(American Journal of Pathology. 1999;154:635-647.)
© 1999 American Society for Investigative Pathology
Genomic Imprinting: Implications for Human Disease
J. Greg Falls*
,
David J. Pulford*
,
Andrew A. Wylie*
and
Randy L. Jirtle*
From the Department of Radiation Oncology,*
Duke
University Medical Center, Durham, North Carolina, and Department of
Safety of Medicines,
Zeneca Pharmaceuticals,
Ltd., Cheshire, United Kingdom
 |
Abstract
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Genomic imprinting refers to an epigenetic marking of genes that
results in monoallelic expression. This parent-of-origin dependent
phenomenon is a notable exception to the laws of Mendelian genetics.
Imprinted genes are intricately involved in fetal and behavioral
development. Consequently, abnormal expression of these genes
results in numerous human genetic disorders including carcinogenesis.
This paper reviews genomic imprinting and its role in human
disease. Additional information about imprinted genes can be found on
the Genomic Imprinting Website at
http://www.geneimprint.com.
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Introduction
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Genomic imprinting (also referred to as gametic or parental
imprinting) is the epigenetic marking of a gene based on its parental
origin that results in monoallelic expression. Genomic imprinting
differs from classical genetics in the sense that the parental
complement of imprinted genes are not equivalent with respect to their
expression, despite both parents contributing equally to the genetic
content of their progeny. The mechanism of imprinting is complex and
not completely understood; however, evidence suggests that the
"imprint mark" is a parental-specific methylation of CpG-rich
domains that is established during gametogenesis. The imprint marks on
a gene must be erasable in the germline when transmitted through
individuals of the opposite sex, but maintained during somatic cell
division (Figure 1)
.

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Figure 1. Imprint establishment and propagation during gametogenesis and
development. The paternal allele
(dashed line) is imprinted and the
maternal allele is expressed
(solid line). The "imprint
mark" (black box) represents a
parental-specific methylation established during gametogenesis.
A: The maternal and paternal genomes have different imprint
patterns following fertilization. B: Both "imprint marks"
and imprint reading are maintained during somatic cell division.
C: The parental specific imprints are erased in the primordial
germ cells. D: The appropriate "imprint marks" are
reestablished for the next generation.
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The total number of publications on genomic imprinting has increased
markedly over the past 10 years and has now reached almost 1500 (Figure 2)
. There are now more than 25 identified
imprinted genes (Table 1)
, and estimates
based on mouse models indicate that as many as 100 to 200 may
exist.1
Imprinted genes are involved in many aspects of
development including fetal and placental growth, cell proliferation,
and adult behavior. Consequently, alteration of normal imprinting
patterns gives rise to numerous human genetic diseases including
cancer. This review examines the role of genomic imprinting in several
human genetic diseases such as the Beckwith-Wiedemann, Prader-Willi,
and Angelman syndromes, as well as the evidence implicating genomic
imprinting in behavioral disorders and carcinogenesis. For excellent
reviews on the mechanistic models of genomic imprinting, consult Reik
and Walter,2
Constancia et al3, and
Barlow.4
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Background
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Genomic imprinting plays a critical
role in embryogenesis as evidenced by certain aberrations of human
pregnancy. The complete hydatidiform mole arises from the fertilization
of an anuclear egg either by a haploid sperm (followed by duplication
of the paternal genome) or two haploid sperm (diandric
diploidy).5
This trophoblastic disease is characterized by
a completely androgenetic (Ag) genome and results in reduced or absent
fetal growth coupled with hyperplastic extraembryonic
growth.6,7
In contrast, ovarian dermoid cysts arise from
the spontaneous activation of an ovarian oocyte resulting in the
duplication of the maternal genome.8
These abnormalities
indicate that normal human development proceeds only when a complete
complement of the paternal and maternal genomes is present.
