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Double-strand break repair model

The double-strand break repair (DSBR) model is a foundational mechanism in (HR) that repairs DNA double-strand breaks (DSBs) by using a homologous DNA template to restore genetic information with high fidelity, originally proposed to explain meiotic recombination events such as gene conversion and crossing over in . In this process, a DSB is enlarged into a gap through resection, generating single-stranded DNA (ssDNA) tails that facilitate strand invasion into the donor duplex, followed by to copy the missing sequence and resolution of intermediate structures to complete repair. This model, first articulated by Szostak, Orr-Weaver, Rothstein, and Stahl in 1983, revolutionized understanding of recombination by shifting focus from single-strand nicks to DSBs as the initiating lesion, providing a unified explanation for nonreciprocal gene conversion via gap repair and postmeiotic segregation from heteroduplex DNA at gap edges. Key steps include: end resection by nucleases like Exo1 and Dna2 to produce 3'-ssDNA overhangs coated with RPA and Rad51 to form a nucleoprotein filament; strand invasion where the Rad51 filament searches for and invades the homologous donor, displacing one strand to form a D-loop; DNA synthesis extending the invading strand using the donor as a template, often by DNA polymerase δ; and resolution through second-end capture, ligation, and either Holliday junction dissolution (non-crossover) or cleavage (crossover products), mediated by proteins such as Rad52, BRCA2, Rad54, and resolvases like Mus81-Eme1. While initially tied to meiosis, the DSBR pathway operates in mitotic cells to suppress genomic instability, prevent loss of heterozygosity, and support DNA damage tolerance, with defects linked to cancer predisposition syndromes like Fanconi anemia and BRCA-related disorders. The model's efficiency and accuracy make HR the preferred DSB repair route in S/G2 phases, contrasting with error-prone non-homologous end joining (NHEJ) dominant in G1.

Fundamentals of Double-Strand Breaks

Definition and Biological Importance

A double-strand break (DSB) is a critical form of DNA damage characterized by a severance in both strands of the DNA double helix at the same or proximate locations, distinguishing it from single-strand breaks (SSBs), which involve only one strand and allow repair using the undamaged complementary strand as a template. DSBs disrupt the continuity of the genome, potentially separating chromosomes into fragments if not addressed. Structurally, DSBs vary in complexity and end configuration: simple DSBs feature clean fractures with minimal surrounding damage, while complex DSBs include clustered lesions such as base modifications or additional breaks nearby, complicating repair; end types include blunt ends (flush, without overhangs) or cohesive ends (with protruding single-stranded sequences that can base-pair). These variations influence repair efficiency and fidelity, with blunt ends often proving more challenging to rejoin accurately than cohesive ones. Biologically, DSBs carry profound importance due to their potential to induce , genomic instability, or heritable mutations if unrepaired or repaired erroneously, leading to outcomes like chromosomal translocations, deletions, or insertions that underpin diseases including cancer. In mammalian cells, endogenous DSBs arise at rates of 10–50 per cell per day under normal conditions, reflecting routine physiological stresses despite cellular safeguards. To avert catastrophe, cells promptly activate repair mechanisms such as or .

Primary Causes

Double-strand breaks (DSBs) in DNA arise from a variety of endogenous and exogenous sources, each contributing to genomic instability if not properly managed. Endogenous causes primarily stem from normal cellular processes that inadvertently damage the DNA backbone. For instance, replication fork collapse occurs when replication machinery stalls at obstacles such as nucleotide shortages or unusual secondary structures, leading to DSB formation through the cleavage of stalled intermediates during S-phase progression. Transcription-associated damage results from conflicts between the transcription and replication machineries, where RNA polymerase complexes generate R-loops—RNA:DNA hybrids—that destabilize the DNA and induce breaks, particularly in regions with high transcriptional activity. In immune cells, programmed DSBs are deliberately introduced during V(D)J recombination by the RAG endonuclease complex to assemble variable regions of immunoglobulin and T-cell receptor genes, while class-switch recombination in B cells involves activation-induced cytidine deaminase (AID) generating DSBs to facilitate antibody isotype switching. Reactive oxygen species (ROS), produced as byproducts of mitochondrial respiration and other metabolic activities, also contribute to endogenous DSBs by oxidizing the DNA sugar-phosphate backbone, with estimates suggesting they account for a significant portion of spontaneous breaks under normal physiological conditions. Exogenous causes introduce DSBs through environmental or therapeutic exposures that directly assault DNA integrity. , such as X-rays and gamma rays, generates DSBs via indirect of water molecules producing reactive radicals that abstract hydrogen atoms from the sugar, often resulting in clustered lesions—multiple damages within a few base pairs—that complicate repair. Chemotherapeutic agents like cause DSBs by binding DNA and generating free radicals that cleave both strands, mimicking effects in . inhibitors, including and , stabilize cleavage complexes during DNA unwinding, converting single-strand breaks into DSBs upon encounter with the replication fork, particularly exacerbating damage in proliferating cells. The frequency of DSBs is context-dependent, with endogenous sources yielding approximately 10–50 breaks per mammalian per day, rising significantly during S and G2 phases due to replication stress that amplifies fork collapse and transcription-replication collisions. Unrepaired DSBs from exogenous sources like can trigger pathways, underscoring their cytotoxic potential.

