Abstract
CircRNAs (circular RNAs) are a class of RNAs generated from circularization with multiple novel functions. Recent studies have revealed the aberrant expression and aberrant functions of circRNAs in various tumors; thus, circRNAs have been recognized as promising cancer biomarkers. However, the underlying mechanisms behind their aberrant expression and functions remain unclear. In this review, we discuss at length the cancer-specific deregulation of circRNAs and the potential underlying aberrant events in circRNA biogenesis, localization and removal in cancer cells.
Background
CircRNAs are a type of RNA in eukaryotes that are spared from exonucleolytic degradation by RNase R given their circular structures and subsequent lack of accessibility of RNase to 3′ and 5′ ends. In 1976, circRNAs were first discovered in a viroid, and they were considered insignificant byproducts for a long period of time (Sanger et al., 1976). Until the last decade, rapid advances in RNA-sequencing have promoted investigations into circular RNAs. CircRNAs can be generally divided into five categories: exonic circRNAs (ecircRNA), circular RNAs from introns (ciRNAs), exon-intron circRNAs (EIciRNA), intergenic circRNAs, and antisense circRNAs (Memczak et al., 2013; Qian et al., 2018). EcircRNAs containing exclusively exon(s) represent the major class, accounting for approximately 85% of all types of circRNAs (Qian et al., 2018). CiRNAs are generated from intron lariats depending on two specific RNA motifs at specific sites, but so far ciRNAs haven’t been revealed to be involved in cancer (Zhang et al., 2013). EIciRNAs consist of both exons and introns that typically localize and function in the nucleus (Li Z. et al., 2015). Two additional circRNAs, namely intergenic circRNAs and antisense circRNAs are not common and are not fully understood to date (Qian et al., 2018). Different types of circRNAs are generated from pre-mRNAs (precursor mRNAs) via different mechanisms (; Zhang Y. et al., 2016), such as exon skipping, intron pairing and RNA-binding proteins, that combine to drive the head-to-tail junctions to join together as previously reviewed (Dragomir and Calin, 2018).
In this review, we focus on the new advances in the abnormal expression and functions of circRNAs in cancers, which may account for tumorigenesis and progression. An increasing number of studies have emerged to reveal how circRNAs alter the behavior of tumor cells, but there are no reports on the mechanisms responsible for their abnormal expression. Based on recent findings on circRNAs, we discuss possible mechanisms behind the deregulation of circRNA in cancers to provide insights into the etiology, diagnosis and therapy of cancers.
Aberrant Expression and Functions of Circrnas in Cancer
In normal tissues, the expression of circRNA exhibits the following characteristics: (1) Conservation of circRNA expression. A study comparing expression patterns of circRNAs among species suggested ancient and conserved features of circRNA expression. The expression of circRNA isoforms is likely to be derived from orthologous genes, and the functional sequence elements of circRNAs are conserved in subsets (Wang P.L. et al., 2014; ; Dong and Ma, 2017). (2) The complexity of circRNA expression (Li X. et al., 2018). A previous study concluded that during evolution, the circRNA expression pattern becomes increasingly complex as the distribution of orientation-opposite complementary sequences in their flanking introns becomes increasingly diverse (Dong and Ma, 2017). From the perspective of individual genes, various circRNAs can be generated from one sequence (Gao et al., 2016). (3) Cell/tissue-specific expression (Zhang Y. et al., 2016). CircRNAs are extraordinarily abundant and diverse in the brain compared with other tissues, and their expression in brain tissue is increased several fold compared with their linear isoforms (Rybak-Wolf et al., 2015). Host genes coding synaptic proteins may serve as a source of abundant circRNA. Recent work in human hematopoietic cells reveals a circular RNA cell-type specific expression pattern (Nicolet et al., 2018). (4) Stage-specific expression. Dynamic expression of certain circRNAs has been observed in some specific developmental stages, such as human pre-implantation embryos (), human fetal development (Szabo et al., 2015), and aging (Westholm et al., 2014). During the differentiation of cells, such as neural cells and myoblasts, abrupt fluctuation of circRNA expression has been reported (Salzman et al., 2013).
