<p>Allelic imbalance, in which two alleles at a given locus exhibit differences in gene expression, chromatin composition and/or protein binding, is a widespread phenomenon in the human and other complex genomes. Most examples concern individual loci located more or less randomly around the genome and thus imply local and gene-specific mechanisms. However, genomic or chromosomal basis for allelic imbalance is supported by multi-locus examples such as those exemplified by domains of imprinted genes, spanning ~1-2 Mb, or by X chromosome inactivation, involving much of an entire chromosome. Recent studies have shown that genes on the two female X chromosomes exhibit a breadth of expression patterns ranging from complete silencing of one allele to fully balanced biallelic expression. Although evidence for heritability of allele-specific chromatin and expression patterns exists at individual loci, it is unknown whether heritability is also reflected in the chromosome-wide patterns of X inactivation.</p><p>The aim of this thesis is to elucidate the extent to which the widespread variable patterns of allelic imbalance on the human X chromosome in females are under genetic control and how access of the transcription machinery to the human inactive X chromosome in females is determined at a genomic level. For the set of variable genes examined in this study, the absence or presence of expression appears to be stochastic with respect to the population rather than abiding by strict genetic rules. Furthermore, variable gene expression that I have detected even among multiple clonal cell lines derived from a single individual suggests fluctuation in transcriptional machinery engagement. I find that, although expression at most genes on the human inactive X chromosome is repressed as a result of X inactivation, a number of loci are accessible to the transcriptional machinery. It appears that RNA Polymerase II is present at alleles on the inactive X even at the promoters of several silenced genes, indicating a potential for expression. </p><p>This thesis embodies a transition in the field of human X chromosome inactivation from gene by gene approaches used in the past to utilizing high-throughput technologies and applying follow-up analytic techniques to draw upon the vast data publicly available from large consortia projects.</p> / Dissertation

<p>Important candidate genes to human bone phenotypes are those involved in the regulation of hormonal action, such as the vitamin D receptor (VDR) and the estrogen receptor-α (ERα) genes and their cofactors. RIZ1 is a specific ERα cofactor proved to strongly enhance the function of the ERα. </p><p>The main focus of this thesis has been to study genetic variants in the VDR and RIZ genes and their associations to human bone phenotypes using candidate gene and functional approaches. Specifically, polymorphisms in the VDR 3’ untranslated region (UTR) and a deletion/insertion polymorphism of a proline in the RIZ gene were investigated.</p><p>The candidate gene approach was applied to large-scale population-based cohorts of pre-and post-menopausal women from Sweden and of elderly men from Sweden and Hong Kong. VDR 3’ UTR polymorphisms were associated with peak bone mass and body composition in young women. Further analysis of common VDR 3’ UTR haplotypes confirmed the association with BMD and risk of fractures in elderly men from Sweden and Hong Kong. The VDR polymorphisms were investigated for cis-acting effects, affecting allelic expression in the normal chromosomal context of human bone cells. The VDR allelic transcripts in the bone samples were unequally expressed, suggesting presence of regulatory variants in the 3’ UTR. </p><p>The polymorphism in the RIZ gene was strongly associated to BMD in pre- and postmenopausal women and in elderly men. The functional analyses included reporter constructs containing the RIZ polymorphic variants transfected in a cell line and its abilities in coactivating the ERα were examined. The variants were functionally different in coactivating the ERα-receptor complex. </p><p>To summarize, the results of this thesis show novel evidence for functional relevant polymorphisms in candidate genes to human bone phenotypes. These polymorphisms may contribute to the variation seen in BMD and risk of fractures in the population.</p>

