Abstract
Urological malignant tumors pose a significant threat to human health, with a high incidence rate each year. Prostate cancer, bladder cancer, and renal cell carcinoma are among the most prevalent and extensively researched urological malignancies. Despite advancements in research, the prognosis for these tumors remains unfavorable due to late detection, postoperative recurrence, and treatment resistance. A thorough investigation into their pathogenesis is crucial for early diagnosis and treatment. Recent studies have highlighted the close association between microRNAs (miRNAs) and cancer progression. miRNAs are small non-coding RNAs composed of 19-23 nucleotides that regulate gene expression by binding to the 3’ untranslated region (3’UTR) of target mRNAs, impacting key cellular processes such as proliferation, differentiation, apoptosis, and migration. Dysregulation of miRNAs can disrupt the expression of oncogenes and tumor suppressor genes, contributing to cancer development. Among the various miRNAs studied, miR-152 has garnered attention for its role in urological malignancies. Several studies have indicated that dysregulation of miR-152 expression is significant in these cancers, warranting a comprehensive review of the evidence. This review focuses on the expression and function of miR-152 in prostate cancer, bladder cancer, and renal cell carcinoma, elucidating its mechanisms in cancer progression and exploring its potential as a therapeutic target and biomarker in urological malignancies.
Introduction
Urological malignancies encompass prostate cancer, bladder cancer, renal cell carcinoma, penile cancer, testicular cancer, and uroepithelial cancer. According to GLOBOCAN, there were approximately 2.5 million new cases of urological malignancies globally in 2022, representing 12.6% of all cancers. These cases resulted in 770,000 deaths, accounting for 8% of all cancer-related deaths (). The number of new cases and deaths of urinary malignant tumors in 2022 has exceeded the number published by GLOBOCAN in 2020 (). Prostate cancer, bladder cancer, and renal cell carcinoma are among the most prevalent and extensively researched urological malignancies. Prostate cancer, the second most common cancer in men, was responsible for 1,466,680 new cases and 396,792 deaths in 2022. The majority of patients with prostate cancer progress to desmoplasia-resistant prostate cancer, leading to a poor prognosis. Bladder cancer, the second most common urological malignancy, ranked ninth in terms of incidence in 2022 () Renal cell carcinoma, although less common than prostate and bladder cancer, saw 434,419 new cases and 155,702 deaths in 2022, ranking 14th among all cancers (). The incidence of urological malignancies is expected to rise globally due to population growth and aging (). These malignancies pose a significant burden on global health and finances, with the United States estimated to have spent $314.7 billion in 2020 on the prevention and treatment of urological malignancies ().
Early urological malignancies are often treated with surgical resection, which boasts a high success rate. However, the lack of specific symptoms in the early stages leads to most patients being diagnosed at an advanced stage. Additionally, some non-invasive biomarkers, like prostate specific antigen (PSA), have limitations in the early diagnosis of prostate cancer, such as low specificity and overdiagnosis (, ). Urine cytological testing is even less sensitive for diagnosing bladder cancer, while cystoscopic biopsy is invasive and inconvenient (). This highlights the urgent need for sensitive diagnostic methods to aid in early urological tumour diagnosis. For patients with advanced cancer, chemotherapy and radiotherapy are commonly used to slow disease progression and improve quality of life. Unfortunately, cancer often develops resistance to these treatments after several courses, posing a significant challenge (). Despite recent advancements in immunotherapy and targeted therapies, challenges persist due to drug-resistant gene mutations post-targeted therapies, immune adverse effects post-immunotherapy, and limited use of targeted drugs due to high costs. Thus, there is a pressing need to develop new therapeutic strategies for urological tumours, necessitating a comprehensive understanding of their pathogenesis.