The aberrant expression of circRNAs is prevalent in a large number of diseases, especially tumors (Haque and Harries, 2017; Lei et al., 2018; E et al., 2018). As a result, circRNAs have been proposed as biomarkers of diagnosis, prognosis or therapy in specific cancers (Meng et al., 2017; Qian et al., 2018; Wang D. et al., 2018; Yang and Wang, 2018; Zhou J. et al., 2018) based on the convenience of detecting circRNA in the blood plasma of patients. The abnormal expression of circRNAs in cancer is usually accompanied by abnormal functions (; Patop and Kadener, 2018).
Abnormal circRNA/lncRNA/miRNA/mRNA Loop
A circRNA called Cdr1as was first discovered as a “miRNA sponge” in human and mouse brains in 2013 (Hansen et al., 2013). CircRNAs, as competitive endogenous RNAs (ceRNAs) with linear mRNAs binding to miRNAs, enhance the expression of target genes (Thomson and Dinger, 2016) and affect the biological behaviors of multiple tumors. For example, the hsa_circ_0007534/miR-761/ZIC5 axis promotes glioma by promoting glial cell proliferation and migration (Li G.F. et al., 2018), and circ-ANAPC7/miR-181 may participate in acute myeloid leukemia pathogenesis (). Other examples of circRNAs functioning as miRNA sponges in cancer processes, such as proliferation, migration, and angiogenesis, are presented in Figure 1 (Mignacca et al., 2016; Liu et al., 2017; Zhong Z. et al., 2017; ; Wang H. et al., 2018). In addition, lncRNA (long non-coding RNA), circRNA and mi-RNA interact with each other in a complicated manner, and they combine as RNA networks in cells (Kleaveland et al., 2018). The circRNA/lncRNA/miRNA/mRNA loop is involved in cancer such as bladder cancer (Li M. et al., 2018) due to the complex associations among circRNAs, lncRNAs, miRNA, mRNA and cancer (Nan et al., 2017; Kleaveland et al., 2018).
FIGURE 1
Aberrant Transcriptional Regulation or Aberrant RNA Splicing
The patterns of circRNAs in transcriptional regulation in the nucleus may have similarities with some lncRNAs in cancer (Eidem et al., 2016; Schmitt and Chang, 2017). However, the regulatory roles of lncRNAs in transcription are considerably more varied as they accumulate and act in both cis and trans, whereas circRNAs accumulate and act in cis (
Aberrant circRNA-Protein Complexes (circRNPs)
CircRNAs exhibit numerous interactions with a large number of proteins as an RBP decoy or a protein scaffold in the cytoplasm (Du et al., 2016; Schneider et al., 2016;
Aberrant Translation
In 2017, circRNAs were first found to be translated under certain conditions (Pamudurti et al., 2017). CircRNA translations can be classified as IRES (internal ribosome entry site) dependent and IRES independent (Tatomer and Wilusz, 2017). IRES-dependent translations are generally found in circ-ZNF609 (Legnini et al., 2017), and IRES-independent translations are generally found in artificial circular RNAs in living HeLa cells (
In addition to disruption of these four functions (that is, as miRNA sponges, in transcription regulation, in protein binding and translation into proteins), circRNAs have the potential to be retro-transcribed and then inserted back into the genome to function as competitive RNA (Dong et al., 2016). Deregulation of circ-Foxo3 and the Foxo3 pseudogene have been detected in tumor growth, and their upregulation has been found to suppress cancer by activating Foxo3 protein (Yang et al., 2016).
The Aberrant Regulation of Circrnas in Cancer
As demonstrated above, aberrant expression of circRNA, i.e., upregulation or downregulation, is prevalent in tumors, which can ultimately promote tumorigenesis or progression. However, why do circRNAs exhibit aberrant expression and function exclusively in cancer cells rather than normal cells? What factors may contribute to circRNA deregulation in cancers? We review and explore answers to these questions in the following section, which is presented in Figure 2.
