genetics of aging, progeria and lamin disorders
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Genetics of aging, progeria and lamin disordersShrestha Ghosh1 and Zhongjun Zhou1,2
Available online at www.sciencedirect.com
ScienceDirect
Premature aging disorders, like Werner syndrome, Bloom’s
syndrome, and Hutchinson–Gilford Progeria Syndrome
(HGPS), have been the subjects of immense interest as they
recapitulate many of the phenotypes observed in physiological
aging. They, therefore, not only provide model systems to study
normal aging processes but also give valuable insights into the
intricate mechanisms underlying senescence. Recent works on
HGPS have revealed alterations in a spectrum of cellular and
molecular pathways involved in the maintenance of genomic
integrity, thus suggesting a profound impact of the nuclear
lamina in nuclear organization, chromatin dynamics, regulation
of gene expression and epigenetics.
Addresses1 Department of Biochemistry, Li Ka Shing Faculty of Medicine, The
University of Hong Kong, Hong Kong2 Shenzhen Institute of Research and Innovation, The University of Hong
Kong, Shenzhen, China
Corresponding author: Zhou, Zhongjun ([email protected])
Current Opinion in Genetics & Development 2014, 26:41–46
This review comes from a themed issue on Molecular and genetic
bases of disease
Edited by Cynthia T McMurray and Jan Vijg
http://dx.doi.org/10.1016/j.gde.2014.05.003
0959-437X/# 2014 Elsevier Ltd. All rights reserved.
IntroductionAging broadly refers to the gradual deterioration of
physical and psychological abilities accompanied by a
decline in the proper body functioning and resistance
to the threats that an individual is exposed to. In the past
few decades, this field has ignited interest in scientific
communities especially because its underlying mechan-
isms began to be unveiled. Although several cellular
pathways have emerged as key players in the process
of biological aging, a significant proportion of them even-
tually converge as the threats being posed on genomic
integrity [1,2]. The insults to genomic stability have
further evolved as causative factor of several premature
aging syndromes like Cockayne syndrome, Werner syn-
drome, HGPS and many more [3]. Here, we review the
genetic alterations leading to progeroid syndromes
(especially progeria) and other laminopathies.
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Physiological and premature aging: from theperspective of geneticsThe prominence of genetic contribution to aging was
primarily advocated by two theories, somatic mutation
theory of aging and DNA damage theory of aging [4,5].
Further, the infliction of insults on genomic DNA from
intercalating agents, radiation, reactive oxygen species
(ROS), and DNA double strand breaks have been
reported to contribute to premature aging phenotypes
in several mice models [6–8]. Additionally, in human
progeroid syndrome HGPS, delayed recruitment of
DNA-damage checkpoint response proteins has been
established as a causative factor for accrued genomic
instability [9]. Similarly, mutation/deletion of several
genes has been shown to accelerate or delay aging pro-
cess. For example, Sirt6-deficient mice display premature
aging phenotypes accompanied with genomic instability
[10]. Mutation in the Insulin/Insulin like growth factor
(IGF1) receptor gene daf-2 has been reported to double
the lifespan of C. elegans [11]. Also, mitochondrial DNA
(mtDNA) mutations result in aging phenotypes in the
mtDNA mutator mouse models [12]. Taken together,
these studies clearly suggest a pivotal part played by
genome maintenance and DNA damage repair in the
process of cellular senescence and aging.
Progeroid syndromes: a genetic backgroundProgeroid or premature aging syndromes are a class of
rarely occurring genetic disorders. They can be broadly
classified into unimodal progeroid syndromes (affecting
only one tissue type) and segmental progeroid syndromes
(affecting several tissues and displaying some but not all
symptoms of normal physiological aging). Familial Alz-
heimer’s disease and Parkinson’s disease fall under the
first category. The segmental progeroid syndromes large-
ly comprise of monogenic disorders with malfunction
arising from single gene mutations in the affected indi-
viduals. Some of the most widely studied examples are
Cockayne syndrome, Werner syndrome, HGPS and
Bloom’s syndrome. They can be further categorized into
four groups based on the type of genes being mutated
(Figure 1) [13–15]. However, the extrapolation of pre-
mature aging to physiological aging has often been
debated since these syndromes recapitulate only a frac-
tion of the alterations observed in normal aging process
and hence might present highly specialized physiological
conditions [16,17]. However, recent studies in HGPS
have gained limelight in connecting premature aging to
normal aging. The findings such as existence of progerin
expression in normal individuals and increase in the level
of progerin in the tissues of coronary arteries with gradual
aging, further support this idea [18].
