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Paired related homeobox 1 transactivates dopamine D2 receptor to maintain propagation and tumorigenicity of glioma-initiating cells Free
Yamu Li1,†, Wen Wang1,†, Fangyu Wang1, Qiushuang Wu1, Wei Li1, Xiaoling Zhong1, Kuan Tian1, Tao Zeng2,3, Liang Gao2, Ying Liu1,4, Shu Li1,4, Xiaobing Jiang5, Guangwei Du6, and Yan Zhou1,*
1Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences at Wuhan University, Wuhan 430072, China
2Department of Neurosurgery, The Tenth Affiliated Hospital, Tongji University, Shanghai 200072, China
3Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
4Medical Research Institute, Wuhan University, Wuhan 430072, China
5Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
6Department of Integrative Biology and Pharmacology, University of Texas Health Science Center at Houston, Houston, TX 77225, USA
These authors contributed equally to this work. *Correspondence to:Yan Zhou, E-mail: yan.zhou@whu.edu.cn
J Mol Cell Biol, Volume 9, Issue 4, August 2017, 302-314,  https://doi.org/10.1093/jmcb/mjx017
Keyword: paired related homeobox 1, dopamine D2 receptor, glioma-initiating cells, glioblastoma

Glioblastoma multiforme (GBM) is a highly invasive brain tumor with limited therapeutic means and poor prognosis. Recent studies indicate that glioma-initiating cells/glioma stem cells (GICs/GSCs) may be responsible for tumor initiation, infiltration, and recurrence. GICs could aberrantly employ molecular machinery balancing self-renewal and differentiation of embryonic neural precursors. Here, we find that paired related homeobox 1 (PRRX1), a homeodomain transcription factor that was previously reported to control skeletal development, is expressed in cortical neural progenitors and is required for their self-renewal and proper differentiation. Further, PRRX1 is overrepresented in glioma samples and labels GICs. Glioma cells and GICs depleted with PRRX1 could not propagate in vitro or form tumors in the xenograft mouse model. The GIC self-renewal function regulated by PRRX1 is mediated by dopamine D2 receptor (DRD2). PRRX1 directly binds to the DRD2 promoter and transactivates its expression in GICs. Blockage of the DRD2 signaling hampers GIC self-renewal, whereas its overexpression restores the propagating and tumorigenic potential of PRRX1-depleted GICs. Finally, PRRX1 potentiates GICs via DRD2-mediated extracellular signal-related kinase (ERK) and AKT activation. Thus, our study suggests that therapeutic targeting the PRRX1−DRD2−ERK/AKT axis in GICs is a promising strategy for treating GBMs.