS-COV-2 pneumonia
  98. Clinical observation on the efficacy of Tongdu Tuina manipulation in the treatment of primary enuresis in children
  99. Dihydroartemisinin ameliorates cerebral I/R injury in rats via regulating VWF and autophagy-mediated SIRT1/FOXO1 pathway
  100. Knockdown of circ_0113656 assuages oxidized low-density lipoprotein-induced vascular smooth muscle cell injury through the miR-188-3p/IGF2 pathway
  101. Low Ang-(1–7) and high des-Arg9 bradykinin serum levels are correlated with cardiovascular risk factors in patients with COVID-19
  102. Effect of maternal age and body mass index on induction of labor with oral misoprostol for premature rupture of membrane at term: A retrospective cross-sectional study
  103. Potential protective effects of Huanglian Jiedu Decoction against COVID-19-associated acute kidney injury: A network-based pharmacological and molecular docking study
  104. Clinical significance of serum MBD3 detection in girls with central precocious puberty
  105. Clinical features of varicella-zoster virus caused neurological diseases detected by metagenomic next-generation sequencing
  106. Collagen treatment of complex anorectal fistula: 3 years follow-up
  107. LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through down-regulating SP-A by sponging to miR-424
  108. Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen – An open-label, randomized trial
  109. SMOC2 plays a role in heart failure via regulating TGF-β1/Smad3 pathway-mediated autophagy
  110. A prospective cohort study of the impact of chronic disease on fall injuries in middle-aged and older adults
  111. circRNA THBS1 silencing inhibits the malignant biological behavior of cervical cancer cells via the regulation of miR-543/HMGB2 axis
  112. hsa_circ_0000285 sponging miR-582-3p promotes neuroblastoma progression by regulating the Wnt/β-catenin signaling pathway
  113. Long non-coding RNA GNAS-AS1 knockdown inhibits proliferation and epithelial–mesenchymal transition of lung adenocarcinoma cells via the microRNA-433-3p/Rab3A axis
  114. lncRNA UCA1 regulates miR-132/Lrrfip1 axis to promote vascular smooth muscle cell proliferation
  115. Twenty-four-color full spectrum flow cytometry panel for minimal residual disease detection in acute myeloid leukemia
  116. Hsa-miR-223-3p participates in the process of anthracycline-induced cardiomyocyte damage by regulating NFIA gene
  117. Anti-inflammatory effect of ApoE23 on Salmonella typhimurium-induced sepsis in mice
  118. Analysis of somatic mutations and key driving factors of cervical cancer progression
  119. Hsa_circ_0028007 regulates the progression of nasopharyngeal carcinoma through the miR-1179/SQLE axis
  120. Variations in sexual function after laparoendoscopic single-site hysterectomy in women with benign gynecologic diseases
  121. Effects of pharmacological delay with roxadustat on multi-territory perforator flap survival in rats
  122. Analysis of heroin effects on calcium channels in rat cardiomyocytes based on transcriptomics and metabolomics
  123. Risk factors of recurrent bacterial vaginosis among women of reproductive age: A cross-sectional study
  124. Alkbh5 plays indispensable roles in maintaining self-renewal of hematopoietic stem cells
  125. Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients
  126. Correlation between microvessel maturity and ISUP grades assessed using contrast-enhanced transrectal ultrasonography in prostate cancer
  127. The protective effect of caffeic acid phenethyl ester in the nephrotoxicity induced by α-cypermethrin
  128. Norepinephrine alleviates cyclosporin A-induced nephrotoxicity by enhancing the expression of SFRP1
  129. Effect of RUNX1/FOXP3 axis on apoptosis of T and B lymphocytes and immunosuppression in sepsis
  130. The function of Foxp1 represses β-adrenergic receptor transcription in the occurrence and development of bladder cancer through STAT3 activity
  131. Risk model and validation of carbapenem-resistant Klebsiella pneumoniae infection in patients with cerebrovascular disease in the ICU
  132. Calycosin protects against chronic prostatitis in rats via inhibition of the p38MAPK/NF-κB pathway
  133. Pan-cancer analysis of the PDE4DIP gene with potential prognostic and immunotherapeutic values in multiple cancers including acute myeloid leukemia
  134. The safety and immunogenicity to inactivated COVID-19 vaccine in patients with hyperlipemia
  135. Circ-UBR4 regulates the proliferation, migration, inflammation, and apoptosis in ox-LDL-induced vascular smooth muscle cells via miR-515-5p/IGF2 axis
  136. Clinical characteristics of current COVID-19 rehabilitation outpatients in China
  137. Luteolin alleviates ulcerative colitis in rats via regulating immune response, oxidative stress, and metabolic profiling
  138. miR-199a-5p inhibits aortic valve calcification by targeting ATF6 and GRP78 in valve interstitial cells
