Rare diseases provide rare insights into DNA repair pathways, TFIIH, aging and cancer

Abstract

The study of rare human diseases has been instrumental in the development of our understanding of human DNA repair processes. This meeting focused on three disorders of DNA repair and transcription: Cockayne syndrome (CS), xeroderma pigmentosum (XP) and trichothiodystrophy (TTD). For the first time, clinicians, basic researchers and patient advocates met together, shared information and discussed their needs and goals. Cancer susceptibility varies greatly from more than 1000-fold increase in XP to normal in CS and TTD. Some patients with CS, XP or TTD have progressive neurological degeneration. The clinical diagnosis of these disorders involves evaluation by several specialties including neurology, dermatology, radiology, pathology and genetics. There is a pressing need for a laboratory to perform clinically certified diagnostic testing in the US. These diseases are quite complex and overlap syndromes have been found. Each can arise from mutations in more than one gene and conversely, different mutations in one gene can give rise to more than one clinical disease. Some of the proteins that are defective in these disorders function in both DNA repair and transcription. They respond to UV and oxidative DNA damage and involve varied functions such as DNA unwinding, transcription initiation, protein ubiquitination, nuclear receptor phosphorylation, promoter release and myc homeostasis. Mouse models offer the possibility of exploring the effects of complex interactions among these genes. These issues were all discussed at a recent workshop.