Institut für Humangenetik
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Sonstige beteiligte Institutionen
- Comprehensive Hearing Center, Department of ORL, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Würzburg, Germany (1)
- DNA Analytics Core Facility, Biocenter, University of Würzburg, Würzburg, Germany (1)
- Department of Animal Ecology and Tropical Biology, University of Würzburg, Würzburg, Germany (1)
- Maastricht University, Maastricht, the Netherlands (1)
Background
VKORC1 has been identified some years ago as the gene encoding vitamin K epoxide reductase (VKOR) – the target protein for coumarin derivates like warfarin or phenprocoumon. Resistance against warfarin and other coumarin-type anticoagulants has been frequently reported over the last 50 years in rodents due to problems in pest control as well as in thrombophilic patients showing variable response to anticoagulant treatment. Many different mutations have already been detected in the VKORC1 gene leading to warfarin resistance in rats, mice and in humans. Since the conventional in vitro dithiothreitol (DTT)-driven VKOR enzymatic assay often did not reflect the in vivo status concerning warfarin resistance, we recently developed a cell culture-based method for coexpression of VKORC1 with coagulation factor IX and subsequent measurement of secreted FIX in order to test warfarin inhibition in wild-type and mutated VKORC1.
Results
In the present study, we coexpressed wild-type factor IX with 12 different VKORC1 variants which were previously detected in warfarin resistant rats and mice. The results show that amino acid substitutions in VKORC1 maintain VKOR activity and are associated with warfarin resistance. When we projected in silico the amino acid substitutions onto the published three-dimensional model of the bacterial VKOR enzyme, the predicted effects matched well the catalytic mechanism proposed for the bacterial enzyme.
Conclusions
The established cell-based system for coexpression of VKORC1 and factor IX uses FIX activity as an indicator of carboxylation efficiency. This system reflects the warfarin resistance status of VKORC1 mutations from anticoagulant resistant rodents more closely than the traditional DTT-driven enzyme assay. All mutations studied were also predicted to be involved in the reaction mechanism.
Background
The impact of task relevance on event-related potential amplitudes of early visual processing was previously demonstrated. Study designs, however, differ greatly, not allowing simultaneous investigation of how both degree of distraction and task relevance influence processing variations. In our study, we combined different features of previous tasks. We used a modified 1-back task in which task relevant and task irrelevant stimuli were alternately presented. The task irrelevant stimuli could be from the same or from a different category as the task relevant stimuli, thereby producing high and low distracting task irrelevant stimuli. In addition, the paradigm comprised a passive viewing condition. Thus, our paradigm enabled us to compare the processing of task relevant stimuli, task irrelevant stimuli with differing degrees of distraction, and passively viewed stimuli. EEG data from twenty participants was collected and mean P100 and N170 amplitudes were analyzed. Furthermore, a potential connection of stimulus processing and symptoms of attention deficit hyperactivity disorder (ADHD) was investigated.
Results
Our results show a modulation of peak N170 amplitudes by task relevance. N170 amplitudes to task relevant stimuli were significantly higher than to high distracting task irrelevant or passively viewed stimuli. In addition, amplitudes to low distracting task irrelevant stimuli were significantly higher than to high distracting stimuli. N170 amplitudes to passively viewed stimuli were not significantly different from either kind of task irrelevant stimuli. Participants with more symptoms of hyperactivity and impulsivity showed decreased N170 amplitudes across all task conditions. On a behavioral level, lower N170 enhancement efficiency was significantly correlated with false alarm responses.
Conclusions
Our results point to a processing enhancement of task relevant stimuli. Unlike P100 amplitudes, N170 amplitudes were strongly influenced by enhancement and enhancement efficiency seemed to have direct behavioral consequences. These findings have potential implications for models of clinical disorders affecting selective attention, especially ADHD.
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.
Fanconi anemia (FA) is a rare genomic instability syndrome. Disease-causing are biallelic mutations in any one of at least 15 genes encoding members of the FA/BRCA pathway of DNA-interstrand crosslink repair. Patients are diagnosed based upon phenotypical manifestationsand the diagnosis of FA is confirmed by the hypersensitivity of cells to DNA interstrand crosslinking agents. Customary molecular diagnostics has become increasingly cumbersome, time-consuming and expensive the more FA genes have been identified. We performed Whole Exome Sequencing (WES) in four FA patients in order to investigate the potential of this method for FA genotyping. In search of an optimal WES methodology we explored different enrichment and sequencing techniques. In each case we were able to identify the pathogenic mutations so that WES provided both, complementation group assignment and mutation detection in a single approach. The mutations included homozygous and heterozygous single base pair substitutions and a two-base-pair duplication in FANCJ, -D1, or - D2. Different WES strategies had no critical influence on the individual outcome. However, database errors and in particular pseudogenes impose obstacles that may prevent correct data perception and interpretation, and thus cause pitfalls. With these difficulties in mind, our results show that WES is a valuable tool for the molecular diagnosis of FA and a sufficiently safe technique, capable of engaging increasingly in competition with classical genetic approaches.
