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. 2025 Sep 19;21(9):e1011608.
doi: 10.1371/journal.pgen.1011608. eCollection 2025 Sep.

Epigenome and transcriptome changes in KMT2D-related Kabuki syndrome Type 1 iPSCs, neuronal progenitors and cortical neurons

Affiliations

Epigenome and transcriptome changes in KMT2D-related Kabuki syndrome Type 1 iPSCs, neuronal progenitors and cortical neurons

Sara Cuvertino et al. PLoS Genet. .

Abstract

Kabuki syndrome type 1 (KS1) is a neurodevelopmental disorder caused by loss-of-function variants in KMT2D which encodes a H3K4 methyltransferase. The mechanisms underlying neurodevelopmental problems in KS1 are still largely unknown. Here, we track the epigenome and transcriptome across three stages of neuronal differentiation using patient-derived induced pluripotent stem cells (iPSCs) to gain insights into the disease mechanism of KS1. In KS1 iPSCs we detected significantly lower levels of functional KMT2D transcript and KMT2D protein, and lower global H3K4me1, H3K4me2 levels and modest reduction in H3K4me3. We identify loss of thousands of H3K4me1 peaks in iPSCs, neuronal progenitors (NPs) and early cortical neurons (CNs) in KS1. We show that the number of lost peaks increase as differentiation progresses. We also identify hundreds of differentially expressed genes (DEGs) in iPSCs, NPs and CNs in KS1. In contrast with the epigenomic changes, the number of DEGs decrease as differentiation progresses. Our analysis reveals significant enrichment of differentially downregulated genes in areas containing putative enhancer regions with H3K4me1 loss. We also identify a set of distinct transcription factor binding sites in differentially methylated regions and a set of DEGs related to KS1 phenotypes. We find that genes regulated by SUZ12, a subunit of Polycomb Repressive complex 2, are over-represented in KS1 DEGs at early stages of differentiation. In conclusion, we present a disease-relevant human cellular model for KS1 that provides mechanistic insights for the disorder and could be used for high throughput drug screening for KS1.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Analysis of KMT2D expression in KS1 iPSCs. A) Schematic representation of KMT2D exons and protein domains and regions with the different KMT2D variants highlighted in pink, red and brown for missense, nonsense and frameshift mutations, respectively. (Dataset 1: DS1-UoM; Dataset 2: DS2-HipSci). B) Log counts per million (CPM+1) mapped reads for KMT2D transcript detected in the integrated RNAseq analysis. REF shows reads with reference sequence – no mutation (light blue) and ALT shows reads with mutation (pink/red/brown as in A). Unpaired T-test was performed to compare differences in number of transcripts in controls (n=53) and KS1 (n=7), difference in number of REF transcripts in controls and KS1 (***p<0.001), number of REF and ALT transcripts in KS1 (*p<0.05) and number of ALT transcripts between KS1 samples with missense mutations and KS1 samples with protein truncating mutations (frameshift and nonsense) (*p<0.05). C) Representative image for Western blot for KMT2D and scatter plot showing KMT2D quantification relative to loading control, HSP90 (n=4; * p<0.05). Variants shown in pink/red/brown as in A. D) Representative images for Western blots for H3K4me1 (n = 3), H3K4me2 (n = 3) and H3K4me3 (n = 4) and scatter plots showing their quantification relative to loading control, HSP90 (*p<0.05). Variants shown in pink/red/brown as in A. E) Log counts per million (CPM+1) mapped reads for pluripotency related transcripts detected in the integrated RNAseq analysis.
Fig 2
Fig 2. Loss of H3K4me1 in KS1 iPSCs.
A) Heatmap of H3K4me1 peaks (subset of consensus regions 20,000 out of 205,973; black), H3K4me1 loss regions (n = 8146; blue), and H3K4me1 gain regions (n = 1163; red) in KS1 (iPSC 3) compared to control (Ctrl 1). B) Volcano plot showing loss (blue) and gain (red) in H3K4me1. C) Bar graph showing number of H3K4me1 peaks in relation to enhancer and promoter regions for total, loss and gain in mono-methylation. Cell-type independent enhancers and promoters were imputed by EpiMap from 833 biosamples and cell-type dependent enhancers and promoters were imputed by EpiMap from DF19.11 iPSCs. D) Top TF motifs predicted in differential H3K4me1 peaks (loss and gain of H3K4me1 in binding regions) between KS1 and control. Number (n) represents the number of times the motif was found within the unique sequences underlying the differential H3K4me1 regions.
