# LncRNA MAGI2-As3 Suppresses the Proliferation and Invasion of Cervical Cancer by Sponging MiR-15b

Authors: Yiqing Chai; Lili Wang; Yanwen Qu; Zhixia Hu
Journal: Journal of Healthcare Engineering
 (2022)

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## Abstract

Background. Cervical cancer is the leading cause of cancer deaths among women, and more than 85% of cervical cancer deaths occur in low and middle-income countries. The purpose of this study is to investigate the functions of MAGI2-AS3 and miR-15b in cervical cancer. Materials and Methods. The mRNA levels of MAGI2-AS3, miR-15b, and CCNE1 were evaluated using RT-qPCR assay. Dual-luciferase reporter gene assay was used to confirm whether miR-15b binds to CCNE1. Results. LncRNA MAGI2-AS3 was downregulated, while miR-15b was upregulated in cervical cancer. Cervical cancer patients with low expression of MAGI2-AS3 have a poor prognosis. Upregulation of MAGI2-AS3 inhibited proliferative and invasive abilities of HeLa cells via regulating the expression of miRNA-15b. MiR-15b inhibitor suppressed cell proliferation and invasion. CCNE1 was a direct target gene of miR-15b, which binds to the 3’-UTR of its mRNA. MiR-15b partially reversed the inhibitory effect of overexpression of MAGI2-AS3 on the proliferation and invasion of HeLa cells. MAGI2-AS3 mediated the expression of CCNE1 in HeLa cells. Conclusion. LncRNA MAGI2-AS3 inhibits the proliferation and invasion of cervical cancer cells via the miRNA-15/CCNE1 axis. Our results illustrates that MAGI2-AS3 can be used as a useful clinical predictor for early diagnosis and prognosis assessment of cervical cancer.


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## Body

## 1. Introduction

Cervical cancer (CC) is the fourth most commonly diagnosed cancer in women and one of the most common cancers in the world. There were approximately 570,000 new cases worldwide in 2018, and 311,000 died of cervical cancer [1, 2]. There are two main types of cervical cancer: cervical squamous cell carcinoma (CSCC), which accounts for approximately 80% to 85% of cervical cancer cases, and the remainder are cervical adenocarcinoma (CAC) [3]. Although treatments such as chemotherapy, radiation, and surgical resection have improved the prognosis of early-stage cervical cancer, the metastasis and recurrence of cervical cancer are the cause of most deaths [4]. Thus, it is urgent to investigate the biomarkers related to cervical cancer metastasis.Long non-coding RNAs (lncRNAs) belong to noncoding RNAs that are greater than 200 nucleotides in length [5]. Increasing evidence has proven that lncRNAs were involved in range of biological processes, including differentiation, tumorigenesis, and metastasis [6]. For instance, lncRNA-H19 activated the CDC42/PAK1 pathway to promote cell proliferation, migration, and invasion by targeting miR-15b in hepatocellular carcinoma [7]. Long noncoding RNA DSCAM-AS1 contributed to tumorigenesis to enhance cell proliferation, migration, and invasion ability in cervical cancer [8]. LncRNA MAGI2-AS3 suppressed cell viability and migration via miR-374b/SMG1 signaling pathway in hepatocellular carcinoma [9]. In addition, MAGI2-AS3 inhibited cell proliferation and invasion through miRNA-23a-3p/PTEN axis in non-small cell lung carcinoma [10]. Therefore, exploring the mechanism of action of lncRNA MAGI2-AS3 may provide new ideas for the clinical treatment of cervical cancer.LncRNAs always regulate cell progression via spongy micro-RNAs [11]. Micro-RNAs (miRNAs) are short noncoding RNAs with a length of approximately 22–25 nucleotides [12]. MiRNAs functioned as regulators in tumorigenesis by cleaving mRNA and suppressing translation [13]. MiR-15b enhanced cell cycle from G1 phase to S phase and reduced cell apoptosis in the treatment of renal cell carcinoma with sunitinib [14]. However, miR-15b represses cell proliferation, migration, invasion, senescence, and apoptosis of ovarian cancer [15].The cyclin E1 (CCNE1) belongs to the highly conserved cyclin family, whose members are characterized by a dramatic periodicity in protein abundance through the cell cycle [16]. CCNE1, acted as a regulator of CDK kinases, whose activity is required for cell cycle G1/S transition [17]. Overexpression of CCNE1 has been observed in many tumors, which can lead to chromosome instability, and thus may contribute to tumorigenesis. In this study, we found that upregulation of MAGI2-AS3 inhibited the proliferative and invasive abilities of HeLa cells via regulating the expression of miRNA-15b. LncRNA MAGI2-AS3 inhibited cell proliferation and invasion of cervical cancer via the miRNA-23a-3p/PTEN axis.


