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BACKGROUND:
We observed a disproportional 18 F-fluorothymidine (F-FLT) uptake in follicular lymphoma (FL) relative to its low cell proliferation. We tested the hypothesis that the 'excess' uptake of 18 F-FLT in FL is related to error-prone DNA repair and investigated whether this also contributes to 18 F-FLT uptake in diffuse large B cell lymphoma (DLBCL).
METHODS:
We performed immunohistochemical stainings to assess the pure DNA replication marker MIB-1 as well as markers of both DNA replication and repair like PCNA, TK-1 and RPA1 on lymph node biopsies of 27 FLs and 35 DLBCLs. In 7 FL and 15 DLBCL patients, 18 F-FLT-PET had been performed.
RESULTS:
18 F-FLT uptake was lower in FL than in DLBCL (median SUVmax 5.7 vs. 8.9, p = 0,004), but the ratio of 18 F-FLT-SUVmax to percentage of MIB-1 positive cells was significantly higher in FL compared with DLBCL (p = 0.001). The median percentage of MIB-1 positive cells was 10% (range, 10% to 20%) in FL and 70% (40% to 80%) in DLBCL. In contrast, the median percentages of PCNA, TK-1 and RPA1 positive cells were 90% (range, 80 to 100), 90% (80 to 100) and 100% (80 to 100) in FL versus 90% (60 to 100), 90% (60 to 100) and 100% (80 to 100) in DLBCL, respectively.
CONCLUSIONS:
This is the first demonstration of a striking discordance between 18 F-FLT uptake in FL and tumour cell proliferation. High expression of DNA replication and repair markers compared with the pure proliferation marker MIB-1 in FL suggests that this discordance might be due to error-prone DNA repair. While DNA repair-related 18 F-FLT uptake considerably contributes to 18 F-FLT uptake in FL, its contribution to 18 F-FLT uptake in highly proliferative DLBCL is small. This apparently high contribution of DNA repair to the 18 F-FLT signal in FL may hamper studies where 18 F-FLT is used to assess response to cytostatic therapy or to distinguish between FL and transformed lymphoma.
DNA alkyltransferase and alkyltransferase-like family proteins are responsible for the repair of highly mutagenic and cytotoxic O\(^6\)-alkylguanine and O\(^4\)-alkylthymine bases in DNA. Their mechanism involves binding to the damaged DNA and flipping the base out of the DNA helix into the active site pocket in the protein. Alkyltransferases then directly and irreversibly transfer the alkyl group from the base to the active site cysteine residue. In contrast, alkyltransferase-like proteins recruit nucleotide excision repair components for O\(^6\)-alkylguanine elimination. One or more of these proteins are found in all kingdoms of life, and where this has been determined, their overall DNA repair mechanism is strictly conserved between organisms. Nevertheless, between species, subtle as well as more extensive differences that affect target lesion preferences and/or introduce additional protein functions have evolved. Examining these differences and their functional consequences is intricately entwined with understanding the details of their DNA repair mechanism(s) and their biological roles. In this review, we will present and discuss various aspects of the current status of knowledge on this intriguing protein family.
The integrity of its DNA is fundamental for every living cell. However, DNA is constantly threatened by exogenous and endogenous damaging agents that can cause a variety of different DNA lesions. The severe consequences of an accumulation of DNA lesions are reflected in cancerogenesis and aging. Several DNA repair mechanisms ensure the repair of DNA lesions and thus maintain DNA integrity. One of these DNA repair mechanisms is nucleotide excision repair (NER), which is famous for its ability to address a large variety of structurally unrelated DNA lesions. A key component of eukaryotic NER is the transcription factor II H (TFIIH) complex, which is not only essential for DNA repair but also for transcription. The TFIIH complex is composed of ten subunits. How these subunits work together during NER to unwind the DNA around the lesion is, however, not yet fully understood. High-resolution structural data and biochemical insights into the function of every subunit are thus indispensable to understand the functional networks within TFIIH. The importance of an intact TFIIH complex is reflected in the severe consequences of patient mutations in the TFIIH subunits XPB, XPD or p8 leading to the hallmark diseases xeroderma pigmentosum, Cockayne syndrome and trichothiodystrophy. Defects in the NER pathway are further associated with several types of cancer including skin cancer.
