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Cell cycle review.pdf

The eukaryotic cell cycle is controlled by a regulatory network, the general features of which are conserved from yeast to humans1. It proceeds through tightly regulated transitions to ensure that specific events take place in an orderly manner. The discovery of cyclins and cyclin-dependent kinases (CDKs), the elucidation of the mechanisms underlying transcriptional control and checkpoint signalling and the characterization of ubiquitin ligase regulatory pathways have revealed that general cell cycle regulatory principles are shared across eukaryotes.

Two crucial aspects of cell cycle regulation are the existence of DNA structure checkpoints, which arrest the cell cycle in response to DNA damage or incomplete replication, and the existence of a ‘commitment point’. This point is known as the ‘restriction point’ in animal cells and ‘start’ in yeast and is defined as the point after which a cell becomes committed to enter the cell cycle and progress through it independently of signals from the environment. The importance of DNA checkpoints and commitment point control for proper cell division is illustrated by the high frequency of mutations found in their constituent regulatory proteins during onco- genesis2. One notable regulatory protein that is often mutated in cancer is the tumour suppressor protein RB3. RB is a potent inhibitor of G1–S transcription (that is, a transcriptional wave that initiates during G1 and is subsequently inactivated during S phase), and its dis- covery over 20 years ago first suggested the dependency of cell cycle commitment on transcriptional regulation in G1 (REFS 4–6). Subsequent studies showed that the

broad mechanisms of eukaryotic G1 cell cycle control are highly conserved7–9,10. Intriguingly, recent work dem- onstrated that DNA checkpoint control depends on the same transcription factors responsible for commitmen t point regulation11.

The dynamic changes in gene expression as a func- tion of cell cycle progression are regulated by specific CDK activities. These variations in gene expression levels control the accumulation of several cyclins and thereby regulate CDK activity, thus driving cell cycle pro gression. Genes regulated during the cell cycle encode several pro- teins that function in the subsequent phase of the cell cycle. In most eukaryotes, cell cycle-regulated transcrip- tion can be grouped into three main waves12. These waves of transcription coincide with the different transition points during the cell cycle, namely G1-to-S, G2-to-M and M-to-G1. Although all three cell cycle transcript waves are well-characterized in yeast, transcription that occurs during the M-to-G1 phase transition in human cells is less well-defined13. Largely on the basis of work carried out in the budding yeast Saccharomyces cerevisiae, it is thought that the subsequent waves of transcription form a continuous regulatory network in which each wave is activated by the previous one and contains acti- vators of the following wave14. Of the cell cycle trans- criptional waves, G1–S transcription has been the most studied because of its important role in the tight regula- tion of G1-to-S phase transition. Derepression of G1–S transcription allows cells to progress into S phase in an unrestrained fashion, a hallmark of cancer. Along with the recently established link of the cell cycle checkpoint

1Medical Research Council (MRC) Laboratory for Molecular Cell Biology, University College London, Gower Street, London, WC1E 6BT, UK. 2Department of Biology, 337 Campus Drive, Stanford University, Stanford, California 94305-5020, USA. e-mails: [email protected]; [email protected]; [email protected] doi:10.1038/nrm3629

Ubiquitin ligase An enzyme that recognizes Lys residues on a target protein and causes the attachment of ubiquitin to these residues.

RB A protein that binds activator E2F proteins to inhibit transcription outside of G1–S in animals. RB is an oncoprotein that is dysfunctional in several major cancers.

Control of cell cycle transcription during G1 and S phases Cosetta Bertoli1, Jan M. Skotheim2 and Robertus A. M. de Bruin1

Abstract | The accurate transition from G1 phase of the cell cycle to S phase is crucial for the control of eukaryotic cell proliferation, and its misregulation promotes oncogenesis. During G1 phase, growth-dependent cyclin-dependent kinase (CDK) activity promotes DNA replication and initiates G1-to-S phase transition. CDK activation initiates a positive feedback loop that further increases CDK activity, and this commits the cell to division by inducing genome-wide transcriptional changes. G1–S transcripts encode proteins that regulate downstream cell cycle events. Recent work is beginning to reveal the complex molecular mechanisms that control the temporal order of transcriptional activation and inactivation, determine distinct functional subgroups of genes and link cell cycle-dependent transcription to DNA replication stress in yeast and mammals.

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Nature Reviews | Molecular Cell Biology

G1a

b c

S G2–M

G e

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e xp

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Checkpoint kinaseG1 cyclin–CDK

Signal

Protein

Positive feedback (Switch)

Transcription

Negative feedback (Oscillator)

Protein

Protein

Transcriptional repression

Transcriptional inhibitor

Cell cycle progression

• G1–S transcription • Cell cycle commitment

Initial signal

G1 cyclin –CDK

G1–S transcription

Transcriptional repressor

Transcriptional inhibitor

(+)

(–)

Pocket proteins Family of proteins, including RB, p107 and p130, that associates with members of the E2F transcription factor family to inhibit transcription. The pocket domain is essential for tumour suppressing activity.

response to replication stress, this unrestrained growth illustrates the importance of cell cycle-regulated trans- cription, which is both driven by and a driving force for cell cycle progression.

Here, we review recent progress in determining the simple but elegant mechanisms by which cells regulate their G1–S phase transcriptional network to control the commitment to cell division and the DNA replication checkpoint response. Although most work has focused on the role of transcriptional activation during cell cycle progression from G1 to S and the genome-wide changes in the transcriptional programme14–16, recent work has uncovered many new insights into the regulation of

commitment to cell division, the temporal confinement of G1–S transcription and the response to DNA repli- cation stress (BOX 1). These systems-level properties are conserved across eukaryotes despite frequent lack of protein sequence homology of transcriptional regulators (BOX 1; TABLE 1). We briefly discuss G1–S transcriptional regulation in the context of other cell cycle pathways, such as cyclins and CDKs, checkpoint signalling and the ubiquitin ligase regulatory pathways, but we also refer readers to more comprehensive reviews on these specific topics17–22. Finally, we share our views on how curren t understanding of the regulation of G1-to-S phase transi- tion may provide a blueprint for future research into the fundamental regulatory mechanisms controlling cell- ular decision-making processes, dynamic changes in gene expression and checkpoint-dependent rewiring of transcriptional networks.

Activation of G1–S transcription Cells commit to enter a new cell cycle during G1 by activating cyclin–CDK-dependent transcription (FIG. 1). G1–S transcriptional activation during late G1 promotes entry into S phase after which expression is turned off. This creates a wave of transcription, which peaks at the G1-to-S transition (BOX 1). The mechanism of G1–S trans criptional activation has been well-established and is conserved from yeast to humans.

E2F family and pocket proteins. In human cells, G1–S transcription depends on the E2F family of transcrip- tion factors and their dimerization partner proteins. Misregulation of E2F function is frequently found in cancer, which further supports the role of G1–S trans- cription in oncogenesis23–28. E2F family members are generally associated with either transcriptional activa- tion (E2F1, E2F2 and E2F3A) or repression (E2F3B, E2F4, E2F5, E2F6, E2F7 and E2F8). However, recent findings revealed a more complex scenario in which activator E2F proteins can act as repressors and repres- sor E2F proteins can activate transcription29–31. In addi- tion to E2F proteins, confining transcription to the late G1 and S phases of the cell cycle requires regulation by pocket proteins, including RB, p107 and p130, which bind and inhibit the expression of E2F-regulated genes6,32–36.

G1–S transcriptional activation in mammalian cells. E2F family members, their DNA binding partners (dimeriza- tion partner proteins) and pocket proteins bind cell cycle gene promoters at different stages of the mitotic cell cycle to ensure the proper temporal expression of target genes4,37 (BOX 2). The association of dimerization partner proteins enhances the DNA-binding affinity of E2F fam- ily members so that they can function as trans criptional regulators38. During early G1, activator E2F proteins are bound and inhibited by RB6, whereas E2F4 (and presum- ably E2F5) bind p130 and p107 at promoters to repress transcription39–42 (FIG. 1b). E2F4 and E2F5 depend on pocket protein binding for nuclear localization. When pocket proteins are phosphorylated by G1 cyclin–CDKs during G1-to-S phase transition, E2F4 and E2F5 are released, shuttled into the cytoplasm4,37,43 and replaced at

Box 1 | Cell cycle-regulated transcription during the G1 and S phases

The G1−S transcriptional network is involved in two crucial aspects of cell cycle regulation: cell division cycle control and maintenance of genome stability. Phosphorylation of transcriptional inhibitors by cyclin-dependent kinase (CDK) releases them from transcription factors to activate G1–S genes, including G1 cyclins (see the figure, part a). This reinforces a positive feedback loop, further committing the cell to a new division cycle and activating G1–S transcription. Negative feedback loops subsequently inactivate transcription, which terminates a wave of gene expression (indicated by the red curve) that peaks at the transition from G1 to S phase. A recently identified negative autoregulatory feedback loop involves transcriptional repressors that are G1–S targets themselves. These repressors accumulate and bind to G1–S gene promoters to turn off transcription when cells progress to S phase. In addition, these transcriptional repressors are directly targeted by the DNA replication checkpoint protein kinases to maintain G1–S transcription during a checkpoint arrest. The fundamental regulatory pathways that drive changes in cell cycle-regulated gene expression during the G1 and S phases of the cell cycle are conserved from yeast to humans. Transcriptional regulators involved in this regulation in various eukaryotic systems are listed in TABLE 1. Conserved systems level properties are involved in G1–S transcriptional regulation across eukaryotes (see the figure, part b). Linking a positive feedback mechanism to a negative feedback loop ensures that a switch-like commitment to activation results in timely inactivation via an oscillator. The particular network wiring required for G1-to-S phase transition involves a transcriptional inhibitor and cell cycle-regulated transcription of G1 cyclins and transcriptional repressors (see the figure, part c).

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promoters by activator E2F family members (E2F1, E2F2 and E2F3A) that initiate transcription40,41. This classic paradigm of the role of activator E2F proteins in inducing G1–S gene expression and driving cell cycle entry derives mainly from studies using cultured cells and flies. More recent evidence from in vivo studies in knockout mice has revealed a more complicated picture29,44. The ablation of all activator E2F proteins, E2F1, E2F2 and E2F3, does not prevent normal proliferation of embryonic stem (ES) cells and intestinal and retinal progenitor cells, suggest- ing that these proteins are dispensable for proliferation in this context. However, an increase in DNA damage and apop tosis is observed in these triple-knockout cells, which suggests a role for transcriptional control by the activator E2F proteins.

A large number of studies used cultured cells re-enterin g the cell cycle after serum removal to analyse trans criptional activation in G1. After prolonged serum withdrawal, cells enter a condition known as quiescence, which is different from the G1 phase of cycling cells and has been defined as the G0 phase of the cell cycle135,136. Both during G0 and early G1, binding of pocket proteins to E2F proteins prevents transcription. The interaction is disrupted by CDK-dependent phosphorylation in mid-G1, resulting in transcriptional activation. In G0, most E2F-responsive promoters are bound and repressed by p130 together with E2F4 (REFS 40,45), whereas in early G1 of cycling cells, p107 also interacts with DNA-bound E2F4 to repress transcription in a similar manner 41.

The relative importance of pocket proteins for transcrip- tional repression during different phases of the cell cycle largely correlates with their protein levels, as pocket pro- teins function in similar ways to repress transcription4. Although p130 seems to be the most abundant pocket protein during quiescence, its levels are greatly reduced during proliferation4. By contrast, RB and p107 are barely detectable in quiescent cells but are found at higher levels in cycling cells; this is likely to be due to E2F-dependent transcription. Recent chromatin immunoprecipitation (ChIP) data suggests that RB is present at promoters during quiescence and in cycling cells, as was com- monly assumed46, as well as in senescent cells, in which it represses G1–S genes. Intriguingly, the permanent exit from the cell cycle in differentiating cells requires acti- vator E2F proteins in complex with RB to repress cell cycle genes29. It is possible that this mechanism of active repression promotes cell cycle exit and is then followed by a more stable repression mediated by E2F4 and E2F5 together with p130 (REF. 29).

Conserved mechanisms govern transcriptional activation. Although there is no conservation at the protein level, a regulatory mechanism for G1–S transcriptional activa- tion similar to that established for mammalian cells was recently found in yeast10,47,48 (FIG. 1c).

In S. cerevisiae many of the genes involved in G1-to- S phase transition are regulated by one of two trans- cription factor complexes, SBF (SCB-binding factor) or

Table 1 | Conservation of cell cycle regulatory proteins*

Regulator type Saccharomyces cerevisiae Schizosaccharomyces pombe Drosophila melanogaster Homo sapiens

G1–S transcriptional regulators

Activators SBF (Swi6–Swi4) MBF (Cdc10–Res1–Res2) E2f1 E2F1, E2F2, E2F3

Repressors MBF (Swi6–Mbp1) E2f2 E2F4, E2F5, E2F6, E2F7, E2F8

Inhibitors Whi5 Possibly Whi5 Rbf1 RB

Co-repressors Nrm1 Nrm1, Yox1 Rbf2 p107, p130

Cyclin–CDK

G1 phase regulator Cdc28–Cln3 Cdc2–Puc1 Cdk4–cyclin D CDK4–cyclin D, CDK6–cyclin D

G1–S phase regulator Cdc28–Cln1, Cdc28–Cln2 Cdc2–Puc1 Cdc2–Cig1

Cdk2–cyclin E CDK2––cyclin E

S phase regulator Cdc28– Clb5, Cdc28–Clb6 Cdc2– Cig1, Cdc2– Cig2

Cdk2–cyclin E, Cdk1–cyclin A, Cdk2–cyclin A

CDK2––cyclin E, CDK1–cyclin A, CDK2–cyclin A

M phase regulator Cdc28– Clb1, Cdc28–Clb2, Cdc28–Clb3, Cdc28–Clb4

Cdc2–Cdc13 Cdk1–cyclin B CDK1–cyclin B

Checkpoint protein kinases

Sensor and/or transducer

Mec1 Rad3 ATR ATR

Tel1 Tel1 ATM ATM

Effector Chk1 Cds1 Chk1 CHK1

Rad53 Chk1 Chk2 CHK2

ATM, ataxia-telangiectasia mutated; ATR, ataxia-telangiectasia and Rad3-related protein; CDK, cyclin-dependent kinase; CHK, checkpoint kinase; MBF, MCB-binding factor; Mec1, mitosis entry checkpoint 1; Rbf, retinoblastoma family; SBF, SCB-binding factor; Tel1, telomere length regulation 1. *Listed are the functional orthologues between yeast, flies and humans of G1−S phase transcriptional regulators, cyclin-CDKs and checkpoint protein kinases. Although the functional orthologues of cyclins, CDKs and the checkpoint protein kinases share significant sequence homology, there is a total lack of sequence homology between yeast and the higher eukaryotic G1–S transcriptional regulators.

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G e

n e

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Transcriptional activation

a Posititive feedback loop

Nature Reviews | Molecular Cell Biology

Cdk4/6

SG1

E2F4 p107

p130

SBF Whi5

E2F1–3 RB

Cyclin D

CDK2 Cyclin E

Cyclin E

CLN1,CLN2

p130 P P

Whi5 P

p107 RB

P

E2F1–3

b Mammals

c Budding yeast

Cdk Cln3

CDK Cln1/2

SBF

Cell cycle

Whi5 An inhibitor of SBF (SCB-binding factor)-dependent transcription during early G1 in yeast.

Regulon A collection of genes under the control of the same regulatory protein.

MBF (MCB-binding factor). SBF comprises of a Swi4 DNA-binding component and Swi6 and is required to activate G1–S transcripts during G1. MBF is composed of an Mbp1 DNA-binding component and Swi6 and is required to repress G1–S transcripts outside of G1. Swi4 and Mbp1 bind to specific G1–S targe t promot- ers through the SCB (Swi4 cell cycle box) and MCB (MluI cell cycle box) recognition sequences, respec- tively. In mammalian cells, G1–S genes are regulated by several E2F transcription factor complexes at differ- ent stages of the cell cycle. In yeast, G1–S transcripts can be roughly divided into two groups: SBF- or MBF- dependent genes. However, it has been shown that in the absence of the either factor, SBF and MBF may be found at each other’s consensus DNA-binding motif 49,50. Although the temporal gene expression pattern induced by either SBF or MBF is similar, the regulatory mecha- nism is distinct. SBF-regulated genes remain switched off in cells that lack the DNA-binding component Swi4, suggesting that SBF is required for transcriptional induction during G1. Conversely, the repressor complex MBF is required to repress transcription outside of G1, as MBF-regulated genes remain activated in cells lack- ing DNA-binding component Mbp1. Thus, although SBF acts more like activator E2F proteins, MBF proteins resemble repressor E2F proteins (FIGS 1,2); however, they share no sequence homology with E2F proteins49,51,52. In addition, the S. cerev isiae transcriptional inhibitor Whi5 is functionally orthologous to pocket proteins despite a complete lack of sequence homology10. During G1, binding of Whi5 to SBF inhibits the activity of SBF, much like pocket proteins inhibit E2F activity (FIG. 1). Whi5 is phosphorylated by G1 cyclin–Cdk, leading to its release from SBF at promoters, export from the nucleus53 and inactivation. This ensures SBF-dependent transcriptiona l activation47,48.

A positive feedback switch ensures commitment. Activation of G1–S transcription by a positive feedback loop creates an ‘all-or-none switch’ that results in the commitment of cells to enter the cell cycle54,55 (FIG. 1a). The point at which cells commit to enter a new cell cycle, after which it will progress independently of signals from the environment, is known as the restriction point in mam- mals and start in yeast. Increased cyclin–CDK activity and the corresponding phosphorylation and inactivation of pocket proteins in mammals, or export and inactiva- tion of Whi5 in S. cerevisiae, allows an initial activation of G1–S transcription factors. The genes encoding the G1 cyclins CLN1 and CLN2 in yeast and cyclin E in mammals are some of the first G1–S genes to be trans- cribed56.Through positive feedback, G1 cyclins increase their own transcription to produce a rapid increase in cyclin–CDK activity that irreversibly leads to cell cycle commitment. In addition to defining the point at which cells commit, the rapid increase in CDK activity driven by this positive feedback results in the timely and coheren t activation of the entire G1–S regulo n54 (BOX 1; FIG. 1).

Positive feedback loops other than the G1 cyc- lins loop have also been implicated in mammalian cells, including, but not limited to, the accumulation

of activator E2F proteins57–59. It is worth noting that although the molecular link between the commitment point and positive feedback activation has been firmly established in yeast55, it is more contentious in mam- malian tissu e culture cells, in which the application of temporal high-resolution imaging approaches, to temporally link transcriptional regulation to cell cycle commitment in single cells, has been more limited60. In fact, some data obtained from single-cell measurements

Figure 1 | G1−S transcriptional activation. a | Schematic showing how the G1–S transcriptional programme, once initiated, is reinforced by a positive feedback loop. b | In mammalian cells, the transcriptional repressors RB, p107 and p130 (collectively known as pocket proteins) are bound to E2F transcription factors to repress expression during early G1. Pocket proteins either prevent activator E2F proteins (such as E2F1, E2F2 and E2F3) to activate transcription or function as co-repressors for repressor E2F proteins (such as E2F4). Phosphorylation of pocket proteins by cyclin D– cyclin-dependent kinase 4 (CDK4) and cyclin D–CDK6 probably releases them from the E2F transcription factors. This induces the transcription of G1–S target gene, including the gene encoding cyclin E. Cyclin E–CDK2 phosphorylates pocket proteins, thereby providing a positive feedback loop. c | Model depicting G1–S transcriptional activation in budding yeast. In early G1, transcription is inhibited by Whi5 binding to the SBF (SCB-binding factor) complex at target promoters. Cln3–Cdk relieves transcriptional inhibition by phosporylating Whi5, which induces its nuclear export and thereby G1–S transcription. Activation of transcription results in the accumulation of Cln1 and Cln2, which in complex with Cdk, further inactivate Whi5 through phosphorylation. This provides positive feedback that results in cell cycle commitment.

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p130

p130 E2F3

E2F2 E2F4

E2F4 E2F5 E2F4 E2F5

E2F1

E2F3 E2F2

E2F1

E2F3 E2F2

E2F1

E2F8 E2F7

E2F6

RB RB

RB

E2F3 E2F2

E2F1

RB RB

RB

Cytoplasmic

Nuclear

Promoters

Transcription Cell cycle

Off On Off Off On

E2F5 RB P

P p130

P p107RB

P

P p130

P p107

p130

E2F5 p107

p130

E2F4 p107

G0 G1–S S–G2 M–G1 G1–S

suggests a model that places the restriction point well before RB phosphorylation and E2F-dependent transcriptiona l activation occur61,62.

DNA replication switch and ordering of cell cycle events. The Cdk inhibitor Sic1 causes a delay between the activa- tion of the transcriptional positive feedback loop and the initiation of DNA replication63,64. In a two-step process, G1 cyclin–Cdk activity is required for Sic1 phosphoryla- tion, which primes Sic1 for subsequent Clb-dependent phosphorylation leading to its degradation65. The mutual inhibition of the S phase cyclins and Sic1 form the basis of an ultrasensitive DNA replication switch that depends on the strong binding affinity of Sic1 for the Clb–Cdk

complex 65. Once activated, the S phase cyclins Clb5 and Clb6 in complex with Cdk phosphorylate Sld2 and Sld3 to initiate the formation of the Sld2–Sld3–Dpb11 complex. This complex mediates the activation of DNA replication66–68.

Cyclin specificity has an important role in ordering cell cycle events18. In particular, the hydrophobic patch on Clb5 binds to RXL motifs, which is important for its specific function in initiating DNA replication69. Similarly, the G1 cyclin Cln2 docks a distinct LP motif, which makes Cln2 highly specific for the transcrip- tional inhibitor Whi5, and Cln3 binds to another, cur- rently unknown motif 70,137. The later B-type cyclin Clb2, although able to initiate replication, lacks the specific

Box 2 | Mammalian cell cycle transcriptional regulation is dependent on E2F and pocket proteins

The E2F family of transcription factors and their dimerization partner proteins act as transcriptional regulators of G1– S transcription.

E2F1, E2F2 and E2F3 These proteins are found in complex with RB during G1121,122. They can be detected at E2F target gene promoters by chromatin immunoprecipitation (ChIP) predominantly during G1-to-S transition, which corresponds with transcriptional induction of G1–S cell cycle genes40,41. As they are E2F targets, E2F1, E2F2 and E2F3 accumulate outside of G1 but are detected, to a significantly lesser extent, in G0 and G1 (see the figure).

E2F4 and E2F5 They are found in complex with p130 in G0 and p107 and p130 in G1 (REFS 40–42,123,124). E2F4 can be detected at E2F target promoters by ChIP predominantly during G0, which corresponds with transcriptional repression, but also during G1 (REFS 40,41). E2F4 is shuttled into the cytoplasm during G1-to-S phase transition when pocket proteins disassociate in response to CDK-dependent phosphorylation43,125. Upon return to interphase, dephosphorylated p107 and p130 associate with E2F4, promoting its transport into the nucleus and binding to target promoters41. Like E2F4, E2F5 is found in complex with p130 (REF. 126) and p107 (REF. 127). The timing at which it binds to target promoters has not been well-established, but it is assumed that binding mirrors that of E2F4 (REF. 39).

E2F6, E2F7 and E2F8 This subset of E2F proteins do not require binding to pocket proteins for its repressor function92,96. E2F6 and E2F7 accumulate during the G1-to-S phase transition and bind to target promoters, which coincides with transcriptional inactivation during S phase (REFS. 89, 98, 99, and C.B. and R.A.M. d-B., unpublished data). The timing of target-promoter binding by E2F8 has not been established, but it is assumed that binding is similar to that of E2F7. E2F8 and E2F7 form homo- and heterodimers to repress transcription88,91,128,129.

RB This protein is found in complex with E2F1, E2F2 and E2F3 in asynchronous cycling cells46. It can be detected by ChIP at target promoters in asynchronous cell cultures and, to a lesser extent, in quiescent cells46. RB accumulates outside of G1.

p107 and p130 These two pocket proteins are found in complex with E2F4 and E2F5 (REFS 35,41,127). p107 accumulates during the G1-to-S phase transition and is detected at target promoters by ChIP during G1 (REF. 41). p130 is predominately detected at target promoters by ChIP in G0 and to a lesser extent in G1 (REFS 40,41). High levels of p130 are detected in G0 and low levels throughout the cell cycle130.

Dimerization partner proteins are omitted for simplicity. Hyperphosphorylation is indicated by ‘P’. Promoter binding for individual E2F family members is only indicated when binding has been established during the cell cycle.

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Nature Reviews | Molecular Cell Biology

Negative feedback loop

Sic1 Cdk

Cln1/2 Cdk

Clb5/6

b Mammals

c Budding yeast

SBF

SBF

CLN1, CLN2

Cyclin E, Cyclin A E2F6–8

p27

MBF MBF

E2F6–8

E2F6–8

NRM1 CLB5, CLB6

Nrm1 Nrm1

E2F1–3

CDK2 Cyclin E

CDK2 Cyclin A E2F1–3

P

P

SG1

G e

n e

e xp

re ss

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a

G1–S transcription

docking ability of earlier cyclins. Rather, Clb2 is char- acterized by a higher intrinsic kinase activity 71. Thus, earlier cyclins have weaker intrinsic activity but this is compensated by specific binding motifs, whereas the later mitotic cyclin Clb2 are characterized by a higher intrinsic activity. This yields an updated quantitative model of Cdk activity that progressively targets an increasing number of substrates through a ‘hand-off ’ from specificity to higher intrinsic activity70,72. Moreover, recent work has demonstrated that a range of complex signal processing functions can be performed by combi- natorial multi-site phosphorylatio n events on individual Cdk substrates65.

Negative feedback turns off transcription Upon G1–S transcriptional activation, cells progress to S phase, initiate DNA replication and subsequently inactivate transcription. It has become increasingly clear that the mechanism of G1–S transcriptional inactivation in both yeast and mammals involves negative feedback loops (FIG. 2). Several feedback mechanisms target the transcriptional activators that drive the G1-to-S phase transition for inactivation. Moreover, recent work shows that the accumulation of transcriptional repressors dur- ing S phase also has an important role in turning off transcription (FIG. 2a).

Inactivation of transcriptional activators. In S. cerevisiae, transcriptional inactivation of SBF targets upon exit from G1 requires the activity of the mitotic cycli n Clb in complex with Cdk1 (also known as Cdc28), which leads to dissociation of SBF from promoters73–76. Clb is initially inhibited during late G1 by the Cdk inhibitor Sic1 (FIG. 2c). The genes encoding G1 cyclins, CLN1 and CLN2, and the Clb cyclins, CLB5 and CLB6, are G1–S target genes, the protein products of which participate in the destruction of Sic1 and the activation of B-type cyclin activity 77. Thus, the regulation of Cln and Clb levels by G1–S transcription forms a negative feed- back loop through which SBF participates in its own inactivation.

As in yeast, inactivation of G1–S transcription in mammals involves multiple negative feedback loops (FIG. 2b). Similarly to the CDK-dependent inactivation of the transcriptional activator SBF, CDK activity has been proposed to inactivate E2F-mediated transcrip- tion during S phase in mammalian cells. This hypo- thesis was based on the observation that E2F1 is bound and phosphorylated by cyclin A–CDK2 both in vitro and in vivo, and that this promotes the dissociation of E2F1 from DNA and the inactivation of E2F1 target genes78–80. Because the gene encoding cyclin A is itself an E2F target, this constitutes a negative feedback loop. Furthermore, the activity of cyclin A–CDK2 is inhib- ited by the CDK inhibitor p27, which is targeted for degradation by c yclin E–CDK2 and cyclin A–CDK2; the genes encoding cyclin E and c yclin A are both tar- gets of E2F proteins, thus contributing to the negative feedback loop81,82. In addition, the ubiquitin ligase regu- latory SCF (S phase kinase-associated protein 2 (SKP2)– culli n 1–F-box protein) complex has been proposed to

regulate the stability of E2F1 during S phase and G2 (REFS 83–85). As the SCF regulatory subunit SKP2 is encoded by an E2F target gene, this also represents a negative feedback loop.

Figure 2 | G1−S transcriptional repression. a | Inactivation of E2F-dependent cell cycle transcription involves multiple negative feedback mechanisms. b | In mammalian cells, G1 cyclin–cyclin-dependent kinase (CDK) (cyclin E–CDK2) together with S phase cyclin–CDK (cyclin A–CDK2) targets the S phase cyclin-specific inhibitor p27 for degradation. The subsequent increase in CDK2 activity results in phosphorylation and release of the activator E2F1, E2F2 and E2F3 transcription factors from gene promoters, thus inactivating transcription. In addition, the E2F targets E2F6, E2F7 and E2F8 accumulate when cells progress to S phase, and they repress transcription when bound to target promoters. The negative feedback mechanism involving the E2F target S phase kinase-associated protein 2 (SKP2), which has a role in targeting E2F1 for degradation via the SCF (SKP2–cullin 1–F-box protein) ubiquitin ligase pathway, has been omitted for simplicity. c | Activation of G1–S transcription in budding yeast results in the accumulation of ~300 gene products, including Nrm1, Cln1, Cln2, Clb5 and Clb6. Some of these proteins are directly or indirectly involved in turning off transcription, thereby forming a negative feedback loop. Cln1–Cdk and Cln2–Cdk prime the Clb–Cdk-specific inhibitor Sic1 for Clb-Cdk phosphorylation, which targets it for degradation (not shown). Clb–Cdk-dependent phosphorylation of SBF (SCB-binding factor) components releases SBF from promoters, and this leads to the inactivation of transcription. MBF (MCB-binding factor)-dependent transcription is inactivated through binding of the MBF-associated co-repressor Nrm1.

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Nrm1 and Yox1 Nrm1 in budding yeast and Nrm1 and Yox1 in fission yeast bind MBF (MCB-binding factor) to inhibit transcription once cells transit into S phase.

Inactivation by transcriptional repression. The mecha- nism of inactivation of MBF-dependent transcription is different from that of SBF-dependent transcriptional inactivation and involves a negative feedback loop based on co-repressors. MBF functions as a cell cycle trans- criptional repressor in a similar way to the mammalian E2F4, E2F5, E2F6, E2F7 and E2F8. It most closely resem- bles E2F4 and E2F5, which repress transcription with co-repressor pocket proteins. However, repressor E2F proteins only bind to promoters during specific phases of the cell cycle, whereas MBF is bound to promoters during the entire cell cycle. Temporally confining MBF activity so that transcription is switched on during G1 and switched off in S phase depends on the co-repressor proteins Nrm1 in S. cerevisiae and Nrm1 and Yox1 in the fission yeast Schizosaccharomyces pombe. Because they are both MBF targets, these proteins are involved in a negative feedback loop49,86 (FIG. 2c). Nrm1 is expressed at low levels during early G1, and it is a target of the APC/C (anaphase- promoting complex; also known as the cyclosome) and is degraded at mitotic exit49,87. Thus, co-repressor s accu- mulate progressively once MBF-regulated gene transcrip- tion is activated, leading to binding of the co-repressors to promoter-bound MBF and concomitant repression of G1–S transcription during S phase. Although Nrm1 and Yox1 seem to have a similar function as pocket proteins in mammalian cells, they actually differ in their ability to repress transcription: whereas Nrm1 and Yox1 func- tion as transcriptional co-repressors during S phase, mammalian pocket proteins do not seem to be involved in turnin g off transcription during S phase when Cdk activit y is high.

Finally, additional negative feedback loops that lead to transcriptional repression dependent on E2F6, E2F7 or E2F8, or a combination of these repressors, have been proposed88,89 (FIG. 2b). The genes encoding these E2F pro- teins are themselves E2F targets and accumulate during the G1-to-S transition90,91. E2F6, E2F7 and E2F8 do not require pocket proteins for their repressor activity88,92–96. As a result, they should be able to repress transcription during S phase and the latter part of the cell cycle when pocket proteins are inhibited by Cdk activity97. Consistent with this view, E2F6 was recently found to repress G1–S transcription in late S phase98 (FIG. 2b). E2F6 accumulates when cells progress to S phase and inactivates transcrip- tion in a timely manner by replacing activator E2F pro- teins at target promoters. Although deletion of E2F6 alone does not affect G1–S transcription in mouse embryonic fibroblasts (MEFs)99, it was shown that, in the absence of E2F6, E2F4 binds to promoters normally bound by E2F6 during S phase, suggesting a compensatory role. Accordingly, depletion of E2F4 in E2F6-knockout MEFs leads to derepression of G1–S genes during S phase. Moreover, E2F7 and E2F8 are likely to be involved in transcriptional inactivation, given that deletion of both E2F7 and E2F8 in MEFs and overexpression of E2F7 in HeLa cells causes activation and inhibition, respectively, of some E2F target genes characteristic of G1-to-S phase transistion88,89. Overall, it seems likely that negative feed- back through atypical repressor E2F proteins is required to turn off G1–S transcription.

Subgroups within G1–S transcripts Single-gene studies in the 1980’s identified subsets of genes differentially regulated during the cell cycle and high- throughput microarray data in the late 1990’s revealed the full extent of cell cycle-dependent gene expression15,100. These and subsequent studies have revealed subgroups of genes, the function and expression timing of which may be correlated.

Subgroups based on function. In S. cerevisiae, over 200 G1–S genes depend on the transcriptional activator SBF and/or the transcriptional repressor MBF. A large body of research has revealed that most of these genes can be grouped into SBF-, MBF-, SBF- and MBF-regulated and ‘switch’ genes (which are regulated by both SBF and MBF at different times during the cell cycle)51,100,101.

Genes that are under the control of either SBF or MBF can also loosely be classified on the basis of their func- tion. Genes involved in driving cell cycle progression, such as the G1 cyclins CLN1 and CLN2, are more likely to be regulated by SBF, whereas MBF-targets are enriched for genes involved in DNA replication, DNA repair and other essential genes.

Controlling essential genes that do not dictate cell cycle timing with a transcriptional repressor such as MBF may constitute a selective advantage in case of MBF absence, as the removal of MBF at any specific promoter results in derepression of those genes rather than lack of expression. Conversely, constitutive derepression of genes involved in cell cycle timing may cause uncontrolled cell proliferation and would be ‘safer’ under the control an activator such as SBF. In addition, the finding that MBF-dependent genes seem to be involved in DNA replication may be a conse- quence of the transcriptional activation of MBF- but not SBF-dependent genes during replication stress101–103. A detailed description of how MBF-dependent transcription is regulated in response to replication stress is discussed below. Recently, another subgroup of genes regulated by an SBF-to-MBF switch during G1-to-S phase transition was identified103. Interestingly, these switch genes are enriched for G1–S genes that cause a cell cycle progression defect when overexpressed but are upregulated in response to replication stress. The dependency of switch genes on SBF during G1 and MBF outside of G1 prevents them from being constitutively expressed in the event of MBF mal- function, yet renders them responsive to replication stress. Interestingly, whereas only a small number of G1–S targets are regulated by the SBF-to-MBF switch in S. cerevisiae, E2F switching at G1–S target promoters in mammalian cells seems to be the norm. Overall, the use of two distinc t transcription factors allows budding yeast to imple- ment combinatorial control of its G1–S transcriptiona l programm e in response to replication stress.

Subgroups based on timing. There is great variation in the expression timing of G1–S genes56. Genes that encode pro- teins involved in the positive feedback loop, such as those encoding G1 cyclins, are activated before other SBF, MBF and E2F target genes. This results in the decision to divide, which is coincident with the transcriptional activation of positive feedback elements, preceding a genome-wide

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change in transcription. In other words, the decision to enter a new cell cycle precedes the activation of the genome-wide change in transcription despite the fact that target genes of both processes are regulated by the same transcription factors. In addition, the yeast co-repressor Nrm1, which is involved in a negative feedbac k, is one of the latest genes to be activated.

The importance of ‘positive feedback first’ and ‘nega- tive feedback last’ was demonstrated when placing CLN2 under control of the NRM1 promoter, which resulted in uncoordinated cell cycle commitment and cell death. Thus, the timing of gene activation involved in feedback regulation to temporally confine G1–S transcription follows a logical order, starting with the robust activa- tion of transcription (dependent on the upregulation of CLN1 and CLN2) in G1 which is finally turned off during S phase (dependent on the upregulation of NRM1). The establishment of this order is not clearly linked to the spe- cific transcription factors that control gene activation and requires further investigation.

Positive feedback first regulation is the most robust feature of transcriptional timing. Even though the timin g of expression of nearly all G1–S genes significantly changes when cell cycle synchrony is established by arresting cells either in G1 phase or mitosis, G1 cyclins that affect positive feedback first regulation are among the earliest activated genes in both cases of cell cycle arrest56. The temporal subdivision into blocks of genes across the cell cycle revealed that when cells enter the cell cycle from mitosis, SBF targets are activated before MBF targets. Conversely, when cells re-enter the cell cycle from G1, the order is reversed and MBF targets are activated before SBF target s. Interestingly, genes that encode proteins involved in the positive feedback loop are likely to be under the control of both the SBF and MBF transcription factors. The dually regulated SBF and MBF targets are activated by either of these two factors (the first one activated), which

ensures these genes are activated early in the cell cycle. Thus, for the genes that can be activated by either SBF or MBF, the induction of either factor is sufficient to initiate transcription and functions as a logical ‘or’ gate, whereby SBF ‘or’ MBF will activate transcription irrespective of the previous cell cycle. This reveals an important mechanistic aspect of transcription al activation.

G1–S transcript subgroups in mammalian cells. As in yeast, the activation timing of individual genes within the G1–S wave of transcription varies greatly in mammalian cells with positive feedback-associated genes being acti- vated first16,56. This suggests that the positive feedback first principle is conserved in eukaryotes. By contrast, cell cycle-dependent transcriptional regulation of specific targe t genes is very poorly conserved across eukaryotes104.

Similarly to SBF and MBF regulating distinct sets of genes in S. cerevisiae, distinct E2F proteins and pocket proteins, perhaps interacting with other co-regulators, might bind to specific promoters to define subgroups. Consistent with this model, many studies suggest that in addition to largely overlapping targets, individual members of the E2F family may display different DNA sequence specificities105,106. However, single-gene analyses indicate similar temporal sequences of E2F and pocket protein binding to the examined genes. It will be interest- ing to see whether and how the composition of E2F target subgroups emerges.

G1–S transcription and genome stability When cells become committed to a division cycle, they ini- tiate DNA replication and progress to S phase. Such cells rely on two DNA structure checkpoints (BOX 3) — the DNA damage checkpoint and the DNA replication checkpoint — to protect themselves from irreversible DNA damage. These checkpoints delay mitotic entry and initiate a spe- cific transcriptional programme. The importance of DNA

Box 3 | The DNA structure checkpoints

To properly replicate the genome and prevent tumorigenesis, cells rely on the DNA structure checkpoints, an evolutionarily conserved set of signalling pathways that monitor DNA damage and the loss of DNA replication fork integrity. These checkpoints delay mitotic entry and initiate a specific transcriptional programme. The signalling pathways involved rely on evolutionarily conserved protein kinases, including the sensor molecules that detect damage or replication stress, that in turn activate transducer proteins that relay the signal to downstream effector proteins required to initiate the full response. DNA structure checkpoints are mediated via the ATM (ataxia-telangiectasia mutated) and ATR (ataxia-telangiec- tasia and Rad3-related protein) protein kinases and their downstream targets checkpoint kinase 1 (CHK1) and/ or CHK2. The nature of the DNA structure triggering the checkpoint response determines the activity of downstream effector kinases: CHK1 is activated by replication fork arrest during S phase, whereas CHK2 is activated by damaged DNA detected during interphase19–21,107,131,132. On this basis, the DNA structure checkpoint can be divided into the DNA replication checkpoint and the DNA damage checkpoint. The DNA replication checkpoint is essential to prevent DNA damage in response to replication stress during S phase, whereas the DNA damage checkpoint is required to detect and resolve DNA damage during interphase131,133. Both checkpoint signalling cascades arrest cell cycle progression, mostly through the regulation of key regulators of cyclin–cyclin-dependent kinase (CDK) activity, such as the phosphatase CDC25 and the CDK inhibitor p21 (REFS 21,131,132,134). CDC25 removes inhibitory phosphorylation from CDK1 and CDK2 to promote CDK activity and therefore mitotic entry. When the checkpoint is engaged, CDC25 becomes phosphorylated and is subsequently degraded to prevent progression through mitosis. Cell cycle arrest ensures that DNA damage can be avoided or that the detected damage can be repaired before division to limit heritable mutation. Although both checkpoints delay progression of mitosis through largely overlapping mechanisms, they induce distinct responses to specific stresses. Two other important checkpoint responses are the transcriptional response and the initiation of programmed cell death when the damage cannot be resolved. The transcriptional response differs between the replication and damage checkpoints, as, for instance, G1–S transcription is only regulated by the replication checkpoint. Programmed cell death is of particular importance in multicellular organisms and is predominately associated with the DNA damage checkpoint response21.

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Nature Reviews | Molecular Cell Biology

MBF MBF

Nrm1 P

Yox1 P

Nrm1 P

E2F1–3

E2F6

CHK1Rad53Cds1

ATRMec1Rad3

P

Fission yeast Budding yeast Humans

Tr an

sc ri

p ti

o n

al re

sp o

n se

D N

A r

e p

lic at

io n

, ch

e ck

p o

in t

si g

n al

lin g

Checkpoint protein kinases

G1–S transcriptional repressors

G1–S transcription factors

DNA replication stress

checkpoint signalling is illustrated by the conservation of the subfamily of checkpoint protei n kinases (TABLE 1).

DNA replication checkpoint. In this Review, we focus on DNA replication checkpoint signalling because recent work has linked this pathway to G1–S transcription. DNA replication stress is defined as inefficient DNA replica- tion that causes DNA replication forks to progress slowly or stall. The DNA replication checkpoint prevents the accumulation of DNA damage as a result of replication stress by stabilizing stalled replication forks, preventing late origin s from firing and enabling replicatio n to resume once the stress has been resolved107.

During DNA replication, cells are particularly vulner- able to genomic instability, as replication forks are prone to stall and collapse when encountering replication blocks or damaged DNA templates. The DNA replica- tion checkpoint transcriptional response probably main- tains G1–S transcription in order to prevent genomic instabilit y98,101,102,108 (FIG. 3).

The replication checkpoint induces G1–S transcription. In both fission and budding yeast, genes that are activated during G1 and that depend on MBF to be inactivated out- side of G1 are induced in response to DNA replication stress11,103,109. Activation of these MBF-responsive genes results from checkpoint signalling-dependent inhibition of the negative feedback loop that turns off G1–S tran- scription during G1-to-S phase transition. The check- point effector kinases Rad53 and Cds1 directly target and inhibit the main G1–S transcriptional co-repressor Nrm1 in buddin g yeast and Nrm1 and Yox1 in fission yeast101,102,110–114 (FIG.  3). Upon phosphorylation, these repressors are no longer able to bind MBF, allowing for continuous expression of MBF-regulated genes.

Maintenance of MBF-regulated gene expression is important for cell survival in response to replication stress because many MBF-targets function in replication, DNA repair and nucleotide synthesis. Consequently, the deletion of Nrm1 and/or Yox1 in fission yeast improves the survival of mutants defective in the DNA replication checkpoint in response to replication stress and, con- versely, overexpression of stabilized Nrm1 in budding yeast increases sensitivity to replication stress.

Conservation of the checkpoint transcriptional response. Similarly to the induction of MBF targets by replication stress in yeast, E2F-dependent transcription is induced in mammals by a closely related mechanism98 (FIG. 3). In response to replication stress, checkpoint kinase 1 (CHK1) phosphorylates and inhibits E2F6, which is responsible for inactivating G1–S transcription during the mitotic cell cycle. Inactivation of E2F6 leads to its release from promoters and allows G1–S transcription to persist. The ability of cells to activate G1–S transcription is cru- cial for survival upon hydroxyurea treatment, probably because E2F targets include proteins that prevent replica- tion fork collapse and DNA damage. This transcriptional response seems to be specific for replication stress, which, in contrast to the DNA damage response, does not induce apoptosis. Interestingly, the DNA damage response can induce pro-apoptotic E2F1 targets115–120. However, these targets are distinct from those normally regulated by E2F1 during the mitotic cell cycle. Despite a distinct lack of conservation of the proteins affecting this regulation, the conservation of the transcriptional response to replica- tion stress underscores the conservation of G1–S control systems-level features across eukaryotes.

Conclusion and perspective In this Review, we emphasized recent work uncovering simple yet elegant mechanisms of gene expression con- trol during G1 and S phases that regulate commitment to cell division, temporally confine G1–S transcription and respond to replication stress. This work has revealed many new insights into how transcription of different G1–S cell cycle genes is restricted to G1 and how this is regulated by DNA replication checkpoint protein kinases as part of the checkpoint transcriptional response. Despite frequent lack of sequence homology, conservation of systems-level properties across eukaryotes is an emerging theme of cell cycle control. Indeed, the conserved regulation of G1–S transcripts by the replication checkpoint suggests a central role for this transcriptional wave in the maintenance of genome stability.

Genome-wide transcriptional changes are a general feature of cellular transitions. Our knowledge of the tran- scriptional regulation of the G1-to-S phase transition may be widely applicable to the study of other such transitions. Resulting from decades of concerted effort, our deep understanding of the G1-to-S phase transition provides a blueprint for future research to investigate fundamen- tal regulatory mechanisms controlling cellular decision- making processes, dynamic changes in gene expression during cellular transitions and context-specific rewiring of transcriptional networks.

Figure 3 | G1−S phase transcription and genome stability. The mechanism by which the DNA replication checkpoint maintains high levels of G1−S transcription in response to replication stress is conserved from yeast to humans. This mechanism involves the inactivation of a transcriptional repressors and/or co-repressors (Nrm1 and Yox1 in yeast and E2F6 in human cells) involved in an autoregulatory negative feedback loop. The downstream effector checkpoint protein kinase (Cds1 in fission yeast, Rad53 in budding yeast and checkpoint kinase 1 (CHK1) in mammals) inactivates the transcriptional repressors Nrm1, Yox1 and E2F6 through phosphorylation to maintain high levels of G1−S transcription. The DNA replication checkpoint protein kinases are conserved from yeast to humans, but the G1–S transcriptional repressors and transcriptional activators are not. MBF, MCB-binding factor.

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109. Gomez-Escoda, B. et al. Yox1 links MBF-dependent transcription to completion of DNA synthesis. EMBO Rep. 12, 84–89 (2011).

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111. de Bruin, R. A. et al. DNA replication checkpoint promotes G1–S transcription by inactivating the MBF repressor Nrm1. Proc. Natl Acad. Sci. USA 105, 11230–11235 (2008). Establishes, together with reference 98, the mechanism of how the DNA replication checkpoint co-opts the cell cycle transcriptional programme to respond to replication stress in fission yeast and in human cells.

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Acknowledgements C.B and R.A.M de Bruin were funded by the Medical Research Council (MRC). J.M.S. was funded by the National Institutes of Health (NIH) (GM092925) and the Burroughs Wellcome Fund. The authors thank A. Johnson and C. Schwarz for care- ful reading of the manuscript. They apologize to colleagues whose work could only be cited indirectly.

