RT Journal Article SR Electronic T1 Computational and cellular studies reveal structural destabilization and degradation of MLH1 variants in Lynch syndrome JF bioRxiv FD Cold Spring Harbor Laboratory SP 622266 DO 10.1101/622266 A1 Amanda B. Abildgaard A1 Amelie Stein A1 Sofie V. Nielsen A1 Katrine Schultz-Knudsen A1 Elena Papaleo A1 Amruta Shrikhande A1 Eva R. Hoffmann A1 Inge Bernstein A1 Anne-Marie Gerdes A1 Masanobu Takahashi A1 Chikashi Ishioka A1 Kresten Lindorff-Larsen A1 Rasmus Hartmann-Petersen YR 2019 UL http://biorxiv.org/content/early/2019/10/13/622266.abstract AB Defective mismatch repair leads to increased mutation rates, and germline loss-of-function variants in the repair component MLH1 cause the hereditary cancer predisposition disorder known as Lynch syndrome. Early diagnosis is important, but complicated by many variants being of unknown significance. Here we show that a majority of the disease-linked MLH1 variants we studied are present at reduced cellular levels. We show that destabilized MLH1 variants are targeted for chaperone-assisted proteasomal degradation, resulting also in degradation of co-factors PMS1 and PMS2. In silico saturation mutagenesis and computational predictions of thermodynamic stability of MLH1 missense variants revealed a correlation between structural destabilization, reduced steady-state levels and loss-of-function. Thus, we suggest that loss of stability and cellular degradation is an important mechanism underlying many MLH1 variants in Lynch syndrome. Combined with analyses of conservation, the thermodynamic stability predictions separate disease-linked from benign MLH1 variants, and therefore hold potential for Lynch syndrome diagnostics.