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42 Molecular and genetic bases of disease
Figure 1
Segmental Progeroid SyndromeUnimodal Progeroid Syndrome
Nucleotide excisionrepair (NER) genes
Other DNA damagesignaling genes
RECQL mutatedgenes
LMNA/ZMPSTE24mutated genes
XerodermaPigmentosum
Bloom’ssyndrome
Hutshinson-Gilford
Progeriasyndrome
AtaxiaTelangiectasia
mutated
RestrictiveDermopathy
Wernersyndrome
RothmundThomsonsyndrome
CockayneSyndrome
Trichothio-dystrophy
Alzheimer’sdisease
Parkinson’sdisease
Progeroid Syndromes (PS)
Current Opinion in Genetics & Development
Categorization of progeroid syndromes: progeroid syndromes can be broadly classified on the basis of number and type of affected tissues and also
on the type of genes mutated/deleted.
Progeria: underlying genetic mechanismsHutchinson–Gilford progeria syndrome (HGPS) is a rare
and severe early onset progeroid syndrome. It was first
reported more than a century ago by Jonathan Hutchinson
in 1886 and Hastings Gilford in 1897 independently
(hence the name HGPS). It gained limelight in 2003
when its underlying genetic defect was discovered. Pro-
geria is characterized predominantly by a unique hetero-
zygous autosomal de novo point mutation in LMNA gene
(C1824 T) which codes for the nuclear lamina protein
lamin A [19,20]. The major nuclear lamin proteins
expressed in humans are lamins A, C, B1, B2 and B3
encoded by the genes LMNA (for both lamins A and C),
LMNB1 and LMNB2 (for both lamins B2 and B3), respect-
ively [21]. These proteins form the only class of inter-
mediate filament proteins in the nucleus which support
the structure and shape of the nucleus, anchor chromatin
and also tether nuclear pore complexes in their appro-
priate functional positions [22]. Lamin A (LA) is pro-
cessed from its precursor prelamin A which contains a
CaaX motif at its C terminal. This Cysteine residue
undergoes farnesylation which leads to the cleavage of
the aaX group followed by a methyl esterification of the
Cysteine residue by isoprenylcysteine carboxyl methyl-
transferase (ICMT). This activates cleavage of an
additional 15 amino acids of the precursor by the metallo-
proteinase, ZMPSTE24, to generate mature lamin A [23].
Current Opinion in Genetics & Development 2014, 26:41–46
In HGPS, a single base substitution (C1824T) in the
LMNA gene activates a cryptic splice site within exon
11, giving rise to a 50 amino acids deleted prelamin A
termed as Progerin that lacks the second cleavage (of 15
amino acids). This farnesylated progerin is considered
toxic to the cells [19,20]. Many mouse models have been
developed so far to study progeria, including Zmpste24�/�
mice, G608G BAC transgenic mice, Keratin 14-progerin
transgenic mice, and Lmna G609G knock-in mice [24].
The pathology of progeria is attributable to several
genetic defects (Figure 2) [25]. Some of them are
described below.
Telomere dysfunctionAging has time and again been associated with accumu-
lation of DNA lesions and defects in DNA damage repair
mechanisms. Telomere shortening and dysfunction is a
chief contributor to this DNA damage and poses serious
threat to the integrity of genome [25]. Telomere attrition
is also a major hallmark of aging and cellular senescence
[26–29]. Mammalian telomeres essentially comprise of
hexameric sequence repeats TTAGGG and the shelterin
protein complex capping the telomere ends [30]. The
telomeres shorten after each replication cycle as DNA
polymerase cannot extend till its extreme end, thereby
generating DNA-damage checkpoint response signaling.
