Les subtélomères forment la transition entre les séquences spécifiques des chromosomes et les répétitions télomériques terminales. Ils semblent capables d’influencer les fonctions télomériques mais les connaissances sur les mécanismes mis en jeu sont encore limitées. Les subtélomères sont pourtant associés à de nombreuses pathologies comme la myopathie facio-scapulo-humérale (FSHD), une dystrophie musculaire secondaire à la contraction de répétitions macrosatellites D4Z4 dans la région subtélomérique 4q35. Afin d’étudier les propriétés de la séquence subtélomérique D4Z4, nous avons créé des constructions reproduisant l’organisation génomique au locus 4q35. Nous avons montré que D4Z4 est capable d’adresser un télomère à la périphérie du noyau. Cette activité est couplée à une activité insulatrice au niveau d’une séquence proximale de 80 pb et est dépendante de CTCF et des Lamines A. De plus, la relocalisation périphérique d’un télomère par D4Z4 s’accompagne d’une réplication plus tardive de celui-ci. Par ailleurs, la recherche de séquences capables de s’opposer à l’effet de position télomérique (TPE) a identifié un élément de 30 pb contenant un site CTCF dans la séquence insulatrice proximale de D4Z4. De même,   l’introduction d’un signal de poly-adénylation entre un gène rapporteur et les répétitions télomériques interfère avec le TPE et est accompagnée d’une diminution d’un transcrit hybride contenant le gène rapporteur et des répétitions télomériques, suggérant un rôle des transcrits télomériques TERRAs dans la régulation du TPE. En conclusion, ce travail a permis de caractériser l’implication de séquences subtélomériques, et notamment D4Z4, dans la régulation des télomères, leur compartimentalisation nucléaire, la réplication ou l’effet de position télomérique. De plus, il apporte un éclairage nouveau sur la physiopathologie de la FSHD et ouvre des perspectives dans la compréhension d’autres pathologies liées aux subtélomères. / Subtelomeres form the transition between chromosome specific sequences and terminal telomeric repeats. They might influence telomeric functions but underlying mechanisms are still unclear. Nevertheless, subtelomeres are associated with a number of human pathologies such as facioscapulohumeral muscular dystrophy (FSHD), an autosomal dominant disease secondary to the contraction of an array of D4Z4 macrosatellite repeats in the subtelomeric region 4q35. In order to study the biological function of the D4Z4 sequence, we created contructs that mimic the genomic organization of the 4q35 locus. We showed that D4Z4 is able to localize a telomere at the nuclear periphery. This perinuclear activity was dependant on interactions with CTCF and A type lamins and lied within a 80 bp proximal sequence that harbors an insulator activity. Moreover, the peripheral positionning of a telomere by D4Z4 is accompanied by a late replication timing of the telomere. We also searched for sequences able to counteract telomeric position effect (TPE) and identified a 30 bp element containing a CTCF binding site in the proximal region of D4Z4. In another construct, the introduction of a poly-adenylation signal between a reporter gene and telomeric repeats counteracted TPE. This effect is accompanied by the production of a hybrid transcript encompassing the reporter gene and telomeric repeats, suggesting a role for the TERRAs telomeric transcripts in TPE regulation. This work contibuted to characterize the role of subtelomeric sequences, especially the D4Z4 macrosatellite, in telomere regulation, their nuclear compartimentalization, their replication or the telomeric position effect. We will discuss the implications in the understanding of the pathophysiology of FSHD and other subtelomeric diseases.

The purpose of the present study was to examine if childhood sexual abuse (CSA) was associated with decreases in mean telomere length (TL), and if social support and/or optimism moderated this association. The study included 99 Caucasian female monozygotic twins, ranging in age from 19-48 (Mage = 30.5, SD = 7.8) at Time 1. Linear mixed effects models were employed to test study hypotheses. Analyses with all participants did not detect an effect of CSA exposure or severity on mean TL, nor were there effects with optimism. However, in analyses that only included women exposed to abuse, increases in social support were associated with increases in mean TL. Further, for women who experienced non-genital abuse, social support was positively associated with mean TL. Findings from the current study clarify the role of CSA in telomere attrition, and factors that may protect against the negative biological effects of CSA.

