# SPINK5 is a Tumor-Suppressor Gene Involved in the Progression of Nonsmall Cell Lung Carcinoma through Negatively Regulating PSIP1

Authors: Jiaojiao Zhang; Jingfeng Rong; Wen Ge; Jing Wang; Wenjin Wang; Hao Chi
Journal: Journal of Healthcare Engineering
 (2022)

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## Abstract

This study aimed to elucidate how SPINK5 affects the malignant phenotypes of NSCLC and the molecular mechanism. NSCLC and adjacent normal tissues were collected to detect the differential level of SPINK5. The influence of SPINK5 on pathological indicators of NSCLC was analyzed. Cellular functions of NSCLC cells overexpressing SPINK5 were assessed by CCK-8, EdU, and transwell assay. By confirming the downstream target of SPINK5, its molecular mechanism on regulating NSCLC was finally explored through rescue experiments. SPINK5 was lowly expressed in NSCLC tissues, and it predicted tumor staging and lymphatic metastasis. In vitro overexpression of SPINK5 declined proliferative and migratory rates in NSCLC cells. PSIP1 was verified as the target gene binding SPINK5, and they displayed a negative correlation in NSCLC tissues. Overexpression of PSIP1 was able to reverse the inhibited proliferative and migratory potentials in NSCLC cells overexpressing SPINK5. SPINK5 level has a close relation to tumor staging and lymphatic metastasis in NSCLC. It serves as a tumor-suppressor gene that inhibits proliferation and migration of NSCLC through negatively regulating PSIP1.


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## Body

## 1. Introduction

Lung carcinoma is the main reason for cancer-associated death and its incidence is in the high place [1, 2]. According to tumor statistics released by the American Cancer Society in 2018, lung carcinoma is the leading cause of both male and female cancer deaths, accounting for 25% of total cancer deaths [3, 4]. In China, the incidence and mortality of lung carcinoma are in the first place [5, 6]. NSCLC, including lung adenocarcinoma and squamous cell carcinoma, is the most commonly diagnosed subtype of lung carcinoma (80–85%) [7]. At present, the 5-year survival of NSCLC has not been significantly enhanced although medical technologies are progressed [8, 9]. Comprehensively understanding the molecular mechanism of NSCLC is beneficial to develop novel therapeutic targets [10, 11].SPINK5 (serine peptidase inhibitor, Kazal type 5) is secreted and synthesized in human pancreatic acinar cells, exerting biological functions of trypsin inhibitor, growth factor-like phenotypes, and autophagy inhibitor [12, 13]. It is located on chromosome 5, containing 4 exons and 3 introns [12, 13]. A mature SPINK5 gene has 56 amino acids, which is connected by 3 disulfide bridges [14]. Recent research has shown the vital function of SPINK5 in pancreatitis and tumors [15–17]. To date, no evidence reported the effects of SPINK5 in lung cancer. Through bioinformatic analysis, SPINK5 was predicted to bind PSIP1. This study aims to explore the role of SPINK5/PSIP1 axis in regulating the malignant progression of NSCLC, therefore providing a novel idea in clinical diagnosis and treatment.


## 2. Materials and Methods

### 2.1. Patients and NSCLC Samples

A total of 46 NSCLC patients undergoing surgical resection in Shuguang Hospital affiliated to Shanghai University of Chinese Medicine were retrospectively analyzed. They did not have preoperative anticancer treatment. T stage of NSCLC was defined by UICC criteria. NSCLC and the paired paracarcinoma tissue were harvested during surgery and stored in liquid nitrogen. Each patient was followed up after discharge for their general condition, symptoms, and imaging examination through telephone and outpatient review. This study was approved by the research ethics committee of our hospital and complied with the Helsinki Declaration. Informed consent was obtained from patients.


