---
title: "ERP44 Expression Predicts Poor Prognosis and Drives Temozolomide Resistance in Lower‑Grade Glioma"
id: "pubmed-42674822"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674822"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674822/"
doi: "10.21873/cgp.20608"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# ERP44 Expression Predicts Poor Prognosis and Drives Temozolomide Resistance in Lower‑Grade Glioma
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674822
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674822/)
- **DOI:** [10.21873/cgp.20608](https://doi.org/10.21873%2Fcgp.20608)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This study investigated the role of **ERP44** (an endoplasmic reticulum resident protein and protein disulfide isomerase family member) in lower‑grade glioma (LGG), analyzing public cohorts and performing cellular and animal experiments. - Bioinformatic analysis used TCGA, GTEx, and CGGA datasets to assess ERP44 expression, clinicopathological associations, prognostic value, and pathway enrichments. - High ERP44 expression was observed in LGG and associated with adverse clinicopathological features: higher WHO grade, IDH wildtype status, and 1p/19q non‑codeletion. - ERP44 overexpression correlated with poorer survival in TCGA and CGGA cohorts and provided strong prognostic performance, including improved risk stratification when included in a multivariable nomogram. - Enrichment analyses (GSEA, GO) linked high ERP44 to immune and inflammatory pathways and to loss of neuronal functional signatures; ERP44 positively correlated with immune infiltration and proliferation/stemness markers. - ERP44 expression predicted temozolomide (TMZ) resistance in silico; functional validation used shRNA knockdown in SW1088 and SW1783 LGG cell lines. - ERP44 knockdown reduced proliferation and colony formation, lowered TMZ IC50, and decreased proliferation marker Ki67 in xenograft tumors; knockdown also enhanced TMZ efficacy and suppressed subcutaneous xenograft growth in mice. - Authors conclude that **ERP44** is a prognostic biomarker that promotes LGG proliferation and **TMZ resistance**, and that ERP44 could be a potential therapeutic target. - Details such as exact sample sizes, hazard ratios, fold changes, statistical values, and specific immune cell types implicated were not reported in the abstract and therefore are not included here.
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China."), [Jia Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42674822)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674822/#full-view-affiliation-2 "Department of Neuroscience, Yale School of Medicine, New Haven, CT, U.S.A."), [Mohammad Rohul Amin](https://pubmed.ncbi.nlm.nih.gov/?term=Amin+MR&cauthor_id=42674822)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674822/#full-view-affiliation-1 "Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China."), [Zhihong Jian](https://pubmed.ncbi.nlm.nih.gov/?term=Jian+Z&cauthor_id=42674822)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674822/#full-view-affiliation-3 "Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China; zhihong@whu.edu.cn.") Affiliations Expand ### Affiliations * 1 Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China. * 2 Department of Neuroscience, Yale School of Medicine, New Haven, CT, U.S.A. * 3 Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China; zhihong@whu.edu.cn. * PMID: **42674822** * DOI: [ 10.21873/cgp.20608 ](https://doi.org/10.21873/cgp.20608) Item in Clipboard # ERP44 Is Associated With Poor Prognosis and Promotes Proliferation and Temozolomide Resistance in Lower-grade Glioma Lingmin Shao et al. Cancer Genomics Proteomics. 2026 Sep-Oct. Show details Display options Display options Format Abstract PubMed PMID Cancer Genomics Proteomics Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cancer+Genomics+Proteomics%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Cancer+Genomics+Proteomics%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674822/) . 2026 Sep-Oct;23(5):914-933. doi: 10.21873/cgp.20608. ### Authors [Lingmin Shao](https://pubmed.ncbi.nlm.nih.gov/?term=Shao+L&cauthor_id=42674822)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674822/#short-view-affiliation-1 "Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China."), [Jia Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42674822)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674822/#short-view-affiliation-2 "Department of Neuroscience, Yale School of Medicine, New Haven, CT, U.S.A."), [Mohammad Rohul Amin](https://pubmed.ncbi.nlm.nih.gov/?term=Amin+MR&cauthor_id=42674822)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674822/#short-view-affiliation-1 "Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China."), [Zhihong Jian](https://pubmed.ncbi.nlm.nih.gov/?term=Jian+Z&cauthor_id=42674822)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674822/#short-view-affiliation-3 "Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China; zhihong@whu.edu.cn.") ### Affiliations * 1 Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China. * 2 Department of Neuroscience, Yale School of Medicine, New Haven, CT, U.S.A. * 3 Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, P.R. China; zhihong@whu.edu.cn. * PMID: **42674822** * DOI: [ 10.21873/cgp.20608 ](https://doi.org/10.21873/cgp.20608) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aim:** Endoplasmic reticulum resident protein 44 (ERP44), a protein disulfide isomerase family member, has been implicated in tumor biology, but its role in lower-grade glioma (LGG) remains unclear. This study investigated the prognostic significance and biological function of ERP44 in LGG, focusing on proliferation and temozolomide (TMZ) resistance. **Materials and methods:** ERP44 expression, clinicopathological associations, and prognostic value were analyzed using The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), and Chinese Glioma Genome Atlas (CGGA) datasets. Time-dependent receiver operating characteristic (ROC) curves, Cox regression, and a prognostic nomogram were constructed. Differential expression, Gene Set Enrichment Analysis (GSEA), Gene Ontology (GO) enrichment, immune infiltration, and drug sensitivity analyses were performed. Functional validation was conducted in SW1088 and SW1783 cells using shRNA-mediated ERP44 knockdown, followed by RT-qPCR, western blotting, CCK-8, colony formation, and TMZ IC50 assays. Subcutaneous xenograft models with or without TMZ treatment were used for _in vivo_ validation. **Results:** ERP44 was markedly upregulated in LGG and associated with higher WHO grade, IDH wildtype status, 1p/19q non-codeletion, and poor survival in TCGA and CGGA cohorts. ERP44 showed strong prognostic performance and improved risk stratification in a multivariable nomogram. Enrichment analyses linked high ERP44 expression to immune/inflammatory pathways and reduced neuronal functional signatures. ERP44 positively correlated with immune infiltration, proliferation/stemness markers, and predicted TMZ resistance, while its knockdown inhibited proliferation and colony formation, reduced TMZ IC50, suppressed xenograft growth, enhanced TMZ efficacy, and decreased Ki67 positivity. **Conclusion:** ERP44 is a prognostic biomarker that promotes LGG proliferation and TMZ resistance, suggesting its potential as a therapeutic target. **Keywords:** ERP44; lower-grade glioma; prognostic biomarker; proliferation; temozolomide resistance. Copyright © 2026 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved. 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