Mutations in the Histone Modifier PRDM6 Are Associated with Isolated Nonsyndromic Patent Ductus Arteriosus  Na Li, Lakshman Subrahmanyan, Emily Smith,

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Mutations in the Histone Modifier PRDM6 Are Associated with Isolated Nonsyndromic Patent Ductus Arteriosus  Na Li, Lakshman Subrahmanyan, Emily Smith, Xiaoqing Yu, Samir Zaidi, Murim Choi, Shrikant Mane, Carol Nelson-Williams, Mohaddeseh Behjati, Mohammad Kazemi, Mohammad Hashemi, Mohsen Fathzadeh, Anand Narayanan, Likun Tian, Farhad Montazeri, Mitra Mani, Michael L. Begleiter, Brian G. Coon, Henry T. Lynch, Eric N. Olson, Hongyu Zhao, Jürgen Ruland, Richard P. Lifton, Arya Mani  The American Journal of Human Genetics  Volume 98, Issue 6, Pages 1082-1091 (June 2016) DOI: 10.1016/j.ajhg.2016.03.022 Copyright © 2016 American Society of Human Genetics Terms and Conditions

Figure 1 PRDM6 p.Arg549Gln in a Large PDA-Affected Kindred (A) Pedigree PDA-101 is shown. Individuals with PDA are indicated by black symbols, individuals without PDA are shown as unfilled symbols, and individuals with unknown PDA status are shown with partially filled squares. Circles represent females, squares represent males, and symbols with a slash through them indicate deceased subjects. Haplotypes on 5q23 are shown under each individual. (B) Multipoint LOD scores for linkage of PDA to 5q23. SNPs tightly linked to the location of PRDM6 in the LOD-1 region are shown. The maximum LOD score is indicated, and the location of PRDM6 is shown. The LOD score peak occurs at θ = 0 with marker rs2081914, and the LOD-1 interval spans 10 cM. (C) The DNA sequence of a segment flanking c.1646G>A in PRDM6 is shown from an unaffected kindred member (left) and a heterozygous mutation carrier (right). This single-base substitution (asterisk) changes the wild-type arginine to glutamine at amino acid 549 (p.Arg549Gln). (D) A portion of the PRDM6 amino acid sequence flanking Arg549 is shown from diverse vertebrate species. The American Journal of Human Genetics 2016 98, 1082-1091DOI: (10.1016/j.ajhg.2016.03.022) Copyright © 2016 American Society of Human Genetics Terms and Conditions

Figure 2 Independent Non-conservative Mutations of PRDM6 in Subjects with PDA (A and B) A pedigree with a DNA segment flanking the PRDM6 c.788G>C mutation (resulting in p.Cys263Ser) and a portion of the protein flanking Cys263 in diverse vertebrate species are shown in (A). A pedigree with a DNA segment flanking the PRDM6 c.1385A>G mutation (resulting in p.Arg549Gln) and a portion of the protein flanking Gln462 in diverse vertebrate species are shown in (B). Individuals with PDA are indicated by black symbols, individuals without PDA are shown as unfilled symbols, and individuals with unknown PDA status are shown with partially filled squares. Circles represent females, squares represent males, and symbols with a slash through them indicate deceased subjects. (C) A schematic of PRDM6 with functional domains and the location of the three independent mutations are shown. Intronic regions are not drawn to scale. ZF denotes zinc finger. The American Journal of Human Genetics 2016 98, 1082-1091DOI: (10.1016/j.ajhg.2016.03.022) Copyright © 2016 American Society of Human Genetics Terms and Conditions

Figure 3 The Effect of PRDM6 Amino Acid Substitutions on Its Nuclear Localization Immunofluorescence staining of wild-type PRDM6, PRDM6 p.Arg549Gln (p.R549Q), and p.Cys263Ser (p.C263S) in HEK293 cells. Whereas wild-type PRDM6 and p.Cys263Ser were localized in the nucleus, p.Arg549Gln was predominantly localized in the cytoplasm. Colors are as follows: blue, DAPI; green, phalloidin; and red, PRDM6 with FLAG tag. Scale bars represent 7 μm. The American Journal of Human Genetics 2016 98, 1082-1091DOI: (10.1016/j.ajhg.2016.03.022) Copyright © 2016 American Society of Human Genetics Terms and Conditions

Figure 4 The Effect of PRDM6 Amino Acid Substitutions on MYH11 Cellular Levels Immunostaining demonstrates the localization of PRDM6 (red) in relationship to the nucleus (blue) and the staining for MYH11 in human aortic smooth muscle cells. Cells infected with wild-type PRDM6, PRDM6 p.Arg549Gln (p.R549Q), and PRDM6 p.Cys263Ser (p.C263S) are shown in the top, middle, and bottom rows, respectively. Wild-type PRDM6 suppressed MYH11. Substitution p.Arg549Gln was largely retained in the cytoplasm, whereas p.Cys263Ser was mainly expressed in the nucleus. In smooth muscle cells overexpressing DNA encoding p.Arg549Gln and p.Cys263Ser, MYH11 staining was comparable to that in non-transfected cells. Dotted lines delineate transfected cells. Scale bars represent 28 μm. The American Journal of Human Genetics 2016 98, 1082-1091DOI: (10.1016/j.ajhg.2016.03.022) Copyright © 2016 American Society of Human Genetics Terms and Conditions

Figure 5 The Effect of PRDM6 Amino Acid Substitutions on the Amounts of H4K20me2, H3K9me2, MYH11, and α-SMA Immunoblot shows the amounts of histones H4K20me2 and H3K9me2 (A) and MYH11 and α-SMA (B) in wild-type human aortic VSMCs transfected with wild-type PRDM6, PRDM6 p.Arg549Gln (p.R549Q), and PRDM6 p.Cys263Ser (p.C263S). Cells transfected with empty vector were used as controls. The lower panel shows the relative intensities by densitometry. Error bars denote the SEM. The American Journal of Human Genetics 2016 98, 1082-1091DOI: (10.1016/j.ajhg.2016.03.022) Copyright © 2016 American Society of Human Genetics Terms and Conditions

Figure 6 Dynamic Changes in PRDM6 Abundance in Mouse DA and Great Vessels (A) H&E staining of the aorta (AO), ductus arteriosus (DA), and pulmonary artery (PA) at E14.5, E17.5, and P0.5. (B and C) IF staining of PRDM6, α-SMA, and CD31 at E14.5, E17.5, and P0.5. (B) PRDM6 was detectable in smooth muscle cells, but not in endothelia cells, of the DA at E14.15 and E17.5. Its amounts were diminished in the DA at P0.5. (C) PRDM6 was persistently detected in smooth muscle cells of the aorta at all three embryonic stages without significant variation. Scale bars represent 37 μm. (D and E) Relative intensities of PRDM6 in the DA (D) and aorta (E) at E14.5, E17.5, and P0.5 in seven mice. L denotes lumen. Arrowheads point toward PRDM6 staining. Error bars denote the SEM. The American Journal of Human Genetics 2016 98, 1082-1091DOI: (10.1016/j.ajhg.2016.03.022) Copyright © 2016 American Society of Human Genetics Terms and Conditions