Upregulated long non-coding RNA AGAP2-AS1 represses LATS2 and KLF2 expression through interacting with EZH2 and LSD1 in non-small-cell lung cancer cells

Abstract

Recently, long non-coding RNAs (lncRNAs) are identified as new crucial regulators of diverse cellular processes, including cell proliferation, differentiation and cancer cells metastasis. Accumulating evidence has revealed that aberrant lncRNA expression plays important roles in carcinogenesis and tumor progression. However, the expression pattern and biological function of lncRNAs in non-small-cell lung cancer (NSCLC) remain largely unknown. In this study, we performed comprehensive analysis of lncRNA expression in human NSCLC samples by using microarray data from Gene Expression Omnibus. After validation in a cohort of 80 pairs of NSCLC tissues, we identified a differentially expressed novel oncogenic lncRNA termed as AGAP2-AS1. The AGAP2-AS1 expression level was significantly upregulated in NSCLC tissues and negatively correlated with poor prognostic outcomes in patients. In vitro loss- and gain-of-function assays revealed that AGAP2-AS1 knockdown inhibited cell proliferation, migration and invasion, and induced cell apoptosis. In vivo assays also confirmed the ability of AGAP2-AS1 to promote tumor growth. Furthermore, mechanistic investigation showed that AGAP2-AS1 could bind with enhancer of zeste homolog 2 and lysine(K)-specific demethylase 1A, and recruit them to KLF2 and LATS2 promoter regions to repress their transcription. Taken together, our findings indicate that AGAP2-AS1 may act as an oncogene by repressing tumor-suppressor LATS2 and KLF2 transcription. By clarifying the AGAP2-AS1 mechanisms underlying NSCLC development and progression, these findings might promote the development of novel therapeutic strategies for this disease.

OPEN

Citation: Cell Death and Disease (2016) 7, e2225; doi:http://dx.doi.org/10.1038/cddis.2016.126

Web End =10.1038/cddis.2016.126

& 2016 Macmillan Publishers Limited All rights reserved 2041-4889/16 http://www.nature.com/cddis

Web End =www.nature.com/cddis

W Li1,5, M Sun2,5, C Zang1, P Ma1, J He1, M Zhang1, Z Huang1, Y Ding3 and Y Shu*,1,4

Recently, long non-coding RNAs (lncRNAs) are identified as new crucial regulators of diverse cellular processes, including cell proliferation, differentiation and cancer cells metastasis. Accumulating evidence has revealed that aberrant lncRNA expression plays important roles in carcinogenesis and tumor progression. However, the expression pattern and biological function of lncRNAs in non-small-cell lung cancer (NSCLC) remain largely unknown. In this study, we performed comprehensive analysis of lncRNA expression in human NSCLC samples by using microarray data from Gene Expression Omnibus. After validation in a cohort of 80 pairs of NSCLC tissues, we identified a differentially expressed novel oncogenic lncRNA termed as AGAP2-AS1. The AGAP2-AS1 expression level was significantly upregulated in NSCLC tissues and negatively correlated with poor prognostic outcomes in patients. In vitro loss- and gain-of-function assays revealed that AGAP2-AS1 knockdown inhibited cell proliferation, migration and invasion, and induced cell apoptosis. In vivo assays also confirmed the ability of AGAP2-AS1 to promote tumor growth. Furthermore, mechanistic investigation showed that AGAP2-AS1 could bind with enhancer of zeste homolog 2 and lysine(K)-specific demethylase 1A, and recruit them to KLF2 and LATS2 promoter regions to repress their transcription. Taken together, our findings indicate that AGAP2-AS1 may act as an oncogene by repressing tumor-suppressor LATS2 and KLF2 transcription. By clarifying the AGAP2-AS1 mechanisms underlying NSCLC development and progression, these findings might promote the development of novel therapeutic strategies for this disease.

Cell Death and Disease (2016) 7, e2225; doi:http://dx.doi.org/10.1038/cddis.2016.126

Web End =10.1038/cddis.2016.126 ; published online 19 May 2016

Lung cancer is the most common type of cancer and the leading cause of cancer-related mortality worldwide, and non-small-cell lung cancer (NSCLC) accounts nearly for 80% of all lung cancer cases.1 NSCLC includes several histological subtypes such as adenocarcinoma, squamous cell carcinoma and large-cell carcinoma.2 In spite of current advances in surgical therapy, chemotherapy and molecular targeting therapy for NSCLC, the overall 5-year survival rate for patients still remains as low as 15%.3 As the rapid development of sequencing technique and tumor biology, genetic diagnosis and molecular targeting treatment have recently become a promising approach for NSCLC therapy.46 Therefore, a well understanding of the molecular mechanisms involved in the NSCLC development, progression and metastasis is critical for the developing of specific diagnostic methods and individualized therapeutic strategies.