  139. The application of iliac fascia space block combined with esketamine intravenous general anesthesia in PFNA surgery of the elderly: A prospective, single-center, controlled trial
  140. Elevated blood acetoacetate levels reduce major adverse cardiac and cerebrovascular events risk in acute myocardial infarction
  141. The effects of progesterone on the healing of obstetric anal sphincter damage in female rats
  142. Identification of cuproptosis-related genes for predicting the development of prostate cancer
  143. Lumican silencing ameliorates β-glycerophosphate-mediated vascular smooth muscle cell calcification by attenuating the inhibition of APOB on KIF2C activity
  144. Targeting PTBP1 blocks glutamine metabolism to improve the cisplatin sensitivity of hepatocarcinoma cells through modulating the mRNA stability of glutaminase
  145. A single center prospective study: Influences of different hip flexion angles on the measurement of lumbar spine bone mineral density by dual energy X-ray absorptiometry
  146. Clinical analysis of AN69ST membrane continuous venous hemofiltration in the treatment of severe sepsis
  147. Antibiotics therapy combined with probiotics administered intravaginally for the treatment of bacterial vaginosis: A systematic review and meta-analysis
  148. Construction of a ceRNA network to reveal a vascular invasion associated prognostic model in hepatocellular carcinoma
  149. A pan-cancer analysis of STAT3 expression and genetic alterations in human tumors
  150. A prognostic signature based on seven T-cell-related cell clustering genes in bladder urothelial carcinoma
  151. Pepsin concentration in oral lavage fluid of rabbit reflux model constructed by dilating the lower esophageal sphincter
  152. The antihypertensive felodipine shows synergistic activity with immune checkpoint blockade and inhibits tumor growth via NFAT1 in LUSC
  153. Tanshinone IIA attenuates valvular interstitial cells’ calcification induced by oxidized low density lipoprotein via reducing endoplasmic reticulum stress
  154. AS-IV enhances the antitumor effects of propofol in NSCLC cells by inhibiting autophagy
  155. Establishment of two oxaliplatin-resistant gallbladder cancer cell lines and comprehensive analysis of dysregulated genes
  156. Trial protocol: Feasibility of neuromodulation with connectivity-guided intermittent theta-burst stimulation for improving cognition in multiple sclerosis
  157. LncRNA LINC00592 mediates the promoter methylation of WIF1 to promote the development of bladder cancer
  158. Factors associated with gastrointestinal dysmotility in critically ill patients
  159. Mechanisms by which spinal cord stimulation intervenes in atrial fibrillation: The involvement of the endothelin-1 and nerve growth factor/p75NTR pathways
  160. Analysis of two-gene signatures and related drugs in small-cell lung cancer by bioinformatics
  161. Silencing USP19 alleviates cigarette smoke extract-induced mitochondrial dysfunction in BEAS-2B cells by targeting FUNDC1
  162. Menstrual irregularities associated with COVID-19 vaccines among women in Saudi Arabia: A survey during 2022
  163. Ferroptosis involves in Schwann cell death in diabetic peripheral neuropathy
  164. The effect of AQP4 on tau protein aggregation in neurodegeneration and persistent neuroinflammation after cerebral microinfarcts
  165. Activation of UBEC2 by transcription factor MYBL2 affects DNA damage and promotes gastric cancer progression and cisplatin resistance
  166. Analysis of clinical characteristics in proximal and distal reflux monitoring among patients with gastroesophageal reflux disease
  167. Exosomal circ-0020887 and circ-0009590 as novel biomarkers for the diagnosis and prediction of short-term adverse cardiovascular outcomes in STEMI patients
  168. Upregulated microRNA-429 confers endometrial stromal cell dysfunction by targeting HIF1AN and regulating the HIF1A/VEGF pathway
  169. Bibliometrics and knowledge map analysis of ultrasound-guided regional anesthesia
  170. Knockdown of NUPR1 inhibits angiogenesis in lung cancer through IRE1/XBP1 and PERK/eIF2α/ATF4 signaling pathways
  171. D-dimer trends predict COVID-19 patient’s prognosis: A retrospective chart review study
  172. WTAP affects intracranial aneurysm progression by regulating m6A methylation modification
  173. Using of endoscopic polypectomy in patients with diagnosed malignant colorectal polyp – The cross-sectional clinical study
  174. Anti-S100A4 antibody administration alleviates bronchial epithelial–mesenchymal transition in asthmatic mice
  175. Prognostic evaluation of system immune-inflammatory index and prognostic nutritional index in double expressor diffuse large B-cell lymphoma
  176. Prevalence and antibiogram of bacteria causing urinary tract infection among patients with chronic kidney disease
  177. Reactive oxygen species within the vaginal space: An additional promoter of cervical intraepithelial neoplasia and uterine cervical cancer development?
