A Profile of Differential DNA Methylation in Sporadic Human Prion Disease Blood: Precedent, Implications and Clinical Promise
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A profile of differential DNA methylation in sporadic human prion disease blood: precedent, implications and clinical promise A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Neuroscience from University College London Luke Child Dabin MRC Prion Unit at UCL Institute of Prion Diseases University College London 2019 Page 1 Declaration I, Luke Child Dabin, attest that the work presented in this thesis is my own. Where information has been derived from others it has been indicated in this thesis. Page 2 Dedication This thesis is dedicated to my family, through whose principles, encouragement and faith in me I have managed to achieve what I have achieved thus far. But it is also dedicated to Badass Cat, who after over a decade of friendship, multiple surgeries, two years living feral and subsisting on local farmers’ livestock, having being hit by two cars consecutively in the space of seconds and returning a day later unharmed yet coated in something else’s blood, recovering from an abscess the vet deemed inoperable on the day of a scheduled euthanasia, and repeatedly arriving home totally unflustered despite having been caught on barbed wire, finally passed from this mortal coil in 2018. Rest in peace, you magnificent bastard. Page 3 Acknowledgements I have been tremendously fortunate to receive supervision, advice and support from my two supervisors, Dr. Emmanuelle Viré and Professor Simon Mead. Having arrived at UCL after two years in Tokyo during which I spent most of my time out of the lab and away from the literature (and with a degree in Biochemistry which focused mostly on protein biology rather than genetics, let alone epigenetics), without their tuition and patience I would not have been able to achieve what I have over the last five years. They enabled me to begin, continue and complete this work, and I cannot overstate the importance of their tutorage. It has been a true privilege. There are many, many scientists whose advice and collaboration have been incredibly helpful over the course of this work. Dr Ankur Chakravarty, Dr Holger Hummerich and Dr. Tyler Gorrie-Stone provided me with advice and support as I learned how to use R, a statistical tool which has and will continue to prove essential to my work. Professor Stephan Beck gave me his time to discuss the technical aspects of epigenetic data and how to thoroughly analyse it, which given his authority within the field was priceless. Professors Jonathan Mill and Katie Lunnon kindly welcomed me to their laboratory for two weeks to learn pyrosequencing, and Dr. Adam Smith and Dr. Rebecca Smith lent me their valuable time to train and advise me on proper experimental design. This technique proved essential for much of this work and I am glad to count them as friends. Dr. Peter Sarkies, Dr. Tony Bélicard and Sheeba Singh welcomed me to their laboratory for pyrosequencing and were tremendously helpful. It is no exaggeration to say that at least half of this PhD rests on their generosity, and I cannot overstate my thanks. Dr. Mina Ryten and Professor Sebastian Brandner examined me for my MPhil-PhD upgrade. They were interested in my work, asked difficult questions and raised points for further consideration, and I am grateful for their time and advice. Professor Brandner and Dr. Zane Jaunmuktane also helped plan further work which will lead to an investigation of brain-derived DNA. Dr. Jaunmuktane spent many hours with myself and Dr. Viré in the containment level 3 laboratory dissecting prion- infected brain tissue, which considering her incredibly busy schedule was and is tremendously appreciated. Page 4 The National Prion Clinic staff have been enormously supportive, answering my questions about the clinical aspects of prion disease and providing clinical data for a range of interesting analyses. For the latter I am very grateful to Joanna Field, Irina Neves Simoes and Rachel Knight who helped me identify patient samples and connect them with clinical metrics. Dr. Akin Nihat, Dr. Hans Odd, Professor Peter Rudge and Dr. Tze-How Mok collected patient and control blood samples for me which are, obviously, beyond value. I am also very grateful to Rachel Raybould at Cardiff and Vale Hospital who provided control DNA samples, which were essential for this work. As well as the National Prion Clinic, I worked closely with the Genetics, Epigenetics and Bioinformatics (née Human Genetics) group of the MRC Institute of Prion Disease at UCL and as a result am indebted to several group members. Fernando Guntoro is one of the newest members of the group and will be continuing the group’s DNA methylation project. As well as being a genial and enthusiastic scientist, his advice regarding machine learning