ASD-risk gene mis-splicing in human DM1 prefrontal cortex
The prefrontal cortex orchestrates executive functions affected in ASD, and previous studies reported transcriptome-wide changes in this brain region29, 37. To test the hypothesis that the DMPK 3'UTR CTGexp mutation leads to mis-splicing of ASD-risk genes, we analyzed human prefrontal cortex (Brodmann area 10; BA10) RNA-seq data generated from DM1 (unknown ASD status) and unaffected control samples (Supplementary Table 1)38. For differential AS analysis, we computed the change of percent spliced in (DPSI) for skipped exons (SE), mutually exclusive exons (MXE), alternative 5′ and 3′ splice sites (A5SS and A3SS) and retained introns (RI). Of all identified AS events (100%) and genes (100%) in DM1 cortex splicing analysis, 1% of AS events met our mis-splicing criteria in the total pool of 7% of mis-spliced genes (Fig. 1a and Supplementary Fig. 1a). To investigate the DM1 splicing profile in genes related to ASD, we retrieved 38 ASD-relevant gene sets from previous studies and available databases (SupplementaryTable 2). Our statistical analysis revealed a significant enrichment of mis-spliced events for 76% of the gene sets (Supplementary Fig. 1b). Importantly, there was a significant enrichment of genes from the Simons Foundation Autism Research Initiative (SFARI; OR = 2.2, FDR = 1.6 x 10-11) database (Fig. 1b and Supplementary Fig. 1b), including SFARI’s ‘high confidence’ (Score 1; OR = 2.7, FDR = 7.3 x 10-6), ‘strong candidate’ (Score 2; OR = 1.8, FDR = 2.7 x 10-2) and ‘suggestive evidence’ (Score 3; OR = 1.9, FDR = 1.1 x 10-4) gene categories. Our analysis also revealed a significant enrichment of high-confidence ASD-risk genes identified in two large Autism Speaks MSSNG-based whole-genome sequencing studies: MSSNG-201739 (OR = 2.2 , FDR = 3.4 x 10-2) and MSSNG-202240 (OR = 2.1, FDR = 8.3 x 10-3) (Fig. 1b and Supplementary Fig. 1b). Out of 36 overlapping ASD-risk genes in both MSSNG-2017 and MSSNG-2022 studies, 17% were mis-spliced in DM1 cortex, including SCN2A, ANK2, SHANK2. We also identified mis-splicing in the DMD gene (Fig. 1c-d and Supplementary Fig. 1c). Mutations in DMD mediate Duchenne muscular dystrophy which can be comorbid with ASD41, 42.
To test whether the level of ASD-risk gene mis-splicing was associated with the degree of CTGexp in DM1 prefrontal cortex, we correlated the CTG repeat length with the mean |DPSI | values for the mis-spliced ASD-risk genes in DM1. We selected previously determined repeat sizes corresponding to the 90th percentile of CTG length distribution (Supplementary Table 1) since a previous study demonstrated the strongest positive correlation between those CTG sizes and general mis-splicing level in DM1 prefrontal cortexes38. This analysis revealed a significant positive correlation between CTGexp size and the number of mis-spliced events in ASD-risk genes from the SFARI (r = 0.83, P = 0.02) and MSSNG-2017 study (r = 0.81, P = 0.03) (Fig. 1e and Supplementary Fig. 1d). Collectively, these results indicated that the DMPK 3'UTR CTGexp mutation in the prefrontal cortex perturbs the splicing of ASD-relevant genes.
