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Peer-reviewedCC BY-NC-NDCancer cell international

ACSF2 Functions as a regulatory switch for PARP inhibitor sensitivity in platinum-sensitive and homologous recombination-proficient high-grade serous ovarian cancer.

10 affiliations
  1. 1Department of Gynecology, Huizhou Central People's Hospital, No. 41, E Ling North Road, Huicheng District, Huizhou, 516001, Guangdong, China.
  2. 2Laboratory of Human Virology and Oncology, Shantou University Medical College, No. 22 Xinling Road, Jinping District, Shantou, 515041, Guangdong, China.
  3. 3Science Research Center, Huizhou Central People's Hospital, Huizhou, 516001, Guangdong, China.
  4. 4Department of Epidemiology and Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China.
  5. 5Department of Dermatology, The First Affiliated Hospital, The Second Clinical Medical College, Shenzhen People's Hospital, Southern University of Science and Technology, Jinan University), Shenzhen, 518020, Guangdong, China.
  6. 6Research Center, Guangzhou Algae Technology, Guangzhou, 510720, Guangdong, China.
  7. 7The First School of Clinical Medicine, Guangdong Medical University, Zhanjiang, 524023, Guangdong, China.
  8. 8Department of Gynecology, Huizhou Central People's Hospital, No. 41, E Ling North Road, Huicheng District, Huizhou, 516001, Guangdong, China. [email protected].
  9. 9Laboratory of Human Virology and Oncology, Shantou University Medical College, No. 22 Xinling Road, Jinping District, Shantou, 515041, Guangdong, China. [email protected].
  10. 10Department of Gynecology, Huizhou Central People's Hospital, No. 41, E Ling North Road, Huicheng District, Huizhou, 516001, Guangdong, China. [email protected].

Abstract

Background

Poly(ADP-ribose) polymerase (PARP) inhibitor resistance represents a major clinical challenge in both homologous recombination deficiency-positive (HRD⁺) and deficiency-negative (HRD⁻) high-grade serous ovarian carcinoma (HGSOC). ACSF2 is aberrantly overexpressed in various malignancies and associated with poor patient prognosis. However, its role and underlying mechanism in PARP inhibitor resistance remain unclear.Objective

This study aimed to investigate whether ACSF2 modulates PARP inhibitor resistance by regulating p53-binding protein 1 (53BP1) nuclear foci formation and to determine if ACSF2 influences histone H4 Lysine 20 di-methylation (H4K20me2)-mediated 53BP1 recruitment via KMT5B in HRD⁻ HGSOC.Methods

Using machine learning, ACSF2 was identified as a key resistance gene to PARP inhibitor. This discovery was based on an integrated analysis of six platinum-sensitive recurrent ovarian cancer (OC) cell lines (HRD±), four PARP inhibitor-resistant patient-derived organoid (PDO) models, and 181 °C tissue samples. Isogenic resistant cell lines were established to validate the role of ACSF2. The functional impact of ACSF2 perturbation was assessed by evaluating 53BP1, breast cancer type 1 susceptibility protein (BRCA1), and phosphorylated H2A histone family member x (γH2AX) foci formation, along with epigenetic markers (KMT5B and H4K20me2). The therapeutic potential of targeting ACSF2 was further examined through in vitro, in vivo, and PDO models.Results

ACSF2 was provisionally identified as key mediator of PARP inhibitor resistance, with high expression correlating with poorer median overall survival in patients (42.00 vs. 49.60 months, P < 0.05). Similarly, ACSF2 acted as a key regulator of Niraparib sensitivity. Overexpression of ACSF2 increased the IC₅₀ (72 h) from 146.89 ± 9.08 µmol/L to 192.27 ± 4.24 µmol/L (P < 0.001), while its knockdown reduced the IC₅₀ to 92.81 ± 2.62 µmol/L (P < 0.001). Mechanistically, ACSF2 suppression significantly enhanced 53BP1 nuclear foci formation (positive cells increased from 12.00 ± 2.90% to 76.65 ± 7.23%; foci count increased > 12-fold; P < 0.001) and suppressed Niraparib-induced BRCA1 foci (median foci reduced from 38.00 [23.24-52.76] to 3.86 [1.50-6.21]), concomitantly promoting DNA damage. This process was associated with upregulation of H4K20me2, which is regulated by KMT5B.Conclusion

ACSF2 promotes Niraparib resistance in HRD⁻ HGSOC by modulating the KMT5B-H4K20me2 axis, thereby inhibiting 53BP1 nuclear aggregation. Targeting ACSF2 restores 53BP1-mediated DNA damage response and re-sensitizes tumors to PARP inhibitor.

