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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">IJO</journal-id>
<journal-title-group>
<journal-title>International Journal of Oncology</journal-title></journal-title-group>
<issn pub-type="ppub">1019-6439</issn>
<issn pub-type="epub">1791-2423</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ijo.2014.2752</article-id>
<article-id pub-id-type="publisher-id">ijo-46-02-0487</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Dual regulation of receptor tyrosine kinase genes <italic>EGFR</italic> and <italic>c-Met</italic> by the tumor-suppressive <italic>microRNA-23b/27b</italic> cluster in bladder cancer</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>CHIYOMARU</surname><given-names>TAKESHI</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>SEKI</surname><given-names>NAOHIKO</given-names></name><xref rid="af3-ijo-46-02-0487" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>INOGUCHI</surname><given-names>SATORU</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>ISHIHARA</surname><given-names>TOMOAKI</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>MATAKI</surname><given-names>HIROKO</given-names></name><xref rid="af2-ijo-46-02-0487" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>MATSUSHITA</surname><given-names>RYOSUKE</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>GOTO</surname><given-names>YUSUKE</given-names></name><xref rid="af3-ijo-46-02-0487" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>NISHIKAWA</surname><given-names>RIKA</given-names></name><xref rid="af3-ijo-46-02-0487" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>TATARANO</surname><given-names>SHUICHI</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>ITESAKO</surname><given-names>TOSHIHIKO</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>NAKAGAWA</surname><given-names>MASAYUKI</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>ENOKIDA</surname><given-names>HIDEKI</given-names></name><xref rid="af1-ijo-46-02-0487" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-ijo-46-02-0487"/></contrib></contrib-group>
<aff id="af1-ijo-46-02-0487">
<label>1</label>Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan</aff>
<aff id="af2-ijo-46-02-0487">
<label>2</label>Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan</aff>
<aff id="af3-ijo-46-02-0487">
<label>3</label>Department of Functional Genomics, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan</aff>
<author-notes>
<corresp id="c1-ijo-46-02-0487">Correspondence to: Dr Hideki Enokida, Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan, E-mail: <email>henokida@m2.kufm.kagoshima-u.ac.jp</email></corresp></author-notes>
<pub-date pub-type="collection">
<month>2</month>
<year>2015</year></pub-date>
<pub-date pub-type="epub">
<day>14</day>
<month>11</month>
<year>2014</year></pub-date>
<volume>46</volume>
<issue>2</issue>
<fpage>487</fpage>
<lpage>496</lpage>
<history>
<date date-type="received">
<day>09</day>
<month>08</month>
<year>2014</year></date>
<date date-type="accepted">
<day>19</day>
<month>09</month>
<year>2014</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2015, Spandidos Publications</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0">
<license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p></license></permissions>
<abstract>
<p>Recent clinical trials of chemotherapeutics for advanced bladder cancer (BC) have shown limited benefits. Therefore, new prognostic markers and more effective treatment strategies are required. One approach to achieve these goals is through the analysis of RNA networks. Our recent studies of microRNA (miRNA) expression signatures revealed that the <italic>microRNA-23b/27b (miR-23b/27b)</italic> cluster is frequently downregulated in various types of human cancers. However, the functional role of the <italic>miR-23b/27b</italic> cluster in BC cells is still unknown. Thus, the aim of the present study was to investigate the functional significance of the <italic>miR-23b/27b</italic> cluster and its regulated molecular targets, with an emphasis on its contributions to BC oncogenesis and metastasis. The expression levels of the <italic>miR-23b/27b</italic> cluster were significantly reduced in BC clinical specimens. Restoration of mature <italic>miR-23b</italic> or <italic>miR-27b</italic> miRNAs significantly inhibited cancer cell migration and invasion, suggesting that these clustered miRNAs function as tumor suppressors. Gene expression data and <italic>in silico</italic> analysis demonstrated that the genes coding for the epidermal growth factor receptor (<italic>EGFR</italic>) and hepatocyte growth factor receptor (<italic>c-Met</italic>) were potential targets of the <italic>miR-23b/27b</italic> cluster. Luciferase reporter assays and western blotting demonstrated that <italic>EGFR</italic> and <italic>c-Met</italic> receptor trypsine kinases were directly regulated by these clustered miRNAs. We conclude that the decreased expression of the tumor-suppressive <italic>miR-23b/27b</italic> cluster enhanced cancer cell proliferation, migration and invasion in BC through direct regulation of <italic>EGFR</italic> and <italic>c-Met</italic> signaling pathways. Our data on RNA networks regulated by tumor-suppressive <italic>miR-23b/27b</italic> provide new insights into the potential mechanisms of BC oncogenesis and metastasis.</p></abstract>
<kwd-group>
<kwd>bladder cancer</kwd>
<kwd>microRNA</kwd>
<kwd><italic>miR-23b</italic></kwd>
<kwd><italic>miR-27b</italic></kwd>
<kwd>tumor suppressor</kwd>
<kwd><italic>EGFR</italic></kwd>
<kwd><italic>c-Met</italic></kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>In developed contries, bladder cancer (BC) is the fifth most commonly diagnosed tumor and the second most common cause of death in patients with genitourinary tract malignancies (<xref rid="b1-ijo-46-02-0487" ref-type="bibr">1</xref>). BCs can be classified into two categories: non-muscle-invasive tumors and muscle-invasive tumors. The 5-year survival frequency for patients with non-muscle-invasive BC is close to 90&#x00025;, whereas patients with muscle-invasive tumors have 5-year survival frequencies of ~60&#x00025; (<xref rid="b2-ijo-46-02-0487" ref-type="bibr">2</xref>). Patients with non-muscle-invasive BC tend to have a high rate of recurrence. Moreover, some patients are found to have muscle-invasive BC at recurrence (<xref rid="b3-ijo-46-02-0487" ref-type="bibr">3</xref>). Recent clinical trials of chemotherapeutics for advanced BC have shown limited benefits. Therefore, new prognostic markers and more effective treatment strategies are required. One approach to achieve these goals is through the analysis of RNA networks.</p>