Experimental evidence for the requirement of both the maternal and
paternal chromosomal complements was demonstrated through the
manipulation of mouse embryos.9,10
Mouse embryos were
altered in vitro to produce diploid Ag or diploid
parthenogenetic (Pg) embryos, possessing only paternal or maternal
chromosomes, respectively. Similarities to the human pregnancy
aberrations were apparent since Ag mouse embryos had reduced fetal
growth and proliferative extraembryonic growth while Pg embryos
maintained relatively normal fetal growth but exhibited poor
extraembryonic growth. Neither Ag nor Pg embryos were viable to
term.9,10
This demonstrates that genes expressed
exclusively from one parental genome exist, and abnormal embryonic
development results from the loss of function of these monoallelically
expressed genes. A mark or imprint conferring parental memory must
therefore differentiate between the parental genomes, be present on the
parental chromosomes through cell division, and be inheritable. This
was confirmed when nuclei from early haploid preimplantation embryos
were transplanted into fertilized eggs following the removal of one
pronucleus. The embryo was viable only if the sex of the donor nucleus
was opposite that of the remaining pronucleus.11
The chromosomal regions responsible for the genomic imprinting effects
observed in mouse embryos were mapped to specific mouse chromosomes by
artificially generating uniparental disomies (UPD) in mice. Certain
regions of distinct chromosomes were responsible for markedly different
phenotypes ranging from embryonic lethality to various growth and
developmental defects apparent only after birth. These effects were
dependent on whether the two copies were inherited entirely from one
parent, resulting in either duplication or deficiency of genes in these
chromosomal regions.12-14
It was initially postulated that
only mouse chromosomes 2, 6, 7, 11, 12, and 17 harbored imprinted
chromosomal regions.15
However, there are now reports of
other chromosomes either containing more localized areas of genomic
imprinting or harboring genes that show more subtle imprinted effects.
UPD also results in phenotypic abnormalities in humans. These include
maternal UPD for chromosomes 2, 7, 14, 15, and 16, and paternal UPD for
chromosomes 6, 11, 14, 15, and 20.16
Classic examples of
diseases associated with regional maternal and paternal UPD on
chromosome 15 include the Prader-Willi syndrome and Angelman syndrome,
respectively. Investigations of these genetic diseases are now helping
to elucidate the mechanisms of genomic imprinting in humans.
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Imprinting of Specific Genes
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The first endogenous imprinted gene identified was mouse
insulin-like growth factor 2 (Igf2), which
encodes for a critical fetal-specific growth factor. A targeted
mutation in Igf2 gave rise to a heterozygous dwarfing
phenotype when the mutation was passed from the father while the
offspring were normal when the mutation was inherited from the
mother.17
Furthermore, the dwarfing phenotype was observed
in paternal heterozygotes and homozygotes suggesting that
Igf2 gene expression is exclusively from the paternal
allele. At about the same time, the mannose 6-phosphate/insulin-like
growth factor type 2 receptor (M6p/Igf2r) gene was
shown to be imprinted and maternally expressed in mice.18
Interestingly, the products of these oppositely imprinted genes
interact at the biochemical level since the degradation of
Igf2 occurs via the M6p/Igf2r.19
When
a mutation was targeted to the M6p/Igf2r in mice, maternal
heterozygotes or homozygotes showed a 30% increase in fetal growth,
but they were not viable at birth.20
Thus, the reciprocally
imprinted Igf2 and M6p/Igf2r genes both play an
important role in regulating embryonic development and fetal
growth.17,20
Numerous techniques have now been used to identify additional imprinted
genes. Positional cloning coupled with candidate gene testing has
identified novel human imprinted genes located in imprinted clusters at
chromosome positions 11p15.5 and 15q11-q13. Techniques have also used
parental differences in DNA methylation and expression to identify
imprinted genes. Subtractive hybridization or differential display
using cDNA from Pg, Ag, and fertilized embryos have yielded novel
imprinted genes such as Peg1/Mest, a mesoderm restricted
hydrolase at mouse chromosome 6; Peg3, a novel zinc-finger
protein on proximal mouse chromosome 7; and Peg5/Nnat
located on mouse chromosome 2.21-23
The Grf1
and U2afl-rs1 imprinted genes were identified by a
genome-wide screen termed restriction landmark genome screening
(RLGS).24,25
Finally, three GABAA receptor subunit genes
(GABRB3, GABRA5, and GABRG3)
were shown to be exclusively expressed from the paternal allele by
microcell-mediated chromosome transfer.26
More recently,
results from a somatic-cell hybrid system indicated that these receptor
subunit genes were not imprinted.27
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Characteristics of Imprinted Genes
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Several theories have been proposed for the endogenous
function of genomic imprinting. Moore and Haig28
have
suggested that genomic imprinting in mammals has evolved from a
conflict of interest between the paternal and maternal genome in
regulating fetal growth. Whereas benefits of a large placenta and fetus
might ensure future propagation of a paternal line, the result may tax
the resources of the mother, thereby compromising future pregnancies.
