Rodden Layne N, Chutake Yogesh K, Gilliam Kaitlyn, Lam Christina, Soragni Elisabetta, Hauser Lauren, Gilliam Matthew, Wiley Graham, Anderson Michael P, Gottesfeld Joel M, Lynch David R, Bidichandani Sanjay I
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Hum Mol Genet. 2021 Feb 4;29(23):3818-3829. doi: 10.1093/hmg/ddaa267.
Friedreich ataxia (FRDA) is typically caused by homozygosity for an expanded GAA triplet-repeat in intron 1 of the FXN gene, which results in transcriptional deficiency via epigenetic silencing. Most patients are homozygous for alleles containing > 500 triplets, but a subset (20%) have at least one expanded allele with < 500 triplets and a distinctly milder phenotype. We show that in FRDA DNA methylation spreads upstream from the expanded repeat, further than previously recognized, and establishes an FRDA-specific region of hypermethylation in intron 1 (90% in FRDA versus < 10% in non-FRDA) as a novel epigenetic signature. The hypermethylation of this differentially methylated region (FRDA-DMR) was observed in a variety of patient-derived cells; it significantly correlated with FXN transcriptional deficiency and age of onset, and it reverted to the non-disease state in isogenically corrected induced pluripotent stem cell (iPSC)-derived neurons. Bisulfite deep sequencing of the FRDA-DMR in peripheral blood mononuclear cells from 73 FRDA patients revealed considerable intra-individual epiallelic variability, including fully methylated, partially methylated, and unmethylated epialleles. Although unmethylated epialleles were rare (median = 0.33%) in typical patients homozygous for long GAA alleles with > 500 triplets, a significantly higher prevalence of unmethylated epialleles (median = 9.8%) was observed in patients with at least one allele containing < 500 triplets, less severe FXN deficiency (>20%) and later onset (>15 years). The higher prevalence in mild FRDA of somatic FXN epialleles devoid of DNA methylation is consistent with variegated epigenetic silencing mediated by expanded triplet-repeats. The proportion of unsilenced somatic FXN genes is an unrecognized phenotypic determinant in FRDA and has implications for the deployment of effective therapies.
弗里德赖希共济失调(FRDA)通常由FXN基因内含子1中GAA三联体重复序列扩增的纯合性引起,这通过表观遗传沉默导致转录缺陷。大多数患者对于包含>500个三联体的等位基因是纯合的,但有一部分患者(约20%)至少有一个包含<500个三联体的扩增等位基因,其表型明显较轻。我们发现,在FRDA中,DNA甲基化从扩增的重复序列向上游扩散的距离比之前认为的更远,并在1号内含子中建立了一个FRDA特异性的高甲基化区域(FRDA中约为90%,而非FRDA中<10%),作为一种新的表观遗传特征。在多种患者来源的细胞中均观察到了这个差异甲基化区域(FRDA-DMR)的高甲基化;它与FXN转录缺陷和发病年龄显著相关,并且在同基因校正的诱导多能干细胞(iPSC)衍生的神经元中恢复到非疾病状态。对73例FRDA患者外周血单个核细胞中FRDA-DMR进行亚硫酸氢盐深度测序,发现个体内等位基因存在显著的表观遗传变异,包括完全甲基化、部分甲基化和未甲基化的表观等位基因。虽然在具有>500个三联体的长GAA等位基因纯合的典型患者中,未甲基化的表观等位基因很少见(中位数 = 0.33%),但在至少有一个包含<500个三联体等位基因、FXN缺陷较轻(>20%)且发病较晚(>15岁)的患者中,观察到未甲基化表观等位基因的患病率显著更高(中位数 = 9.8%)。轻度FRDA中缺乏DNA甲基化的体细胞FXN表观等位基因患病率较高,这与扩增的三联体重复介导的斑驳表观遗传沉默一致。未沉默的体细胞FXN基因比例是FRDA中一个未被认识到的表型决定因素,对有效治疗方法的应用具有重要意义。