<p>Recent studies have demonstrated the importance of non-coding RNAs (ncRNAs). Participation of these RNAs in human diseases, including cancer, is now apparent (<xref rid="b4-ijo-46-02-0487" ref-type="bibr">4</xref>). For example, microRNAs (miRNAs) are small ncRNA molecules (19&#x02013;22 bases in length) that regulate protein-coding gene expression by repressing translation or cleaving RNA transcripts in a sequence-specific manner (<xref rid="b5-ijo-46-02-0487" ref-type="bibr">5</xref>). Numerous recent studies have reported that miRNAs are aberrantly expressed in many human cancers. In fact, miRNAs play significant roles in the initiation, development and metastasis of human cancers (<xref rid="b6-ijo-46-02-0487" ref-type="bibr">6</xref>).</p>
<p>Important new information has been gained through the analysis of the cancer-related miRNA networks. We have used our miRNA expression signatures to investigate several tumor-suppressive miRNAs and their regulated cancer pathways (<xref rid="b7-ijo-46-02-0487" ref-type="bibr">7</xref>&#x02013;<xref rid="b11-ijo-46-02-0487" ref-type="bibr">11</xref>). Notably, some miRNAs are located in close proximity in the human genome; these are termed clustered miRNAs. We previously reported that <italic>miR-1/133a</italic>, <italic>miR-29s</italic>, <italic>miR-143/145</italic> and <italic>miR-195/497</italic> formed clusters and that these clusters function as tumor suppressors, targeting several oncogenic genes in human cancers, including BC (<xref rid="b7-ijo-46-02-0487" ref-type="bibr">7</xref>,<xref rid="b12-ijo-46-02-0487" ref-type="bibr">12</xref>&#x02013;<xref rid="b21-ijo-46-02-0487" ref-type="bibr">21</xref>).</p>
<p>Previously, our miRNA expression signatures revealed that <italic>miR-23b/27b</italic> clustered miRNAs were significantly reduced in several cancer tissues (<xref rid="b8-ijo-46-02-0487" ref-type="bibr">8</xref>,<xref rid="b9-ijo-46-02-0487" ref-type="bibr">9</xref>). Our deep sequencing miRNA signature of BC also annotated downregulation of <italic>miR-23b</italic> in cancer tissues (<xref rid="b7-ijo-46-02-0487" ref-type="bibr">7</xref>). In contrast, Jin <italic>et al</italic> showed that the expression of <italic>miR-23b</italic> and <italic>miR-27b</italic> was highly upregulated in human breast cancer, and knockdown of these miRNAs substantially repressed breast cancer growth (<xref rid="b22-ijo-46-02-0487" ref-type="bibr">22</xref>). Thus, the expression status of the <italic>miR-23b/27b</italic> cluster is not consistent among different types of cancers. Importantly, the functional roles of the <italic>miR-23b/27b</italic> cluster have not been fully investigated in BC.</p>
<p>The aim of the present study was to investigate the functional significance of <italic>miR-23b/27b</italic> clustered miRNAs and to identify the molecular targets regulated by these miRNAs in BC cells. We found that restoration of <italic>miR-23b</italic> or <italic>miR-27b</italic> mature miRNAs significantly inhibited cancer cell migration and invasion. Gene expression data and <italic>in silico</italic> analysis demonstrated that epidermal growth factor receptor (<italic>EGFR</italic>) and hepatocyte growth factor receptor (<italic>c-Met</italic>) were potential targets of the <italic>miR-23b/27b</italic> cluster. Elucidation of the cancer pathways and targets regulated by tumour-suppressive <italic>miR-23b/27b</italic> cluster will provide new insights into the potential mechanisms of oncogenesis and metastasis of BC.</p></sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title>Clinical specimens</title>
<p>A total of 58 BC and 25 normal bladder specimens were collected from patients who underwent cystectomy or transurethral resection of bladder tumors (TUR-BT) at the Kagoshima University Hospital. The 25 normal bladder specimens were derived from patients without BC. Samples were processed and stored in RNAlater<sup>&#x000AE;</sup> (Qiagen, Valencia, CA, USA) at &#x02212;20&#x000B0;C until RNA extraction. The samples were staged in accordance with the tumor-node-metastasis classification system of the American Joint Committee on Cancer/Union Internationale Contre le Cancer (UICC), and they were histologically graded. Written informed consent was obtained from all patients and the present study was approved by the Bioethics Committee of Kagoshima University. The patients&#x02019; backgrounds and clinicopathological characteristics are summarized in <xref rid="tI-ijo-46-02-0487" ref-type="table">Table I</xref>.</p></sec>
<sec>
<title>Cell culture and RNA extraction</title>
<p>We used the human BC cell lines BOY and T24. BOY was established in our laboratory from a male Asian patient, 66-years old, who was diagnosed with stage III BC with lung metastasis. T24 was obtained from the ATCC. The cell lines were incubated in minimum essential medium (MEM) supplemented with 10&#x00025; fetal bovine serum and maintained in a humidified incubator (5&#x00025; CO<sub>2</sub>) at 37&#x000B0;C. Total RNA was extracted as previously described (<xref rid="b23-ijo-46-02-0487" ref-type="bibr">23</xref>).</p></sec>
<sec>
<title>Quantitative real-time RT-PCR</title>
<p>Stem-loop RT-PCR for <italic>miR-23b</italic> (P/N 000400; Applied Biosystems, Foster City, CA, USA) and <italic>miR-27b</italic> (P/N 000409; Applied Biosystems) were used to quantitate miRNAs according to previously published conditions (<xref rid="b11-ijo-46-02-0487" ref-type="bibr">11</xref>). To normalize data for quantifying the miRNAs, we used <italic>RNU48</italic> (P/N 001006; Applied Biosystems). The &#x003B4;-&#x003B4; threshold count method was used to calculate the fold-change.</p></sec>
<sec>
<title>Mature miRNA transfection</title>
<p>As previously described (<xref rid="b11-ijo-46-02-0487" ref-type="bibr">11</xref>), the BC cell lines were transfected with Lipofectamine RNAiMAX transfection reagent (Invitrogen, Carlsbad, CA, USA) and Opti-MEM (Invitrogen) with 10 nM mature miRNA molecules. As the negative control, Pre-miR miRNA precursor (P/N AM17111; Applied Biosystems) was used in gain-of-function experiments.</p></sec>