Over the past decade, the fast advent of high-throughput sequencing-based gene expression profiling technologies and bioinformatics has facilitated large-scale studies of human

Abbreviations: CI, confidence interval; EZH2, enhancer of zeste homolog 2; LSD1, lysine (K)-specific demethylase 1A; NSCLC, non-small-cell lung cancer; lncRNA, long non-coding RNA; MTT, 3-(4,5-dimethylthiazol-2- yl)-2,5-diphenyltetrazolium bromide; qPCR, quantitative reverse-transcription PCR; shRNA, small hairpin RNA

Upregulated long non-coding RNA AGAP2-AS1 represses LATS2 and KLF2 expression through interacting with EZH2 and LSD1 in non-small-cell lung cancer cells

genomics, which leading to the identification of non-coding RNAs.7,8 It is becoming apparent that only 2% of the transcribed human genome codes for protein, whereas the large majority of genome is transcribed into ncRNAs including microRNAs, long non-coding RNAs (lncRNAs) and pseudogenes.9 Recently, the contributions of miRNAs to various aspects of cellular processes have been clearly documented;10 however, the lncRNAs counterpart is not well characterized. The ENCODE project and GENCODE annotation have revealed the prevalence of thousands of lncRNAs, but only few of them have been assigned with biological function.11,12 Interestingly, these lncRNAs involve in modulation of a large range of cellular processes including reprogramming stem cell pluripotency, parental imprinting and cancer cell proliferation and metastasis through chromatin remodeling, epigenetic modification and sponging miRNAs.1315

Recently, lots of studies have linked the aberrant lncRNAs expression with diverse human diseases, particularly

1Department of Oncology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Peoples Republic of China; 2Department of Bioinformatics and Computational Biology, UT MD Anderson Cancer Center, Houston, TX, USA; 3Department of Pathology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Peoples Republic of China and 4Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center For Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, Peoples Republic of China*Corresponding author: Y Shu, Department of Oncology, First Affiliated Hospital, Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210009, Peoples Republic of China. Tel:[phone]; Fax: [phone]; E-mail: mailto:[email protected]

Web End [email protected]

5These authors contributed equally to this work and should be regarded as joint first authors.

Received 16.10.15; revised 23.3.16; accepted 13.4.16; Edited by R Mantovani

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cancers.16,17 For example, lncRNA ROR promotes tumor-igenesis by serving as a decoy oncoRNA through repelling the G9A methyltransferase and promoting the release of histone H3K9 methylation from the TESC promoter.18 Meanwhile, AOC4P suppresses hepatocellular carcinoma metastasis by inhibiting epithelialmesenchymal transition process through binding with vimentin and promoting its degradation.19 In

addition, upregulated LUADT1 promotes lung adenocarcinoma cell proliferation via binding with SUZ12 and suppression of p27 expression.20 These findings indicate that lncRNAs play critical roles in human cancer development and progression, hence, identification of more cancer-associated lncRNAs and investigating their biological functions and mechanisms are essential for better understanding the molecular biology of NSCLC tumorigenesis.

Our previous studies revealed that P53-regulated lncRNA TUG1 affects cell proliferation through interacting with enhancer of zeste homolog 2 (EZH2) and epigenetically regulating HOXB7 expression in NSCLC cells.21 Moreover, overexpression of ANRIL exerts oncogenic function through promoting NSCLC cells proliferation via recruiting EZH2 to KLF2 and P21 promoter regions and repressing their transcription.22 In this study, we identified an new lncRNAAGAP2-AS1, which is located in chromosome 12q14.1 and 1567 nt in length. We found that AGAP2-AS1 was upregulated in NSCLC tissues and cells, and its overexpression is associated with poor prognosis in patients. Furthermore, loss-or gain-of-function assays were performed to investigate the contributions of AGAP2-AS1 to NSCLC tumorigenesis and progression. Moreover, investigation was performed to determine through which mechanism that AGAP2-AS1 regulating its targets in NSCLC cells. This study will provide new insights into the biological functions of AGAP2-AS1 as well as its regulatory mechanisms of targets in NSCLC.

Results

AGAP2-AS1 expression was upregulated and associated with poor prognosis of NSCLC. To investigate lncRNA expression levels in NSCLC tissues compared with normal tissues, we first analyzed the microarray data from Gene Expression Omnibus data sets (GSE19188 and GSE18842). The results showed that lncRNA AGAP2-AS1 expression was upregulated in NSCLC tissues compared with normal tissues (Figure 1a). Furthermore, AGAP2-AS1 expression levels were determined in a cohort of 80 pairs of NSCLC tissues and adjacent normal tissues by quantitative reverse-transcription PCR (qPCR). The results revealed that AGAP2-AS1 expression was increased (fold change 41.5, Po0.01)

in 72.5% (58/80) of cancerous tissues compared with normal tissues (Figure 1b). Moreover, the relationship between AGAP2-AS1 expression and clinical features in NSCLC patients was analyzed; the results showed that increased AGAP2-AS1 levels were correlated with tumor size (Po0.01)

and advanced pathological stage (Po0.01) in NSCLC patients. However, AGAP2-AS1 expression level was not associated with other parameters such as gender (P = 0.822) and age (P = 0.823) in NSCLC (Table 1).

KaplanMeier survival analysis was further conducted to investigate the correlation between AGAP2-AS1 expression and NSCLC patient prognosis. According to relative AGAP2-AS1 expression in tumor tissues, the 80 NSCLC patients were classified into two groups: the high AGAP2-AS1 group (n = 40, fold change mean ratio) and the low AGAP2-AS1 group (n = 40, fold change mean ratio; Figure 1c). The overall survival rate over 3 years was 17.8% for the high AGAP2-AS1 group and 34.6% for the low AGAP2-AS1 group. Median survival time was 24 months for the high AGAP2-AS1 group and 31 months for the low AGAP2-AS1 group (Figure 1d). With respect to progression-free survival, this was 11.6% for the high AGAP2-AS1 group and 30.2% for the low AGAP2-AS1 group. Median survival time was 20 months for the high AGAP2-AS1 group and 29 months for the low AGAP2-AS1 group (Figure 1e). Furthermore, univariate analysis identified four prognostic factors: tumor size, lymphatic metastasis, tumor-node-metastasis (TNM) stage and AGAP2-AS1 expression level. Multivariate analysis of the four prognostic factors confirmed that HR for AGAP2-AS1 expression is 3.422 (95% confidence interval (CI): 1.8516.327) of progression-free survival, indicating that AGAP2-AS1 expression may serve as a potential independent prognostic value in NSCLC (Table 2).

