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Post-Translational Modifications of the Mini-Chromosome Maintenance Proteins in DNA Replication

The eukaryotic mini-chromosome maintenance (MCM) complex, composed of MCM proteins 2–7, is the core component of the replisome that acts as the DNA replicative helicase to unwind duplex DNA and initiate DNA replication. MCM10 tightly binds the cell division control protein 45 homolog (CDC45)/MCM2–7/ DNA replication complex Go-Ichi-Ni-San (GINS) (CMG) complex that stimulates CMG helicase activity. The MCM8–MCM9 complex may have a non-essential role in activating the pre-replicative complex in the gap 1 (G1) phase by recruiting cell division cycle 6 (CDC6) to the origin recognition complex (ORC). Each MCM subunit has a distinct function achieved by differential post-translational modifications (PTMs) in both DNA replication process and response to replication stress. Such PTMs include phosphorylation, ubiquitination, small ubiquitin-like modifier (SUMO)ylation, O-N-acetyl-D-glucosamine (GlcNAc)ylation, and acetylation. These PTMs have an important role in controlling replication progress and genome stability. Because MCM proteins are associated with various human diseases, they are regarded as potential targets for therapeutic development. In this review, we summarize the different PTMs of the MCM proteins, their involvement in DNA replication and disease development, and the potential therapeutic implications.


Introduction
DNA replication is a complex and systematic process that ensures faithful duplication of the genome and subsequent cell division only once per cell cycle. In the first step of DNA replication, the pre-replicative complex (pre-RC) forms at the origin recognition complex (ORC), which consists of six subunits, ORC1-6; ORC1-6 then recognize and bind to autonomously replicating sequences. In early gap 1 (G1) phase, the ORC recruits the DNA replication licensing factor cell division cycle 6 (CDC6) and chromatin licensing and DNA replication factor 1 (CDT1) to the replication origins, and this recruitment subsequently promotes loading of the mini-chromosome maintenance (MCM) complex MCM2-7 onto chromatin [1]. Once loaded, CDC6 and CDT1 are released from the chromatin to prevent MCM2-7 reloading in the synthesis (S) phase and replication occurring more than once per cell cycle. In late G1 phase, cell division control protein 45 (CDC45) and the DNA replication complex Go-Ichi-Ni-San (GINS) bind to the MCM2-7 hexamer to form a CDC45/MCM2-7/GINS (CMG) complex, which activates MCM helicase activity [2]. At the same time, MCM10 brings the DNA polymerase α/primase complex to the replication origins for replication initiation [1]. During S phase, replication on leading and lagging strands relies on different DNA polymerases; the leading strand is replicated by DNA polymerase ε, while the lagging strand is replicated by DNA polymerase δ [3].
Rad51 foci formation upon DNA damage [25,26]. These data support the important role of MCM proteins both in DNA replication and the DNA damage response.

