PostGenetics - PostGene Diseases - PostGenetic Medicine

Hereditary Diseases: “Not all is in the genes”

this compilation is by the

International PostGenetics Society

(established 1st of September, 2005)

--
Thakker
NEW YORK TIMES, February 7, 2006
"There are about 30,000 genes in the human genome, but there are at least 150,000 different genetic disorders," Dr. Thakker said. "You can't just look at the genes that code for proteins, you've got to look at the surrounding regulatory regions, as well in the 'junk.' "

Mattick' Review
Non-coding RNAs may provide the key... Dysregulation of miRNAs..in a mouse knockout of presenilin (Alzheimer's), miR-175 implicated.. in early-onset Parkinson's disease

Sharp
"It's a revolution in how we understand the genome and how the cell functions," says MIT Nobel laureate Phillip Sharp. "There's a whole new frontier there." Sharp and a few microRNA researchers have founded Alnylam Pharmaceuticals to invent RNA-based drugs to treat Parkinson's, cystic fibrosis and spinal injury. The firm has development deals with Merck and Novartis, and such rivals as San Francisco's Sirna Therapeutics are in pursuit.

Lesson
PostGenetics can not be accomplished by individual effort - even workshops may not do justice to the challange.
Creation of an International (PostGenetics) Society was needed.

A brief science-statement is compiled by
IPGS Honorary Chairman Malcolm J. Simons and IPGS Originator Andras J. Pellionisz, click here

A REPRESENTATIVE LIST OF PROVEN OR SUSPECTED "POSTGENE DISEASES"

AIDS
ALCOHOLISM
ALPORT SYNDROME
ALZHEIMER'S DISEASE
ANGELMAN SYNDROME
ASTHMA

ATAXIA TELANGIECTASIA
AUTISM
AUTOIMMUNE DISEASES
BIPOLAR DISORDER
BRUGADA SYNDROME - ARRYTHMIA
CANCER: CARTILAGE HAIR HYPOPLASIA
CANCER: LUNG
CANCER: LYMPHOMA
CANCER: MULIPLE MYELOMA
CANCER: NON-POLYPOSIS COLORECTAL
CANCER: PROSTATE
CANCER: THYROID
CARDIOVASCULAR DISEASE
CYSTIC FIBROSIS
DIABETES MELLITUS TYPE II
DiGEORGE SYNDROME
DUCHENNE MUSCULAR DYSTROPHY
DYSKERATOSIS CONGENITA
EPILEPSY
ESSENTIAL HYPERTENSION
FAMILIAL DYSAUTOSOMIA
FRAGILE X SYNDROME, AUTISM
FRIEDREICH CEREBELLAR ATAXIA
HIRSCHSPRUNG DISEASE
HYPERCHOLESTEROLEMIA, FAMILIAL
HYPER-FERRITINEMIA-CATARACT SYNDROME, FAMILIAL
HYPER-IgM SYNDROME TYPE 1
LUPUS ERYTHEMATOSUS
LYMPHOMA, B-CELL
MALARIA
MEASLES
MELANOMA

MENTAL RETARDATION
MULTIPLE SCLEROSIS
MYOCARDIAL INFARCTION
MYOTONIC DYSTROPHY
NEUROFIBROMATOSIS
PARKINSONS' DISEASE
PRADER-WILLI SYNDROME
PSEUDOXANTHOMA ELASTICUM (PXE, GROENBLAD-STRANDBERG SYNDROME)
PSORIASIS
RETT SYNDROME
RETINITIS PIGMENTOSA
SCLERODERMA
SPINOCEREBELLAR ATAXIA
STROKE
SCHIZOPHRENIA

TAY-SACHS DISEASE
TOURETTE SYNDROME
VON WILLEBRAND DISEASE

GO TO DETAILS
OF A REPRESENTATIVE LIST OF PROVEN OR SUSPECTED 
"POSTGENE DISEASES"

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Forbes, December issue of 2005:

"What genetic researchers used to call junk DNA may conceal the most important medical secrets of all"

"This will revolutionize human genetics over the next few decades, says David Haussler, a Howard Hughes investigator at UC, Santa Cruz who was on the government team that decoded the human genome. He predicts that most disease-causing genetic flaws will be found lurking in our junk DNA."

"It's a revolution in how we understand the genome and how the cell functions," says MIT Nobel laureate Phillip Sharp.

"PostGenetic Diseases"

A primary goal of IPGS is to elevate awareness of the fact that "some, if not all" hereditary diseases do not stop at the boundaries of "genes" (especially since the definition of "gene" over the Century of 1905-2005 became increasingly restrictive).

The so-called "'Junk' DNA diseases", now defined as "PostGenetic Diseases", is a newly emerging field, and PostGenetics evolves its proper terminology. The presently "umbrella" term should certainly not be taken too literally; it does *not* deny the existence of "Gene diseases". It merely opens up a field of "Genomic diseases beyond genes". The most important and now undeniable fact is that in the Second Century of Genomics (after 100 years of "Genetics") it is already established that hereditarty diseases do not stop at the boundaries of (artificial and conceptually ambiguous) old term "gene".

Those diseases for which it has already been documented that they don't, and those that are strongly suspected that they don't, are complied here on an ongoing bases - comment by Dr. Andras Pellionisz, originator of IPGS.

"PostGenetic Medicine": Personalized Medicine, focusing on PostGenetic Diseases

2005 was also the year in which a new chapter of Medicine opened up, termed here "PostGenetic Medicine". It is already evident, that once "PostGenetic diseases" are recognized as such, Medicine is jumping on entirely new methods and business models following from the new paradigm of PostGenetics. While this field in 2005 is its infancy, there is no question that it will rapidly hyperescalate.

Textbook by IPGS Founder Falus, Andras (ed.)
Immunogenomics and Human Disease


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Background

Prelude: M Ridley, Genome: The Autobiography of Species in 23 Chapters (1999) Fourth Estate, London, 55

"Open any catalogue of the human genome and you will be confronted not with a list of human potentialities, but a list of diseases, mostly named after pairs of obscure central-European doctors. This gene causes Niemann-Pick disease; that one causes Wolf-Hirschhorn syndrome. The impression given is that genes are there to cause diseases. .."

"Yet to define genes by the diseases they cause is about as absurd as defining organs of the body by the diseases they get: livers are there to cause cirrhosis, hearts to cause heart attacks and brains to cause strokes. It is a measure, not of our knowledge but of our ignorance, that this is the way the genome catalogues read. It is literally true that the only thing we know about some genes is that their malfunction causes a particular disease. This is a pitifully small thing to know about a gene, and a terribly misleading one. It leads to the dangerous shorthand that runs as follows: `X has got the Wolf-Hirschhorn gene'. Wrong. We all have the Wolf-Hirschhorn gene, except, ironically, people who have Wolf-Hirschhorn syndrome. Their sickness is caused by the fact that the gene is missing altogether. In the rest of us the gene is a positive, not a negative force. The sufferers have the mutation, not the gene."

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International PostGenetics Society (IPGS - among its Founders some pairs of "central-European doctors"...) calls attention to the well documented facts, that many dreadful diseases are caused not by "genes" but by errors in the "non-coding DNA" ("junkDNA"). The list is by no means is full - it is for representative purposes.