Important candidate genes to human bone phenotypes are those involved in the regulation of hormonal action, such as the vitamin D receptor (VDR) and the estrogen receptor-α (ERα) genes and their cofactors. RIZ1 is a specific ERα cofactor proved to strongly enhance the function of the ERα. The main focus of this thesis has been to study genetic variants in the VDR and RIZ genes and their associations to human bone phenotypes using candidate gene and functional approaches. Specifically, polymorphisms in the VDR 3’ untranslated region (UTR) and a deletion/insertion polymorphism of a proline in the RIZ gene were investigated. The candidate gene approach was applied to large-scale population-based cohorts of pre-and post-menopausal women from Sweden and of elderly men from Sweden and Hong Kong. VDR 3’ UTR polymorphisms were associated with peak bone mass and body composition in young women. Further analysis of common VDR 3’ UTR haplotypes confirmed the association with BMD and risk of fractures in elderly men from Sweden and Hong Kong. The VDR polymorphisms were investigated for cis-acting effects, affecting allelic expression in the normal chromosomal context of human bone cells. The VDR allelic transcripts in the bone samples were unequally expressed, suggesting presence of regulatory variants in the 3’ UTR. The polymorphism in the RIZ gene was strongly associated to BMD in pre- and postmenopausal women and in elderly men. The functional analyses included reporter constructs containing the RIZ polymorphic variants transfected in a cell line and its abilities in coactivating the ERα were examined. The variants were functionally different in coactivating the ERα-receptor complex. To summarize, the results of this thesis show novel evidence for functional relevant polymorphisms in candidate genes to human bone phenotypes. These polymorphisms may contribute to the variation seen in BMD and risk of fractures in the population.

Les thérapies ciblées ont amélioré la survie des patients atteints de mélanome cutané métastatique, toutefois certains patients échappent au traitement. La réponse au traitement met en jeu des paramètres dépendants du patient, de la biologie de la tumeur, et de la survenue de mécanismes de résistance largement étudiés.Le but de ce travail est d’étudier deux marqueurs mesurables en pratique clinique lors du suivi des patients, pour leur potentiel prédictif de réponse aux inhibiteurs de BRAF en monothérapie, l’un biologique et l’autre pharmacologique : la charge allélique mutée (CAM), définie par le rapport muté/total, des oncogènes BRAF et NRAS, et la concentration plasmatique de vemurafenib (CPV).Nous rapportons pour la première fois la prévalence et les mécanismes du déséquilibre allélique des oncogènes BRAF et NRAS, défini par une CAM élevée (>60%) ou faible (≤30%), par opposition à une CAM « hétérozygote » équilibrée (entre 30 et 60%). Des arguments in vitro et in vivo soutiennent l’hypothèse qu’une CAM BRAFV600E >60% puisse être associée à une meilleure réponse aux inhibiteurs de BRAF. La CAM de NRAS ne semble pas être un marqueur pronostique au moment du diagnostic de mélanome, toutefois sa valeur prédictive sur la réponse aux inhibiteurs de MEK sera intéressante à étudier.Nous montrons pour la première fois l’impact du dosage de la CPV lors du suivi des patients traités en monothérapie. Une CPV basse serait prédictive d’une progression ; ainsi, la CPV semble être un marqueur prédictif original de réponse, pour lequel la valeur seuil ainsi que les mécanismes pharmacogénétiques impliqués restent à déterminer. / Targeted therapies have improved survival in patients with metastatic cutaneous melanoma, but some patients escape treatment. Response to treatment involves parameters dependent of the patient, the tumor biology, and the occurrence of resistance mechanisms extensively investigated. The aim of this work is to study two measurable markers in clinical practice in patient monitoring, for their predictive potential of response to BRAF inhibitors monotherapy; the first one is biological and the other one is pharmacological: mutant allele burden (MAB), defined by the ratio mutant/total, of BRAF and NRAS oncogenes, and plasma vemurafenib concentration (PVC).We report for the first time the prevalence and the mechanisms of BRAF and NRAS oncogenic allelic imbalance, defined by a high (>60%) or a low (≤30%) MAB, as opposed to a balanced “heterozygous” MAB (30 to 60%). In vitro experiments and in vivo data support the hypothesis that a BRAFV600E MAB >60% may be associated with a better response to BRAF inhibitors. NRAS MAB does not seem to be a baseline prognostic marker, but its predictive value of response to MEK inhibitors will be interesting to investigate.We demonstrated for the first time the impact of CPV assay during the monitoring of patients treated with monotherapy. A low CPV would be predictive of progression; thus, CPV appears to be an original predictive marker of response, for which the threshold value and the involved pharmacogenetic mechanisms remain to be determined.