Knockdown or upregulation of AGAP2-AS1 expression in NSCLC cells. To investigate the biological function of AGAP2-AS1 in NSCLC cells, we first performed qPCR analysis to detect the expression of AGAP2-AS1 in eight human NSCLC cell lines, including both adenocarcinoma and squamous carcinoma subtypes and one normal cell line. The results showed that AGAP2-AS1 is significantly upregulated in H1299 and H1975 cells, whereas it exhibited relative low levels in A549 and SPCA1 cells (Supplementary Figure 1A). Furthermore, we knockdown its expression through transfection of AGAP2-AS1 siRNA or small hairpin RNA (shRNA) in H1299 and H1975 cells, and upregulated its expression in A549 and SPCA1 cells through transfection of AGAP2-AS1 vector. Results of qPCR analysis showed that AGAP2-AS1 expression was knocked down by 89% in si-AGAP2-AS1 1#-transfected cells, 87% in si-AGAP2-AS1 2#-transfected cells and ~ 90% in shRNA-transfected cells. AGAP2-AS1 expression was upregulated by 38 folds in A549 cells and 10 folds in SPCA1 cells in AGAP2-AS1 overexpression-vector-transfected cells when compared with control cells (Supplementary Figures 1BD).

Effect of AGAP2-AS1 on proliferation and apoptosis of NSCLC cells. To assess the effect of AGAP2-AS1 on NSCLC cell phenotype, we performed loss- and gain-of-function investigations. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays revealed that cell growth was inhibited when AGAP2-AS1 expression was knocked down in H1299 and H1975 cells compared with controls (Figure 2a). In contrast, overexpression of AGAP2-AS1 could promote A549 and SPCA1 cell proliferation (Figure 2b). In addition, colony formation assay results showed that clonogenic ability was impaired following down-regulation of AGAP2-AS1 in H1299 and H1975 cells, whereas AGAP2-AS1 overexpression increased clone

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Figure 1 Relative AGAP2-AS1 expression in NSCLC tissues and its clinical significance. (a) Relative expression of AGAP2-AS1 in NSCLC tissues compared with normal tissue was analyzed by using Gene Expression Omnibus data sets GSE18842 and GSE19188. (b) Relative expression of AGAP2-AS1 in NSCLC tissues (n = 80) compared with corresponding non-tumor tissues (n = 80) was examined by qPCR and normalized to GAPDH expression. Results were presented as the delta CT value. Data are presented as mean s.e.m. (c) AGAP2-AS1 expression was classified into two groups according to the median value of AGAP2-AS1 expression level in NSCLC tissues sample. (d and e) KaplanMeier method with the log-rank test was used to analyze the overall survival and progression-free survival curves of patients in high and low AGAP2-AS1 expression groups

formation ability in A549 and SPCA1 cells (Figure 2c and Supplementary Figure 2A). Furthermore, Edu staining assays also revealed that knockdown of AGAP2-AS1 decreased NSCLC cell proliferation, whereas its overexpression increased NSCLC cell proliferation (Figure 2d and Supplementary Figure 2B).

To examine whether the effect of AGAP2-AS1 on proliferation of NSCLC cells reflected cell cycle transition, flow cytometry analysis was performed to investigate cell cycle progression. The results showed that H1299 and H1975 cells transfected with si-AGAP2-AS1 had an arrest at the G1/G0 phase (Figure 2e). Furthermore, we performed flow cytometry and Tunel staining analysis to determine whether cell apoptosis involved in AGAP2-AS1 knockdown induced cell growth arrest. As shown in Figure 3a, the early apoptotic (UR) and late apoptotic (LR) rate of AGAP2-AS1 knockdown in H1299 and H1975 cells are higher than control cells. Meanwhile, the Tunel staining-positive cell (green; blue, nuclear) rate is higher in H1299 and H1975 cells, which are transfected with AGAP2-AS1 siRNA, compared with control cells

(Figure 3b). These data indicate that AGAP2-AS1 promotes the proliferation phenotype of NSCLC cells (Table 2).

AGAP2-AS1 involved in migration and invasion of NSCLC cells. As invasion and metastasis of cancer cells is a significant aspect of cancer progression, we investigated the effect of AGAP2-AS1 on migration and invasion ability of NSCLC cells by using Transwells assays. The results indicated that knockdown of AGAP2-AS1 inhibited the migration ability of NSCLC cells by ~ 70% and invasion ability by 60% when compared with control cells (Figures 3c and d). These results suggested that knockdown of AGAP2-AS1 expression had tumor-suppressive effects that impeded migration and invasion phenotype of NSCLC cells.

