Waheba Elsayed, Shih-Chieh Chieh Chiang, Tommaso Iannitti, Mateusz Jurga, Mohamed K. Hassan, Ian Coldicott, Sherif F. El-Khamisy, Kurt J. De Vos, Adrian Higginbottom, Evangelia Karyka, Padraig J. Mulcahy, Vera Lukashchuk, Katherine E. Lewis, Jayanth S. Chandran, Mimoun Azzouz, Pamela J. Shaw, Callum Walker, Swagat Ray, Saul Herranz-Martin, Guillaume M. Hautbergue, Chunyan Liao, and Ioannis Tsagakis
A hexanucleotide repeat expansion represents the most common genetic cause of\ud amyotrophic lateral sclerosis (ALS) and frontotemporal dementia, though the\ud mechanisms by which the expansion cause neurodegeneration are poorly understood. We\ud report elevated levels of DNA/RNA hybrids (R-loops) and double-strand breaks (DSBs) in\ud rodent neurons, human cells, and in C9orf72-ALS patient spinal cord tissues.\ud Accumulation of endogenous DNA damage is concomitant with defective ATM-mediated\ud DNA repair signalling and accumulation of protein-linked DNA breaks. We further\ud reveal that defective ATM-mediated DNA repair is a consequence of p62 accumulation,\ud which impairs H2A ubiquitylation and perturbs ATM signalling. Adeno-associated virus-\ud mediated expression of C9orf72-related RNA and dipeptide repeats in the murine central\ud nervous system causes elevated DSBs, ATM defects, and triggers neurodegeneration.\ud These findings identify R-Loops, DSBs, and defective ATM-mediated repair as\ud pathological consequences of C9orf72 expansions, and suggest that C9orf72-linked\ud neurodegeneration is driven, at least in part, by genomic instability.