Predicting 3D Structure, Cross Talks, and Prognostic Significance of KLF9 in Cervical Cancer

<jats:p>Our study aimed to identify the new blood-based biomarkers for the diagnosis and prognosis of cervical cancer. Moreover, the three-dimensional (3D) structure of Kruppel-like factor 9 (<jats:italic>KLF9</jats:italic>) was also determined in order to better understand its function, and a signaling pathway was constructed to identity its upstream and downstream targets. In the current study, the co-expressions of tumor protein D52 (<jats:italic>TPD52</jats:italic>), <jats:italic>KLF9</jats:italic>, microRNA 223 (miR-223), and protein kinase C epsilon (<jats:italic>PKCϵ</jats:italic>) were evaluated in cervical cancer patients and a possible relation with disease outcome was revealed. The expressions of <jats:italic>TPD52</jats:italic>, <jats:italic>KLF9</jats:italic>, miR-223, and <jats:italic>PKCϵ</jats:italic> were studied in the blood of 100 cervical cancer patients and 100 healthy controls using real-time PCR. The 3D structure of <jats:italic>KLF9</jats:italic> was determined through homology modeling <jats:italic>via</jats:italic> the SWISS-MODEL and assessed using the Ramachandran plot. The predicted 3D structure of <jats:italic>KLF9</jats:italic> had a similarity index of 62% with its template (<jats:italic>KLF4</jats:italic>) with no bad bonds in it. In order to construct a genetic pathway, depicting the crosstalk between understudied genes, STRING analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG), and DAVID software were used. The constructed genetic pathway showed that all the understudied genes are linked to each other and involved in the PI3K/Akt signaling pathway. There was a 23-fold increase in <jats:italic>TPD52</jats:italic> expression, a 2-fold increase in miR-223 expression, a 0.14-fold decrease in <jats:italic>KLF9</jats:italic> expression, and a 0.05-fold decrease of <jats:italic>PKCϵ</jats:italic> expression in cervical cancer. In the present study, we observed an association of the expressions of <jats:italic>TPD52</jats:italic>, <jats:italic>KLF9</jats:italic>, miR-223, and <jats:italic>PKCϵ</jats:italic> with tumor stage, metastasis, and treatment status of cervical cancer patients. Elevated expressions of <jats:italic>TPD52</jats:italic> and miR-223 and reduced expressions of <jats:italic>KLF9</jats:italic> and <jats:italic>PKCϵ</jats:italic> in peripheral blood of cervical cancer patients may serve as predictors of disease diagnosis and prognosis. Nevertheless, further <jats:italic>in vitro</jats:italic> and tissue-level studies are required to strengthen their role as potential diagnostic and prognostic biomarkers.</jats:p>