Expansions and deletions of triplet repeat sequences that cause human hereditary neurological diseases were previously suggested to be mediated by the formation of DNA hairpins on the lagging strand during replication. The replication properties of CTG⅐CAG, CGG⅐CCG, and TTC⅐GAA repeats were studied in Escherichia coli using an in vivo phagemid system as a model for continuous leading strand synthesis. The repeats were substantially deleted when the CTG, CGG, and GAA repeats were the templates for rolling circle replication from the f1 phage origin. The deletions may be mediated by hairpins formed by these repeat tracts. The distributions of the deletion products of the CTG⅐CAG and CGG⅐CCG tracts indicated that hairpins of discrete sizes mediate deletions during complementary strand synthesis. Deletions during rolling circle synthesis are caused by larger hairpins of specific sizes. Thus, most deletion products were of defined lengths, suggesting a preference for specific hairpin intermediates. Small expansions of the CTG⅐CAG and CGG⅐CCG repeats were also observed, presumably due to the formation of CTG and CGG hairpins on the nascent complementary strand. Since rolling circle replication has been established in vitro as a model for leading strand synthesis, we conclude that triplet repeat instability can also occur on the leading strand of DNA replication.The genetic instability of three triplet repeat sequences (TRS), 1 CTG⅐CAG, CGG⅐CCG, and TTC⅐GAA, has been shown to result in approximately 12 hereditary neurological diseases (1-3) including myotonic dystrophy (4), Kennedy's disease (5), fragile X disease (6), and Freidreich's ataxia (7). These diseases are inherited in a non-Mendelian fashion by a phenomenon called "anticipation," which is characterized by an increase in severity and a decrease in age of onset from one generation to the next. The anomalous expansion of TRS has been identified as the molecular basis for anticipation (1). Triplet repeat tracts are highly polymorphic and have been shown to range from five to approximately 40 repeats in normal human chromosomes. Expansion of these tracts can result in type I and type II diseases as classified by Paulson and Fischbeck (3). Whereas type I diseases are characterized by modestly expanded TRS (approximately 30 -80 repeats) in the coding region of a gene, type II diseases contain massive expansions (Ͼ1000 repeats) of the triplet repeat tract in the 5Ј-UTR or 3Ј-UTR or in an intron of a gene (1, 3).Escherichia coli has been used as a genetically tractable system for the study of TRS in vivo (8). The genetic instability of TRS in E. coli is dependent on its orientation relative to the unidirectional ColE1 origin of replication as well as host cell growth phase and transcription (9 -13). Other factors including genetic background (12), methyl-directed mismatch repair (14), and expression of single-stranded DNA binding protein (SSB) (15) are also important. The effect of the orientation of the TRS with respect to the direction of replication on its instabi...