Conversely, if fetal and placental growth is held in check, more
offspring from the mother's (and possibly different father's)
lineage may be produced. Accordingly, the mother would be predicted to
imprint or silence genes that promote placental and fetal growth,
whereas the father would imprint genes that inhibit growth.
In support of this theory, the gene encoding the fetal growth factor,
Igf2, is maternally imprinted, whereas H19, which
encodes for an untranslated RNA involved in silencing Igf2
expression, is paternally imprinted.17,29,30
The result of
this reciprocal imprinting is parent-of-origin, monoallelic paternal
expression of the gene encoding for Igf2. Interestingly, the genes that
encode for the M6p/Igf2r which degrades Igf2, and Meg1/Grb10 which
inhibits Igf2 signaling are both paternally imprinted, adding further
support for this theory.18,19,31
An alternative proposal for imprinting suggests that the cytosine
methylation involved in imprint regulation evolved as a defense
mechanism for the inactivation of parasitic sequences such as
transposable elements and proviral DNA.32
This is supported
by the finding that 5-aza-deoxycytidine, an inhibitor of cytosine DNA
methyltransferase, activates silent retroviruses.33
Irrespective of the reason for the evolution of genomic imprinting in
mammals, the functional consequences of genomic imprinting include the
inhibition of parthenogenesis and the loss of protection from
deleterious recessive mutations.
As more imprinted genes are identified, the characteristics of
imprinting are becoming apparent. For example, two chromosomal regions
harbor more than one imprinted gene. These imprinting clusters reside
at human chromosome 11p15.5 (syntenic to the distal region of mouse
chromosome 7) and human chromosome 15q11-q13 (syntenic to the central
region of mouse chromosome 7). Within these imprinted gene clusters,
genes have been identified that encode for untranslated
RNA34,35
and antisense RNA36,37
that may be
involved in imprint control. Some imprinted genes, such as
H19 and IGF2, that are located in imprinted
clusters show coordinate regulation. Imprinted genes also often reside
in chromosomal regions that undergo asynchronous
replication,38,39
and the meiotic recombination frequencies
in these regions may differ between the male and female germ
cells.40
Another characteristic of imprinted genes is an
associated allele-specific DNA methylation of cytosine residues in CpG
dinucleotides that appears to distinguish the parental
alleles.41-43
Repetitive elements associated with the
areas of differential methylation have also been identified in several
imprinted genes (ie, H19, M6p/Igf2r,
U2afbp-rs, and
p57KIP2).44-48
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Imprinting in Genetic Diseases
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Beckwith-Wiedemann Syndrome
There are a number of human genetic diseases associated with
imprinting defects (reviewed in 49 and 50
). Beckwith-Wiedemann
syndrome (BWS) maps to 11p15 and is characterized by general
overgrowth with symptoms including hemihypertrophy, macroglossia,
and visceromegaly. Genomic imprinting in BWS was first suspected when
preferential maternal transmission of mutations was observed in some
BWS families.51
Additionally, approximately 1020% of BWS
individuals are predisposed to embryonal tumors, the most frequent of
which are Wilms' tumors and adenocortical carcinoma.52
The
rate of Wilms' tumor formation in the BWS population is 1000-fold
higher than in the normal population, and these tumors often show
preferential loss of maternal 11p15.53
The majority of BWS
cases arise sporadically; however, in both sporadic and familial forms,
a small percentage exhibits UPD at chromosome 11p15. In these cases,
the remainder of the chromosome is biparental in inheritance,
indicative of somatic mosaicism through a postfertilization mitotic
recombination event.54,55
The most common molecular event occurring in BWS patients that do not
have cytogenetic abnormalities is the biallelic expression of
IGF2 due to loss of imprinting (LOI).56,57
LOI
at the IGF2 locus may be accompanied by the methylation