The herein described work focused on five TFIIH subunits derived from the thermophilic fungus Chaetomium thermophilum, the p34/p44 pair and the ternary XPB/p52/p8 complex. The interaction between p34 and p44 was characterized based on a high-resolution structure of the p34_vWA/p44_RING minimal complex. Biochemical studies of the p34/p44 interaction led to the disclosure of an additional interaction between the p34 and p44 subunits, which had not been characterized so far. The p34/p44 interaction was shown to be central to TFIIH, which justifies the presence of several redundant interfaces to safeguard the interaction between the two proteins and might explain why so far, no patient mutations in these subunits have been identified. The p52 subunit of TFIIH was known to be crucial to stimulate the ATPase activity of XPB, which is required during NER. This work presents the first entire atomic resolution structural characterization of p52, which was derived of several crystal structures of p52 variants and a p52/p8 variant thereby demonstrating the interaction between p52 and p8. The precise structural model of p52 offered the possibility to investigate interactions with other TFIIH subunits in more detail. The middle domain 2 of p52 and the N-terminal domain of XPB were shown to mediate the main interaction between the two subunits. An analysis of the p52 crystal structures within recently published cryo-electron microscopy structures of TFIIH provides a model of how p52 and p8 stimulate the ATPase activity of XPB, which is essential for NER and transcription. The structural and biochemical findings of this work provide an additional building block towards the uncovering of the architecture and function of this essential transcription factor.
Fanconi anemia (FA) is an autosomal recessive or X-chromosomal inherited disorder, which is not only phenotypically but also genotypically very heterogeneous. While its hallmark feature is progressive bone marrow failure, many yet not all patients suffer additionally from typical congenital malformations like radial ray defects and growth retardation. In young adulthood the cumulative risk for developing hematological or other malignancies is compared to the general population several hundred-fold increased. The underlying molecular defect is the deficiency of DNA interstrand crosslink (ICL) repair. ICLs are deleterious lesions, which interfere with crucial cellular processes like transcription and replication and thereby can lead to malignant transformation, premature senescence or cell death. To overcome this threat evolution developed a highly complex network of interacting DNA repair pathways, which is conserved completely only in vertebrates. The so called FA/BRCA DNA damage response pathway is able to recognize ICLs on stalled replication forks and promotes their repair through homologous recombination (HR). Today we know 15 FA genes (FANCA, -B, -C, -D1, -D2, -E, -F, -G, -I, -J, -L, -M, -N, -O and -P) whose products are involved in this pathway. Although more than 80% of FA patients carry biallelic mutations in either FANCA, FANCC or FANCG, there are still some who cannot be assigned to any of the known complementation groups. This work aimed to indentify the di¬sease causing mutations in a cohort of those unassigned patients. Initial screens of the candidate genes FAN1, MHF1 and MHF2 did not reveal any pathogenic alterations. Moreover, FAN1 could be excluded as FA candidate gene because patients carrying a homozygous microdeletion including the FAN1 locus did not show a phenotype comparable to FA patients. In the case of MHF1 and MHF2 the reason for the negative screening result is not clear. Mutation carriers might be rare or, regarding the diverse and also FA pathway independent protein functions, phenotypically not comparable to FA patients. Nevertheless, this study contri¬buted to the identification and characterization of the most recent members of the FA pathway - RAD51C (FANCO), SLX4 (FANCP) and XPF (FANCQ). FANCO is one of the RAD51 paralogs and is involved in crucial steps of HR. But since the only reported FA-O patient has so far not developed any hematological anomalies, FANCO is tentatively designated as gene underlying an FA-like disorder. In contrast, patients carrying biallelic mutations in FANCP do not only show hematological anomalies, but as well congenital malformations typical for FA. The distinct role of FANCP in the FA pathway could not be determined, but it is most likely the coordination of structure-specific nucleases during ICL excision. One of these nucleases is the heterodimer XPF/ERCC1. XPF is probably disease causing in the complementation group FA-Q and is the first FA gene, which was identified by Next Generation Sequencing (NGS). Extraordinarily is that mutations in this gene had previously been reported to cause two other disorders, xeroderma pigmentosum and segmental progeria. Despite some overlaps, it was shown that the divergent phenotypes could clearly be distinguished and are caused by distinct functional defects of XPF. Additionally, this work aimed to improve and accelerate the genotyping process of FA patients in general. Therefore, classical approaches should be complemented or fully replaced by approa¬ches using NGS. Massively parallel sequencing of the whole exome proved to be most appro¬priate and the establishment of an FA-specific analysis pipeline facilitated improved molecular diagnostics by combining complementation group assignment and mutation analysis in one step. Consequently two NGS studies revealed the pathogenic defect in several previously unassigned FA patients and thereby added another patient to one of the most recent subtypes, FA-P. In summary, this work contributed not only to further completion of the FA/BRCA DNA repair network by adding three novel genes, it also showed that classical molecular approaches for re¬search as well as for diagnostics could be replaced by NGS.