This eventually gets accrued on to elicit an irreversible
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Chromatin remodeling defects in progeria Ghosh and Zhou 43
Figure 2
Epigeneticalterations
Telomeredysfunction
Altered gene-proteininteractions
LMNA genemutations
Hutchinson-Gilford
progeriasyndrome
(HGPS)Chromatin
remodeling defects
Symptoms observed:
Alopecia
Atherosclerosis
Cachexia
Kidney failure
Scleroderma
Cardiovascular problems
Cellular phenotypes:
Hterochromatin loss
Nuclear lobulation
Increased apoptosis
Impaired DNA damage repair
Mitochondrial dysfunction
Cell-cycle regulation defects
Current Opinion in Genetics & Development
Defective genetic pathways and consequences of HGPS: several defects in different genetic pathways contribute to the cellular malfunctions and
severe symptoms observed in Hutchinson–Gilford Progeria Syndrome patients.
growth arrest, eventually resulting in senescence [31–33].
Recent studies suggest an inter-play between progerin
accumulation and telomere dysfunction. In HGPS cells, it
is reported that telomerase, a telomere-elongating ribo-
nucleoprotein comprising a reverse transcriptase (TERT)
and RNA component (TERC), extends cellular lifespan
by toning down the DNA damage signaling triggered by
progerin. In addition, progerin-induced DNA damage
signaling is shown to concentrate in telomeres and majorly
associate with telomere aggregates [34�,35]. On the other
hand, fibroblast clones from HGPS patients have shown to
senesce even after reinstating telomere length and activity
[36]. Taken together, the cause and effect of telomere-
progerin relationship still remains largely elusive. Intrigu-
ingly, a recent publication demonstrated that lamin A
Dexon9 mutation caused telomere and chromatin defects
but did not result in genomic instability [37]. Thus the
mechanistic link between telomere attrition, progerin
accumulation and genomic instability and their inter-
dependence on each other still needs further investigation
to draw a more concrete conclusion.
Perturbed epigenetic regulationEpigenetic modifications like DNA methylation, acety-
lation, phosphorylation, and ubiquitylation, are known to
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regulate the dynamics of chromatin organization. DNA
methylation typically characterizes heterochromatin
(the more transcriptionally silent form) while acetylated
N-terminal histone tails promote euchromatin formation
(the actively transcribing form) [38,39]. As observed in
cellular senescence, HGPS fibroblasts also show marked
decline in heterochromatin markers like histone H3
lysine 9 methylation (H3K9me) and HP1 proteins that
further decrease with passage [40–42]. Interestingly, our
recent data demonstrated an increase in H3K9 trimethy-
lation in Zmpste24�/� cells due to elevation in SUV39H1
(methyltransferase responsible for H3K9me3) levels
[43�]. This discrepancy was attributable to the difference
in passage numbers of the primary human cells used in
experimentation as perfectly matched wildtype primary
dermal fibroblasts are unlikely to be obtained. To this
end, data from mice are more reliable. Our data estab-
lished that SUV39H1 depletion could partially alleviate
DNA damage repair and delay senescence in progeroid
cells. Other epigenetic modifications like downregulated
H3K27 trimethylation and upregulated H4K20 trimethy-
lation have also been reported in HGPS cells [44,45]. Our
previous report also identified H4K16 hypoacetylation
in Zmpste24�/� mice [46]. In addition, we showed that
decrease in H4K16 acetylation could also be observed in
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44 Molecular and genetic bases of disease
normally aging cells. This epigenetic modification led to
improper recruitment of damage repair proteins to DNA
lesions. Treatment of the mutant mice with HDAC
inhibitor, Sodium Butyrate (NaB), restored the acety-
lation level of H4 and partially rescued the progeroid
features in mice. This finding provides a novel thera-
peutic strategy for progeria. On the whole, these reports
suggest that targeting epigenetic modifiers can have
potential benefits in the intervention of premature aging.