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No amount of $$$ spent on "Gene Discovery" will reveal the cause of a disease if it originates in the 98.7% of DNA - that are "non-genes". Many tens of millions of patients affected with the listed (and similar) diseases may wish their tax dollars put to work in "PostGene Discovery".

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A PRELIMINARY SURVERY OF PROMINENT "POSTGENE DISEASES" (FORMERLY "JUNK DNA DISEASES")

The Big Picture

AS BIOLOGISTS SIFT more and more novel kinds of active RNA genes out of the long-neglected introns and intergenic stretches of DNA, they are realizing that science is still far from having a complete parts list for humans or any other higher species. Unlike protein-making genes, which have standard "start" and "stop" codes, RNA-only genes vary so much that computer programs cannot reliably pick them out of DNA sequences. To spur the technology on, the NHGRI is launching this autumn an ambitious $36-million project to produce an "Encyclopedia of DNA Elements." The goal is to catalogue every kind of RNA and protein made from a select 1 percent of the human genome in three years.

No one knows yet just what the big picture of genetics will look like once this hidden layer of information is made visible, "Indeed, what was damned as junk because it was not understood may, in fact, turn out to be the very basis of human complexity,'' Mattick suggests. Pseudogenes, riboswitches and all the rest aside, there is a good reason to suspect that is true. Active RNA, it is now coming out, helps to control the large-scale structure of the chromosomes and some crucial chemical modifications to them--an entirely different, epigenetic layer of information in the genome.

The exploration of that epigenetic layer is answering old conundrums: How do human beings survive with a genome horribly cluttered by seemingly useless, parasitic bits of DNA? Why is it so hard to clone an adult animal yet so easy to clone an embryo? Why do certain traits skip generations in an apparently unpredictable way?

DNA sequences long considered genomic garbage are finally getting a little respect. Researchers have figured out how short stretches of DNA that do not normally code for proteins worm their way into genes.

This can result in the production of abnormal proteins and lead to genetic diseases, such as Alport Syndrome, a rare kidney disease.

A growing number of hereditary neurodegenerative disorders have been found to be caused by expansion of trinucleotide repeats. A smaller number of diseases such as fragile X syndrome, myotonic dystrophy, and Friedreich's ataxia, have been found to be due to expansions in non-coding DNA.

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RNA regulation: a new genetics? (Mattick, 2004)

... Non-coding transcripts. An increasing number of ncRNA genes are being identified, several of which have links to human diseases such as B-cell lymphoma, lung cancer, prostate cancer, cartilage-hair hypoplasia, spinocerebellar ataxia type 8, DiGeorge syndrome, autism and schizophrenia, among others14,25,26,29,42–44.

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Med J Aust. 2003 Aug 18;179(4):212-6.

The human genome and the future of medicine.

Mattick JS. Institute for Molecular Bioscience, University of Queensland, St Lucia, QLD 4072, Australia. j.mattick@imb.uq.edu.au

The draft human genome sequence (about 3 billion base pairs) was completed in 2001. Humans have fewer protein-coding genes than expected, and most of these are highly conserved among animals. Humans and other complex organisms produce massive amounts of non-coding RNAs, which may form another level of genetic output that controls differentiation and development. Aside from classical monogenic diseases and other differences caused by mutations and polymorphisms in protein-coding genes, much of the variation between individuals, including that which may affect our predispositions to common diseases, is probably due to differences in the non-coding regions of the genome (ie, the control architecture of the system). Within 10 years we can expect to see: increased penetration of DNA diagnostic tests to assess risk of disease, to diagnose pathogens, to determine the best treatment regimens, and for individual identification; a range of new pharmaceuticals as well as new gene and cell therapies to repair damage, to optimise health and to minimise future disease risk; and medicine become increasingly personalised, with the knowledge of individual genetic make-up and lifestyle influences.

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Non-coding RNA in the nervous system

Mark F. Mehler and John S. Mattick


Abstract

Increasing evidence suggests that the development and function of the nervous system is heavily dependent on RNA editing and the intricate spatiotemporal expression of a wide repertoire of non-coding RNAs, including micro RNAs, small nucleolar RNAs and longer non-coding RNAs. Non-coding RNAs may provide the key to understanding the multi-tiered links between neural development, nervous system function, and neurological diseases.


Introduction

The nervous system is unique among organs in its precise and sophisticated patterns of regional cellular morphogenesis, cellular diversity, membrane electrical properties, responses to changing environmental inputs and perturbations, neural network connections, and dynamic activity-dependent alterations in synaptic strength underlying higher order cognitive functions including learning and memory (Abrous et al., 2005).

These functional properties are, in turn, orchestrated by a corresponding set of multilayered developmental mechanisms (Mehler, 2002a, b), including neural induction, neural patterning and axis formation within the evolving neural plate and neural tube, elaboration of stem cell generative zones throughout the neuraxis and the evolution of connections between specialized regional neuronal and glial cell types.

Alterations of specific components of these developmental stages and maturational processes result in a broad spectrum of neurodevelopmental disorders and predispose to an equally complex array of adult neurological and neuropsychiatric disorders of unknown aetiology, underscoring the levels of complexity in developmental and mature brain-behaviour relationships. However, we have little understanding of the genetic programs and molecular mechanisms that orchestrate nervous system development, plasticity and function, or how these programs and mechanisms are perturbed in disease.

Although only about 1.2% of the mammalian genome encodes proteins, most of the genome is transcribed, in complex patterns of interlacing and overlapping transcripts from both strands (Carninci et al., 2005; Cheng et al., 2005a; Frith et al., 2005;

Katayama et al., 2005; Engstrom et al., 2006; Mattick & Makunin, 2006), at least some of which are processed to form small regulatory RNAs such as microRNAs and small nucleolar RNAs (reviewed in (Mattick & Makunin, 2005). A range of evidence suggests that these RNAs form complex networks that direct the trajectories of differentiation and development, via regulation of chromatin modification, transcription, RNA modification, splicing, mRNA translation, and RNA stability (Mattick & Gagen, 2001; Mattick, 2003, 2004a) as well as other mechanisms (Prasanth et al., 2005; Willingham et al., 2005). It is also clear that multiple classes of non-coding RNAs (ncRNAs) are overly represented in the central and peripheral nervous system (Hsieh & Gage, 2004; Kim et al., 2004; Rogelj & Giese, 2004; Cheng et al., 2005b; Davies et al., 2005; Klein et al., 2005; Rogaev, 2005; Cao et al., 2006; Ravasi et al., 2006), underscoring the likelihood that nervous system development and function is heavily dependent on RNA regulatory networks, and that perturbations of these networks underlie many neurological diseases.


