LncRNA SOX2‐OT regulates AKT/ERK and SOX2/GLI‐1 expression, hinders therapy, and worsens clinical prognosis in malignant lung diseases

The involvement of LncRNA SOX2‐overlapping transcript (SOX2‐OT), SOX2, and GLI‐1 transcription factors in cancer has been well documented. Nonetheless, it is still unknown whether co‐expressed SOX2‐OT/SOX2 or SOX2‐OT/SOX2/GLI‐1 axes are epigenetically/transcriptionally involved in terms of resistance to oncology therapy and in poorer clinical outcomes for patients with lung cancer. We evaluated the role of SOX2‐OT/SOX2 and SOX2‐OT/SOX2/GLI‐1 axes using RT‐qPCR, western blot, immunofluorescence analyses, gene silencing, cellular cytotoxic, and ChIP‐qPCR assays on human cell lines, solid lung malignant tumors, and normal lung tissue. We detected that the SOX2‐OT/SOX2/GLI‐1 axis promotes resistance to tyrosine kinase inhibitor (TKI)‐erlotinib and cisplatin‐based therapy. Evidence from this study show that SOX2‐OT modulates the expression/activation of EGFR‐pathway members AKT/ERK. Further, both SOX2‐OT and GLI‐1 genes are epigenetically regulated at their promoter sequences, in an LncRNA SOX2‐OT‐dependent manner, mainly through modifying the enrichment of the activation histone mark H3K4me3/H3K27Ac, versus the repressive histone mark H3K9me3/H3K27me3. In addition, we identified that inhibition of SOX2‐OT and reduced expression of SOX2/GLI‐1 sensitizes lung cancer cells to EGFR/TKI‐erlotinib or cisplatin‐based treatment. Finally, we show that high co‐expression of SOX2‐OT/SOX2 transcripts and SOX2/GLI‐1 proteins appears to correlate with a poor clinical prognosis and lung malignant phenotype. Collectively, these results present evidence that LncRNA SOX2‐OT modulates an orchestrated resistance mechanism, promoting poor prognosis and human lung malignancy through genetic, epigenetic, and post‐translational mechanisms.