FIGURE 2

Potential aberrant regulation of circRNA biogenesis, export from the nucleus and removal in cancer cells. The left part of the figure presents how circRNAs are generated, exported from the nucleus to cytoplasm and removed in cancer cells. First, the parental gene sequences of circRNA in cancer may be aberrant. Pre-mRNA is transcribed from DNA, and RNA PolII and transcription factors could be deregulated. CircRNAs are generated through co-transcriptional back-splicing or post-transcriptional back-splicing from pre-mRNA with disordered spliceosomal machinery. EcircRNAs are exported from the nucleus to cytoplasm in a manner similar to linear mRNA. In the cytoplasm, circRNAs may exhibit aberrant functions in cancer. Finally, circRNAs are degraded or exported from the cell through exosomes in an abnormal manner. The right part of figure is a conceptual diagram corresponding to the left side of the figure.
Aberrant Events in circRNAs Biogenesis
In normal cells, the accumulation of nascent circRNAs contributes considerably to their detection at steady-state levels (
Aberrant Cis-Elements
Cis-elements typically refer to long complementary flanking introns (repetitive or non-repetitive) in pre-mRNA. Cis-elements play a predominant role in the regulation of circRNA production, especially in humans (
On the other hand, mutations in certain intronic repeats are prevalent in cancers such as gastric cancer (Kim et al., 2013). Intron retention in mature mRNAs is associated with a number of human diseases, including cancer, as an orchestrated phenomenon (Wong et al., 2016). Moreover, intron retention contributes to tumor-suppressor inactivation (Jung and Lee, 2015). In addition, intron retention in the conversion from EIciRNA to ecircRNA not only alters the steady-state levels of circRNAs but also changes their localization because the intronic sequences may function as ribonucleic nuclear retention elements (
Similar to intron mutations, editing enzymes have the potential to diminish the complementarity of flanking introns in cancer. For example, ADAR mainly targets Alu elements, and aberrant ADAR activity has been linked to a variety of cancers (Wang et al., 2017). In addition to cis-elements, alterations of proteins such as the ribonucleoprotein named HNRNPC, which is related to the formation of Alu elements, should be taken into consideration (Wu et al., 2018).
Aberrant Chromosomes and Genomes
Chromosomal and genomic abnormalities such as translocation have been linked to cancers in many studies. First, circRNAs derived from fusion-genes are characteristic of tumors, such as leukemia and non-small cell lung cancer (Guarnerio et al., 2016; Tan et al., 2018). In leukemia, fusion circRNAs promote proliferation and cause therapeutic resistance (Guarnerio et al., 2016). In non-small cell lung cancer, fusion circRNA named F-circEA from the EML4-ALK fusion gene has recently been revealed to promote cell migration and invasion (Tan et al., 2018). The possibility of circularization increases when the chromosomes harbor translocations, which may cause the juxtaposition of intron sequences. In other words, genomic rearrangements generate aberrant cis-elements and promote back-splicing (Guarnerio et al., 2016). Chromosomal translocations have the potential to generate cancer-specific circRNAs, the universality of which was confirmed in the models of artificial NPM1-ALK fusion genes (
Aberrant Transcription
Promoter mutations and aberrant expression or enzymatic activity of RNA PolII can result in transcription suspension (Liu et al., 2013). To better understand the regulation of circRNA transcription, further investigations of conflicts over the order of back-splicing and transcription are required. Although early analysis concluded that splicing events mostly occur co-transcriptionally in most cells and tissues (Pandya-Jones and Black, 2009;
Transcription factors, which are vital players in transcription, are associated with various tumor-specific genes (
Aberrant Spliceosomal Machinery
Canonical spliceosomal splicing mechanism and back-splicing mechanism are involved in the biogenesis of circRNA (Quan and Li, 2018). The back-splicing mechanism is affected by canonical splicing signals (Starke et al., 2015). Given that aberrant RNA splicing has been linked to cancer (Scotti and Swanson, 2016), the spliceosomal machinery may contribute to circRNA deregulation in cancer. Mutations in splice sites and spliceosome components, including five small nuclear RNAs (snRNA), affect the steady-state levels of circular RNAs (Liang et al., 2017).