MicroRNAs

MicroRNAs (miRNAs) are short 21-23 nucleotide regulatory sequences that inhibit the translation or stability of target RNAs (reviewed in (Mattick & Makunin, 2005; Zamore & Haley, 2005). In mice, there are numerous brain-specific miRNAs (Krichevsky et al., 2003; Cheng et al., 2005b; Lim et al., 2005; Xie et al., 2005), a significant subset of which have been directly implicated in neural development and neural cell differentiation (Kawasaki & Taira, 2003; Smirnova et al., 2005). A wide variety of miRNAs are localized to neuronal subtypes with the highest concentration in the cerebral cortex and the cerebellum (Kosik & Krichevsky, 2005; Krichevsky et al., 2006). Additional miRNAs are present within glial cell subtypes with others exhibiting more ubiquitous or neural progenitor cell-specific patterns of expression (Krichevsky et al., 2003; Klein et al., 2005; Smirnova et al., 2005). In zebrafish, the miRNA miR-430 rescues defects of neurulation, neural tube formation, segmental morphogenesis, neural stem cell maintenance and axonal pathfinding observed in dicer mutants that are defective in miRNA processing - although not completely, indicating that that other miRNAs are involved in later stages of neural development (Giraldez et al., 2005).

miRNAs are also abundantly expressed in the adult brain and appear to regulate the maintenance of mature neural traits and synaptic plasticity (Krichevsky et al., 2003; Jin et al., 2004; Sempere et al., 2004; Cheng et al., 2005b; Kosik & Krichevsky, 2005; Smirnova et al., 2005; Conaco et al., 2006; Schratt et al., 2006). Numerous studies suggest that miRNAs are intimately involved in synaptic function and input specificity during memory formation (Martin & Kosik, 2002; Schaeffer et al., 2003; Kim et al., 2004; Lugli et al., 2005; Ashraf et al., 2006; Schratt et al., 2006). Moreover, transcripts encoding synapse-associated proteins also comprise the largest subgroup of predicted miRNA targets, including synapsin 1 and the fragile X mental retardation protein (FMRP) (John et al., 2004).

A novel RNA called dsNRSE (double-stranded neuron-restrictive silencing element) that resembles a miRNA in structure and length acts as a transcriptional activator of neuronal differentiation genes by converting the neuronal silencer factor (REST/NRSF) from a transcriptional repressor in undifferentiated and non-neuronal cells to a transcriptional activator during neuroblast differentiation (Kuwabara et al., 2004). Interestingly, recent studies have revealed that REST modulates the expression of a family of miRNAs including the CNS-specific miR-124a (Conaco et al., 2006).

Perturbations in miRNAs are associated with a number of neural diseases. Deletion of DGCR8, which encodes a component of the complex that processes miRNAs (Gregory et al., 2004; Landthaler et al., 2004), results in DiGeorge syndrome, a multi-system disorder associated with significant learning disabilities (Shiohama et al., 2003).

Dysregulation of miRNAs also occurs in a mouse knockout of presenilin 1, the gene mutated in a subset of early familial forms of Alzheimer’s disease (AD) (Krichevsky et al., 2003). Further, miR-175 has been implicated in a form of X-linked mental retardation (MRX3) and in a type of early-onset Parkinson’s disease (Waisman syndrome) (Dostie et al., 2003). Other studies have implicated miRNAs in diverse neuropsychiatric conditions, particularly those associated with developmental pathogenesis (Rogaev, 2005). In addition, predicted miRNA targets include numerous proteins implicated in neurodevelopmental and neurodegenerative diseases (Rogaev, 2005). Sequence variations in the binding site for miR-189 in the SLIT and Trk-like family member1 (SLITRK1) mRNA have been associated with Tourette’s syndrome (Abelson et al., 2005). SLITRK1 is essential for neuronal growth, guidance and neurite branching and is also differentially expressed in many different neural tumours (Aruga & Mikoshiba, 2003; Aruga et al., 2003). Profound over-expression of miR-21 is seen in glioblastoma multiforme, a highly malignant tumour of the brain, whereas less dramatic degrees of miR-21 over-expression are seen in other neural-specific tumour types (Chan et al., 2005).

In mammals, ADARs are differentially expressed during organogenesis with ADAR3 restricted to brain and ADAR2 preferentially expressed in the nervous system (Chen et al., 2000; Bass, 2002). RNA editing also exhibits precise CNS regional specificity and essential regulatory roles during neuronal maturation (Lai et al., 1997; Kohr et al., 1998; Bernard et al., 1999; Paupard et al., 2000). RNA editing can also affect multiple sites on the same RNA with diverse functional outcomes catalyzed by different ADARs (Valente & Nishikura, 2005). ADAR mutants exhibit complex behavioural defects in C. elegans, Drosophila and mice (Reenan, 2001; Tonkin et al., 2002). Moreover, abnormalities in RNA editing have been implicated in a spectrum of nervous system disorders including Alzheimer’s and Huntington’s diseases, amyotrophic lateral sclerosis, epilepsy, schizophrenia, depression, suicidal ideation, autosomal dominant episodic ataxia type I and Prader-Willi and Angelman syndromes (reviewed in (Valente & Nishikura, 2005).

Intriguingly, in humans, A-I editing occurs far more frequently in transcripts than had been previously appreciated, with the vast majority of the editing occurring in inverted Alu repeats predicted to form intra-molecular duplexes in non-coding RNA sequences in introns, intergenic transcripts and UTRs (Athanasiadis et al., 2004; Blow et al., 2004; Kim et al., 2004; Levanon et al., 2004). These observations raise the intriguing possibility that the predominance of Alu elements in the human genome (10.5% of which is comprised of Alu elements) may not be simply an accident of history, [anybody said it was? - AJP] but the result of positive selection for these sequences as a natural substrate for A-I editing, in turn driven by selection for increased cognitive capacity in the primate lineage (Mattick, 2004b).

It is also worth noting that other small brain-specific trans-acting RNAs such as the primate-specific dendritic BC200 RNA and the analogous rodent dendritic BC1 RNA are both descended from retrotransposed sequences (Martignetti & Brosius, 1993; Ohashi et al., 2000), and it appears likely that many, if not most, transposon-derived sequences in our genome have been exapted into function, primarily at the regulatory level (Brosius,1999).


Longer non-coding RNAs

There are tens of thousands of larger ncRNAs, both polyadenylated and nonpolyadenylated, that are transcribed from the mammalian genome (Carninci et al., 2005; Cheng et al., 2005a; Kapranov et al., 2005; Engstrom et al., 2006), many of which MBII-78 and MBII-85 (Cavaille et al., 2000; Huttenhofer et al., 2001; Rogelj & Giese, 2004). At least some of these miRNAs show differential expression in different areas of the brain, such as the hippocampus and amygdala, areas associated with learning and memory, and are transiently modulated during contextual memory consolidation (fear conditioning) (Rogelj et al., 2003). Human homologs of these snoRNAs are also highly enriched in brain (Cavaille et al., 2000). Certain snoRNAs (RBI-36) exhibit genusspecific functions in rat brain, further attesting to the potential complexity of nonhousekeeping snoRNA functions in the nervous system (Cavaille et al., 2001).

In addition it has recently been shown that HBII-52 modifies the A-I RNA editing and alternative splicing of the serotonin 5-HT (2C) receptor subunit (Kishore & Stamm, 2006). HBII-52 is not expressed in the Prader-Willi developmental syndrome and 5-HT (2C) receptor isoforms distinct from the normal expression pattern are present, suggesting that anomalous splicing may contribute to disease pathogenesis (Cavaille et al., 2000; Kishore & Stamm, 2006). In humans, HBII-13, HBII-52 and HBII-85 map to the Prader-Willi syndrome locus suggesting that snoRNAs may be involved in, or regulated by, genomic imprinting (Rogelj & Giese, 2004). Many larger non-coding RNAs are also imprinted and also implicated in the genetic transactions which underlie imprinting, which clearly affects brain development and function in a variety of ways (see below).


