Epigenetic silencing of miRNA-143 regulates apoptosis by targeting BCL2 in human intervertebral disc degeneration

Epigenetic silencing of miRNA-143 regulates apoptosis by targeting BCL2 in human intervertebral disc degeneration

Accepted Manuscript Epigenetic silencing of miRNA-143 regulates apoptosis by targeting BCL2 in human intervertebral disc degeneration Kangcheng Zhao,...

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Accepted Manuscript Epigenetic silencing of miRNA-143 regulates apoptosis by targeting BCL2 in human intervertebral disc degeneration

Kangcheng Zhao, Yukun Zhang, Kang Liang, Yu Song, Kun Wang, Shuai Li, Xinghuo Wu, Wenbin Hua, Zengwu Shao, Shuhua Yang, Cao Yang PII: DOI: Reference:

S0378-1119(17)30565-6 doi: 10.1016/j.gene.2017.07.043 GENE 42067

To appear in:

Gene

Received date: Revised date: Accepted date:

9 December 2016 7 July 2017 13 July 2017

Please cite this article as: Kangcheng Zhao, Yukun Zhang, Kang Liang, Yu Song, Kun Wang, Shuai Li, Xinghuo Wu, Wenbin Hua, Zengwu Shao, Shuhua Yang, Cao Yang , Epigenetic silencing of miRNA-143 regulates apoptosis by targeting BCL2 in human intervertebral disc degeneration, Gene (2017), doi: 10.1016/j.gene.2017.07.043

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ACCEPTED MANUSCRIPT

Epigenetic silencing of miRNA-143 regulates apoptosis by targeting BCL2 in human intervertebral disc degeneration

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Kangcheng Zhao , Yukun Zhang1, Kang Liang, Yu Song, Kun Wang, Shuai Li, Xinghuo

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Wu, Wenbin Hua, Zengwu Shao, Shuhua Yang, Cao Yang*

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Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong

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University of Science and Technology, Wuhan, 430022, China

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These authors contributed equally to this work.

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* Corresponding author: Cao Yang

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Abstract Accumulating evidence indicates that microRNAs can regulate the apoptosis of various cells. Apoptosis of nucleus pulposus cells plays an important role in the progression of intervertebral disc degeneration. The aim of this study is to investigate whether

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microRNA-143 (miRNA-143) is involved in the progression of intervertebral disc

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degeneration. In this study, the expression of miRNA-143 and its biological modulatory

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effects were examined. Messenger RNA and protein expression of miRNA-143 and B-cell lymphoma-2 (BCL2) in both normal and degenerative disc tissues was determined by using

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RT-PCR and western-blot assays. After miRNA-143 transfection, BCL2 expression and NP

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cell apoptosis were assessed by using RT-PCR, western-blot, and flow cytometry. The relationship between miRNA-143 and BCL2 was assessed by bioinformatics and dual assays.

Epigenetic

regulation

of

miRNA-143

was

determined

by

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luciferase

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methylation-specific PCR and the effect of hypomethylation using 5-AZA. In this study, miRNA-143 expression significantly increased, while that of BCL2 decreased in degenerative

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disc specimens. In addition, CpG islands in the promoter region of miRNA-143 were

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hypomethylated in degenerative disc tissues. Furthermore, bioinformatics analysis and luciferase reporter assay indicated that BCL2 was a target gene of miRNA-143, and miRNA-143 suppressed BCL2 messenger RNA (mRNA) and protein expression. MiRNAmiRNA-143 overexpression enhances apoptosis of nucleus pulposus cells, while miRNA-143 inhibitor had the opposite effect. BCL2 knockdown reversed the effects of the miRNA-143 inhibitor on nucleus pulposus apoptosis. Our results suggest that miRNA-143 promotes the progression of nucleus pulposus apoptosis by directly targeting BCL2,

ACCEPTED MANUSCRIPT providing a potential therapeutic target for the treatment of intervertebral disc degeneration disease.

