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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">OL</journal-id>
<journal-title-group>
<journal-title>Oncology Letters</journal-title>
</journal-title-group>
<issn pub-type="ppub">1792-1074</issn>
<issn pub-type="epub">1792-1082</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ol.2018.8613</article-id>
<article-id pub-id-type="publisher-id">OL-0-0-8613</article-id>
<article-categories>
<subj-group>
<subject>Review</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>MALAT1: A long non-coding RNA highly associated with human cancers</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Zhao</surname><given-names>Miaomiao</given-names></name>
<xref rid="af1-ol-0-0-8613" ref-type="aff">1</xref>
<xref rid="af2-ol-0-0-8613" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author"><name><surname>Wang</surname><given-names>Songpo</given-names></name>
<xref rid="af1-ol-0-0-8613" ref-type="aff">1</xref>
<xref rid="c1-ol-0-0-8613" ref-type="corresp"/></contrib>
<contrib contrib-type="author"><name><surname>Li</surname><given-names>Qi</given-names></name>
<xref rid="af3-ol-0-0-8613" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author"><name><surname>Ji</surname><given-names>Qing</given-names></name>
<xref rid="af3-ol-0-0-8613" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author"><name><surname>Guo</surname><given-names>Piaoting</given-names></name>
<xref rid="af1-ol-0-0-8613" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author"><name><surname>Liu</surname><given-names>Xiaowei</given-names></name>
<xref rid="af1-ol-0-0-8613" ref-type="aff">1</xref></contrib>
</contrib-group>
<aff id="af1-ol-0-0-8613"><label>1</label>Department of Traditional Chinese Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, P.R. China</aff>
<aff id="af2-ol-0-0-8613"><label>2</label>Department of Oncology, Zhengzhou Traditional Chinese Medicine Hospital, Zhengzhou 450007, P.R. China</aff>
<aff id="af3-ol-0-0-8613"><label>3</label>Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P.R. China</aff>
<author-notes>
<corresp id="c1-ol-0-0-8613"><italic>Correspondence to</italic>: Professor Songpo Wang, Department of Traditional Chinese Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Hongkou, Shanghai 200080, P.R. China, E-mail: <email>13386259791@163.com</email></corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>07</month>
<year>2018</year></pub-date>
<pub-date pub-type="epub">
<day>02</day>
<month>05</month>
<year>2018</year></pub-date>
<volume>16</volume>
<issue>1</issue>
<fpage>19</fpage>
<lpage>26</lpage>
<history>
<date date-type="received"><day>21</day><month>09</month><year>2015</year></date>
<date date-type="accepted"><day>21</day><month>03</month><year>2017</year></date>
</history>
<permissions>
<copyright-statement>Copyright: &#x00A9; Zhao et al.</copyright-statement>
<copyright-year>2018</copyright-year>
<license license-type="open-access">
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivs License</ext-link>, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.</license-p></license>
</permissions>
<abstract>
<p>Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), a well-known lncRNA associated with numerous diseases, particularly cancer, has received increased attention. The expression of MALAT1 was determined to be upregulated in numerous types of tumors and MALAT1 exhibited effects on tumor cell proliferation, migration, invasion and apoptosis. The abnormal expression of MALAT1 was identified in almost in every organ of the digestive system. MALAT1 performed an important role in the pathological alterations of organs that are associated with sex hormones and several reproductive system cancers. MALAT1 participates in molecular pathways. In the clinical application of MALAT1, MALAT1 was considered as a potential biomarker for the diagnosis and prediction of cancers, and may also serve as therapeutic target for treatment of specific tumors. This review summarizes the abnormal expression of MALAT1 in cancer, its significant effect on the primary features of cancer, as well as the underlying molecular mechanisms of MALAT1 in various cancers. According to studies on MALAT1, we introduce the upstream and downstream substances associated with the function of MALAT1. These reviewed studies promote the clinical application of MALAT1 in the aspect of diagnosis and treatment of different cancers, and may help point out new study directions for MALAT1.</p>
</abstract>
<kwd-group>
<kwd>long non-coding RNA</kwd>
<kwd>metastasis-associated lung adenocarcinoma transcript 1</kwd>
<kwd>cancer</kwd>
<kwd>clinical application</kwd>
<kwd>molecular mechanism</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<label>1.</label>
<title>Introduction</title>
<p>For decades, studies have focused on protein-coding genes, as they are significantly involved in the mechanisms of cancer initiation and progression. Mutation or deletion of the TP53 may lead to development of Li-Fraumeni syndrome, a disease that leads to increased likelihood of developing tumors during early adulthood (<xref rid="b1-ol-0-0-8613" ref-type="bibr">1</xref>). PTEN may suppress the growth of tumor cells by antagonizing protein tyrosine kinases and may regulate the invasion and metastasis of tumor cells through interaction with focal adhesion (<xref rid="b2-ol-0-0-8613" ref-type="bibr">2</xref>). Completion of the human genome sequencing project (<xref rid="b3-ol-0-0-8613" ref-type="bibr">3</xref>), enriched the available information regarding genome organization and content. Along with the identification that non-protein coding RNAs (ncRNAs) account for the majority of human genome-transcripted sequences (<xref rid="b4-ol-0-0-8613" ref-type="bibr">4</xref>), ncRNAs have attracted markedly growing research interest.</p>
