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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Cell Dev. Biol.</journal-id>
<journal-title>Frontiers in Cell and Developmental Biology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell Dev. Biol.</abbrev-journal-title>
<issn pub-type="epub">2296-634X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fcell.2021.716730</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cell and Developmental Biology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Ribosome Proteins Represented by RPL27A Mark the Development and Metastasis of Triple-Negative Breast Cancer in Mouse and Human</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name><surname>Zhao</surname> <given-names>Weipeng</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1354078/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Li</surname> <given-names>Xichuan</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/760207/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Nian</surname> <given-names>Weiqi</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Wang</surname> <given-names>Jun</given-names></name>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Wang</surname> <given-names>Xiaorui</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Sun</surname> <given-names>Linlin</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Zhu</surname> <given-names>Ye</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Tong</surname> <given-names>Zhongsheng</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c002"><sup>&#x002A;</sup></xref>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Key Laboratory of Cancer Prevention and Therapy, Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer</institution>, <addr-line>Tianjin</addr-line>, <country>China</country></aff>
<aff id="aff2"><sup>2</sup><institution>Tianjin Key Laboratory of Animal and Plant Resistance, College of Life Sciences, Tianjin Normal University</institution>, <addr-line>Tianjin</addr-line>, <country>China</country></aff>
<aff id="aff3"><sup>3</sup><institution>Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital</institution>, <addr-line>Chongqing</addr-line>, <country>China</country></aff>
<aff id="aff4"><sup>4</sup><institution>Department of Oncology, The First Affiliated Hospital of Shandong First Medical University</institution>, <addr-line>Jinan</addr-line>, <country>China</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Paloma Ordonez Moran, University of Nottingham, United Kingdom</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Shifeng Xue, National University of Singapore, Singapore; Yutian Zou, Sun Yat-sen University Cancer Center, China</p></fn>
<corresp id="c001">&#x002A;Correspondence: Weipeng Zhao, <email>weipengzhao_oncology@yahoo.com</email></corresp>
<corresp id="c002">Zhongsheng Tong, <email>tongzhongsheng_on@163.com</email></corresp>
<fn fn-type="other" id="fn004"><p>This article was submitted to Molecular and Cellular Oncology, a section of the journal Frontiers in Cell and Developmental Biology</p></fn>
</author-notes>
<pub-date pub-type="epub">
<day>23</day>
<month>08</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>9</volume>
<elocation-id>716730</elocation-id>
<history>
<date date-type="received">
<day>29</day>
<month>05</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>28</day>
<month>07</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2021 Zhao, Li, Nian, Wang, Wang, Sun, Zhu and Tong.</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Zhao, Li, Nian, Wang, Wang, Sun, Zhu and Tong</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p>Triple-negative breast cancer (TNBC) is known to have a poor prognosis and limited treatment options. The lack of targeted therapies and poor prognosis of patients with TNBC have made it urgent to discover novel critical diagnosis and therapeutic targets in the TNBC field. Here, in the current study, we integrated the single-cell RNA-sequencing (scRNA-seq) data from four normal mouse mammary tissues and four mouse breast tumors. Comparative analysis was conducted to identify the gene profiles of normal epithelial cells and cancer cells at different models. Surprisingly, two ribosomal protein genes, Rpl27a and Rpl15, were significantly upregulated in the cancer cells in all the TNBC models. Next, we accessed the scRNA-seq data from human primary and metastatic TNBC tissues, and comparative analysis revealed gene profiles of human primary and metastatic TNBC cancer cells. Ribosomal protein genes, represented by RPL27A and RPL15, showed significantly upregulated expression in metastatic TNBC cancer cells. Pathway analysis on the upregulated genes of the metastatic TNBC cancer cells identified the key regulators and signaling pathways that were driving the metastasis of the TNBC cancer cells. Specifically, EIF2 signaling was significantly activated, and major member genes of this signaling pathway were upregulated. <italic>In vitro</italic> study revealed that targeting RPL27A or EIF2 signaling in a TNBC cell line, MDA-MB-231, significantly reduced cell migration and invasion. Altogether, these data suggested that the RPL27A gene is conducting critical functions in TNBC cancer development and metastasis and is a potential therapeutic target for TNBC.</p>
</abstract>
<kwd-group>
<kwd>single cell RNA-sequencing</kwd>
<kwd>triple negative breast cancer</kwd>
<kwd>ribosomal protein</kwd>
<kwd>RPL27A</kwd>
<kwd>EIF2 signaling</kwd>
</kwd-group>
<counts>
<fig-count count="8"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="53"/>
<page-count count="16"/>
<word-count count="0"/>
</counts>
</article-meta>
</front>
<body>
<sec id="S1">
<title>Introduction</title>
<p>Triple-negative breast cancer (TNBC) is defined as a type of breast cancer deficient of expression of estrogen receptor (ER), progesterone receptor (PR), and HER2 protein and present a particularly challenging therapeutic target due to their highly invasive nature and relatively low response to therapeutics (<xref ref-type="bibr" rid="B16">Garrido-Castro et al., 2019</xref>). In comparison to other types of breast cancer, TNBC is characterized by its aggressive behavior, high metastatic potential, poor prognosis, and proneness to relapse (<xref ref-type="bibr" rid="B48">Yin et al., 2020</xref>). The definition of TNBC applies to breast cancer that lack the expression of ER, PR, and HER2, and all of these are molecular targets of therapeutic agents. Nevertheless, chemotherapy is still the primary established treatment option for patients with early-stage TNBC and those with advanced-stage TNBC (<xref ref-type="bibr" rid="B4">Bianchini et al., 2016</xref>), but the efficacy of conventional postoperative adjuvant chemoradiotherapy is poor. The residual metastatic lesions frequently lead to tumor recurrence after surgery (<xref ref-type="bibr" rid="B48">Yin et al., 2020</xref>). Due to the special molecular and genetic phenotypes, TNBC is not sensitive to endocrine therapy or molecular targeted therapy. Bevacizumab has been added to chemotherapeutic drugs to treat TNBC in some countries, although there is not any demonstrated overall survival benefit (<xref ref-type="bibr" rid="B7">Collignon et al., 2016</xref>). Many other standard adjuvant and neoadjuvant regimens including anthracyclines, cyclophosphamide, and taxanes are used, but their efficiencies are yet to be determined (<xref ref-type="bibr" rid="B7">Collignon et al., 2016</xref>). Although increasing research is going on to identify specific targets and develop additional and better systemic treatment options, there are no approved targeted therapies for TNBC up to now.</p>
<p>Ribosomal proteins are many of the proteins that, in conjunction with rRNA, make up the ribosomal subunits involved in the cellular process of translation (<xref ref-type="bibr" rid="B53">Zhou et al., 2015</xref>). Beyond their essential roles in ribosome assembly and protein translation, ribosome-independent functions of ribosomal proteins have also been greatly appreciated, especially in the study achievements connecting cancer diagnosis and therapy (<xref ref-type="bibr" rid="B35">Penzo et al., 2019</xref>).</p>
<p>A number of tumor suppressors and oncogenic proteins often control the progression of cancer cells by regulating ribosome biogenesis and global protein synthesis (<xref ref-type="bibr" rid="B39">Ruggero and Pandolfi, 2003</xref>; <xref ref-type="bibr" rid="B41">Silvera et al., 2010</xref>). Interestingly, individual ribosome-independent ribosomal proteins also conduct critical functions in tumorigenesis, especially in breast cancer. For instance, upregulation of RPL19 induces ER stress, resulting in increased sensitivity to ER stress and enhanced cell death in MCF7 breast cancer cells (<xref ref-type="bibr" rid="B23">Hong et al., 2014</xref>). RPS16 and TNFSF10 as two direct targets of miR-7641 and many other ribosomal proteins that are frequently co-expressed with RPS16 in breast cancer are also deregulated by miR-7641. This is making miR-7641a potential targeting factor to improve the efficacy of cancer therapy (<xref ref-type="bibr" rid="B36">Reza et al., 2017</xref>). Targeting RPL39 and MLF2 reduces tumor initiation and metastasis in breast cancer by inhibiting nitric oxide synthase signaling. RPL5 downregulation is also associated with breast cancer cell proliferation and tumor progression in transgenic mice and human tumor xenograft mouse models (<xref ref-type="bibr" rid="B13">Fancello et al., 2017</xref>). All these <italic>in vitro</italic> studies shed light on the functions of ribosomal proteins on breast cancer phenotypes, but few were TNBC specific. A more interesting study identified two previously unidentified cancer genes, RPL39 and MLF2, by selective shRNA knockdown of genes from this tumorigenic signature, which impacted breast cancer stem cell self-renewal and lung metastases. Knockdown of these genes in TNBC models significantly reduced primary tumor growth, as well as metastasis (<xref ref-type="bibr" rid="B8">Dave et al., 2014</xref>). Another most recent study revealed that RPL15-overexpressing circulating tumor cells markedly increased metastatic burden in mice.</p>
<p>Interestingly, in the current study, through a complete research on the published single-cell RNA-sequencing (scRNA-seq) databases, by comparative analysis of normal mouse breast epithelial cell and TNBC cancer cells in mouse models, as well human primary and brain metastatic TNBC at single cell levels, we revealed that RPL15 was significantly increased in mouse tumor cells and metastatic TNBC compared to corresponding controls. A more interesting gene is RPL27A, which also showed ectopic expression and potentially promoted TNBC development and metastasis <italic>via</italic> the EIF2 signaling pathway. These findings revealed a novel molecular biomarker and a potential related signaling pathway for the prognosis and response prediction of TNBC to traditional therapy and new molecular target agents.</p>
</sec>
<sec id="S2" sec-type="materials|methods">
<title>Materials and Methods</title>
<sec id="S2.SS1">
<title>Reuse of scRNA-Seq Dataset</title>
<p>Single-cell RNA-sequencing on mammary epithelial cells across four developmental stages (nulliparous, mid-gestation, lactation, and post involution) were described by the original report (<xref ref-type="bibr" rid="B2">Bach et al., 2017</xref>). We accessed the processed data of this scRNA-seq dataset from the Gene Expression Omnibus under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="GSE106273">GSE106273</ext-link> and raw data of the scRNA-seq from Sequence Read Archive (SRA) under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="PRJNA416110">PRJNA416110</ext-link> for our analysis. scRNA-seq data on different mouse models of breast cancer were retrieved from GEO under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="GSE123366">GSE123366</ext-link> and SRA under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="PRJNA508501">PRJNA508501</ext-link> (<xref ref-type="bibr" rid="B47">Yeo et al., 2020</xref>). scRNA-seq data on primary TNBC were retrieved from GEO under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="GSE118389">GSE118389</ext-link> and SRA under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="PRJNA485429">PRJNA485429</ext-link> (<xref ref-type="bibr" rid="B25">Karaayvaz et al., 2018</xref>), and scRNA-seq data on brain metastatic TNBC were retrieved from GEO under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="GSE143423">GSE143423</ext-link> and SRA under accession number <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="PRJNA600483">PRJNA600483</ext-link>.</p>
