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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Oncol.</journal-id>
<journal-title>Frontiers in Oncology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Oncol.</abbrev-journal-title>
<issn pub-type="epub">2234-943X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fonc.2024.1346531</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Oncology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>miR-939-3p induces sarcoma proliferation and poor prognosis via suppressing BATF2</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Xu</surname>
<given-names>Wanwen</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
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<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Huang</surname>
<given-names>Yinghui</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1694935"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
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<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
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</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Lei</surname>
<given-names>Zengjie</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/789602"/>
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<contrib contrib-type="author" corresp="yes">
<name>
<surname>Zhou</surname>
<given-names>Jie</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2652685"/>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
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<aff id="aff1">
<sup>1</sup>
<institution>Wuhan Third Hospital (Tongren Hospital of Wuhan University)</institution>, <addr-line>Wuhan, Hubei</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University</institution>, <addr-line>Chongqing</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University</institution>, <addr-line>Nanjing</addr-line>, <country>China</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Department of Oncology and Southwest Cancer Center, Southwest Hospital, Army Medical University (Third Military Medical University)</institution>, <addr-line>Chongqing</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Shilpa S. Dhar, University of Texas MD Anderson Cancer Center, United States</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Shayani Dasgupta, University of Texas MD Anderson Cancer Center, United States</p>
<p>Chi-Wai Cheng, The University of Hong Kong, Hong Kong SAR, China</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Jie Zhou, <email xlink:href="mailto:zhoujie_fl@163.com">zhoujie_fl@163.com</email>; Zengjie Lei, <email xlink:href="mailto:leizengjie@163.com">leizengjie@163.com</email>
</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>14</day>
<month>02</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>14</volume>
<elocation-id>1346531</elocation-id>
<history>
<date date-type="received">
<day>30</day>
<month>11</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>31</day>
<month>01</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2024 Xu, Huang, Lei and Zhou</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Xu, Huang, Lei and Zhou</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>Sarcoma is a rare and aggressive malignancy with poor prognosis, in which oncogene activation and tumor suppressor inactivation are involved. Accumulated studies suggested basic leucine zipper transcription factor ATF-like 2 (BATF2) as a candidate tumor suppressor, but its specific role and mechanism in sarcoma remain unclear.</p>
</sec>
<sec>
<title>Methods</title>
<p>The expression levels of BATF2 and miR-939-3p were evaluated by using human sarcoma samples, cell lines and xenograft mouse models. Bioinformatics analysis, qPCR, Western blot, cell proliferation assay, overexpression plasmid construction, point mutation and dual luciferase reporter assay were utilized to investigate the role and mechanism of miR-939-3p in sarcoma.</p>
</sec>
<sec>
<title>Results</title>
<p>In this study, we demonstrated that the expression of BATF2 was downregulated in human sarcoma tissues and cell lines. The downregulation of BATF2 was negatively associated with the prognosis of sarcoma patients. Subsequent bioinformatic prediction and experimental validations showed that BATF2 expression was reduced by microRNA (miR)-939-3p mimic and increased by miR-939-3p inhibitor. Additionally, miR-939-3p was upregulated in sarcoma tissues and cells, correlating with a poor prognosis of sarcoma patients. Moreover, miR-939-3p overexpression suppressed sarcoma cell proliferation, which was significantly attenuated by the restoration of BATF2, while siRNA-mediated knockdown of BATF2 aggravated the miR-939-3p-induced promotion of sarcoma cell proliferation. Further computational algorithms and dual-luciferase reporter assays demonstrated that miR-939-3p repressed BATF2 expression via directly binding to its 3&#x2019; untranslated region (3&#x2019; UTR).</p>
</sec>
<sec>
<title>Conclusion</title>
<p>Collectively, these findings identified miR-939-3p as a novel regulator of BATF2, as well as a prognostic biomarker in sarcoma, and revealed that suppressing miR-939-3p or inducing BATF2 expression may serve as a promising therapeutic strategy against sarcoma.</p>
</sec>
</abstract>
<kwd-group>
<kwd>BATF2</kwd>
<kwd>miR-939-3p</kwd>
<kwd>sarcoma</kwd>