Competing interests statement The authors declare no competing financial interests.

FURTHER INFORMATION Jan M. Skotheim’s homepage: http://skotheimlab.com Robertus A. M. de Bruin’s homepage: http://www.ucl.ac.uk/ lmcb/research-group/rob-de-bruin-research-group

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  • Abstract | The accurate transition from G1 phase of the cell cycle to S phase is crucial for the control of eukaryotic cell proliferation, and its misregulation promotes oncogenesis. During G1 phase, growth-dependent cyclin-dependent kinase (CDK) activity
  • Activation of G1–S transcription
  • Box 1 | Cell cycle-regulated transcription during the G1 and S phases
  • Table 1 | Conservation of cell cycle regulatory proteins*
  • Figure 1 | G1−S transcriptional activation. a | Schematic showing how the G1–S transcriptional programme, once initiated, is reinforced by a positive feedback loop. b | In mammalian cells, the transcriptional repressors RB, p107 and p130 (collectively kno
  • Box 2 | Mammalian cell cycle transcriptional regulation is dependent on E2F and pocket proteins
  • Negative feedback turns off transcription
  • Figure 2 | G1−S transcriptional repression. a | Inactivation of E2F‑dependent cell cycle transcription involves multiple negative feedback mechanisms. b | In mammalian cells, G1 cyclin–cyclin-dependent kinase (CDK) (cyclin E–CDK2) together with S phase cy
  • Subgroups within G1–S transcripts
  • G1–S transcription and genome stability
  • Box 3 | The DNA structure checkpoints
  • Figure 3 | G1−S phase transcription and genome stability. The mechanism by which the DNA replication checkpoint maintains high levels of G1−S transcription in response to replication stress is conserved from yeast to humans. This mechanism involves the in
  • Conclusion and perspective

Embryonic Stem Cells.pdf

Department of Medicine and Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA. *These authors contributed equally to this work. Correspondence to C.M.V. e-mail: [email protected] doi:10.1038/nrm1713 Published online 15th August 2005

PLURIPOTENT The ability to give rise to all embryonic tissues, but not extra-embryonic tissues. Totipotent cells can give rise to all embryonic and extra- embryonic (trophectodermal) tissues.

INNER CELL MASS A mass of pluripotent cells in the interior of the developing blastocyst that give rise to all embryonic tissues. The blastocyst is part of the pre- implantation-stage embryo and consists of a hollow sphere of cells with a distinct outer trophectoderm layer and an inner cell mass.

THE MOLECULAR REPERTOIRE OF THE ‘ALMIGHTY’ STEM CELL Craig E. Eckfeldt*, Eric M. Mendenhall* and Catherine M. Verfaillie

Abstract | Stem cells share the defining characteristics of self-renewal, which maintains or expands the stem-cell pool, and multi-lineage differentiation, which generates and regenerates tissues. Stem-cell self-renewal and differentiation are influenced by the convergence of intrinsic cellular signals and extrinsic microenvironmental cues from the surrounding stem-cell niche, but the specific signals involved are poorly understood. Recently, several studies have sought to identify the genetic mechanisms that underlie the stem-cell phenotype. Such a molecular road map of stem-cell function should lead to an understanding of the true potential of stem cells.

Multicellular organisms such as humans develop from PLURIPOTENT stem cells that are present in the INNER CELL MASS (ICM) of the blastocyst and that generate the tril- lions of mature cells that make up the adult individual. Such pluripotent stem cells can not only divide to give rise to daughter pluripotent stem cells — so called self-renewing cell divisions — but they can also dif- ferentiate to give rise to all the cells of the mesoderm, endoderm and ectoderm as well as germ cells (FIG. 1). During development, pluripotent stem cells from the ICM become increasingly restricted in their lineage potential and generate tissue-specific, MULTIPOTENT stem cells. These multipotent stem cells give rise to progeny that comprise specific, mature tissue. Although this hierarchical archetypal model of stem-cell biology is generally the rule, recent reports have described the persistence of stem cells with less lineage-restricted differentiation potential into post-natal life1 BOX 1.

When isolated from the blastocyst in vitro, the pluripotent stem cells of the ICM can be maintained in culture as embryonic stem cell (ESC) lines. Murine (m)ESCs were first isolated in 1981 REF. 2 and are the most extensively characterized pluripotent cell type, and human (h)ESCs were isolated and characterized in the late 1990s3. Primordial germ cells (PGCs), which are derived from the GENITAL RIDGE of early embryos, are another type of pluripotent cell4. There are also ESC lines that have been derived from chicken and rhesus

monkey5,6, however, in this review we will focus on the pluripotent ESCs from mouse and human.

The self-renewal and multi-lineage differentiation characteristics of stem cells from embryonic and most adult sources make these cells uniquely suited for regenerative medicine, tissue repair and gene therapy applications. An increasing number of in vitro and in vivo studies have shown that stem cells can reca- pitulate embryonic and adult tissue development, and can therefore repair injured or congenitally defective tissues. However, the mechanisms that govern the self- renewal and multi-lineage differentiation potential of stem cells remain largely unknown. Although stem- cell fate decisions might have a stochastic component7, increasing evidence indicates that extrinsic signals from the stem-cell microenvironment, or niche, can con- verge on intrinsic cellular signals to regulate stem-cell proliferation and cell-fate decisions. Various molecu- lar techniques have been used to reveal the molecular regulation of stem-cell fate decisions BOX 2.

It has been postulated that, although each unique stem cell can be characterized by the expression of a specific set of genes, the defining self-renewal and multi-lineage differentiation characteristics of stem cells are encoded by a shared set of genes that are expressed by all distinct stem-cell populations, and that therefore represents a conserved stem-cell molec- ular signature8–10. Several studies have examined the

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d))

MULTIPOTENT The ability to give rise to the diverse cell types of one or a few tissues.

GENITAL RIDGE The bilateral structures in the developing embryo that give rise to the gonads.

TRANSCRIPTOME The entire transcriptional repertoire of a cell or cell population.

gene-expression pattern of both embryonic and adult stem-cell populations. Although these analyses have provided some insights into the genetic mechanisms that are responsible for the stem-cell phenotype, there are inconsistencies in the resultant lists of ‘stemness’ genes. So far, it is not known whether these inconsist- encies are due to technical disparities, or whether these results signify that ‘stemness’ is not defined by a unique set of genes. In this review, we focus on the molecu- lar signature of embryonic and adult stem cells and their microenvironmental niches as a means of better understanding the stem-cell phenotype. We explain how these datasets can be used to further unravel the molecular regulation of stem cells, which will be required to exploit their full therapeutic potential.

Molecular signature of embryonic stem cells Transcription profiling has revealed that most dif- ferentiated cell types express only 10–20% of their genes, consisting of a mix of ubiquitous housekeep- ing genes and tissue-specific genes11. By contrast, 30–60% of genes are expressed in ESCs11–14. These data might be consistent with the theory of stem-cell ‘priming’ — the hypothesis that stem cells express many different lineage-specific genes at low levels15–18. There is evidence to indicate that much of the chromatin of embryonic and adult stem cells is in an open, accessible state, which might allow the promiscuous expression of lineage-specific genes, and that epigenetic modifications of chromatin structure and/or methylation of DNA leads to a more restricted gene-expression pattern concomitant with lineage differentiation19. It is possible that such low- level transcription enables the rapid regulation of genes that is required for differentiation during development or following injury, by maintaining a transcriptionally permissive chromatin structure.

Furthermore, the low-level expression of multiple lineage-specific surface receptors in stem cells might allow the cell to detect a wide range of extracellular sig- nals to respond to complex microenvironmental cues. However, for many lineage-specific transcripts found in stem cells, no corresponding protein can be detected, which indicates that gene expression is either post- transcriptionally repressed or that transcript levels do not reach a critical threshold until the cell receives intrinsic and/or extrinsic cues to differentiate. Therefore, the theory that low-level transcription allows the cells to sample the microenvironment might not be correct.

Murine embryonic stem cells. Several studies have evaluated the TRANSCRIPTOME of mESC lines. Most of these have compared the gene-expression profiles of single mESC lines with that of adult stem cells, mature differentiated cells and TROPHECTODERM. For instance, comparison of the mESC line CCE with adult haemat- opoietic stem cells (HSCs), neural stem cells (NSCs) and mature blood cells identified several transcripts, including the HOMEODOMAIN TRANSCRIPTION FACTOR Oct4 (also known as Pou5F1 or Oct3/4)8, that were enriched in mESCs, whereas a study that compared the gene- expression profiles of the mESC line R1 with trophec- toderm and fibroblasts identified 124 ESC-enriched genes, which also included Oct4 REF. 20. A large scale EST SEQUENCING project that analysed 19 different tissues including early mouse embryos, mESCs, newborn organs and adult stem-cell populations identified 75 genes that were expressed specifically by mESCs21.

Oct4 and another homeodomain transcription factor, Nanog, are among the functionally characterized genes that are crucial to the mESC molecular signature22–24. In the absence of Oct4, mESCs TRANSDIFFERENTIATE into tro- phectodermal cells22, whereas loss of Nanog results in an increase in extra-embryonic endodermal transcripts24. Overexpression of Nanog allows mESC growth in the absence of leukaemia inhibitory factor (LIF)23 — a factor that is required for the maintenance of mESC lines — whereas overexpression of Oct4 induces the

Figure 1 | The stem-cell hierarchy. The totipotent zygote formed by the fusion of egg and sperm divides to form the inner cell mass (ICM) and the extra-embryonic (EE) tissue of the blastocyst. When isolated from the blastocyst in vitro, the cells of the ICM can be maintained in culture as pluripotent embryonic stem cell (ESC) lines. During the development of the embryo, the pluripotent stem cells in the ICM become increasingly restricted in their lineage potential and generate tissue-specific, multipotent stem cells. These include epidermal stem cells (bulge cells) that form skin and hair, haematopoietic stem cells in the bone marrow that give rise to all haematopoietic cells, neural stem cells in the subventricular zone of the brain, gastrointestinal stem cells that are located in the crypt of the small intestine, oval cells that give rise to liver (not shown), and mesenchymal stem cells that reside in the bone marrow and can form bone, stromal cells and adipocytes (not shown)88,115.

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TROPHECTODERM The outer portion of the blastocyst that gives rise to the embryonic portion of the placenta.

HOMEODOMAIN TRANSCRIPTION FACTOR A transcription factor that contains a homeodomain DNA- binding domain.

EST SEQUENCING The sequencing of short segments of expressed genes (expressed sequence tags or ESTs) present in cDNA libraries that can be used for gene cloning or to show which genes are present in a cell population.

TRANSDIFFERENTIATE Differentiation of one cell type directly to another cell type without dedifferentiation to a more primitive intermediate.

STEMCELL PLASTICITY The apparent ability of a stem/ progenitor cell fated to a particular tissue to acquire a differentiated phenotype of a different tissue.

differentiation of mESCs into endoderm and meso- derm. Nanog, Oct4 and LIF-mediated JAK–STAT3 activation therefore represent independent pathways that maintain mESC pluripotency and self renewal25. Mitsui et al. performed an IN SILICO DIFFERENTIAL DISPLAY and identified 20 genes that were specifically expressed in mESCs and in mouse pre-implantation embryos24. These included Oct4 and Nanog; as well as zinc finger protein-42 (Zfp42, also known as Rex1), the transcrip- tion factor Utf1, the constitutively active Ras protein ES- cell-expressed Ras (Eras), and the growth factor Tdgf1 (also known as Cripto); all these genes were previously known to be important for ESC self-renewal24. When OCT4 is found in a complex with the transcription fac- tor SOX2, it upregulates its own expression as well as the expression of Fgf4, Zfp42 REFS 24,26 and Nanog (S. Yamanaka, personal communication), which identi- fies Oct4 as a key regulator of ESC genes (reviewed in REFS 26,27). The downstream targets of Nanog and Zfp42 have yet to be reported. Importantly, none of the genes mentioned above were identified through global gene- expression profiling. Instead, most were identified as downstream targets of Oct4. Ongoing studies are now using candidate-gene approaches to evaluate the role of these and other genes and pathways that are involved in the maintenance, cell signalling, metabolism and cell cycle of ESCs25.

Human embryonic stem cells. Several studies have compared the transcriptome of hESC lines with differ- ent populations of more mature cells and mESCs12,13,28. In the most extensive study, the transcriptomes of six different hESC lines were compared with universal RNA29. This study identified 92 genes that showed increased levels of expression in all 6 hESC lines, including OCT4, NANOG and TDGF1. Only 15 of the 92 genes were classified as ‘unknown’, which is much less than other studies12,13,28, perhaps owing to an under-representation of unknown genes on the arrays used. By comparing the gene-expression profile of three independent hESC lines, Abeyta et al. found that 52% of all genes examined were expressed in all three cell lines11. Most of these 7,385 genes are ubiquitously expressed, but tissue-specific genes that have been implicated in stem-cell self-renewal and pluripotency, such as OCT4, SOX2 and TDGF1, were also expressed in all three hESC lines11. A comparison of all the gene- expression profiles of hESC lines described so far iden- tify LIN28, OCT4, NANOG, DNMT3B, TGIF, TDGF1, CHEK2, GDF3, GJA1 and FLJ21837 among others, as being expressed in all these lines11,13,14,28–30.

Cross-species embryonic stem-cell comparisons. Although human and mouse ESCs show many simi- larities, these two cell types also have several differ- ences. For instance, both hESCs and mESCs are typically cultured in the presence of mouse embryonic fibroblasts (MEFs), but hESCs, unlike mESCs, do not require exogenous LIF-mediated JAK–STAT3 activa- tion to maintain their pluripotency in culture, although STAT3 might be activated by other means in hESCs25,27. Maintenance of the pluripotent state of mESC lines also requires bone morphogenetic protein-4 (BMP4)31; by contrast, BMP4 induces trophoblast differentiation in hESCs32. Unlike mESCs, hESCs can be maintained MEF-free using fibroblast growth factor-2 (FGF2)33. This indicates that some of the important signal path- ways that are required for pluripotency differ between human and mouse ESCs. These differences might explain the discordance between human and mouse ESC expression profiles — comparisons of several important studies show that only 13–55% of transcripts that are enriched in mESC lines are also enriched in hESC lines but, by contrast, comparisons between different hESC lines are 85–99% concordant11,12,25,29. Furthermore, some mESC-enriched transcripts are not expressed in all of the hESC lines examined by expression profiling so far, despite being implicated in self-renewal and pluripotency. For example, ZFP42 is not expressed in the hESC line HES4, STAT3 is not expressed in H9 cells, and SOX2 and ESG1 are not expressed in other hESC lines analysed in these experi- ments11,29. Therefore, the expression of Zfp42, Oct4 and Sox2, which form a transcriptional feedback loop, is upregulated in mESCs, whereas only OCT4 is consist- ently expressed in hESCs. This might indicate that, in hESCs, OCT4 does not require the presence of SOX2 to activate transcription. Therefore, the differences in gene expression that have been noted between mESCs

Box 1 | Adult stem-cell plasticity*

Adult stem cells are thought to be multipotent, but not pluripotent like embryonic stem cells (ESCs). However, in the past few years, more than 300 reports have indicated that adult stem cells might possess developmental capabilities that resemble those of more immature, pluripotent cells, similar to ESCs.

The main criticism regarding the claims of adult STEMCELL PLASTICITY is that most studies that describe such plasticity do not fulfill the criteria commonly used to describe stem cells: For instance, most studies published so far have not definitively proved that the greater potency of adult stem cells can be ascribed to a single cell that can differentiate into the tissue of origin and one or more additional tissues. Furthermore, most studies have equated differentiation with the acquisition of morphological and phenotypic characteristics of a novel cell type, but have not proven the functionality of the resulting cells. Similarly, few, if any, studies have shown that the adult stem cell can robustly repopulate not only the tissue from which it originates but also another tissue.

There are four plausible explanations for the observed plasticity of adult stem cells: • The apparent differentiation of an adult stem cell to a cell lineage other than the

tissue of origin could be due to contamination of the population by a stem cell or progenitor cell from the second tissue of origin.

• Fusion between donor and recipient cells, as occurs in heterokaryons, with silencing of the genetic programme of one of the two cells. There is evidence that fusion can occur in vitro and in vivo.

• Stem cells might dedifferentiate and then redifferentiate, or might be reprogrammed, in a manner similar to that found in other species (that is, blastema formation in amphibians), during metaplasia, or as occurs in somatic cell nuclear transplantation.

• Pluripotent stem cells generated before or after gastrulation might persist during development into adulthood.

*REFS 110–114 specifically address adult stem-cell plasticity.

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Northern blotting, RPA, RT-PCR (Individual mRNA transcripts)

Subtractive hybridization

Population B cDNA

Population B mRNA

Population A cDNA

Glass slide

Population A mRNA

cDNA: mRNA hybrids

mRNA expressed in A > B

mRNA expressed in B > A

Serial analysis of gene expression

Gene-expression arrays

Macroarray Microarray

Labelled cDNA or cRNA

Gene-specific 14mers

Ligation into sequencing vectors to determine the relative abundance of expressed sequences

Measurement of labelled cDNA or cRNA intensity at a specific location on an array to determine abundance of mRNA transcripts

Population B mRNA

Population A mRNA

Nylon membrane

and hESCs might identify differences in the signal pathways that are required for pluripotency in differ- ent species.

Molecular signature of adult stem cells Pluripotent stem cells are crucial for generating the

diverse array of all mature tissues during embryonic development. A subset of their progeny, so-called adult or tissue-specific stem cells, retains self-renewal and multi-lineage differentiation potential into adult- hood. Such adult stem cells, however, have much less self-renewal capacity compared with ESCs and are not pluripotent. Adult stem cells have been identified in many tissues, where they continuously generate and regenerate mature tissues either as part of nor- mal physiology or in response to injury TABLE 1. Haematopoietic, neural, epidermal and gastrointesti- nal stem cells have been phenotypically characterized, and this has facilitated the analysis of their gene- expression patterns. However, complex organs with numerous cell types such as the lung or kidney might not be maintained by a single type of stem cell, but by several stem-cell types that have yet to be identified. In general, the lack of phenotypic markers that can be used to purify most tissue-specific stem cells and the lack of appropriate assays to assess the function of many adult stem cells have impeded gene-expression analysis.

Haematopoietic stem cells. The HSCs that reside in the bone marrow microenvironment during adult life are the best-characterized adult stem cells, and therefore serve as the model for stem-cell biology (FIG. 2). HSCs are also at the forefront of our understanding of the molecular regulation of the adult stem-cell phenotype. Investigation of the function and molecular regulation of HSCs and their progeny, haematopoietic progenitor cells (HPCs), has been facilitated by the development of monoclonal antibodies to cell-surface antigens and FLUORESCENCE ACTIVATED CELL SORTING, which allow purifi- cation of murine (m)HSCs to near homogeneity34. The advent of molecular techniques that make it possible to perform gene-expression analysis using a few or even single cells has enabled a detailed analysis of the extrinsic and intrinsic signals that govern HSC-fate decisions.

Most cell-intrinsic genes that define HSCs were identified before the advent of genome-wide micro- array analysis, owing to their involvement in clonal genetic aberrations in haematopoietic malignancies. For instance, recurrent chromosomal translocations in human acute T-cell leukaemias that deregulate the expression or function of genes such as NOTCH1 REF. 35, TAL1 (also known as SCL)36,37 and LMO2 REF. 38 result in proliferation of primitive haemat- opoietic progenitor cells in the absence of normal differentiation. These observations led to the subse- quent characterization of these genes as important transcriptional regulators involved in the initial stages of non-malignant haematopoietic development in ani- mal models39–41. Notch1 is a transmembrane surface receptor that functions as a developmental regulator of cell-fate decisions through interactions with sur- face-expressed Notch ligands on neighbouring cells. On ligand binding, Notch1 is proteolytically processed thereby liberating its intracellular domain that subse- quently translocates to the nucleus and functions as a

Box 2 | Common techniques for gene-expression analysis

Traditionally, individual transcripts were identified by hybridizing radio-labelled complementary nucleic-acid probes in Northern blot or RNase protection assays (RPAs). Alternatively, a complementary DNA (cDNA) copy of the entire transcriptome can be generated, followed by the identification of specific genes by PCR or direct sequencing of cDNA. These analyses represent a gold standard for gene- expression analysis, but are difficult to perform on a large scale.

Subtractive hybridization (SH) (see figure, left) is used to characterize transcripts that are differentially expressed between two cell populations. The cDNA synthesized from one population is mixed with mRNA from another population, which results in the formation of cDNA–mRNA hybrids of transcripts that are expressed in both populations. More abundant mRNA remains unhybridized, and can then be isolated and characterized. SH does not require specific sequence information and generates a global picture of differential gene expression, but provides little information regarding the relative abundance of transcripts.

Serial analysis of gene expression (SAGE; see figure, centre) involves digesting cDNA to generate short (~14 base pair), gene-specific sequence tags that represent the transcriptome of a cell population, followed by sequencing and quantitation of these tags. SAGE does not require prior knowledge of target sequences and provides a quantitative and global analysis of gene expression.

cDNA macroarray analysis (see figure, right) is performed by hybridizing cDNA from a cell population with gene-specific cDNA probes that are immobilized onto nylon membranes. cDNA and oligonucleotide microarray analyses are conceptually similar to macroarrays, but are typically performed by synthesis and hybridization of complementary (c)RNA to gene-specific oligonucleotides (25–60mers) that are immobilized on glass slides. For each assay, gene-expression data are extracted by normalization and quantitation of radioactive or fluorescent tags that have been incorporated into the test cDNA or cRNA to determine the abundance of specific sequences. Global gene-expression profiling using array technology allows assessment of the differential expression of tens of thousands of transcripts from a small number of input cells, but it is limited by the requirement of prior sequence information for probe design.

cRNA A complementary RNA molecule that hybridizes with a specific messenger RNA sequence.

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IN SILICO DIFFERENTIAL DISPLAY The use of computer algorithms to determine differential expression of transcripts from gene-expression databases.

FLUORESCENCE ACTIVATED CELL SORTING Automated, high-speed sorting of cell populations based on the presence of intrinsic fluorescent labels such as GFP expression, or extrinsic fluorescent labels such as monoclonal antibodies conjugated to fluorochromes.

HOMEOBOX HOX GENE FAMILY A family of transcriptional regulators that share a conserved homeobox DNA- binding domain, and that are involved in the regulation of embryonic and adult developmental fates.

POLYCOMB PCG GENE FAMILY Genes encoding a family of proteins that form complexes that modify chromatin structure and selectively repress gene transcription.

WNT GENE FAMILY A family of genes that mediate intercellular signalling through secreted glycoprotein Wnt ligands.

transcription factor. Overexpression of a constitutively active form of Notch1 in murine HSCs creates clonal multipotent haematopoietic cell lines that can recon- stitute the haematopoietic system without evidence of leukaemic transformation39. Likewise, stimulation of HSCs through the Notch ligands, Delta and Jagged, results in an expansion of primitive murine and human in vivo repopulating cells consistent with a role for Notch signalling in stem-cell self-renewal42–45. Further insights into the genetic control of HSC function come from reverse-transcriptase polymerase chain reaction (RT-PCR)-based screening methods that are designed to determine the expression patterns of specific genes and gene families in subsets of human and murine haematopoietic stem and progenitor cells. Several RT-PCR-based approaches have focused on crucial regulators of embryonic development such as the HOMEOBOX HOX GENE FAMILY, POLYCOMB PCG GENE FAMILY and WNT GENE FAMILY46–48. This approach has been effective in identifying genes that are selectively expressed in the most primitive subsets of haematopoietic cells and that functionally regulate HSC-fate decisions. Hoxb4 is one of the most well-characterized genes involved in the self-renewal of human and murine long-term, repopulating HSCs49–51. Identified in a similar man- ner, both the polycomb gene Bmi1, as well as frizzled receptors that bind secreted Wnt ligands, were found to be expressed in primitive haematopoietic cells47,48 and were subsequently proven to have crucial roles in HSC self-renewal52,53. Other genes that are implicated in the HSC phenotype have been identified on the basis of their roles in the development of mesoderm and its derivatives; for example, the morphogens sonic hedgehog (SHH) and BMP4 REF. 54. And more HSC

genes have been identified on the basis of phenotypic observations such as quiescence; for example, Cdkn1a (also known as p21), which was found to be selectively expressed in the most primitive haematopoietic cells, and was subsequently shown to be crucial for mainte- nance of the mHSC pool55.

These studies provide insight into the molecular regulation of the HSC phenotype. Specifically, long- term maintenance of the stem-cell pool requires qui- escence of HSCs, and therefore Bmi1, a transcriptional repressor, and Cdkn1a, a cell-cycle inhibitor, probably regulate this aspect of the HSC phenotype. Expansion of the HSC pool requires symmetric self-renewing cell divisions that give rise to two daughter cells that retain HSC function. Hoxb4, Wnt signalling and Notch sig- nalling represent the best-characterized mechanisms thought to drive symmetric self-renewal of HSCs.

Early strategies to determine a more global genetic programme of HSCs used subtractive hybridiza- tion of highly purified murine fetal liver and murine adult bone marrow HSCs in combination with high- density cDNA macroarrays to delineate genes that are expressed in HSCs56. The presence of previously characterized HSC-associated genes among those identified, such as the genes that encode cell-surface molecules FLT3 and CD34 as well as the transcrip- tional regulator Runx1 gene, confirmed the validity of this experimental approach and indicated that genes and signalling pathways that had not previously been implicated in haematopoietic development might be important in HSC behaviour56. To distribute the data on the HSC-specific transcriptome and to foster the collaborations that are essential to approach a problem as complex as the genetic regulation of stem cells, these

Table 1 | Mammalian adult stem cells

Tissue Stem cell Niche Progeny References

Blood Haematopoietic stem cell

Endosteal surface of bone marrow

All myeloid and lymphoid blood lineages

7–10,16–18,34–63, 86,90,91,99,100

Mesenchyme Mesenchymal stem cell

Within bone marrow cavity

Bone, cartilage, tendon, smooth muscle, adipose tissue and stroma

116

Brain Neural stem cell/ neurosphere

Subventricular zone and hippocampus

Neurons, glial cells and oligodendrocytes

8–10,57,64–70,88

Gut Crypt cell/gut epithelial progenitor

Gut crypt Enterocytes, enteroendocrine cells, goblet cells and Paneth cells

74,75

Heart Cardiac progenitor Not determined Cardiac myocytes 117

Liver Oval cell Terminal biliary ductule Hepatocytes and cholangiocytes

118–120

Pancreas Pancreas-derived multipotent precursors

Not determined Pancreatic endocrine and acinar cells

121,122

Skeletal muscle Satellite cell Between sarcolemma and basil lamina

Myocytes/myofibrils 123

Skin/hair Bulge cell Bulge in hair follicle Epidermis, hair follicles and sebaceous glands

71–73

Male germ cells A s spermatogonia Basement membrane

of seminiferous tubule Sperm 124

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Hoxb4 Bmi1 Cdkn1a

Gata1 Epor Mpl

BMP4 SHH

Notch pathway Wnt pathway

Genes/pathways associated with haematopoietic cell function Gene expression of individual lineage-specific transcripts

Genes/pathways associated with self-renewal Self-renewal and multi-lineage differentiation potential Promiscuous gene expression of multiple lineage-specific transcripts

Globin genes Mpo

HSC

CLP B cell

T cell

NK cell

Erythrocyte

Granulocyte

Monocyte

CMP

MEP

GMP

Stem cell Progenitor cells Mature cells

Megakaryocyte

results were compiled in an open access, searchable stem-cell database (SCDb; see the Online links box)56.

Not long after the establishment of the SCDb, further expression-profiling studies were performed using different combinations of phenotypically and ontogenically distinct murine HSCs and HPCs. One analysis of transcripts enriched in mHSCs that were derived from adult bone marrow identified several genes that were classified in the SCDb as genes expressed in HSCs derived from murine fetal liver56,57. These included angiopoietin-1 (Angpt1) and the angiopoietin receptor, Tek (also called Tie2). A functional role for Tek and Angpt1 in enhancing

primitive cobblestone formation by mHSCs in vitro (a surrogate readout for HSC-like cells) and in the maintenance of mHSCs in vivo has recently been demonstrated58, which supports the validity of this analysis. The expression of this ligand–receptor pair in HSCs indicates that HSC-fate decisions might be regulated in an autocrine or paracrine fashion. Although comparisons of adult and fetal HSCs have identified shared patterns of gene expression, there is only partial concordance between gene expression in adult and fetal HSCs (reviewed in REF. 59), which might reflect fundamental differences between ontogenically distinct HSCs57,60.

A comparison between mHSCs and murine multipotent progenitors (MPPs), which have only limited self-renewal potential, found that genes that are implicated in the development and self-renewal of mHSCs, such as Bmp4, Bmi1 and Notch1, were expressed at higher levels in the HSCs61. Almost half of the genes analysed on a 1,200 probe high-density cDNA macroarray were expressed at detectable levels in mHSCs, and differentiation to mMPPs and com- mitted cells resulted in the upregulation of specific lineage markers with concomitant loss of global gene expression16. Similar results were seen in a more exten- sive analysis of HSCs, MPPs, common myeloid pro- genitors (CMPs) and common lymphoid progenitors (CLPs) — more than 40% of haematopoiesis-related genes analysed, including HSC-specific as well as other lineage-specific transcripts, were expressed in HSCs, and this transcriptional promiscuity was lost during lineage commitment17. Therefore, similar to ESCs, HSCs have a transcriptionally accessible genome that becomes progressively more restricted coincident with lineage differentiation (FIG. 2).

In contrast to mHSCs and murine haematopoetic progenitor cells (HPCs), hHSCs have not yet been purified to homogeneity on the basis of their surface phenotype. Therefore, defining the transcriptome of hHSCs has been complicated by the greater heteroge- neity of hHSC and hHPC populations. Nevertheless, comparison of the transcriptomes of highly puri- fied mHSCs and the more heterogeneous human CD34+CD38– cells has identified approximately 40% congruence. Considering the challenges of hetero- geneity and comparative genomics8, this is probably a conservative figure. It is probable that advances in the ability to prospectively isolate human HSCs using strategies that enrich for HSCs, for example, the exclu- sion of rhodamine 123 REF. 62, or aldehyde dehydro- genase activity63, will show greater conservation of the molecular signature for murine and human HSCs.

Neural stem cells. Until recently, it was thought that few, if any, stem cells were present in the adult central nervous system (CNS). However, several studies have now shown that NSCs persist into adulthood in the subventricular zone of the lateral ventricles and the dentate gyrus of the hippocampus. These NSCs con- tinuously give rise to new neurons to replace those that die in the normal aging process or in neurodegenerative

Figure 2 | The haematopoietic stem cell. Haematopoietic stem cells (HSCs) supply the entire repertoire of mature blood cells for the lifetime of an organism. To accomplish this task, HSCs are endowed with self-renewal capacity that maintains and expands the stem-cell pool, and multi-lineage differentiation potential that produces the diverse components of the mature haematopoietic system. As HSCs differentiate, they lose the ability to self-renew and become increasingly restricted in their lineage potential. Genes and proteins associated with the self- renewal of HSCs (for example, Hoxb4 REFS 4951, Bmi1 REF. 53, Cdkn1a55, BMP4 REF. 54, SHH54, the Notch pathway39,42–45 and the Wnt pathway52) are highly expressed in HSCs, but are downregulated in committed progenitor and mature haematopoietic cells. HSCs also promiscuously express multiple lineage-specific transcripts at low levels, however, differentiation is associated with the loss of this promiscuous transcript expression and selective expression of individual lineage-specific genes17.CLP, common lymphoid progenitor; CMP, common myeloid progenitor; GMP, granulocyte monocyte progenitor; MEP, megakaryocyte erythrocyte progenitor; NK, natural killer.

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disorders64. Although some phenotypic markers have been identified that allow selection of NSCs65, NSCs are most commonly isolated by culture as neurospheres — a heterogeneous population that also contains more mature cells. Various studies have sought to define the expression profile of NSCs by comparing the gene-expression profiles of human and murine neurospheres66–68, murine retinal progenitor cells69, or NSC-containing neuroepithelial cells70 with those of more mature neural progenitors or mature neurons. Confirming the validity of these studies, several genes with known roles during CNS development, such as the transcriptional regulators Sox2, Pax6 and Lhx2, and the cell-cycle regulator Ccnd1 (also known as Cyclin D1; REFS 6670) were shown to be enriched in NSC-containing populations in these studies. And, consistent with other stem-cell gene-profiling studies, many genes that have no known role in neural develop- ment, and transcripts without any known function are expressed in NSC-enriched populations9,66–70. Further characterization of the function of these genes might provide novel insights into the molecular regulation of NSCs and their progeny. However, because of the considerable heterogeneity of isolated NSC-containing cell populations, it is unlikely that the true transcrip- tome of NSCs is reflected in these studies. Advances in the methods used to isolate pure populations of NSCs from the brain or from ESCs will lead to a bet- ter characterization of the NSC molecular signature. Towards this goal, human NSCs have been purified to near homogeneity65, but the transcriptional profile of such cells has yet to be determined.

Epidermal stem cells. The stem cells that generate skin epithelium and skin appendages (known as bulge cells) are found in a niche in the bulge of the root sheath of hairs (FIG. 1). Bulge cells give rise to both epidermis and hair follicles in transplant experiments, and develop into colonies of undifferentiated cells in vitro71. Murine bulge cells can be isolated using a GFP label that is expressed under the control of the ‘bulge-preferred’ keratin-15 promoter in combination with the expres- sion of CD34 and integrin-α6 cell surface antigens, or by the retention of bromodeoxyuridine in these qui- escent cells (label retaining cells)71–73. Whether these approaches purify epidermal stem cells to homogene- ity, or whether there are several distinct stem cells in the bulge is not yet clear71. Expression profiling of bulge stem cells by two independent laboratories has iden- tified 97–157 genes that are differentially expressed in bulge cells when compared with differentiated keratinocytes, with 80–90% concordance between the different studies71,72. These genes include FGF1 and its receptor, transforming growth factor-β (TGFβ) activa- tors, BMP and Wnt pathway inhibitors71,73, which are all known to be involved in the regulation of epidermal stem-cell proliferation and differentiation.

Gastrointestinal stem cells. The gene-expression pro- files of gastric epithelial progenitor (GEP) cells have been compared with those of more mature zymogen

cells and acid-secreting parietal cells74, and the expres- sion profiles of small intestinal epithelial progenitor cells (SiEPs) have been compared with Paneth cells75 — each cell type was identified on the basis of its precise location in the crypts of the gastric and small intestinal mucosa. Of the 147 genes thought to define GEPs, 11 were also upregulated in SiEPs, and another 22 transcripts that were upregulated in SiEPs encode functionally related family members or additional subunits of multi-subunit complexes of transcripts enriched in GEPs75. This surprising degree of overlap between the GEP and SiEP datasets indicates that shared mechanisms probably regulate both SiEP and GEP function. With advances in the phenotypic characterization of adult stem cells, it is probable that more homogeneous stem and progenitor cells from the gastrointestinal tract will be isolated, and that fewer background transcripts will obscure potentially relevant stem-cell-specific transcripts.

Cross-tissue-specific stem-cell comparisons. Despite the shortcomings in gene-expression evaluation for many adult stem-cell populations, comparison between the molecular signatures of HSCs, NSCs, bulge stem cells and gastrointestinal stem cells have identified several classes of genes that might be expressed in all tissue- specific stem cells. For instance, 15–30% of genes that are expressed specifically in HSCs, but not in HPCs, are also specifically expressed in NSC-enriched populations8,9,57; and 14% of genes that are expressed in bulge stem cells are also expressed in HSCs and NSCs71. Among these are genes involved in Wnt sig- nalling (for example, Tcfs and Fzd7), Notch signalling (for example, Hes1), adhesion (for example, Itga6) and transcriptional regulation (for example, Bmi1).

The stem-cell niche Stem cells exist in vivo in a complex microenviron- ment, or niche, which is composed of differentiated somatic cells and extracellular matrix, as well as stem cells and their progeny. The niche provides factors that maintain the self-renewal ability of stem cells and prevent their differentiation. Most insights into the role of stem-cell niches come from studies on Drosophila melanogaster germ stem cells (GSCs; reviewed in REFS 76,77), which interact with specialized somatic cells in the niche — known as cap cells (during oogenesis in the ovary)78 or hub cells (during spermatogenesis in the testes)79–81 (FIG. 3). This physical interaction main- tains the undifferentiated state of the stem cell and is mediated through a cadherin–catenin pathway82. The GSC-cap/hub-cell interaction also regulates symmet- ric versus asymmetric GSC divisions by polarizing the stem cell and affecting the orientation of the mitotic spindle and the segregation of differentiation and stem-cell determinants in daughter cells83–85.

Similar to GSCs, mammalian adult stem cells reside in niches that protect the ability of the stem cell to self- renew and that prevent differentiation. Niches have been identified for epidermal stem cells, gastrointestinal stem cells, HSCsand NSCs. In common with GSC niches,

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HSC

Endosteal bone surface

PTH (from outside niche)

PTH/PTHR1 Integrins

CXCL12 (secreted by osteoblasts) CXCL12/CXCR4 Wnts/Frizzled

Wnts (secreted by osteoblasts)

Notch1

KitI

Kit

BMSC

a Germ stem-cell niche b Haematopoietic stem-cell niche

Terminal filament

Cadherin– catenin junctions

Cap

GSCGSC ECM

Jag1

adult stem-cell niches contain extracellular matrix components and cell-surface ligands that ‘bind’ the stem cell to the niche by cadherin and integrin interactions71. Moreover, niche-derived factors that regulate stem-cell fate are conserved from GSC niches to most adult stem- cell niches. For instance, in the HSC niche, osteoblasts express Notch ligands that support HSC self-renewal, as shown by the promotion of the self-renewal of HSCs45,86 owing to overexpression of activated parathyroid hor- mone receptors (which upregulates Notch ligand expres- sion). A similar mechanism operates in NSC niches87. Other mechanisms through which niches regulate the fate of adult stem cells is by the secretion of Wnts and soluble Frizzled receptors48,71,88, by the production of members of the TGFβ/BMP family71,86 and by the production of Kitl (also known as stem cell factor)71,89,90 (FIG. 3).

Identification of the precise location of epidermal and gastrointestinal stem cells has facilitated analy- sis of the gene-expression profile of the surrounding niche cells. With the identification of the precise location of HSCs in the bone marrow, such studies are now also possible for HSC-niche cells. Another method to identify niche-derived extrinsic regula- tors of stem-cell fate is by the creation of stromal cell lines that support stem-cell self-renewal in vitro. For

instance, subtractive hybridization was used to com- pare the transcriptome of a fetal-liver stromal cell line (known as AFT024) that supports HSC main- tenance in vitro, with fetal-liver-derived stromal cell lines that do not support the maintenance of HSCs. Genes that were expressed in the supportive AFT024 cell line were compiled in an internet-based stromal cell database (StroCDb; see the Online links box). Among the genes that were preferentially expressed in AFT024 were Kitl, Bmp2, Wnt5a and Dll1, as well as many secreted and surface molecules with no known haematopoietic function91.

Although adult stem cells can undergo asymmetric and symmetric divisions, how physical interactions between somatic stem cells and their niches regulate these cell divisions, as has been described for GSCs92, remains largely unknown. As other roles of the D. melanogaster GSC niche seem to be conserved in mammalian adult stem cells, the mechanisms that underly asymmetric versus symmetric cell divisions will probably also be conserved from fly to man and from germ stem cell to adult stem cell.

A conserved stem-cell molecular signature? It has been suggested that the self-renewal and multi- lineage differentiation characteristics of stem cells is the result of a genetic programme that is common to stem cells of all origins, and that stem cells therefore share a conserved molecular signature. Two seminal studies have compared the gene-expression profiles of murine ESCs, HSCs and neurospheres8,9. In one study, 283 genes were expressed by all three stem-cell popu- lations8 and in the second, 216 genes were expressed by all three stem-cell sources9. These genes comprised both known genes as well as genes without an anno- tated function. However, a comparison of these two independent studies, which used seemingly compara- ble input cell populations and methodologies, revealed only six common stem-cell genes that were identified in both studies10 TABLE 2. In a third study, investigators compared the gene-expression profiles of murine ESCs, neurospheres and retinal progenitor cells, and found that 385 genes were expressed in all three cell types10. When compared with the first two studies however, only one gene, integrin-α6 (Itga6) was expressed in all stem-cell populations TABLE 2.

Possible explanations for the discrepancies observed include technical and methodological differences among the three analyses, such as differences in the stem-cell isolation methods, the type of gene arrays used and the type of computational analyses used to identify shared stem-cell genes. In fact, the number of shared ‘stemness’ genes increased substantially when the data were com- pared using the same algorithms to define differential gene expression59. However, as a much higher degree of congruence was seen when gene expression in ESCs (n = 332) or NSCs (n = 236) was compared between the studies (p < 10–8), methodological differences alone might not fully explain the failure to find more shared stem-cell genes10. Another explanation might be that genes that confer stem-cell activity might not be

Figure 3 | Molecular regulation of stem-cell niches. a | Components of the stem-cell niche provide cell–cell and cell–matrix interactions that are crucial for protecting the integrity and function of the resident stem cells. Cadherin–catenin-mediated interactions between somatic cap cells (cap) and the Drosophila melanogaster germ stem cells (GSCs) in the ovary maintain the stem cells in an undifferentiated state. They also regulate symmetric versus asymmetric cell divisions by polarizing the mitotic spindle and facilitating the partitioning of the cellular contents into the daughter cells. b | The functional interactions between stem cells and their niches have been conserved from flies to mammals. Within the extracellular matrix (ECM) at the endosteal surface of the bone marrow cavity, osteoblasts and other bone-marrow stromal cells (BMSCs) regulate haematopoietic stem cells (HSCs) through secreted signals as well as by cell–cell and cell–matrix interactions. Chemokines such as CXCL12 provide a signal to recruit CXCR4- expressing HSCs to the appropriate niche, whereas ECM components interact with HSC- expressed integrins to retain the stem cells. Niche cells also provide haematopoietic cytokines such as Kitl. Further regulation of HSCs by the HSC niche depends on activation of Notch signalling by Jagged ligands (Jag1), and Wnt signalling by secreted Wnt ligands45,48. The HSC niche itself is regulated by paracrine factors such as parathyroid hormone (PTH) and its receptor (PTHR1) that can alter the cellular composition and size of the niche, and thereby regulate HSC numbers45. Part a of the figure was modified with permission from REF. 78 © (2000) American Association for the Advancement of Science.

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represented on the oligonucleotide-based microarrays that were used for gene-expression analysis10, therefore precluding the identification of important genes that are expressed in all stem cells. The use of subtractive hybridization and serial analysis of gene expression (SAGE) that do not share these limitations would circumvent this problem. It has also been suggested

that shared stem-cell genes might be expressed only transiently and would therefore be difficult to detect in a homeostatic stem-cell population10. Furthermore, stem-cell genes might not be expressed exclusively in stem cells, but might also be expressed — albeit at lower or higher levels — in differentiated cells, and therefore would be more difficult to identify by differential

Table 2 | Overlap of stem-cell-specific genes

Gene symbol* Gene description Functional annotation

Fortunel and Ramalho-Santos datasets

1110068L01Rik RIKEN cDNA 1110068L01 gene Not determined

1810009A15Rik RIKEN cDNA 1810009A15 gene Not determined

2410015N17Rik RIKEN cDNA 2410015N17 gene Not determined

2410080P20Rik RIKEN cDNA 2410080P20 gene Not determined

2410091N08Rik RIKEN cDNA 2410091N08 gene Not determined

2700084L22Rik RIKEN cDNA 2700084L22 gene Protein modification

2810436B06Rik RIKEN cDNA 2810436B06 gene Chloride transport

AA407558 Expressed sequence AA407558 Not determined

AA420417 Expressed sequence AA420417 Not determined

C81206 Expressed sequence C81206 Not determined

Cdkap1 CDK2-associated protein-1 Cell growth and/or maintenance

Chd1 Chromodomain helicase DNA binding protein-1 Chromatin assembly/disassembly

eIF4Ebp1 eIF4E binding protein-1 Insulin receptor signalling pathway

Etl1 Enhancer trap locus-1 Transcriptional regulation

Gfer Growth factor, Erv1 (S. cerevisiae)-like Not determined

Nol5 Nucleolar protein-5 Not determined

Rnf4 Ring finger protein-4 Transcriptional regulation

Sfrs3 Splicing factor, arginine/serine-rich 3 (SRp20) mRNA splice-site selection

Tead2 TEA domain family member-2 Transcriptional regulation

Tmk Thymidylate kinase Nucleotide biosynthesis

Trif-pending TRIF gene Not determined

Zfx Zinc finger protein X-linked Transcriptional regulation

Ivanova and Ramalho-Santos datasets

AI643885 Expressed sequence AI643885 Not determined

Cpx1-pending Metallocarboxypeptidase-1 Not determined

Laptm4b Lysosomal-associated protein transmembrane-4B Not determined

Lce-pending Long chain fatty acyl elongase Fatty acid elongation

Pkd2 Polycystic kidney disease-2 Cation transport

Fortunel and Ivanova datasets

Edr1 Early development regulator-1 Development

Tcf3 Transcription factor-3 Transcriptional regulation

Fortunel, Ramalho-Santos and Ivanova datasets

Itga6 Integrin-α6 Integrin signalling pathway *Transcripts for the corresponding gene symbols were identified as more highly expressed in multiple adult and embryonic stem-cell populations compared with their progeny using gene-expression microarrays, and they therefore represent conserved stem-cell- specific genes. Each subheading lists the studies that were included for each section. The stem-cell populations analysed in these studies were murine haematopoietic stem cells (mHSCs), murine embryonic stem cells (mESCs) and murine neural progenitor cells (mNPCs) by Ivanova et al.8; mHSCs, mESCs and mNPCs by Ramalho-Santos et al.9; and mHSCs, mESCs and murine retinal progenitor cells by Fortunel et al.10 This table is adapted from Fortunel et al.10 CDK, cyclin-dependent kinase; elF, eukaryotic translation-initiation factor; S. cerevisiae, Saccharomyces cerevisiae.

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microRNA A family of short, non-coding RNA molecules (~22 nucleotides) that post-transcriptionally regulate target-gene expression primarily by inhibiting protein translation.

RNAi A functional tool that use small interfering RNAs (siRNAs) to knock down gene expression through sequence-specific decay of target mRNA molecules.

MORPHOLINO ANTISENSE OLIGONUCLEOTIDES Chemically synthesized oligonucleotide analogues used to knock down gene expression by specifically binding to target transcripts to inhibit RNA splicing or translation.

CHIP Technique used to immunoprecipitate complexes of DNA with associated proteins.

expression analysis. Consistent with this notion, only 4 of the 216 genes identified by Ramalho-Santos et al. as ‘stemness genes’, were not expressed in the differenti- ated cell populations analysed by differential display9. Therefore, stem-cell function might not be imparted on cells by a defined and limited set of master stem-cell- specific genes or by a small number of pathways, but by the combined effect of the complex upregulation or downregulation of many different genes and gene path- ways. These studies might also indicate that a conserved stem-cell molecular signature does not exist.

