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<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<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.2018.4435</article-id>
<article-id pub-id-type="publisher-id">ijo-53-02-0725</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>HRAS as a potential therapeutic target of salirasib RAS inhibitor in bladder cancer</article-title></title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Sugita</surname><given-names>Satoshi</given-names></name><xref rid="fn1-ijo-53-02-0725" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Enokida</surname><given-names>Hideki</given-names></name><xref rid="fn1-ijo-53-02-0725" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Yoshino</surname><given-names>Hirofumi</given-names></name><xref ref-type="corresp" rid="c1-ijo-53-02-0725"/></contrib>
<contrib contrib-type="author">
<name><surname>Miyamoto</surname><given-names>Kazutaka</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>Yonemori</surname><given-names>Masaya</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>Sakaguchi</surname><given-names>Takashi</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>Osako</surname><given-names>Yoichi</given-names></name></contrib>
<contrib contrib-type="author">
<name><surname>Nakagawa</surname><given-names>Masayuki</given-names></name></contrib>
<aff id="af1-ijo-53-02-0725">Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima 890-8520, Japan</aff></contrib-group>
<author-notes>
<corresp id="c1-ijo-53-02-0725">Correspondence to: Dr Hirofumi Yoshino, Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima 890-8520, Japan, E-mail: <email>hyoshino@m3.kufm.kagoshima-u.ac.jp</email></corresp><fn id="fn1-ijo-53-02-0725">
<label>&#x0002A;</label>
<p>Contributed equally</p></fn></author-notes>
<pub-date pub-type="collection">
<month>08</month>
<year>2018</year></pub-date>
<pub-date pub-type="epub">
<day>11</day>
<month>06</month>
<year>2018</year></pub-date>
<volume>53</volume>
<issue>2</issue>
<fpage>725</fpage>
<lpage>736</lpage>
<history>
<date date-type="received">
<day>26</day>
<month>01</month>
<year>2018</year></date>
<date date-type="accepted">
<day>10</day>
<month>05</month>
<year>2018</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2018, Spandidos Publications</copyright-statement>
<copyright-year>2018</copyright-year></permissions>
<abstract>
<p>The active form of the small GTPase RAS binds to downstream effectors to promote cell growth and proliferation. RAS signal enhancement contributes to tumorigenesis, invasion, and metastasis in various different cancers. HRAS proto-oncogene GTPase (HRAS), one of the RAS isoforms, was the first human oncogene for which mutations were reported in T24 bladder cancer (BC) cells in 1982, and HRAS mutation or upregulation has been reported in several cancers. According to data from The Cancer Genome Atlas, <italic>HRAS</italic> expression was significantly upregulated in clinical BC samples compared to healthy samples (P=0.0024). <italic>HRAS</italic> expression was also significantly upregulated in BC with HRAS mutation compared to patients without HRAS mutation (P&lt;0.0001). The tumor suppressive effect of salirasib, a RAS inhibitor, has been reported in several cancer types, but only at relatively high concentrations. As such, RAS inhibitors have not been used for clinical applications. The aim of the current study was to investigate the therapeutic potential of targeting HRAS using salirasib and small interfering RNA (siRNA) and to characterize the mechanism by which HRAS functions using recently developed quantitative <italic>in vitro</italic> proteome-assisted multiple reaction monitoring for protein absolute quantification (iMPAQT), in BC cells. iMPAQT allows measurement of the absolute abundance of any human protein with the high quantitative accuracy. Salirasib and siRNA targeting of <italic>HRAS</italic> inhibited cell proliferation, migration and invasion in HRAS wild type and HRAS-mutated cell lines. Proteomic analyses revealed that several metabolic pathways, including the oxidative phosphorylation pathway and glycolysis, were significantly downregulated in salirasib-treated BC cells. However, the expression levels of hexokinase 2, phosphoglycerate kinase 1, pyruvate kinase, muscle (PKM)1, PKM2 and lactate dehydrogenase A, which are downstream of RAS and target genes of hypoxia inducible factor-1&#x003B1;, were not notably downregulated, which may explain the high concentration of salirasib required to inhibit cell viability. These findings provide insight into the mechanisms of salirasib, and suggest the need for novel therapeutic strategies to treat cancers such as BC.</p></abstract>
<kwd-group>
<kwd>bladder cancer</kwd>
<kwd>HRAS proto-oncogene GTPase</kwd>
<kwd>RAS inhibitor</kwd>
<kwd>salirasib</kwd>
<kwd><italic>in vitro</italic> proteome-assisted multiple reaction monitoring for protein absolute quantification</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Bladder cancer (BC) was the 5th most commonly diagnosed cancer and the 8th most common cause of cancer-associated mortality among the 40 European Union countries in 2012. In that same year, 429,800 new cases of BC were diagnosed, and 165,000 patients succumbed to BC worldwide (<xref rid="b1-ijo-53-02-0725" ref-type="bibr">1</xref>,<xref rid="b2-ijo-53-02-0725" ref-type="bibr">2</xref>). The 5-year survival rate of patients with BC has improved by only a small percentage during the last 30 years according to the National Cancer Institute program Surveillance, Epidemiology and End Results (<xref rid="b3-ijo-53-02-0725" ref-type="bibr">3</xref>). One factor in the lack of improvement in BC survival rates is the limited efficacy of cisplatin-based combination chemotherapy (<xref rid="b4-ijo-53-02-0725" ref-type="bibr">4</xref>). Thus, innovative therapeutic strategies are required to improve BC outcomes.</p>
<p>RAS proteins are small molecular weight GTPases that couple extracellular signals to intracellular effector pathways. Mammalian cells encode three closely related RAS proteins, HRas proto-oncogene GTPase (HRAS), NRAS protooncogene GTPase (NRAS) and KRAS proto-oncogene GTPase (KRAS), which have critical roles in fundamental cellular processes, including proliferation, survival, differentiation, motility and transcription (<xref rid="b5-ijo-53-02-0725" ref-type="bibr">5</xref>). The RAS pathway is one of the most commonly deregulated pathways in human cancer (<xref rid="b6-ijo-53-02-0725" ref-type="bibr">6</xref>), and activating mutations in RAS genes occur in ~30% of all tumors (<xref rid="b7-ijo-53-02-0725" ref-type="bibr">7</xref>). These mutations typically render RAS as constitutively GTP-bound, resulting in activation of downstream effector pathways regardless of extracellular stimulation (<xref rid="b6-ijo-53-02-0725" ref-type="bibr">6</xref>). Substitution of glycine for valine at amino acid 12 (G12V) is one of the most frequently observed RAS mutations that interferes with GTPase-activating protein-mediated GTP hydrolysis, leading to excess amounts of active GTP-bound RAS. Notably, the type of mutated <italic>RAS</italic> gene (<italic>HRAS</italic>, <italic>KRAS</italic> or <italic>NRAS</italic>) varies depending on the tumor type; KRAS mutations are frequently detected in pancreatic carcinoma (80&#x02013;90%) and colorectal carcinoma (30&#x02013;60%), whereas HRAS mutations are frequent in BC (7&#x02013;66%) and thyroid cancer (0&#x02013;60%) (<xref rid="b8-ijo-53-02-0725" ref-type="bibr">8</xref>).</p>
<p>RAS is considered 'undruggable' because the RAS protein lacks a druggable binding pocket (<xref rid="b9-ijo-53-02-0725" ref-type="bibr">9</xref>,<xref rid="b10-ijo-53-02-0725" ref-type="bibr">10</xref>). Additionally, development of specific and competitive nucleotide inhibitors is challenging, because RAS binds nucleotide ligands with high affinity (<xref rid="b10-ijo-53-02-0725" ref-type="bibr">10</xref>). To overcome these challenges, the RAS antagonist salirasib, also termed farnesylthiosalicylate, was designed to competitively inhibit attachment of GTP-bound RAS to the plasma membrane, which in turn inactivates RAS signaling (<xref rid="b11-ijo-53-02-0725" ref-type="bibr">11</xref>). Salirasib inhibits all RAS isoforms and inhibits the growth of RAS-driven cancer (<xref rid="b11-ijo-53-02-0725" ref-type="bibr">11</xref>,<xref rid="b12-ijo-53-02-0725" ref-type="bibr">12</xref>). Although applications of salirasib have been tested in several clinical trials for cancers other than BC (<xref rid="b13-ijo-53-02-0725" ref-type="bibr">13</xref>&#x02013;<xref rid="b16-ijo-53-02-0725" ref-type="bibr">16</xref>), it exhibited insufficient tumor suppressive effects in trials in which salirasib was the single agent. In addition, relatively high concentrations of salirasib were required to achieve sufficient tumor suppressive effects (<xref rid="b17-ijo-53-02-0725" ref-type="bibr">17</xref>,<xref rid="b18-ijo-53-02-0725" ref-type="bibr">18</xref>). Therefore, a more detailed examination of the effects of salirasib is required to understand the mechanism by which salirasib acts on RAS. Recently, Matsumoto <italic>et al</italic> (<xref rid="b19-ijo-53-02-0725" ref-type="bibr">19</xref>) developed a targeted proteomics platform, <italic>in vitro</italic> proteome-assisted multiple reaction monitoring for protein absolute quantification (iMPAQT), that analyzes 18,000 human recombinant proteins to enable absolute protein quantification on a genome-wide scale (<xref rid="b19-ijo-53-02-0725" ref-type="bibr">19</xref>) and overcome limitations in quantitative accuracy, reproducibility, and analysis speed associated with conventional analysis methods. Use of iMPAQT allows large-scale and accurate assessment of protein abundances that can influence cellular phenotypes.</p>