First, recurrent mutations in spliceosomal genes, such as SF3B1, SRSF2 and U2AF1, are responsible for mis-splicing and vulnerabilities in cancer (
Aberrant Trans-Acting Factors
Trans-acting factors are also important triggers of back-splicing in addition to cis-acting factors. To date, Mbl and QKI are the most typical trans-acting factors as revealed in current studies. Mbl binds to the flanking introns of circMbl in Drosophila and human (
Some enzymes, such as RNA helicase, are vital players in regulating circRNA in cancer. The RNA helicase DHX9 is overexpressed in lung cancer (
Other proteins with the potential to function as trans-acting factors in circRNA biogenesis include the immune factors NF90/NF110 (Li et al., 2017). These proteins increase circRNA expression in a manner similar to chromosome translocations (juxtaposing and intron pairing) and serve as components of circRNPs in the antiviral immune response in HeLa cells (Li et al., 2017).
Aberrant Epigenetic Regulation
Advanced sequencing has revealed that greater than 50% of cancers exhibit mutations involved in chromatin organization (Kleppe et al., 2018).
There are two hypothetical mechanisms behind epigenetic aberrations involved in circRNA deregulation. First, chromatin remodeling factors and post-translational modifications of histones impact the transcription rate, which may subsequently affect the production of circRNAs (Zhang Y. et al., 2016). Second, chromatin remodeling is likely to affect diverse alternative splicing events involved in the biogenesis of circRNAs (
In addition to DNA methylation and histone modifications, post-transcriptional modifications of circRNAs are associated with circRNA deregulation. The three most abundant epitranscriptomic marks of RNA are pseudouridine (Ψ), N6-methyladenosine (m6A) and 5-methylcytosine (m5C). These marks tend to determine the fates of long noncoding RNAs. RNA modifications promote colorectal cancer by upregulating oncogenes or downregulating tumor suppressor genes (Porcellini et al., 2018). Cancer-related long noncoding RNAs, such as MALAT1, exhibit multiple post-transcriptional modifications; however, no aberrant modification in circRNA has been discovered (Jacob et al., 2017). Among these RNA modifications, m6A is the most common modification (
Aberrant Regulation in circRNA Export From Nucleus
Upon formation in the nucleus, ecircRNAs tend to be transported to the cytoplasm via a mechanism similar to linear RNA export, and the nuclear pore complex is an important player (Hautbergue, 2017). A methyl-guanosine cap and poly(A) tail are the determinants for RNA exportation from the nucleus (Tuck and Tollervey, 2013). The precise mechanism by which circRNAs without free ends are exported from the nuclear pore complex remains unknown. However, recent studies have found that the length of mature circRNAs plays an important role in determining whether the circRNA is exported or retained, which contradicts the retained intron restriction hypothesis (Huang et al., 2018; Wan and Hopper, 2018). By knocking out the genes associated with RNA exportation, UAP56 and URH49 have been identified to control the location of circRNAs in HeLa cells. In detail, UAP56 is responsible for the export of long circRNAs, whereas URH49 is responsible for the short circRNAs (Huang et al., 2018; Wan and Hopper, 2018). However, this research is based on artificial circular RNAs in HeLa cells, and the mechanism by which natural circRNAs with known functions are exported from the nucleus requires further exploration. Although studies on circRNA export are limited, different cellular localizations of non-coding RNAs have been linked to numerous diseases (Tuck and Tollervey, 2013). It is hypothesized that dysfunctions in the “transporting” or “sorting” mechanisms of circRNAs may contribute to aberrant circRNA expression in tumors (
Aberrant circRNA Removal by Cleavage and Exosomes
Degradation of circRNAs in the cytoplasm remains largely uncharacterized, but there is evidence for their existence. For instance, AGO2/miR-671-mediated cleavage of CiRS-7 autoregulates CiRS-7 as confirmed in HEK293 and HeLa cells (Hansen et al., 2011). Thus, the anomalous expression of miR-671 and AGO2, the major components of the RNA-induced silencing complex (RISC), influence the amount of CiRS-7.