Microexon mis-splicing of ASD-risk genes in mouse Mbnl1; Mbnl2 conditional double knockout frontal cortex
The strong correlation between CTGexp length and the degree of ASD-risk gene transcript mis-splicing suggests the involvement of MBNL regulation in the prefrontal cortex. To test this possibility, we performed differential AS analysis on RNA-seq data from adult Mbnl1-/-; Mbnl2c/c; Nestin-Cre+/- conditional double knockout mice (Mbnl1; Mbnl2 cDKO, hereafter Mbnl cDKO) versus wild-type (WT) frontal cortex samples43. The Mbnl cDKO mice bypass the embryonic lethality of constitutive Mbnl1-/-; Mbnl2-/- DKO mice and provide a nervous system-specific model where Mbnl1 expression is absent in all tissues while Mbnl2 is lost only in neuronal and glial precursor cells. The Mbnl cDKO is characterized by RNA mis-splicing, altered cortical neuronal and synaptic structures and widespread brain anatomical changes43-46. In total, 5% of AS events in 13% of detected genes were mis-spliced (Fig. 2a and Supplementary Fig. 2a). Similar to human DM1, 61% of ASD-relevant gene lists were significantly enriched among the mis-spliced genes in the Mbnl cDKO frontal cortex, including ASD-risk genes from the SFARI (OR = 1.7, FDR = 1.2 x 10-6), MSSNG-2017(OR = 2.6, FDR = 2.6 x 10-3) and MSSNG-2022 (OR = 1.7, FDR = 5.6 x 10-2) studies (Fig. 2b and Supplementary Fig. 2b). The overlap between SFARI, MSSNG-2017 and MSSNG-2022 mis-spliced ASD-risk genes in DM1 and Mbnl cDKO frontal cortexes varied from 30% to 58% (Fig. 2c). In total, we identified a significant overlap of 55 mis-spliced ASD-risk genes (e.g., SCN2A) between mouse and human frontal cortex (OR = 1.7, P = 1.6 x 10-12, Fisher's exact test) (Fig. 2d).
Neuronal miE (defined here as a 3-33 bp SE) mis-splicing is a hallmark of ASD brains, which can lead to ASD-like behaviors in mice30, 33, 34. We noticed significant disproportional miE mis-spliced events in both Mbnl cDKO and DM1 cortex (Fig. 2e). MiEs constituted 4% of all detected SE events in WT mouse frontal cortex but represented 10% ofmis-spliced SE events in Mbnl cDKO (OR = 2.9, FDR = 2.4 x 10-24), as well as 15%, 23% and 35% when they are found within ASD-risk genes from the SFARI (OR = 4.5, FDR = 1.5 x 10-9), MSSNG-2022 (OR = 7.4, FDR = 4.5 x 10-4), and MSSNG-2017 (OR = 13.0, FDR = 5.4 x 10-7) studies, respectively. Similarly, the proportion of miE mis-splicing events increased from 2% to 8% in DM1 prefrontal cortex (OR = 3.8, FDR = 8.1 x 10-26), and to 19%, 17%, and 44% in ASD-risk genes from the SFARI (OR = 10.0, FDR = 2.2 x 10-17), MSSNG-2022 (OR = 8.8, FDR = 7.7 x 10-3), and MSSNG-2017 (OR = 33.2, FDR = 4.4 x 10-8) studies, respectively. In total, we identified mis-spliced miE events in 33 genes that are present in both human DM1 and mouse Mbnl cDKO cortex, including evolutionary conserved miEs in high-confidence ASD-risk genes, such as ANK2, TANC2, and DMD (Fig. 2f-g).
Since previous studies have shown that miEs can locally modulate protein structure30, we performed comparative in silico modeling of peptides with/without miE-encoded amino acid (aa) sequences to test their potential for protein modulation. This analysis showed that some mis-spliced miEs might modulate internal (e.g., Ank2 and Nrxn1) or C-terminal (e.g., Dmd and Shank3) protein structures (Fig. 2h and Supplementary Fig. 2c-d). For example, the inclusionof thehighly conserved Ank2 miE (12 nt) along with the use of a proximal alternative 3′ splice sites (A3SS) results in protein isoform with a TIP aa sequence, whereas miE exclusion promotes distal A3SS usage (15 nt), and results in a protein isoform with a LRSF aa sequence containing a S901 phosphorylation site47 (Fig. 2h and Supplementary Fig. 2c). For Dmd, a 32 nt miE modulates the structure of the highly conserved dystrophin C-terminus that interacts with other proteins48 (Supplementary Fig. 2d).