<p>In the current study, the therapeutic of potential of <italic>HRAS</italic> knockdown by salirasib or RNA interference was investigated in two BC cell lines (T24 cells with HRAS G12V mutation and BOY cells without HRAS mutation). Furthermore, newly developed quantitative proteome analysis of BC cells treated with salirasib was performed to elucidate the mechanisms underlying the actions of salirasib toward HRAS.</p></sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title>Analysis in the BC cohort of The Cancer Genome Atlas (TCGA)</title>
<p>Sequencing data were available for 407 BC samples and 19 normal bladder epithelial samples in TCGA database (tcga-data.nci.nih. gov/tcga/). We used TCGA to analyze <italic>HRAS</italic> mRNA expression levels in normal and BC tissues and to evaluate differences in <italic>HRAS</italic> mRNA expression levels according to HRAS mutational status. RNA-Seq by Expectation Maximization software was used for gene expression quantification (<xref rid="b20-ijo-53-02-0725" ref-type="bibr">20</xref>). Full sequencing information, somatic mutation information, and clinical information were acquired using UCSC Xena (xena.ucsc.ed/) and TCGA. The current study meets publication guidelines provided by TCGA (<ext-link xlink:href="http://cancergenome.nih.gov/publications/publicationguidelines" ext-link-type="uri">cancergenome.nih.gov/publications/publicationguidelines</ext-link>).</p></sec>
<sec>
<title>Cell culture and RNA extraction</title>
<p>Four human BC cell lines were used. T24, KK47 and UMUC cells, which were obtained from the American Type Culture Collection (Manassas, VA, USA), and BOY cells, which were established in our laboratory from a 66-year-old Asian male patient diagnosed with stage III BC with lung metastasis. These cell lines were maintained in the minimum essential Eagle's medium (Sigma-Aldrich; Merck KGaA, Darmstadt, Germany), containing 10% fetal bovine serum (Equitech-Bio, Inc., Kerrville, TX, USA), 50 <italic>&#x000B5;</italic>g/ml streptomycin, and 50 U/ml penicillin in a humidified atmosphere of 95% air/5% CO<sub>2</sub> at 37&#x000B0;C. Total RNA was isolated using Isogen (Nippon Gene Co., Ltd., Tokyo, Japan) according to the manufacturer's protocol. The integrity of the RNA was checked with an RNA 6000 Nano assay kit and a 2100 Bioanalyzer (Agilent Technologies, Inc., Santa Clara, CA, USA).</p></sec>
<sec>
<title>Reverse transcription-quantitative polymerase chain reaction (RT-qPCR)</title>
<p>A SYBR-Green qPCR-based array approach was used for RT-qPCR. RT was performed using the TaqMan High-Capacity cDNA Reverse Transcription Kit (cat. no. 4368814; Applied Biosystems; Thermo Fisher Scientific, Inc., Waltham, MA, USA) under the incubation conditions (25&#x000B0;C for 10 min, 37&#x000B0;C for 120 min and 85&#x000B0;C for 5 min) according to the manufacturer's instructions. The primer set for determination of mRNA expression levels was as follows: <italic>HRAS</italic>, forward, 5&#x02032;-ATGACGGAATATAAGCTGGTGGT-3&#x02032; and reverse, 5&#x02032;-GGCACGTCTCCCCATCAATG-3&#x02032;; hypoxia inducible factor-1&#x003B1; (<italic>HIF-1&#x003B1;</italic>), forward, 5&#x02032;-GAACGTCGAAAAGAAAA GTCTCG-3&#x02032; and reverse, 5&#x02032;-CCTTATCAAGATGCGAACTC ACA-3&#x02032;; glucuronidase &#x003B2; (<italic>GUSB</italic>), forward, 5&#x02032;-CGTCCCACCTAGAATCTGCT-3&#x02032; and reverse, 5&#x02032;-TTGCTCACAAAGGT CACAGG-3&#x02032;. The experimental procedures followed the protocol recommended by the manufacturer. RT-qPCR was performed with 500 ng total RNA using the Power SYBR-Green Master Mix (cat. no. 4367659) with the 7300 Real-time PCR System (both from Applied Biosystems; Thermo Fisher Scientific, Inc.). Amplification specificity was monitored using the dissociation curve of the amplified product. All data values were normalized with respect to <italic>GUSB</italic>, and the &#x00394;&#x00394;Cq method was used to calculate the fold-change (<xref rid="b21-ijo-53-02-0725" ref-type="bibr">21</xref>). Human Bladder Total RNA (cat. no. AM7990; Applied Biosystems; Thermo Fisher Scientific, Inc.) as control RNA derived from normal bladder tissue.</p></sec>
<sec>
<title>Salirasib treatment</title>
<p>For <italic>in vitro</italic> experiments, salirasib (CAS 162520-00-5; Santa Cruz Biotechnology, Inc., Dallas, TX, USA) was solubilized in 0.1% DMSO. The salirasib/DMSO solution and control vehicle (0.1% DMSO) were prepared in Dulbecco's modified Eagle's medium at different concentrations, and each mixture was placed in cell culture plates (8&#x000D7;10<sup>4</sup>/ml) so that the final salirasib concentrations were 1.6, 3.1, 6.3, 12.5, 25, 50, 100 and 200 <italic>&#x000B5;</italic>M, whereas the DMSO concentration was adjusted to 0.1%. Each cell culture plate was treated with salirasib or control vehicle for 24 h. For <italic>in vivo</italic> experiments, salirasib was solubilized with 0.5% ethanol. The salirasib/ethanol solution was alkalinized with 1 N NaOH and then diluted with phosphate buffered saline to yield a 4 mg/ml (pH 8.0) solution. This solution or control vehicle (0.5% ethanol) were intraperitoneally (i.p.) injected daily 100 <italic>&#x000B5;</italic>l per mouse.</p></sec>
<sec>
<title>Transfection with small interfering RNA (siRNA)</title>
<p>As described previously (<xref rid="b22-ijo-53-02-0725" ref-type="bibr">22</xref>), T24 and BOY cells were transfected using Lipofectamine RNAiMAX transfection reagent and Opti-MEM (both from Thermo Fisher Scientific, Inc.) together with 10 nM HRAS siRNA (nos. Hs_HRAS_1174, Hs_HRAS_1177 and Hs_HRAS_1178; Sigma-Aldrich; Merck KGaA) or negative-control siRNA (no. D-001810-10; Thermo Fisher Scientific, Inc.) for loss-of-function experiments. The sequences of the siRNAs were as follows: Hs_HRAS_1174_s, 5&#x02032;rGUrGrCrCUrGUUrGr GrArCrAUrCrCUrGTT; Hs_HRAS_1174_as, 5&#x02032;rCrArGrGr AUrGUrCrCrArArCrArGrGrCrArCTT; Hs_HRAS_1177_s, 5&#x02032;rGrArCrGUrGrCrCUrGUUrGrGrArCrAUrCTT; Hs_HRAS_1177_as, 5&#x02032;rGrAUrGUrCrCrArArCrArGrGrCrArCr GUrCTT; Hs_HRAS_1178_s, 5&#x02032;rGrGrGrCUUrCrCUrGUrGU rGUrGUUUTT; and Hs_HRAS_1178_as, 5&#x02032;rArArArCrArCrAr CrArCrArGrGrArArGrCrCrCTT. Subsequent experiments were performed 72 h after siRNA transfection.</p></sec>
<sec>
<title>Cell proliferation, migration, and invasion assays</title>
<p>T24 and BOY cells were transfected with 10 nM siRNA by reverse transfection. Cells were seeded in 96-well plates with 3&#x000D7;10<sup>3</sup> cells/well for XTT assays. After 72 h, cell proliferation was determined using a Cell Proliferation Kit II (Roche Diagnostics GmbH, Mannheim, Germany) as described previously (<xref rid="b22-ijo-53-02-0725" ref-type="bibr">22</xref>). Cell migration activity was evaluated with wound healing assays. Cells were plated in 6-well plates at 2&#x000D7;10<sup>5</sup> cells per well, and after 48 h of transfection the cell monolayer was scraped using a P-20 micropipette tip. The initial (0 h) and residual gap length 18 h after wounding were calculated from photomicrographs as previously described (<xref rid="b22-ijo-53-02-0725" ref-type="bibr">22</xref>). Cell invasion assays were performed using modified Boyden chambers consisting of Matrigel-coated Transwell membrane filter inserts with 8-<italic>&#x000B5;</italic>M pores in 24 well tissue culture plates (BD Biosciences, San Jose, CA, USA). At 72 h after transfection, cells were plated in 24-well plates at 1&#x000D7;10<sup>5</sup> cells/well. Minimum essential Eagle's medium containing 10% fetal bovine serum (Equitech-Bio, Inc.) in the lower chamber served as the chemoattractant, as described previously (<xref rid="b22-ijo-53-02-0725" ref-type="bibr">22</xref>). Medium Eagle fetal bovine serum and cells were prepared in the upper chamber and incubated for 24 h.</p></sec>
<sec>
<title>Western blot analysis</title>
