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RNA modifications, notably N6-methyladenosine (m6A) methylation, have risen to prominence as pivotal orchestrators of gene expression and cellular dynamics. Within this array of modifications, the m6A methylation of RNA, especially within messenger RNA (mRNA) transcripts, has garnered considerable interest due to its profound involvement in diverse biological phenomena and the onset of pathological conditions. In this exhaustive exposition, we undertake a thorough examination of the impact exerted by m6A modifications upon mRNA molecules, elucidating their ramifications for disease etiology. Emphasizing the most recent advancements and revelations in the field, our review endeavors to illuminate the intricate interplay between RNA modifications and pathological states.

Effects of m6A Modifications on mRNA

m6A modifications on mRNA have surfaced as crucial regulators of gene expression, exerting influence over diverse facets of RNA metabolism and cellular functions. Governed by methyltransferases ("writers"), acknowledged by binding proteins ("readers"), and eliminated by demethylases ("erasers"), these modifications intricately modulate mRNA stability, splicing, localization, and translation. This section delves into the elaborate mechanisms and consequential effects of m6A modifications on mRNA.

Figure 4. The workflow of 16S rRNA sequencing for human microbiome analysis.

An overview of N6-methyladenosine (m6A) and m6A-associated enzymes (Hong, J., et al. Exp Mol Med (2022).)

mRNA Stability Regulation

m6A modifications constitute a pivotal determinant in the maintenance of mRNA stability, exerting a profound influence on RNA degradation kinetics and turnover dynamics. The enzymatic addition of m6A marks, orchestrated by methyltransferase complexes such as METTL3/METTL14, typically confers heightened mRNA stability by impeding the recognition and subsequent degradation by RNA decay machinery. Conversely, the enzymatic removal of m6A marks, facilitated by demethylases like FTO and ALKBH5, precipitates mRNA degradation, thereby instigating swift turnover processes.

Illustratively, a study conducted by Wang et al. in 2014 delineated the significance of m6A modifications localized within the 3′ untranslated regions (UTRs) of specific mRNAs. Their findings elucidated how these modifications bolster mRNA stability by thwarting miRNA-mediated degradation pathways. This mechanism of stabilization emerged as indispensable for upholding the integrity of critical regulatory transcripts implicated in the orchestration of cellular processes such as cell cycle progression and cellular differentiation.

Splicing Regulation

m6A modifications intricately govern alternative splicing dynamics by intricately modulating the recruitment of essential splicing factors and RNA-binding proteins to pre-mRNA transcripts. Such modifications wield the capacity to either bolster or impede exon inclusion events, consequently engendering mRNA isoforms endowed with distinct coding potentials and functional attributes.

Pioneering work by Dominissini et al. in 2012 unearthed the pivotal role of METTL3-mediated m6A modifications in close proximity to splice sites. This strategic positioning facilitated the recruitment of the splicing factor HNRNPC, thereby fostering exon inclusion within target mRNAs. Conversely, experimental perturbation of METTL3 activity precipitated aberrant splicing patterns, thereby eliciting discernible alterations in gene expression profiles.

Translation Regulation

m6A modifications wield notable influence over mRNA translation efficiency and ribosome occupancy, manifesting in diverse regulatory effects on cellular protein synthesis. This regulatory role encompasses both the enhancement and suppression of translation initiation rates, mediated by the nuanced modulation of mRNA accessibility to ribosomes and translation initiation factors.

Recent investigations have shed light on the mechanistic underpinnings of these regulatory processes. Specifically, YTHDF proteins, known as m6A-binding readers, have emerged as key orchestrators in the translation control nexus. These proteins interface with components of the translation initiation machinery, such as eIF3, facilitating the recruitment of ribosomes to m6A-modified transcripts. Through this orchestrated recruitment, cap-independent translation initiation is potentiated, thereby fostering the expedient translation of select target mRNAs. Notably, among these targets are transcripts encoding pivotal regulatory proteins including oncogenes and growth factors, underscoring the biological significance of m6A-mediated translational regulation in cellular physiology.

Localization and Subcellular Trafficking

Moreover, m6A modifications wield considerable influence over mRNA localization and subcellular trafficking, orchestrating the precise targeting of transcripts to distinct subcellular locales or RNA granules. These modifications serve as determinants for the spatial distribution of mRNAs within cells and govern their localized translation activities, thereby intricately regulating pivotal cellular processes such as synaptic plasticity and stress responses.

In a seminal study by Ke et al. in 2017, the pivotal role of m6A modifications in neuronal mRNA dynamics was elucidated. Specifically, these modifications were found to facilitate the localization of neuronal mRNAs to dendritic and synaptic regions, where they engaged in localized translation events in response to synaptic activity cues. This localized translation machinery emerged as indispensable for the swift modulation of synaptic strength and neuronal plasticity within the intricate neural circuitry of the brain.

mRNA m6A in Disease Pathogenesis


m6A modifications have emerged as pivotal factors in the pathogenesis of diverse cancer types, exerting influence over oncogenic signaling cascades, tumor progression dynamics, and therapeutic efficacy. Notably, research conducted by Li et al. (2017) illuminated the significance of dysregulated m6A methylation, particularly under the auspices of METTL3, in fostering the onset and perpetuation of acute myeloid leukemia (AML). By orchestrating the deposition of m6A marks on oncogenic transcripts such as c-MYC and BCL2, METTL3 facilitates their translation, thereby propelling leukemogenesis and imparting resistance to differentiation-based therapeutic interventions (Li et al., 2017).