Knockdown of AGAP2-AS1 inhibits NSCLC cells tumor-igenesis in vivo. To explore whether AGAP2-AS1 could also affect tumorigenesis in vivo, H1299 cells were stably transfected with sh-AGAP2-AS1(1#) or empty vector. The MTT assays showed that transfection of sh-AGAP2-AS1

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Table 1 Correlation between AGAP2-AS1 expression and clinicopathological characteristics of NSCLC patients

Characteristics AGAP2-AS1 levels 2 test P-value

High expression (n = 40)

Low expression (n = 40)

Age (years) 65 22 21 0.823 465 18 19

GenderMale 22 23 0.822 Female 18 17

Histological subtypeSquamous cell carcinoma 25 20 0.260 Adenocarcinoma 15 20

TNM stageIa+Ib 5 19 0.000389a IIa+IIb 15 15IIIa 20 6

Tumor size (cm) 5 15 31 0.000296a 45 25 9

Lymph metastasisNo 14 21 0.115 Yes 26 19

Smoking historyYes 26 25 0.816 Never 14 15

aOverall Po0.05

vector impaired H1299 cell growth in vitro, and previous colon formation assays also showed that H1299 cells showed decreased colon formation ability when transfected with sh-AGAP2-AS1 1# vector. Next, sh-AGAP2-AS1 1# or empty vector stably transfected H1299 cells were injected into mice. 18 days after the injection, the tumors formed in the sh-AGAP2-AS1 group were substantially smaller than those in the control group (Figure 4a). Meanwhile, the tumor weight was significantly lower in the sh-AGAP2-AS1 group(0.22 0.09 g) compared with the empty vector group(0.085 0.02 g; Figure 4b). In addition, qPCR assays showed that the levels of AGAP2-AS1 expression in tumor tissues formed from sh-AGAP2-AS1 cells were lower than in tumors formed in the control group (Figure 4c). Furthermore, tumors formed from sh-AGAP2-AS1-transfected H1299 cells exhibited decreased positive for Ki67 and increased positive for Tunel than that from control cells (Figure 4d). These data indicate that knockdown of AGAP2-AS1 inhibits tumor growth in vivo.

AGAP2-AS1 represses LATS2 and KLF2 transcription via binding with EZH2 and LSD1 in NSCLC cells. Generally, lncRNAs involve in regulation of cancer cells phenotype through activation of oncogenes or inactivation of tumor suppressors by binding with specific RNA-binding proteins. To investigate the molecular mechanism of AGAP2-AS1 in NSCLC cells, we first examined the distribution of AGAP2-AS1 in NSCLC cells. According to the distribution of

glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and U1, the nucleus/cytoplasm separation is success. The results showed that there is AGAP2-AS1 RNA in both the nucleus and the cytoplasm, and the rate of AGAP2-AS1 in the nucleus is more higher (Figure 5a). Next, we performed RNA immunoprecipitation assays to examine the interaction of AGAP2-AS1 and potential RNA-binding proteins that regulate targets at transcriptional level in NSCLC cells. The results revealed that AGAP2-AS1 directly bind with EZH2 and lysine (K)-specific demethylase 1A (LSD1), but not other RNA-binding proteins (CoREST, SIRT1 and TDP43) in NSCLC cells (Figure 5b). Furthermore, we chose several EZH2 or LSD1 potential targets (P15, P21, LATS1, LATS2, RND1, KLF2, E-cadherin, PTEN, ASPP2 and RRAD) with tumor-suppressor function, and hypothesized that they may involve in the contributions of AGAP2-AS1 to NSCLC progression. The qPCR assays showed that LATS2 expression was increased by 2.3 folds in H1299 and 3.0 folds in H1975 cells, whereas KLF2 expression was increased by 4.5 folds in H1299 and 2.5 folds in H1975 cells when AGAP2-AS1 was knocked down (Figure 5c). However, knockdown of AGAP2-AS1 could not affect other gene expression levels. Furthermore, the western blot assays showed the same results (Figure 5d), which indicated that LATS2 and KLF2 might be AGAP2-AS1 novel targets in NSCLC cells. In addition, correlation analysis showed that there is an inverse relationship between AGAP2-AS1 and LATS2 or KLF2 expression in NSCLC tissues (Supplementary Figure 2C).

Importantly, qPCR results also showed that inhibition of EZH2 and LSD1 expression led to increased LATS2 and KLF2 expression in H1299 and H1975 cells (Figure 5e). To further determine whether AGAP2-AS1 suppressed LATS2 and KLF2 expression through interacting with EZH2 and LSD1, we performed chromatin immunoprecipitation analysis. The results showed that EZH2 and LSD1 could directly bind to LATS2 and KLF2 promoter region and mediate H3K27 trimethylation or H3K4me2 demethylation modification (Figure 5f). However, knockdown of AGAP2-AS1 reduced their binding ability and H3K27 trimethylation or H3K4me2 demethylation modification (Figure 5g). These data indicated that AGAP2-AS1 contributes to NSCLC cell proliferation and apoptosis partly through repressing LATS2 and KLF2 expression in NSCLC cells.

