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Distribution of CpG dinucleotide in the human genome and differences in methylation patterns between normal and tumor cells. In the majority of the mammalian genome, depicted as exons 2 and 3 of a sample gene (numbered boxes), introns of the gene (line between the exons), and regions outside the gene, the CpG dinucleotide has been depleted over evolution as shown by the sparse number of such sites (lollipops). Small regions of DNA, approximately 0.5-4.0 kb in size, harbor the expected number of CpG sites and are termed CpG islands. Many of these are associated with promoter regions of approximately half of the genes in the genome (frequent lollipops surrounding exon 1 of the sample gene). In normal cells, most CpG sites outside CpG islands are methylated (yellow lollipops) while most gene promoter CpG island sites are unmethylated (open lollipops). This unmethylated Source: Cancer, The Online Metabolic and Molecular Bases of Inherited Disease state of the promoter CpG islands is a permissive state for active gene transcription (arrow, top panel). In cancer cells, the DNA methylation and chromatin Valle CpG D, Beaudet B, Kinzler KW, Antonarakis SE, that Ballabio A, Gibson K, Mitchell G. The Online Metabolic Molecular patterns are Citation: shifted. Many sites inAL, theVogelstein bulk genome and coding region of genes should be methylated become unmethylated, and aand growing list Bases of Inherited Disease; 2014 Available at: http://mhmedical.com/ Accessed: May 12, 2017 of genes have abnormal methylation of CpG island-containing promoters with associated transcriptional silencing (X at transcription start site). Copyright © 2017 McGraw-Hill Education. All rights reserved