Base mismatches Copy Number Variations DNA LESION DNA REPAIR PATHWAY Nucleotide Excision Repair Base Excision Repair ICL Repair DSB Repair Mismatch Repair Figure 1: Genome maintenance pathways The genome is challenged constantly by a wide range of endogenous and exogenous DNA damaging agents. Many types of DNA lesions exist, such as abasic sites, bulky adducts, DNA strand breaks, base mismatches, and interstrand crosslinks. To avoid genome instability, five main DNA repair pathways exist: nucleotide excision repair, base excision repair, double strand break repair, mismatch repair, and DNA interstrand crosslink repair. 22 Chapter 1
Interstrand Crosslink RepairDNA-interstrand crosslinks (ICLs) are DNA lesions that covalently bind the two strands of the double helix 76 . Because ICLs block strand separation, which is required for DNA replication and transcription, they are among the most toxic DNA lesions. ICL-inducing agents are effective in chemotherapy because they preferentially affect rapidly-dividing cells, such as cancer cells 77 .
ICL inducing agents
Exogenous sources of ICLsMany drugs used for chemotherapy induce ICLs, such as cisplatin and its derivatives, mitomycin C (MMC), deoxybutane (DEB), psoralens, and nitrogen mustards. These agents cause a multitude of DNA adducts, and ICLs represent just a small percentage of the lesions formed 78 . Yet, ICLs are considered the main cause of toxicity of these drugs. Although all ICLs are formed by crosslinking the two strands of the DNA, the chemical and structural properties of the various ICLs differ widely. First, the sequence context in which an ICL can form depends on the chemistry of the ICLinducing agent. For example, cisplatin and MMC induce ICLs in a 5' CG context, while psoralens act in a 5' TA sequence 78 . Secondly, the structure of the ICL and the resulting distortion of the DNA double helix differs depending on the ICL-inducing agent (Figure 5). Cisplatin causes a major distortion of the double helix, forcing the bases opposite the crosslinked Gs to be extrahelical. On the other hand, MMC, psoralens, and nitrogen mustards cause minor distortions in the DNA structure 78 .
Endogenous sources of ICLsStudying ICLs formed endogenously in cells is challenging due to the scarcity of these lesions and the lack of detection methods. However, both in vivo and in vitro studies identified aldehydes as a possible endogenous source of ICLs. Aldehydes are a highly reactive class of endogenous metabolites that can form a variety of DNA adducts, including ICLs 79 (Figure 5). Acetaldehyde is a product of ethanol oxidation and the metabolism of carbohydrates, and can form ICLs between guanines 80,81 . Formaldehyde is an aldehyde that is highly concentrated in human plasma and is formed during various cellular processes such as dealkylation of methylated DNA and histone demethylation [81][82][83] . Other ICL-inducing aldehydes are generated through lipid peroxidation, such as acrolein, malondialdehyde, crotonaldehyde, and 4-hydroxynonenal 84 .In chapter 2 we show that ...