Fanconi anemia (FA) is a rare recessive disorder characterized by genome instability,
congenital malformations, progressive bone marrow failure, and predisposition to hematologic
malignancies and solid tumors
1
. At the cellular level, hypersensitivity to DNA interstrand crosslinks (ICLs) is
the defining feature in FA
2
. Mutations in thirteen distinct FA genes
3
have been shown to interfere with the DNA-replication dependent repair of lesions
involving crosslinked DNA at stalled replication forks
4
. Depletion of SLX4, which interacts with multiple nucleases and has been recently
identified as a Holliday junction resolvase
5–7
, results in increased sensitivity of the cells to DNA crosslinking agents. Here we
report the identification of biallelic SLX4 mutations in two patients with typical
clinical features of FA and show that the cellular defects in the patients’ cells
are complemented by wild-type SLX4, demonstrating that biallelic mutations in SLX4/FANCP
cause a new subtype of Fanconi anemia, FA-P.
SLX4 is a multidomain scaffold protein interacting with three distinct nucleases SLX1,
ERCC4/XPF-ERCC1, and MUS81-EME1
5–7
. While the SLX4-SLX1 interaction is largely responsible for the Holliday junction
resolvase activity seen in the complex, SLX4 can also stimulate the activity of ERCC4/XPF
and MUS81 nucleases, both of which have been previously implicated in the processing
of interstrand crosslinks (ICLs)
8
. The finding that depletion of SLX4 leads to increased sensitivity to cross-linking
agents and camptothecin
5–7
prompted us to investigate SLX4 as a candidate gene for Fanconi anemia
1
.
So far, mutations in thirteen genes are responsible for FA. Eight of the FA proteins
(FANCA/B/C/E/F/G/L/M) form a core complex, a nuclear E3 ubiquitin ligase
2
which ubiquitinates FANCI and FANCD2
9,10
. These two activated proteins subsequently localize as an FANCI/FANCD2 (ID) complex
to chromatin and direct repair
4
in part through interaction with the newly identified nuclease FAN1
11–14
. Cells with mutations in the FA core complex (except for FANCM) lack monoubiquitination
of FANCD2. The other FA proteins are FANCJ/BRIP1, a helicase, and homologous recombination
(HR) effectors, FANCN/PALB2 and FANCD1/BRCA2. Recently, RAD51C, also involved in HR
repair, has been found to be mutated in three patients with an FA-like disorder
15
. Cells mutated in FANCJ/N/D1 and RAD51C have normal FANCD2 monoubiquitination and
these genes are thought to work downstream of the ID complex.
As depletion of SLX4 in a U2OS cell line does not affect FANCD2 ubiquitination (Figure
1A and B), we sequenced SLX4 in the families from the International Fanconi Anemia
Registry
16
with unassigned FA complementation groups and normal FANCD2 modification (Figure 1C)
and identified two families carrying germline mutations, IFAR1084 and IFAR414 (Figure
1D). Phenotypes of the two patients are summarized in Table 1. The lymphoblastoid
cell line (LCL) (RA3042) and fibroblasts (RA3083) from the patient 1084/1 showed increased
genomic instability (Figure 1E and Table 2) and increased sensitivity to Mitomycin
C (MMC) (Figure S1A). The 414/1 patient’s LCL (RA 1376) was not sensitive to MMC suggestive
of reversion (Figure S1B); however, his skin fibroblasts (RA 3331) displayed a high
degree of DEB induced chromosomal instability (Figure 1E and Table 2) and sensitivity
to MMC. No UV sensitivity was observed in fibroblasts from either of the patients
(Figure S1C and D). Fibroblasts from the patient 414/1 (RA3331), but interestingly
not patient 1084/1 (RA3083), were sensitive to camptothecin (CPT), a topoisomerase
I inhibitor (Figure S1E and F).