In the past two decades, the study of miRNAs has sparked a molecular revolution, with numerous studies demonstrating their significant role in cancer. miRNAs impact essential cellular processes like cell proliferation, differentiation, cell cycle regulation, invasion, metastasis, and angiogenesis by modulating the expression of target genes. Given the close connection between these processes and cancer, miRNAs are intricately linked to cancer development. Among the well-researched miRNAs in oncology, miR-152 stands out for its consistent oncogenic role across various cancer types, including colorectal (, ), gastric (, ), hepatocellular (, ), lung (–), breast (, ), ovarian (, ), cervical (, ), and glioma (, ). While studies on the relationship between miR-152 and urological tumors abound, a comprehensive review on this subject is lacking. This paper aims to fill this gap by examining the impact of miR-152 on biological behaviors of cancer cells in urological tumors, such as proliferation, invasion, metastasis, angiogenesis, and apoptosis. It also explores the potential of miR-152 as a biomarker for early diagnosis, treatment, and prognosis of urological tumors, as well as its therapeutic implications in miRNA-based cancer treatments. By delving into the role of miR-152, this review seeks to enhance our understanding of the pathogenesis and therapeutic strategies for urological malignancies.
Overview of miRNAs
miRNAs were initially discovered in 1993 in the nematode Caenorhabditis elegans (), Since then, a growing number of miRNAs have been identified and characterized, with over 28,000 miRNAs currently known across a variety of organisms (). These small RNAs, approximately 19-23 nucleotides in length, are evolutionarily conserved and play a crucial role in gene expression regulation. They typically bind to the 3’ untranslated region (3’ UTR) of target mRNA, leading to either degradation or inhibition of translation (, ). In some rare instances, miRNAs can enhance translation of target genes, contributing to post-transcriptional gene regulation (, , ). It is estimated that miRNAs regulate at least one-third of all genes (). The biogenesis of miRNA is an extremely complex process, as shown in Figure 1.
Figure 1
miRNAs play a crucial role in regulating cellular processes, with their dysregulation linked to various diseases, including cancer. The connection between cancer and dysregulated miRNA expression was initially observed in patients with chronic lymphocytic leukaemia (CML), where the absence of chromosomal regions coding for miR15 and miR16 was noted (
Function and expression regulation of miR-152
miR-152, a member of the miR-148/152 family along with miR-148a and miR-148b, was initially discovered in the mouse colon through tissue-specific cloning (
Aberrant expression of miR-152 has been observed in various oncological and non-oncological diseases. For instance, Nielsen et al. identified 12 upregulated human miRNAs, including miR-152, in the serum of patients with type 1 diabetes (
miR-152 has been extensively studied in various types of tumors, showing reduced expression and potential as a tumor suppressor miRNA. For instance, in hepatocellular carcinoma, miR-152-3p was significantly down-regulated in tumor tissues compared to non-tumor tissues. Overexpression of miR-152-3p inhibited ROBO1, blocking the malignant characteristics of hepatocellular carcinoma (
The expression and activity of miR-152 are tightly regulated both temporally and spatially in normal physiological conditions. Disruption of this regulation is closely linked to various human diseases, such as cancer growth and metastasis (
miR-152 in prostate cancer
Among the studies focusing on miR-152 and urological tumors, prostate cancer has been the most extensively researched. Numerous studies have demonstrated that miR-152 is downregulated in prostate cancer tissues and cell lines, and its altered expression is intricately linked to the development of prostate cancer (Figure 2). Restoring miR-152 expression has been shown to impede the progression of prostate cancer by targeting and suppressing genes and signaling pathways that are crucial in cancer development. This inhibition ultimately hinders the advancement of prostate cancer. The subsequent discussion provides a detailed explanation of the role and mechanism of miR-152 in prostate cancer.
Figure 2

Roles of miR-152 and its targeted proteins and signaling cascades in the development of urologic malignancies.
