OLFM4 promotes intrahepatic cholangiocarcinoma progression through a PKM2-glycolysis-histone lactylation feedback loop.

Metabolic reprogramming is increasingly recognized as a key characteristic of intrahepatic cholangiocarcinoma (ICC) initiation and progression. Among these metabolic alterations, glycolysis is central for supporting tumor growth. Elucidating the precise molecular mechanisms of glycolysis in ICC is critical for developing precision therapies. Here, comprehensive integrative analyses revealed that olfactomedin 4 (OLFM4) is upregulated in ICC specimens and is associated with adverse patient outcomes. Mechanistically, OLFM4 promotes ICC progression by recruiting ubiquitin specific peptidase 10 (USP10) to stabilize pyruvate kinase M2 (PKM2). This interaction enhances glycolysis and lactate production, thereby elevating histone lactylation, with a prominent impact on H3K18 lactylation (H3K18la). Consequently, H3K18la positively regulates OLFM4 transcription, establishing a positive glycolysis-histone lactylation feedback loop. Notably, tiliroside, a candidate pharmacological inhibitor of OLFM4, demonstrated antitumor efficacy in ICC. Collectively, these findings support targeting OLFM4 as a promising therapeutic strategy for ICC management.