Abstract
Several inherited human syndromes that severely affect organogenesis and other developmental processes are caused by mutations in replication stress response (RSR) genes. Although the molecular machinery of RSR is conserved, disease-causing mutations in RSR-genes may have distinct tissue-specific outcomes, indicating that progenitor cells may differ in their responses to RSR inactivation. Therefore, understanding how different cell types respond to replication stress is crucial to uncover the mechanisms of RSR-related human syndromes. Here, we review the ocular manifestations in RSR-related human syndromes and summarize recent findings investigating the mechanisms of RSR during eye development in vivo. We highlight a remarkable heterogeneity of progenitor cells responses to RSR inactivation and discuss its implications for RSR-related human syndromes.
Introduction
Maintenance of genome stability is essential for development and homeostasis, and failures in processes required for genomic stability are associated with various human syndromes (; Negrini et al., 2010; O’Driscoll, 2012). DNA replication, transcriptional regulation and chromatin modifications must be precisely coordinated to ensure faithful transmission of genetic information to stem/progenitor cell pools that expand during development (Prioleau and MacAlpine, 2016). During DNA synthesis, many sources of genotoxic stress may slow or stall the progression of replication forks, a condition defined as replication stress. As a consequence, cells trigger the replication stress response (RSR). Activation of the RSR signaling pathways may slow DNA replication and allow extra time for DNA repair, preventing DNA mutations, chromosomal rearrangements and, therefore, genomic instability (Zeman and Cimprich, 2014; Techer et al., 2017; Tubbs and Nussenzweig, 2017). Due to its essential role during replication and development, mutations in genes that code proteins required for RSR are associated with several developmental syndromes (Zeman and Cimprich, 2014; ). Here, we review the ocular manifestations in RSR-related human syndromes and discuss recent findings investigating tissue-specific RSR in the developing eye that may contribute to understanding how defective-RSR drives developmental malformations.
Replication Stress Response
Single-stranded DNA (ssDNA) breaks are proposed to be the most frequent DNA lesion (∼75%) and those are normally generated during DNA replication (; Tubbs and Nussenzweig, 2017). The formation ssDNA stretches and aberrant replication fork structures lead to the activation of the ATR kinase, the master regulator of the RSR (Figure 1A). When exposed, long ssDNA stretches are coated by the replication protein A (RPA) complex. ATR-interacting protein (ATRIP), a mutually dependent partner of ATR, directly binds to RPA and recruits ATR to the RPA-ssDNA sites (; ; Zou and Elledge, 2003; ; ) (Figure 1A). ATR recruitment is not sufficient for its full activation and many regulatory partners are necessary (Saldivar et al., 2017). In double-stranded DNA-ssDNA (dsDNA-ssDNA) junctions, such as the ones found in stalled replication forks, ATR activation requires DNA topoisomerase II-binding protein 1 (TOPBP1) (). TOPBP1 recruitment to dsDNA-ssDNA junctions depends on its interaction with RAD9, member of the 9-1-1 clamp complex (RAD9-RAD1-HUS1) that is recruited by the clamp load factor RAD17 (; ; ) (Figure 1A). TOPBP1 recruitment depends on other proteins, including the MRE11-RAD50-NBS1 (MRN) complex and RHINO (; ). Importantly, NBS1 and the MRN complex are directly involved in ATR activation and cells from patients with inactivating mutations in NBS1 exhibit defective RSR (Stiff et al., 2005; ; Shiotani et al., 2013). In ssDNA regions without ssDNA-dsDNA junctions, RSR activation can be mediated by ETAA1, that directly interacts with RPA and activates ATR through its ATR-activating domain (AAD) domain (Figure 1A; ; ; ; Thada and Cortez, 2019). Studies in human cell lines suggested that ATR activation by TOPBP1 and ETAA1 may occur in different contexts. TOPBP1 would activate ATR upon induced replication stress and ETAA1 would trigger ATR activation in unchallenged replication to avoid under-replicated DNA during the S-M transition (Saldivar et al., 2018). In addition, ATR can be directly activated by NBS1, although the mechanisms are not clear since NBS1 does not have an AAD domain ().
FIGURE 1
RSR depends not only on ATR-mediated signal transduction but also on its downstream effectors, specially the checkpoint protein 1 (CHK1) (Saldivar et al., 2017). ATR phosphorylates CHK1 in multiple sites and CHK1 activation depends on its partner CLASPIN (
Inactivation of the Replication Stress Response in vivo
Highlighting the importance of ATR activation for unchallenged cell proliferation during development in vivo, inactivation of various “RSR genes” (here defined as genes necessary for full activation of ATR-CHK1 signaling following replication stress) is embryonic lethal in mice (
Replication Stress Response in vivo: Focus on the Eye
The eye is the sensory organ responsible for vision and is composed of three main tissues: cornea, lens and retina (Figure 2A). The anterior segment of the eye comprises the cornea, the iris and the lens, a transparent structure that focus the light to the back of the eye. The main tissue of its posterior segment is the retina, the neural part of the eye responsible for detection and preprocessing of the visual stimuli before transmission to the visual centers of the brain through the optic nerve (
FIGURE 2

Tissue-specific effects of replication stress response (RSR) inactivation in developing mouse eye. Schematic representation of ocular development in wild-type mice (A) and the consequences of RSR inactivation in lens (B,C) or retinal progenitor cells (D,E) in Trp53-proficient (B,D) and Trp53-deficient scenarios (C,E). RSR inactivation by the loss of ATRIP leads to progenitor cell apoptosis in both the lens and retina. Only in the retina, Trp53-deficiency rescued embryonic apoptosis and the consequent secondary phenotypes.
