Human tissue samples
In total, 46 normal cervical epithelium tissues, 41 high-grade squamous intraepithelial lesions (HSILs), and 75 cervical cancer tissues were collected for qRT-PCR assays. Cervical cancer samples were obtained from patients who underwent radical hysterectomy, HSIL samples were obtained from patients who underwent colposcopy biopsy, and normal cervical tissues were collected from patients who underwent hysterectomy because of benign gynecological diseases. All the samples were collected from September 2015 to September 2020 at Women’s Hospital, Zhejiang University School of Medicine, China. Patients provided informed consent to obtain samples, and the study was subject to approval by the Hospital Ethical Committee. Patient information for all specimens is shown in Additional file 1: Table S1. Tissue samples were stored in RNA storage solution at 4°C and stored at -80°C until use.
Identification of HPV type
The HPV type of tissue samples was identified using the 21 HPV GenoArray Diagnostic Kit (Innovation Technologies of Hybribio). With the use of PCR principles to amplify extracted HPV DNA from cervical samples, amplified DNA amplicons were then hybridized with immobilized specific HPV probes on a HybriMem membrane under the patented flow-through hybridization technique. The enzyme immunoassay method was applied for color development to obtain test results. HPV-negative specimens used for RNA sequencing were amplified with the common primer my09/11 PCR of HPV L1 to further determine the HPV-negative status.
RNA extraction and qRT-PCR
RNA was extracted using TRIzol reagent (Invitrogen, Carlsbad, CA, USA) according to the manufacturer's instructions. For tissue samples used to validate circRNA expression, the RNA integrity number (RIN) was assessed. qRT-PCR analyses were performed using the PrimeScript RT Reagent Kit and SYBR Premix Ex Taq (TaKaRa, Japan). All the primers are presented in Additional file 2: Table S2.
Cell line culture
The human cervical cancer cell line SiHa and the human embryonic renal cell line HEK293 were obtained from the American Type Culture Collection (ATCC, USA). The human cervical cancer CaSki cell line was obtained from the Cell Resource Center, Shanghai Institute of Life Sciences, Chinese Academy of Sciences (China), where it was tested and authenticated. It was not cultured continuously for more than 3 months. The SiHa cell line was cultured in DMEM (BI, Israel) supplemented with 10% FBS and maintained at 37°C in 5% CO2, whereas the cervical cancer cell line CaSki and the human embryonic renal cell line HEK293 were cultured in RPMI-1640 (BI, Israel) containing 10% FBS.
RNA-fluorescence in situ hybridization (FISH) assay
CY3-labeled probes targeting the junction point sequence were used to visualize circCDKN2B-AS1 in situ (details of the probes are shown in Additional file 2: Table S2). SiHa and CaSki cells were plated onto slides and incubated overnight. Triton X-100 (0.5%) was added after washing the slides with PBS 3 times and then incubated at room temperature for 15 min. Then, the cells were fixed with 4% paraformaldehyde for 5 min and incubated with 100% ethanol. After discarding ethanol, the denatured probe was added to immerse the slides. Then, the slides were incubated at 37°C overnight. Nuclei were counterstained with DAPI-antifade solution, and images were taken on a laser confocal microscope (TCS SP2 AOBS).
RNaseR resistance assay
RNA samples were incubated with or without 2 U/µg RNaseR at 37°C for 15 min.
Northern blot assay
The probe targeting the junction point of circCDKN2B-AS1 was synthesized and labeled with digoxigenin (DIG, details of probes are shown in Additional file 2: Table S2). Fifteen micrograms of total RNA was separated by 1% denaturing formaldehyde gel electrophoresis at 25 V overnight and transferred to Hybond-N + membranes (Amersham, UK, RPN303B). Prehybridization was carried out at 50°C for 2 h in DIG Easy Hyb solution (Roche). Hybridization was performed at 50°C overnight. The membrane was washed stringently and blocked in blocking solution for 1 h. Blots were detected by anti-DIG antibody staining and recorded using X-ray films with the chemiluminescence substrate CSPD (Roche).
Western blot assay
Cellular proteins were extracted using lysis buffer. In total, 20 µg of total protein was separated using 10% SurePAGE (GenScript, USA, M00665) and transferred to PVDF membranes (Bio-Rad, USA, 1620177). The antibodies used were as follows: IMP3 (EMD Millipore), HK2 (Abcam), GAPDH (Diagbio) E-cadherin (CST) and β-Catenin (CST).