## 2. Materials and Methods

### 2.1. Clinical Samples

During 2015 to 2018, we collected 47 cervical cancer patients from Shandong Provincial Hospital Affiliated to Shandong First Medical University and obtained pairs of cervical cancer tissues and corresponding normal tissues. The excised tissue samples are frozen in liquid nitrogen, followed by cryopreservation. All patients did not receive any therapy before surgery. Our study was approved by the Ethics Committee of Shandong Provincial Hospital Affiliated to Shandong First Medical University, and all patients signed written informed consent.


### 2.2. Cell Culture and Transfection

A normal cervix epithelial Ect1/E6E7 cell and three cervical cancer cell lines HeLa, SiHa, and CaSki were obtained from American Tissue Culture Collection (ATCC, USA). All cells were cultured in RPMI-1640 (Hyclone, USA) containing 10% fetal bovine serum (FBS) in a humidified atmosphere with 5% CO2 at 37 °C.MAGI2-AS3 overexpression vector (pEX-MAGI2-AS3) and the control vector were purchased from Ribobio (Guangzhou, China). The miR-15b mimic, miR-15b inhibitor, and the corresponding controls (NC) were synthesized by GenePharma (Shanghai, China). Lipofectamine 2000 (Invitrogen Life Technology) was used to transfect pEX-MAGI2-AS3, miR-15b mimic, and miR-15b inhibitor into HeLa cells. All cells were harvested at 48 h after transfection.


### 2.3. RNA Extraction and Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR)

The TRIzol reagent (Invitrogen Life Technology) was used to isolate total RNA from HCC tissues or cells. The RT-PCR kit (Takara, Dalian, China) or Hairpin-it miRNA qPCR quantitation kit (GenePharma) was used to perform the reverse-transcription and synthesize the first cDNA chain. The SYBR Green-based PCR kit (TAKARA Biotechnology, Dalian, China) was conducted to carry out the qPCR in an iQ5 Multicolor real-time PCR detection system (Bio-Rad Laboratories, Hercules, CA). The primers were MAGI2-AS3: forward, 5′-CACCTTGCTTGACAACTTGA-3’ and reverse, 5′-CATTACAGCTCGGCTACTGC-3’; glyceraldehyde 3‐phosphate dehydrogenase (GAPDH): forward, 5′‐ACCACAGTCCATGCCATCAC-3′ and reverse, 5′-TCCACCACCCTGTTGCTGTA-3’; miR-15b: forward, 5′-CTCAACTGGTGTCGTGGAGTCGGCAATTCAGTTGAGTGTAA-3′ and reverse, 5′-ACACTCCAGCTGGGTTAGCAGCACATC-3’; U6: forward, 5′-ATTGGAACGATACAGAGAAGATT-3′ and reverse, 5′-GGAACGCTTCACGAATTTG-3’.


### 2.4. Transwell Assay

Cell invasion assay was carried out using Transwell inserts (Corning, Blacksburg, VA, USA) with a filter of 8μm pores (BD Biosciences, San Diego, CA) according to the manufacturers’ instructions. The upper chamber was added 200 μl medium containing 5 × 105 cells without serum, and the lower chamber was filled with 600 μl medium with 20% FBS. After 24 h of incubation, the invaded cells were fixed and stained with methanol and crystal violet. A light microscope (Olympus Corporation, Tokyo, Japan) was used to count the number of the invading cells.


### 2.5. Cell Counting Kit-8 (CCK-8)

Cell counting kit-8 (CCK-8; Dojindo Laboratories, Kumamoto, Japan) was conducted to evaluate cell proliferation following manufacturer’s instructions. Each well was added with 10μl CCK-8 solution, and then the absorbance was measured using a spectrophotometer (Thermo Fisher Scientific, MA, USA).


