Journal
ELIFE
Volume 10, Issue -, Pages -Publisher
eLIFE SCIENCES PUBL LTD
DOI: 10.7554/eLife.67622
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Funding
- National Key R&D Program of China [2017YFE0103400]
- National Institutes of Health [EY028758, CA013696, EY030580, OD020351, EY027285, EY019007, EY018213, EY024698, EY026682, GM127652]
- Foundation Fighting Blindness [PPA-1218-0751-COLU]
- Schneeweiss Stem Cell Fund [SDHDOH01-C32590GG-3450000]
- Nancy Kobi Karp
- Crowley Family Funds
- Rosenbaum Family Foundation
- Alcon Research Institute
- Gebroe Family Foundation
- Research to Prevent Blindness
- Irma T. Hirschl/Monique WeillCaulier Trust
- Columbia University
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This study reveals that loss-of-function and gain-of-function mutations of the BEST1 gene in patients exhibit different requirements for mutant to wild-type molecule ratios, suggesting distinct epigenetic requirements in bestrophinopathy development. Furthermore, gain-of-function mutations have a strong dominant effect that impedes the restoration of BEST1-dependent Cl- currents in RPE cells by gene augmentation, unlike the rescue of loss-of-function mutations. It is also shown that gain-of-function mutations can be rescued by a combination of gene augmentation and CRISPR/Cas9-mediated knockdown of endogenous BEST1 expression, providing a universal treatment strategy for bestrophinopathy patients with different mutation types.
Genetic mutation of the human BEST1 gene, which encodes a Ca2+-activated Cl- channel (BEST1) predominantly expressed in retinal pigment epithelium (RPE), causes a spectrum of retinal degenerative disorders commonly known as bestrophinopathies. Previously, we showed that BEST1 plays an indispensable role in generating Ca2+-dependent Cl- currents in human RPE cells, and the deficiency of BEST1 function in patient-derived RPE is rescuable by gene augmentation (Li et al., 2017). Here, we report that BEST1 patient-derived loss-of-function and gain-of-function mutations require different mutant to wild-type (WT) molecule ratios for phenotypic manifestation, underlying their distinct epigenetic requirements in bestrophinopathy development, and suggesting that some of the previously classified autosomal dominant mutations actually behave in a dominant-negative manner. Importantly, the strong dominant effect of BEST1 gain-of-function mutations prohibits the restoration of BEST1-dependent Cl- currents in RPE cells by gene augmentation, in contrast to the efficient rescue of loss-of-function mutations via the same approach. Moreover, we demonstrate that gain-of-function mutations are rescuable by a combination of gene augmentation with CRISPR/Cas9-mediated knockdown of endogenous BEST1 expression, providing a universal treatment strategy for all bestrophinopathy patients regardless of their mutation types.
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