Chronic stress stimulated HIF-AS3/HIF-1α loop in neoplastic cells and promoted lung cancer progression through macrophage inactivation [A549 and H1299]

Chronic psychological stress is closely linked to malignant disorders, with novel modulators potentially mitigating tumor progression by regulating interactions between neoplastic cells and immune cells. This study identified lncRNA HIF1A-AS3 as a key driver of stress-induced lung cancer progression. Chronic stress models in mice with implanted lung cancer cells revealed significant upregulation of HIF1A-AS3 in stressed groups and human lung cancer tissues. Functional studies showed HIF1A-AS3 promotes cancer cell proliferation and invasion by activating HIF-1ɑ translation through interaction with YBX1, forming a positive feedback loop where HIF-1ɑ enhances HIF1A-AS3 transcription. Additionally, HIF1A-AS3 drove macrophage M2 polarization and reduced phagocytosis under hypoxia. Targeting the HIF1A-AS3/HIF-1ɑ loop effectively counteracted stress-induced lung cancer progression in vivo, highlighting its potential as a diagnostic and therapeutic target for stress-exacerbated lung cancer.