Abstract

BackgroundTBX20 plays an important role in heart development; however, its epigenetic regulation in the pathogenesis of tetralogy of Fallot (TOF) remains unclear.MethodsThe methylation levels of the TBX20 promoter region in the right ventricular myocardial tissues of TOF and control samples were measured by the Sequenom MassARRAY platform. Bisulphite-sequencing PCR (BSP) was used to confirm the TBX20 methylation of CpG sites in cells. Dual-luciferase reporter assays were performed to detect the influence of TBX20 methylation and Sp1 transcription factors on gene activity. An electrophoretic mobility shift assay (EMSA) was used to explore the binding of the Sp1 transcription factor to the TBX20 promoter.ResultsTOF cases had a significantly lower TBX20_M1 methylation level than controls (median methylation: 20.40% vs. 38.73%; p = 0.0047). The Sp1 transcription factor, which binds to Sp1 binding sites in the TBX20_M1 region and promotes TBX20 gene activity, was blocked by the methylation of Sp1 binding sites in normal controls. With decreasing methylation in the TOF cases, the Sp1 transcription factor can bind to its binding site within the TBX20 promoter M1 region and promote TBX20 gene expression.ConclusionsHypomethylation of the TBX20 promoter region was observed in the TOF cases, and the high expression of the TBX20 gene may be caused by activated Sp1 transcription factor binding because of the decreasing methylation at the Sp1 transcription factor binding sites within TBX20_M1.

Highlights

  • TBX20 plays an important role in heart development; its epigenetic regulation in the pathogenesis of tetralogy of Fallot (TOF) remains unclear

  • NKX2–5 and HAND1 are essential for heart development, and Sheng et al demonstrated that the aberrant methylation status of the NKX2–5 gene body

  • Methylation status for the TBX 20 gene in TOF patients and controls The methylation status of the TBX20 gene promoter was determined by the Sequenom MassARRAY platform

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Summary

Introduction

TBX20 plays an important role in heart development; its epigenetic regulation in the pathogenesis of tetralogy of Fallot (TOF) remains unclear. Tetralogy of Fallot (TOF) is characterized by pulmonary outflow tract obstruction, ventricular septal defects, overriding aortic roots, and right ventricular hypertrophy [1]. This condition occurs in one out of every 2500 live births, accounting for 11.4% of all severe congenital heart disease (CHD) cases with serious illness in the neonatal period or early infancy [2]. Many studies have demonstrated that the abnormal expression of cardiac-related genes influences cardiac normal development and contributes to the pathogenesis of TOF [3,4,5]. NKX2–5 and HAND1 are essential for heart development, and Sheng et al demonstrated that the aberrant methylation status of the NKX2–5 gene body

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