In most trinucleotide repeat (TNR) diseases, the primary factor determining the likelihood of expansions is the length of the TNR. In some diseases, however, stable alleles contain one to three base pair substitutions that interrupt the TNR tract. The unexpected stability of these alleles compared to the frequent expansions of perfect TNRs suggested that interruptions somehow block expansions and that expansions occur only upon loss of at least one interruption. The work in this study uses a yeast genetic assay to examine the mechanism of stabilization conferred by two interruptions of a 25-repeat tract. Expansion rates are reduced up to 90-fold compared to an uninterrupted allele. Stabilization is greatest when the interruption is replicated early on the lagging strand, relative to the rest of the TNR. Although expansions are infrequent, they are often polar, gaining new DNA within the largest available stretch of perfect repeats. Surprisingly, interruptions are always retained and sometimes even duplicated, suggesting that expansion in yeast cells can proceed without loss of the interruption. These findings support a stabilization model in which interruptions contribute in cis to reduce hairpin formation during TNR replication and thus inhibit expansion rates.Trinucleotide repeat (TNR) instability has been found in more than 12 human neurological diseases that have many common genetic traits (1,7,18). One of the most important predictors of TNR expansions is the length of the triplet tract. In normal populations, the TNR is highly polymorphic but relatively short. In affected individuals the TNR is expanded anywhere from 5 to 2,000 repeats, depending on the disease locus (1, 7, 18). Not only does expansion often lead to disease but longer repeats are also further destabilized, expanding with even higher frequency upon subsequent transmissions. The cutoff between short, stable alleles and long, unstable alleles has been termed the threshold (1,7,18). Once a threshold of about 35 repeats is reached, the likelihood of expansion in the next generation is greatly increased.The purity of the TNR tract also influences its mutability. There are three examples of TNR diseases in which most normal, stable alleles contain one to three point mutations, or interruptions, interspersed within the perfect repeat tract. SCA1 (spinocerebellar ataxia type 1 gene) contains CAT interruptions in a CAG tract (2), the CGG tract of the fragile X syndrome gene FMR1 is punctuated with AGGs (3, 9, 13, 25), and CAAs are dispersed through the CAG tract of SCA2 (10, 21, 23). About 1% of normal Friedreich's ataxia alleles have five to eight GAGGAA hexanucleotide interruptions within a GAA tract (17). In contrast, expanded alleles of these genes have fewer or no interruptions. This correlation has led to the suggestion that one or more interruptions must be lost before expansion can occur (2,3,9,10,13,22,25). The most direct test of this hypothesis would be to look at expansions that arise directly from interrupted alleles. However, it has no...