RNA editing

Adenosine to inosine (A-I) RNA editing catalyzed by ADARs is particularly active in the brain, especially in transcripts encoding proteins involved in nerve cell function (Bass, 2002), such as voltage-gated ion channels, ligand-gated receptors, intracellular transduction molecules, apoptosis and cell cycle arrest proteins and modulators of presynaptic terminal integrity (Morse et al., 2002; Hoopengardner et al., 2003; Maas et al., 2003; Athanasiadis et al., 2004; Gelbard, 2004; Levanon et al., 2004; Wang et al., 2004a; Valente & Nishikura, 2005). A-I editing has the capacity to change the coding capacity of mRNA (Bass, 2002), to modulate splice site choice (Laurencikiene et al., 2006), miRNA and miRNA target diversity (Blow et al., 2006), miRNA processing (Yang et al., 2006), and perhaps other targets including chromatin architecture (Fernandez et al., 2005; Valente & Nishikura, 2005), as well as to be inhibited by snoRNAs (Vitali et al., 2005), further evidence of the complexity of RNA regulatory networks.

Regulatory actions are only beginning to be understood (reviewed in (Korneev & O'Shea, 2005). These antisense RNAs exhibit dynamic developmentally regulated and spatially discrete expression profiles, and modulate the expression of genes involved in brain morphogenesis, stem cell renewal and proliferation, stress responses, cell polarity and cytoskeletal functions, and neuronal survival, maturation and synaptic plasticity (Korneev & O'Shea, 2005).

In both schizophrenia and bipolar illness, susceptibility loci are present within the disabled in schizophrenia 1 (DISC1) gene and in the large antisense DISC2 RNA that modulates its expression (Millar et al., 2000; Millar et al., 2004). DISC1 is involved in intracellular transport, cell polarity and neuronal migration and disruption of function during cortical developmental may, in part, underlie the developmental pathogenesis of these heterogeneous neuropsychiatric diseases (Kamiya et al., 2005).


Non-coding RNAs and brain imprinting

Imprinted genes have essential roles in both neural development and adult CNS functioning, and alterations in their expression profiles are associated with a spectrum of complex neurodevelopmental and neuropsychiatric disorders (Costa, 2005; Davies et al., 2005; Davies et al., 2006). These allele-selective genes exhibit preferential and exquisite cell-specific patterns of expression within the brain, and are frequently processed from larger transcriptional units encompassing multiple tandemly repeated snoRNAs and miRNAs (Sleutels et al., 2000; Seitz et al., 2004; Davies et al., 2005; Lewis & Reik, 2006). These imprinted loci also generate a complex spectrum of spliced and unspliced larger ncRNAs of presently unknown function (Sleutels et al., 2000; Davies et al., 2005; O'Neill, 2005; Furuno, 2006). Additional ncRNAs associated with imprinted loci include the production of antisense RNAs to reciprocally imprinted neighbouring protein-coding genes (Sleutels et al., 2000; Davies et al., 2005). The seminal role of imprinted genes in regulating distinct brain signalling systems and in mediating brain-behaviour relationships is illustrated by the spectrum of neurological diseases associated with parent of origin effects and caused by disruptions in imprinted loci: autism, schizophrenia, attention deficit hyperactivity disorder, bipolar disorder and Tourette’s syndrome (see Davies et al., 2004; Wang et al., 2004b; Davies et al., 2005; Davies et al., 2006).


Transfer RNAs and ribosomal RNAs

Transfer RNAs (tRNAs) and ribosomal RNAs (rRNAs) have recently been implicated in a broad array of neural developmental and mature CNS functions as indicated by the effects of mutations in these two classes of ncRNAs which underlie a range of neurodevelopmental, neurodegenerative and neuropsychiatric diseases, including chronic progressive external ophthalmoplegia (CPEO), Kearn-Sayre syndrome (KSS: CPEO with retinal degeneration), MELAS syndrome (mitochondrial encephalopathy with stroke-like syndromes and migraine headaches), MERRF syndrome (myoclonus epilepsy, mitochondrial myopathy, cerebellar ataxia and less commonly dementia, hearing loss and peripheral neuropathy) (reviewed in Dimauro, 2004; Dimauro & Davidzon, 2005; Fattal et al., 2006) and motor neuron disease (Borthwick et al., 2006). MELAS syndrome and other tRNA-mediated diseases are also associated with prominent neuropsychiatric diseases including schizophrenia, psychosis, delirium, personality disorders, major depressive disorders, and anxiety disorders (Fattal et al., 2006).


RNA trinucleotide expansions

A range of neurodevelopmental and neurodegenerative diseases associated with trinucleotide repeat expansion appear to be caused by RNA-mediated mechanisms (reviewed in Gallo et al., 2005; Gatchel & Zoghbi, 2005). These include fragile X syndrome which results from dramatically expanded (>200) CGG repeats in the 5’ UTR of the Fmr1 gene and the related disease associated with smaller (60-200) trinucleotide repeat expansions called FXTAS (fragile X tremor/ataxia syndrome) (FXTAS) associated with tremor, cerebellar ataxia, cognitive decline, peripheral neuropathy, Parkinson’s disease, autonomic dysfunction, proximal muscle weakness, multisystem atrophy and dementia (Hagerman et al., 2005; Van Esch, 2006). Trinucleotide repeat expansions also underlie myotonic dystrophy, which is predominantly a muscle disorder but exists in two forms with associated CNS pathology: DM1 with mental retardation, memory and visuo-spatial and executive dysfunction and DM2 with preferential executive dysfunction (D'Angelo & Bresolin, 2006). DM1 is associated with CTG expansion within the 3’ UTR of the dystrophia myotonica protein kinase gene, DMPK, and DM2 is linked to CCTG expansion in intron 1 of the zinc finger protein gene, ZNF9 (Brook et al., 1992; Fu et al., 1992; Mahadevan et al., 1992; Ranum et al., 1998; Liquori et al., 2001). These mutant RNAs orchestrate different forms of pathogenesis through the degree and type of repeat length expansion and their molecular interactions with RNAbinding proteins of the muscleblind-like (MBNL) family (Jiang et al., 2004; Pascual et al., 2006).

Several forms of spinocerebellar ataxia (SCA) may also be caused by different RNAmediated pathological mechanisms. SCA8 results from CTG expansion of the 3’ UTR of an untranslated antisense RNA with partial overlap with the Kelch-like 1 (KLHL1) gene (Koob et al., 1999; Nemes et al., 2000; Mutsuddi et al., 2004; Gatchel & Zoghbi, 2005).

Moreover, using SCA8 as a sensitized background in a modifier screen resulted in the identification of four novel ncRNAs with preferential neuronal expression (Mutsuddi et al., 2004). SCA10 is mediated by an unstable ATTCT repeat expansion in the 3’ end of a large intron of a gene of presently unknown function that may result in transcriptional silencing or in a different RNA-associated toxic mechanism (Matsuura et al., 2000). SCA12 is caused by CAG expansion in the non-coding 5’ promoter/5’ UTR of the PPP2R2B gene, which encodes a brain specific regulatory subunit of protein phosphatase 2A (Holmes et al., 1999). Depending on the precise location of the expanded trinucleotide repeat, disease pathogenesis may be mediated by distinct trans-dominant RNA or alternate toxic gain of function mechanisms (Holmes et al., 2003).