Although no definitive set of genes that defines all stem cells has been identified, several signalling path- ways have been identified that seem to regulate dif- ferent types of stem cell. For instance, canonical Wnt signalling through β-catenin has been implicated in the maintenance and self-renewal of ESCs as well as adult stem cells, such as epidermal, gastrointestinal, haematopoietic and neural stem cells93. Although acti- vation of β-catenin induces the self-renewal of various stem cells, this is not the only mechanism that supports self-renewal, as HSCs that lack β-catenin maintain their self-renewal capacity94 and Wnt activators are downregulated in skin stem cells compared with their progeny72,73. Notch signalling is another developmen- tal regulatory pathway that can mediate self-renewal of stem cells — Notch signals promote the mainte- nance and self-renewal of neural, haematopoietic, gastrointestinal and epidermal stem cells by inhibiting differentiation95. Moreover, interaction between the Wnt and Notch signalling pathways might provide the cellular signals that are needed to drive proliferation (Wnt signals) in the absence of differentiation (Notch signals), leading to symmetric self-renewing cell divi- sions required for stem-cell expansion96. Regulation of stem-cell fate in vivo is undoubtedly more complex, involving polycomb genes, such as Bmi1, and devel- opmental morphogens, such as Hedgehog, that have both been shown to regulate fate decisions for several stem-cell types95. It should again be noted that few, if any, of these shared stem-cell regulators were identi- fied by global gene-expression analysis.

Implications and future directions The inability to identify a consensus stem-cell gene- expression signature has led some researchers to ques- tion the validity of such a strategy97. Despite some of the caveats regarding the different studies that have characterized the transcriptome of defined stem cells discussed above, it is clear that progress is being made towards defining gene-expression patterns associated with stem-cell behaviour. The ultimate goal of defining a molecular signature of stem cells will be advanced further when it becomes possible to purify stem cells to homogeneity.

However, expression profiles do not necessarily dic- tate which of the genes or gene pathways are functionally involved in self-renewal and pluripotency/multipotency. There is increasing evidence that the proteome and transcriptome of cells are only partially overlapping98, and this complicates elucidation of the functional roles

of expressed genes in stem-cell function. For instance, highly purified mHSCs express low levels of mRNA for lineage-specific genes before lineage commitment99, and fewer than 25% of genes that have been analysed have consistent levels of both mRNA and protein expression during myeloid cell differentiation100. Although tech- niques to define the proteome are less sensitive than large-scale transcriptional profiling, it is possible that a proportion of differentially expressed genes identified in any large-scale transcriptional screen encode proteins that are subject to post-translational modifications that alter protein stability, structure or localization. Therefore, the abundance of mRNA transcripts does not infer functionality. Furthermore, studies in Caenorhabditis elegans have shown that microRNAS, small non-coding RNA sequences, can modify mRNA translation and therefore have implications for protein synthesis and gene function101. A large number of microRNAs are also found in mammalian cells, including stem cells102,103 — such microRNAs could modulate expressed genes to refine complex cellular functions such as self-renewal and lineage commitment.

Therefore, a crucial step for determining the implica- tions of gene-expression profiles is to design gene-target- ing experiments that functionally characterize the genes and gene pathways of interest. Currently, several groups are exploring approaches to functionally validate stem- cell gene-expression data, which include the creation of knockout mice or the use of RNAi and gene overexpres- sion in cell-culture models. An alternative approach is the use of model organisms to define stem-cell-specific genes, for example, RNAi in C. elegans and MORPHOLINO ANTISENSE OLIGONUCLEOTIDES (MOs) in Xenopus laevis and zebrafish have been used to evaluate loss-of-function phenotypes in a high-throughput manner104–108. This comparative genomics approach might increase the likelihood of identifying pathways that are important for stem-cell function owing to evolutionary conserva- tion. In a recent study, the functional roles of genes that were differentially expressed between human HSCs and HPCs were evaluated using a zebrafish model of hae- matopoiesis109. In this system, MO-based knockdown of 14 out of 61 transcripts (23%) that were differentially expressed in HSCs compared with HPCs and that had no previously known roles in early haematopoiesis resulted in defective haematopoietic-cell development in MO-injected zebrafish embryos, showing the usefulness of model organisms for large-scale functional validation of transcriptional profiles.

As complex transcriptional networks that confer spe- cialized cellular functions often result from the relatively simple actions of important transcription factors, studies will also be needed to determine the protein–DNA inter- actions that regulate the entire cellular transcriptome. For instance, chromatin immunoprecipitation CHIP analysis can be used to gain insight into the proteins that mediate complex cellular gene-expression patterns. When com- bined with PCR for focused analysis of transcriptional regulation or with large promoter arrays, such analyses might begin to identify the gene networks that regulate stem-cell behaviour.

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Insights into the genes and gene pathways that regu- late stem-cell function will advance not only our basic understanding of stem cells but also the entire field of regenerative medicine, with important implications for the development of clinically applicable stem-cell therapies. Defining the combination of cellular signals,

extrinsic growth factors and small molecules that allow the expansion of adult stem cells in vitro or in vivo, or that enhance the differentiation of embryonic or adult stem cells to functional mature progeny, might ultimately lead to the development of novel therapies for a host of currently incurable genetic and degenerative disorders.

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Acknowledgements The authors would like to acknowledge the work of our colleagues that we have discussed, and apologize to our colleagues whose work was not discussed due to space limitations.

Competing interests statement The authors declare no competing financial interests.

Online links

DATABASES The following terms in this article are linked online to: Entrez Gene: http://www.ncbi.nlm.nih.gov/entrez/query. fcgi?db=gene Angpt1 | Bmi1 | BMP4 | Ccnd1 | Cdkn1a | CHEK2 | DNMT3B | Eras | FGF1 | GDF3 | GJA1 | Hoxb4 | Lhx2 | LIN28 | LMO2 | Nanog | NOTCH1 | Oct4 | Pax6 | Runx1 | SHH |SOX2 | TAL1 | Tek | Tdgf1 | TDGF1 | TGIF | Utf1 | Zfp42

FURTHER INFORMATION Catherine Verfaillie’s Institute: http://www.stemcell.umn.edu National Institutes of Health Stem Cell Information: http://stemcells.nih.gov The Stem Cell Database (SCDB): http://stemcell.princeton.edu The Stem Cell Genome Anatomy Project (SCGAP): http://www.scgap.org The Stromal Cell Database (StroCDB): http://stromalcell.princeton.edu Access to this interactive links box is free online.

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Epigenetics and disease.pdf

nature biotechnology volume 28 number 10 oCTober 2010 1 0 5 7

generated from the same donor DNA are not identical to, and develop diseases with different penetrance from, their donor1,3. Human clones that arise spontaneously—monozygotic twins—are identical at the DNA sequence level, but have different DNA methylation4,5 and his- tone modification profiles4 that might affect the penetrance of several diseases, such as cancer4 or autoimmune disorders6. But this phenom- enon is also observed at a single cell level: how can stem cells develop into any type of cell and how does a liver cell always give rise to two new liver cells after cell division? Again, epigenetics seems to be part of the answer as it has been described as one of the key factors in cellular differentiation7,8 (see the review by Meissner9 in this issue).

The importance of epigenetics in maintaining normal development and biology is reflected by the observation that many diseases develop when the wrong type of epigenetic marks are introduced or are added at the wrong time or at the wrong place10. For instance, a clear causality role for DNA methylation in cancer is suggested by hypermethylation of some genes (e.g., p16INK4a, p14ARF and MGMT) as an early event in tumorigenesis, as well as by tumor type-specific methylation landscape11. Here we summarize recent progress in the field of epigenetic research and its role in disease, preparing ourselves for the surprises that epigenetics might hold in the future.

Epigenetic modifications and their machineries For didactic purposes, epigenetic modifications can be grouped into three main categories: DNA methylation, histone modifications and nucleosome positioning. It is important to keep in mind the interplay between epige- netic factors—as the observed outcome is always the sum of their interac- tions—and the many positive and negative feedback mechanisms.

DNA methylation. The most widely studied epigenetic modification in humans is cytosine methylation. DNA methylation occurs almost exclusively in the context of CpG dinucleotides. The CpG dinucleotides tend to cluster in regions called CpG islands1, defined as regions of

Even before DNA was identified as the molecule of inheritance, scientists knew that not every gene in an organism can be active in each cell at all times. Even so, all cells in an organism share the same genetic information. Conrad Waddington coined the term ‘epigenetic landscape’1,2 for the molecular mechanisms that convert this genetic information into observable traits or phenotypes. In many instances, epigenetic gene expression patterns and associated phenotypes persist through mitosis or even meiosis, although no change in the primary DNA sequence has occurred. Consequently, epigenetics is generally understood to be the study of mechanisms that control gene expression in a potentially heritable way.

Recent breakthroughs in the understanding of the mechanisms under- lying epigenetic phenomena and their prevalence as contributors to the development of human disease have led to a greatly enhanced interest in epigenetic research.

On a molecular level, covalent modifications of cytosine bases and histones, and changes in the positioning of nucleosomes are commonly regarded as the driving epigenetic mechanisms. They are fundamental to the regulation of many cellular processes, including gene and microRNA expression, DNA-protein interactions, suppression of transposable ele- ment mobility, cellular differentiation, embryogenesis, X-chromosome inactivation and genomic imprinting.

In multicellular organisms, the ability of epigenetic marks to persist during development and potentially be transmitted to offspring may be necessary for generating the large range of different phenotypes that arise from the same genotype1,3–5. For instance, cloned animals

Epigenetic modifications and human disease Anna Portela1 & Manel Esteller1,2

Epigenetics is one of the most rapidly expanding fields in biology. The recent characterization of a human DNA methylome at single nucleotide resolution, the discovery of the CpG island shores, the finding of new histone variants and modifications, and the unveiling of genome-wide nucleosome positioning maps highlight the accelerating speed of discovery over the past two years. Increasing interest in epigenetics has been accompanied by technological breakthroughs that now make it possible to undertake large-scale epigenomic studies. These allow the mapping of epigenetic marks, such as DNA methylation, histone modifications and nucleosome positioning, which are critical for regulating gene and noncoding RNA expression. In turn, we are learning how aberrant placement of these epigenetic marks and mutations in the epigenetic machinery is involved in disease. Thus, a comprehensive understanding of epigenetic mechanisms, their interactions and alterations in health and disease, has become a priority in biomedical research.

1Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Catalonia, Spain. 2Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain. Correspondence should be addressed to M.E. ([email protected]).

Published online 13 October 2010; doi:10.1038/nbt.1685

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DNA methylation does not occur exclusively at CpG islands. The term CpG island shores, referring to regions of lower CpG density that lie in close proximity (~2 kb) of CpG islands, has recently been coined. The methylation of these CpG island shores is closely associated with tran- scriptional inactivation (Fig. 1b). Most of the tissue-specific DNA methy- lation seems to occur not at CpG islands but at CpG island shores19,20. Differentially methylated CpG island shores are sufficient to distinguish between specific tissues and are conserved between human and mouse. Moreover, 70% of the differentially methylated regions in reprogramming are associated with CpG island shores20,21.

DNA methylation is less frequently coupled with transcriptional acti- vation, as when, for instance, it occurs at gene bodies (Fig. 1c). Gene body methylation is common in ubiquitously expressed genes and is positively correlated with gene expression22. It has been proposed that it might be related to elongation efficiency and prevention of spurious initiations of transcription23.

DNA methylation and DNA methylation–associated proteins not only participate in gene transcription regulation in cis, but also act in trans, being involved in nuclear organization and in the establish- ment of specific chromosomal territories. An imprinted region can physically interact with sequences distant in the primary sequence or on different chromosomes. These physical interactions in trans can

more than 200 bases with a G+C content of at least 50% and a ratio of observed to statistically expected CpG frequencies of at least 0.6. CpG dinucleotides are usually quite rare in mammalian genomes (~1%). About 60% of human gene promoters are associated with CpG islands and are usually unmethylated in normal cells, although some of them (~6%) become methylated in a tissue-specific manner during early development or in differentiated tissues12 (Fig. 1a).

In general, CpG-island methylation is associated with gene silenc- ing. DNA methylation plays a key role in genomic imprinting, where hypermethylation at one of the two parental alleles leads to monoal- lelic expression13. A similar gene-dosage reduction is observed in X-chromosome inactivation in females14.

DNA methylation can inhibit gene expression by various mechanisms. Methylated DNA can promote the recruitment of methyl-CpG-binding domain (MBD) proteins. MBD family members in turn recruit histone- modifying and chromatin-remodeling complexes to methylated sites15,16. DNA methylation can also directly inhibit transcription by precluding the recruitment of DNA binding proteins from their target sites17. In contrast, unmethylated CpG islands generate a chromatin structure favorable for gene expression by recruiting Cfp1, which associates with histone methyl- transferase Setd1, creating domains rich in the histone methylation mark H3K4 trimethylation (H3K4me3; see below)18.

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Figure 1 DNA methylation patterns. DNA methylation can occur in different regions of the genome. The alteration of these patterns leads to disease in the cells. The normal scenario is depicted in the left column and alterations of this pattern are shown on the right. (a) CpG islands at promoters of genes are normally unmethylated, allowing transcription. Aberrant hypermethylation leads to transcriptional inactivation. (b) The same pattern is observed when studying island shores, which are located up to 2 kb upstream of the CpG island. (c) However, when methylation occurs at the gene body, it facilitates transcription, preventing spurious transcription initiations. In disease, the gene body tends to demethylate, allowing transcription to be initiated at several incorrect sites. (d) Finally, repetitive sequences appear to be hypermethylated, preventing chromosomal instability, translocations and gene disruption through the reactivation of endoparasitic sequences. This pattern is also altered in disease.

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are restored in induced pluripotent stem cells, suggesting a key role in origin and maintenance of pluripotent state28,29. Mechanisms of no-CpG methylation remain unclear29.

In addition to 5-methylcytosines, 5-hydroxymethyl-2′-deoxycytidine has also been observed. So far, 5-hydroxymethyl-2′-deoxycytidine has been reported in Purkinje cells (constituting 0.6% of total nucleotides) and in granule cells (constituting 0.2% of total nucleotides), but it seems not to be present in cancer cell lines30. These new DNA modifications need to be further studied to determine their implications for normal and diseased epigenetic regulation.

More work is also required in the development of new technological approaches31,32 and powerful analytical tools33, which have proven to be crucial for the progress of the field34. Massive parallel sequencing is providing lots of data, but its accurate analysis and interpretation, and its price remain as the last drawbacks to work with DNA methylomes at base resolution. Beyond sequencing-based technologies, the recently released, refined methylation arrays are worth considering for certain genomic questions.

DNA methylation is mediated by the DNMT family of enzymes that catalyze the transfer of a methyl group from S-adenosyl methionine to DNA. In mammals, five members of the DNMT family have been reported: DNMT1, DNMT2, DNMT3a, DNMT3b and DNMT3L, but only DNMT1, DNMT3a and DNMT3b possess methyltransferase activity.

regulate transcription, as shown for the H19 imprinting control region and the Osbpl1a/Impact loci24. Other examples of epigenetic players that cause three-dimensional (3D) rearrangements of the genome to regulate gene expression are the DNA methylation enzyme (DNA meth- yltransferase 1; DNMT1) that participates in the maintenance of the nucleolar compartment architecture25 and the methyl-CpG-binding domain (MBD) protein MeCP2, which is required for the formation of a silent chromatin loop at the Dlx5-Dlx6 locus26 (the 3D organization of the genome is discussed in more detail in the review by van Steensel and Dekker27 in this issue).

DNA methylation is not only linked to gene transcription regulation. A significant fraction of deeply methylated CpGs is found in repeti- tive elements (Fig. 1d). This DNA methylation is needed to protect chromosomal integrity, which is achieved by preventing reactivation of endoparasitic sequences that cause chromosomal instability, transloca- tions and gene disruption11.

Although DNA methylation mainly occurs in the CpG dinucle- otide context in mammals, non-CG methylation has recently been described in humans at CHG and CHH sites (where H is A, C or T). CHG and CHH methylation has been found in stem cells and seems to be enriched in gene bodies directly correlated with gene expres- sion and to be depleted in protein binding sites and enhancers28. The levels of non-CpG methylation decrease during differentiation and

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CHD5 expression is repressed by CpG island methylation

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p400 has HAT activity

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Figure 2 Epigenetic machinery and interplay among epigenetic factors. Epigenetic marks are catalyzed by different epigenetic complexes, whose principal families are illustrated here. (a–c) Epigenetic regulation depends on the interplay among the different players: DNA methylation (a), histone marks (b) and nucleosome positioning (c). The interaction among the different factors brings about the final outcome. This figure illustrates selected examples of the possible interrelations among the various epigenetic players.

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All histones are subject to post-transcriptional modification. Several post-transcriptional modifications occur in histone tails: acetylation, methylation, phosphorylation, ubiquitination, SUMOylation and ADP- ribosylation52,54, among others (Fig. 3). Histone modifications have important roles in transcriptional regulation, DNA repair55, DNA repli- cation, alternative splicing56 and chromosome condensation52.

In relation to its transcriptional state, the human genome can be roughly divided into actively transcribed euchromatin and transcriptionally inac- tive heterochromatin. Euchromatin is characterized by high levels of acetylation and trimethylated H3K4, H3K36 and H3K79. On the other hand, heterochromatin is characterized by low levels of acetylation and high levels of H3K9, H3K27 and H4K20 methylation57. Recent studies have demonstrated that histone modification levels are predictive for gene expression. Actively transcribed genes are characterized by high levels of H3K4me3, H3K27ac, H2BK5ac and H4K20me1 in the promoter and H3K79me1 and H4K20me1 along the gene body58 (Fig. 4).

However, the notion of heterochromatin as a transcriptionally inactive region has been challenged by the discovery of numerous noncoding RNAs (ncRNAs) derived from heterochromatic loci51. For instance, Schizosaccharomyces pombe centromeric regions express siRNAs that bind to the RNA-induced transcriptional silenc- ing complex and provide sequence specificity to the complex. The RNA-induced transcriptional silencing complex is required for H3K9 methylation at centromeric repeats and for the recruitment of the histone methylation enzyme Clr4, which is essential for the spread- ing of heterochromatic domains51,59,60. But centromeric siRNAs are not the only ncRNAs that are capable of directing histone modifica- tions61. Well-known examples of this phenomenon in humans are the ncRNAs XIST and HOTAIR. XIST is involved in the silencing of the inactive X chromosome in females, through the recruitment of Polycomb-repressing complexes (PRC) with methyltransferase and histone ubiquitinase activity62,63. HOTAIR is a lincRNA transcribed from the HOXC cluster that represses genes in the HOXD cluster by recruiting the histone methyltransferase PRC2 (ref. 64).

All the modifications described so far are covalent post-transcrip- tional modifications. However, a new type of modification has recently been described. The histone H3 tail is clipped after the Ala21 residue, cutting off the N-terminal 21 residues and associated post-transcrip- tional modifications. This modification represents the first massive clearing of histone marks to be reported. Histone H3 clipping seems to be inhibited by H3K4me65.

Histones can be modified at different sites simultaneously. The core histones forming the nucleosome can each have several modifications, giving rise to cross-talk among the different marks. Communication among histone modifications can occur within the same site66, in the same histone tail67 and among different histone tails68 (Fig. 2b). Thus, a single histone mark does not determine outcome alone; instead, it is the combination of all marks in a nucleosome or region that specifies outcome. A recent paper has described the existence of up to 51 distinct ‘chromatin states’ based on the enrichment of specific combinations of histone modifications. Distinct biological roles are suggested for the different chromatin states69. An interesting case of co-existing histone modifications is found in ES cells within the ‘bivalent domains’, where the H3K4me3 active mark is found together with the H3K27me3 repres- sive mark at promoters of developmentally important genes. Bivalent domains enable ES cells to tightly regulate and rapidly activate gene expression during different developmental processes, but are lost with cell commitment70,71.

As mentioned before, all the epigenetic players interact with each other. An interesting example of the interplay between histone modi- fications and DNA methylation is the relationship between DNMT3L

The catalytic members of the DNMT family are customarily classi- fied into de novo DNMTs (DNMT3A and DNMT3B) and maintenance DNMTs (DNMT1). DNMT3A and DNMT3B are thought to be respon- sible for establishing the pattern of methylation during embryonic devel- opment. The de novo DNMTs are highly expressed in embryonic stem (ES) cells and downregulated in differentiated cells15. The DNMT3 family con- tains a third member, DNMT3L, which is required for establishing mater- nal genomic imprinting, despite being catalytically inactive35. DNMT3L is expressed during gametogenesis when genomic imprinting takes place. It acts as a general stimulatory factor for DNMT3a and DNMT3b and interacts and co-localizes with them in the nucleus36,37.

The maintenance DNMT, DNMT1, has a 30- to 40-fold preference for hemimethylated DNA, and also has de novo DNMT activity. DNMT1 is the most abundant DNMT in the cell and is transcribed mostly during the S phase of the cell cycle. It is most often needed to methylate hemimethy- lated sites that are generated during semi-conservative DNA replication (Fig. 2). In a cellular context the affinity of DNMT1 to newly synthesized DNA is increased by its interaction with the DNA polymerase processing factor proliferating cell nuclear antigen (PCNA), ensuring localization to the replication fork38. The ubiquitin-like plant homeodomain and RING finger domain-containing protein 1 (UHRF1) could perform a similar function, tethering DNMT1 to hemimethylated DNA, thanks to its SET and RING associated–domain, that shows strong preferential binding to hemimethylated CpGs39 (Fig. 2a).

However, the division of labor between de novo and maintenance methylation is not always so clear, and a revised model has recently been proposed by Jones and Liang40. The updated model still supports the idea that the bulk of DNA methylation in dividing cells would be maintained by DNMT1 in conjunction with UHRF1 and PCNA. But it also proposes that DNMT3A and DNMT3B, which have been shown to anchor strongly to nucleosomes containing methylated DNA41 (Fig. 2a), are compartmentalized in methylated regions, methylating the sites missed by DNMT1 at the replication fork. Finally, DNMT2, despite containing all the catalytic signature motifs of conventional DNMTs, has almost no DNMT activity. However, it has been reported that DNMT2 methylates tRNAAsp (ref. 42).

One of the most intriguing questions in the DNA methylation field is how the DNA methylation machinery is directed to specific sequences in the genome. Several mechanisms have been proposed, mainly suggest- ing interaction of DNMTs with other epigenetic factors41,43–47 (Fig. 2). More recently, small inhibitory (si)RNA-mediated, RNA-directed DNA methylation have also been described. In plants, RNA-directed DNA methylation is a stepwise process initiated by double-stranded RNAs that recruit DNMTs to catalyze de novo DNA methylation of specific regions including not only gene promoters but also repetitive sequences48–51. Although the process is well studied in plants and some of the RNA- directed DNA methylation components are conserved in mammals, it is still unclear if similar processes are involved in regulating DNA methyla- tion in animals. There are no reports suggesting the involvement of long intergenic ncRNA (lincRNAs) in DNA methylation.

Histone modifications. Histones are key players in epigenetics. The core histones H2A, H2B, H3 and H4 group into two H2.A-H2.B dimers and one H3-H4 tetramer to form the nucleosome. A 147-bp segment of DNA wrapped in 1.65 turns around the histone octamer and neighbor- ing nucleosomes are separated by, on average, ~50 bp of free DNA. The core histones are predominantly globular except for their N-terminal tails, which are unstructured52. Histone H1 is called the linker histone. It does not form part of the nucleosome but binds to the linker DNA (that is, the DNA separating two histone complexes), sealing off the nucleosome at the location where DNA enters and leaves53.

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Nucleosome positioning. Nucleosomes are a barrier to transcrip- tion that blocks access of activators and transcription factors to their sites on DNA, at the same time they inhibit the elongation of the transcripts by engaged polymerases. The packaging of DNA into nucleosomes appears to affect all stages of transcription, thereby regulating gene expression.

In particular, the precise position of nucleosomes around the tran- scription start sites (TSSs) has an important influence on the initia- tion of transcription. A preferential positioning of nucleosomes can be described at any given genomic locus. Nucleosome displacements of as few as 30 bp at TSS have been implicated in changes in the activity of RNA polymerase II. Moreover, the 5′ and 3′ ends of genes possess nucleosome-free regions needed to provide space for the assembly and disassembly of the transcription machinery. The loss of a nucleosome directly upstream of the TSS is tightly correlated with gene activation, whereas the occlusion of the TSS by a nucleosome is associated with gene repression77,78 (Fig. 4).

Nucleosome positioning not only determines accessibility of the tran- scription factors to their target DNA sequence but has also been reported to play an important role in shaping the methylation landscape79 (Fig. 4). Besides transcription regulation, nucleosome occupancy also participates in directing meiotic recombination events80.

The precise function of nucleosomes is influenced by the incorpora- tion of different histone variants. Histone variants are distinguished from core histones by the fact that they are expressed outside of S phase and are incorporated into chromatin independently from DNA replication. They differ from core histones in their tails, in their domain structure and in a few key amino acids57. Histone variants regulate nucleosome positioning and gene expression23. For example, the incorporation of the histone variant H2A.Z protects genes against DNA methylation81. Thus, the interplay among different epigenetic partners becomes evident once

and H3K4. DNMT3L specifically interacts with histone H3 tails, inducing de novo DNA methylation by recruitment of DNMT3A; however, this interaction is strongly inhibited by H3K4me43. Furthermore, several histone methyltransferases have also been reported to direct DNA methylation to specific genomic targets by recruiting DNMTs44,45, helping in this way to set the silenced state established by the repressive histone marks. Moreover, histone methyltransferases and demethylases can also modulate the stability of DNMT proteins, thereby regulating DNA methylation levels46,47 (Fig. 2b). On the other hand, DNA methylation can also direct his- tone modifications. For instance, methylated DNA mediates H3K9me through MeCP2 recruitment72.

Many enzymes that catalyze covalent post-transcriptional modi- fications have been described52,73. Because the modifications are dynamic, enzymes to remove these post-transcriptional modifications have also been reported52,73,74. However, the list of histone modifi- cations, its writers and erasers, might not yet be completed. Of the enzymes that modify histones, methyltransferases, histone demethy- lases and kinases are the most specific to individual histone subunits and residues52,75. Conversely, most of the histone acetyltransferases (HATs) and histone deacetylases (HDACs) are not highly specific and modify more than one residue.

Many transcriptional co-activators (e.g., GCN5, PCAF, CBP, p300, Tip60 and MOF) have been reported to possess intrinsic HAT activity, whereas many transcriptional co-repressor complexes (e.g., mSin3a, NCoR/SMRT and Mi-2/NuRD) contain subunits with HDAC activity66. Surprisingly, it has recently been reported that HDACs and HATs are both targeted to transcribed regions of active genes by phosphorylated RNA polymerase II. Thus, most HDACs in the human genome function to reset chromatin by removing acetylation at active genes, whereas HATs, by contrast, are mainly linked to transcriptional activation76.

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Figure 3 Histone modifications. All histones are subject to post-transcriptional modifications, which mainly occur in histone tails. The main post- transcriptional modifications are depicted in this figure: acetylation (blue), methylation (red), phosphorylation (yellow) and ubiquitination (green). The number in gray under each amino acid represents its position in the sequence.

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peptidase 6 (DPP6) in melanomas are other well-studied examples of hypomethylated genes in cancer19,92. The most common LOI event due to hypomethylation is insulin-like growth factor 2 (IGF2), which has been reported in a wide range of tumor types, including breast, liver, lung and colon cancer96.

In contrast to global DNA hypomethylation, hypermethylation is observed at specific CpG islands (Fig. 1a). The transcriptional inactiva- tion caused by promoter hypermethylation affects genes involved in the main cellular pathways: DNA repair (hMLH1, MGMT, WRN, BRCA1), vitamin response (RARB2, CRBP1), Ras signaling (RASSFIA, NOREIA), cell cycle control (p16INK4a, p15INK4b, RB), p53 network (p14ARF, p73 (also known as TP73), HIC-1) and apoptosis (TMS1, DAPK1, WIF-1, SFRP1), among others15. Hypermethylated promoters have been pro- posed as a new generation of biomarkers and hold great diagnostic and prognostic promise for clinicians97 (reviewed in more detail by Jones and colleagues98 in this issue).

However, even though the focus of most studies is on CpG islands located in promoters, recent findings suggest that most of the aberrant DNA meth- ylation in cancer occurs in CpG island shores (e.g., in HOXA2 and GATA2) (Fig. 1b). Notably, most changes in CpG island shores (45–65%) seem to be associated with regions that become hypermethylated during normal tissue differentiation (e.g., in TGFB1 and PAX5)19,20. Differential DNA methylation seems to correlate with gene expression at CpG island shores just as it does with CpG islands21.

Human tumors are also characterized by an overall miRNA downregu- lation99 often caused by hypermethylation at the miRNA promoters100. For example, miR-124a is repressed by hypermethylation, mediating CDK6 activation and Rb phosphorylation101. Interestingly, inactivation of miRNA expression by hypermethylation is not only linked to cancer but also to metastasis development. Silencing of miR-148, miR-34b/c and miR-9 by promoter hypermethylation favors tumor dissemination from the original location102.

Hypermethylation patterns are tumor-type specific and it is still unclear why certain regions become hypermethylated, whereas others remain unmethylated. One possibility is that inactivation of particular genes confers a growth advantage, resulting in clonal selection15. In some cases, it has also been proposed that aberrant CpG-island meth- ylation could be due to the recruitment of DNMTs and HDACs to specific target genes mediated by fusion proteins, such as the promyelo- cytic leukemia–retinoic acid receptor-α (PML–RARA) fusion protein, expressed in some leukemias103. Another possibility is the spreading of methylation from highly methylated sequences to their surroundings is more pronounced in cancer. It has been reported that epigenetic silencing by DNA methylation can span 1-Mb-long regions of a chro- mosome104, resembling the loss of heterozygosity often observed in human tumors. This global distortion of the DNA methylation pattern could also be mediated by dysregulation of DNMT expression. DNMT1 and DNMT3b are overexpressed in many tumor types105. Moreover, DNMT expression can also be regulated by miRNAs. The miR-29 family is known to directly target and downregulate DNMT3A and DNMT3B, and indirectly target DNMT1 (ref. 106) (Fig. 2a).

Histone modifications. The most prominent alteration in histone modifi- cation in cancer cells is a global reduction of monoacetylated H4K16 (ref. 107). Loss of acetylation is mediated by HDACs, which have been found to be overexpressed108 or mutated109 in different tumor types. The main class of HDACs implicated in this process is the Sirtuin family of proteins110. Gene expression and deacetylase activity of SirT1 is upregulated in several cancer types. Moreover, SirT1 interacts with DNMT1, thus affecting DNA methylation patterns25. HDAC expression can be regulated by miRNAs, such as miR-449a, which, by repressing the expression of HDAC-1 in

more. The nucleosome remodeling machinery is influenced by DNA methylation82 and has been linked with specific histone modifications83 (Fig. 2c). MicroRNAs (miRNAs) can also regulate histone variant replace- ment84 or interact with chromatin remodeling complexes mediating the exchange of specific subunits85.

Several groups of large macromolecular complexes are known to move, destabilize, eject or restructure nucleosomes in an ATP hydrolysis–depen- dent manner. These complexes, known as chromatin remodeling com- plexes, can be classified into four families (SWI/SNF, ISWI, CHD and INO80) that share similar ATPase domains but differ in the composition of their unique subunits86.

In the first of these families, the SWI/SNF family, members have as a catalytic unit either Brahma (BRM) or BRG1, which share ~75% of iden- tity but differ in their first 60 amino acids. SWI/SNF family complexes are master regulators of gene expression, regulating expression of—among others—FOS, CSF-1, CRYAB, MIM-1, p21 (also known as CDKN1A), HSP70, VIM and CCNA2. Moreover, SWI/SNF has also been reported to modulate alternative splicing87.

Many members of the second class, the ISWI family, such as ACF and CHRAC, have been reported to promote chromatin assembly and to repress transcription. However, NURF, another complex of this family, is capable of activating RNA polymerase II thus participating in transcrip- tional activation88.

In the CHD family, some members participate in the sliding and ejec- tion of nucleosomes, promoting transcription; however, others, such as the Mi-2/NuRD complex, have repressive roles and contain HDAC activity and MBD proteins88 (Fig. 2c).

Members of the last group, the INO80 family, have been reported to participate in multiple cellular processes: transcriptional activation, DNA repair, telomere regulation, chromosome segregation and DNA replication among others86. However, the SWR1 member has the unique ability to restructure the nucleosome, removing the H2A-H2B dimers and replacing them with H2A.Z-H2B dimers88 (Fig. 2c).

Epigenetic modifications in cancer In addition to featuring classic genetic mutations, cancer cells present a profoundly distorted epigenetic landscape (Table 1). The cancer epigenome is characterized by global changes in DNA methylation, histone modification patterns and chromatin-modifying enzyme- expression profiles11,89, which play important roles in cancer initia- tion and progression.

DNA methylation. Cancer cells are characterized by a massive global loss of DNA methylation90 (20–60% less overall 5-methyl-cytosine). At the same time, the acquisition of specific patterns of hypermethylation at the CpG islands of certain promoters is frequently observed (Fig. 1a).

Global hypomethylation occurs mainly at repetitive sequences, promoting chromosomal instability, translocations, gene disruption and reactivation of endoparasitic sequences90,91 (Fig. 1d). A clear case is the LINE family member L1, which has been shown to be hypomethylated in a wide range of cancers, including breast, lung, bladder and liver tumors92.

Hypomethylation at specific promoters can activate the aber- rant expression of oncogenes and induce loss of imprinting (LOI) in some loci. For instance, MASPIN (also known as SERPINB5), a tumor suppressor gene that becomes hypermethylated in breast and prostate epithelial cells93, appears to be hypomethylated in other tumor types. MASPIN hypomethylation, and therefore its expres- sion, increases with the degree of dedifferentiation of some types of cancer cells94,95. S100P in pancreatic cancer, SNCG in breast and ovar- ian cancers and melanoma-associated gene (MAGE) and dipeptidyl

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by cytokine signaling. H3K41ph prevents the binding of heterochromatin protein1α (HP1α) to this region of H3, increasing the expression of the genes located there, as it was reported in the lmo2 promoter. JAK2 is frequently activated by chromosomal translocations or point mutations in hematological malignancies126.

Nucleosome positioning. All families of chromatin remodelers have been tied to cancer, although in most cases the molecular mechanisms underlying their function remain unclear. For instance, BRG1 and BRM, the ATPase subunits of SWI/SNF complexes, have been characterized as tumor suppressors and are silenced in about 15–20% of primary non- small-cell lung cancers127. Surprisingly, an oncogenic role for BRG1 as a p53 destabilizer has also been proposed128. Mutations in SNF5, a subunit of the SWI/SNF remodeling complex, have been observed in sporadic renal rhabdoid tumors and in choroid plexus carcinomas, meduloblasto- mas and central primitive neuroectodermal tumors129.

Nucleosome remodeling is also involved in the transcriptional repres- sion by promoter hypermethylation (Fig. 4). Promoter hypermethylation results in the occupation of the TSS by a nucleosome, as has been reported for MLH1 in colon cancer130. The genes encoding subunits of the chro- matin remodeling complexes (e.g., CHD5 (ref. 131)) themselves are also targets of CpG island hypermethylation in cancer, thereby downregu- lating its expression and impairing the normal chromatin remodeling processes (Fig. 2c).

In addition to nucleosome positioning, histone variants have also been related to cancer. For example, increased expression of MacroH2A is involved in senescence. Thus, lung tumors with highly expressed MacroH2A have a better prognosis, with lower proliferation rates and less frequent recurrence132.

Epigenetic modifications in neurodevelopmental disorders The central nervous system is one of the most complex systems in humans. Not only do the different regions of an organ present different expression patterns, but the same cell type has different transcriptional regulation depending on its localization in the organ133. The mitotic exit, when neu- ral cells lose their multipotency, is a key step in nervous system develop- ment85,134, requiring a very precise tuning of the transcriptional program. Epigenetic factors are key players in this regulation. Genetic mutations in epigenetic genes cause dysfunctions that lead to certain neurodevel- opmental disorders. Here, we classify them according to the epigenetic machinery that becomes mutated.

prostate cancer cells, regulates cell growth and viability111 (Fig. 2b). In addition to alteration in HDAC expression, several cancer types (e.g., colon, uterus, lung and leukemia) also bear translocations leading to the formation of aberrant fusion proteins, mutations or deletions in HATs and HAT-related genes112,113, thus contributing to the global imbalance of histone acetylation.

Besides the global loss of H4K16ac, cancer cells suffer a global loss of the active mark H3K4me3 (ref. 114) and the repressive mark H4K20me3 (ref. 107), and a gain in the repressive marks H3K9me (ref. 115) and H3K27me3 (ref. 116). Altered distribution of the histone methyl marks in cancer cells is mainly due to the aberrant expression of both histone methyltransferases and histone demethy- lases75. A recent publication has described inactivating mutations in the histone methyltransferase SETD2 and in the histone demethylase UTX and JARID1C in renal carcinomas117. Another example is the histone methyltransferase EZH2—a subunit of the PRC2 and PRC3 complexes—which enhances proliferation and neoplastic transfor- mation and is overexpressed in several cancer types. Overexpression of the lincRNA HOTAIR in breast tumors and metastases retargets PRC2 and alters H3K27me3 landscape118. Moreover, EZH2 expres- sion is upregulated in many cancer tumors due to the genomic loss of miR-101 (ref. 119). In addition to its histone methyltransferase activ- ity, EZH2 interacts with DNMTs directly controlling DNA methyla- tion116. NSD1, another histone methyltransferase, has been reported to undergo promoter DNA methylation-dependent silencing in neu- roblastomas120. DOT1L, the major H3K79 histone methyltransferase, is essential for the establishment of a euchromatic state that allows the expression of tumor suppressor genes121,122.

In leukemias, the presence of mixed lineage leukemia (MLL) fusion oncoproteins leads to aberrant patterns of H3K79 and H3K4 methylation, resulting in altered gene expression of MLL targets123,124. Some histone demethylases (e.g., GASC1, LSD1, JmjC and UTRX) have also been shown to be upregulated or amplified in several cancers, including prostate cancer and squamous cell carcinomas125.

Although further studies are needed, histone phosphorylation also seems to be relevant in cancer. Histone phosphorylation plays a role in DNA damage-repair response, chromosome stability and apopto- sis. Recently JAK2, a nonreceptor tyrosine kinase that regulates several cellular processes by inducing cytoplasmic signaling cascade, has been reported also to be present in the nucleus, directly phosphorylating H3Y41 (Fig. 2b). Phosphorylated H3Y41 (H3Y41ph) levels are regulated

H3K9 H3K9 H3K9 H3K9 H3K27

H4K20 H4K20 H4K20 H3K27 H3K27

H3K4

H3K36 H3K79

M

M

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M M

M M

M MM

MM

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A AA

Figure 4 Nucleosome positioning patterns. Nucleosome positioning plays an important role in transcriptional regulation. Transcriptionally active gene promoters possess a nucleosome-free region at the 5′ and 3′ untranslated region, providing space for the assembly and disassembly of the transcription machinery. The loss of a nucleosome directly upstream of the TSS is also necessary for gene activation, whereas the occlusion of this position leads to transcription repression. DNA methylation regulates transcription, and thus interferes with nucleosome positioning. Methylated DNA seems to be associated with ‘closed’ chromatin domains, where DNA is condensed into strictly positioned nucleosomes, thereby impeding transcription. Conversely, unmethylated DNA is associated with ‘opened’ chromatin domains, which allow transcription.

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in the cAMP-response element binding protein (CBP), in another 3% of cases with mutations in EP300 and in ~42% of cases with an unidentified cause. CBP and EP300 function as transcriptional co-activators in addition to their HAT activity135. In Cbp+/− mice H2B acetylation is reduced by more than 30%, suggesting that the failure in long-term memory forma- tion could be explained by chromatin changes in one or several loci that control memory storage141.

The neurodevelopmental disease Coffin-Lowry syndrome is a rare X-linked disorder caused by loss-of-function mutations in RSK2, a serine/threonine protein kinase. RSK2 participates in the MAP kinase pathway, inducing the transient transcription of a set of genes. RSK2 mediates H3S10ph directly, changing chromatin structure and facilitating the binding of CBP, which acetylates H3 residues. Thus, RSK2 promotes gene transcription through chromatin opening142.

Nucleosome positioning. ATRX syndrome is an X-linked disorder caused by mutations in ATRX, a member of the Snf2 family of chromatin

DNA methylation. Rett syndrome is an X-linked neurological disease caused by point mutations in the MBD protein MeCP2. Both upregu- lation and downregulation of MeCP2 in the brain are associated with neurodevelopmental defects. Customarily, MeCP2 has been considered to function as a gene silencer, mediating the recruitment of HDACs to methylated DNA (Fig. 2b). Recently, new data have highlighted impor- tant roles for MeCP2 in chromatin architecture, regulation of mRNA splicing135,136 and active transcription of genes (e.g., Sst, Gprin1)137. Although transcriptional alterations have been described in some genes (e.g., Fkbp5, Mobp, Ddc and S100a9)138, imprinted regions (e.g., DLX5) and miRNAs (e.g., miR-184)139,140, MeCP2 deficiency does not result in high levels of genome-wide transcriptional alteration. It stills remains unknown whether or not the described alterations are causative.

Histone modifications. Rubinstein-Taybi syndrome is an autosomal dominant disorder associated with the dysfunction of a HAT. It is a geneti- cally heterogeneous disease associated in ~55% of cases with mutations

Table 1 Epigenetic modifications in human diseases

Aberrant epigenetic mark Alteration Consequences Examples of genes affected and/or resulting disease

Cancer

DNA methylation CpG island hypermethylation Transcription repression MLH1 (colon, endometrium, stomach11), BRCA1 (breast, ovary11), MGMT (several tumor types11), p16INK4a (colon11)

CpG island hypomethylation Transcription activation MASPIN (pancreas92), S100P (pancreas92), SNCG (breast and ovary92), MAGE (melanomas92)

CpG island shore hypermethylation Transcription repression HOXA2 (colon20),GATA2 (colon20)

Repetitive sequences hypomethylation Transposition, recombination genomic instability

L1 (ref. 11), IAP11, Sat2 (ref. 107)

Histone modification Loss of H3 and H4 acetylation Transcription repression p21WAF1 (also known as CDKN1A)11

Loss of H3K4me3 Transcription repression HOX genes

Loss of H4K20me3 Loss of heterochromatic structure Sat2, D4Z4 (ref. 107)

Gain of H3K9me and H3K27me3 Transcription repression CDKN2A, RASSF1 (refs. 115–116)

Nucleosome positioning Silencing and/or mutation of remodeler subunits

Diverse, leading to oncogenic transformation BRG1, CHD5 (refs. 127–131)

Aberrant recruitment of remodelers Transcription repression PLM-RARa103 recruits NuRD

Histone variants replacement Diverse (promotion cell cycle/destabilization of chromosomal boundaries)

H2A.Z overexpression/loss

Neurological disorders

DNA methylation CpG island hypermethylation Transcription repression Alzheimer’s disease (NEP)135

CpG island hypomethylation Transcription activation Multiple sclerosis (PADI2)135

Repetitive sequences aberrant methylation Transposition, recombination genomic instability

ATRX syndrome (subtelomeric repeats)135,143

Histone modification Aberrant acetylation Diverse Parkinson’s and Huntington’s diseases135

Aberrant methylation Diverse Huntington’s disease and Friedreich’s ataxia135

Aberrant phosphorylation Diverse Alzheimer’s disease135

Nucleosome positioning Misposition in trinucleotide repeats Creation of a ‘closed’ chromatin domain Congenital myotonic dystrophy151

Autoimmune diseases

DNA methylation CpG island hypermethylation Transcription repression Rheumatoid arthritis (DR3)154,155

CpG island hypomethylation Transcription activation SLE (PRF1, CD70, CD154, AIM2)6

Repetitive sequences aberrant methylation Transposition, recombination genomic instability

ICF (Sat2, Sat3), rheumatoid arthritis (L1)152,155

Histone modification Aberrant acetylation Diverse SLE (CD154, IL10, IFN-γ)6

Aberrant methylation Diverse Diabetes type 1 (CLTA4, IL6)159

Aberrant phosphorylation Diverse SLE (NF-κB targets)

Nucleosome positioning SNPs in the 17q12-q21 region Allele-specific differences in nucleosome distribution

Diabetes type 1 (CLTA4, IL6)

Histone variants replacement Interferes with proper remodeling Rheumatoid arthritis (histone variant macroH2A at NF-κB targets)157

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Nucleosome positioning. It has been suggested that the amplifica- tion of CTG repeats in congenital myotonic dystrophy is a very strong nucleosome positioning signal that mediates the creation of a closed chro- matin domain151. Despite this fact, which needs further investigation, little is known about the possible implications of nucleosome positioning or histone variants in neuronal malignancies.

Epigenetic modifications in autoimmune diseases Autoimmune diseases are characterized by the breakdown of immune tolerance to specific self-antigens. Different types of epigenetic alterations have been reported in this type of disorder (Table 1).

DNA methylation. Most of the research relating autoimmunity disorders and epigenetic changes has focused on DNA methylation alterations. In fact, one of the best known autoimmune diseases, the ICF (immunodefi- ciency, centromeric instability and facial anomalies) syndrome, is caused by heterozygous mutations in DNMT3B. ICF patients show marked DNA hypomethylation in the pericentromeric satellite 2 and 3 repeats, alpha satellite sequences, Alu sequences and the D4Z4 and NBL2 repeats. Conversely, ICF patients have almost unchanged global DNA methylation levels143,147, although several genes regulating development, neurogenesis and immune function have aberrant expression152.

Other autoimmune diseases, unrelated to mutations in the DNA methylation machinery, also present global hypomethylation, as is the case for systemic lupus erythematosus (SLE) and rheumatoid arthritis. The hypomethylated regions are not yet well defined, although some hypomethylated sites have been reported. SLE patients have DNA hypomethylation in PRF1, CD70, CD154, IFGNR2, MMP14, LCN2, CSF3R and AIM2 among other genes, and also in the ribosomal RNA gene promoter, 18S and 28S (ref. 6). The mechanisms responsible for this widespread hypomethylation are beginning to be revealed. It has been recently reported that hypomethylation in SLE is partially mediated by miR-21 and miR-148a that directly and indirectly target DNMT1 (ref. 153). In rheumatoid arthritis, not only hypomethylated sites (e.g., in L1 and IL6) but also hypermethylated sites (e.g., in DR3) have been described154,155.