Keywords: Intervertebral disc degeneration; BCL2; miRNA-143; apoptosis; methylation;

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human nucleus pulposus

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1. Introduction Lower back pain (LBP) is one of the most common diseases, affecting the quality of life of patients and becoming a socioeconomic burden worldwide. The causes of LBP include aging, abnormal mechanical loading, trauma, and genetic predisposition. However, for many

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patients, the major cause of LBP is intervertebral disc degeneration (IVDD) (Chen et al., 2015;

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Le Maitre et al., 2015). IVDD is characterized by extracellular matrix degradation and

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decreased number of viable cells (Jiang et al., 2013; Vergroesen et al., 2015), which is mainly attributed to an imbalance of cell apoptosis. The intervertebral disc presents a complex

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structure with three sections: the nucleus pulposus (NP), end plate, and annulus fibrosus (AF).

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NP cells play a crucial role in maintaining the normal physiological function via the synthesis of extracellular matrix (ECM) components to resist mechanical loads (Wang et al., 2015a).

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The decrease of NP cells associated with apoptosis is considered as an initial trigger for

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IVDD (Ding et al., 2013; Ma et al., 2015). Apoptosis plays a crucial role in the pathological process of cell death (Wang et al., 2015a). Studies demonstrated that aberrant cell apoptosis is

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responsible for many degenerative diseases such as Alzheimer’s disease, osteoarthritis, IVDD,

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and cancer (Li et al., 2015a; Gupta et al., 2016; Yan et al., 2016). MicroRNAs (miRNAs) are small noncoding RNAs (17–25 nucleotides), which regulate gene expression, resulting in the inhibition of translation or degradation. They play important regulatory roles in multitudinous biological cellular processes such as differentiation, proliferation, and apoptosis (Bartel, 2004; Sayed and Abdellatif, 2011; Wang et al., 2015a; Liu et al., 2016). Recent studies demonstrated that miRNAs such as miRNA-494, miRNA-27a, miRNA-155, and miRNA-15b play important regulatory roles in the progression of IVDD

ACCEPTED MANUSCRIPT (Wang et al., 2011; Wang et al., 2015a; Wang et al., 2015b; Cai et al., 2017). MiRNA-143 is also broadly involved in cellular processes such as proliferation, invasion, apoptosis, and senescence (Zhang et al., 2013; Sekar et al., 2016). Aberrant miRNA-143 expression is observed in many tumors such as gastric, prostate, and colorectal cancer (Ji, 2010; Qian et al.,

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2013), indicating a potentially regulatory role in tumor progression. However, the expression

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and the role of miRNA-143 in degenerative disc NP cells are still unclear.

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BCL2 gene is located on chromosome 18, which was discovered as part of the t(14;18) chromosomal translocation in patients with follicular lymphoma and diffuse large B cell

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lymphoma (DLBCL). The protein encoded by BCL2 supports cell survival by blocking

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apoptosis rather than by increasing the cell division rate (Hardwick and Soane, 2013; de Araujo Junior et al., 2015). Data support that apoptosis is involved in pathological IVDD (Ma

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et al., 2015). Therefore, BCL2 overexpression in human NP may slow down the degeneration

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of IVD by preventing apoptosis of NP cells. DNA methylation is an important epigenetic process regulating the expression of target

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genes and usually results in gene silencing by inhibiting the binding of transcription factors or

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recruitment of methyl-binding proteins and the associated chromatin remodeling factors. The CpG islands distributed in the human genome play crucial roles in the methylation process. The gene silencing function of miRNA promoter CpG islands is a common mechanism during tumorigenesis (Pronina et al., 2016). Considering that the imbalance of cell apoptosis caused by dysfunction of miRNA expression is the common mechanism of tumorigenesis and disc degeneration, methylation may be an important regulatory mechanism. Considering the important roles of miRNAs and BCL2 in the pathogenesis of IVDD and

ACCEPTED MANUSCRIPT the putative BCL2 binding site for miRNA-143, we hypothesized that miRNA-143 might affect IVDD via BCL2. In addition, we investigated whether methylation, which is involved in various diseases and impacts on many miRNA promoters (Long et al., 2014; Li et al., 2015b), was involved in the association between miRNA-143 and NP cell apoptosis.

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Thus, this study aimed to identify whether miRNA-143 expression increased in

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degenerative disc tissues, and whether it targets BCL2 to induce apoptosis. Our study might

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provide insights useful for the development of novel therapies for clinical LBP treatment.

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2. Materials and Methods

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2.1 Ethics statement

The study was approved by the ethics committee of Tongji Medical College, Huazhong

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University of Science and Technology (HUST). All IVD specimens were obtained in

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accordance with the World Medical Association Declaration of Helsinki Ethical Principles for

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Medical Research Involving Human Subjects. All patients signed a written informed consent.

