The human ankyrin-1 gene (ANK1) contains 3 tissue-specific alternative promoters. We have shown previously that the erythroid-specific ankyrin 1 (ANK1E) core promoter contains a 5 DNase I hypersensitive site (HS) with barrier insulator function that prevents gene silencing in vitro and in vivo. Mutations in the ANK1E barrier region lead to decreased ANK1 mRNA levels and hereditary spherocytosis. In this report, we demonstrate a second ANK1E regulatory element located in an adjacent pair of DNase I HS located 5.6 kb 3 of the ANK1E promoter at the 3 boundary of an erythroid-specific DNase Isensitive chromatin domain. The 3 regulatory element exhibits enhancer activity in vitro and in transgenic mice, and it has the histone modifications associated with an enhancer element. One of the ANK1E 3HS contains an NF-E2 binding site that is required for enhancer function. We show that a chromatin loop brings the 3 enhancer and NF-E2 into proximity with the 5 barrier region including the ANK1E core promoter. These observations demonstrate a model for the tissuespecific activation of alternative promoters that may be applicable to the ϳ 30% of mammalian genes with alternative promoters that exhibit distinct expression patterns. (Blood. 2012;120(17):3586-3593)
IntroductionHereditary spherocytosis (OMIM 182900) is an inherited hemolytic anemia that affects approximately 1 in 2000 people. [1][2][3] Hereditary spherocytosis takes its name from the spherical-shaped erythrocytes observed on the peripheral blood smear of affected patients. 1 Clinically, hereditary spherocytosis patients present with anemia that can vary from nearly asymptomatic to severe and transfusion-dependent. 1 Other hematologic findings include reticulocytosis, elevated mean corpuscular hemoglobin concentration, and increased erythrocyte osmotic fragility after incubation. 1 The most commonly mutated gene in hereditary spherocytosis is ANK1; this gene encodes a critical component of the erythrocyte membrane skeleton, the ankyrin 1 protein. 1 Less frequent mutations associated with hereditary spherocytosis have been described in the SLC4A1 (band 3), SPTB (-spectrin), EPB4.2 (band 4.2), and SPTA (␣-spectrin) genes. 1 Most of these mutations occur in the coding sequence of these genes and lead to functional protein deficiencies. Despite advances in diagnostic DNA sequencing, roughly 50% of hereditary spherocytosis patients do not have a molecular diagnosis. 1 Roughly 30% of mammalian genes have multiple, distinct alternative promoters and first exons, 4 and genes expressed in erythroid cells contain an even higher frequency of alternative promoters and first exons (35%). 5 The human ANK1 gene contains 3 distinct, tissue-specific alternative promoters and first exons that are spliced to a common exon 2 in different cell types. The ANK1B promoter and first exon is expressed exclusively in brain and muscle cells and is located 138 kb upstream of exon 2. The erythroid-specific ANK1E promoter and first exon is located 39 kb upstream of exon 2. The ANK1A promoter and...