Importantly, the eye represents a unique model to study the impact of defective RSR to organogenesis because: (1) of the vast knowledge about its development in mammals; (2) it is a non-essential organ, therefore a powerful model to analyze genetic interactions, and evaluate the long term consequences of essential genes inactivation; (3) there is a substantial amount of genetic tools available; (4) it is composed of tissues derived from distinct developmental lineages, making it ideal to study progenitor cells of different lineages. In addition, although clinical studies have shown ophthalmological manifestations in RSR-related syndromes (Figure 1B), the origins of these manifestations in these syndromes have been underexplored and raising awareness to this topic may bring important contributions to patients.
Loss-of-function mutations in ATR/ATRIP or in NBS1 are among the known causes of Seckel or Nijmegen breakage syndrome, respectively. These syndromes are characterized by moderate to severe tissue-growth impairments, neurodevelopmental defects and a series of ocular manifestations that have been reported in patients (
Ocular Manifestations in Replication Stress-Related Human Syndromes
Microphthalmia
Microphthalmia is a disorder characterized by abnormally small eyes that display high genetic heterogeneity and may occur as part of a syndrome. Disproportional ocular growth may contribute to microphthalmia, since microphthalmic eyes are more affected in the posterior segment than the anterior (Verma and Fitzpatrick, 2007). Microphthalmia has been reported in both Seckel and Nijmegen breakage syndromes (Figure 1B). Studies in animal models (discussed in the next sections) suggested that defective cell proliferation and increased cell death may be the cause of microphthalmia following the inactivation of RSR genes (Yang et al., 2006; Rodrigues et al., 2013;
Cataract
Although treatable, cataracts are the most common cause of blindness. Congenital cataracts, the ones in which the opacification of the lens is detected at birth, are a clinical feature of almost 200 syndromic genetic diseases (
Retinal Neurodegeneration
Glaucoma is characterized by structural damage to the optic nerve and retinal ganglion cell degeneration, leading to loss of vision due to the interruption of the transmission of information from the eye to the brain (Quigley, 2011;
Lessons From Mouse Models
Genetic inactivation of NBS1 in mice was key to understanding the etiology of Nijmegen breakage syndrome (
In the developing eye, NBS1-deficiency in the lens leads to cell death, proliferation defects and microphthalmia (Yang et al., 2006;
Interestingly, a specific synergy between NBS1 loss and TRP53 was also revealed in lens progenitor cells. In the developing brain, TRP53 inactivation rescues cell death and proliferation defects and brain growth defects caused by NBS1 loss (
Recently, we explored the function of another RSR gene by analyzing the function of ATRIP following tissue-specific inactivation in mice (Figure 2). As shown in transformed human cells (
We have also evaluated the effects of RSR inactivation in the mouse retina. ATRIP loss in embryonic retinal progenitor cells induces DNA damage accumulation and cell death, leading to lamination defects, photoreceptor degeneration and loss of vision (
In contrast to the lens, inactivation of Trp53 rescues the cell death of retinal progenitor cells, neurodegeneration and visual impairment caused by ATRIP loss, indicating that TRP53-dependent apoptosis is the driver of retinal malformations caused by Atrip inactivation (
Discussion
Based on the above-described studies we propose that the eye growth defects observed in replication-stress related syndrome patients are caused by the essential function of the affected genes in RSR in progenitor cells during embryogenesis. For example, tissue dysplasia and photoreceptor degeneration observed in Atrip-deficient retinas are a secondary consequence of progenitor apoptosis caused by the defective RSR in progenitor cells during embryonic development (
The DDR is an evolutionarily conserved process that is often believed to operate by universal uniform principles. However, given that different progenitor cells have distinct transcriptional programs, metabolism, microenvironment and face different DNA-damaging insults, the DDR presents cell type- and developmental stage-specific adaptations (
Publisher’s Note
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Statements
Author contributions
Both authors wrote the manuscript and read and agreed to the published version of the manuscript.
Funding
This work was supported by the Brazilian National Council of Scientific and Technological Development (CNPq) (439031/2018-4 and 313064/2017-2 to RM), the Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) (E-26/210.500/2019 to RM), and The International Retinal Research Foundation.
Acknowledgments
We apologize to the authors whose work could not be cited due to space limitations. We would like to thank Clara F. Charlier for reading and helpful discussion.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Summary
Keywords
genome stability, cell cycle, DNA damage, chekcpoint, ATR, organogenesis, retina, lens
Citation
Matos-Rodrigues GE and Martins RAP (2021) An Eye in the Replication Stress Response: Lessons From Tissue-Specific Studies in vivo. Front. Cell Dev. Biol. 9:731308. doi: 10.3389/fcell.2021.731308
Received
26 June 2021
Accepted
21 September 2021
Published
04 November 2021
Volume
9 - 2021
Edited by
Nicolas Hoch, University of São Paulo, Brazil
Reviewed by
Chunsik Lee, Sun Yat-sen University, China; Vanesa Gottifredi, IIBBA-CONICET Leloir Institute Foundation, Argentina
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Copyright
© 2021 Matos-Rodrigues and Martins.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Gabriel E. Matos-Rodrigues, gabriel.rodrigues@nih.govRodrigo A. P. Martins, rodrigo.martins@icb.ufrj.br
†Present address: Gabriel E. Matos-Rodrigues, Laboratory of Genome Integrity, National Cancer Institute, National Institutes of Health (NIH), Bethesda, MD, United States
This article was submitted to Signaling, a section of the journal Frontiers in Cell and Developmental Biology
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