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Genome-wide association studies found that increased risk for atrial fibrillation (AF), the most common human heart arrhythmia, is associated with noncoding sequence variants located in proximity to PITX2 Cardiomyocyte-specific epigenomic and comparative genomics uncovered 2 AF-associated enhancers neighboring PITX2 with varying conservation in mice. Chromosome conformation capture experiments in mice revealed that the Pitx2c promoter directly contacted the AF-associated enhancer regions. CRISPR/Cas9-mediated deletion of a 20-kb topologically engaged enhancer led to reduced Pitx2c transcription and AF predisposition. Allele-specific chromatin immunoprecipitation sequencing on hybrid heterozygous enhancer knockout mice revealed that long-range interaction of an AF-associated region with the Pitx2c promoter was required for maintenance of the Pitx2c promoter chromatin state. Long-range looping was mediated by CCCTC-binding factor (CTCF), since genetic disruption of the intronic CTCF-binding site caused reduced Pitx2c expression, AF predisposition, and diminished active chromatin marks on Pitx2 AF risk variants located at 4q25 reside in genomic regions possessing long-range transcriptional regulatory functions directed at PITX2.

Citation

Min Zhang, Matthew C Hill, Zachary A Kadow, Ji Ho Suh, Nathan R Tucker, Amelia W Hall, Tien T Tran, Paul S Swinton, John P Leach, Kenneth B Margulies, Patrick T Ellinor, Na Li, James F Martin. Long-range Pitx2c enhancer-promoter interactions prevent predisposition to atrial fibrillation. Proceedings of the National Academy of Sciences of the United States of America. 2019 Nov 05;116(45):22692-22698

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PMID: 31636200

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