CHARGE and Kabuki Syndromes: Gene-Specific DNA Methylation Signatures Identify Epigenetic Mechanisms Linking These Clinically Overlapping Conditions
Open accessAbstract
Epigenetic dysregulation has emerged as a recurring mechanism in the etiology of neurodevelopmental disorders. Two such disorders, CHARGE and Kabuki syndromes, result from loss of function mutations in chromodomain helicase DNA-binding protein 7 ( CHD7 LOF ) and lysine (K) methyltransferase 2D ( KMT2D LOF ), respectively. Although these two syndromes are clinically distinct, there is significant phenotypic overlap. We therefore expected that epigenetically driven developmental pathways regulated by CHD7 and KMT2D would overlap and that DNA methylation (DNAm) alterations downstream of the mutations in these genes would identify common target genes, elucidating a mechanistic link between these two conditions, as well as specific target genes for each disorder. Genome-wide DNAm profiles in individuals with CHARGE and Kabuki syndromes with CHD7 LOF or KMT2D LOF identified distinct sets of DNAm differences in each of the disorders, which were used to generate two unique, highly specific and sensitive DNAm signatures. These DNAm signatures were able to differentiate pathogenic mutations in these two genes from controls and from each other. Analysis of the DNAm targets in each gene-specific signature identified both common gene targets, including homeobox A5 ( HOXA5 ), which could account for some of the clinical overlap in CHARGE and Kabuki syndromes, as well as distinct gene targets. Our findings demonstrate how characterization of the epigenome can contribute to our understanding of disease pathophysiology for epigenetic disorders, paving the way for explorations of novel therapeutics.
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Direct functional genomic exploration of accessible and disease-relevant tissues from patients using RNA sequencing and DNA methylation assays can identify previously cryptic causal genetic variants, particularly in under-explored noncoding regions.
“Direct functional genomic exploration of accessible and disease-relevant tissues from patients using RNA sequencing and DNA methylation assays30,31 can identify previously cryptic causal genetic variants, particularly in under-explored regions outside protein-coding genes32,33.”
From A brief history of human disease genetics (2020) · cites this paper as [31]
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Self-citationPatients with a Kabuki syndrome phenotype demonstrate DNA methylation abnormalities
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Discovery of the First-in-Class G9a/GLP Covalent Inhibitors
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CHARGEd with neural crest defects
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Self-citationInhibition of Notch signaling rescues cardiovascular development in Kabuki Syndrome
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Self-citationDNA Methylation of the Oxytocin Receptor Across Neurodevelopmental Disorders
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Self-citationDeficiency of TET3 leads to a genome-wide DNA hypermethylation episignature in human whole blood
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Cellular neurometabolism: a tentative to connect cell biology and metabolism in neurology
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Self-citationEpisignature analysis of moderate effects and mosaics
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DNA Methylation Signature for JARID2-Neurodevelopmental Syndrome
Verberne, E. A., van der Laan, L., Haghshenas, S., Rooney, K., Levy, M. A., Alders, M. M., Maas, S. M., Jansen, S., Liedén, A., Anderlid, B., et al. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23148001 · Cited by 19 · see citing works
Awamleh, Z., Choufani, S., Cytrynbaum, C. S., Alkuraya, F. S., Scherer, S. W., Fernandes, S., Rosas, C., Louro, P., Dias, P., Neves, M. T., et al. (2022) · Human Molecular Genetics · doi:10.1093/hmg/ddac289 · Cited by 19 · see citing works
Self-citationThe omics era: a nexus of untapped potential for Mendelian chromatinopathies
Nava, A. A., & Arboleda, V. A. (2023) · Human Genetics · doi:10.1007/s00439-023-02560-2 · Cited by 19 · see citing works
Epigenotype–genotype–phenotype correlations in SETD1A and SETD2 chromatin disorders
Lee, S. L., Menzies, L. A., Hay, E., Ochoa, E., Docquier, F., Rodger, F., Deshpande, C., Foulds, N. C., Jacquemont, S., Jizi, K., et al. (2023) · Human Molecular Genetics · doi:10.1093/hmg/ddad079 · Cited by 19 · see citing works
Comparison of Methylation Episignatures in KMT2B - and KMT2D -Related Human Disorders
Lee, S. L., Ochoa, E., Barwick, K. E., Cif, L., Rodger, F., Docquier, F., Pérez‐Dueñas, B., Clark, G. R., Martín, J., Banka, S., et al. (2022) · Epigenomics · doi:10.2217/epi-2021-0521 · Cited by 18 · see citing works
Expanded Insights Into Mechanisms of Gene Expression and Disease Related Disruptions
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Haghshenas, S., Levy, M. A., Kerkhof, J., Aref‐Eshghi, E., McConkey, H., Balcı, T. B., Siu, V. M., Skinner, C. D., Stevenson, R. E., Sadiković, B., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22031111 · Cited by 17 · see citing works
