The occurrence of triplet-repeat expansion (TRE) during transmission of genetic information is involved in many neurological and neuromuscular diseases including Fragile X syndrome and myotonic dystrophy. DNA slippage during replicative synthesis appears to cause TRE. The causes of DNA slippage, however, remain mostly unknown. We investigated the effects of abasic sites on the occurrence of TRE during DNA replication in vitro using Escherichia coli Klenow polymerase I as the model polymerase. Here we show that a single abasic site analog, synthesized in the triplet-repeat tract at the 5 end of the template strand, induced dramatic TRE during DNA synthesis. The amount of TRE induced decreased when the abasic site was moved to the middle of the repeat tract, consistent with effectively decreasing the length of the repeat tract. Placing the abasic site in the primer did not induce TRE. TRE was sequence-dependent. The damage-induced increase in growing strand TRE depended on the sequence of the growing strand repeat as AAT ϳ ATT > CAG > CTG. The expansions required replication from a primer complementary to the repeat tract. The expanded tracts were sequenced and contained multiple additions of the original repeat. The results imply that DNA damage can play a significant role in generating TRE in vivo.The occurrence of triplet-repeat expansion (TRE) 1 during transmission of genetic information is involved in many diseases including Fragile X syndrome (1-3), the most common form of mental retardation; myotonic dystrophy, a neuromuscular disorder; and several neurodegenerative disorders (1, 2). DNA slippage (4) during replicative synthesis is believed to be a major contributor to TRE in vivo (5-8), because elimination of recombination in yeast (9) and in Escherichia coli (10) does not influence TRE, whereas elimination of mismatch repair does (10, 11). Pausing or blockage of DNA replication has been proposed to promote slippage by giving the DNA replication complex more time to dissociate and form misaligned DNA intermediates (12, 13). Hairpins (14 -18), bulges (19,20), tetraplexes (18, 21), and possibly "slipped" structures (22, 23) have been proposed to promote DNA slippage. The structures were proposed to act either as intermediates, by their formation within the repeat or by blocking or pausing replication toward the end of the repeat (12, 24) or a combination of both (13,17,24). Replication pause sites are hot spots for nucleotide misincorporation (25). If pausing also induces slippage, the occurrence within the repeat tract of DNA damage that blocks DNA replication could profoundly effect TRE.Studies of replication of DNA template-primers in vitro with DNA polymerase alone are important for their potential ability to uncover mutation mechanisms. Replication of triplet-repeat tracts in vitro shows TRE (26 -29). Here, we report the effects of tract length, tract sequence, and DNA damage on TRE during DNA replication in vitro. The abasic site analog tetrahydrofuran (THF) was used as the model DNA damage lesion. A...