<p>Long non-coding RNAs (lncRNAs) are a type of RNA molecule with a length of &#x003E;200 nucleotides (nt), which are unable to encode proteins (<xref rid="b5-ol-0-0-8613" ref-type="bibr">5</xref>). Specifically, lncRNAs have been defined as RNA molecules that may function as either primary or spliced transcripts, and do not match with these known classes of small RNAs or structural RNAs (<xref rid="b6-ol-0-0-8613" ref-type="bibr">6</xref>). lncRNAs regulate gene expression through various processes, including chromatin modification, transcription and post-transcription (<xref rid="b6-ol-0-0-8613" ref-type="bibr">6</xref>,<xref rid="b7-ol-0-0-8613" ref-type="bibr">7</xref>). lncRNAs can regulate the transcription processing by interacting with RNA binding proteins, co-activating transcription factors, or repressing the promoters of target genes (<xref rid="b8-ol-0-0-8613" ref-type="bibr">8</xref>&#x2013;<xref rid="b10-ol-0-0-8613" ref-type="bibr">10</xref>). Although these lncRNAs cannot encode proteins, their roles in cellular functions are indispensable as well as complex.</p>
</sec>
<sec>
<label>2.</label>
<title>Research background of MALAT1</title>
<p>Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), also termed nuclear enriched abundant transcript 2, is a long intergenic non-coding RNA (lincRNA) with &#x003E;8,000 nts, located on chromosome 11q13 (<xref rid="b11-ol-0-0-8613" ref-type="bibr">11</xref>). Sequences of lncRNAs are highly evolutionarily conserved among species, which predicts the potentially important biological functions of MALAT1 (<xref rid="b11-ol-0-0-8613" ref-type="bibr">11</xref>). In 2003, MALAT1 was firstly identified to be significantly associated with the metastasis of early-stage non-small cell lung cancer (NSCLC), and therefore MALAT1 was proposed to be a prognostic marker for stage I NSCLC (<xref rid="b11-ol-0-0-8613" ref-type="bibr">11</xref>). Since then, studies about MALAT1 have gradually increased. A search for all the MALAT1-associated publications on PubMed was performed, and the statistical result is shown in <xref rid="f1-ol-0-0-8613" ref-type="fig">Fig. 1</xref>. As shown in <xref rid="f1-ol-0-0-8613" ref-type="fig">Fig. 1</xref>, between 2003 and December 2014, the amount of relevant studies increased year-by-year, indicating growing interest of researchers in MALAT1. Among all these articles, cancer-associated studies accounted for ~20&#x0025; of the total. In addition to cancers, several non-cancer diseases, including myocardial infarction and hyperghlycemia, have also been reported to be associated with MALAT1 (<xref rid="b12-ol-0-0-8613" ref-type="bibr">12</xref>&#x2013;<xref rid="b16-ol-0-0-8613" ref-type="bibr">16</xref>). Studies have identified that MALAT1 performs a vital role in regulating the function of endothelial cell and vessel growth (<xref rid="b12-ol-0-0-8613" ref-type="bibr">12</xref>), and the role was evidenced in the cardiovascular vascular system (<xref rid="b13-ol-0-0-8613" ref-type="bibr">13</xref>). In addition, the abnormal expression of MALAT1 in patients with myocardial infarction indicated that it performs an important role in cardiovascular diseases (<xref rid="b14-ol-0-0-8613" ref-type="bibr">14</xref>). Notably, MALAT1 was also involved in hyperglycemia by inducing inflammatory processes (<xref rid="b15-ol-0-0-8613" ref-type="bibr">15</xref>), and in diabetic retinopathy it was improperly regulated (<xref rid="b16-ol-0-0-8613" ref-type="bibr">16</xref>). MALAT1 also affected the progression of proliferative vitreoretinopathy (<xref rid="b17-ol-0-0-8613" ref-type="bibr">17</xref>), hereditary degenerative disease myotonic dystrophy type 1 (<xref rid="b18-ol-0-0-8613" ref-type="bibr">18</xref>) and keratoacanthoma (<xref rid="b19-ol-0-0-8613" ref-type="bibr">19</xref>). In addition, the upregulation of MALAT1 was identified in the cerebellum, hippocampus and brain stem of human alcoholics (<xref rid="b20-ol-0-0-8613" ref-type="bibr">20</xref>) and the progression of microtia (<xref rid="b21-ol-0-0-8613" ref-type="bibr">21</xref>) were reported to be associated with MALAT1 expression. Therefore, MALAT1 is widely involved in numerous pathological processes.</p>
</sec>
<sec>
<label>3.</label>
<title>Association of MALAT1 with cancers</title>
<p>Since the association between MALAT1 and NSCLC was identified, its important roles as an lncRNA in cancer have been considered as a paradigm (<xref rid="b22-ol-0-0-8613" ref-type="bibr">22</xref>). The expression of MALAT1 was found to be upregulated in numerous types of tumor, and MALAT1 exhibited marked effects on tumor cell proliferation, migration, invasion and apoptosis (<xref rid="b22-ol-0-0-8613" ref-type="bibr">22</xref>). The advances in clinical study about MALAT1 on cancer during recent years are summarized in <xref rid="tI-ol-0-0-8613" ref-type="table">Table I</xref>.</p>
<sec>
<title/>
<sec>