<p>Cells were harvested 72 h after transfection, and lysates were prepared in radioimmunoprecipitation assay lysis buffer (Thermo Fisher Scientific, Inc.) containing protease inhibitor cocktail (Sigma-Aldrich; Merck KGaA). Proteins were quantified by Bradford method using BioPhotometer (Eppendorf, Hamburg, Germany). Proteins (50 <italic>&#x000B5;</italic>g) were separated by NuPAGE on 4&#x02013;12% bistris gels (Invitrogen; Thermo Fisher Scientific, Inc.) and transferred to polyvinylidene difluoride membranes. Following blocking in Tris-buffered saline containing 0.1% Tween-20 (TBS-T) with 5% nonfat dry milk for 15 min at 25&#x000B0;C, membranes were washed four times in TBS-T and incubated with primary antibodies overnight at 4&#x000B0;C. Immunoblotting was performed with diluted rabbit polyclonal anti-HRAS antibodies (1:1,000; cat. no. GTX116041; GeneTex, Inc., Irvine, CA, USA), goat polyclonal anti-HIF-1&#x003B1; antibodies (1:1,000; cat. no. AF1935; R&amp;D Systems, Inc., Minneapolis, MN, USA) and rabbit polyclonal anti-&#x003B2;-actin antibodies (1:1,000; cat. no. bs-0061R; BIOSS, Beijing, China) according to the manufacturer's instructions for each antigen. The secondary antibodies were peroxidase-labelled anti-rabbit IgG (1 h at 25&#x000B0;C; 1:5,000; cat. no. 7074S; Cell Signaling Technology, Inc., Danvers, MA, USA) and anti-goat IgG (1 h at 25&#x000B0;C; 1:5,000; cat. no. sc-2020; Santa Cruz Biotechnology, Inc.). Specific complexes were visualized with an enhanced chemiluminescence detection system (GE Healthcare Life Sciences, Little Chalfont, UK) as described previously (<xref rid="b23-ijo-53-02-0725" ref-type="bibr">23</xref>).</p></sec>
<sec>
<title>Proteomic analysis</title>
<p>To comprehensively investigate metabolic changes in BC cells treated with salirasib, proteomic analysis was performed using iMPAQT (<xref rid="b19-ijo-53-02-0725" ref-type="bibr">19</xref>). Proteins with downregulated expression were detected in salirasib-treated BC cells compared with untreated cells (fold change &lt;0.5) and proteins that were common to both T24 and BOY were identified. The proteins were then categorized into Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways through GeneCodis analysis (<ext-link xlink:href="http://genecodis.cnb.csic.es" ext-link-type="uri">genecodis.cnb.csic.es</ext-link>).</p></sec>
<sec>
<title>In vivo tumor xenograft model</title>
<p>To investigate <italic>in vivo</italic> effects of salirasib, a mixture containing 100 <italic>&#x000B5;</italic>l BOY cells (5&#x000D7;10<sup>6</sup>) and 100 <italic>&#x000B5;</italic>l Matrigel Matrix (Corning Incorporated, Corning, NY, USA) was injected subcutaneously into one side flank of 9 female nude mice (BALB/c nu/nu; 8 weeks old; 16&#x02013;19 g). The mice were randomly separated into salirasib-treated (n=5) and control (n=4) groups. Each breeding room was kept at a temperature of 23&#x000B1;1&#x000B0;C and a humidity of 40&#x02013;70%. The light/dark cycle was set to 12 h. Food and water was placed to be accessible from each cage. From the day following tumor implantation, salirasib (0.4 mg/mouse, i.p., daily) and control vehicle (0.5% ethanol, 100 <italic>&#x000B5;</italic>l/mouse, i.p., daily) treatment were administered for 25 days. Tumor sizes were measured twice weekly and tumor volumes were calculated as follows: Tumor volume = &#x0005B;(long axis length in millimeters/2) &#x000D7; (short axis length/2)<sup>2</sup> &#x000D7; &#x003C0; &#x000D7; 4&#x0005D;/3. All animal experiments were performed in accordance with institutional guidelines and were approved by the animal care review board of Kagoshima University (Kagoshima, Japan).</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Data are presented as the mean &#x000B1; standard deviation at least three independent experiments. The relationships between two groups were analyzed using Mann-Whitney U tests. The relationships between three or more variables and numerical values were analyzed using Bonferroni-adjusted Mann-Whitney U tests. All analyses were performed using Expert StatView software, version 5.0 (SAS Institute, Inc., Cary, NC, USA). P&lt;0.05 was considered to indicate a statistically significant difference.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Expression levels of HRAS in BC and BC cell lines</title>
<p>The expression levels of <italic>HRAS</italic> were evaluated using TCGA data from BC samples (n=407) and normal samples (n=19). <italic>HRAS</italic> expression levels were significantly upregulated in tumor tissues compared with those in normal bladder epithelia (tumor, 10.314&#x000B1;0.813; normal, 9.707&#x000B1;0.826; P=0.0024, Mann-Whitney U tests; <xref rid="f1-ijo-53-02-0725" ref-type="fig">Fig. 1A</xref>). Furthermore, <italic>HRAS</italic> expression was significantly upregulated in patients with BC with mutant HRAS compared with patients with wild-type HRAS (mutant HRAS, 11.277&#x000B1;0.805; wild-type HRAS, 10.267&#x000B1;0.788; P&lt;0.0001, Mann-Whitney U tests) (<xref rid="f1-ijo-53-02-0725" ref-type="fig">Fig. 1B</xref>). <italic>HRAS</italic> mRNA expression was also significantly upregulated in BC cell lines compared to patients with normal bladder tissues (T24, 5.960&#x000B1;0.344, P&lt;0.0001; BOY, 7.528&#x000B1;1.506, P&lt;0.0001; KK47, 2.934&#x000B1;0.464, P=0.0176; UMUC, 3.561&#x000B1;0.854, P=0.0034; Bonferroni-adjusted Mann-Whitney U tests; <xref rid="f1-ijo-53-02-0725" ref-type="fig">Fig. 1C</xref>). Sequencing data from TCGA revealed that T24 cells had HRAS<sup>G12V</sup> (the substitution of glycine by valine at codon 12 in HRAS) and BOY cells had wild-type HRAS (<xref rid="f1-ijo-53-02-0725" ref-type="fig">Fig. 1D</xref>).</p></sec>
<sec>
<title>Effects of HRAS knockdown on cell proliferation, migration, and invasion of BC cell lines</title>
<p>To investigate the functional role of HRAS in BC cells, loss-of-function studies were performed using T24 and BOY BC cells transfected with three <italic>si-HRAS</italic> constructs (<italic>si-HRAS</italic>-1, <italic>si-HRAS</italic>-2 and <italic>si-HRAS</italic>-3). RT-qPCR analysis and western blot analysis indicated that these siRNAs effectively downregulated HRAS mRNA and protein expression in both cell lines (<xref rid="f2-ijo-53-02-0725" ref-type="fig">Fig. 2A</xref>). XTT assays demonstrated that cell proliferation was inhibited in <italic>si-HRAS</italic> transfectants compared with mock or siRNA-control transfectants (T24, mock 1.0&#x000B1;0.047, control 1.0&#x000B1;0.015, <italic>si-HRAS</italic>-1 0.701&#x000B1;0.015, <italic>si-HRAS</italic>-2 0.615&#x000B1;0.011, <italic>si-HRAS</italic>-3 0.599&#x000B1;0.024; BOY, mock 1.0&#x000B1;0.024, control 0.996&#x000B1;0.087, <italic>si-HRAS</italic>-1 0.585&#x000B1;0.030, <italic>si-HRAS</italic>-2 0.499&#x000B1;0.020, <italic>si-HRAS</italic>-3 0.508&#x000B1;0.016; each P&lt;0.0001, Bonferroni-adjusted Mann-Whitney test; <xref rid="f2-ijo-53-02-0725" ref-type="fig">Fig. 2B</xref>). Cell migration activity was also significantly inhibited in <italic>si-HRAS</italic> transfectants compared with mock or siRNA-control transfectants (T24, mock 1.0&#x000B1;0.111, control 1.013&#x000B1;0.117, <italic>si-HRAS</italic>-1 0.684&#x000B1;0.198, <italic>si-HRAS</italic>-2 0.583&#x000B1;0.309, <italic>si-HRAS</italic>-3 0.462&#x000B1;0.348, P=0.0019 and P&lt;0.0001 vs. mock; BOY, mock 1.0&#x000B1;0.186, control 0.978&#x000B1;0.080, <italic>si-HRAS</italic>-1 0.158&#x000B1;0.105, <italic>si-HRAS</italic>-2 0.438&#x000B1;0.130, <italic>si-HRAS</italic>-3 0.448&#x000B1;0.186, each P&lt;0.0001 vs. mock, Bonferroni-adjusted Mann-Whitney test; <xref rid="f2-ijo-53-02-0725" ref-type="fig">Fig. 2C</xref>), as was cell invasion activity in Matrigel assays (T24, mock 1.0&#x000B1;0.280, control 1.443&#x000B1;0.289, <italic>si-HRAS</italic>-1 0.543&#x000B1;0.113, <italic>si-HRAS</italic>-2 0.552&#x000B1;0.154, <italic>si-HRAS</italic>-3 0.353&#x000B1;0.074; BOY, mock 1.0&#x000B1;0.288, control 1.309&#x000B1;0.268, <italic>si-HRAS</italic>-1 0.117&#x000B1;0.070, <italic>si-HRAS</italic>-2 0.296&#x000B1;0.121, <italic>si-HRAS</italic>-3 0.142&#x000B1;0.086, each P&lt;0.0001, Bonferroni-adjusted Mann-Whitney test; <xref rid="f2-ijo-53-02-0725" ref-type="fig">Fig. 2D</xref>).</p></sec>
<sec>
<title>Effects of salirasib on cell proliferation, migration, and invasion activities in BC cell lines</title>
<p>The effect of salirasib treatment was investigated in T24 and BOY cells. XTT assays demonstrated that &#x02265;100 <italic>&#x000B5;</italic>M salirasib significantly reduced T24 and BOY viability compared with untreated cells (each P&lt;0.0001, Bonferroni-adjusted Mann-Whitney test; <xref rid="f3-ijo-53-02-0725" ref-type="fig">Fig. 3A</xref>). Salirasib treatment significantly reduced T24 and BOY cell migration compared with the mock control (T24, mock 1.0&#x000B1;0.258, salirasib 0.498&#x000B1;0.326, P=0.0020; BOY, mock 1.0&#x000B1;0.470, salirasib 0.556&#x000B1;0.289, P= 0.0193, Mann-Whitney U tests; <xref rid="f3-ijo-53-02-0725" ref-type="fig">Fig. 3B</xref>) and invasion activity (T24, mock 1.0&#x000B1;0.336, salirasib 0.200&#x000B1;0.116; BOY, mock 1.0&#x000B1;0.477, salirasib 0.122&#x000B1;0.125, P=0.0009, Mann-Whitney U tests; <xref rid="f3-ijo-53-02-0725" ref-type="fig">Fig. 3C</xref>) relative to untreated cells.</p></sec>