Histone modifications. Little is known about the role of histone modi- fications in autoimmune diseases, although initial studies are begin- ning to shed some light in this area. In human SLE T-cells, the HDAC inhibitor trichostatin A reverses the aberrant expression of CD154, IL10 and interferon (IFN)-γ products156. A role for histone modifications in rheumatoid arthritis has also been described. Because the transcrip- tion factor NF-κB—a key regulator inflammatory—binds very poorly to nucleosomal DNA, histone modifications are needed to allow effi- cient NF-κB binding to its targets: histone H3K9 and S10 (also known as PSMD6) phosphoacetylation, reduction in H3K9me and increase in H3/H4 acetylation157. Thus, in rheumatoid arthritis, the reduced activity of HDACs plays a key role in regulating NF-κB–mediated gene expression158. Patients with type 1 diabetes also present a characteristic pattern of histone marks, showing lymphocytes but not monocytes with increased H3K9me2 in a subset of genes associated with autoimmune and inflammatory pathways (e.g., CLTA4, IL6)159.

However, histone modifications have a role not only in transcription regulation. Nucleosomes are key autoantigens in SLE, being present in the circulation because of increased apoptosis and/or insufficient clearance. In apoptosis, histone modifications occur, such as H2BS14 phosphorylation160, H3T45 phosphorylation161, H3K4 trimethyla- tion162, H4 triacetylation at K8, K12 and K16 (ref. 163) as well as H2BK12 acetylation164. It has been suggested that histone modifica- tions arising during apoptosis make released apoptotic nucleosomes

remodelers. The ATRX protein interacts with the SET domain of the histone methyltransferase EZH2, the Daxx transcriptional cofactor, MeCP2 and the chromoshadow domain of HP1 proteins. It partici- pates among other cellular processes in heterochromatin formation, chromosome alignment at the meiotic spindle, chromosome cohesion in somatic cells and maintenance of X-chromosome inactivation in women. Because no DNA repair defects or genomic instability occurs in ATRX patients, it has been suggested that ATRX may regulate the transcription of a specific set of target genes. Although global DNA methylation is unchanged in ATRX patients, aberrant DNA methyla- tion in some repetitive sequences has been reported135,143.

Epigenetic modifications in neurodegenerative and neurological diseases Recent studies have also shed some light on the relationship between epigenetic alterations and neurodegenerative and/or neurological diseases. The majority of the evidence centers on DNA methylation and histone modification (Table 1).

DNA methylation. DNA methylation patterns appear to be distorted in a great deal of neurological diseases, giving rise to hyper- and hypomethylated sites. For instance, FMR1 promoter hypermethyla- tion has been described in Fragile X syndrome patients. Fragile X syndrome is caused by a CGG trinucleotide repeat expansion in the 5′-untranslated region of FMR1. Expansion of the CGG trinucleotide repeats to >200 copies induces methylation of FMR1, leading to its transcriptional silencing144. Other reported cases of hypermethy- lated promoters include neprilysin (NEP, also known as MME) in Alzheimer’s disease, FXN in Friedreich’s ataxia and SMN2 in spinal muscular atrophy135.

Conversely, hypomethylated sites have also been reported. For example, the substantia nigra of Parkinson’s patients overexpresses tumor necrosis factor alpha (TNFα) due to its promoter hypomethy- lation, thereby inducing apoptosis of neuronal cells145. Other cases of hypomethylation were reported in the promoter region of PADI2 for multiple sclerosis patients135 and in the Avp enhancer for mice subjected to early-life stress146. Alterations in DNA methylation pat- terns not only affect gene promoters but may also lead to LOI. Classic examples of LOI are the Prader-Willi and the Angelman syndromes. Both diseases involve aberrant DNA methylation in the imprint- ing controlled region at 15q11-q13. Prader-Willi syndrome arises from the loss of paternally expressed genes in this region, whereas Angelman syndrome arises from the loss of the maternally expressed UBE3A gene147.

Histone modifications. The pattern of histone marks is also altered in neurological diseases, histone hypoacetylation being the most fre- quently observed change. A good example of histone hypoacetylation is amyotrophic lateral sclerosis (ALS). ALS patients have aggregates of the protein FUS in cytoplasmic deposits of misfolded proteins. FUS is able to bind CBP, strongly inhibiting its HAT activity and to negatively regulate specific CREB target genes. Thus, overexpression of FUS induces histone hypoacetylation135. Other cases of hypoacetylation in neurological diseases are found in Parkinson’s and Huntington’s disease135 and Friedreich’s ataxia148. Despite histone hypoacetylation, more changes relating neurological diseases and histone marks have been reported. For example, histone acetylation and phosphoryla- tion alterations are typical in Alzheimer’s disease and epilepsy, H3K9 hypertrimethylation has been described in Huntington’s disease135 and Friedreich’s ataxia149 and the histone demethylase PHF8 has been involved in X-linked mental retardation150.

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would be of enormous use in basic and applied research and would be relevant for focusing pharmacological research on the most promising epigenetic targets. A key topic for future research is the implementation of mechanisms for the release of whole genome methylation and histone modification maps into public databases.

COMPETING FINANCIAL INTERESTS The authors declare no competing financial interests.

Published online at http://www.nature.com/naturebiotechnology/. Reprints and permissions information is available online at http://npg.nature.com/ reprintsandpermissions/.

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Conclusions and perspectives In the past decade the fast-evolving field of epigenetics has taken center stage, as shown by the results of a simple PubMed search of the term ‘epi- genetic’: there were around 200 papers published in 1999, but more than 2,500 in 2009. Such startling growth in the number of publications attests to the intense research activity being undertaken in the field.

Great progress has been made in the description of epigenetic modi- fications in normal and diseased tissues. Thus far, efforts in epigenetic research have mainly focused on cancer, but as the field has grown, it has provided new insights into other types of diseases, particularly neu- rological and autoimmune diseases. Epigenetic alterations are likely to be found in other disorders; indeed, they have already been described in cardiovascular diseases166–168, metabolic diseases169, myopathies170 and children born from assisted reproductive treatments171.

In the past months, we have witnessed a flood of new discoveries: the description of comprehensive DNA methylomes of humans22 and viruses146, the putative identification of non-CpG methylation28, the definition of CpG island shores19, the involvement of aberrant DNA methylation in other diseases besides cancer6,135, the description of new histone modifications and histone variants and their roles45,126,161, the report of new epigenetic machinery such as the DNA demethylase Tet1 (refs. 172,173) and the histone kinase JAK2 (ref. 126), the description of new mutations in the epigenetic machinery99 and the flurry of ncRNA studies that highlight the importance of RNA-mediated regulation in epigentics174,175.

Many key questions remain unanswered: what are the functions of non- CpG methylation and 5-hydroxymethylcytosine in human cells? Are there new DNA or histone modifications yet to be discovered? What are the rules of the so-called histone code? What are the roles and function of ncRNAs and how many more ncRNAs are yet to be described? How is the placement of epigenetic marks and its specificity regulated? How are caus- ative epigenetic changes going to be distinguished from mere bystander alterations? Is it always clear whether a specific epigenetic modification is a cause or a consequence of a certain process? One of the most intrigu- ing questions is how do the various epigenetic players interact and what mechanisms convey sequence specificity to the enzymes involved? Further research is needed and efforts focused on such questions will be key in our progress toward a complete map of epigenetic regulation.

Advances in technological development are enabling epigenomic analysis on a large scale. The first whole-genome, high-resolution maps for epigenetic modifications are appearing, but we should not stop here. Detailed human DNA methylomes, histone modification and nucleosome positioning maps in healthy and diseased tissues are needed. In this regard several international projects and initiatives have been established: the NIH Roadmap Epigenomics Program, the ENCODE Project, the AHEAD Project and the Epigenomics NCBI browser, among others (see the commentaries by Bernstein and colleagues176 and Satterlee and colleagues177 in this issue). The detailed study of the epigenetic maps

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Maintaining cell differentiation.pdf

The question of whether cellular differentiation is asso- ciated with irreversible restrictions in the capacity to generate immature cells that can support the develop- ment of a new organism has been central to biologists for almost a century. In 1938, Hans Spemann1 suggested that the transfer of cell nuclei between different cells could resolve this fundamental question. That differentiated cells are not irreversibly locked in their mature identity but retain a capacity to generate all other cell types of an organism has indeed been demonstrated in somatic cell nuclear transfer (SCNT) experiments, in which they can be reprogrammed into pluripotency 2,3. Numerous other studies have tackled this question by other approaches, including induced cell fusions and forced expression of key developmental transcription factors (BOX 1). The most striking advancement, which has far-reaching implications in the area of cell engineering, is the gen- eration of induced pluripotent stem cells (iPSCs) by forced expression of only a few transcription factors4. These manipulations, which are discussed in numerous excellent reviews5–7, have clearly demonstrated that the differenti- ated state is certainly not ‘terminal’ in the sense that it is an irreversible cellular state. However, the more dif- ferentiated a cell is, the more difficult it is to reprogram8 (reviewed in REF. 9), demonstrating that fully mature cells have an extraordinary ability to maintain their differentiated traits.

The consequences of loss of phenotype or uncontrolled transdifferentiation would of course be detrimental: cancer is associated with transitions that resemble reprogramming

into more undifferentiated or even pluripotent-like states10,11, and other abnormal cellular states, such as those that are seen in certain metaplasias, are characterized by loss of a normal cellular identity (reviewed in REF. 12).

In recent years, many of the signalling pathways and transcriptional mechanisms that underlie important cell fate decisions and the establishment of differenti- ated traits have been elucidated. The mechanisms that ensure how cellular identities are stably maintained in mammalian cells are less understood, but our growing knowledge of how cell fates arise is making it increas- ingly feasible to begin addressing this question as well. In this Review, we look at experiments such as cell fusions and the ectopic expression of specific transcription fac- tors and discuss what they can tell us about mechanisms that maintain cell identity. Key transcription factors that are important for specifying cell identities during devel- opment often remain expressed in mature cell types. We also discuss how experimental strategies such as condi- tional gene ablation in mice are helping to elucidate how certain transcription factors are continuously required to prevent the loss of acquired cell identities, whereas others are more dispensable in differentiated cells. We describe how such results may relate to the function of transcription factors within more or less stable regula- tory networks and how different types of mature cells may be distinct with respect to their intrinsic plastic- ity and propensity to convert into alternative cellular identities. Finally, we discuss the implications of the maintenance of differentiated cell identity for disease.

Ludwig Institute for Cancer Research Ltd, BOX 240, Karolinska Institutet, S-171 77 Stockholm, Sweden; and Department of Cell and Molecular Biology, Karolinska Institutet, von Eulers väg 3, 171 77 Stockholm, Sweden. e-mails: [email protected]; [email protected] doi:10.1038/nrg3209

Somatic cell nuclear transfer (SCNT). The process by which the nucleus from an adult cell is transferred into a previously enucleated cell; the reconstructed oocyte is activated, which initiates subsequent development.

Reprogramming The conversion of a differentiated cell to another cell type, either to another differentiated cell type (transdifferentiation) or to a progenitor (dedifferentiation).

Maintaining differentiated cellular identity Johan Holmberg and Thomas Perlmann

Abstract | Various studies have demonstrated that somatic differentiated cells can be reprogrammed into other differentiated states or into pluripotency, thus showing that the differentiated cellular state is not irreversible. These findings have generated intense interest in the process of reprogramming and in mechanisms that govern the pluripotent state. However, the realization that differentiated cells can be triggered to switch to considerably different lineages also emphasizes that we need to understand how the identity of mature cells is normally maintained. Here we review recent studies on how the differentiated state is controlled at the transcriptional level and discuss how new insights have begun to elucidate mechanisms underlying the stable maintenance of mature cell identities.

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NATURE REVIEWS | G E N E T I C S VO LU M E 1 3 | J U N E 2 0 1 2 | 429

© 2012 Macmillan Publishers Limited. All rights reserved

Induced pluripotent stem cells (iPSCs). Pluripotent cells that can be generated from many different types of somatic cells by expression of only a few pluripotency-related transcription factors and that have properties of embryonic stem cells.

Metaplasias Environmentally induced processes in which one differentiated cell type is transformed into another differentiated cell type.

Heterokaryons Non-dividing cells that contain two or more nuclei in a common cytoplasm as a consequence of cell fusion between cells of different identities.

Binary cell specification The process through which two different cell types are specified from a common progenitor.

Lessons from reprogramming Heterokaryons and the importance of continuous instructive regulation. The use of cell fusions has proved to be important in addressing questions of how differen- tiated cellular traits are maintained. Induced cell fusions of differentiated cells can form multinuclear non-divid- ing heterokaryons, in which nuclei from the original cells remain intact13,14. Heterokaryons can thus be regarded as ultimate gain-of-function experiments that allow inter- rogation of how the complete cellular content of one cell influences the genome of another. Fusing cells from one species with a different cell type from another spe- cies made it possible to follow species-specific marker gene expression in resulting heterokaryons. This type of experiment demonstrated that unidentified regulators of one cell can enforce cell-type-specific gene activation in the nucleus of another 15. Thus, when mouse myo- tubes are fused to different human cell types, including fibroblasts, neural cells, keratinocytes, B lymphocytes or hepatocytes, their differentiated traits are rapidly sup- pressed, and human muscle cell markers are induced15–20. It seems as if the fusion partner that contributes quan- titatively more cytoplasm and nuclei will dominate and induce rapid and efficient reprogramming of the fusion partner’s genome19. Recent studies have also begun to address the influence of histone modifications and DNA methylation in the reprogramming process in hetero- karyons20–22. Together, the data point to the important

conclusion that reprogramming is rapid, highly efficient and does not require ongoing DNA replication for major changes in gene expression and patterns of DNA and histone modifications.

Data from cell fusion experiments thus support the important concept that the differentiated state is con- tinuously governed by instructive regulators that remain active in non-dividing differentiated cells. This idea was proposed as early as 1991 by Blau and Baltimore23 and was based on emerging reports of the plasticity of dif- ferentiation states, including studies of reprogrammed nuclei in heterokaryons and transcription-factor- induced transdifferentiation events.

Transcription-factor-induced reprogramming. Intense interest in how cell types are specified from undiffer- entiated stem cell populations has revealed the central role of transcription factors that orchestrate the pro- gressive development of specific cell lineages into ter- minally differentiated states. These findings also set the stage for more direct investigation of how specific tran- scription factors contribute to the active maintenance of cellular identities. The function of transcription factors can thus be studied both by forced expres- sion in cells in which they are not normally expressed and by loss-of-function experiments in which selected transcription factors have been ablated.

Numerous studies analysing how forced mis- expression of transcription factors influence cells have demonstrated robust lineage reprogramming in per- missive cellular contexts. This was first demonstrated in the 1980s when Weintraub and co-workers24 showed that the muscle-specific transcription factor myo- blast determination protein 1 (MYOD1) can induce myotube formation when it has been mis-expressed in dividing fibroblasts. Other more recent examples include switching of committed erythroid precur- sors into monocytic lineage, or vice versa25–27, lineage conversion of muscle cell progenitors into brown fat cells28 and numerous examples of robust lineage switch- ing in central nervous system progenitors29–33. In cell fate specification, transcription factors often function in cross-inhibitory regulation of other transcription factors to regulate mutually exclusive developmental binary cell specification decisions (FIG. 1a). Such cell fate determination is followed by feedforward induction of additional transcription factors that cooperatively execute the continued differentiation process, as sche- matically illustrated in FIG. 1a. Such feedforward cascades ensure fidelity and specificity in regulation and have frequently been observed as one of the major regula- tory network motifs used in development (reviewed in REFS 34,35). Transcription factors can evidently mimic such regulatory events and can also induce efficient binary switching in permissive cellular contexts in which they have been ectopically expressed (reviewed in REF. 5). Other experimentally induced cell fate con- versions lead to more dramatic developmental ‘jumps’ — a process that is often referred to as transdifferentia- tion — and seem to occur through mechanisms that do not closely recapitulate normal developmental cell fate

Box 1 | Different strategies to achieve reprogramming of cells

Differentiated cells are usually stably maintained and do not alter their phenotypes into alternative cellular identities. However, for more than 50 years, it has been evident that the differentiated state is not irreversible. Using different strategies, the following experimental paradigms have revealed a striking plasticity in the differentiated state.

Somatic cell nuclear transfer Reprogramming into totipotency was first demonstrated by Gurdon’s somatic cell nuclear transfer experiment, whereby a nucleus from a differentiated cell that had been transferred to an enucleated oocyte was reprogrammed so that it could support the development of an animal2. Such reprogramming has since then also been reproduced in mammals3.

Cell fusion Cell fusion of somatic cells can form non-dividing multinuclear cells that are referred to as heterokaryons. They can be of different identity and species, and thus it is possible to analyse expression of markers from each original cell type and determine the extent of reprogramming13–15.

Induced pluripotent stem cells A striking reprogramming method that may be of considerable importance for cell regenerative medicine is the demonstration that generation of induced pluripotent stem cells can be achieved by overexpression of a only a few key transcription factors in somatic cells: for example, POU domain, class 5, transcription factor 1 (POU5F1), SOX2, Krüppel-like factor 4 (KLF4) and MYC4.

Transdifferentiation by transcription factor expression Direct reprogramming into alternative cellular identities (a process that is often referred to as transdifferentiation) can also be achieved as a result of forced transcription factor expression. This was first shown for myoblast determination protein 1 (MYOD1) that could convert fibroblasts into skeletal muscle cells24. Numerous examples have now been described and show that combinations of transcription factors can convert fibroblasts, for example, into other types of differentiated cells, such as macrophages, neurons and hepatocytes (reviewed in REF. 5).

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Cell type 1a

b

Cell type 2

A + B → CA → B

A D

A + B + C

D + E → FD → E D + E + F

A

A

A A D B C B C D

C D

A B

Lineage committment leads to binary switch

Cross-antagonistic regulation of transcription factors A and D

Feedforward induction of transcription factors B and C

Feedforward induction of transcription factors E and F

‘Terminal selector’ regulation in, for example, C. elegans neurons

Hypothetical more complex regulatory logic in higher vertebrates

Effector genes

Transcription factor Transcription factor network

Feedforward cascades Hierarchical organization of several transcription factors emanating from an initiating transcription factor that sequentially activates downstream transcription factors that in turn activate each other.

switching. For example, in some studies, transcription- factor-induced lineage reprogramming of fibroblasts into cell types such as cardiomyocytes, neurons or macrophages occurs without transit through an inter- mediate undifferentiated state36–42. The in vivo repro- gramming of adult exocrine pancreatic cells into insulin-producing β-cells by mis-expression of three pancreatic developmental transcription factors in adult mice provides another example of transdifferentia- tion that does not require transition through a prolif- erative progenitor state43. A common theme in these

experiments is the use of several transcription factor combinations, emphasizing that selected combinations of factors have a profound instructive capacity that is independent of developmental context. This concept corresponds well with the heterokaryon experiments, which demonstrate that sustained instructive regulation defines the identity of differentiated cells.

Instructive transcription factor networks Studies have begun to address how transcription fac- tors that are required in early cell fate specification and that remain expressed in differentiated cells also contribute to the differentiated cell identity in mature cells. A number of such experiments have focused on nerve cells, which are interesting models for character- izing mechanisms that are needed to maintain a stable cell identity owing to their longevity in higher animals.

Neuron identities in C. elegans are maintained by terminal selector genes. The simple body plan in fully developed Caenorhabditis elegans has enabled genetic studies that have elucidated mechanisms underlying the development of neurons as well as mechanisms that are important for the maintenance of neuronal traits. In developing neuronal cell lineages, sequen- tially acting regulatory inputs initiate the expression of neuron-type-specific transcription factors, which are sometimes referred to as terminal selectors, whose expression is maintained throughout the life of mature neurons (reviewed in REF. 44) (FIG. 1b). Transcription factors can be efficient inducers of cellular identity owing to their ability to control the expression of various genes (which are here referred to as effector genes) that coordinately result in the phenotypes of a particular cell type. Terminal selectors maintain their own expression through autoregulation, thus ensur- ing stable maintenance of cell identity. For example, sensory neurons (ASE neurons) are maintained in this way by CHE-1, a transcription factor that regulates ASE-specific genes by binding to ‘ASE-motifs’45–47. In C. elegans che‑1-null mutants, ASE neuronal traits are lost, whereas pan-neuronal characteristics are main- tained without apparent acquisition of an alternative neuronal fate. This indicates that although the termi- nal selector gene che‑1 is continuously required for maintenance of the ASE-neuron-specific phenotypes, more generic cellular properties that are shared with other neurons are not maintained by terminal selec- tors. Maintenance of other neuron-specific identities follows a similar logic: for example, in mechanosensory and AIY interneurons, which depend on the continuous activity of MEC-3–UNC-86 and TTX-3–CEH-10 het- erodimers, respectively48–52. Cholinergic motor neuron traits are controlled by a specific cis-regulatory signa- ture and the continuous expression of the transcription factor UNC-3 (REF. 53). From these and other examples, it appears that neuronal identities in C. elegans are pre- dominantly maintained by a simple regulatory logic that depends on the continuous instructive activities of a few key transcription factors that are specifically expressed in different cell types (FIG. 1b).

Figure 1 | Feedforward regulatory cascades of transcription factors functioning in cell development and maintenance. a | A simple developmental binary stem cell switch. The two transcription factors A and D are autoregulating their own expression and are also involved in a mutual cross-inhibitory regulation. Owing to a shift in the balance between A and D expression — for example, as a consequence of a developmental signalling event — cell lineage specification directs the differentiation into either cell type 1 or cell type 2. During the progressive development of these cell types, feedforward induction of additional transcription factors leads to the co-expression of several lineage-specific transcription factors (A, B and C in cell type 1 and D, E and F in cell type 2). The transcription factors expressed during differentiation are also often continuously expressed in mature cells. Numerous examples of such binary switching and feedforward regulation has been described (for examples, see REF. 5). b | Transcription factors, referred to as terminal selectors, have key roles in, for example, Caenorhabditis elegans neuron-specific lineage determination and maintenance44. In the example on the left, the terminal selector A controls lineage-specific target genes (shown by the DNA under the arrows) by binding to common cis-regulatory elements in target genes. Binding of A to two of the effector genes is illustrated in more detail. To the right, a hypothetical more complex regulatory logic in higher vertebrates is illustrated. A more elaborate network of transcription factors (A, B, C and D in this example) are maintained in a regulatory network. Target genes are not all regulated by a similar cis-regulatory logic. Instead, different combinations of lineage-specific transcription factors are co-regulating different subsets of target genes in distinct ways, as illustrated in the three examples.

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a

b

c

d

Lymphatic endothelial cell Blood endothelial cell

Pax5 ablation T cell

Macrophage

Prox1 ablation

Foxp3 ablation

B cell

TReg cell TH1 cell

Progenitor

Granulosa ovary cell Sertoli testis cell

Foxl2 ablation

Dmrt1 ablation

Terminal selectors Transcription factors that directly control effector genes for determining mature cell identity. They typically act by binding conserved sequence motifs in multiple effector genes, such as in ion channel genes and other neuron-specific genes in neurons. They were first proposed by Hobert for Caenorhabditis elegans neurons but are potentially applicable to other mature cell types.

Effector genes Genes that define the cell-type-specific functional properties of a terminally differentiated cell.

Transcription factor combinatorial codes. Do simi- lar principles apply to more complex organisms, such as mammals, that have nervous systems consisting of several hundred distinct cell types? Interestingly, many genes that are specifically expressed in photoreceptors of the mouse retina are controlled by direct binding of the homeodomain transcription factor CRX, indicating that this transcription factor can be defined as a mammalian terminal selector54. By contrast, other observations in higher vertebrates imply a more complex regulation. Despite C. elegans dopamine neuron-specific traits being controlled by AST-1 (REF. 55), expression of dopamine

pathway genes in mice is independent of the mammalian counterpart ETV1 (REF. 56). Instead, it seems as if a larger panel of transcription factors controls mammalian dif- ferentiation57,58, particularly involving complex and yet poorly characterized combinatorial coding, whereby subsets of effector genes are controlled by different com- binations of transcription factors; only when the tran- scription factors are co-expressed can they induce the full repertoire of cognate differentiation genes (FIG. 1b). This might be an extension of simple combinatorial coding that is seen for some C. elegans cell types: for example, TTX-3–CEH-10 and MEC-3–UNC-86 het- erodimer pairs co-regulate differentiation genes in AIY and mechanosensory neurons, respectively49–51.

Transcription factor codes can emerge from simple feedforward induction, as depicted in FIG. 1a. Peptidergic neuron subtypes in Drosophila melanogaster provide a useful example. These cell types are specified by feed- forward induction of transcription factors that establish related but unique transcription factor codes with dis- tinct information value within differentiating postmitotic neurons59. Interestingly, mis-expression of the factors defining one of these cell-type-specific codes results in dramatic ectopic activation of neuropeptidergic genes in a large number of neurons, regardless of their developmen- tal history, thus demonstrating that a defined transcrip- tion factor combination can be sufficient for instructing the genome to turn on a repertoire of effector genes59. Importantly, by conditional ablation, it has recently been established that these developmental transcription factors are continuously required in mature neurons to maintain their identities60. Thus, regulatory cascades that act in development seem to generate end-point states consist- ing of transcription factor networks that by themselves are fully capable of providing a complete and sufficient instructive ‘code’ for the maintenance of cell-type-specific gene expression programs in differentiated cells.

Control of labile differentiated states Guardians of differentiated cell identity in mammals. Recent studies have been conducted for interrogating the extent to which transcription factors involved in specifying cell identity are continually required for the maintenance of this identity. These studies have been helped by an increasing availability of mouse strains that have been engineered to express the Cre recombinase using tissue-specific promoters. These strains include those that express tamoxifen-inducible Cre–ERT2 for the excision of LoxP-flanked target genes at chosen time- points61. These models enable gene ablation in differ- entiated mouse tissues, thus allowing experiments that can distinguish between defects resulting from disrupted developmental as opposed to maintenance mechanisms.

The ablation of some transcription factors in differ- entiated mammalian cells results in a dramatic loss of phenotype accompanied by acquisition of alternative fates62–69, demonstrating the existence of individual tran- scription factors that are crucially involved in securing the differentiated state (FIG. 2). How do they play such fundamental parts and what do they reveal about the cell types in which they are expressed?

Figure 2 | Guardians of differentiated cell identities. Examples of differentiated cell types that are controlled by key transcription factors, as revealed by conditional gene ablation experiments. a | Conditional targeting of paired box gene 5 (Pax5) in mature B cells leads to the generation of uncommitted proliferating progenitors that can differentiate into T cells and along the more distant macrophage lineage. b | The targeting of forkhead box P3 (Foxp3) in regulatory T cells (T

Reg cells)

leads to direct reprogramming into T helper 1 (T H 1) cells.

c | Conditional targeting of prospero-related homeobox 1 (Prox1) in lymphatic endothelial cells leads to direct reprogramming into blood endothelial cells. d | Conditional targeting of forkhead box L2 (Foxl2) in adult ovaries leads to the induction of Sertoli and Leydig cells. Interestingly, the ablation of doublesex and mab-3 related transcription factor 1 (Dmrt1) in the adult testis leads to induction of granulosa-like cells, demonstrating that differentiated cells in both female and male gonads are labile and susceptible to transdifferentiation.

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B  cell lineage commitment and differentiation requires the paired-box transcription factor PAX5 (REF. 70). Conditional ablation of Pax5 in committed develop- ing pro-B  cells reverts them to uncommitted pro- genitor cells with the potential to differentiate into macrophages or T cells71. Interestingly, in animals that are depleted of immature B cells, conditional ablation of Pax5 specifically in mature B  cells results in a loss of mature B cell characteristics. These dedifferentiated Pax5‑depleted B cells closely resemble normal uncom- mitted progenitors and are endowed with the potential to generate multiple haematopoietic cell types62. An impres- sive outcome of these experiments was the demonstra- tion that isolated and purified mature Pax5-deficient B  cells were able to rescue lymphopoiesis in T-cell- deficient Rag2−/− mice. Moreover, these cells were also able, albeit at a lower frequency, to differentiate into the more remote myeloid lineage and to differentiate into macrophages. PAX5 normally promotes the differentia- tion of B cells by directly binding and activating numer- ous B cell effector genes72. The exact regulatory targets that were responsible for mature B cell reprogramming in Pax5-ablated mice remain unknown, but several genes that are either directly or indirectly repressed by PAX5 in pro-B cells have been identified, encoding proteins such as cell surface receptors that are dispensable for B cell dif- ferentiation72. Thus, these striking observations clearly demonstrate that Pax5 is crucial not only for promoting B cell development but also for maintaining the identity of terminally differentiated B cells62.

Another example is ablation of prospero-related homeobox 1 (Prox1), which encodes a transcription factor that is essential for cell fate determination of lymphatic endothelial cells73. When this gene is acutely ablated by tamoxifen activation of Cre–ERT2 either in immature or adult lymphatic vessels, a rapid transition occurs, leading to upregulation of blood endothelial cell markers and suppression of lymphatic endothelial cell markers. Other histological features also indicate that a robust reprogramming occurs as a result of Prox1 ablation. In contrast to the results with Pax5 ablation in differentiated B cells, however, loss of Prox1 leads to a direct conversion to blood endothelial cells without passing through an immature progenitor state64.

Yet another switch in phenotype that fundamentally alters sex characteristics has been reported after abla- tion of forkhead box L2 (Foxl2) transcription factor gene in the adult mouse ovary. Foxl2 promotes female gonad differentiation in normal development74,75. Remarkably, adult Foxl2 ablation resulted in a rapid reprogramming of granulosa and theca cell lineages into Sertoli cells and testosterone-producing Leydig cells65. Only three weeks after ablation, major histological changes that affected almost the whole gonad were detected. Testosterone serum levels in these mice were comparable to those in normal male mice, and major sex reversal of secondary target tissues in response to elevated testosterone was also observed. Genome-wide transcriptome analysis indicated major changes in the gene expression program to one bearing a greater resemblance to male rather than female gonads after Foxl2 ablation. Importantly, the

rapid and near-complete transition strongly suggests that Foxl2 ablation induces transdifferentiation, rather than dedifferentiation, followed by normal development of male-gonad-like cell types. FOXL2 directly represses the expression of the transcription-factor-encoding gene SRY-box containing gene 9 (Sox9), which is a primary target of the male determining SRY transcription factor. Thus, FOXL2 is responsible for the continuous main- tenance of gonad characteristics in female mice, both during development and in the adult65.

Interestingly, a corresponding situation is evident in males. Accordingly, adult male ablation of doublesex and mab-3 related transcription factor 1 (Dmrt1), which is expressed in male gonads, leads to Foxl2 activation and transdifferentiation of Sertoli cells into granulosa- like cells, resulting in partial feminization. DMRT1 directly represses the expression of Foxl2, indicating that these two factors are central components in a labile balance controlling female and male gonad mainte- nance throughout adult life69. A corresponding role of DMRT1 was recently described in medaka fish in which male gonads first form but then transdifferentiate into female gonads in Dmrt1-mutant fish76.

Lineage switching is associated with an intrinsic plastic- ity of the differentiated cell fate. Do these and other rare examples of lineage switching in adult mammalian cells indicate the existence of mechanisms that guard against acquisition of alternative cell fates in most or even all differentiated cell types? Although this remains possible, and is difficult to rule out, it seems likely that examples of dramatic lineage conversion reflect a physiological requirement for a high degree of cellular plasticity in certain cell types. Indeed, fully differentiated B cells are normally plastic, which is evident when considering that antigen stimulation of the B cell receptor triggers a switch in phenotype from Pax5-expressing B cells to antibody-secreting plasma cells that do not express Pax5 (REF. 77). In this context, it is interesting to note that genes repressed by PAX5 do not show enrichment of Polycomb group (PcG)-mediated histone H3 trimethylated at lysine 27 (H3K27me3), marks that are usually associated with repressed chromatin, perhaps reflecting a requirement for rapid activation of suppressed genes following reduced Pax5 expression72. Such a flexibility of the differentiated state may also explain the efficiency whereby mature B cells can be reprogrammed into macrophages after mis-expression of CCAAT/enhancer binding protein-α (C/EBPα) and C/EBPβ, which suppress Pax5 activity78. Other cell types of the lymphocyte lineage may also be unusually plastic, as suggested by the observation that mature regulatory T cells are converted to helper T cells after ablation of the forkhead box P3 (Foxp3) transcrip- tion factor gene67,68 and that, following ablation of the Bcl11b transcription factor gene, several types of mature T cells convert into natural-killer-like cells66.

Endoderm-derived pancreatic and liver cells are addi- tional examples of quite labile differentiated states with an inherent ability to change phenotype. Interestingly, acute ablation of adult mouse pancreatic β-cells trig- gers the conversion of glucagon-producing α-cells

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into insulin-producing β-cells79. Again, although the molecular events remain unclear, this example indicates the existence of an impressive plasticity that has been adapted for a physiological cell replacement mechanism.

Finally, a requirement to regulate the differentiated state of female and male gonad cell types may be related to an evolutionarily conserved requirement for postnatal sex conversion, which is common in lower vertebrates. Indeed, the mutual antagonistic relationship between Sox9 and Foxl2 is evident in lower vertebrates and is therefore an evolutionarily conserved sex determination mechanism.

Control of stable differentiated states As mentioned earlier, a common observation is that transcription factors that are essential in early cell type specification and differentiation continue to be expressed in cells that have acquired a fully differenti- ated phenotype. Moreover, many such developmental key transcription factors bind directly to a large pro- portion of cognate effector genes, as demonstrated from transcription factor binding studies72,80–82. Does this sustained expression and direct binding to many effector genes mean that continued expression of these transcription factors is required to maintain cellular identities instructively? Perhaps somewhat counter- intuitively, several conditional mouse knockout studies have demonstrated relatively mild phenotypes when key transcription factor genes that are involved in early differentiation are instead ablated in adult tissues.

For example, PC12 ETS domain-containing tran- scription factor 1 (PET1; also known as FEV) and LIM homeobox transcription factor 1β (LMX1β) are transcription factors that have key roles in the devel- opment of serotonergic (5-HT) neurons in the central nervous system. Both factors are maintained in adult postmitotic 5-HT neurons83–85. Whereas early knockout of these factors results in severe loss of all (for Lmx1b) or almost all (for Pet1) differentiated 5-HT neurons86,87, ablation of Lmx1b or Pet1 in adult mouse brains leads only to behavioural abnormalities and downregulation of several 5-HT neuron markers83,88. However, cells are retained, and gross histological features seem normal. Moreover, several genes that are dependent on Pet1 or Lmx1b in early development remain active after ablation of these genes in adult mice.

There are further examples of increasingly mild phe- notypes when genes are knocked out later during dif- ferentiation in mice. These include Nurr1 (also known as Nr4a2), which encodes a key transcription factor that is required for dopaminergic neuron differentiation58. In Nurr1-null mice, a complete block of dopamine neu- ron differentiation results in the complete absence of these neurons in newborn mice, whereas adult ablation results in downregulation of some dopamine neuron markers, but cells are retained and appear to be mor- phologically normal58. Additionally, Foxa1 and Foxa2 have unique and redundant functions in morphogenesis of endoderm-derived tissues, including the pancreas89,90 (reviewed in REF. 91). Combined conditional knockout of Foxa1 and Foxa2 in adult mice results in abnormal β-islet

cell function and dysregulation of differentiation genes, but cells are maintained and gross tissue morphology is preserved92.

Stable downstream networks may underlie the robust- ness of differentiated cell identities. Several explana- tions are of course possible for why late ablation of key developmental transcription factors is less disrup- tive. For example, related transcription factors that are co-expressed with a given transcription factor may be redundant at a late but not early time point in develop- ment. Furthermore, some of these transcription factors may have early roles: for example, in binary cell specifica- tion mechanisms in proliferating progenitor populations, as illustrated in FIG. 1a. Germline-null mutations there- fore disrupt cell specification events that are unrelated to a function in regulating cognate effector genes in differ- entiated cells. However, relatively mild phenotypes that arise after ablation in mature cells may also reflect that the particular cell type is more stable than those described above, in which transcription factors seem to exist as key nodal points. It is difficult to rule out that such nodal points will eventually be identified in all cell types, but a more likely hypothesis is that mild phenotypes that arise after disruption of key developmental transcrip- tion factors reflect how transcription factor networks are stabilized over time by redundant functions by closely or more distantly related transcription factors. The principal difference between labile or stable differenti- ated states could thus depend, in part, on the stability of respective transcription factor network as depicted in FIG. 3. Studies of transcription factors expressed in devel- oping and mature hepatocytes demonstrate this point.

Hepatocyte nuclear factor 4α (HNF4α) is dispen- sable for hepatic specification, but embryonic Hnf4a knockout leads to a disrupted hepatocyte differen- tiation93,94. Late hepatocyte-specific Hnf4a ablation causes altered gene expression but not an overall loss of hepatocyte identity95. Similarly, inactivation of other hepatocyte transcription factors after specification of the hepatic lineage has been shown to alter gene expres- sion without leading to loss of overall liver cell identity 96. These results can be understood when considering how an elaborate hepatocyte transcription factor network is established over time. HNF4α has been shown to bind to promoters of over 40% of all liver expressed genes, which are commonly co-regulated by other liver-specific transcription factors82. In early differentiation, simple hierarchical feedforward cascades seem to establish co-expression of transcription factors that progressively become interconnected in an elaborate transcription factor network (FIG. 1a). Interestingly, although adult hepatocyte-specific ablation of Hnf4a only modestly affects expression of other liver-expressed transcrip- tion factor genes, germline knockout is much more disruptive to the less elaborate transcription factor net- work in developing hepatocytes97,98. This trend closely correlates with an overall severe loss of liver tran- scription factor occupancy in the promoters of other transcription factor genes when Hnf4a is ablated early, but not late, during hepatocyte differentiation.

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b Stable cell identities

C D

B A

H G

E F

Cell type 1 Cell type 2

a

C D

B A

H G

E F

Cell type 1 Cell type 2

c Stable cell identities

C D

B A

H G

E F

Cell type 1 Cell type 2

Cell identities susceptible to switching

Stable transcription factor networks are not easily perturbed owing to their intrinsic stability

Identities can be altered by regulatory binary switching, resembling developmental identity switching

Other regulatory networks are not easily activated owing to, for example, the absence of direct cross-regulation between alternative networks

It is reasonable to assume that a similar establishment of increasingly more elaborate and stable transcription factor networks in maturing cells is common. For exam- ple, expression of PET1 is lost in early but not in late Lmx1b conditional knockout cells, suggesting that it becomes ‘secured’ by redundant interactions as devel- opment proceeds83,86,87. Conceivably, the stability of such networks is also related to the stability of the phenotype so that long-lived cells, such as neurons, are depend- ent on more elaborate and redundant cross-regulatory interactions.

DNA and chromatin modifications may add stability to differentiated identities. Experiments described above, including the robust reprogramming seen in hetero- karyons, are clearly consistent with the view that most active genes require the presence of instructive DNA- binding transcription factors that need to be continuously expressed in the differentiated cells. However, differenti- ated states may in principle be stable because other regu- latory networks are inaccessible, as shown in FIG. 3c, or, for example, they may be stabilized by the establishment of DNA and/or histone modifications that do not require continuous instructive factors for their maintenance. The regulation of D. melanogaster larval body segment identity provides a useful example. Segment identity is dependent on proper expression of the homeobox (Hox) and engrailed genes. Their initial expression is dictated by several early-expressed transcription factors; the proper Hox gene expression pattern is maintained even as devel- opment proceeds after the early-expressed transcription

factors are no longer present. Maintenance, but not the establishment, of appropriate Hox and engrailed gene expression is dependent on Trithorax group (TrxG) and PcG proteins that introduce, interpret and propagate activating and repressing histone methylation marks99,100 (reviewed in REFS 101–103). Recent studies suggest that non-coding RNAs are also involved in the maintenance of Hox gene expression. For example, in adult human skin fibroblasts, the non-coding RNA HOTAIR has been reported to regulate the HOXD cluster through recruit- ment of repressive PcG proteins104,105. PcG proteins are also required for proper silencing of hundreds of genes involved in cell fate determination106–111. How cellular DNA and his- tone modifications may affect the continuous requirement for instructive transcription factors and maintenance of gene expression is principally illustrated in FIG. 4.

Progressive silencing of genes of alternative cell fates is dictated by instructive transcription factors and is associated with repressive histone modifications at silenced genes111–113. Increased deposition of repres- sive histone modifications can facilitate DNA meth- ylation114–117 and chromatin compaction by chromatin remodellers118,119. Such a repressive chromatin environ- ment can thus serve as a stable endpoint that can silence aberrant transcription without the need for continued presence of transcription factors that initiated repres- sion, as illustrated in FIG. 4c. Evidence for such a persis- tent ‘memory’ of previous instructive events is derived from reprogramming experiments by SCNT120 (reviewed in REF. 9) or from the generation of iPSCs121. Although cells fulfil criteria of pluripotency122, a memory of the

Figure 3 | Models for how transcription factor networks might control the stability of the differentiated state. a | In cells endowed with intrinsic high plasticity — for example, stem and progenitor cells or mature B cells — the transcriptional networks that govern distinct phenotypes are characterized by labile transcription factor networks and active cross-inhibition sets the stage for binary switching between cell types 1 and 2, respectively. This can occur even in a mature cell if transcription factor A is ablated. Forkhead box L2 (FOXL2) and other ‘guardians’ of the differentiated state seem to represent such key transcription factors. b | It seems likely that stably differentiated cell types are controlled by more elaborate transcription factor networks, illustrated by more cross-regulatory interactions (arrows) and autoregulation. As a consequence, even if factors A and E are involved in a cross-inhibitory regulation of each other, the stability of each respective network will prevent a switching between cell types 1 and 2 (symbolized by the vertical dotted line) even in the event of transcription factor ablation. c | Other transcription factor regulatory networks may not be accessible in more stable differentiated cells owing to, for example, absence of direct cross-regulation or more permanent silencing of alternative networks. Thus, in such situations, genetic ablation of a transcription factor may be sufficient to disrupt an existing network but may not necessarily lead to activation of other lineage-specific factors expressed in other cell types.

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c

b

a Establishment Maintenance

Continuous instructive regulation of active genes

Continuous instructive regulation of repressed genes

Maintained stably suppressed gene expression as a consequence of formation of stably silenced chromatin. May not require continuous binding of instructive factors

A

R

R

A

R

Epigenetic modifications Heritable changes in gene expression that do not depend on a change in DNA sequence.

somatic cell of origin persists, at least in some iPSC lines. As a consequence, iPSCs that have been generated from pancreatic β-islet cells and from different haematopoi- etic cell types more easily differentiate into cell types that are more closely related to the cell type of origin121,123,124. In addition, many iPSC lines retain patterns of DNA methylation and histone modifications resembling their cells of origin123–125, and such modifications also appear to render differentiated cells more resistant to reprogramming126 (reviewed in REF. 9). Well-established phenomena such as X-chromosome inactivation and imprinting provide additional examples of repressed states that seem to persist passively in the chromatin and are ‘remembered’ even in cellular contexts in which the other allele is active (reviewed in REFS 127,128).

DNA and histone marks are often referred to as epigenetic modifications. However, the term ‘epigenetic’ is somewhat misleading in this context. As it is diffi- cult to prove that chromatin modifications established during development are passively retained, instructive DNA-binding regulators that have not yet been found to interact with a given regulatory region may in fact be responsible. It is also important to note that a cellular memory resulting from an initial instructive event does not necessarily involve DNA and histone modifica- tions that are passively retained. Such regulation can be explained by a simple feedforward regulation, whereby an initiating transcription factor leads to the expression of another factor that is then maintained by autoregulation.

Maintenance of phenotype in disease An interesting question is how transcriptional control of cellular maintenance relates to disease. Several studies have revealed a correlation between the grade of tumour malignancy and the expression of transcription factors that are associated with embryonic stem cell pluripo- tency and enhanced self-renewal10,11. Thus, a reasonable assumption is that factors guarding against re-entry into an undifferentiated, proliferative state will have tumour suppressor capacity. Indeed, one of the consequences of Pax5 deletion in mature B cells in mice is the develop- ment of aggressive lymphomas62, and PAX5 seems to be a tumour suppressor in human acute lymphoblastic leu- kaemia, as revealed from monoallelic loss-of-function mutations in a large proportion of these cancers129. The loss of factors that are necessary for maintaining the mature and non-proliferative state in already dif- ferentiated cells could have similar roles in protecting against other types of cancers.

As discussed above, Foxp3 is crucial for the main- tenance of the regulatory T cell phenotype, and thus it guards against excessive immunoreactivity. Mice with a conditional Foxp3 knockout67 or even with only attenu- ated expression of Foxp3 (REF. 68) therefore develop a severe autoimmune pathology, and Foxp3 dysregula- tion has also been associated with various autoimmune disorders in humans130,131.

That transcription factors referred to above as guard- ians of the differentiated state have been associated with

Figure 4 | Dependency of instructive factors in the regulation of the chromatin state is distinct for active versus repressed genes. a | An activating transcription factor (A) is important for the induction of expression of a gene. Gene activation is associated with several modifications in chromatin structure (shown by the blue circles). As exemplified by numerous studies in this Review, the same or other instructive transcription factors are continuously required for the maintained expression of active effector genes also in mature cells. b | Induced repression of expression of a gene is illustrated. The binding of a transcriptional repressor (R) is associated with repressive chromatin modifications (red circles). In one scenario, continued repression depends on continuous binding of a transcriptional repressor to maintain the repression. c | Alternatively, the initial repressive chromatin modifications (red circles; for example, histone modifications) are followed by additional repressive chromatin or DNA modifications (yellow boxes; for example, 5-methyl cytosine methylation of promoter DNA) or chromatin compaction, thus leading to a more permanently silenced state that may not require continuous presence of instructive transcriptional repressors. Presumably, several layers of suppressive chromatin modifications stabilize the differentiated state and provide a barrier against transdifferentiation or reprogramming into the pluripotent state. In some reprogrammed cells, such suppressed chromatin is retained as a ‘memory’ of their cellular origin.

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disease may seem intuitive. However, it is also likely that the transcriptional control of more stable cellular states would also be targeted by disease-promoting processes. For example, the requirement to keep neurons intact over many decades suggests that cellular dysfunction leading to difficulties in maintaining neuronal pheno- type may be associated with neurodegenerative disease. Indeed, early symptoms in several neurodegenerative disorders are likely to be caused by loss of neuronal func- tion rather than by cell death132. Interestingly, and in sup- port of this notion, dysregulation and polymorphisms affecting genes that encode dopaminergic neuron tran- scription factors, such as NURR1, PITX3 and LMX1B, have been associated with Parkinson’s disease and schizophrenia, suggesting that disruption of instructive mechanisms that maintain the dopaminergic phenotype may increase susceptibility to disease133,134. In addition, another sign that neurodegenerative disease may be associated with difficulties in securing the differentiated state are observations of neuronal cell cycle re-entry, in particular in Alzheimer’s disease. Under these pathologi- cal conditions, neurons are capable of synthesizing DNA (that is, progressing through S phase) but not undergo- ing mitosis. How this affects disease progression is not yet understood, but it seems likely that it contributes to the degenerative process135.