The G-quadruplex DNA is a four-stranded DNA structure that is highly susceptible to oxidation due to its G-rich sequence and its structure. Oxidative DNA base damages can be mutagenic or lethal to cells if they are left unrepaired. The base excision repair (BER) pathway is the predominant pathway for repair of oxidized DNA bases. DNA glycosylases are the first enzymes in BER and are responsible for removing base lesions from DNA. How DNA glycosylases remove base lesions from duplex and single-stranded DNA has been intensively studied, while how they act on G-quadruplex DNA remains to be explored. In Chapter II of this dissertation, we studied the glycosylase activity of the five mammalian DNA glycosylases (OGG1, NTH1, NEIL1, NEIL2 and mouse Neil3) on G-quadruplex DNA formed by telomere sequences that contain a single base lesion. We found that telomeric sequences that contain thymine glycol (Tg), 8-oxo-7,8-dihydroguanine (8-oxoG), guanidinohydantoin (Gh) or spiroiminodihydantoin (Sp) all formed the basket form of an antiparallel G-quadruplex DNA structure in Na+ solution. We also showed that no glycosylase was able to remove 8-oxoG from quadruplex DNA, while its further oxidation products, Sp and Gh, were good substrates for mNeil3 and NEIL1 in quadruplex DNA. In addition, mNeil3 is the only enzyme that removes Tg from quadruplex DNA and the glycosylase strongly prefers Tg in the telomere sequence context in both single-stranded and double-stranded DNA. In Chapter III, we extended our study to telomeric G-quadruplex DNA in K+ solution and we also studied quadruplex DNA formed by promoter sequences. We found that 8-oxoG, Gh and Sp reduce the thermostability and alter the folding of telomeric quadruplex DNA in a location-dependent manner. Also, the NEIL1 and NEIL3 DNA glycosylases are able to remove hydantoin lesions but none of the glycosylases, including OGG1, are able to remove 8-oxoG from telomeric quadruplex DNA in K+ solution. Interestingly, NEIL1 or NEIL3 do not efficiently remove hydantoin lesions at the site that is most prone to oxidation in quadruplex DNA. However, hydantoin lesions at the same site in quadruplex DNA are removed much more rapidly by NEIL1, NEIL2 and NEIL3, when an extra telomere TTAGGG repeat is added to the commonly studied four-repeat quadruplex DNA to make it a five-repeat telomere quadruplex DNA. We also show that APE1 cleaves furan in selected positions in Na+-coordinated telomeric quadruplex DNA structures. We use promoter sequences of the VEGF and c-MYC genes as models to study promoter G-quadruplex DNA structures, and show that the NEIL glycosylases primarily remove Gh from Na+-coordinated antiparallel quadruplex DNA but not from K+-coordinated parallel quadruplex DNA containing VEGF or c-MYC promoter sequences. Taken together, our data show that the NEIL DNA glycosylases may be involved in both telomere maintenance and gene regulation.

The primary study aim was to evaluate the latent biological effect of childhood sexual abuse (CSA) on adults by quantifying acquired cytogenetic changes and cortisol levels in identical twins who were discordant (N=22) or concordant (N=2) for a history of CSA. Although the difference scores for cortisol values between discordant identical co-twins were not significantly different from zero, a trend was observed for the twins exposed to intercourse, the most severe form of CSA, to have a blunted cortisol awakening response. Acquired cytogenetic changes were assessed by scoring telomere lengths and somatic cell abnormality frequencies via a cytokinesis-block micronucleus (MN) assay. No significant difference in overall telomere intensity values was observed between co-twins, but chromosome-specific telomere differences were observed in the individuals exposed to intercourse compared to their unabused co-twins ([χ2(45)= 62.88; p= 0.040 and χ2(45)= 73.72; p= 0.004). Specifically, shortened telomeres were observed on the short arms of chromosomes 3, 5, & 6, and long arms of chromosomes 11 & 13. A significant increase in MN frequencies was observed in the abused twins compared to unabused twins (t=2.65; df=16; p=0.009). A significant interaction between micronuclei frequencies and age was also observed, suggesting that the biological effects of stress are cumulative (coefficient [SE] = 0.030 [0.009]; p=0.0006). However, the pattern of chromatin present in MN, which was assessed using spectral karyotyping methodologies, was not limited to the subset of chromosomes with telomeric attrition. In summary, this is the first assessment of acquired chromosomal abnormalities, chromosome-specific telomere lengths and cortisol levels in identical adult twins discordant for exposure to CSA. Given that a portion of biological changes were most pronounced in the intercourse discordant twins, these findings support a possible dose-response relationship with CSA severity. Our data also suggest that the MN assay is a superior tool in assessing the latent effects of stress compared to either cortisol profiling or the measurement of telomere lengths. Collectively, application of the information gained from these studies may allow for novel screening techniques to identify individuals who are most at risk for developing stress-associated disease states.

