# Potential value of expression of receptor accessory protein 4 for evaluating the prognosis of lower-grade glioma patients

## TL;DR

This study explores how REEP4 expression and methylation affect survival and immune responses in lower-grade glioma patients.

## Contribution

The study is the first to investigate REEP4 in malignant tumors and its potential as a prognostic and therapeutic marker.

## Key findings

- High REEP4 expression and low methylation at cg16311504 correlate with lower survival rates in LGG patients.
- REEP4 is linked to cancer-related pathways like cell cycle and MAPK signaling.
- High REEP4 expression correlates with increased immune cell infiltration and PD-L1 expression in LGG.

## Abstract

Background: REEP4 is involved in the regulation of the biological process of mitosis. Lower grade glioma (LGG), as a malignant tumor, is accompanied by abnormalities in mitosis, but there have been no reports of REEP4 so far.

Methods: We collected transcriptome data, DNA methylation data and the clinical characteristics of thousands of patients with LGG. Various big data analysis methods and molecular biology experiments were employed to reveal the impact of REEP4 on the pathological process of LGG.

Results: It was found that the expression of REEP4 was significantly elevated and negatively regulated by its methylation site. Therefore, both the high expression of REEP4 and low methylation state of cg16311504 showed that the patients are correlated with lower patient survival rate. In addition, high REEP4 expression participates in the regulation of various cancer-related cellular signaling pathways, such as the cell cycle, MAPK signaling pathway, NOD-like receptor signaling pathway, etc. More importantly, the level of immune cell infiltration significantly increased in the high expression group of REEP4 in the LGG tumor microenvironment and REEP4 has a high positive correlation with PD-L1 and other immune checkpoints.

Conclusions: In brief, this study is the first to introduce REEP4 in malignant tumors, which can be used as an independent risk factor that participates in the malignant process of LGG. More importantly, REEP4 has the potential to become a new star in the field of anti-tumor treatment.