Liver Diseases

Beyond its involvement in cancer, aberrant mRNA m6A modifications have garnered attention for their implication in the pathogenesis of liver disorders, notably hepatocellular carcinoma (HCC) and non-alcoholic fatty liver disease (NAFLD). Recent investigations underscore the significance of dysregulated m6A methylation, particularly orchestrated by METTL3 and YTHDF2, in driving HCC progression through the modulation of tumor suppressor and oncogene expression profiles (Chen et al., 2018). Moreover, the association of m6A modifications with the onset of hepatic steatosis and fibrosis within NAFLD elucidates their pivotal role in the pathophysiology of liver diseases (Zhou et al., 2019).

Neurological Disorders

Furthermore, aberrant mRNA m6A modifications have been implicated in the pathogenesis of a spectrum of neurological disorders, encompassing Alzheimer’s disease (AD) and Parkinson’s disease (PD). Investigations conducted by Song et al. (2019) illuminated the association between perturbed m6A methylation levels, notably within the hippocampus and cortex, and cognitive decline coupled with synaptic dysfunction in individuals afflicted with AD. Similarly, perturbed m6A modifications have been discerned in the cerebral tissues of PD patients, exacerbating the dysregulation of dopaminergic signaling pathways and precipitating neuronal degeneration (Engel et al., 2018).

Cardiovascular Diseases

Moreover, mounting evidence underscores the involvement of mRNA m6A modifications in the pathogenesis of cardiovascular diseases, encompassing atherosclerosis and heart failure. Investigations have delineated how dysregulated m6A methylation, notably under the mediation of METTL3 and FTO, intricately modulates the expression of genes pivotal in endothelial dysfunction, inflammatory responses, and lipid metabolism, thereby fostering the initiation and progression of atherosclerotic plaques (Han et al., 2020). Furthermore, perturbed m6A methylation profiles have been correlated with adverse cardiac remodeling and compromised contractile function among patients afflicted with heart failure, underscoring the potential of targeting m6A modifications for therapeutic intervention in cardiovascular pathologies (Dorn, 2019).

Functions of m6A modification-related proteins in neurological diseases.

Disease type m6A regulator Function
Alzheimer’s disease METTL3 Involve in the pathogenesis of AD
FTO regulate the mTOR signaling pathway and affected the development of AD
HNRNPA2B1 Involved in the regulation of AD
Parkinson’s Disease METTL14 Affect the production of key enzymes required for dopamine synthesis
FTO Maintain dopaminergic neuron function
HNRNPC regulate dopaminergic proliferation
ALKBH5 Relate to the risk of PD
Major depressive disorder FTO Target ADRB2 induces depression-like behaviors
FTO Target the CaMKII/CREB signaling pathway modulates hippocampal synaptic plasticity
FTO Affect resistance to tricyclic antidepressants
FTO regulate the function of astrocytes
Stroke METTL3 Involve in the formation of early stress granule cells
YTHDF1 Involve in inflammatory response in stroke model mice
YTHDC1 Influence the degradation of PTEN mRNA
Glioblastoma METTL3 Influence self-renewal capacity of GBM cells
METTL3 Influence the development process of GBM
METTL3 Influence tumor growth and development
METTL3 Maintain specific gene expression in GSCs and regulate oncogenic-related signaling pathways
METTL3 Regulates DNA repair factors and affects cellular drug resistance
WTAP Involve in carcinogenesis
FTO Affect GBM cell proliferation, migration and invasion
ALKBH5 Influence the GSCs self-renewal and tumorigenesis
ALKBH5 Influence the radioresistance and invasive ability of GSCs
YTHDF2 Influence the development process of GBM
YTHDF2 Influence the GBM cell proliferation, invasion, and tumorigenesis
YTHDF2 Involve in UBXN1 mRNA degradation
IGFBP1/2/3 Affects the formation of GBM microenvironment, regulates carcinogenic factors, affects GBM aerobic glycolysis, and affects GBM prognosis


In essence, m6A modifications on mRNA wield significant influence over RNA metabolism and cellular functionalities, encompassing mRNA stability, splicing modulation, translation regulation, and subcellular localization. Serving as a dynamic regulatory stratum, these modifications intricately modulate gene expression in response to diverse cellular signals and environmental cues, underscoring their pivotal role in maintaining cellular equilibrium and influencing disease etiology.

The dysregulation of mRNA m6A modifications is implicated in a spectrum of diseases, spanning cancer, liver disorders, neurological ailments, and cardiovascular conditions. Elucidating the molecular underpinnings governing m6A dysregulation holds promise for unveiling novel insights into disease pathophysiology and catalyzing the development of targeted therapeutic interventions.


  1. Li, Z. et al. (2017). FTO plays an oncogenic role in acute myeloid leukemia as a N6-methyladenosine RNA demethylase. Cancer Cell, 31(1), 127-141.
  2. Chen, M. et al. (2018). RNA N6-methyladenosine methyltransferase-like 3 promotes liver cancer progression through YTHDF2-dependent posttranscriptional silencing of SOCS2. Hepatology, 67(6), 2254-2270.
  3. Zhou, X. et al. (2019). m6A mRNA methylation-mediated HNF3γ reduction renders hepatocellular carcinoma dedifferentiation and sorafenib resistance. Signal Transduction and Targeted Therapy, 4, 1-12.
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