<sec>
<title>Proteomic analysis in BC cells treated with salirasib</title>
<p>To comprehensively investigate metabolic changes in BC cells treated with salirasib, proteomic analysis of metabolism-associated genes was performed using iMPAQT. The results revealed 58 proteins with downregulated expression (fold change &lt;0.5) in both T24 and BOY BC cells treated with salirasib compared to untreated cells (<xref rid="tI-ijo-53-02-0725" ref-type="table">Table I</xref>). GeneCodis analysis to categorize the proteins into KEGG pathways demonstrated that these proteins were included in 50 pathways that were significantly enriched following salirasib treatment (listed in descending order of corrected P-values in <xref rid="tII-ijo-53-02-0725" ref-type="table">Table II</xref>; <xref rid="f4-ijo-53-02-0725" ref-type="fig">Fig. 4</xref>). 'Oxidative phosphorylation', 'pyrimidine metabolism', 'glycolysis/gluconeogenesis', 'pentose phosphate pathway', 'cysteine and methionine metabolism', 'glutathione metabolism', and 'purine metabolism' were significantly downregulated pathways in BC cells treated with salirasib. However, target genes of the RAS effector HIF-1&#x003B1;, including hexokinase 2, phosphoglycerate kinase 1, pyruvate kinase, muscle (PKM)1, PKM2 and lactate dehydrogenase A, showed only modest downregulation (fold change &gt;0.5 in T24 and BOY cells) (<xref rid="tIII-ijo-53-02-0725" ref-type="table">Table III</xref>) (<xref rid="b24-ijo-53-02-0725" ref-type="bibr">24</xref>&#x02013;<xref rid="b26-ijo-53-02-0725" ref-type="bibr">26</xref>). Furthermore, RT-qPCR analysis and western blot analysis indicated that expression of HIF-1&#x003B1; was not downregulated in salirasib-treated BC cells (<xref rid="f5-ijo-53-02-0725" ref-type="fig">Fig. 5</xref>) (<xref rid="b5-ijo-53-02-0725" ref-type="bibr">5</xref>,<xref rid="b27-ijo-53-02-0725" ref-type="bibr">27</xref>).</p></sec>
<sec>
<title>Xenograft model study to investigate the in vivo effects of salirasib</title>
<p>To investigate the <italic>in vivo</italic> effects of salirasib, either salirasib or control vehicle was i.p. injected daily into BC xenograft mice from one day after tumor implantation. There was no difference in tumor growth between the salirasib-treated group (n=5, 545.9&#x000B1;187.4 mm<sup>3</sup>) and control group (n=4, 511.2&#x000B1;165.6 mm<sup>3</sup>) (<xref rid="f6-ijo-53-02-0725" ref-type="fig">Fig. 6</xref>) on day 27 after tumor implantation.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p><italic>HRAS</italic> was the first human oncogene reported in the T24 BC cell line in 1982 (<xref rid="b28-ijo-53-02-0725" ref-type="bibr">28</xref>). Several reports have indicated that <italic>HRAS</italic> mutations critically influence tumorigenesis and development of BC (<xref rid="b8-ijo-53-02-0725" ref-type="bibr">8</xref>,<xref rid="b29-ijo-53-02-0725" ref-type="bibr">29</xref>&#x02013;<xref rid="b33-ijo-53-02-0725" ref-type="bibr">33</xref>). Haliassos <italic>et al</italic> (<xref rid="b29-ijo-53-02-0725" ref-type="bibr">29</xref>) detected HRAS codon 12 point mutations in 66% of BC specimens and the mutant HRAS allele in the urine of 47% of patients with BC, Pandith <italic>et al</italic> (<xref rid="b33-ijo-53-02-0725" ref-type="bibr">33</xref>) reported that HRAS single nucleotide polymorphism increases BC risk, and rare allele is a predictive marker of advanced bladder tumors. However, RAS had been considered to be 'undruggable' because the RAS protein lacked a druggable binding pocket until salirasib was produced. Salirasib inhibits RAS-dependent cell growth by dislodging all isoforms of RAS from the plasma membrane (<xref rid="b11-ijo-53-02-0725" ref-type="bibr">11</xref>,<xref rid="b12-ijo-53-02-0725" ref-type="bibr">12</xref>). The anti-tumor efficacy of salirasib has been demonstrated in several cell lines and xenograft models (<xref rid="b17-ijo-53-02-0725" ref-type="bibr">17</xref>,<xref rid="b34-ijo-53-02-0725" ref-type="bibr">34</xref>&#x02013;<xref rid="b36-ijo-53-02-0725" ref-type="bibr">36</xref>). Goldberg <italic>et al</italic> (<xref rid="b34-ijo-53-02-0725" ref-type="bibr">34</xref>) demonstrated that salirasib induces pancreatic cancer cell death and tumor shrinkage in mice, and that salirasib was efficient and nontoxic for treatment of glioblastoma in a rat model (<xref rid="b35-ijo-53-02-0725" ref-type="bibr">35</xref>). Charette <italic>et al</italic> (<xref rid="b36-ijo-53-02-0725" ref-type="bibr">36</xref>) reported that salirasib inhibits the growth of hepatocarcinoma cell lines <italic>in vitro</italic> and <italic>in vivo</italic> through RAS and mTOR inhibition. Salirasib was evaluated as a single agent in two clinical trials; however, neither produced promising results in patients with KRAS mutation positive lung adenocarcinoma (<xref rid="b13-ijo-53-02-0725" ref-type="bibr">13</xref>) or refractory hematologic malignancies (<xref rid="b14-ijo-53-02-0725" ref-type="bibr">14</xref>). Even though these clinical trials demonstrated the relative safety of salirasib, diarrhea, nausea and fatigue were the most common toxicities, and there were no grade 4 or 5 drug-associated adverse events or dose-limiting toxicity. On the other hand, results of a combination study of salirasib with gemcitabine to treat pancreatic adenocarcinoma were sufficiently encouraging to warrant further investigation (<xref rid="b15-ijo-53-02-0725" ref-type="bibr">15</xref>,<xref rid="b16-ijo-53-02-0725" ref-type="bibr">16</xref>).</p>
<p>Although the efficacy of salirasib has been reported for several types of cancers, to the best of our knowledge, this is the first report concerning the effect of salirasib in BC. Two BC cell lines were used to evaluate the ability of salirasib to target HRAS. T24 carries the HRAS<sup>G12V</sup> mutation (substitution of glycine by valine at codon 12 of <italic>HRAS</italic>) and sequencing data demonstrated that BOY cells have wild-type HRAS. siRNA-induced <italic>HRAS</italic> knockdown and salirasib inhibition of HRAS exerted tumor suppressive effects regardless of HRAS mutational status <italic>in vitro</italic>, which was consistent with several previously published results demonstrating a lack of correlation between RAS mutational status and response to RAS-targeting therapy (<xref rid="b37-ijo-53-02-0725" ref-type="bibr">37</xref>,<xref rid="b38-ijo-53-02-0725" ref-type="bibr">38</xref>). However, salirasib still required relatively high concentrations to achieve a tumor-suppressive effect <italic>in vitro</italic>, and exhibited no tumor-suppressive effects <italic>in vivo</italic>.</p>
<p>It had been reported that oncogenic RAS predominantly affects the metabolic reprogramming of cancer cells through the upregulation of HIF-1&#x003B1;, one of target genes of RAS (<xref rid="b5-ijo-53-02-0725" ref-type="bibr">5</xref>). Although salirasib is known to competitively block intracellular signaling via the RAS cascade, there are no reports concerning comprehensive metabolomic analysis of salirasib mechanisms. In the current study, proteomic analysis was performed using iMPAQT to investigate metabolic changes in salirasib-treated BC cells. Pathway analysis using the proteomic data indicated that 50 pathways were significantly downregulated following salirasib treatment of BC cells, including 'Oxidative phosphorylation', 'Glycolysis/gluconeogenesis', and 'Pentose phosphate pathway'. However, proteomic analysis showed that the expression of proteins downstream of HIF-1&#x003B1; were not significantly downregulated. Furthermore, HIF-1&#x003B1; expression was not efficiently suppressed in salirasib-treated BC cells, although it was previously reported that salirasib suppressed HIF-1&#x003B1; expression in other type of cancer cells (<xref rid="b27-ijo-53-02-0725" ref-type="bibr">27</xref>). Therefore, downregulation of RAS target genes in <italic>in vitro</italic> assays involving BC cell lines may require a high concentration of salirasib, and this need for high concentrations was responsible for the lack of tumor suppressive effects observed in the BC xenograft mouse model. In this study, whether factors downstream of HIF-1&#x003B1; were insufficiently downregulated in the tumors from animal experiments was not analyzed by iMPAQT, because iMPAQT is so sensitive that contamination of surrounding tissues adjacent to tumor tissue may make the interpretation of the results difficult. However, these analyses of micro-dissected <italic>in vivo</italic> samples will be performed in the future. Recently, a novel RAS inhibitor developed using an innovative approach was reported to inhibit tumor growth in animal models of RAS-dependent cancers at low concentrations (<xref rid="b39-ijo-53-02-0725" ref-type="bibr">39</xref>). This novel RAS inhibitor was computationally designed to target multiple sites on RAS proteins, thus enabling sufficient affinity and selectivity for pharmacological RAS inhibition. This new inhibitor may provide successful targeting of RAS in the near future. Therefore, clinical trials with these inhibitors or next-generation RAS inhibitors are required to improve cancer treatment options in the near future.</p>
