Single-molecule DNA analysis of testicular germ cells isolated by laser capture microdissection from two Huntington disease patients showed that trinucleotide repeat expansion mutations were present before the end of the first meiotic division, and some mutations were present even before meiosis began. Most of the larger Huntington disease mutations were found in the postmeiotic cell population, suggesting that expansions may continue to occur during meiosis and͞or after meiosis is complete. Defining the germ-line cell compartments where the trinucleotide repeat expansions occur could help to elucidate the underlying mechanisms of instability.A t least 14 diseases result from expansion in the number of trinucleotide repeats (TNR) in or adjacent to a proteincoding gene (1-3). In most cases, the repeat sequence consists of CAG͞CTG triplets. The expanded alleles characteristically undergo further expansion when the disease gene is transmitted from an affected parent to the offspring, resulting in increased disease severity and an earlier age of onset. Based on studies in model systems, a variety of molecular mechanisms have been proposed to explain TNR expansion, including meiotic recombination (4-7), DNA replication slippage (2,(8)(9)(10)(11)(12)(13)(14), and DNA damage repair (15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Whether one or all of these processes actually contribute to germ-line expansion mutations in humans is not known, although it is widely accepted that secondary structure formation by TNR tracts is a critical step in the mutation process (reviewed in refs. 2 and 25-28).Defining the germ-line cell compartments where the TNR expansions occur in humans could help reveal the underlying mechanisms. The presence of expansion mutations in spermatogonia would be consistent with a mitotic mutation process mediated by replication slippage or DNA damage repair. Expansions occurring during meiosis might suggest a role for double strand break formation induced by the SPO11 protein (29-31), whereas expansions after meiosis is completed would implicate DNA damage repair.No direct information on the presence or absence of CAG͞ CTG expansion mutations in the various human germ-line cell compartments is available. We investigated the germ line of two men who died from Huntington disease (HD). When men transmit the HD mutation, the relative increase in repeat number among their offspring [or in their sperm (32)] is among the highest observed for CAG͞CTG tract instability (reviewed in ref. 33). We analyzed testicular germ cells isolated by laser capture microdissection (LCM) (34). We showed that TNR expansion mutations are present before the end of the first meiotic division, and are even present before meiosis begins. Because a greater proportion of the larger human mutations were found in the postmeiotic cell population, we propose that some expansions may continue to occur after the beginning of meiosis. In humans, TNR mutations may arise at different stages of germ-line development, possibly as a result of several d...