### 2.6. Luciferase Reporter Assay

StarBase v2.0 (http://starbase.sysu.edu.cn/) software predicted the putative miRNA binding sites in the MAGI2-AS3 sequences. HeLa cells were seeded in 6-well plates. The wild-type (WT) or mutant (MUT) MAGI2-AS3 binding sites and the miR-15b mimic or NC (GenePharma Biotechnology, Shanghai, China) were cotransfected in HeLa cells using Lipofectamine 2000 according to the manufacturer’s instructions. Cells were harvested 48 h after transfection, and assayed using a luciferase reporter assay system (Promega, Madison, WI, USA) according to the manufacturer’s instructions.


### 2.7. Statistical Analysis

GraphPad Prism software, version 5.0 (GraphPad Software, La Jolla, CA) was used to perform the statistical analyses. The data are expressed as the mean ± standard deviation (SD). The difference between two or more groups was compared by Student’st-test and a one-way analysis of variance. Spearman’s correlation analysis was used to assess the relationships between MAGI2-AS3 and miR-15b. P < 0.05 is considered to be of statistical significances. Results were from at least three independent experiments.


## 2.1. Clinical Samples

During 2015 to 2018, we collected 47 cervical cancer patients from Shandong Provincial Hospital Affiliated to Shandong First Medical University and obtained pairs of cervical cancer tissues and corresponding normal tissues. The excised tissue samples are frozen in liquid nitrogen, followed by cryopreservation. All patients did not receive any therapy before surgery. Our study was approved by the Ethics Committee of Shandong Provincial Hospital Affiliated to Shandong First Medical University, and all patients signed written informed consent.


## 2.2. Cell Culture and Transfection

A normal cervix epithelial Ect1/E6E7 cell and three cervical cancer cell lines HeLa, SiHa, and CaSki were obtained from American Tissue Culture Collection (ATCC, USA). All cells were cultured in RPMI-1640 (Hyclone, USA) containing 10% fetal bovine serum (FBS) in a humidified atmosphere with 5% CO2 at 37 °C.MAGI2-AS3 overexpression vector (pEX-MAGI2-AS3) and the control vector were purchased from Ribobio (Guangzhou, China). The miR-15b mimic, miR-15b inhibitor, and the corresponding controls (NC) were synthesized by GenePharma (Shanghai, China). Lipofectamine 2000 (Invitrogen Life Technology) was used to transfect pEX-MAGI2-AS3, miR-15b mimic, and miR-15b inhibitor into HeLa cells. All cells were harvested at 48 h after transfection.


## 2.3. RNA Extraction and Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR)

The TRIzol reagent (Invitrogen Life Technology) was used to isolate total RNA from HCC tissues or cells. The RT-PCR kit (Takara, Dalian, China) or Hairpin-it miRNA qPCR quantitation kit (GenePharma) was used to perform the reverse-transcription and synthesize the first cDNA chain. The SYBR Green-based PCR kit (TAKARA Biotechnology, Dalian, China) was conducted to carry out the qPCR in an iQ5 Multicolor real-time PCR detection system (Bio-Rad Laboratories, Hercules, CA). The primers were MAGI2-AS3: forward, 5′-CACCTTGCTTGACAACTTGA-3’ and reverse, 5′-CATTACAGCTCGGCTACTGC-3’; glyceraldehyde 3‐phosphate dehydrogenase (GAPDH): forward, 5′‐ACCACAGTCCATGCCATCAC-3′ and reverse, 5′-TCCACCACCCTGTTGCTGTA-3’; miR-15b: forward, 5′-CTCAACTGGTGTCGTGGAGTCGGCAATTCAGTTGAGTGTAA-3′ and reverse, 5′-ACACTCCAGCTGGGTTAGCAGCACATC-3’; U6: forward, 5′-ATTGGAACGATACAGAGAAGATT-3′ and reverse, 5′-GGAACGCTTCACGAATTTG-3’.


