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Radiation Oncology/Radiobiology/DNA Repair
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Repair of Radiation-Induced DNA Damage
Single Strand Damage Repair
Single strand breaks are common occurrence; 1 Gy of radiation induces ~1000 SSB per cell
Given this, cells have efficient machinery to repair SSB
However, single strand breaks are also important to double strand break formation
Ionizing radiation often occurs in clusters, and some SSB will be created in proximity to areas with base damage. In these, the temporary strand nick performed during BER can combine with the near SSB to form a DSB
If SSB happens in a replication fork during S-phase, the fork collapses and there is a single-end double-strand break. These cannot be repaired by NHEJ (since there are not two ds breaks), and must be attempted to be repaired by HR. This may be a problem in tumors with HR deficiencies (such as BRCA1 and BRCA2 mutations), and PARP inhibition seems particularly effective in these settings
Base Excision Repair (BER)
Major pathway responsible for repair of hydrolytic and oxidative base damage (e.g. Uracil, 8OH-guanine, abasic sites)
Damage is recognized by Poly (ADP-ribose) polymerase (PARP)
Depending on the number of bases damaged, BER proceeds through either Short Patch or Long Patch pathway
Short Patch BER
DNA glycosylase excises the base leading to AP Site (apurinic site). There are different glycosylases which recognize specific bases
AP endonuclease (APE-1) removes the sugar residue
DNA polymerase β replaces the correct nucleotide
DNA ligase III and XRCC1 complex ligate the free DNA strands together
Long Patch BER
DNA glycosylase excises the base leading to AP Site (apurinic site). There are different glycosylases which recognize specific bases
AP endonuclease (APE-1/AP Lyase) removes the sugar residues
PCNA (Proliferating cell nuclear antigen) serves as an adapter for proteins involved in the subsequent steps
DNA polymerase δ/ε and PCNA complex duplicate the correct nucleotide sequence, duplicating it even under the undamaged strand
Flap endonuclease 1 (FEN1) and PCNA complex snips off normal overhang of the prior undamaged strand
DNA ligase I and PCNA complex ligate the free DNA strands together
Defects generally do not increase radiation sensitivity, but lead to increased mutation rate. Defect in XRCC1 does increase radiosensitivity (1.7X), but this may be due to its role in SSB repair
Inhibition of PARP and XRCC1 is efficient in HR-deficient tumors
Hereditary Syndromes:
No human diseases resulting from BER mutation have thus far been identified
Nucleotide Excision Repair (NER)
Major pathway responsible for repair of bulky DNA adducts (e.g. pyrimidine dimers); as such, it is not critically important for radiation oncology
Overview of the steps involved (see more at wikipedia
Incision in DNA surrounding the damage; this is typically a bracket 24 - 32 bp long
Removal of the entire region containing the adducts
Repair synthesis of DNA
DNA ligation
Proteins involved include XPA,XPB, XPC,XPD,XPE,XPF, and XPG (linked to Xeroderma pigmentosum patients) and CSA (ERCC8) and CSB (ERCC6) (linked to Cockayne syndrome)
Defects generally do not increase radiation sensitivity, but lead to increased sensitivity to UV damage and to anticancer agents that induce bulky addicts (e.g. alkylating agents)
Hereditary Syndromes:
Xeroderma Pigmentosum
Cockayne Syndrome
Mismatch Repair
Pathway responsible for removes base-base mismatches and small insertion/ deletion mismatches
Overview of the steps involved
Initiation: MSH2, MSH3, and MSH6 surround DNA; MLH1 and PSM2
Excision and resynthesis: Polymerase δ/ε and PCNA complex
DNA ligation with DNA ligase I
Defects generally do not increase radiation sensitivity, but lead to increased mutation rate
Mutations in MLH, MSH, or PSM families result in microsatellite instability (small base insertions or deletions) and cancer (e.g. sporadic endometrial cancer)
Hereditary Syndromes:
Hereditary Non-Polyposis Colon Cancer (HNPCC).