<sec>
<title>Cell proliferation, migration and invasion assays</title>
<p>Cell proliferation was determined using an XTT assay performed according to the manufacturer&#x02019;s instructions. Cell migration activity was evaluated with a wound healing assay and cell invasion assays were done using modified Boyden chambers as previously described (<xref rid="b23-ijo-46-02-0487" ref-type="bibr">23</xref>). All experiments were performed in triplicate.</p></sec>
<sec>
<title>Putative miR-23b and miR-27b target gene pathway analysis and expression</title>
<p>To obtain putative miR-23b- and <italic>miR-27b</italic>-regulated genes, we used the TargetScan database (Release 6.2, <ext-link xlink:href="http://www.targetscan.org/" ext-link-type="uri">http://www.targetscan.org/</ext-link>). To identify signaling pathways regulated by the <italic>miR-23b/27b</italic> cluster, <italic>in silico</italic> and gene expression data were analyzed in the Kyoto Encyclopedia of Genes and Genomics (KEGG) pathway categories using the GeneCodis program. We performed gene expression analyses for all candidate genes involved in each of the pathways identified by GeneCodis3 software analysis using microarray expression data. The data were approved by the Gene Expression Omnibus (GEO) and were assigned GEO accession numbers (GSE11783 and GSE31684). For microarray expression data, we examined 90 BCs and 6 normal bladder epithelium collected from patients, none of whom had been exposed to chemotherapy before surgery. The data were normalized and analyzed with GeneSpring (Agilent Technologies, Santa Clara, CA, USA). Statistical analyses were conducted using the Mann-Whitney U test.</p></sec>
<sec>
<title>Western blotting</title>
<p>Three days after transfection, protein lysates (20 &#x003BC;g) were separated in NuPAGE on 4&#x02013;12&#x00025; Bis-Tris gels (Invitrogen) and transferred to polyvinylidene fluoride membranes as previously described (<xref rid="b23-ijo-46-02-0487" ref-type="bibr">23</xref>). Antibodies against EGFR and c-Met were purchased from Cell Signaling Technology (Danvers, MA, USA). Antibodies against GAPDH were purchased from Chemicon (Temecula, CA, USA). Specific complexes were visualized with an echochemiluminescence (ECL) detection system (GE Healthcare, Little Chalfont, UK).</p></sec>
<sec>
<title>Plasmid construction and dual-luciferase reporter assays</title>
<p>miRNA target sequences were inserted between the <italic>Xho</italic>I-<italic>Pme</italic>I restriction sites in the 3&#x02032;-untranslated region (UTR) of the <italic>hRluc</italic> gene in the psiCHECK-2 vector (C8021; Promega, Madison, WI, USA). miRNA target sequences targeted by <italic>miR-23b</italic> and <italic>miR-27b</italic> are summarized in <xref rid="tII-ijo-46-02-0487" ref-type="table">Table II</xref>.</p>
<p>T24 cells were transfected with 50 ng of the vector and 10 nM miRNA using Lipofectamine 2000 (Invitrogen). The activities of firefly and <italic>Renilla</italic> luciferases in cell lysates were determined with a dual-luciferase assay system (E1910; Promega). Normalized data were calculated as the ratio of <italic>Renilla</italic>/firefly luciferase activities.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Relationships between 2 or 3 variables and numerical values were analyzed using the Mann-Whitney U test or Bonferroni adjusted Mann-Whitney U test. Spearman&#x02019;s rank test was used to evaluate the correlation between the expressions of <italic>miR-23b</italic> and <italic>miR-27b</italic>. Expert StatView, version 4 was used in these analyses.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Expression levels of miR-23b/27b cluster in BC clinical specimens</title>
<p>We evaluated the expression levels of <italic>miR-23b</italic> and <italic>miR-27b</italic> in BC tissues (n=58) and normal bladder specimens (n=25). The expression levels of <italic>miR-23b</italic> and <italic>miR-27b</italic> were significantly lower in tumor tissues than in corresponding non-cancerous tissues (both P&lt;0.0001; <xref rid="f1-ijo-46-02-0487" ref-type="fig">Fig. 1A</xref>). Spearman&#x02019;s rank test showed a positive correlation between the expression of <italic>miR-23b</italic> and that of <italic>miR-27b</italic> (r=0.966 and P&lt;0.0001; <xref rid="f1-ijo-46-02-0487" ref-type="fig">Fig. 1B</xref>). These results suggested that <italic>miR-23b</italic> and <italic>miR-27b</italic> were significantly downregulated in BC and could represent putative tumor suppressors in BC.</p></sec>
<sec>
<title>Effects of restoring miR-23b and miR-27b expression on cell proliferation, migration and invasion activities in cancer cell lines</title>
<p>To examine the functional roles of <italic>miR-23b</italic> and <italic>miR-27b</italic>, we performed gain-of-function studies using miRNA transfection into BOY and T24 cells. XTT assays revealed significant inhibition of cell proliferation in BOY and T24 cells transfected with <italic>miR-23b</italic> and <italic>miR-27b</italic> in comparison with mock-transfected cells and control transfectants (BOY: P=0.0011 and P&lt;0.0001, respectively; T24: P=0.0035 and P&lt;0.0001, respectively) (<xref rid="f2-ijo-46-02-0487" ref-type="fig">Fig. 2A</xref>).</p>
<p>Moreover, wound healing assays demonstrated significant inhibition of cell migration was observed in BOY and T24 cells transfected with <italic>miR-23b</italic> and <italic>miR-27b</italic> (BOY: P&lt;0.0001 and P=0.0001, respectively; T24: both P&lt;0.0001) (<xref rid="f2-ijo-46-02-0487" ref-type="fig">Fig. 2B</xref>).</p>
<p>Similarly, <italic>Matrigel</italic> invasion assays revealed that transfection with these miRNAs reduced cell invasion. Indeed, the number of invading cells was significantly decreased in BOY and T24 cells transfected with <italic>miR-23b</italic> and <italic>miR-27b</italic> (BOY: P&lt;0.0024 and P&lt;0.0001, respectively; T24: P&lt;0.0075 and P&lt;0.0001, respectively) (<xref rid="f2-ijo-46-02-0487" ref-type="fig">Fig. 2C</xref>).</p></sec>
<sec>
<title>Identification of targets pathways and genes regulated by the miR-23b/27b cluster in BC cells</title>