Regulation of the ASD-risk gene splicing program during cortex development
To assess the developmental splicing pattern of ASD-risk genes, we analyzed gene expression data for five mammalian, including human, brains at different developmental stages49. Our analysis showed an evolutionarily conserved increase of MBNL2 expression during neonate/P0 to middle childhood/P14 brain development (Fig. 3a and Supplementary Fig. 3a). Although MBNL1 expression increases simultaneously, its expression in the developed brain is approximately 3-fold lower than MBNL2. To assess the association between Mbnl1 and Mbnl2 gene expression and MBNL-sensitive splicing transitions in the developing mouse cortex, we evaluated RNA-seq data from WT mice50. We computed mean |DPSI | values at nine developmental time points for AS events mis-spliced in ASD-risk genes in the Mbnl cDKO cortex and correlated them with Mbnl expression levels. As anticipated, the correlation between these variables was very strong for ASD-risk genes from the SFARI (r = 0.89, P = 1.2 x 10-3), MSSNG-2017 (r = 0.90, P = 9.0 x 10-4), and MSSNG-2022 (r = 0.91, P = 7.0 x 10-4) studies (Fig. 3b and Supplementary Fig. 3b). In agreement, the correlation remained strong for MBNL-sensitive miEs in the ASD-risk genes from the SFARI (r = 0.91, P = 5.0 x 10-4), MSSNG-2017 (r = 0.83, P = 5.5 x 10-3), and MSSNG-2022 (r = 0.76, P = 1.6 x 10-3) studies (Fig. 3b and Supplementary Fig. 3b). Differential AS analysis demonstrated that 48-56% of mis-spliced AS events in ASD-risk genes were significantly changed between embryonic and adult cortex (Supplementary Fig. 3c). For example, Scn2a1 MXE, Ank2 miE, Tanc2 miE, and Dmd miE splicing transitions occurred at early developmental stages to reach a plateau postnatally between two and four weeks of age (Fig. 3c-d and Supplementary Fig. 3d), which is consistent with the developmental expression patterns of Mbnls (Fig. 3a).
To assess whether prenatal MBNL loss influences splicing of ASD-risk genes, we analyzed RNA-seq data of the primary embryonic cortical neuron samples from Mbnl cDKO, constitutive Mbnl1-/- KO (hereafter Mbnl1 KO), constitutive Mbnl2-/- KO (hereafter Mbnl2 KO) and WT mice 51. We performed differential splicing analysis followed by ASD-risk gene enrichment analysis. In agreement with the relatively low embryonic Mbnl1 and Mbnl2 expression levels (Fig. 3 and Supplementary Fig. 3a), we did not observe significant enrichment of mis-splicing for ASD-risk genes from the SFARI (OR = 1.3, FDR = 0.17), MSSNG-2017 (OR = 1.0, FDR = 1.00) and MSSNG-2022 (OR = 1.3, FDR = 0.62) studies in the embryonic Mbnl cDKO. However, in agreement with the additive effect of Mbnl paralogs loss, we noticed a greater degree of mis-splicing events in ASD-risk genes in Mbnl cDKO compared to Mbnl1 KO and Mbnl2 KO embryonic cortical neurons, including Dmd miE (Fig. 3e-f and Supplementary Fig. 3e). To further investigate the impact of DMPK CTGexp mutation on the ASD-risk gene splicing program in the developing human brain, we also analyzed DM1 and control brain organoid RNA-seq samples52 followed by the differential splicing and ASD-risk gene enrichment analyses. We found a significant enrichment of mis-spliced events in ASD-risk genes from the SFARI (OR = 1.6, FDR = 6.6 x 10-11), MSSNG-2017 (OR = 3.3, FDR = 1.3 x 10-6) and MSSNG-2022 (OR = 2.6, FDR = 3.6 x 10-7) studies in the DM1 brain organoid, including previously identified DMD miE (Fig. 3g-h). Overall, these results indicated that MBNL proteins govern the splicing patterns of multiple ASD-risk genes, including miEs, in the developing brain.
MBNL2 loss causes ASD-risk gene mis-splicing in multiple brain regions
Mbnl2 is the predominant gene paralog expressed in the adult human and mouse cerebral cortex, hippocampus, and cerebellum (Fig. 4a and Supplementary Fig. 4a-b), and these brain regions are known to be involved in ASD53, 54. To test the hypothesis that Mbnl2 loss perturbs splicing of ASD-risk genes in multiple brain regions, we performed RT-PCR splicing analysis of Scn2a MXE, Nrxn1 miE and Shank3 miE in frontal cortex, hippocampus, and cerebellum of adult Mbnl2 KO and WT mice. Two of three tested AS events demonstrated the most profound mis-splicing in the hippocampus (Fig. 4b and Supplementary Fig. 4c-d). Thus, to investigate Mbnl2-mediated AS regulation in ASD-risk genes in the hippocampus, we performed differential splicing analysis on RNA-seq data from Mbnl2 KO55. In total, 4% of AS events were perturbed in 8% of detected genes, including Scn2a, Ank2, Nrxn1, and Shank3 (Fig. 4c-e and Supplementary Fig. 4e-f). As observed for the Mbnl cDKO, 53% of ASD-relevant gene lists were significantly enriched among the mis-spliced genes in the Mbnl2 KO hippocampus, including ASD-risk genes from the SFARI (OR = 2.0, FDR = 7.2 x 10-7), MSSNG-2017 (OR = 4.0, FDR = 6.8 x 10-5) and MSSNG-2022 (OR = 2.6, FDR = 1.4 x 10-3) studies (Fig. 4f and Supplementary Fig. 4g). Approximately 9% of all mis-spliced ASD-risk genes in Mbnl2 hippocampus overlapped with those found in DM1 prefrontal cortex and Mbnl cDKO frontal cortex (Fig. 4g). The most consistently mis-spliced events were Ank2 miE and Scn2a MXE. Therefore, Mbnl2 loss alone impacts the alternative splicing of ASD-risk genes in multiple ASD-relevant brain regions, including the hippocampus.