Gene knockdown and overexpression
The human circCDKN2B-AS1 linear sequence was inserted into the plasmid vector pLent-EF1a-circRNA-CMV-RFP-P2A-Puro, and lentiviruses stably overexpressing circCDKN2B-AS1 were constructed (Weizhen, Shandong, China). A nonfluorescent circCDKN2B-AS1 overexpression plasmid was constructed for apoptosis detection using the plasmid vector (Weizhen, Shandong, China). The full-length products and the junction point of the circCDKN2B-AS1-overexpressing products were determined by Sanger sequencing after RT-PCR. Short hairpin RNAs (shRNAs) specific to circCDKN2B-AS1 were inserted into the lentiviral vector GV334 (GeneChem, Shanghai, China). Stable cell lines were obtained by puromycin resistance. The human HK2 overexpression plasmid was purchased from GeneChem. All of the small interfering RNA (siRNA) and primer sequences used in this study are presented in Additional file 2: Table S2.
Cell viability, migration, invasion and apoptosis assays
In vitro cell viability was detected using Cell Counting Kit-8 assays (Dojindo, Japan). Transwell assays were performed at 48 h after transfection: 1 x 104 cells were resuspended in serum-free Opti-MEM medium, and cell invasion/migration was examined in Transwell cell culture chamber filters coated on the upper side with/without Matrigel (Corning Biocoat) as previously described [34].The wound healing assays we performed by using culture insert(ibidi, Germany, 80206) according to the instructions of the manufacturer. The apoptotic rates of SiHa and CaSki cells were determined at 72 h after transfection using an Annexin V-FITC/PI Apoptosis Kit (Mutisiences, China, AP101-100-kit). For cells transfected with circCDKN2B-AS1-overexpressing or empty plasmids, apoptosis was induced by incubation with serum-free medium for 6 h.
Extracellular acidification rate (ECAR)
Assays were performed using a Seahorse XFe96 analyzer (Seahorse Bioscience, Agilent) according to the manufacturer’s instructions. The ECAR was measured using a Seahorse XF Glycolytic Rate Assay Kit (Seahorse Bioscience, Agilent, 103044-100) and a Seahorse XF Glycolysis Stress Test Kit (Seahorse Bioscience, Agilent, 103020-100). The glycolytic capacities of cells were analyzed with the Seahorse XF Glycolysis Rate/Stress Test Report Generator package. The %PER from glycolysis was calculated by subtracting the acidification from CO2 produced by the mitochondria.
Inhibition of glycolysis in cells
We inhibited the glycolysis level of cervical cancer cells in vitro by adding 2-DG (5mM, Seahorse Bioscience, Agilent,103044-100).
Biotin-labeled RNA pull-down assay and mass spectrometry analysis
Biotin-labeled RNA pull-down assays were performed using a Pierce™ Magnetic RNA-Protein Pull-down Kit (Thermo Scientific, USA, 20164). Briefly, cell lysates were prepared using standard lysis buffers (Thermo Scientific, USA). Biotin-labeled DNA probes (details of probes are shown in Additional file 2: Table S2) were incubated with streptavidin magnetic beads for 30 minutes at room temperature with agitation. Cell lysates were incubated with streptavidin magnetic beads at 4°C overnight. Magnetic beads were thoroughly washed. The proteins bound to the magnetic bead were separated with SurePAGE (GenScript, USA, M00665), and the region of interest was excised and subjected to mass spectrometry analysis (Lumingbio, Shanghai, China).
RNA immunoprecipitation (RIP) assay
RIP assays were performed with a Magna RIP™ Quad RNA-Binding Protein Immunoprecipitation Kit (Sigma-Aldrich, USA, 17-704) according to the instructions of the manufacturer.
Determination of mRNA half-life
To assess the half-life of HK2 mRNA, actinomycin-D (5 µg/ml, Sigma, A4262) was added to block mRNA synthesis. Total RNA was collected at different time points and subjected to RT-qPCR analysis. The expression level of HK2 mRNA was normalized to that of 18S rRNA and plotted as a percentage of the value at time 0 (set at 100%).
Design and synthesis of inhibitory peptides
The inhibitory peptides for blocking the interaction between circCDKN2B-AS1 and IMP3 were designed and synthesized by ChinaPeptides Co. Ltd. (Shanghai, China). The inhibitory peptides were synthesized by linking the biotin-labeled 11-amino acid cell-penetrating peptide YGRKKRRQRRR of the Tat protein transduction domain with the core amino acids of IMP3 at the N-terminus (purity greater than 95%).
Biotin peptide pull-down assay
Biotin-labeled peptides were incubated with streptavidin magnetic beads (Thermo Scientific, USA, 88817) for 4 h at 4°C. Then, the bead-peptide complex was incubated with total RNA at 4°C overnight. Beads were extensively washed, and RNAs that precipitated were measured by qRT-PCR.