<p>To gain further insight into the molecular mechanisms and pathways regulated by the tumor-suppressive <italic>miR-23b/27b</italic> cluster in BC, we performed a combination of gene expression and <italic>in silico</italic> analyses. The strategy for selecting <italic>miR-23b/27b</italic> cluster-regulated pathways is shown in <xref rid="f3-ijo-46-02-0487" ref-type="fig">Fig. 3</xref>.</p>
<p>The TargetScan program showed that 4206 and 4075 genes had putative target sites for <italic>miR-23b</italic> and <italic>miR-27b</italic>-, respectively, in their 3&#x02032;-UTR regions. To confirm the expression levels of these genes in clinical BC tissues, GEO database (GEO accession number: GSE11783 and GSE31684) analysis was performed. The data showed that 1827 and 1733 genes were 2.0-fold or more upregulated in BC tissues compared to normal tissues for <italic>miR-23b</italic> and <italic>miR-27b</italic> target genes, respectively. KEGG analysis revealed that the top &#x02018;pathway&#x02019; (greatest number of genes) was &#x02018;Pathways in cancer&#x02019; (<xref rid="tIII-ijo-46-02-0487" ref-type="table">Table III</xref>). Several common putative target genes were included in this pathway (<xref rid="tIV-ijo-46-02-0487" ref-type="table">Table IV</xref>). We focused on <italic>EGFR</italic>, <italic>RET</italic> and <italic>c-Met</italic> genes that coded for tyrosine kinase receptors.</p></sec>
<sec>
<title>EGFR and c-Met were regulated by miR-23b and miR-27b</title>
<p>We performed western blot analysis of BOY and T24 cells to investigate whether EGFR, RET and c-Met expression were downregulated by restoration of <italic>miR-23b</italic> and <italic>miR-27b</italic>. Expression of EGFR protein was significantly repressed in <italic>miR-27b</italic> transfectants in comparison with mock or miR-control transfectants (<xref rid="f4-ijo-46-02-0487" ref-type="fig">Fig. 4</xref>). The protein expression level of c-Met was significantly repressed in <italic>miR-23b</italic> and <italic>miR-27b</italic> transfectants ( <xref rid="f4-ijo-46-02-0487" ref-type="fig">Fig. 4</xref>). RET protein expression was not repressed in either <italic>miR-23b</italic> or <italic>miR-27b</italic> transfectants (<xref rid="f4-ijo-46-02-0487" ref-type="fig">Fig. 4</xref>).</p></sec>
<sec>
<title>EGFR and c-Met were directly targeted by miR-23b and miR-27b</title>
<p>We performed a luciferase reporter assay in T24 to determine whether <italic>EGFR</italic> and <italic>c-Met</italic> had target sites for <italic>miR-23b</italic> and <italic>miR-27b</italic>. The TargetScan database predicted that two putative <italic>miR-27b</italic> binding sites existed in the 3&#x02032;-UTR of <italic>EGFR</italic> (positions 200&#x02013;207 and 430&#x02013;436; <xref rid="f5-ijo-46-02-0487" ref-type="fig">Fig. 5A</xref>). The database showed that one putative <italic>miR-23b</italic> binding site existed in the 3&#x02032;-UTR of <italic>EGFR</italic>. However, EGFR protein expression was not repressed in <italic>miR-23b</italic> transfectants (<xref rid="f4-ijo-46-02-0487" ref-type="fig">Fig. 4</xref>). Therefore, we performed a luciferase reporter assay to determine whether <italic>EGFR</italic> had target sites for <italic>miR-27b</italic>. The database also predicted that two putative <italic>miR-23b</italic> binding sites and one putative <italic>miR-27b</italic> binding site existed in the <italic>c-Met</italic> 3&#x02032;-UTR (positions 1019&#x02013;1026, 2065&#x02013;2072 and 1564&#x02013;1571, respectively; <xref rid="f5-ijo-46-02-0487" ref-type="fig">Fig. 5B</xref>). We used wild-type and mutant vectors encoding either the partial sequence of the 3&#x02032;-UTRs of <italic>EGFR</italic> and <italic>c-Met</italic>, including the predicted <italic>miR-23b</italic> and <italic>miR-27b</italic> target sites.</p>
<p>We found that the luminescence intensity was significantly reduced by transfection of <italic>miR-27b</italic> with the wild-type vector carrying the 3&#x02032;-UTR of <italic>EGFR</italic> (position 200&#x02013;207: P&lt;0.0001; position 430&#x02013;436: P&lt;0.0001; <xref rid="f5-ijo-46-02-0487" ref-type="fig">Fig. 5B</xref>), whereas transfection with a mutant vector showed no decrease in luminescence.</p>
<p>With regards to <italic>c-Met</italic>, the luminescence intensity was significantly reduced by transfection of <italic>miR-23b</italic> with vectors carrying a portion of the 3&#x02032;-UTR of <italic>c-Met</italic> (position 1019&#x02013;1026: P&lt;0.0001; position 2065&#x02013;2072: P&lt;0.0001; <xref rid="f5-ijo-46-02-0487" ref-type="fig">Fig. 5B</xref>) and the luminescence intensity was also reduced by transfection of <italic>miR-27b</italic> with the vector carrying the 3&#x02032;-UTR of <italic>c-Met</italic> (position 1564&#x02013;1571: P&lt;0.0001; <xref rid="f5-ijo-46-02-0487" ref-type="fig">Fig. 5B</xref>), whereas transfection with a mutant vector failed to decrease luminescence.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Aberrant expression of the <italic>miR-23b/27b</italic> cluster has been reported in several types of human cancers; however, the expression status varies according to the cancer type. Decreased expression of the <italic>miR-23b/27b</italic> cluster has been observed in castration-resistant prostate cancer (<xref rid="b24-ijo-46-02-0487" ref-type="bibr">24</xref>) and drug-resistant Ehrlich ascites tumor (<xref rid="b25-ijo-46-02-0487" ref-type="bibr">25</xref>). In contrast, upregulation of the <italic>miR-23b/27b</italic> cluster was reported in breast cancer (<xref rid="b22-ijo-46-02-0487" ref-type="bibr">22</xref>) and chemoresistant ovarian cancer cells (<xref rid="b26-ijo-46-02-0487" ref-type="bibr">26</xref>). In the present study, our data demonstrated that <italic>miR-23b</italic> and <italic>miR-27b</italic> expression was significantly downregulated in BC clinical specimens. Functional analysis demonstrated that restoration of <italic>miR-23b</italic> and <italic>miR-27b</italic> in BC cells inhibited cancer cell proliferation, migration and invasion. Those results suggest that the <italic>miR-23b/27b</italic> cluster functions as a tumor suppressor and may contribute to metastasis in BC. Of particular interest, our recent study showed that <italic>miR-24-1</italic>, which is located close to the <italic>miR-23b/27b</italic> cluster, was downregulated in BC tissues and functioned as a tumor suppressor targeting FOXM1 (<xref rid="b27-ijo-46-02-0487" ref-type="bibr">27</xref>). Thus, our data suggest that the <italic>miR-23b/27b</italic> cluster, including <italic>miR-24-1</italic>, functions as a tumor suppressor and significantly contributes to BC oncogenesis and metastasis.</p>