Prostate cancer is known for its aggressive nature, with a strong invasive ability that allows it to infiltrate and metastasize to surrounding tissues, contributing to its poor prognosis and high rate of postoperative recurrence. Chen et al. conducted a study on miR-152 expression in 48 primary prostate cancers, finding a significant down-regulation compared to non-malignant control tissues. Specifically, patients with a Gleason score >7 showed lower levels of miR-152, which was also associated with the pathological stage of prostate cancer. Overexpression of miR-152 in PC-3 and DU145 cells effectively suppressed the invasive and migratory abilities of prostate cancer cells by targeting TGFα, a key player in EGFR signaling (
Ramalho-Carvalho et al. employed a combined approach involving micro-RNA expression analysis and differential methylation localization to identify novel miRNAs downregulated by aberrant DNA methylation in prostate cancer. They discovered a transcription unit comprising COPZ2-miR-152-3p (
Feng et al. discovered a synergistic effect of miR-148-3p and miR-152-3p in prostate cancer. Their study revealed a reduction in the expression of both miR-148-3p and miR-152-3p in prostate cancer cells. Functional assays conducted in vitro showed that the combined overexpression of miR-148-3p and miR-152-3p had a greater inhibitory impact on cell proliferation and apoptosis induction compared to individual overexpression. This suggests a synergistic relationship between miR-148-3p and miR-152-3p in inhibiting the growth of PC3 and LNCaP cells (
miR-152 is present in prostate cancer and is involved in a feedback pathway with DNMT1, serving as a target gene for miR-152. miR-152 functions by repressing DNMT1 expression post-transcriptionally. Conversely, increased expression of DNMT1 results in widespread hypermethylation of DNA, leading to a notable decrease in miR-152 expression (
Wang et al. found that lncRNA SNHG3 expression was markedly upregulated in prostate cancer tissues and cell lines, correlating with poor prognosis. Functional assays revealed that SNHG3 overexpression promoted proliferation, migration, and invasion of prostate cancer cells while inhibiting apoptosis (
In summary, miR-152 is frequently downregulated in prostate cancer tissues and cell lines. Acting as a tumor suppressor miRNA, miR-152 targets and suppresses pro-oncogenic factors, leading to the inhibition of prostate cancer cell growth, movement, and invasion. It also triggers cell cycle arrest and apoptosis, ultimately impeding the progression and spread of prostate cancer. These findings indicate that miR-152 holds promise as a potential target for prostate cancer therapy.
miR-152 in bladder cancer
Bladder cancer is a prevalent malignancy among urological tumors, with approximately 70% of patients being diagnosed with non-muscle invasive bladder cancer. Out of these cases, 50%-70% face recurrence, and 10%-20% progress to muscle invasive bladder cancer with a poor prognosis (
miR-152 in renal cell carcinoma
Renal cell carcinoma (RCC) is the third most common urological tumor with a high mortality rate. Clear renal cell carcinoma (ccRCC) is a predominant subtype, constituting approximately 80% of RCC cases (
The potential of miR-152 as a biomarker for urological malignancies
Biomarkers play a crucial role in providing valuable cancer-related information for the early screening, diagnosis, treatment, and prognosis of cancer. The traditional prostate cancer diagnostic indicator, blood PSA, has faced criticism in recent years due to its lack of specificity, false positives, and potential for overdiagnosis in benign prostate disorders (
Liu et al. investigated the use of miR-146a and miR-152 in prostate cancer and their association with clinicopathological parameters. They found that the serum levels of miR-152 in prostate cancer patients were significantly lower compared to normal levels. The expression of miR-152 was strongly linked to clinical stage, presence of bone metastasis, and pathological stage. The diagnostic accuracy of prostate cancer using miR-152 was evaluated with an area under the curve (AUC) of 0.699 and a specificity of 94.64%. Furthermore, combined detection with miR-146a showed higher sensitivity than individual detection, suggesting that monitoring changes in the expression of miR-146a and miR-152 in serum could enhance the diagnostic precision of prostate cancer (
Early diagnosis of bladder cancer is crucial for reducing mortality rates. While urine cytology is a simple and non-invasive method, its sensitivity is limited. Cystoscopy-guided biopsy is the gold standard but is invasive and inconvenient for cancer screening. Therefore, the search for more sensitive and non-invasive biomarkers continues. Serum miRNA has emerged as a promising option for bladder cancer diagnosis and prognosis. A study on genome-wide miRNA analysis identified six miRNAs, including miR-152, in serum with high accuracy and sensitivity levels, outperforming urinary cytology. Notably, miR-152 was linked to NMIBC tumor recurrence, indicating its clinical significance (
In a bioinformatics analysis of potential therapeutic targets for hypertension-associated renal cell carcinoma (RCC), miR-152-3p was identified as significantly associated with hypertension-associated RCC (
In summary, miR-152 in serum demonstrates high specificity and sensitivity in diagnosing prostate cancer, aiding in early detection. It is associated with the pathological stage and Gleason score of prostate cancer. Furthermore, miR-152 facilitates early monitoring of postoperative prostate cancer recurrence and metastasis risk, complementing the limitations of PSA. This suggests that miR-152 holds significant promise as a biomarker for the diagnosis, treatment, and prognosis of prostate cancer. In bladder cancer, miR-152, alongside other miRNAs, shows high sensitivity across various stages and offers clinical value in predicting postoperative recurrence. Studies also link miR-152 to renal cell carcinoma, indicating its potential as a biomarker for postoperative follow-up, although further research is necessary to fully understand its clinical significance.