<title>Aberrant expression and multiple biological functions of MALAT1 in different cancers</title>
<p>Following the first identification of MALAT1 in NSCLC(11), a subsequent study on NSCLC about MALAT1 hypothesized that the apparent overexpression of MALAT1 in stage I and II NSCLC primary tumors increased the likelihood to metastasis (<xref rid="b23-ol-0-0-8613" ref-type="bibr">23</xref>). Furthermore, increased MALAT1 expression contributed to brain metastasis by promoting epithelial-mesenchymal transition (EMT) in NSCLC (<xref rid="b24-ol-0-0-8613" ref-type="bibr">24</xref>).</p>
<p>Undoubtedly, the action of MALAT1 on digestive system cancer deserves wide attention. It was demonstrated that in esophageal squamous cell carcinoma (ESCC), the overexpression of MALAT1 promoted tumor proliferation and metastasis (<xref rid="b25-ol-0-0-8613" ref-type="bibr">25</xref>). In gastric cancer, the high-level expression of MALAT1 was reported to promote the development and the peritoneal metastasis of cancer (<xref rid="b26-ol-0-0-8613" ref-type="bibr">26</xref>). A previous clinical study showed that MALAT1 was associated with colorectal cancer (CRC), and its elevated expression may be a negative prognostic factor of patients with stage II/III CRC (<xref rid="b27-ol-0-0-8613" ref-type="bibr">27</xref>). MALAT1 was also revealed to be upregulated in hepatocellular carcinoma, and its overexpression may indicate a higher risk of tumor recurrence following liver transplantation (<xref rid="b28-ol-0-0-8613" ref-type="bibr">28</xref>). In a clinical study on pancreatic cancer, the abnormal overexpression of MALAT1 was identified as an unfavorable predictor for its clinical progression and prognosis (<xref rid="b29-ol-0-0-8613" ref-type="bibr">29</xref>). In accordance with the former research, studies on pancreatic cancer <italic>in vitro</italic> using seven associated cell lines confirmed the role of MALAT1 in promoting cell growth, migration and invasion (<xref rid="b30-ol-0-0-8613" ref-type="bibr">30</xref>).</p>
<p>The situation was similar in clear cell renal carcinoma; patients with higher levels of MALAT1 indicated worse tumor progression and poor prognosis, and exploration revealed that knockdown of MALAT1 could inhibit proliferation, migration and invasion in renal cancer cells (<xref rid="b31-ol-0-0-8613" ref-type="bibr">31</xref>). A previous study on bladder cancer revealed that MALAT1 promoted EMT-associated cell migration and may be activated via Wnt signaling (<xref rid="b32-ol-0-0-8613" ref-type="bibr">32</xref>). The upregulated MALAT1 was associated with the ability of proliferation, apoptosis and motility in urothelial carcinoma of bladder cancer cells (<xref rid="b33-ol-0-0-8613" ref-type="bibr">33</xref>). Therefore, its effect on the urinary system was also noteworthy.</p>
<p>It appeared that MALAT1 performed an important role in the pathological changes of organs that are highly associated with sex hormones and several reproductive system cancers (<xref rid="b34-ol-0-0-8613" ref-type="bibr">34</xref>&#x2013;<xref rid="b37-ol-0-0-8613" ref-type="bibr">37</xref>). The upregulation of MALAT1 was involved in the progression of castration-resistant prostate cancer (CRPC) and was associated with the maintenance of tumorigenicity (<xref rid="b34-ol-0-0-8613" ref-type="bibr">34</xref>). It was also shown to be one of the 10 most highly-expressed transcripts in CRPC, involving RNA processing and resulting in incomplete splicing (<xref rid="b35-ol-0-0-8613" ref-type="bibr">35</xref>). In addition, the inhibitory effect of 17&#x03B2;-estradiol treatment on breast tumor cell proliferation, migration and invasion was elucidated to be not ER&#x03B1;-dependent but dose-dependent by downregulating the expression level of MALAT1 (<xref rid="b36-ol-0-0-8613" ref-type="bibr">36</xref>). Furthermore, in cervical cancer, upregulated MALAT1 was associated with positive human papilloma virus (HPV) in cervical squamous cells (<xref rid="b37-ol-0-0-8613" ref-type="bibr">37</xref>), and MALAT1 was found effect cervical cancer cell proliferation and invasion(38).</p>
<p>MALAT1 was also studied in several other types of cancers (<xref rid="b39-ol-0-0-8613" ref-type="bibr">39</xref>&#x2013;<xref rid="b42-ol-0-0-8613" ref-type="bibr">42</xref>). Among numerous lncRNAs, MALAT1 was revealed to be the second most largely upregulated lncRNA in adrenocortical cancer (<xref rid="b39-ol-0-0-8613" ref-type="bibr">39</xref>). In patients with multiple myeloma, MALAT1 was reported as overexpressed (<xref rid="b40-ol-0-0-8613" ref-type="bibr">40</xref>). The markedly high expression of MALAT1 was also shown to be associated with melanoma metastasis (<xref rid="b41-ol-0-0-8613" ref-type="bibr">41</xref>). In the progression of osteosarcoma, MALAT1 was reported to promote tumor proliferation and metastasis via the phosphoinositide 3-kinase (PI3K)/Akt pathway (<xref rid="b42-ol-0-0-8613" ref-type="bibr">42</xref>).</p>
<p>In conclusion, these studies demonstrated that MALAT1 serves as an oncogenic gene during the progression of diverse cancers, and that the potential functions of MALAT1 are associated with the basic features of cancer, including proliferation, metastasis, invasion and apoptosis.</p>
</sec>
<sec>
<title>Preliminary studies on clinical application of MALAT1 in cancers</title>
