Theranostics 2017; 7(12):3138-3154. doi:10.7150/thno.19506

Research Paper

RBFOX3 Promotes Tumor Growth and Progression via hTERT Signaling and Predicts a Poor Prognosis in Hepatocellular Carcinoma

Tianze Liu1, 4*, Wenbin Li1*, Wenjing Lu4*, Miao Chen1*, Meihua Luo2, Changlin Zhang1, Yixin Li1, Ge Qin1, Dingbo Shi1, Binyi Xiao1, Huijuan Qiu1, Wendan Yu3, Lan Kang3, Tiebang Kang1, Wenlin Huang1, 5, Xinfa Yu2✉, Xiaojun Wu1✉, Wuguo Deng1✉

1. Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, China;
2. ShunDe Hospital of Southern Medical University, Foshan, Guangdong, China;
3. Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China;
4. The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China;
5. State Key Laboratory of Targeted Drug for Tumors of Guangdong Province, Guangzhou Double Bioproduct Inc., Guangzhou, China.
* These authors contributed equally to this article.


Activation of the telomere maintenance mechanism is a key hallmark of cancer. Human telomerase reverse transcriptase (hTERT) is the catalytic subunit of telomerase, which is highly expressed in more than 80% of tumors, including hepatocellular carcinoma (HCC). However, the exact mechanisms by which hTERT is up-regulated in HCCs and promotes tumor growth and progression is not fully understood. The aim of this study was to discover the novel molecular targets that modulate hTERT signaling and HCC growth. In this study, we pulled down and identified RBFOX3 (RNA binding protein fox-1 homolog 3) as a novel hTERT promoter-binding protein in HCC cells using biotin-streptavidin-agarose pull-down and proteomics approach, and validated it as a regulatory factor for hTERT signaling and tumor growth in HCCs. Knockdown of RBFOX3 suppressed the promoter activity and expression of hTERT and consequently inhibited the growth and progression of HCC cells in vitro and in vivo. The suppression of HCC growth mediated by RBFOX3 knockdown could be rescued by hTERT overexpression. Conversely, exogenous overexpression of RBFOX3 activated the promoter activity and expression of hTERT and promoted the growth and progression of HCC cells. Moreover, we found that RBFOX3 interacted with AP-2β to regulate the expression of hTERT. Furthermore, we demonstrated that RBFOX3 expression was higher in the tumor tissues of HCC patients compared to the corresponding paracancer tissues, and was positively correlated with hTERT expression. Kaplan-Meier analysis showed that the HCC patients with high levels of RBFOX3 and hTERT had poor prognosis. Collectively, our data indicate that RBFOX3 promotes HCC growth and progression and predicts a poor prognosis by activating the hTERT signaling, and suggest that the RBFOX3/hTERT pathway may be a potential therapeutic target for HCC patients.

Keywords: HCC, telomerase reverse transcriptase, promoter-binding protein.

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How to cite this article:
Liu T, Li W, Lu W, Chen M, Luo M, Zhang C, Li Y, Qin G, Shi D, Xiao B, Qiu H, Yu W, Kang L, Kang T, Huang W, Yu X, Wu X, Deng W. RBFOX3 Promotes Tumor Growth and Progression via hTERT Signaling and Predicts a Poor Prognosis in Hepatocellular Carcinoma. Theranostics 2017; 7(12):3138-3154. doi:10.7150/thno.19506. Available from