Background
ACSL4 has been reported to be related to tumor genesis and involved in the processes of ferroptosis. However, the expression levels and prognostic value of ACSL4 in clear cell renal cell carcinoma (ccRCC) remain unclear.
Methods
The Oncomine and TCGA databases were used to predict the expression of ACSL4 mRNA in ccRCC and its association with ccRCC prognosis. The expression levels of ACSL4 were determined in human RCC tissues by real-time PCR. Kaplan-Meier curves were used to analyze the diagnostic and prognostic significance of ACSL4 in ccRCC. A ferroptosis inducer (erastin) was used to investigate the effects of ACSL4 on ferroptosis in ccRCC cell lines.
Results
The expression level of ACSL4 was significantly down-regulated in ccRCC tissues (P < 0.001), which was consistent with the analysis of the Oncomine and TCGA database. Then, immunohistochemical results demonstrated that the ACSL4 was weak or not detected in ccRCC tissues than that in normal tissues. ACSL4 differential expression level was significantly related to gender, ccRCC subtypes, nodal invasion, tumor grade and cancer stages (all P < 0.001). Survival analysis revealed that overall survival was favorable in ccRCC patients with ACSL4 high expression (P = 0.014). Overexpression of ACSL4 by gene transfection restores ferroptosis sensitization in cancer cells, whereas suppression of ACSL4 expression by RNAi increases ferroptosis resistance. Mechanically, protein ubiquitination may be involved in ACSL4-mediated ferroptosis.
Conclusions
As a monitor and contributor of ferroptosis, ACSL4 was decreased in ccRCC and served as a useful diagnostic and prognostic biomarker, which will be a new potential therapeutic target for ccRCC.