### 2.2. Cell Lines and Reagents

NSCLC cell lines (A549, H1299, PC-9, H358, and SPC-A1) and the human bronchial epithelial cell line (BEAS-2B) purchased from American Type Culture Collection (ATCC) (Manassas, VA, USA) were cultivated in Dulbecco’s modified eagle medium (DMEM) (Gibco, Rockville, MD, USA) containing 10% fetal bovine serum (FBS) (Gibco, Rockville, MD, USA) in a humidified environment with 5% CO2 at 37°C.


### 2.3. Transfection

Transfection plasmids were synthesized by GenePharma (Shanghai, China). Cells were cultured to 40–60% density in a 6-well plate and transfected using Lipofectamine 2000 (Invitrogen, Carlsbad, CA, USA). After 48 h cell transfection, cells were collected for verifying transfection efficacy and functional experiments.


### 2.4. Cell Proliferation Assay

Cells were inoculated in a 96-well plate with 2 × 103 cells/well. At 24, 48, 72, and 96 h, optical density at 450 nm of each sample was recorded using the cell counting kit-8 (CCK-8) kit (Dojindo Laboratories, Kumamoto, Japan) for plotting the viability curves.


### 2.5. 5-Ethynyl-2′-Deoxyuridine (EdU) Assay

10μL of EdU (50 μM) was applied for cell labeling. Two hours later, cells were incubated with 4% methanol for 20 min, followed by PBS washing and incubation with Cell-Light™EdU Apollo®488 (Life Technologies, New York, NY, USA). 4′,6-Diamidino-2-phenylindole (DAPI) was used for nuclei staining in the dark. Finally, cells were washed in phosphate buffered saline (PBS) and captured for calculating EdU-positive rate.


### 2.6. Transwell Migration Assay

Cell suspension was prepared at 5 × 105 cells/mL. 200 μL of suspension and 700 μL of medium containing 20% FBS were, respectively, added on the top and bottom of a transwell insert and cultured for 48 h. Migratory cells on the bottom were induced with methanol for 15 min, 0.2% crystal violet for 20 min, and captured using a microscope. Five random fields per sample were selected for capturing and counting migratory cells.


### 2.7. Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR)

Cells were lysed using TRIzol reagent (Invitrogen, Carlsbad, CA, USA) for isolating RNAs. Qualified RNAs were reversely transcribed into complementary deoxyribose nucleic acids (cDNAs) using the AMV reverse transcription kit (TaKaRa, Otsu, Japan), followed by qRT-PCR using SYBR®Premix Ex Taq™ (TaKaRa, Otsu, Japan). Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) was the internal reference. Each sample was performed in triplicate, and the relative level was calculated by 2−ΔΔCt. The following plasmids were used in qRT-PCR. SPINK5: forward: 5′-ACCTGTAGGCGACTTGCATC-3′; reverse: 5′-TCATGGCACATTTCCTGATCT-3′; PSIP1: forward: 5′-CGATTCCGAGCCGTTGAGA-3′; reverse: 5′-TCCCGACGCGCCTGC-3′; GAPDH: forward: 5′-CCTGGCACCCAGCACAAT-3′; reverse: 5′-TGCCGTAGGTGTCCCTTTG-3′.


### 2.8. Western Blot

Cells were lysed in radioimmunoprecipitation assay (RIPA) (Beyotime, Shanghai, China) on ice for 15 min, and the mixture was centrifuged at 14000× g, 4°C for 15 min. The concentration of cellular protein was determined by the bicinchoninic acid (BCA) method (Beyotime, Shanghai, China). Protein samples with the adjusted same concentration were separated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and loaded on polyvinylidene fluoride (PVDF) membrane (Millipore, Billerica, MA, USA). The membrane was cut into small pieces according to the molecular size and blocked in 5% skim milk for 2 h. They were incubated with primary and secondary antibodies, followed by band exposure and grey value analyses.