Conclusions and future directions As emphasized by studies described in this Review, in some cells requiring a high degree of plasticity, there is a dependency on finely balanced binary switching mech- anisms that are similar to those that are fundamental in cell fate specification during development. By contrast, in more stably differentiated cells, we hypothesize that labile binary relationships have either been eliminated or stabilized by redundant cross-regulation involving a sufficient number of additional transcription factors and/or regulatory RNAs; these networks are stable so that even in the event of ablation of single key factors, the overall differentiated state is not easily perturbed. In addition, repressive histone modifications and DNA methylation also contribute to the stability of the dif- ferentiated cell identity.

Our understanding of how transcription factors and chromatin-modifying processes are integrated in regu- lating the differentiated state in mammals remains lim- ited, and it will be important in future studies to elucidate how regulatory network architectures can accommodate stringent requirements that balance stability versus flex- ibility. Such studies are now feasible through mouse models for conditional gene ablation in differentiated

cells and chromatin immunoprecipitation followed by next-generation sequencing (ChIP–seq) techniques for the genome-wide mapping of transcription factor binding sites and DNA and histone modifications.

Moreover, focusing on how other gene regulatory mechanisms contribute to the stability of the differenti- ated state will be important. For example, it seems to be likely that differentiated cells, which are generally post- mitotic, depend on a strict control to prevent cell cycle re-entry. It will be interesting to understand to what extent cell cycle control mechanisms are interlinked with the control of the differentiated state. For example, in the D. melanogaster eye, the expression of the retino- blastoma tumour suppressor protein (RB) homologue rbf, in combination with components of the Hippo tumour suppressor pathway, is necessary to maintain the differentiated identity of retinal photoreceptor cells136, but it does not seem to be required for preventing cell cycle re-entry. By contrast, in differentiated horizontal interneurons of the mouse retina, members of the RB family are required to prevent re-entry into the cell cycle, but intriguingly both structural and functional features of differentiated horizontal interneurons are retained when RB family functions are lost137. Thus, these stud- ies that focus on known tumour suppressor pathways seem to indicate that the control of cell cycle exit and dif- ferentiation are not always inextricably linked. In addi- tion to the cell-intrinsic mechanisms for maintenance discussed in this Review, it is also important to point out that extrinsic signalling can provide instructive cues that are necessary for identity maintenance. For example, the maintenance of specific neuron identities depends on the continuous secretion of bone morphogenic protein from surrounding tissue138,139. Little is understood about such regulation in other cell types, but it is an important area for further investigation.

The intense recent interest in reprogramming emphasizes the importance of understanding how cells normally secure their identities in stably differentiated cells, because studies focusing both on how differen- tiated states are maintained and on how they can be directly reprogrammed seem to constitute two sides of the same coin. With increasing understanding of how the differentiated state is stably maintained, it may even- tually become possible to interfere with these processes in ways that may facilitate the generation of iPSCs and other deliberate cell lineage conversions that may be clinically relevant. Moreover, and as discussed above, it is also anticipated that mechanisms controlling the differentiated state will be relevant in future attempts to treat cancer and cell degenerative diseases.

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124. Polo, J. M. et al. Cell type of origin influences the molecular and functional properties of mouse induced pluripotent stem cells. Nature Biotech. 28, 848–855 (2010).

125. Lister, R. et al. Hotspots of aberrant epigenomic reprogramming in human induced pluripotent stem cells. Nature 471, 68–73 (2011).

126. Epsztejn-Litman, S. et al. De novo DNA methylation promoted by G9a prevents reprogramming of embryonically silenced genes. Nature Struct. Mol. Biol. 15, 1176–1183 (2008).

127. Payer, B., Lee, J. T. & Namekawa, S. H. X-inactivation and X-reactivation: epigenetic hallmarks of mammalian reproduction and pluripotent stem cells. Hum. Genet. 130, 265–280 (2011).

128. Payer, B. & Lee, J. T. X chromosome dosage compensation: how mammals keep the balance. Annu. Rev. Genet. 42, 733–772 (2008).

129. Mullighan, C. G. et al. Genome-wide analysis of genetic alterations in acute lymphoblastic leukaemia. Nature 446, 758–764 (2007).

130. Balandina, A., Lecart, S., Dartevelle, P., Saoudi, A. & Berrih-Aknin, S. Functional defect of regulatory CD4+CD25+ T cells in the thymus of patients with autoimmune myasthenia gravis. Blood 105, 735–741 (2005).

131. Miura, Y. et al. Association of Foxp3 regulatory gene expression with graft-versus-host disease. Blood 104, 2187–2193 (2004).

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Acknowledgements We would like to thank Ö. Wrange and members of our labo- ratories for valuable ideas and discussion. This work was sup- ported by grants from the Swedish Research Council via Linnaeus grant (T.P.), the Swedish Strategic Research Foundation (T.P.), the Swedish Research Council (J.H.) and the Swedish Cancer Society (J.H). We apologize to the authors of the many interesting studies that could not be included owing to space constraints.

Competing interests statement The authors declare no competing financial interests.

FURTHER INFORMATION Johan Holmberg’s homepage: http://ki.se/ki/jsp/polopoly.jsp ?d=27086&a=88851&cid=27089&l=en Thomas Perlmann’s homepage: http://www.licr.ki.se/D_ groups/d4_Gene-Expression.php

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MicroRNA.pdf

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Many roads to maturity: microRNA biogenesis pathways and their regulation Julia Winter1,3, Stephanie Jung1,3, Sarina Keller1, Richard I. Gregory2 and Sven Diederichs1,4

MicroRNAs are important regulators of gene expression that control both physiological and pathological processes such as development and cancer. Although their mode of action has attracted great attention, the principles governing their expression and activity are only beginning to emerge. Recent studies have introduced a paradigm shift in our understanding of the microRNA biogenesis pathway, which was previously believed to be universal to all microRNAs. Maturation steps specific to individual microRNAs have been uncovered, and these offer a plethora of regulatory options after transcription with multiple proteins affecting microRNA processing efficiency. Here we review the recent advances in knowledge of the microRNA biosynthesis pathways and discuss their impact on post-transcriptional microRNA regulation during tumour development.

MicroRNAs (miRNAs) are short (20–23-nucleotide), endogenous, single-stranded RNA molecules that regulate gene expression1. Mature miRNAs and Argonaute (Ago) proteins form the RNA-induced silenc- ing complex (RISC), a ribonucleoprotein complex mediating post- transcriptional gene silencing2–5. Complementary base-pairing of the miRNA guides RISC to target messenger RNAs, which are degraded, destabilized or translationally inhibited by the Ago protein6,7. Proteomic studies have recently uncovered the broad impact of a single miRNA on hundreds of targets8,9. Many cellular pathways are affected by the regulatory function of miRNAs; the most prominent of these pathways control developmental and oncogenic processes10–20. Notably, miRNA processing defects also enhance tumorigenesis21. Although insights into the regulatory function of miRNAs are beginning to emerge, much less is known about the regulation of miRNA expression and activity. Recently, evidence for post-transcriptional control of miRNA activity has been accumulating22–26.

In contrast to the linear miRNA processing pathway that was ini- tially thought to be universal for the biogenesis of all mature miRNAs (Fig. 1), multiple discoveries led to the recognition of miRNA-specific differences that open a plethora of regulatory options to express and process individual miRNAs differentially. Here we review the recent progress made in elucidating the complexity of miRNA processing and post-transcriptional regulation. Although we focus predominantly on the mammalian system, related information obtained from other model systems including the fruitfly Drosophila melanogaster, the nematode Caenorhabditis elegans and the plant Arabidopsis thaliana will also be presented where applicable.

1Helmholtz-University-Group ‘Molecular RNA Biology & Cancer’, German Cancer Research Center (DKFZ) and Institute of Pathology, University of Heidelberg, B150 INF 581, D-69120 Heidelberg, Germany. 2Stem Cell Program, Children’s Hospital Boston, Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Harvard Stem Cell Institute, Boston, Massachusetts 02115, USA. 3These authors contributed equally to the work. 4Correspondence should be addressed to S.D. (e-mail: [email protected])

Early steps: microRNA processing in the nucleus Transcription of the pri-miRNA. miRNA genes are transcribed by either RNA polymerase II or RNA polymerase III into primary miRNA transcripts (pri-miRNA)27–29. Many pri-miRNAs are polyadenylated and capped — hallmarks of polymerase II transcription. Their transcription is sensitive to treatment with the polymerase II inhibitor α-amanitin, and polymerase II binds to promoter sequences upstream of the miR-23a/ miR-27a/miR-24-2 cluster27,28. In contrast, miRNAs encoded by the larg- est human miRNA cluster, C19MC, are transcribed by polymerase III29. Both RNA polymerases are regulated differently and recognize specific promoter and terminator elements, facilitating a wide variety of regu- latory options. Expression of selected miRNAs is under the control of transcription factors, for example c-Myc or p53 (refs 17, 19), or depends on the methylation of their promoter sequences30–32. In addition, it has been shown that each miRNA located in the same genomic cluster can be transcribed and regulated independently33. However, controls of miRNA transcription steps are not necessarily universal34,35, and regulatory mech- anisms at the transcriptional level are beyond the scope of this review.

microRNA editing. RNA editing of primary transcripts by ADARs (adenosine deaminases acting on RNA) modifies adenosine (A) into inosine (I). Because the base-pairing properties of inosine are similar to those of guanosine (G), A-to-I editing of miRNA precursors may change their sequence, base-pairing and structural properties and can influ- ence their further processing as well as their target recognition abilities. Several examples of editing-mediated regulation of miRNA processing have been described (see Box 1).

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pri-miRNA cleavage by the Drosha–DGCR8 microprocessor complex. The pri-miRNA is next endonucleolytically cleaved by the nuclear micro- processor complex formed by the RNase III enzyme Drosha (RNASEN) and the DGCR8 (DiGeorge critical region 8) protein (also known as Pasha (Partner of Drosha) in D. melanogaster and C. elegans)36 (Fig. 2a). DGCR8/ Pasha contains two double-stranded RNA-binding domains and is essen- tial for miRNA processing in all organisms tested37–40. An average human pri-miRNA contains a hairpin stem of 33 base-pairs, a terminal loop and two single-stranded flanking regions upstream and downstream of the hairpin. The double-stranded stem and the unpaired flanking regions are critical for DGCR8 binding and Drosha cleavage, but the loop region or the specific sequences are less important for this step41–43. A single nucleotide polymorphism in a miRNA precursor stem can block Drosha processing44. Nevertheless, many miRNA sequence aberrations observed in human tumours alter the secondary structure without affecting process- ing, and reveal the structural flexibility of the microprocessor34.

The two RNase domains of Drosha cleave the 5´ and 3´ arms of the pri- miRNA hairpin39, whereas DGCR8 directly and stably interacts with the pri-miRNA and functions as a molecular ruler to determine the precise cleavage site41. Drosha cleaves 11 base pairs away from the single-stranded RNA/double-stranded RNA junction at the base of the hairpin stem.

Drosha-mediated cleavage of the pri-miRNA occurs co-transcriptionally and precedes splicing of the protein-encoding or non-coding host RNA that contains the miRNAs. Splicing is not inhibited by Drosha-mediated cleavage, because a continuous intron is not required for splicing45,46.

microRNA-specific regulation of the microprocessor complex. Drosha-mediated pri-miRNA processing was recently shown to be subject to regulation by miRNA-specific mechanisms. Drosha forms two different complexes, a small microprocessor complex that contains only Drosha and DGCR8 and processes many pri-miRNAs, and a larger complex that contains RNA helicases, double-stranded RNA binding proteins, heterogeneous nuclear ribonucleoproteins and Ewing’s sarcoma proteins38. The RNA helicases p72 and p68 are part of the large Drosha complex and might act as specificity factors for the processing of a sub- set of pri-miRNAs (Fig. 2b). Expression levels of several miRNAs are reduced in homozygous p68−/− or p72−/− knockout mice, whereas other miRNAs remain unaffected47.

Drosha-mediated cleavage can also be regulated for individual miR- NAs: the heterogeneous nuclear ribonucleoprotein A1 (hnRNP A1) binds specifically to pri-miR-18a and facilitates its processing. Loss of hnRNP A1 diminishes the abundance of mature miR-18a (Fig. 2c), but hnRNP A1 does not have any impact on other miRNAs that are located in the same miR-17 genomic cluster, demonstrating the extraordinary specificity of miR-18a biogenesis48. hnRNP A1 binds to the conserved loop of the pri-miR-18a and changes the hairpin conformation to create a more favourable cleavage site for Drosha49. About 14% of the human pri-miRNA loops are conserved between different species and could provide anchor points for similar regulatory mechanisms.

Transforming growth factor-β (TGF-β) and bone morphogenetic factors (BMPs) induce the maturation of miR-21 by regulating the microprocessor activity. TGF-β and BMP bring about the recruitment

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Figure 1 The ‘linear’ canonical pathway of microRNA processing. The miRNA processing pathway has long been viewed as linear and universal to all mammalian miRNAs. This canonical maturation includes the production of the primary miRNA transcript (pri-miRNA) by RNA polymerase II or III and cleavage of the pri-miRNA by the microprocessor complex Drosha–DGCR8 (Pasha) in the nucleus. The resulting precursor hairpin, the pre-miRNA, is exported from the nucleus by Exportin-5–Ran-GTP. In the cytoplasm, the RNase Dicer in complex with the double-stranded RNA-binding protein TRBP cleaves the pre-miRNA hairpin to its mature length. The functional strand of the mature miRNA is loaded together with Argonaute (Ago2) proteins into the RNA-induced silencing complex (RISC), where it guides RISC to silence target mRNAs through mRNA cleavage, translational repression or deadenylation, whereas the passenger strand (black) is degraded. In this review we discuss the many branches, crossroads and detours in miRNA processing that lead to the conclusion that many different ways exist to generate a mature miRNA.

Editing is defined as a post-transcriptional change of RNA sequences by deamination of adenosine (A) to inosine (I), altering the base- pairing and structural properties of the transcript. Editing of miRNA transcripts by ADAR1 and ADAR2 was first described for miR-22 (ref. 116) followed by miR-151, miR-197, miR-223, miR-376a, miR- 379 and miR-99a (ref. 117), as well as miR-142, miR-223, miR-1-1 and miR-143 (ref. 118). In pri-miR-142, A-to-I editing inhibits its cleavage by the endonuclease Drosha and results in its degradation by the ribonuclease Tudor-SN, which preferentially cleaves double- stranded RNA containing inosine–uracil pairs118,119. However, edit- ing of other pri-miRNAs was shown to enhance their processing by Drosha120. Editing can also influence further downstream processing steps: pri-miR-151 editing abolishes its cleavage by Dicer in the cyto- plasm. It remains to be established whether miRNA editing events are predominantly nuclear or cytoplasmic and whether they occur on the pri-miRNA or on the precursor miRNA (pre-miRNA)121. In addition to altering miRNA processing, miRNA editing can have an impact on miRNA target specificity. For example, a single A-to-I change in the miR-376 precursor redirects the mature miRNA to a new target, resulting in altered protein expression in mice122. In summary, miRNA editing can influence processing at multiple steps or can change the miRNA complementarity to target sequences, increasing the diversity of the cellular miRNA pool.

BOX 1 microRNA editing

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of ligand-specific signal transducers (the SMAD proteins) to the pri- miR-21 transcript in complex with the RNA helicase DDX5 (p68). As a consequence, Drosha-mediated processing of pri-miR-21 is strongly enhanced and the abundance of mature miR-21 increases, ultimately resulting in a contractile phenotype in vascular smooth muscle cells (Fig. 2d)50.

Mirtrons: splicing replaces Drosha cleavage. Surprisingly, Drosha- mediated processing of pri-miRNAs into pre-miRNAs is not obligatory. Intron-derived miRNAs are released from their host transcripts after splicing (Fig. 2e). If the intron resulting from the action of the splicing machinery and the lariat debranching enzyme has the appropriate size to form a hairpin resembling a pre-miRNA, it bypasses Drosha cleavage and is further processed in the cytoplasm by Dicer51,52. These miRNAs, called mirtrons, have been discovered in several species including mam- mals, D. melanogaster and C. elegans51–53.

Lin-28 regulates let-7 processing and precursor stability. Lin-28 is a stem-cell-specific regulator of let-7 processing that uses mul- tiple mechanisms54–58. Lin-28 was found to be necessary and suffi- cient to block microprocessor-mediated cleavage of the pri-miRNA (Fig. 3a)54. Mature let-7g increases during embryonic stem cell dif- ferentiation but the pri-miRNA levels remain constant, indicating post-transcriptional regulation of maturation. Recombinant Lin-28 blocks pri-miRNA processing, and knockdown of Lin-28 facilitates the expression of mature let-7 (ref. 54). The miRNA binding site of the Drosha competitor Lin-28 maps to conserved bases in the ter- minal loop of pri-let-7 (refs 56, 57). Intriguingly, although the loop region is considered dispensable for microprocessor action, many miRNAs have evolutionarily conserved loops potentially containing regulatory information49.

Post-transcriptional self-regulation of the microprocessor complex. The miRNA processing factors are also regulated post-transcription- ally or post-translationally. For example, the two components of the microprocessor complex regulate each other. DGCR8 stabilizes Drosha through an interaction between its conserved carboxy-terminal domain with the middle domain of Drosha (Fig. 4a)59. In turn, Drosha cleaves two hairpin structures in the 5´ untranslated region and the coding sequence of the Dgcr8 mRNA60. The Dgcr8 mRNA is then degraded, resulting in a negative feedback loop reducing Dgcr8 expression when sufficient microprocessor activity is available (Fig. 4b). The discovery that Drosha can directly cleave hairpin structures in mRNAs also points to the possibility that the two Drosha complexes in the cell regulate mRNAs independently of miRNAs.

Exportin-5–Ran-GTP mediate the export of the pre-miRNA. After nuclear processing, the pre-miRNA is exported into the cytoplasm by Exportin-5 (XPO5) in complex with Ran-GTP61. Knockdown of Exportin-5 leads to a decreased abundance of mature miRNAs but not to a nuclear accumulation of the pre-miRNA, indicating that Exportin-5 also protects pre-miRNAs against nuclear digestion61–63. Exportin-5 rec- ognizes the pre-miRNA independently of its sequence or the loop struc- ture. A defined length of the double-stranded stem and the 3´ overhangs are important for successful binding to Exportin-5, ensuring the export of only correctly processed pre-miRNAs63–65.

Coming of age: microRNA maturation in the cytoplasm The RISC loading complex (RLC): Dicer, TRBP and PACT join Ago2. RISC is the cytoplasmic effector machine of the miRNA pathway and contains a single-stranded miRNA guiding it to its target mRNAs. Cytoplasmic miRNA processing and RISC assembly are mediated by the RISC loading complex (RLC) (Fig. 5a). RLC is a multi-protein com- plex composed of the RNase Dicer, the double-stranded RNA-binding domain proteins TRBP (Tar RNA binding protein) and PACT (protein activator of PKR), and the core component Argonaute-2 (Ago2)66–69, which also mediates RISC effects on mRNA targets.

TRBP and PACT are not essential for Dicer-mediated cleavage of the pre-miRNA (see below) but they facilitate it, and TRBP stabilizes Dicer67,68,70. Depletion of TRBP or PACT reduces the efficiency of post-transcriptional gene silencing, and both might have overlapping functions in the miRNA and small interfering RNA (siRNA) pathway. Although they both participate in the recruitment of Ago2 (refs 68, 70), the in vitro reconstitution of RISC loading and activation is achieved by Dicer, TRBP and Ago2 alone69. Formation of the human RLC complex is initiated independently of ATP hydrolysis by the assembly of Dicer, TRBP and Ago2, and the exported hairpin only joins the RLC after the formation of this ternary complex (Fig. 5a)66,71.

Ago2-mediated pre-miRNA cleavage: the ac-pre-miRNA. For miRNAs that display a high degree of complementarity along the hairpin stem, an additional endonucleolytic cleavage step occurs before Dicer-mediated

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Figure 2 Regulation of pri-miRNA processing. (a) The microprocessor complex Drosha–DGCR8 cleaves the pri-miRNA, releasing the pre-miRNA. (b) Some miRNAs require additional specificity factors (for example p68 and p72) for efficient cleavage. (c) Interaction of pri-miR-18a with hnRNP A1 facilitates cleavage of this specific miRNA by Drosha. (d) TGF-β signalling induces SMAD binding to the miR-21 precursor and enhances its efficient processing by Drosha. (e) Splicing can replace Drosha processing if the released and debranched intron (mirtron) has the length and hairpin structure of a pre-miRNA.

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cleavage: the slicer activity of Ago2 cleaves the 3´ arm of the hairpin — the prospective passenger strand — in the middle to generate a nicked hairpin, producing the Ago2-cleaved precursor miRNA or ac-pre-miRNA (Fig. 5b)72. Dicer can process this precursor as efficiently as the pre-miRNAs. The Ago2-mediated step most probably facilitates subsequent strand dis- sociation and RISC activation, in a similar manner to its function in the siRNA pathway73–77. Thus, in another example of miRNA-specific process- ing, pre-miRNAs undergo two different fates after nuclear export. This early function of Ago2 in miRNA processing might explain why it associates with the RLC before the pre-miRNA and corroborates earlier findings in other species that Ago proteins are active players in miRNA biogenesis78,79.

Cleavage of the hairpin into a duplex by Dicer. The RNase III Dicer cleaves off the loop of the pre-miRNA or the nicked ac-pre-miRNA and generates a roughly 22-nucleotide miRNA duplex with two nucleotides pro- truding as overhangs at each 3´ end. This cleavage is essential for miRNA processing and has been described in many organisms, including C. elegans, D. melanogaster and mammals80–83. Deletion of Dicer decreases or abrogates the production of mature miRNAs81,82. In mice, deletion of this evolution- arily conserved endonuclease leads to lethality early in development84, an effect that could be related to its crucial role in miRNA processing.

The number of genes encoding Dicer-like proteins varies from ten in A. thaliana to only one in vertebrates80,85. The single copy of Dicer in the mammalian genome might explain its essential role in miRNA biogenesis. Several modes of Dicer cleavage activity regulation have been described. The amino-terminal DExD/H-box helicase domain of human Dicer inhib- its its cleavage activity; TRBP binds to Dicer in this region and activates Dicer through a conformational rearrangement86. Dicer is also regulated by its product let-7, which targets Dicer mRNA, creating a feedback loop87. Additional mechanisms to regulate Dicer activity may exist: pre-miR-138 is expressed ubiquitously but its mature form is restricted to certain cell types, indicating tissue-specific processing of this miRNA22.

Lin-28 double act. Beyond its effect on nuclear microprocessor activity, Lin-28 also regulates pre-let-7 maturation in the cytoplasm. Notably, Lin-28 was shown to inhibit Dicer cleavage in vitro (Fig. 3b)55. Importantly, a third mode of action for Lin-28-mediated inhibition of let-7 maturation has been characterized in detail (Fig. 3b)58. Lin-28

associates with cytoplasmic pre-let-7 and induces its polyuridylation at the 3´ end by an unidentified terminal uridylyl transferase enzyme (TUTase), leading to its degradation by an unidentified nuclease activ- ity. In A. thaliana, uridylation is known to accelerate the decay of mature miRNA, and miRNA methylation by Hen1 protects them against uri- dylation and degradation88.

Only members of the let-7 family are subject to Lin-28-mediated processing inhibition or uridylation, whereas other human miRNAs are not affected, indicating the strong specificity of these effects54–56,58. Lin-28 could contribute post-transcriptionally to the regulation of let-7 expression in development and cancer23.

Unwinding the microRNA duplex into guide and passenger strand. After Dicer-mediated cleavage, Dicer and its interactors TRBP or PACT dissociate from the miRNA duplex. To form the active RISC that performs gene silencing, the double-stranded duplex needs to be separated into the functional guide strand, which is complementary to the target, and the pas- senger strand, which is subsequently degraded. Although multiple helicases have been linked to the miRNA pathway, a universal helicase responsible for duplex unwinding has not yet been identified. Helicases associated with RISC formation or activity include p68, p72, RNA helicase A (RHA), RCK/ p54, TNRC6B, Gemin3/4 and human Mov10 or its D. melanogaster ortho- logue Armitage89–93. In mice, p68 is found complexed with let-7 and can unwind it92. Depletion of RCK/p54 leads to decreased miRNA-mediated RNA interference (RNAi) but not siRNA-mediated RNAi91. These find- ings indicate that specific helicases may regulate miRNAs differentially. However, the results of RISC loading and reconstitution experiments in the absence of ATP indicate that helicases might not be generally required66,69,71. For example, Ago2 facilitates duplex unwinding and RISC activation by cleaving the passenger strand of siRNAs or pre-miRNAs72–76.

Guide strand selection, asymmetry and small RNA sorting. In princi- ple, the miRNA duplex could give rise to two different mature miRNAs. However, in a similar manner to siRNA duplexes, only one strand is usu- ally incorporated into RISC and guides the complex to target mRNAs; the other strand is degraded94. This functional asymmetry depends on the thermodynamic stability of the base pairs at the two ends of the duplex: the miRNA strand with the less stable base pair at its 5´ end in the duplex is loaded into RISC95.

In D. melanogaster, miRNAs and siRNAs participate in a common sort- ing step that partitions them into effector complexes with different Ago proteins96,97; fully complementary duplex siRNAs are incorporated into an Ago2-RISC, whereas a distinct, unidentified mechanism incorporates

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Figure 3 Lin-28 inhibits let-7 biogenesis. Different mechanisms suppress the maturation of let-7 by the RNA-binding protein Lin-28. (a) Lin-28 inhibits Drosha-mediated processing of pri-let-7. (b) Lin-28 inhibits Dicer- mediated cleavage of pre-let-7 and recruits a terminal uridylyl transferase (TUTase) to pre-let-7. The uridylated up-let-7 is not processed but is degraded by nucleases.

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Figure 4 Regulation of microRNA processing factors. (a) DGCR8 enhances the protein stability of its partner Drosha. (b) Drosha cleaves two hairpin structures in the Dgcr8 mRNA, which is subsequently degraded. (c) Serine phosphorylation of Ago2 regulates its localization to P-bodies. (d) Prolyl hydroxylation affects the stability of human Ago2.

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partly complementary miRNAs into an Ago1-RISC. In flies, the precise length and position of the 5´ ends of guide and passenger strands increase after Ago2 loading, further ensuring the formation of the correct miRNA with the designated seed sequence98. Whereas sorting in D. melanogaster depends on duplex complementarity, the 5´ terminal nucleotide is the decisive point in A. thaliana85. It still remains to be explained how sorting is achieved in mammals.

Argonaute proteins: regulators and effectors. Ago proteins exert multi- ple functions in the miRNA pathway: they participate in miRNA process- ing by generating the ac-pre-miRNA72, and they are the RISC effector proteins mediating the mRNA degradation, destabilization or translational inhibition2–7. In addition, Ago proteins regulate miRNA abundance post- transcriptionally, and loss of endogenous Ago2 diminishes the expression and activity of mature miRNA72,99,100. This particular function of Ago2 is independent of its slicer function and endonuclease activity. Most prob- ably, the capacity of Ago proteins to bind to mature miRNAs stabilizes these short molecules. Hence, Ago2 is a prime candidate to coordinate the regulation of miRNAs, their biogenesis and their function.

Recent discoveries unravelled prolyl-4-hydroxylation and phosphor- ylation of Ago2 as regulatory mechanisms of Ago2 activity101,102. Human Ago2 is phosphorylated at residue Ser 387 by p38 MAP kinase under cellular stress conditions, aiding in the localization of Ago2 to process- ing bodies (Fig. 4c)102. P-bodies are sites of accumulation of untranslated mRNAs and of multiple enzymes involved in mRNA turnover and trans- lational repression, including Ago proteins and miRNAs103,104. In addi- tion, hydroxylation of Pro 700 on the Ago2 protein by the type I collagen prolyl-4-hydroxylase (C-P4H(I)) stabilizes it (Fig. 4d)101.

Re-import of microRNA into the nucleus. In contrast to most other ani- mal miRNAs, the mature human miR-29b is predominantly localized to the nucleus. It has a distinctive hexanucleotide terminal motif, a transfer- able nuclear localization element; this suggests that, despite their shortness, miRNAs might contain cis-acting regulatory motifs105. NRDE-3, a mem- ber of the extensive C. elegans Argonaute family, participates in nuclear import106. The nuclear localization of a fraction of the cellular Ago2 pool in human cells is affected by the RAN-GTP shuttle protein Importin-8, which is also required for miRNA-guided cytoplasmic regulation of a sub- set of mRNAs107. The re-import of miRNAs into the nucleus is especially relevant because evidence is accumulating that miRNAs could regulate gene expression in the nucleus at the transcriptional level108,109.

Half-life and degradation of microRNA. In comparison with our increas- ing knowledge about miRNA processing, surprisingly little is known about the half-life and degradation of individual miRNAs. Only in A. thaliana has a family of exoribonucleases degrading miRNAs been identified110. Mature miRNAs are generally rather stable, as demonstrated by the long persistence of most miRNAs after RNAi-mediated depletion of process- ing enzymes36,38. Nevertheless, as yet unidentified mechanisms may con- trol miRNA turnover. The marked decrease in miR-122 within 1 h after treatment of liver cells with interferon supports this notion111. In addition, miRNA activity could also be regulated after processing by blocking the miRNA binding sites on their target mRNA by RNA-binding proteins112.

Conclusions and outlook: cellular effects of microRNA-specific processing and post-transcriptional regulation In summary, miRNA biosynthesis can no longer be viewed as one general

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3´ 5´

miRNA duplex 5´

3´ 3´

5´3´

5´3´

Mature miRNA

miRNA precursor

Protein factor

Active RNase

RISC loading complex (RLC)

Ago2

Dicer TRBP

Ago2

Dicer

TRBP

TRBPDicer Ago2

Dicer TRBP

Dicer Ago2

TRBP

a

b

Figure 5 Ago2 generates an additional intermediate, the ac-pre-miRNA. (a) Dicer and TRBP interact before Ago2 is recruited to form a ternary complex that binds to the exported pre-miRNA constituting the RISC loading complex (RLC). (b) After pre-miRNA binding, Dicer releases the

mature miRNA duplex. For some miRNAs, however, Ago2 cleaves first the prospective passenger strand, generating a nicked hairpin called ac-pre-miRNA or Ago2-cleaved pre-miRNA. Adapted from ref. 72, with permission.

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pathway universal to all miRNAs. Many steps can be performed in multi- ple ways, omitted or replaced, and are affected by different mechanisms for individual miRNAs. Most importantly, these specific differences in miRNA processing suggest multiple opportunities for post-transcriptional regulation of miRNA expression. In addition, insights into the regulation of miRNA processing could be applied to enhance RNAi100,113, which uses some of the same machinery. Because little is yet known about the stability and degradation of miRNAs, this is a promising area for the discovery of novel regulatory mechanisms. The identification of more interaction partners of individual precursors will further broaden the spectrum of control mechanisms. Ultimately, the characterization of miRNA–protein interactomes will be an invaluable tool with which to gain a full under- standing of the complex circuitries governing miRNA activity.

Numerous studies have uncovered highly specific miRNA profiles dur- ing development or tumorigenesis. Their function as important regula- tors of differentiation, proliferation, apoptosis or metabolism is nowadays undisputed. The discovery of regulation of let-7 processing by Lin-28 during stem cell differentiation illustrates how insights into miRNA processing help elucidate the function of a miRNA and its regulator in the maintenance and differentiation of pluripotent stem cells54,114.

Post-transcriptional regulation of miRNA processing also occurs in cancer cells26 and might explain the aberrant miRNA expression pat- terns frequently observed in cancer24,25 with a notable global reduction of mature miRNAs15. In addition, reduced expression of Dicer is associ- ated with a poor prognosis in lung cancer115. The significance of miRNA processing regulation for tumorigenesis has recently been established experimentally: knockdown of Drosha, Dgcr8 or Dicer was shown to pro- mote transformation21. An appealing hypothesis to explain the general miRNA suppression observed in cancers is that it is linked to a deficit in miRNA processing. However, support from a primary tumour proving this causality is still lacking. Unravelling the mechanisms underlying miRNA regulation in cancer and other diseases is a central challenge for miRNA research in the coming years. Deepening our knowledge about miRNA maturation in pathological as well as physiological settings will enable us to gain a comprehensive understanding of their many roles in health and disease.

In the near future, therapeutic approaches will be developed that are based on small RNAs targeting genes with an established disease asso- ciation, such as oncogenes. However, the small RNAs provide only the specificity component of the RNAi machinery, and they rely critically on the endogenous miRNA pathway to execute their function. Thus, understanding the regulatory mechanisms of the miRNA pathway is also a prerequisite for the development and successful application of all RNAi-based drugs.

AcKnoWleDGementS We apologize to all scientists whose work could not be cited in this review as a result of space constraints. Research in the Diederichs laboratory is funded by grants from the Helmholtz Society (VH-NG-504), the German Cancer Research Center DKFZ, the Institute of Pathology, University of Heidelberg, and the Marie Curie Programme of the European Commission. Research in the Gregory laboratory is supported by the Children’s Hospital, Boston, the Harvard Stem Cell Institute, the March of Dimes Basil O’Conner award, the Charles H. Hood Foundation, and the Emerald Foundation. R.I.G. is a Pew Research Scholar.

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mitochondria and cell death.pdf

Apoptosis is a genetically encoded programme leading to cell death that is involved in normal development and homeostasis throughout the animal kingdom. Deregulated apoptosis has been implicated in diverse pathologies, including cancer and neurodegenerative disease. The defining morphological characteristics of apoptosis include cell shrinkage, nuclear fragmentation, chromatin condensation and membrane blebbing, all of which are due to the proteolytic activity of the caspase proteases1,2 (BOX 1; see Supplementary information S1 (movie)). Caspases orchestrate apoptosis through the cleavage of numerous proteins, ultimately leading to the phagocytic recognition and engulfment of the dying cell.

In vertebrate cells, apoptosis typically proceeds through one of two signalling cascades termed the intrinsic and extrinsic pathways, both of which converge on activating the executioner caspases, caspase 3 and caspase 7 (FIG. 1). In the intrinsic pathway, mitochondrial outer membrane per- meabilization (MOMP), which leads to the release of pro- apoptotic proteins from the mitochondrial intermembrane space (IMS), is the crucial event driving initiator caspase activation and apoptosis (BOX 2). Following its release from mitochondria, cytochrome c binds apoptotic protease- activating factor 1 (APAF1), inducing its conformational change and oligomerization and leading to the formation of a caspase activation platform termed the apoptosome. The apoptosome recruits, dimerizes and activates an

initiator caspase, caspase 9, which, in turn, cleaves and activates caspase 3 and caspase 7. Mitochondrial release of second mitochondria-derived activator of caspase (SMAC; also known as DIABLO) and OMI (also known as HTRA2) blocks X-linked inhibitor of apoptosis protein (XIAP)-mediated inhibition of caspase activity. MOMP is a highly regulated process, primarily controlled through interactions between pro- and anti-apoptotic members of the B cell lymphoma 2 (BCL-2) family (BOX 3).

In the extrinsic pathway, death receptor ligation causes the recruitment of adaptor molecules, such as FAS-associated death domain protein (FADD), that bind, dimerize and activate an initiator caspase, c aspase 8. Active caspase 8 directly cleaves and activates the execu- tioner caspases, caspase 3 and caspase 7. In so-called type I cells, caspase 8-mediated activation of the executioner caspases is sufficient to induce apoptosis in the absence of MOMP. Crosstalk between the extrinsic and intrinsic pathways occurs through caspase 8-mediated cleavage of BCL-2 homology 3 (BH3)-interacting domain death agonist (BID; a BH3 domain-only protein), leading to BID activa- tion and MOMP. This step is crucial for death receptor- induced apoptosis in type II cells. The requirement for MOMP-induced XIAP antagonism discriminates between type I and type II cells in death receptor-mediated apop- tosis. Hepatocytes are an in vivo type II cell; injection of wild-type mice with the FAS death receptor ligand, FASL,

Department of Immunology, St Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, Tennessee 38105, USA. Correspondence to D.R.G e-mail: [email protected] doi:10.1038/nrm2952 Published online 4 August 2010

Mitochondria and cell death: outer membrane permeabilization and beyond Stephen W. G. Tait and Douglas R. Green

Abstract | Mitochondrial outer membrane permeabilization (MOMP) is often required for activation of the caspase proteases that cause apoptotic cell death. Various intermembrane space (IMS) proteins, such as cytochrome c, promote caspase activation following their mitochondrial release. As a consequence, mitochondrial outer membrane integrity is highly controlled, primarily through interactions between pro- and anti-apoptotic members of the B cell lymphoma 2 (BCL-2) protein family. Following MOMP by pro-apoptotic BCL-2-associated X protein (BAX) or BCL-2 antagonist or killer (BAK), additional regulatory mechanisms govern the mitochondrial release of IMS proteins and caspase activity. MOMP typically leads to cell death irrespective of caspase activity by causing a progressive decline in mitochondrial function, although cells can survive this under certain circumstances, which may have pathophysiological consequences.

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Nature Reviews | Molecular Cell Biology

Inactive monomer

Dimerization and interchain cleavage

Active caspase 8 Inactive dimer Active dimer

a

b

FA D

D

FA D

D

Initiator apoptotic caspases Executioner apoptotic caspases

Caspase 8 activation Executioner caspase activation

Caspase 2, caspase 8 and caspase 9

Pro-domain Large subunit Small subunit

Caspase 3, caspase 6 and caspase 7

Large subunit Small subunit

Active initiator caspase

Tubular mitochondrial network Multiple fused mitochondria forming filamentous, elongated structures. These networks are highly dynamic owing to constant rounds of mitochondrial fission and fusion.

causes hepatocyte apoptosis that leads to rapid, fatal hepatitis, whereas BID-deficient mice are resistant to this3. Combined loss of BID and XIAP restores hepato- cyte apoptotic sensitivity and hepatitis following FASL injection, providing genetic proof that MOMP-induced XIAP antagonism is required for FASL-induced apoptosis in hepatocytes4.

In vertebrates, most apoptotic stimuli require MOMP for caspase activation and apoptosis. In contrast, MOMP is dispensable for apoptosis in the invertebrate organisms Drosophila melanogaster and Caenorhabditis elegans5. when MOMP has been detected in D. melanogaster, it seems to be a consequence rather than a cause of caspase activa- tion6. Interestingly, although MOMP does not contribute to apoptosis, fission of the tubular mitochondrial network promotes apoptosis in both C. elegans and D. melanogaster through an as yet undefined mechanism6,7.

In most cases, MOMP is a point of no return for cell survival as cells die irrespective of caspase activity follow- ing MOMP8. Given this importance, addressing how the mitochondrial outer membrane is selectively breached, and why this causes cell death, remains an intense area of basic and translational research. Here, we focus on recent studies that provide new insight into how MOMP occurs, the nature of membrane permeabilization and how the release of IMS proteins can be regulated post-MOMP. we then discuss the regulation of caspase activity post- MOMP and how MOMP brings about cell death in either a caspase-dependent or caspase-independent manner. Finally, we review data showing that MOMP is not always an obligatory death sentence, as some cells can recover.

Pulling the trigger: activation of MOMP BCL-2-mediated regulation of MOMP is discussed only briefly here, and the reader is referred to recent, extensive reviews for further details9,10. Activation of either BCL-2- associated X protein (BAX) or BCL-2 antagonist or killer (BAK) is essential for MOMP as cells lacking both pro- teins fail to undergo MOMP and apoptosis in response to diverse intrinsic stimuli11. BAX and BAK activity is largely controlled through interactions with other members of the BCL-2 family (BOX 3).

On activation, BAX and BAK undergo extensive conformational changes, leading to the mitochondrial targeting of BAX and the homo-oligomerization of BAK and BAX12–14. Oligomerization of BAX or BAK is likely to be required for MOMP as mutants of either protein that fail to form oligomers are unable to cause MOMP15,16. FRET-based analysis of BAX-mediated liposome permeabil- ization has provided compelling, real-time evidence for direct and dynamic interactions between truncated BID (tBID) and BAX, which precede BAX membrane inser- tion and liposome permeabilization17. This supports a model in which BAX (and by analogy BAK) activation requires interaction with BH3-only proteins. Structural analysis of BAX in complex with a chemically stapled BCL-2-interacting mediator of cell death (BIM; also known as BCL2L11) BH3 domain peptide termed BIM SAHB (stablized α-helices of BCL-2 domains) revealed a somewhat unexpected interaction site18. BIM SAHB does not bind in the BAX hydrophobic BH3-binding pocket (as occurs when the BID BH3 domain binds BAK19) but, instead, binds on the opposite side of BAX. Mutations in BAX that inhibit BIM SAHB binding attenuate BAX- induced MOMP, supporting a functional relevance for this interaction during BAX activation. However, it remains unclear whether direct activator proteins such as tBID and BIM interact with BAX in a similar manner to BIM SAHB, and whether BAK undergoes a similar activation mechanism by BIM SAHB.

A model for BAK activation and oligomerization, sup- ported by biochemical data, has recently been proposed16 (FIG. 2). In this model, BAK activation leads to exposure of its BH3 domain and its insertion into the hydro phobic groove of an adjacent, activated BAK molecule. The interaction is reciprocated, leading to the formation of a symmetrical BAK homodimer. Higher-order BAK oligo- mers are formed by dimer–dimer interactions mediated

Box 1 | Caspase classification and activation

Caspases (Cys Asp acid proteases) cleave substrates in a highly specific manner after the Asp residue in short tetrapeptide (X-X-X-Asp) motifs. Besides apoptotic roles, some caspase family members have non-apoptotic functions in processes such as cytokine maturation, inflammation and differentiation. Additionally, apoptotic caspases can have non-apoptotic roles in certain circumstances128–130. Apoptotic caspases can be divided into two classes: initiator and executioner caspases (see the figure, part a). Initiator caspases (caspase 2, caspase 8 and caspase 9) are the apical caspases in apoptosis signalling cascades and their activation is normally required for executioner caspase (caspase 3, caspase 6 and caspase 7) activation. The repertoire of initiator caspase substrates is limited and includes self-cleavage, BCL-2 homology 3 (BH3)-interacting domain death agonist (BID) and executioner caspases. By contrast, executioner caspases cleave hundreds of different substrates and are largely responsible for the phenotypic changes seen during apoptosis. Initiator caspase activation first involves dimerization of inactive caspase monomers (see the figure, part b). In the case of caspase 8, following death receptor ligation, dimers are formed by the recruitment of caspase 8 monomers through their pro-domains to the adaptor molecule FAS-associated death domain protein (FADD). Dimerization and interdomain cleavage are required for the activation and stabilization of mature caspase 8 (REFs 131–133). Although dimerization is required for caspase 9 activation and interdomain cleavage occurs, cleavage is involved in the attenuation rather than promotion of caspase 9 activity89,134. The activation mechanism of executioner caspases differs from that of initiator caspases (see the figure, part b). Executioner caspases are present as dimers in cells and are activated by cleavage, leading to intramolecular rearrangements and the formation of an enzymatically active dimer.

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Pro-caspase 9

APAF1

Apoptosome

Ligand (FASL, TRAIL or TNF)

FA D

D

FA D

D

C as

p as

e 8

C as

p as

e 8

Death receptor

Caspase 8 Caspase 8

Active caspases

b Extrinsica Intrinsic

Plasma membrane

DNA damage or ER stress

BH3-only protein activation

BID

tBID

Mitochondrion

Outer membrane

IMS

Matrix

BAX or BAK

MOMP

Cytochrome c

Caspase 3 Caspase 7

Apoptosis

Anti-apoptotic BCL-2 proteins

XIAP

OMI SMAC

through a cryptic interface that is exposed following BAK activation20. Mutational analysis suggests that there is a similar mechanism for BAX homo-oligomerization15.

exactly how many molecules of BAX or BAK must oligomerize for MOMP to occur is unclear. One study found that four BAX molecules are sufficient to per- meabilize an artificial membrane, whereas another study detected much larger BAX oligomers in apoptotic cells21,22. More recently, using single-cell imaging, the number of BAX molecules in a MOMP-inducing complex has been estimated at more than one hundred, although smaller complexes could not have been detected by this means owing to the limits of optical resolution23. Accurately determining the amount of active BAX and BAK molec- ules required for MOMP will provide insight into how MOMP occurs. However, this remains challenging owing largely to the small amounts of activated BAX and BAK that are required for MOMP and because both proteins continue to homo-oligomerize post-MOMP24.

Mechanisms of MOMP Although the requirement for activated BAX and BAK to induce MOMP is not debated, the means by which they carry out this task is. Here, we discuss the biophysical characteristics of MOMP, its kinetics and whether it allows for selective or non-selective release of IMS proteins. we then review how active BAX and BAK are thought to permeabilize the mitochondrial outer membrane.

Biophysical characteristics of MOMP. Live-cell imaging of MOMP, by monitoring the release of green fluores- cent protein (GFP)–cytochrome c from mitochondria during apoptosis, demonstrated that, although the onset of MOMP is highly variable, most mitochondria undergo MOMP within 5 minutes of initiation25. More recently, single-cell imaging at high temporal resolution has shown that MOMP can initiate from a defined point or points in a cell and proceed in a wave-like manner across all mito- chondria in the cell. Although the mechanism remains unclear, inhibitor studies implicate roles for protein phos- phorylation and endoplasmic reticulum Ca2+ pumps in wave propagation26–28. Potentially, caspase activity may con- tribute to intracellular MOMP waves through cleavage and activation of BID. However, somewhat at odds with these findings is the observation that the length of time between the first and last mitochondrion in a cell to undergo MOMP is unaffected by lowering temperature, which argues against an enzymatic component to the process25. This discordance may be due to the higher temporal resolution achieved in more recent studies, or, perhaps rather than contributing to wave propagation, enzymatic processes may lower the initial threshold for individual mitochondria to undergo MOMP, thereby indirectly affecting release kinetics.

whether MOMP displays any selectivity for the release of different IMS proteins has been subject to much scru- tiny. BAX-mediated liposome permeabilization in vitro leads to the equally efficient release of 10 kDa and 2 MDa dextrans, suggesting that MOMP displays no selectivity for protein size29. In cells, proteins larger than 100 kDa (the predicted size of soluble SMAC–GFP dimers) are released following MOMP. In contrast, a tetrameric SMAC–dsRed

Figure 1 | intrinsic and extrinsic pathways of apoptosis. a | Intrinsic apoptotic stimuli, such as DNA damage or endoplasmic reticulum (ER) stress, activate B cell lymphoma 2 (BCL-2) homology 3 (BH3)-only proteins leading to BCL-2-associated X protein (BAX) and BCL-2 antagonist or killer (BAK) activation and mitochondrial outer membrane permeabilization (MOMP). Anti-apoptotic BCL-2 proteins prevent MOMP by binding BH3-only proteins and activated BAX or BAK. Following MOMP, release of various proteins from the mitochondrial intermembrane space (IMS) promotes caspase activation and apoptosis. Cytochrome c binds apoptotic protease-activating factor 1 (APAF1), inducing its oligomerization and thereby forming a structure termed the apoptosome that recruits and activates an initiator caspase, caspase 9. Caspase 9 cleaves and activates executioner caspases, caspase 3 and caspase 7, leading to apoptosis. Mitochondrial release of second mitochondria-derived activator of caspase (SMAC; also known as DIABLO) and OMI (also known as HTRA2) neutralizes the caspase inhibitory function of X-linked inhibitor of apoptosis protein (XIAP). b | The extrinsic apoptotic pathway is initiated by the ligation of death receptors with their cognate ligands, leading to the recruitment of adaptor molecules such as FAS-associated death domain protein (FADD) and then caspase 8. This results in the dimerization and activation of caspase 8, which can then directly cleave and activate caspase 3 and caspase 7, leading to apoptosis. Crosstalk between the extrinsic and intrinsic pathways occurs through caspase 8 cleavage and activation of the BH3-only protein BH3-interacting domain death agonist (BID), the product of which (truncated BID; tBID) is required in some cell types for death receptor-induced apoptosis. FASL, FAS ligand; TNF, tumour necrosis factor; TRAIL, TNF-related apoptosis-inducing ligand.