<p>Next, we investigated the pathways/targets that were regulated by the tumor-suppressive <italic>miR-23b/27b</italic> cluster in BC cells. To identify tumor-suppressive, miRNA-regulated molecular pathways, we used a combination of expression data and <italic>in silico</italic> database analysis. Using this strategy, we have identified molecular targets and pathways in several types of cancer that are regulated by tumor-suppressive miRNAs, including BC (<xref rid="b7-ijo-46-02-0487" ref-type="bibr">7</xref>&#x02013;<xref rid="b11-ijo-46-02-0487" ref-type="bibr">11</xref>). In the present study, &#x02018;pathways in cancer&#x02019;, the &#x02018;MAPK signaling pathway&#x02019; and &#x02018;cytokine-cytokine receptor interaction&#x02019; were significantly selected as candidate pathways regulated by the <italic>miR-23b/27b</italic> cluster in BC cells. Among these pathways, we focused attention on &#x02018;pathways in cancer&#x02019; and searched for putative targets of <italic>miR-23b/27b</italic> regulation. We focused on tyrosine kinase receptors such as <italic>EGFR</italic>, <italic>RET</italic> and <italic>c-Met</italic> genes because molecularly targeted therapies aimed at inhibiting their activities have been developed recently for several types of cancer (<xref rid="b28-ijo-46-02-0487" ref-type="bibr">28</xref>). Our results showed that <italic>EGFR</italic> was directly regulated by <italic>miR-27b</italic> and that <italic>c-Met</italic> was directly regulated by both <italic>miR-23b</italic> and <italic>miR-27b</italic>. Unfortunately, <italic>RET</italic> was not controlled by either miRNA.</p>
<p><italic>EGFR</italic> is the cell-surface receptor for members of the epidermal growth factor family of extracellular protein ligands (<xref rid="b29-ijo-46-02-0487" ref-type="bibr">29</xref>). Receptor activation initiates several signal transduction cascades, including the MAPK, Akt and JNK pathways, leading to DNA synthesis and cell proliferation (<xref rid="b30-ijo-46-02-0487" ref-type="bibr">30</xref>). Previous studies showed that overexpression of EGFR occurred in BC and the expression level correlated with tumor grade, stage and survival (<xref rid="b31-ijo-46-02-0487" ref-type="bibr">31</xref>&#x02013;<xref rid="b33-ijo-46-02-0487" ref-type="bibr">33</xref>).</p>
<p>Another receptor, <italic>c-Met</italic> (hepatocyte growth factor receptor) activates multiple signal transduction pathways such as those involving RAS, PI3K-Akt, STAT and &#x003B2;-catenin (<xref rid="b34-ijo-46-02-0487" ref-type="bibr">34</xref>&#x02013;<xref rid="b37-ijo-46-02-0487" ref-type="bibr">37</xref>). The expression of c-Met and phosphorylated c-Met are positively correlated with tumor grade, stage, tumor size and survival of several types of cancers. It is likely that c-Met could be a promising therapeutic target in disease (<xref rid="b38-ijo-46-02-0487" ref-type="bibr">38</xref>,<xref rid="b39-ijo-46-02-0487" ref-type="bibr">39</xref>). The amplification frequency of c-Met is approximately 20&#x00025; in patients who have acquired resistance to EGFR tyrosine kinase inhibitors (<xref rid="b40-ijo-46-02-0487" ref-type="bibr">40</xref>). Therefore, inhibition of EGFR and c-Met and their associated signaling pathways could be a potent strategy for cancer therapy. Studies of dual tyrosine kinase inhibitors are underway (<xref rid="b41-ijo-46-02-0487" ref-type="bibr">41</xref>). Several laboratories have shown that miRNAs directly inhibit EGFR or/and c-Met expression, such as <italic>miR-7</italic>, <italic>miR-146a</italic>, <italic>miR-574-3p</italic>, <italic>miR-34a</italic>, <italic>miR-130a</italic> and <italic>miR-1/206</italic> (<xref rid="b42-ijo-46-02-0487" ref-type="bibr">42</xref>&#x02013;<xref rid="b47-ijo-46-02-0487" ref-type="bibr">47</xref>). In addition, a recent study demonstrated that <italic>miR-27a</italic> regulated both EGFR and c-Met in non-small cell lung cancer (<xref rid="b48-ijo-46-02-0487" ref-type="bibr">48</xref>). In the present study, the <italic>miR-23b/27b</italic> cluster regulated EGFR and c-Met in BC cells. Therefore, inhibition of two separate tyrosine kinases via the tumor-suppressive <italic>miR-23b/27b</italic> cluster represents an attractive possibility in the development of new treatment options in cancer.</p>
<p>In conclusion, downregulation of the <italic>miR-23b/27b</italic> cluster is a frequent event in BC. Moreover, tumor-suppressive <italic>miR-23b</italic> and <italic>miR-27b</italic> directly regulated tyrosine kinase receptor genes <italic>EGFR</italic> and <italic>c-Met</italic>. Identification of molecular targets regulated by tumor-suppressive miRNAs will provide insights into the potential mechanisms of BC oncogenesis and metastasis, facilitating the development of novel therapeutic strategies for the treatment of BC.</p></sec></body>
<back>
<ack>
<title>Acknowledgements</title>
<p>The present study was supported by the KAKENHI (B), 26293354; and (C), 25462490.</p></ack>
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<floats-group>
<fig id="f1-ijo-46-02-0487" position="float">
<label>Figure 1</label>
<caption>
<p>Expression levels of <italic>miR-23b/27b</italic> in clinical bladder specimens. (A) <italic>miR-23b/27b</italic> expression levels were significantly lower in 58 BC clinical specimens than in 25 normal bladder specimens. (B) The expression of <italic>miR-23b</italic> and <italic>miR-27b</italic> was positively correlated.</p></caption>
<graphic xlink:href="IJO-46-02-0487-g00.gif"/></fig>
<fig id="f2-ijo-46-02-0487" position="float">
<label>Figure 2</label>
<caption>
<p>Effects of <italic>miR-23b/27b</italic> transfection into BC cell lines BOY and T24. (A) Cell proliferation determined by XTT assay. <sup>*</sup>P&lt;0.005. <sup>**</sup>P&lt;0.0001. (B) Cell migration activity determined with the wound healing assay. <sup>*</sup>P&lt;0.0005. <sup>**</sup>P&lt;0.0001. (C) Cell invasion activity determined with the Matrigel invasion assay. <sup>*</sup>P&lt;0.01. <sup>**</sup>P&lt;0.0001.</p></caption>
<graphic xlink:href="IJO-46-02-0487-g01.gif"/></fig>
<fig id="f3-ijo-46-02-0487" position="float">
<label>Figure 3</label>
<caption>