### 2.9. Dual-Luciferase Reporter Assay

PmirGLO-SPINK5-WT and pmirGLO-SPINK5-MUT were synthesized based on the predicted binding site in the 3′untranslated region (3′UTR) of SPINK5 and PSIP1. They were, respectively, cotransfected in HEK293T cells with pcDNA-NC or pcDNA-PSIP1 for 48 h. Luciferase activity (Promega, Madison, WI, USA) was finally measured in a standard method.


### 2.10. Statistical Analysis

Statistical Product and Service Solutions (SPSS) 22.0 (IBM, Armonk, NY, USA) was used for statistical analyses and data were expressed as mean ± standard deviation. Differences between groups were compared by thet-test. Clinical significance of SPINK5 in affecting NSCLC was analyzed by the chi-square test. P < 0.05 was considered as statistically significant.


## 2.1. Patients and NSCLC Samples

A total of 46 NSCLC patients undergoing surgical resection in Shuguang Hospital affiliated to Shanghai University of Chinese Medicine were retrospectively analyzed. They did not have preoperative anticancer treatment. T stage of NSCLC was defined by UICC criteria. NSCLC and the paired paracarcinoma tissue were harvested during surgery and stored in liquid nitrogen. Each patient was followed up after discharge for their general condition, symptoms, and imaging examination through telephone and outpatient review. This study was approved by the research ethics committee of our hospital and complied with the Helsinki Declaration. Informed consent was obtained from patients.


## 2.2. Cell Lines and Reagents

NSCLC cell lines (A549, H1299, PC-9, H358, and SPC-A1) and the human bronchial epithelial cell line (BEAS-2B) purchased from American Type Culture Collection (ATCC) (Manassas, VA, USA) were cultivated in Dulbecco’s modified eagle medium (DMEM) (Gibco, Rockville, MD, USA) containing 10% fetal bovine serum (FBS) (Gibco, Rockville, MD, USA) in a humidified environment with 5% CO2 at 37°C.


## 2.3. Transfection

Transfection plasmids were synthesized by GenePharma (Shanghai, China). Cells were cultured to 40–60% density in a 6-well plate and transfected using Lipofectamine 2000 (Invitrogen, Carlsbad, CA, USA). After 48 h cell transfection, cells were collected for verifying transfection efficacy and functional experiments.


## 2.4. Cell Proliferation Assay

Cells were inoculated in a 96-well plate with 2 × 103 cells/well. At 24, 48, 72, and 96 h, optical density at 450 nm of each sample was recorded using the cell counting kit-8 (CCK-8) kit (Dojindo Laboratories, Kumamoto, Japan) for plotting the viability curves.


## 2.5. 5-Ethynyl-2′-Deoxyuridine (EdU) Assay

10μL of EdU (50 μM) was applied for cell labeling. Two hours later, cells were incubated with 4% methanol for 20 min, followed by PBS washing and incubation with Cell-Light™EdU Apollo®488 (Life Technologies, New York, NY, USA). 4′,6-Diamidino-2-phenylindole (DAPI) was used for nuclei staining in the dark. Finally, cells were washed in phosphate buffered saline (PBS) and captured for calculating EdU-positive rate.


## 2.6. Transwell Migration Assay

Cell suspension was prepared at 5 × 105 cells/mL. 200 μL of suspension and 700 μL of medium containing 20% FBS were, respectively, added on the top and bottom of a transwell insert and cultured for 48 h. Migratory cells on the bottom were induced with methanol for 15 min, 0.2% crystal violet for 20 min, and captured using a microscope. Five random fields per sample were selected for capturing and counting migratory cells.