and/or silencing of the active maternal allele of
H19.58,59
This H19-dependent event is
consistent with an enhancer-competition model for the co-regulation of
these genes.60
Translocations in BWS patients may also lead to LOI at the
IGF2 locus, but without loss of H19
imprinting.61
These translocations affect imprinting by
disrupting a gene involved in imprint control, or by altering the
function of an imprinting center (IC). Therefore, disruption of
IGF2 imprinting in BWS may also occur via an
H19-independent event.56,57
The imprinted
KvLQT1 gene located centromeric to IGF2 spans a
common breakpoint region in BWS, and has been proposed to maintain
regional imprint control at 11p15.5.60
KvLQT1
shows preferential expression from the maternal allele in most tissues
examined except the heart where it is biallelically
expressed.62
This explains why KvLQT1,
responsible for the autosomal dominant cardiac arrhythmia long QT
syndrome, shows no parent-of-origin effect in this disorder. The
maternally expressed p57KIP2, which encodes for
a cyclin-dependent kinase inhibitor, also maps to 11p15.5. Abnormal
imprinting and epigenetic silencing of p57KIP2
is found in some individuals with BWS,63
and mutations are
present in about 5% of BWS patients.64-66
To date, ten imprinted genes have been mapped to 11p15.5 (Table 1)
.
Flanking these imprinted genes are the non-imprinted NAP2
(centromeric border) and L23MRP (telomeric border)
genes.67
The syntenic region in the mouse, distal
chromosome 7, confirms the existence of an imprinting cluster at this
chromosomal location.68
A possible explanation for the
involvement of multiple genes in BWS (even if IGF2
overexpression is directly responsible for BWS) is that one or more of
the adjacent genes (eg, H19, p57KIP2,
KvLQT1) are involved in the regulation of IGF2
expression. Experimental evidence supports this postulate since
transgenic mice that overexpress Igf2 develop symptoms
similar to BWS.69
Prader-Willi and Angelman Syndromes
Two clinically distinct genetic diseases associated with genomic
imprinting on chromosome 15q11-q13 are the Prader-Willi syndrome (PWS)
and the Angelman syndrome (AS). Each syndrome is associated with
deficiencies in sexual development and growth, and behavioral and
mental problems including retardation.70,71
Major
diagnostic criteria for PWS patients include hypotonia, hyperphagia and
obesity, hypogonadism and developmental delay.72
AS
patients often display ataxia, tremulousness, sleep disorders,
seizures, and hyperactivity. Severe mental retardation accompanied with
a lack of speech may also be present, but AS individuals often display
a happy disposition with outbreaks of laughter.73
PWS and AS are autosomal dominant disorders showing parent-of-origin
effects since the inherited diseases are transmitted from only one of
the parents. Approximately 70% of PWS and AS individuals have a
de novo 3- to 4-megabase deletion in their paternal or
maternal chromosome 15q11-q13, respectively. Maternal UPD occurs in
most of the remaining PWS patients (25%); however, paternal UPD only
occurs in about 4% of AS patients.16,74
The preferential
loss of parental alleles associated with different phenotypes, coupled
with the instances of UPD indicate the involvement of imprinted genes
(ie, paternally expressed gene(s) for PWS and maternally expressed
gene(s) for AS).70
Recently, approximately 20% of the AS
patients without a chromosomal deletion were found to have truncating
mutations in UBE3A, a gene encoding a ubiquitin protein
ligase involved in protein turnover.75,76
UBE3A,
mapped to 15q11-q13, has now been reported to be maternally expressed
in the human brain.77,78
Thus, abnormalities in the
maternal-specific expression of UBE3A during brain
development has been proposed for AS.79
This region also
harbors four imprinted, paternally expressed candidate PWS genes: small
nuclear riboprotein-associated polypeptide N (SNRPN),
Imprinted in Prader-Willi (IPW), zinc finger 127
(ZNF127), and necdin
(NDN).35,80-82
The imprinted,
paternally expressed transcripts of PAR1,
PAR5, and PAR-SN may also be involved in PWS.