<kwd>prognosis</kwd>
<kwd>therapeutic target</kwd>
</kwd-group>    <contract-sponsor id="cn001">Natural Science Foundation Project of Chongqing, Chongqing Science and Technology Commission<named-content content-type="fundref-id">10.13039/501100012669</named-content>
</contract-sponsor>    <contract-sponsor id="cn002">National Natural Science Foundation of China<named-content content-type="fundref-id">10.13039/501100001809</named-content>
</contract-sponsor>
<counts>
<fig-count count="7"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="41"/>
<page-count count="11"/>
<word-count count="4393"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Molecular and Cellular Oncology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<label>1</label>
<title>Introduction</title>
<p>Sarcomas are rare cancers predominantly derived from embryonic mesoderm, accounting for approximately 1% of human malignancies, which primarily affect younger patients and are difficult to treat (<xref ref-type="bibr" rid="B1">1</xref>&#x2013;<xref ref-type="bibr" rid="B3">3</xref>). The histologic and molecular diversity, coupled with limited access to specialized sarcoma centers, often leads to erroneous therapeutic plans (<xref ref-type="bibr" rid="B4">4</xref>). Currently, localized sarcomas are typically treated with surgery, and chemotherapy or targeted therapy is employed for metastatic disease (<xref ref-type="bibr" rid="B2">2</xref>), while immunotherapy for sarcoma remains largely investigational (<xref ref-type="bibr" rid="B2">2</xref>, <xref ref-type="bibr" rid="B4">4</xref>, <xref ref-type="bibr" rid="B5">5</xref>). Despite numerous clinical trials exploring various chemotherapy regimens, the progression-free survival rates range from 3 to 7 months, with an overall survival (OS) of 12 to 18 months (<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>). Therefore, gaining a comprehensive insight into the mechanism underlying sarcoma tumorigenesis and progression is crucial to develop effective therapeutic approaches against this disease.</p>
<p>Among the sarcoma-related risk factors, the activation of oncogenes and silencing of tumor suppressor genes play vital roles during sarcoma tumorigenesis (<xref ref-type="bibr" rid="B2">2</xref>, <xref ref-type="bibr" rid="B8">8</xref>). Recently, we and others have identified basic leucine zipper transcription factor ATF-like 2 (BATF2) as a tumor suppressor (<xref ref-type="bibr" rid="B9">9</xref>&#x2013;<xref ref-type="bibr" rid="B18">18</xref>). BATF2 is mainly expressed in normal cells but not in the corresponding tumor cells, while the restoration of BATF2 inhibits cancer cell proliferation, invasion and metastasis (<xref ref-type="bibr" rid="B13">13</xref>, <xref ref-type="bibr" rid="B14">14</xref>), highlighting its potential as a therapeutic target in cancer. Further investigation into BATF2 dysfunction revealed no mutations in the exons of the <italic>BATF2</italic> gene in hepatocellular carcinoma (<xref ref-type="bibr" rid="B16">16</xref>). Consequently, multiple studies, including our own, focused on elucidating the upstream transcription factors, N6-methyladenosine modification and nuclear-cytoplasmic translocation of BATF2 to understand gene expression regulation (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B13">13</xref>&#x2013;<xref ref-type="bibr" rid="B15">15</xref>, <xref ref-type="bibr" rid="B18">18</xref>&#x2013;<xref ref-type="bibr" rid="B20">20</xref>). However, these findings have still not clarified the cause of BATF2 downregulation. Further, its role and underlying mechanisms in sarcoma remain unknown.</p>
<p>MicroRNAs (miRs) are small non-coding RNAs, possessing approximately 22 nucleotides, which can regulate gene expression through binding to the 3&#x2019; untranslated region (3&#x2019; UTR) of its target mRNAs, ultimately contributing to mRNA cleavage and translational inhibition (<xref ref-type="bibr" rid="B21">21</xref>, <xref ref-type="bibr" rid="B22">22</xref>). As post-transcriptional regulators, miRNAs have been implicated in modulating various malignant behaviors, including cancer cell proliferation, apoptosis, motility, adhesion and drug resistance (<xref ref-type="bibr" rid="B22">22</xref>). Many miRNAs are directly or indirectly associated with oncogenes and can function as either tumor suppressors or oncomiRs (<xref ref-type="bibr" rid="B23">23</xref>). During sarcoma initiation and progression, changes in the expression patterns of certain miRNAs significantly impact sarcoma cell proliferation, invasion, and apoptosis (<xref ref-type="bibr" rid="B8">8</xref>). However, the precise molecular mechanism by which miRNAs regulate BATF2 to enhance sarcoma growth remains elusive.</p>
<p>In this study, we demonstrated a downregulation of BATF2 in sarcoma, which was positively correlated with prognosis. <italic>In vitro</italic> and <italic>in vivo</italic> experiments revealed that miR-939-3p enhanced sarcoma proliferation through suppressing BATF2 expression via binding to its 3&#x2019; UTR. These findings highlight the miR-939-3p/BATF2 axis as a promising therapeutic target for sarcoma patients.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<label>2</label>
<title>Materials and methods</title>
<sec id="s2_1">
<label>2.1</label>
<title>Cell culture</title>