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2.1 Sample collection

All subjects were vertebral column spine surgery patients admitted to The Union Hospital Orthopaedic Hospital of HUST (Wuhan, China). The normal human IVD tissues were obtained from patients with idiopathic scoliosis classified as Pfirrmann grade I or II according to Magnetic Resonance Imaging (MRI) (n = 10; mean age, 22.3 ± 4.25; range, 17–40). The IVDD tissues were obtained from the LBP patients with disc degeneration classified as Pfirrmann grade IV according to MRI (n = 10; mean age, 25.8 ± 5.32, 25–58).

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2.3 Isolation and culture of human degenerative NP cells The human NP tissues were microscopically isolated from IVD tissues using a scalpel, under sterile conditions. These NP tissues were then washed with PBS twice and cut into 1

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mm3 fragments. These fragments were digested by 0.25% trypsin solution containing 1%

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ethylenediaminetetraacetic acid (EDTA) for 30 min and type II collagenase (Invitrogen,

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Carlsbad, CA, USA) for 3–4 hours at 37C. Tissue debris was removed by passing through a 200 m filter and then the NP cells were resuspended in DMEM/F12 containing 15% fetal

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bovine serum (FBS), 100 g/mL streptomycin, 100 U/mL penicillin, and 1%

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L-glutamine and incubated at 37C in an atmosphere containing 5% CO2. When at 80–90% confluence, cells were digested by 0.25% trypsin solution and subcultured in culture

2.4 Cell transfection

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flasks. The third passage of NP cells was used for all experiments.

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MiRNA-143 mimic, miRNA-143 mimic-scr, miRNA-143 inhibitor, miRNA-143

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inhibitor-scr, BCL2 siRNA, and BCL2 siRNA-scr were purchased from RiboBio (Guangzhou, China). MiRNA-143 mimic and miRNA-143 inhibitor were used to promote and inhibit miRNA-143 expression, respectively. BCL2 siRNA was used to inhibit BCL2 expression. They were transfected into NP cells using Lipofectamine 2000 (Invitrogen) according to the manufacturer’s instructions. After 48 hours, NP cells were harvested and used for further analyses.

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2.5 RNA extraction and quantitative real-time polymerase chain reaction (qRT-PCR) Total RNA was extracted from human NP tissues using TRIZOL reagent (Aidlab, Beijing China) according to the manufacturer’s instruction. The purity and concentration of RNA were measured by using an ultraviolet spectrophotometer (Shunyu, shanghai, China).

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qRT-PCR was conducted to quantify miRNA-143, BCL2, and caspase-3/9 expression using

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the 7500 real-time PCR instrument (Applied Biosystems, Foster City, CA, USA) in a final

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volume of 20 L. The primers used for qRT-PCR are listed in Table 1. All experiments were performed in triplicate. The quantitative miRNA data were normalized to U6 and mRNA

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expression of BCL2, caspase-3, and caspase-9 was normalized to that of -actin. The

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fold-change in gene expression relative to the control was calculated by the 2-△△Ct method.

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2.6 Western blot analysis

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NP specimens were randomly selected and protein concentrations were determined by using the BCA assay (Beyotime, Shanghai, China). Human NP cells were washed with PBS at

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4C (pH = 7.2–7.3) and lysed by using RIPA lysis Buffer (Beyotime) on ice. Protein

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concentration was measured as described above. Protein samples were separated on 10% sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and transferred to polyvinylidene fluoride (PVDF) membranes (Millipore, Billerica, MA, USA). Finally, membranes were treated with ECL reagent (ThermoFisher Scientific, Waltham, MA, USA) and visualized. GAPDH was used as an internal control. The experiment was repeated three times.

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2.7 miRNA-143 target prediction and 3-UTR luciferase reporter assay TargetScan (www.targetscan.org) was used to predict the target genes of miRNA-143. BCL2 contained a putative miRNA-143 binding site. BCL2 3-Untranslated Region (3-UTR) luciferase reporter was inserted into the 3-UTR region of pmir-Report construct (Promega,

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Madison, WI, USA). The BCL2 3-UTR luciferase reporter deleted for the miRNA-143 target

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site was created by PCR amplification of the BCL2 3-UTR luciferase reporter construct

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lacking the miRNA-143 bind target site. Normal NP cells (5  103) were co-transfected with luciferase reporter plasmid, internal control prl-tk-renilla-luciferase plasmid, and the indicated

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RNAs. After 48 hours, luciferase activity was measured by using the Dual-Luciferase

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Reporter Assay System (Promega) according to the manufacturer’s instructions. Firefly

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luciferase activity was normalized to Renilla luciferase activity.