Biallelic mutations in MCPH1 cause primary microcephaly (MCPH) with the cellular phenotype of defective chromosome condensation. MCPH1 encodes a multifunctional protein that notably is involved in brain development, regulation of chromosome condensation, and DNA damage response. In the present studies, we detected that MCPH1 encodes several distinct transcripts, including two major forms: full-length MCPH1 (MCPH1-FL) and a second transcript lacking the six 39 exons (MCPH1De9–14). Both variants show comparable tissue-specific expression patterns, demonstrate nuclear localization that is mediated independently via separate NLS motifs, and are more abundant in certain fetal than adult organs. In addition, the expression of either isoform complements the chromosome condensation defect found in genetically MCPH1-deficient or MCPH1 siRNA-depleted cells, demonstrating a redundancy of both MCPH1 isoforms for the regulation of chromosome condensation. Strikingly however, both transcripts are regulated antagonistically during cell-cycle progression and there are functional differences between the isoforms with regard to the DNA damage response; MCPH1-FL localizes to phosphorylated H2AX repair foci following ionizing irradiation, while MCPH1De9–14 was evenly distributed in the nucleus. In summary, our results demonstrate here that MCPH1 encodes different isoforms that are differentially regulated at the transcript level and have different functions at the protein level.
Background: The etiology of secondary cancer in childhood cancer survivors is largely unclear. Exposure of normal somatic cells to radiation and/or chemotherapy can damage DNA and if not all DNA lesions are properly fixed, the mis-repair may lead to pathological consequences. It is plausible to assume that genetic differences, i.e. in the pathways responsible for cell cycle control and DNA repair, play a critical role in the development of secondary cancer. Methodology/Findings: To identify factors that may influence the susceptibility for second cancer formation, we recruited 20 individuals who survived a childhood malignancy and then developed a second cancer as well as 20 carefully matched control individuals with childhood malignancy but without a second cancer. By antibody microarrays, we screened primary fibroblasts of matched patients for differences in the amount of representative DNA repair-associated proteins. We found constitutively decreased levels of RAD9A and several other DNA repair proteins in two-cancer patients, compared to onecancer patients. The RAD9A protein level increased in response to DNA damage, however to a lesser extent in the twocancer patients. Quantification of mRNA expression by real-time RT PCR revealed lower RAD9A mRNA levels in both untreated and 1 Gy c-irradiated cells of two-cancer patients. Conclusions/Significance: Collectively, our results support the idea that modulation of RAD9A and other cell cycle arrest and DNA repair proteins contribute to the risk of developing a second malignancy in childhood cancer patients.
DNA methylation is an epigenetic modification that plays an important role in gene regulation. It can be influenced by stochastic events, environmental factors and developmental programs. However, little is known about the natural variation of genespecific methylation patterns. In this study, we performed quantitative methylation analyses of six differentially methylated imprinted genes (H19, MEG3, LIT1, NESP55, PEG3 and SNRPN), one hypermethylated pluripotency gene (OCT4) and one hypomethylated tumor suppressor gene (APC) in chorionic villus, fetal and adult cortex, and adult blood samples. Both average methylation level and range of methylation variation depended on the gene locus, tissue type and/or developmental stage. We found considerable variability of functionally important methylation patterns among unrelated healthy individuals and a trend toward more similar methylation levels in monozygotic twins than in dizygotic twins. Imprinted genes showed relatively little methylation changes associated with aging in individuals who are >25 years. The relative differences in methylation among neighboring CpGs in the generally hypomethylated APC promoter may not only reflect stochastic fluctuations but also depend on the tissue type. Our results are consistent with the view that most methylation variation may arise after fertilization, leading to epigenetic mosaicism.