## 2.7. Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR)

Cells were lysed using TRIzol reagent (Invitrogen, Carlsbad, CA, USA) for isolating RNAs. Qualified RNAs were reversely transcribed into complementary deoxyribose nucleic acids (cDNAs) using the AMV reverse transcription kit (TaKaRa, Otsu, Japan), followed by qRT-PCR using SYBR®Premix Ex Taq™ (TaKaRa, Otsu, Japan). Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) was the internal reference. Each sample was performed in triplicate, and the relative level was calculated by 2−ΔΔCt. The following plasmids were used in qRT-PCR. SPINK5: forward: 5′-ACCTGTAGGCGACTTGCATC-3′; reverse: 5′-TCATGGCACATTTCCTGATCT-3′; PSIP1: forward: 5′-CGATTCCGAGCCGTTGAGA-3′; reverse: 5′-TCCCGACGCGCCTGC-3′; GAPDH: forward: 5′-CCTGGCACCCAGCACAAT-3′; reverse: 5′-TGCCGTAGGTGTCCCTTTG-3′.


## 2.8. Western Blot

Cells were lysed in radioimmunoprecipitation assay (RIPA) (Beyotime, Shanghai, China) on ice for 15 min, and the mixture was centrifuged at 14000× g, 4°C for 15 min. The concentration of cellular protein was determined by the bicinchoninic acid (BCA) method (Beyotime, Shanghai, China). Protein samples with the adjusted same concentration were separated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and loaded on polyvinylidene fluoride (PVDF) membrane (Millipore, Billerica, MA, USA). The membrane was cut into small pieces according to the molecular size and blocked in 5% skim milk for 2 h. They were incubated with primary and secondary antibodies, followed by band exposure and grey value analyses.


## 2.9. Dual-Luciferase Reporter Assay

PmirGLO-SPINK5-WT and pmirGLO-SPINK5-MUT were synthesized based on the predicted binding site in the 3′untranslated region (3′UTR) of SPINK5 and PSIP1. They were, respectively, cotransfected in HEK293T cells with pcDNA-NC or pcDNA-PSIP1 for 48 h. Luciferase activity (Promega, Madison, WI, USA) was finally measured in a standard method.


## 2.10. Statistical Analysis

Statistical Product and Service Solutions (SPSS) 22.0 (IBM, Armonk, NY, USA) was used for statistical analyses and data were expressed as mean ± standard deviation. Differences between groups were compared by thet-test. Clinical significance of SPINK5 in affecting NSCLC was analyzed by the chi-square test. P < 0.05 was considered as statistically significant.


## 3. Results

### 3.1. Clinical Significance of Downregulated SPINK5 in NSCLC

The results of qRT-PCR showed that the expression level of SPINK5 in NSCLC tissues was significantly lower than that in adjacent tissues (Figure1(a)). In addition, compared with BEAS-2B cells, the SPINK5 level was much lower in NSCLC cells (Figure 1(b)). According to the median level of SPINK5 in 46 NSCLC tissues, recruited patients were divided into the high expression group and low expression group. The relationship between SPINK5 expression and pathological parameters of NSCLC patients was analyzed. As given in Table 1, lymphatic metastasis and high T staging were more likely to occur in patients with low expression of SPINK5. Therefore, SPINK5 may be used as a new biological indicator to predict the malignant progression of NSCLC.Figure 1
Clinical significance of downregulated SPINK5 in NSCLC. (a) Differential level of SPINK5 in NSCLC and normal tissues. (b) SPINK5 levels in NSCLC cell lines.∗P<0.05, ∗∗P<0.01, ∗∗∗P<0.001.
(a)(b)Table 1
Demographic data of the patients with nonsmall cell lung cancer in low and high SPINK5 expression groups.
ParametersNumber of casesSPINK5 expressionP valueHigh (n = 28)Low (n = 18)Age (years)<60221390.813≥6024159GenderMale221570.331Female241311T stageT1-T2282260.002T3-T418612Lymph node metastasisNo302280.018Yes16610Distance metastasisNo3220120.732Yes1486


