Human Mendelian disease and in vivo mutagenesis screening define the molecular architecture of the U8 snoRNA

Over 50 mutations in the vertebrate specific box C/D small nucleolar RNA U8 have been reported to cause leukoencephalopathy with calcifications and cysts (LCC), a progressive cerebral microangiopathy presenting at any age between early infancy and late adulthood. Notably, the majority of these disease-associated mutations are annotated as variants of uncertain significance due to an inability to predict their effect on U8 function. Here, using a zebrafish bioassay, we performed in vivo mutagenesis screening to explore the molecular pathology of LCC. We demonstrate that LCC-associated mutations cluster in function and molecular behaviour according to distinct structural domains within U8, differentially impairing U8 processing, activity and stability. Further, we show that when U8 function is hypomorphic, exogenous human U8 and the endogenous zebrafish U8.3 paralogue increase in stability through a newly discovered post-transcriptional mechanism. This latter response is compromised in patients with LCC due to the presence of a common polymorphism of an N6-methyladenosine modified nucleotide, which we predict to impact disease penetrance.