Imprinting defects resulting from microdeletions targeted to the
SNRPN gene have been identified in a small percentage of PWS
patients that maintain both parental complements of
15q11-q13.80,83,84
These deletions alter SNRPN
promoter methylation and prevent expression of its paternal allele.
This results in the silencing of other paternally expressed genes in
the cluster.83,85
These microdeletions apparently disrupt
an imprinting center85
involved in resetting the correct
imprinting pattern during gametogenesis.84,85
The alternate
use of SNRPN transcripts (BD exons) may be involved in the
normal imprinting process.86
Offspring inheriting
microdeletions from their mother exhibit no apparent phenotype;
however, a subsequent paternal transmission results in PWS. In
comparison, a small percentage of AS patients have similar
microdeletions in the SNRPN gene (albeit in a region farther
upstream) that disrupt the resetting of the imprinting pattern. In this
case, progeny inheriting paternal microdeletions do not develop AS, but
maternal transmission to offspring results in AS. These PWS and AS
microdeletion results support the IC hypothesis, but a bipartite
structure must be present since the minimally deleted regions
responsible for PWS and AS are distinct.87
An alternate
mechanism for imprinting maintenance in this region relies on an
enhancer-competition model between cis-linked
genes;4,88
however, methylation analysis of the PWS/AS
region reported by Schumacher et al89
does not support
this.
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Imprinting in Brain and Behavior Development
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The paternally expressed human MEST gene maps to 7q32,
a region where maternal UPD is associated with intrauterine and
postnatal growth retardation.21,90
Recently, a targeted
deletion was introduced into the coding sequence of the mouse
Mest gene to determine its function.91
When the
deletion was paternally derived, Mest +/- mice were viable and
fertile; however, they exhibited growth retardation and increased
lethality. Mest-/+ animals (deletion maternally derived)
showed none of these effects indicating that the phenotypic
consequences of this mutation are detected only through paternal
inheritance. Interestingly, Lefebvre et al91
found
decreased reproductive fitness in the females that inherited the
targeted disruption from their father. This effect was not based on the
genotype of the progeny, but rather was due to an abnormal nurturing
behavior of the mutant parturient females. Aberrant behavior of the
mothers included failure to ingest the extraembryonic tissues (a normal
behavior in most mammals), reduced rate of nest building, and pup
neglecting. When the pups were fostered to wild-type females, no
phenotypic differences between wild-type pups and Mest-/+
pups were apparent.
The results of this study demonstrate that the paternally expressed
Mest is a positive regulator of embryonic growth, and is
involved in the regulation of mammalian behavior associated with the
rearing of offspring. These findings are consistent with the hypothesis
that the imprinting of genes arises from the conflict of interest of
the parental genomes in mammals,28
and supports the
importance of imprinted genes in brain development. Previous results
using Pg and Ag mouse embryos suggested that both maternally and
paternally derived genes contribute to the growth and function of
specific brain regions in a complementary fashion.92
Keverne et al93
found that Ag cells primarily contributed
to hypothalamic composition, whereas Pg cells localized to the cortex,
striatum, and hippocampus, but not to the hypothalamus. Brain growth
was enhanced by Pg cells and retarded by Ag cells, further supporting
the postulate that genomic imprinting is critically involved in
mammalian brain development.
Evidence for imprinting effects in human diseases associated with
mental abnormalities includes the aforementioned Prader-Willi and
Angelman syndromes. There is now also evidence of cognitive imprinting
effects in humans displaying normal intelligence. Skuse et
al94
recently reported that an imprinted X-linked locus is
potentially responsible for differences in cognitive function of
females with Turner's syndrome. Although normal females (46,XX)
inherit an X chromosome from both their mother and father, only one X
chromosome is inactivated. Turner's syndrome is a sporadic disorder
resulting when all or part of one X chromosome is deleted in females.
These females display normal intelligence, but overall have a higher
incidence of social difficulties.95,96
Turner syndrome
women who inherit the X chromosome from their mother (45,Xm) generally
exhibit more behavioral difficulties than those inheriting the X
chromosome from their father (45,Xp). This finding provides the first
evidence of genomic imprinting on the human X chromosome.94
Based on cytogenetic analysis of these patients, partial deletions of
the short arm of the paternally derived X chromosome were found. This
suggests that the putative imprinted locus escapes X-inactivation and
potentially lies in Xp11.23-Xqter. Interestingly, Miller and
Willard97
have recently identified a 5.5 megabase region on
the human Xp11.21-p11.22 that contains eight expressed sequences which
escape X inactivation. However, an imprinted gene(s) in this region is
yet to be identified.