Repression of LATS2 is partly involved in the oncogenic function of AGAP2-AS1. To determine whether LATS2 and KLF2 are involved in the AGAP2-AS1-induced promotion of NSCLC cell proliferation, we performed gain-of-function assays. In our previous study, we have reported that KLF2 expression is downregulated in NSCLC tissues and cells, and its overexpression inhibited migration and proliferation of NSCLC cells.23 Here, we performed gain-of-function assays of LATS2 in H1299 cells, and the western blot assays showed that LATS2 expression was significantly increased in H1299 cells that were transfected with pCDNA-LATS2 compared with control cells (Figure 6a). Moreover, MTT and colony formation assays revealed that overexpression of LATS2 impaired H1299 cell proliferation and colon formation ability in vitro (Figures 6b and c). Flow cytometry analysis indicated that the apoptotic rate of LATS2 overexpression in H1299

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Figure 2 Effects of AGAP2-AS1 on NSCLC cell proliferation and cell cycle progression in vitro. (a and b) MTTassays were used to determine the cell viability for si-AGAP2-AS1-transfected H1299 and H1975 cells, or pCDNA-AGAP2-AS1-transfected A549 and SPCA1 cells. (c) Colony-forming assays were conducted to determine the cloning ability of sh-AGAP2-AS1-transfected H1299 and H1975 cells, and control cells. (d) EdU staining assays were conducted to determine the viability of si-AGAP2-AS1-transfected H1299 and H1975 cells. Red, EdU staining for dividing cell; blue, DAPI staining for nuclear. (e) Flow cytometry assays were performed to analyze the cell cycle progression when NSCLC cells transfected with si-AGAP2-AS1. The bar chart represented the percentage of cells in G0/G1, S or G2/M phase, as indicated. All experiments were performed in biological triplicates with three technical replicates and values represented the mean S.E.M. *Po0.05, **Po0.01

cells is increased by ~ 10% than that in control cells (Figure 6d). Furthermore, to determine whether AGAP2-AS1 regulate NSCLC cell proliferation via repressing LATS2 expression, rescue assays were performed. H1299 cells were co-transfected with si-AGAP2-AS1 and si-LATS2, the results of MTT and colony formation assays showed that co-transfection could partially rescue si-AGAP2-AS1-impaired proliferation in H1299 cells (Figures 6e and f). These data revealed that AGAP2-AS1 regulates NSCLC cell proliferation partly through the downregulation of LATS2 expression.

Discussion

In the past decade, benefits of the fast development of sequencing technique and bioinformatics, more and more lncRNAs are identified and their aberrant expression in

multiple human cancers including NSCLC is revealed.24,25

For example, lncRNA AB073614 promotes tumorigenesis and predicts poor prognosis through targeting ERK1/2 and AKT-mediated signaling pathway in ovarian cancer.26 In addition, several studies reveal that lncRNAs have a more tissue-specific expression pattern than protein-coding genes,12

which indicates that lncRNA may serve as more sensitive biomarkers for different cancers. Therefore, identification of NSCLC-associated lncRNAs, investigation of their clinical significance and biological function may facilitate the development of lncRNA-directed diagnosis and therapy against this malignancy.

In the present study, we identified a new lncRNA AGAP2-AS1 and demonstrated that its expression was upregulated in NSCLC tissues. Increased AGAP2-AS1 expression is associated with poor prognosis and short survival time in NSCLC patients. Moreover, knockdown of

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Figure 3 Knockdown of AGAP2-AS1 induced NSCLC cell apoptosis and inhibited cell migration and invasion in vitro. (a) Flow cytometry assays were performed to analyze the cell apoptosis in si-AGAP2-AS1-transfected H1299 and H1975 cells. LL, dead cells; UL, viable cells; LR, early apoptotic cells; UR, terminal apoptotic cells. (b) Tunel staining assays were performed to analyze the cell apoptosis when AGAP2-AS1 was knocked down. Green, apoptotic cell; blue, DAPI staining for nuclear. (c and d) Transwell assays were used to determine the effect of knockdown of AGAP2-AS1 on cell migration and invasion. The cells on the lower chamber were stained and presented, and cell number in random six perspective was calculated. All experiments were performed in biological triplicates with three technical replicates and data represented the mean S.E.M. *Po0.05, **Po0.01

AGAP2-AS1 inhibited the cell proliferation, migration and invasion, and promoted apoptosis in NSCLC cells. The in vivo studies also confirmed that knockdown of AGAP2-AS1 suppressed tumor growth in NSCLC cells. Furthermore, we determined that knockdown of AGAP2-AS1-mediated tumor-suppressive effects on NSCLC cells are partly dependent on regulation of LATS2 and KLF2 expression. Here, we showed

for the first time that AGAP2-AS1 exerted oncogenic functions in human NSCLC cells by suppression of tumor suppressors LATS2 and KLF2. It is clear that lncRNAs regulate target expression through various mechanisms, such as recruiting chromatin-modifying enzymes to target genes and regulating their transcription either in cis or in trans, serving as scaffolds for bind relevant molecular components or function as

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Table 2 Univariate and multivariate analysis of survival in NSCLC patients

Variables Univariate analysis Multivariate analysis

HR 95% CI P value HR 95% CI P value

Univariate and multivariate analysis of disease-free survival in NSCLC patients (n = 80)Age 1.102 0.6831.778 0.691Gender 0.876 0.5441.412 0.587Smoker 0.733 0.4481.201 0.218Histological subtype 0.524 0.3210.856 0.010 0.598 0.3531.012 0.055 Tumor size 1.818 1.1252.936 0.015 1.336 0.8012.227 0.267 Lymphatic metastasis 2.027 1.2473.295 0.004 1.557 0.9132.654 0.104 TNM stage (I versus II or IIIa) 2.469 1.7783.427 o0.001 1.912 1.2972.819 0.001

AGAP2-AS1 expression 2.027 1.2473.295 0.004 3.422 1.8516.327 o0.001

Univariate and multivariate analysis of overall survival in NSCLC patients (n = 80)Age 1.104 0.6231.957 0.735Gender 0.850 0.4781.513 0.580Smoker 0.695 0.3831.263 0.233Histological subtype 0.660 0.3691.179 0.160Tumor size 2.018 1.1403.572 0.016 1.665 0.9143.034 0.096 Lymphatic metastasis 3.133 1.6515.945 o0.001 1.799 0.9003.597 0.095