Conclusion

The known list of both small and large ncRNAs that are involved in the nervous system almost certainly represents only a tiny fraction of the total transcriptome devoted to RNA-mediated mechanisms underlying the development, functional complexity and plasticity of the mammalian brain. Indeed, it appears that the majority of human genomic programming is devoted to RNA-based regulatory circuitry (Mattick, 2003; Mattick & Makunin, 2006). It also appears that the traditional presumption that most genetic information is transacted by proteins has led to a fundamental misunderstanding of the genetic programming of human differentiation and development, both generally and specifically in the brain, where RNA transactions appear to be at their most complex.

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Molecule crucial for processing non-coding RNA identified
October 21, 2005

Long-standing scientific question resolved

PHILADELPHIA – The discovery in 1977 that the coding regions of a gene could appear in separate segments along the DNA won the 1993 Nobel Prize in Physiology or Medicine for Richard J. Roberts and Phillip A. Sharp. The active segments of a gene were termed exons, separated from each other within the gene by inactive introns.

The research suggested the necessary existence of a number of biological processes and active entities, many of which have since been tracked down by other scientists. Some, however, have resisted intensive inquiry. Now, researchers at The Wistar Institute and colleagues have resolved one of the important biological questions to which this earlier research pointed. A report on their findings appears in the October 21 issue of Cell.

Researchers who followed Roberts and Sharp discovered a molecular machine called a spliceosome, which was responsible for processing messenger RNA, or mRNA, the gene transcript from which proteins are produced. The spliceosome does this by snipping out the introns from the mRNA and then stitching together the exons into the finished mRNA. The activity takes place in the nucleus of the cell.

The spliceosome itself is composed of proteins and so-called small nuclear RNAs, or snRNAs. These snRNAs, as is the case with other forms of non-coding RNA in the nucleus, never produce proteins but play important roles in facilitating and regulating genetic activity. How these snRNAs were processed, however, remained a mystery for over twenty years. And because the spliceosome underlies the successful transcription of every single gene in the body, the question has been a vital one to answer.

In the new study, the Wistar-led research team identifies an entirely novel multi-protein complex called the Integrator that plays a central role in the processing of snRNAs. The Integrator appears to perform two important duties simultaneously. It binds a molecule called CTD, which is a component of the polymerase enzyme that transcribes snRNA genes, and it also binds to the specific genes that code for the snRNAs. With CTD as a platform, the Integrator forms a bridge between the genes and the polymerase components that transcribe them. Then, as the polymerase transcribes the genes into RNA, the Integrator processes the RNA into finished snRNAs ready for transport into the cytoplasm and incorporation into the spliceosome.

Interestingly, the Integrator contains at least 12 subunits, all of which were previously unknown to scientists. The Integrator also appears to be an evolutionarily conserved complex, appearing in animals as diverse as humans, worms, and flies.

“The Integrator complex appears to be completely new, previously undefined in any way, which is surprising in this era of the Human Genome Project,” says Ramin Shiekhattar, Ph.D., a professor at Wistar and senior author on the Cell study. “People had hypothesized that a complex of this kind must exist and had looked for it for many years, but until now it had eluded them.”

The lead author on the Cell study is David Baillat, Ph.D. Mohamed-Ali Hakimi, Anders M. Naar, Ali Shilatifard, and Neil Cooch are coauthors. Baillat and Cooch are both members of the Shiekhattar laboratory at Wistar. Hakimi is at the CNRS in France, Naar is affiliated with Harvard Medical School and the Massachusetts General Hospital Cancer Center, and Shilatifard is at the St. Louis University Health Sciences Center. Senior author Shiekhattar is a professor in two programs at Wistar, the Gene Expression and Regulation program and the Molecular and Cellular Oncogenesis program. Support for the research was provided by the National Institutes of Health.

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DETAILS OF A REPRESENTATIVE LIST OF PROVEN OR SUSPECTED "POSTGENE DISEASES"

AIDS

32-nucleotide deletion, associated with defence against hiv/aids, is a predominant mutation of CCR5 gene in the population of Georgia.

Kamkamidze G, Capoulade-Metay C, Butsashvili M, Dudoit Y, Chubinishvili O, Debre P, Theodorou L.

There is a special interest to investigate genetic peculiarities in the populations with a low HIV seroprevalence. Despite of presence of high-risk conditions for rapid spread of HIV/AIDS epidemics in Georgia, the prevalence of this infection in the country remains very low. We studied polymorphisms of CCR5 gene in Georgians. Blood samples from 190 women randomly selected from the cohort of pregnant women involved in the program of prevention of mother-to-child HIV transmission in Georgia have been investigated. Two-step PCR was used to amplify the whole CCR5 genetic sequence. Detection of mutations and polymorphisms was done by dHPLC. All samples showing specific patterns by dHPLC, were sequenced to identify the exact nature of the mutation. It was shown that CCR5-delta32 mutation is a predominant alteration of CCR5 gene among Georgians. All subjects bearing this mutation were heterozygotes. Frequency of delta32 CCR5 allele in the population of Georgia was equal to 5%. Only one case of R223Q mutation and two cases of mutations in the non-coding region of CCR5 gene were also found. Our findings differ from the existing data showing the absence of the CCR5-delta32 mutation among Georgians and provide further support to the hypothesis on a Northeastern European origin of this mutation and North to South gradient of its distribution.

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ALCOHOLISM

Alternative splicing and promoter use in the human GABRA2 gene.

Tian H, Chen HJ, Cross TH, Edenberg HJ. Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, 635 Barnhill Drive, Room 4063E, Indianapolis, IN 46202-5122, USA.

GABA(A) receptors mediate the majority of the fast synaptic inhibition in the mammalian brain. They are the targets of several important drugs, including benzodiazepines, which are used as anxiolytics, sedatives, anti-convulsants, and in the treatment of alcohol withdrawal symptoms. Non-coding variations in GABRA2, the gene encoding the alpha2 subunit, are associated with the risk for alcoholism, suggesting that regulatory differences are important. GABRA2 mRNAs from whole human brain and from three brain regions were examined for evidence of alternative splicing using reverse transcription-PCR and DNA sequencing. A complex pattern of alternative splicing and alternative promoter use of the human GABRA2 mRNA was demonstrated. There are four major isoforms consisting of combinations of two alternative 5' and 3' exons, as well as minor isoforms lacking exon 4 or exon 8. The alternative 5' exons each lie downstream of a functional promoter sequence, as shown by transient transfection assays. The promoter activities of naturally occurring haplotypes differed, indicating genetic differences in gene expression.

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ALPORT SYNDROME

Unusual deep intronic mutations in the COL4A5 gene cause X linked Alport syndrome.

King K, Flinter FA, Nihalani V, Green PM.

Division of Medical and Molecular Genetics, 7th Floor Guy's Tower, GKT school of Medicine, King's College, SE1 9RT London, UK.