En 1975, Wilson et King ont proposé que l'évolution opère non seulement via des changements affectant la structure des protéines, mais aussi via des mutations qui modifient la régulation génétique. L'étude des éléments régulateurs de l'expression génétique a un rôle important dans la compréhension de l'expression de différentes maladies et de la réponse thérapeutique. Nous avons développé un algorithme bio- informatique qui nous permet rapidement de trouver des sites de régulation génétique à travers tout le génome et pour une grande quantité de gènes. Notre approche consiste à trouver des sites polymorphes (SNPs) qui sont en déséquilibre de liaison avec le débalancement allélique (AI) afin de cartographier la région régulatrice et le site responsable. Notre méthode est avantageuse par rapport à d'autres méthodes, car elle n'a pas besoin des données « phasées». De plus, les données de débalancement allélique ne sont pas affectées par des facteurs externes étant donné qu'ils sont mesurés dans la même cellule. Nous avons démontré que notre approche est fiable et qu'elle peut détecter des sites loin du gène. De plus, il peut être appliqué à des données de génotypage sans avoir besoin de les « phaser » . / Wilson and King (1975) proposed that evolution frequently operates through mutations affecting genetic regulation. Likewise, it is expected that genetic variation responsible for inter-individual differences will be due to variation in regulatory sites. Identifying such sites is thus important in the genetic and medical research. We have developed a new bioinformatics algorithm to find genome-wide regulatory sites for a big number of genes. Individuals carrying different alleles at a regulatory site will exhibit allelic imbalance(AI) due to differential expression of the two copies the same locus. Our approach consists of searching polymorphic sites (SNPs) in linkage disequilibrium with AI in order to map regulatory regions. We have detected many SNPs associated to the regulation of different genes pointed in previous studies. We have also found regulatory regions far from the transcription start site (TSS). The major advantage of this method is that phased data is not needed. In addition, AI data has the benefit of not being affected by external factors since it is measured in the same cell. The results show that our approach is reliable and it can detect sites far from the gene.

La prise en charge du mélanome métastatique a été bouleversée par les thérapies ciblées comme les inhibiteurs de RAF (RAFi) et les inhibiteurs de MEK (MEKi). Les RAFi permettent dans le mélanome BRAF V600 muté d’améliorer la survie mais leur effet est limité en monothérapie par l’hyperactivation paradoxale de la voie des MAPK dans les cellules non BRAF V600 mutée qui est responsable de l’apparition de mélanomes primitifs induits. Dans ce travail nous montrons la différence entre les modifications transcriptomiques induites par les RAFi dans des lignées cellulaires de mélanome BRAF mutées par rapport à celles induites dans des lignées non BRAF mutées ce qui a permis d’identifier des gènes potentiellement impliqués dans le développement de mélanomes induits. L’efficacité des RAFi est également limitée dans le temps par la survenue de résistances acquises. Nous montrons qu’une charge allélique mutée (CAM) de BRAF V600 élevée est potentiellement associée à une bonne réponse au traitement par RAFi et que la plasticité cellulaire induite par ZEB1 est associée à la résistance aux RAFi. Il n’existe pour le moment pas de thérapie ciblée approuvée dans le mélanome métastatique NRAS muté. Les MEKi sont limités par des résistances qui ne leur ont pas permis d’améliorer significativement la survie des patients. Nous montrons qu’une amplification de NRAS et la mutation MEK P124L sont responsables de résistance aux MEKi dans le mélanome NRAS muté. Nous avons testé le tramétinib (MEKi) en association avec d’autres thérapies ciblées dans des PDX de mélanome NRAS muté afin de mettre en évidence des combinaisons qui améliorent l’efficacité anti tumorale des MEKi dans cette indication / Targeted therapies like RAF inhibitors (RAFi) and MEK inhibitors (MEKi) have completely changed the therapeutic landscape in metastatic melanome. RAFi offer increased survival in patients with BRAF V600 mutated metastatic melanoma but they are limited in their use as single agents by an hyperactivation of the MAPK signaling pathway in non BRAF mutated cells that is responsible for the developpement of treatment induced primary melanomas. In this work we show the differences in the transcriptomic modifications induced by RAF inhibitos in BRAF mutated melanoma cell lines and NRAS mutated cell lines and we identified potential genes implicated in the development of treatment induced melanomas. The anti-tumor efficacity of RAFi is also limited by the acquired resistances that appear after several months of treatment. We show that a high BRAF V600E mutant allelic burden is potentially associated with a good response to RAFi and that ZEB1 induced cell plasticity is responsible for resistance to RAFi. No targeted therapy is approuved for NRAS mutated melanoma. Innate and acquired resistances limit the developpment of MEKi in this setting. We show that NRAS amplification and a MEK P124L mutation are responsible for resistance in NRAS melanoma. Finally, we tested five targeted therapies in combination with trametinib in NRAS mutated PDXs to identify combinations that improve the anti-tumoral effect of MEKi in this setting

