Bhattacharjee and Nandi Cell Communication and Signaling (2017) 15:41 DOI 10.1186/s12964-017-0195-9 REVIEW Open Access DNA damage response and cancer therapeutics through the lens of the Fanconi Anemia DNA repair pathway Sonali Bhattacharjee* and Saikat Nandi* Abstract Fanconi Anemia (FA) is a rare, inherited genomic instability disorder, caused by mutations in genes involved in the repair of interstrand DNA crosslinks (ICLs). The FA signaling network contains a unique nuclear protein complex that mediates the monoubiquitylation of the FANCD2 and FANCI heterodimer, and coordinates activities of the downstream DNA repair pathway including nucleotide excision repair, translesion synthesis, and homologous recombination. FA proteins act at different steps of ICL repair in sensing, recognition and processing of DNA lesions. The multi-protein network is tightly regulated by complex mechanisms, such as ubiquitination, phosphorylation, and degradation signals that are critical for the maintenance of genome integrity and suppressing tumorigenesis. Here, we discuss recent advances in our understanding of how the FA proteins participate in ICL repair and regulation of the FA signaling network that assures the safeguard of the genome. We further discuss the potential application of designing small molecule inhibitors that inhibit the FA pathway and are synthetic lethal with DNA repair enzymes that can be used for cancer therapeutics. Keywords: DNA repair, Fanconi Anemia (FA) signaling network, DNA damage response, Cancer therapeutics, Synthetic lethality, Combination Therapy Genomic instability, Interstrand crosslink (ICL), Homologous recombination, Translesion synthesis Background Additional clinical features included microcephaly, vitiligo Fanconi Anemia (FA), a rare genetic cancer-susceptibility and hypoplasia of the testes [8]. After nearly four decades syndrome is a recessive autosomal or X-linked genetic dis- another article reported an accumulation of large number ease [1–3]. FA is characterized by genomic instability, of chromatid breaks in the blood lymphocytes of FA pa- bone marrow failure leading to progressive aplastic tients [9]. Due to high frequencies of chromosomal abnor- anemia, chromosomal fragility and heightened susceptibil- malities, predominantly chromatid breaks during S-phase ity to cancer, particularly acute myelogenous leukemia of the cell cycle, researchers concluded that FA patients (AML) [1, 4]. With an incidence of ~1–5 per 1,000,000 have impaired double strand break repair (DSBR) [10]. births, many FA patients suffer from developmental disor- Also despite the varied clinical phenotypes of the disease, ders and physical abnormalities ranging from short stat- a defining characteristic of FA cells is the cellular hyper- ure, abnormal skin pigmentation, organ malformation, sensitivity to DNA crosslinking agents such as mitomycin hypogonadism, and developmental delay [5]. Patients are C (MMC), chemotherapeutic agent cisplatin (CDDP), and often diagnosed with early onset of solid tumors including diepoxybutane (DEB) [9, 11–15]. These crosslinks block squamous cell carcinomas of the head and neck, cervical ongoing DNA replication, DNA transcription, and if left cancer and liver tumors [6, 7]. FA was first described by unrepaired, activate cell apoptosis [16]. The observation the Swiss pediatrician Guido Fanconi in 1927 while treat- that a functional FA pathway is required for processing ing a family of five siblings, three of whom presented with damage after exposure to crosslinking agents has led to developmental birth defects and died from an early-onset a great deal of research implicating the FA pathway in of clinical features resembling pernicious anemia [8]. crosslink repair and the maintenance of genomic stabil- ity [17, 18]. Additionally, since the FA pathway has also * Correspondence: [email protected]; [email protected] been associated with cancer susceptibility, a better Cold Spring Harbor Laboratory, New York, USA © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Bhattacharjee and Nandi Cell Communication and Signaling (2017) 15:41 Page 2 of 10 understanding of the mechanisms and roles of this Mechanistic details of replication-dependent ICL re- pathway will enable the development of better-targeted pair emerged from studies in Xenopus egg extracts cancer therapeutics. where replication-coupled ICL repair was reconstituted In this review will we will focus on the repair of DNA in vitro by using site-specific ICL