PER1 Is a Prognostic Biomarker and Correlated with Immune Infiltrates
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ORIGINAL RESEARCH published: 17 June 2021 doi: 10.3389/fgene.2021.697471 PER1 Is a Prognostic Biomarker and Correlated With Immune Infiltrates in Ovarian Cancer Mali Chen 1†, Lili Zhang 1†, Xiaolong Liu 2, Zhen Ma 2 and Ling Lv 1* 1 Department of Obstetrics, Gansu Province Maternity and Child-Care Hospital, Lanzhou, China, 2 Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou, China Background: Period circadian protein homolog 1 (PER1) is an important component of the biorhythm molecular oscillation system and plays an important part in the development and progression of mammalian cancer. However, the correlations of PER1 with prognosis and tumor-infiltrating lymphocytes in ovarian cancer (OV) remain unclear. Methods: The Oncomine and TIMER databases were used to examine the expression Edited by: of PER1 in OV. Kaplan–Meier Plotter and PrognoScan were used to evaluate the Longxiang Xie, Henan University, China relationship between PER1 and prognosis. Kaplan–Meier Plotter was used to analyze Reviewed by: the relationships between PER1 and clinicopathological features of OV patients. The Gan Luan, relationship between PER1 expression and immune infiltration in OV was investigated New Jersey Institute of Technology, United States using the TIMER database and CIBERSORT algorithm. The STRING database was used Peijie Wu, to analyze PER1-related protein functional groups, the GeneMANIA online tool was used Chengdu University of Traditional to analyze gene groups with similar functions to those of PER1, and Network Analyst was Chinese Medicine, China used to identify transcription factors that regulate PER1. The correlation between PER1 *Correspondence: Ling Lv and immunoinvasion of OV was analyzed using TIMER. Finally, quantitative real-time [email protected] polymerase chain reaction (qRT-PCR) was performed to detect PER1 expression. †These authors have contributed Results: PER1 was differentially expressed in different cancer tissues, and its expression equally to this work and share first authorship in various OV subtypes was lower than that in normal ovarian tissue. OV patients with low PER1 expression had a reduced overall survival rate. Decreased PER1 expression in Specialty section: stage 1 and stage 1+2 OV patients was related to poor prognosis, while increased PER1 This article was submitted to + Cancer Genetics and Oncogenomics, expression in stage 3 4 patients and TP53 mutation were related to poor overall survival a section of the journal and progression-free survival. We identified eight genes whose expression was strongly Frontiers in Genetics correlated with that of PER1, as well as four transcription factors that regulate PER1. Received: 19 April 2021 In OV, PER1 expression levels were positively correlated with infiltration levels of cells Accepted: 19 May 2021 Published: 17 June 2021 including neutrophils, regulatory T cells, and M2 macrophages, and closely related to a Citation: variety of immune markers. Reduced expression of PER1 was significantly associated Chen M, Zhang L, Liu X, Ma Z and with poor overall survival. Lv L (2021) PER1 Is a Prognostic Biomarker and Correlated With Conclusion: These findings suggest that PER1 could be used as a prognostic Immune Infiltrates in Ovarian Cancer. biomarker to determine prognosis and immune infiltration in OV patients. Front. Genet. 12:697471. doi: 10.3389/fgene.2021.697471 Keywords: ovarian cancer, PER1, bioinformatics, diagnosis and prognosis biomarkers, immune infiltrates Frontiers in Genetics | www.frontiersin.org 1 June 2021 | Volume 12 | Article 697471 Chen et al. PER1 in OV INTRODUCTION MATERIALS AND METHODS Ovarian cancer (OV) is the fifth leading cause of cancer-related Tissue Samples deaths in women worldwide (Dong et al., 2014). Despite advances We collected 60 OV cancerous and paracancerous tissue in diagnosis, surgery, chemotherapy, and radiation therapy, OV samples together with associated clinical information from continues to have a poor survival rate and the highest mortality Gansu Provincial Maternal and Child Health Hospital. None of rate among gynecological cancers. OV patients diagnosed at an the subjects underwent radiotherapy or chemotherapy prior to advanced stage have poor prognosis and high recurrence rates. the surgery. All patient materials were obtained with informed Determining effective markers for early diagnosis and prognosis consent, and this study was carried out with the approval of the is thus essential to reduce mortality and ensure effective therapy Clinical Research Ethics Committees. for OV (Bowtell et al., 2015). Period circadian protein homolog 1 (PER1) is a core gene qRT-PCR involved in circadian rhythm. It is located on the short arm TRIzol reagent (Invitrogen, Carlsbad, CA, USA) was used for of human chromosome 17 (17p12–p13.1) and has a total total RNA extraction from tissues. RNA was reverse transcribed ∼ length of 16kb (Badiu, 2003). PER1 also has an important into cDNA using a RevertAid First Strand cDNA Synthesis Kit effect on the occurrence and development of tumors. Its (Thermo-Fisher Scientific, Waltham, MA, USA). Subsequently, main functions involve regulating the body’s circadian rhythm, with the cDNA as the template, qRT-PCR was performed regulating the cell cycle, and promoting DNA damage repair. using SYBR Premix Ex TaqTM (TaKaRa, Otsu, Shiga, Japan). Many studies have shown that PER1 directly regulates levels Relative gene expression was calculated by the 2–Ct method. of reactive oxygen species in multiple organs and regulates key GAPDH served as the internal reference. The primer sequences effectors of energy substrate utilization in response to daily were as follows (“F” represents “forward”; “R” represents behavioral rhythms and oxidative stress, thereby maintaining “reverse”). GAPDH: 5′-AGAAGGCTGGGGCTCATTTG- the daily rhythms of mitochondrial morphology and function 3′(F), 5′AGGGGCCATCCACAGTCTTC-3′(R); PER1: ′ ′ (Sun et al., 2020). Changes in expression levels of PER1 5 -CTGCTACAGGCACGTTCAAG-3 (F), 5′-CTCAGGG have been found in some cancers, including pancreatic cancer ACCAAGGCTAGTG-3′(R). (Guo et al., 2020), oral squamous cell carcinoma (Yang et al., 2020), endometrial cancer (Wang et al., 2020), colorectal cancer (Holipah and Kuroda, 2020), and non-small-cell carcinoma Oncomine Database Analysis (Lin et al., 2020), but this has not been studied in OV. It Oncomine is currently the world’s largest oncogene chip database has also been reported that the occurrence and development and data mining platform, containing 715 gene expression of cancer, as well as its prognosis and treatment outcomes, datasets and 86,733 tumor and normal tissue samples. Here, the are closely related to the abnormal expression of certain Oncomine database was used to detect the differential expression circadian clock genes (Cao et al., 2009; Sahar and Sassone- of PER1 between OV tissues and normal ovarian tissues. The data Corsi, 2009; Yang et al., 2009). Based on these findings, we type was mRNA, and differential genes were identified by t-test propose that PER1 could be used as a prognostic indicator with the following screening criteria: fold change >2, P < 0.05. in OV. We also note that circadian rhythm is closely related to GEPIA Database Analysis the human immune system (Lange et al., 2010). Abnormalities GEPIA is a newly developed bioinformatics platform for analysis of the biological clock contribute to exhaustion of T cells and processing of transcriptome data from The Cancer Genome and overall upregulation of immunosuppressive molecules Atlas (TCGA) and GTEx databases. We analyzed the correlations (including programmed death ligand 1 [PD-L1] and cytotoxic T between PER1 and other genes using the “Correlation Analysis” lymphocyte-associated antigen 4 [CTLA-4]); however, the impact module of GEPIA with P < 0.05 as the screening criterion. of PER1 on the immune environment of OV remains unknown. In this research, we analyzed the expression levels of PER1 in OV, using the online tools TIMER and Oncomine, TIMER Database and studied the relationships between PER1 expression and TIMER (https://cistrome.shinyapps.io/timer/) is a database for clinicopathological parameters. The prognostic value of comprehensive analysis of tumor immunity. We used the PER1 expression in OV was determined using Kaplan–Meier “Gene” module to analyze the correlations between PER1 gene Plotter and the PrognoScan database. Quantitative real-time expression and infiltration of immune cells, including CD4+ PCR (qRT-PCR) was used to detect PER1 expression, and T cells, CD8+ T cells, B cells, neutrophils, macrophages, and patients were divided into high and low PER1 expression dendritic cells. Immune cells included in the new version groups for survival analysis. In addition, we used the of TIMER showed increased infiltration levels, as presented TIMER database to determine the correlations between in the results section. We used the “Diff Exp” module to PER1 and immune cell infiltration. Our findings reveal detect the differential expression of the PER1 gene in different an important role of PER1 in OV and also clarify the tumor tissues and normal tissues. Then, we used TIMER to potential relationship of PER1 with tumor immunity and detect the correlations between PER1 and immune markers of its underlying mechanism. immune cells. Frontiers in Genetics | www.frontiersin.org 2 June 2021 | Volume 12 | Article 697471 Chen et al. PER1 in OV Survival Analysis and Prognosis Evaluation control samples were available for OV (Figure 1B). We further We used Kaplan–Meier