## 2.4. Transwell Assay

Cell invasion assay was carried out using Transwell inserts (Corning, Blacksburg, VA, USA) with a filter of 8μm pores (BD Biosciences, San Diego, CA) according to the manufacturers’ instructions. The upper chamber was added 200 μl medium containing 5 × 105 cells without serum, and the lower chamber was filled with 600 μl medium with 20% FBS. After 24 h of incubation, the invaded cells were fixed and stained with methanol and crystal violet. A light microscope (Olympus Corporation, Tokyo, Japan) was used to count the number of the invading cells.


## 2.5. Cell Counting Kit-8 (CCK-8)

Cell counting kit-8 (CCK-8; Dojindo Laboratories, Kumamoto, Japan) was conducted to evaluate cell proliferation following manufacturer’s instructions. Each well was added with 10μl CCK-8 solution, and then the absorbance was measured using a spectrophotometer (Thermo Fisher Scientific, MA, USA).


## 2.6. Luciferase Reporter Assay

StarBase v2.0 (http://starbase.sysu.edu.cn/) software predicted the putative miRNA binding sites in the MAGI2-AS3 sequences. HeLa cells were seeded in 6-well plates. The wild-type (WT) or mutant (MUT) MAGI2-AS3 binding sites and the miR-15b mimic or NC (GenePharma Biotechnology, Shanghai, China) were cotransfected in HeLa cells using Lipofectamine 2000 according to the manufacturer’s instructions. Cells were harvested 48 h after transfection, and assayed using a luciferase reporter assay system (Promega, Madison, WI, USA) according to the manufacturer’s instructions.


## 2.7. Statistical Analysis

GraphPad Prism software, version 5.0 (GraphPad Software, La Jolla, CA) was used to perform the statistical analyses. The data are expressed as the mean ± standard deviation (SD). The difference between two or more groups was compared by Student’st-test and a one-way analysis of variance. Spearman’s correlation analysis was used to assess the relationships between MAGI2-AS3 and miR-15b. P < 0.05 is considered to be of statistical significances. Results were from at least three independent experiments.


## 3. Results

### 3.1. MAGI2-As3 Expresses Low Expression in Cervical Cancer

RT-qPCR was conducted to measure the expression of MAGI2-AS3 in tissues and cell lines. As expected, the expression of MAGI2-AS3 in cervical cancer tissues was lower than that of matched adjacent normal tissues (Figure1(a)). Moreover, MAGI2-AS3 has been found to be downregulated in cervical cancer patients at III-IV stage compared with the I-II stage (Figure 1(b)). Similarly, the expression of MAGI2-AS3 was lower in cervical cancer cell lines HeLa, SiHa, and CaSki than the normal cervix epithelial Ect1/E6E7 cells (Figure 1(c)). Kaplan–Meier curve was employed to evaluate the overall survival of cervical cancer patients, indicating that downregulation of MAGI2-AS3 predicted a worse prognosis (Figure 1(d)).Figure 1
MAGI2-AS3 exhibits low expression in cervical cancer (a) MAGI2-AS3 has a lower expression in cervical cancer tissues than matched adjacent normal tissues. (b) MAGI2-AS3 was downregulated in cervical cancer patients at III-IV stage compared with the I-II stage. (c) MAGI2-AS3 expression was lower in cervical cancer cell lines than the normal cervix epithelial cells. (d) Kaplan–Meier curve indicated that downregulation of MAGI2-AS3 predicted a worse prognosis.
(a)(b)(c)(d)


### 3.2. Overexpression of MAGI2-As3 Suppresses the Proliferative and Invasive Abilities in HeLa Cells

The transfection efficacy of pEX-MAGI2-AS3 transfected in HeLa cells was determined by RT-qPCR assay (Figure2(a)). CCK-8 and transwell assays were applied to assess the cell proliferative and invasive capacities. Cell proliferation was inhibited by transfecting with pEX-MAGI2-AS3 in comparison with negative control (Figure 2(b)). Similarly, the invasive ability of HeLa cells was attenuated by overexpressing MAGI2-AS3 (Figure 2(c)).Figure 2
Overexpression of MAGI2-AS3 suppresses the proliferative and invasive abilities in HeLa cells (a) The transfection efficacy of transfection of pEX-MAGI2-AS3 in HeLa cells using RT-qPCR assay. (b) Cell proliferation was inhibited by transfecting with pEX-MAGI2-AS3 in comparison with negative control. (c) The invasive ability of HeLa cells was attenuated by the overexpression of MAGI2-AS3.
(a)(b)(c)