  178. Identification of disulfidptosis-related genes and immune infiltration in lower-grade glioma
  179. A new technique for uterine-preserving pelvic organ prolapse surgery: Laparoscopic rectus abdominis hysteropexy for uterine prolapse by comparing with traditional techniques
  180. Self-isolation of an Italian long-term care facility during COVID-19 pandemic: A comparison study on care-related infectious episodes
  181. A comparative study on the overlapping effects of clinically applicable therapeutic interventions in patients with central nervous system damage
  182. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up
  183. The diagnostic accuracy of touch imprint cytology for sentinel lymph node metastases of breast cancer: An up-to-date meta-analysis of 4,073 patients
  184. Mortality associated with Sjögren’s syndrome in the United States in the 1999–2020 period: A multiple cause-of-death study
  185. CircMMP11 as a prognostic biomarker mediates miR-361-3p/HMGB1 axis to accelerate malignant progression of hepatocellular carcinoma
  186. Analysis of the clinical characteristics and prognosis of adult de novo acute myeloid leukemia (none APL) with PTPN11 mutations
  187. KMT2A maintains stemness of gastric cancer cells through regulating Wnt/β-catenin signaling-activated transcriptional factor KLF11
  188. Evaluation of placental oxygenation by near-infrared spectroscopy in relation to ultrasound maturation grade in physiological term pregnancies
  189. The role of ultrasonographic findings for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer
  190. Construction of immunogenic cell death-related molecular subtypes and prognostic signature in colorectal cancer
  191. Long-term prognostic value of high-sensitivity cardiac troponin-I in patients with idiopathic dilated cardiomyopathy
  192. Establishing a novel Fanconi anemia signaling pathway-associated prognostic model and tumor clustering for pediatric acute myeloid leukemia patients
  193. Integrative bioinformatics analysis reveals STAT2 as a novel biomarker of inflammation-related cardiac dysfunction in atrial fibrillation
  194. Adipose-derived stem cells repair radiation-induced chronic lung injury via inhibiting TGF-β1/Smad 3 signaling pathway
  195. Real-world practice of idiopathic pulmonary fibrosis: Results from a 2000–2016 cohort
  196. lncRNA LENGA sponges miR-378 to promote myocardial fibrosis in atrial fibrillation
  197. Diagnostic value of urinary Tamm-Horsfall protein and 24 h urine osmolality for recurrent calcium oxalate stones of the upper urinary tract: Cross-sectional study
  198. The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer
  199. The spike protein of SARS-CoV-2 induces inflammation and EMT of lung epithelial cells and fibroblasts through the upregulation of GADD45A
  200. Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis
  201. MiR-1278 targets CALD1 and suppresses the progression of gastric cancer via the MAPK pathway
  202. Metabolomic analysis of serum short-chain fatty acid concentrations in a mouse of MPTP-induced Parkinson’s disease after dietary supplementation with branched-chain amino acids
  203. Cimifugin inhibits adipogenesis and TNF-α-induced insulin resistance in 3T3-L1 cells
  204. Predictors of gastrointestinal complaints in patients on metformin therapy
  205. Prescribing patterns in patients with chronic obstructive pulmonary disease and atrial fibrillation
  206. A retrospective analysis of the effect of latent tuberculosis infection on clinical pregnancy outcomes of in vitro fertilization–fresh embryo transferred in infertile women
  207. Appropriateness and clinical outcomes of short sustained low-efficiency dialysis: A national experience
  208. miR-29 regulates metabolism by inhibiting JNK-1 expression in non-obese patients with type 2 diabetes mellitus and NAFLD
  209. Clinical features and management of lymphoepithelial cyst
  210. Serum VEGF, high-sensitivity CRP, and cystatin-C assist in the diagnosis of type 2 diabetic retinopathy complicated with hyperuricemia
  211. ENPP1 ameliorates vascular calcification via inhibiting the osteogenic transformation of VSMCs and generating PPi
  212. Significance of monitoring the levels of thyroid hormone antibodies and glucose and lipid metabolism antibodies in patients suffer from type 2 diabetes
  213. The causal relationship between immune cells and different kidney diseases: A Mendelian randomization study
  214. Interleukin 33, soluble suppression of tumorigenicity 2, interleukin 27, and galectin 3 as predictors for outcome in patients admitted to intensive care units