TNM stage 3.524 2.3065.383 o0.001 2.807 1.6824.683 o0.001 AGAP2-AS1 expression (low versus high) 5.121 2.53810.332 o0.001 2.760 1.3235.757 0.007

Figure 4 Effect of AGAP2-AS1 knockdown on tumor growth in vivo. (a) The stable AGAP2-AS1 knockdown H1299 cells were used for the in vivo study. The nude mice carrying tumors from respective groups were shown and tumor growth curves were measured 4 days after the injection of H1299 cells. Tumor volume was calculated every 3 days. (b) Tumor weight of each tumor sample form two groups are represented, and values represented the mean S.E.M. (c) QPCR analysis of AGAP2-AS1 expression in tumor tissues formed from H1299/sh-AGAP2-AS1 and H1299/empty vector. (d) Tumors developed from sh-AGAP2-AS1-transfected H1299 cells showed lower Ki67 protein and higher Tunel staining levels than tumors developed by control cells. Left, H&E staining; middle, Ki67 immunostaining; right, Tunel staining. All experiments were performed in biological triplicates with three technical replicates and data represented the mean S.E.M. *Po0.05, **Po0.01

competing endogenous RNAs by binding with miRNA response elements to release miRNA regulation of their targets.13,15,27 In this study, we found that AGAP2-AS1 could

bind with EZH2 and LSD1, and recruit them to LATS2 and KLF2 promoter regions to repress their transcription in NSCLC cells.

EZH2, an core subunit of polycomb repressive complex2, is a histone methyltransferase that specifically catalyze the trimethylation of lysine residue 27 of histone 3 (H3K27me3) of target genes;28 LSD1 is the core of the REST repressor and the first identified histone demethylase that specifically H3K4me1/2 demethylase.29 Interestingly, there is evidence

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Figure 5 AGAP2-AS1 interacted with EZH2 and LSD1 to repress KLF2 and LATS2 expression. (a) Relative AGAP2-AS1 levels in cell cytoplasm or nucleus of H1299 and H1975 cells were detected by qPCR. GAPDH was used as cytoplasm control and U1 was used as nucleus control. The distribution of AGAP2-AS1 RNA in the cytoplasm or the nucleus was presented as percentage rate of total RNA. (b) RNA levels in immunoprecipitates with EZH2, SUZ12, LSD1, CoREST, SIRT1 and TDP43 were determined by qPCR. Expression levels of AGAP2-AS1 RNA were presented as fold enrichment relative to IgG immunoprecipitate. (c) The levels of P15, P21, LATS1, LATS2, RND1, KLF2, E-cadherin, PTEN, RRAD and ASPP2 messenger RNA were determined by qPCR when knockdown of AGAP2-AS1 in H1299 and H1975 cells. (d) The KLF2 and LATS2 protein levels were determined by western blot analysis in AGAP2-AS1 knockdown H1299 and H1975 cells. (e) The KLF2 and LATS2 expression levels were determined by qPCR when knockdown of EZH2 or LSD1 in H1299 and H1975 cells. (f and g) Chromatin immunoprecipitation-qPCR analysis of EZH2 and LSD1 occupancy, H3K27me3 and H3K4me2 binding to the KLF2 or LATS2 promoter regions in H1299 and H1975 cells, and IgG as a negative control. The mean values and S.E.M. were calculated from triplicates of a representative experiment. *Po0.05, **Po0.01

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Figure 6 AGAP2-AS1 function as oncogene by repressing LATS2 expression in NSCLC cells. H1299 cells were transfected with pCDNA-LATS2 or co-transfected with si-AGAP2-AS1 and si-LATS2. (a) The protein level of LATS2 was detected by western blot in H1299 cell, which is transfected with pCDNA-LATS2 or empty vector. (b and c) MTT assays and colony-forming assays were used to determine the cell viability and cloning ability in pCDNA-LATS2- or empty vector-transfected H1299 cells. (d) Apoptosis was determined by flow cytometry in pCDNA-LATS2- or empty vector-transfected H1299 cells. LL, dead cells; UL, viable cells; LR, early apoptotic cells; UR, late apoptotic cells. (e and f) MTT assays and colony-forming assays were used to determine the cell viability and cloning ability in negative control siRNA, si-AGAP2-AS1- or siAGAP2-AS1- and si-KLF2-co-transfetced H1299 cells. Values represent the mean S.E.M from three independent experiments. *Po0.05 and **Po0.01

indicated that both of them overexpression involved in promotion of NSCLC cells proliferation and metastasis through silencing of tumor suppressors transcription, such as KLF2.30,31 KLF2 is a member of zinc finger-containing

transcription factors (KLF), and its expression is diminished in multiple cancers and possesses tumor-suppressor features.32

Our previous study has revealed its expression, prognostic significance and tumor-suppressive roles in NSCLC. Here, we further demonstrated that its transcription as well as LATS2 could be repressed by EZH2 and LSD1 mediated by lncRNA AGAP2-AS1 in NSCLC cells. LATS2 is a important member of the large tumor-suppressor family, which has been identified as a new regulator of cellular homeostasis.33 Importantly, the missed expression of LATS2 has been found in multiple human cancers including NSCLC, and our results also revealed that upregulated its levels inhibited NSCLC cells growth and induced apoptosis. Taken together, our findings indicate that lncRNA AGAP2-AS1 may function as an oncogene and its increased expression contributes to NSCLC development and progression.