<p>As aforementioned, MALAT1 serves a vital role in several cancers, and increasing efforts have been devoted to developing MALAT1-based cancer diagnosis and treatment. The deregulation of MALAT1 in certain types of tumor tissues and association with tumor cell proliferation, migration and invasion make it potential diagnostic biomarkers (<xref rid="b4-ol-0-0-8613" ref-type="bibr">4</xref>,<xref rid="b16-ol-0-0-8613" ref-type="bibr">16</xref>,<xref rid="b27-ol-0-0-8613" ref-type="bibr">27</xref>,<xref rid="b29-ol-0-0-8613" ref-type="bibr">29</xref>,<xref rid="b39-ol-0-0-8613" ref-type="bibr">39</xref>). One study has already revealed that urine MALAT1 may act as a promising diagnostic biomarker for prostate cancer based on a multicenter evaluation (<xref rid="b43-ol-0-0-8613" ref-type="bibr">43</xref>). In addition, MALAT1-derived miniRNA in the plasma may be used to detect and diagnose prostate cancer (<xref rid="b44-ol-0-0-8613" ref-type="bibr">44</xref>). Other applications about MALAT1 on predicting cancer progression, prognosis, recurrence and metastasis have always been important directions in cancer research. A study about the association between the expression of MALAT1 in the peripheral whole blood of patients and lung cancer progression indicated that its expression level may reflect the host response to lung cancer development (<xref rid="b45-ol-0-0-8613" ref-type="bibr">45</xref>).</p>
<p>In addition to its advantages as diagnostic or predictive biomarkers, MALAT1 and substances interacting with it may also serve as therapeutic targets in specific tumors (<xref rid="b46-ol-0-0-8613" ref-type="bibr">46</xref>&#x2013;<xref rid="b48-ol-0-0-8613" ref-type="bibr">48</xref>). Several synthetic artificial microRNAs targeting MALAT1 and other genes successfully exhibited anticancer effects on two bladder cancer cell lines (<xref rid="b46-ol-0-0-8613" ref-type="bibr">46</xref>), which was at the forefront of the application study. The tumor-suppressive ability of Myc-6, a small synthetic chemical pyrrole-imidazole polyamide, on human osteosarcoma MG63 cells was suggested to be partly associated with the specific decrease of MALAT1 (<xref rid="b47-ol-0-0-8613" ref-type="bibr">47</xref>). In another study about the histone demethylase jumonji domain-containing protein 1A (JMJD1A) and MALAT1, the small molecule JMJD1A inhibitor dimethyloxaloylglycine was demonstrated be able to suppress neuroblastoma cell migration and invasion (<xref rid="b48-ol-0-0-8613" ref-type="bibr">48</xref>). These studies laid the basis of clinical applications.</p>
<p>Clinical application studies about MALAT1 were not confined to the aforementioned fields. In the study of the genotoxic stress-induced apoptosis, MALAT1 was markedly downregulated in bleomycin-treated HeLa and MCF-7 cells (<xref rid="b49-ol-0-0-8613" ref-type="bibr">49</xref>). MALAT1 was one of the significant lncRNAs in laryngeal squamous cell carcinoma; the expression of MALAT1 decreased when patients were treated with increasing concentrations of cisplatin and paclitaxel (<xref rid="b50-ol-0-0-8613" ref-type="bibr">50</xref>). MALAT1 was previously identified to be involved in drug action in high-grade osteosarcoma, suggesting its potential to modulate the drug sensitivity (<xref rid="b51-ol-0-0-8613" ref-type="bibr">51</xref>). Therefore, the association between MALAT1 and drug action is noteworthy.</p>
</sec>
</sec>
</sec>
<sec>
<label>4.</label>
<title>Molecular mechanisms of MALAT1 in cancers</title>
<p>MALAT1 co-localizes with SC35 splicing domains which were also known as interchromatin granule clusters or nuclear speckles, and the localization of MALAT1 suggests its function in RNA metabolism (<xref rid="b52-ol-0-0-8613" ref-type="bibr">52</xref>) MALAT1 is a nuclear-retained RNA, and has been shown to be involved in pre-mRNA processing in mammalian cells (<xref rid="b53-ol-0-0-8613" ref-type="bibr">53</xref>). The 3&#x2032; end processing of MALAT1 generates the mature MALAT1 transcript and a tRNA-like RNA cytoplasmic RNA (<xref rid="b54-ol-0-0-8613" ref-type="bibr">54</xref>). Mature MALAT1 lacking a poly (A) tail was protected by the triple helix structure to maintain the stability of its 3&#x2032; ends, and the triple helix could also serve as a translational enhancer (<xref rid="b55-ol-0-0-8613" ref-type="bibr">55</xref>). MALAT1 was involved in mRNA processing, splicing and exporting (<xref rid="b56-ol-0-0-8613" ref-type="bibr">56</xref>), and these findings laid the basis of the MALAT1 function.</p>
<sec>
<title/>
<sec>
<title>MALAT1 is regulated by upstream genes or proteins</title>
<p>The expression of MALAT1 was regulated by numerous genes or proteins during transcription and post-transcriptional processing (<xref rid="f2-ol-0-0-8613" ref-type="fig">Fig. 2</xref>). Sp1 and JMJD1A were reported to regulate the expression of MALAT1 by binding to the gene promoter, consequently affecting the transcription processing (<xref rid="b48-ol-0-0-8613" ref-type="bibr">48</xref>,<xref rid="b57-ol-0-0-8613" ref-type="bibr">57</xref>). A study revealed that Sp1 may bind to the promoter to activate MALAT1, leading to the upregulation of MALAT1 in lung cancer (<xref rid="b57-ol-0-0-8613" ref-type="bibr">57</xref>). By binding to the promoter and activating the transcription of MALAT1, the histone demethylase JMJD1A upregulated the expression of MALAT1, facilitating neuroblastoma cell migration and invasion (<xref rid="b48-ol-0-0-8613" ref-type="bibr">48</xref>). In a study on the sex determining region Y-box (Sox) 17 in esophageal cancer, MALAT1 was confirmed as one of the new suppressive downstream genes in its transcriptional network (<xref rid="b58-ol-0-0-8613" ref-type="bibr">58</xref>). MALAT1 was reported to perform an important role in modulating proliferation of early-stage hematopoietic cells, and p53 regulated the process of hematopoietic differentiation via changing MALAT1 expression (<xref rid="b59-ol-0-0-8613" ref-type="bibr">59</xref>).</p>