<p>The human fibrosarcoma cell line HT-1080, synovial sarcoma cell line SW-982 and human skin fibroblast cell line HSF were obtained from iCell Bioscience (Shanghai, China). The stable transfection of HT-1080 cells was performed as we described (<xref ref-type="bibr" rid="B9">9</xref>). Briefly, HT-1080 cells were transfected with lentivirus-packaged recombinant plasmids expressing miR-939-3p or negative control (Tsingke Biotechnology, Shanghai, China), and resistant cells were selected by using Puromycin (Sigma, St. Louis, MO, USA) to establish stable cell lines.</p>
</sec>
<sec id="s2_2">
<label>2.2</label>
<title>Human samples</title>
<p>Sarcoma, colorectal cancer (CRC) and the corresponding paratumor tissues from 12 patients were separately collected from the People&#x2019;s Hospital of Xishui County (Zunyi, China). The study was carried out in accordance with the Declaration of Helsinki and approved by the People&#x2019;s Hospital of Xishui County. Written informed consent has been obtained from all patients.</p>
</sec>
<sec id="s2_3">
<label>2.3</label>
<title>Animal studies</title>
<p>Four-week-old female nude mice were purchased from the Beijing Huafukang Biotechnology (Beijing, China). The mice were subcutaneously injected with 5&#x2009;&#xd7;&#x2009;10<sup>6</sup> HT-1080 cells in 0.2 mL PBS per mouse with or without stable miR-939-3p overexpression (n&#x2009;=&#x2009;5). After 21 days, the xenografts were excised, measured for volume and weight, and further processed for RNA and protein extraction, which was approved by the Animal Welfare and Ethics Committee of Army Medical University.</p>
</sec>
<sec id="s2_4">
<label>2.4</label>
<title>qPCR</title>
<p>Total RNA of HT-1080 cells and tumor tissues was extracted by using an RNA Purified Total RNA Extraction Kit (Beyotime), and then reversely transcribed into cDNA with RT Master Mix (MedChemExpress, Monmouth Junction, NJ, USA), as we previously described (<xref ref-type="bibr" rid="B24">24</xref>). qPCR was performed using a SYBR Green qPCR kit (MedChemExpress). Specific primer sets were provided in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>.</p>
</sec>
<sec id="s2_5">
<label>2.5</label>
<title>miRNA extraction and qPCR</title>
<p>To quantify miR-939-3p, total RNA, including miRNA, was extracted using the RNAiso Plus reagent (TaKaRa, Shiga, Japan), which was reversely transcribed into cDNA by using a miRNA First Strand cDNA Synthesis kit from Sangon (Shanghai, China). qPCR was performed using a SYBR Green qPCR kit (MedChemExpress). The primer sets were listed in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S2</bold>
</xref>.</p>
</sec>
<sec id="s2_6">
<label>2.6</label>
<title>Western blot</title>
<p>Western blot was performed as we described (<xref ref-type="bibr" rid="B24">24</xref>). Briefly, proteins were extracted from sarcoma cells and tissues by using RIPA lysis buffer (Beyotime). Proteins were separated and transferred onto PVDF membranes, which were then incubated with the antibodies against BATF2 (Abcam, Cambridge, MA, USA) or &#x3b2;-actin (Santa Cruz, Dallas, TX, USA), followed by the incubation of secondary antibody. Gray-scale of the bands were quantified by using ImageJ software.</p>
</sec>
<sec id="s2_7">
<label>2.7</label>
<title>Immunohistochemistry staining</title>
<p>Immunohistochemistry (IHC) staining was performed to detect the expression levels of BATF2 (Abcam) and Ki67 (Santa Cruz) in tumor xenografts as we previously described (<xref ref-type="bibr" rid="B9">9</xref>).</p>
</sec>
<sec id="s2_8">
<label>2.8</label>
<title>Gene expression profiling interactive analysis</title>
<p>GEPIA (<xref ref-type="bibr" rid="B25">25</xref>) is a publicly available platform integrating data based on The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) project. It provides comprehensive pan-cancer analysis of RNA-sequencing data, including gene expression, correlation, and survival analysis.</p>
</sec>
<sec id="s2_9">
<label>2.9</label>
<title>CancerMIRNome</title>
<p>The correlation between miR-939-3p expression levels and the prognosis of sarcoma patients, as well as the circulating miR-939-3p expression levels, were analyzed by using CancerMIRNome online database (<xref ref-type="bibr" rid="B26">26</xref>). CancerMIRNome is publicly available that enables analysis of miRNAs from TCGA projects and circulating miRNome datasets. Data are available from the Gene Expression Omnibus (GSE124158).</p>
</sec>
<sec id="s2_10">
<label>2.10</label>
<title>miRNA binding sites prediction</title>
<p>Potential miRNAs targeting BATF2 were predicted using miRDB, miRwalk and targetScan software programs. The potential binding sites of miR-939-3p in BATF2 3&#x2032; UTR were analyzed by using targetScan online software.</p>
</sec>
<sec id="s2_11">
<label>2.11</label>
<title>miRNA overexpression and knockdown</title>
<p>MiR-939-3p mimics or inhibitors, and negative controls were purchased from Tsingke Biotechnology, which were listed in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S3</bold>
</xref>. HT-1080 cells were harvested 48 h after transfection using Lipofectamine 3000 (Invitrogen).</p>
</sec>
<sec id="s2_12">
<label>2.12</label>
<title>BATF2 overexpression and knockdown</title>
<p>Mammalian BATF2 overexpression plasmids (pBATF2) and empty plasmid vector pcDNA3.1 (pControl) were purchased from Tsingke Biotechnology for transfection into HT-1080 cells by using Lipofectamine 3000 (Invitrogen). siRNA targeting BATF2 and scramble siRNA were bought from Santa Cruz.</p>
