Genes that escape from X-chromosome inactivation: Potential contributors to Klinefelter syndrome

Am J Med Genet C Semin Med Genet. 2020 Jun;184(2):226-238. doi: 10.1002/ajmg.c.31800. Epub 2020 May 22.

Abstract

One of the two X chromosomes in females is epigenetically inactivated, thereby compensating for the dosage difference in X-linked genes between XX females and XY males. Not all X-linked genes are completely inactivated, however, with 12% of genes escaping X chromosome inactivation and another 15% of genes varying in their X chromosome inactivation status across individuals, tissues or cells. Expression of these genes from the second and otherwise inactive X chromosome may underlie sex differences between males and females, and feature in many of the symptoms of XXY Klinefelter males, who have both an inactive X and a Y chromosome. We review the approaches used to identify genes that escape from X-chromosome inactivation and discuss the nature of their sex-biased expression. These genes are enriched on the short arm of the X chromosome, and, in addition to genes in the pseudoautosomal regions, include genes with and without Y-chromosomal counterparts. We highlight candidate escape genes for some of the features of Klinefelter syndrome and discuss our current understanding of the mechanisms underlying silencing and escape on the X chromosome as well as additional differences between the X in males and females that may contribute to Klinefelter syndrome.

Keywords: Klinefelter syndrome; X-chromosome inactivation; dosage compensation; escape from XCI; sex chromosome aneuploidy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Chromosomes, Human, X / genetics*
  • Chromosomes, Human, Y / genetics
  • Female
  • Gene Expression Regulation / genetics
  • Genes, X-Linked / genetics*
  • Humans
  • Klinefelter Syndrome / genetics*
  • Klinefelter Syndrome / pathology
  • Male
  • X Chromosome Inactivation / genetics*

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