Fanconi Anemia Core Complex Gene Promoters Harbor Conserved Transcription Regulatory Elements
(2011)
The Fanconi anemia (FA) gene family is a recent addition to the complex network of proteins that respond to and repair certain types of DNA damage in the human genome. Since little is known about the regulation of this novel group of genes at the DNA level, we characterized the promoters of the eight genes (FANCA, B, C, E, F, G, L and M) that compose the FA core complex. The promoters of these genes show the characteristic attributes of housekeeping genes, such as a high GC content and CpG islands, a lack of TATA boxes and a low conservation. The promoters functioned in a monodirectional way and were, in their most active regions, comparable in strength to the SV40 promoter in our reporter plasmids. They were also marked by a distinctive transcriptional start site (TSS). In the 59 region of each promoter, we identified a region that was able to negatively regulate the promoter activity in HeLa and HEK 293 cells in isolation. The central and 39 regions of the promoter sequences harbor binding sites for several common and rare transcription factors, including STAT, SMAD, E2F, AP1 and YY1, which indicates that there may be cross-connections to several established regulatory pathways. Electrophoretic mobility shift assays and siRNA experiments confirmed the shared regulatory responses between the prominent members of the TGF-b and JAK/STAT pathways and members of the FA core complex. Although the promoters are not well conserved, they share region and sequence specific regulatory motifs and transcription factor binding sites (TBFs), and we identified a bi-partite nature to these promoters. These results support a hypothesis based on the co-evolution of the FA core complex genes that was expanded to include their promoters.
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.
Epimutations in Germ-Cell and Embryo Development: Possible Consequences for Assisted Reproduction
(2011)
Assisted reproductive technologies (ART) emerged in the late 1970’s as a therapy for human infertility. Up till now more than 3 million babies have been conceived through ART, demonstrating the safety and efficiency of the technique. Published reports showed an increase in the rate of imprinting disorders (Beckwith Wiedemann Syndrome, Angelman Syndrome, etc.) in babies born after ART. What are the effects imposed through ART and should researchers reassess its safety and implications on the future offspring? Throughout this thesis, I analyzed the methylation patterns of germ cells and embryos to determine whether in vitro maturation and in vitro fertilization have a negative impact on the epigenetic patterns. Furthermore, DNA methylation was compared between sperm of infertile and presumably fertile controls in order to understand whether epigenetic disturbances lead to infertility at the first place. The occurrence of methylation aberrations in germ cells of infertile patients could be transmitted to new-borns and then cause epigenetic disorders. In order to elucidate the imprinting status within single cells, I developed a new technique based on limiting dilution where bisulfite treated DNA is distributed across several wells before amplification. This allowed methylation measurement at the single allele level as well parent of origin detection. In a total of 141 sperm samples from couples undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) including 106 with male factor or combined infertility and 28 with female infertility, I detected a significant correlation between lower quality of semen parameters (sperm count, percentage of abnormal sperm, and percentage of motile sperm) and the rate of imprinting errors. ALU repeats displayed a higher methylation in sperm DNA of patients leading to a pregnancy and live birth, compared to patients in which pregnancy was not achieved or a spontaneous abortion occurred. A discriminant analysis based on ALU methylation allowed correct classification of >70% of cases. Preliminary data from illumina methylation arrays where more than 27,000 CpGs were analyzed determined that only a single CpG site from the open reading frame C14orf93 was significantly different between the infertile and presumably fertile control group. However, further improvements on data normalization might permit detection of other differentially methylated regions. Comparison of embryos after natural conception, in vitro fertilized embryos from superovulated oocytes, and embryos achieved through fertilization of in vitro cultured oocytes revealed no dramatic effect on the imprinting patterns of Igf2r, H19, and Snrpn. Oocyte cryotop vitrification did not result in a dramatic increase of imprinting mutations in oocytes even though the rate of sporadic methylation errors in single Snrpn CpGs were higher within the in-vitrified group. Collectively, the results I will present within this thesis suggest an increase in the rate of imprinting errors within the germ cells of infertile patients, in addition to a decrease in genome wide methylation of ALU repetitive elements. I did not observe a detrimental effect on the methylation patterns of oocytes and the resulting embryos using in vitro maturation of oocytes and/or standard IVF with in vivo grown superovulated oocytes.
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.