</sec>
<sec id="s2_13">
<label>2.13</label>
<title>Cell proliferation assay</title>
<p>HT-1080 cells were seeded into a 96-well plate and co-transfected with vector control or BATF2 overexpression plasmids and miR-939-3p mimic or inhibitor. Cell viability was determined by using Cell Counting Kit 8 (CCK-8) (Dojindo, Kumamoto, Japan) after 48 h or a Bromodeoxyuridine (BrdU) ELISA kit (Roche, Burgess Hill, UK) according to the manufacturer&#x2019;s instructions.</p>
</sec>
<sec id="s2_14">
<label>2.14</label>
<title>Reporter plasmids construction and point mutation</title>
<p>The human <italic>BATF2</italic> 3&#x2019; UTR sequences containing putative binding sites of miR-939-3p were cloned into pGL4 vector (Promega, Madison, WI, USA). The primer sets and restriction enzymes were listed in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S4</bold>
</xref>. For point mutation, the binding sites (5&#x2032;-GCCCAGG-3&#x2032;) of miR-939-3p in <italic>BATF2</italic> 3&#x2032; UTR were mutated into 5&#x2032;-ATTTCAA-3&#x2032; by using a MutanBEST kit (Takara).</p>
</sec>
<sec id="s2_15">
<label>2.15</label>
<title>Dual luciferase reporter assay</title>
<p>HT-1080 cells were transiently co-transfected with the recombinant plasmids or pAP-1-Luc (BD Biosciences, Oxford, UK) and negative control or miR-939-3p mimic along with Renilla plasmids using Lipofectamine 3000 (Invitrogen) for dual-luciferase reporter gene assay (Promega), as we previously described (<xref ref-type="bibr" rid="B27">27</xref>).</p>
</sec>
<sec id="s2_16">
<label>2.16</label>
<title>Statistical analysis</title>
<p>Data were presented as mean&#x2009;&#xb1;&#x2009;SD and analyzed by using Graphpad Prism 8 software. Comparisons were statistically significant at <italic>P</italic>&#x2009;&lt;&#x2009;0.05 by using unpaired <italic>t</italic>-test or ANOVA.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<label>3</label>
<title>Results</title>
<sec id="s3_1">
<label>3.1</label>
<title>Downregulation of BATF2 correlates with poor prognosis of sarcoma</title>
<p>We first explored the expression levels of BATF2 in human soft tissue sarcoma. It was found that BATF2 mRNA and protein levels were significantly decreased in 12 cases of sarcoma tissues, compared to the corresponding adjacent tissues (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1A, B</bold>
</xref>). Besides, BATF2 mRNA and protein expression was also downregulated in human fibrosarcoma cells (HT-1080) and synovial sarcoma cells (SW-982), compared with that in human skin fibroblast cells (HSF) (<xref ref-type="fig" rid="f1">
<bold>Figures&#xa0;1C, D</bold>
</xref>). Further, sarcoma patients were divided into two groups according to BATF2 expression levels. Compared with patients with high BATF2 expression (n&#x2009;=&#x2009;131), patients with low BATF2 expression (n&#x2009;=&#x2009;131) had obviously worse survival (<italic>P</italic>&#x2009;=&#x2009;0.031) with a hazard ratio of 0.65 (<italic>P</italic> = 0.031) (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1E</bold>
</xref>). These findings indicated that BATF2 was downregulated in sarcoma and negatively associated with the prognosis of sarcoma patients.</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>Downregulation of BATF2 correlates with poor prognosis of sarcoma. <bold>(A&#x2013;D)</bold> qPCR and Western blot analysis of the expression level of BATF2 in soft tissue sarcoma and pericarcinoma <bold>(A, B)</bold> and the human skin fibroblast cell line (HSF), human fibrosarcoma cell line (HT-1080) and synovial sarcoma cell line (SW-982) <bold>(C, D)</bold>. <bold>(E)</bold> Kaplan-Meier estimates of overall survival time based on BATF2 expression levels from 262 CRC patients by using a GEPIA database. Hazard ratio (HR) = 0.65. <italic>P</italic>(HR) = 0.031. *<italic>P &lt;</italic> 0.05, **<italic>P</italic> &lt; 0.01, ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-14-1346531-g001.tif"/>
</fig>
</sec>
<sec id="s3_2">
<label>3.2</label>
<title>miR-939-3p inhibits BATF2 expression in sarcom</title>
<p>Since miRNAs play an extensive role in modulating gene expression in sarcoma (<xref ref-type="bibr" rid="B21">21</xref>, <xref ref-type="bibr" rid="B22">22</xref>), we hypothesized that BATF2 might be regulated by miRNA. To test this hypothesis, we utilized miRDB, miRwalk and targetScan software programs to identify miRNAs that had potential binding sites in the 3&#x2032; UTR of BATF2 (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2A</bold>
</xref>). We then screened the predicted nine miRNAs using quantitative PCR (qPCR) in both sarcoma tissues (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2B</bold>
</xref>) and cell lines (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2C</bold>
</xref>), which showed that miR-939-3p and miR-455-5p were upregulated in sarcoma tissues and cells compared to controls. Further, BATF2 expression was reduced by miR-939-3p mimic and increased by miR-939-3p inhibitor in both HT-1080 and SW-982 cells (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2D&#x2013;G</bold>
</xref>). However, neither the mimic nor the inhibitor of miR-455-5p could regulate BATF2 expression (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2H&#x2013;K</bold>
