Abstract

Werner Syndrome (WS) and Bloom Syndrome (BS) are disorders of DNA damage repair caused by biallelic disruption of the WRN or BLM DNA helicases respectively. Both are commonly associated with insulin resistant diabetes, usually accompanied by dyslipidemia and fatty liver, as seen in lipodystrophies. In keeping with this, progressive reduction of subcutaneous adipose tissue is commonly observed. To interrogate the underlying cause of adipose tissue dysfunction in these syndromes, CRISPR/Cas9 genome editing was used to generate human pluripotent stem cell (hPSC) lacking either functional WRN or BLM helicase. No deleterious effects were observed in WRN−/− or BLM−/− embryonic stem cells, however upon their differentiation into adipocyte precursors (AP), premature senescence emerged, impairing later stages of adipogenesis. The resulting adipocytes were also found to be senescent, with increased levels of senescent markers and senescence-associated secretory phenotype (SASP) components. SASP components initiate and reinforce senescence in adjacent cells, which is likely to create a positive feedback loop of cellular senescence within the adipocyte precursor compartment, as demonstrated in normal ageing. Such a scenario could progressively attenuate adipose mass and function, giving rise to “lipodystrophy-like” insulin resistance. Further assessment of pharmacological senolytic strategies are warranted to mitigate this component of Werner and Bloom syndromes.

Highlights

  • An estimated 425 million people were living with diabetes in 2017, a number projected to increase to 629 million by 20451. 90% of this is accounted for by type 2 diabetes (T2D), intimately related to increasing obesity

  • In which severe metabolic disease is associated with obvious deficiency of adipose tissue, there are a range of more complex, pleiotropic disorders which feature dyslipidaemic insulin resistance and diabetes with lesser anatomical abnormality of adipose distribution, sometimes only gradually becoming apparent with age

  • Using WRN-/- and BLM-/- human pluripotent stem cell lines generated using CRISPR/Cas[9], this study aimed to model the adipose tissue phenotype seen in Werner Syndrome (WS) and Bloom Syndrome (BS) patients to assess the role played by senescence at different stages of adipose development

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Summary

Introduction

An estimated 425 million people were living with diabetes in 2017, a number projected to increase to 629 million by 20451. 90% of this is accounted for by type 2 diabetes (T2D), intimately related to increasing obesity. In which severe metabolic disease is associated with obvious deficiency of adipose tissue, there are a range of more complex, pleiotropic disorders which feature dyslipidaemic insulin resistance and diabetes with lesser anatomical abnormality of adipose distribution, sometimes only gradually becoming apparent with age Several of these are caused by defects in genes involved in the cellular response to DNA damage. BS patients typically exhibit post-natal growth retardation, a facial ‘butterfly’ rash on sun exposure, defective cellular and humoral immunity, and increased cancer risk, and are reported to exhibit a high prevalence of diabetes mellitus, dyslipidaemia and fatty liver[13,14] Both syndromes metabolically phenocopy lipodystrophy and obesity, and some reduction of subcutaneous adipose tissue is reported in both syndromes[7,14]. Using WRN-/- and BLM-/- human pluripotent stem cell lines generated using CRISPR/Cas[9], this study aimed to model the adipose tissue phenotype seen in WS and BS patients to assess the role played by senescence at different stages of adipose development

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