Packaging and export of circRNAs by extracellular vesicles or microvesicle release seems common in mammalian cells (Lasda and Parker, 2016) given that circRNAs have been noted in exosomes and blood plasma (Li Y. et al., 2015). Accordingly, alterations of proteins associated with the packaging of extracellular vesicles or microvesicles and their protein compositions could cause deregulation. Additionally, extracellular vesicles could influence the tumor microenvironment by communicating with other cells (Wu et al., 2017), and significantly impact the immune response in tumor cells. Aberrant extracellular vesicles have been recognized as emerging therapeutic targets for cancer (Wu et al., 2017).
Conclusion
CircRNAs that are aberrantly expressed in cancers exhibit abnormal roles as miRNA sponges, protein decoys, transcription regulators, or regulators of translation into proteins. The potential mechanisms involved in deregulation were outlined, including in their biogenesis from parental genes, export from the nucleus to the cytoplasm and removal from the cell.
The underlying mechanisms are potentially considerably more complicated than that described above, as they may exhibit multiple interactions. For instance, intron retention that contributes to the aberrant cis-elements may result from the dysfunctions of spliceosomal machinery, such as splice site mutations (Ge and Porse, 2014).
As a cancer cell is viewed as the outcome of alterations in genetics, epigenetics and epitranscriptomics (Porcellini et al., 2018), the deregulation of circRNAs may be associated with these factors as well as other uncharacterized components. The deregulation mechanism of circRNAs is a new field that requires further exploration. In the future, more deregulated circRNAs will be discovered in human diseases, especially cancer, and circRNAs may display more functions. The profound understanding of the deregulation of circRNA mechanisms may provide more possibilities for better diagnosis, prognosis, and treatment of cancer. To date, the potential advantages of circRNAs as biomarkers for tumors have been highlighted given their abundance, stability and tissue-specific expression (Qian et al., 2018). Specific circRNAs can be detected in the blood plasma of patients to track the progression of the corresponding cancer. A better understanding of the mechanisms involved will serve as a significant breakthrough in this area.
Availability of Data and Material
The material supporting the conclusion of this review has been included within the article.
Statements
Author contributions
All authors read and approved the final manuscript.
Funding
This work was supported by grants from the National Science Foundation of China (81802871).
Acknowledgments
We are grateful to members of the Wu laboratories for discussions.
Conflict of interest
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.
Abbreviations
- circRNA
circular RNA
- Mbl
muscleblind
- m6A
N6-methyladenosine
- QKI
quaking
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Summary
Keywords
circRNA, deregulation, cancer, non-coding RNA, genetic
Citation
Wu Q, Li P, Wu M and Liu Q (2019) Deregulation of Circular RNAs in Cancer From the Perspectives of Aberrant Biogenesis, Transport and Removal. Front. Genet. 10:16. doi: 10.3389/fgene.2019.00016
Received
26 September 2018
Accepted
14 January 2019
Published
01 February 2019
Volume
10 - 2019
Edited by
Michael Eccles, University of Otago, New Zealand
Reviewed by
Marjan Askarian-Amiri, The University of Auckland, New Zealand; Jyotsna Batra, Queensland University of Technology, Australia
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© 2019 Wu, Li, Wu and Liu.
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*Correspondence: Qiang Liu, aoyebuhuijia@163.com
This article was submitted to Cancer Genetics, a section of the journal Frontiers in Genetics
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