</xref>), suggesting that BATF2 expression was repressed by miR-939-3p in sarcoma.</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>BATF2 expression was repressed by miR-939-3p in sarcoma. <bold>(A)</bold> miRNAs in the 3&#x2032;-untranslated region (UTR) region of BATF2 were predicted by using miRDB, miRwalk and targetScan software programs, and 9 common miRNAs were found. <bold>(B, C)</bold> qPCR screening of the predicted 9 miRNAs in control and sarcoma tissues from sarcoma patients <bold>(B)</bold> and HSF and HT-1080 cells <bold>(C)</bold>. <bold>(D&#x2013;K)</bold> qPCR and Western blot analysis of BATF2 expression in HT-1080 cells or SW-982 cells transfected with the mimic or inhibitor of miR-939-3p or miR-455-5p. ns: not significant. *<italic>P &lt;</italic> 0.05, **<italic>P</italic> &lt; 0.01, ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-14-1346531-g002.tif"/>
</fig>
</sec>
<sec id="s3_3">
<label>3.3</label>
<title>Upregulation of miR-939-3p associates with poor prognosis of sarcoma</title>
<p>To explore the role of miR-939-3p, we collected sarcoma tissues and observed an elevated expression of miR-939-3p compared to pericarcinoma tissues (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>). Similarly, sarcoma cell lines (HT-1080 and SW-982) also exhibited higher levels of miR-939-3p compared to a human skin fibroblast cell line (HSF) (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3B</bold>
</xref>). Moreover, circulating miR-939-3p levels were found to be upregulated in sarcoma patients with various histological subtypes, including glioma, malignant soft tissue tumor, pancreatic cancer, gastric cancer, intermediate soft tissue tumor, lung cancer, benign soft tissue tumor, esophageal cancer, colorectal cancer and hepatocellular carcinoma, compared to healthy individuals (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3C</bold>
</xref>).</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Upregulation of miR-939-3p associates with poor prognosis of sarcoma. <bold>(A, B)</bold> qPCR analysis of the expression of miR-939-3p in soft tissue sarcoma and pericarcinoma <bold>(A)</bold> and the human skin fibroblast cell line (HSF), human fibrosarcoma cell line (HT-1080) and synovial sarcoma cell line (SW-982) <bold>(B)</bold>. <bold>(C)</bold> Circulating miR-939-3p levels in healthy individuals (n = 275) and sarcoma patients with various histological subtypes, including glioma (n = 30), malignant soft tissue tumor (n = 402), pancreatic cancer (n = 30), gastric cancer (n = 30), intermediate soft tissue tumor (n = 144), lung cancer (n = 30), benign soft tissue tumor (n = 30), esophageal cancer (n = 30), colorectal cancer (n = 30) and hepatocellular carcinoma (n = 30), were analyzed by using a CancerMIRNome database. <bold>(D&#x2013;G)</bold> Cell viabilities of HT-1080 or SW-982 cells transfected with control, miR-939-3p mimic or inhibitor separately for two days were analyzed by using cell counting kit 8 or BrdU ELISA kit. <bold>(H)</bold> Kaplan-Meier estimates of overall survival time based on miR-939 expression levels from 259 sarcoma patients by using a CancerMIRNome database. Hazard ratio (HR) = 2.69. *<italic>P &lt;</italic> 0.05, **<italic>P</italic>&#xa0;&lt; 0.01, ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-14-1346531-g003.tif"/>
</fig>
<p>Functional experiments further revealed that the viabilities of HT-1080 and SW-982 cells were enhanced by miR-939-3p mimic, while suppressed by miR-939-3p inhibitor, as evidenced by CCK-8 and BrdU incorporation assay (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3D&#x2013;G</bold>
</xref>). Consistent with our hypothesis, Kaplan Meier survival analysis showed a negative correlation between miR-939-3p expression levels and the prognosis of sarcoma patients, as analyzed using both the CancerMIRNome database (<italic>P</italic>&#x2009;=&#x2009;0.014, with a hazard ratio of 2.69) (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3H</bold>
</xref>) and UALCAN databases (<italic>P</italic>&#x2009;=&#x2009;0.0036) (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S1</bold>
</xref>). These data revealed that miR-939-3p was significantly upregulated in sarcoma and was inversely associated with the prognosis of sarcoma patients.</p>
</sec>
<sec id="s3_4">
<label>3.4</label>
<title>miR-939-3p suppresses BATF2 expression via directly binding to its 3&#x2019; UTR</title>
<p>Statistical analysis showed a significantly negative correlation between miR-939-3p and BATF2 expression levels in both sarcoma tissues (r = -0.8600, <italic>P</italic> = 0.0003) (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4A</bold>
</xref>) and colon cancer tissues (r = -0.7162, <italic>P</italic> = 0.0088) (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S2</bold>
</xref>), implying the involvement of a potential miR-939-3p/BATF2 signaling pathway in sarcoma. Based on the predicted binding sites of miR-939-3p in the 3&#x2019; UTR of BATF2 mRNA (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4B</bold>
</xref>), we postulated that miR-939-3p could suppress BATF2 expression through binding to its 3&#x2019; UTR. As shown in <xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4C</bold>
</xref>, luciferase reporter assays confirmed that overexpression of miR-939-3p suppressed the luciferase activity of wild-type (WT) recombinant BATF2 3&#x2019; UTR. As expected, miR-939-3p mimic had no effect on the fluorescence intensity in mutant BATF2 3&#x2019; UTR, where potential binding sites were mutated into ATTTCAA (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4B, C</bold>