### 3.2. Overexpression of SPINK5 Inhibited NSCLC to Proliferate and Migrate

In NSCLC cell lines H1299 and SPC-A1, the SPINK5 overexpression model was first constructed. The qRT-PCR results suggested that transfection of pcDNA-SPINK5 could significantly upregulate SPINK5 in NSCLC cells (Figure2(a)). Subsequently, CCK-8 assay uncovered that compared with those transfected with pcDNA-NC, viability remarkably decreased after overexpression of SPINK5 in H1299 and SPC-A1 cells (Figure 2(b)). Consistently, EdU assay also yielded the conclusion that overexpression of SPINK5 attenuated the proliferative rate in NSCLC cells (Figure 2(c)). In addition, the migratory ability in H1299 and SPC-A1 cells was reduced after overexpression of SPINK5 (Figure 2(d)).Figure 2
Overexpression of SPINK5 inhibited NSCLC to proliferate and migrate. (a) Transfection efficacy of pcDNA-SPINK5 in H1299 and SPC-A1 cells. (b) Viability in H1299 and SPC-A1 cells overexpressing SPINK5. (c) EdU-positive rate in H1299 and SPC-A1 cells overexpressing SPINK5. (d) Migration in H1299 and SPC-A1 cells overexpressing SPINK5.∗P<0.05, ∗∗P<0.01.
(a)(b)(c)(d)


### 3.3. PSIP1 Was Highly Expressed in NSCLC Tissues and Cell Lines and Bound to SPINK5

To further explore the way of SPINK5 to alleviate the malignant progression of NSCLC, we predicted the potential downstream gene of SPINK5. A binding site pairing to SPINK5 sequences was identified in PSIP1 3′UTR. In H1299 and SPC-A1 cells overexpressing SPINK5, PSIP1 was markedly downregulated (Figure3(a)). Converse to the expression characteristic of SPINK5, PSIP1 was upregulated in NSCLC tissues and cell lines (Figures 3(b) and 3(c)). Moreover, a negative correlation was discovered between SPINK5 and PSIP1 levels in NSCLC tissues. Converse to the expression characteristic of SPINK5, PSIP1 was upregulated in NSCLC tissues and cell lines. Later, dual-luciferase reporter assay uncovered that overexpression of PSIP1 was only able to decrease luciferase activity in pmirGLO-SPINK5-WT, verifying the binding between SPINK5 and PSIP1 (Figure 3(d)).Figure 3
PSIP1 was highly expressed in NSCLC tissues and cell lines and bound to SPINK5. (a) PSIP1 level in H1299 and SPC-A1 cells overexpressing SPINK5. (b) Differential level of PSIP1 in NSCLC and normal tissues. (c) PSIP1 levels in NSCLC cell lines. (d) The interaction between SPINK5 and PSIP1.∗P<0.05, ∗∗P<0.01, ∗∗∗P<0.001.
(a)(b)(c)(d)


### 3.4. SPINK5/PSIP1 Axis Inhibited NSCLC to Proliferate and Migrate

Rescue experiments were carried out to elucidate the synergistical regulation of both SPINK5 and PSIP1 in cell phenotypes of NSCLC. Co-overexpression of SPINK5 and PSIP1 resulted in a lower level of SPINK5 in H1299 and SPC-A1 cells than those overexpressing SPINK5 (Figure4(a)). Subsequently, both CCK-8 and EdU assays showed that compared with single transfection of pcDNA-SPINK5, the proliferative capacity of NSCLC cells was markedly enhanced by cotransfection of pcDNA-SPINK5 and pcDNA-PSIP1 (Figures 4(b) and 4(c)). A higher number of migratory cells was detected in NSCLC cells co-overexpressing SPINK5 and PSIP1 than those overexpressing SPINK5 only (Figure 4(d)).Figure 4
SPINK5/PSIP1 axis inhibited NSCLC to proliferate and migrate. (a) SPINK5 levels in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1. (b) Viability in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1. (c) EdU-positive rate in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1. (d) Migration in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1.∗P<0.05, ∗∗P<0.01.
(a)(b)(c)(d)