</sec>
<sec id="S2.SS2">
<title>scRNA-Seq Analysis and Differentially Expressed Gene Identification</title>
<p>RStudio software package Seurat was used for the analysis of matrix data of scRNA-seq. Sample objects were integrated or merged by either sample individuals or their disease status. Anchors were generated, listing all the Seurat objects as input, and integrated/merged data were created for integration. In the integrated/merged Seurat object, &#x201C;nFeature_RNA,&#x201D; &#x201C;nCount_RNA,&#x201D; and &#x201C;percent.MT&#x201D; were defined to represent number of genes, number of transcripts, and percentage of mitochondrial initiated genes in each cell of each sample, respectively. Quality control (QC) was performed by removing the low-quality events and doublets by excluding the cells with extreme nCount_RNA or nFeature_RNA and high percent.MT.</p>
<p>Canonical cell-type markers were used to identify and define the major cell types. For the epithelial/cancer cell lineage, we used common epithelial cell marker genes [CDH1 (Cdh1), KRT18 (Krt18), and KRT5 (Krt5)] and endothelial cell marker genes [CDH5 (Cdh5), PECAM1 (Pecam1), and EMCN (Emcn)]. Total immune cells were identified by PTPRC (Ptprc), CD68 (Cd68), and CSF1R (Csf1r). For the mesenchymal cell component, COL1A1 (Col1a1), COL1A2 (Col1a2), COL3A1 (Col3a1), and FAP were used. The cancer/epithelial cell clusters were extracted from other cell types and re-clustered for further analysis.</p>
</sec>
<sec id="S2.SS3">
<title>Pseudotime Analysis With Slingshot and Ingenuity Pathway Analysis</title>
<p>The scRNA-seq data of epithelial/cancer cells were loaded into Slingshot packages, and major clusters were identified for pseudotime analysis. Analysis on inferred trajectory and principal curves demonstrated smoothed representations of each subcluster. Output principal curves were smoothed representations of each disease status, and pseudotime values were computed by projecting the cells onto the principal curves. For the Ingenuity Pathway Analysis (IPA), differentially expressed genes of each disease status were identified and were loaded into the IPA client (QIAGEN) to demonstrate the key ingenuity canonical pathways and upstream regulators. The ingenuity canonical pathways, upstream regulators, and graphical summary of the regulatory networks were exported from the IPA.</p>
</sec>
<sec id="S2.SS4">
<title>Cell Culture and Knockdown Assay</title>
<p>MDA-MB-231 cell (<ext-link ext-link-type="uri" xlink:href="https://scicrunch.org/resolver/RRID:CVCL_0062">RRID: CVCL_0062</ext-link>) was purchased from American Type Culture Collection (ATCC) and was cultured in L-15 medium supplemented with 10% FBS, penicillin (100 U/ml), and streptomycin (100 &#x03BC;g/ml). The cells have been authenticated using STR profiling within the last 3 years. All experiments were performed with mycoplasma-free cells. MDA-MB-231 cells were cultured in six-well plates to 30&#x2013;60% confluency and shRPL27A (Santa Cruz Biotechnology), or scramble lentiviral particles were mixed in complete medium together with polybrene (10 &#x03BC;g/ml). Cells were cultured with lentiviral particles for 4 h, and then the medium was changed. Cells were cultured until confluency and were passaged for further use. For the EIF2 inhibitor assay, 20 and 50 &#x03BC;m Sal003 were used, and the same amount of DMSO was used as controls.</p>
</sec>
<sec id="S2.SS5">
<title>RNA Extraction and Quantitative Real-Time PCR</title>
<p>The RNeasy Mini kit (QIAGEN) was used to extract total RNA from samples following transfection according to the manufacturer&#x2019;s protocols. The expression of human RPL27A was determined using the SYBR Green Master Mix kit (Roche). Human GAPDH was used as an internal control gene, and relative expression levels were calculated by using the 2<sup>&#x2013;&#x0394;&#x0394;Ct</sup> method. The sequences of specific primer pairs are described below: RPL27A-F 5&#x2032;-ACGGGTGAATGCTGCTAAAA-3&#x2032; and RPL27A-R 5&#x2032;-GAAGAATTTGGCCTTCACGA-3&#x2032;; RPL37A-F 5&#x2032;-ACATGGCCAAACGTACCA-3&#x2032; and RPL37A-R 5&#x2032;-TGCTG GCTGATTTCAATTTT-3&#x2032;; RPL30-F 5&#x2032;-ATGGCCAAACGTA CCAAG-3&#x2032; and RPL30-R 5&#x2032;-AAGTGTACTTGGCGTGCTG-3&#x2032;; RPL39 primer (Bio-Rad, qHsaCED0038310); RPL36 primer (Bio-Rad, qHsaCED0038433); RPL36A primer (Bio-Rad, qHsaCED0044302); RPL15 primer (Bio-Rad, qHsaCED0038184); RPL21 primer (Bio-Rad, qHsaCED0038684); RPL38 primer (Bio-Rad, qHsaCID0038174); RPS7 primer (Bio-Rad, qHsaCID0038168); RPS15A primer (Bio-Rad, qHsaCED0038046); RPS17 primer (Bio-Rad, qHsaCED0041771); RPS21 primer (Bio-Rad, qHsaCID0023899); RPS27A primer (Bio-Rad, qHsaCED0038707); RPS29 primer (Bio-Rad, qHsaCED0038808); and GAPDH-F 5&#x2032;-AGCCACATCGCTCAGACAC-3&#x2032; and GAPDH-R 5&#x2032;-GCCCA ATACGACCAAATCC-3&#x2032;.</p>
</sec>
<sec id="S2.SS6">
<title>Western Blotting</title>
<p>RIPA buffer (Thermo Fisher Scientific) and Protease and Phosphatase Inhibitor (Thermo Fisher Scientific) were used to extract proteins. The primary antibodies against antibody for RPL27A (NBP2-38025, Novus Biologicals) and GAPDH (NB300-221, Novus Biologicals) and secondary antibodies were anti-mouse IgG-HRP (7076S, Cell Signaling Technology) and anti-rabbit IgG-HRP (7074S, Cell Signaling Technology). The protein blots were visualized using an ECL Western Blotting Substrate (Thermo Fisher Scientific).</p>
</sec>
<sec id="S2.SS7">
<title>Migration and Invasion Assay</title>
<p>Twenty-four-well chambers (Corning) were used or migration assay, and 24-well Matrigel invasion chambers (BD Biosciences) were used for invasion assay. MDA-MB-231 cells (5 &#x00D7; 10<sup>4</sup>) were placed in 100-&#x03BC;l serum-free medium in the migration/migration chamber, and 750 &#x03BC;l complete medium was placed into the lower wells. After culturing for 24 h, cells were fixed with 100% methanol for 20 min and stained with Trypan blue for 30 min. Non-migrating cells on the upper side of the filter were removed with cotton swabs. Migration and invasion were quantified by counting the number of cells on the lower surface of the filter.</p>
</sec>
<sec id="S2.SS8">
<title>Statistical Analysis</title>
<p>The cell number of each cluster or each disease status was determined in Seurat. Student&#x2019;s two-tailed <italic>t</italic>-test was used for comparing differences between two groups, and <italic>p</italic> &#x003C; 0.05 was considered statistically significant: <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05; <sup>&#x2217;&#x2217;</sup><italic>p</italic> &#x003C; 0.01; <sup>&#x2217;&#x2217;&#x2217;</sup><italic>p</italic> &#x003C; 0.001, <sup>&#x002A;&#x002A;&#x002A;&#x002A;</sup><italic>p</italic> &#x003C; 0.0001. The cell numbers and cell percentages were calculated and were plotted using GraphPad Prism 8.</p>
</sec>
<sec id="S2.SS9">
<title>Data and Code Availability</title>
<p>All the scRNA-seq data are available in GEO (accession numbers are above), and the codes regarding to the data analysis are accessible upon request.</p>
</sec>
</sec>
<sec id="S3">
<title>Results</title>
<sec id="S3.SS1">
<title>Single-Cell Profiling of TNBC Cells and Normal Breast Epithelial Cells</title>
<p>To gain insights into the heterogeneity within mammary tumors, a recent study performed single-cell transcriptional profiling of breast tumor cells from four mouse models (<xref ref-type="bibr" rid="B47">Yeo et al., 2020</xref>). The MMTV-Neu (NEU) tumor was ER<sup>&#x2013;</sup>/PR<sup>&#x2013;</sup>/HER2<sup>+</sup>, while the MMTV-PyMT (FF99WT) tumor was ER<sup>&#x2013;</sup>/PR<sup>&#x2013;</sup>/HER2<sup>low</sup>; the BRCA1-null (BRCA1) tumor which mimics basal-like breast cancers was ER<sup>&#x2013;</sup>/PR<sup>&#x2013;</sup>/HER<sup>&#x2013;</sup>, and the 4T1 transplant tumor was a known ER<sup>&#x2013;</sup>/PR<sup>&#x2013;</sup>/HER<sup>&#x2013;</sup> mouse model. To study the gene profiles of the tumor cells in these four models, we reaccessed the scRNA-seq data from GEO. We first integrated all the scRNA-seq data of different samples and models and corrected the batch effects. Cell qualities in each sample were visualized by violin plots. Cells that met the requirement were retained, and cells with extreme nFeature_RNA and nCount_RNA or high percent.MT were removed (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 1A,B</xref>). After clustering, the distribution of each sample (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 1C</xref>) and each model (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 1D</xref>) was visualized by Uniform Manifold Approximation and Projection (UMAP). In total, 14 major cell clusters were identified, and the clusters of each model were also visualized (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 1E</xref>).</p>
<p>We then checked the expression of the canonical cell-type markers: cancer/epithelial cell marker genes (Cdh1, Krt18, and Krt5); mesenchymal cell marker genes (Col1a1, Col1a2, and Col3a1); immune cell marker genes (Ptprc, Cd68, and Csf1r); and endothelial cell marker genes (Pecam1, Emcn, and Cdh5) (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 1F</xref>). Based on the transcripts of these genes, we accordingly identified the cancer cells, mesenchymal/endothelial cells in the integrated data, and each tumor model (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 1G,H</xref>). Then the cancer cells were subset from the integrated data and re-clustered. Cells from each sample (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 2A</xref>) and model (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 2B</xref>) were visualized to confirm the batch correction. Although some cells showed biased distribution in a few clusters of the integrated data, suggesting different cell numbers in some samples in these clusters, most of the cells were evenly distributed (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 2C,D</xref>).</p>
<p>We next determined the transcript of basal marker Krt5 and the luminal marker Krt18. Notably, all the cancer cells from the four models showed high Krt18 expression, and only some cells from the BRCA1 model, a basal-like breast cancer model, showed a detectable Krt5 transcript (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 2E</xref>). We also checked the transcriptional levels of ER genes, PR genes, and HER2 (Erbb2) and found rare transcripts in the cancer cells of all the tumor models, even in the NEU model (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 2F</xref>), suggesting that these were good models to mimic TNBC.</p>
<p>As the control of the tumor cells, we then accessed another scRNA-seq dataset on normal mouse mammary epithelial cells at four developmental stages: nulliparous, mid-gestation, lactation, and post involution (<xref ref-type="bibr" rid="B2">Bach et al., 2017</xref>). Similarly, sample integration and QC were performed on these data (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 3A,B</xref>). After clustering, cells from different samples and developmental stages, as well as the cell clusters, were visualized by UMAP (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 3C&#x2013;E</xref>). The major cell types, including epithelial cells, mesenchymal cells, immune cells, and endothelial cells, were identified by checking canonical cell-type marker genes (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 3F&#x2013;H</xref>). The epithelial cells were then subset and re-clustered, and epithelial cells from different stages (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 4A,B</xref>) showed biased distribution in the clusters (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 4C,D</xref>), suggesting that the gene profiles in different stages differed significantly, confirming the findings in the original study (<xref ref-type="bibr" rid="B2">Bach et al., 2017</xref>). The basal marker Krt5 and the luminal marker Krt18 were used to confirm this (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 4E,F</xref>). It was clear that the epithelial cells in nulliparous and mid-gestation stages were composed of both Krt18<sup>+</sup> and Krt5<sup>+</sup> cells, and in the lactation stage, the epithelial cells were mostly Krt5<sup>+</sup> cells, while in the post involution stage, the epithelial cells were mainly Krt18<sup>+</sup> cells (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 4E,F</xref>).</p>
</sec>
<sec id="S3.SS2">
<title>Breast Cancer Cell Profiling Compared to Normal Mammary Epithelial Cells</title>