Nude mice xenograft experiments
This study was conducted in full accordance with the ARRIVE guidelines for reporting animal research [35]. All animal experiments were approved by the Animal Ethical and Welfare Committee of Zhejiang Chinese Medical University under an Affidavit of Approval of Animal Ethical and Welfare license (No. IACUC-20190128-01) and in accordance with the Animals (Scientific Procedures) Act, 1986 (UK) (amended 2013). BALB/c nude mice (4 weeks old±1week, weighing 18±5 grams, female) were ordered from Shanghai SLAC Laboratory Animal Company, Ltd. (China). Nude mice were randomly divided into two groups and anesthetized by inhalation of isoflurane gas (2-3%) also under the effect of muscle relaxation. In total, 107 stable SiHa cells were resuspended in 100 μL PBS and injected subcutaneously under the left armpit of 4-week-old nude mice (n = 10 per group). The length and width of the subcutaneous tumor were measured once a week for 5 weeks, and the volume of the subcutaneous tumor was calculated according to the following formula: volume (cm3) = (length×width2)/2. Five weeks after injection, 6 mice in each group were randomly selected and sacrificed by intravenous injection of pentobarbital (100 mg/kg), and subcutaneous tumors were harvested. A portion of the tumor was stored in RNA storage solution to extract RNA, and the remainder of the tumor was fixed with paraformaldehyde for immunohistochemistry and hematoxylin and eosin (HE) staining. The other 4 mice in each group were subjected to microPET/CT scans. Another 20 nude mice (4 weeks old) were randomly divided into 4 groups (n=5 per group) and injected subcutaneously under the left armpit with 107 stable SiHa cells. siRNAs targeting a negative control (NC) or HK2 were mixed with FECT and Opti-MEM medium and injected into the subcutaneous tumor every week. The volume of the subcutaneous tumor was calculated according to the following formula: volume (cm3) = (length×width2)/2. Four weeks after the injection of cells, mice were sacrificed, and subcutaneous tumors were harvested, weighed, and stored at -80°C for RNA extraction, lactic acid (LA)/pyruvic acid (PA) detection and RIP assays.
MicroPET/CT scans in nude mice
MicroPET/CT imaging of nude mice was performed using the SuperArgus PET/CT 4R system (Sedecal, Spain) five weeks after cell injection. Briefly, 4 tumor-bearing nude mice in each group were anesthetized by inhalation of isoflurane gas (2-3%). Then, nude mice were injected with 7.4 MBq (200 μCi) of 18F-FDG via the abdominal cavity and scanned at 120 min after injection. Nude mice were subjected to a 10-min microCT scan and then to a 15-min microPET scan. Scans were performed under isoflurane (1-1.5%) inhalation to maintain anesthesia. Images of nude mice were reconstructed manually. The PET/CT camera Vista explore was used to calculate the average standardized uptake volume (SUVAVG). Then, the mice were sacrificed by intravenous injection of pentobarbital (100 mg/kg).
Digestion of subcutaneous tumors
Subcutaneous tumors were digested with 10 mg type 1 collagenase (Worthington, 49E19342, USA) at 37°C for 60 minutes. The digestion products were centrifuged at 1200 r for 5 minutes, and the precipitate was subjected further to RIP assays and RNA extraction.
Detection of LA and PA
The levels of LA and PA in 10 mg subcutaneous tumors from each mouse were detected by using an LA detection kit (Solarbio, China, BC2230) and a PA detection kit (Solarbio, China, BC2200).
Zebrafish embryo model
Zebrafish (AB, wild type [WT], 48-h embryo) embryos were obtained from the Core Facilities, Zhejiang University, School of Medicine, cultured in Petri dishes with an appropriate amount of water and placed in a 28°C incubator under constant temperature and light. Then, 0.003% 1-phenyl-2-thiourea (PTU) (Sigma) was added within 24 h after the embryo was produced. In total, 200 SiHa cells were harvested after transfection and resuspended in PBS. Plasma membranes were stained with red-fluorescent Alexa Fluor® 594 wheat germ agglutinin of the Image-iT™ LIVE Plasma Membrane and Nuclear Labeling Kit (Molecular Probes, USA, I34406). Zebrafish embryos were anesthetized with 0.016% tricaine (Sigma). Then, the cells were injected into the yolk sac of zebrafish embryos. Then, we obtained images with a fluorescence microscope at 48 h after injection. The area of red fluorescence in the zebrafish yolk sac was calculated using ImageJ software [33]. Next, the zebrafish embryos were anesthetized with an overdose of tricaine.
Immunohistochemical staining
Immunohistochemical staining with an antibody specific to HK2 (Proteintech, USA) and quantitative evaluation were performed as previously described [36].
Statistical analysis
Statistical significance was calculated by using GraphPad Prism 5 software. All experiments were repeated at least three times.