title: A CpG mutational hotspot in a ONECUT binding site accounts for the prevalent variant of hemophilia B Leyden.
abstract: Hemophilia B, or the "royal disease," arises from mutations in coagulation factor IX (F9). Mutations within the F9 promoter are associated with a remarkable hemophilia B subtype, termed hemophilia B Leyden, in which symptoms ameliorate after puberty. Mutations at the -5/-6 site (nucleotides -5 and -6 relative to the transcription start site, designated +1) account for the majority of Leyden cases and have been postulated to disrupt the binding of a transcriptional activator, the identity of which has remained elusive for more than 20 years. Here, we show that ONECUT transcription factors (ONECUT1 and ONECUT2) bind to the -5/-6 site. The various hemophilia B Leyden mutations that have been reported in this site inhibit ONECUT binding to varying degrees, which correlate well with their associated clinical severities. In addition, expression of F9 is crucially dependent on ONECUT factors in vivo, and as such, mice deficient in ONECUT1, ONECUT2, or both exhibit depleted levels of F9. Taken together, our findings establish ONECUT transcription factors as the missing hemophilia B Leyden regulators that operate through the -5/-6 site.
authors.affiliation: School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington, NSW 2052, Australia.
authors.forename: Alister P W
authors.initials: AP
authors.lastname: Funnell
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wilson
authors.forename: Benoit
authors.initials: B
authors.lastname: Ballester
authors.forename: Ka Sin
authors.initials: KS
authors.lastname: Mak
authors.forename: Jon
authors.initials: J
authors.lastname: Burdach
authors.forename: Natisha
authors.initials: N
authors.lastname: Magan
authors.forename: Richard C M
authors.initials: RC
authors.lastname: Pearson
authors.forename: Frederic P
authors.initials: FP
authors.lastname: Lemaigre
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Stowell
authors.forename: Duncan T
authors.initials: DT
authors.lastname: Odom
authors.forename: Paul
authors.initials: P
authors.lastname: Flicek
authors.forename: Merlin
authors.initials: M
authors.lastname: Crossley
mesh_terms: D000818:Animals; D001665:Binding Sites; D045744:Cell Line, Tumor; D004268:DNA-Binding Proteins / Q000378:metabolism; D005164:Factor IX / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D002836:Hemophilia B / Q000235:genetics*; D056945:Hep G2 Cells; D051559:Hepatocyte Nuclear Factor 6 / Q000378:metabolism*; D018398:Homeodomain Proteins / Q000378:metabolism*; D006801:Humans; D008099:Liver / Q000378:metabolism; D008297:Male; D051379:Mice; D018345:Mice, Knockout; D009154:Mutation; D011401:Promoter Regions, Genetic; D014157:Transcription Factors / Q000378:metabolism*; D014158:Transcription, Genetic
chemical_list: D004268:DNA-Binding Proteins; D051559:Hepatocyte Nuclear Factor 6; D018398:Homeodomain Proteins; C487964:ONECUT2 protein, mouse; C496606:Onecut1 protein, mouse; D014157:Transcription Factors; D005164:Factor IX