<p>In conclusion, the current study demonstrated that salirasib and siRNA-induced <italic>HRAS</italic> knockdown produced tumor suppressive effects regardless of HRAS mutational status in BC cell lines. However, high concentrations of salirasib were required to inhibit cell proliferation, migration and invasion activity <italic>in vitro</italic>, and the same high concentrations exhibited no tumor suppressive effects <italic>in vivo</italic>. Proteomic analysis revealed that several metabolic pathways were significantly downregulated in BC cells treated with salirasib. However, salirasib treatment of BC cells did not significantly affect expression of genes targeted by HIF-1&#x003B1; in BC cells. These findings provide novel information concerning the mechanism of salirasib effects, and suggest that novel therapeutics involving combination therapies of salirasib with other inhibitors, or the newly-identified novel RAS inhibitor, may be effective for treating BC and other types of cancer.</p></sec></body>
<back>
<ack>
<title>Acknowledgments</title>
<p>The authors wish to thank Ms. Mutsumi Miyazaki, (Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan) for laboratory assistance.</p></ack>
<sec sec-type="other">
<title>Funding</title>
<p>This study was supported by JSPS Grants-in-Aid for Scientific Research (grant nos. 16H05464, 17H04332 and 16K11015).</p></sec>
<sec sec-type="materials">
<title>Availability of data and materials</title>
<p>The analyzed datasets generated during the study are available from the corresponding author on reasonable request.</p></sec>
<sec sec-type="other">
<title>Authors' contributions</title>
<p>HY conceived and designed the experiments. SS, HY, KM, MY, TS and YO performed the experiments. SS, HE, HY and KM performed the validation and formal analysis. SS and KM wrote the manuscript. HE, HY and MN interpreted experimental data for the work, and reviewed and revised the manuscript. HE, HY and MN acquired funding. All authors have read and approved the final manuscript.</p></sec>
<sec sec-type="other">
<title>Ethics approval and consent to participate</title>
<p>Not applicable.</p></sec>
<sec sec-type="other">
<title>Patient consent for publication</title>
<p>Not applicable.</p></sec>
<sec sec-type="other">
<title>Competing interests</title>
<p>The authors declare that they have no competing interests.</p></sec>
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<floats-group>
<fig id="f1-ijo-53-02-0725" position="float">
<label>Figure 1</label>
<caption>
<p>Expression levels of <italic>HRAS</italic> in BC cell lines and clinical BC samples. Significant upregulation of <italic>HRAS</italic> expression levels in reverse transcription-quantitative polymerase chain reaction in (A) BC tumor samples compared with those of normal bladder samples (P=0.0024; data analyzed by Mann-Whitney U test are presented as the boxplots) and (B) BC samples with mutant <italic>HRAS</italic> compared with patients with wild-type <italic>HRAS</italic> (P&lt;0.0001, data analyzed by Mann-Whitney U test are presented as the boxplots) and (C) BC cell lines compared with normal bladder tissues (<sup>&#x0002A;</sup>P= 0.0176, <sup>&#x0002A;&#x0002A;</sup>P= 0.0034, <sup>&#x0002A;&#x0002A;&#x0002A;</sup>P&lt;0.0001 vs. normal; data analyzed by Bonferroni-adjusted Mann-Whitney test are presented as the mean &#x000B1; standard deviation from three independent experiments). (D) Difference in <italic>HRAS</italic> mutation status among BC cell lines. Sequencing revealed that T24 had HRAS<sup>G12V</sup> (substitution of glycine by valine at codon 12 in <italic>HRAS</italic>) and BOY had wild-type <italic>HRAS</italic>. BC, bladder cancer; HRAS, HRAS proto-oncogene GTPase.</p></caption>
<graphic xlink:href="IJO-53-02-0725-g00.tif"/></fig>
<fig id="f2-ijo-53-02-0725" position="float">
<label>Figure 2</label>
<caption>
<p>Effects of siRNA-induced <italic>HRAS</italic> knockdown on bladder cancer cell lines. (A) Transfection of T24 and BOY cells with si-HRAS show significant (<sup>&#x0002A;</sup>P&lt;0.0001 vs. mock, Bonferroni-adjusted Mann-Whitney test) downregulation of HRAS mRNA and protein expression by reverse transcription-quantitative polymerase chain reaction and western blotting, respectively. Glucuronidase &#x003B2; and &#x003B2;-actin were used as internal and loading controls, respectively. siRNA-induced <italic>HRAS</italic> knockdown inhibited cell proliferation, migration, and invasion as determined by (B) XTT, (C) wound healing and (D) Matrigel invasion assays. (<sup>&#x0002A;</sup>P=0.002 and <sup>&#x0002A;&#x0002A;</sup>P&lt;0.0001 vs. mock, Bonferroni-adjusted Mann-Whitney test). All data are presented as the mean &#x000B1; standard deviation. All results represent reproducible data from at least three independent experiments. si, small interfering RNA.</p></caption>
<graphic xlink:href="IJO-53-02-0725-g01.tif"/></fig>
<fig id="f3-ijo-53-02-0725" position="float">
<label>Figure 3</label>
<caption>
<p>Salirasib inhibition of cell proliferation, migration, and invasion. Compared with vehicle-treated cells, treatment of T24 and BOY cells with 100 and 200 <italic>&#x000B5;</italic>M salirasib inhibited (A) cell proliferation in XTT assays (each <sup>&#x0002A;</sup>P&lt;0.0001, Bonferroni-adjusted Mann-Whitney U test). Treatment of of T24 and BOY cells with salirasib (100 <italic>&#x000B5;</italic>M) inhibited (B) cell migration in would healing assays (P=0.002 and P=0.0194, respectively, Mann-Whitney U test) and (C) cell invasion in Matrigel invasion assays (each P=0.0009, Mann-Whitney U test). Data are presented as the mean &#x000B1; standard deviation. All results represent reproducible data from at least three independent experiments.</p></caption>
<graphic xlink:href="IJO-53-02-0725-g02.tif"/></fig>
<fig id="f4-ijo-53-02-0725" position="float">
<label>Figure 4</label>
<caption>
<p>Strategy to identify metabolic pathways downregulated in salirasib-treated BC cells. Proteomic analysis using iMPAQT detected 58 proteins down-regulated in both T24 and BOY BC cells treated with salirasib (FC&lt;0.5). Categorization of these proteins into KEGG pathways using GeneCodis analysis showed that 50 pathways were downregulated following salirasib treatment of BC cells. BC, breast cancer; iMPAQT, <italic>in vitro</italic> proteome-assisted multiple reaction monitoring for protein absolute quantification; FC, fold change; KEGG, Kyoto Encyclopedia of Genes and Genomes.</p></caption>
<graphic xlink:href="IJO-53-02-0725-g03.tif"/></fig>
<fig id="f5-ijo-53-02-0725" position="float">
<label>Figure 5</label>
<caption>
<p>Effect of salirasib on HIF-1&#x003B1;. (A) Reverse transcription-quantitative polymerase chain reaction analysis and (B) western blot analysis indicated that HIF-1&#x003B1; mRNA and protein expression were not effectively down-regulated in salirasib-treated bladder cancer cells. Data are presented as the mean &#x000B1; standard deviation. All results represent reproducible data from at least three independent experiments. HIF-1&#x003B1;, hypoxia inducible factor-1&#x003B1;.</p></caption>
<graphic xlink:href="IJO-53-02-0725-g04.tif"/></fig>
<fig id="f6-ijo-53-02-0725" position="float">
<label>Figure 6</label>
<caption>
<p><italic>In vivo</italic> effects of salirasib in xenograft models. Salirasib and control vehicle were intraperitoneally injected daily into BOY cell bladder cancer xenograft mice for 25 days from the day following tumor implantation. There was no difference in tumor size between the salirasib-treated group (n=5) and control group (n=4) at any indicated time point after tumor implantation. The statistical analysis was performed by Mann-Whitney U test. Data are presented as the mean &#x000B1; standard deviation. The result represents reproducible data from at least three independent experiments.</p></caption>
<graphic xlink:href="IJO-53-02-0725-g05.tif"/></fig>
<table-wrap id="tI-ijo-53-02-0725" position="float">
<label>Table I</label>
<caption>
<p>Metabolic changes in bladder cancer cells treated by salirasib.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" rowspan="2" align="left">Gene symbol</th>
<th valign="bottom" rowspan="2" align="center">Description</th>
<th colspan="3" valign="bottom" align="center">Expression ratio (treated/untreated cells)
<hr/></th></tr>
<tr>
<th valign="bottom" align="center">T24</th>
<th valign="bottom" align="center">BOY</th>
<th valign="bottom" align="center">Mean of T24 and BOY</th></tr></thead>