<p>The strategy for selecting target pathways regulated by the <italic>miR-23b/27b</italic> cluster.</p></caption>
<graphic xlink:href="IJO-46-02-0487-g02.gif"/></fig>
<fig id="f4-ijo-46-02-0487" position="float">
<label>Figure 4</label>
<caption>
<p>EGFR and c-Met protein expression levels were suppressed by <italic>miR-23b/27b</italic> transfection in BOY and T24 cells. Expression of EGFR, c-Met and RET protein as revealed by western blot analysis. GAPDH was used as a loading control.</p></caption>
<graphic xlink:href="IJO-46-02-0487-g03.gif"/></fig>
<fig id="f5-ijo-46-02-0487" position="float">
<label>Figure 5</label>
<caption>
<p>(A) Luciferase reporter assays using vectors encoding putative target sites in the 3&#x02032;-UTR. T24 cells were transiently transfected with Pre-miR miRNA precursor or negative control, followed by transient transfection with wild-type 3&#x02032;-UTR reporter plasmids or mutated 3&#x02032;-UTR plasmids. <italic>Renilla</italic> luciferase activity was measured 24 h after transfection. The results are normalized to firefly luciferase values. <sup>*</sup>P&lt;0.0001. (B) Luciferase reporter assays using vectors encoding putative target sites in the <italic>c-Met</italic> 3&#x02032;-UTR.</p></caption>
<graphic xlink:href="IJO-46-02-0487-g04.gif"/>
<graphic xlink:href="IJO-46-02-0487-g05.gif"/></fig>
<table-wrap id="tI-ijo-46-02-0487" position="float">
<label>Table I</label>
<caption>
<p>Patient characteristics.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" align="left">Characteristics</th>
<th valign="bottom" align="center">Data</th></tr></thead>
<tbody>
<tr>
<td colspan="2" valign="top" align="left">Bladder cancer</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Total number</td>
<td valign="top" align="center">58</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Median age (range) (years)</td>
<td valign="top" align="center">71 (47&#x02013;91)</td></tr>
<tr>
<td colspan="2" valign="top" align="left">&#x02003;Gender</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;Male</td>
<td valign="top" align="center">45 (78&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;Female</td>
<td valign="top" align="center">13 (22&#x00025;)</td></tr>
<tr>
<td colspan="2" valign="top" align="left">&#x02003;Pathological tumor stage</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;pTis</td>
<td valign="top" align="center">2 (3&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;pTa</td>
<td valign="top" align="center">7 (12&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;pT1</td>
<td valign="top" align="center">10 (17&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;pT2</td>
<td valign="top" align="center">15 (26&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;pT3</td>
<td valign="top" align="center">7 (12&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;pT4</td>
<td valign="top" align="center">5 (9&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;Unknown</td>
<td valign="top" align="center">12 (21&#x00025;)</td></tr>
<tr>
<td colspan="2" valign="top" align="left">&#x02003;Grade</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;G1</td>
<td valign="top" align="center">2 (3&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;G2</td>
<td valign="top" align="center">29 (50&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;G3</td>
<td valign="top" align="center">21 (36&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;Unknown</td>
<td valign="top" align="center">6 (1&#x00025;)</td></tr>
<tr>
<td colspan="2" valign="top" align="left">&#x02003;Operation</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;Cystectomy</td>
<td valign="top" align="center">23 (40&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">&#x02003;&#x02003;TUR-BT</td>
<td valign="top" align="center">35 (60&#x00025;)</td></tr>
<tr>
<td valign="top" align="left">Normal bladder epithelium</td>
<td valign="top" align="center">25</td></tr></tbody></table></table-wrap>
<table-wrap id="tII-ijo-46-02-0487" position="float">
<label>Table II</label>
<caption>
<p>Insert 3&#x02032;-UTR sequence of <italic>EGFR</italic> and <italic>c-Met</italic>.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" align="left">Gene</th>
<th valign="bottom" align="center">Target sites</th>
<th valign="bottom" align="center">3&#x02032;-UTR position</th>
<th valign="bottom" align="center"/>
<th valign="bottom" align="center">Sequence (5&#x02032;-3&#x02032;)</th></tr></thead>
<tbody>
<tr>
<td valign="top" align="left"><italic>EGFR</italic></td>
<td valign="top" align="center">miR-27b</td>
<td valign="top" align="left">200&#x02013;207</td>
<td valign="top" align="left">Wild</td>
<td valign="top" align="left">gccaggaagtacttccacctcgggcacattttgggaagttgcattcctttgtcttcaa<bold><underline>actgtgaa</underline></bold>gcatttacagaaacgcatccagcaag<break/>aatattgtccctttgagcagaaatttatctttcaaagaggtatatttgaaaaaaaaaaaaagtatatgtgaggatttttattgattgg</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center"/>
<td valign="top" align="left"/>
<td valign="top" align="left">Mutation</td>
<td valign="top" align="left">gccaggaagtacttccacctcgggcacattttgggaagttgcattcctttgtcttcaa<bold><underline>tgacactt</underline></bold>gcatttacagaaacgcatccagcaag<break/>aatattgtccctttgagcagaaatttatctttcaaagaggtatatttgaaaaaaaaaaaaagtatatgtgaggatttttattgattgg</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center"/>
<td valign="top" align="left">430&#x02013;436</td>
<td valign="top" align="left">Wild</td>
<td valign="top" align="left">ggatcttggagtttttcattgtcgctattgatttttacttcaatgggctcttccaacaaggaagaagcttgctggtagcacttgctaccctg<break/>agttcatccaggccca<bold><underline>actgtga</underline></bold>gcaaggagcacaagccacaagtcttccagaggatgcttgattccagtggttctgcttcaaggctt</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center"/>
<td valign="top" align="left"/>
<td valign="top" align="left">Mutation</td>
<td valign="top" align="left">ggatcttggagtttttcattgtcgctattgatttttacttcaatgggctcttccaacaaggaagaagcttgctggtagcacttgctaccctg<break/>agttcatccaggccca<bold><underline>tgacact</underline></bold>gcaaggagcacaagccacaagtcttccagaggatgcttgattccagtggttctgcttcaaggctt</td></tr>
<tr>
<td valign="top" align="left"><italic>c-Met</italic></td>
<td valign="top" align="center">miR-23b</td>
<td valign="top" align="left">1019&#x02013;1026</td>
<td valign="top" align="left">Wild</td>