  215. Identification of diagnostic immune-related gene biomarkers for predicting heart failure after acute myocardial infarction
  216. Long-term administration of probiotics prevents gastrointestinal mucosal barrier dysfunction in septic mice partly by upregulating the 5-HT degradation pathway
  217. miR-192 inhibits the activation of hepatic stellate cells by targeting Rictor
  218. Diagnostic and prognostic value of MR-pro ADM, procalcitonin, and copeptin in sepsis
  219. Review Articles
  220. Prenatal diagnosis of fetal defects and its implications on the delivery mode
  221. Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis
  222. Characteristics of antibiotic resistance mechanisms and genes of Klebsiella pneumoniae
  223. Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series
  224. Vitamin C and epigenetics: A short physiological overview
  225. Ebselen: A promising therapy protecting cardiomyocytes from excess iron in iron-overloaded thalassemia patients
  226. Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery
  227. Mechanism of rhubarb in the treatment of hyperlipidemia: A recent review
  228. Surgical management and outcomes of traumatic global brachial plexus injury: A concise review and our center approach
  229. The progress of autoimmune hepatitis research and future challenges
  230. METTL16 in human diseases: What should we do next?
  231. New insights into the prevention of ureteral stents encrustation
  232. VISTA as a prospective immune checkpoint in gynecological malignant tumors: A review of the literature
  233. Case Reports
  234. Mycobacterium xenopi infection of the kidney and lymph nodes: A case report
  235. Genetic mutation of SLC6A20 (c.1072T > C) in a family with nephrolithiasis: A case report
  236. Chronic hepatitis B complicated with secondary hemochromatosis was cured clinically: A case report
  237. Liver abscess complicated with multiple organ invasive infection caused by hematogenous disseminated hypervirulent Klebsiella pneumoniae: A case report
  238. Urokinase-based lock solutions for catheter salvage: A case of an upcoming kidney transplant recipient
  239. Two case reports of maturity-onset diabetes of the young type 3 caused by the hepatocyte nuclear factor 1α gene mutation
  240. Immune checkpoint inhibitor-related pancreatitis: What is known and what is not
  241. Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review
  242. Clinicopathological characteristics and diagnosis of hepatic sinusoidal obstruction syndrome caused by Tusanqi – Case report and literature review
  243. Synchronous triple primary gastrointestinal malignant tumors treated with laparoscopic surgery: A case report
  244. CT-guided percutaneous microwave ablation combined with bone cement injection for the treatment of transverse metastases: A case report
  245. Malignant hyperthermia: Report on a successful rescue of a case with the highest temperature of 44.2°C
  246. Anesthetic management of fetal pulmonary valvuloplasty: A case report
  247. Rapid Communication
  248. Impact of COVID-19 lockdown on glycemic levels during pregnancy: A retrospective analysis
  249. Erratum
  250. Erratum to “Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway”
  251. Erratum to: “Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p”
  252. Retraction
  253. Retraction of “Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients”
  254. Retraction of “circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis”
  255. Retraction of “miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells”
  256. Retraction of “SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis”
  257. Retraction of “circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury”
  258. Retraction of “lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells”
  259. Special issue Linking Pathobiological Mechanisms to Clinical Application for cardiovascular diseases
  260. Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery
  261. Special issue The evolving saga of RNAs from bench to bedside - Part I
  262. FBLIM1 mRNA is a novel prognostic biomarker and is associated with immune infiltrates in glioma
  263. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part III
  264. Development of a machine learning-based signature utilizing inflammatory response genes for predicting prognosis and immune microenvironment in ovarian cancer
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