Direct regulation of ASD-relevant microexons by MBNL proteins
To support the observation that Mbnl proteins directly regulate splicing of high-confidence ASD-risk genes, we first performed differential AS analysis on RNA-seq data from a mouse brain-derived catecholaminergic (CAD) neuronal cell line with siRNA-mediated Mbnl1; Mbnl2 double knockdown (hereafter Mbnl DKD) versus control51. In total, 5% of AS events in 15% of detected genes were mis-spliced (Fig. 5a and Supplementary Fig. 5a), and 45% of ASD-risk gene lists were significantly enriched among the mis-spliced genes in the Mbnl DKD CAD cell line, including ASD-risk genes from the SFARI (OR = 1.6, FDR = 2.2 x 10-5), MSSNG-2017 (OR = 2.7, FDR = 2.7 x 10-3) and MSSNG-2022 (OR = 2.1, FDR = 5.2 x 10-3) studies (Fig. 5b and Supplementary Fig. 5b). Like mouse Mbnl DKO frontal cortex and Mbnl2 KO hippocampus, mis-spliced miEs in ASD-risk genes from the SFARI (OR = 3.7, FDR = 9.9 x 10-6), MSSNG-2017 (OR = 9.2, FDR = 2.1 x 10-4) and MSSNG-2022 (OR = 4.1, FDR = 5.2 x 10-2) studies were significantly enriched in Mbnl DKD CAD cells (Fig. 5c). We identified Ank2 miE mis-splicing similar to the previously analyzed DM1, Mbnl cDKO, and Mbnl2 KO brain regions (Fig. 5d).
Next, we performed a MBNL binding site enrichment analysis for SE mis-splicing in ASD-relevant genes. Based on our previous MBNL-RNA interaction studies17, 56, 57, we determined YGCYGCY and YGCY(N)0-5YGCY as high affinity MBNL-binding sequences. We performed a genome-wide distribution analysis of intronic MBNL-binding motifs ±500 bp from alternative SE splice sites. We detected a significant enrichment of Mbnl binding sequences in mis-spliced ASD genes in DM1 (OR = 1.4, FDR = 0.011) and Mbnl cDKO (OR = 1.3, FDR = 0.012) frontal cortex, Mbnl DKD CAD cells (OR = 1.3, FDR = 0.011) as well as Mbnl2 KO hippocampus (OR = 1.5, FDR = 0.011) (Fig. 5e).