<p>The post-transcriptional processing of MALAT1 is complex (<xref rid="b60-ol-0-0-8613" ref-type="bibr">60</xref>). In NSCLC, TDP-43 may regulate the expression of MALAT1 by directly binding to MALAT1 RNA (<xref rid="b61-ol-0-0-8613" ref-type="bibr">61</xref>). The interactions with nucleic acids, including miRNAs, during post-transcriptional processing significantly affect the expression and functions of MALAT1 (<xref rid="b62-ol-0-0-8613" ref-type="bibr">62</xref>&#x2013;<xref rid="b65-ol-0-0-8613" ref-type="bibr">65</xref>). By downregulating K-ras and MALAT1, hsa-miR-1 was identified to suppress the development of breast cancer (<xref rid="b62-ol-0-0-8613" ref-type="bibr">62</xref>). Similarly, MALAT1 was suggested as suppressed by hsa-miR-125b in bladder cancer (<xref rid="b63-ol-0-0-8613" ref-type="bibr">63</xref>). In the study of the posttranscriptional regulation of MALAT1 in ESCC, studies identified that the posttranscriptional silencing of MALAT1 could suppress tumor proliferation, migration and invasion by miR-101 and miR-217 (<xref rid="b64-ol-0-0-8613" ref-type="bibr">64</xref>). miR-9 was also reported to modulate the degradation of MALAT1 by targeting AGO2-mediated regulation in the nucleus (<xref rid="b65-ol-0-0-8613" ref-type="bibr">65</xref>).</p>
<p>As the mechanism underlying the expression and function of MALAT1 is complex, the interactions between upstream regulators and MALAT1 are not simple either. According to a related study, MALAT1 was associated with yes-associated protein (YAP) and serine/arginine-rich splicing factor 1 (SRSF1) at transcriptional and post-transcriptional processing in liver cancer (<xref rid="b60-ol-0-0-8613" ref-type="bibr">60</xref>), and the associations among MALAT1, YAP and SRSF1 were complicated.</p>
</sec>
<sec>
<title>MALAT1 regulates downstream gene expression</title>
<p>Modulation of gene expression is one of the most important functions of lncRNA (<xref rid="b6-ol-0-0-8613" ref-type="bibr">6</xref>). In lung cancer, the pivotal function of MALAT1 associated with metastasis phenotype was not alternative splicing but regulating the expression of 23 concerning genes, including melanoma inhibitory activity 2, roundabout 1, glypican 6, latrophilin 2, CUB domain containing protein 1 and ATP-binding cassette, subfamily A, member 1 (<xref rid="b66-ol-0-0-8613" ref-type="bibr">66</xref>). It was previously revealed in NSCLC that the MALAT1 levels affect the expression of B-cell lymphoma (Bcl-2), and Bcl-2 was identified to affect the prognosis (<xref rid="b67-ol-0-0-8613" ref-type="bibr">67</xref>). Notably, MALAT1 was identified to promote the expression of caspase-3, &#x2212;8 and Bcl-2-associated X protein, and inhibit the expression of Bcl-2 and Bcl-extra-large, subsequently affecting cervical cancer cells proliferation and invasion (<xref rid="b68-ol-0-0-8613" ref-type="bibr">68</xref>). PPKA kinase anchor protein 9 was indicated to be the target protein of MALAT1 in colorectal cancer, and the two of them were involved in tumor promotion (<xref rid="b69-ol-0-0-8613" ref-type="bibr">69</xref>). One study has shown that the promotion of MALAT1 on the stem cell-like phenotypes in pancreatic cancer cells is associated with increased expression of Sox2, a self-renewal associated factor (<xref rid="b70-ol-0-0-8613" ref-type="bibr">70</xref>). Another study on multiple myeloma revealed that in mesenchymal stem cells, MALAT1 promoted the activation of the promoter of latent transforming growth factor-&#x03B2; binding protein (LTBPS) via regulating recruitment of Sp1 to LTBPS, and the interaction of MALAT1 with Sp1 and LTBP3 promoter increased the expression of LTBPS (<xref rid="b71-ol-0-0-8613" ref-type="bibr">71</xref>). In terms of its mechanism on regulating the proliferation of cancer cells, MALAT1 modulated the expression level of transcription factor B-MYB, an oncogenic gene involved in cell cycle progression (<xref rid="b72-ol-0-0-8613" ref-type="bibr">72</xref>). The downstream genes associated with MALAT1 are listed in <xref rid="f2-ol-0-0-8613" ref-type="fig">Fig. 2</xref>.</p>
</sec>
<sec>
<title>Interaction between MALAT1 and other genes</title>
