In mammals, male X hemizygosity neccesitates dosage compensation of X-linked genes by means of X chromosome inactivation (XCI) in XX females. Because either X chromosome can be silenced, heterozygous females are typically mosaic for expression of parental alleles and therefore less susceptible to X-linked disorders than hemizygous males. When XCI is skewed however, disease penetrance rises with the fraction of cells that have silenced the functional allele. As a result, both males and females are exposed to the cumulative burden of monogenic disease harbored on the X chromosome. Yet, the inactive X chromsome (Xi) is not entirely silent: some genes, in particular those with paralogous copies on the Y chromosome (X-Y gene pairs), are exempt from dosage compensation and escape XCI. Turner syndrome (TS, karyotype 45,X) reflects a sensitivity to the dosage of such ?escapee? genes, and adds to the significant X-linked health burden through cardiovascular and renal malformations, as well as high rates of spontaneous termination of 45,X conceptuses. Much of the XCI field has focused on implicating and dissecting requisite gene silencing pathways, using the mouse X as the primary model. In contrast, the mechanism(s) that enable escapees to sustain expression from an otherwise repressed chromosome territory have received little attention, especially in humans. As a result, the identity, lineage-specificity, and regulatory mechanisms of escapees remain unresolved. Building on our allele-specific genomics and XCI expertise, we propose to address these questions in otherwise isogenic 45,X/46,XX human pluripotent stem cells. This platform will enable us to 1.) quantify allele-specific expression across the human X and along distinct cell lineages, 2.) dissect the local and long-range regulatory logic of escapees, and 3.) assess dosage-sensitive contributions of individual escapees. These advances will aid the interpretation of human X-linked variants, complement an expanding glossary of gene regulatory elements, and reveal how escapees manage to resist silencing. Such mechanstic insights may yield novel means of manipulating regulatory elements, and subsequently translate into generalized, epigenetic approaches to X-linked disease in heterozygous females, as well as gene dosage correction in TS and other dosage-sensitive disorders in the human genome.

Public Health Relevance

Although females and have two X chromosomes, only one X is active in any given cell, while the other is inactive. However, some X-linked genes are expressed from both X chromosomes and thought to be lacking dosage in Turner Syndrome (TS). This chromosomal abnormality (45,X or XO) is observed in 1:2000 live births, and represents one of the leading causes of spontaneous terminations. The exact identity and relative contributions of these genes to TS is unknown, as are the molecular mechanisms that allow these genes to be expressed from active and inactive X. The research program described herein aims to answer these questions and inform research into TS and other X-linked diseases.

National Institute of Health (NIH)
National Institute of General Medical Sciences (NIGMS)
Unknown (R35)
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Special Emphasis Panel (ZRG1)
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Carter, Anthony D
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University of Connecticut
Schools of Medicine
United States
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