</xref>). To validate the miR-939-3p/BATF2 axis, we further examined the downstream genes of BATF2 (<xref ref-type="bibr" rid="B13">13</xref>). Luciferase reporter gene assay and qPCR analysis showed that both AP-1 activity and MET proto-oncogene receptor tyrosine kinase (MET) expression were induced by miR-939-3p mimic, while repressed by miR-939-3p inhibitor (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4D, E</bold>
</xref>). These results demonstrated that miR-939-3p suppresses BATF2 expression through directly binding to its 3&#x2019; UTR.</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>miR-939-3p suppresses BATF2 expression via binding to its 3&#x2019;UTR region. <bold>(A)</bold> Statistical analysis of the negative correlation between miR-939-3p and BATF2 mRNA expression levels by using linear regression and Pearson correlation analysis. <bold>(B)</bold> Bioinformatic analysis of the binding sites of miR-939-3p in the 3&#x2019; UTR of BATF2 mRNA. <bold>(C)</bold> A luciferase reporter assay was performed to verify the binding of miR-939-3p in the 3&#x2019; UTR of BATF2 mRNA. The wild type (WT) 3&#x2019; UTR (GCCCAGG) was mutated into mutant 3&#x2019; UTR (ATTTCAA). ns: not significant. **<italic>P</italic> &lt; 0.01. <bold>(D)</bold> pAP-1-Luc was co-transfected with Renilla into HT-1080 cells in combined with control or miR-939 mimic or inhibitor for luciferase reporter gene assay. pAP-1-Luc activity was normalized against Renilla activity. <bold>(E)</bold> qPCR analysis of MET expression in HT-1080 cells transfected with control or miR-939 mimic or inhibitor. *<italic>P &lt;</italic> 0.05, **<italic>P</italic> &lt; 0.01, ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-14-1346531-g004.tif"/>
</fig>
</sec>
<sec id="s3_5">
<label>3.5</label>
<title>Overexpression of BATF2 attenuates miR-939-3p-mediated sarcoma proliferation</title>
<p>To investigate whether miR-939-3p-mediated regulation of BATF2 is involved in sarcoma proliferation, HT-1080 cells were transfected with BATF2 overexpression plasmids (pBATF2) or control plasmids (pControl) (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5A</bold>
</xref>). It was found that overexpression of BATF2 significantly alleviated the miR-939-3p-mediated suppression of BATF2 expression and promotion of sarcoma cell proliferation (<xref ref-type="fig" rid="f5">
<bold>Figures&#xa0;5B&#x2013;E</bold>
</xref>), as well as cell migration and invasion (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S3</bold>
</xref>). Besides, miR-939-3p could neither further enhance sarcoma cell proliferation nor regulate AP-1 activity or MET expression, when BATF2 was knocked down by a large amount of siRNA in HT-1080 cells (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figures S4A&#x2013;E</bold>
</xref>). These findings collectively suggest that miR-939-3p could induce sarcoma cell proliferation via inhibiting the expression of BATF2.</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>Overexpression of BATF2 attenuates miR-939-3p-mediated cancer proliferation. <bold>(A)</bold> Recombinant BATF2 plasmids (pBATF2) or control plasmids (pControl) were separately transfected into HT-1080 cells by using Lipofectamine 3000. <bold>(B, C)</bold> qPCR and Western blot analysis of BATF2 expression in HT-1080 cells transfected with pControl or pBATF2 treated with control or miR-939-3p mimic. <bold>(D, E)</bold> Cell viability of cells in <bold>(B)</bold> was analyzed by using CCK-8 or BrdU ELISA kit. ns: not significant, *<italic>P &lt;</italic> 0.05, **<italic>P</italic> &lt; 0.01, ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-14-1346531-g005.tif"/>
</fig>
</sec>
<sec id="s3_6">
<label>3.6</label>
<title>miR-939-3p enhances sarcoma growth <italic>in vivo</italic>
</title>
<p>To further examine the role of miR-939-3p, <italic>in vivo</italic> experiments utilizing xenograft nude mouse models were conducted. HT-1080 cells stably infected with lentivirus expressing miR-939-3p or control were injected into the mice separately. Compared to the control mice, the miR-939-3p group exhibited larger tumor volumes and weights (<xref ref-type="fig" rid="f6">
<bold>Figures&#xa0;6A&#x2013;C</bold>
</xref>). As anticipated, miR-939-3p expression was significantly higher in the xenografts of miR-939-3p group, whereas the expression levels of BATF2 mRNA and protein were much lower, compared to the control mice (<xref ref-type="fig" rid="f6">
<bold>Figures&#xa0;6D&#x2013;G</bold>
</xref>), while immunohistochemical staining of Ki67, a biomarker of cell proliferation, showed that Ki67 expression was much higher in tumor xenografts from miR-939-treated mice than that in control mice (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6H</bold>
</xref>). These data revealed that miR-939-3p enhanced sarcoma growth <italic>in vivo</italic>.</p>
<fig id="f6" position="float">
<label>Figure&#xa0;6</label>
<caption>
