An Investigation into Cis-elements, Rare Mutations, and Slipped-DNA Detection at Trinucleotide Repeat Disease-associated Loci

Gene-specific trinucleotide repeat expansions are the cause of an ever-growing number of disorders, including myotonic dystrophy type 1 (DM1) and spinocerebellar ataxia type 7 (SCA7). Both DM1, and SCA7 are characterized by large differences in repeat numbers between tissues that are differentially affected, indicating tissue-specific mechanisms of repeat instability. The mechanism(s) of both somatic as well as germline instability are complex and still poorly understood, with evidence supporting the contribution of cis-elements, trans factors, and DNA metabolic processes that are hypothesized to involve alternative structure formation within the DNA tract. This thesis involves investigations into the role of a particular cis-element (CTCF) on instability, as well as the detection of slipped-DNAs in patient tissues and the presence of rare mutations within those same tissues. Here I identify the first endogenous cis-element reported to show regulation of instability at a trinucleotide repeat disease locus, the DNA binding site for the insulator protein CCCTC- binding factor (CTCF) downstream of the SCA7 repeat. Using a mouse model with a mutation in the CTCF binding domain, I show that the loss of CTCF binding stimulates germline and somatic instability in a tissue-specific and age-dependent manner. The binding of CTCF likely protects the repeat tract from expansion by shielding it from other elements that may contribute to expansion. DNA metabolic processes such as replication, repair, and transcription likely play a role in repeat expansion at disease loci, with the general mechanism hypothesized to be the extrusion and aberrant repair of slipped-DNA structures during the unwinding process for each. While characterizing DM1 patient tissues in order to isolate slipped-DNA structures, I characterized two non-CTG repeat insertion mutations that had completely replaced the repeat tract in a small subset of cells in only two tissues in one patient. Given the hypermutable nature of expanded repeat tracts, it is possible that these types of mutations are more common than suspected. Finally, I report on the detection and isolation of slipped-DNA structures from the endogenous DM1 locus from patient tissues. The slip-outs appear as clusters along a length of DNA, rather than single isolated slip-outs, and more unstable tissues contain greater amounts of slipped-DNA compared to more stable tissues. This detection implies that slipped-DNA structures are not merely transient intermediates in the mutation and expansion process as has long been assumed, but remain within the DNA at detectable levels. The data reported herein both furthers our understanding of trinucleotide repeat instability, and additionally confirms the decades-long hypothesis that slipped-DNAs are in fact forming in patient tissues in a tissue-specific manner.Ph