Background: Cancer patients are increasingly treated with alpha-particle-emitting radiopharmaceuticals. At the subcellular level, alpha particles induce densely spaced ionizations and molecular damage. Induction of DNA lesions, especially clustered DNA double-strand breaks (DSBs), threatens a cell's survival. Currently, it is under debate to what extent the spatial topology of the damaged chromatin regions and the repair protein arrangements are contributing. Methods: Super-resolution light microscopy (SMLM) in combination with cluster analysis of single molecule signal-point density regions of DSB repair markers was applied to investigate the nano-structure of DNA damage foci tracks of Ra-223 in-solution irradiated leukocytes. Results: Alpha-damaged chromatin tracks were efficiently outlined by γ-H2AX that formed large (super) foci composed of numerous 60–80 nm-sized nano-foci. Alpha damage tracks contained 60–70% of all γ-H2AX point signals in a nucleus, while less than 30% of 53BP1, MRE11 or p-ATM signals were located inside γ-H2AX damage tracks. MRE11 and p-ATM protein fluorescent tags formed focal nano-clusters of about 20 nm peak size. There were, on average, 12 (±9) MRE11 nanoclusters in a typical γ-H2AX-marked alpha track, suggesting a minimal number of MRE11-processed DSBs per track. Our SMLM data suggest regularly arranged nano-structures during DNA repair in the damaged chromatin domain.
Fanconi anemia (FA) is a rare bone marrow failure and cancer predisposition syndrome resulting from pathogenic mutations in genes encoding proteins participating in the repair of DNA interstrand crosslinks (ICLs). Mutations in 17 genes (FANCA-FANCS) have been identified in FA patients, defining 17 complementation groups. Here, we describe an individual presenting with typical FA features who is deficient for the ubiquitin-conjugating enzyme (E2), UBE2T. UBE2T is known to interact with FANCL, the E3 ubiquitin-ligase component of the multiprotein FA core complex, and is necessary for the monoubiquitination of FANCD2 and FANCI. Proband fibroblasts do not display FANCD2 and FANCI monoubiquitination, do not form FANCD2 foci following treatment with mitomycin C, and are hypersensitive to crosslinking agents. These cellular defects are complemented by expression of wild-type UBE2T, demonstrating that deficiency of the protein UBE2T can lead to Fanconi anemia. UBE2T gene gains an alias of FANCT.
The general transcription factor IIH (TFIIH) is a multi-protein complex and its 10 subunits are engaged in an intricate protein–protein interaction network critical for the regulation of its transcription and DNA repair activities that are so far little understood on a molecular level. In this study, we focused on the p44 and the p34 subunits, which are central for the structural integrity of core-TFIIH. We solved crystal structures of a complex formed by the p34 N-terminal vWA and p44 C-terminal zinc binding domains from Chaetomium thermophilum and from Homo sapiens. Intriguingly, our functional analyses clearly revealed the presence of a second interface located in the C-terminal zinc binding region of p34, which can rescue a disrupted interaction between the p34 vWA and the p44 RING domain. In addition, we demonstrate that the C-terminal zinc binding domain of p34 assumes a central role with respect to the stability and function of TFIIH. Our data reveal a redundant interaction network within core-TFIIH, which may serve to minimize the susceptibility to mutational impairment. This provides first insights why so far no mutations in the p34 or p44 TFIIH-core subunits have been identified that would lead to the hallmark nucleotide excision repair syndromes xeroderma pigmentosum or trichothiodystrophy.