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BibTeX
@article{cheng2026acsf2,
  title = {{ACSF2 Functions as a regulatory switch for PARP inhibitor sensitivity in platinum-sensitive and homologous recombination-proficient high-grade serous ovarian cancer.}},
  author = {Sijia Cheng and Jiayi Li and Yunzhi Ling and Jiaru Luo and Dan Zhou and Tianle Mao and Tingting Luo and Yanyang Tu and Jinlin Du and Minghui Zhou and Qingsong Qin and Yanqin Ji},
  journal = {Cancer cell international},
  year = {2026},
  month = jul,
  doi = {10.1186/s12935-026-04426-9},
  url = {https://europepmc.org/article/MED/42894212},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - ACSF2 Functions as a regulatory switch for PARP inhibitor sensitivity in platinum-sensitive and homologous recombination-proficient high-grade serous ovarian cancer.
AU  - Sijia Cheng
AU  - Jiayi Li
AU  - Yunzhi Ling
AU  - Jiaru Luo
AU  - Dan Zhou
AU  - Tianle Mao
AU  - Tingting Luo
AU  - Yanyang Tu
AU  - Jinlin Du
AU  - Minghui Zhou
AU  - Qingsong Qin
AU  - Yanqin Ji
PY  - 2026
DA  - 2026/07/01
JO  - Cancer cell international
DO  - 10.1186/s12935-026-04426-9
UR  - https://europepmc.org/article/MED/42894212
AB  - Background  Poly(ADP-ribose) polymerase (PARP) inhibitor resistance represents a major clinical challenge in both homologous recombination deficiency-positive (HRD⁺) and deficiency-negative (HRD⁻) high-grade serous ovarian carcinoma (HGSOC). ACSF2 is aberrantly overexpressed in various malignancies and associated with poor patient prognosis. However, its role and underlying mechanism in PARP inhibitor resistance remain unclear.Objective  This study aimed to investigate whether ACSF2 modulates PARP inhibitor resistance by regulating p53-binding protein 1 (53BP1) nuclear foci formation and to determine if ACSF2 influences histone H4 Lysine 20 di-methylation (H4K20me2)-mediated 53BP1 recruitment via KMT5B in HRD⁻ HGSOC.Methods  Using machine learning, ACSF2 was identified as a key resistance gene to PARP inhibitor. This discovery was based on an integrated analysis of six platinum-sensitive recurrent ovarian cancer (OC) cell lines (HRD±), four PARP inhibitor-resistant patient-derived organoid (PDO) models, and 181 °C tissue samples. Isogenic resistant cell lines were established to validate the role of ACSF2. The functional impact of ACSF2 perturbation was assessed by evaluating 53BP1, breast cancer type 1 susceptibility protein (BRCA1), and phosphorylated H2A histone family member x (γH2AX) foci formation, along with epigenetic markers (KMT5B and H4K20me2). The therapeutic potential of targeting ACSF2 was further examined through in vitro, in vivo, and PDO models.Results  ACSF2 was provisionally identified as key mediator of PARP inhibitor resistance, with high expression correlating with poorer median overall survival in patients (42.00 vs. 49.60 months, P < 0.05). Similarly, ACSF2 acted as a key regulator of Niraparib sensitivity. Overexpression of ACSF2 increased the IC₅₀ (72 h) from 146.89 ± 9.08 µmol/L to 192.27 ± 4.24 µmol/L (P < 0.001), while its knockdown reduced the IC₅₀ to 92.81 ± 2.62 µmol/L (P < 0.001). Mechanistically, ACSF2 suppression significantly enhanced 53BP1 nuclear foci formation (positive cells increased from 12.00 ± 2.90% to 76.65 ± 7.23%; foci count increased > 12-fold; P < 0.001) and suppressed Niraparib-induced BRCA1 foci (median foci reduced from 38.00 [23.24-52.76] to 3.86 [1.50-6.21]), concomitantly promoting DNA damage. This process was associated with upregulation of H4K20me2, which is regulated by KMT5B.Conclusion  ACSF2 promotes Niraparib resistance in HRD⁻ HGSOC by modulating the KMT5B-H4K20me2 axis, thereby inhibiting 53BP1 nuclear aggregation. Targeting ACSF2 restores 53BP1-mediated DNA damage response and re-sensitizes tumors to PARP inhibitor.
SN  - 1475-2867
ER  -