Les télomères sont des structures nucléo-protéiques présentes à l'extrémité des chromosomes. Ils sont un des facteurs garant de la stabilité génomique. Ils assurent la protection des extrémités des chromosomes et leur entière réplication. Les dysfonctionnements du télomère sont impliqués dans la tumorigénèse et le vieillissement.Un des rôles majeurs des télomères est d'éviter que les extrémités des chromosomes ne soient reconnues comme des cassures double brin de l'ADN et traitées comme telles par la machinerie de réparation. Cependant, de nombreuses protéines impliquées dans la reconnaissance et le métabolisme des cassures double brin, comme la protéine Tel1 et le complexe MRX par exemple, sont présentes au niveau des télomères et participent au maintien de leur taille par la télomérase. En s'appuyant sur cette analogie, j'ai étudié le rôle télomérique de l'endonucléase Sae2 et de l'hélicase Sgs1, impliquées dans l'étape de dégradation du brin 5' qui précède la réparation des cassures double brin de l'ADN par recombinaison.Les rôles des protéines Sae2 et Sgs1 ont été étudiés sur les télomères natifs et sur les télomères érodés lors de la sénescence réplicative. L'ensemble de mes résultats suggèrent que, bien que les télomères érodés en absence de télomérase soient reconnus comme une cassure double brin de l'ADN et traités comme tels par les nucléases et hélicases, le rôle majeur de Sae2 et Sgs1 au niveau des télomères natifs serait de les protéger contre des recombinaisons illégitimes au cours de leur réplication. / Telomeres are nucleoprotein complexes that protect the extremities of linear chromosomes, avoiding end-to-end fusions and nucleolytic degradation of chromosome ends. The failure of cells to properly maintain telomeres can be an important source of chromosome instability involved in cancer progression and aging.A major role of telomeres is to prevent chromosome ends from being recognized as damage-induced double-strand DNA breaks (DSBs). However, many proteins involved in recognition and processing of DSBs are also involved in telomeres maintenance, like Tel1 and MRX. Based on this analogy, I have studied the role at telomeres of the role of the endonuclease Sae2 and the helicase Sgs1, two proteins that have a key function in the processing of DSBs through nucleolytic degradation of their 5' end.The role of protein Sae2 and Sgs1 has been studied at native and eroded telomeres. My results showed that eroded telomeres, in telomerase deficient cells, are recognized and resected as a double-strand break DNA by a set of nucleases and helicases including Sae2 and sgs1. In contrast, the main role of Sae2 and Sgs1 at native telomeres would be to protect telomeres against illegitimate recombination during replication.

Le glioblastome, tumeur maligne des tissus astrocytaires, est de mauvais pronostic. Malgré un traitement standard invasif (chirurgie, radiochimiothérapie), la médiane de survie des patients n’excède pas 14 mois, essentiellement due à la récidive tumorale (radiorésistance des cellules résiduelles). L’hadronthérapie par ion carbone offre des atouts radiobiologiques importants : i) Balistique très précise (épargne les tissus sains), ii) Efficacité Biologique Relative (EBR) supérieure à la radiothérapie conventionnelle (augmentation de la dose possible), iii) Réponse indépendante de l’effet oxygène (tumeurs hypoxiques). L’hadronthérapie a montré des résultats prometteurs en traitement du glioblastome. Cependant, la rareté des centres offrant cette thérapeutique oblige les cliniciens à utiliser des marqueurs prédictifs de réponse à la radiothérapie conventionnelle afin de mieux orienter les patients diagnostiqués mauvais répondeur. L’homéostasie télomérique est connue pour moduler la radiosensibilité de différents types de cancer. Aussi, ce travail présente deux axes. D’une part, nous avons déterminé que la taille des télomères et l’expression de POT-1 (Protection Of Telomere1) peuvent être utilisées par les cliniciens pour diagnostiquer les patients mauvais répondeurs au traitement standard et ainsi les orienter vers l’hadronthérapie où leurs pronostics seraient meilleurs. D’autre part, nous avons montré qu’un traitement pharmacologique dirigé contre la télomérase (GRN163L, Geron Corp) pouvait améliorer les résultats de la radiothérapie conventionnelle sur un modèle in vivo de glioblastome humain chez la souris / Glioblastoma, high grade tumor of neuroepithelial tissue, is poor prognosis cancer. Despite an invasive standard treatment (surgery, radiochemotherapy), the overall survival of patients does not exceed 15 months, largely due to aggressive recurrence (radioresistance of residual cells). Hadrontherapy