<td valign="top" align="left">cattaagaaaatttgtatgaaataatttagtcatcatgaaatatttagttgtcatataaaaacccactgtttgagaatgatgctactctgat<break/>ctaatg<bold><underline>aatgtga</underline></bold>acatgtagatgttttgtgtgtatttttttaaatgaaaactcaaaataagacaagtaatttgttgataaatatttt</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center"/>
<td valign="top" align="left"/>
<td valign="top" align="left">Mutation</td>
<td valign="top" align="left">cattaagaaaatttgtatgaaataatttagtcatcatgaaatatttagttgtcatataaaaacccactgtttgagaatgatgctactctgat<break/>ctaatg<bold><underline>ttacact</underline></bold>tcatgtagatgttttgtgtgtatttttttaaatgaaaactcaaaataagacaagtaatttgttgataaatatttt</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center"/>
<td valign="top" align="left">2065&#x02013;2072</td>
<td valign="top" align="left">Wild</td>
<td valign="top" align="left">gaactcggggaaacatcccatcaacaggactacacacttgtatatacattcttgagaacactgc<bold><underline>aatgtga</underline></bold>aaatcacgtttgctatttata<break/>aacttgtccttagattaatgtgtctggacagattgtgggagtaagtgattcttctaagaattagatacttgtcactgcctatacctgc</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center"/>
<td valign="top" align="left"/>
<td valign="top" align="left">Mutation</td>
<td valign="top" align="left">gaactcggggaaacatcccatcaacaggactacacacttgtatatacattcttgagaacactgc<bold><underline>ttacact</underline></bold>taatcacgtttgctatttata<break/>aacttgtccttagattaatgtgtctggacagattgtgggagtaagtgattcttctaagaattagatacttgtcactgcctatacctgc</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center">miR-27b</td>
<td valign="top" align="left">1564&#x02013;1571</td>
<td valign="top" align="left">Wild</td>
<td valign="top" align="left">taactggttttgtcgacgtaaacatttaaagtgttatattttttataaaaatgtttatttttaatgatatgagaaaaattttgttaggccac<break/>aaaaacactgc<bold><underline>actgtgaa</underline></bold>cattttagaaaaggtatgtcagactgggattaatgacagcatgattttcaatgactgtaaattgcgata</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="center"/>
<td valign="top" align="left"/>
<td valign="top" align="left">Mutation</td>
<td valign="top" align="left">taactggttttgtcgacgtaaacatttaaagtgttatattttttataaaaatgtttatttttaatgatatgagaaaaattttgttaggccac<break/>aaaaacactgc<bold><underline>tgacactt</underline></bold>cattttagaaaaggtatgtcagactgggattaatgacagcatgattttcaatgactgtaaattgcgata</td></tr></tbody></table></table-wrap>
<table-wrap id="tIII-ijo-46-02-0487" position="float">
<label>Table III</label>
<caption>
<p>Top 10 enriched pathways in <italic>miR-23b</italic> and <italic>miR-27b</italic>.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" align="left">Annotations</th>
<th valign="bottom" align="center">No. of genes</th>
<th valign="bottom" align="center">P-value</th></tr></thead>
<tbody>
<tr>
<td colspan="3" valign="top" align="left"><italic>miR-23b</italic></td></tr>
<tr>
<td valign="top" align="left">&#x02003;Pathways in cancer</td>
<td valign="top" align="center">50</td>
<td valign="top" align="center">5.09E-15</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Neuroactive ligand-receptor interaction</td>
<td valign="top" align="center">39</td>
<td valign="top" align="center">5.52E-11</td></tr>
<tr>
<td valign="top" align="left">&#x02003;MAPK signaling pathway</td>
<td valign="top" align="center">24</td>
<td valign="top" align="center">4.60E-04</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Cytokine-cytokine receptor interaction</td>
<td valign="top" align="center">23</td>
<td valign="top" align="center">8.97E-04</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Endocytosis</td>
<td valign="top" align="center">22</td>
<td valign="top" align="center">6.98E-05</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Focal adhesion</td>
<td valign="top" align="center">21</td>
<td valign="top" align="center">2.03E-04</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Regulation of actin cytoskeleton</td>
<td valign="top" align="center">21</td>
<td valign="top" align="center">3.72E-04</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Calcium signaling pathway</td>
<td valign="top" align="center">20</td>
<td valign="top" align="center">1.35E-04</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Glutamatergic synapse</td>
<td valign="top" align="center">19</td>
<td valign="top" align="center">6.90E-06</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Chemokine signaling pathway</td>
<td valign="top" align="center">19</td>
<td valign="top" align="center">5.79E-04</td></tr>
<tr>
<td colspan="3" valign="top" align="left"><italic>miR-27b</italic></td></tr>
<tr>
<td valign="top" align="left">&#x02003;Pathways in cancer</td>
<td valign="top" align="center">42</td>
<td valign="top" align="center">2.14E-10</td></tr>
<tr>
<td valign="top" align="left">&#x02003;MAPK signaling pathway</td>
<td valign="top" align="center">30</td>
<td valign="top" align="center">1.30E-06</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Neuroactive ligand-receptor interaction</td>
<td valign="top" align="center">29</td>
<td valign="top" align="center">4.67E-06</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Calcium signaling pathway</td>
<td valign="top" align="center">24</td>
<td valign="top" align="center">1.23E-06</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Axon guidance</td>
<td valign="top" align="center">23</td>
<td valign="top" align="center">2.23E-08</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Regulation of actin cytoskeleton</td>
<td valign="top" align="center">22</td>
<td valign="top" align="center">1.42E-04</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Endocytosis</td>
<td valign="top" align="center">20</td>
<td valign="top" align="center">3.85E-04</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Glutamatergic synapse</td>
<td valign="top" align="center">19</td>
<td valign="top" align="center">3.35E-06</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Chemokine signaling pathway</td>
<td valign="top" align="center">18</td>
<td valign="top" align="center">1.34E-03</td></tr>
<tr>
<td valign="top" align="left">&#x02003;Cytokine-cytokine receptor interaction</td>
<td valign="top" align="center">18</td>
<td valign="top" align="center">2.10E-02</td></tr></tbody></table></table-wrap>
<table-wrap id="tIV-ijo-46-02-0487" position="float">
<label>Table IV</label>
<caption>
<p><italic>miR-23b/27b</italic> common target genes highly expressed in bladder cancer.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="2" valign="bottom" align="center">Clinical BCs</th>