<p>In this thesis, the four-color fluorescence tag-microarray minisequencing system pioneered by our group was further developed and applied for analysing genetic variation in human DNA and RNA. A SNP marker panel representing different chromosomal regions was established and used for identification of informative SNP markers for monitoring chimerism after stem cell transplantation (SCT). The success of SCT was monitored by measuring the allelic ratios of informative SNPs in follow-up samples from nine patients with leukaemia. The results agreed with data obtained using microsatellite markers. Further the same SNP marker panel was used for evaluation of two whole genome amplification methods, primer extension preamplification (PEP) and multiple displacement amplification (MDA) in comparison with genomic DNA with respect to SNP genotyping success and accuracy in tag-array minisequencing. Identical results were obtained from MDA products and genomic DNA.</p><p>The tag-microarray minisequencing system was also established for multiplexed quantification of imbalanced expression of SNP alleles. Two endothelial cell lines and a panel of ten coding SNPs in five genes were used as model system. Six heterozygous SNPs were genotyped in RNA (cDNA) from the cell lines. Comparison of the relative amounts of the SNPs alleles in cDNA to heterozygote SNPs in genomic DNA displayed four SNPs with significant imbalanced expression between the SNP alleles. Finally, the tag-array minisequencing system was modified for detection of splice variants in mRNA from five leukaemia cell lines. A panel of 20 cancer-related genes with 74 alternatively splice variants was screened. Over half of the splice variants were detected in the cell lines, and similar alternative splicing patterns were observed in each cell line. The results were verified by size analysis of the PCR product subjected to the minisequencing primer extension reaction. The data from both methods agreed well, evidencing for a high sensitivity of our system.</p>

In this thesis, the four-color fluorescence tag-microarray minisequencing system pioneered by our group was further developed and applied for analysing genetic variation in human DNA and RNA. A SNP marker panel representing different chromosomal regions was established and used for identification of informative SNP markers for monitoring chimerism after stem cell transplantation (SCT). The success of SCT was monitored by measuring the allelic ratios of informative SNPs in follow-up samples from nine patients with leukaemia. The results agreed with data obtained using microsatellite markers. Further the same SNP marker panel was used for evaluation of two whole genome amplification methods, primer extension preamplification (PEP) and multiple displacement amplification (MDA) in comparison with genomic DNA with respect to SNP genotyping success and accuracy in tag-array minisequencing. Identical results were obtained from MDA products and genomic DNA. The tag-microarray minisequencing system was also established for multiplexed quantification of imbalanced expression of SNP alleles. Two endothelial cell lines and a panel of ten coding SNPs in five genes were used as model system. Six heterozygous SNPs were genotyped in RNA (cDNA) from the cell lines. Comparison of the relative amounts of the SNPs alleles in cDNA to heterozygote SNPs in genomic DNA displayed four SNPs with significant imbalanced expression between the SNP alleles. Finally, the tag-array minisequencing system was modified for detection of splice variants in mRNA from five leukaemia cell lines. A panel of 20 cancer-related genes with 74 alternatively splice variants was screened. Over half of the splice variants were detected in the cell lines, and similar alternative splicing patterns were observed in each cell line. The results were verified by size analysis of the PCR product subjected to the minisequencing primer extension reaction. The data from both methods agreed well, evidencing for a high sensitivity of our system.