<p>The underlying mechanism of MALAT1 promoting tumor growth and metastasis in colorectal cancer was revealed to be associated with its competitive binding to the tumor suppressor gene splicing factor proline and glutamine rich (SFPQ) and subsequently releasing SFPQ from the SFPQ/polypyrimidine tract binding protein 2 (PTBP2) complex, which was accompanied by increased SFPQ-detached PTBP2, which served as a proto-oncogene (<xref rid="b73-ol-0-0-8613" ref-type="bibr">73</xref>). In gastric cancer, MALAT1 promoted cellular proliferation partly by recruiting the splicing factor SF2/alternative splicing factor, a member of the serine/arginine-rich protein family (<xref rid="b74-ol-0-0-8613" ref-type="bibr">74</xref>). According to a study on bladder cancer, MALAT1 also mediated the TGF-&#x03B2;-induced EMT and was associated with suppressor of zeste12, thus promoting tumor metastasis (<xref rid="b75-ol-0-0-8613" ref-type="bibr">75</xref>). To investigate the mechanism underlying the promotion of MALAT1, a recent study conducted on renal cell carcinoma showed that the binding of MALAT1 and enhancer of zeste homolog 2 affected the epithelial-mesenchymal transition by affecting the expression of E-cadherin and &#x03B2;-catenin, thus, finally affecting the tumor progression (<xref rid="b76-ol-0-0-8613" ref-type="bibr">76</xref>). Furthermore, its reciprocal interaction with miR-205 was also disclosed (<xref rid="b76-ol-0-0-8613" ref-type="bibr">76</xref>). miR-205 was not the only miRNA involved in the reciprocal interaction with MALAT1; it was demonstrated that MALAT1 could regulate the radiosensitivity of HR-HPV&#x002B; cervical cancer by the reciprocal repression between MALAT1 and miR-145 (<xref rid="b77-ol-0-0-8613" ref-type="bibr">77</xref>). The reciprocal interaction between MALAT1 and miR-124 was also involved in the growth and invasion of HR-HPV-positive cervical cancer cells via the MALAT1-miR-124-RBG2 axis (<xref rid="b78-ol-0-0-8613" ref-type="bibr">78</xref>). In <xref rid="f2-ol-0-0-8613" ref-type="fig">Fig. 2</xref> we show the interaction.</p>
</sec>
<sec>
<title>Signaling pathways involving MALAT1</title>
<p>MALAT1 has been found to be associated with a multitude of molecular pathways, which in turn complicated the mechanism of action (<xref rid="b25-ol-0-0-8613" ref-type="bibr">25</xref>,<xref rid="b68-ol-0-0-8613" ref-type="bibr">68</xref>,<xref rid="b79-ol-0-0-8613" ref-type="bibr">79</xref>&#x2013;<xref rid="b83-ol-0-0-8613" ref-type="bibr">83</xref>). It modulated nuclear factor-&#x03BA;B/RelA, which is involved in the process of EMT (<xref rid="b79-ol-0-0-8613" ref-type="bibr">79</xref>). Furthermore, another study on breast cancer revealed that the expression of MALAT1 could regulate EMT through the PI3K-AKT pathway (<xref rid="b68-ol-0-0-8613" ref-type="bibr">68</xref>), which was also involved in the progression of osteosarcoma (<xref rid="b41-ol-0-0-8613" ref-type="bibr">41</xref>). In ESCC, the overexpression of MALAT1 was demonstrated to promote tumor proliferation and metastasis by dephosphorylating the ATM-CHK2 pathway (<xref rid="b25-ol-0-0-8613" ref-type="bibr">25</xref>). In the study of gallbladder carcinoma, researchers found MALAT1 acted as an oncogenic lncRNA by activating the extracellular-signal regulated kinase/mitogen-activated protein kinase pathway (<xref rid="b80-ol-0-0-8613" ref-type="bibr">80</xref>). Another study on glioblastoma revealed MALAT1 was the top downregulated gene in the WNT inhibitory factor 1-expressing cells, and identified that knockdown of MALAT1 could reduce the migration of glioblastoma cells (<xref rid="b81-ol-0-0-8613" ref-type="bibr">81</xref>). Furthermore, this study also suggested the possible association between the non-canonical Wnt signaling and MALAT1 (<xref rid="b81-ol-0-0-8613" ref-type="bibr">81</xref>). Chemokine (C-C motif) ligand 5, derived from tumor-associated dendritic cell, was revealed to be associated with colon cancer progression through the MALAT1/Snail pathway (<xref rid="b82-ol-0-0-8613" ref-type="bibr">82</xref>). In addition, the PCDH10-Wnt/&#x03B2;-catenin-MALAT1 regulatory axis was established in a study on endometrioid endometrial cancer (<xref rid="b83-ol-0-0-8613" ref-type="bibr">83</xref>).</p>
</sec>
</sec>
</sec>
<sec>
<label>5.</label>
<title>Perspectives and challenges</title>
<p>Firstly, MALAT1 is an important lncRNA involved in numerous biological processes. The critical roles of MALAT1 in gene regulation and the noticeable effect on the basic function of cells, particularly on tumor cells, have been confirmed by numerous concerning studies (<xref rid="b72-ol-0-0-8613" ref-type="bibr">72</xref>,<xref rid="b84-ol-0-0-8613" ref-type="bibr">84</xref>&#x2013;<xref rid="b86-ol-0-0-8613" ref-type="bibr">86</xref>). However, certain results of these studies were inconsistent. A study showed that the quantitative loss of MALAT1 had no effect on the phenotypes of human lung or liver cancer cells, including proliferation and cell cycle progression (<xref rid="b87-ol-0-0-8613" ref-type="bibr">87</xref>), which disagreed with other studies (<xref rid="b11-ol-0-0-8613" ref-type="bibr">11</xref>,<xref rid="b59-ol-0-0-8613" ref-type="bibr">59</xref>,<xref rid="b88-ol-0-0-8613" ref-type="bibr">88</xref>). Similarly, the expression of MALAT1 also differed significantly from another study on hepatocellular carcinoma, according to the expression profiles of lncRNAs (<xref rid="b89-ol-0-0-8613" ref-type="bibr">89</xref>). Secondly, since numerous molecular mechanisms underlying the action of MALAT1 remain unclear, multiple experiments are required to explore and verify its functions. Furthermore, certain parts of mechanisms underlying the progression of different cancers appear to be the same. For example, the abnormal expression of MALAT1 was found almost in every organ of the digestive system (<xref rid="b25-ol-0-0-8613" ref-type="bibr">25</xref>&#x2013;<xref rid="b30-ol-0-0-8613" ref-type="bibr">30</xref>), MALAT1 and PI3K-AKT pathway are involved in osteosarcoma and breast cancer (<xref rid="b42-ol-0-0-8613" ref-type="bibr">42</xref>,<xref rid="b68-ol-0-0-8613" ref-type="bibr">68</xref>). It is then important to confirm whether these shared mechanisms are universal. Furthermore, in terms of the diverse types of diseases associated with MALAT1, research fields should be expanded to its associated functions in addition to cancer. Finally, there is no doubt that the application of MALAT1 was diverse. During the development of MALAT1-based cancer diagnosis and treatment, with the expectation of its advantages as a diagnostic biomarker, predictive biomarker or therapeutic targets in specific tumors, its effect on drug action is also a good study direction on its clinical application.</p>