<tbody>
<tr>
<td valign="top" align="left">AHCYL1</td>
<td valign="top" align="left">Adenosylhomocysteinase-like 1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">AK3</td>
<td valign="top" align="left">Adenylate kinase 3</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">ALDH3A2</td>
<td valign="top" align="left">Aldehyde dehydrogenase 3 family, member A2</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">ALDH9A1</td>
<td valign="top" align="left">Aldehyde dehydrogenase 9 family, member A1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">ASNS</td>
<td valign="top" align="left">Asparagine synthetase (glutamine-hydrolyzing)</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">ATP5L</td>
<td valign="top" align="left">ATP synthase, H<sup>+</sup> transporting, mitochondrial Fo complex, subunit G</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">ATP6V1E1</td>
<td valign="top" align="left">Atpase, H<sup>+</sup> transporting, lysosomal, V1 subunit E1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">ATP6V1G1</td>
<td valign="top" align="left">Atpase, H<sup>+</sup> transporting, lysosomal, V1 subunit G1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">DCXR</td>
<td valign="top" align="left">Dicarbonyl/L-xylulose reductase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">DERA</td>
<td valign="top" align="left">Deoxyribose-phosphate aldolase (putative)</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">DLD</td>
<td valign="top" align="left">Dihydrolipoamide dehydrogenase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">G6PD</td>
<td valign="top" align="left">Glucose-6-phosphate dehydrogenase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">GBA</td>
<td valign="top" align="left">Glucosidase &#x003B2;, acid</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">GMPPA</td>
<td valign="top" align="left">GDP-mannose pyrophosphorylase A</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">GMPR2</td>
<td valign="top" align="left">Guanosine monophosphate reductase 2</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">GNPDA1</td>
<td valign="top" align="left">Glucosamine-6-phosphate deaminase 1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">HSD17B12</td>
<td valign="top" align="left">Hydroxysteroid (17-&#x003B2;) dehydrogenase 12</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">IDI1</td>
<td valign="top" align="left">Isopentenyl-diphosphate delta isomerase 1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">IVD</td>
<td valign="top" align="left">Isovaleryl-coa dehydrogenase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">MPST</td>
<td valign="top" align="left">Mercaptopyruvate sulfurtransferase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">MTMR1</td>
<td valign="top" align="left">Myotubularin related protein 1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">NDUFS8</td>
<td valign="top" align="left">NADH dehydrogenase (ubiquinone)</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left"/>
<td valign="top" align="left">Fe-S protein 8, 2 (NADH-coenzyme Q reductase)</td>
<td valign="top" align="center"/>
<td valign="top" align="center"/>
<td valign="top" align="center"/></tr>
<tr>
<td valign="top" align="left">NUDT9</td>
<td valign="top" align="left">Nudix (nucleoside diphosphate linked moiety X)-type motif 9</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PAFAH1B3</td>
<td valign="top" align="left">Platelet-activating factor acetylhydrolase 1b, catalytic subunit 3</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PANK4</td>
<td valign="top" align="left">Pantothenate kinase 4</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PFKM</td>
<td valign="top" align="left">Phosphofructokinase, muscle</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PGD</td>
<td valign="top" align="left">Phosphogluconate dehydrogenase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PGM2</td>
<td valign="top" align="left">Phosphoglucomutase 2</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PLOD3</td>
<td valign="top" align="left">Procollagen-lysine, 2-oxoglutarate 5-dioxygenase 3</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PMVK</td>
<td valign="top" align="left">Phosphomevalonate kinase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">PRIM1</td>
<td valign="top" align="left">Primase, DNA, polypeptide 1</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">SCP2</td>
<td valign="top" align="left">Sterol carrier protein 2</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">UQCRB</td>
<td valign="top" align="left">Ubiquinol-cytochrome c reductase binding protein</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">ND</td></tr>
<tr>
<td valign="top" align="left">GAPDH</td>
<td valign="top" align="left">Glyceraldehyde-3-phosphate dehydrogenase</td>
<td valign="top" align="center">0.068</td>
<td valign="top" align="center">0.113</td>
<td valign="top" align="center">0.091</td></tr>
<tr>
<td valign="top" align="left">GOT1</td>
<td valign="top" align="left">Glutamic-oxaloacetic transaminase 1, soluble (aspartate aminotransferase 1)</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">0.242</td>
<td valign="top" align="center">0.121</td></tr>
<tr>
<td valign="top" align="left">BCAT1</td>
<td valign="top" align="left">Branched chain amino-acid transaminase 1, cytosolic</td>
<td valign="top" align="center">0.247</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">0.123</td></tr>
<tr>
<td valign="top" align="left">AASDHPPT</td>
<td valign="top" align="left">Aminoadipate-semialdehyde dehydrogenase-phosphopantetheinyl transferase</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">0.256</td>
<td valign="top" align="center">0.128</td></tr>
<tr>
<td valign="top" align="left">UAP1</td>
<td valign="top" align="left">UDP-N-acteylglucosamine pyrophosphorylase 1</td>
<td valign="top" align="center">0.107</td>
<td valign="top" align="center">0.212</td>
<td valign="top" align="center">0.16</td></tr>
<tr>
<td valign="top" align="left">PGM3</td>
<td valign="top" align="left">Phosphoglucomutase 3</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">0.393</td>
<td valign="top" align="center">0.197</td></tr>
<tr>
<td valign="top" align="left">PAFAH1B2</td>
<td valign="top" align="left">Platelet-activating factor acetylhydrolase 1b, catalytic subunit 2</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">0.405</td>
<td valign="top" align="center">0.203</td></tr>
<tr>
<td valign="top" align="left">BLVRB</td>
<td valign="top" align="left">Biliverdin reductase B (flavin reductase (NADPH))</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">0.407</td>
<td valign="top" align="center">0.204</td></tr>
<tr>
<td valign="top" align="left">NDUFS1</td>
<td valign="top" align="left">NADH dehydrogenase (ubiquinone) Fe-S protein 1, 7 (NADH-coenzyme Q reductase)</td>
<td valign="top" align="center">ND</td>
<td valign="top" align="center">0.492</td>
<td valign="top" align="center">0.246</td></tr>
<tr>
<td valign="top" align="left">DLST</td>
<td valign="top" align="left">Dihydrolipoamide S-succinyltransferase (E2 component of 2-oxo-glutarate complex)</td>
<td valign="top" align="center">0.293</td>
<td valign="top" align="center">0.201</td>
<td valign="top" align="center">0.247</td></tr>
<tr>
<td valign="top" align="left">PHGDH</td>
<td valign="top" align="left">Phosphoglycerate dehydrogenase</td>
<td valign="top" align="center">0.224</td>
<td valign="top" align="center">0.284</td>
<td valign="top" align="center">0.254</td></tr>
<tr>
<td valign="top" align="left">HMOX1</td>
<td valign="top" align="left">Heme oxygenase (decycling) 1</td>
<td valign="top" align="center">0.165</td>
<td valign="top" align="center">0.378</td>
<td valign="top" align="center">0.271</td></tr>
<tr>
<td valign="top" align="left">DUT</td>
<td valign="top" align="left">Deoxyuridine triphosphatase</td>
<td valign="top" align="center">0.223</td>
<td valign="top" align="center">0.369</td>
<td valign="top" align="center">0.296</td></tr>
<tr>
<td valign="top" align="left">AHCY</td>
<td valign="top" align="left">Adenosylhomocysteinase</td>
<td valign="top" align="center">0.297</td>
<td valign="top" align="center">0.315</td>
<td valign="top" align="center">0.306</td></tr>
<tr>
<td valign="top" align="left">ATP5A1</td>
<td valign="top" align="left">ATP synthase, H<sup>+</sup> transporting, mitochondrial F1 complex, &#x003B1; subunit 1, cardiac muscle</td>
<td valign="top" align="center">0.252</td>
<td valign="top" align="center">0.363</td>
<td valign="top" align="center">0.308</td></tr>
<tr>
<td valign="top" align="left">SRM</td>
<td valign="top" align="left">Spermidine synthase</td>
<td valign="top" align="center">0.297</td>
<td valign="top" align="center">0.401</td>
<td valign="top" align="center">0.349</td></tr>
<tr>
<td valign="top" align="left">RRM1</td>
<td valign="top" align="left">Ribonucleotide reductase M1</td>