with Carbon ion beam have strong radiobiological arguments: i) high ballistic precision (save healthy tissues), ii) Relative Biological Efficiency (RBE) above conventional radiotherapy (dose escalation), iii) independent response of oxygen enhancement ratio (hypoxic tumors). Hadrontherapy have shown promising preliminary results in treatment of brain tumors. However, the rareness of health centers which purposed Handrontheray necessitates the use of predictive markers of resistance to conventional radiotherapy to address bad responder patient. Telomere homeostasis is also known to modulate radiosensitivity of different types of cancer. Thus, this work has two arms. On the one hand, we have shown that telomere length and POT1 (Protection Of Telomere1) level (RNA and protein) can be used by clinicians to diagnose bad responder of standard treatment and towards the hadrontherapy. On the other hand, we have shown that pharmacological treatment inhibitory of telomerase (GRN163L, Geron Corp) can improve the radiationinduced responses to conventional radiotherapy on human glioblastoma mice model

Le carcinome hépatocellulaire (HCC) est une tumeur de mauvais pronostic caractérisée, comme la plupart de cancers, par l'association paradoxale de télomères courts et d'une importante activité télomérase. Cette attrition télomérique joue un rôle central dans l'instabilité chromosomique à l'origine de la promotion et de l'évolution tumorale. Les premières causes d'HCC correspondent aux infections chroniques par les virus hépatotropes : virus de l'hépatite B (VHB) et virus de l'hépatite C (VHC). Dans une première étape nous avons disséqué les dérégulations télomériques dans les HCC et les cirrhoses liées au VHB, VHC ou encore à l'alcool. Nous avons observé que ces dérégulations sont acquises tôt, au stade prétumoral, et persistent au stade tumoral. Ces dérégulations sont spécifiques d'un carcinogène donné. Aux stades tardifs et tumoraux de l'infection par le VHB, les cellules hépatiques expriment fréquemment une protéine tronquée en partie C-terminale d'HBx ainsi que des formes réarrangées du gène PreS/S telle que PreS2. Dans une seconde étape nous avons trouvé qu'à l'opposé de la forme sauvage, HBx tronquée réprime hTERT, diminue l'activité télomérase, raccourcit les télomères, augmente la proportion de ponts anaphasiques et déclenche la sénescence de cellules primaires. Sachant qu'au stade tumoral les cellules transformées ré-expriment hTERT nous avons testé l'effet d'une coexpression de PreS2 et d'HBx tronquée et avons pu montrer que PreS2 contrecarrait l'effet répresseur d'HBx sur hTERT. Néanmoins de façon étonnante, PreS2 ne parvenait pas à rallonger les télomères en présence d'HBx tronquée. Les facteurs protégeant les télomères coopèrent avec la télomérase pour l'élongation et plusieurs de ces protéines sont par ailleurs impliquées dans la réparation des dommages à l'ADN. Nous avons trouvé qu'HBx tronquée modifiait spécifiquement l'expression de la plupart des protéines du télosome selon un patron connu pour inhiber l'effet de la télomérase. Nous avons montré que des dommages à l'ADN télomérique liés à l'incubation de cellules primaires avec la néocarcinostatine inhibaient l'élongation des télomères par hTERT. Ayant trouvé que PreS2 et HBx tronquée induisaient des dommages à l'ADN, nous proposons que cet effet explique l'impossibilité pour PreS2 d'allonger les télomères de cellules exprimant HBx tronquée / Among the numerous genetic defects that underly with hepatocarcinogenesis, telomere abnormalities seem to play a role both in tumor promotion and maintenance. Telomeres, the chromosome extremities, are protected by specific proteins, the Shelterin complex and by additional factors. Besides telomerase dysregulation, changes in the expression of these telomere factors have been observed in cancers. Herewe first tested the hypothesis that such dysregulations might occur in HCC with patterns depending onthe cause of HCC. For HBV-, HCV- and alcool-dependant HCC we found that telomeric dysregulations appear to be carcinogen-specific and occur early during the course of the disease and are persistent in the tumor. At the late stage of HBV-dependent disease and corresponding tumors, hepatocytes produce 3’ deleted mutants of HBx (3’DM HBx) but also a rearranged form of the PreS/S gene: PreS2. We then found that, unlike WT HBx, 3’ DM HBx repress hTERT transcription, decrease telomerase activity, shorten telomere length, increase anaphase bridges and trigger senescence in transfected primary cells. It’s well known that hTERT it re-expressed in tumors, so we tested PreS2 and 3’DM HBx transfection. We show that PreS2 counteracts 3’DM HBx effect on hTERT transcription and telomerase activity. However surprisingly PreS2 wasn’t able to elongate telomeres in 3’DM HBx expressing cells. Telomeric factors interact with telomerase allowing telomere elongation. Moreover many of these factors are implicated in DNA damage repair systems. We found that all Shelterin’s and some other telomeric factors’s expression in dyregulated in 3’DM HBx expressing cells. Moreover we show that neocarcinostatin dependent DNA damage in MRC5 primary cell prevent hTERT-based telomere elongation. Also finding that PreS2 and 3’DM induce DNA damage, we suggest that 3’DM HBx prevents PreS2 and hTERT- based telomere elongation