### 3.3. MAGI2-As3 Sponges MiRNA-15b as a ceRNA

The expression of miR-15b was calculated after altering MAGI2-AS3, and we are surprised to discover that the expression of miR-15b was reduced when overexpression of MAGI2-AS3 in HeLa cells (Figure3(a)). The expression of miR-15b was increased in HeLa, SiHa, and CaSki cells versus normal cervix epithelial cell Ect1/E6E7 (Figure 3(b)). Likewise, the expression of miR-15b was also measured, and we found that miRNA-15b was upregulated in cervical cancer tissues compared with the paracancerous tissue samples (Figure 3(c)). Due to the expression of MAGI2-AS3 and miR-15b in cervical cancer tissues, the correlation analysis was measured. Not unfortunately, it has a negative correlation between the mRNA level of MAGI2-AS3 and miR-15b in cervical cancer tissues (Figure 3(d)). Thus, all the results demonstrated that MAGI2-AS3 sponged miRNA-15b and negatively regulated its expression in cervical cancer.Figure 3
MAGI2-AS3 sponges miRNA-15b as a ceRNA. (a) The expression of miR-15b was reduced when overexpression of MAGI2-AS3 in HeLa cells. (b) The expression of miR-15b was increased in cervical cancer cells versus normal cervix epithelial cell. (c) MiRNA-15b was upregulated in cervical cancer tissues compared with the paracancerous tissue samples. (d) It has a negative correlation between the mRNA level of MAGI2-AS3 and miR-15b in cervical cancer tissues.
(a)(b)(c)(d)


### 3.4. Knockdown of MiR-15b Suppresses the Proliferation and Invasion in HeLa Cells

To investigate the functions of miR-15b, the expression of miR-15b was reduced by miR-15b inhibitor (P < 0.05) (Figure 4(a)). Cell proliferation was inhibited after miR-15b was knocked down compared with the negative control (P < 0.05) (Figure 4(b)). Similarly, miR-15b inhibitor reduced the invasive ability of HeLa cells (P < 0.05) (Figure 4(c)). All the findings suggested that silencing miR-15b suppressed HeLa cell proliferation and invasion.Figure 4
Knockdown of miR-15b suppresses the proliferation and invasion in HeLa cells. (a) The expression of miR-15b was reduced by miR-15b inhibitor. (b) Cell proliferation was inhibited after knockdown miR-15b. (c) MiR-15b inhibitor reduced the invasive ability in HeLa cells.
(a)(b)(c)


### 3.5. MiR-15b Restores the Inhibitory Effect of MAGI2-As3 on HeLa Cells

In order to find out whether miR-15b has an effect on the function of MAGI2-AS3, miR-15b mimics were transfected into MAGI2-AS3 overexpressing HeLa cells, and the transfection efficiency was calculated by RT-qPCR (P < 0.05) (Figure 5(a)). CCK-8 results demonstrated that retransfection of miR-15b mimic enhanced cell viability versus only transfected pEX-MAGI2-AS3 group (P < 0.05) (Figure 5(b)). Moreover, HeLa cells cotransfected with miR-15b mimic and pEX-MAGI2-AS3 cause a great increase of cell invasion compared with pEX-MAGI2-AS3 group (P < 0.05) (Figure 5(c)). The results revealed that miR-15b restored the inhibitory effect of MAGI2-AS3 on the proliferation and invasion in HeLa cells.Figure 5
MiR-15b restores the inhibitory effect of MAGI2-AS3 on HeLa cells. (a) MiR-15b mimics were transfected into MAGI2-AS3 overexpressing HeLa cells. (b) Retransfection of miR-15b mimic enhanced cell viability. (c) Cotransfected with miR-15b mimic and pEX-MAGI2-AS3 cause a great increase of cell invasion compared with pEX-MAGI2-AS3 group.
(a)(b)(c)