Major Repair Pathways

Homologous Recombination Pathways

() is a conservative, template-dependent mechanism for repairing double-strand breaks (DSBs) that utilizes a homologous DNA sequence, typically the sister , to accurately restore the original genetic information with minimal errors. This pathway is predominantly active during the S and G2 phases of the , when a suitable template is available, and it contrasts with error-prone alternatives by prioritizing fidelity over speed. HR proceeds through a series of coordinated steps initiated by DSB recognition and end processing, ensuring high-fidelity repair that preserves . The process begins with end resection, where the MRN complex (consisting of MRE11, RAD50, and NBS1) together with CtIP initiates the 5'-3' degradation of DSB ends to generate long 3' single-stranded DNA (ssDNA) overhangs, exposing homologous sequences for pairing. These ssDNA tails are initially bound by replication protein A (RPA), which is subsequently displaced by the recombinase RAD51 to form a nucleoprotein filament capable of searching for and invading the homologous donor duplex. Assembly of the RAD51 filament is facilitated by mediator proteins including BRCA1, BRCA2, PALB2, and RAD51 paralogs (RAD51B, RAD51C, RAD51D, XRCC2, XRCC3), which stabilize the filament and promote strand exchange. This invasion forms a displacement loop (D-loop), initiating DNA synthesis to copy the template sequence. One major subpathway is the canonical double-strand break repair (DSBR) model, where both DSB ends engage the homologous template, leading to the formation of double Holliday junctions (dHJs). After initial strand invasion by one end and , the second DSB end is captured, and branch migration extends the heteroduplex regions. The dHJs are then resolved either by dissolution via the BTR complex ( helicase, TOP3A topoisomerase, and RMI1/2) to yield non-crossover products or by endonucleolytic resolution using GEN1 or MUS81-EME1 to produce both crossover and non-crossover outcomes. This model, proposed by Szostak et al. in 1983, accounts for both conversion and potential chromosomal crossovers observed in meiotic and . DSBR ensures conservative repair but can introduce genetic rearrangements if crossovers occur between non-sister chromatids. In contrast, synthesis-dependent strand annealing (SDSA) is a non-crossover subpathway that predominates in mitotic cells for gene conversion without exchange. Following formation and extensive from the invading strand, the newly synthesized arm is displaced from the template and anneals directly to the homologous sequences on the other resected DSB end, followed by gap filling and ligation. This process avoids second-end capture and formation, minimizing crossover risks. Evidence for SDSA emerged from studies in showing efficient copying of ectopic sequences without reciprocal exchange, as demonstrated by Nassif et al. in 1994. SDSA relies on the same initial resection and invasion machinery but is promoted by helicases like SRS2 in that unwind extended s to facilitate annealing. Break-induced replication (BIR) addresses one-ended DSBs, such as those arising from collapsed replication forks or eroded , where only one end can invade a homologous template. The invading 3' end primes semi-conservative that proceeds unidirectionally over long distances, often hundreds of kilobases, using standard replication factors like POLδ and PCNA after an initial RAD51-dependent invasion phase. Unlike DSBR or SDSA, BIR results in conservative replication of the donor sequence without restoring the second end, leading to distal to the break. This pathway is particularly vital in telomerase-deficient cells for maintenance and is associated with higher due to error-prone polymerases involved in later stages. Seminal work as reviewed by Haber in highlighting its role in repairing terminal deletions. Key regulators include PIF1 , which limits excessive BIR to prevent genomic instability. Single-strand annealing (SSA) is a homology-directed but mutagenic HR variant that operates when repeats flank the DSB, bypassing the need for an intact sister . Extensive resection by EXO1 or DNA2 exposes complementary sequences in direct repeats, which anneal via RAD52 mediation, followed by removal of non-annealed flaps by ERCC1-XPF and ligation. This results in deletion of the intervening sequence between repeats, introducing loss-of-heterozygosity and potential genomic rearrangements. SSA is RAD51-independent but suppressed in S/ to favor canonical HR, and it predominates in G1 or in HR-deficient contexts. The mechanism was first modeled by Lin et al. in 1984 using recombination in mammalian cells, establishing its role in end-to-end joining via homology. Overall, HR subpathways achieve near-zero error rates for short-tract repair in DSBR and SDSA, but BIR and SSA can promote instability through structural variations.