Therapeutic strategies for tumours based on miRNA therapy
miRNAs play a significant role in cancer regulation and can be targeted for therapeutic purposes. Cancer-associated miRNAs, categorized as oncogenic or tumor-suppressor miRNAs, can be targeted through two mechanisms. For oncogenic miRNAs, miRNA inhibitors can be administered to patients to reduce or eliminate their activity by isolating and binding to the miRNAs (
Gene therapy, which involves the therapeutic delivery of nucleic acids into cancer cells, has been regarded as a promising approach for decades. Recently, the U.S. Food and Drug Administration (FDA) has approved several new therapies utilizing small interfering RNA (siRNA), signaling the onset of a new era in targeted therapy. In 2018, the FDA approved Patisiran, the first-ever siRNA-based drug, for the treatment of transthyretin-mediated amyloidosis, representing a significant milestone in the history of RNA interference (RNAi) technology (
Despite the existing challenges associated with miRNA therapy for cancer treatment, addressing these issues could lead to significant breakthroughs in the management of various diseases, including cancer. Notably, miR-152 has demonstrated considerable promise in the treatment of cancer, particularly in relation to urinary malignancies. Studies indicate that miR-152 functions as a tumor-suppressor miRNA with decreased expression in prostate, bladder, and renal cell carcinomas. In vitro experiments have shown that overexpression of miR-152 can inhibit cancer cell proliferation, migration, invasion, angiogenesis, and promote apoptosis. This tumor-suppressor effect has also been validated in vivo through tumor xenografts (
Conclusion and prospects
This review provides a comprehensive summary of the relationship between miR-152 and urological tumors (Table 1). Current research indicates that miR-152 acts as a tumor-suppressor miRNA in prostate, bladder, and renal cell carcinomas. By targeting downstream genes and signaling pathways associated with the biological behaviors of cancer cells, miR-152 inhibits tumor progression. Furthermore, studies demonstrate that miR-152 interacts with multiple genes and signaling cascades, forming a protein-protein interaction network that plays a role in the pathophysiological process of urological malignancies. These findings suggest that miR-152 could be a promising gene target for the treatment of urological malignancies. In the realm of urological malignancies, the expression of miR-152 exhibits notable variations and is closely linked to key pathological parameters such as cancer stage, grading, and metastasis. This suggests that miR-152 holds promise as a biomarker for the detection, treatment, and prognosis of urological malignancies. For instance, in prostate cancer, serum miR-152 demonstrates high sensitivity and specificity in diagnosing the disease, as well as in monitoring metastasis and postoperative recurrence. Similarly, in bladder cancer, serum miR-152 exhibits high sensitivity across different stages of the disease, surpassing the sensitivity of urocytology. This indicates that miR-152 could serve as a non-invasive biomarker with significant potential in the realm of urological malignancies. However, there are certain limitations in the current research on miR-152 in urological malignancies. Firstly, miR-152 remains relatively understudied in the urinary system, particularly in renal cell carcinoma, and the precise mechanism of miR-152 in urological malignancies remains poorly understood. Secondly, there is a lack of information on the stability of miR-152 and its targeting of tissues in vivo in current studies on miR-152 and urinary malignancies. Lastly, existing studies are predominantly focused on cellular and animal models, with a scarcity of clinical research. Numerous challenges need to be addressed before miR-152 can be effectively utilized in clinical settings. Once these challenges are overcome, miR-152 has the potential to emerge as an innovative therapeutic avenue for urological malignancies.