In the context of this thesis, I investigated the molecular causes and functional consequences of genetic instability using a human inherited disease, Fanconi anemia. FA patients display a highly variable clinical phenotype, including congenital abnormalities, progressive bone marrow failure and a high cancer risk. The FA cellular phenotype is characterized by spontaneous and inducible chromosomal instability, and a typical S/G2 phase arrest after exposure to DNA-damaging agents. So far, 13 genes have been identified, whose biallelic (or, in the case of X-linked FANCB, hemizygous) mutations cause this multisystem disorder. The FA proteins interact in a multiprotein network, instrumental and essential in the cellular response to DNA damage. A more comprehensive summary of Fanconi anemia and its myriad clinical, cellular and molecular manifestations is provided in the introduction section of this thesis. The results of my experimental work are presented as published papers and manuscripts ready to be submitted. In the first publication, I investigated the connection between FA genes and bladder tumors. The question I tried to answer was whether a disruption of the FA/BRCA pathway may be a frequent and possibly causal event in bladder cancer, explaining the hypersensitivity of these cells to DNA-crosslinking agents. On the basis of my experimental data I arrived at the conclusion that disruption of the FA/BRCA pathway might be detrimental rather than advantageous for the majority tumor types by rendering them vulnerable towards DNA damaging agents and oxidative stress. The second publication deals with the gene coding for the core complex protein FANCE and tries to answer the question why FANCE is so rarely affected among FA-patients. The conclusion from these studies is that like FANCF, FANCE functions as a probable adaptor protein with a high tolerance towards amino acid substitutions which would explain the relative rareness of FA-E patients. I have also investigated the FANCL gene whose product functions as the catalytic subunit of the E3 ligase. The third publication addresses this issue by providing the first comprehensive description of genetic alterations and phenotypic manifestations in a series of three FA-L patients. The results of my study show that genetic alterations of FANCL are compatible with survival, these alterations may include large deletions such as so far common only in the FANCA gene, FA-L phenotypes can be mild to severe, and FANCL belongs to the group of FA genes that may undergo somatic reversion. The central protein of the FA/BRCA network, FANCD2, is the subject of the fourth publication presented in this thesis. Most importantly, we were able to show that there are no biallelic null mutations in FANCD2. Correspondingly, residual protein of both FANCD2-isotypes (FANCD2-S and FANCD2-L) was present in all available patient cell lines. This suggests that complete abrogation of the FANCD2 protein cannot be tolerated and causes early embryonic lethality. There are at least three FA proteins that are not required for the posttranslational modification of FANCD2. One of these proteins is the 5’-3’ helicase BRIP1 (BRCA1-interacting protein 1), a protein that interacts directly with the breast cancer susceptibility protein BRCA1. I participated in the identification of BRIP1 as the FA protein FANCJ. This discovery is described in the fifth publication of this thesis. The newly discovered protein BRIP1/FANCJ seems to act as one of the mediators of genomic maintenance downstream of FANCD2. Another protein identified downstream of FANCD2 is PALB2. PALB2 was originally discovered as “partner and localizer of BRCA2”. In a candidate gene approach we tested patients with early childhood cancers but without mutations in BRCA2 for mutations in PALB2 (publication 6). PALB2 was identified as a novel FA gene and designated FANCN. FA-N patients are very severely affected. The last publication included in my thesis describes the identification of the FA gene FANCI as the second monoubiquitinated member of the FA/BRCA pathway (publication 7). We identified biallelic mutations in KIAA1794 in four FA patients, thus proving the genuine FA-nature of this candidate sequence. The general discussion provides a synopsis of the results and conclusions of my work with the state of art of FA research.
