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FOXK2 promotes ovarian cancer stemness by regulating the unfolded protein response pathway
Yaqi Zhang, … , Mazhar Adli, Daniela Matei
Yaqi Zhang, … , Mazhar Adli, Daniela Matei
Published March 29, 2022
Citation Information: J Clin Invest. 2022;132(10):e151591. https://doi.org/10.1172/JCI151591.
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Research Article Cell biology Oncology

FOXK2 promotes ovarian cancer stemness by regulating the unfolded protein response pathway

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Abstract

Understanding the regulatory programs enabling cancer stem cells (CSCs) to self-renew and drive tumorigenicity could identify new treatments. Through comparative chromatin-state and gene expression analyses in ovarian CSCs versus non-CSCs, we identified FOXK2 as a highly expressed stemness-specific transcription factor in ovarian cancer. Its genetic depletion diminished stemness features and reduced tumor initiation capacity. Our mechanistic studies highlight that FOXK2 directly regulated IRE1α (encoded by ERN1) expression, a key sensor for the unfolded protein response (UPR). Chromatin immunoprecipitation and sequencing revealed that FOXK2 bound to an intronic regulatory element of ERN1. Blocking FOXK2 from binding to this enhancer by using a catalytically inactive CRISPR/Cas9 (dCas9) diminished IRE1α transcription. At the molecular level, FOXK2-driven upregulation of IRE1α led to alternative XBP1 splicing and activation of stemness pathways, while genetic or pharmacological blockade of this sensor of the UPR inhibited ovarian CSCs. Collectively, these data establish what we believe is a new function for FOXK2 as a key transcriptional regulator of CSCs and a mediator of the UPR, providing insight into potentially targetable new pathways in CSCs.

Authors

Yaqi Zhang, Yinu Wang, Guangyuan Zhao, Edward J. Tanner, Mazhar Adli, Daniela Matei

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Figure 1

FOXK2 expression is upregulated in ovarian CSCs.

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FOXK2 expression is upregulated in ovarian CSCs.
(A and B) FOXK2 mRNA ex...
(A and B) FOXK2 mRNA expression levels measured by qRT-PCR in ALDH+ and ALDH– cells sorted by FACS from HGSOC tumors (n = 5) (A), or from OVCAR5 (n = 3) and COV362 (n = 3) OC cell lines (B). (C) FOXK2 mRNA expression in ALDH-enriched spheroids and monolayers generated from OVCAR5, OVCAR3, and COV362 (n = 3 per cell line). (D) FOXK2 IHC staining in sections of fallopian tube epithelium (FTE, n = 6) and tumors after neoadjuvant chemotherapy (NACT, n = 19) from a tissue microarray (TMA). (E) FOXK2 expression from RNA-seq data analyzed with RSEM in normal FTE tissue (n = 5) and OC tissue (OV, n = 427) from TCGA and GTEx databases. (F) A Kaplan-Meier plot shows survival of OC patients with high (top 25th percentile, n = 155) and low (bottom 25th percentile, n = 154) FOXK2 mRNA expression levels obtained from TCGA and GEO databases (n = 614). (G) Upper: FOXK2 expression levels measured by qRT-PCR (n = 3) in OVCAR5, OVCAR3, and patient HGSOC primary cells transduced with 2 different shRNAs targeting FOXK2 (shFOXK2-1 and shFOXK2-2) or control shRNAs (shCtrl). Lower: Western blot of FOXK2 protein levels in shCtrl and shFOXK2 OVCAR5 and OVCAR3 cells. (H) Percentage of ALDH+ cells determined by flow cytometry analysis in shFOXK2- and shCtrl-transduced OVCAR5, OVCAR3, and COV362 cells (n = 3 per cell line) (upper), and representative analysis of the ALDH+ cell populations in OVCAR5 cells (lower). (I) Relative cell viability in spheroids generated by shFOXK2 and shCtrl OVCAR5, OVCAR3, or COV362 cells (n = 6). *P < 0.05; **P < 0.01; ***P < 0.005; ****P < 0.0001, by log-rank test for survival (F) and unpaired, 2-tailed Student’s t test for the other panels.

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