DNA methylation signatures for chromatinopathies: current challenges and future applications
Awamleh, Z., Goodman, S. J., Choufani, S., & Weksberg, R. (2023) · Human Genetics · doi:10.1007/s00439-023-02544-2 · Cited by 17 · see citing works
Self-citationClinical epigenetics: a primer for the practitioner
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Verrall, C. E., Patel, S., Travitz, L., Tchieu, J. H., Dale, R. C., Kasparian, N. A., Winlaw, D. S., & Blue, G. M. (2023) · Translational Pediatrics · doi:10.21037/tp-22-687 · Cited by 15 · see citing works
Germline pathogenic variants in HNRNPU are associated with alterations in blood methylome
Lee, S. L., Ochoa, E., Badura‐Stronka, M., Donnelly, D., Lederer, D., Lynch, S. A., Gardham, A., Morton, J., Stewart, H. S., Docquier, F., et al. (2023) · European Journal of Human Genetics · doi:10.1038/s41431-023-01422-9 · Cited by 16 · see citing works
Human methylome variation across Infinium 450K data on the Gene Expression Omnibus
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Further Introduction of DNA Methylation (DNAm) Arrays in Regular Diagnostics
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Awamleh, Z., Goodman, S. J., Kallurkar, P. S., Wu, W., Lu, K., Choufani, S., Turinsky, A. L., & Weksberg, R. (2022) · Current Protocols · doi:10.1002/cpz1.597 · Cited by 15 · see citing works
Self-citationClinical and molecular characterization study of Chinese Kabuki syndrome in Hong Kong
So, P. L., Luk, H., Yu, K. P. T., Cheng, S. S. W., Hau, E. W. L., Ho, S., Lam, S. T. S., & Lo, I. F. M. (2020) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.62003 · Cited by 15 · see citing works
Sakaguchi, Y., Yoshihashi, H., Uehara, T., Miyama, S., Kosaki, K., & Takenouchi, T. (2020) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.62020 · Cited by 15 · see citing works
Goodman, S. J., Cytrynbaum, C. S., Chung, B. H., Chater‐Diehl, E., Aziz, C., Turinsky, A. L., Kellam, B., Keller, M., Ko, J. M., Caluseriu, O., et al. (2020) · Journal of Translational Genetics and Genomics · doi:10.20517/jtgg.2020.23 · Cited by 15 · see citing works
Self-citationAberrant DNA methylation as a diagnostic biomarker of diabetic embryopathy
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Craniofacial and cardiac defects in chd7 zebrafish mutants mimic CHARGE syndrome
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Awamleh, Z., Choufani, S., Wu, W., Rots, D., Dingemans, A. J. M., Kasri, N. N., Boronat, S., Ibáñez‐Micó, S., Herraiz, L. C., Ferrer, I., et al. (2024) · European Journal of Human Genetics · doi:10.1038/s41431-024-01538-6 · Cited by 13 · see citing works
Self-citationDon’t brush off buccal data heterogeneity
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Neuroimaging in Kabuki syndrome and another KMT2D ‐related disorder
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Epigenetic studies and pediatric research
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- Authors
- Butcher, D. T., Cytrynbaum, C., Turinsky, A. L., Siu, M. T., Inbar-Feigenberg, M., Mendoza-Londono, R., Chitayat, D., Walker, S., Machado, J., Caluseriu, O., Dupuis, L., Grafodatskaya, D., Reardon, W., Gilbert-Dussardier, B., Verloes, A., Bilan, F., Milunsky, J. M., Basran, R., Papsin, B., Stockley, T. L., Scherer, S. W., Choufani, S., Brudno, M., & Weksberg, R.
- Affiliations
- Hospital for Sick Children (CA)
- University of Toronto (CA)
- Mount Sinai Hospital (CA)
- Manitoba Harm Reduction Network (CA)
- University of Alberta (CA)
- McMaster University (CA)
- Children's Health Ireland at Crumlin (IE)
- Center for Human Genetics (US)
- University Health Network (CA)
- Corresponding author
- Weksberg, Rosanna
- ORCID
- Venue
- The American Journal of Human Genetics
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 100
- Issue
- 5
- Pages
- 773-788
- ISSN
- 0002-9297 (ISSN-L)
- PMC
- PMC5420353
- OpenAlex
- W2610666651
- Cited by
- 200
- References
- 92
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 17 · 2023: 27 · 2022: 26 · 2021: 24 · 2020: 29 · 2019: 29 · 2018: 15 · 2017: 7 · 2016: 1
- FWCI
- 13.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The American Journal of Human Genetics (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Genetics › Congenital Ear and Nasal Anomalies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Keywords
- CHARGE syndrome, Kabuki syndrome, CHD7, KMT2D, DNA methylation signature, epigenetic dysregulation, neurodevelopmental disorders, loss-of-function mutations, HOXA5, phenotypic overlap, epigenetic disorders, disease pathophysiology
- MeSH terms
- Abnormalities, Multiple, Cell Line, DNA Helicases, DNA-Binding Proteins, Face, Gene Expression Regulation, Hematologic Diseases, Humans, Leukocytes, Mononuclear, Mutation, Neoplasm Proteins, Sensitivity and Specificity, Reproducibility of Results, Vestibular Diseases, Genome, Human, Homeodomain Proteins, DNA Methylation, Epigenesis, Genetic, CHARGE Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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