<p>The cancer cells were subset from the tumor models, and the normal epithelial cells were subset from normal mammary datasets, and then these cells were merged (<xref ref-type="fig" rid="F1">Figure 1A</xref>). Due to the gene profile differences, the cancer cells and normal epithelial cells showed distinct clusters (<xref ref-type="fig" rid="F1">Figure 1B</xref>). The integrated data were clustered, and 17 major cell clusters were identified (<xref ref-type="fig" rid="F1">Figure 1C</xref>). Most of the clusters showed specific expression of either the luminal markers Krt18 and Krt8 or basal markers Krt14, Krt5, and Acta2 (<xref ref-type="fig" rid="F1">Figure 1D</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption><p>Gene expression patterns of the cancer cells and normal epithelial cells. <bold>(A,B)</bold> Distribution of normal and cancer cells <bold>(A)</bold> and cells from different developmental stages and mouse models <bold>(B)</bold> in the merged data. <bold>(C)</bold> Identification of the major cell clusters in the merged scRNA-seq data. <bold>(D)</bold> Transcription of the canonical luminal marker genes and basal marker genes in the merged data. <bold>(E,F)</bold> Heatmap visualization of the top 100 genes of cells from each developmental stage and breast cancer mouse model <bold>(E)</bold> and the top 500 genes of the normal epithelial cells and cancer cells <bold>(F)</bold>. <bold>(G,H)</bold> Violin plot presentation of the top 20 genes upregulated in normal <bold>(G)</bold> or cancer <bold>(H)</bold> cells.</p></caption>
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<p>To determine the gene profiles of the cells of different developmental stages/models, we performed comparative analysis on the scRNA-seq data, and the top 100 genes were presented by heatmap, suggesting distinct gene profiling patterns in each developmental stage/model (<xref ref-type="fig" rid="F1">Figure 1E</xref>). Further comparative analysis was used to identify the profiling difference of normal epithelial cells and cancer cells. The top 500 genes in the total normal epithelial cells and total cancer cells were visualized by heatmap (<xref ref-type="fig" rid="F1">Figure 1F</xref>). The top 20 upregulated genes in normal epithelial cells (<xref ref-type="fig" rid="F1">Figure 1G</xref>) and in cancer cells (<xref ref-type="fig" rid="F1">Figure 1H</xref>) were visualized by violin plots. Most of the top genes identified in normal epithelial cells, including Acta2 (<xref ref-type="bibr" rid="B45">Weymouth et al., 2012</xref>), Mylk, Cnn1 (<xref ref-type="bibr" rid="B5">Bresson et al., 2018</xref>), and multiple Krt genes (<xref ref-type="bibr" rid="B26">Kendrick et al., 2008</xref>), were associated with normal development and functions of mammary gland, such as maintenance of lactation, mammary stem cell function, and lineage commitment determination. Notably, two function-unidentified ribosome protein genes, Rpl13a and Rpl29, were significantly downregulated in cancer cells (<xref ref-type="fig" rid="F1">Figure 1G</xref> and <xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 5A</xref>). Of the top genes upregulated in the cancer cells, most were reported to be breast cancer-promoting genes. Specifically, AGTG1 is one of the recurrent mutated genes in breast cancer (<xref ref-type="bibr" rid="B6">Ciriello et al., 2015</xref>). Lalba is reported to not be expressed in healthy tissues except during lactation, while it is expressed at high levels in a subset of human breast cancers, especially TNBC (<xref ref-type="bibr" rid="B43">Tuohy, 2014</xref>). Higher SPP1 gene expression in primary tumors was found to be associated with risk of recurrence in ER<sup>+</sup> breast cancer among patients with endocrine treatment (<xref ref-type="bibr" rid="B19">Gothlin Eremo et al., 2020</xref>). Modification of Sumo2 was associated with the progression and metastasis of breast cancer (<xref ref-type="bibr" rid="B42">Subramonian et al., 2014</xref>). Other genes were associated with cell adhesion and migration of breast cancer cell [DUOXA1 (<xref ref-type="bibr" rid="B34">Ostrakhovitch and Li, 2010</xref>) and PGAM1 (<xref ref-type="bibr" rid="B50">Zhang et al., 2017</xref>)], prognosis of breast cancer [PGK1 (<xref ref-type="bibr" rid="B15">Fu et al., 2018</xref>) and KLK10 (<xref ref-type="bibr" rid="B28">Kioulafa et al., 2009</xref>)], or clinical outcome in breast cancer [RBM3 (<xref ref-type="bibr" rid="B24">Jogi et al., 2009</xref>) and AQP5 (<xref ref-type="bibr" rid="B30">Lee et al., 2014</xref>)]. Another gene was Rpl15, which was recently reported to markedly increase metastatic burden in TNBC mouse models (<xref ref-type="bibr" rid="B11">Ebright et al., 2020</xref>). This was further confirmed in our study by the data that an increased expression of Rpl15 gene was found in the cancer cells. A more interesting gene was Rpl27a, which also showed significantly increased transcript in cancer cell (<xref ref-type="fig" rid="F1">Figure 1H</xref> and <xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 5A</xref>) and whose functions had rarely been studied in diseases or cancers.</p>
</sec>
<sec id="S3.SS3">
<title>Rpl27a Is Upregulated in Cancer Cells of Murine TNBC Models</title>
<p>To better clarify the expression level of Rpl27a, the transcripts were visualized by both violin plots and UMAPs (<xref ref-type="fig" rid="F2">Figure 2A</xref> and <xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 5A</xref>). The transcripts of Rpl27a in split violin plots (<xref ref-type="fig" rid="F2">Figure 2B</xref>) and UMAPs (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 6</xref>) further confirmed the significantly upregulated transcription in cancer cells of all the cancer models compared to normal epithelial cells in all the mammary developmental stages. Consistently, Rpl15 was also significantly upregulated and Rpl29 and Rpl13a were downregulated (<xref ref-type="fig" rid="F2">Figures 2A,B</xref> and <xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 5A, 6</xref>). To further quantify the expression of Rpl27a, we calculated the percentage of the cells with Rpl27a expression at Rpl27a &#x003E; 3. Notably, percentages of cells with Rpl27a expression among the four tumor models were comparable but were significantly higher than those of normal mammary epithelial cells of developmental stages (<xref ref-type="fig" rid="F2">Figure 2C</xref>). This was also true for Rpl15 (<xref ref-type="fig" rid="F2">Figure 2D</xref>). On the contrary, percentages of Rpl29-expressing and Rpl13a-expressing cells were notably decreased in cancer models (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 5B,C</xref>). These data confirmed that Rpl27a was potentially a diagnosis biomarker for TNBC in the mouse models, but its expression levels in human breast cancer and its functions and underlying mechanisms needed to be further determined.</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption><p>Upregulated Rpl27a and Rpl15 in cancer cells of the mouse models. <bold>(A)</bold> Violin plots showing transcription levels of Rpl27a, Rpl15, Rpl29, and Rpl13a in normal epithelial cells and breast cancer cells. <bold>(B)</bold> Visualization of transcription levels of Rpl27a, Rpl15, Rpl29, and Rpl13a in epithelial cells of each developmental stage and breast cancer cells of each mouse model by split violin plots. <bold>(C,D)</bold> Quantification of the percentage of cells with Rpl27a &#x003E; 3 <bold>(C)</bold> or Rpl15 &#x003E; 3 <bold>(D)</bold> in each developmental stage and breast cancer mouse model. &#x002A;&#x002A;&#x002A;&#x002A;<italic>p</italic> &#x003C; 0.0001.</p></caption>
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<sec id="S3.SS4">
<title>Gene Expression Patterns of Primary and Metastatic TNBC Cells</title>
<p>To validate the expression of Rpl27a in human TNBC tumor cells, we first accessed a published scRNA-seq data on primary human TNBC tumors (<xref ref-type="bibr" rid="B25">Karaayvaz et al., 2018</xref>). Similar to the analysis of mouse scRNA-seq data, we performed QC to remove the low-quality cells (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 7A,B</xref>). High-quality cells were then clustered (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 7C</xref>), and major cell types were identified by canonical cell-type marker expression (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 7D,E</xref>). The cancer cells were subset for further analysis (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 7F</xref>). We also extracted the scRNA-seq data on human metastatic TNBC cells to the brain from another dataset. Two batches of data were integrated, and QC was performed to remove the low-quality cells (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 8A,B</xref>). Retained cells were clustered (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 8C</xref>), and major cell types were defined (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 8D,E</xref>). Cancer cells were then subset for further analysis (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 8F</xref>).</p>
<p>The purified primary and metastatic cancer cells were integrated and clustered (<xref ref-type="fig" rid="F3">Figure 3A</xref>), and three major cell clusters were identified (<xref ref-type="fig" rid="F3">Figure 3B</xref>). Quantitatively, primary cancer cells shared equal percentage in cluster 0 and cluster 2 and had lower percentage in cluster 1 (<xref ref-type="fig" rid="F3">Figure 3C</xref>). To determine the lineage differentiation potentials of the cancer clusters, we loaded the cells into Slingshot packages, packages that provided unified interface to dozens of different trajectory inference methods <italic>via</italic> docker containers, for pseudotime analysis. The cancer cell clusters were matched to the clusters defined above, and the development went along a cluster 1&#x2013;cluster 0&#x2013;cluster 2 axis (<xref ref-type="fig" rid="F3">Figure 3D</xref>). Analysis on inferred trajectory and principal curves demonstrated smoothed representations of each subcluster (<xref ref-type="fig" rid="F3">Figure 3E</xref>). Slingshot analysis revealed a pseudotime starting from cluster 1 and ending at cluster 2 (<xref ref-type="fig" rid="F3">Figure 3F</xref>), which is consistent with the quantification analysis that primary cells contributed higher-percentage cells to cluster 1 and lower-percentage cells to cluster 2 compared to metastatic cells (<xref ref-type="fig" rid="F3">Figure 3C</xref>, bottom panel). This analysis suggested that most metastatic cells (cluster 2) were mostly derived from less metastatic cells (clusters 0 and 1).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption><p>Gene expression patterns of primary and metastatic cancer cells of human TNBC cells. <bold>(A)</bold> Purified primary and metastatic cancer cells were integrated, and UMAP showed cell distribution. <bold>(B)</bold> Cells were clustered, and three clusters were identified. <bold>(C)</bold> The cell percentage of primary and metastatic cancer cells in each cluster and the cell percentage of each cluster in primary and metastatic cancer cells were quantified. <bold>(D,E)</bold> Slingshot analysis identified the inferred trajectory <bold>(D)</bold> and principal curves <bold>(E)</bold> of the cancer cell clusters. <bold>(F)</bold> Pseudotime analysis for the cancer cell clusters was visualized by UMAP. <bold>(G,H)</bold> Heatmap visualization of the top 100 genes of each cancer cell cluster <bold>(G)</bold> and top 500 genes of the primary and metastatic cancer cells <bold>(H)</bold>. <bold>(I,J)</bold> The violin plot showed the top 20 genes upregulated in primary <bold>(I)</bold> or metastatic <bold>(J)</bold> cancer cells.</p></caption>
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<p>Comparative analysis revealed gene expression patterns of the three clusters, which was presented by the top 100 genes of each cluster (<xref ref-type="fig" rid="F3">Figure 3G</xref>). Gene profiles visualized by the top 500 genes confirmed the specific gene expression patterns of both primary and metastatic cancer cells (<xref ref-type="fig" rid="F3">Figure 3H</xref>). We then visualized the top 20 upregulated genes of both primary and metastatic cancer cells and showed their expression by violin plots (<xref ref-type="fig" rid="F3">Figures 3I,J</xref>). Many of the genes upregulated in primary cancer cells showed some potential association in breast cancer progression and metastasis inhibition. In both genetically engineered mouse models and xenograft models, lncRNA MALAT1 overexpression inhibits, while MALAT1 deficiency induces breast cancer metastasis, which is reversed by re-expression of MALAT1, suggesting that MALAT1 is a metastasis-suppressing lncRNA (<xref ref-type="bibr" rid="B27">Kim et al., 2018</xref>). SRSF3 and HNRNPH1 regulate a splicing hotspot of HER2 in breast cancer cells (<xref ref-type="bibr" rid="B17">Gautrey et al., 2015</xref>). Another lncRNA KCNQ1OT1 is correlated with human breast cancer cell development through inverse regulation of miR-145 (<xref ref-type="bibr" rid="B14">Feng et al., 2018</xref>). TRA2A promotes paclitaxel resistance and tumor progression in TNBC <italic>via</italic> regulating alternative splicing (<xref ref-type="bibr" rid="B31">Liu et al., 2017</xref>). Notably, majority of the genes upregulated in metastatic cancer cells were ribosome protein genes (<xref ref-type="fig" rid="F3">Figure 3J</xref>), suggesting that these genes were closely related with TNBC cell metastasis.</p>