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FRET (Förster resonance energy transfer). The non-radiative transfer of energy from a donor fluorophore to an acceptor fluorophore that is typically <80 Å away. FRET will only occur between fluorophores in which the emission spectrum of the donor has a significant overlap with the excitation of the acceptor.

Liposome A vesicle made of lipid bilayer in an aqueous environment. Membrane proteins can be incorporated in the bilayer.

fusion protein (with a predicted size of 190 kDa) failed to undergo release on MOMP, suggesting that MOMP may have size limitations in vivo30. Potentially, this retention may also be due to physicochemical properties such as enhanced membrane binding of the tetrameric molecule. Live single-cell imaging of multiple IMS proteins showed identical kinetics of IMS protein release from mitochondria following MOMP, irrespective of size31. However, in another study it was found that the duration of MOMP was slightly longer in the case of SMAC–mCherry (with a predicted dimeric size of 100 kDa) relative to cytochrome c–GFP (with a predicted size of 42 kDa)28. Importantly, in both studies the onset of SMAC and cytochrome c release was simultaneous, indicating that they exit mitochondria by a similar mechanism. Selective release of IMS pro- teins following MOMP has been seen in cells deficient for dystrophin-related protein 1 (DRP1; also known as uTRn), a dynamin-like protein that is required for mito- chondrial fission. In DRP1-deficient cells, SMAC readily undergoes mitochondrial release but most cytochrome c is retained in mitochondria following MOMP32–34. However, the means by which DRP1 promotes mitochondrial cytochrome c release following MOMP remain unclear.

Proteinaceous channels. BCL-2 proteins such as BAX and BCL-XL (also known as BCL2L1) display structural simi- larities with bacterial pore-forming toxins, leading to the hypothesis that BAX and BAK themselves might directly form pores in the mitochondrial outer membrane35,36 (FIG. 2). Along these lines, several studies have found that BAX forms ion channels or membrane pores in artificial membranes; however, anti-apoptotic BCL-2 proteins can also form membrane channels in vitro37. More recent evi- dence for MOMP occurring through a BAX or BAK pore has emerged from patch-clamping analysis of mitochon- dria undergoing MOMP. using tBID to trigger MOMP, a mitochondrial outer membrane channel is formed that increases in conductance (and therefore size) over time, with similar kinetics to MOMP, implicating the channel (termed by the authors as the mitochondrial apoptosis- induced channel (MAC)) as the cause of MOMP38. The step-wise growth of these channels suggests that sequential recruitment of activated, membrane-bound BAX and BAK dimers to a small pore results in a channel of increasing size, which ultimately allows cytochrome c to be released from the mitochondrial IMS. Inhibitors that block MAC formation in vitro inhibit MOMP and apoptosis in cells, in support of MAC as the relevant MOMP-inducing mecha- nism, although it remains possible that these inhibitors may directly block BAX and BAK activation39. One caveat concerning the BAX or BAK pore model is that most studies have described channels that are only large enough to accommodate cytochrome c, but MOMP clearly allows for the release of much larger proteins, as noted above.

Rather than BAX and BAK forming pores themselves, it has been proposed that the modulation of existing mito- chondrial channels such as the mitochondrial perme- ability transition pore complex (PTPC) — a multiprotein complex built up at the contact site between the inner and outer mitochondrial membranes — may have a causal role in MOMP. Cells lacking cyclophilin D, an essential com- ponent of the PTPC, display normal apoptotic sensitivity to a range of stimuli, effectively ruling out any role for the PTPC in MOMP40–42. Alternatively, MOMP has been pos- tulated to require BAK and BAX modulation of v oltage- dependent anion channel (vDAC) function. vDACs are the main pathway for metabolite diffusion across the mitochondria. However, loss of all three vDAC isoforms imparts no resistance of cells or isolated mitochondria to either MOMP or apoptosis43. Other studies have found that vDAC2 interactions with BAK are required to hold BAK inactive or for its mitochondrial localization44,45.

Lipidic pores. An alternative model suggests that inter- action of activated BAX and BAK with outer membrane lipids leads to membrane bending and, ultimately, forma- tion of transient lipid pores or inverted micelles, thereby allowing IMS protein release46–48 (FIG. 2). Lipid pores would account for several key aspects of MOMP, includ- ing the release of large IMS proteins and the difficulties in visualizing proteinaceous pores in the mitochondrial outer membrane. Accordingly, activated BAX can induce liposome permeabilization in vitro, leading to the release of encapsulated protein or dextrans in a size-independent manner 17,29. Recently, cryo-electron microscopy (eM)

Box 2 | Apoptogenic IMS proteins

cytochrome c. Although cytochrome c is primarily recognized as a key component of electron transport during oxidative phosphorylation, it is also absolutely required for caspase activation following mitochondrial outer membrane permeabilization (MOMP). Cells lacking cytochrome c fail to activate caspases and are resistant to intrinsic apoptosis135. Moreover, knock-in mice expressing cytochrome c Lys27Ala, which retains respiratory chain function but cannot bind apoptotic protease-activating factor 1 (APAF1), display similar neurological phenotypes to APAF1- and caspase 9-null mice, and cytochrome c Lys72Ala knock-in cells fail to activate caspases and undergo apoptosis following pro-apoptotic stimuli136. Cytochrome c Lys72Ala-expressing thymocytes display apoptotic sensitivity, in contrast to the resistance seen in APAF1-null and BAX–BAK double knockout thymocytes137, suggesting that other MOMP-dependent mediators of APAF1 activation might exist, although cytochrome c Lys72Ala might also retain a residual capacity to activate APAF1 (REF. 138).

SMac and oMi X-linked inhibitor of apoptosis protein (XIAP) inhibits caspase activity by directly binding active caspases, caspase 9, caspase 3 and caspase 7 (REF. 139). MOMP counteracts this through the release of second mitochondria-derived activator of caspase (SMAC; also known as DIABLO) and OMI (also known as HTRA2), two intermembrane space (IMS) proteins that directly bind XIAP and antagonize its ability to inhibit caspases140–142. Loss of SMAC or OMI, either alone or in combination, does not result in resistance to cell death. In fact, paradoxically, OMI-deficient cells are more sensitive to many intrinsic apoptotic stimuli, which may be due to the loss of OMI’s mitochondria chaperone function143. The recent discovery that IAP antagonistic drugs induce degradation of IAPs, thereby deregulating nuclear factor κB (NF-κB) signalling and causing tumour necrosis factor (TNF)-dependent death, raises the interesting possibility that SMAC and OMI may also modulate IAP levels and NF-κB signalling following their release144–146. others The role of apoptosis-inducing factor (AIF) in promoting cell death is unclear. Following MOMP, AIF release is either slow or requires caspases and therefore probably does not contribute greatly to apoptotic cell death31,147. However, mitochondrial release of AIF (for example, by calpain51) may contribute to cell death in cell types such as neurons when caspase function downstream of MOMP is inhibited, leading to caspase-inde- pendent cell death (CICD). Endonuclease G is a mitochondrial IMS protein that can also be released following MOMP, whereby it contributes to apoptosis and CICD through cleavage of nuclear DNA148. However, endonuclease G deficiency has no effect on apoptotic DNA fragmentation or CICD149.

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BH4 BH3 BH1 BH2 TM

BH3 BH1 BH2 TM

BH3

Effectors

Anti-apoptotic BCL-2 protein BAX or BAK

Pro-apoptotic BCL-2 proteins

BH3-only proteins

BH3-only protein

Anti-apoptotic BCL-2 protein

BH3-only protein BH3-only protein

Sensitizer Direct activator

BCL-2, BCL-W, BCL-XL, A1 and MCL-1

BAK, BAX and BOK

BID, BIM, BAD, BIK, BMF, BNIP3, HRK, NOXA and PUMA

Direct activator–derepressor model

Active

BAX or BAK

Active

a Anti-apoptotic BCL-2 proteins

b Indirect activator model

Patch clamping An electrophysiological technique used for measuring ion channel activity over membranes. Typically, a small diameter (1μm) micropipette serves as the electrode and is applied to a small area of membrane (the ‘patch’), allowing the activity of one or a few ion channels to be measured.

Micelle An aggregate (typically spherical) of varying size comprised of lipids. In aqueous environments, the hydrophobic lipid tails orientate to the centre of the micelle and the hydrophilic head groups are on the surface.

analysis of BAX-permeabilized liposomes revealed openings of varying size (25–100 nm) that appeared concurrently with permeabilization in a manner that was BCL-XL inhibitable49. The diameter of these open- ings is consistent with the ability of BAX to induce the size-independent release of dextrans. Supporting a lipidic pore model, the edges of these BAX-induced pores are smooth and devoid of proteinaceous material. In contrast, protein pores formed by the toxin pneumolysin, as ana- lysed by cryo-eM, are uniform in nature and decorated around the edges with toxin molecules50. However, similar pore-like structures have yet to be found on mitochondria during MOMP.

Post-MOMP regulation of IMS proteins Although MOMP itself provides little specificity as to which IMS proteins are released, studies suggest that release of different IMS proteins can be selective. This may be through the regulation of IMS protein inter action with mitochondrial membranes or by mitochondrial inner membrane remodelling.

IMS protein membrane attachment. Apoptosis induc- ing factor (AIF) is an IMS protein that is anchored on the mitochondrial inner membrane and displays much slower release kinetics than cytochrome c following MOMP31. This protracted release may be owing to the requirement for AIF cleavage post-MOMP by cytosolic proteases to liberate AIF from the mitochondrial inner membrane. One candidate protease is cytosolic calpain I, which can cleave AIF in vitro to promote its release from permeabilized mitochondria51.

electrostatic interactions between cytochrome c and the mitochondrial lipid cardiolipin have been proposed to regulate its release52. However, it might be expected that the ionic strength of the cytosol should suffice to disrupt these interactions53.

Post-MOMP mitochondrial inner membrane remodelling. Other mechanisms may control IMS protein release fol- lowing MOMP. Mitochondrial cristae are involutions of the mitochondrial inner membrane that greatly increase the mitochondrial surface area available for oxidative phosphorylation and ATP synthesis. Cristae are dynamic structures and their accessibility to the IMS is largely dictated through regulation of cristae junction size. As most cytochrome c resides in mitochondrial cristae, sev- eral studies have addressed whether cristae remodelling provides an additional means of regulating cytochrome c release following MOMP. various BH3-only proteins, including BID, BIM, BnIP3 (BCL-2 and adenovirus e1B 19 kDa protein-interacting protein 3) and BCL-2- interacting killer (BIK) have been found to promote mitochondrial cristae remodelling 54–57. Treatment of mitochondria in vitro with the BH3 protein tBID induced dramatic inner membrane remodelling, leading to inter- connected cristae with widened junctions and cyto- chrome c mobilization into the IMS55. Two IMS proteins, optic atrophy protein 1 (OPA1; a dynamin-like GTPase) and presenilins-associated rhomboid-like protein (PARL; a rhomboid protease) have been found to regulate cristae remodelling during apoptosis58,59. Following MOMP, dis- assembly of OPA1 hetero-oligomers is required for the widening of cristae junctions, whereas PARL cleavage of OPA1 generates an OPA1 cleavage product that maintains tight cristae junctions that prevent cytochrome c release. Functionally, PARL loss renders cells more susceptible to apoptosis induced by intrinsic stimuli, whereas OPA1 overexpression is protective58,59.

Although cristae remodelling requires activated BAX or BAK, it can occur in the absence of MOMP because pharmacological inhibitors of MOMP still allow remod- elling to occur54. Remodelling was associated with the mobilization of cytochrome c to the IMS and, like pre vious studies, disassembly of OPA1 was required for remodel- ling to occur. In this study, however, gross changes in mitochondrial morphology were not apparent. Instead, a subtle narrowing, rather than widening, of cristae junc- tions occurred. Similarly, correlative light microscopy and eM of apoptotic cells revealed that gross alterations in mitochondrial structure were detected only after MOMP and caspase activation had occurred, arguing against a causal role for large mitochondrial structural changes

Box 3 | Regulation of MOMP by the BCL-2 family

The B cell lymphoma 2 (BCL-2) family of proteins is divided into three groups based on their BCL-2 homology (BH) domain organization (see the figure, part a). Pro-apoptotic BCL-2 proteins can be sub-divided into effectors (the proteins that actually cause mitochondrial outer membrane permeabilization (MOMP)) or BH3 only (the proteins that relay the apoptotic signal to the effectors). Although BCL-2-related ovarian killer protein (BOK) displays similar domain architecture to BCL-2-associated X protein (BAX) and BCL-2 antagonist or killer (BAK), there is little evidence that it is a functional effector. Two prominent models of BAX and BAK activation have been proposed, termed the indirect activator (or neutralization) and direct activator–derepressor models of activation150,151 (see the figure, part b). The indirect activator model asserts that BAX and BAK are bound in a constitutively active state by anti-apoptotic BCL-2 proteins and that competitive interactions of BH3-only proteins with anti-apoptotic BCL-2 family members is sufficient to release activated BAX and BAK. In the direct activator–derepressor model, BAX and BAK are activated following interaction with a subset of BH3-only proteins known as direct activators, and anti-apoptotic BCL-2 proteins prevent MOMP either by sequestering the activating BH3-only proteins or by inhibiting activated BAX and BAK. A second subset of BH3-only proteins, termed sensitizers, cannot directly activate BAX and BAK but neutralize anti-apoptotic BCL-2 proteins. Definitive proof for either model has proved challenging; it is likely that aspects of both models are correct. BAD, BCL-2 antagonist of cell death; BID, BH3-interacting domain death agonist; BIK, BCL-2-interacting killer; BIM, BCL-2-interacting mediator of cell death; BMF, BCL-2-modifying factor; BNIP3, BCL-2 and adenovirus E1B 19 kDa protein-interacting protein 3; HRK, harakiri; PUMA, p53 upregulated modulator of apoptosis; TM, transmembrane.

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BAX or BAK Symmetrical dimer formation

Higher-order oligomerization

MOMP

BAX or BAK

Dimer–dimer interaction interface exposed

BH3 BH3 BH3

BH3 BH3

BH3 BH3

BH3 BH3

BAX or BAK

Cytochrome c Cytochrome c

Exposure of BH3 domain

Proteinaceous channels Lipidic pores

IMS IMS

BH3-only protein

Cristae junction A connection between the mitochondrial cristae and the mitochondrial IMs. The diameter of cristae junctions can be altered, thereby regulating the accessibility of mitochondrial cristae to the IMs.

Nitrosylation A post-translational protein modification involving the addition of a nitrosyl group to the Cys residue of a target protein, potentially altering target protein function.

in promoting IMS protein release60. Given that even in a closed conformation cristae junction width should easily accommodate cytochrome c exit, it is unlikely that altera- tions in cristae width per se regulate cytochrome c release. One study has found that cytochrome c resides either in the IMS or in the mitochondrial cristae and these pools do not readily interchange61. By contrast, the basal dif- fusability of cytochrome c in mitochondria has recently been shown to account for its rapid and complete release on MOMP62. Some studies have found that partial release of cytochrome c is sufficient to drive apoptosis, albeit at slower kinetics, whereas others have found apoptosis is blocked under these conditions32–34,54,55. These contrast- ing results may simply reflect varying thresholds for cytochrome c-induced caspase activation in different cell types63.

Post-MOMP regulation of caspase activity In addition to inhibition by XIAP, various mechanisms curtail caspase activity following MOMP. under healthy conditions, these inhibitory mechanisms may exist to preserve cell viability should accidental MOMP occur in a limited number of mitochondria, but they are over- whelmed when MOMP occurs in most mitochondria, such as during apoptosis. Caspase activation following MOMP in a minority of mitochondria has been pro- posed to initiate a MOMP amplification loop through the executioner caspase-mediated cleavage and activa- tion of proteins such as BID and BCL-2 (REFs 64,65). Post- MOMP regulation of caspase activity centres around the

regulation of caspase 9 activity, either directly or indirectly, through effects that occur on cytochrome c-induced APAF1 apopto some formation (FIG. 3).

Regulation of apoptosome assembly. Following mito- chondrial release, cytochrome c promotes APAF1 con- formational changes, leading to APAF1 oligomerization and assembly into a heptameric, wheel-like structure (the apoptosome) that recruits pro-caspase 9, promoting its dimerization and activation. Apoptosome formation requires APAF1-mediated dATP binding66. Paradoxically, physiological levels of nucleotides inhibit apoptosis by directly binding cytochrome c, preventing APAF1– cytochrome c interactions and apoptosome formation67. Along similar lines, transfer RnA (tRnA) binds cyto- chrome c and inhibits apoptosome formation by blocking the interaction of cytochrome c with APAF1 (REF. 68).

The pro-apoptotic activity of cytochrome c may also be regulated by redox, whereby cytochrome c oxida- tion promotes its pro-apoptotic activity and reduction inhibits it69,70. Mechanistically, the means by which the redox status affects the pro-apoptotic function of cyto- chrome c is unknown and other studies have found that reduced cytochrome c is still proficient at activat- ing caspases in vitro71,72. The addition of a haem moiety to cytochrome c occurs in the mitochondrial IMS and is required for its ability to promote caspase activity following MOMP73. Interestingly, nitrosylation of the cytochrome c haem moiety occurs under apoptotic conditions74. Modelling the effects of nitrative stress by disruption of the cytochrome c Met80–haem interaction promotes cytochrome c nuclear translocation in non- apoptotic cells, leading to the upregulation of a protective stress response. This suggests that nitrosylation can impart novel non-apoptotic roles on cytochrome c75.

normal intracellular levels of potassium also inhibit apoptosome assembly. This inhibition can be overcome by increased concentrations of cytochrome c, suggest- ing that extensive MOMP, as seen during apoptosis, is required for caspase activation and apoptosis76. Intracellular levels of Ca2+ have also been found to inhibit apoptosome activity by blocking nucleotide exchange on monomeric APAF1, thereby inhibiting apoptosome formation77. various proteins, including heat shock proteins such as HSP70 and HSP90, have been shown to negatively influence apoptosome function, either by inhibiting its formation or by preventing the recruitment of pro-caspase 9 (REFs 78–81).

Apoptosome activity can also be positively modu- lated, thereby enhancing caspase 9 activity. Putative HLADR-associated protein I (PHAPI; also known as pp32) stimulates apoptosome activity and caspase acti- vation by preventing APAF1 aggregation and promoting nucleotide exchange on APAF1 (REFs 82,83). Reduced expression of PHAPI imparts apoptotic resistance to cells, enabling clonogenic survival that may be relevant during tumorigenesis84. Interestingly, APAF1 also has a non-apoptotic role in regulating DnA damage-induced cell cycle arrest, raising the possibility that modulators of APAF1 apoptotic function can also alter its cell cycle checkpoint functions85.

Figure 2 | BaX and BaK activation and pore formation. The binding of B cell lymphoma 2 (BCL-2) homology 3 domain (BH3)-only proteins to BCL-2-associated X protein (BAX) and BCL-2 antagonist or killer (BAK) leads to extensive conformational changes during their activation. The BH3 domain and hydrophobic cleft are exposed, allowing symmetrical BAX or BAK dimers to form through reciprocal BH3 domain–cleft interactions. During activation, a dimer–dimer interaction surface is also exposed, allowing higher-order oligomers to form. Higher-order oligomers promote mitochondrial outer membrane permeabilization (MOMP) by unclear means, perhaps through forming proteinaceous channels or by destabilizing lipid membranes and forming lipidic pores. IMS, intermembrane space.

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Caspase 9

Apoptosome

Fe

ATP or tRNA

Cytochrome c

Cytochrome cNO

[K+] APAF1

APAF1 aggregation

dATP dADP

dATP dADP

PHAP1

Caspase 9

ATP ADP CDK1,

ERK1 or ERK2

P

↓PCID1

[Ca2+]

Regulation of caspase 9 activation. Several kinases have been shown to phosphorylate caspase 9, inhibiting its enzy- matic activity86. In human caspase 9, Thr125 is the main inhibitory phosphorylation site and is targeted by several kinases, including extracellular signal-regulated kinase 1 (eRK1; also known as MAPK3), eRK2 (also known as MAPK1) and cyclin-dependent kinase 1 (CDK1)–cyclin B1 (REFs 87,88). Phosphorylation of Thr125 or mutation to a phosphomimetic residue impairs the ability of cyto- chrome c to induce caspase activity in vitro88. During mitosis, CDK1–cyclin B1-mediated phosophorylation of caspase 9 on Thr125 attenuates its activity. Prolonged mitotic arrest, induced by microtubule stabilizing agents such as taxol, leads to caspase 9-dependent death that can be enhanced by inhibition of caspase 9 phosphorylation at Thr125 (REF. 87). Although it is clear that phosphorylation can negatively affect caspase 9 activity, the means by which this occurs is unclear as it does not affect the recruitment of caspase 9 to the apoptosome88. whether phosphoryla- tion inhibits other aspects of caspase 9 activation, such as its ability to dimerize, remains to be tested.

Apoptosome-mediated activation of caspase 9 leads to caspase 9 auto-processing, which greatly reduces its affin- ity for the apoptosome and results in the loss of caspase 9 activity 89. Therefore, apoptosome-mediated caspase 9 activation is a ‘molecular timer’, the activity of which is largely due to intracellular caspase 9 levels. Accordingly, regulation of caspase 9 expression also controls caspase activity post-MOMP. PCI domain-containing protein 1 (PCID1; also known as eIF3M) is the human orthologue of Tango 7, a pro-apoptotic effector that regulates expres- sion of the D. melanogaster initiator caspase pro-Dronc90. Interestingly, downregulation of PCID1 decreases expres- sion of pro-caspase 9, leading to the reduction of caspase

activity during apoptosis. Although it is not known how PCID1 regulates pro-caspase 9 levels, the finding that PCID1 is commonly downregulated in pancreatic cancer suggests that it may be clinically important91.

The end game: how MOMP kills cells MOMP leads to the rapid activation of caspases and apoptosis. However, in the absence of caspase activity (for example in APAF1- and caspase 9-deficient back- grounds92–94), cells undergo caspase-independent cell death (CICD), which thereby defines MOMP as a point of no return (see Supplementary information S2 (movie)). Although cell death is the usual outcome following MOMP, the mechanisms and kinetics by which cells die differ greatly depending on caspase activity. Here, we review what happens after MOMP and how these events bring about cellular demise through caspase-dependent and caspase-independent means (FIG. 4).

Cellular effects of MOMP. Following MOMP, caspase activ ation ensues and results in the cleavage of hundreds of proteins and, ultimately, apoptosis. Caspase cleavage of any given protein substrate can activate or inhibit its func- tion and, although hundreds of caspase substrates have been identified, many are probably innocent bystanders that play no actual part in apoptosis2. In the absence of caspase activity, cell death normally occurs following MOMP, albeit with much slower kinetics than apoptosis. MOMP has been proposed to cause CICD either by the release of IMS proteins, such as AIF and endonuclease G, or through a progressive decline in mitochondrial func- tion leading, among other effects, to ATP depletion95. Cells can continue to undergo cell division following MOMP provided that caspase activity is inhibited96.

Figure 3 | Post-MoMP regulation of caspase activity. Cytochrome c binds an apoptotic protease-activating factor 1 (APAF1) monomer, leading to its oligomerization into a heptameric wheel-like structure called the apoptosome that recruits and activates caspase 9. Physiologic levels of nucleotides such as ATP or transfer RNA (tRNA) can block cytochrome c binding to APAF1 and inhibit apoptosome formation by directly binding cytochrome c. Cytochrome c requires its haem moiety, which is acquired in the mitochondrial intermembrane space, in order to bind and activate APAF1. Nitrosative stress can modify the haem moiety and attenuate the pro-apoptotic function of cytochrome c. Intracellular levels of potassium inhibit apoptosome formation, at least in part, by competing with cytochrome c for APAF1 binding, but high levels of cytochrome c can overcome this inhibition. Binding of cytochrome c to APAF1 stimulates APAF1-dependent dATP hydrolysis, driving apoptosome formation. Putative HLADR-associated protein I (PHAPI; also known as pp32) enhances this process by both promoting nucleotide exchange on APAF1 and inhibiting aggregation of the APAF1 monomer. Intracellular Ca2+ can inhibit nucleotide exchange, thereby blocking apoptosome formation. Direct phosphorylation of caspase 9 by kinases, including cyclin-dependent kinase 1 (CDK1)–cyclin B1, extracellular signal-regulated kinase 1 (ERK1; also known as MAPK3) and ERK2 (also known as MAPK1), inhibits caspase 9 activity by unknown means. Finally, downregulation of PCI domain-containing protein 1 (PCID1; also known as EIF3M) can negatively regulate caspase 9 levels, thereby effecting caspase activation following mitochondrial outer membrane permeabilization (MOMP). NO, nitric oxide.

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ROS production and ATP depletion

Plasma membrane permeabilization

Nature Reviews | Molecular Cell Biology

III IIIIV IVII III I

ADP + Pi

ADP + Pi

ATPATP

∆Ψm ∆ΨmH + H+

TIM23

Cleaved TIM23

Matrix protein

Matrix

Inner membrane

IMS

Outer membrane

Caspase 3 Caspase 7

Apoptosome

Mitochondrion Decline in complex I–IV function and ATP synthesis

b Caspase independenta Caspase dependent

Proteasome

Cellular substrate cleavage

Mitophagy

Autophagosome

Plasma membrane Phosphatidylserine exposure

Cytochrome c

Caspase 3 Caspase 7

Complex V Respiratory chain

In this study, CICD correlated with a progressive decline in the mitochondrial function and ATP generation that preceded the mitochondrial release of AIF and endo- nuclease G, suggesting that MOMP contributes to CICD primarily through loss of mitochondrial function.

Mitochondrial effects of MOMP. Mitochondria are dynamic organelles that constantly undergo cycles of fission and fusion with one another. wide-scale mito- chondrial fission occurs at or around the point of MOMP, irrespective of caspase activity but dependent on DRP1 (REF. 97). The role of mitochondrial fission during apoptosis in mammalian cells is unclear and, although fission occurs after MOMP, it may not depend on it28,98,99.

MOMP and fission can be dissociated as fission occurs in situations where MOMP is blocked following an apoptotic stimulus, for example when BCL-XL is overexpressed98. Indeed, other studies have found that BCL-2 family members regulate mitochondrial morphology in healthy cells100,101.

Although fission is not required for MOMP, DRP1 may contribute to this process. Pharmacological inhibitors of DRP1 block MOMP in vitro, a setting in which mito- chondrial fission does not occur, thereby implying that DRP1 contributes to BAX- or BAK-induced MOMP independently of mitochondrial fission102. However, cells lacking DRP1 undergo MOMP, ruling out an absolute requirement for DRP1 for this event33,103.

Figure 4 | cellular effects of MoMP. a | Caspase-dependent effects. Mitochondrial outer membrane permeabilization (MOMP) leads to the release of cytochrome c from mitochondria, which activates caspases to cleave numerous cellular substrates, causing apoptosis. Respiratory chain complexes I–IV generate the proton gradient over the mitochondrial inner membrane that drives ATP generation by ATP synthase (complex V). Executioner caspases (caspase 3 and caspase 7) enter the mitochondrial intermembrane space (IMS) following MOMP, disrupting complex I and complex II activity. In the case of complex I, this occurs partly through cleavage of an essential complex I subunit, NADH–ubiquinone oxidoreductase 75 kDa subunit (NDUFS1). Collectively, these caspase-dependent effects lead to a loss of transmembrane potential (ΔΨ

m ) and

ATP synthesis, and an increase in reactive oxygen species (ROS) production. These effects of mitochondrial dysfunction contribute to the exposure of phosphatidylserine on the outer leaflet of the plasma membrane and its permeabilization, which occurs during apoptosis. b | Caspase-independent effects. Following MOMP, initial levels of cytochrome c in the cytoplasm are sufficient to support respiration in the permeabilized mitochondria. In the long-term, levels of cytochrome c might be rate limiting owing to proteasome-dependent degradation. Even in the absence of caspase activity, respiratory chain complex I – IV activity drops over time, leading to a gradual loss in ΔΨ

m and ATP synthesis, which effectively starves

the cell. TIM23 is an essential component of the inner membrane protein translocase. Following MOMP, TIM23 undergoes inactivation through cleavage by an unknown intramitochondrial protease, effectively blocking new protein import into the mitochondrial matrix. Finally, MOMP triggers the removal of permeabilized mitochondria by the autophagic machinery, a process termed mitophagy.

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Transmembrane potential The voltage (or electrical potential) difference between one side of a membrane and the other.

Post-mitotic cell A cell that is neither preparing to nor undergoing cell division.

Pentose–phosphate shunt A metabolic pathway that generates NADPH and pentose sugars from glucose-6- phosphate. Indirectly, NADPH serves as an important antioxidant by reducing glutathione.

The maintenance of mitochondrial transmembrane potential (ΔΨm) is crucial for many mitochondrial func- tions, including ATP synthesis, ion homeostasis and protein import into the mitochondrial matrix. Following MOMP, ΔΨm is dissipated through caspase-dependent and caspase-independent means104,105. Caspase-dependent dissipation of ΔΨm is mediated, at least in part, through caspase cleavage of nADH–ubiquinone oxidoreductase 75 kDa subunit (nDuFS1), an essential component of respiratory chain complex I106. In permeabilized mito- chondria, executioner caspases gain entry to the IMS and cleave nDuFS1, which leads to a sequential reduction in complex I activity, a drop in ΔΨm, a rapid reduction in ATP synthesis and an increase in reactive oxygen species (ROS). Interestingly, expression of a non-cleavable form of nDuFS1 delays the kinetics of ΔΨm loss and phos- phatidylserine exposure on the outer leaflet of the plasma membrane (a key feature of apoptosis that contributes to the phagocytosis of the dying cell) following MOMP. This indicates a direct role for caspase-induced mitochondrial dysfunction in mediating this process. Furthermore, modulation of mitochondrial dysfunction during apop- tosis by the expression of non-cleavable nDuFS1 alters how the immune system responds to a dying cell107. Caspase-dependent mitochondrial ROS production oxi- dizes the immunostimulatory protein high mobility group protein B1 (HMGB1) in dying cells, thereby promoting immune tolerance, whereas expression of non-cleavable nDuFS1 reduces ROS levels, which blocks HMGB1 oxidation and leads instead to an immunostimulatory response. There are probably other mitochondrial caspase targets as non-cleavable nDuFS1 only partially rescues the caspase-dependent loss in ΔΨm, and respiratory chain complex II activity is also inhibited following MOMP in a caspase-dependent manner106,108.

Mitochondrial function deteriorates even in the absence of caspase activity, leading to a progressive loss in ΔΨm and ATP production, although how this occurs remains unclear96,109. Analysis of cells undergoing CICD has shown that respiratory complexes I and Iv are lost in the absence of caspase activity at later time points follow- ing MOMP. One obvious reason for the loss of respiratory function might be cytochrome c release. However, fol- lowing MOMP, cytochrome c remains at sufficiently high levels in the mitochondrial IMS to allow respiration105. At later time points, proteasome-dependent degradation of cytochrome c may promote respiratory dysfunction110. Alternatively, access of cytosolic enzymes to the mito- chondrial IMS following MOMP may lead to inactivating post-translational modifications such as cleavage of cru- cial mitochondrial proteins. TIM23, an essential compo- nent of the inner membrane protein translocase complex, undergoes proteolytic inactivation following MOMP111. Cleavage of TIM23 was found to require an intra- mitochondrial protease and was associated with reduced cell viability following MOMP. Dysfunctional mitochon- dria can be specifically targeted for autophagic degradation through a process termed mitophagy. Mitophagy triggers include the loss of mitochondrial membrane potential and membrane permeability trans ition112–114. Interestingly, MOMP has also been shown to promote mitophagy109,115.

Although mitophagy is primarily a homeostatic mecha- nism to ensure damaged mitochondria are removed, taken to its extreme, mitophagy can remove all mito- chondria from a cell, effectively committing that cell to death115. However, one recent study showed that com- plete removal of mitochondria by enhanced mitophagy did not result in cell death for at least 4 days, suggesting that this is not a mechanism of cell death in short time frames114. The finding that cells can survive, at least in the short term, without mitochondria also suggests that CICD is not due solely to the loss of mitochondrial func- tion, but may also involve an active role for permeabilized mitochondria.

Cellular recovery post-MOMP The prevailing view that MOMP is a point of no return for cell survival is likely to be true in most, but importantly not all, situations. Recovery from MOMP probably has important pathophysiological consequences, enabling long-term survival of post-mitotic cells and promoting tumour cell survival95. Here, we review the mechanisms that govern cell survival following MOMP.

Survival following ‘accidental’ MOMP. Typically, MOMP causes the permeabilization of most mitochondria, leading to lethal caspase activation. However, studies have shown that there is a threshold for cytochrome c-mediated cas- pase activation that is influenced by many factors such as nucleotide and XIAP levels, as we have already discussed. This raises the possibility that in a minority of mitochon- dria MOMP might be insufficient to trigger apoptosis. Laser irradiation of neuronal mitochondria, leading to permeabilization of 15% of the mitochondrial population, was insufficient to trigger apoptosis116. However, whether accidental MOMP occurs in a few mitochondria in the absence of apoptosis remains an open question.

Post-mitotic cellular recovery. Sympathetic neurons and cardiomyocytes can survive following MOMP, perhaps necessitated by the life-long requirement for these post- mitotic cells117,118. Following terminal differentiation, both cell types express low levels of APAF1 and are unrespon- sive to microinjection of cytochrome c119,120. Apoptotic sensitivity is restored following upregulation of APAF1, addition of recombinant SMAC or deletion of XIAP, implicating an important role for XIAP-mediated caspase inhibition in regulating cell death. Both cell types survive following MOMP, suggesting that endogenous SMAC and OMI are at insufficient levels to neutralize XIAP activ- ity121,122. In the case of neurons, prolonged apoptotic sig- nalling following nerve growth factor (nGF) withdrawal induces a so-called ‘competence to die’ owing to down- regulation of XIAP levels121. The redox status of cyto- chrome c influences its pro-apoptotic activity following MOMP in neurons123 (see above). neurons display high levels of glycolysis, which, besides producing ATP, raises the intracellular levels of glutathione synthase (GSH) though the pentose–phosphate shunt. Following MOMP, cytochrome c is reduced and held inactive by GSH, which inhibits caspase activation, whereas oxidation of cyto- chrome c promotes its activity. Tumour cells, similar to

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neuronal cells, are typically glycolytic and therefore may also inhibit the pro-apoptotic activity of cytochrome c in a similar manner.

Recovery in proliferating cells. Proliferating cells can also recover from MOMP provided caspase activity is inhibited. This may have important implications for oncogenesis and cancer therapy because tumour cells often display defects in caspase activation downstream of MOMP, through diverse mechanisms such as reduction in APAF1 expression or upregulation of XIAP109,124,125. using a retroviral cDnA screen, glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was found to protect cells from death downstream of MOMP, provided that caspase activ- ity was inhibited, owing to its well-characterized role in glycolysis and a novel role in autophagy induction, partly through the upregulation of autophagy-related protein 12 (ATG12)109. The anticancer drug imatinib (Gleevec; novartis), inhibits breakpoint cluster region protein (BCR)–abelson (ABL) kinase function and promotes both apoptosis and CICD. Interestingly, in some imatinib- resistant BCR–ABL-expressing cells, higher levels of GAPDH produce resistance to CICD that can be reverted by limited small interfering RnA knockdown of GAPDH, suggesting that protection from CICD by GAPDH may be therapeutically relevant126.

One intriguing aspect concerning cellular recovery following MOMP is how the crucial process of cell- ular repopulation with intact mitochondria occurs. Addressing this issue, a recent study has found that MOMP can be incomplete, such that some mitochondria fail to undergo MOMP following an apoptotic stimulus and remain intact127. Increased levels of anti-apoptotic BCL-2 proteins on specific mitochondria probably account for their resistance to MOMP, supported by a lack of BAX or BAK activation on these mitochondria and reversion to complete MOMP after treatment with the BCL-2 antagonist, ABT-737. Importantly, the pres- ence of intact mitochondria strongly correlates with

cellular recovery under conditions of MOMP, suggesting that these are the ‘seed’ mitochondria that can repopulate the cell. In healthy neurons, MOMP leading to caspase 3 activation is required for effective AMPA (α-amino-3- hydroxy-5-methyl-4-isoxazole propionic acid) receptor internalization at postsynaptic junctions128. Incomplete MOMP probably plays an important role in this process by promoting receptor internalization while preserving cell viability.

Concluding remarks Considerable progress has been made in recent years addressing the regulation of MOMP, how it occurs and why it brings about cell death. However, many outstanding questions remain. Although we are beginning to under- stand how BAX and BAK become activated, the means by which they permeabilize the mitochondrial outer membrane remain elusive. Cell survival is possible fol- lowing MOMP but it remains unclear whether MOMP in a minority of mitochondria actually occurs under healthy conditions, an event that would explain why cells can regulate caspase activity post-MOMP.

How MOMP initiates caspase activation leading to apoptosis is relatively well elucidated. In contrast, beyond ‘mitochondrial catastrophe’, we have very little mechanistic insight into how MOMP contributes to cell death in a caspase-independent manner. Following from this, the manner by which a cell dies following MOMP, either by caspase-dependent or caspase-independent means, may have profound effects on how the immune system and neighbouring cells react to it, but this is under-studied. Finally, as we have discussed, MOMP need not always lead to a dead end: both post-mitotic and mitotic cells can recover from MOMP, although the detailed mecha- nisms governing cell survival remain scarce. In summary, many fundamental questions remain about the process of MOMP and how it controls life and death, and we anti cipate that future findings will greatly facilitate the manipulation of this process for therapeutic purposes.

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Acknowledgements We thank A. Oberst, F. Llambi and J. Tait-Mulder for critical reading of the manuscript.

Competing interests statement The authors declare no competing financial interests.

DATABASES UniProtKB: http://www.uniprot.org AIF | APAF1 | BAK | BAX | BCL-XL | BID | BIK | BIM | BNIP3 | caspase 3 | caspase 7 | caspase 8 | caspase 9 | DRP1 | FADD | FASL | NDUFS1 | OMI | OPA1 | PARL | PCID1 | PHAPI | SMAC | TIM23 | XIAP

FURTHER INFORMATION Douglas R. Green’s homepage: http://www.stjude.org/green Deathbase: http://deathbase.org/

SUPPLEMENTARY INFORMATION See online article: S1 (movie) | S2 (movie)

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Nuclear Receptor structure Implications for Function.pdf

ANRV300-PH69-09 ARI 8 January 2007 15:57

Nuclear Receptor Structure: Implications for Function David L. Bain, Aaron F. Heneghan, Keith D. Connaghan-Jones, and Michael T. Miura Department of Pharmaceutical Sciences, University of Colorado Health Sciences Center, Denver, Colorado 80262; email: [email protected], [email protected], [email protected], [email protected]

Annu. Rev. Physiol. 2007. 69:201–20

First published online as a Review in Advance on November 30, 2006

The Annual Review of Physiology is online at http://physiol.annualreviews.org

This article’s doi: 10.1146/annurev.physiol.69.031905.160308

Copyright c© 2007 by Annual Reviews. All rights reserved

0066-4278/07/0315-0201$20.00

Key Words

DNA-binding domain, ligand-binding domain, activation function, progesterone receptor, crystallography, NMR

Abstract Small lipophilic molecules such as steroidal hormones, retinoids, and free fatty acids control many of the reproductive, developmental, and metabolic processes in eukaryotes. The mediators of these effects are nuclear receptor proteins, ligand-activated transcription factors capable of regulating the expression of complex gene networks. This review addresses the structure and structural properties of nuclear receptors, focusing on the well-studied ligand-binding and DNA- binding domains as well as our still-emerging understanding of the largely unstructured N-terminal regions. To emphasize the allosteric interdependence among these subunits, a more detailed inspection of the structural properties of the human progesterone receptor is presented. Finally, this work is placed in the context of developing a quantitative and mechanistic understanding of nuclear receptor function.

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PR: progesterone receptor

ER: estrogen receptor

GR: glucocorticoid receptor

AR: androgen receptor

TR: thyroid receptor

RXR: retinoic X receptor

INTRODUCTION

Nuclear receptors are intracellular transcrip- tion factors that regulate the activity of com- plex gene networks (1, 2). The proteins define a superfamily responsible for major as- pects of eukaryotic development, differentia- tion, reproduction, and metabolic homeosta- sis. This superfamily is typically subdivided into three families, or classes. The steroid receptor family (class I) includes the pro- gesterone receptor (PR), estrogen receptor (ER), glucocorticoid receptor (GR), androgen receptor (AR), and mineralocorticoid recep- tor. The thyroid/retinoid family (class II) in- cludes the thyroid receptor (TR), vitamin D receptor (VDR), retinoic acid receptor (RAR), and peroxisome proliferator–activated recep- tor (PPAR). The third class of receptors has long been termed the orphan receptor family: It defines a set of proteins identified by com- parative sequence analysis as belonging to the nuclear receptor superfamily but for which the cognate ligand is unknown. The orphan receptors have received particular attention of late because some of the newly identified lig- ands (e.g., bile acids) implicate their receptors in a variety of metabolic processes, including lipid homeostasis (3).

Although all nuclear receptors regulate gene expression, among the three classes there are subtle differences in the biochem- ical mechanisms by which the receptors carry out this function. With regard to the steroid receptor family, traditional models posit that, upon binding their hormonal ligand, the re- ceptors release heat shock proteins, translo- cate into the nucleus, and bind as homodimers to imperfect palindromic (i.e., inverted re- peat) response elements at upstream promoter sites. ER recognizes a consensus sequence of AGGTCA, and the remaining steroid re- ceptors recognize a consensus AGAACA se- quence. DNA binding is coupled to the recruitment of coactivator proteins and subse- quent transcriptional activation. The steroid receptors bind as head-to-head dimers: One protomer of the dimer binds to the highly con-

served hexanucleotide half-site, and the sec- ond protomer binds to a less conserved hex- anucleotide sequence. The two half-sites are separated by an invariant three nucleotides, although the type of nucleotide is not highly conserved.

The class II receptor proteins typically function as heterodimers; TR, VDR, RAR, and PPAR associate with the retinoic X recep- tor (RXR) and bind as a dimeric complex to di- rect repeat response elements. The protomers within the heterodimer recognize a hexanu- cleotide consensus sequence of AGGTCA. Unlike the steroid receptors, these proteins bind in a head-to-tail orientation and can ac- commodate small changes in the number of nucleotides between the half-sites necessary for combinatorial specificity (4). From a func- tional perspective, the heterodimers tend to stay bound to their response elements regard- less of whether agonist ligands are present: In the absence of ligand, gene activation is prevented by corepressor interactions with the DNA-bound heterodimer. Upon bind- ing ligand, corepressor proteins are released and coactivators are recruited, leading to tran- scriptional activation.

A complete understanding of orphan re- ceptor function is still developing, but cur- rent evidence indicates that orphan recep- tors either can heterodimerize with RXR or can bind as monomers at response elements to carry out their function. Typically these proteins recognize similar hexanucleotide se- quences, as do the class II receptors, but be- cause some of the orphan receptors also bind as monomers, the DNA sequences flanking the recognition sites are also critical.

The above models have served as a cen- tral framework for understanding nuclear re- ceptor action. However, their limitations are evident in work demonstrating that the abil- ity of nuclear receptors to regulate gene ex- pression depends upon allosterically mediated structural transitions both within the recep- tor and among coactivating proteins and the promoter DNA. Some of these transitions in- volve localized changes in helical orientation,

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whereas others involve global disorder-order transitions. The physical mechanisms un- derlying allosterically driven structural re- arrangements are largely unknown. Adding to the complexity, nuclear receptor–coactivator interactions at the promoter are not static in character but instead involve highly unstable, time-dependent processes involving upward of 50 or so proteins (5, 6). Keeping this in mind, we present here an overview of nuclear receptor structure-function relationships, fol- lowed by an analysis of the structure and struc- tural properties of nuclear receptor subunits. Finally, we discuss the structural and physical properties of the human PR, both of its sub- units and of the holoprotein, as a case study for pointing out the strengths and weaknesses in our understanding of receptor function.

OVERVIEW OF NUCLEAR RECEPTOR STRUCTURE-FUNCTION RELATIONSHIPS

Early biochemical studies of partially purified receptors demonstrated that nuclear receptor proteins contained two structural subunits: a moderately conserved C-terminal ligand- binding domain (LBD) and a highly con- served and centrally located DNA-binding domain (DBD) (see Figure 1) (7, 8). The LBD serves a number of critical functions. First, as indicated by its name, the LBD con- tains an interior binding pocket specific for its cognate hormone or ligand. Second, the domain contains a ligand-regulated transcrip- tional activation function (AF-2) necessary for recruiting various coactivating proteins. The coactivators are then capable of interacting with chromatin-remodeling proteins and the general transcriptional activation machinery (9). Finally, the LBD is the primary media- tor of solution self-assembly reactions (e.g., dimerization or tetramerization) necessary for high-affinity DNA response element binding (10).

The second identified subunit, the DBD, docks the receptor to the hexanucleotide

AF-1 DBD

N C

H LBD AF-2

P-box T-box A-box

Helix-1 D-box Helix-2

CTE

Figure 1 Schematic layout of nuclear receptor structure. AF, activation function; DBD, DNA-binding domain; H, hinge; LBD, ligand-binding domain. Shown below the schematic of the full-length receptor is an expanded view of the DBD, indicating the relative locations of the P-box, D-box, T-box, A-box, helix 1, helix 2, and the C-terminal extension (CTE).

LBD: ligand-binding domain

DBD: DNA-binding domain

AF: activation function

response elements located within nuclear receptor–regulated promoters. As discussed in more detail below, the DBD also serves as an allosteric transmitter of information to other regions of the receptor molecule. The DBD is connected to the LBD via a short amino acid sequence termed the hinge. The complete functional properties of the hinge sequence are still unclear, although it can be phosphorylated, and phosphorylation is cou- pled to increased transcriptional activation (11, 12).