### 3.6. CCNE1 Is a Direct Target of MiR-15b

Next, we designed to explore how MAGI2-AS3 and miR-15b were involved in the cervical cancer progression. TargetScan analysis showed that there was an evolutionarily conserved miR-15b binding site in the 3’-UTR of CCNE1 mRNA (Figure6(a)). Subsequently, the luciferase reporter assay indicated that the luciferase activity of wild-type CCNE1 was decreased. Meanwhile, miR-15b mimic does not alter the luciferase activity of the mutant CCNE1, which demonstrated specific binding of CCNE1 3’-UTR to miR-15b (Figure 6(b)). Furthermore, the expression of CCNE1 was reduced after transfection with miR-15b inhibitor (Figure 6(c)). In addition, the expression of CCNE1 was increased by knockdown of MAGI2-AS3, while it was decreased by overexpressing MAGI2-AS3 (Figure 6(d)). All results exhibit that CCNE1 is a target gene of miR-15b, and its expression is mediated by MAGI2-AS3.Figure 6
CCNE1 is a direct target of miR-15b. (a) TargetScan analysis showed that there was an evolutionarily conserved miR-15b binding site in the 3’-UTR of CCNE1 mRNA. (b) Luciferase reporter assay indicated that CCNE1 3’-UTR bound specifically to miR-15b. (c) The expression of CCNE1 was reduced after transfecting miR-15b inhibitor. (d) The expression of CCNE1 was increased by knockdown of MAGI2-AS3, while it was decreased by overexpressing MAGI2-AS3.
(a)(b)(c)(d)


## 3.1. MAGI2-As3 Expresses Low Expression in Cervical Cancer

RT-qPCR was conducted to measure the expression of MAGI2-AS3 in tissues and cell lines. As expected, the expression of MAGI2-AS3 in cervical cancer tissues was lower than that of matched adjacent normal tissues (Figure1(a)). Moreover, MAGI2-AS3 has been found to be downregulated in cervical cancer patients at III-IV stage compared with the I-II stage (Figure 1(b)). Similarly, the expression of MAGI2-AS3 was lower in cervical cancer cell lines HeLa, SiHa, and CaSki than the normal cervix epithelial Ect1/E6E7 cells (Figure 1(c)). Kaplan–Meier curve was employed to evaluate the overall survival of cervical cancer patients, indicating that downregulation of MAGI2-AS3 predicted a worse prognosis (Figure 1(d)).Figure 1
MAGI2-AS3 exhibits low expression in cervical cancer (a) MAGI2-AS3 has a lower expression in cervical cancer tissues than matched adjacent normal tissues. (b) MAGI2-AS3 was downregulated in cervical cancer patients at III-IV stage compared with the I-II stage. (c) MAGI2-AS3 expression was lower in cervical cancer cell lines than the normal cervix epithelial cells. (d) Kaplan–Meier curve indicated that downregulation of MAGI2-AS3 predicted a worse prognosis.
(a)(b)(c)(d)


## 3.2. Overexpression of MAGI2-As3 Suppresses the Proliferative and Invasive Abilities in HeLa Cells

The transfection efficacy of pEX-MAGI2-AS3 transfected in HeLa cells was determined by RT-qPCR assay (Figure2(a)). CCK-8 and transwell assays were applied to assess the cell proliferative and invasive capacities. Cell proliferation was inhibited by transfecting with pEX-MAGI2-AS3 in comparison with negative control (Figure 2(b)). Similarly, the invasive ability of HeLa cells was attenuated by overexpressing MAGI2-AS3 (Figure 2(c)).Figure 2
Overexpression of MAGI2-AS3 suppresses the proliferative and invasive abilities in HeLa cells (a) The transfection efficacy of transfection of pEX-MAGI2-AS3 in HeLa cells using RT-qPCR assay. (b) Cell proliferation was inhibited by transfecting with pEX-MAGI2-AS3 in comparison with negative control. (c) The invasive ability of HeLa cells was attenuated by the overexpression of MAGI2-AS3.
(a)(b)(c)


