Kruppel-like factor 9 promotes neuroblastoma differentiation via targeting the sonic hedgehog signaling pathway

Background Neuroblastoma (NB) is a deadly solid tumor of children. Kruppel-like factor 9 (KLF9) has prodifferentiation and tumor suppression functions in several types of cancers. Here, we aimed to investigate the effects of KLF9 on NB differentiation and growth and to elucidate the underlying mechanism. Procedure Sixty-five NB paraffin samples were assessed for expression levels of KLF9 and sonic hedgehog (SHH) signaling pathway proteins by immunohistochemistry. The associations between expression of KLF9 and the SHH pathway components and patients' clinicopathologic characteristics were estimated. The impacts of KLF9 on cell differentiation, proliferation, and invasion were investigated in two NB cell lines (SH-SY5Y and IMR32). Additionally, chromatin immunoprecipitation (ChIP) and luciferase reporter assays were used to elucidate the mechanism by which KLF9 regulates SHH signaling. Results Differentiating NB specimens showed significantly higher KLF9 expression levels than undifferentiated/poorly differentiated ones. Moreover, increased KLF9 expression was associated with favorable prognoses in patients with NB. A negative correlation was found between KLF9 and SHH signaling expression levels in NB specimens. In vitro assays revealed that KLF9 promoted the differentiation of NB cells and inhibited their proliferation and invasion via suppression of the SHH pathway. Furthermore, KLF9 binding sites in the SHH promoter were identified by ChIP and luciferase reporter assays. Conclusions KLF9 exerts prodifferentiation and growth-inhibition effects on NB via suppression of the SHH pathway, suggesting a potential role of KLF9 in NB therapy.