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Mucin 15 (MUC15) is reportedly aberrant in human malignancies, including hepatocellular carcinoma (HCC). However, the role of MUC15 in the regulation of liver tumor-initiating cells (T-ICs) remains unknown. Here, we report that expression of MUC15 is downregulated in liver T-ICs, chemoresistance and recurrent HCC samples. Functional studies reveal that MUC15 inhibits hepatoma cells self-renewal, malignant proliferation, tumorigenicity, and chemoresistance. Mechanistically, MUC15 interacts with c-MET and subsequently inactivates the PI3K/AKT/SOX2 signaling pathway. Moreover, we find that miR-183-5p.1 directly targets MUC15 3′-UTR in liver T-ICs. Coincidentally, SOX2 feedback inhibits MUC15 expression by directly transactivating miR-183-5p.1, thus completing a feedforward regulatory circuit in liver T-ICs. Importantly, MUC15/c-MET/PI3K/AKT/SOX2 axis determines the responses of hepatoma cells to lenvatinib treatment, and MUC15 overexpression abrogated lenvatinib resistance. Analysis of patient cohort, patient-derived tumor organoids and patient-derived xenografts further suggests that the MUC15 may predict lenvatinib benefits in HCC patients. Collectively, our findings suggest the crucial role of the miR-183-5p.1/MUC15/c-MET/PI3K/AKT/SOX2 regulatory circuit in regulating liver T-ICs properties, suggesting potential therapeutic targets for HCC.

Downregulation of MUC15 by miR-183-5p.1 promotes liver tumor-initiating cells properties and tumorigenesis via regulating c-MET/PI3K/AKT/SOX2 axis