DNA Damage Bypass
Occurs when a moving replication fork encounters damage in the template strand
Important component of cellular response to DNA damage, and contributes similar survival as NER and HR
Rad 18 binds to DNA, Rad 6 ubiquitylates PCNA
PCNA may determine if a recombinatorial bypass (error-free) or translesion bypass (error-prone) will take place. Not well understood
SRS2 is a helicase, which blocks further homologous recombination
Recombination bypass proteins include Rad5, Ubc13, Mms2
Translesion bypass proteins include DNA polymerase ζ and η
Please see Rosewell Park lecture for more information
DNA Alkylation
MGMT
MGMT (O6-methylguanine-DNA methyltransferase) gene is located on chromosome 10q26
It encodes DNA-repair proteins that removes alkyl groups from O6 position on guaning
Repair of DNA by MGMT consumes the protein, which must be replaced by the cell
O6-methylguanine lesions are induced by chemotherapy alkylating agents, and if left unrepaired, trigger cytotoxicity and apoptosis
Epigenetic silencing of MGMT gene by promoter methylation results in loss of MGMT expression and reduced DNA repair. Please see the Glioblastoma chapter for more information
Double Strand Damage Repair
There are two main pathways for repair of DSBs
Nonhomologous end-joining (NHEJ): primarily active during G0, G1, early S when sister chromatid not present, though also active in G2/M. Joins two double strand breaks. Error-prone
Homologous recombination repair (HRR): during G2/M when sister chromatid is present. Copies information from the undamaged chromosome. Error-free
The role of single-strand annealing as a repair pathway for DSB has not been well clarified, but seems to involve homologous recombination as well
Nonhomologous End-Joining (NHEJ)
Joins two DSB ends together, without requiring a template
Low fidelity, with frequent deletions or insertions at the break site. While this may increase mutations, it allows the cell to survive. Also used for immunoglobulin V(D)J recombination
Starts with Ku70/Ku80 heterodimer binding to free DNA ends, and acting as a scaffold
It then recruits DNA-PKcs (PRKDC), which acts as a bridge between the two free DNA ends. It also phosphorylates a number of target proteins involved in DNA repair and cell cycle control
DNA-PKcs complexes with Artemis, which is an endonuclease to process the DNA ends
Several other enzymes, including nucleases and polymerases, then fill in or remove single-strand overhangs. This process can result in insertions or deletions
Final step is ligation of the two ends together by ligase IV, assisted by XRCC4 and XLF
Hypersensitivity to ionizing radiation
Hereditary syndromes:
DNA-PKcs, Artemis, XLF: Radiosensitive Severe Combined Immunodeficiency (RS-SCID) (19075392)
LIG4 (Ligase IV gene): LIG4 syndrome, similar to SCID
Homologous Recombination (HR)
Uses homologous DNA (replicated DNA) as a template to repair damage
May take up to 6 hours or more to complete
Starts with creating single strand overhang regions around each side of the break by resecting part of the 5' -> 3' strand, with MRN playing a major role
MRN complex (MRE11-RAD50-NBS1) holds the broken ends of DNA, such that MRE11 attaches to the broken DNA ends, while RAD50 bridges the break, and NBS1 activates ATM to start the repair
BRCA1 is recruited by H2AX to regulate the activity of the MRN complex
Replication protein A (RPA) coats each single strand overhang as scaffold
RAD51 complex attaches around the ssDNA to create a nucleoprotine filament and searches for the homologue strand. There are multiple versions of RAD51 that participate in this process (e.g. RAD51B, RAD51C, RAD51D, XRCC2, XRCC3)
BRCA2 facilitates loading of RAD51 onto the RPA-covered single strand overhang
FANC-D2 regulates function of BRCA2, and is also involved in S-phase checkpoint
RAD52 and RAD54 are supporting proteins to RAD51 in this process
Helicases BLM, TopIIIA, WRN, and others unwind the homologous DNA double strand; RAD54 may also play some role in this process
The identity of polymerases and ligases involved in copying the damaged strand based on the homologous template is not known, although Ligase I is probably involved
MMS4 and MUS81 resolve the Holiday junction crossovers
Hereditary Syndromes:
MRE11:Ataxia-Telangiectasia-Like Disorder (ATLD)
NBS1: Nijmegen Breakage Syndrome (NBS)
RAD50: Nijmegen Breakage Syndrome-Like Disorder (NBSLD)
BLM: Bloom Syndrome