</sec>
<sec id="S3.SS5">
<title>Upregulation of RPL27A in Cancer Cells of Human TNBC Tissues</title>
<p>Among the ribosome protein genes, the RPL27A and RPL15 genes were upregulated in metastatic cancer cells with significant differences, which was consistent with the data in mouse breast cancer models (<xref ref-type="fig" rid="F4">Figures 4A,C</xref>). The split UMAP visualization of RPL27A and RPL15 expressions in primary and metastatic cancer cells confirmed these differences (<xref ref-type="fig" rid="F4">Figures 4B,D</xref>). As RPL15 was a reported pro-metastasis gene in breast cancer (<xref ref-type="bibr" rid="B11">Ebright et al., 2020</xref>), we next checked the transcript colocalization of RPL27A with RPL15 in primary, metastatic, and integrated data. Surprisingly, RPL27A was well colocalized with RPL15 only in metastatic cancer cells; however, in primary cancer cells, the transcripts of the two genes were low and rarely colocalized (<xref ref-type="fig" rid="F4">Figure 4E</xref>). Although Rpl29 and Rpl13a were downregulated in cancer cells of mouse models compared to normal mammary epithelial cells, these two genes were significantly upregulated in metastatic cancer cells compared to primary cancer cells (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 9</xref>). These inconsistent findings suggested diverse functions of these genes or an inconsistent phenotype between mouse models and human tumor data (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 9</xref>). Notably, the transcript levels of these four genes in total cells were also upregulated in metastatic TNBC tissues (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 10A</xref>).</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption><p>Upregulated RPL27A and RPL15 in metastatic TNBC cancer cells. <bold>(A,C)</bold> Violin plot representing the expression of RPL27A <bold>(A)</bold> and RPL15 <bold>(C)</bold> in primary and metastatic TNBC cancer cells. <bold>(B,D)</bold> UMAP confirmation of RPL27A <bold>(B)</bold> and RPL15 <bold>(D)</bold> expression in primary and metastatic TNBC cancer cells. <bold>(E)</bold> Colocalization of RPL27A and RPL15 transcription in the integrated TNBC cancer cells, primary TNBC cancer cells, and metastatic TNBC cancer cells.</p></caption>
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<sec id="S3.SS6">
<title>Blocking RPL27A Blunted TNBC Cell Migration and Invasion</title>
<p>To further confirm the potentials of RPL27A in regulating cancer cell metastasis, an <italic>in vitro</italic> model was generated on a human TNBC cell line, MDA-MB-231. RPL27A knockdown was performed on MDA-MB-231 cells by shRPL27A adenovirus transfection, and the knockdown efficiency was confirmed by quantitative real-time PCR (qRT-PCR) and western blot (<xref ref-type="fig" rid="F5">Figures 5A&#x2013;C</xref>). The cells were then used for migration and invasion assays, and significantly reduced cell numbers in both migration and invasion assays were confirmed by cell quantification (<xref ref-type="fig" rid="F5">Figures 5D&#x2013;G</xref>). These data further suggested that RPL27A was required for TNBC cell metastasis. More interestingly, RPL27A knockdown also caused significant downregulation of many other ribosomal genes (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 10B</xref>).</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption><p>RPL27A knockdown decreased cell migration and invasion in the TNBC cell line. <bold>(A&#x2013;C)</bold> Knockdown efficiency of RPL27A in MDA-MB-231 cells was confirmed by qRT-PCR <bold>(A)</bold> and western blot <bold>(B,C)</bold>. <bold>(D,F)</bold> Representative images of migration <bold>(D)</bold> and invasion <bold>(F)</bold> assays on RPL27A-knockdown and controls cells. <bold>(E,G)</bold> Quantification of cell numbers in each image of migration <bold>(E)</bold> and invasion <bold>(G)</bold> assays. Scale bar, 50 &#x03BC;m. &#x002A;&#x002A;<italic>p</italic> &#x003C; 0.01; &#x002A;&#x002A;&#x002A;<italic>p</italic> &#x003C; 0.001.</p></caption>
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<sec id="S3.SS7">
<title>Deregulated Ribosomal Gene Expression in Metastatic TNBC Cells</title>
<p>As many of the ribosomal protein genes were in the top gene list of the metastatic human TNBC cells, we proposed that the ribosomal protein genes were deregulated in TNBC metastasis. We then listed all the significantly differentially expressed ribosome protein genes and visualized them by heatmap (<xref ref-type="fig" rid="F6">Figure 6A</xref>), and among them RPL27A, RPL15, RPL13A, and RPL29 were the top genes. We also separated the RPL genes and RPS genes and scored their expression by UMAPs (<xref ref-type="fig" rid="F6">Figures 6B,C</xref>). Both the scores of RPL genes and RPS genes were significantly higher in metastatic cancer cell compared to those of primary cancer cells (<xref ref-type="fig" rid="F6">Figures 6B,C</xref>). We next input these genes and their corresponding expression fold changes and <italic>p</italic>-values into IPA, and the top ingenuity canonical pathways and upstream regulators were visualized by bar plots (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figures 10C,D</xref>). The graphic regulatory network based on the IPA revealed that EIF2 signaling was the core regulating signaling pathway (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 10E</xref>).</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption><p>Deregulated ribosome protein genes in metastatic cancer cells. <bold>(A)</bold> Heatmap visualization of the expression of upregulated ribosome protein genes in the primary and metastatic cancer cells. <bold>(B,C)</bold> Scores of the RPL genes <bold>(B)</bold> and RPS genes <bold>(C)</bold> in primary, metastatic, and integrated data.</p></caption>
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</sec>
<sec id="S3.SS8">
<title>Activated EIF2 Signaling in Metastatic TNBC Cells</title>
<p>Epithelial&#x2013;mesenchymal transition (EMT) is one of the major characteristics of breast cancer metastasis. EMT programs were believed to reflect a loss of epithelial gene expression signatures and morphologies that gave way to those associated with mesenchymal cells and their enhanced migratory and invasive behaviors (<xref ref-type="bibr" rid="B18">Gooding and Schiemann, 2020</xref>). To check the EMT activities of the primary and metastatic cancer cells, the transcriptional levels of canonical EMT-related signature genes, including epithelial feature genes (CDH1, KRT8, KRT18, CTNNB1, and ZEB1), mesenchymal feature genes (VIM, S100A4, FN1, and LAMA5), and EMT signature genes (SNAI1, SNAI2, ITGB6, TGFB1, and TGFB2) were visualized and compared between primary and metastatic cancer cells (<xref ref-type="fig" rid="F7">Figure 7A</xref>). Significantly decreased epithelial signatures and increased mesenchymal and EMT signatures were found in metastatic cancer cells. Scoring of the epithelial signatures and mesenchymal signatures on primary and metastatic cancer cells further confirmed decreased epithelial scores and increased mesenchymal scores in metastatic cancer cells (<xref ref-type="fig" rid="F7">Figures 7B,C</xref>).</p>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption><p>Increased EMT activities and activated EIF2 signaling in metastatic cancer cells. <bold>(A)</bold> Violin plot visualization of representative EMT marker gene expression in primary and metastatic cancer cells. <bold>(B,C)</bold> UMAP visualization of epithelial <bold>(B)</bold> and mesenchymal <bold>(C)</bold> scores of the primary and metastatic cancer cells. <bold>(D)</bold> Bar plots of the top ingenuity canonical pathways based on the upregulated genes of the metastatic cancer cells. <bold>(E)</bold> Increased expression of EIF2 signaling effector genes in metastatic cancer cells by violin plots. Color codes: orange, upregulated; blue, downregulated. Color shapes: different molecular/gene types. Lines: solid lines, direct regulation; dashed lines, indirect regulation. <bold>(F)</bold> Graphic regulatory networks of the top signaling pathways and regulators of metastatic cancer cells.</p></caption>
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<p>To determine the major cancer metastasis-related signaling pathways, the differentially expressed genes between primary and metastatic cancer cells were input into IPA. The top 1 ingenuity canonical pathway was EIF2 signaling, and this (<xref ref-type="fig" rid="F7">Figure 7D</xref>), together with the IPA on ribosome protein genes, further confirmed that EIF2 signaling was the key driver of the TNBC metastasis in human. To further confirm that, we checked the expression of the major component genes of EIF2 signaling and found upregulation of multiple genes, including EIF2AK1 (HRI protein coding gene), EIF2AK2 (PKR protein coding gene), EIF2AK4 (GCN2 protein coding gene), EIF2B5, and AKT2 (<xref ref-type="fig" rid="F7">Figure 7E</xref>; <xref ref-type="bibr" rid="B37">Rios-Fuller et al., 2020</xref>). Other ingenuity canonical pathways included regulation of eIF4 and p70S6K signaling and mTOR signaling (<xref ref-type="fig" rid="F7">Figure 7D</xref>), both of which were closely associated with TNBC biological activities (<xref ref-type="bibr" rid="B33">Madden et al., 2014</xref>; <xref ref-type="bibr" rid="B44">Wang et al., 2017</xref>; <xref ref-type="bibr" rid="B49">Zagorac et al., 2018</xref>). Graphic regulatory networks integrating ingenuity canonical pathways and upstream regulators of the metastatic cells gave a core pathway of cell viability of breast cancer cells, which was closely related with EIF2 signaling and regulators of RB1, TP53, and MYC (<xref ref-type="fig" rid="F7">Figure 7F</xref>).</p>
<p>The salubrinal derivative Sal003 is the most commonly used eIF2&#x03B1; inhibitor II (<xref ref-type="bibr" rid="B38">Robert et al., 2006</xref>; <xref ref-type="bibr" rid="B3">Baltzis et al., 2007</xref>). To better validate the functions of EIF2 in TNBC metastasis, we inhibited EIF2 signaling in the MDA-MB-231 cells with Sal003 at different doses. Consistently, both the mRNA levels of RPL27A and RPL15 were significantly decreased after Sal003 treatment at a dose-dependent manner (<xref ref-type="fig" rid="F8">Figures 8A,B</xref>), and this is also true for many other ribosome-related genes we detected (<xref ref-type="supplementary-material" rid="DS1">Supplementary Figure 10F</xref>). More importantly, Sal003 treatment dramatically attenuated MDA-MB-231 cell migration and invasion (<xref ref-type="fig" rid="F8">Figures 8C&#x2013;F</xref>), suggesting an attractively reduced metastasis potential in cancer cells when blocking EIF2 signaling. All these findings supplied basic foundations for further studies and potential therapeutic target development of TNBC and were likely to attract a broad audience.</p>
<fig id="F8" position="float">
<label>FIGURE 8</label>
<caption><p>Blocking EIF2 signaling decreased TNBC cell migration and invasion. <bold>(A,B)</bold> mRNA levels of RPL27A and RPL15 in MDA-MB-231 cells after treatment of different doses of the EIF2 signaling inhibitor Sal003. <bold>(C,E)</bold> Representative images of migration <bold>(C)</bold> and invasion <bold>(E)</bold> assays on MDA-MB-231 cells after treatment of different doses of Sal003 or DMSO control. <bold>(D,F)</bold> Quantification of cell numbers in each image of migration <bold>(D)</bold> and invasion <bold>(F)</bold> assays. Scale bar, 50 &#x03BC;m. &#x002A;&#x002A;<italic>p</italic> &#x003C; 0.01; &#x002A;&#x002A;&#x002A;<italic>p</italic> &#x003C; 0.001; &#x002A;&#x002A;&#x002A;&#x002A;<italic>p</italic> &#x003C; 0.0001.</p></caption>
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<sec id="S4">
<title>Discussion</title>
