A rare genetic disease, Fanconi anemia (FA), now attracts broader attention from cancer biologists and basic researchers in the DNA repair and ubiquitin biology fields as well as from hematologists. FA is a chromosome instability syndrome characterized by childhood-onset aplastic anemia, cancer or leukemia susceptibility, and cellular hypersensitivity to DNA crosslinking agents. Identification of 11 genes for FA has led to progress in the molecular understanding of this disease.
IntroductionMany hematologists are familiar with Fanconi anemia (FA) as a cause of childhood-onset aplastic anemia. However, this rare genetic disease now attracts broader attention from cancer biologists and basic researchers. FA is a rare chromosome instability syndrome characterized by aplastic anemia, cancer and leukemia susceptibility, and cellular hypersensitivity to interstrand DNA crosslinking agents, such as cisplatin, mitomycin C (MMC), diepoxybutane (DEB), and melphalan. [1][2][3] Treatment with these agents causes increased chromosome breakage in cells derived from patients with FA. 4 Because of this hypersensitivity to DNA crosslinking agents, many researchers have speculated that the primary defect of FA cells is in DNA damage response or DNA repair, although until recently direct evidence of a connection between FA and DNA repair had not been shown.Recent identification of the responsible genes for FA has changed our view of the molecular pathogenesis of the disease. FA can be divided into at least 12 complementation groups (A, B, C, D1, D2, E, F, G, I, J, L, and M) defined by cell fusion studies, and 11 of the 12 responsible FA genes have been identified (Table 1; Figure 1). [5][6][7][8] Proteins encoded by FA genes (FA proteins) include a ubiquitin ligase (FANCL/PHF9/ POG), 9 a monoubiquitinated protein (FANCD2), 10,11 a helicase (FANCJ/ BACH1/BRIP1), 7,8,12 a protein with helicase motifs and a nuclease motif (FANCM), and a well-known breast/ovarian cancer susceptibility protein (FANCD1/BRCA2). 13 FA proteins (including BRCA2) and another well-known breast/ovarian cancer susceptibility protein, BRCA1, cooperate in a common DNA repair process that is required for cellular resistance to DNA interstrand crosslinks (ICLs), and a concept of the Fanconi anemia-BRCA pathway 14 (or FA-BRCA network 15 ) has been proposed. Furthermore, molecular and functional interaction of FA proteins with proteins [ATM (ataxia-telangiectasia mutated), 16 MRE11, 17 BLM, [18][19][20]17,21 and ATR (ATM and Rad3-related) 22,23 ] responsible for other rare genetic chromosome instability syndromes [ataxia telangiectasia, 24 AT-like disorder, 25 Bloom syndrome, 26 Nijmegen breakage syndrome (NBS), 27 and Seckel syndrome, respectively] in DNA damage response is now evident. Therefore, the FA pathway appears to regulate DNA repair.Ubiquitination is a posttranslational modification in which a 76-residue small protein, ubiquitin, is covalently attached to a target protein (reviewed in Mani and Gelmann 28 ). Polyubiquitination is well known for its funct...