<p>miR-939-3p enhances sarcoma growth <italic>in vivo</italic>. Xenograft nude mouse models were constructed by subcutaneously injecting 5 &#xd7; 10<sup>6</sup> HT-1080 cells stably infected with lentivirus expressing miR-939-3p or control separately (n = 5 per group). <bold>(A)</bold> The tumor volume was calculated every 3 days, and the mice were sacrificed 21 days after cell inoculation. <bold>(B, C)</bold> The xenografts were excised for the comparisons of tumor size and weight. <bold>(D)</bold> qPCR analysis of miR-939-3p expression in the xenografts. <bold>(E, F)</bold> qPCR and Western blot analyses of BATF2 expression in the xenografts. <bold>(G, H)</bold> Immunohistochemical analyses of the expressions levels of BATF2 and Ki67 in tumor xenografts. n = 5 per group. Data are expressed as mean &#xb1; SD. *<italic>P &lt;</italic> 0.05, **<italic>P</italic> &lt; 0.01, ***<italic>P</italic> &lt; 0.001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-14-1346531-g006.tif"/>
</fig>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<label>4</label>
<title>Discussion</title>
<p>Sarcoma is a type of mesenchymal neoplasm exhibiting distinct prognosis, clinical behavior and treatment options (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B28">28</xref>, <xref ref-type="bibr" rid="B29">29</xref>). Sarcoma is regarded as a formidable type of malignancy to treat, as conventional chemotherapies have yielded frustratingly slow progress, while immunotherapy remains an investigational approach, making sarcoma one of the most difficult tumors to treat (<xref ref-type="bibr" rid="B4">4</xref>). Due to its rarity and histologic heterogeneity, the understanding of sarcoma biology is also relatively limited, compared with that of common epithelial cancers (<xref ref-type="bibr" rid="B1">1</xref>). Notably, the clinical behavior of sarcoma results from interactions at many levels, among which the oncogenes and tumor suppressor genes are crucial driving force for tumorigenesis and progression (<xref ref-type="bibr" rid="B8">8</xref>, <xref ref-type="bibr" rid="B30">30</xref>). We and others have previously found that BATF2 is an important tumor suppressor in many cancers (<xref ref-type="bibr" rid="B9">9</xref>&#x2013;<xref ref-type="bibr" rid="B18">18</xref>), although its role in sarcoma remains unknown. In this study, we found that BATF2 was downregulated in sarcoma tissues and cells, correlating with a poor prognosis of sarcoma patients. Further investigation revealed that BATF2 inhibited the proliferation of sarcoma cells, although the regulatory mechanism and its role in sarcoma remain unclear.</p>
<p>BATF2 belongs to the activator protein 1 (AP-1) family and inhibits AP-1 activity mainly through interacting with AP-1 via its bZIP domain, thereby leading to tumor repression (<xref ref-type="bibr" rid="B10">10</xref>&#x2013;<xref ref-type="bibr" rid="B13">13</xref>). It has been reported that BATF2 is primarily expressed in normal cells but not in the corresponding tumor cells, while the upregulation of BATF2 has been shown to inhibit cancer cell proliferation, angiogenesis, invasion and metastasis (<xref ref-type="bibr" rid="B13">13</xref>, <xref ref-type="bibr" rid="B14">14</xref>), underscoring its importance in cancer therapy. Because of the myriad of tumor suppressor functions of BATF2, it is imperative to elucidate the mechanisms underlying how BATF2 is regulated during tumorigenesis and development. We and others have recently explored the regulators of BATF2, including transcriptional factors, N6-methyladenosine modification and nuclear-cytoplasmic translocation (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B15">15</xref>). Our previous studies have reported glucocorticoid receptor, a transcriptional factor, which suppresses lymphoma cells through inducing BATF2 expression (<xref ref-type="bibr" rid="B10">10</xref>). We have also found that repressing the nuclear export of BATF2 by mutating its nuclear export sequence and suppressing the expression of chromosome region maintenance 1 (CRM1) might serve as potential therapeutic approaches for patients with colorectal cancer (<xref ref-type="bibr" rid="B9">9</xref>). Nevertheless, these studies have still not clarified the reason for the downregulation of BATF2, especially in sarcomas.</p>
<p>In this study, the bioinformatic analysis and experimental verification identified miR-939-3p as a candidate regulator of BATF2 in sarcoma tissues and cell lines, and upregulation of miR-939-3p was associated with a poor prognosis of sarcoma patients, suggesting its role as a potent prognostic biomarker and therapeutic target during sarcoma progression. As reported, miRNAs play a vital role in gene regulatory networks, and have gradually been demonstrated as promising diagnostic and prognostic biomarkers in human cancers, as well as potential targets for cancer therapy (<xref ref-type="bibr" rid="B22">22</xref>, <xref ref-type="bibr" rid="B23">23</xref>, <xref ref-type="bibr" rid="B31">31</xref>). More importantly, accumulated studies have established the therapeutic potential of miRNA mimics or antagomirs against cancer (<xref ref-type="bibr" rid="B32">32</xref>&#x2013;<xref ref-type="bibr" rid="B36">36</xref>). Specifically, miR-939-3p is involved in the pathological processes of tumorigenesis and progression (<xref ref-type="bibr" rid="B37">37</xref>&#x2013;<xref ref-type="bibr" rid="B39">39</xref>). In ovarian cancer, miR-939 was demonstrated to promote tumor proliferation by repressing the expression of adenomatous polyposis coli 2 (APC2) (<xref ref-type="bibr" rid="B37">37</xref>). In hepatocellular carcinoma, miR-939-3p induced epithelial-mesenchymal transition via targeting estrogen receptor 1 (ESR1) (<xref