Best disease, also termed vitelliform macular dystrophy type 2, VMD2, (OMIM #153700), is an autosomal dominant, early onset macular dystrophy associated with a remarkable accumulation of lipofuscin-like material within and beneath the retinal pigment epithelium (RPE). The VMD2 gene mutated in Best disease encodes a 585 amino acid putative transmembrane protein named bestrophin, and is preferentially expressed in the RPE. The protein has a complex membrane topology with 4-6 putative transmembrane domains (TMDs) and is presumably involved in Ca2+-dependent transport of chloride ions across the membrane. The vast majority of known disease-associated alterations are missense mutations nonrandomly distributed across the highly conserved N-terminal half of the protein with clusters near the predicted TMDs. The mechanism connecting Best disease pathology with the identified mutations or the Cl- channel function is not yet clear. To further elucidate the biological function of the bestrophin protein and to identify the molecular mechanisms underlying the disease, a search for interacting partners of bestrophin was performed using the GAL4-based yeast two hybrid system (Y2H). Screening of a bovine RPE cDNA library with various truncated bestrophin baits resulted in the identification of 53 putative interacting partners of bestrophin. However, verification of the interaction has excluded all candidate clones. Our comprehensive Y2H analyses suggest that bestrophin may not be suitable for traditional yeast two hybrid screens likely due to the fact that the protein is integral to the membrane and even fragments thereof may not be transported to the nucleus which is, however a prerequisite for protein interaction in the yeast system. Bestrophin belongs to a large family of integral membrane proteins with more than 100 members identified to date originating from evolutionarily diverse organisms such as mammals, insects and worms. The most distinctive feature of the bestrophin family, besides the invariant RFP (arginine-phenylalanine-proline) domain, is an evolutionarily highly conserved N-terminal region. To clarify the phylogenetic relationship among bestrophin homologues and to identify structural and functional motifs conserved across family members, a bioinformatics/phylogenetic study of the conserved N-terminal region was conducted. Phylogenetic analysis of the bestrophin homologues reveals existence of four evolutionary conserved family members in mammals, with high homology to the human VMD2, VMD2-L1 to L3 proteins. The significant level of protein sequence similarity between divergent species suggests that each of the bestrophin family members has a unique, Chapter One: Summary 2 evolutionarily conserved function and that the divergence of bestrophin into several family members occurred before the divergence of individual mammalian species.
The human retina is a multilayered neuroectodermal tissue specialized in the transformation of light energy into electric impulses which can be transmitted to the brain where they are perceived as vision. Since the retina is easily accessible and functional aspects are directly recordable, the study of this tissue has been at the forefront of neuroscience research for over a century. Studies have revealed that the distinct functions of the retina require a large degree of differentiation which is achieved by the coordinated function of approximately 55 different cell types. The highly structured anatomy and the functional differentiation of the retina is a result of its distinctive transcriptome and proteome. Due to the complexity of the retina it has been difficult to estimate the number of genes actively transcribed in this tissue. Great efforts in the elucidation of retinal disease genes have led to the identification of 139 retina disease loci with 90 of the corresponding genes cloned thus far . In contrast to the success in the hereditary disorders, efforts to identify the genetic factors conferring manifestations known as age-related macular degeneration (AMD) have revealed sparse results. AMD is a retinal disease affecting a significant percentage of the older population. This disorder is likely due to exogenic as well as genetic factors. To further our understanding of retinal physiology and facilitate the identification of genes underlying retinal degenerations, particularly AMD, our efforts concentrated on the systematic analysis of the retinal transcriptome. Since approximately half of all retinal degeneration-associated genes identified to date are preferentially expressed in retina, it is plausible that the investigation of gene expression profiles and the identification of retina-expressed transcripts could be an important starting point for characterizing candidate genes for the retinal diseases. The expressed sequence tags approach included the assessment of all retinal expressed sequence tags (EST) clusters indexed in the UniGene database and of 1080 single-pass ESTs derived from an in-house generated human retina suppression subtracted hybridization (SSH) cDNA library. In total, 6603 EST clusters were evaluated during this thesis and detailed in-silico analysis was performed on 750 EST clusters. The expression of the genes was evaluated using reverse transcriptase-polymerase chain reaction (RT-PCR), followed by confirmation using quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR), as well as conventional and virtual Northern blot analysis. The expression profiling of 337 selected EST clusters led to the identification