End-Joining Pathways

End-joining pathways repair double-strand breaks (DSBs) through homology-independent or microhomology-dependent mechanisms that rapidly ligate broken DNA ends without requiring an extensive homologous template, though both are inherently error-prone and can introduce insertions or deletions at repair junctions. These pathways include classical (NHEJ), which directly rejoins ends with minimal processing, and (MMEJ, also known as alternative end joining or alt-EJ), which anneals short homologous sequences for alignment. Unlike , end-joining is faster but less accurate, often leading to genomic instability if over-relied upon. Non-homologous end joining (NHEJ) is the predominant DSB repair pathway in mammalian cells, active throughout the but especially dominant in G0/G1 and early S phases. The process begins with the Ku70/Ku80 heterodimer (Ku) rapidly binding to free DNA ends, forming a ring around the break to protect against nuclease degradation and recruit other factors. Ku then tethers the ends in a synaptic complex and activates DNA-dependent catalytic subunit (), which autophosphorylates to facilitate end processing. For incompatible ends, such as those with overhangs or hairpins, the Artemis nuclease—activated by the DNA-PKcs/Artemis complex—trims or opens structures to generate ligatable termini. Final ligation is performed by the XRCC4-DNA ligase IV (LIG4) complex, stabilized by XRCC4-like factor (XLF), which seals the nick and completes repair. This core machinery enables rapid synapsis and end-tethering, minimizing diffusion of breaks. NHEJ preserves the original sequence more faithfully than other end-joining routes when ends are compatible, with error-free repairs occurring in 35–75% of cases for blunt or cohesive ends; however, it introduces small insertions or deletions (indels) in the remaining 25–65%, particularly at complex or damaged termini. These alterations typically involve 1–4 changes, arising from limited fill-in or activity during processing. Microhomology-mediated end joining (MMEJ) serves as a backup mechanism, utilizing short stretches of 2–20 base pairs of microhomology flanking the DSB for end annealing, and is particularly active in cells deficient for , such as BRCA1/2 mutants. Initiation involves poly(ADP-ribose) polymerase 1 () binding to DNA ends and promoting limited 5' resection by the MRN complex (MRE11-RAD50-NBS1) to expose microhomologies. DNA polymerase θ (Polθ) then anneals the microhomologous regions, fills in gaps via its polymerase activity, and flaps out non-homologous flaps via its domain, generating larger deletions than NHEJ. Ligation is completed by DNA ligase III (LIG3) in complex with XRCC1, independent of the LIG4 pathway. MMEJ occurs throughout the but is suppressed in normal conditions by NHEJ and homologous recombination factors. MMEJ is highly mutagenic, invariably producing deletions by excising the region between microhomologies plus one copy of the itself, often resulting in 10–100 losses at junctions—far more extensive than NHEJ's small indels—and additional insertions from Polθ's error-prone synthesis. This pathway's reliance on microhomology distinguishes it from NHEJ's direct tethering, leading to greater sequence loss but enabling repair in contexts where clean ends are unavailable.