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2.8 Methylation assay

We detected the methylation status of miRNA-143 promoter in degenerative and normal

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disc tissue extracts by using methylation-specific PCR (MSP) analysis. Genomic DNA was

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isolated from degenerative and normal disc tissues by using DNA extraction kit (Promega) according to the manufacturer’s instructions. The primer sequences used for MSP were as follows:

methylated,

forward:

ATTAGTTAGGTATGGTGGTGTACGT

and

reverse:

TTTAAAACAAAATCTCCCTCTATCG;

unmethylated,

forward:

ATTAGTTAGGTATGGTGGTGTATGT

and

reverse:

TTAAAACAAAATCTCCCTCTATCAC. The PCR products were electrophoresed on a 3% agarose gel.

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2.9 Flow cytometry Apoptosis was detected by using the Annexin V-APC apoptosis detection kit (BD Pharmingen, San Jose, CA, USA) according to the manufacturer’s instructions. Cells

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positively stained for annexin V-APC only and for both Annexin V-APC and PI represented

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apoptotic cells.

2.10 Statistical analysis

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Data are expressed as means ± standard deviation (SD). Statistical analysis was

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performed by using the SPSS 18.0 (SPSS, Chicago, IL, USA). Comparisons of differences between groups parameters were performed by using Student’s t-test or ANOVA. P values

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less than 0.05 were considered statistically significant.

3. Results

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3.1 Differential expression of miRNA-143 and BCL2 in degenerative disc tissues

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compared to that in normal disc tissues To determine the biological roles of miRNA-143 and BCL2 in human IVDD, we compared the expression of miRNA-143 and BCL2 mRNA in human normal and degenerative NPs by RT-PCR (Fig. 1A and B). MiRNA-143 expression was up-regulated, while that of BCL2 mRNA was down-regulated in degenerative disc tissues compared to those in normal disc tissues. MiRNA-143 and BCL2 expression negatively correlated (Fig. 1C). Furthermore, BCL2 protein expression was significantly decreased in degenerative disc

ACCEPTED MANUSCRIPT tissues compared to that in normal disc tissues (Fig. 1D and E). These results suggest that miRNA-143 and BCL2 are, at least in part, involved in human disc degeneration development.

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3.2 miRNA-143 modulates BCL2 expression and promotes NP cell apoptosis

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NP cells were transfected with scrambled control oligo or with miRNA-143 mimic,

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which presented high transfection efficiency (Fig. 2A). BCL2 expression was decreased in cells transfected with miRNA-143 mimics compared to control cells and cells treated with the

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inhibitor (Fig. 2B). Moreover, BCL2 protein expression was significantly decreased in the

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miRNA-143 mimic-transfected group compared to that in control and inhibitor groups (Fig. 2C and D). Furthermore, caspase-3 and caspase-9 expression increased in the miRNA-143

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mimic-transfected group. It has been reported that extracellular-signal-regulated kinase 5

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(ERK5) is a target of miRNA-143 (Akao et al., 2009). To investigate the effect of miRNA-143 in degenerative NP cells, we detected ERK5 expression. ERK5 protein

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expression was decreased in miRNA-143 mimic-transfected cells and increased in

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miRNA-143 inhibitor-transfected cells (Fig. 2E and F). To intuitively verify the regulatory relationship between miRNA-143 and NP cell apoptosis, we used flow cytometry (Fig. 2G and H). Apoptosis was significantly increased in the miRNA-143 mimic-transfected group compared to that in the control and inhibitor-transfected groups. These results demonstrated that miRNA-143 promoted NP cell apoptosis.

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3.3 miRNA-143 regulates NP cell apoptosis by directly targeting BCL2 Using TargetScan prediction, we determined that BCL2, an important molecule protecting many cell types from apoptosis, contains two miRNA-143 target sites (Fig. 3A). To verify the relationship between BCL2 and miRNA-143, a dual luciferase reporter system was

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employed. Luciferase activity was decreased in the miRNA-143 co-transfected group and this

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miRNA-143-induced decrease in luciferase activity was partially weakened when either of the

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binding sites was deleted (Fig. 3B). BCL2 expression was directly suppressed by miRNA-143 in NP cells (Fig. 3C, D, and E). These results demonstrate that miRNA-143 directly regulates

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BCL2 expression and suggest that miRNA-143 may implement its pro-apoptosis function by

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inhibiting BCL2 expression.