</sec>
</body>
<back>
<ack>
<title>Acknowledgements</title>
<p>The authors would like to thank Xueqing Hu for writing assistance.</p>
</ack>
<sec>
<title>Funding</title>
<p>The National Natural Science Foundation of China (grant no. 81520108031) supported this review.</p>
</sec>
<sec>
<title>Availability of data and materials</title>
<p>The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.</p>
</sec>
<sec>
<title>Authors&#x0027; contributions</title>
<p>SW made substantial contributions to design. QJ and QL were involved in drafting the manuscript or revising it critically for important intellectual content, XL and PG were involved in acquiring, and analyzing related articles and data. MZ was a major contributor in writing the manuscript. All authors read and approved the final manuscript.</p>
</sec>
<sec>
<title>Ethics approval and consent to participate</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Consent for publication</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Competing interests</title>
<p>The authors declare no conflict of interests.</p>
</sec>
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<floats-group>
<fig id="f1-ol-0-0-8613" position="float">
<label>Figure 1.</label>
<caption><p>Literature about MALAT1. Articles were searched on PubMed, limited to &#x2018;between 2003 and December 2014&#x2019;.</p></caption>
<graphic xlink:href="ol-16-01-0019-g00.tif"/>
</fig>
<fig id="f2-ol-0-0-8613" position="float">
<label>Figure 2.</label>
<caption><p>Genes, proteins or miRNAs associated with MALAT1. The upstream regulators during the transcriptional and posttranscriptional procession and the downstream genes modulated by MALAT1 are exhibited. In addition, reciprocal interaction and other associations between MALAT1 and other genes, proteins or miRNAs are shown. MALAT1, metastasis-associated lung adenocarcinoma transcript 1; SOX17, sex-determining region-Y-box 17; SRSF1, serine/arginine-rich splicing factor 1; YAP, yes-associated protein 1; Bcl-2, B-cell lymphoma-2; miR/miRNA, microRNA; ABCA1, ATP-binding cassette transporter member 1; ROBO1, roundabout guidance receptor 1; GPC6, glupican 6; CDCP1, CUB domain-containing protein 1; LPHN2, latrophilin-2, a cell-adhesion G protein-coupled receptor and presumptive &#x03B1;-latrotoxin receptor; MIA2, melanoma inhibitory activity 2; LTBP3, latent transforming growth factor &#x03B2;-binding protein 3; PTBP2, polypyrimidine tract binding protein 2; SFPQ, splicing factor proline-glutamine rich; suz12, suz12 polycomb repressive complex 2 subunit; Ezh2, enhancer of zeste homolog 2; Bax, Bcl-2-associated X protein; Bcl-xl, B-cell lymphoma-extra-large; TDP43, TAR DNA-binding protein 43; lncRNA, long non-coding RNA; AKAP-9, A-kinase anchor protein-9.</p></caption>
<graphic xlink:href="ol-16-01-0019-g01.tif"/>
</fig>
<table-wrap id="tI-ol-0-0-8613" position="float">
<label>Table I.</label>
<caption><p>Research advances of MALAT1 in cancers.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Cancers</th>
<th align="center" valign="bottom">Function of MALAT1</th>
<th align="center" valign="bottom">(Refs.)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">NSCLC</td>
<td align="left" valign="top">Associated with metastasis and survival</td>
<td align="center" valign="top">(<xref rid="b4-ol-0-0-8613" ref-type="bibr">4</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">A prognostic parameter for stage I and stage II NSCLC</td>
<td align="center" valign="top">(<xref rid="b4-ol-0-0-8613" ref-type="bibr">4</xref>,<xref rid="b16-ol-0-0-8613" ref-type="bibr">16</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Contributes to brain metastasis</td>
<td align="center" valign="top">(<xref rid="b24-ol-0-0-8613" ref-type="bibr">24</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Esophageal Squamous cell carcinoma</td>
<td align="left" valign="top">Promotes tumor proliferation and metastasis</td>
<td align="center" valign="top">(<xref rid="b25-ol-0-0-8613" ref-type="bibr">25</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Gastric cancer</td>
<td align="left" valign="top">Promotes the development and peritoneal metastasis of cancer</td>
<td align="center" valign="top">(<xref rid="b26-ol-0-0-8613" ref-type="bibr">26</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Promotes cell proliferation</td>
<td align="center" valign="top">(<xref rid="b35-ol-0-0-8613" ref-type="bibr">35</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">CRC</td>
<td align="left" valign="top">A negative prognostic factor to patients with stage II/III CRC</td>
<td align="center" valign="top">(<xref rid="b27-ol-0-0-8613" ref-type="bibr">27</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Hepatocellular carcinoma</td>
