RT Journal Article T1 Primary constitutional MLH1 epimutations: a focal epigenetic event. A1 Dámaso, Estela A1 Castillejo, Adela A1 Arias, María Del Mar A1 Canet-Hermida, Julia A1 Navarro, Matilde A1 Del Valle, Jesús A1 Campos, Olga A1 Fernández, Anna A1 Marín, Fátima A1 Turchetti, Daniela A1 García-Díaz, Juan de Dios A1 Lázaro, Conxi A1 Genuardi, Maurizio A1 Rueda, Daniel A1 Alonso, Ángel A1 Soto, Jose Luis A1 Hitchins, Megan A1 Pineda, Marta A1 Capellá, Gabriel AB Constitutional MLH1 epimutations are characterised by monoallelic methylation of the MLH1 promoter throughout normal tissues, accompanied by allele-specific silencing. The mechanism underlying primary MLH1 epimutations is currently unknown. The aim of this study was to perform an in-depth characterisation of constitutional MLH1 epimutations targeting the aberrantly methylated region around MLH1 and other genomic loci. Twelve MLH1 epimutation carriers, 61 Lynch syndrome patients, and 41 healthy controls, were analysed by Infinium 450 K array. Targeted molecular techniques were used to characterise the MLH1 epimutation carriers and their inheritance pattern. No nucleotide or structural variants were identified in-cis on the epimutated allele in 10 carriers, in which inter-generational methylation erasure was demonstrated in two, suggesting primary type of epimutation. CNVs outside the MLH1 locus were found in two cases. EPM2AIP1-MLH1 CpG island was identified as the sole differentially methylated region in MLH1 epimutation carriers compared to controls. Primary constitutional MLH1 epimutations arise as a focal epigenetic event at the EPM2AIP1-MLH1 CpG island in the absence of cis-acting genetic variants. Further molecular characterisation is needed to elucidate the mechanistic basis of MLH1 epimutations and their heritability/reversibility. YR 2018 FD 2018-10-04 LK https://hdl.handle.net/10668/25384 UL https://hdl.handle.net/10668/25384 LA en DS RISalud RD Apr 6, 2025