of 111 transcripts, of which 60 are specific or abundant to the retina, 3 are expressed at high levels in the retinal pigment epithelium (RPE), and 48 are expressed in brain as well as in retina. The EST approach used to select candidate transcripts allowed us to assess the effectiveness of the two available resources, the UniGene database and the retinal SSH (retSSH) cDNA library. From the results obtained, it is evident that the generation of suppression subtracted libraries to identify cell-specific transcripts constitutes the most straight-forward and efficient strategy. In addition to the high percentage of candidate genes that are identified from an SSH cDNA library, it has the added benefit that genes expressed at low levels can be identified. Furthermore, comparison of our retina-enriched gene set with previously published studies demonstrated only limited overlap of the identified genes further confirming the valuable source of retinal genes from our retinal SSH cDNA library. The effort of our and other groups has resulted in the establishment of the full-length coding sequence of 55 of the 111 genes uniquely or preferentially expressed in the retina. Using various methods such as bioinformatical analysis, EST assembly, cDNA library screening, and rapid amplification of cDNA ends (RACE) a number of genes were cloned in the scope of this thesis including C1orf32, C4orf11, C7orf9, C12orf7, C14orf29, DAPL1, and GRM7. Bioinformatic analyses and cDNA library screening were used to isolate the full-length cDNA sequence and determine the genomic organization of C7orf9, also identified as RFRP. This 1190 bp retina-specific transcript from chromosome 7p15.3 encodes a precursor protein for at least two small neuropeptides, referred to as RFRP-1 and RFRP-3. Since C7orf9 is localized in the critical region for dominant cystoid macular dystrophy (CYMD) its role in the pathology was investigated. Southern blot analysis and sequencing of samples from two affected individuals of the original pedigree used to localize the disease gene excluded the gene from involvement in this disease. Multiple isoforms of the C12orf7 gene were assembled from a number of clones identified from library screenings, PCR amplifications, and RACE experiments. The gene variants, transcribed from chromosome 12q13.13, have been found to be expressed exclusively in retina. Because of the multiple alternative splicing of the gene, we can only speculate about the nature of the protein it encodes. The longest transcript, which includes all six exons plus the last intervening sequence, encodes a 471 aa protein which contains a nuclear localization signal and five ankyrin repeats. The existence of many isoforms is also observed in mouse suggesting that they may have a relevant role in cellular physiology. Five novel splice variants of the glutamate metabotropic receptor 7 (GRM7) resulting from the use of alternative 3’-end exons were identified and characterized. One of the novel variants, GRM7_v3, encodes a 924 aa protein and is therefore the longest putative GRM7 protein reported to date. Even though they are not retina-specific, the isoforms are preferentially expressed in the nervous system. Although the functional properties of the specific carboxyl-termini are still unclear, it is known that axon targeting of GRM7_v1 is mediated by the last 60 aa of the protein. Hence the novel isoforms may direct the protein to specific subcellular localizations. The C1orf32 gene, preferentially expressed in retina, is organized in 10 exons and is transcribed from chromosome 1q24.1. Bioinformatic analyses of the 639 aa putative protein not only identified the mouse and rat orthologous genes but also the LISCH7 gene as a potential member of the same family. Since the LISCH7 protein has been shown to function as a low density lipoprotein receptor, the C1orf32 protein may be involved in retinal lipid homeostasis. Disturbances in lipid metabolism have been proposed as one of the pathways involved in AMD etiology. Thus, the role of C1orf32 in this complex disease should be investigated. Expression analyses of the death-associated protein-like 1 (DAPL1) gene revealed that it is expressed in both the retina and the RPE at high levels. The 552 bp transcript encodes a 107 aa putative protein and is transcribed from chromosome 2q24.1. In-silico analyses identified an additional 12 related proteins from various species which share high similarity constituting a novel protein family. The similarity to the death-associated-protein (DAP) is particularly interesting since this protein has been found to be indispensable for programmed cell death. Therefore, DAPL1 is an excellent candidate for retinal disease as apoptosis is generally the ultimate cause in retinal degeneration. The retina-specific C4orf11 and C14orf29 genes localized on chromosome 4q21.22 and 14q22.1, respectively, are both transcribed in more than one isoform. The encoded proteins do not contain any known domains but because of their retina-specific expression they may be important for proper retinal physiology. As part of the long-term goals of the project, several of the cloned genes are being genotyped to construct single nucleotide polymorphism (SNP) maps. Projects to investigate haplotype frequencies of candidate genes in large cohorts of controls and AMD patients are ongoing. Thus, by establishing a collection of 111 genes expressed exclusively or preferentially in the retina, the present work has laid the foundation for future research in retinal diseases.
