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Exome sequencing of individuals with Huntington’s disease implicates FAN1 nuclease activity in slowing CAG expansion and disease onset

McAllister, Branduff, Donaldson, Jasmine ORCID:, Binda, Caroline, Powell, Sophie, Chughtai, Uroosa, Edwards, Gareth, Stone, Joseph, Lobanov, Sergey ORCID:, Elliston, Linda, Schuhmacher, Laura, Rees, Elliott ORCID:, Menzies, Georgina ORCID:, Ciosi, Marc, Maxwell, Alastair, Chao, Michael, Eun Pyo, Hong, Lucente, Diane, Wheeler, Vanessa, Jong-Min, Lee, MacDonald, Marcy, Long, Jeffrey, Aylward, Elizabeth, Landwehrmeyer, G. Bernhard, Rosser, Anne ORCID:, REGISTRY Investigators of the European Huntington’s disease netw, Paulsen, Jane, PREDICT-HD Investigators of the Huntington Study Group, Williams, Nigel ORCID:, Gusella, James, Monckton, Darren, Allen, Nicholas, Holmans, Peter ORCID:, Jones, Lesley ORCID: and Massey, Thomas ORCID: 2022. Exome sequencing of individuals with Huntington’s disease implicates FAN1 nuclease activity in slowing CAG expansion and disease onset. Nature Neuroscience 25 , pp. 446-457. 10.1038/s41593-022-01033-5

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The age at onset of motor symptoms in Huntington’s disease (HD) is driven by HTT CAG repeat length but modified by other genes. In this study, we used exome sequencing of 683 patients with HD with extremes of onset or phenotype relative to CAG length to identify rare variants associated with clinical effect. We discovered damaging coding variants in candidate modifier genes identified in previous genome-wide association studies associated with altered HD onset or severity. Variants in FAN1 clustered in its DNA-binding and nuclease domains and were associated predominantly with earlier-onset HD. Nuclease activities of purified variants in vitro correlated with residual age at motor onset of HD. Mutating endogenous FAN1 to a nuclease-inactive form in an induced pluripotent stem cell model of HD led to rates of CAG expansion similar to those observed with complete FAN1 knockout. Together, these data implicate FAN1 nuclease activity in slowing somatic repeat expansion and hence onset of HD.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License
Publisher: Nature Research
ISSN: 1097-6256
Funders: Wellcome Trust
Date of First Compliant Deposit: 30 March 2022
Date of Acceptance: 11 February 2022
Last Modified: 12 Oct 2023 04:43

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