In summary, our study showed for the first time that lncRNA AGAP2-AS1 is upregulated in NSCLC tissues and cells, and its overexpression may be a negative prognostic factor for NSCLC patients. Knockdown of AGAP2-AS1 exerted tumor-

suppressive functions through reducing cell proliferation, migration and inducing apoptosis in NSCLC cells. Furthermore, the oncogenic effect of AGAP2-AS1 is partially through epigenetic silencing of the LATS2 and KLF2 expression by binding with EZH2 and LSD1. Our findings may further explain the understanding of NSCLC pathogenesis, and facilitate the development of lncRNA-directed diagnostics and therapeutics against this disease. However, further studies are required to clarify AGAP2-AS1 regulation of other potential target expression and the mechanism that underlie regulatory behaviors in NSCLC cells.

Materials and MethodsTissue collection. We obtained 80 paired NSCLC and adjacent normal tissues from patients who were diagnosed with NSCLC based on histopathological evaluation and underwent surgery at the Jiangsu Province Hospital between 2010 and 2011. Clinicopathological characteristics, including TNM staging and tumor size, were recorded. No local or systemic treatment was conducted in these patients before surgery. All collected tissue samples were immediately snap-frozen in liquid nitrogen and stored at 80 C until required. Our study was approved by the Research Ethics Committee of Nanjing Medical University, China. Written informed consent was obtained from all patients.

Cell lines. Five adenocarcinoma cell lines (A549, PC9, SPCA1, H1975 and H1299), three squamous carcinomas cell lines (H520, SK-MES-1 and H1703) and

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one normal bronchial epithelial cell line 16HBE were purchased from the Institute of Biochemistry and Cell Biology of the Chinese Academy of Sciences (Shanghai, China). A549, H1975, H1299 and H520 cells were cultured in RPMI-1640; 16HBE, PC9, SPCA1 and SK-MES-1 cells were cultured in DMEM (GIBCO-BRL,Thermo Fisher Scientific, Shanghai, China) medium supplemented with 10% fetal bovine serum, 100 U/ml penicillin and 100 mg/ml streptomycin (Invitrogen, Carlsbad, CA, USA) at 37 C/5% CO2. All cell lines were authenticated by short-tandem repeat

DNA profiling.

RNA extraction and qPCR assays. Total RNA was isolated with Trizol reagent (Invitrogen, Carlsbad, CA, USA) according to the manufacturers instructions. 1 g RNA was reverse transcribed in a final volume of 20 l using random primers under standard conditions for the PrimeScript RT reagent Kit (TaKaRa, Dalian, China). SYBR Premix Ex Taq (TaKaRa) was used to determine AGAP2-AS1 expression levels, following the manufacturers instructions. Results were normalized to the expression of GAPDH. The specific primers used are shown in Supplementary Table 1. Our qPCR results were analyzed and expressed relative to threshold cycle (CT) values, and then converted to fold changes.

Plasmid generation. The AGAP2-AS1 cDNA sequence was synthesized and added with HindIII and XbaI Endo-end link, and the sequence were ligated into the pCDNA3.1 vector (Invitrogen, Shanghai, China) that have been digested by HindIII and XbaI. The vector was then transformed into competent cells for amplification. AGAP2-AS1 short-hairpin RNA oligos directed against AGAP2-AS1 was synthesized, with each containing 4 nucleotide overhangs necessary for directional cloning. Then, oligos were annealed and ligated into the pENTR H1 vector using T4 DNA ligase. The LATS2 and KLF2 vectors were purchased from Genechem company (Shanghai, China).

Cell transfection. Plasmid vectors (pCDNA-AGAP2-AS1, sh-AGAP2-AS1, pCDNA-LATS2, pCDNA-KLF2 and empty vector) for transfection were prepared using DNA Midiprep or Midiprep kits (Qiagen, Hilden, Germany). The si-AGAP2-AS1, si-LATS2 or si-NC were transfected into H1299 or H1975 cells. The siRNA and shRNA sequences were shown in Supplementary Table 1. Negative control siRNA is purchased from Invitrogene (CAT#12935-110, Shanghai, China). H1299 or H1975 cells were grown on six-well plates to confluency and transfected using Lipofectamine 2000 (Invitrogen) according to the manufacturers instructions. At 48 h post transfection, cells were harvested for qPCR or western blot analysis. The sh-AGAP2-AS1 or empty vector stably transfected to H1299 cells were selected by G418 for 2 weeks, and then the cloned cells were collected for in vivo tumorigenesis assays.

Cell viability assays. Cell viability was monitored using Cell Proliferation Reagent Kit I (MTT; Roche Applied Science, Penzberg, Germany). The H1299 or H1975 cells transfected with si-AGAP2-AS1 (3000 cells/well) were grown in 96-well plates. Cell viability was assessed every 24 h following the manufacturers protocol. All experiments were performed in quadruplicate. For each treatment group, wells were assessed in triplicate. For EdU assay, cells were cultured in 24-well plates, and 10 M of EdU was added to each well. After 2 h, the cells were fixed with 4% formaldehyde for 30 min. After washing, EdU can be detected with a Click-iTR EdU Kit for 30 min, and the cells were stained with DAPI for 5 min and visualized using a fluorescent microscope (Olympus, Tokyo, Japan). The EdU incorporation rate was counted using Image-Pro Plus (IPP) 6.0 software (Media Cybernetics, Bethesda, MD, USA).