Age related macular degeneration (AMD) is the leading cause of visual impairment in the elderly and the major cause of blindness in the developed world. To date, the molecular mechanisms underlying the disease are not well understood although in recent years a primary involvement of the retinal pigment epithelium (RPE) has become evident. The aim of the present study is to systematically analyse genes which are differentially expressed in the RPE, and to assess their possible association with mechanisms and pathways likely to be related to retinal disease, in particular AMD. Towards this goal, 2379 expressed sequence tags (ESTs) were established from an inhouse generated RPE cDNA library. This library was constructed by using the suppression subtraction hybridization (SSH) technique which normalises redundant sequences and ensures enrichment of rare transcripts. In a first phase, 1002 ESTs were sequenced and subjected to comprehensive alignment with public nucleotide and protein databases. A search of the 1002 ESTs against the human genome draft sequence yielded 168 known genes, 51 predicted genes, 15 unknown transcripts and 41 clones with no significant similarity. Reverse Northern blot hybridization was performed for 318 EST clusters to identify abundantly expressed genes in the RPE and to prioritize subsequent analyses. Representative clones were spotted onto a nylon membrane and hybridized with cDNA probes of driver (heart and liver) and tester (RPE) used in the cDNA library construction. Subsequently, 107 EST clusters were subjected to Northern blot hybridizations. These analyses identified 7 RPE-specific, 3 retina-specific, 7 RPE/retina-specific, and 7 tissue restricted transcripts, while 29 EST clusters were ubiquitously expressed, and evaluation was not possible for another 54 EST clusters. Of the 24 transcripts with specific or restricted expression, 16 clones were selected for further characterization. The predicted gene MGC2477 and 2 novel isoforms of the human transient receptor potential cation channel, subfamily M, member 3 (TRPM3) were cloned and further described in detail. In addition, polymorphic variations for these 2 genes as well as for the human MT-Protocadherin gene were determined. For MGC2477, 15 single nucleotide polymorphisms (SNPs) were identified, with 13 having a frequency of the minor allele greater than 20%. 10 of the 15 SNPs have not been reported in so far in public SNP repertoires. Partial assessment of the TRPM3 gene yielded 35 SNPs. Of these, 30 (85.7%) were highly frequent (0.17-0.5%), and 14 (40%) were novel. The MT-Protocadherin gene revealed 35 SNPs, including 28 (80%) with high frequency of the minor allele. 23 (65.7%) were novel SNPs. These SNPs will be used to construct the most common haplotypes. These will be used in case/control association studies in 400 AMD patients and 200 ethnically and aged matched controls to assess a possible contribution of these genes in the etiology of AMD.
There is substantial interest in the identification of genes underlying susceptibility to complex human diseases because of the potential utility of such genes in disease prediction and therapy. The complex age-related macular degeneration (AMD) is a prevalent cause of legal blindness in industrialized countries and predominantly affects the elderly population over 75 years of age. Although vision loss in AMD results from photoreceptor cell death in the central retina, the initial pathogenesis likely involves processes in the retinal pigment epithelium (RPE) (Liang and Godley, 2003). The goal of the current study was to identify and characterize genes specifically or abundantly expressed in the RPE in order to determine more comprehensively the transcriptome of the RPE. In addition, our aim was to assess the role of these genes in AMD pathogenesis. Towards this end, a bovine cDNA library enriched for RPE transcripts was constructed in-house using a PCR-based suppression subtractive hybridization (SSH) technique (Diatchenko et al., 1996, 1999), which normalizes for sequence abundance and achieves high enrichment for differentially expressed genes. CAP3 (Huang and Madan, 1999) was used to assemble the high quality sequences of all the 2379 ESTs into clusters or singletons. 1.2% of the 2379 RPE-ESTs contains vector sequences and was excluded from further analysis. 5% of the RPE-ESTs showed homology to multipe chromosomes and were not included in further assembly process. The rest of the ESTs (2245) were assembled into 175 contigs and 509 singletons, which revealed approximately 684 unique genes in the dataset. Out of the 684, 343 bovine RPE transcripts did not align to their human orthologues. A large fraction of clones were shown to include a considerable 3´untranslated regions of the gene that are not conserved between bovine and human. It is the coding regions that can be conserved between bovine and human and not the 3’ UTR (Sharma et al., 2002). Therefore, more sequencing from the cDNA library with reclustering of those 343 ESTs together with continuous blasting might reveal their human orthologoues. To handle the large volume of data that the RPE cDNA library project has generated a highly efficient and user-friendly RDBMS was designed. Using RDBMS data storage can be managed efficiently and flexibly. The RDBMS allows displaying the results in query-based form and report format with additional annotations, links and search functions. Out of the 341 known and predicted genes identified in this study, 2 were further analyzed. The RPE or/and retina specificity of these two clones were further confirmed by RT-PCR analysis in adult human tissues. Construction of a single nucleotide polymphism (SNP) map was initiated as a first step in future case/control association studies. SNP genotyping was carried out for one of these two clones (RPE01-D2, now known as RDH12). 12 SNPs were identified from direct sequencing of the 23.4-kb region, of which 5 are of high frequency. In a next step, comparison of allele frequencies between AMD patients and healthy controls is required. Completion of the expression analysis for other predicted genes identified during this study is in progress using real time RT-PCR and will provide additional candidate genes for further analyses. This study is expected to contribute to our understanding of the genetic basis of RPE function and to clarify the role of the RPE-expressed genes in the predisposition to AMD. It may also help reveal the mechanisms and pathways that are involved in the development of AMD or other retinal dystrophies.