WRN: Werner syndrome
FANC-D2: Fanconi Anemia (FA)
ATM: Ataxia-Telangiectasia
ATR: ATR-Seckel syndrome
Single Strand Annealing (SSA)
A transitional process between NHEJ and HR
One strand on each side of the break is digested away, until a region of homology is found between the remaining two strands
The two single strands are annealed at that point
The complementary strands that were digested are reconstituted
Results in loss of genetic information
Please see this page for more detail and pictures
NHEJ vs HR
NHEJ happens along in all phases of the cell cycle
HR is specific only to dividing cells, since it occurs in S and G2 phase
In G1 phase, double strand DNA damage is repaired with NHEJ, while in S-G2 phases, both processes are active and compete against each other
Therefore, in slowly dividing or non-dividing tissues (e.g. spinal cord or stromal tissues), primary repair process is NHEJ
There is some evidence that MRN is active in both processes, and that it may regulate the choice between NHEJ and HR in dividing cells
If one of the components is defective, it leads to various genomic instability disorders and increased malignancy
Cross-Link Repair
Genes and pathways used for DNA-DNA and DNA-protein cross-links are under investigation
The pathway depends on homologous recombination
DNA Repair Literature
Saarland (Germany); 2008 18805648 -- "DNA Double-Strand Break Rejoining in Complex Normal Tissues." (Rube Ce, Int J Radiat Oncol Biol Phys. 2008 Sep 19. [Epub ahead of print])
TBI in mice model. Formation and rejoining of DSBs analyzed via gammaH2AX in both early responding (small intestine) and late responding (lung, brain, heart, kidney) tissues
Outcome: Linear dose correlation of gammaH2AX to dose. Various normal tissues exhibited identical kinetics of gammaH2AX foc loss, despite different clinical radiation response
Conclusion: Identical kinetics of DSB rejoining in various organs suggest that tissue specifice difference in radiation response are independent of DSB rejoining
Oxford; 2008 18571480 -- "Interplay of two major repair pathways in the processing of complex double-strand DNA breaks." (Dobbs TA, DNA Repair (Amst). 2008 Aug 2;7(8):1372-83. Epub 2008 Jun 20.)
Evaluation of base excision repair and DSB ligation
Conclusion: Reduced efficiency of repair of complex DSBs
London Research Institute; 2008 18596698 -- "Mre11-Rad50-Nbs1-dependent processing of DNA breaks generates oligonucleotides that stimulate ATM activity." (Jazayeri A, EMBO J. 2008 Jul 3. [Epub ahead of print])
Wayne State; 2007 17967316 -- "Transition in Survival From Low-Dose Hyper-Radiosensitivity to Increased Radioresistance Is Independent of Activation of ATM SER1981 Activity." (Krueger SA, Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1262-71.)
Role of ATM and downstream G2 cell-cycle checkpoint in low-dose hyper-radiosensitivity
Harvard; 2007 17525332 -- "ATM and ATR substrate analysis reveals extensive protein networks responsive to DNA damage." (Matsuoka S, Science. 2007 May 25;316(5828):1160-6.)
Proteomic analysis of ATM/ATR phosphorylated proteins
>900 regulated sites found on >700 proteins, many involved in DNA damage response
ERCC1
Impacts DNA damage from lesions caused by UV light, exogenous chemicals that induce bulky DNA adducts (eg cisplatin)
1/16 genes in nucleotide excision repair complex
Forms heterodimer with XPF, which excises 5' DNA strand relative to site of damage. This is final step of the excision process
16957145 -- "DNA repair by ERCC1 in non-small-cell lung cancer and cisplatin-based adjuvant chemotherapy." (Olaussen, N Engl J Med. 2006 Sep 7;355(10):983-91.)
Prognostic for benefit of chemo in resected NSCLC
Summary of Damage - Repair
Thymine glycol - BER
8-OH-guanine - BER
Urea/uracil - BER
Bulky adducts, pyrimidine dimers - NER
Nucleotide error - Mismatch repair
DNA double strand break - NHEJ or HR
Review
2007 17512070 -- "DNA damage-induced signalling in ataxia-telangiectasia and related syndromes." (Lavin MF, Radiother Oncol. 2007 Jun;83(3):231-7. Epub 2007 May 23.)
2007 18066093 -- "DNA double-strand break repair and development." (Phillips ER, Oncogene. 2007 Dec 10;26(56):7799-808.)
2002 12016139 -- "Sensing and repairing DNA double-strand breaks." (Jackson SP, Carcinogenesis. 2002 May;23(5):687-96.)
1998 9806612 -- "Monitoring and signaling of radiation-induced damage in mammalian cells." (Szumiel I, Radiat Res. 1998 Nov;150(5 Suppl):S92-101.)