Imunossenescência, termo que designa o envelhecimento do sistema imune, contribui com o aumento das infecções, doença autoimune, câncer e baixa eficiência das vacinações, favorecendo o aumento da morbi-mortalidade entre os indivíduos idosos. Dentre as mudanças, destacam-se as alterações no tamanho da subpopulação de célula T, com aumento de células de memória e diminuição de células naive; no padrão de secreção de citocinas, na capacidade de replicação das células e na produção de anticorpos, as quais culminam em um estado pró-inflamatório chamado \'inflamm-aging\' e uma capacidade diminuída para responder a novos antígenos. Além disto, o acúmulo de linfócitos T CD8+CD28- nos idosos também se correlaciona com uma diminuição do controle sobre a infecção. No entanto, há poucos relatos sobre o papel do exercício regular na prevenção ou tratamento de imunossenescência. O objetivo deste estudo foi verificar os efeitos da atividade física intensa e regular na imunossenescência de idosos. Foram selecionados 15 indivíduos idosos em treinamento intenso de corrida (meia maratona e/ou maratona há pelo menos 5 anos, TI), e 16 indivíduos idosos não praticantes de atividade física, NT. Todos os indivíduos eram do sexo masculino, com idade entre 65 a 85 anos, apresentavam auto percepção de saúde positiva e ausência de co-morbidades e/ou em tratamento com impacto significativo para o sistema imune. Foram avaliadas as subpopulações de células T (CD8+CD28+ e CD8+CD28-; CD4+ naive e de memória) em relação ao comprimento de seus telômeros, resposta proliferativa e marcadores de apoptose, síntese de citocinas (Th1/Th2); níveis séricos de citocinas inflamatórias; frequência das subpopulações (naive, memória central, memória efetora e terminalmente diferenciada) dos linfócitos T CD4+ e CD8+ no sangue periférico e a quantificação da produção de anticorpos anti-Influenza. Verificamos no grupo TI, em relação ao NT, aumento de células TME e diminuição de TEMRA; maior proliferação de linfócitos T CD4+ naive estimulados com mitógeno; maior comprimento do telômero em linfócitos T CD3+, T CD3+CD8+ e T CD3+CD8+CD28-, esta última considerada subpopulação associada à imunossenescência; preservação dos mecanismos anti-apoptóricos, verificado pelo aumento da expressão in vitro de Bcl-2 e redução de caspase-3 em células TCD4+ (memória e naive) e T CD8+ (senescentes e não senescentes) não estimuladas; parâmetros estes denotando uma provável melhor capacidade funcional de células T. Além disso, verificamos aumento da produção sérica de títulos de anticorpos anti-influenza pré e pós-vacinação, evidenciando possível papel adjuvante do exercício intenso na resposta vacinal. E finalmente, observamos equivalência entre os dois grupos com relação ao padrão de secreção de citocinas séricas e secretadas in vitro associadas com o Inflammaging. Os resultados evidenciaram que a prática da atividade física intensa e regular teria um efeito protetor contra alguns parâmetros associados à imunossenescência / Immunosenescence, the term used to designate the process of aging of the immune system, is associated with to the increased rate of infections, autoimmune diseases, cancer and low efficiency of vaccinations in elderly, favoring their increased morbidity and mortality. Immunosenescence is associated with changes in the size of the T cell subpopulation with increased proportion of memory T cells and decrease proportion of naive T cells, in the pattern of cytokine secretion, in cell replication capability and in antibody production, all of which culminate in a pro-inflammatory state called \"inflamm-aging\" and diminished capacity to responding to new antigens. In addition, the accumulation of CD8+CD28- lymphocytes in elderly also correlates with a decreased control of infections. However, there are few reports on the role of chronic regular exercise in the prevention or treatment of immunosenescence. The objective of this study was to investigate the effects of intense regular physical activity on immunosenescence of