Most nuclear receptors contain amino acid sequences N-terminal to the DBD. These residues contain a transcriptional activation function termed AF-1. In contrast to the moderately conserved AF-2 sequence em- bedded within the LBD, the AF-1 sequence shows weak conservation (<15%) across the nuclear receptor superfamily and even within subgroups such as the steroid receptor family. This lack of sequence homology (both within AF-1 and in the greater N-terminal region) may be critical in explaining, for example, how closely related steroid receptors can bind to similar response elements in vitro yet differentially regulate gene promoters containing those same binding sequences in vivo. Finally, although the AF-1 sequence can function as a ligand-independent tran- scriptional activator, it also can functionally synergize with AF-2 (13).

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Figure 2 Representative ribbon diagrams of ligand-binding domain (LBD) structures for the three classes of nuclear receptors. (a) Apo-RXR (retinoic X receptor) structure (20). (b) Estrogen receptor alpha (ERα) LBD bound to agonist ligand and coactivator LXXLL peptide (28). (c). Peroxisome proliferator– activated receptor (PPAR) bound to antagonist ligand and corepressor LXXLL peptide (31).

The functional properties of residues lo- cated between the far N terminus and AF-1 are the least understood of any of the nu- clear receptor sequences. For at least some receptors, these residues play a role in atten- uating or modulating transcriptional activa- tion properties (14, 15). Additionally, serine and threonine residues located within this se- quence are phosphorylated in response to lig- and binding and the cell cycle and thus func- tion as signal transduction sensors (16, 17). It is not clear whether phosphorylation or other posttranslational modifications (18) are linked to changes in nuclear receptor structure, al- though it is well documented in model pep- tide systems that phosphorylation of amino acid side chains can alternatively stabilize or destabilize secondary structure (19).

NUCLEAR RECEPTOR STRUCTURE

The Ligand-Binding Domain

The first high-resolution structure of a nu- clear receptor LBD was revealed in 1995,

when the apo-RXR structure was deter- mined using a crystallographic approach (see Figure 2a) (20). Since then, approximately half of the nuclear receptor LBD structures have been determined either by crystallogra- phy or by NMR spectroscopy (for a summary, see Reference 21). Without exception, each structure reveals a globular domain made up of approximately 12 α-helices. At the tertiary level, the helices typically form three antipar- allel helical sheets that combine to make what is often described as an α-helical sandwich. The ligand-binding pocket for each receptor is located in the interior of the structure and is formed by a subset of the surrounding helices.

The strength and specificity of LBD- ligand complexes are based largely on hy- drophobic interactions, extensive hydrogen- bonding networks, and the steric size and shape of the binding pocket. In the case of steroid receptors, for example, hydrophobic regions within the pocket closely contour the shape of the ligand, and polar groups serve to specifically bind and orient it (22–26). Taken together, these contributions allow the re- ceptors to discriminate among closely related

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steroidal structures. With regard to the entire nuclear receptor superfamily, the overall size and shape of the binding pockets apparently correlate with receptor function (21). Thus, steroid receptors that maintain high affinity toward only a small number of ligands have smaller volumes within their binding pockets but extensive polar side chains that can pre- cisely hydrogen bond with the natural ligand. By contrast, orphan receptors that interact with diverse metabolic ligands tend to have larger-volume binding pockets that can ac- commodate a number of different structures.

The LBD includes a ligand-dependent ac- tivation function (AF-2) capable of recruiting proteins such as the steroid receptor coactiva- tor (SRC) family (9). The structural interface for this function localizes to a hydrophobic groove formed by several helices of the LBD, including helix 12 (also called the AF-2 he- lix). Coactivators that contain helical LXXLL motifs bind via hydrophobic interactions in the groove. Interaction specificity is conferred by charge-clamp electrostatic interactions be- tween the LBD and coactivator residues that cap each end of the two-turn LXXLL helix.

Agonist ligands regulate LBD-coactivator interactions by modulating the conforma- tional mobility of both the LBD and helix 12. In the absence of agonist, the LBD is inac- tive either because helix 12 is positioned away from the LBD core structure, and thus un- able to complete formation of the hydropho- bic groove (Figure 2a) (20), or the domain exists as a broad ensemble of conformations, only a few of which are in the active form (27). Upon binding an activating ligand, he- lix 12 is stabilized against the surface of the LBD, allowing formation of the hydropho- bic binding groove and coactivator recruit- ment (Figure 2b) (28). Stabilization can occur through direct contacts between the ligand and helix 12 (22), by interactions with ligand- stabilized helices near the binding pocket (28), or by long-range interactions between the ligand-binding and coactivator-binding pock- ets (29). Another means of regulation occurs at the quaternary level: RXR proteins maintain a

tetrameric state that physically prevents coac- tivator binding. Agonist binding is coupled to dissociation of tetramers to dimers, resulting in the concomitant formation and exposure of the hydrophobic groove (30).

How do antagonist ligands and corepres- sor proteins prevent coactivator recruitment? Antagonists can inhibit coactivator binding by sterically blocking the ability of helix 12 to ap- proach the core LBD structure (23, 31) or by inducing helix 12 to bind in the hydropho- bic groove and thus unproductively mimic the coactivator (28). For nuclear receptors such as PPAR, corepressors can also prevent coactivator recruitment (32–34). Like coac- tivators, these molecules contain LXXLL- binding motifs and thus are able to rec- ognize the hydrophobic residues that make up AF-2. However, unlike coactivators, the corepressor-binding motif forms a lengthy three-turn helix that sterically blocks helix 12 from acquiring an active conformation and thus prevents formation of the hydrophobic binding cleft (Figure 2c) (31). The LBD- corepressor complex can be further stabi- lized by the presence of the antagonist lig- and, which not only prevents helix 12 from forming the active conformation but, impor- tantly, creates a larger binding surface for the corepressor LXXLL motif.

The DNA-Binding Domain

The glucocorticoid receptor (GR) DBD was one of the first structures determined for any receptor subunit and still serves as a rep- resentative model for the nuclear receptor superfamily (Figure 3a) (35–37). The GR DBD folds into a globular domain made up of two nonequivalent zinc-finger structures; each zinc atom is coordinated by four cys- teine residues. The atoms are necessary to re- tain stable domain structure and function be- cause removal of the zinc ion leads to protein unfolding and loss of DNA-binding activity (38). Also prominent in the structure are two α-helices; the N-terminal helix (helix 1) di- rectly interacts with the major groove of each

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DNA half-site, making base-specific contacts, whereas the C-terminal helix (helix 2) overlays helix 1 in a perpendicular fashion and con- tributes to stabilization of the overall protein structure.

The GR DBD is monomeric in solution but can undergo DNA-induced dimerization upon binding a palindromic (inverted repeat) response element. The residues that make up the dimer interface are located within the C- terminal zinc finger and define the D-box; the residues critical to sequence-specific DNA binding are located within helix 1 and are defined as the P-box. A comparison of the free GR structure with the DNA-bound struc- ture indicates that interactions between the P-box and the DNA half-site are coupled to conformational changes in the D-box neces- sary for cooperative recruitment of the second monomer (39). Thus, the specific binding se- quence acts as an allosteric effector of func- tion. Similar results were seen for the Class II family discussed below.

The RXR-TR heterodimer bound to a di- rect repeat sequence is representative of class II receptor structure (Figure 3b) (40). The overall tertiary fold of each protomer of the heterodimer, including the two zinc fingers and α-helices, is similar to that of the GR structure. Moreover, analogous to what was seen in the GR DBD structure, DNA bind- ing is coupled to structural changes necessary for heterodimer formation and high-affinity

←−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−−− Figure 3 Ribbon diagrams of DNA-binding domain (DBD) structures complexed to their response elements for the three classes of nuclear receptors. (a) The glucocorticoid (GR) DBD homodimer bound to an inverted repeat response element (37). (b) The retinoic X receptor (RXR)–thyroid receptor (TR) heterodimer bound to a direct repeat response element (40). The RXR protomer is shown to the left, and the TR protomer is shown to the right. (c) The estrogen-related receptor 2 (ERR2) orphan receptor monomer bound to a half-site response element (43). The axis of helix 1 is oriented toward the viewer; helix 2 is above and perpendicular to helix 1.

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binding. However, in the case of RXR, DNA binding is linked to both helix formation and helix loss (41): Helical ordering occurs in the second zinc-finger region and is required for heterodimerization. Helical unfolding occurs in the C-terminal extension (CTE) of the DBD and appears necessary for heterodimer formation. [By contrast, modeling analysis indicates that this helix must be present to allow RXR homodimer formation (41).] In the case of TR, two helices within the CTE play critical roles in DNA binding and het- erodimer assembly: (a) A helix in the CTE T-box sequence is necessary to complete the heterodimeric interface with the second zinc- finger helix of RXR, and (b) a helix within an A-box sequence makes extensive contacts with the DNA. Whether these two helices are induced upon DNA binding is unclear in the absence of a TR structure unliganded to DNA.

A complete picture of the structural ba- sis of DNA binding by orphan receptors is still coming into focus (42). However, for at least a subset of these receptors, DNA bind- ing occurs through a monomer-binding re- action rather than heterodimerization with RXR. Like RXR and TR, orphan recep- tors such as the estrogen-related receptor 2 protein (ERR2) generate high-affinity bind- ing through the use of the CTE of the core DBD (43). However, in the absence of DNA, the CTE of ERR2 is largely unstruc- tured. Upon binding a hexanucleotide half- site, the CTE becomes ordered by interact- ing with the DNA minor groove at sequences flanking the canonical response element (see Figure 3c). The interacting sequences local- ize to an A-box within the CTE, and the contacts contribute significantly to the en- hanced stability of binding. Additionally, the CTE folds back on itself to form a pseudo– dimer interface with the core DBD struc- ture. This latter interaction not only adds greater stability to the protein-DNA assem- bly but suggests that receptor dimerization arose from a progenitor monomer-binding species.

CTE: C-terminal extension

ERR: estrogen-related receptor

Sequences N-Terminal to the DNA-Binding Domain

Our knowledge of the structural properties of sequences N-terminal to the DBD contin- ues to lag behind that of the LBD and DBD. However, various studies on steroid receptor N-terminal regions have revealed that these sequences tend to be unstructured or weakly folded in isolation and yet can acquire sig- nificant secondary and tertiary structure by exposure to interacting macromolecules (ei- ther proteins or DNA) or by perturbation of solution conditions. It is not clear whether these phenomena can be extended to the N- terminal sequences of type II and type III receptors because the latter have not been as intensively investigated. However, analy- sis of the RXR N-terminal sequence suggests that this receptor shares, at least qualitatively, some of the characteristics seen in the steroid receptors (44). A summary and analysis of the results found for several steroid receptor pro- teins are below.

Evidence for minimal folded structure in steroid receptor N-terminal regions dates back to early proteolysis studies (7, 8). Consis- tent with this, work on the isolated GR AF- 1 (also known as tau-1) revealed that it was largely random coil in solution (45). How- ever, spectroscopic analysis of this AF in the presence of the naturally occurring osmolyte TMAO demonstrated that the sequence could acquire secondary and tertiary structure, thus making it competent to interact with tran- scription factors, including TBP and SRC-1 (46). Additionally, studies using a GR con- struct containing the N-terminal sequence linked to its DBD demonstrated that bind- ing to DNA response elements could also in- crease structure within AF-1, thus implicating the DBD as an allosteric mediator of commu- nication between the response elements and activation function (47).

In parallel with this work, limited proteol- ysis studies on the human progesterone recep- tor (PR) demonstrated that the N-terminal re- gions contained structure but that structural

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stability was highly dependent on the presence of the DBD (48, 49) (discussed in more de- tail below). Furthermore, these studies were the first to map the locations of N-terminal structural instability and found that these lo- cations corresponded to previously identified phosphorylation motifs and the AF-1 func- tional domain boundary. Additionally, analy- sis of PR when it was bound to a palindromic response element revealed DNA-dependent changes in structure that localized to AF-1 and to the hinge.

Studies on the AR AF-1 revealed prop- erties like those seen in the GR studies de- scribed above. The isolated AF contained only a low degree of secondary structure in the ab- sence of stabilizing agents, but the addition of TMAO induced a more structured and α- helical conformation (50). Additionally, fluo- rescence studies indicated that DNA response element binding was coupled to changes in N- terminal structure (51) and that interactions with the general transcription factor TFIIF triggered changes in AF-1 structure (52).

Finally, CD and NMR analyses of the N- terminal regions of ER-α and ER-β demon- strated that both sequences were unstructured in vitro (53). However, only the ER-α con- struct could interact with the TATA-binding protein, and interaction was coupled to in- duction of structure. Evidence of an induced- folding reaction within ER-α was consistent with the results of limited proteolysis studies of ER-β, which demonstrated that promoter binding was linked to structural changes in the holoprotein (54). Furthermore, the types of structural changes were specific to the type of promoter sequence and coupled to differ- ential interactions of coactivators.

The effect that DNA has on the N- terminal structure of nuclear receptors is in agreement with a broader theme that eu- karyotic promoter-binding sites do not sim- ply act as docking stations to allow the lo- calized assembly of transcription factors but that the sites also function as ligands capa- ble of influencing receptor structure via al- losteric mechanisms (55). Unfortunately, the

physical mechanism(s) by which these struc- tural changes occur in nuclear receptors re- mains unclear. Some insight into the ori- gins of allosteric coupling may be found in studies of the glucocorticoid receptor DBD: Analysis of DBD mutants shown to be con- stitutive transcriptional activators found that the mutations mapped near regions known to undergo DNA-dependent conformational changes (39, 56). Moreover, the structures of the mutant DBDs in the absence of DNA were largely identical to those found for the wild-type DBD when bound to DNA (57). In other words, the mutations decoupled a normally DNA-induced structural switch. How exactly this structural change might lead to activation remains unclear—the structural changes themselves may form a surface ca- pable of directly interacting with coactiva- tors or may trigger conformational changes in AF-1, thus leading to subsequent coacti- vator recruitment. A variation on this theme may come from recent work demonstrating that the JDP-2 protein, analogous to a DNA response element, can bind to the PR DBD and induce structural changes within the N- terminal AF-1 (58).

Steroid receptor N-terminal sequences have a number of common properties, such as having a partially or totally unfolded struc- ture and the ability to modulate that struc- ture allosterically. However, it is still not clear whether these phenomena occur by a similar physical folding mechanism and whether they apply to other nuclear receptor N-terminal sequences. The use of different techniques and approaches for analyzing each steroid receptor is a contributing factor, as is our still-developing understanding of the phys- ical mechanisms underlying protein folding and disorder-order transitions within protein subunits. Thus, side-by-side comparative and quantitative analysis will be necessary to ascer- tain whether steroid receptors use similar ap- proaches to mediate folding and function. Al- though a common folding mechanism would be an appealing result, it may be an unlikely one, given the lack of N-terminal sequence

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identity among nuclear receptors. In fact, the structural properties and folding mechanisms of N-terminal steroid receptor sequences may differ precisely to generate receptor-specific functional responses via differential recruit- ment of coactivators, for example (59).

Another unresolved question is why the N- terminal sequences exist as unfolded or par- tially folded conformational ensembles. In the past few years, an increasing number of pro- teins have been found to be natively unfolded or intrinsically disordered (60). It is not yet clear whether nuclear receptor N-terminal se- quences are truly natively unfolded, although they share some of the defining characteristics (61). If these sequences are indeed unfolded in vivo, the functional basis likely is to increase the specificity of receptor-coactivator inter- actions via only folding (and thus interacting) with appropriate target proteins. Additionally, a linked folding-binding reaction will result in a decrease in the intrinsic energetics of the interaction owing to an entropic penalty to folding; this weakened affinity may allow for a more functionally nimble gene regulatory switch.

In conclusion, the above structural stud- ies have given us enormous insight into the properties of nuclear receptor subunits, yet it is still not clear how the parts of the recep- tors interact to generate holoprotein function. To emphasize the strengths and limitations of our understanding of these relationships, we present below a more detailed analysis of the PR subunit and holoprotein properties.

A CASE STUDY: THE HUMAN PROGESTERONE RECEPTOR

As noted in the Introduction, PR belongs to the steroid receptor family of nuclear recep- tors. PR mediates the action of the hormone progesterone, a key ligand in reproduction and pregnancy. Understanding PR function is complicated in part because the receptor exists in vivo as two functionally distinct isoforms, PR-A and PR-B (62). As shown in Figure 4a, the two isoforms are identical, except the A-

a

b

AF-1BUS AF-3

DBD

1

PR-B PR-A

165 456 556 638 688 933

H LBD AF-2

677 933

LBD AF-2

542 648

DBD

AF-1 DBD

165

NT-A

456 556 638 688

H

AF-1 DBD

1651

NT-B

456 556 638 688

HBUS AF-3

Figure 4 Schematic of full-length progesterone receptor (PR) isoform structure and of experimentally analyzed deletion constructs. (a) Schematic layout of the two full-length isoforms. (b) Amino acid composition of the deletion constructs discussed in the text. Abbreviations used: AF, activation function; BUS, B-unique sequence; DBD, DNA-binding domain; H, hinge; LBD, ligand-binding domain.

PR-B: progesterone receptor B-isoform

receptor is lacking 164 amino acids at its N ter- minus. As seen in all other nuclear receptors, the isoforms contain a C-terminal LBD and a centrally located DBD. The two domains are linked by a 50-amino-acid hinge sequence of unclear function in PR. Transcriptional acti- vation functions are located N-terminal to the DBD (AF-1) and within the LBD (AF-2). In apparent contrast to all other nuclear recep- tors, there is a third activation function (AF-3) located within the 164-residue B-unique se- quence (BUS). (63). This AF is not a tradi- tional transcriptional activator: It can function only in the context of its homologous DBD,

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suggesting that direct contact between the two surfaces is necessary to carry out function.

Despite their high degree of sequence identity, the two isoforms display signifi- cantly different functional properties on nat- ural and synthetic promoters: (a) PR-B is typ- ically a much stronger transcriptional acti- vator than PR-A (63). (b) The antiprogestin RU486 acts as a partial antagonist toward the B-receptor, although it is a pure antag- onist toward the A-receptor (64). (c) PR-A gene knockout mice develop uterine dyspla- sia and abnormal ovaries, whereas PR-B gene knockouts affect the mammary glands, caus- ing premature ductal growth arrest and in- complete lobular-alveolar differentiation (65, 66). (d) Microarray studies have demonstrated that the two isoforms regulate different sub- sets of genes (67). The mechanistic origins of these differences have yet to be elucidated.

The Ligand-Binding Domain

Williams & Sigler (26) in 1998 elucidated the first high-resolution structure of the PR LBD complexed to its ligand, progesterone (Figure 4b). As observed in all other recep- tor LBDs, the PR structure is composed of a globular, antiparallel α-helical sandwich. Al- though the structure retains the canonical ter- tiary fold (Figure 2), it is made up of only ten helices: Helix 2 is entirely missing in the PR structure, and helices 10 and 11 are con- densed into a single contiguous unit. Helix 12, most critical to regulating coactivator re- cruitment, is longer than in other LBDs and spans across the ligand-binding pocket. Pro- gesterone binds in what Williams and Sigler term the lower half of the LBD, forming highly specific hydrogen bonds and van der Waals contacts with residues from a short β- turn and helices 3, 5, 7, 11, and 12. Additional hydrophobic interactions between the ligand and the walls of the binding pocket contribute to the stability and specificity of the binding reaction.

Because the PR LBD has not yet been crys- tallized in the presence of an LXXLL coacti-

vator peptide, the exact nature of the receptor- coactivator interaction is unclear. However, structural comparison to other LBD struc- tures reveals that helix 12 participates in form- ing a hydrophobic groove likely necessary for binding a coactivating protein (68). Stabiliza- tion of the helix in the presence of proges- terone comes from hydrophobic interactions with helix 4 and by hydrogen bonding with the agonist hormone. By comparison, man- ual positioning of the progesterone antagonist RU486 results in steric clashes with helix 12 and tryptophan 755, which contacts helix 12 in the progesterone-bound structure (26). These observations suggest that helix 12 would have to be displaced in the presence of antagonist and thus would be unable to form the interface necessary for coactivator recruitment.

Several additional PR LBD structures, complexed with various steroidal and non- steroidal ligands, have been solved since the first structure was determined (69–71). Re- gardless of ligand type, the LBD maintains the same tertiary fold as that discussed above. However, close inspection of the interactions at the binding pocket reveals that receptor- ligand contacts are adjusted depending on lig- and type. As a consequence, the volume of the PR LBD binding pocket is modulated from 490 Å3 to 730 Å3, depending on the ligand. The volume changes are accommodated by readjustments of main-chain and side-chain orientations at the binding interface. These studies illuminate the ability of the PR LBD to adjust its local conformation to accom- modate a range of ligand types and struc- tures. These studies also may slightly blur the distinction between seemingly highly specific steroid receptor–ligand interactions and the less specific nature of orphan receptor–ligand interactions (21).

The DNA-Binding Domain

Recently, the structure of the PR DBD com- plexed to a palindromic response element was determined using X-ray crystallography (see Figure 4b; 72). As seen for other steroid

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receptor structures, PR binds the DNA as a dimer, using a head-to-head orientation. The overall tertiary fold of the core DBD struc- ture is also quite similar to that of other nu- clear receptor DBDs (see Figure 3a). If we use the nomenclature defined above, helix 1 of each DBD monomer lies within the major groove of the hexanucleotide half-site, and he- lix 2 lies above and perpendicular to helix 1. C-terminal to helix 2 is a short helix termed helix 2′. Analysis of the protein-DNA interac- tions reveals that amino acid side-chain con- tacts with bases in the major groove are al- most identical to those seen for the closely related glucocorticoid and androgen recep- tors. However, the minor groove within the trinucleotide spacer between each half-site is highly compressed relative to that of the GR- and AR-DNA complexes. The functional im- plications of this latter observation are still un- der investigation.

Despite the many similarities to other receptor DBD structures, several surpris- ing observations may have implications for steroid receptor promoter recognition and functional specificity. Most notably, the CTE of the DBD interacted directly with the minor groove of the DNA at bases outside each hex- anucleotide response element. Furthermore, mutational analysis revealed that the CTE contributed to overall PR binding affinity and to the receptor’s ability to bind isolated half- sites. The contribution of the CTE is not due to nonspecific interactions, as a binding site- selection assay revealed that DBD binding is coupled to sequence preferences that flank the canonical hexanucleotide sequence.

What might these results mean? As dis- cussed above, the CTEs of class II and class III receptors are important for high-affinity DNA binding. In particular, the CTE plays a significant role in the binding of orphan re- ceptor monomers to half-sites. The results de- scribed for the PR DBD may suggest a simi- lar role: PR-regulated promoters tend not to exhibit clearly recognizable palindromic re- sponse elements. Rather, the promoters are often composed of poorly conserved palin-

dromic sites or clustered half-sites, suggesting that the PR CTE helps to stabilize binding at these promoters. Moreover, because steroid receptors can recognize the same response el- ements yet differentially regulate promoters containing those response elements, the non- conserved CTE may play a role in the se- lective binding of steroid receptors at target promoters.

Residues N-Terminal to the DNA-Binding Domain

Using biochemical and biophysical ap- proaches, Horwitz and coworkers (48, 49) demonstrated that PR isoforms lacking only the LBD (denoted as NTA and NTB; see Figure 4b) maintain considerable structure in the N-terminal region. However, analysis in- dicated that this “structure” exists in solution as an ensemble of extended conformations rather than as any unique globular-type fold. Mapping studies revealed that the regions of lowest structural stability corresponded to previously identified phosphorylation motifs and the functional boundaries of the AF-1 subunit; regions of high stability were inter- spersed among these sites. However, these re- sults do not imply that the folded sequences are intrinsically stable, as PR fragments that no longer contained the DBD were immedi- ately degraded by proteases. Taken together, these observations indicated that the DBD can stabilize and influence N-terminal structure. These results may also explain why nuclear receptor activation functions are typically un- folded when studied in isolation.

Upon binding to a palindromic response element, both NTA and NTB underwent changes in conformation. These changes were localized to the AF-1 region and the hinge and thus demonstrated that DNA binding is coupled to allosteric structural transitions me- diated through the DBD. DNA-dependent changes in N-terminal structure appear to be a common theme for nuclear receptors, al- though the functional implications are not en- tirely clear. Evidence suggests that changes

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Free energy change (�G): is related to the equilibrium dissociation constant (Kd) through the standard expression �G = −RT ln 1/Kd

are necessary for recruitment of coactivat- ing proteins to the promoter (73). However, the hypothesis that DNA-bound receptors truly recruit coactivators—that is, increase the binding energetics of the AF-coactivator interaction—has yet to be rigorously tested (cf. 74).

Biochemical analysis of NTA and NTB re- vealed that the macroscopic structural proper- ties of residues common to both isoforms were largely identical. In contrast, analytical ultra- centrifugation analysis demonstrated that the two constructs showed differences in their en- semble distribution of hydrodynamic confor- mations and that these differences occurred at the level of either secondary or tertiary struc- ture. This observation led to the hypothe- sis that isoform-specific functional differences were not due to macroscopic structural dif- ferences between the two isoforms but rather that the BUS could stabilize a more function- ally active set of conformers within the PR-B ensemble relative to that existing in the PR-A ensemble.

The Progesterone Receptor Holoprotein

As of this writing, neither of the PR isoforms (nor any other full-length nuclear receptor) has yielded to crystallographic or NMR-based structural analysis. The likely culprits are lack of tightly folded structure in the N-terminal region and difficulties in generating function- ally homogeneous and highly concentrated receptor preparations. In spite of these issues, it has been possible to carry out rigorous ther- modynamic and hydrodynamic studies of the PR isoforms, and these studies may offer some insight into the gross structural properties of full-length nuclear receptors.

Analytical ultracentrifugation analysis of highly purified and functionally homoge- neous PR-B demonstrates that the receptor undergoes self-association in the micromo- lar range (75). This affinity is considerably weaker than the nanomolar dimerization con- stants semiquantitatively estimated for full-

length GR (76, 77) and ER (78 and refer- ences therein) and is consistent with the small dimerization interface seen in the PR LBD crystal structure (26). However, the isolated PR LBD and PR constructs lacking the LBD are purely monomeric in solution (26, 48, 49). Therefore, the ability of the holoprotein to dimerize indicates that self-association is a global property of PR—it cannot be attributed solely to the LBD, even if that domain pro- vides the sole dimerization interface. Thus, from a structural perspective, these results in- dicate that sequences and structures outside of the interface allosterically contribute to the dimerization energetics.

A functional consequence of a micromolar dimerization constant is that, at the nanomo- lar concentrations of PR-B necessary to initi- ate DNA binding, the receptor is almost en- tirely (99.9%) monomeric in solution (79). This observation raises the question as to whether preformed PR dimers are the ac- tive DNA-binding species (80, 81). In other words, may it be the case that the monomer is instead the active species? This question takes on greater weight when one examines the energetics of PR binding to its response elements: Thermodynamic analysis of PR- B:DNA interactions reveals that the PR-B dimer has an intrinsic dissociation constant of 81 pM (equivalent to a −12.8 kcal mol−1 free energy change), indicative of extremely high binding affinity and in stark contrast to the ap- parent nanomolar binding affinities seen by visual inspection of binding curves (79, 82). By comparison, analysis of the binding data, through the use of a model in which only solution monomers bind to DNA half-sites, resolves an intrinsic dissociation constant of 39 nM (−9.4 kcal mol−1 binding free en- ergy). Thus, successive monomer binding to a palindromic binding site is thermodynami- cally favored over preformed dimer binding by +6.0 kcal mol−1. Furthermore, if PR-B assembles at its response elements only as a dimer, this betrays the notion that recep- tors have only moderate DNA-binding affin- ity and makes it somewhat unclear why the

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dimer would need accessory proteins to cre- ate a highly stable protein-DNA complex (82). By contrast, if monomer:half-site interactions are dominant, they would be perfectly posi- tioned to take advantage of enhanced binding via accessory proteins. Finally, the thermo- dynamic studies suggest that caution should be observed in the experimental design of DNA-binding techniques such as gel shift as- says. Because these assays typically use short, labeled oligonucleotides at low nanomolar concentrations, the picomolar affinity of PR dimers (or other nuclear receptors) may cause the resulting binding data to reflect the stoi- chiometric addition of bound protein rather than any meaningful equilibrium binding affinity.

Regardless of how PR assembles at re- sponse elements, the interactions are cou- pled to conformational transitions outside the DBD, most notably in the AF-1 and hinge se- quences (48, 49). Because these changes can include dramatic disorder-to-order folding transitions, investigators have presumed that folding must be energetically costly. How- ever, it was not until recently that the amount of this cost was actually experimentally esti- mated. Thermodynamic analysis revealed an enormous +6 kcal mol−1 unfavorable contri- bution to PR dimer assembly at a palindromic response element (79). This penalty correlates with structural changes in both the DNA and the protein, and thus assignment of the ener- getics to specific sequences and residues is not yet possible. However, the size of the penalty indicates that there are large hurdles associ- ated with rearranging receptor-DNA struc- ture (see side bar, Macromolecular Interac- tions and Effective Concentrations). Taken together with the picomolar dimer binding affinity, the energetics of PR-DNA interac- tions reflect a balance of very strong favor- able and unfavorable forces, perhaps analo- gous to that seen in protein folding. Finally, this view is not limited to interactions at indi- vidual binding sites: A strong cooperative in- teraction (99–400-fold increase in overall sta- bility) between adjacently bound PR dimers

Stokes radius (rs): represents the hydrodynamic radius of a macromolecule when modeled as a rigid sphere

MACROMOLECULAR INTERACTIONS AND EFFECTIVE CONCENTRATIONS

The size of a +6 kcal mol−1 energetic penalty to PR-B bind- ing can be put in perspective by considering the relationship of the penalty size to the receptor’s effective concentration at the DNA-binding site (83, 84). Effective concentrations are typically used to emphasize the localized increase in reactant concentration upon complex formation. For example, the ar- chitecture of an enzymatic active site serves to orient reactive side chains in close proximity to a bound substrate. The con- sequence of this interaction is that the effective concentration of the substrate, relative to its concentration in bulk solution, can be increased greater than 10,000-fold, leading to increased rates of catalysis. By contrast, the large penalty to PR-B bind- ing results in the more than 10,000-fold reduction in effective concentration of a receptor protomer at the DNA-binding site relative to the receptor concentration in bulk solution. That PR-B nonetheless forms a stable complex with the re- sponse element is a testament to the strong favorable forces underlying the picomolar intrinsic binding affinity.

is coupled to energetically unfavorable defor- mation of the promoter DNA (79). A chal- lenge for structural biology will be to connect more directly the observed thermodynamics with receptor-DNA structural features.

The self-assembly energetics of PR-B are driven, at least in part, by electrostatic interac- tions (75). Thus, at high salt concentrations, the PR-B dimer dissociates to a hydrodynam- ically homogeneous monomer. This result al- lows one to assign some gross structural prop- erties to the receptor isoform. For example, under these conditions the PR-B monomer has a Stokes radius of 64 Å and sediments as a highly asymmetric structure, having a frictional ratio of 1.67. If modeled as a hy- drated prolate ellipsoid, PR-B has a major-to- minor-axis ratio of approximately 13:1. Lim- ited proteolysis of the monomeric receptor indicates that this asymmetry is not due to an actual ellipsoid or rod-like conformation but instead arises from a nonglobular [but roughly spherical (48)] structure, with sequences N- terminal to the DBD existing as an unfolded

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or partially folded ensemble of conformations. Comparison to previous work on the B- isoform lacking its C-terminal LBD (49) re- veals that the holoprotein maintains different rates and patterns of proteolysis within the AF-1 and hinge sequences (84a), thus indi- cating that the LBD intramolecularly mod- ulates the conformation(s) of these regions. This difference may have implications for un- derstanding the functional synergy seen in the holoreceptor when compared with vari- ous deletion constructs (13).

Clearly, our resolution of the structural properties of full-length PR-B falls well short of the atomic-level detail available for the iso- lated DBD and LBD. Nonetheless, it is still possible to compare directly the results of each of the studies to obtain a more comprehen- sive perspective of PR structure. Figure 5

shows a schematic of the experimentally de- termined hydrodynamic volumes of the full- length PR-B monomer [Stokes radius of 64 Å (75)] relative to the calculated volumes of the monomeric LBD and DBD (Stokes radii of 25 Å and 19 Å, respectively) when modeled as rigid spheres. The size of the full-length re- ceptor dwarfs that of the individual domains. In particular, there is a 38-fold increase in vol- ume when comparing the full-length recep- tor (regardless of its detailed atomic structure) with that of the isolated DBD. This disparity arises in part simply because the DBD makes up less than 10% of the molecular mass of the holoprotein. However, the primary rea- son for the volume difference is the low pack- ing density of the conformationally extended N-terminal peptide chain. Similar results are seen when comparing the holoprotein with its

Figure 5 Schematic representation of the hydrodynamic properties of the full-length progesterone receptor B-isoform (PR-B) monomer, a monomeric core DNA-binding domain (DBD), and a monomeric ligand-binding domain (LBD) when modeled as rigid spheres. Shown as a black and white wire structure is the predicted volume of the PR-B monomer as determined from the Stokes radius (rs = 64 Å; V = 4/3π r3). Inset in blue and red are the predicted volumes of the PR LBD monomer and DBD monomer, respectively (rs = 25 Å for the LBD and 19 Å for the DBD). For perspective, ribbon diagrams of the LBD and DBD structures are overlaid. The Stokes radii of the monomeric species either were experimentally determined, using combined sedimentation velocity and sedimentation equilibrium analysis (PR-B; 75), or calculated from the atomic coordinates of the PR LBD and GR DBD crystal structures (26, 37), using bead modeling (87, 88). The schematic is drawn to scale. (Because the coordinates of the PR DBD structure had not been released at the time of this writing, the coordinates of the essentially identical GR DBD structure were used for the calculation.)

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isolated LBD: There is a 17-fold increase in volume. These observations, although lacking in atomic-level precision, are entirely accurate at the hydrodynamic level. We hope that the comparisons emphasize the challenges that lie ahead in obtaining a clearer picture of recep- tor structure-function relationships.

UNANSWERED QUESTIONS AND FUTURE DIRECTIONS

As described in this review, although nu- clear receptors have a modular functional and structural layout, the various parts of the pro- tein (domains, activation functions, recogni- tion motifs, binding interfaces, etc.) do not act independently. Instead, receptor function arises through a nonlinear sum of interac- tions both within the protein and between various transcription factors and promoter re- sponse elements. Moreover, many of these interactions are coupled to complex struc- tural rearrangements or large-scale folding reactions. A major challenge in understand- ing nuclear receptor function will be in defin- ing the quantitative mechanisms by which the interactions among these parts translate into the “system” behavior of the intact holopro- tein (and by extension, the intact transcrip-

tional activation complex). For example, even as the physical and chemical forces neces- sary to induce folding of AF-1 sequences are beginning to be understood, the molecular mechanisms by which these events occur nat- urally, through allosteric communication via the DBD and DNA, are largely unknown. Similarly, although the stereochemical basis for understanding LBD-coactivator interac- tions is well characterized, this viewpoint of- fers minimal insight into the mechanisms by which these interactions are coupled to large- scale folding of the coactivating protein (85). Our understanding of these issues will be greatly advanced if a high-resolution struc- ture of a full-length receptor or receptor- coactivator complex is determined. However, it is doubtful that only structural analysis will reveal the mechanisms underlying func- tion. Rather, any quantitative and predictive understanding of receptor function will re- quire structural and biochemical analyses to be integrated with rigorous thermodynamic and kinetic dissections of the macromolecu- lar interactions. Much remains to be learned about the molecular origins of nuclear re- ceptor structure-function relationships, and a fundamental understanding will require a multidisciplinary approach.

SUMMARY POINTS

1. Nuclear receptors are made up of a modular structure that includes a C-terminal ligand-binding domain, a centrally located DNA-binding domain, and multiple transcriptional activation functions.

2. Although modular in structure, the receptor subunits do not act independently in the context of the holoprotein; allosteric interactions between the subunits are critical to the ability of nuclear receptors to function as efficient gene regulatory switches.

3. Allosteric interactions are coupled to both subtle and dramatic changes in struc- ture. The physical mechanisms underlying allosteric communication are yet to be determined.

ACKNOWLEDGMENTS

We thank Dr. Mair Churchill for generously sharing results of the PR DBD structural analysis prior to publication. This work was supported in part by NIH grants R01-DK061933 (to D.L.B.) and F32-DK070519 (to A.F.H.).

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Annual Review of Physiology

Volume 69, 2007Contents

Frontispiece Clay M. Armstrong � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �xx

PERSPECTIVES, David L. Garbers, Editor

Life Among the Axons Clay M. Armstrong � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �1

CARDIOVASCULAR PHYSIOLOGY, Jeffrey Robbins, Section Editor

Mitochondrial Ion Channels Brian O’Rourke � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 19

Preconditioning: The Mitochondrial Connection Elizabeth Murphy and Charles Steenbergen � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 51

CELL PHYSIOLOGY, David E. Clapham, Section Editor

Iron Homeostasis Nancy C. Andrews and Paul J. Schmidt � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 69

Transporters as Channels Louis J. DeFelice and Tapasree Goswami � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 87

ECOLOGICAL, EVOLUTIONARY, AND COMPARATIVE PHYSIOLOGY, Martin E. Feder, Section Editor

Hypoxia Tolerance in Mammals and Birds: From the Wilderness to the Clinic Jan-Marino Ramirez, Lars P. Folkow, and Arnoldus S. Blix � � � � � � � � � � � � � � � � � � � � � � � � � 113

Hypoxia Tolerance in Reptiles, Amphibians, and Fishes: Life with Variable Oxygen Availability Philip E. Bickler and Leslie T. Buck � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 145

ENDOCRINOLOGY, Kathryn B. Horwitz, Section Editor

Integration of Rapid Signaling Events with Steroid Hormone Receptor Action in Breast and Prostate Cancer Carol A. Lange, Daniel Gioeli, Stephen R. Hammes, and Paul C. Marker � � � � � � � � � � 171

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Nuclear Receptor Structure: Implications for Function David L. Bain, Aaron F. Heneghan, Keith D. Connaghan-Jones,

and Michael T. Miura � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 201

GASTROINTESTINAL PHYSIOLOGY, John Williams, Section Editor

Regulation of Intestinal Cholesterol Absorption David Q.-H. Wang � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 221

Why Does Pancreatic Overstimulation Cause Pancreatitis? Ashok K. Saluja, Markus M. Lerch, Phoebe A. Phillips, and Vikas Dudeja � � � � � � � � � � 249

NEUROPHYSIOLOGY, Richard Aldrich, Section Editor

Timing and Computation in Inner Retinal Circuitry Stephen A. Baccus � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 271

Understanding Circuit Dynamics Using the Stomatogastric Nervous System of Lobsters and Crabs Eve Marder and Dirk Bucher � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 291

RENAL AND ELECTROLYTE PHYSIOLOGY, Gerhard H. Giebisch, Section Editor

Molecular Mechanisms of Renal Ammonia Transport I. David Weiner and L. Lee Hamm � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 317

Phosphatonins and the Regulation of Phosphate Homeostasis Theresa Berndt and Rajiv Kumar � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 341

Specificity and Regulation of Renal Sulfate Transporters Daniel Markovich and Peter S. Aronson � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 361

RESPIRATORY PHYSIOLOGY, Richard C. Boucher, Jr., Section Editor

Overview of Structure and Function of Mammalian Cilia Peter Satir and Søren Tvorup Christensen � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 377

Regulation of Mammalian Ciliary Beating Matthias Salathe � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 401

Genetic Defects in Ciliary Structure and Function Maimoona A. Zariwala, Michael R. Knowles, and Heymut Omran � � � � � � � � � � � � � � � � � � 423

SPECIAL TOPIC, β-ARRESTINS, Robert J. Lefkowitz, Special Topic Editor

Regulation of Receptor Trafficking by GRKs and Arrestins Catherine A.C. Moore, Shawn K. Milano, and Jeffrey L. Benovic � � � � � � � � � � � � � � � � � � � � 451

β-Arrestins and Cell Signaling Scott M. DeWire, Seungkirl Ahn, Robert J. Lefkowitz, and Sudha K. Shenoy � � � � � � 483

xiv Contents

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Physiological Roles of G Protein–Coupled Receptor Kinases and Arrestins Richard T. Premont and Raul R. Gainetdinov � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 511

Stop That Cell! β-Arrestin-Dependent Chemotaxis: A Tale of Localized Actin Assembly and Receptor Desensitization Kathryn A. DeFea � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 535

Regulation of Receptor Tyrosine Kinase Signaling by GRKs and β-Arrestins Christopher J. Hupfeld and Jerrold M. Olefsky � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 561

Indexes

Cumulative Index of Contributing Authors, Volumes 65–69 � � � � � � � � � � � � � � � � � � � � � � � � 579

Cumulative Index of Chapter Titles, Volumes 65–69 � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 582

Errata

An online log of corrections to Annual Review of Physiology chapters (if any, 1997 to the present) may be found at http://physiol.annualreviews.org/errata.shtml

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Telomeres.pdf

Linear DNA fragments are toxic to mammalian cells and effective mechanisms have evolved to deal with them. These mechanisms involve signalling cascades, resulting in the detection, enzymatic degradation or repair of the fragments, cell cycle arrest and/or cell death. Failure to appropriately respond to broken DNA can result in the unequal distribution of genetic material during cell divi­ sion, genome instability and, eventually, the development of malignancies.

The natural ends of linear chromosomes resemble DNA breaks but differ in that their repair would lead to deleterious chromosome fusions and therefore has to be avoided. Avoiding inappropriate repair is accomplished by specialized ribonucleoprotein structures, termed telo­ meres. Telomeres are composed of long tracts of double­ stranded TTAGGG repeats, which extend for 9–15 kb in humans but can be as long as 100 kb in rodents. The actual end of the telomere is discernible by the presence of a 50–300­nucleotide protrusion of single­stranded repeats from the 3′ end, termed the G­tail or G­overhang1 (FIG. 1). This G­overhang is presumably the result of highly regulated post­replicative 5′–3′ exonucleolytic resection of the C­rich strand.

In somatic cells that lack telomere length maintenance mechanisms, the failure of lagging­strand synthesis to fully replicate the parental strain2 coupled with the processing required to generate the G­overhang result in the progressive removal of telomeric sequence in each round of replication. In stem cells, germ cells and lineage progenitor cells, this telomere shortening is offset by the addition of newly synthesized repeats by the telomerase complex, which uses the 3′ OH of the G­overhang as

its substrate (BOX 1). It is not clear how the G­overhang provides protection from the pathways that detect and process broken DNA, but it has been proposed that it can be sequestered into a lasso­like structure known as the T­loop3 (FIG. 1). The closed configuration of the T­loop provides a protective cap that defines the natural end of the chromosome and masks the telomere from the DNA damage response (DDR) machinery (FIG. 2). Therefore, the generation and manipulation of the G­overhang by telomerase in telomerase­positive cells is an important point of convergence of end protection and telomere length­maintenance mechanisms.

Here, we discuss how functional telomeres prevent chromosomes from fusion, which factors contribute to chro­ mosome end protection and how dysfunctional telomeres can be the source of genome instability and cancer.

Shelterin organizes and defines telomeres The repetitive and GC­rich nature of telomeric DNA endows it with the capability to form higher­order DNA secondary structures, such as G‑quadruplexes, which have been proposed to be obstacles for the replication machinery4,5. TTAGGG repeats have also been shown to be poor substrates for nucleosome assembly in vitro6, and, therefore, telomeric chromatin is quite distinctive7. Given these properties, telomeres are thought to resemble fragile sites, and telomeric proteins aid the DNA replication machinery in the accurate duplication of chromosome ends8,9. This is further substantiated by the observation that the complete replication of telomeric DNA tends to occur later than other chromosomal regions10 (R.O.S and J.K, unpublished observations).

The Salk Institute for Biological Studies, Molecular and Cell Biology Laboratory, 10010 North Torrey Pines Road, La Jolla, California 92037, USA. Correspondence to J.K. e‑mail: [email protected] doi:10.1038/nrm2848 Published online 3 February 2010

G-quadruplex A higher‑order DNA structure consisting of G quartets in which guanosine residues are donors and acceptors in a G–G base pair. This structure is an obstacle to the moving replication fork.

Fragile site A site in a chromosome at which breaks frequently occur.

Telomeres: protecting chromosomes against genome instability Roderick J. O’Sullivan and Jan Karlseder

Abstract | The natural ends of linear chromosomes require unique genetic and structural adaptations to facilitate the protection of genetic material. This is achieved by the sequestration of the telomeric sequence into a protective nucleoprotein cap that masks the ends from constitutive exposure to the DNA damage response machinery. When telomeres are unmasked, genome instability arises. Balancing capping requirements with telomere replication and the enzymatic processing steps that are obligatory for telomere function is a complex problem. Telomeric proteins and their interacting factors create an environment at chromosome ends that inhibits DNA repair; however, the repair machinery is essential for proper telomere function.

REVIEWS

NATuRe RevIewS | M o l e c u l a r c e l l B i o lo gy vO Lu m e 1 1 | m A R C H 2 0 1 0 | 171

f o c u s o n G e n o m e i n s ta b i l i t y

© 20 Macmillan Publishers Limited. All rights reserved10

Nature Reviews | Molecular Cell Biology

5′- –′3 –′53′-

5′- –′3 –′53′-

5′- 3′-

9–15 kb dsDNA repeats 50–300 nt 3′ G-overhang

Chromosome

TRF1TRF2 POT1

RAP1

TPP1TIN2

TI N2

TIN2

RAD52D, RAD54, BLM, WRN, MRN, tankyrase 1 and APOLLO

TPP1 TPP1TRF1

TRF2 RA

P1

POT1 POT1

POT1 POT1

TRF1 TRF2

TIN2

TRF1 TRF2

RAP1 RAP1 ATM

UUAGGGD-loop

T-loop

TERRA

ATRTERT DKC1

TR

Because of the unusual properties of telomeres, a bona fide telomeric protein complex has evolved. In mammals this complex is termed shelterin and con­ sists of six individual proteins: telomeric repeat­binding factor 1 (TRF1; also known as TeRF1), TRF2 (also known as TeRF2), repressor and activator protein 1 (RAP1; also known as TeRF2IP), TRF1­interacting nuclear protein 2 (TIN2; also known as TINF2), POT1­and TIN2­interacting protein (TPP1; also known as ACD) and protection of telomeres 1 (POT1)11 (FIG. 1).