To verify this hypothesis, we used a BCL2 siRNA. The results showed that BCL2

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mRNA and protein expression levels decreased in the BCL2 siRNA group (Fig. 3C, 3D and

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E), while the mRNA and protein expression of caspase-3 and caspase-9 increased in the BCL2 siRNA group (Fig. 3C, 3D and E), indicating that caspase-3 and caspase-9 expression

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is regulated by BCL2. Flow cytometry indicated that apoptosis of NP cells increased in the

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BCL2 siRNA group (Fig. 3F and G). These results indicated that NP cell apoptosis was at least partially regulated by BCL2. In contrast, when using the miRNA-143 inhibitor, BCL2 expression increased, while that of both caspase-3 and caspase-9 decreased (Fig. 3C, D, and E). Apoptosis of NP cells also decreased in the miRNA-143 inhibitor group (Fig. 3F and G). Addition of the BCL2 siRNA into the miRNA-143 inhibitor group abrogated these effects (Fig. 3F and G). These results confirmed that miRNA-143 promotes apoptosis of NP cells by directly inhibiting BCL2 expression.

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3.4 Demethylation enhances miRNA-143 expression level and induces NP cell apoptosis MSP assay showed that the methylation level of degenerative NP tissues was decreased compared to that in normal NP tissues (Fig. 4A). The expression of miRNA-143 was increased in the 5-AZA treatment groups compared to the control groups (Fig. 4B). BCL2

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mRNA and protein expression decreased, while the mRNA and protein expression of

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caspase-3 and caspase-9 increased in the 5-AZA treatment groups compared to that in the

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5-AZA untreated groups (Fig. 4C and 4D). In addition, miRNA-143 expression was not affected by 5-AZA in the miRNA-143 inhibitor-treated groups. To analyze whether BCL2 is

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directly regulated by the demethylation drug, 5-AZA, we used miRNA-143 inhibitor to

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dislodge miRNA-143 expression in the cytoplasm. BCL2 expression did not significantly change compared to the 5-AZA untreated groups in the miRNA-143 inhibitor groups. Similar

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results were obtained for caspase-3/9 (fig. 4C and 4D). The results confirmed that

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methylation regulated miRNA-143 expression and NP cell apoptosis.

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4.Discussion

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Previous studies showed that NP cell apoptosis plays an important role in the pathological process of IVDD (Guo et al., 2016; Wang et al., 2016). Increasing evidence showed that miRNAs regulate diverse biological and pathological processes, including cell growth, differentiation, apoptosis, and carcinogenesis (Ma et al., 2007; Chen et al., 2012; Zhou et al., 2015). The role of miRNA-143 in regulating cell apoptosis in cancer has been studied (Ji, 2010; Gregersen et al., 2012; Shimbo et al., 2014), but the expression and role of miRNA-143 in human NP cell apoptosis are unclear.

ACCEPTED MANUSCRIPT In this study, we determined that miRNA-143 expression is significantly higher in degenerative NP tissues than in normal NP tissues. In addition, we demonstrated that miRNA-143 enhances NP cell apoptosis. In the process of NP cell apoptosis, a number of changes are observed such as senescence, apoptosis, and autophagy. Apoptosis is one of the

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most important factors in the process of NP cell death. BCL2 is known as a critical

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anti-apoptosis gene in mammalian cells. BCL2 protein displays genetic alterations in various

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tissues (Araujo Junior et al., 2013; Afroze et al., 2016; Borkan, 2016), helping the cells evade apoptosis by inhibiting pro-apoptotic genes and promoting anti-apoptotic genes. Aberrant

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expression of apoptosis-related genes is known as a critical mechanism for disc degeneration

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(Jiang et al., 2014; Zhang et al., 2016). Recent studies showed that BCL2 is expressed in NP tissues and plays an important role in the progression of NP cell apoptosis (Ding et al., 2012;

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Miyazaki et al., 2015; Shi et al., 2015). Additionally, recent studies suggest that miRNA-143

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modulates BCL2 expression (Ji, 2010; Shi et al., 2015; Li et al., 2016). We speculated that miRNA-143 contributed to apoptosis of NP cells by targeting BCL2.