Chromatin remodeling: an emerging player inpremature agingA plethora of ATP-dependent or covalently modifying
remodeling factors largely regulates chromatin structure
and compaction that determines DNA accessibility to
several chromatin-associated factors required for DNA
replication, transcription and damage repair. The identi-
fication of NURD (Nucleosome Remodeling Deacety-
lase) complex’s pivotal role in aging further strengthened
this idea [47]. NURD is a chromatin remodeling complex
containing seven subunits which primarily function in
histone deacetylation and methyl-CpG binding [48].
HGPS cells as well as normally aged cells show decline
in several NURD components like HDAC1 and histone
chaperones RBBP4. It is also reported that knockdown of
NURD components reiterates chromatin defects and
DNA damage observed in aging [47]. Similarly, histone
H4K20 methylase SET8 has also been demonstrated to
elevate DNA damage when depleted in normal cells [49].
In addition to these, our recent study identified defective
ATM-Kap1 signaling as a major contributor to DNA
damage repair defects observed in Zmpste24�/� MEFs
(mouse embryonic fibroblasts). We also showed that Kap-
1 knockdown could rescue those defects along with
chromatin remodeling impairments and delay senescence
in the mutant MEFs [50]. Recently, it has also been
reported that decreased ICMT activity resulted in pre-
lamin A mislocalization, causing enhanced AKT- mam-
malian target of rapamycin (mTOR) signaling and
delayed senescence in HGPS fibroblasts [51��]. Apart
from these, our research on mammalian sirtuin SIRT1
(class III histone deacetylase and mono-ADP ribosyl-
transferase) has yielded very promising results and pro-
vided a novel mechanistic explanation to resveratrol’s
anti-aging effects [52�]. Taken together, the above find-
ings clearly advocate a promising role for the chromatin
modifiers in understanding the intricate molecular mech-
anisms underlying premature senescence.
Altered protein interactionsIt is reported that progerin elicits chromatin organization
changes globally by increasing interactions with a specific
subset of genes in addition to those that are associated
with lamin A [53]. In addition, the inner nuclear mem-
brane protein SUN1 is observed to over-accumulate in
HGPS cells and LMNA mutant fibroblasts. Minimizing
this over-accumulation ameliorated nuclear defects and
Current Opinion in Genetics & Development 2014, 26:41–46
cellular senescence [54�]. Several such protein interaction
defects have been reported which also partly explain the
pathology of progeria. For example, altered interaction in
between lamin A/progerin and various transcription fac-
tors like PRX1, MEOX/GAX, TWIST2, have been
described to contribute to progeroid phenotypes [25].
Atypical HGPS conditionsApart from the known heterozygous point mutation
C1824 T observed in classical HGPS, two recent reports
described that a C1579 T missense mutation in exon 9
results in R527 C substitution causing progeria [55,56�].This homozygous mutation caused several typical HGPS
phenotypes in the patients along with digestive system
disorders and more severe skeletal damage. In both cases,
the siblings were homozygous while their parents were
heterozygous for this mutation. In addition, three differ-
ent substitutions at the 527 coding site in LMNA gene viz.
R527P, R527H and R527C/R471C cause different dis-
orders like Emery–Dreifuss Muscular dystrophy and
mandibuloacral dysplasia [56]. Intriguingly, homozygous
mutation G1626G, that is p.K542N affecting both lamins
A and C is also observed to cause HGPS [57]. This study
challenged the concept of only lamin A mutations to be
responsible for causing HGPS. Another report revealed
an additional heterozygous mutation in LMNA gene
G1821A causing neonatal progeria [58]. These reports
are thus suggestive of the existence of varied forms of
point mutations in LMNA gene that can also result in
progeroid phenotypes.