Sequencing of the cDNA from the 1084/1 patient’s cells revealed skipping of Exon 5
(Figure S2A), due to a homozygous point mutation in the canonical splice donor dinucleotide
GT in intron 5 (c.1163+2T>A) in the genomic DNA (Figure S2B). Both parents were found
to be heterozygous and an unaffected sibling was found to be negative for this mutation
(Figure S2B). The predicted effect of this mutation is a 70 amino acid deletion of
amino acids (aa) 317 to 387 of SLX4 (p.R317_F387del), leading to an in-frame deletion
of the conserved Cys and Leu of the first UBZ domain and the whole second UBZ domain
(Figure 2A, Figure S2C). Immunoprecipitation of SLX4 from the cell line RA3083 confirmed
the presence of a slightly shorter protein product (Figure 2B, lane 5, Figure S2D)
In patient 414/1, a heterozygous frameshift mutation in exon 2 (c.514delC) was detected
by sequencing of the full length RT-PCR product (Figure S3A) and confirmed in the
genomic DNA of the patient and his father (Figure S3B). The predicted protein effect
of this frame-shift mutation is a truncated protein with N-terminal 171aa of SLX4
followed by 22 non-SLX4 aa (p.L172FfsX22) (Figure 2A). The second allele of SLX4 in
the second patient, identified as described in Online Methods, showed a large genomic
deletion from intron 9 to exon 12 resulting in c.2013+225_3147delinsCC (Figure S3C,
S3D, and S3E). The predicted effect of this mutation is a truncated protein with N-terminal
671aa of SLX4 followed by 119 non-SLX4 aa due to a frameshift (p.L672VfsX119) (Figure
2A). Consequently, immunoprecipitation with the antibody against SLX4 failed to identify
the full-length protein in the patient’s fibroblasts RA3331 (Figure 2B, lane 6).
To prove that the mutations identified in SLX4 were causal for the FA phenotype of
both patients, we introduced the WT or the mutant SLX4 cDNAs into the patients’ fibroblasts
(RA3083 and RA3331) and performed functional complementation assays (Figure 3 and
Figure S4). Expression of WT SLX4 in both cell lines almost fully rescued the MMC
sensitivity (Figure 3A, Figure S4A, and S4B), the late S/G2 arrest with MMC treatment
(Figure 3B, Figure S4C, S4D, and S4E), and the chromosomal instability after treatment
with DEB (Figure S4F). Some residual MMC sensitivity, cell cycle arrest, and chromosomal
breakage is most likely due to some cells losing expression of the SLX4 as evident
by immunofluorescence analysis (data not shown). Introduction of the mutant proteins
did not rescue the FA phenotypes of the patients’ cells although a slight improvement
was noted in the various assays possibly due to overexpression of the mutant proteins,
which might have residual function. These experiments demonstrate that biallelic SLX4
mutations cause a new subtype of Fanconi anemia, FA-P and FANCP becomes an alias for
the SLX4 gene.
SLX4 interacts with multiple factors, two of which, ERCC4/XPF and MUS81 have been
previously implicated in crosslink repair
8
. We therefore tested whether the mutant SLX4 proteins from both patients still interacted
with the ERCC4/XPF and MUS81 complexes. We found that ERCC4/XPF, MUS81, and ERCC1
co-immunoprecipitate with endogenous mutant SLX4 (p.R317_F387del) from RA3083 fibroblasts
(Figure 4A, lane 5 and Figure S5A, lane 4), although the levels of the mutant SLX4
protein were consistently lower in multiple experiments leading to diminished immunoprecipitation
of the interacting factors. The second patient’s SLX4 p.L672VfsX119 overexpressed
in RA3331 fibroblasts showed diminished but present interaction with ERCC4/XPF and
ERCC1, but not with MUS81 (Figure 4B, lane 3). This was consistent with the previous
findings that MUS81 interacts with aa 684–1834 fragment of the SLX4 protein
7
which are deleted in the p.L672VfsX119 mutant protein. Immunoprecipitation with an
antibody recognizing the N terminus of SLX4 from RA3331 cells showed greatly diminished
interaction with ERCC4/XPF, ERCC1, and MUS81 (Figure S5B, lane 6).
As UBZ domains are known to interact with ubiquitin
17
, we hypothesized that the absence of the tandem UBZ domains in the mutant SLX4 from
patient 1084/1 might disrupt the binding of the SLX4 complex to ubiquitin chains of
repair proteins at the sites of DNA damage, as shown for the tandem UBZ domains of
RAP80
18
. We therefore performed in vitro ubiquitin binding assays (Figure 4C) that showed
binding of the isolated UBZ domains of SLX4 to the K63 chains of ubiquitin (Figure
4C, lane 8). When the two conserved cysteines from each UBZ domain were mutated to
alanines (Figure S2C) the binding was reduced to background levels seen with GST alone
(Figure 4C, compare lane 7 and 9), suggesting the possibility that SLX4 may localize
to the sites of damage through binding to K63 ubiquitinated substrates. As SLX4 would
localize other proteins including ERCC4/XPF, MUS81 and SLX1 to sites of DNA damage,
the SLX4 deficient patient cell lines described here are important tools to understand
which interactions of SLX4 are essential for the repair of cross-linked DNA and ultimately
to define the importance of the SLX4/FANCP function in the FA pathway. Patient phenotypes
also provide an important clue. FA patients with mutations in FANCN/PALB2 or FANCD1/BRCA2
genes, which are essential for homologous recombination, have very early onset of
childhood solid tumors and AML
19,20
. FA patients with SLX4/FANCP mutations show a milder phenotype more akin to that
seen in FA patients with mutations in the FA core or the ID complex components. This
suggests that the Holliday junction resolution, an integral step of homologous recombination,
might not be the essential function of SLX4 in the somatic compartment during crosslink
repair and that the repair depends on the other nucleases, ERCC4/XPF and MUS81 that
interact with SLX4.