The double­stranded telomeric repeats are bound by TRF1 and TRF2, whereas POT1 attaches to the single­ stranded G­overhang. These DNA binding modules are bridged by TPP1 and TIN2 and are crucial for chromo­ some end protection and telomere length regulation. TRF1 and TRF2 are constitutively present at telomeres and the proportion of TRF1 and TRF2 loaded on telo­ meres is important for telomere length regulation. TRF1 has DNA remodelling activity12,13 and has recently been shown to promote the efficient replication of telomeres8,9. TRF2 primarily functions in chromosome end protec­ tion by promoting topological changes in telomeric DNA14, T­loop assembly 15,16 and the suppression of ataxia telangiectasia mutated (ATm)­dependent DDR and non­homologous end joining (NHeJ)17,18 (BOX 2). TRF2 also has a role in chromatin assembly, indicated by the finding that TRF2 overexpression causes aberrant nucleosome spacing and decreases the abundance of the core histones H3 and H4 at chromosome ends19. The function of RAP1 is more enigmatic. unlike its homol­ ogue in Saccharomyces cerevisiae, mammalian RAP1 does not bind TTAGGG repeats and its telo meric locali­ zation is dependent on inter action with TRF2 (ReF. 20), but it has recently been implicated in the inhibition of NHeJ in vitro and in vivo21,22. POT1 contributes to telo­ mere protection by binding to the G­overhang and by the suppression of ATm­ and RAD3­related protein (ATR)­dependent DDR pathways17,23. Furthermore, the high specificity of POT1 for single­stranded telomeric DNA leaves the possibility open that POT1 might bind to the displaced G­strand in the T­loop and ‘lock in’ the closed configuration of this structure (FIG. 1). The load­ ing of POT1 and TPP1 onto the G­overhang is also an important determinant of telomere length and current models suggest that POT1 and TPP1 compete with telo­ merase for access to it23. A direct interaction between TPP1 and telomerase has been shown to bolster telo­ merase processivity24,25. However, increased loading of POT1 along the G­overhang seems to block telomerase accessibility to the 3′ OH substrate.

Taken together, the shelterin complex, despite consist­ ing of only six proteins, has an immensely complex role in telomere length regulation, protection from enzymatic attack and recruitment of required enzymatic activities, and in the control of signalling cascades from the natural chromosome ends. Although our understanding of the individual roles of shelterin components is growing fast, much remains to be discovered about the transcriptional, translational and post­translational regulation of these components and about the importance of shelterin stoichiometry on cell cycle changes, DNA damage and differentiation.

In a recent study, the biochemical purification of the telomeric proteome produced a list of 210 proteins that interacted with and might influence telomeric struc­ ture26. many of these factors have previously been inde­ pendently shown to localize to telomeres, where they form a complex to modulate the formation of higher­ order telomeric DNA and chromatin, unravel secondary DNA structures and promote resection and strand inva­ sion of the G­overhang into the double­stranded DNA,

Figure 1 | The structure of human telomeres. Human telomeres consist of many kilobases of TTAGGG repeats, with a G-rich leading strand and a C-rich lagging strand. The G-strand extends in the 3′ direction, forming the G-overhang. The shelterin complex27, consisting of the double-stranded telomeric repeat-binding factor 1 (TRF1; also known as TERF1) and TRF2 (also known as TERF2), the TRF2-interacting factor repressor and activator protein 1 (RAP1; also known as TERF2IP), the bridging molecules TRF1-interacting nuclear protein 2 (TIN2; also known as TINF2) and POT1- and TIN2-interacting protein (TPP1; also known as ACD) and the telomeric protection factor protection of telomeres 1 (POT1), covers the double- and single-stranded repeats. Shelterin members interact with many other factors that transiently localize to telomeres, frequently in a cell-cycle-dependent manner. These factors aid in the generation of a protective structure at chromosome ends, here referred to as the telomeric loop, or T-loop. The T-loop is generated by invasion of the single-stranded G-overhang into the double-stranded TTAGGG repeats. The looped structure protects telomeres on several levels. Invasion effectively sequesters the G-overhang and allows natural chromosome ends to be distinguished from double-strand breaks. The ataxia telangiectasia mutated (ATM)-dependent signalling cascade is inhibited by TRF2 and the ATM- and RAD3-related protein (ATR)-dependent signalling pathway is inhibited by POT1. Telomerase is probably inhibited by the shelterin complex, and it is thought that telomeric repeat-containing RNA (TERRA) has a role in this inhibition. BLM, Bloom syndrome protein; DKC1, dyskerin; MRN, MRE11, RAD50 and NBS1; TERT, telomerase reverse transcriptase; WRN, Werner syndrome ATP-dependent helicase.

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Pontin

-′3 -′5

Chromosome

TERT Reptin

TR DKC1

TERT DKC1

TR

TCAB1

Cajal body

Nucleus Cytoplasm

Displacement loop A single‑stranded DNA loop, resulting from the invasion and pairing of a DNA end into homologous double‑stranded sequences.

Replicative senescence A permanently differentiated state that cells enter when their telomeres become critically short or a threshold of DNA damage is exceeded.

consequently aiding in the generation of the displacement loop (D­loop)27,28. In addition, there is a growing number of proteins that localize to telomeres that are involved in the assembly and regulation of telo merase in cells in which this complex is expressed29–31.

A recent addition to the telomeric ribonucleoprotein complex is telomeric repeat­containing RNA (TeRRA). For many years telomeres were viewed as transcrip­ tionally inert. However, transcription of the C­strand of telomeres by RNA polymerase II produces long uuAGGG­containing transcripts that are regulated by the nonsense­mediated decay pathway 32–34. TeRRAs display a strong inverse correlation with telomerase activity 34,35 and it is speculated that they are non­ coding, structural RNAs that maintain higher­order telo meric chromatin structures, either by forming highly stable DNA–RNA hybrids34 or through interaction with TRF236,37.

Taken together, it is becoming increasingly obvious that the six­protein telomeric core shelterin complex provides the basis for a highly regulated and sophisti­ cated network of proteins and RNA, which responds to the ever­changing environment in cells during the lifespan of an organism.

Molecular basis of telomere dysfunction The interactions of telomeric DNA with shelterin and telo­ merase are highly regulated and are essential for chromo­ some end protection. Defects in shelterin components and telomerase directly and adversely affect telomere struc­ ture and length, and, as a result, inappropriate changes in telomere length and/or structure are commonly thought of as the primary triggers of telo mere dysfunction. Here, we first examine the proposition that changes in telomere length lead to telomere dysfunction.

The role of telomere length in end protection. In somatic cells that naturally lack telomere length­maintenance pathways, replication itself and the post­replicative res­ toration of the protective cap at chromosome ends is accompanied by a net loss of 100–200 bp of telomeric sequence in every cell division. The molecular basis for this DNA loss is the inability of conventional polymer­ ases to fully replicate the parent DNA by lagging­strand synthesis (termed the end replication problem)2, com­ bined with the requirement to enzymatically generate G­overhangs on both leading and lagging strand replica­ tion products38–40. As a function of the rate of replication­ associated telomere shortening and initial telomere length, a somatic cell can only undergo a defined number of doublings before telomeres become critically short, lose their protective properties and send cells into a terminal arrest termed replicative senescence, or cause cell death. This mechanism limits the replicative lifespan of indi­ vidual cells and probably of some cellular compartments in organisms and, therefore, is a tumour suppressive pathway that prevents cells from becoming immortal41,42. Introduction of the catalytic subunit of telomerase into somatic cells is sufficient to counteract replicative telo­ mere shortening 42,43; however, as a consequence, such cells are only rendered immortal, not transformed44. ectopic expression of the catalytic subunit of telomerase extends the lifespan of cancer­resistant mice, showing a role of the telomerase complex in organism longevity45. The fact that most cancers need to activate a telomere length maintenance pathway for survival emphasizes the attraction of this unifying principle as a potential target for cancer therapy, and several efforts are underway to develop in vivo inhibitors of telomerase.

The true length of telomeres that lose their protective function is unclear and subject to debate. Yeast cells car­ rying a single telomere devoid of any telomeric repeats are still capable of several divisions before cell cycle arrest, suggesting that telomere length is not the only determi­ nant of proliferative potential46. Telomeres in primary human fibroblasts that enter senescence are readily detectable by imaging techniques that lack the sensitivity of detecting less than 0.5 kb of repeat sequence47, and the bulk of telomeres, as determined by southern analysis, seem to be around 4 kb48. In primary mouse cells, in which telomere lengths are far greater than in human cells, replicative senescence is frequently seen after a few population doublings in culture, suggesting that the com­ plete loss of telomeric sequence is unlikely to be a trigger for the loss of proliferative potential. However, ultra­short telomeres of ~ 13 repeats, termed T­stumps, have been

Box 1 | The telomerase complex

The discovery by Greider and Blackburn that telomeric repeats are added de novo to the end of eukaryotic chromosomes by telomerase is one of the most important findings in the recent history of molecular biology108. The telomerase complex was biochemically purified and consists of the catalytic telomerase reverse transcriptase (TERT), the RNA subunit telomerase template RNA (TR), which provides the template for repeat synthesis at chromosome ends, and dyskerin (DKC1), a key auxillary protein109 (see the figure). This complex is assembled in Cajal bodies in the nucleus and is shuttled to telomeres by an accessory factor, telomerase Cajal body protein 1 (TCAB1)31. The ATPases pontin (also known as RUVBL1) and reptin (also known as RUVBL2) sequester this immature complex into an active conformation, whereupon it associates with the terminal exposed 3′ hydroxyl group and initiates nucleotide addition at the chromosome ends30. For many years it was thought that telomerase preferentially elongated the shortest telomeres in the cell110,111; however, recent studies have suggested that telomerase is more promiscuous and randomly targets telomeres during S phase in cancer cells112. By doing so, telomerase counteracts the generational shortening of telomeres, maintaining telomere length and stability. Maintaining telomere stability is essential for highly proliferative cells such as stem cells and lineage progenitors, perhaps as a requisite for ‘stemness’. Mice lacking the RNA subunit have smaller stem cell compartments and reduced stem cell proliferation, differentiation and self-renewal113. This manifests as a phenotype of accelerated ageing and atrophy of key tissues in animals lacking functional telomerase114.

Recently, non-telomeric functions for mammalian TERT have been suggested, which include the regulation of global chromatin dynamics, stem cell proliferation and transcription of developmentally regulated genes29,115,116.

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ARTEMIS

µ and λ

TO PB

P ATR RAD17 P

P

P P

P

9-1-1

RPA

P CHK1

P

P

CHK2

P CDC25A

S phase cell cycle arrest

G1 or G2–M cell cycle arrest, senescence or apoptosis

Double-strand break

Ub Ub

P

Ub Ub

ATM

MRN P

MRN

P

ATM P

p53 P

a DNA damage sensing pathways b DNA repair pathways

Ku70 Ku80

DNA-PK

5′ 3′ 5′

3′

5′ 3′

5′ 3′ 5′

3′

P

Ub Ub

P

Ub Ub

MRN MRN 5′ 3′ 5′

3′

P

Ub Ub

P

Ub Ub

MRN

MRN

5′ 3′

5′ 3′

5′ 3′

5′ 3′ 5′

3′

5′ 3′ 5′

3′

5′ 3′ 5′

3′

5′ 3′ 5′

3′ Ku70 Ku80

µ and λ

5′ 3′ 5′

3′ Ligase IV

Ligase IV

ATR

RAD51 RAD52

5′ 3′ 5′

3′

5′ 3′

RPA

Single-strand break Non-homologous end joining Homologous recombination

Me Me

Me Me

shown to efficiently protect chromosome ends when cellular proliferation bypasses p53­ and p16­imposed checkpoints, which sense critically short chromosome ends, and in cancer cells49. Therefore, the hypothesis of critically short telomere length, a phrase borrowed from observations of yeast telomeres and defined by sequence loss, apparently does not apply in mammals, in which the telomere­dependent limitation of the proliferative lifespan is much more complex.

we suggest that senescence could be triggered by the accumulation of damage and stress in cells, resulting from additive signals of shorter telomeres, increased replicative stress in ageing cells, reactive oxygen species, chromatin changes, degradation of the nuclear envelope and pore complexes, and protein damage50–53. The more a single component contributes to the total damage, the less additional damage is required to exceed the critical threshold. This is illustrated by the fact that primary

Figure 2 | The processing of damaged DNa. a | Damage sensing pathways. Upon single-strand breakage or fork stalling (induced by replicative stress or ultraviolet C, for example), the ataxia telangiectasia mutated (ATM)- and RAD3-related protein (ATR)-dependent pathway is activated and replication protein A (RPA) binds to the strands. ATR phosphorylates RAD17, the 9-1-1 complex, topoisomerase IIβ-binding protein 1 (TOPBP1) and CHK1 (also known as CHEK1), which mediates cell cycle arrest through CDC25A. At double-strand breaks (induced by γ-irradiation, for example) the chromatin structure is dynamically restructured, exemplified by the ATM-dependent phosphorylation of histone H2A variant H2AX. The sensing of the double-strand break by the MRN complex (consisting of MRE11, RAD50 and NBS1) triggers the targeting of downstream mediators and the activation of repair pathways. The key event is ATM-dependent activation of CHK2 (also known as CHEK2) and p53, which induces G1 and G2–M phase arrest. A failure to repair the double-strand break results in permanent cell cycle exit, senescence or apoptosis. b | DNA repair pathways. The primary pathways for repair are non-homologous end joining (NHEJ) and homologous recombination (HR). NHEJ is the major pathway, functioning throughout the cell cycle. NHEJ requires the sensing of lesions by the ATP-dependent DNA helicase 2 subunits Ku70 (also known as XRCC6) or Ku80 (also known as XRCC5), activation of DNA-dependent protein kinase (DNA-PK) and the 3′–5′ endonucleolytic resection of the break. The break is then filled in by DNA polymerase-μ (μ) and DNA polymerase-λ (λ) and the ends are fused by DNA ligase IV. NHEJ is error prone and defects in NHEJ are frequently linked with cancer. During S phase or G2–M phase damage, the cell employs the error-free HR pathway. ATM and MRN mediate recognition and resection, and the single-stranded DNA overhang is detected by ATR and RPA, promoting association of RAD51 and RAD52. The HR machinery mediates synthesis of new DNA strands using the overhang sequence as a template. This mechanism ensures that the original DNA sequence is faithfully restored and genetic integrity is maintained. Me, methyl group; P, phospho group; Ub, ubiquitin.

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c

DAPI TTAGGG γH2AX Merge

DAPI TTAGGG TP53BP1 Merge

DAPI PML TRF2 Merge

a

b

cells grown under low oxygen conditions undergo many more population doublings and enter senescence with shorter bulk telomeres than primary cells grown in atmospheric conditions.

The role of telomere uncapping in genome instability. Telomeres can lose their protective function when they shorten to a critical length or when they fail to mask themselves from recognition by the DDR machinery, even in the presence of long stretches of TTAGGG repeats. The most striking and obvious example of acute telomere uncapping is illustrated by the removal of TRF2 from telomeres, either by a dominant­negative allele18,54,55 or by targeted deletion of the gene in mice56,57. within a few cell divisions, all chromosome ends are detected as DNA breaks and they then fuse in an ATm pathway­ dependent manner, leading to the appearance of meta­ phase chromosomes as a ‘plate of spaghetti’56,57 (BOX 2). POT1, although strongly implicated in telomere protec­ tion in yeast58, has a less pronounced capping phenotype in mammals. mouse cells possess two POT1 proteins, POT1A and POT1B, suggesting a recent expansion of the shelterin complex in rodents59,60, and POT1A is suffi­ cient to repress damage signalling at telomeres. The sub­ sequent processing of dysfunctional telomeres is almost identical to the canonical DDR at intra­chromosomal break sites. The association of tumour suppressor p53­ binding protein 1 (TP53BP1), a protein involved in the detection and processing of double­strand breaks, with several telo meres creates large chromatin domains that are conducive for the covalent fusion of chromosomes61,62. The build­up of DDR proteins as well as changes in local telomeric chromatin structure, exemplified by γH2AX — a variant of histone H2A that localizes to sites of DNA damage — can be visualized by fluorescence­based tech­ niques such as telomere dysfunction­induced foci (BOX 2). These are almost identical to the foci detected at sites of breaks and repair following irradiation­induced DNA damage63. Telomere dysfunction­induced foci are seen in almost all settings of engineered telomere dysfunc­ tion and also in cells that undergo replicative senescence, blurring the boundary between the telomere uncapping and telomere length phenotypes.

Recently, it has been shown that the accumulation of damage signals in cells is required for senescence entry, and that DDR components function to suppress the detri­ mental outcomes that arise from replicative stress64,65. Therefore, the changes in telomeric chromatin and the loading of DDR proteins on several telo meres could pro­ vide the impetus for cell cycle exit and the induction of apoptosis or senescence, depending on the cell type. How are these telomeres selected? Cell­cycle­dependent chro­ matin dynamics or cell­cycle­dependent phosphoryl ation of DDR proteins might influence the choice and timing of these events so addressing this question will be complex, but essential in the future.

many of the phenotypes seen in engineered and acute human and mouse models of telomere dysfunction only manifest in circumstances in which p53 and/or retinoblas­ toma (RB) pathways are absent or suppressed, allowing cell growth in the presence of DNA damage signals. This emphasizes the role of these essential tumour suppressor pathways (FIG. 3) in detecting damaged chromosome ends. The involvement of p53 and RB suggests that dysfunctional telomeres signal in the same way as intra­ chromosomal breaks. In addition, contrary to primary

Box 2 | Cytological representation of telomere dysfunction

Covalent fusions are efficiently detected by the spreading of metaphase chromosomes and the marking of telomeres by fluorescent in situ hybridization (see the figure, part a). This allows for the distinction of fusions in the presence (left panel) and the absence (centre panel) of telomeric TTAGGG repeats. The right panel represents a metaphase in which all chromosomes have been fused owing to the deletion of telomeric repeat-binding factor 2 (TRF2; also known as TERF2). DNA has been stained in red and telomeric repeats in blue .

Telomeres that are detected as damage can be visualized as telomere dysfunction- induced foci (see the figure, part b). Cells are simultaneously stained with antibodies against factors that localize to sites of damage and with probes that recognize telomeric DNA. Although the chance for telomeric colocalization with intra-chromosomal damage sites is slim, the merged images clearly distinguish telomeres that bind damage factors and, therefore, can be considered as recognized by the DNA damage response machinery. Here, the DNA of an interphase nucleus has been stained in blue, telomeres in green and the histone H2A variant γH2AX (upper panel) or tumour suppressor p53-binding protein 1 (TP53BP1; lower panel) in red. The yellow dots (indicated by white arrows) in the merged images represent the colocalization of γH2AX or TP53BP1 with telomeres.

Alternative lengthening of telomeres (ALT)-associated promyelocytic leukaemia (PML) bodies (APBs) (see the figure, part c) are structures in cells that employ the recombination-based ALT mechanism for telomere length regulation117,118. They are loci that contain telomeric DNA, telomeric proteins and factors involved in DNA metabolism. Here, the DNA of an interphase nucleus has been stained in blue, PML in green and TRF2 as a marker for telomeres in red. The right panel is a merge of all three. It has been proposed that APBs are the sites of telomeric recombination; however, they could also simply be storage pools for the proteins that are required for ALT and for ALT by-products. Right panel image in part a courtesy of E. Lazzerini Denchi, the Scripps Research Institute, California, USA.

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5′- 3′-

5′- 3′-

5′- 3′-

5′- 3′- -5′

-3′

5′- 3′-

Loss of p53 and RB

-5′ -3′

TRF2 POT1 POT1

RAP1

ATM MRN

TP 53

BP 1

Ligase IV

TP53BP1

Torsional strain

Genome instability

Chromatid break

Spindle pole body

Fused chromosomes

Mitotic spindle

Homologous recombination A repair pathway in which homologous sequences align and genetic information is copied from one DNA strand to the other.

Werner syndrome An inherited genetic disease that is characterized by premature‑ageing symptoms and the early onset of cancer.

Sister telomere loss The loss of telomeric sequences from a single sister chromatid while the other telomere stays intact.

human cells, primary mouse fibroblasts display a high level of telomerase activity, giving rise to the speculation that extension of the 3′ G­overhang by telo merase has a role in signalling from mouse telomeres but the same effects would not arise in human somatic cells.

Dysfunctional telomeres are also potential substrates for homologous recombination (HR) (FIG. 2). expression of TRF2 lacking the amino­terminal basic domain results in a massive loss of telomeric sequence and the formation of extra­chromosomal circular arrays of double­stranded TTAGGG repeats, termed T­circles66. This suggests that the N­terminal basic domain is involved in protect­ ing telomeres against inappropriate HR events, poten­ tially by binding to telomeric Holliday junctions and directly inhibiting resolvase activity 67. The N­terminal basic TRF2 domain also directly interacts with werner syndrome ATP­dependent helicase (wRN), a RecQ

helicase that is missing in patients suffering from Werner syndrome. Therefore, it has been hypothesized that the strand invasion that would otherwise be promoted by wRN cannot occur. The exposed G­overhang then engages in rampant HR, resulting in sister telomere loss, sister chromatid exchange and other gross chromosomal aberrations. Finally, the recently identified TeRRAs have been shown to interact with the basic domain of TRF2 (ReF. 36) and suppression of TeRRAs leads to changes in heterochromatin states; however, the molecular pathways involved are not known. This lends support to the idea that TeRRAs might function in the suppression of HR by forming stable, higher­order structures at telo meres. Solving the enigma of TeRRAs will undoubtedly prove challenging, particularly judging from the difficulties encountered in analysing other non­coding RNAs such as X inactive­specific transcript (XIST), a transcript that has a major role in the X chromosome­inactivation process.

Recognition of telomeres as DNA damage It is assumed that dysfunctional telomeres are recognized as damage in the same ways that a cell detects intra­ chromosomal double­strand breaks (FIG. 3). However, many factors involved in damage recognition can be found at functional telomeres, suggesting a dual role for the DDR machinery in chromosome end protection and detection of uncapped telomeres.

Interactions of telomeres with DDR machineries. One of the major functions of telomeres is to shield the natural chromosome ends from inappropriate repair and to dis­ tinguish them from intra­chromosomal double­strand breaks. It was therefore surprising and seemed para­ doxical that many proteins that have a major role in the detection of DNA damage as well as in signalling to DDR cascades localize to functional telomeres. The yeast mRX complex (consisting of mre11, Rad50 and Xrn2) and the ATm­ and ATR­related kinases Tel1 and mec1 are all involved in the early phases of DNA damage detection, are all found at yeast telomeres and their deletions all lead to telomere length and telomere de­protection pheno­ types68–71. Similarly, human cells derived from patients suffering from Nijmegen breakage syndrome and ataxia tel‑ angiectasia display accelerated telomere shortening 72,73, but the pathways that lead to increased loss of TTAGGG repeats are not clear. Also, as in yeast, the mammalian mRN complex (consisting of mRe11, RAD50 and NBS1 — the homologue of yeast Xrn2), ATm and ATR can be detected at telomeres, suggesting that the DDR machinery has a pivotal role at functional and dysfunctional telomeres74,75.

TRF2 and POT1 have major roles in the interaction of telomeres with the DDR machinery. Human telom­ eres that lose telomeric TRF2 succumb to ATm­ and p53­dependent death in cells that are competent for apoptosis55. However, TRF2 also seems to be capable of directly inhibiting ATm signalling at chromosome ends by generating an environment in which the capa­ bility of ATm to autophosphorylate and self­activate is compromised76,77. These preliminary findings suggest a complex role for shelterin components in suppressing

Figure 3 | Telomeres as the cause of genome instability. When telomeres lose protection and shorten to the Hayflick limit, owing to either extensive loss of TTAGGG repeats or loss of protective factors such as telomeric repeat-binding factor 2 (TRF2; also known as TERF2) and protection of telomeres 1 (POT1), they are recognized as being damaged by a pathway that depends on the MRN complex (consisting of MRE11, RAD50 and NBS1) and the ataxia telangiectasia mutated (ATM) kinase. Next, the 3′ G-overhang is lost, the chromatin structure changes (by dimethylation of Lys20 of histone H4 and of Lys79 of H3, for example) and tumour suppressor p53-binding protein 1 (TP53BP1) is recruited to allow for greater mobility. This facilitates the non-homologous end joining (NHEJ)-dependent covalent fusion of chromosome ends. In the absence of the p53- and retinoblastoma (RB)-dependent tumour suppressor pathways, cells containing nuclei with fused chromosome ends continue to cycle. When the fused chromosomes pass through mitosis they break randomly, leading to unequal distribution of genetic material in the daughter cells. These fusion–breakage–bridge cycles continue through the following cell divisions, leading to multiple non-reciprocal translocations and genome instability. RAP1, repressor and activator protein 1.

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Sister chromatid exchange The HR‑based exchange of DNA strands between sister chromatids.

Nijmegen breakage syndrome A rare syndrome characterized by chromosomal instability that is a result of mutations in the Nijmegen breakage syndrome 1 (NBS1; also known as NBN) gene.

Ataxia telangiectasia A rare, inherited disease, characterized by neurodegeneration, cancer susceptibility and radiation sensitivity, that is caused by mutations in the ATM gene.

Non-reciprocal translocation The transfer of genetic information from one non‑homologous chromosome to another.

ATm­ and ATR­dependent damaging pathways (FIG. 3) that was recently molecularly defined by the targeted deletion of TRF2 and POT1 in mice. Analysis of mice lacking combinations of TRF2, POT1, ATm and ATR revealed independently controlled pathways17. TRF2 and POT1 were shown to act separately, whereby TRF2 repressed ATm and POT1 prevented activation of the ATR signalling cascade. when ATm or ATR signalling was inhibited, dysfunctional chromosome ends were not detected as damage, and NHeJ­dependent fusion was evaded17. Activation of ATm by TRF2 was dependent on the mRN complex, and it is possible that TRF2 inhibits mRN activation at functional telomeres by preventing it from binding to their ends62. The mRN complex has also been suggested to be required for the proper processing of telomeres after replication and in the processing of dysfunctional telomeres before fusion, emphasizing the multiple roles this complex has at telo meres62,75,78 (FIG. 3).

Getting ever closer to the primary signal event that initiates detection of dysfunctional telomeres by the DDR machinery, it was discovered that the binding of TP53BP1 to uncapped telomeres is an essential event for NHeJ­ dependent end­to­end fusion61. Dysfunctional telomeres bound to TP53BP1 were found to be much more mobile than telomeres without TP53BP1, suggesting that alter­ ing telomere mobility enhances the chances of finding a partner telomere for fusion, thereby facilitating NHeJ repair reactions that involve distant sites61.

Taken together, it is becoming increasingly clear that the interactions of functional and dysfunctional telo­ meres with the DDR machineries are highly complex and that many levels of interaction exist. Functional telomeres require the DDR machinery for efficient replication of TTAGGG repeats, processing of the ends after replication and formation of a protective cap at chromosome ends. Dysfunctional telomeres require the same machinery for detection of uncapped telomeres, processing of those uncapped telomeres for repair and for mobility to enhance the efficiency of repair. Adding to the complex­ ity are individual and specific interactions of shelterin components with the signalling molecules in the damage repair cascades, and at this point the field has not even scratched the surface of the post­transcriptional modifica­ tions that are expected to also have roles in the protection of telomeres and in the signalling from them.

Amplification of the signal. Although it is becoming clearer how telomeres interact with the DDR machinery and how uncapped telomeres initiate signalling cascades, it is not known how the localized damage signal at chromo some ends gets translated into a response that affects the whole cell. ATm comes to mind as a molecule that is capable of amplifying damage signals, as it has been suggested that localized damage leads to phosphorylation of most of the ATm molecules in a cell, potentially through changes in chromatin structure79 (BOX 3). However, the specialized nature of the telomeric environment, in which ATm is directly and locally suppressed, argues against this pos­ sibility 76,77. This is supported by the finding that local ATm activation can occur at telomeres in the absence of a response that spreads throughout the nucleus75.

Nevertheless, it is likely that chromatin has a role in signal amplification as changes in chromatin structure can efficiently spread through the nucleus and could be established and re­established rapidly in every cell cycle. Telomeric and subtelomeric chromatin in mice display marks of heterochromatin, particularly trimethylation of Lys9 of H3 (H3K9me3) and of Lys20 of H4 (H4K20me3) (BOX 3). Increasing evidence suggests that histone and DNA methylation and the enzymes involved in these events have a key role in regulating telomere length, and that these events are also likely to have a role in signalling from dysfunctional telomeres7,80–83 (BOX 3).

To date, little is known about the effects of replication­ associated telomere shortening or telomere dysfunction on global chromatin changes, and it is not clear yet whether the long telomeres in mice directly compare to short human telomeres. It will be exciting to see whether signalling from telomeres is involved in global changes in chromatin and histone modifications, and whether this is the mechanism that translates localized damage signals to a nucleus­wide level.

Telomeres as sources of genome instability In 1938, mcClintock noticed that chromosomes in plants that had previously been irradiated with X­rays engaged in spontaneous chromosome breakage–fusion–bridge cycles. This laid the foundation for the hypothesis that aberrantly fused chromosomes will break in the sub­ sequent cell division, thereby leading to the unequal and random distribution of genetic material into the daughter cells84 (FIG. 3). Dysfunctional telomeres that fail to be dis­ tinguished from broken DNA lend themselves perfectly to the hypothesis that loss of chromosome end protec­ tion leads to genome instability through mcClintock’s breakage–fusion–bridge cycles. This hypothesis was formally proved in mice, in which targeted deletion of the RNA subunit of telomerase rendered the telo merase complex inactive for telomere length maintenance85. As a consequence, telomeres shortened progressively by approximately 5 kb per generation and, after four generations, telomeres lacking TTAGGG signals were detected. Loss of telomeric sequences led to chromo­ some end­to­end fusions, chromosomal abnormalities and aneuploidy, supporting the suggestion that loss of chromosome end protection can be the basis for genome instability in mammals.

However, these data originally seemed inconsistent with the findings that telomerase is activated in most human tumours86 and that cells that fail to maintain their telomeres succumb to replicative senescence or cell death. Again, the p53­dependent signalling pathway emerged as a key player when it was discovered that the deletion of p53 attenuated the adverse effects of telomere dysfunction in late generations of mice that lacked an active telomerase complex. Consequently, it was sug­ gested that the loss of telomerase and p53 cooperate to promote cellular transformation87. Telomere attrition in a mouse model lacking p53 similarly led to genome instability based on the breakage–fusion–bridge cycle and to a massive increase in non‑reciprocal translocations. This resulted in the development of epithelial cancers,

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H4 H3

SIRT6

a G1 functional telomeres

b S–G2 functional telomeres

c Dysfunctional telomeres

HP1 HP1

TRF2 TRF2 TRF2TRF2 TRF2TRF2 POT1

TRF2 TRF2

H4

H3

H3

H4 H3

H4

TRF2

UUAGGG

TERRA

TelomereSubtelomere

TTAGGG

Ac Ac Ac Ac

Ac Ac

TP53BP1

TP53BP1 Ac

Ac

Ac

Ac

Ac Ac

TRF2 TRF2

Me Me

Me Me

Me Me

Me Me

Me Me

Me Me

Me Me

Ac Me

Me

Me Me

Me Me

Me Me

Me Me

TP53BP1Me Me

Me Me Me

Me Me Me

HP1 HP1

Me Me Me

Me Me Me

Me

Me

Me

Me

H4K20

H3K9

H3K79

DNA methylation

Me Me Me Me

TTAGGG

TTAGGG

Me Me

therefore linking telomere dysfunction with genome instability and malignancy88 (FIG. 3). eventually a model emerged that recognizes and emphasizes the dual role that telomerase has89. when telomerase is activated in cells that have entered breakage–fusion–bridge cycles and have lost tumour suppressive pathways, such as the p53 and RB pathways, telomeres are stabilized and immortality in the presence of genome instability is promoted, pushing cells towards malignancy. However, when telomerase is activated before telomeres become critically short, telomeres never reach a state at which they would be processed by the NHeJ machinery and

fused. In this case, telomerase acts to suppress the accu­ mulation of chromosomal aberrations and genome instability and, although controversial, it has been argued that bursts of telomerase might be useful to counteract transformation and cancer development.

Telomere­driven genome instability can also ensue in the presence of long stretches of double­stranded telo­ meric repeats. when TRF2 was removed from telo meres by expression of a dominant­negative allele, chromosome ends fused, displaying long stretches of TTAGGG repeats at the fusion sites54 (BOX 2). when cells continued to cycle, the chromosomes entered fusion–breakage–bridge cycles,

Box 3 | Mammalian telomeric chromatin

In human chromatin, 147 base pairs of DNA are wrapped around nucleosomes, which are comprised of histones H3, H4, H2A and H2B119. The amino-terminal tails of histones are subject to an elaborate system of post-translational modification, namely through the addition and removal of acetyl (Ac), methyl (Me), phospho and ubiquitin groups. These are viewed as epigenetic marks and function by extending the informational capacity of cells120. The distribution of these marks, across diverse regions of the genome, results in the simplified classification of areas as either heterochromatic or euchromatic.

G1 phase telomeric chromatin has hallmarks of constitutive heterochromatin: the trimethylation of Lys9 of H3 (H3K9me3) and of Lys20 of H4 (H4K20me3) and heterochromatin protein 1 (HP1) binding36,121 (see the figure, part a, right). Subtelomeric chromatin can be distinguished by a regular nucleosomal distribution, extensive DNA methylation122 and histone post-translational modifications that are distinct from those at telomeres (part a, left). The replication of DNA during S phase coincides with the disruption and restoration of the parental chromatin identity. Newly synthesized histones are acetylated at Lys5, Lys12 and Lys16 of H4 and at Lys9 and Lys56 of H3 (ReF. 123). The removal of these acetyl groups at telomeres by SIRT proteins seems to be important for regulating the association of accessory proteins to telomeres, as exhibited by the relationship between the acetylation of Lys9 of H3 (H3K9ac), SIRT6 and Werner syndrome ATP-dependent helicase (WRN) function124 (see the figure, part b).

Changes in chromatin structure have been shown to occur at dysfunctional telomeres7. These changes are often similar to those exhibited at sites of DNA damage, such as phosphorylation of H2AX, changes in H4K20me2 levels and recruitment of tumour suppressor p53-binding protein 1 (TP53BP1), implying that there is a general ‘epigenetic’ stress response (see the figure, part c). However, it is still unclear whether changes seen at dysfunctional telomeres are proactive or merely responsive to changes in telomeric architecture. Nuclear reprogramming also leads to dramatic changes in telomeric chromatin and telomere length, emphasizing the dynamic and developmentally regulated nature of chromosome ends125. POT1, protection of telomeres 1; TERRA, telomeric repeat-containing RNA; TRF2, telomeric repeat-binding factor 2.

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resulting in non­reciprocal translocations and genome instability, showing that a telomere capping dysfunction can lead to the same outcome as telomere dysfunction owing to catastrophic loss of telomeric repeats18. It would be expected, therefore, that partial or complete loss of TRF2 could be implicated in cancer development; how­ ever, little evidence for this hypothesis has been found so far. TRF1 and TRF2 have been found to be upregulated in gastric carcinoma and during hepatocarcinogenesis; however, it is not intuitively obvious as to how over­ expression of these proteins might contribute to cancer development 90,91. when TRF2 was overexpressed in basal and stem cells of the epidermis, skin cancer levels increased in mice, again suggesting that destabiliza­ tion of the shelterin complex by overexpression or removal of individual complex members can lead to malignancy92,93.

Telomeres, owing to their G­rich and repetitive nature, act as obstacles to the replication fork and require telo­ meric proteins for efficient duplication, as was originally observed in Schizosaccharomyces pombe94. Targeted dele­ tion of TRF1 in mice revealed that telomeres represent fragile sites, and replication forks stall without the aid of this telomeric factor 8. It remains to be established whether TRF1­driven replication defects directly con­ tribute to genome instability but it has been noted that mice that harbour a deletion of TRF1 in the stratified epi­ thelia display epithelia dysplasia and develop squamous cell carcinomas in a p53­negative background9.

The RecQ helicase wRN also contributes to efficient telomere replication. Overexpression of a dominant­ negative allele of wRN led to the occasional loss of telo meres generated by the lagging­strand machinery, a phenotype that was counteracted by telomerase47. Accordingly, targeted deletion of wRN in mice led to phenotypes that resemble the human werner Syndrome only when telo merase was co­deleted95. However, in the case of wRN deletion there is little doubt that telomere­ driven genome instability ensues, as cells deficient for telomerase and wRN accumulate chromosomal aberrations and show elevated recombination rates between telomeres of sister chromatids96, and the genomic instability seen in human werner Syndrome cells is directly dependent on telomere function97.

Taken together, there is no doubt that telomere dys­ function, be it due to loss of telomeric sequences, loss of telomere capping, end protection or telomere replication problems, can lead to genome instability and cancer. It remains to be investigated whether mutations or aber­ rant expression patterns of shelterin components and shelterin­associating factors have direct roles in tumor­ i genesis in humans, and whether such proteins lend themselves as targets for cancer therapy.

Telomere dysfunction in disease Although the link between telomeres, telomere dys­ function, telomere replication and cancer has been well established, there are no telomere­ or telomerase­based therapies so far. Small­molecule telomerase inhibitors, despite working well in vitro and in tissue culture, are yet to pass clinical trials and be established in standard care.

Similarly, efforts to generate telomerase­based cancer vaccines have so far failed to lead to viable therapies. Although the approaches are promising and telomere length maintenance and function make for unifying can­ cer targets, only time and effort will tell whether such approaches are crowned by success.

Recently, telomere function has been directly impli­ cated in two additional diseases, dyskeratosis congenita and idiopathic pulmonar y fibrosis. Dyskeratosis congenita is an inherited disease that is marked by bone marrow failure, abnormal skin pigmentation, nail dystrophy and leucoplakia98,99. X­linked recessive dyskeratosis congenita is caused by mutations in dys­ kerin, a protein that associates with a subgroup of small nucleolar RNAs and also with the RNA component of telomerase (TeRC) — an association that stabilizes the shelterin complex100. Autosomal dominant dyskeratosis congenita has been linked to mutations in TeRC itself 101, in the catalytic telomerase subunit TeRT102 and in the shelterin component TIN2103,104. One unify­ ing feature in dyskeratosis congenita is short telomeres, and the importance of limit ing telomere length has been emphasized by the observation that mice that suffer from extensive telomere shortening because of a lack of POT1B suffer from clear signs of the disease105.

Idiopathic pulmonary fibrosis is a lung disorder that is marked by progressive scarring, which leads to destruction of lung architecture with a frequently fatal outcome. The discovery that short telomeres correlate with idiopathic pulmonary fibrosis eventually led to the finding that heterozygous mutations in TeRT or TeRC can be the cause of the disease106,107. It is not obvious how short telomeres, usually associated with limited pro­ liferation potential of stem cells or other rapidly divid­ ing tissues, can lead to a scarring phenotype in lungs only, but it will be exciting to learn about the implicated pathways in the future.

Conclusions and perspectives Telomere biology has come far in the past 70 years, from the observation by mcClintock that chromosomes need protection to the award of the 2009 Nobel price in Physiology and medicine to Blackburn, Greider and Szostak for the discovery of telomerase and the effects of telomere shortening on cells. Telomere function has been implicated in the replicative ageing process and shown to have a major role in the establishment of genome instability in cancer development. Our understanding of mammalian telomeric proteins has progressed from the idea that they simply cover the TTAGGG repeats. we now know that the core telomeric complex, shelterin, regulates telomere length and inhibits deleterious signal­ ling cascades at telomeres, while simultaneously inter­ acting with and harnessing the DDR machineries to aid in telomere processing and reinforce telomere stability. In addition, telomeric proteins and telomere length reg­ ulation have been implicated in stem cell management and various human diseases.

However, some major questions remain. It is not clear what the primary signal is that detects critically short or uncapped telomeres. It is not known how the signal

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gets translated and amplified throughout the nucleus or whether this cascade has a role in organism ageing and disease. It remains to be discovered how functional telomeres change throughout the lifespan of an organ­ ism and whether telomeric proteins are modified dur­ ing the cell cycle or during ageing. It is not understood

how mutations in individual telomeric proteins affect diseases such as dyskeratosis congenita and idiopathic pulmonary fibrosis. And finally, although the connec­ tion between telomere shortening, telomere dysfunction and cancer is now abundantly clear, this knowledge has not yet translated to disease management.

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Acknowledgements R.O.S. is supported by the George E. Hewitt Foundation for Medical Research and J.K. acknowledges support by the National Institutes of Health (RO1 GM06525 and RO1 AG025837). We thank A. Cesare, D. Lackner, C. Naeger and L. Oganesian for images.

Competing interests statement The authors declare no competing financial interests.

DATABASES entrez Gene: http://www.ncbi.nlm.nih.gov/gene XIST omim: http://www.ncbi.nlm.nih.gov/omim Autosomal dominant dyskeratosis congenita | Gastric carcinoma | Idiopathic pulmonary fibrosis | Werner Syndrome | X-linked recessive dyskeratosis congenita uniProtKb: http://www.uniprot.org ATM | ATR | Mec1 | POT1 | POT1A | POT1B | RAP1 | RB | Tel1 | TIN2 | TP53BP1 | TPP1 | TRF1 | TRF2 | WRN

FURTHER INFORMATION Jan Karlseder’s homepage: http://www.salk.edu/faculty/karlseder.html all liNks are acTive iN The oNliNe pDf

R e V i e W s

NATuRe RevIewS | M o l e c u l a r c e l l B i o lo gy vO Lu m e 1 1 | m A R C H 2 0 1 0 | 181

f o c u s o n G e n o m e i n s ta b i l i t y

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  • Shelterin organizes and defines telomeres
  • Abstract | The natural ends of linear chromosomes require unique genetic and structural adaptations to facilitate the protection of genetic material. This is achieved by the sequestration of the telomeric sequence into a protective nucleoprotein cap that masks the ends from constitutive exposure to the DNA damage response machinery. When telomeres are unmasked, genome instability arises. Balancing capping requirements with telomere replication and the enzymatic processing steps that are obligatory for telomere function is a complex problem. Telomeric proteins and their interacting factors create an environment at chromosome ends that inhibits DNA repair; however, the repair machinery is essential for proper telomere function.
  • Figure 1 | The structure of human telomeres. Human telomeres consist of many kilobases of TTAGGG repeats, with a G-rich leading strand and a C-rich lagging strand. The G-strand extends in the 3′ direction, forming the G‑overhang. The shelterin complex27, consisting of the double-stranded telomeric repeat-binding factor 1 (TRF1; also known as TERF1) and TRF2 (also known as TERF2), the TRF2-interacting factor repressor and activator protein 1 (RAP1; also known as TERF2IP), the bridging molecules TRF1-interacting nuclear protein 2 (TIN2; also known as TINF2) and POT1- and TIN2-interacting protein (TPP1; also known as ACD) and the telomeric protection factor protection of telomeres 1 (POT1), covers the double- and single-stranded repeats. Shelterin members interact with many other factors that transiently localize to telomeres, frequently in a cell-cycle-dependent manner. These factors aid in the generation of a protective structure at chromosome ends, here referred to as the telomeric loop, or T‑loop. The T-loop is generated by invasion of the single-stranded G‑overhang into the double-stranded TTAGGG repeats. The looped structure protects telomeres on several levels. Invasion effectively sequesters the G‑overhang and allows natural chromosome ends to be distinguished from double-strand breaks. The ataxia telangiectasia mutated (ATM)-dependent signalling cascade is inhibited by TRF2 and the ATM- and RAD3-related protein (ATR)-dependent signalling pathway is inhibited by POT1. Telomerase is probably inhibited by the shelterin complex, and it is thought that telomeric repeat-containing RNA (TERRA) has a role in this inhibition. BLM, Bloom syndrome protein; DKC1, dyskerin; MRN, MRE11, RAD50 and NBS1; TERT, telomerase reverse transcriptase; WRN, Werner syndrome ATP-dependent helicase.
  • Box 1 | The telomerase complex
  • Molecular basis of telomere dysfunction
  • Figure 2 | The processing of damaged DNA. a | Damage sensing pathways. Upon single-strand breakage or fork stalling (induced by replicative stress or ultraviolet C, for example), the ataxia telangiectasia mutated (ATM)- and RAD3-related protein (ATR)-dependent pathway is activated and replication protein A (RPA) binds to the strands. ATR phosphorylates RAD17, the 9‑1‑1 complex, topoisomerase IIβ-binding protein 1 (TOPBP1) and CHK1 (also known as CHEK1), which mediates cell cycle arrest through CDC25A. At double-strand breaks (induced by γ-irradiation, for example) the chromatin structure is dynamically restructured, exemplified by the ATM-dependent phosphorylation of histone H2A variant H2AX. The sensing of the double-strand break by the MRN complex (consisting of MRE11, RAD50 and NBS1) triggers the targeting of downstream mediators and the activation of repair pathways. The key event is ATM-dependent activation of CHK2 (also known as CHEK2) and p53, which induces G1 and G2–M phase arrest. A failure to repair the double-strand break results in permanent cell cycle exit, senescence or apoptosis. b | DNA repair pathways. The primary pathways for repair are non-homologous end joining (NHEJ) and homologous recombination (HR). NHEJ is the major pathway, functioning throughout the cell cycle. NHEJ requires the sensing of lesions by the ATP-dependent DNA helicase 2 subunits Ku70 (also known as XRCC6) or Ku80 (also known as XRCC5), activation of DNA-dependent protein kinase (DNA-PK) and the 3′–5′ endonucleolytic resection of the break. The break is then filled in by DNA polymerase-μ (μ) and DNA polymerase-λ (λ) and the ends are fused by DNA ligase IV. NHEJ is error prone and defects in NHEJ are frequently linked with cancer. During S phase or G2–M phase damage, the cell employs the error-free HR pathway. ATM and MRN mediate recognition and resection, and the single-stranded DNA overhang is detected by ATR and RPA, promoting association of RAD51 and RAD52. The HR machinery mediates synthesis of new DNA strands using the overhang sequence as a template. This mechanism ensures that the original DNA sequence is faithfully restored and genetic integrity is maintained. Me, methyl group; P, phospho group; Ub, ubiquitin.
  • Box 2 | Cytological representation of telomere dysfunction
  • Figure 3 | Telomeres as the cause of genome instability. When telomeres lose protection and shorten to the Hayflick limit, owing to either extensive loss of TTAGGG repeats or loss of protective factors such as telomeric repeat-binding factor 2 (TRF2; also known as TERF2) and protection of telomeres 1 (POT1), they are recognized as being damaged by a pathway that depends on the MRN complex (consisting of MRE11, RAD50 and NBS1) and the ataxia telangiectasia mutated (ATM) kinase. Next, the 3′ G-overhang is lost, the chromatin structure changes (by dimethylation of Lys20 of histone H4 and of Lys79 of H3, for example) and tumour suppressor p53-binding protein 1 (TP53BP1) is recruited to allow for greater mobility. This facilitates the non-homologous end joining (NHEJ)-dependent covalent fusion of chromosome ends. In the absence of the p53- and retinoblastoma (RB)-dependent tumour suppressor pathways, cells containing nuclei with fused chromosome ends continue to cycle. When the fused chromosomes pass through mitosis they break randomly, leading to unequal distribution of genetic material in the daughter cells. These fusion–breakage–bridge cycles continue through the following cell divisions, leading to multiple non-reciprocal translocations and genome instability. RAP1, repressor and activator protein 1.
  • Recognition of telomeres as DNA damage
  • Telomeres as sources of genome instability
  • Box 3 | Mammalian telomeric chromatin
  • Telomere dysfunction in disease
  • Conclusions and perspectives