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In this study, we found that miRNA-143 significantly regulated BCL2 expression. Thus,

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we focused on the function of miRNA-143 in the process of NP cell apoptosis. Our results demonstrated that miRNA-143 mimics significantly decreased BCL2 expression and increased NP cell apoptosis, while miRNA-143 inhibitors had the opposite effect. Our results indicate that miRNA-143 regulates BCL2 expression, thereby inducing NP cell apoptosis. A previous study showed that EKR5 is a target of miRNA-143 (Akao et al., 2009). Our results confirmed that miRNA-143 regulates ERK5 expression in degenerative human NP cells. The results demonstrate successful targeted effects of miRNA-143. Furthermore, the present

ACCEPTED MANUSCRIPT results indicated that deregulated miRNA-143 may enhance apoptosis in human IVDD by inhibiting BCL2, implying that miRNA-143 may have an etiological and therapeutic role in IVDD. We still do not know why miRNA-143 is up-regulated in degenerative discs. Epigenetics

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influence gene expression and phenotype manifestation without any changes in the DNA

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sequence. The aberrant CpG hyper-methylation constitutes a mechanism for miRNA silencing

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(Suzuki et al., 2012). However, the distribution of CpGs is not uniform. Although previous studies demonstrated that the expression of miRNA-143 is regulated by methylation (Dou et

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al., 2012), whether miRNA-143 expression and the process of disc degeneration are affected

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by methylation remains unclear.

In this study, we found that miRNA-143 methylation in degenerative NP cells was lower

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than that in normal NP cells. Additionally, miRNA-143 expression increased when the gene

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was de-methylated by 5-AZA treatment, and caspase-3/9 mRNA and protein expression increased, while that of BCL2 decreased. In addition, BCL2 and caspase-3/9 expression was

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not affected by 5-AZA after miRNA-143 depletion in the degenerative NP cells. Thus, the

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hypo-methylation status of NP cells may modulate miRNA-143 expression and induce NP cell apoptosis in IVDD. In conclusion, we demonstrated that miRNA-143 overexpression induced a decrease in the number of NP cells by reducing BCL2 expression in human degenerative NP cells and that miRNA-143 expression and function were regulated by NP cell methylation. We provide unequivocal evidence that miRNA-143 expression is up-regulated in the degenerative NP tissues in vivo and it plays a critical role in the process of human NP cell apoptosis by directly

ACCEPTED MANUSCRIPT targeting BCL2 in vitro for the first time. In addition, hyper-methylation status was observed in degenerative human NP cells in vivo, and miRNA-143 expression and function were regulated by DNA methylation status in human NP cells in vitro. Although further studies are needed especially in vivo studies, our results suggest that miRNA-143 plays a pivotal role in

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the pathogenesis of IVDD and may become a candidate for the development of RNA-based

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treatments against disc degeneration.

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Conflicts of interest

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The authors declared no conflict of interest with respect to the research, authorship, and

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Acknowledgments

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publication of this article.

This study was supported by the National Natural Science Foundation of China

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(No.81072187, No.81541056 and U1603121).

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ACCEPTED MANUSCRIPT Fig. 1 Differential expression of miRNA-143 and BCL2 in degenerative NP tissues compared with that in normal NP tissues. (A) miRNA-143 expression in normal and degenerative NP tissues was examined by PCR. (B) BCL2 mRNA expression in normal and degenerative NP tissues. (C) Relationship between miRNA-143 and BCL2 expression. (D) and (E) BCL2

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protein expression in normal and degenerative NP tissues. Results are shown as mean ± SD.

