Pseudoexons are intronic sequences that are approximately the same length as exons (200 bp) with apparently viable donor and acceptor splice sites but which are not normally spliced in the mature mRNA transcript. Despite the known abundance of exon splicing silencer regulatory elements within introns [1], it is not possible to formulate general rules for pseudoexon repression without remembering that splicing is very much dependent upon local context [2,3]. Normal exons need to encode the information for both protein synthesis and RNA splicing, so one might expect differences in pseudoexons with regard to several factors, including the distribution of splice consensus sequences, splicing enhancers, splicing silencers and secondary structures. In line with these considerations, bioinformatics studies have observed enrichment of exon splicing silencer elements within pseudoexons relative to exonic splicing enhancer elements [4,5]. Furthermore, it has been suggested that it is defective splice sites rather than the lack of enhancers that account for non-splicing of pseudoexon sequences, although even perfect consensus sequences are not always adequate for correct splicing [6]. To complicate matters further, it has been recently suggested that some pseudoexons are authentic exons whose inclusion leads to efficient nonsense-mediated decay, such as the pseudoexon located downstream of mutually exclusive exons 2 and 3 of the rat a-tropomyosin gene, which acts both as an alternative exon that leads to nonsense-mediated decay and as a zero-length exon [7].Nonetheless, in a clinical setting, pathological pseudoexon sequences have been identified by simple activation of cryptic splice sites which reinforce their strength, de novo creation, the inactivation ⁄ activation In disease-associated genes, understanding the functional significance of deep intronic nucleotide variants represents a difficult challenge. We previously reported that an NF1 intron 30 exonization event is triggered from a single correct nomenclature is 'c.293 27,[294][295]. In this paper, we investigate which characteristics play a role in regulating inclusion of the aberrant pseudoexon. Our investigation shows that pseudoexon inclusion levels are strongly downregulated by polypyrimidine tract binding protein and its homologue neuronal polypyrimidine tract binding protein. In particular, we provide evidence that the functional effect of polypyrimidine tract binding protein is proportional to its concentration, and map the cisacting elements that are principally responsible for this negative regulation. These results highlight the importance of evaluating local sequence context for diagnostic purposes, and the utility of developing therapies to turn off activated pseudoexons.Abbreviations NF1, neurofibromatosis type 1; nPTB, neuronal polypyrimidine tract binding protein; PTB, polypyrimidine tract binding protein.