Fig 3
Fig 3. Correlation between changes in transcripts and H3K4me1 in KS1 iPSCs.
A) Volcano plot showing down and up regulated genes on autosomal chromosomes in KS1 (iPSC 3) compared to controls (Ctrl 1) (adjp<0.05, -1 > Log2FC>1). Genes highlighted are related to the GO categories in blue and red. Top 3 genes with highest or lowest Log2FC are highlighted by black text. B) WebGestalt was performed on DEGs (adjp < 0.05; -1 > Log2FC>1) between KS1 iPSC and control iPSC. Gene ontology categories for biological processes are shown in the bar graphs (FDR < 0.05). Red bars correspond to up DEGs, blue to down DEGs and red and blue to both. C) Karyoplot showing up (red) and down (blue) DEGs on each chromosome. Lime-green regions represent 100Kb up and downstream regions within H3K4me1 loss. Different grey colours represent the different G band staining and red represents centromere. Blue lines above chromosomes represent regions of enrichment of downregulated DEGs and red lines for upregulated DEGs (FDR < 0.05; hypergeometric test) D) Scatter plot showing change in expression and change in H3K4me1 within ±100kb of DEGs.
Fig 4
Fig 4. Loss of H3K4me1 in KS1 neural progenitors and neurons.
A) Schematic representation of the neuronal differentiation protocol. B) RNAseq analysis showing transcript level for key neuronal markers in control (Ctrl 1) and KS1 (iPSC 3) samples at stem cell, progenitor and neuronal stages. C-D) Line graph of H3K4me1 peaks (black), H3K4me1 loss regions (blue), and H3K4me1 gain regions (red) for neuronal progenitors and neurons. E-F) Bar graph showing number of H3K4me1 peaks in relation to enhancer and promoter regions for total, loss and gain in mono-methylation. Cell-type independent enhancers and promoters were imputed by EpiMap from 833 biosamples and cell-type dependent enhancers and promoters were imputed by EpiMap either from (E) H9-derived neural progenitors or from (F) H1-derived neurons. G-H) Top TF motifs predicted in differential H3K4me1 peaks (loss and gain of H3K4me1 in binding regions) between KS1 and control. Number (n) represents the number of times the motif was found within the unique sequences underlying the differential H3K4me1 regions. I) Intersection analysis showing H3K4me1 peaks in common between iPSC, Progenitor (Prog) and Neurons (Neur) (hypergeometric test; ****p < 0.0001) between KS1 (c.16019G > A) and control.
Fig 5
Fig 5. Changes in the transcriptome in KS1 neural progenitors and neurons and comparison of transcriptomic and epigenomic changes during neuronal differentiation.
A-B) Volcano plot showing down and up regulated genes on autosomal chromosomes in KS1 (iPSC 3) compared to controls (Ctrl 1) (adjp<0.05, -1 > Log2FC>1 in red/blue; adjp<0.1, -1 > Log2FC>1 in light-red/light-blue). Top 3 genes with highest or lowest Log2FC are highlighted in black. C-D) WebGestalt was performed on DEGs (adjp<0.1, -1 > Log2FC>1) between KS1 and control in neural progenitor and neuronal cells. Gene ontology categories for biological processes are shown in the bar graphs (FDR < 0.1) Red bars correspond to upregulated (up) DEGs, blue to downregulated (down) DEGs and red and blue to both up- and downregulated genes. E) Intersection analysis showing DEGs in common between iPSC, Progenitor (Prog) and Neurons (Neur) between KS1 (c.16019G > A) and control (exact test; ****p < 0.0001). F) Intersection analysis showing Down DEGs and H3K4me1 loss peaks in common between iPSC, Progenitor (Prog) and Neurons (Neur) between KS1 (c.16019G > A) and control.
Fig 6
Fig 6. Validation of the transcriptome in KS1 neural progenitors and neurons.
Comparison of Log2FC of DEGs from the original dataset and validation dataset (KS1 iPSC 1, iPSC 2, iPSC 3 compared to Ctrl 1, Ctrl 2, Ctrl 3) at iPSC (Day 0) (A), neural progenitor (Day 18) (C) and neuronal stages (Day 30) (E). WebGestalt over-representation analysis was performed on DEGs from validation dataset. Gene ontology categories for biological processes for iPSC (Day 0) (B), neural progenitor (Day 18) (D) and neurons (Day 30) (F) are shown in the bar graphs (FDR<0.05). Red bars correspond to upregulated DEGs, blue to downregulated DEGs and red and blue to both up- and downregulated genes. * indicates GO categories that have been observed in the original dataset.

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