<td valign="top" align="center">0.347</td>
<td valign="top" align="center">0.36</td>
<td valign="top" align="center">0.353</td></tr>
<tr>
<td valign="top" align="left">ACAT1</td>
<td valign="top" align="left">Acetyl-coa acetyltransferase 1</td>
<td valign="top" align="center">0.271</td>
<td valign="top" align="center">0.439</td>
<td valign="top" align="center">0.355</td></tr>
<tr>
<td valign="top" align="left">ISYNA1</td>
<td valign="top" align="left">Inositol-3-phosphate synthase 1</td>
<td valign="top" align="center">0.234</td>
<td valign="top" align="center">0.48</td>
<td valign="top" align="center">0.357</td></tr>
<tr>
<td valign="top" align="left">NDUFA4</td>
<td valign="top" align="left">NADH dehydrogenase (ubiquinone) 1&#x003B1; subcomplex, 4</td>
<td valign="top" align="center">0.286</td>
<td valign="top" align="center">0.45</td>
<td valign="top" align="center">0.368</td></tr>
<tr>
<td valign="top" align="left">RRM2B</td>
<td valign="top" align="left">Ribonucleotide reductase M2 B (TP53 inducible)</td>
<td valign="top" align="center">0.373</td>
<td valign="top" align="center">0.435</td>
<td valign="top" align="center">0.404</td></tr>
<tr>
<td valign="top" align="left">NUDT2</td>
<td valign="top" align="left">Nudix (nucleoside diphosphate linked moiety X)-type motif 2</td>
<td valign="top" align="center">0.443</td>
<td valign="top" align="center">0.383</td>
<td valign="top" align="center">0.413</td></tr>
<tr>
<td valign="top" align="left">UQCRQ</td>
<td valign="top" align="left">Ubiquinol-cytochrome c reductase, complex III subunit VII</td>
<td valign="top" align="center">0.414</td>
<td valign="top" align="center">0.451</td>
<td valign="top" align="center">0.432</td></tr>
<tr>
<td valign="top" align="left">CMPK1</td>
<td valign="top" align="left">Cytidine monophosphate (UMP-CMP) kinase 1, cytosolic</td>
<td valign="top" align="center">0.462</td>
<td valign="top" align="center">0.443</td>
<td valign="top" align="center">0.452</td></tr>
<tr>
<td valign="top" align="left">ATP6V1B2</td>
<td valign="top" align="left">Atpase, H<sup>+</sup> transporting, lysosomal, V1 subunit B2</td>
<td valign="top" align="center">0.498</td>
<td valign="top" align="center">0.479</td>
<td valign="top" align="center">0.489</td></tr></tbody></table>
<table-wrap-foot><fn id="tfn1-ijo-53-02-0725">
<p>ND, not detectable (set as 0).</p></fn></table-wrap-foot></table-wrap>
<table-wrap id="tII-ijo-53-02-0725" position="float">
<label>Table II</label>
<caption>
<p>Downregulated KEGG pathways in bladder cancer cells treated by salirasib.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" align="left">KEGGID</th>
<th valign="bottom" align="center">Annotations</th>
<th valign="bottom" align="center">Number of genes</th>
<th valign="bottom" align="center">Corrected P-value</th>
<th valign="bottom" align="center">Genes</th></tr></thead>
<tbody>
<tr>
<td valign="top" align="left">00190</td>
<td valign="top" align="left">Oxidative phosphorylation</td>
<td valign="top" align="center">10</td>
<td valign="top" align="center">1.22&#x000D7;10<sup>&#x02212;12</sup></td>
<td valign="top" align="left">ATP5A1, ATP6V1G1, NDUFS8, ATP5L, ATP6V1E1, NDUFA4, NDUFS1, UQCRB, ATP6V1B2, UQCRQ</td></tr>
<tr>
<td valign="top" align="left">00280</td>
<td valign="top" align="left">Valine, leucine and isoleucine degradation</td>
<td valign="top" align="center">6</td>
<td valign="top" align="center">3.79&#x000D7;10<sup>&#x02212;9</sup></td>
<td valign="top" align="left">ALDH3A2, DLD, BCAT1, IVD, ALDH9A1, ACAT1</td></tr>
<tr>
<td valign="top" align="left">00240</td>
<td valign="top" align="left">Pyrimidine metabolism</td>
<td valign="top" align="center">7</td>
<td valign="top" align="center">4.84&#x000D7;10<sup>&#x02212;9</sup></td>
<td valign="top" align="left">CMPK1, NUDT2, RRM2B, AK3, RRM1, PRIM1, DUT</td></tr>
<tr>
<td valign="top" align="left">00010</td>
<td valign="top" align="left">Glycolysis/gluconeogenesis</td>
<td valign="top" align="center">6</td>
<td valign="top" align="center">1.29&#x000D7;10<sup>&#x02212;8</sup></td>
<td valign="top" align="left">ALDH3A2, PGM2, DLD, ALDH9A1, GAPDH, PFKM</td></tr>
<tr>
<td valign="top" align="left">00030</td>
<td valign="top" align="left">Pentose phosphate pathway</td>
<td valign="top" align="center">5</td>
<td valign="top" align="center">1.43&#x000D7;10<sup>&#x02212;8</sup></td>
<td valign="top" align="left">PGM2, DERA, G6PD, PGD, PFKM</td></tr>
<tr>
<td valign="top" align="left">00270</td>
<td valign="top" align="left">Cysteine and methionine metabolism</td>
<td valign="top" align="center">5</td>
<td valign="top" align="center">4.39&#x000D7;10<sup>&#x02212;8</sup></td>
<td valign="top" align="left">MPST, AHCY, AHCYL1, SRM, GOT1</td></tr>
<tr>
<td valign="top" align="left">00480</td>
<td valign="top" align="left">Glutathione metabolism</td>
<td valign="top" align="center">5</td>
<td valign="top" align="center">8.35&#x000D7;10<sup>&#x02212;8</sup></td>
<td valign="top" align="left">RRM2B, G6PD, RRM1, SRM, PGD</td></tr>
<tr>
<td valign="top" align="left">00230</td>
<td valign="top" align="left">Purine metabolism</td>
<td valign="top" align="center">7</td>
<td valign="top" align="center">8.57&#x000D7;10<sup>&#x02212;8</sup></td>
<td valign="top" align="left">NUDT2, PGM2, GMPR2, RRM2B, RRM1, NUDT9, PRIM1</td></tr>
<tr>
<td valign="top" align="left">05010</td>
<td valign="top" align="left">Alzheimer's disease</td>
<td valign="top" align="center">7</td>
<td valign="top" align="center">9.31&#x000D7;10<sup>&#x02212;8</sup></td>
<td valign="top" align="left">ATP5A1, NDUFS8, NDUFA4, NDUFS1, UQCRB, GAPDH, UQCRQ</td></tr>
<tr>
<td valign="top" align="left">00520</td>
<td valign="top" align="left">Amino sugar and nucleotide sugar metabolism</td>
<td valign="top" align="center">5</td>
<td valign="top" align="center">1.18&#x000D7;10<sup>&#x02212;7</sup></td>
<td valign="top" align="left">PGM2, UAP1, GMPPA, PGM3, GNPDA1</td></tr>
<tr>
<td valign="top" align="left">00310</td>
<td valign="top" align="left">Lysine degradation</td>
<td valign="top" align="center">5</td>
<td valign="top" align="center">1.19&#x000D7;10<sup>&#x02212;7</sup></td>
<td valign="top" align="left">ALDH3A2, ALDH9A1, PLOD3, DLST, ACAT1</td></tr>
<tr>
<td valign="top" align="left">05012</td>
<td valign="top" align="left">Parkinson's disease</td>
<td valign="top" align="center">6</td>
<td valign="top" align="center">4.55&#x000D7;10<sup>&#x02212;7</sup></td>
<td valign="top" align="left">ATP5A1, NDUFS8, NDUFA4, NDUFS1, UQCRB, UQCRQ</td></tr>
<tr>
<td valign="top" align="left">05016</td>
<td valign="top" align="left">Huntington's disease</td>
<td valign="top" align="center">6</td>
<td valign="top" align="center">2.79&#x000D7;10<sup>&#x02212;6</sup></td>
<td valign="top" align="left">ATP5A1, NDUFS8, NDUFA4, NDUFS1, UQCRB, UQCRQ</td></tr>
<tr>
<td valign="top" align="left">00620</td>
<td valign="top" align="left">Pyruvate metabolism</td>
<td valign="top" align="center">4</td>
<td valign="top" align="center">2.79&#x000D7;10<sup>&#x02212;6</sup></td>
<td valign="top" align="left">ALDH3A2, DLD, ALDH9A1, ACAT1</td></tr>
<tr>
<td valign="top" align="left">00330</td>
<td valign="top" align="left">Arginine and proline metabolism</td>
<td valign="top" align="center">4</td>
<td valign="top" align="center">8.56&#x000D7;10<sup>&#x02212;6</sup></td>
<td valign="top" align="left">ALDH3A2, ALDH9A1, SRM, GOT1</td></tr>
<tr>
<td valign="top" align="left">00900</td>
<td valign="top" align="left">Terpenoid backbone biosynthesis</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">8.57&#x000D7;10<sup>&#x02212;6</sup></td>
<td valign="top" align="left">PMVK, IDI1, ACAT1</td></tr>
<tr>
<td valign="top" align="left">00770</td>
<td valign="top" align="left">Pantothenate and CoA biosynthesis</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">1.13&#x000D7;10<sup>&#x02212;5</sup></td>
<td valign="top" align="left">BCAT1, AASDHPPT, PANK4</td></tr>
<tr>
<td valign="top" align="left">00410</td>
<td valign="top" align="left">&#x003B2;-alanine metabolism</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">3.82&#x000D7;10<sup>&#x02212;5</sup></td>
<td valign="top" align="left">ALDH3A2, ALDH9A1, SRM</td></tr>
<tr>
<td valign="top" align="left">04966</td>
<td valign="top" align="left">Collecting duct acid secretion</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">3.82&#x000D7;10<sup>&#x02212;5</sup></td>
<td valign="top" align="left">ATP6V1G1, ATP6V1E1, ATP6V1B2</td></tr>
<tr>
<td valign="top" align="left">00640</td>
<td valign="top" align="left">Propanoate metabolism</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">6.87&#x000D7;10<sup>&#x02212;5</sup></td>
<td valign="top" align="left">ALDH3A2, ALDH9A1, ACAT1</td></tr>
<tr>
<td valign="top" align="left">00051</td>
<td valign="top" align="left">Fructose and mannose metabolism</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">9.37&#x000D7;10<sup>&#x02212;5</sup></td>
