Yanyan Chen: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Tao Wang: Department of Gastroenterology, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, P.R. China. ORCID
Mengxi Huang: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Qin Liu: Department of Gastroenterology, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, P.R. China.
Chao Hu: Department of Orthopedics, 904 Hospital of PLA, North Xingyuan Road, Beitang District, Wuxi, Jiangsu, P.R. China.
Bin Wang: Department of Gastroenterology, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, P.R. China. ORCID
Dong Han: Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Southern Medical University, Nanjing, Jiangsu Province, P.R. China.
Cheng Chen: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Junliang Zhang: Department of Orthopedics, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Zhiping Li: Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Southern Medical University, Nanjing, Jiangsu Province, P.R. China.
Chao Liu: Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China.
Wenbin Lei: Department of Orthopedics, Tianshui Cooperation of Chinese and Western Medicine Hospital, Tianshui, Gansu Province, P.R. China.
Yue Chang: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Meijuan Wu: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Dan Xiang: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Yitian Chen: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Rui Wang: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China. ORCID
Weiqian Huang: Department of Orthopedics, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China.
Zengjie Lei: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China. leizengjie@163.com chuxiaoyuan000@163.com.
Xiaoyuan Chu: Department of Medical Oncology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, P.R. China. leizengjie@163.com chuxiaoyuan000@163.com.
Despite the fact that osteosarcoma is one of the most common primary bone malignancies with poor prognosis, the mechanism behind the pathogenesis of osteosarcoma is only partially known. Here we characterized differentially expressed genes by extensive analysis of several publicly available gene expression profile datasets and identified musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB) as a key transcriptional regulator in osteosarcoma progression. MAFB was highly expressed in tumor tissues and required for proliferation and tumorigenicity of osteosarcoma cells. MAFB expression was elevated in osteosarcoma stem cells to maintain their self-renewal potential and through upregulation of stem cell regulator Sox9 at the transcriptional level. Sox9 in turn activated MAFB expression via direct recognition of its sequence binding enrichment motif on the MAFB locus, thereby forming a positive feedback regulatory loop. Sox9-mediated feedback activation of MAFB was pivotal to tumorsphere-forming and tumor-initiating capacities of osteosarcoma stem cells. Moreover, expression of MAFB and Sox9 was highly correlated in osteosarcoma and associated with disease progression. Combined detection of both MAFB and Sox9 represented a promising prognostic biomarker that stratified a subset of patients with osteosarcoma with shortest overall survival. Taken together, these findings reveal a MAFB-Sox9 reciprocal regulatory axis driving cancer stemness and malignancy in osteosarcoma and identify novel molecular targets that might be therapeutically applicable in clinical settings. SIGNIFICANCE: Transcription factors MAFB and Sox9 form a positive feedback loop to maintain cell stemness and tumor growth and , revealing a potential target pathway for therapeutic intervention in osteosarcoma.