<p>Triple-negative breast cancer accounts for approximately 10&#x2013;15% of all breast cancers and has a higher incidence in some specific ethnicities, including Latin, African, and African American women (<xref ref-type="bibr" rid="B32">Lund et al., 2009</xref>). These tumors are characterized by aggressive behaviors, with a trend to early relapse and capable of metastatically spreading to the lung, liver, and central nervous system, as well as having poorer survival (<xref ref-type="bibr" rid="B9">Dent et al., 2007</xref>). However, to date, targeted therapies have not significantly improved survival in patients with TNBC, and chemotherapy remains the standard of clinical care (<xref ref-type="bibr" rid="B16">Garrido-Castro et al., 2019</xref>). The identification of biomarkers that can help guide treatment decisions in TNBC remains a clinically unmet need.</p>
<p>To improve the therapeutic benefit of TNBC treatment, numbers of agents have been under exploration of clinical studies, including immunotherapies and targeted therapies in the networks of tumor&#x2013;stroma, DNA damage response, cell surface or intracellular receptors, and signaling pathways as well as cell surface markers for selective drug delivery and antibody&#x2013;drug conjugates (<xref ref-type="bibr" rid="B46">Won and Spruck, 2020</xref>). Recent advances in new agents have been made for specific subgroups of patients with PD-L1<sup>+</sup> tumors (<xref ref-type="bibr" rid="B40">Schutz et al., 2017</xref>) or gBRCAm tumors (<xref ref-type="bibr" rid="B46">Won and Spruck, 2020</xref>). However, only a small subgroup of those patients responds to immune checkpoint or PARP inhibitors, and some often develop resistance and relapse. In these complex tumor microenvironments, a specific therapeutic agent often shows variable responses, thus compromising the survival endpoints, especially in an unselected TNBC population. Therefore, developing novel predictive biomarkers is crucial for selecting patients who will benefit the most from a given therapy.</p>
<p>The development of single-cell technologies provides additional insights on tumor microenvironments and diverse cell-type interactions and thus facilitates a compelling rationale for new treatments based on novel biomarkers (<xref ref-type="bibr" rid="B10">Ding et al., 2020</xref>; <xref ref-type="bibr" rid="B12">Fan et al., 2020</xref>; <xref ref-type="bibr" rid="B20">Guruprasad et al., 2021</xref>). Single-cell omics studies enable gene expression profiling at the single-cell levels and detection of gene expression differences within cell populations and among disease stages. Therefore, novel biomarkers related to cancer progression and response to target therapies might be revealed by these novel technologies. Here, in the current study, by using scRNA-seq profiling of cancer-associated cells and comparative analysis, we developed specific gene expression patterns during TNBC development, progression, and metastasis in both murine and human cells. Among the deregulated gene candidates, ribosome protein genes were highly involved in TNBC development and metastasis, and two of the most consistent genes between mouse models and human cancer were RPL15 and RPL27A.</p>
<p>A most recent study conducted an <italic>in vivo</italic> genome-wide CRISPR activation screen in circulating tumor cells from breast cancer patients to identify genes that promoted distant metastasis in mice. Genes coding for ribosomal proteins and regulators of translation were enriched in this screen. Overexpression of RPL15 increased metastatic growth in multiple organs and selectively enhanced translation of other ribosomal proteins and cell cycle regulators (<xref ref-type="bibr" rid="B11">Ebright et al., 2020</xref>). This report, in coordination with our data, confirmed the participation of RPL15 in breast cancer cell metastasis.</p>
<p>RPL27A, a ribosomal subunit protein, has been well studied to conduct diverse responsibilities in multiple disease phenotypes; however, its functions in cancer, especially in breast cancers, have been rarely determined with a few exceptions. RPL27A was one of the genes that are frequently co-expressed in breast cancer patients with RPS16, which was thought to be one of the targets of miR-7641 (<xref ref-type="bibr" rid="B36">Reza et al., 2017</xref>). RPL27A was also one of the differentially expressed genes in the ribosome pathway involved in breast cancer using the Gibbs sampling approach (<xref ref-type="bibr" rid="B52">Zhou et al., 2017</xref>). Moreover, RPL27A was thought to be a target of miR-595 and might contribute to the myelodysplastic phenotype through ribosomal dysgenesis <italic>via</italic> the effects of p53 activation, ribosome synthesis, and maturation (<xref ref-type="bibr" rid="B1">Alkhatabi et al., 2016</xref>). Although these studies had some correlation with RPL27A, the specific functions and mechanisms of RPL27A were largely unknown. In the current study, we well described the involvement of RPL27A in TNBC development and metastasis in murine and human cells. Consistent to its upregulation in metastatic cancer cells, knockdown of RPL27A significantly decreased the migration and invasion of the TNBC cell line, as well as other ribosome-related genes. IPA identified a key signaling pathway, EIF2 signaling, which was potentially driving the deregulation of ribosomal genes and metastasis of the TNBC cancer cells. Although the involvements of EIF2 in initiation and progression of tumor have been actively studied, the current understanding of the roles eIF2&#x03B1; in cancer (<xref ref-type="bibr" rid="B22">Holcik, 2015</xref>; <xref ref-type="bibr" rid="B29">Koromilas, 2015</xref>; <xref ref-type="bibr" rid="B21">Hao et al., 2020</xref>), especially breast cancer, is still unclear and needs further investigation (<xref ref-type="bibr" rid="B51">Zheng et al., 2014</xref>). Our <italic>in vitro</italic> assays demonstrated that blocking EIF2 signaling significantly inhibited TNBC cell migration and invasion. Although the mechanisms of this signaling pathway in breast cancer metastasis needed further investigation, our findings shed light on the discovery of novel biomarkers for TNBC and might generate a foundation for future studies of ribosome proteins in the development, progression, and metastasis of TNBC. We believed that RPL27A was a specific biomarker for TNBC diagnosis and was potentially a novel therapeutic target for TNBC.</p>
</sec>
<sec id="S5">
<title>Data Availability Statement</title>
<p>The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/<xref ref-type="supplementary-material" rid="DS1">Supplementary Material</xref>.</p>
</sec>
<sec id="S6">
<title>Ethics Statement</title>
<p>All human lung experiments were approved by the Institutional Review Board of Tianjin Medical University Cancer Institute and Hospital and were in accordance with the guidelines outlined by the IRB. The patients/participants provided their written informed consent to participate in this study.</p>
</sec>
<sec id="S7">
<title>Author Contributions</title>
<p>WZ and ZT conceived the study and prepared the manuscript. WZ and XL analyzed the data. WZ and YZ prepared the reagents and performed the experiments. JW, XW, and LS reviewed the result and the discussion of the manuscript. All authors read and approved the manuscript.</p>
</sec>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="pudiscl1">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
<back>
<fn-group>
<fn fn-type="financial-disclosure">
<p><bold>Funding.</bold> This work was supported by grants from the National Natural Science Foundation of China (grant number 81472183) and the Natural Science Foundation of Tianjin (grant number 18JCYBJC91600).</p>
</fn>
</fn-group>
<sec id="S9" sec-type="supplementary-material">
<title>Supplementary Material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fcell.2021.716730/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fcell.2021.716730/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="Data_Sheet_1.pdf" id="DS1" mimetype="application/pdf" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
<ref-list>
<title>References</title>
<ref id="B1"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Alkhatabi</surname> <given-names>H. A.</given-names></name> <name><surname>McLornan</surname> <given-names>D. P.</given-names></name> <name><surname>Kulasekararaj</surname> <given-names>A. G.</given-names></name> <name><surname>Malik</surname> <given-names>F.</given-names></name> <name><surname>Seidl</surname> <given-names>T.</given-names></name> <name><surname>Darling</surname> <given-names>D.</given-names></name><etal/></person-group> (<year>2016</year>). <article-title>RPL27A is a target of miR-595 and may contribute to the myelodysplastic phenotype through ribosomal dysgenesis.</article-title> <source><italic>Oncotarget</italic></source> <volume>7</volume> <fpage>47875</fpage>&#x2013;<lpage>47890</lpage>. <pub-id pub-id-type="doi">10.18632/oncotarget.10293</pub-id> <pub-id pub-id-type="pmid">27374104</pub-id></citation></ref>
<ref id="B2"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bach</surname> <given-names>K.</given-names></name> <name><surname>Pensa</surname> <given-names>S.</given-names></name> <name><surname>Grzelak</surname> <given-names>M.</given-names></name> <name><surname>Hadfield</surname> <given-names>J.</given-names></name> <name><surname>Adams</surname> <given-names>D. J.</given-names></name> <name><surname>Marioni</surname> <given-names>J. C.</given-names></name><etal/></person-group> (<year>2017</year>). <article-title>Differentiation dynamics of mammary epithelial cells revealed by single-cell RNA sequencing.</article-title> <source><italic>Nat. Commun.</italic></source> <volume>8</volume>:<fpage>2128</fpage>. <pub-id pub-id-type="doi">10.1038/s41467-017-02001-5</pub-id> <pub-id pub-id-type="pmid">29225342</pub-id></citation></ref>
<ref id="B3"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Baltzis</surname> <given-names>D.</given-names></name> <name><surname>Pluquet</surname> <given-names>O.</given-names></name> <name><surname>Papadakis</surname> <given-names>A. I.</given-names></name> <name><surname>Kazemi</surname> <given-names>S.</given-names></name> <name><surname>Qu</surname> <given-names>L. K.</given-names></name> <name><surname>Koromilas</surname> <given-names>A. E.</given-names></name></person-group> (<year>2007</year>). <article-title>The eIF2alpha kinases PERK and PKR activate glycogen synthase kinase 3 to promote the proteasomal degradation of p53.</article-title> <source><italic>J. Biol. Chem.</italic></source> <volume>282</volume> <fpage>31675</fpage>&#x2013;<lpage>31687</lpage>. <pub-id pub-id-type="doi">10.1074/jbc.M704491200</pub-id> <pub-id pub-id-type="pmid">17785458</pub-id></citation></ref>
<ref id="B4"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bianchini</surname> <given-names>G.</given-names></name> <name><surname>Balko</surname> <given-names>J. M.</given-names></name> <name><surname>Mayer</surname> <given-names>I. A.</given-names></name> <name><surname>Sanders</surname> <given-names>M. E.</given-names></name> <name><surname>Gianni</surname> <given-names>L.</given-names></name></person-group> (<year>2016</year>). <article-title>Triple-negative breast cancer: challenges and opportunities of a heterogeneous disease.</article-title> <source><italic>Nat. Rev. Clin. Oncol.</italic></source> <volume>13</volume> <fpage>674</fpage>&#x2013;<lpage>690</lpage>. <pub-id pub-id-type="doi">10.1038/nrclinonc.2016.66</pub-id> <pub-id pub-id-type="pmid">27184417</pub-id></citation></ref>
<ref id="B5"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bresson</surname> <given-names>L.</given-names></name> <name><surname>Faraldo</surname> <given-names>M. M.</given-names></name> <name><surname>Di-Cicco</surname> <given-names>A.</given-names></name> <name><surname>Quintanilla</surname> <given-names>M.</given-names></name> <name><surname>Glukhova</surname> <given-names>M. A.</given-names></name> <name><surname>Deugnier</surname> <given-names>M. A.</given-names></name></person-group> (<year>2018</year>). <article-title>Podoplanin regulates mammary stem cell function and tumorigenesis by potentiating Wnt/beta-catenin signaling.</article-title> <source><italic>Development</italic></source> <volume>145</volume>:<fpage>dev160382</fpage>. <pub-id pub-id-type="doi">10.1242/dev.160382</pub-id> <pub-id pub-id-type="pmid">29361573</pub-id></citation></ref>