Human caretaker genes play a central role in the DNA damage response. Their defects cause a number of rare diseases which show genetic instability and increased propensity to malignant cell growth. The first of these diseases to be described in this thesis is Fanconi anemia (FA), a rare chromosome instability disorder with recessive inheritance characterized by progressive bone marrow failure, variable congenital malformations, and cancer predisposition. There are at least 13 FA complementation groups (FA-A, B, C, D1, D2, E, F, G, I, J, L, M and N), each representing mutations in a distinct gene. To date, except FANCI all the corresponding genes have been identified, denoted as FANC-A, B, C, D1/BRCA2, D2, E, F, G, J/BRIP1/BACH1, L/PHF9, M/Hef and N/PALB2.Further information is provided in chapters 1 and 2. FA cells are characterized by high sensitivity to DNA crosslinking agents and to elevated oxygen tension, but it is controversial whether they are also radiosensitive. Systematic testing (chapter 3) of primary skin fibroblast cultures from all currently known FA complementation groups revealed no increased sensitivity towards ionizing radiation (IR) and ultra-violet light (UV) when growing cells at physiological (5% v/v) oxygen levels. Despite considerable interstrain variations FA cells showed no systematic differences to cell cultures derived from healthy controls, whereas positive controls (Ataxia telangiectasia and Cockayne syndrome) proved highly sensitive to IR or UV. Lack of radiosensitivity was also shown for the FANCD2 gene, a central gene in the FA/BRCA pathway whose mutational inactivation was studied in a large patient cohort. FA patients excluded previously from complementation groups FA-A, -C, E, F, G or L were screened for mutations in FANCD2. Even though mutation analysis of FANCD2 is complicated by the presence of pseudogene regions, biallelic FANCD2 mutations were identified in a series of 32 patients (chapter 4). The predominant types of mutations result in aberrant splicing causing exon skipping, exonisation of intronic sequence, activation of cryptic and creation of new 3´ splice sites. Many alleles were recurrent and could be associated with ethnicity. Interestingly, residual FANCD2 protein was observed in all available patient cell lines, and functionality was indicated by the presence of the monoubiquitinated FANCD2 isoform. This suggests that viability of FA-D2 patients depends on the presence of hypomorphic or leaky mutations. In chapter 5 the worldwide second FA patient belonging to complementation group FA-L is reported. Genetic analysis of patient derived fibroblasts revealed heterozygosity for a 5-bp deletion (exon 7) and a missense substitution (exon 11). In contrast to the tested fibroblasts two independent lymphoid cell lines proved resistant to the DNA crosslinking agent mitomycin C and showed proficient FANCD2 monoubiquitination. The functional reversion due to a compensating mutation in the splice acceptor site results in aberrant splicing and the restoration of the open reading frame. However, the revertant mosaicsm was restricted to the lymphatic cell lines such that there was no clinical improvement involving the other hematopoietic cell lineages, and bone marrow transplantation was required to treat the patients bone marrow failure. A direct link of Fanconi anemia to other DNA repair processes was provided by the identification of the BRCA1 interacting protein 1, BRIP1/BACH1, as a genuine FA gene (chapter 6). Genetic mapping of consanguineous Inuit families resulted in the identification of truncating mutations in BRIP1. In contrast to most of the other FA patients FANCD2 monoubiquitination was intact, linking these patients to complementation group FA-J. Biallelic mutations in BRIP1 were found in eight additional patients, one of whom was assigned previously to FA-J by somatic cell fusion. Therefore it could be shown that the postulated FANCJ gene is identical with BRIP1. This finding emphasizes the close connection between the BRCA- and the FA-family of genes, both involved in the DNA damage response. Biallelic mutations in BRCA2/FANCD1 cause a severe form of Fanconi anemia with childhood malignancies. Recently, a BRCA2 interacting protein was identified as a “partner and localizer of BRCA2” (PALB2) which confers cellular MMC resistance. A candidate gene approach revealed biallelic mutations in seven FA patients that developed solid tumors in early childhood (chapter 7). Patient cells show no or little PALB2 protein, lack of MMC induced RAD51 foci formation, and high