elderly men. We selected 15 elderly men with intensive training for at least the last 5 years (IT, participating in half marathon and/or marathon), and 16 elderly men not training, NT. They were 65-85 years and had self perception of positive health and lack of co-morbidities and/or treatment with significant impact on the immune system. T-cell subpopulations were assessed (CD8+CD28+ and CD8+CD28-; CD4+ naive and memory) with respect to telomere length, proliferative responses, apoptosis markers, cytokine synthesis (Th1/Th2); serum levels of inflammatory cytokines; distribution of the naive, central memory, effector memory, and terminally differentiated CD4+ and CD8+ lymphocyte subpopulations in peripheral blood, and anti-influenza antibodies production. We found in the IT group, compared with the NT, in the T-cell subsets, increased percentages of effector memory T-cells and decreased percentages of terminally differentiated T-cells; higher proliferation of naive CD4+T cells stimulated with mitogen; larger telomere length in TCD3+, TCD3+CD8+ and TCD3+CD8+CD28- cells (the latter subset being a marker of immunosenescence), preservation of the anti-apoptotic mechanisms, indicated by increased Bcl-2 expression and decreased caspase-3 expression in in vitro resting memory and naive CD4+ T-cell and in senescent and non-senescent CD8+ T-cells; all of which denote a potentially better T-cell functioning. There was also increased anti-influenza antibody titers pre and post-vaccination, indicating a possible adjuvant role of intense exercise in vaccine responses. Finally there was a similar pattern between the two groups in in vitro secreted and in serum cytokines associated with Inflamm-aging. The results showed that the practice of regular intense physical activity has a protective effect against some parameters associated with immunosenescence

A fisiopatologia das síndromes de falência da medula óssea (FMO) está relacionada a mecanismos adquiridos de destruição das células-tronco hematopoeiticas na medula ou a defeitos constitucionais em genes fundamentais para o reparo do DNA e manutenção dos telômeros. A anemia aplástica (AA), o protótipo das doenças de FMO, pode ter etiologia adquirida ou constitucional. A avaliação genética de pacientes com AA adquirida tem como objetivo a detecção de mutações somáticas que possam ser usadas como marcadores de resposta ao tratamento imunossupressor. Diferentemente, em pacientes com AA constitucional, a avaliação genética é fundamental para detecção de mutações etiológicas na doença do paciente, sendo essencial para o tratamento e seleção de doadores de medula óssea. Contudo, o papel das mutações constitucionais na fisiopatologia e modulação imunológica da AA adquirida ainda não é conhecido. Neste estudo, nós sequenciamos pacientes com AA de duas coortes independentes utilizando diferentes painéis de sequenciamento de genes alvos. A primeira coorte, composta por 13 pacientes com AA adquirida, foi sequenciada utilizando um painel com 165 genes relacionados à FMO, neoplasias hematológicas, reparo de DNA, manutenção dos telômeros e vias de resposta imune. A segunda coorte, composta por 59 pacientes investigados para doença constitucional, foi sequenciada com um painel de sequenciamento comercial com 49 genes relacionados à FMO hereditária. Foram identificadas alterações potencialmente patogênicas em três dos cinco pacientes com AA adquirida que não responderam à imunossupressão: dois pacientes com variantes em TERT e um com uma variante em DHX36. Não foram identificadas variantes funcionalmente relevantes nos pacientes que responderam ao tratamento imunossupressor. Em contraste, foram identificadas variantes potencialmente patogênicas em RTEL1 em 8 pacientes com AA constitucional. Variantes em RTEL1 foram associadas tanto ao encurtamento telomérico quanto à erosão excessiva do 3\' overhang, independentemente do comprimento dos telômeros. Desse modo, apenas a medida do comprimento dos telômeros não foi suficiente para identificar todos ospacientes com disfunções teloméricas. As plataformas de sequenciamento de nova geração diminuíram o custo e o tempo para a avaliação genética dos pacientes com FMO. Em nosso estudo, os pacientes com AA adquirida não apresentaram um padrão genético associado à sua resposta ao tratamento com imunossupressores, no entanto, o sequenciamento da coorte com suspeita de AA constitucional foi capaz de identificar o defeito genético associado à doença do paciente em 40% dos casos. O uso de dados clínicos, investigação familiar, análises in silico e testes funcionais foram essenciais para uma correta interpretação da patogenicidade de novas variantes identificadas por