<td valign="top" align="left">GMPPA, MTMR1, PFKM</td></tr>
<tr>
<td valign="top" align="left">00071</td>
<td valign="top" align="left">Fatty acid metabolism</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">0.000127</td>
<td valign="top" align="left">ALDH3A2, ALDH9A1, ACAT1</td></tr>
<tr>
<td valign="top" align="left">00380</td>
<td valign="top" align="left">Tryptophan metabolism</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">0.000127</td>
<td valign="top" align="left">ALDH3A2, ALDH9A1, ACAT1</td></tr>
<tr>
<td valign="top" align="left">05110</td>
<td valign="top" align="left">Vibrio cholerae infection</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">0.000264</td>
<td valign="top" align="left">ATP6V1G1, ATP6V1E1, ATP6V1B2</td></tr>
<tr>
<td valign="top" align="left">05120</td>
<td valign="top" align="left">Epithelial cell signaling in <italic>Helicobacter pylori</italic> infection</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">0.000509</td>
<td valign="top" align="left">ATP6V1G1, ATP6V1E1, ATP6V1B2</td></tr>
<tr>
<td valign="top" align="left">05323</td>
<td valign="top" align="left">Rheumatoid arthritis</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">0.000953</td>
<td valign="top" align="left">ATP6V1G1, ATP6V1E1, ATP6V1B2</td></tr>
<tr>
<td valign="top" align="left">00053</td>
<td valign="top" align="left">Ascorbate and aldarate metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002054</td>
<td valign="top" align="left">ALDH3A2, ALDH9A1</td></tr>
<tr>
<td valign="top" align="left">00052</td>
<td valign="top" align="left">Galactose metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002137</td>
<td valign="top" align="left">PGM2, PFKM</td></tr>
<tr>
<td valign="top" align="left">00340</td>
<td valign="top" align="left">Histidine metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002381</td>
<td valign="top" align="left">ALDH3A2, ALDH9A1</td></tr>
<tr>
<td valign="top" align="left">00020</td>
<td valign="top" align="left">Citrate cycle (TCA cycle)</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002464</td>
<td valign="top" align="left">DLD, DLST</td></tr>
<tr>
<td valign="top" align="left">00040</td>
<td valign="top" align="left">Pentose and glucuronate interconversions</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002546</td>
<td valign="top" align="left">ALDH3A2, DCXR</td></tr>
<tr>
<td valign="top" align="left">00250</td>
<td valign="top" align="left">Alanine, aspartate and glutamate metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002548</td>
<td valign="top" align="left">ASNS, GOT1</td></tr>
<tr>
<td valign="top" align="left">00260</td>
<td valign="top" align="left">Glycine, serine and threonine metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002548</td>
<td valign="top" align="left">DLD, PHGDH</td></tr>
<tr>
<td valign="top" align="left">00565</td>
<td valign="top" align="left">Ether lipid metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.002791</td>
<td valign="top" align="left">PAFAH1B3, PAFAH1B2</td></tr>
<tr>
<td valign="top" align="left">04145</td>
<td valign="top" align="left">Phagosome</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">0.002924</td>
<td valign="top" align="left">ATP6V1G1, ATP6V1E1, ATP6V1B2</td></tr>
<tr>
<td valign="top" align="left">00860</td>
<td valign="top" align="left">Porphyrin and chlorophyll metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.004011</td>
<td valign="top" align="left">HMOX1, BLVRB</td></tr>
<tr>
<td valign="top" align="left">00561</td>
<td valign="top" align="left">Glycerolipid metabolism</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.004873</td>
<td valign="top" align="left">ALDH3A2, ALDH9A1</td></tr>
<tr>
<td valign="top" align="left">04260</td>
<td valign="top" align="left">Cardiac muscle contraction</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.011811</td>
<td valign="top" align="left">UQCRB, UQCRQ</td></tr>
<tr>
<td valign="top" align="left">04146</td>
<td valign="top" align="left">Peroxisome</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">0.011811</td>
<td valign="top" align="left">PMVK, SCP2</td></tr>
<tr>
<td valign="top" align="left">00400</td>
<td valign="top" align="left">Phenylalanine, tyrosine and tryptophan biosynthesis</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.013097</td>
<td valign="top" align="left">GOT1</td></tr>
<tr>
<td valign="top" align="left">00072</td>
<td valign="top" align="left">Synthesis and degradation of ketone bodies</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.022922</td>
<td valign="top" align="left">ACAT1</td></tr>
<tr>
<td valign="top" align="left">00290</td>
<td valign="top" align="left">Valine, leucine and isoleucine biosynthesis</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.024264</td>
<td valign="top" align="left">BCAT1</td></tr>
<tr>
<td valign="top" align="left">04122</td>
<td valign="top" align="left">Sulfur relay system</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.024264</td>
<td valign="top" align="left">MPST</td></tr>
<tr>
<td valign="top" align="left">00740</td>
<td valign="top" align="left">Riboflavin metabolism</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.026063</td>
<td valign="top" align="left">BLVRB</td></tr>
<tr>
<td valign="top" align="left">00360</td>
<td valign="top" align="left">Phenylalanine metabolism</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.036111</td>
<td valign="top" align="left">GOT1</td></tr>
<tr>
<td valign="top" align="left">00120</td>
<td valign="top" align="left">Primary bile acid biosynthesis</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.036111</td>
<td valign="top" align="left">SCP2</td></tr>
<tr>
<td valign="top" align="left">00511</td>
<td valign="top" align="left">Other glycan degradation</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.03752</td>
<td valign="top" align="left">GBA</td></tr>
<tr>
<td valign="top" align="left">00630</td>
<td valign="top" align="left">Glyoxylate and dicarboxylate metabolism</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.038867</td>
<td valign="top" align="left">ACAT1</td></tr>
<tr>
<td valign="top" align="left">01040</td>
<td valign="top" align="left">Biosynthesis of unsaturated fatty acids</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.044309</td>
<td valign="top" align="left">HSD17B12</td></tr>
<tr>
<td valign="top" align="left">00910</td>
<td valign="top" align="left">Nitrogen metabolism</td>
<td valign="top" align="center">1</td>
<td valign="top" align="center">0.04748</td>
<td valign="top" align="left">ASNS</td></tr></tbody></table>
<table-wrap-foot><fn id="tfn2-ijo-53-02-0725">
<p>KEGG, Kyoto Encyclopedia of Genes and Genomes.</p></fn></table-wrap-foot></table-wrap>
<table-wrap id="tIII-ijo-53-02-0725" position="float">
<label>Table III</label>
<caption>
<p>Effects of salirasib downstream of hypoxia inducible factor-1&#x003B1;.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" align="left">Name</th>
<th valign="bottom" align="center">Description</th>
<th valign="bottom" align="center">T24 fold change</th>
<th valign="bottom" align="center">BOY fold change</th>
<th valign="bottom" align="center">Mean of T24 and BOY</th></tr></thead>
<tbody>
<tr>
<td valign="top" align="left">PKM2</td>
<td valign="top" align="left">Pyruvate kinase, muscle 2</td>
<td valign="top" align="center">1.369</td>
<td valign="top" align="center">1.194</td>
<td valign="top" align="center">1.281</td></tr>
<tr>
<td valign="top" align="left">LDHA</td>
<td valign="top" align="left">Lactate dehydrogenase A</td>
<td valign="top" align="center">0.918</td>
<td valign="top" align="center">1.005</td>
<td valign="top" align="center">0.961</td></tr>
<tr>
<td valign="top" align="left">PKM1</td>
<td valign="top" align="left">Pyruvate kinase, muscle 1</td>
<td valign="top" align="center">0.900</td>
<td valign="top" align="center">1.044</td>
<td valign="top" align="center">0.972</td></tr>
<tr>
<td valign="top" align="left">PGK1</td>
<td valign="top" align="left">Phosphoglycerate kinase 1</td>
<td valign="top" align="center">0.857</td>
<td valign="top" align="center">1.192</td>
<td valign="top" align="center">1.025</td></tr>
<tr>
<td valign="top" align="left">HK2</td>
<td valign="top" align="left">Hexokinase 2</td>
<td valign="top" align="center">0.735</td>
<td valign="top" align="center">0.697</td>
<td valign="top" align="center">0.716</td></tr>
<tr>
<td valign="top" align="left">ENO1</td>
<td valign="top" align="left">Enolase 1, (&#x003B1;)</td>
<td valign="top" align="center">0.453</td>
<td valign="top" align="center">0.587</td>
<td valign="top" align="center">0.520</td></tr>
<tr>
<td valign="top" align="left">GAPDH</td>
<td valign="top" align="left">Glyceraldehyde-3-phosphate dehydrogenase</td>
<td valign="top" align="center">0.068</td>
<td valign="top" align="center">0.113</td>
<td valign="top" align="center">0.091</td></tr></tbody></table></table-wrap></floats-group></article>