Regulation of Repair Pathways

DNA Damage Response Mechanisms

The DNA damage response (DDR) to double-strand breaks (DSBs) initiates a of signaling events that detect the , amplify the signal, and coordinate cellular decisions to halt proliferation until repair is achieved or, if irreparable, trigger . This response is primarily orchestrated by the ataxia-telangiectasia mutated () kinase for direct DSBs and the ataxia-telangiectasia and Rad3-related (ATR) kinase for replication-associated damage, leading to the activation of checkpoints that arrest the at key transitions. These mechanisms ensure genomic integrity by recruiting repair factors and preventing the propagation of mutations. ATM activation occurs rapidly upon DSB sensing by the MRE11-RAD50-NBS1 (MRN) complex, which recruits and autophosphorylates at serine 1981, enabling its kinase activity. Activated ATM then phosphorylates histone H2AX at serine 139, forming γ-H2AX foci that serve as platforms for further signaling. These foci recruit mediator of DNA damage checkpoint protein 1 (MDC1), which binds directly to γ-H2AX via its BRCT domains, amplifying ATM signaling and facilitating the accumulation of downstream effectors such as 53BP1 and at the break site. 53BP1 promotes by shielding ends from resection, while supports through its activity in complex with BARD1. This hierarchical recruitment establishes a chromatin-bound signaling hub essential for DSB coordination. In contrast, ATR activation is prominent in replication-associated DSBs, where stalled forks generate extensive single-stranded DNA (ssDNA) coated by (RPA). RPA-ssDNA recruits the ATR-interacting protein (ATRIP), which docks the ATR-ATRIP complex to the site, while TOPBP1 or ETAA1 stimulates ATR kinase activity. This pathway intersects DSB repair by stabilizing forks and promoting resection to generate substrates for , particularly during . ATR phosphorylates checkpoint kinase 1 (CHK1) at serine 345, amplifying the response. The activates multiple checkpoint pathways to enforce arrests, allowing time for repair. The G1/S checkpoint is mediated by ATM-CHK2- signaling, where CHK2 phosphorylates at serine 20, stabilizing it to transcriptionally induce p21 and inhibit (CDK2), preventing S-phase entry. Intra-S phase arrest occurs via ATR-CHK1, which phosphorylates CDC25A for its degradation, slowing replication fork progression. The G2/M checkpoint, activated by both ATM-CHK2 and ATR-CHK1, inhibits CDC25C to block CDK1 activation and mitotic entry. These arrests are p53-dependent in G1 but more reliant on CHK1/2 in S/G2, collectively pausing the in response to DSBs. The Fanconi anemia (FA) pathway, though primarily dedicated to interstrand crosslink repair, intersects DSB responses through monoubiquitination of FANCD2-FANCI by the FA core complex upon DNA damage sensing. Ubiquitinated FANCD2 accumulates at stalled forks and DSBs, recruiting nucleases like FAN1 to promote end resection and homologous recombination, thereby linking ICL-induced DSBs to high-fidelity repair. This coordination enhances DSB repair efficiency in contexts of replication stress. Recent studies have uncovered additional layers of regulation involving molecules, which actively influence DSB repair outcomes. Nascent transcripts and other RNAs can modulate end-joining pathways and by facilitating protein recruitment or altering chromatin structure at break sites, providing a sequence-specific regulatory mechanism that enhances repair fidelity. Repair foci emerge as dynamic nuclear structures at DSB sites, nucleated by γ-H2AX and MDC1 to concentrate repair factors such as 53BP1, , and MRN into liquid-like condensates via . These foci facilitate efficient signaling and factor exchange, with proteins diffusing in and out to orchestrate repair without permanent sequestration. DSB-induced foci typically form within minutes and resolve upon repair completion, serving as visible markers of active . If DSBs remain unrepaired, the promotes through activation, where stabilized transcriptionally upregulates pro-apoptotic effectors like BAX, leading to mitochondrial outer membrane permeabilization and activation. This -BAX axis eliminates cells with persistent genomic instability, preventing tumorigenesis. The thus influences pathway selection by modulating accessibility and factor availability at breaks.

Factors Influencing Pathway Selection

The choice of double-strand break (DSB) repair pathway is profoundly influenced by the physical characteristics of the DNA ends generated by the break. Clean, blunt, or minimally damaged ends are preferentially repaired by (NHEJ), as this pathway efficiently ligates compatible termini without extensive processing. In contrast, "dirty" ends featuring overhangs, chemical modifications, or secondary structures often require end processing, which can favor (HR) if resection occurs to generate single-stranded DNA tails compatible with strand invasion. Resected ends, in particular, commit the break to HR by preventing NHEJ factor binding and promoting the recruitment of resection nucleases like MRN and EXO1. Cell cycle phase serves as a primary of pathway selection, ensuring error-free repair when possible. NHEJ predominates in , where the absence of a sister chromatid template limits ; here, 53BP1 accumulates at DSB sites to shield ends from resection, facilitating rapid NHEJ ligation.00656-9) In S and G2 phases, (CDK1) phosphorylates CtIP, activating end resection and thereby suppressing NHEJ while promoting using the newly replicated sister chromatid as a template. This temporal regulation minimizes mutagenesis, as HR fidelity is higher post-replication. Antagonistic interactions between key regulators further fine-tune pathway choice. The proteins 53BP1 and compete at DSB sites: 53BP1 promotes NHEJ by inhibiting resection and recruiting RIF1 to compact around breaks, whereas counteracts this by promoting resection through RAP80 displacement and CtIP activation, thereby favoring . Pharmacological interventions like exacerbate this balance; by trapping on DNA and inducing replication fork collapse into DSBs, they shift repair toward (MMEJ) in HR-deficient cells, where NHEJ and are compromised, leading to . Organismal context also modulates pathway preferences, reflecting evolutionary adaptations to genomic stability needs. In , is the dominant pathway for DSB repair due to efficient homologous template availability and minimal reliance on NHEJ, which is error-prone and less utilized. Mammalian cells, however, balance NHEJ and , with NHEJ handling ~80% of breaks for rapid repair, while higher eukaryotes in HR-deficient states increasingly invoke alternative end-joining (alt-EJ, including MMEJ) to compensate. During , SPO11-induced DSBs are exclusively repaired via to generate crossovers essential for chromosome segregation; factors like MLH1 ensure interference and proper resolution of double Holliday junctions into crossovers. The origin of the DSB dictates pathway utilization to suit biological context. Replication-associated DSBs, often arising from fork collapse, preferentially engage break-induced replication (BIR), a HR variant that uses long-tract synthesis from a single end to restart forks and prevent loss of genetic information. In contrast, programmed DSBs during V(D)J recombination in lymphocytes are strictly repaired by NHEJ to join variable (V), diversity (D), and joining (J) gene segments, enabling antigen receptor diversity while suppressing error-prone alternatives.