En 1975, Wilson et King ont proposé que l'évolution opère non seulement via des changements affectant la structure des protéines, mais aussi via des mutations qui modifient la régulation génétique. L'étude des éléments régulateurs de l'expression génétique a un rôle important dans la compréhension de l'expression de différentes maladies et de la réponse thérapeutique. Nous avons développé un algorithme bio- informatique qui nous permet rapidement de trouver des sites de régulation génétique à travers tout le génome et pour une grande quantité de gènes. Notre approche consiste à trouver des sites polymorphes (SNPs) qui sont en déséquilibre de liaison avec le débalancement allélique (AI) afin de cartographier la région régulatrice et le site responsable. Notre méthode est avantageuse par rapport à d'autres méthodes, car elle n'a pas besoin des données « phasées». De plus, les données de débalancement allélique ne sont pas affectées par des facteurs externes étant donné qu'ils sont mesurés dans la même cellule. Nous avons démontré que notre approche est fiable et qu'elle peut détecter des sites loin du gène. De plus, il peut être appliqué à des données de génotypage sans avoir besoin de les « phaser » . / Wilson and King (1975) proposed that evolution frequently operates through mutations affecting genetic regulation. Likewise, it is expected that genetic variation responsible for inter-individual differences will be due to variation in regulatory sites. Identifying such sites is thus important in the genetic and medical research. We have developed a new bioinformatics algorithm to find genome-wide regulatory sites for a big number of genes. Individuals carrying different alleles at a regulatory site will exhibit allelic imbalance(AI) due to differential expression of the two copies the same locus. Our approach consists of searching polymorphic sites (SNPs) in linkage disequilibrium with AI in order to map regulatory regions. We have detected many SNPs associated to the regulation of different genes pointed in previous studies. We have also found regulatory regions far from the transcription start site (TSS). The major advantage of this method is that phased data is not needed. In addition, AI data has the benefit of not being affected by external factors since it is measured in the same cell. The results show that our approach is reliable and it can detect sites far from the gene.

Genetic variation is a strong risk factor for many human diseases, including diabetes, cancer, cardiovascular disease, depression, autoimmunity and asthma. Most of the disease genes identified so far alter the amino acid sequences of encoded proteins. However, a significant number of genetic variants affecting complex diseases may alter the regulation of gene transcription. The map of the regulatory elements in the human genome is still to a large extent unknown, and it remains a challenge to separate the functional regulatory genetic variations from linked neutral variations. The objective of this thesis was to develop methods for the identification of genetic variation with a potential to affect the transcriptional regulation of human genes, and to analyze potential regulatory polymorphisms in the CD36 glycoprotein, a candidate gene for cardiovascular disease. An in silico tool for the prediction of regulatory polymorphisms in human genes was implemented and is available at www.cisreg.ca/RAVEN. The tool was evaluated using experimentally verified regulatory single nucleotide polymorphisms (SNPs) collected from the scientific literature, and tested in combination with experimental detection of allele specific expression of target genes (allelic imbalance). Regulatory SNPs were shown to be located in evolutionary conserved regions more often than background SNPs, but predicted transcription factor binding sites were unable to enrich for regulatory SNPs unless additional information linking transcription factors with the target genes were available. The in silico tool was applied to the CD36 glycoprotein, a candidate gene for cardiovascular disease. Potential regulatory SNPs in the alternative promoters of this gene were identified and evaluated in vitro and in vivo using a clinical study for coronary artery disease. We observed association to the plasma concentrations of inflammation markers (serum amyloid A protein and C-reactive protein) in myocardial infarction patients, which highlights the need for further analyses of potential regulatory polymorphisms in this gene. Taken together, this thesis describes an in silico approach to identify putative regulatory polymorphisms which can be useful for directing limited laboratory resources to the polymorphisms most likely to have a phenotypic effect.