chromosomal instability. Transduction of PALB2 cDNA complemented the MMC sensitive phenotype. Therefore, biallelic mutations in PALB2 cause a new subtype of FA, denoted as FA-N, which is connected with a high and early cancer risk. With respect to one of the most prominent but least understood caretaker gene syndromes, Fanconi anemia, this thesis has expanded our knowledge as follows: 1. refutation of major cellular radiosensitivity of FA cell lines regardless of complementation group, 2. detection of hypomorphic mutations and residual protein levels as a prerequisite for viability of the FANCD2 gene, 3. description of the worldwide second patient belonging to complementation group FA-L whose lymphocytes exhibit a novel type of somatic reversion, 4. participation in the discovery and functional characterization of two novel FA genes (FANCJ and FANCN). The last chapter of the thesis deals with a DNA repair pathway that is activated following exposure to ionizing radation. One of the central proteins responding to radiation-induced DNA damage is the product of the ATM gene which signals to a myriad of other proteins in response to DNA double strand breaks, including the NMR complex. This complex formed by the NBS1/MRE11/RAD50 proteins is thought to act as a specifi c sensor of DNA double-strand breaks. Mutations of MRE11 and NBS1 are associated with the radiation sensitivity syndromes Ataxia-telangiectasia-like disorder (AT-LD) and Nijmegen breakage syndrome (NBS), respectively. Chapter 8 presents the first ever identified patient with RAD50 deficiency due to biallelic germline mutations in the RAD50 gene. An 18-year-old German girl who has a variant form of NBS without immunodeficiency was found to be compound heterozygous for a nonsense mutation and the loss of the natural termination signal in the RAD50 gene. RAD50 protein expression was reduced to less than one tenth of normal in her fibroblasts and lymphoblastoid cells. At the nuclear level, RAD50 deficiency was associated with a high frequency of spontaneous chromatid exchanges and with the failure to form MRE11 and NBS1 nuclear foci in response to irradiation. ATM autophosphorylation, phosphorylation of p53 at serine 15 and the transcriptional induction of p21/WAF1 mRNA were reduced, and there was no evidence for Ser343 phosphorylation of NBS1 in RAD50 defi cient cells following irradiation. These defects could be complemented by expression of wildtype RAD50 cDNA. Our data shows that RAD50 modulates, like NBS1 and MRE11, the ATM-mediated DNA damage response and the G1/S cell cycle checkpoint. In addition, RAD50 appears to be required for nuclear localization of MRE11, and for NBS1 focus formation, underlining its importance for the proper function of the NMR complex. Owing to the studies performed within the framework of this thesis, RAD50 deficiency can now be added to the growing list of human caretaker gene syndromes with pronounced radiosensitivity that is distinctive at both the cellular and the clinical level from deficiencies involving the other members of the NMR complex.
Background: Genes that, when mutated, cause Fanconi anemia or greatly increase breast cancer risk encode for proteins that converge on a homology-directed DNA damage repair process. Mutations in the SLX4 gene, which encodes for a scaffold protein involved in the repair of interstrand cross-links, have recently been identified in unclassified Fanconi anemia patients. A mutation analysis of SLX4 in German or Byelorussian familial cases of breast cancer without detected mutations in BRCA1 or BRCA2 has been completed, with globally negative results.
Methods: The genomic region of SLX4, comprising all exons and exon-intron boundaries, was sequenced in 94 Spanish familial breast cancer cases that match a criterion indicating the potential presence of a highly-penetrant germline mutation, following exclusion of BRCA1 or BRCA2 mutations.
Results: This mutational analysis revealed extensive genetic variation of SLX4, with 21 novel single nucleotide variants; however, none could be linked to a clear alteration of the protein function. Nonetheless, genotyping 10 variants (nine novel, all missense amino acid changes) in a set of controls (138 women and 146 men) did not detect seven of them. Conclusions: Overall, while the results of this study do not identify clearly pathogenic mutations of SLX4 contributing to breast cancer risk, further genetic analysis, combined with functional assays of the identified rare variants, may be warranted to conclusively assess the potential link with the disease.