Simon Edvardson, Claudia M. Nicolae, Pankaj B

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Heterozygous De Novo UBTF Gain-of-Function Variant Is Associated with Neurodegeneration in Childhood Simon Edvardson, Claudia M. Nicolae, Pankaj B. Agrawal, Cyril Mignot, Katelyn Payne, Asuri Narayan Prasad, Chitra Prasad, Laurie Sadler, Caroline Nava, Thomas E. Mullen, Amber Begtrup, Berivan Baskin, Zöe Powis, Avraham Shaag, Boris Keren, George-Lucian Moldovan, Orly Elpeleg The American Journal of Human Genetics Volume 101, Issue 2, Pages 267-273 (August 2017) DOI: 10.1016/j.ajhg.2017.07.002 Copyright © 2017 American Society of Human Genetics Terms and Conditions

Figure 1 Affected Individual 2 at Age 1 Year (A), 6 Years (B), and 10 Years (C) The American Journal of Human Genetics 2017 101, 267-273DOI: (10.1016/j.ajhg.2017.07.002) Copyright © 2017 American Society of Human Genetics Terms and Conditions

Figure 2 Progressive Cortical Atrophy Observed in Serial Brain MRI (A–C) Parasagittal T1-weighted brain MRI of affected individual 3 at age 4, 9, and 11 years, respectively. Note progressive cortical atrophy with slight cerebellar atrophy. (D and E) Axial and Midsagittal T1 images of affected individual 4 at age 15 years. Note cortical and cerebellar atrophy. (F) Axial T2 of affected individual 6 at age 8 years. Note cortical atrophy and periventricular white matter hyperintensity (arrows). (G and H) T2 weighted axial and sagittal sequences. Early imaging on affected individual 2 showing modest ventricular dilatation ex-vacuo associated with a thin corpus callous (arrows). (I and J) T2 Weighted axial and sagittal FLAIR sequences in a follow up imaging study repeated after 6 years showing dramatic cortical atrophy and ex-vacuo ventricular dilatation. Note is made of the subdural hygroma below the tentorium in (J). The American Journal of Human Genetics 2017 101, 267-273DOI: (10.1016/j.ajhg.2017.07.002) Copyright © 2017 American Society of Human Genetics Terms and Conditions

Figure 3 Mutant UBF Is Hyperactive and Drives Increased Expression of rDNA Genes, Associated with Nucleolar Alterations (A) Western blot analysis of cells of control and affected individual showing that the UBTF mutation does not affect UBF steady state levels, its phosphorylation status, or the levels of the Pol I subunits PolR1E, TAF1A, and TAFC. (B) Schematic representation of the rDNA gene locus, indicating the location of each primer set used: Promoter, external transcribed spacer (ETS), and non-transcribed spacer (NTS). (C) UBF ChIP-qPCR showing that UBF binding to the Promoter and ETS region is significantly increased in cells of the affected individual compared to control cells. Binding was quantified relative to input material, and shown as normalized to the NTS locus in control cells. Bars represent the average of three independent experiments, and error bars represent SD. The asterisk indicates statistical significance (p < 0.05) evaluated using the t test (two-tailed, equal variance). (D) Quantification of 18S expression in cells of affected individual and control, using real-time qPCR, quantified relative to GAPDH expression. Two different 18S primer sets were used. The results are shown as normalized to control cells. Bars represent the average of three independent experiments, and error bars represent SD. The asterisk indicates statistical significance (p < 0.05) evaluated using the t test (two-tailed, equal variance). (E) Representative micrographs of anti-nucleolin immunofluorescence showing altered nucloelar pattern in affected individual cells. (F) Quantification of nucleolar size. Nucleolar area was quantified using ImageJ and statistical analysis was done with Prism (t test, two-tailed, equal variance). Asterisks indicate statistical significance (p < 0.0001). The mean ± SEM is also shown. (G) Quantification of the number of nucleoli in each cell (117 control and 151 affected individual cells were analyzed). The American Journal of Human Genetics 2017 101, 267-273DOI: (10.1016/j.ajhg.2017.07.002) Copyright © 2017 American Society of Human Genetics Terms and Conditions