<ref id="B6"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ciriello</surname> <given-names>G.</given-names></name> <name><surname>Gatza</surname> <given-names>M. L.</given-names></name> <name><surname>Beck</surname> <given-names>A. H.</given-names></name> <name><surname>Wilkerson</surname> <given-names>M. D.</given-names></name> <name><surname>Rhie</surname> <given-names>S. K.</given-names></name> <name><surname>Pastore</surname> <given-names>A.</given-names></name><etal/></person-group> (<year>2015</year>). <article-title>Comprehensive molecular portraits of invasive lobular breast cancer.</article-title> <source><italic>Cell</italic></source> <volume>163</volume> <fpage>506</fpage>&#x2013;<lpage>519</lpage>. <pub-id pub-id-type="doi">10.1016/j.cell.2015.09.033</pub-id> <pub-id pub-id-type="pmid">26451490</pub-id></citation></ref>
<ref id="B7"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Collignon</surname> <given-names>J.</given-names></name> <name><surname>Lousberg</surname> <given-names>L.</given-names></name> <name><surname>Schroeder</surname> <given-names>H.</given-names></name> <name><surname>Jerusalem</surname> <given-names>G.</given-names></name></person-group> (<year>2016</year>). <article-title>Triple-negative breast cancer: treatment challenges and solutions.</article-title> <source><italic>Breast Cancer (Dove Med. Press)</italic></source> <volume>8</volume> <fpage>93</fpage>&#x2013;<lpage>107</lpage>. <pub-id pub-id-type="doi">10.2147/BCTT.S69488</pub-id> <pub-id pub-id-type="pmid">27284266</pub-id></citation></ref>
<ref id="B8"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Dave</surname> <given-names>B.</given-names></name> <name><surname>Granados-Principal</surname> <given-names>S.</given-names></name> <name><surname>Zhu</surname> <given-names>R.</given-names></name> <name><surname>Benz</surname> <given-names>S.</given-names></name> <name><surname>Rabizadeh</surname> <given-names>S.</given-names></name> <name><surname>Soon-Shiong</surname> <given-names>P.</given-names></name><etal/></person-group> (<year>2014</year>). <article-title>Targeting RPL39 and MLF2 reduces tumor initiation and metastasis in breast cancer by inhibiting nitric oxide synthase signaling.</article-title> <source><italic>Proc. Natl. Acad. Sci. U.S.A.</italic></source> <volume>111</volume> <fpage>8838</fpage>&#x2013;<lpage>8843</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.1320769111</pub-id> <pub-id pub-id-type="pmid">24876273</pub-id></citation></ref>
<ref id="B9"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Dent</surname> <given-names>R.</given-names></name> <name><surname>Trudeau</surname> <given-names>M.</given-names></name> <name><surname>Pritchard</surname> <given-names>K. I.</given-names></name> <name><surname>Hanna</surname> <given-names>W. M.</given-names></name> <name><surname>Kahn</surname> <given-names>H. K.</given-names></name> <name><surname>Sawka</surname> <given-names>C. A.</given-names></name><etal/></person-group> (<year>2007</year>). <article-title>Triple-negative breast cancer: clinical features and patterns of recurrence.</article-title> <source><italic>Clin. Cancer Res.</italic></source> <volume>13(15 Pt 1)</volume> <fpage>4429</fpage>&#x2013;<lpage>4434</lpage>. <pub-id pub-id-type="doi">10.1158/1078-0432.CCR-06-3045</pub-id> <pub-id pub-id-type="pmid">17671126</pub-id></citation></ref>
<ref id="B10"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ding</surname> <given-names>S.</given-names></name> <name><surname>Chen</surname> <given-names>X.</given-names></name> <name><surname>Shen</surname> <given-names>K.</given-names></name></person-group> (<year>2020</year>). <article-title>Single-cell RNA sequencing in breast cancer: understanding tumor heterogeneity and paving roads to individualized therapy.</article-title> <source><italic>Cancer Commun. (Lond)</italic></source> <volume>40</volume> <fpage>329</fpage>&#x2013;<lpage>344</lpage>. <pub-id pub-id-type="doi">10.1002/cac2.12078</pub-id> <pub-id pub-id-type="pmid">32654419</pub-id></citation></ref>
<ref id="B11"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ebright</surname> <given-names>R. Y.</given-names></name> <name><surname>Lee</surname> <given-names>S.</given-names></name> <name><surname>Wittner</surname> <given-names>B. S.</given-names></name> <name><surname>Niederhoffer</surname> <given-names>K. L.</given-names></name> <name><surname>Nicholson</surname> <given-names>B. T.</given-names></name> <name><surname>Bardia</surname> <given-names>A.</given-names></name><etal/></person-group> (<year>2020</year>). <article-title>Deregulation of ribosomal protein expression and translation promotes breast cancer metastasis.</article-title> <source><italic>Science</italic></source> <volume>367</volume> <fpage>1468</fpage>&#x2013;<lpage>1473</lpage>. <pub-id pub-id-type="doi">10.1126/science.aay0939</pub-id> <pub-id pub-id-type="pmid">32029688</pub-id></citation></ref>
<ref id="B12"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fan</surname> <given-names>J.</given-names></name> <name><surname>Slowikowski</surname> <given-names>K.</given-names></name> <name><surname>Zhang</surname> <given-names>F.</given-names></name></person-group> (<year>2020</year>). <article-title>Single-cell transcriptomics in cancer: computational challenges and opportunities.</article-title> <source><italic>Exp. Mol. Med.</italic></source> <volume>52</volume> <fpage>1452</fpage>&#x2013;<lpage>1465</lpage>. <pub-id pub-id-type="doi">10.1038/s12276-020-0422-0</pub-id> <pub-id pub-id-type="pmid">32929226</pub-id></citation></ref>
<ref id="B13"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fancello</surname> <given-names>L.</given-names></name> <name><surname>Kampen</surname> <given-names>K. R.</given-names></name> <name><surname>Hofman</surname> <given-names>I. J.</given-names></name> <name><surname>Verbeeck</surname> <given-names>J.</given-names></name> <name><surname>De Keersmaecker</surname> <given-names>K.</given-names></name></person-group> (<year>2017</year>). <article-title>The ribosomal protein gene RPL5 is a <italic>haploinsufficient tumor</italic> suppressor in multiple cancer types.</article-title> <source><italic>Oncotarget</italic></source> <volume>8</volume> <fpage>14462</fpage>&#x2013;<lpage>14478</lpage>. <pub-id pub-id-type="doi">10.18632/oncotarget.14895</pub-id> <pub-id pub-id-type="pmid">28147343</pub-id></citation></ref>
<ref id="B14"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Feng</surname> <given-names>W.</given-names></name> <name><surname>Wang</surname> <given-names>C.</given-names></name> <name><surname>Liang</surname> <given-names>C.</given-names></name> <name><surname>Yang</surname> <given-names>H.</given-names></name> <name><surname>Chen</surname> <given-names>D.</given-names></name> <name><surname>Yu</surname> <given-names>X.</given-names></name><etal/></person-group> (<year>2018</year>). <article-title>The dysregulated expression of KCNQ1OT1 and its interaction with downstream factors miR-145/CCNE2 in breast cancer cells.</article-title> <source><italic>Cell Physiol. Biochem.</italic></source> <volume>49</volume> <fpage>432</fpage>&#x2013;<lpage>446</lpage>. <pub-id pub-id-type="doi">10.1159/000492978</pub-id> <pub-id pub-id-type="pmid">30157476</pub-id></citation></ref>
<ref id="B15"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fu</surname> <given-names>D.</given-names></name> <name><surname>He</surname> <given-names>C.</given-names></name> <name><surname>Wei</surname> <given-names>J.</given-names></name> <name><surname>Zhang</surname> <given-names>Z.</given-names></name> <name><surname>Luo</surname> <given-names>Y.</given-names></name> <name><surname>Tan</surname> <given-names>H.</given-names></name><etal/></person-group> (<year>2018</year>). <article-title>PGK1 is a potential survival biomarker and invasion promoter by regulating the HIF-1alpha-mediated epithelial-mesenchymal transition process in breast cancer.</article-title> <source><italic>Cell Physiol. Biochem.</italic></source> <volume>51</volume> <fpage>2434</fpage>&#x2013;<lpage>2444</lpage>. <pub-id pub-id-type="doi">10.1159/000495900</pub-id> <pub-id pub-id-type="pmid">30537744</pub-id></citation></ref>
<ref id="B16"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Garrido-Castro</surname> <given-names>A. C.</given-names></name> <name><surname>Lin</surname> <given-names>N. U.</given-names></name> <name><surname>Polyak</surname> <given-names>K.</given-names></name></person-group> (<year>2019</year>). <article-title>Insights into molecular classifications of triple-negative breast cancer: improving patient selection for treatment.</article-title> <source><italic>Cancer Discov.</italic></source> <volume>9</volume> <fpage>176</fpage>&#x2013;<lpage>198</lpage>. <pub-id pub-id-type="doi">10.1158/2159-8290.CD-18-1177</pub-id> <pub-id pub-id-type="pmid">30679171</pub-id></citation></ref>
<ref id="B17"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gautrey</surname> <given-names>H.</given-names></name> <name><surname>Jackson</surname> <given-names>C.</given-names></name> <name><surname>Dittrich</surname> <given-names>A. L.</given-names></name> <name><surname>Browell</surname> <given-names>D.</given-names></name> <name><surname>Lennard</surname> <given-names>T.</given-names></name> <name><surname>Tyson-Capper</surname> <given-names>A.</given-names></name></person-group> (<year>2015</year>). <article-title>SRSF3 and hnRNP H1 regulate a splicing hotspot of HER2 in breast cancer cells.</article-title> <source><italic>RNA Biol.</italic></source> <volume>12</volume> <fpage>1139</fpage>&#x2013;<lpage>1151</lpage>. <pub-id pub-id-type="doi">10.1080/15476286.2015.1076610</pub-id> <pub-id pub-id-type="pmid">26367347</pub-id></citation></ref>
<ref id="B18"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gooding</surname> <given-names>A. J.</given-names></name> <name><surname>Schiemann</surname> <given-names>W. P.</given-names></name></person-group> (<year>2020</year>). <article-title>Epithelial-Mesenchymal transition programs and cancer stem cell phenotypes: mediators of breast cancer therapy resistance.</article-title> <source><italic>Mol. Cancer Res.</italic></source> <volume>18</volume> <fpage>1257</fpage>&#x2013;<lpage>1270</lpage>. <pub-id pub-id-type="doi">10.1158/1541-7786.MCR-20-0067</pub-id> <pub-id pub-id-type="pmid">32503922</pub-id></citation></ref>
<ref id="B19"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gothlin Eremo</surname> <given-names>A.</given-names></name> <name><surname>Lagergren</surname> <given-names>K.</given-names></name> <name><surname>Othman</surname> <given-names>L.</given-names></name> <name><surname>Montgomery</surname> <given-names>S.</given-names></name> <name><surname>Andersson</surname> <given-names>G.</given-names></name> <name><surname>Tina</surname> <given-names>E.</given-names></name></person-group> (<year>2020</year>). <article-title>Evaluation of SPP1/osteopontin expression as predictor of recurrence in tamoxifen treated breast cancer.</article-title> <source><italic>Sci. Rep.</italic></source> <volume>10</volume>:<fpage>1451</fpage>. <pub-id pub-id-type="doi">10.1038/s41598-020-58323-w</pub-id> <pub-id pub-id-type="pmid">31996744</pub-id></citation></ref>
<ref id="B20"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Guruprasad</surname> <given-names>P.</given-names></name> <name><surname>Lee</surname> <given-names>Y. G.</given-names></name> <name><surname>Kim</surname> <given-names>K. H.</given-names></name> <name><surname>Ruella</surname> <given-names>M.</given-names></name></person-group> (<year>2021</year>). <article-title>The current landscape of single-cell transcriptomics for cancer immunotherapy.</article-title> <source><italic>J. Exp. Med.</italic></source> <volume>218</volume>:<fpage>e20201574</fpage>. <pub-id pub-id-type="doi">10.1084/jem.20201574</pub-id> <pub-id pub-id-type="pmid">33601414</pub-id></citation></ref>
<ref id="B21"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hao</surname> <given-names>P. Q.</given-names></name> <name><surname>Yu</surname> <given-names>J. J.</given-names></name> <name><surname>Ward</surname> <given-names>R.</given-names></name> <name><surname>Liu</surname> <given-names>Y.</given-names></name> <name><surname>Hao</surname> <given-names>Q.</given-names></name> <name><surname>An</surname> <given-names>S.</given-names></name><etal/></person-group> (<year>2020</year>). <article-title>Eukaryotic translation initiation factors as promising targets in cancer therapy.</article-title> <source><italic>Cell Commun. Signal.</italic></source> <volume>18</volume>:<fpage>175</fpage>. <pub-id pub-id-type="doi">10.1186/s12964-020-00607-9</pub-id> <pub-id pub-id-type="pmid">33148274</pub-id></citation></ref>