Flow cytometry. H1299 or H1975 cells, which were transfected with si-AGAP2-AS1, were harvested 48 h after transfection by trypsinization, then were double stained with FITC-Annexin V and Propidium iodide (PI) using the FITCAnnexin V Apoptosis Detection Kit (BD Biosciences) according to the manufacturers recommendations. The cells were analyzed with a flow cytometry (FACScan; BD Biosciences) equipped with a CellQuest software (BD Biosciences, San Jose, CA, USA). Cells were discriminated into viable cells, dead cells, early apoptotic cells and late apoptotic cells. For cell cycle analysis, cells were stained with PI using the CycleTEST PLUS DNA Reagent Kit (BD Biosciences) following the protocol and analyzed by FACScan. The percentage of the cells in G0/G1, S and G2/M phase was counted and compared.

Cell migration and invasion assays. For migration and invasion assays, 24-well Transwell chambers with 8-m-pore size polycarbonate membrane was

used (Corning Incorporated, Corning, NY, USA). For invasion assays, 1 105 cells in serum-free RPMI-1640 medium were seeded on the top side of the membrane pre-coated with Matrigel (BD, Franklin Lakes, NJ, USA; without Matrigel for migration assays). RPMI-1640 containing with 10% fetal bovine serum was added to the lower chamber. After incubation for 24 h, cells inside the upper chamber were removed with cottons swabs, while cells on the lower membrane surface were fixed and then stained with 0.5% Crystal violet solution. Five fields were counted randomly in each well.

Tumor formation assay. Four-week-old female athymic BALB/c nude mice were maintained under pathogen-free conditions and manipulated according to protocols. H1299 cells were stably transfected with sh-AGAP2-AS1 or empty vector, harvested and washed with phosphate-buffered saline. A total of 1 107 cells was subcutaneously injected into a single side of the posterior flank of each mouse. Tumor growth was examined every 3 days, and tumor volumes were calculated using the equation V = 0.5 D d2 (V, volume; D, longitudinal diameter; d, latitudinal diameter). After 18 days, mice were killed and the subcutaneous growth of each tumor was examined. This study was carried out in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health. The protocol was approved by the Committee on the Ethics of Animal Experiments of the Nanjing Medical University.

Subcellular fractionation location. PARIS Kit (Life Technologies, CA, USA) was used to separate of nuclear and cytosolic fractions of NSCLC cells according to the manufacturers instructions. QPCR was used to detect AGAP2-AS1, GAPDH and U1 RNA levels in cytoplasm and nuclear fraction. GAPDH was used as cytoplasm control, and U1 was used as nuclear control. The relative rate of AGAP2-AS1, GAPDH and U1 in cytoplasm or nuclear part was presented as the percentage of the total RNA.

RNA immunoprecipitation. H1299 and H1975 cells were lysed for immunoprecipitation of endogenous polycomb repressive complex2 and LSD1. The supernatants were incubated with protein A/G Sepharose beads coated with antibodies that recognized EZH2, LSD1, SNRNP70 or with control IgG (EMD Millipore, Darmstadt, Germany) for 6 h at 4 C. After the beads were washed with wash buffer, the complexes were incubated with 0.1% SDS/0.5 mg/ml Proteinase K (30 min at 55 C) to remove proteins, respectively. The RNA isolated from the immunoprecipitation materials was further assessed by qPCR analysis.

Chromatin immunoprecipitation. H1299 and H1975 cells were treated with formaldehyde and incubated for 10 min to generate DNAprotein cross-links. Cell lysates were then sonicated to generate chromatin fragments of 200300 bp and immunoprecipitated with EZH2, H3K27me3, LSD1 and H3K4me2-specific antibody (Millipore) or IgG as control. Precipitated chromatin DNA was recovered and analyzed by qPCR.

Western blot assay and antibodies. Cell protein lysates were separated by 10% SDS-polyacrylamide gel electrophoresis, transferred to NC membranes (Sigma-Aldrich, St. Louis, USA) and incubated with specific antibodies. ECL chromogenic substrate was used to were quantified by densitometry (Quantity One software; Bio-Rad, Hercules, CA, USA). GAPDH antibody was used as control. Anti-LATS2 was purchased from Cell Signaling Technology, Inc. (Danvers, MA, USA) and Anti-KLF2 were purchased from Sigma.

Statistical analysis. All statistical analyses were performed using SPSS 17.0 software (IBM, Chicago, IL, USA). The significance of differences between groups was estimated by the Student's t-test, Wilcoxon test or 2 test. Disease-free survival and overall survival rates were calculated by the KaplanMeier method with the log-rank test applied for comparison. The date of survival were evaluated by univariate and multivariate Cox proportional hazards models. Variables with Po0.05 in univariate analysis were used in subsequent multivariate analysis on the basis of

Cox regression analyses. Kendalls Tau-b and Pearson correlation analyses were used to investigate the correlation between AGAP2-AS1 and LATS2 or KLF2 expressions. Two-sided P-values were calculated, and a probability level of 0.05 was chosen for statistical significance.

Conflict of InterestThe authors declare no conflict of interest.

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Acknowledgements. This work was supported by the National Natural Science Foundation of China (81272532), Jiangsu Province Clinical Science and Technology projects (Clinical Research Center, BL2012008) and Priority Academic Program Development of Jiangsu Higher Education Institution (PAPD, JX10231801) to Y Shu. W Li was supported by the National Natural Science Foundation of China (81302012).

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