ref-type="bibr" rid="B38">38</xref>). Besides, miR-939-3p was identified as a potential independent prognostic marker in lung cancer (<xref ref-type="bibr" rid="B39">39</xref>). Although miR-939-3p has been studied in several cancers, its contribution to sarcoma proliferation had not been investigated. This work demonstrated for the first time that upregulation of miR-939-3p promoted sarcoma cell proliferation <italic>in vitro</italic> and enhanced tumor growth <italic>in vivo</italic>. Notably, clinical survival analysis revealed a negative correlation between miR-939-3p and BATF2 expression levels, and subsequent mechanistic studies illustrated that miR-939-3p suppressed BATF2 expression via binding to its 3&#x2019; UTR region. It has also been reported that miR-939 could induce mRNA degradation of its target gene (<xref ref-type="bibr" rid="B40">40</xref>), further supporting our results. These findings may shed new light on the oncogenic role of miR-939-3p targeting BATF2 in sarcomas.</p>
<p>Moreover, this study also found that circulating miR-939-3p levels were higher in tumor patients than that in healthy individuals. Due to their stable existence in circulation and enormous potential as non-invasive early detection biomarkers for cancer (<xref ref-type="bibr" rid="B22">22</xref>, <xref ref-type="bibr" rid="B23">23</xref>), exploring the role of circulating miR-939-3p as a biomarker for sarcomas is also an interesting topic. Besides, it has been reported that miRNA-765 mediated multidrug resistance (MDR) via targeting BATF2 in gastric cancer cells (<xref ref-type="bibr" rid="B19">19</xref>). To investigate the roles of miRNA in chemo-resistance, a previous report have examined the miRNA expression profiles on 4 responder and 4 non-responder colon cancer to chemotherapy (<xref ref-type="bibr" rid="B41">41</xref>). The miRNA profiling data indicated that miR-939 was one of the most upregulated miRNAs in responder, compared with non-responder. However, subsequent screening and validation experiments excluded miR-939, since there was no significant difference in the expression level of miR-939 between non-responder and responder colon cancer patients (<xref ref-type="bibr" rid="B41">41</xref>). Therefore, it would be also interesting to explore the association between miR-939-3p and MDR in the future studies.</p>
<p>In summary, this study identified BATF2 as the target gene of miR-939-3p in sarcoma, and revealed that both upregulated miR-939-3p and downregulated BATF2 expression levels were significantly associated with a poor prognosis of sarcoma patients. Further mechanistic studies demonstrated that miR-939-3p promoted sarcoma cell proliferation via binding to the 3&#x2019; UTR of BATF2 (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7</bold>
</xref>). These findings suggest that suppressing miR-939-3p or inducing BATF2 expression may represent a new therapeutic strategy for sarcoma treatment, which may provide novel insights for the development of potent therapeutic approaches for sarcoma patients.</p>
<fig id="f7" position="float">
<label>Figure&#xa0;7</label>
<caption>
<p>A proposed model elucidating the mechanism of miR-939-3p-induced sarcoma proliferation and poor prognosis through suppressing BATF2 via directly binding to its 3&#x2019; UTR.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fonc-14-1346531-g007.tif"/>
</fig>
</sec>
<sec id="s5" sec-type="data-availability">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Material</bold>
</xref>. Further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec id="s6" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>The studies involving humans were approved by People&#x2019;s Hospital of Xishui County. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. The animal study was approved by Animal Welfare and Ethics Committee of Army Medical University. The study was conducted in accordance with the local legislation and institutional requirements.</p>
</sec>
<sec id="s7" sec-type="author-contributions">
<title>Author contributions</title>
<p>WX: Data curation, Formal analysis, Investigation, Methodology, Resources, Writing &#x2013; original draft. YH: Funding acquisition, Methodology, Software, Validation, Writing &#x2013; review &amp; editing. ZL: Software, Supervision, Validation, Visualization, Writing &#x2013; review &amp; editing. JZ: Conceptualization, Funding acquisition, Project administration, Supervision, Writing &#x2013; review &amp; editing.</p>
</sec>
</body>
<back>
<sec id="s8" sec-type="funding-information">
<title>Funding</title>
<p>The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by Natural Science Foundation of Chongqing Science &amp; Technology Commission (CSTB2022NSCQ-MSX0220) and National Natural Science Foundation of China (No. 82322012, 82170705, 81802783).</p>
</sec>
<sec id="s9" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s10" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s11" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fonc.2024.1346531/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fonc.2024.1346531/full#supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="DataSheet_1.zip" id="SM1" mimetype="application/zip"/>
<supplementary-material xlink:href="DataSheet_2.docx" id="SM2" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
</sec>
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