Lactate, an end-product of intracellular glycolysis, has evolved from being a metabolic waste product to a molecule with recognized significance in both physiological and pathological processes, particularly in the context of cancer. This paradigm shift was sparked by the discovery of the Warburg effect, which highlights the aberrant reliance of tumor cells on aerobic glycolysis for energy production, leading to excessive lactate accumulation[21]. Lactate has since been implicated in two core characteristics of cancer: immune evasion and metabolic reprogramming[22]. Recent studies have exhibited that lactate can mediate protein modification, regulate genes expression in macrophages, somatic cells, and cancer cells by lysine lactylation[23]. As one of the most ubiquitous types of posttranscriptional modification, m6A is reported to involve in the development and progression of numerous diseases, including cancer. However, the interplay between m6A and lactylation remains unexplored. To our knowledge, this investigation represents the first attempt to examine the relationship between m6A-lactylation-related genes and prognosis in HCC patients. Our findings may provide novel insights into the role of these modifications in HCC progression.
In our study, we identified the prognostic lactylation-m6A related genes and HCC patients in TCGA data cohort were divided into two cluster. Patients in cluster-1 had a poor prognosis than these in cluster-2. The immune cells infiltration was different between two cluster. Subsequently, employing LASSO regression, a prognostic model was formulated and patients were stratified into high- and low-risk categories. Through univariate and multivariate Cox regression analyses, this model encompassing 7 risk-associated genes was established as an independent prognostic determinant. The K-M survival analysis revealed significantly inferior survival among high-risk patients relative to their low-risk counterparts. Similar findings were replicated in the ICGC dataset. Notably, accumulating evidence underscores the predictive relevance of TMB, not only in the context of immunotherapy, but also when combined with chemotherapy[24, 25]. In our research, we found that patients who had the high-TMB combined with a high-risk score had a poorer prognosis. GSEA analysis was used to explore the different pathways with enrichment in high- and low-risk groups. High-risk group were highly correlated with DNA replication, ECM receptor interaction, intestinal immune network, and low-risk group was highly enrichment in drug metabolism, fatty acid metabolism and other metabolic processes. Furthermore, we found that there was a higher immune score, lower stromal score, and higher expression of coinhibitory molecules in high-risk group compared with low-risk group. The drug response in high and low-risk group also showed significant difference which indicated the risk score may successfully predict the patients' response to treatment with certain drugs.
We further investigated the protein expression of risk genes (G6PD, PRKDC, HDAC1, CCT5, KIF2C, TCOF1 and PPM1G) in HAP database. Consistent with the expression of RNA level, the protein expression of TCOF1, HDAC1 and PRKDC was upregulated in HCC tissue than normal tissue. While, the protein of G6PD, CCT5, KIF2 and PPM1G were very low or no detected in in HPA database which probably be due to post-translation modification or degradation of protein. K-M survival analysis showed the high expression of TCOF1 and HDAC1 was correlated with a shorter survival time, but PRKDC had no influence for patients' survival. TCOF1 is generally regarded as a nucleolar factor that collaborates with upstream binding factor (UBF) to regulate ribosomal DNA (rDNA) transcription in eukaryotes[26]. It has been established that TCOF1 exerts a significant influence on both neural crest development and the biosynthesis of ribosomes[27, 28]. However, recent studies have found that TCOF1 probably appears to be antitumorigenic or protumorigenic depending on the tumor type and conditions. One research reported that TCOF1 downregulation was observed in human T-cell acute lymphoblastic leukemia (T-ALL) cells and TCOF1 haploinsufficiency promoted an increased incidence of T-ALL in mice[29]. Conversely, upregulation of TCOF1 is observed in triple-negative breast cancer (TNBC)[30], HCC[31, 32] and correlates with a poor prognosis. Mechanically, TCOF1 regulates KRAS-activated genes, epithelial‐mesenchymal transition (EMT) genes, and promotes the expression ribosomal RNA (rRNA) production which is a hallmark of cancer[32]. Histone deacetylase 1 (HDAC1) is one of the classes Ⅰ HDACs, and impacts whole animal physiology and health by not only directly regulating transcription via deacetylation of histones but also enzyme through activity direct deacetylation[33]. In T cell-mediated immune diseases, HDAC1 acted as the key regulator to acute and chronic adaptation to environment stimuli such as allergen, stress[34, 35]. However, the regulatory function of HDAC1 on inflammatory signaling is paradoxical, as it can either stimulate or inhibit such responses, contingent upon the specific contextual cues or extracellular stimuli encountered[33]. Similarity, HDAC1 also have complex role in regulating cell proliferation, such as an acceleration for cancer cells[36] and an anti-proliferative effect for endothelial cells. HDAC1 was identified as the critical direct m6A target in bipotent progenitor[37]. Overexpression of HDAC1 was supposed to be associated with tumor progression and metastasis[38, 39]. HDAC1 was also involved in drug resistance by regulating the genes expression[40]. Several HDAC inhibitors have exhibited promising results in the treatment for multiple carcinoma[41]. In our study, we identified that TCOF1 and HDAC1 were the key prognostic genes for HCC patients and more research is needed to further reveal the role of these two genes in HCC progression.
However, there is still some limitations in our study. The first limitation is that protein lactylation is a novel field, more and more lactylation-related genes will be discovered in the future. Secondly, our reliance on predominantly retrospective data sourced from public repositories necessitates the need for further corroboration through fundamental experimental validations. Thirdly, our work lacks a comprehensive elucidating of the precise molecular mechanisms controlling the critical roles of key genes in HCC progression. Finally, the complex interaction between HCC cells and the immune microenvironment in the context of lactation-M6A modification remains an area for further study.
In summary, our research might provide a novel perspective for forecasting the prognosis of HCC patients and uncovered the relationship between lactylation-related genes and HCC. Our results provided great potential for advancing research of lactylation and m6A in HCC.