Parent-of-origin effects involved in other behavioral and brain
disorders have also been reported. Included among these are bipolar
affective disorder,98-100
schizophrenia,101,102
and autism.103
However,
the involvement of genomic imprinting in these examples remains to be
elucidated. For an extensive summary of parent-of-origin effects in
human disease, consult Morison and Reeve.104
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Imprinting in Human Cancer
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There are numerous reports of tumors showing a bias in allelic
loss. On a genome-wide scale, the complete hydatidiform mole and benign
ovarian dermoid cyst arise from cells that are completely Ag or Pg in
origin, respectively.105,106
In addition, numerous tumors
are associated with the preferential loss of a particular parental
chromosome, indicating the involvement of imprinted genes. Examples
include neuroblastoma (maternal chromosome 1p36 and paternal chromosome
2),107
acute myeloblastic leukemia (paternal chromosome
7),108
Wilms' tumor (maternal chromosome
11p15.5),109
rhabdomyosarcoma (maternal chromosome
11p15.5),110
and sporadic osteosarcoma (maternal chromosome
13).111
A role for genomic imprinting has also been
implicated in the development of familial glomus tumors based on
inheritance patterns since tumor susceptibility is inherited
paternally.112
Imprinted genes can be involved in carcinogenesis in several ways
(Figure 3)
. Loss of heterozygosity or UPD
at an imprinted region may result in the deletion of the only
functional copy of a tumor suppressor gene. Alternatively, LOI or UPD
of an imprinted gene that promoted cell growth may allow gene
expression to be inappropriately increased. Finally, mutational
inactivation of an IC might result in the aberrant expression of
multiple imprinted oncogenes and/or tumor suppressor genes present in
an imprinted chromosomal region.

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Figure 3. A: Only one allele of a tumor suppressor gene
(T) is expressed because
of genomic imprinting
(TX). Loss of
heterozygosity (LOH) of
the expressed allele or an inactivating mutation in the expressed
allele (TM)
results in loss of tumor suppressor function. B: Only one
allele of the proto-oncogene
(P) is expressed because
of genomic imprinting
(PX). Loss of
imprinting (LOI) or
uniparental disomy (UPD)
results in biallelic expression of the proto-oncogene.
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Aberrant genomic imprinting and its role in cancer are best exemplified
by studies on Wilms' tumor, a childhood tumor that arises from
metanephric blastemal cells. Direct genetic evidence linking
tumorigenesis and aberrant imprinting was identified when 70% of
Wilms' tumors were found to have biallelic IGF2
expression.113-115
Inactivation of H19 was also
present in a number of these cases.115
The H19
gene possesses a CpG island in its promoter that is normally methylated
on the paternal allele and unmethylated on the maternal
allele.44,45,115
An enhancer competition model for the
reciprocal control of expression of the imprinted IGF2 and
H19 genes has recently been proposed.116,117
Thus, LOI of the IGF2 gene in Wilms' tumor could result
from loss of H19 expression.116,117
This
scenario is supported by the finding that H19 null
transgenic mice show biallelic expression of
IGF2.118
The coupling of biallelic
IGF2 gene expression with H19 inactivation is
even observed in phenotypically normal kidney tissue surrounding the
Wilms' tumor. This suggests that the inactivation of H19
and the biallelic expression of IGF2 are linked, and occur
early in development.119
Other human malignancies showing
LOI at the IGF2 locus are presented in Table 2
. These results indicate deregulation of
IGF2 imprinting is mechanistically involved in the
development of a variety of tumors.