## 3.3. MAGI2-As3 Sponges MiRNA-15b as a ceRNA

The expression of miR-15b was calculated after altering MAGI2-AS3, and we are surprised to discover that the expression of miR-15b was reduced when overexpression of MAGI2-AS3 in HeLa cells (Figure3(a)). The expression of miR-15b was increased in HeLa, SiHa, and CaSki cells versus normal cervix epithelial cell Ect1/E6E7 (Figure 3(b)). Likewise, the expression of miR-15b was also measured, and we found that miRNA-15b was upregulated in cervical cancer tissues compared with the paracancerous tissue samples (Figure 3(c)). Due to the expression of MAGI2-AS3 and miR-15b in cervical cancer tissues, the correlation analysis was measured. Not unfortunately, it has a negative correlation between the mRNA level of MAGI2-AS3 and miR-15b in cervical cancer tissues (Figure 3(d)). Thus, all the results demonstrated that MAGI2-AS3 sponged miRNA-15b and negatively regulated its expression in cervical cancer.Figure 3
MAGI2-AS3 sponges miRNA-15b as a ceRNA. (a) The expression of miR-15b was reduced when overexpression of MAGI2-AS3 in HeLa cells. (b) The expression of miR-15b was increased in cervical cancer cells versus normal cervix epithelial cell. (c) MiRNA-15b was upregulated in cervical cancer tissues compared with the paracancerous tissue samples. (d) It has a negative correlation between the mRNA level of MAGI2-AS3 and miR-15b in cervical cancer tissues.
(a)(b)(c)(d)


## 3.4. Knockdown of MiR-15b Suppresses the Proliferation and Invasion in HeLa Cells

To investigate the functions of miR-15b, the expression of miR-15b was reduced by miR-15b inhibitor (P < 0.05) (Figure 4(a)). Cell proliferation was inhibited after miR-15b was knocked down compared with the negative control (P < 0.05) (Figure 4(b)). Similarly, miR-15b inhibitor reduced the invasive ability of HeLa cells (P < 0.05) (Figure 4(c)). All the findings suggested that silencing miR-15b suppressed HeLa cell proliferation and invasion.Figure 4
Knockdown of miR-15b suppresses the proliferation and invasion in HeLa cells. (a) The expression of miR-15b was reduced by miR-15b inhibitor. (b) Cell proliferation was inhibited after knockdown miR-15b. (c) MiR-15b inhibitor reduced the invasive ability in HeLa cells.
(a)(b)(c)


## 3.5. MiR-15b Restores the Inhibitory Effect of MAGI2-As3 on HeLa Cells

In order to find out whether miR-15b has an effect on the function of MAGI2-AS3, miR-15b mimics were transfected into MAGI2-AS3 overexpressing HeLa cells, and the transfection efficiency was calculated by RT-qPCR (P < 0.05) (Figure 5(a)). CCK-8 results demonstrated that retransfection of miR-15b mimic enhanced cell viability versus only transfected pEX-MAGI2-AS3 group (P < 0.05) (Figure 5(b)). Moreover, HeLa cells cotransfected with miR-15b mimic and pEX-MAGI2-AS3 cause a great increase of cell invasion compared with pEX-MAGI2-AS3 group (P < 0.05) (Figure 5(c)). The results revealed that miR-15b restored the inhibitory effect of MAGI2-AS3 on the proliferation and invasion in HeLa cells.Figure 5
MiR-15b restores the inhibitory effect of MAGI2-AS3 on HeLa cells. (a) MiR-15b mimics were transfected into MAGI2-AS3 overexpressing HeLa cells. (b) Retransfection of miR-15b mimic enhanced cell viability. (c) Cotransfected with miR-15b mimic and pEX-MAGI2-AS3 cause a great increase of cell invasion compared with pEX-MAGI2-AS3 group.
(a)(b)(c)


## 3.6. CCNE1 Is a Direct Target of MiR-15b

Next, we designed to explore how MAGI2-AS3 and miR-15b were involved in the cervical cancer progression. TargetScan analysis showed that there was an evolutionarily conserved miR-15b binding site in the 3’-UTR of CCNE1 mRNA (Figure6(a)). Subsequently, the luciferase reporter assay indicated that the luciferase activity of wild-type CCNE1 was decreased. Meanwhile, miR-15b mimic does not alter the luciferase activity of the mutant CCNE1, which demonstrated specific binding of CCNE1 3’-UTR to miR-15b (Figure 6(b)). Furthermore, the expression of CCNE1 was reduced after transfection with miR-15b inhibitor (Figure 6(c)). In addition, the expression of CCNE1 was increased by knockdown of MAGI2-AS3, while it was decreased by overexpressing MAGI2-AS3 (Figure 6(d)). All results exhibit that CCNE1 is a target gene of miR-15b, and its expression is mediated by MAGI2-AS3.Figure 6
CCNE1 is a direct target of miR-15b. (a) TargetScan analysis showed that there was an evolutionarily conserved miR-15b binding site in the 3’-UTR of CCNE1 mRNA. (b) Luciferase reporter assay indicated that CCNE1 3’-UTR bound specifically to miR-15b. (c) The expression of CCNE1 was reduced after transfecting miR-15b inhibitor. (d) The expression of CCNE1 was increased by knockdown of MAGI2-AS3, while it was decreased by overexpressing MAGI2-AS3.
(a)(b)(c)(d)


