# Profiling of 5-hydroxymethylcytosine in blood reveals preferential enrichment at exon-intron junctions and predictive value for Parkinson’s disease

**Authors:** Philipp Antczak, Peter Brandt, Lav Radosavljević, Per Svenningsson, Joëlle Rüegg, Kristina Bečanović

PMC · DOI: 10.1038/s41531-026-01322-x · NPJ Parkinson's Disease · 2026-03-20

## TL;DR

This study shows that 5-hydroxymethylcytosine levels in blood are lower in Parkinson’s disease patients and may serve as a potential biomarker.

## Contribution

The study identifies 5hmC as a predictive biomarker for Parkinson’s disease and reveals its enrichment near exon-intron junctions.

## Key findings

- Global 5hmC levels are significantly reduced in PD patients compared to controls.
- Differentially methylated and hydroxymethylated regions are enriched within introns and near exon-intron junctions.
- Global 5hmC levels combined with age and sex can predict Parkinson’s disease status.

## Abstract

5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) are epigenetic modifications increasingly recognized for their roles in Parkinson’s disease (PD). In this study, we profiled 5mC and 5hmC in blood samples from individuals with PD to explore their relevance to disease status and progression. We observed significantly reduced global 5hmC levels in peripheral blood mononuclear cells (PBMCs) from PD cases compared to controls. Using the Illumina EPIC BeadArray, we conducted genome-wide analyses of 5mC and 5hmC in a subset of PD cases and controls to explore methylation and hydroxymethylation patterns. We identified differentially methylated and hydroxymethylated positions and regions enriched within introns, with both types of regions showing a marked concentration near exon-intron junctions. Positional analysis relative to exon–intron junctions revealed that proximal and distal regions mapped to partially different functional themes, suggesting that genomic context provides additional biological insight. Functional enrichment analyses also highlighted distinct biological roles for 5mC and 5hmC, with associated genes implicated in neurodevelopment, vascular remodeling, and neuroimmune signaling. Additionally, we demonstrate that global 5hmC levels, in combination with age and sex, are predictive of disease status, highlighting the potential of 5hmC as a blood-based biomarker for PD.

## Linked entities

- **Diseases:** Parkinson’s disease (MONDO:0005180)

