PAX7 target genes are globally repressed in facioscapulohumeral muscular dystrophy skeletal muscle

Nat Commun. 2017 Dec 18;8(1):2152. doi: 10.1038/s41467-017-01200-4.


Facioscapulohumeral muscular dystrophy (FSHD) is a prevalent, incurable myopathy, linked to hypomethylation of D4Z4 repeats on chromosome 4q causing expression of the DUX4 transcription factor. However, DUX4 is difficult to detect in FSHD muscle biopsies and it is debatable how robust changes in DUX4 target gene expression are as an FSHD biomarker. PAX7 is a master regulator of myogenesis that rescues DUX4-mediated apoptosis. Here, we show that suppression of PAX7 target genes is a hallmark of FSHD, and that it is as major a signature of FSHD muscle as DUX4 target gene expression. This is shown using meta-analysis of over six FSHD muscle biopsy gene expression studies, and validated by RNA-sequencing on FSHD patient-derived myoblasts. DUX4 also inhibits PAX7 from activating its transcriptional target genes and vice versa. Furthermore, PAX7 target gene repression can explain oxidative stress sensitivity and epigenetic changes in FSHD. Thus, PAX7 target gene repression is a hallmark of FSHD that should be considered in the investigation of FSHD pathology and therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cells, Cultured
  • Gene Expression Profiling*
  • Gene Expression Regulation*
  • HEK293 Cells
  • Homeodomain Proteins / genetics
  • Humans
  • Meta-Analysis as Topic
  • Mice
  • Muscle, Skeletal / metabolism*
  • Muscle, Skeletal / pathology
  • Muscular Dystrophy, Facioscapulohumeral / genetics*
  • Myoblasts / cytology
  • Myoblasts / metabolism
  • NIH 3T3 Cells
  • PAX7 Transcription Factor / genetics*
  • Sequence Analysis, RNA


  • DUX4L1 protein, human
  • Homeodomain Proteins
  • PAX7 Transcription Factor
  • PAX7 protein, human