## 3.1. Clinical Significance of Downregulated SPINK5 in NSCLC

The results of qRT-PCR showed that the expression level of SPINK5 in NSCLC tissues was significantly lower than that in adjacent tissues (Figure1(a)). In addition, compared with BEAS-2B cells, the SPINK5 level was much lower in NSCLC cells (Figure 1(b)). According to the median level of SPINK5 in 46 NSCLC tissues, recruited patients were divided into the high expression group and low expression group. The relationship between SPINK5 expression and pathological parameters of NSCLC patients was analyzed. As given in Table 1, lymphatic metastasis and high T staging were more likely to occur in patients with low expression of SPINK5. Therefore, SPINK5 may be used as a new biological indicator to predict the malignant progression of NSCLC.Figure 1
Clinical significance of downregulated SPINK5 in NSCLC. (a) Differential level of SPINK5 in NSCLC and normal tissues. (b) SPINK5 levels in NSCLC cell lines.∗P<0.05, ∗∗P<0.01, ∗∗∗P<0.001.
(a)(b)Table 1
Demographic data of the patients with nonsmall cell lung cancer in low and high SPINK5 expression groups.
ParametersNumber of casesSPINK5 expressionP valueHigh (n = 28)Low (n = 18)Age (years)<60221390.813≥6024159GenderMale221570.331Female241311T stageT1-T2282260.002T3-T418612Lymph node metastasisNo302280.018Yes16610Distance metastasisNo3220120.732Yes1486


## 3.2. Overexpression of SPINK5 Inhibited NSCLC to Proliferate and Migrate

In NSCLC cell lines H1299 and SPC-A1, the SPINK5 overexpression model was first constructed. The qRT-PCR results suggested that transfection of pcDNA-SPINK5 could significantly upregulate SPINK5 in NSCLC cells (Figure2(a)). Subsequently, CCK-8 assay uncovered that compared with those transfected with pcDNA-NC, viability remarkably decreased after overexpression of SPINK5 in H1299 and SPC-A1 cells (Figure 2(b)). Consistently, EdU assay also yielded the conclusion that overexpression of SPINK5 attenuated the proliferative rate in NSCLC cells (Figure 2(c)). In addition, the migratory ability in H1299 and SPC-A1 cells was reduced after overexpression of SPINK5 (Figure 2(d)).Figure 2
Overexpression of SPINK5 inhibited NSCLC to proliferate and migrate. (a) Transfection efficacy of pcDNA-SPINK5 in H1299 and SPC-A1 cells. (b) Viability in H1299 and SPC-A1 cells overexpressing SPINK5. (c) EdU-positive rate in H1299 and SPC-A1 cells overexpressing SPINK5. (d) Migration in H1299 and SPC-A1 cells overexpressing SPINK5.∗P<0.05, ∗∗P<0.01.
(a)(b)(c)(d)


## 3.3. PSIP1 Was Highly Expressed in NSCLC Tissues and Cell Lines and Bound to SPINK5

To further explore the way of SPINK5 to alleviate the malignant progression of NSCLC, we predicted the potential downstream gene of SPINK5. A binding site pairing to SPINK5 sequences was identified in PSIP1 3′UTR. In H1299 and SPC-A1 cells overexpressing SPINK5, PSIP1 was markedly downregulated (Figure3(a)). Converse to the expression characteristic of SPINK5, PSIP1 was upregulated in NSCLC tissues and cell lines (Figures 3(b) and 3(c)). Moreover, a negative correlation was discovered between SPINK5 and PSIP1 levels in NSCLC tissues. Converse to the expression characteristic of SPINK5, PSIP1 was upregulated in NSCLC tissues and cell lines. Later, dual-luciferase reporter assay uncovered that overexpression of PSIP1 was only able to decrease luciferase activity in pmirGLO-SPINK5-WT, verifying the binding between SPINK5 and PSIP1 (Figure 3(d)).Figure 3
PSIP1 was highly expressed in NSCLC tissues and cell lines and bound to SPINK5. (a) PSIP1 level in H1299 and SPC-A1 cells overexpressing SPINK5. (b) Differential level of PSIP1 in NSCLC and normal tissues. (c) PSIP1 levels in NSCLC cell lines. (d) The interaction between SPINK5 and PSIP1.∗P<0.05, ∗∗P<0.01, ∗∗∗P<0.001.
(a)(b)(c)(d)