## Full-text entities

- **Genes:** Ephb2 (Eph receptor B2) [NCBI Gene 13844] {aka Cek5, Drt, ETECK, Erk, Hek5, Nuk}, Clec7a (C-type lectin domain family 7, member a) [NCBI Gene 56644] {aka BGR, Clecsf12, beta-GR}, LRRTM4 (leucine rich repeat transmembrane neuronal 4) [NCBI Gene 80059], IL34 (interleukin 34) [NCBI Gene 146433] {aka C16orf77, IL-34}, RAPGEF2 (Rap guanine nucleotide exchange factor 2) [NCBI Gene 9693] {aka CNrasGEF, NRAPGEP, PDZ-GEF1, PDZGEF1, RA-GEF, RA-GEF-1}, KLHL35 (kelch like family member 35) [NCBI Gene 283212], NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, Kcnq1 (potassium voltage-gated channel, subfamily Q, member 1) [NCBI Gene 16535] {aka KVLQT1, Kcna9}, CDON (cell adhesion associated, oncogene regulated) [NCBI Gene 50937] {aka CDO, CDON1, HPE11, Ihog, ORCAM}, ABHD16A (abhydrolase domain containing 16A, phospholipase) [NCBI Gene 7920] {aka BAT5, D6S82E, NG26, PP199, SPG86, hBAT5}, PTPRQ (protein tyrosine phosphatase receptor type Q) [NCBI Gene 374462] {aka DFNA73, DFNB84, DFNB84A, PTPGMC1, R-PTP-Q}, KLF4 (KLF transcription factor 4) [NCBI Gene 9314] {aka EZF, GKLF}, Hipk2 (homeodomain interacting protein kinase 2) [NCBI Gene 15258] {aka 1110014O20Rik, B230339E18Rik, Stank}, IL2 (interleukin 2) [NCBI Gene 3558] {aka IL-2, TCGF, lymphokine}, SNCA (synuclein alpha) [NCBI Gene 6622] {aka NACP, PARK1, PARK4, PD1}, PRKN (parkin RBR E3 ubiquitin protein ligase) [NCBI Gene 5071] {aka AR-JP, LPRS2, PARK2, PDJ}, GM2A (ganglioside GM2 activator) [NCBI Gene 2760] {aka GM2-AP, GM2AP, SAP-3}, Egfr (epidermal growth factor receptor) [NCBI Gene 13649] {aka 9030024J15Rik, Erbb, Errb1, Errp, Wa5, wa-2}, Foxc2 (forkhead box C2) [NCBI Gene 14234] {aka Fkh14, Hfhbf3, MFH-1, Mfh1}, Olfm1 (olfactomedin 1) [NCBI Gene 56177] {aka AMY, Noe1, OlfA, Pancortin, Pancortin3}, Smarca4 (SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily a, member 4) [NCBI Gene 20586] {aka BAF190A, Brg1, HP1-BP72, SNF2beta, SW1/SNF, b2b508.1Clo}, MROS (Melkersson-Rosenthal syndrome) [NCBI Gene 8011] {aka MRS}, ZMIZ1 (zinc finger MIZ-type containing 1) [NCBI Gene 57178] {aka MIZ, NEDDFSA, RAI17, TRAFIP10, ZIMP10}, CDH4 (cadherin 4) [NCBI Gene 1002] {aka CAD4, R-CAD, RCAD}, CLPSL1 (colipase like 1) [NCBI Gene 340204] {aka C6orf127, ESP32, dJ510O8.6}, Gba1 (glucosylceramidase beta 1) [NCBI Gene 14466] {aka GC, GCase, GLUC, Gba, betaGC}, Ahi1 (Abelson helper integration site 1) [NCBI Gene 52906] {aka 1700015F03Rik, Ahi-1, D10Bwg0629e}, CD5 (CD5 molecule) [NCBI Gene 921] {aka LEU1, T1}, MLXIPL (MLX interacting protein like) [NCBI Gene 51085] {aka CHREBP, MIO, MONDOB, WBSCR14, WS-bHLH, bHLHd14}, Baiap2 (brain-specific angiogenesis inhibitor 1-associated protein 2) [NCBI Gene 108100] {aka IRSp53}, Zhx2 (zinc fingers and homeoboxes 2) [NCBI Gene 387609] {aka Afr-1, Afr1, Raf, mKIAA0854}, GBA1 (glucosylceramidase beta 1) [NCBI Gene 2629] {aka GBA, GCB, GLUC}, Grik5 (glutamate receptor, ionotropic, kainate 5 (gamma 2)) [NCBI Gene 14809] {aka GluK5, GluRgamma2, KA2}, PLXNA4 (plexin A4) [NCBI Gene 91584] {aka FAYV2820, PLEXA4, PLXNA4A, PLXNA4B, PRO34003}, Myocd (myocardin) [NCBI Gene 214384] {aka BSAC2A, Srfcp}, LAPTM5 (lysosomal protein transmembrane 5) [NCBI Gene 7805] {aka CLAST6}, Tnik (TRAF2 and NCK interacting kinase) [NCBI Gene 665113] {aka 1500031A17Rik, 4831440I19Rik, C530008O15Rik, C630040K21Rik}, LRRK2 (leucine rich repeat kinase 2) [NCBI Gene 120892] {aka AURA17, DARDARIN, PARK8, RIPK7, ROCO2}, TMEM175 (transmembrane protein 175) [NCBI Gene 84286] {aka hTMEM175}
- **Diseases:** constipation (MESH:D003248), depression (MESH:D003866), rigidity (MESH:D009127), neurodegeneration (MESH:D019636), PD (MESH:D010300), sleep disorders (MESH:D012893), cognitive dysfunction (MESH:D003072), neuroinflammation (MESH:D000090862), motor impairment and disability (MESH:D009069), degeneration of dopaminergic neurons (MESH:D009410), traumatic brain injury (MESH:D000070642), postural instability (MESH:D054972), resting tremor (MESH:D014202), bradykinesia (MESH:D018476), AD (MESH:D000544)
- **Chemicals:** heavy metals (MESH:D019216), calcium (MESH:D002118), 5-hmC (-), EDTA (MESH:D004492), lipid (MESH:D008055), lysophospholipid (MESH:D008246), NaOH (MESH:D012972), alcohol (MESH:D000438), 5-methylcytosine (MESH:D044503), cytosine (MESH:D003596), 5-hydroxymethylcytosine (MESH:C011865), bisulfite (MESH:C042345), caffeine (MESH:D002110), dopamine (MESH:D004298), levodopa (MESH:D007980)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]
- **Mutations:** E326K, (AUC) of 0, L444P, N370S

## Full text

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## Figures

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## References

2 references — full list in the complete paper: https://tomesphere.com/paper/PMC13022309/full.md

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Source: https://tomesphere.com/paper/PMC13022309