was incredibly helpful during the final months of my PhD. James Uphill has recently left the group, but his knowledge of patient sample locations, his diligence and his humour were much appreciated during the first half of my PhD. I have very fond memories of James’ antics, and his presence at Wednesday group meetings is missed. Gary Adamson left the group relatively early on in the course of my studies, but was cheerful, helpful and unfailingly “got” my jokes. He, James and Ron had just finished cataloguing the group’s inventory of over 50,000 DNA samples as I began my PhD. Without this resource my work would have been next to impossible, and Gary’s sense of order and attention to detail doubtlessly contributed immensely to this titanic effort. Penny Norsworth’s work and my own have not overlapped extensively, but in the face of low morale and fatigue her cheerfulness, supply of Dilbert comics and daily coffee shop runs have fuelled no small part of this manuscript. Ron Druyeh, master of the Ultra-Low Temperature freezers, has also moved on from the group. My work with frozen blood, serum and DNA samples stored in off- site containment level 3 laboratories would have been impossible without Ron, and his diligence and work ethic were inspirational. Page 5 Tracy Campbell has been tirelessly supportive when it comes to identifying samples and connected data. Above and beyond this, however, were her advice and patience during the early stages of my PhD as I began to extract DNA from prion patient blood. Her years of experience working in the group have benefited me when I had questions about rare aspects of the disease, and it’s been a pleasure to spot her when extracting patient DNA or setting up sequencing reactions. Andrew Thompson shares our office space and is a warm and thoughtful colleague. His clinical insight into facets of prion disease pathology and treatment has emerged in his questions and comments when I presented my work to the department and frequently led to invaluable discussions and new ideas. I have shared space with many people and cannot thank them all, but Amir Mayahi, Dr. Azadeh Khalili-Shirazi, David Ruegg, Professor Elizabeth Fisher, Dr. Frances Wiseman, Jackie Linehan, Dr. Jonathan Wadsworth, Kevin Williams, Dr. Laszlo Hosszu, Dr. Malin Sandberg, Mark Batchelor, Nunu Anora, Professor Parmjit Jat, Samantha McCleod, Dr. Sylvia Purro, Tamsin Nazari and Ryan Peter have all helped me on many occasions during my PhD, been friendly and approachable, and exemplify the scientific ideal of very nice but clever people working together to solve hard problems. I’ll miss them all. I must also thank other PhD students for moral support but also mentorship and advice. The foremost of these is Carolin Cyran who is a fellow Wolfson PhD student. Carolin has been a pleasure to share space, time, food and conversation with, and has been a patient soundboard for all my questions (of which there have been many) no matter how stupid (as previous). I am indebted to her and am delighted to have been able to celebrate her many successes over the previous years, which have been inspiring. I must thank several PhD students who have passed through or remained in our group, namely Emma Jones, François Kroll, Ines Whitworth, Julia Ravey and Thanos Dimitriadis. It has been exciting to meet you, share ideas and experiences and also pints in the King and Queen, and I wish you all the very best in your futures. There is a plethora of other students and friends without whom quite a difficult journey would have been more painful. I owe particular thanks to Alan Mejia-Maza, Dr. Alexandra Philiastides, Bernie Simone, Caroline Casey, Claudia Cannovò, Dr. David Thomas, Francesca De Giorgio, Grace O’Reagan, Heather Whittaker, Dr. Page 6 Justin Tosh, Madeleine Reilly, Nora Thoeng, Dr. Prasanth Sivakumar, Dr. Ruchi Kumari Kaushik and Dr. Xun Choong. I wish to highlight Dr. Laura Pulford for her enthusiastic support and statistical advice, who was a shining star in the Institute of Neurology student office, and who died towards the end of her PhD. I deeply miss her. I have friends who have supported me through tough times during my PhD who deserve gratitude. Caitlin Greenwood is a PhD student at Bristol with whom I have shared the woes and anxieties of the PhD experience, and who has unfailingly given me sound advice on handling problems and encouraged me to consider my health as a priority. Dr. Jonny Scaramanga has been a touchstone for PhD-related concerns and provided thoughtful comments on balancing the weights of qualitative and quantitative data. Melissa Liau has been a tremendously supportive and patient partner and has helped keep me sane when obstacles seem insurmountable. Dr. James Bonner and Dr. Karen Frudd have inspired me throughout the course of their PhD and provided much needed friendship and sympathy throughout my own studies.