Since our data indicated Mbnl proteins preferentially regulate ASD-risk gene miE splicing, we selected the highly conserved Ank212 nt miE, which was consistently mis-spliced in our various models, to study the molecular mechanism underlying miE splicing. To assess whether Mbnl directly regulates Ank2 miE inclusion, we analyzed Mbnl2 crosslinking and immunoprecipitation sequencing (CLIP-seq) samples from adult WT hippocampi55. A cluster of CLIP-seq reads indicates an Mbnl2-RNA interaction region. In agreement with previous studies demonstrating that Mbnl binding within the downstream intron of an alternative SE promotes its inclusion55, 58, we identified a Mbnl2-CLIP-seq cluster covering a conserved TGCT(N)3TGCT(N)13-18TGCT/C sequence ~55 bp downstream 5' splice site in Ank2/ANK2 intron (Fig. 5f and Supplementary Fig. 5c). Based on our previous MBNL-RNA interaction studies17, 56, 57, we anticipated this motif represents high affinity MBNL-binding sequences. In silico RNA secondary structure modeling predicted that MBNL binding motifs are localized in less structured RNA regions (SupplementaryFig. 5d). Since splicing of the Ank2 miE to the A3SS results in mRNA isoforms differing by only 3 nt (as explained earlier), we took advantage of our previously developed Atp2a1 E22 inclusion minigene (Atp2a1-WT) assay for RNA-MBNL interactions56. We deleted an experimentally confirmed MBNL-binding motif within the downstream intron 22 of the mouse Atp2a1-WT minigene (Atp2a1-D) and inserted the 90 bp mouse Ank2 and human ANK2 conserved intronic sequence TGCT(N)3TGCT(N)13-18TGCT/C (Atp2a1-Ank2, Atp2a1-ANK2) and mutated GGCT(N)3TGAT(N)13-18TGTT/C sequences (Atp2a1-mutAnk2, Atp2a1-mutANK2;substitutions are underlined) (Fig. 5f-g). The disruption of YGCY (Y = U/C) motifs is known to lower the affinity of MBNL proteins for RNA57. We transfected HeLa cells with these Atp2a1 minigenes and measured E22 inclusion by RT-PCR. In contrast to Atp2a1-D, Atp2a1-mutAnk2, and Atp2a1-mutANK2 minigenes, Atp2a1-WT, Atp2a1-Ank2, and Atp2a1-ANK2 were sensitive to the endogenous level of MBNL proteins (Fig. 5h). To support our observation, we co-transfected Atp2a1 minigenes and MBNL1, MBNL2 or EGFP (control) expression vectors. Atp2a1-Ank2 E22 and Atp2a1-ANK2 E22 were significantly more included than Atp2a1-mutAnk2 and Atp2a1-mutANK2 (Fig. 5h and Supplementary Fig. 5e) indicating that MBNL proteins directly regulate miE splicing in an ASD-risk gene. All these results support our proposal that MBNL directly regulates the splicing of ASD-risk genes miEs.
MBNL inhibition in DM1 mimics miE mis-splicing in idiopathic ASD
To ascertain whether there were common mis-spliced genes and AS events between DM1 and ASD, we retrieved adult idiopathic ASD prefrontal cortex (BA9) samples from the PsychENCODE Consortium (SupplementaryTable 1)28, 59. Our differential AS analysis revealed 0.3% of mis-spliced events in 2% of analyzed genes (Fig. 6a and Supplementary Fig. 6a), and 15 mis-spliced AS events overlapped between DM1 and ASD (OR = 3.5, P = 5.7 x 10-5, Fisher's exact test), including ANK2 miE (Fig. 6b). Previous reports have linked neuronal miE mis-splicing in idiopathic ASD brains to reduced SRRM4 (nSR100) expression30. Like Mbnl1 and Mbnl2, Srrm3 and Srrm4 are paralogs that regulate the same set of neuronal miEs60. To ascertain whether there are common mis-spliced ASD-relevant miEs between Mbnl loss and Srrm loss, we retrieved RNA-seq data from the mouse Neuro2a (N2a) cell line with siRNA-mediated Srrm3; Srrm4 double knockdowns (hereafter Srrm DKD) versus control60. Our differential AS analysis revealed 2% of mis-spliced events in 7% of analyzed genes (Fig. 6c and Supplementary Fig. 6b), and 63% of ASD-risk gene lists were significantly enriched by the mis-spliced genes in the Srrm DKD N2a cell line (SupplementaryFig. 6c). As anticipated, Srrm DKD preferentially altered miE splicing (OR = 22, FDR 6.8 x 10-207), including miE in ASD-risk genes from the SFARI (OR = 23, FDR = 1.7 x 10-34), MSSNG-2017 (OR = 34, FDR = 5.1 x 10-9) and MSSNG-2022 (OR = 25, FDR = 1.9 x 10-8) studies (SupplementaryFig. 6d). In total, we identified a non-random overlap of 153 mis-spliced AS events between Mbnl DKD CAD and Srrm DKD N2a (OR = 4.5, P = 4.0 x 10-44, Fisher's exact test), including 34 altered miE events (OR = 2.0, P = 4.5 x 10-3, Fisher's exact test). 41% of overlapping mis-spliced miEs showed concordant DPSI changes in Mbnl DKD and Srrm DKD, all of which demonstrated exon exclusion in the transcripts (DPSI < 0) (Fig. 6d). For example, we identified the Ank2 miE as an overlapping mis-spliced event that underwent exon exclusion in the transcripts in both Mbnl DKD and Srrm DKD cells (Fig. 5d and 6e).