The X-linked form of Alport syndrome is caused by mutations in the COL4A5 gene in Xq22. This large multiexonic gene has, in the past, been difficult to screen, with several studies detecting only about 50% of mutations. We report three novel intronic mutations that may, in part, explain this poor success rate and demonstrate that single base changes deep within introns can, and do, cause disease: one mutation creates a new donor splice site within an intron resulting in the inclusion of a novel in-frame cryptic exon; a second mutation results in a new exon splice enhancer sequence (ESE) that promotes splicing of a cryptic exon containing a stop codon; a third patient exhibits exon skipping as a result of a base substitution within the polypyrimidine tract that precedes the acceptor splice site. All three cases would have been missed using an exon-by-exon DNA screening approach.

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ALZHEIMER'S DISEASE

The transcriptional factor LBP-1c/CP2/LSF gene on chromosome 12 is a genetic determinant of Alzheimer's disease.

Lambert JC, Goumidi L, Vrieze FW, Frigard B, Harris JM, Cummings A, Coates J, Pasquier F, Cottel D, Gaillac M, St Clair D, Mann DM, Hardy J, Lendon CL, Amouyel P, Chartier-Harlin MC.

INSERM U508, Institut Pasteur de Lille, 1 rue du Professeur Calmette, BP 245, 59019 Lille Cedex, France.

PubMed Abstract:

Although the varepsilon4 allele of the apolipoprotein E gene appears as an important biological marker for Alzheimer's disease (AD) susceptibility, other genetic determinants are clearly implicated in the AD process. Here, we propose that a genetic variation in the transcriptional factor LBP-1c/CP2/LSF gene, located close to the LRP locus, is a genetic susceptibility factor for AD. We report an association between a non-coding polymorphism (G-->A) in the 3'-untranslated region of this gene and sporadic AD in French and British populations and a similar trend in a North American population. The combined analysis of these three independent populations provides evidence of a protective effect of the A allele (OR = 0.58, 95% CI 0.44-0.75). We describe a potential biologically relevant role for the A allele whereby it reduces binding to nuclear protein(s). The absence of the A allele was associated with a lower LBP-1c/CP2/LSF gene expression in lymphocytes from AD cases compared with controls. Our data suggest that polymorphic variation in the implication of the LBP-1c/CP2/LSF gene may be important for the pathogenesis of AD, particularly since LBP-1c/CP2/LSF interacts with proteins such as GSKbeta, Fe65 and certain factors involved in the inflammatory response.

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Candidate gene association studies of genes involved in neuronal cholinergic transmission in Alzheimer's disease suggests choline acetyltransferase as a candidate deserving further study.

Am J Med Genet B Neuropsychiatr Genet. 2005 Jan 5;132(1):5-8

Cook LJ, Ho LW, Wang L, Terrenoire E, Brayne C, Evans JG, Xuereb J, Cairns NJ, Turic D, Hollingworth P, Moore PJ, Jehu L, Archer N, Walter S, Foy C, Edmondson A, Powell J, Lovestone S, Williams J, Rubinsztein DC. Department of Medical Genetics, Cambridge Institute for Medical Research, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2XY, UK

Consistent deficits in the cholinergic system are evident in the brains of Alzheimer's Disease (AD) patients, including reductions in the activities of acetylcholine, acetylcholinesterase (AChE), and choline acetyltransferase (ChAT), increased butyrylcholinesterase (BChE) activity, and a selective loss of nicotinic acetylcholine receptors (nAChRs). Accordingly, we have analyzed polymorphisms in the genes encoding AChE, ChAT, BChE, and several of the subunit genes from neuronal nAChRs, for genetic associations with late-onset AD. A significant association for disease was detected for a non-coding polymorphism in ChAT (allele chi(1) (2) = 12.84, P = 0.0003; genotype chi(2) (2) = 11.89, P = 0.0026). Although replication analysis did not confirm the significance of this finding when the replication samples were considered alone (allele chi(1) (2) = 1.02, P = 0.32; genotype chi(2) (2) = 1.101, P = 0.58) the trends were in the correct direction and a significant association remained when the two sample sets were pooled (allele chi(1) (2) = 12.37, P = 0.0004; genotype chi(2) (2) = 11.61, P = 0.003). Previous studies have reported significant disease associations for both the K-variant of BChE and the coding ChAT rs3810950 polymorphism with AD. Replication analyses of these two loci failed to detect any significant association for disease in our case-control samples.

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Med Hypotheses. 2006;66(6):1140-1. Epub 2006 Feb 14.

Transfection "Junk" DNA - A link to the pathogenesis of Alzheimer's disease?

Macdonald AB. St. Catherine of Siena Medical Center, Department of Pathology, 50 Rte 25 A, Smithtown, NY 11787, USA.

A transfection product incorporates in[to] one molecule of human DNA, an inserted segment of DNA from another species. This communication addresses the hypothesis that a novel variation of the theme of transfection, namely "junk transfection" for which no protein product and no RNA is transcribed, might offer insights into the pathogenesis of Alzheimer's disease. It is hypothesized that spirochetal DNA gains access to the intracellular compartment of nerve cells during the subclinical latency phase of neuroborreliosis and chemically combines with human DNA. A previously reported Molecular interrogation of Alzheimer's disease autopsy tissues has yielded novel DNA sequences containing the 11q human chromosome and a short piece of the Borrelia burgdorferi Flagellin B DNA. Although the usually encountered transfection product bundles an entire nonhuman gene within it, this model proposes that shorter inserts into the human genome constitute "junk transfection" because no protein is derived from them. Junk transfections would offer an important new cognitive model for the detection of occult infections as the root causes for the Tauopathies, which are degenerative neurological disorders, including Alzheimer's disease.

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Neurosci Lett. 2003 Oct 23;350(2):77-80.

Association analysis between anterior-pharynx defective-1 genes polymorphisms and Alzheimer's disease.

Poli M, Gatta LB, Archetti S, Padovani A, Albertini A, Finazzi D. Institute of Chemistry, Faculty of Medicine, University of Brescia, viale Europa 11, 25123 Brescia, Italy.

Recent biological studies indicate the importance of anterior-pharynx defective-1 (APH-1) proteins in Alzheimer's disease (AD) pathogenesis. We scanned APH-1 genes for the presence of sequence variations by denaturing high performance liquid chromatography and analyzed their distribution in an Italian sample of 113 AD patients and 132 controls. We found six different polymorphisms: three of them, all in APH-1b, predict an aminoacid substitution (T27I, V199L and F217L); the others are either silent or in non-coding regions. None of them is significantly associated with the disease; data stratification by the apolipoprotein E epsilon4 carrier status show a trend for coexistence of the transversion c+651T>G (F217L) with the epsilon4 allele. Our data suggest that polymorphisms in APH-1a/b coding regions are not linked with higher risk for sporadic AD in our Italian population sample.

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Neurosci Lett. 2004 Oct 14;369(2):104-7.

Association between a T/C polymorphism in intron 2 of cholesterol 24S-hydroxylase gene and Alzheimer's disease in Chinese.

Wang B, Zhang C, Zheng W, Lu Z, Zheng C, Yang Z, Wang L, Jin F. Center for Human and Animal Genetics, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, China.