Fanconi anemia (FA) is a genetically and phenotypically heterogenous autoso- mal recessive disease associated with chromosomal instability, progressive bone marrow failure, typical birth defects and predisposition to neoplasia. The clinical phenotype is similar in all known complementation groups (FA-A, FA-B, FA-C,FA-D1, FA-D2, FA-E, FA-F and FA-G). The cellular phenotype is characterized by hypersensitivity to DNA crosslinking agents (MMC,DEB), which is exploited as a diagnostic tool. Alltogether, the FA proteins constitute a multiprotein pathway whose precise biochemical function(s) remain unknown. FANCA, FANCC, FANCE, FANCF and FANCG interact in a nuclear complex upstream of FANCD2. Complementation group FA-D1 was recently shown to be due to biallelic mutations in the human breast cancer gene 2 (BRCA2). After DNA damage, the nuclear complex regulates monoubiquitylation of FANCD2, result- ing in targeting of this protein into nuclear foci together with BRCA1 and other DNA damage response proteins. The close connection resp. identity of the FA genes and known players of the DSB repair pathways (BRCA1, BRCA2, Rad51) firmly establishs an important role of the FA gene family in the maintenance of genome integrity. The chapter 1 provides a general introduction to the thesis describing the current knowledge and unsolved problems of Fanconi anemia. The following chapters represent papers submitted or published in scientific literature. They are succeeded by a short general discussion (chapter 7). Mutation analysis in the Fanconi anemia genes revealed gene specific mutation spectra as well as different distributions throughout the genes. These results are described in chapter 1 and chapter 2 with main attention to the first genes identified, namely FANCC, FANCA and FANCG. In chapter 2 we provide general background on mutation analysis and we report all mutations published for FANCA, FANCC and FANCG as well as our own unpublished mutations until the year 2000. In chapter 3 we report a shift of the mutation spectrum previously reported for FANCC after examining ten FA-patients belonging to complementation group C. Seven of those patients carried at least one previously unknown mutation, whereas the other three patients carried five alleles with the Dutch founder mu- tation 65delG and one allele with the Ashkenazi founder mutation IVS4+4A>T, albeit without any known Ashkenazi ancestry. We also describe the first large deletion in FANCC. The newly detected alterations include two missense mu- tations (L423P and T529P) in the 3´-area of the FANCC gene. Since the only previously described missense mutation L554P is also located in this area, a case can be made for the existence of functional domain(s) in that region of the gene. In chapter 4 we report the spectrum of mutations found in the FANCG gene com- piled by several laboratories working on FA. As with other FA genes, most muta- tions have been found only once, however, the truncating mutation, E105X, was identified as a German founder mutation after haplotype analysis. Direct compar- ison of the murine and the human protein sequences revealed two leucine zipper motifs. In one of these the only identified missense mutation was located at a conserved residue, suggesting the leucine zipper providing an essential protein-protein interaction required for FANCG function. With regard to genotype-phenotype correlations, two patients carrying a homozygous E105X mutation were seen to have an early onset of the hematological disorder, whereas the missense mutation seems to lead to a disease with later onset and milder clinical course. In chapter 5 we explore the phenomenon of revertant mosaicism which emerges quite frequently in peripheral blood cells of patients suffering from FA. We de- scribe the types of reversion found in five mosaic FA-patients belonging to com- plementation groups FA-A and FA-C. For our single FA-C-patient intragenic crossover could be proven as the mechanism of self-correction. In the remaining four patients (all of them being compound heterozygous in FANCA), either the paternal or maternal allele has reverted back to WT sequence. We also describe a first example of in vitro phenotypic reversion via the emergence of a compensat- ing missense mutation 15 amino acids downstream of the constitutional mutation explaining the MMC-resistance of the lymphoblastoid cell line of this patient. In chapter 6 we report two FA-A mosaic patients where it could be shown that the spontaneous reversion had taken place in a single hematopoietic stem cell. This has been done by separating blood cells from both patients and searching for the reverted mutation in their granulocytes, monocytes, T- and B-lymphocytes as well as in skin fibroblasts. In both patients, all hematopoietic lineages, but not the fibroblasts, carried the reversion, and comparison to their increase in erythrocyte and platelet counts over time demonstrated that reversion must have taken place in a single hematopoietic stem cell. This corrected stem cell then has been able to undergo self-renewal and also to create a corrected progeny, which over time repopulated all hematopoietic lineages. The pancytopenia of these patients has been cured due to the strong selective growth advantage of the corrected cells in vivo and the increased apoptosis of the mutant hematopoietic cells.