<td align="left" valign="top">Predicts a significantly increased risk of tumor recurrence following liver transplantation</td>
<td align="center" valign="top">(<xref rid="b28-ol-0-0-8613" ref-type="bibr">28</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Modulating cell proliferation</td>
<td align="center" valign="top">(<xref rid="b59-ol-0-0-8613" ref-type="bibr">59</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Pancreatic cancer</td>
<td align="left" valign="top">Unfavorable predictor for its clinical progression and prognosis</td>
<td align="center" valign="top">(<xref rid="b29-ol-0-0-8613" ref-type="bibr">29</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Promotes cell growth, migration and invasion</td>
<td align="center" valign="top">(<xref rid="b30-ol-0-0-8613" ref-type="bibr">30</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Promotes the stem cell-like phenotypes in cancer cells</td>
<td align="center" valign="top">(<xref rid="b70-ol-0-0-8613" ref-type="bibr">70</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Clear cell renal carcinoma</td>
<td align="left" valign="top">Associated with proliferation, migration and invasion, indicates tumor progression and poor prognosis</td>
<td align="center" valign="top">(<xref rid="b31-ol-0-0-8613" ref-type="bibr">31</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Bladder cancer</td>
<td align="left" valign="top">Promotes cell migration with the EMT</td>
<td align="center" valign="top">(<xref rid="b32-ol-0-0-8613" ref-type="bibr">32</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Mediates the TGF&#x03B2;-induced EMT and promotes tumor metastasis</td>
<td align="center" valign="top">(<xref rid="b75-ol-0-0-8613" ref-type="bibr">75</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Urothelial carcinoma of the bladder</td>
<td align="left" valign="top">Associated with proliferation, apoptosis and motility</td>
<td align="center" valign="top">(<xref rid="b33-ol-0-0-8613" ref-type="bibr">33</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Castration-resistant prostate cancer</td>
<td align="left" valign="top">Maintains tumorigenicity</td>
<td align="center" valign="top">(<xref rid="b34-ol-0-0-8613" ref-type="bibr">34</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Involved in RNA processing and resulting in incomplete splicing</td>
<td align="center" valign="top">(<xref rid="b35-ol-0-0-8613" ref-type="bibr">35</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Breast cancer</td>
<td align="left" valign="top">Involved in the inhibitory effect of 17&#x03B2;-Estradiol treatment on breast tumor cell proliferation, migration and invasion</td>
<td align="center" valign="top">(<xref rid="b36-ol-0-0-8613" ref-type="bibr">36</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Regulated EMT</td>
<td align="center" valign="top">(<xref rid="b68-ol-0-0-8613" ref-type="bibr">68</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Cervical cancer</td>
<td align="left" valign="top">Associated with the positive of human papilloma virus in cervical squamous cells</td>
<td align="center" valign="top">(<xref rid="b37-ol-0-0-8613" ref-type="bibr">37</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Effected cervical cancer cell proliferation and invasion</td>
<td align="center" valign="top">(<xref rid="b38-ol-0-0-8613" ref-type="bibr">38</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Adrenocortical cancer</td>
<td align="left" valign="top">The second most upregulated lncRNA</td>
<td align="center" valign="top">(<xref rid="b39-ol-0-0-8613" ref-type="bibr">39</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Multiple myeloma</td>
<td align="left" valign="top">Predicts early progression</td>
<td align="center" valign="top">(<xref rid="b40-ol-0-0-8613" ref-type="bibr">40</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Melanoma</td>
<td align="left" valign="top">Associated with the metastasis</td>
<td align="center" valign="top">(<xref rid="b41-ol-0-0-8613" ref-type="bibr">41</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Osteosarcoma</td>
<td align="left" valign="top">Promotes tumor proliferation and metastasis</td>
<td align="center" valign="top">(<xref rid="b42-ol-0-0-8613" ref-type="bibr">42</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Involved in drug action in high-grade osteosarcoma</td>
<td align="center" valign="top">(<xref rid="b51-ol-0-0-8613" ref-type="bibr">51</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Neuroblastoma</td>
<td align="left" valign="top">Involved in neuroblastoma cells migration and invasion</td>
<td align="center" valign="top">(<xref rid="b48-ol-0-0-8613" ref-type="bibr">48</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Glioblastoma</td>
<td align="left" valign="top">Affects the migration of glioblastoma cells</td>
<td align="center" valign="top">(<xref rid="b81-ol-0-0-8613" ref-type="bibr">81</xref>)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1-ol-0-0-8613"><p>MALAT1, metastasis-associated lung adenocarcinoma transcript 1; EMT, epithelial-mesenchymal transition; lncRNA, long non-coding RNA; TGF&#x03B2;, transforming growth factor &#x03B2;; CRC, colorectal cancer; NSCLC, non-small cell lung cancer.</p></fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</article>