Consequences of Defective Repair

Implications for Aging

Deficiencies in double-strand break (DSB) repair contribute to the accumulation of unrepaired DSBs in aging cells, manifesting as persistent γ-H2AX foci that indicate ongoing DNA damage response activation. This persistence reflects a failure to resolve breaks efficiently, leading to chronic genomic instability. Additionally, reliance on alternative (alt-NHEJ) for telomere maintenance results in telomere shortening, exacerbating and organismal aging. The decline in (NHEJ) efficiency with age, partly due to reduced Ku80 protein levels, heightens genomic instability by impairing the repair of DSBs in non-dividing cells. Similarly, (HR) is compromised through downregulation of expression, which promotes error-prone repair and mutation accumulation as cells age. Progeroid syndromes provide compelling evidence for the link between DSB repair defects and accelerated aging; for instance, arises from mutations in the WRN , which promotes classical NHEJ and inhibits alt-NHEJ, and its deficiency leads to genomic instability, premature , and organismal decline. , a hallmark of aging, generates excessive DSBs that overwhelm repair capacities, triggering through upregulation of and p21 pathways that enforce irreversible arrest. In models with DSB repair deficiencies, such as those lacking key NHEJ or components, phenotypes like frailty, reduced lifespan, and dysfunction are accelerated, mirroring natural aging processes.

Role in Cancer Development

Defects in double-strand break (DSB) repair pathways significantly contribute to cancer development by promoting genomic instability, a hallmark that enables tumor initiation and progression. Mutations in key (HR) genes, such as and , lead to HR deficiency (HRD), forcing cells to rely on error-prone alternatives like non-homologous end-joining (NHEJ) and (MMEJ), which generate insertions/deletions (indels) and structural variants that drive tumorigenesis. For instance, BRCA1/2 loss is a frequent driver in various cancers, impairing accurate DSB repair and resulting in elevated mutation burdens. Similarly, mutations in NHEJ components, such as LIG4, disrupt precise end ligation, increasing chromosomal translocations observed in lymphomas and other hematologic malignancies. Unrepaired or misrepaired DSBs exacerbate genomic instability, facilitating rapid evolutionary changes in cancer cells, including —a catastrophic shattering and reassembly of chromosomes that generates complex rearrangements. This process is particularly prevalent in tumors with DSB repair deficiencies, where persistent breaks lead to oncogenic amplifications, deletions, and fusions that promote progression. Evidence from hereditary syndromes underscores this link: BRCA1/2 mutations confer high lifetime risks of breast (up to 72%) and ovarian (up to 44%) cancers due to inherited HRD. In sporadic cancers, co-mutations in TP53, which impairs DNA damage response (DDR) coordination, compound DSB repair defects, accelerating across tumor types. Therapeutically, these vulnerabilities enable targeted interventions, such as , which exploit in HR-deficient cells by trapping PARP on DNA and causing replication fork collapse, selectively killing BRCA-mutant tumors while sparing normal cells. Recent post-2020 screens have identified novel synthetic lethal interactions in DSB repair pathways, revealing tumor-specific dependencies like or loss that sensitize cancers to inhibitors beyond BRCA contexts, with comprehensive genetic catalogs as of 2025 further mapping key repair interactions.

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