## 4. Discussion

Increasing evidence indicated that lncRNAs played vital functions in the progression of cervical cancer [18,19]. For instance, lncRNA-CTS promoted metastasis and epithelial-to-mesenchymal transition through regulating miR-505/ZEB2 axis in cervical cancer [20]. Long noncoding RNA ZNF667-AS1 inhibited tumor invasion by counteracting downregulation of micro-RNA-93-3p-dependent PEG3 in cervical cancer [21]. In our study, we discovered that MAGI2-AS3 was low expressed in cervical tissues. Also, through comparing the expression of MAGI2-AS3 in different stage, we found that the expression of MAGI2-AS3 was lower in III-IV stages than I-II stages. The overall survival of cervical cancer patients were calculated and compared its relationship with the expression of MAGI2-AS3. The results indicated that low expression of MAGI2-AS3 was associated with poor prognosis. Previous studies demonstrated that MAGI2-AS3 played tumor suppressive roles in high-grade serous ovarian carcinoma and breast cancer [22,23]. Consistent with the previous studies, we discovered that upregulation of MAGI2-AS3 suppressed cell proliferation and invasion in HeLa cells. However, MAGI2-AS3 promoted progression of gastric cancer and colorectal cancer [24,25]; thus, we conjectured that MAGI2-AS3 might have tissue specificity.LncRNAs often acted as the endogenous competitive RNA (ceRNAs) of miRNA. LncRNA MAGI2-AS3 inhibited cell invasion and migration via sponging microRNA-374a [26]. Similarly, the spongy of MAGI2-AS3 miR-15b inhibited the progression of bladder cancer [27]. In this study, we discovered that overexpression of MAGI2-AS3 reduced the expression of miR-15b. Evidence showed that miR-15b promoted cell proliferation and invasion by targeting AXIN2 in liver cancer [28]. However, the expression of miR-15b inhibited tumor progression via directly targeting MYCN in neuroblastoma [29]. But the expression of miR-15b in cervical cancer is unknown; thus, we conducted RT-qPCR to assess miR-15b. We found that the expression of miR-15b was higher in cervical cancer cells and tissues. Moreover, the expression of MAGI2-AS3 has a negative connection with miR-15b in cervical cancer tissues. However, we have no evidence to prove whether MAGI2-AS3 and miR-15b directly bind, which was a limitation in this study. Next, the functional tests were performed after knockdown miR-15b in HeLa cells. We discovered that miR-15b inhibitor can impair cell proliferation and invasion of HeLa cells. Furthermore, miR-15b partially reversed the promotive functions of MAGI2-AS3 on HeLa cell viability and invasion. MiR-15b regulates cell differentiation and survival by targeting CCNE1 in APL cells [30]. Consistent with the above findings, miR-15b was confirmed to be directly binding to the 3’UTR of CCNE1 by luciferase report assay. The expression of CCNE1 was suppressed by upregulating miR-15b in HeLa cells. Meanwhile, overexpression of MAGI2-AS3 enhanced the expression of CCNE1, and low expression of MAGI2-AS3 reduced the expression of CCNE1. Thus, we proposed that MAGI2-AS3 enhanced cervical cancer cell proliferation and invasion via regulating the miR-15b/CCNE1 axis.


## 5. Conclusion

We found that MAGI2-AS3 inhibited the growth and invasion of cervical cancer by regulating the miR-15b/CCNE1 pathway. The findings of this study provide new insights into how MAGI2-AS3 could be an effective target for the diagnosis of cervical cancer. However, it is not enough to support the clinical application of MAGI2-AS3, and more research is urgently needed.



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