A polymorphism (T/C) in intron 2 of the cholesterol 24-hydroxylase (CYP46) gene has recently been reported to be associated with the risk for late-onset Alzheimer's disease (LOAD). To investigate possible involvement of the CYP46 gene and apolipoprotein E (APOE) gene polymorphisms in the manifestation of LOAD, we analyzed 99 sporadic LOAD patients and 113 healthy controls of China. We found an obvious association between CYP46 TT genotype and LOAD (OR = 2.98, 95% CI 1.64-5.44, P < 0.001). A clear increase of the risk to develop LOAD was also observed in subjects carrying both the CYP46 TT genotype and the APOE epsilon4-allele (OR = 12.94, 95% CI 4.26-39.32, P < 0.001). Our data reveal that the polymorphism of CYP46 intron 2 is implicated in the susceptibility to LOAD and a strong synergistic interaction between CYP46 TT homozoygots and APOE epsilon4 carrier status on the risk of LOAD.

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ANGELMAN SYNDROME

The increasing number of RNA polymease II transcripts without any apparent open reading frame has increased our awareness that gene functions can be selected for without involving a protein product. [By conventional "Genetics" a "non-coding gene" is a contradiction in terms. "Genes" are defined as the "protein coding sequences" of the DNA, as opposed to the "non-coding DNA", which used to be described as "non-genic Junk". The Angelman- and related Prader-Willi Syndromes are living examples of the breakdown of overy rigid definition of "Genetics" - giving a strong impetus for moving to PostGenetics. - comment by A. Pellionisz]

By using the H19 gene as a point of reference, we highlight here several common features among non-coding genes, such as their antisense position in subchromosomal expression domains which are often genomically imprinted. We also discuss the need to critically examine the translatability of transcripts which are considered non-coding. Finally, we present a model to explain the origin of non-coding genes.

The human chromosome region 15q13-15, which is associated with genetic and epigenetic disturbances that generate both Prader-Willi syndrome and Angelmann syndrome, harbours non-coding genes such as IPW/Ipw, PAR1, PAR5, PARSN and ASR1,2 (ref. 14). IPW/Ipw (imprinted gene in Prader-Willi syndrome) expresses a processed RNA with no significant ORFs, which is localized predominantly in the cytoplasm15. An antisense RNA is produced from the ZNF127 locus, which encodes a protein with RING zinc-finger and multiple zinc-finger motifs. The ZNF127 and ZNF127 AS RNA vary in their expression patterns as well as in size of the transcripts12. The biological functions of IPW (sense) and ZNF127 (antisense) transcripts, if any, are not clear at this moment. The SNRPN gene, which spans 360 kb of DNA produces both coding and non-coding imprinted transcripts16. The exons at the 3¢ part of the gene generate a coding mRNA when spliced with exon 1 and noncoding RNAs when spliced with the 5¢ BD exons16. BD transcripts, encoded by two alternative 5¢ exons, BD1B and BD1A, have two alternative start sites and are subject to alternative splicing16. They are expressed from the paternal chromosome only, as the BD exons are heavily methylated on the maternal chromosome (16). It has recently been shown that paternally imprinted antisense RNA is produced at the 3¢ UTR of Angelmann syndrome gene, UBE3A (11), which encodes ubiquitin protein ligase that functions in protein turnover17.

ASTHMA

Variation in conserved non-coding sequences on chromosome 5q and susceptibility to asthma and atopy.
Donfack J, Schneider DH, Tan Z, Kurz T, Dubchak I, Frazer KA, Ober C.

Evolutionarily conserved sequences likely have biological function. Methods: To determine whether variation in conserved sequences in non-coding DNA contributes to risk for human disease, we studied six conserved non-coding elements in the Th2 cytokine cluster on human chromosome 5q31 in a large Hutterite pedigree and in samples of outbred European American and African American asthma cases and controls. RESULTS: Among six conserved non-coding elements (>100 bp, >70% identity; human-mouse comparison), we identified one single nucleotide polymorphism (SNP) in each of two conserved elements and six SNPs in the flanking regions of three conserved elements. We genotyped our samples for four of these SNPs and an additional three SNPs each in the IL13 and IL4 genes. While there was only modest evidence for association with single SNPs in the Hutterite and European American samples (P <0.05), there were highly significant associations in European Americans between asthma and haplotypes comprised of SNPs in the IL4 gene (P <0.001), including a SNP in a conserved non-coding element. Furthermore, variation in the IL13 gene was strongly associated with total IgE (P = 0.00022) and allergic sensitization to mold allergens (P = 0.00076) in the Hutterites, and more modestly associated with sensitization to molds in the European Americans and African Americans (P < 0.01). CONCLUSIONS: These results indicate that there is overall little variation in the conserved non-coding elements on 5q31, but variation in IL4 and IL13, including possibly one SNP in a conserved element, influence asthma and atopic phenotypes in diverse populations.

Full text

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ATAXIA TELANGIECTASIA

Exon-scanning mutation analysis of the ATM gene in patients with ataxia-telangiectasia.
Vorechovsky I, Luo L, Prudente S, Chessa L, Russo G, Kanariou M, James M, Negrini M, Webster AD, Hammarstrom L.
Department of Bioscience, NOVUM, Karolinska Institute, Huddinge, Sweden.

Using a polymerase chain reaction single strand conformation polymorphism (PCR-SSCP) assay, which amplifies individually all coding exons of the ATM gene deficient ataxia-telangiectasia (A-T), we have analyzed 10 patients with A-T for ATM mutations. Mutation were detected in 9 patients. We describe the first ATM mutation in the splice junction found in the 5' splice site of intron 17, leading to exon skipping. However, most mutations were small deletions or insertions resulting in premature termination of the translation product. The development of DNA-based methods for detection of unknown mutations and further characterization of ATM mutation pattern will facilitate identification of A-T carriers and assessment of their cancer risk.

PostGenetic Medicine of Ataxia Telangiectasia:

Bone marrow transplantation restores immune system function and prevents lymphoma in Atm-deficient mice.

Blood. 2004 Jul 15;104(2):572-8. Epub 2004 Mar 25.

Bagley J, Cortes ML, Breakefield XO, Iacomini J. Transplantation Biology

Research Center, Massachusetts General Hospital, MGH-East, 149-5210 13th St,
Boston, MA 02129, USA.

Ataxia-telangiectasia (A-T) is a human autosomal recessive disease caused by mutations in the gene encoding ataxia-telangiectasia mutated (ATM). A-T is characterized by progressive cerebellar degeneration, variable immunodeficiency, and a high incidence of leukemia and lymphoma. Recurrent sino-pulmonary infections secondary to immunodeficiency and hematopoietic malignancies are major causes of morbidity and mortality in A-T patients. In mice, an introduced mutation in Atm leads to a phenotype that recapitulates many of the symptoms of A-T, including immune system abnormalities and susceptibility to malignancy. Here we show that the replacement of the bone marrow compartment in Atm knockout mice (Atm(-/-)) using a clinically relevant, nonmyeloablative host-conditioning regimen can be used to overcome the immune deficiencies and prevent the malignancies observed in these mice.

Therefore, bone marrow transplantation may prove to be of therapeutic benefit in A-T patients.

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AUTISM

See Fragile X / Autism

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AUTOIMMUNE DISEASES

Association of the T-cell regulatory gene CTLA4 with susceptibility to autoimmune disease.