<ref id="B22"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Holcik</surname> <given-names>M.</given-names></name></person-group> (<year>2015</year>). <article-title>Could the elF2 alpha-independent translation be the achilles heel of cancer?</article-title> <source><italic>Front. Oncol.</italic></source> <volume>5</volume>:<fpage>264</fpage>. <pub-id pub-id-type="doi">10.3389/fonc.2015.00264</pub-id> <pub-id pub-id-type="pmid">26636041</pub-id></citation></ref>
<ref id="B23"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hong</surname> <given-names>M.</given-names></name> <name><surname>Kim</surname> <given-names>H.</given-names></name> <name><surname>Kim</surname> <given-names>I.</given-names></name></person-group> (<year>2014</year>). <article-title>Ribosomal protein L19 overexpression activates the unfolded protein response and sensitizes MCF7 breast cancer cells to endoplasmic reticulum stress-induced cell death.</article-title> <source><italic>Biochem. Biophys. Res. Commun.</italic></source> <volume>450</volume> <fpage>673</fpage>&#x2013;<lpage>678</lpage>. <pub-id pub-id-type="doi">10.1016/j.bbrc.2014.06.036</pub-id> <pub-id pub-id-type="pmid">24950402</pub-id></citation></ref>
<ref id="B24"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jogi</surname> <given-names>A.</given-names></name> <name><surname>Brennan</surname> <given-names>D. J.</given-names></name> <name><surname>Ryden</surname> <given-names>L.</given-names></name> <name><surname>Magnusson</surname> <given-names>K.</given-names></name> <name><surname>Ferno</surname> <given-names>M.</given-names></name> <name><surname>Stal</surname> <given-names>O.</given-names></name><etal/></person-group> (<year>2009</year>). <article-title>Nuclear expression of the RNA-binding protein RBM3 is associated with an improved clinical outcome in breast cancer.</article-title> <source><italic>Mod. Pathol.</italic></source> <volume>22</volume> <fpage>1564</fpage>&#x2013;<lpage>1574</lpage>. <pub-id pub-id-type="doi">10.1038/modpathol.2009.124</pub-id> <pub-id pub-id-type="pmid">19734850</pub-id></citation></ref>
<ref id="B25"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Karaayvaz</surname> <given-names>M.</given-names></name> <name><surname>Cristea</surname> <given-names>S.</given-names></name> <name><surname>Gillespie</surname> <given-names>S. M.</given-names></name> <name><surname>Patel</surname> <given-names>A. P.</given-names></name> <name><surname>Mylvaganam</surname> <given-names>R.</given-names></name> <name><surname>Luo</surname> <given-names>C. C.</given-names></name><etal/></person-group> (<year>2018</year>). <article-title>Unravelling subclonal heterogeneity and aggressive disease states in TNBC through single-cell RNA-seq.</article-title> <source><italic>Nat. Commun.</italic></source> <volume>9</volume>:<fpage>3588</fpage>. <pub-id pub-id-type="doi">10.1038/s41467-018-06052-0</pub-id> <pub-id pub-id-type="pmid">30181541</pub-id></citation></ref>
<ref id="B26"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kendrick</surname> <given-names>H.</given-names></name> <name><surname>Regan</surname> <given-names>J. L.</given-names></name> <name><surname>Magnay</surname> <given-names>F. A.</given-names></name> <name><surname>Grigoriadis</surname> <given-names>A.</given-names></name> <name><surname>Mitsopoulos</surname> <given-names>C.</given-names></name> <name><surname>Zvelebil</surname> <given-names>M.</given-names></name><etal/></person-group> (<year>2008</year>). <article-title>Transcriptome analysis of mammary epithelial subpopulations identifies novel determinants of lineage commitment and cell fate.</article-title> <source><italic>BMC Genomics</italic></source> <volume>9</volume>:<fpage>591</fpage>. <pub-id pub-id-type="doi">10.1186/1471-2164-9-591</pub-id> <pub-id pub-id-type="pmid">19063729</pub-id></citation></ref>
<ref id="B27"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kim</surname> <given-names>J.</given-names></name> <name><surname>Piao</surname> <given-names>H. L.</given-names></name> <name><surname>Kim</surname> <given-names>B. J.</given-names></name> <name><surname>Yao</surname> <given-names>F.</given-names></name> <name><surname>Han</surname> <given-names>Z.</given-names></name> <name><surname>Wang</surname> <given-names>Y.</given-names></name><etal/></person-group> (<year>2018</year>). <article-title>Long noncoding RNA MALAT1 suppresses breast cancer metastasis.</article-title> <source><italic>Nat. Genet.</italic></source> <volume>50</volume> <fpage>1705</fpage>&#x2013;<lpage>1715</lpage>. <pub-id pub-id-type="doi">10.1038/s41588-018-0252-3</pub-id> <pub-id pub-id-type="pmid">30349115</pub-id></citation></ref>
<ref id="B28"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kioulafa</surname> <given-names>M.</given-names></name> <name><surname>Kaklamanis</surname> <given-names>L.</given-names></name> <name><surname>Stathopoulos</surname> <given-names>E.</given-names></name> <name><surname>Mavroudis</surname> <given-names>D.</given-names></name> <name><surname>Georgoulias</surname> <given-names>V.</given-names></name> <name><surname>Lianidou</surname> <given-names>E. S.</given-names></name></person-group> (<year>2009</year>). <article-title>Kallikrein 10 (KLK10) methylation as a novel prognostic biomarker in early breast cancer.</article-title> <source><italic>Ann. Oncol.</italic></source> <volume>20</volume> <fpage>1020</fpage>&#x2013;<lpage>1025</lpage>. <pub-id pub-id-type="doi">10.1093/annonc/mdn733</pub-id> <pub-id pub-id-type="pmid">19150938</pub-id></citation></ref>
<ref id="B29"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Koromilas</surname> <given-names>A. E.</given-names></name></person-group> (<year>2015</year>). <article-title>Roles of the translation initiation factor eIF2 alpha serine 51 phosphorylation in cancer formation and treatment.</article-title> <source><italic>Bba-Gene Regul. Mech.</italic></source> <volume>1849</volume> <fpage>871</fpage>&#x2013;<lpage>880</lpage>. <pub-id pub-id-type="doi">10.1016/j.bbagrm.2014.12.007</pub-id> <pub-id pub-id-type="pmid">25497381</pub-id></citation></ref>
<ref id="B30"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname> <given-names>S. J.</given-names></name> <name><surname>Chae</surname> <given-names>Y. S.</given-names></name> <name><surname>Kim</surname> <given-names>J. G.</given-names></name> <name><surname>Kim</surname> <given-names>W. W.</given-names></name> <name><surname>Jung</surname> <given-names>J. H.</given-names></name> <name><surname>Park</surname> <given-names>H. Y.</given-names></name><etal/></person-group> (<year>2014</year>). <article-title>AQP5 expression predicts survival in patients with early breast cancer.</article-title> <source><italic>Ann. Surg. Oncol.</italic></source> <volume>21</volume> <fpage>375</fpage>&#x2013;<lpage>383</lpage>. <pub-id pub-id-type="doi">10.1245/s10434-013-3317-7</pub-id> <pub-id pub-id-type="pmid">24114055</pub-id></citation></ref>
<ref id="B31"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname> <given-names>T.</given-names></name> <name><surname>Sun</surname> <given-names>H.</given-names></name> <name><surname>Zhu</surname> <given-names>D.</given-names></name> <name><surname>Dong</surname> <given-names>X.</given-names></name> <name><surname>Liu</surname> <given-names>F.</given-names></name> <name><surname>Liang</surname> <given-names>X.</given-names></name><etal/></person-group> (<year>2017</year>). <article-title>TRA2A promoted paclitaxel resistance and tumor progression in triple-negative breast cancers via regulating alternative splicing.</article-title> <source><italic>Mol. Cancer Ther.</italic></source> <volume>16</volume> <fpage>1377</fpage>&#x2013;<lpage>1388</lpage>. <pub-id pub-id-type="doi">10.1158/1535-7163.MCT-17-0026</pub-id> <pub-id pub-id-type="pmid">28416606</pub-id></citation></ref>
<ref id="B32"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lund</surname> <given-names>M. J.</given-names></name> <name><surname>Trivers</surname> <given-names>K. F.</given-names></name> <name><surname>Porter</surname> <given-names>P. L.</given-names></name> <name><surname>Coates</surname> <given-names>R. J.</given-names></name> <name><surname>Leyland-Jones</surname> <given-names>B.</given-names></name> <name><surname>Brawley</surname> <given-names>O. W.</given-names></name><etal/></person-group> (<year>2009</year>). <article-title>Race and triple negative threats to breast cancer survival: a population-based study in Atlanta, GA.</article-title> <source><italic>Breast Cancer Res. Treat.</italic></source> <volume>113</volume> <fpage>357</fpage>&#x2013;<lpage>370</lpage>. <pub-id pub-id-type="doi">10.1007/s10549-008-9926-3</pub-id> <pub-id pub-id-type="pmid">18324472</pub-id></citation></ref>
<ref id="B33"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Madden</surname> <given-names>J. M.</given-names></name> <name><surname>Mueller</surname> <given-names>K. L.</given-names></name> <name><surname>Bollig-Fischer</surname> <given-names>A.</given-names></name> <name><surname>Stemmer</surname> <given-names>P.</given-names></name> <name><surname>Mattingly</surname> <given-names>R. R.</given-names></name> <name><surname>Boerner</surname> <given-names>J. L.</given-names></name></person-group> (<year>2014</year>). <article-title>Abrogating phosphorylation of eIF4B is required for EGFR and mTOR inhibitor synergy in triple-negative breast cancer.</article-title> <source><italic>Breast Cancer Res. Treat.</italic></source> <volume>147</volume> <fpage>283</fpage>&#x2013;<lpage>293</lpage>. <pub-id pub-id-type="doi">10.1007/s10549-014-3102-8</pub-id> <pub-id pub-id-type="pmid">25129346</pub-id></citation></ref>
<ref id="B34"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ostrakhovitch</surname> <given-names>E. A.</given-names></name> <name><surname>Li</surname> <given-names>S. S.</given-names></name></person-group> (<year>2010</year>). <article-title>NIP1/DUOXA1 expression in epithelial breast cancer cells: regulation of cell adhesion and actin dynamics.</article-title> <source><italic>Breast Cancer Res. Treat.</italic></source> <volume>119</volume> <fpage>773</fpage>&#x2013;<lpage>786</lpage>. <pub-id pub-id-type="doi">10.1007/s10549-009-0372-7</pub-id> <pub-id pub-id-type="pmid">19322654</pub-id></citation></ref>
<ref id="B35"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Penzo</surname> <given-names>M.</given-names></name> <name><surname>Montanaro</surname> <given-names>L.</given-names></name> <name><surname>Trere</surname> <given-names>D.</given-names></name> <name><surname>Derenzini</surname> <given-names>M.</given-names></name></person-group> (<year>2019</year>). <article-title>The ribosome biogenesis-cancer connection.</article-title> <source><italic>Cells</italic></source> <volume>8</volume>:<fpage>55</fpage>. <pub-id pub-id-type="doi">10.3390/cells8010055</pub-id> <pub-id pub-id-type="pmid">30650663</pub-id></citation></ref>
<ref id="B36"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Reza</surname> <given-names>A.</given-names></name> <name><surname>Choi</surname> <given-names>Y. J.</given-names></name> <name><surname>Yuan</surname> <given-names>Y. G.</given-names></name> <name><surname>Das</surname> <given-names>J.</given-names></name> <name><surname>Yasuda</surname> <given-names>H.</given-names></name> <name><surname>Kim</surname> <given-names>J. H.</given-names></name></person-group> (<year>2017</year>). <article-title>MicroRNA-7641 is a regulator of ribosomal proteins and a promising targeting factor to improve the efficacy of cancer therapy.</article-title> <source><italic>Sci. Rep.</italic></source> <volume>7</volume>:<fpage>8365</fpage>. <pub-id pub-id-type="doi">10.1038/s41598-017-08737-w</pub-id> <pub-id pub-id-type="pmid">28827731</pub-id></citation></ref>
<ref id="B37"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rios-Fuller</surname> <given-names>T. J.</given-names></name> <name><surname>Mahe</surname> <given-names>M.</given-names></name> <name><surname>Walters</surname> <given-names>B.</given-names></name> <name><surname>Abbadi</surname> <given-names>D.</given-names></name> <name><surname>Perez-Baos</surname> <given-names>S.</given-names></name> <name><surname>Gadi</surname> <given-names>A.</given-names></name><etal/></person-group> (<year>2020</year>). <article-title>Translation regulation by eIF2alpha phosphorylation and mTORC1 signaling pathways in non-communicable diseases (n.d.).</article-title> <source><italic>Int. J. Mol. Sci.</italic></source> <volume>21</volume>:<fpage>5301</fpage>. <pub-id pub-id-type="doi">10.3390/ijms21155301</pub-id> <pub-id pub-id-type="pmid">32722591</pub-id></citation></ref>
