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Peer-reviewedCC BY-NC-ND 4.0Cellular Oncology

P4HA2 mediates hypoxia-induced collagen remodeling to promote tumor progression in head and neck squamous cell carcinoma

6 affiliations
  1. 1Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
  2. 2Department of Preventive Dentistry, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
  3. 3Department of Stomatology, Xiang’an Hospital of Xiamen University, Xiamen, China
  4. 4Department of Pathology, Ningde Municipal Hospital, Ningde Normal University, Ningde, China
  5. 5Department of Pathology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
  6. 6Department of Pathology, National Region Center, Binhai Campus of the First Affilated Hospital, Fujian Medical University, Fuzhou, China

Abstract

Purpose: This study investigated the clinical significance, regulatory mechanisms, and functional roles of Prolyl 4-Hydroxylase Subunit Alpha 2 (P4HA2) in head and neck squamous cell carcinoma (HNSCC), focusing on its involvement in hypoxia-driven extracellular matrix (ECM) remodeling and tumor progression.

Methods: Immunohistochemical (IHC) analysis was performed on 108 clinical HNSCC specimens to evaluate the expression of P4HA2 and Hypoxia-Inducible Factor-1 Alpha (HIF-1α) and their association with patient prognosis. These clinical findings were further validated using bioinformatic data from public cohorts. The transcriptional regulation of P4HA2 by HIF-1α under hypoxic conditions was investigated via chromatin immunoprecipitation (ChIP). Functional assays, including assessments of P4HA2’s dependency on its essential cofactor vitamin C, were conducted in HNSCC cell lines to evaluate cell proliferation, migration, and invasion in vitro. The role of P4HA2 in tumor growth and microenvironmental remodeling in vivo was examined using xenograft mouse models.

Results: P4HA2 and HIF-1α were upregulated in HNSCC and associated with poor prognosis. Hypoxia-induced HIF-1α directly activated P4HA2 transcription. P4HA2 promoted collagen deposition and ECM remodeling, facilitating HNSCC cell proliferation, migration, and invasion, with its collagen-producing effects enhanced by vitamin C. In vivo, P4HA2 overexpression accelerated tumor growth, accompanied by enhanced HIF-1α signaling and collagen production.

Conclusion: P4HA2 is a key effector of the hypoxia/HIF-1α axis, driving collagen remodeling to promote HNSCC progression, suggesting its potential as a therapeutic target.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13402-026-01268-5.

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BibTeX
@article{zhang2026p4ha2,
  title = {{P4HA2 mediates hypoxia-induced collagen remodeling to promote tumor progression in head and neck squamous cell carcinoma}},
  author = {Chaochao Zhang and Ruihuan Gan and Limei Wang and Qiuling Chen and Yuxiang Yan and Youguang Lu and Dali Zheng and Ke Zheng},
  journal = {Cellular Oncology},
  year = {2026},
  month = jul,
  doi = {10.1007/s13402-026-01268-5},
  url = {https://doi.org/10.1007/s13402-026-01268-5},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - P4HA2 mediates hypoxia-induced collagen remodeling to promote tumor progression in head and neck squamous cell carcinoma
AU  - Chaochao Zhang
AU  - Ruihuan Gan
AU  - Limei Wang
AU  - Qiuling Chen
AU  - Yuxiang Yan
AU  - Youguang Lu
AU  - Dali Zheng
AU  - Ke Zheng
PY  - 2026
DA  - 2026/07/30
JO  - Cellular Oncology
DO  - 10.1007/s13402-026-01268-5
UR  - https://doi.org/10.1007/s13402-026-01268-5
AB  - Purpose: This study investigated the clinical significance, regulatory mechanisms, and functional roles of Prolyl 4-Hydroxylase Subunit Alpha 2 (P4HA2) in head and neck squamous cell carcinoma (HNSCC), focusing on its involvement in hypoxia-driven extracellular matrix (ECM) remodeling and tumor progression.  Methods: Immunohistochemical (IHC) analysis was performed on 108 clinical HNSCC specimens to evaluate the expression of P4HA2 and Hypoxia-Inducible Factor-1 Alpha (HIF-1α) and their association with patient prognosis. These clinical findings were further validated using bioinformatic data from public cohorts. The transcriptional regulation of P4HA2 by HIF-1α under hypoxic conditions was investigated via chromatin immunoprecipitation (ChIP). Functional assays, including assessments of P4HA2’s dependency on its essential cofactor vitamin C, were conducted in HNSCC cell lines to evaluate cell proliferation, migration, and invasion in vitro. The role of P4HA2 in tumor growth and microenvironmental remodeling in vivo was examined using xenograft mouse models.  Results: P4HA2 and HIF-1α were upregulated in HNSCC and associated with poor prognosis. Hypoxia-induced HIF-1α directly activated P4HA2 transcription. P4HA2 promoted collagen deposition and ECM remodeling, facilitating HNSCC cell proliferation, migration, and invasion, with its collagen-producing effects enhanced by vitamin C. In vivo, P4HA2 overexpression accelerated tumor growth, accompanied by enhanced HIF-1α signaling and collagen production.  Conclusion: P4HA2 is a key effector of the hypoxia/HIF-1α axis, driving collagen remodeling to promote HNSCC progression, suggesting its potential as a therapeutic target.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13402-026-01268-5.
SN  - 2211-3428
SN  - 2211-3436
ER  -