templates [27]. When interstrand crosslinks (ICLs) by the FA network of pro- a plasmid containing a site-specific ICL is incubated in teins. We aim to summarize our current understanding this cell-free system, replication initiates at multiple ori- of ICL repair largely based on studies in the mammalian gins of replication sites on the plasmid with two replica- system. We will discuss the etiology of ICLs, the DNA tion forks converging on the ICL. Initially, the leading repair pathways involved in the repair of ICLs, FA pro- strand polymerases stall ~20 nucleotides from the cross- teins, FA-DNA repair network and conclude with a per- link due to steric hindrance by the replisome (replicative spective on targeting the FA pathway to identify helicase complex consisting of Cdc45, MCM2-7 and the anticancer therapeutic strategies. GINS, collectively referred to as the CMG complex, and the replication polymerase) [27–29] which travels along Interstrand crosslinks the leading strand template and pauses at the lesion [30] ICLs are highly toxic DNA lesions that prevent the separ- (Fig. 1). After the initial fork pause, the stalled CMGs ation of the Watson and Crick strands of the double helix are unloaded and lesion bypass is initiated when the by covalently linking the two DNA strands. In doing so leading strand of a single fork is extended to within 1 ICLs block critical cellular processes such as transcription nucleotide of the ICL lesion [30, 31]. Concurrent with and replication. ICLs can lead to gross-chromosomal ab- this, the structure-specific endonucleases localize to the errations like chromosome deletion, chromosome loss site of the ICL and promote dual incisions on either side and DNA breaks [19]. The ability of ICLs to impede DNA of the ICL, a process also referred to as “unhooking” of replication and thereby block cell proliferation is used in the ICL [32]. A number of endonucleases have been im- chemotherapy to treat various cancers [20]. Chemothera- plicated in the incision events of ICL repair including peutic drugs like cisplatin and its derivatives, carboplatin the 3′ flap endonuclease XPF-ERCC1, MUS81-EME1, and oxaliplatin are bifunctional alkylating agents that form FAN1, the 5′ flap endonuclease SLX1 and the scaffold- ICLs [21]. Although ICL repair remains poorly under- ing protein SLX4 [33–44]. TLS polymerases then fill in stood, factors involved in nucleotide excision repair the gap at the site of the DNA incision. TLS incorpo- (NER), homologous recombination (HR), and translesion rates a nucleotide across the ICL lesion by utilizing the synthesis (TLS) have been implicated in ICL removal and error-prone DNA polymerase ζ. This allows the leading subsequent repair [22]. In non-proliferating cells such as strand to be extended and ligated to the first down- quiescent cells, NER plays an important role in ICL recog- stream Okazaki fragment [12, 45, 46]. Finally, the broken nition and removal [23, 24]. In contrast, in cells undergo- sister chromatids generated by incision generates a DSB ing genome duplication, the DNA replication machinery in the DNA that is repaired by RAD51-mediated HR serves as a sensor for ICLs. This subsequently triggers utilizing the intact sister chromatid as a homology donor DNA damage checkpoint activation and initiates repair. In [47, 48] (Fig. 1). these S-phase cells, HR and TLS are the DSBR pathways In recent years the role of FA network of proteins in employed for ICL repair [24]. In the past several years the replication-dependent ICL repair has been the subject of role of FA network of proteins in the detection and repair intense research in many laboratories. In this section, we of ICLs by promoting HR has been much better summarize the functions of the FA network of proteins understood. in ICL repair and discuss the mechanisms by which they function in the repair of ICLs by promoting HR. Mechanistic insights into replication-dependent ICL repair ICL repair is initiated when a traveling replication fork is Overview of the Fanconi Anemia DNA damage response stalled due to collision with a lesion on the DNA that trig- pathway gers the activation of the DNA repair machinery [12, 22, The FA pathway is a nuclear multi-protein network com- 25]. Structure-specific endonucleases generate incisions on prised of 20 complementation groups and associated genes. either side of the ICL, followed by TLS and then HR- Interestingly, 19 of the 20 genes of this network are autoso- mediated replication fork restart