FMR1 reactivating treatments in Fragile X iPSC-derived neural progenitors in-vitro and in-vivo

Fragile X syndrome (FXS) is caused primarily by a CGG repeat expansion mutation in the FMR1 gene that triggers its epigenetic silencing. In order to investigate the role of different epigenetic regulatory layers in the silencing of FMR1 expression, we tested a collection of epigenetic modulators for the ability to reactivate the FMR1 locus. While inhibitors of DNA methylatransferase induced the highest levels of FMR1 mRNA expression, a combination of a DNMT inhibitor and a novel epigenetic agent was able to potentiate the effect of reactivating treatment. To better assess the rescue effect observed following direct demethylation, we characterized the long-term and genome-wide effects of FMR1 reactivation, and established an in vivo system for FMR1 reactivating therapy analysis. Systemic treatment with a DNMT inhibitor in mice carrying transplants of differentiated FXS-iPSCs was able to robustly induce FMR1 expression in the affected tissue, which was maintained for a prolonged period of time. Finally, we show a proof-of-principle for FMR1 reactivating therapy in the context of the central nervous system.