Because imprinted genes are functionally haploid, an imprinted tumor
suppressor gene would be predicted to increase cancer susceptibility
since the inactivation of only one allele would eliminate tumor
suppressor function. WT1,120,121p57KIP2 122-124 and
M6P/IGF2R125-128
represent imprinted genes
implicated in tumor suppression. p57KIP2, mapped
to 11p15.5, encodes for a cyclin-dependent kinase inhibitor that is
maternally expressed. Epigenetic silencing of the expressed allele has
been reported in some tumors and BWS patients.63
Additionally, approximately 5% of BWS patients have
p57KIP2 mutations;64
however,
p57KIP2 mutations have not been identified in
tumors. Thus, the putative tumor suppressor function of
p57KIP2 remains to be clarified. Recently,
NOEY2 (ARHI), a novel ras-related, maternally
imprinted gene at 1p31, was identified as a putative tumor suppressor
gene in breast and ovarian carcinomas. In the majority of cases, the
functional allele was lost.129
Recent reports demonstrate that the M6P/IGF2R at 6q26 is
inactivated in a variety of tumors at the earliest stage of
transformation.126-128
The M6P/IGF2R plays an
integral part in the intracellular sorting of lysosomal enzymes, the
activation of the growth inhibitor transforming growth factor-ß1
(TGF-ß1), and the degradation of IGF2, but it is not directly
involved in cell signaling.19,130
The M6P/IGF2R
is mutated in 60% of dysplastic liver lesions and hepatocellular
carcinomas of patients with or without hepatitis virus
infection.125,126,128
The M6P/IGF2R is also
mutated in 30% of breast tumors,127
and the gene contains
a polyG region that is a common mutational target in colon, gastric and
endometrial tumors with mismatch repair deficiencies and microsatellite
instability.128,131,132
Moreover, it has recently been
reported that the M6P/IGF2R is mutated in human glioma
samples that do not contain mutations in the transforming growth
factor-ß type II receptor (TGFBRII) or
Bax genes.133
In both breast127,134
and liver carcinogenesis,128
the allelic inactivation of
M6P/IGF2R occurs as an early event, during the initiation
rather than the progression stage of transformation.
Although imprinting among individuals and mammalian species is
generally conserved, the imprint status of M6P/IGF2R in
humans and rodents is strikingly different. The M6p/Igf2r is
imprinted in mice18
and rats,135
but imprinting
at this locus appears to be a polymorphic trait in humans, with most
individuals having biallelic expression.136-138
The
existence of individuals with an imprinted M6P/IGF2R tumor
suppressor suggests that they may have increased susceptibility to
tumor development because of aberrant imprint control. This postulate
is supported by Xu et al139
who recently reported partial
imprinting of M6P/IGF2R in 50% of Wilms' tumor patients.
The precise molecular mechanism for genomic imprinting of
M6P/IGF2R is not completely defined. Methylation of a CpG
rich region in intron 2 (Region 2) of the expressed maternal allele has
been shown to carry the imprint signal for this gene in
mice.46,140
Birger et al141
have identified a
113-bp sequence, in region 2 of the mouse M6p/Igf2r gene,
that serves as a methylation imprinting box responsible for the
establishment of differential methylation. Furthermore, this region
appears to function as the promoter of an antisense transcript that
originates only from the repressed paternal allele. This indicates that
a form of expression competition regulates imprinting of the
M6p/Igf2r gene in mice.140
Region 2 of the human
M6P/IGF2R also contains parent-of-origin methylation, but
gene expression is biallelic.142,143
Consequently, humans
and mice appear to possess an altered ability to read the
M6P/IGF2R imprint marks.
Functional polymorphic imprinting has also been observed for human
genes encoding IGF2,144WT1,120
and the human 5-HT2A receptor
gene HTR2A.145
Recently, the mouse
Kvlqt1 gene has been shown to undergo developmental
relaxation of imprinting in a strain-dependent fashion.146
Whether polymorphic genomic imprinting occurs in other genes, and
functions in determining individual and/or species differences in
susceptibility to diseases remains to be determined.
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Footnotes
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Address reprint requests to Randy L. Jirtle, Box 3433, Duke University Medical Center, Durham, NC 27710. E-mail: jirtle{at}radonc.duke.edu
Supported by National Institutes of Health grants CA25951 and ES08823, Department of Defense Grant DAMD17-98-1-8305 (to J.G.F. and R.L.J.), and Zeneca Pharmaceuticals (to D.J.P. and A.A.W).
Accepted for publication January 6, 1999.
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