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X-chromosome methylation patterns in females with multiple sclerosis

Calnin, T.; Maltby, V. E.; Burnard, S. M.; Xavier, A.; Simpson-Yap, S.; van der Mei, I.; Broadley, S.; Taylor, B. V.; Butzkueven, H.; Ponsonby, A.-L.; Scott, R. J.; Jagodic, M.; Jokubaitis, V. G.; Lechner-Scott, J.; Lea, R. A.

2026-10-14 genetic and genomic medicine
10.64898/2026.10.13.26365261 medRxiv
Show abstract

Multiple sclerosis (MS) is approximately three times more common in females than in males, but sex-linked epigenetic mechanisms remain incompletely understood. We tested whether X-chromosome DNA methylation differs in females with MS and whether associated sites preferentially map to genes normally subject to X-chromosome inactivation (XCI). An X-chromosome-focused epigenome-wide association study was performed in whole blood from three datasets comprising 496 females with MS and 509 female controls, with independent evaluation in isolated CD4+ T cells (80 cases, 76 controls). At FDR < 0.01, 3 182 X-chromosome CpGs were hypomethylated in MS (mean {Delta}{beta} = -0.035). Hypomethylated CpGs were strongly enriched in non-escape genes normally subject to XCI relative to escape genes (OR 6.77; p = 1.55x10-57) and mapped to immune and chromatin-related processes. Exploratory cis-mQTL analysis identified strong local genetic effects at a small subset of loci, including WAS, IRAK1 and TLR7. In CD4+ T cells, 2 080 of the 3,182 whole-blood hypomethylated CpGs (65.4%) were also significantly hypomethylated. These findings identify a reproducible X-chromosome hypomethylation signature in female MS and support direct investigation of inactive-X regulation, XCI escape and X-linked immune gene dosage.

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