sequenciamento de nova geração. / The pathophysiology of bone marrow failure (BMF) can be immune, as in acquired aplastic anemia (AA), or constitutional, due to germline mutations in genes critical for DNA repair and telomere maintenance. The genetic screening of patients with constitutional AA is performed to detect germline mutations that are etiologic in patients\' disease. That is critical for treatment decisions and to identify a donor for a bone marrow transplant. In acquired AA, the genetic screening has been used to detect somatic mutations that can predict patients\' outcomes after treatment, as the role of germline mutations in this disease is yet not clear. To investigate the role of germline variants in AA, we screened two independent cohorts with two different targeting sequencing panels; a first cohort composed by 13 patients with acquired AA that was screened using a panel with 165 genes related to BMF, hematologic malignancies, DNA repair, telomere maintenance, and immune response pathways. A second cohort composed of 59 patients suspected to have a constitutional disease screened by a commercial Inherited Bone Marrow Failure Sequencing panel. In our first cohort, while patients without functional relevant germline variants responded to immunosuppression treatment (n=8), three out of 5 nonresponder patients were identified with variants in telomere biology genes. We found patients carrying TERT and DHX36 variants. In our constitutional AA cohort, we identified 8 patients carrying variants in the RTEL1 gene, a helicase critical to telomere maintenance. RTEL1 variants associated with both patients\' overall telomere shortening and single-stranded 3\' overhang erosion independent of telomere length. Also, 3\' overhang erosion was associated with patients\' predisposition to clonal evolution. In this context, the variants identified in the helicases genes DHX36 and RTEL1 were both associated with patients\' normal telomere length and poor outcomes. Also, telomere length measurement alone was insufficient to identify all primary telomere defects. The platforms of next-generation sequencing decreased the cost and time for the genetic screening of patients with BMF. In our study, acquired AA patients did not display a clear genetic pattern associated with their immunosuppressive treatment response. In contrast, the sequencing of the cohort selected based on their suspicion to have an inherited diseaseidentified a molecular defect that might be pathogenic in up to 40% of patients, including the RTEL1 variants. Pathogenicity assessment of genetic variants requires a combination of clinical, in silico, and functional data required to avoid misinterpretation of common variants.

Thesis advisor: Clare O'Connor / Telomeres are repeated sequences at the ends of chromosomes, which promote chromosome stability by preventing the loss of necessary nucleotides from the DNA with successive rounds of replication. Telomeres are elongated by the enzyme telomerase, which has both a protein component and an RNA component. In the yeast Saccharomyces cerevisiae, the TLC1 gene encodes the RNA component of the enzyme. Telomerase RNA interacts with several proteins to perform its function, including the Ku protein, which binds to the end of the DNA and helps to recruit telomerase to the chromosome thereby facilitating the lengthening of chromosome ends. Ku interacts with telomerase RNA at the site of a 48-nucleotide stem-loop on the RNA's structure. Previous experiments have shown that yeast strains engineered to carry two copies of the TLCI gene exhibit higher levels of telomerase RNA than those that have only one copy of the gene. Also, a yeast strain carrying a copy of the mutant tlc1Δ48 gene, which contains a deletion of the 48-nucleotide stem-loop, contains lower levels of telomerase RNA than a strain with the wild type TLC1 gene. This series of experiments is investigating whether the copy number of the telomerase RNA gene affects the elongation of telomeres in S. cerevisiae. In order to determine this effect, the de novo telomere addition of four strains was examined, as were the native telomere lengths of these strains. The assay indicated that the efficiency of telomere elongation was unchanged by increasing the copy number of the wild type gene but was increased upon increasing the copy number of the mutant gene. Analysis of the native telomere lengths showed that increasing the copy number of either the wild type or the mutant gene allowed the cells to maintain their telomeres at a longer length. / Thesis (BS) — Boston College, 2008. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Biology. / Discipline: College Honors Program.