Table 1
| Tumour type | Expression | Upstream Targets | Downstream Targets | References |
|---|---|---|---|---|
| Prostate cancer | Down | NA | KLF4 | ( |
| Down | circANKS1B | TGFα | ( | |
| Down | NA | TMEM97 | ( | |
| Down | HOTAIR | FOXR2 | ( | |
| Down | LncRNA SNHG3 | SLC7A11 | ( | |
| Down | NA | HMGA2 | ( | |
| Bladder cancer | Down | NA | DNMT1 | ( |
| Down | NA | DNMT1 | ( | |
| NA | lncRNA CCAT1 | NA | ( | |
| Down | NA | KIF14 | ( | |
| Renal cell carcinoma | Down | LncRNA HCG18 | RAB14 | ( |
| NA | NA | HLA-G | ( |
miR-152 and its targets in urological malignancies.
In conclusion, miR-152 has demonstrated significant promise as both a therapeutic target and biomarker for urological malignancies. However, there are unresolved issues that must be addressed before miR-152 can realize its full potential in the treatment of urological malignancies and other types of tumors. Further research is essential to expand our understanding in this field.
Statements
Author contributions
XL: Writing – original draft. BQ: Writing – review & editing. XC: Writing – original draft. MS: Writing – original draft. SZ: Writing – original draft. XZ: Writing – review & editing. JH: Supervision, Writing – review & editing.
Funding
The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by Zhejiang Provincial Natural Science Foundation of China under Grant (No. LGY23H050001), Science and Technology Planning Project of Taizhou City, Zhejiang Province (ID: 22ywa19), Zhejiang Medical and Health Science and Technology Program (No. 2023KY1328).
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.
Publisher’s note
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.
Abbreviations
PSA, prostate specific antigen; 3’ UTR, 3’untranslated region; pri-miRNAs, primary miRNAs; pre-miRNAs, precursor miRNAs; RISC, RNA-induced silencing complex; AGO2, assistance of argonaut 2 protein; CML, chronic lymphocytic leukaemia; oncomiRs, oncogenic miRNAs; miRsupps, tumor suppressor miRNAs; ATG14, autophagy-related protein 14; DNMT1, DNA methyltransferase 1; ELF1, ETS transcription factor 1; ceRNAs, competing endogenous RNAs; TGFα, transforming growth factor-alpha; NOL4, nucleolin 4; TMEM97, transmembrane protein 97; KLF4, Kruppel-like factor 4; PTEN, phosphate and tensin homolog; SNHG3, Small nucleolar RNA host gene 3; KIF14, Kinesin family member 14; HMGA2, high mobility histone A2; RCC, Renal cell carcinoma; HLA-G, human leukocyte antigen G; AUC, area under the curve; siRNA, small interfering RNA.
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Summary
Keywords
miR-152, urological malignancy, therapeutic target, biomarker, microRNA
Citation
Li X, Qian B, Chen X, Shen M, Zhao S, Zhang X and He J (2024) The role of miR-152 in urological tumors: potential biomarkers and therapeutic targets. Front. Immunol. 15:1464327. doi: 10.3389/fimmu.2024.1464327
Received
13 July 2024
Accepted
28 October 2024
Published
13 November 2024
Volume
15 - 2024
Edited by
Giandomenico Roviello, University of Firenze, Italy
Reviewed by
Soumasree De, University of Bern, Switzerland
Ying Shi, Huazhong University of Science and Technology, China
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Copyright
© 2024 Li, Qian, Chen, Shen, Zhao, Zhang and He.
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.
*Correspondence: Xinsheng Zhang, zhangxs0624@163.com; Jian He, jianhe20200606@163.com
†These authors have contributed equally to this work
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