Genes and mechanisms involved in common complex diseases, such as the autoimmune disorders that affect approximately 5% of the population, remain obscure. Here we identify polymorphisms of the cytotoxic T lymphocyte antigen 4 gene (CTLA4)--which encodes a vital negative regulatory molecule of the immune system--as candidates for primary determinants of risk of the common autoimmune disorders Graves' disease, autoimmune hypothyroidism and type 1 diabetes. In humans, disease susceptibility was mapped to a non-coding 6.1 kb 3' region of CTLA4, the common allelic variation of which was correlated with lower messenger RNA levels of the soluble alternative splice form of CTLA4. In the mouse model of type 1 diabetes, susceptibility was also associated with variation in CTLA-4 gene splicing with reduced production of a splice form encoding a molecule lacking the CD80/CD86 ligand-binding domain. Genetic mapping of variants conferring a small disease risk can identify pathways in complex disorders, as exemplified by our discovery of inherited, quantitative alterations of CTLA4 contributing to autoimmune tissue destruction.

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Nature. 2003 May 29;423(6939):506-11. Epub 2003 Apr 30.

Association of the T-cell regulatory gene CTLA4 with susceptibility to autoimmune disease.

Ueda H, Howson JM, Esposito L, Heward J, Snook H, Chamberlain G, Rainbow DB, Hunter KM, Smith AN, Di Genova G, Herr MH, Dahlman I, Payne F, Smyth D, Lowe C, Twells RC, Howlett S, Healy B, Nutland S, Rance HE, Everett V, Smink LJ, Lam AC, Cordell HJ, Walker NM, Bordin C, Hulme J, Motzo C, Cucca F, Hess JF, Metzker ML, Rogers J, Gregory S, Allahabadia A, Nithiyananthan R, Tuomilehto-Wolf E, Tuomilehto J, Bingley P, Gillespie KM, Undlien DE, Ronningen KS, Guja C, Ionescu-Tirgoviste C, Savage DA, Maxwell AP, Carson DJ, Patterson CC, Franklyn JA, Clayton DG, Peterson LB, Wicker LS, Todd JA, Gough SC. Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Cambridge Institute for Medical Research, University of Cambridge, Wellcome Trust/MRC Building, Cambridge, CB2 2XY, UK.

Genes and mechanisms involved in common complex diseases, such as the autoimmune disorders that affect approximately 5% of the population, remain obscure. Here we identify polymorphisms of the cytotoxic T lymphocyte antigen 4 gene (CTLA4)--which encodes a vital negative regulatory molecule of the immune system--as candidates for primary determinants of risk of the common autoimmune disorders Graves' disease, autoimmune hypothyroidism and type 1 diabetes. In humans, disease susceptibility was mapped to a non-coding 6.1 kb 3' region of CTLA4, the common allelic variation of which was correlated with lower messenger RNA levels of the soluble alternative splice form of CTLA4. In the mouse model of type 1 diabetes, susceptibility was also associated with variation in CTLA-4 gene splicing with reduced production of a splice form encoding a molecule lacking the CD80/CD86 ligand-binding domain. Genetic mapping of variants conferring a small disease risk can identify pathways in complex disorders, as exemplified by our discovery of inherited, quantitative alterations of CTLA4 contributing to autoimmune tissue destruction.

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Immunogenetics. 2002 Nov;54(8):591-5. Epub 2002 Oct 9.

Novel polymorphisms in HLA-DOA and HLA-DOB in B-cell malignancies.

van Lith M, van Ham M, Neefjes J. Division of Tumor Biology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.

In B cells, HLA-DO controls HLA-DM-mediated peptide loading on MHC class II molecules. We analyzed whether HLA-DO mutations are associated with autoimmune diseases characterized by an autoantibody component and with a linkage to HLA-DR or HLA-DQ. These diseases include systemic lupus erythematosus, rheumatoid arthritis, celiac disease, and Graves' disease. In addition, several B-cell leukemias were screened for mutations in HLA-DO. A limited number of polymorphisms in DOA and DOB were found, most of which are non-coding changes or result in a conserved amino acid change. A novel non-conserved Arg to Cys mutation in DOA was found in a patient suffering from chronic lymphocytic leukemia. Further analysis did not reveal any effect on the function of HLA-DO. We conclude that HLA-DO variants are not critically involved in the autoimmune diseases and B-cell leukemias studied here.

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BIPOLAR DISORDER

G protein receptor kinase 3 (GRK3)

Further stronger evidence for the role of GRK3 in bipolar disorder came from experiments conducted by Tom Barrett in the lab. Tom identified families with the strongest evidence of linkage to the GRK3 locus who would be most likely to be transmitting a mutation in the GRK3 gene. He then sequenced much of the gene in an effort to find disease causing mutations or just anonymous markers. This was a big job! He sequenced all coding regions and most of the non-coding regions. He found no coding sequence variants, but he did find six sequence variants in the promoter of the gene. These SNPs were in such a position so as to possibly influence the regulation of when the gene was turned on and off. Tom then examined these SNPs in about 150 families from the UCSD/UBC/UC and NIMH sets using the transmission disequilibrium test (TDT). This analysis indicated genetic association to two of these SNPs. We were then fortunate to be able to collaborate with Jim Kennedy at the U. of Toronto and to study another set of 250 triad families with bipolar disorder. Our results for one of the SNPs (P-5) was replicated in this sample!

Together these data argue that a regulatory mutation in or near the GRK3 promoter causes this gene to fail to be expressed when dopamine stimulates receptors in the brain. These receptors then fail to be desensitized in the normal fashion. This results in an effective supersensitivity to dopamine. This is exciting because post-synaptic dopamine receptor supersensitivity has been hypothesized for many decades based on many other lines of research.

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BRUGADA SYNDROME - ARRYTHMIA

Cryptic 5' splice site activation in SCN5A associated with Brugada syndrome.

Hong K, Guerchicoff A, Pollevick GD, Oliva A, Dumaine R, de Zutter M, Burashnikov E, Wu YS, Brugada J, Brugada P, Brugada R.

Molecular Genetics, Masonic Medical Research Laboratory, 2150 Bleecker Street, Utica, NY 13501, USA.

The Brugada syndrome (BS) is characterized by ST segment elevation in the right precordial leads and sudden cardiac death. The disease is linked to mutations in SCN5A in approximately 20% of cases. We collected a large family with BS and have identified a novel intronic mutation. We performed the clinical, genetic, molecular and biophysical characterization of this disease-causing mutation. With direct sequencing we identified an intronic insertion of TGGG 5 bp from the end of the Exon 27 of SCN5A. For transcript analysis, we investigated Epstein-Barr-transformed lymphoblastoid cell lines from patients and controls. Total RNA was extracted and RT-PCR experiments were performed to analyze the splicing patterns in exon 27 and 28. We identified two bands, one of the expected size and the other which showed a 96 bp deletion in exon 27, leading to a 32 amino acid in-frame deletion involving segments 2 and 3 of Domain IV of the SCN5A protein. This finding indicates that the intronic mutation creates a cryptic splice site inside Exon 27. Biophysical analysis using whole-cell patch-clamp techniques showed a complete loss of function of the mutated channels when heterologously expressed. In summary, this is the first report of a dysfunctional sodium channel created by an intronic mutation giving rise to cryptic splice site activation in SCN5A in a family with the BS. The deletion of fragments of segments 2 and 3 of Domain IV leads to complete loss of function, consistent with the biophysical data found in several mutations causing BS.

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