<th valign="bottom" align="center"/>
<th valign="bottom" align="center"/>
<th valign="bottom" align="center"/></tr>
<tr>
<th colspan="2" valign="bottom" align="left">
<hr/></th>
<th valign="bottom" align="center"/>
<th valign="bottom" align="center"/>
<th valign="bottom" align="center"/></tr>
<tr>
<th valign="bottom" align="left">Change</th>
<th valign="bottom" align="center">P-value</th>
<th valign="bottom" align="center">Entrez gene ID</th>
<th valign="bottom" align="center">Symbol</th>
<th valign="bottom" align="center">Description</th></tr></thead>
<tbody>
<tr>
<td valign="top" align="left">19.55</td>
<td valign="top" align="center">4.67E-05</td>
<td valign="top" align="right">7849</td>
<td valign="top" align="left"><italic>PAX8</italic></td>
<td valign="top" align="left">Paired box 8</td></tr>
<tr>
<td valign="top" align="left">6.79</td>
<td valign="top" align="center">1.14E-04</td>
<td valign="top" align="right">1021</td>
<td valign="top" align="left"><italic>CDK6</italic></td>
<td valign="top" align="left">Cyclin-dependent kinase 6</td></tr>
<tr>
<td valign="top" align="left">5.98</td>
<td valign="top" align="center">1.64E-04</td>
<td valign="top" align="right">1956</td>
<td valign="top" align="left"><italic>EGFR</italic></td>
<td valign="top" align="left">Epidermal growth factor receptor</td></tr>
<tr>
<td valign="top" align="left">5.00</td>
<td valign="top" align="center">2.65E-04</td>
<td valign="top" align="right">2034</td>
<td valign="top" align="left"><italic>EPAS1</italic></td>
<td valign="top" align="left">Endothelial PAS domain protein 1</td></tr>
<tr>
<td valign="top" align="left">4.74</td>
<td valign="top" align="center">1.21E-04</td>
<td valign="top" align="right">208</td>
<td valign="top" align="left"><italic>AKT2</italic></td>
<td valign="top" align="left">v-akt murine thymoma viral oncogene homolog 2</td></tr>
<tr>
<td valign="top" align="left">4.60</td>
<td valign="top" align="center">5.91E-04</td>
<td valign="top" align="right">2246</td>
<td valign="top" align="left"><italic>FGF1</italic></td>
<td valign="top" align="left">Fibroblast growth factor 1 (acidic)</td></tr>
<tr>
<td valign="top" align="left">4.20</td>
<td valign="top" align="center">8.23E-04</td>
<td valign="top" align="right">861</td>
<td valign="top" align="left"><italic>RUNX1</italic></td>
<td valign="top" align="left">Runt-related transcription factor 1</td></tr>
<tr>
<td valign="top" align="left">3.96</td>
<td valign="top" align="center">3.16E-03</td>
<td valign="top" align="right">2250</td>
<td valign="top" align="left"><italic>FGF5</italic></td>
<td valign="top" align="left">Fibroblast growth factor 5</td></tr>
<tr>
<td valign="top" align="left">3.91</td>
<td valign="top" align="center">3.75E-04</td>
<td valign="top" align="right">7170</td>
<td valign="top" align="left"><italic>TPM3</italic></td>
<td valign="top" align="left">Tropomyosin 3</td></tr>
<tr>
<td valign="top" align="left">3.75</td>
<td valign="top" align="center">4.46E-04</td>
<td valign="top" align="right">4089</td>
<td valign="top" align="left"><italic>SMAD4</italic></td>
<td valign="top" align="left">SMAD family member 4</td></tr>
<tr>
<td valign="top" align="left">3.75</td>
<td valign="top" align="center">5.59E-04</td>
<td valign="top" align="right">3918</td>
<td valign="top" align="left"><italic>LAMC2</italic></td>
<td valign="top" align="left">Laminin, &#x003B3; 2</td></tr>
<tr>
<td valign="top" align="left">3.42</td>
<td valign="top" align="center">7.80E-05</td>
<td valign="top" align="right">862</td>
<td valign="top" align="left"><italic>RUNX1T1</italic></td>
<td valign="top" align="left">Runt-related transcription factor 1; translocated to, 1 (cyclin D-related)</td></tr>
<tr>
<td valign="top" align="left">3.31</td>
<td valign="top" align="center">6.45E-05</td>
<td valign="top" align="right">5979</td>
<td valign="top" align="left"><italic>RET</italic></td>
<td valign="top" align="left">Ret proto-oncogene</td></tr>
<tr>
<td valign="top" align="left">3.09</td>
<td valign="top" align="center">1.75E-02</td>
<td valign="top" align="right">4286</td>
<td valign="top" align="left"><italic>MITF</italic></td>
<td valign="top" align="left">Microphthalmia-associated transcription factor</td></tr>
<tr>
<td valign="top" align="left">2.87</td>
<td valign="top" align="center">8.69E-04</td>
<td valign="top" align="right">4233</td>
<td valign="top" align="left"><italic>c-Met</italic></td>
<td valign="top" align="left">Met proto-oncogene</td></tr>
<tr>
<td valign="top" align="left">2.83</td>
<td valign="top" align="center">1.15E-02</td>
<td valign="top" align="right">2259</td>
<td valign="top" align="left"><italic>FGF14</italic></td>
<td valign="top" align="left">Fibroblast growth factor 14</td></tr>
<tr>
<td valign="top" align="left">2.83</td>
<td valign="top" align="center">1.14E-04</td>
<td valign="top" align="right">3845</td>
<td valign="top" align="left"><italic>KRAS</italic></td>
<td valign="top" align="left">Kirsten rat sarcoma viral oncogene homolog</td></tr>
<tr>
<td valign="top" align="left">2.68</td>
<td valign="top" align="center">2.32E-02</td>
<td valign="top" align="right">7188</td>
<td valign="top" align="left"><italic>TRAF5</italic></td>
<td valign="top" align="left">TNF receptor-associated factor 5</td></tr>
<tr>
<td valign="top" align="left">2.63</td>
<td valign="top" align="center">2.73E-03</td>
<td valign="top" align="right">2932</td>
<td valign="top" align="left"><italic>GSK3B</italic></td>
<td valign="top" align="left">Glycogen synthase kinase 3 &#x003B2;</td></tr>
<tr>
<td valign="top" align="left">2.60</td>
<td valign="top" align="center">1.82E-03</td>
<td valign="top" align="right">5594</td>
<td valign="top" align="left"><italic>MAPK1</italic></td>
<td valign="top" align="left">Mitogen-activated protein kinase 1</td></tr>
<tr>
<td valign="top" align="left">2.40</td>
<td valign="top" align="center">1.48E-03</td>
<td valign="top" align="right">4193</td>
<td valign="top" align="left"><italic>MDM2</italic></td>
<td valign="top" align="left">MDM2 oncogene, E3 ubiquitin protein ligase</td></tr>
<tr>
<td valign="top" align="left">2.37</td>
<td valign="top" align="center">1.40E-03</td>
<td valign="top" align="right">5579</td>
<td valign="top" align="left"><italic>PRKCB</italic></td>
<td valign="top" align="left">Protein kinase C, &#x003B2;</td></tr></tbody></table></table-wrap></floats-group></article>