## 3.4. SPINK5/PSIP1 Axis Inhibited NSCLC to Proliferate and Migrate

Rescue experiments were carried out to elucidate the synergistical regulation of both SPINK5 and PSIP1 in cell phenotypes of NSCLC. Co-overexpression of SPINK5 and PSIP1 resulted in a lower level of SPINK5 in H1299 and SPC-A1 cells than those overexpressing SPINK5 (Figure4(a)). Subsequently, both CCK-8 and EdU assays showed that compared with single transfection of pcDNA-SPINK5, the proliferative capacity of NSCLC cells was markedly enhanced by cotransfection of pcDNA-SPINK5 and pcDNA-PSIP1 (Figures 4(b) and 4(c)). A higher number of migratory cells was detected in NSCLC cells co-overexpressing SPINK5 and PSIP1 than those overexpressing SPINK5 only (Figure 4(d)).Figure 4
SPINK5/PSIP1 axis inhibited NSCLC to proliferate and migrate. (a) SPINK5 levels in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1. (b) Viability in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1. (c) EdU-positive rate in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1. (d) Migration in H1299 and SPC-A1 cells co-overexpressing SPINK5 and PSIP1.∗P<0.05, ∗∗P<0.01.
(a)(b)(c)(d)


## 4. Discussion

Although most patients have received the active treatment, the 5-year survival of NSCLC is lower than 15% [5–7]. For the diagnosis and treatment of NSCLC, there is still a lack of adequate gene targets. Hence, it is very necessary to screen for more suitable biomarkers of NSCLC with high specificity and sensitivity [8–10]. In recent years, with the progress of genetic engineering and proteomics, the discovery of new tumor markers has become possible [10, 11]. SPINK5 is a secreted polypeptide, which is able to inhibit the activities of various serine proteases such as trypsinogen [12–15]. Subsequent research found that SPINK5 participates in the development of human cancers through EGFR signaling owing to the similar structure to that of EGF [15–17]. A previous study demonstrated that SPINK5 was differentially expressed between ever and never smokers, with concordant higher expression in ever smokers [18].In the present study, SPINK5 was downregulated in NSCLC tissues in comparison to normal ones. Its level was identified to have a relation to tumor staging and lymphatic metastasis of NSCLC. Therefore, it is speculated that SPINK5 may serve an anticancer role in NSCLC. Subsequently, H1299 and SPC-A1 cells with a relatively low expression of SPINK5 were selected to generate SPINK5 overexpression models by transfection of pcDNA-SPINK5. Overexpression of SPINK5 resulted in decline of proliferative and migratory potentials of NSCLC.As PSIP1 is predicted and verified to be the downstream gene of SPINK5, its biological function in affecting NSCLC cell behaviors was analyzed. PSIP1 was upregulated in NSCLC tissues and negatively correlated to SPINK5. In addition, overexpression of PSIP1 could reverse the inhibited proliferative and migratory potentials in NSCLC cells overexpressing SPINK5. Taken together, SPINK5 and its target PSIP1 synergistically alleviated the malignant progression of NSCLC through a negative feedback loop.In conclusion, SPINK5 level has a close relation to tumor staging and lymphatic metastasis in NSCLC. It serves as a tumor-suppressor gene that is responsible for inhibiting NSCLC proliferation and migration through negatively regulating PSIP1.



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*Source: 2209979-2022-03-25.xml*