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Data are representative of three independent experiments. *P < 0.05 vs. normal tissues

Fig. 2 MiRNA-143 modulates BCL2 expression and promotes NP cell apoptosis. (A)

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MiRNA-143 expression was examined by RT-PCR. (B) The mRNA expression of BCL2 and

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caspase-3/9 was examined by RT-PCR. (C) (D) Protein expression of BCL2 and caspase-3/9. (E) Protein levels of ERK5. (F) Quantitative analysis of the protein expression of ERK5. (G)

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Flow cytometry analysis of NP cell apoptosis. (H) Percentage of apoptotic NP cells. Results

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are shown as mean ± SD. Data are representative of three independent experiments. *P < 0.05

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vs. miR-143 mimic NC, #P < 0.05 vs. miR-143 inhibitor NC

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Fig. 3 MiRNA-143 promotes the apoptosis of NP cells by directly targeting BCL2. (A) Human BCL2 may be a molecular target of miRNA-143. (B) Firefly luciferase activity measured and normalized by Renilla luciferase activity. Normal NP cells were co-transfected with empty vector, human BCL2 3-UTR firefly luciferase reporter plasmid, or either one or both deletions of the putative target sites as indicated, together with pTK-Renilla-luciferase plasmids, control, or miRNA-143 mimic as indicated. (C) mRNA expression of BCL2 and caspase-3/9 in NP cells. (D) Protein levels of BCL2 and caspase-3/9. (E) Quantitative analysis

ACCEPTED MANUSCRIPT of the protein expression of BCL2 and caspase-3/9 in NP cells. (F) Flow cytometry. (G) Percentage of apoptotic NP cells. Results are shown as mean ± SD. Data are representative of three independent experiments. *P < 0.05 vs. control, #P < 0.05 vs. siRNA scr and P < 0.05 vs.

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miR-143 inhibitor + BCL2 siRNA

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Fig. 4 Demethylation enhances miRNA-143 expression and induces NP cell apoptosis. (A)

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Hypo-methylation status was detected in degenerative NP tissues compared to normal NP tissues by MSP experiment. (B) MiRNA-143 expression was up-regulated after 5-AZA

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treatment compared to the control group. (C) mRNA expression of BCL2 and caspase-3/9

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was detected by RT-PCR. (D) Protein expression of BCL2 and caspase-3/9. (E) Quantitative analysis of BCL2 and caspase-3/9 protein expression. Results are shown as mean ± SD. Data

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are representative of three independent experiments. *P < 0.05 vs. 5-AZA untreated groups.

Fig. 5 Schematic model illustrating how miRNA-143 regulates NP cell apoptosis via BCL2

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and the effect of methylation. During the transcriptional progress from DNA to miRNA-143,

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the increase in DNA promoter methylation status results in decreased miRNA-143 expression. miRNA-143 inhibits the translation from BCL2 mRNA to BCL2 protein by combining with BCL2 3-UTR. BCL2 decreases NP cell apoptosis by inhibiting caspase-3/9 activation.

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Oligonucleotide sequence Forward (5-3)

Product

Reverse (5-3)

size

GCCTTCTTTGAGTTCGGTGG

GAAATCAAACAGAGGCCGCA

192

Caspase-3

ACTGGACTGTGGCATTGAGA GCACAAAGCGACTGGATGAA

162

Caspase-9

CCTGTGTCGGTCGAGAAGAT

TGGGTGTGGGCAAACTAGAT

247

U6

CGCTTCGGCAGCACATATAC

AAATATGGAACGCTTCACGA

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β-actin

AGCGAGCATCCCCCAAAGTT GGGCACGAAGGCTCATCATT

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BCL-2

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Graphical abstract

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Abbreviation list

Lower back pain

IVDD

Intervertebral disc degeneration

NP

Nucleus pulposus

AF

Annulus fibrosus

ECM

Extracellular matrix

MiRNA

MicroRNA

BCL2

B-cell lymphoma-2

HUST

Huazhong University of Science and Technology

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LBP

Intervertebral disc

MRI

Magnetic Resonance Imaging

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IVD

Sodium dodecyl sulfate-polyacrylamide gel electrophoresis

PVDF

Polyvinylidene fluoride

3-UTR

3’- Untranslated Regions

mRNA ERK5

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Quantitative real-time polymerase chain reaction

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qRT-PCR

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SDS-PAGE

Messenger RNA Extracellular-signal-regulated kinase 5

ACCEPTED MANUSCRIPT Highlights: 1. A high expression of miRNA-143 was observed in human IVDD tissues. 2. MiR-143 promotes the nucleus pulposus apoptosis in human IVDD by directly targeting BCL2. 3. BCL2 decreases nucleus pulposus cell apoptosis via restraint caspase-3/9.

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4. A high frequency of miRNA-143 methylation was observed in human IVDD tissues.

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5. DNA methylation of miR-143 regulates the expression of miR-143 in IVDD