<ref id="B38"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Robert</surname> <given-names>F.</given-names></name> <name><surname>Kapp</surname> <given-names>L. D.</given-names></name> <name><surname>Khan</surname> <given-names>S. N.</given-names></name> <name><surname>Acker</surname> <given-names>M. G.</given-names></name> <name><surname>Kolitz</surname> <given-names>S.</given-names></name> <name><surname>Kazemi</surname> <given-names>S.</given-names></name><etal/></person-group> (<year>2006</year>). <article-title>Initiation of protein synthesis by hepatitis C virus is refractory to reduced eIF2 center dot GTP center dot Met-tRNA(i)(Met) ternary complex availability.</article-title> <source><italic>Mol. Biol. Cell</italic></source> <volume>17</volume> <fpage>4632</fpage>&#x2013;<lpage>4644</lpage>. <pub-id pub-id-type="doi">10.1091/mbc.E06-06-0478</pub-id> <pub-id pub-id-type="pmid">16928960</pub-id></citation></ref>
<ref id="B39"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ruggero</surname> <given-names>D.</given-names></name> <name><surname>Pandolfi</surname> <given-names>P. P.</given-names></name></person-group> (<year>2003</year>). <article-title>Does the ribosome translate cancer?</article-title> <source><italic>Nat. Rev. Cancer</italic></source> <volume>3</volume> <fpage>179</fpage>&#x2013;<lpage>192</lpage>. <pub-id pub-id-type="doi">10.1038/nrc1015</pub-id> <pub-id pub-id-type="pmid">12612653</pub-id></citation></ref>
<ref id="B40"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Schutz</surname> <given-names>F.</given-names></name> <name><surname>Stefanovic</surname> <given-names>S.</given-names></name> <name><surname>Mayer</surname> <given-names>L.</given-names></name> <name><surname>von Au</surname> <given-names>A.</given-names></name> <name><surname>Domschke</surname> <given-names>C.</given-names></name> <name><surname>Sohn</surname> <given-names>C.</given-names></name></person-group> (<year>2017</year>). <article-title>PD-1/PD-L1 pathway in breast cancer.</article-title> <source><italic>Oncol. Res. Treat.</italic></source> <volume>40</volume> <fpage>294</fpage>&#x2013;<lpage>297</lpage>. <pub-id pub-id-type="doi">10.1159/000464353</pub-id> <pub-id pub-id-type="pmid">28346916</pub-id></citation></ref>
<ref id="B41"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Silvera</surname> <given-names>D.</given-names></name> <name><surname>Formenti</surname> <given-names>S. C.</given-names></name> <name><surname>Schneider</surname> <given-names>R. J.</given-names></name></person-group> (<year>2010</year>). <article-title>Translational control in cancer.</article-title> <source><italic>Nat. Rev. Cancer</italic></source> <volume>10</volume> <fpage>254</fpage>&#x2013;<lpage>266</lpage>. <pub-id pub-id-type="doi">10.1038/nrc2824</pub-id> <pub-id pub-id-type="pmid">20332778</pub-id></citation></ref>
<ref id="B42"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Subramonian</surname> <given-names>D.</given-names></name> <name><surname>Raghunayakula</surname> <given-names>S.</given-names></name> <name><surname>Olsen</surname> <given-names>J. V.</given-names></name> <name><surname>Beningo</surname> <given-names>K. A.</given-names></name> <name><surname>Paschen</surname> <given-names>W.</given-names></name> <name><surname>Zhang</surname> <given-names>X. D.</given-names></name></person-group> (<year>2014</year>). <article-title>Analysis of changes in SUMO-2/3 modification during breast cancer progression and metastasis.</article-title> <source><italic>J. Proteome Res.</italic></source> <volume>13</volume> <fpage>3905</fpage>&#x2013;<lpage>3918</lpage>. <pub-id pub-id-type="doi">10.1021/pr500119a</pub-id> <pub-id pub-id-type="pmid">25072996</pub-id></citation></ref>
<ref id="B43"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tuohy</surname> <given-names>V. K.</given-names></name></person-group> (<year>2014</year>). <article-title>Retired self-proteins as vaccine targets for primary immunoprevention of adult-onset cancers.</article-title> <source><italic>Expert. Rev. Vaccines</italic></source> <volume>13</volume> <fpage>1447</fpage>&#x2013;<lpage>1462</lpage>. <pub-id pub-id-type="doi">10.1586/14760584.2014.953063</pub-id> <pub-id pub-id-type="pmid">25172043</pub-id></citation></ref>
<ref id="B44"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>X.</given-names></name> <name><surname>Yao</surname> <given-names>J.</given-names></name> <name><surname>Wang</surname> <given-names>J.</given-names></name> <name><surname>Zhang</surname> <given-names>Q.</given-names></name> <name><surname>Brady</surname> <given-names>S. W.</given-names></name> <name><surname>Arun</surname> <given-names>B.</given-names></name><etal/></person-group> (<year>2017</year>). <article-title>Targeting Aberrant p70S6K activation for estrogen receptor-negative breast cancer prevention.</article-title> <source><italic>Cancer Prev. Res. (Phila)</italic></source> <volume>10</volume> <fpage>641</fpage>&#x2013;<lpage>650</lpage>. <pub-id pub-id-type="doi">10.1158/1940-6207.CAPR-17-0106</pub-id> <pub-id pub-id-type="pmid">28877935</pub-id></citation></ref>
<ref id="B45"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Weymouth</surname> <given-names>N.</given-names></name> <name><surname>Shi</surname> <given-names>Z.</given-names></name> <name><surname>Rockey</surname> <given-names>D. C.</given-names></name></person-group> (<year>2012</year>). <article-title>Smooth muscle alpha actin is specifically required for the maintenance of lactation.</article-title> <source><italic>Dev. Biol.</italic></source> <volume>363</volume> <fpage>1</fpage>&#x2013;<lpage>14</lpage>. <pub-id pub-id-type="doi">10.1016/j.ydbio.2011.11.002</pub-id> <pub-id pub-id-type="pmid">22123032</pub-id></citation></ref>
<ref id="B46"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Won</surname> <given-names>K. A.</given-names></name> <name><surname>Spruck</surname> <given-names>C.</given-names></name></person-group> (<year>2020</year>). <article-title>Triplenegative breast cancer therapy: current and future perspectives (Review).</article-title> <source><italic>Int. J. Oncol.</italic></source> <volume>57</volume> <fpage>1245</fpage>&#x2013;<lpage>1261</lpage>. <pub-id pub-id-type="doi">10.3892/ijo.2020.5135</pub-id> <pub-id pub-id-type="pmid">33174058</pub-id></citation></ref>
<ref id="B47"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yeo</surname> <given-names>S. K.</given-names></name> <name><surname>Zhu</surname> <given-names>X.</given-names></name> <name><surname>Okamoto</surname> <given-names>T.</given-names></name> <name><surname>Hao</surname> <given-names>M.</given-names></name> <name><surname>Wang</surname> <given-names>C.</given-names></name> <name><surname>Lu</surname> <given-names>P.</given-names></name><etal/></person-group> (<year>2020</year>). <article-title>Single-cell RNA-sequencing reveals distinct patterns of cell state heterogeneity in mouse models of breast cancer.</article-title> <source><italic>Elife</italic></source> <volume>9</volume>:<fpage>e58810</fpage>. <pub-id pub-id-type="doi">10.7554/eLife.58810</pub-id> <pub-id pub-id-type="pmid">32840210</pub-id></citation></ref>
<ref id="B48"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yin</surname> <given-names>L.</given-names></name> <name><surname>Duan</surname> <given-names>J. J.</given-names></name> <name><surname>Bian</surname> <given-names>X. W.</given-names></name> <name><surname>Yu</surname> <given-names>S. C.</given-names></name></person-group> (<year>2020</year>). <article-title>Triple-negative breast cancer molecular subtyping and treatment progress.</article-title> <source><italic>Breast Cancer Res.</italic></source> <volume>22</volume>:<fpage>61</fpage>. <pub-id pub-id-type="doi">10.1186/s13058-020-01296-5</pub-id> <pub-id pub-id-type="pmid">32517735</pub-id></citation></ref>
<ref id="B49"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zagorac</surname> <given-names>I.</given-names></name> <name><surname>Fernandez-Gaitero</surname> <given-names>S.</given-names></name> <name><surname>Penning</surname> <given-names>R.</given-names></name> <name><surname>Post</surname> <given-names>H.</given-names></name> <name><surname>Bueno</surname> <given-names>M. J.</given-names></name> <name><surname>Mouron</surname> <given-names>S.</given-names></name><etal/></person-group> (<year>2018</year>). <article-title><italic>In vivo phosphoproteomics</italic> reveals kinase activity profiles that predict treatment outcome in triple-negative breast cancer.</article-title> <source><italic>Nat. Commun.</italic></source> <volume>9</volume>:<fpage>3501</fpage>. <pub-id pub-id-type="doi">10.1038/s41467-018-05742-z</pub-id> <pub-id pub-id-type="pmid">30158526</pub-id></citation></ref>
<ref id="B50"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhang</surname> <given-names>D.</given-names></name> <name><surname>Jin</surname> <given-names>N.</given-names></name> <name><surname>Sun</surname> <given-names>W.</given-names></name> <name><surname>Li</surname> <given-names>X.</given-names></name> <name><surname>Liu</surname> <given-names>B.</given-names></name> <name><surname>Xie</surname> <given-names>Z.</given-names></name><etal/></person-group> (<year>2017</year>). <article-title>Phosphoglycerate mutase 1 promotes cancer cell migration independent of its metabolic activity.</article-title> <source><italic>Oncogene</italic></source> <volume>36</volume> <fpage>2900</fpage>&#x2013;<lpage>2909</lpage>. <pub-id pub-id-type="doi">10.1038/onc.2016.446</pub-id> <pub-id pub-id-type="pmid">27991922</pub-id></citation></ref>
<ref id="B51"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zheng</surname> <given-names>Q. L.</given-names></name> <name><surname>Ye</surname> <given-names>J. J.</given-names></name> <name><surname>Cao</surname> <given-names>J.</given-names></name></person-group> (<year>2014</year>). <article-title>Translational regulator eIF2 alpha in tumor.</article-title> <source><italic>Tumor. Biol.</italic></source> <volume>35</volume> <fpage>6255</fpage>&#x2013;<lpage>6264</lpage>. <pub-id pub-id-type="doi">10.1007/s13277-014-1789-0</pub-id> <pub-id pub-id-type="pmid">24609900</pub-id></citation></ref>
<ref id="B52"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhou</surname> <given-names>G.</given-names></name> <name><surname>Lu</surname> <given-names>M. Q.</given-names></name> <name><surname>Li</surname> <given-names>D. J.</given-names></name> <name><surname>Gao</surname> <given-names>B. A.</given-names></name> <name><surname>Guo</surname> <given-names>R.</given-names></name></person-group> (<year>2017</year>). <article-title>Identification of differentially expressed molecular functions associated with breast cancer using Gibbs sampling.</article-title> <source><italic>Oncol. Lett.</italic></source> <volume>14</volume> <fpage>7489</fpage>&#x2013;<lpage>7494</lpage>. <pub-id pub-id-type="doi">10.3892/ol.2017.7158</pub-id> <pub-id pub-id-type="pmid">29344193</pub-id></citation></ref>
<ref id="B53"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhou</surname> <given-names>X.</given-names></name> <name><surname>Liao</surname> <given-names>W. J.</given-names></name> <name><surname>Liao</surname> <given-names>J. M.</given-names></name> <name><surname>Liao</surname> <given-names>P.</given-names></name> <name><surname>Lu</surname> <given-names>H.</given-names></name></person-group> (<year>2015</year>). <article-title>Ribosomal proteins: functions beyond the ribosome.</article-title> <source><italic>J. Mol. Cell Biol.</italic></source> <volume>7</volume> <fpage>92</fpage>&#x2013;<lpage>104</lpage>. <pub-id pub-id-type="doi">10.1093/jmcb/mjv014</pub-id> <pub-id pub-id-type="pmid">25735597</pub-id></citation></ref>
</ref-list>
<glossary>
<title>Abbreviations</title>
<def-list id="DL1">
<def-item><term>scRNA-seq</term><def><p>single-cell RNA sequencing</p></def></def-item>
<def-item><term>TNBC</term><def><p>triple-negative breast cancer</p></def></def-item>
<def-item><term>RPL27A</term><def><p>ribosomal protein L27a</p></def></def-item>
<def-item><term>RPL15</term><def><p>ribosomal protein L15</p></def></def-item>
<def-item><term>RPL29</term><def><p>ribosomal protein L29</p></def></def-item>
<def-item><term>RPL13A</term><def><p>ribosomal protein L13a</p></def></def-item>
<def-item><term>UMAP</term><def><p>Uniform Manifold Approximation and Projection</p></def></def-item>
<def-item><term>ER</term><def><p>estrogen receptor</p></def></def-item>
<def-item><term>PR</term><def><p>progesterone receptor</p></def></def-item>
<def-item><term>GEO</term><def><p>Gene Expression Omnibus</p></def></def-item>
<def-item><term>SRA</term><def><p>Sequence Read Archive</p></def></def-item>
<def-item><term>EMT</term><def><p>epithelial&#x2013;mesenchymal transition</p></def></def-item>
<def-item><term>EIF2</term><def><p>eukaryotic initiation factor 2.</p></def></def-item>
</def-list>
</glossary>
</back>
</article>