SLX4/FANCP represents a second protein (besides FANCM) that is conserved in lower
eukaryotes, which do not have any other FA pathway components. Yeast SLX4, like human
SLX4 interacts with orthologs of ERCC4/XPF and SLX1 and the work in this model organism
will provide insight into the function of the FA pathway in human cells. Since germ-line
mutations in three FA genes (FANCD1/BRCA1, FANCN/PALB2, FANCJ/BRIP1) and RAD51C, mutated
in an FA-like disorder, are associated with a high risk of developing familial breast
and ovarian cancers
21–24
, SLX4 should also be sequenced in patients from pedigrees where no other predisposing
mutations could be identified.
SLX4 Reference Sequences
NCBI Reference Sequence: NM_032444.2, NCBI Reference Sequence: NP_115820.2
Methods
Subjects
Cell lines and genomic DNA samples were derived from individuals with Fanconi anemia
and their family members registered in the International Fanconi Anemia Registry after
obtaining informed written consent. The Institutional Review Board of The Rockefeller
University approved the studies.
Cell Culture
U2OS cells were grown in Dulbecco Modified Eagle medium (DMEM) supplemented with 10%
(v/v) FBS, 100 units of penicillin per ml, and 0.1 mg streptomycin per ml (all from
Invitrogen). Lymphoblast cell lines were grown in RPMI supplemented as above except
with 20% FBS. Fibroblasts were grown as above except with 15% FBS and non-essential
amino acids. Fibroblasts were grown in 3% oxygen. BJ cells are normal foreskin fibroblasts
and were obtained from ATCC. Patients’ fibroblasts were immortalized using a catalytic
subunit of telomerase (hTERT) or were transformed using HPVE6 and E7 proteins.
cDNA and Genomic Sequencing
RNA was extracted from the cell lines using Qiagen RNeasy Plus Mini Kit. First strand
cDNAs were then synthesized using the Invitrogen SuperScript™ III Reverse Transcriptase
kit. SLX4 RT-PCR was done using primers 621 and 624 (see Supplementary Table 1) and
Invitrogen Platinum® Pfx DNA Polymerase kit. PCR products were cleaned up using USB
Exo-sapit kit before set up for sequencing, done by Genewiz, Inc. (NJ). Primers 623,
627, 628, 629, 630, 633, 634,639, 640, and 641 were used to sequence the full length
SLX4 (see Supplementary Table 1). Genomic PCR was done using Qiagen Taq Polymerase
with primers shown in Supplementary Table 1. The PCR products were cleaned up using
USB Exo-sapit kit before set up for sequencing. In most cases, the PCR primers were
also suitable for sequencing.
Identification of the second allele in IFAR414/1
In order to identify the second allele in RA 3331 cell line, full genomic sequencing
of the coding exons was done on the patient’s and the maternal DNA. A genomic deletion
was found likely, based on informative polymorphic markers in exon 12: c.3162G>A (p.S1054S,
rs76488917), c.3365C>T (p.P1122L, rs714181). Amplification of parts of the cDNA followed
by the detailed sequence analysis revealed retention of IVS9 through c.2013+224, with
deletion of c.2013+225_3147 and insertion of two cytosine nucleotides in its place:
hence c.2013+225_3147del4890insCC (Figure S2D). To confirm this result, a genomic
PCR assay was set up using primers flanking the deletion. The resulting wild-type
amplicon (6821bp) failed to amplify under the PCR conditions we used but the deleted
allele, resulted in a 1931bp amplicon from the patient‘s and the mother’s DNA, but
not the father’s DNA (Figure S3E). Direct sequencing of the mutant amplicon confirms
the result observed in the cDNA (Figure S3C). The sequencing result appears homozygous
since the wild type allele does not amplify.