SRRM4 protein promotes neuronal miE inclusion by binding to an intronic UGC motif approximately 15 nt upstream the 3′SS of targeted exon61. In contrast, MBNL proteins bind to downstream intronic UGCY motifs to promote alternative exon inclusion58, 62. To support that MBNL and SRRM4 regulate Ank2 miE inclusion binding to distinct sequences, we retrieved available CLIP-seq data from an N2a cell line expressing flagged SRRM4 protein61. As expected, we identified a SRRM4-CLIP-seq reads cluster covering a conserved UGC motif 9 nt upstream Ank2 miE, and there were no reads supporting SRRM4 interaction with the MBNL binding site and vice versa (Fig. 5f, 6f and Supplementary Fig. 6e).
In contrast to MBNL2, SRRM4 has a relatively higher expression in embryonic compared to postnatal brain in human and mouse (SupplementaryFig. 6e). As predicted, Srrm4 and Srrm3 gene expression levels were unchanged in Mbnl cDKO frontal cortex, Mbnl2 KO hippocampus, and Mbnl DKD CAD cells (SupplementaryFig. 6f). Interestingly, we noticed the significant 28% reduction of SRRM4 RNA in DM1 brain, however this downregulation did not correlate with CTGexp (r = -0.41, P = 0.36) (SupplementaryFig. 6f-g). These results indicate that the MBNL and SRRM proteins regulate splicing of ASD-relevant miEs, such as ANK2 miE (Fig. 6g), in an independent manner.
Social interaction deficits in Mbnl2 knockout and Dmpk 3'UTR CTGexp knockin mice.
Ekström and colleagues have reported that DM1 children have a higher incidence of impaired social interaction and communication skills63, and thus we tested sociability in our DM1 mouse models using the three-chamber test. The three-chamber test involves three phases: habituation, sociability, and social novelty64 (Fig. 7a). We first selected heterozygous Dmpk 3'UTR (CTG)480/WT knockin (hereafter Dmpk-(CTG)480/WT KI) and homozygous Dmpk-(CTG)480/480 KI mouse models to study phenotypic outcomes. Both Dmpk-(CTG)480/WT KI and Dmpk-(CTG)480/480 KI reproduce characteristic DM1 pathological molecular signatures, including MBNL sequestration on Dmpk 3'UTR (CUG)480 RNAs, RNA mis-splicing in the vulnerable cell types, and DMPK protein loss65. Importantly, the molecular phenotypes are significantly more exaggerated in homozygous Dmpk-(CTG)480/480KIcompared to heterozygous Dmpk-(CTG)480/WT KI65. In the sociability phase of the three-chamber test, WT and heterozygous Dmpk-(CTG)480/WT KI mice spent significantly more time in the chamber with a novel animal (Stranger 1) than a novel object (Fig. 7b). In contrast, homozygous Dmpk-(CTG)480/480 KI mice showed no significant preference for the chamber with novel animal over the novel object (Fig. 7b), signifying a lack of sociability.
To test the hypothesis that MBNL inhibition underlies the social deficit, we evaluated Mbnl2 KO and Mbnl1 KO mouse models. The Mbnl1 KO is characterized by muscle (e.g., myotonia), immune system and vision pathology66, 67, whereas the Mbnl2 KO exhibits central nervous system abnormalities, including neuronal morphology and synaptic changes45, 55, 68. Like homozygous Dmpk-(CTG)480/480KI, and in contrast to WT, Mbnl2 KO mice did not spend significantly more time in the chamber with a novel animal (Fig. 7c). Additionally, Mbnl2 KO mice also showed no significant preference for social novelty when presented with a familiar animal (Stranger 1) and a novel animal (Stranger 2) in the social novelty phase (SupplementaryFig. 7a). Since Mbnl1 is the dominant Mbnl paralog expressed in skeletal muscles, testing Mbnl1 KO mice in the social test failed to provide reliable results due to their profoundly limited mobility evident during the habituation phase (Fig. 7d). In contrast, Mbnl2 KO mice did not exhibit significant exploratory locomotor deficits in the three-chamber test and the open-field test (Fig. 7d and Supplementary Fig. 7b).
These mouse behavioral results showed that either Dmpk-(CTG)480/480 expression or MBNL2 protein loss led to social interaction deficits, a key diagnostic feature of DM1-associated ASD. The variability observed in the three-chamber test for both homozygous Dmpk-(CTG)480/480 and Mbnl2 KO mice suggests incomplete penetrance of this phenotype.