Other lamin disordersTill date, nearly 15 disorders have been attributed to
LMNA mutations. These disorders arising from defects in
nuclear lamin genes are collectively termed as lamino-
pathies. Apart from the accelerated aging syndromes like
HGPS, atypical Werner syndrome, and Restrictive der-
mopathy (also caused by loss of ZMPSTE24 gene), lamin
related disorders also encompass several striated muscle
diseases, peripheral nerve disorders, lipodystrophy, and
bone diseases [59]. LMNA gene mutations like Emery–Dreifuss muscular dystrophy and Limb-girdle muscular
dystrophy also result in dilated cardiomyopathy which
causes mortality. Apart from these, deletion mutation in
ZMPSTE24 gene results in partially mature lamin A and
causes Mandibuloacral dysplasia and Restrictive dermo-
pathy. Furthermore, homozygous loss of lamin A function
results in peripheral nerve myelination loss, thereby
causing Charcot–Marie tooth syndrome. Mutations in
LMNB1 and LMNB2 also result in adult-onset lipodystro-
phy and partial lipodystrophy respectively. In addition,
homozygous and heterozygous mutations in the lamin B
receptor (LBR) cause Greenberg skeletal dysplasia and
Pelger–Huet anomaly respectively [60]. This whole spec-
trum of laminopathies clearly indicates the significance of
nuclear lamin genes in maintaining genomic integrity and
proper cellular functioning.
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Chromatin remodeling defects in progeria Ghosh and Zhou 45
DiscussionSo far, there have been numerous studies highlighting the
importance of genetics in the field of premature aging
related disorders. With upcoming reports on several gene
functions, the genetic mechanisms underlying these dis-
orders are becoming clearer. Several novel studies are
being carried out in order that not only lifespan but also
healthspan of individuals could be enhanced. However,
the complications associated with progeria are numerous
making it more challenging to devise one solution for
targeting all of them. But, with the advent of several
promising genetic approaches, it is expected that an
effective therapy could be devised to ameliorate the
severe progeroid phenotypes observed in patients.
AcknowledgementsWe would like to acknowledge the supports from National Natural ScienceFoundation of China (81330009), Chinese Ministry of Science andTechnology (973 Project 2011CB964700), and Hong Kong ResearchCouncil CRF (HKU2/CRF/13G).
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52.�
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53. Kubben N, Adriaens M, Meuleman W, Voncken JW, VanSteensel B, Misteli T: Mapping of lamin A-and progerin-interacting genome regions. Chromosoma 2012, 121:447-464.
54.�
Chen CY, Chi YH, Mutalif RA, Starost MF, Myers TG, Anderson SA,Stewart CL, Jeang KT: Accumulation of the inner nuclearenvelope protein sun1 is pathogenic in progeric anddystrophic laminopathies. Cell 2012, 149:565-577.
This paper revealed the pathogenesis of SUN1 protein accumulation inHGPS conditions and nuclear defects were rescued upon SUN1 reduc-tion delaying senescence.
55. Liang L, Zhang H, Gu X: Homozygous LMNA mutation R527C inatypical Hutchinson–Gilford progeria syndrome: evidence forautosomal recessive inheritance. Acta Paediatr 2009, 98:1365-1368.
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Xiong Z, Lu Y, Xue J, Luo S, Xu X, Zhang L, Peng H, Li W, Chen D,Hu Z, Xia K: Hutchinson–Gilford progeria syndromeaccompanied by severe skeletal abnormalities in two Chinesesiblings: two case reports. J Med Case Rep 2013, 7:63.
This report identified another point mutation in LMNA gene causing HGPSand claimed that this particular mutation could be inherited in an auto-somal recessive manner.
57. Plasilova M, Chattopadhyay C, Ghosh A, Wenzel F, Demougin P,Noppen C, Schaub N, Szinnai G, Terracianno L, Heinimann K:Discordant gene expression signatures and relatedphenotypic differences in lamin A-and A/C-relatedHutchinson–Gilford progeria syndrome (HGPS). PLoS One2011, 6:e21433.
58. Reunert J, Wentzell R, Walter M, Jakubiczka S, Zenker M, Brune T,Rust T, Marquardt T: Neonatal progeria: increased ratio ofprogerin to lamin A leads to progeria of the newborn. Eur JHum Genet 2012, 20:933-937.
59. Carboni N, Politano L, Floris M, Mateddu A, Solla E, Olla S,Maggi L, Antoneitta MM, Piras R, Cocco E: Overlappingsyndromes in laminopathies: a meta-analysis of the reportedliterature. Acta Myol 2013, 32:7.
60. Schreiber KH, Kennedy BK: When lamins go bad: nuclearstructure and disease. Cell 2013, 152:1365-1375.
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