Plasmids
The WT SLX4 cDNA was a kind gift from the Harper lab. Mutant alleles were amplified
and recombined into pDONR223
25
. pDONR223 derivatives were recombined into pHAGE vectors or pDEST15 using LR clonase
(Invitrogen). HPV16 E6E7 genes (gift from Howley lab) were subcloned into pMSCVneo
(Clontech) and used to transform the primary cells. pWZLhTERT
26
was used to immortalize RA3083 and BJ cell lines.
Antibodies
The following antibodies were used: FANCD2 (Novus NB100-182), GFP (Roche 11814460001),
HA (Covance MMS-101R), SLX4 (Bethyl A302-269A and A302-270A) ERCC4/XPF (Neomarkers
Ab-1), ERCC1 (Neomarkers Ab-2) Mus81 (Abcam, MTA30 2G10/3), Ubiquitin (Millipore,
MAB1510) and an antibody raised against aa 251-402 of SLX4 (Bethyl).
Mutagenesis
Mutagenesis was performed using multisite mutagenesis kit (Agilent) using primers
shown in Supplementary Table 2.
RNAi
siRNA transfections were performed using LipofectamineRNAiMAX as suggested by the
manufacturer with the final siRNA concentration of 50 nM. siRNAs (Invitrogen) are
shown in Supplementary Table 3.
RT-qPCR
Superscript III reverse transcriptase followed by Platinum cybergreen super mix (Invitrogen)
were used according to the manufacturer’s instructions. Actin was used as control.
Ubiquitin binding assay
5 µg purified GST SLX4_aa251-402, GST SLX4_aa251-402 ZNF1andZNF2 mutants or GST alone
as a control were added to 7.5 µl GST-beads and 1 µg mono-Ub, Ub-K48 or Ub-K63 (Boston
Biochem) in 100 µl binding buffer (50 mM Tris pH 7.5, 150 mM NaCl, 10% glycerol, 0.1%
Triton, 2 mM NEM, 200 µg/ml BSA) and incubated for 3 hours at 4°C. After washing 5
times with binding buffer, the samples were boiled and loaded on a Bis-Tris gel (Invitrogen)
and immunoblotted with anti-ubiquitin antibody (Millipore, MAB1510).
Cell cycle studies
For cell cycle analysis, cells were left untreated or were treated with 100 nM MMC
and were grown for 48 hours. Collected cells were resuspended in 300 µl PBS. While
vortexing, 700 µl of ice cold 100% (v/v) ethanol were added drop-wise and the suspension
was stored at −20°C at least overnight. 30 min before FACS, cells were spun down,
resuspended in propidium iodine (PI) mix (1 ml PBS, 10 µl RNase [of stock solution
of 20 mg/ml], 10 µl PI [of stock solution of 1 mg/ml]), and analyzed using FACSCalibur
(Becton Dickinson). Cell cycle analysis was performed using the FlowJo software (Tree
Star, Inc).
Breakage analysis
Cells were treated with 0.1 µg DEB per mL of media for 72 hours, arrested with colcemid
(0.17 ug per mL of media) for 20 minutes (LCL) or 2 hours for fibroblasts, harvested,
incubated for 10 min at 37°C in 0.075 M KCl, and fixed in the freshly prepared methanol:glacial
acidic acid (3:1 vol/vol). Cells were stored at 4°C and when needed dropped onto wet
slides and air-dried at 40°C for 60 minutes before staining with Karyomax Giemsa (Invitrogen)
Gurr Buffer for 3 minutes. After rinsing with fresh Gurr Buffer followed by distilled
water, the slides were fully dried 40°C for 60 minutes and scanned using the Metasystems
Metafer application.
Immunoprecipitations
For immunoprecipitations, cells were lysed in MCLB (50 mM Tris, 150 mM NaCl and 0.5%
NP-40) supplemented with protease Inhibitors (Roche), and phosphatase inhibitors (Calbiochem).
1 or 2 mg protein extract was incubated with 5 µg of the indicated antibody and 10
µl of Protein A/G PLUS-Agarose (Santa Cruz). Following five washes in lysis buffer,
the immunoprecipitates were eluted in tris-Glycine SDS sample buffer and size-fractionated
on Novex 3–8% Tris-Acetate gel (Invitrogen).
Mitomycin C sensitivity assay
Cells were plated in a 6-well plate in triplicate at a density of 2.5×104 cells per
well. 24 hours later, MMC was added at final concentrations from 0 to 100 nM. After
8 days in culture, cell numbers were determined using a Z2 Coulter Counter (Beckman
Coulter). The cell number after MMC treatment was normalized to the cell number in
the untreated sample to arrive at the % survival.
Supplementary Material
supp material