Best disease (OMIM 153700) is an early-onset, autosomal dominant maculopathy characterized by egg yolk-like lesions in the central retina. The disease gene, the vitelliform macular dystrophy gene type 2 (VMD2), encodes a 585-aa VMD2 transmembrane protein, termed bestrophin. The protein is predominantly expressed on the basolateral side of the retinal pigment epithelium (RPE) and is thought to be involved in the transport of chloride ions. Bestrophin as well as three closely related VMD2-like proteins (VMD2L1-L3) contain multiple putative transmembrane (TM) domains and an invariant tripeptide (RFP) motif in the N-terminal half of the protein. This and the tissue-restricted expression to polarized epithelial cells are typical features of the VMD2 RFP-TM family. Best disease is predominantly caused by missense mutations, clustering in four distinct „hotspots“ in the evolutionary highly conserved N-terminal region of the protein. To further augment the spectrum of mutations and to gain novel insights into the underlying molecular mechanisms, we screened VMD2 in a large cohort of affected patients. In total, nine novel VMD2 mutations were identified, raising the total number of known Best disease-related mutations from 83 to 92. Eight out of nine novel mutations are hotspot-specific missense mutations, underscoring their functional/structural significance and corroborating the dominant-negative nature of the mutations. Of special interest is a one-basepair deletion (Pro260fsX288) encoding a truncated protein with a deletion of an important functional domain (TM domain four) as well as the entire C-terminal half of bestrophin. For the first time, a nonsense mutation leading to a 50 % non-functional protein has been identified suggesting that on rare occassions Best disease may be caused by haploinsufficiency. Molecular diagnostics strongly requires a reliable classification of VMD2 sequence changes into pathogenic and non-pathogenic types. Since the molecular pathomechanism is unclear at present, the pathogenicity of novel sequence changes of VMD2 are currently assessed in light of known mutations. We therefore initiated a publicly accessible VMD2 mutation database (http://www.uni-wuerzburg.de/humangenetics/vmd2.html) and are collecting and administrating the growing number of mutations, rare sequence variants and common polymorphisms. Missense mutations may disrupt the function of proteins in numerous ways. To evaluate the functional consequences of VMD2 mutations in respect to intracellular mislocalization and/or protein elimination, a set of molecular tools were generated. These included the establishment of an in vitro COS7 heterologous expression assay, the generation of numerous VMD2 mutations by site-directed mutagenesis as well as the development of bestrophin-specific antibodies. Surprisingly, membrane fractionation/Western blot experiments revealed no significant quantitative differences between intact and mutant bestrophin. Irrelevant of the type or location of mutation, incorporation of mutant bestrophin to the membraneous fraction was observed. Thus, impaired membrane integration may be ruled out as causative pathomechanism of Best disease consistent with a dominant-negative effect of the mutations. In a different approach, efforts were directed towards identifying and characterizing the VMD2 RFP-TM protein family in mouse. While clarification of the genomic organization of murine Vmd2 was required as basis to generate Vmd2-targeted animals (see below), the study of closely related proteins (Vmd2L1, Vmd2L2 and Vmd2L3) may provide further clues as to the function of bestrophin. For this, biocomputational as well as RT PCR analyses were performed. Moreover, the novel genes were analyzed by real time quantitative RT PCR, displaying predominant expression in testis, colon and skeletal muscle of Vmd2, Vmd2L1 and Vmd2L3 transcripts, respectively as well as in eye tissue. Interestingly, neither an ORF was determined for murine Vmd2L2 nor was the transcript present in a panel of 12 mouse tissues, suggesting that murine Vmd2L2 may represent a functionally inactive pseudogene. The murine Vmd2L3 gene, as its human counterpart, is a highly differentially spliced transcript. Finally, generating mouse models of Best disease will provide essential tools to investigate the pathophysiology of bestrophin in vivo. We have initiated the generation of two different mouse lineages, one deficient of Vmd2 (knock-out) and the other carrying a human disease-related mutation (Tyr227Asn) in the orthologous murine gene (knock-in). Genetic engineering of both constructs has been achieved and presently, four ES clones harboring the homologous recombination event (Vmd2+/-) have been isolated and are ready for the subsequent steps to generate chimeric animals. The resulting mouse lineages will represent two key models to elucidate the functional role of bestrophin in Best disease, in RPE development and physiology.