Involvement of the MCM Proteins in Human Disease
Ensuring high-fidelity replication that occurs once per cell cycle and a proper response to spontaneous or external replication stress is essential to maintain genome integrity and normal cell growth and proliferation. Should these processes fail, various human diseases will ensue. Numerous genetic alterations of the MCM complex were uncovered by genome sequencing (Table 1). Gao et al. identified a heterozygous missense mutation (Arg44 to Cys) in the MCM2 gene that specifically segregated with eight affected members of a four-generation Chinese family with autosomal dominant non-syndromic deafness (DFNA70) [27]. DFNA70 is characterized by non-syndromic sensorineural and post-lingual progressive hearing loss caused by damage to structures in the inner ear, with no additional effects on other tissues [28]. Overexpression of the MCM2 (Arg44 to Cys) mutant induces apoptosis but has no obvious impact on cell proliferation, which leads to the hypothesis that MCM2 mutation-induced apoptosis gives rise to progressive hearing loss [27].
Casey et al. and Hughes et al. independently identified a rare pathogenic variant, MCM4 (c. 71-1insG), which segregated with patients with natural killer cell and glucocorticoid deficiency with DNA repair defect (NKGCD) [29,30]. NKGCD is an autosomal recessive disorder characterized by microcephaly, decreased numbers of natural killer cells, and recurrent viral infections [31]. The MCM4 insertion generates a stop codon in the N-terminus, resulting in a truncated protein that may lead to DNA repair disorder and cell-cycle delay, but without compromising MCM2-7 complex formation [29][30][31][32]. In a mouse model, it was found that a Chaos3 (chromosome aberrations occurring spontaneously 3) mutation in MCM4 (Phe345 to Ile) resulted in genome instability and mammary adenocarcinomas [33].
MCM5 is involved in Meier-Gorlin syndrome-8 (MGORS8)-a form of primordial dwarfism (PD) in which growth problems begin before birth [34]. Vetro et al. identified biallelic variants in MCM5 (c.850_851delAG in exon 7; c.1397C-T transition in exon 11) in a 4.75-year-old boy with MGORS8 [35]. Although there are no reports on the direct relationship between MCM5 variants and human disease, decreased MCM5 expression correlates with a growth defect in zebrafish [36] and c.850_851delAG mutant embryos show cell-cycle progression defects. In yeast, MCM5 depletion is lethal, and re-introduction of a p.Thr501 to Ile mutant (corresponding to the Thr466 to Ile variant in human) is not sufficient as a rescue. These phenomena lead to the hypothesis that MCM5 is involved in Meier-Gorlin syndrome via a DNA replication defect [34].
MCM8 and MCM9 are both implicated in premature ovarian failure (POF) that is characterized by loss of menstrual function before 40 years of age. Three mutations were identified in MCM8 (Pro149 to Arg; c.1954-1G-A in intron 14; c.1469-1470insTA) and three mutations in MCM9 (c.1732þ2T > C; Arg132 to Ter; Glu495 to Ter) that segregate with this disease [37][38][39][40][41]. Furthermore, Al Asiri et al. found that fibroblasts derived from a patient with POF carried more chromosomal breaks than fibroblasts derived from the patient's unaffected daughter [40]. A Pro149 to Arg mutation in MCM8 compromises its recruitment to DSB sites. It was also found that both Mcm8 −/− and Mcm9 −/− mice exhibit impaired homologous recombination (HR)-mediated DNA repair, leading to defects in gametogenesis [42]. These works reveal the important functions of MCM8 and MCM9 in ovary maturation. Thus, it is considered that dysfunctional mutations in MCM8 and MCM9 can lead to genomic instability and POF disorder potentially due to a crucial function of the MCM8-MCM9 complex in HR repair [40].
Although these mutations in the MCM genes are associated with human diseases (Table 1), the underlying molecular mechanisms regarding how they contribute to the initiation and development of these diseases are still unclear. Urgent work is required to understand how these genes contribute to disease in order to develop effective therapeutic strategies.

Involvement of the MCM Proteins in Human Cancer
Multiple studies revealed that dysfunctional alterations to the MCM genes may have a notable impact on tumorigenesis in various cancers [43][44][45]. A recent review highlighted that CMG complex-related genes are highly overexpressed in various cancers [8]. We explored The Cancer Genome Atlas to summarize the alterations (mutations, amplifications, and deletions) in MCM2-10 genes in different cancers (Table 2). In 10 cancer cohorts including >250 patients, we found that at least one of the MCM genes was amplified in head and neck squamous cell carcinoma, esophageal adenocarcinoma, hepatocellular carcinoma, invasive breast carcinoma, and pancreatic adenocarcinoma. In cutaneous melanoma, uterine endometrioid carcinoma, and mucinous carcinoma, we found that the MCM subunits were mutated at a high frequency. This finding was especially the case in prostate adenocarcinoma, where we found a high frequency of MCM6 (3.61%) and MCM9 (6.16%) deletions in 1803 cases. We also detected a high percentage of amplifications in MCM4 and MCM7 genes in various cancers, such as serous ovarian cancer and head and neck squamous cell carcinoma, implying that MCM7 and MCM4 may have a role in promoting tumorigenesis and could serve as credible prognostic markers for cancer diagnosis. These datasets support that alterations to MCM genes are strongly associated with tumorigenesis. We believe that studies that will provide the detailed molecular mechanisms of MCM alterations in cancer are needed to develop better cancer therapies. Replicative helicases and polymerases have important roles in normal cell proliferation; thus, their abnormal expression or dysfunctional alterations may promote tumorigenesis. Many studies are focusing on searching for therapeutic targets and developing small molecules for cancer treatment, and MCM proteins are of great interest as potential targets. Seo et al. described nine small molecules-iovastatin, metformin, genistein, trichostatin A, bromodomain and extraterminal domain proteins inhibitor (BETi), breviscapine, heliquinomycin, ciprofloxacin, and widdrol-to target the MCMs via three main strategies [8]. The first strategy focuses on downregulating MCM expression to suppress tumor cell growth. The second strategy aims to inhibit MCM enzymatic activity [46]. The third strategy is based on developing a cancer vaccine. Of these nine molecules, heliquinomycin and ciprofloxacin inhibit MCM4/6/7 helicase activity [47][48][49], while the others negatively regulate the MCM2-7 complex or subunit (MCM2, MCM5, MCM7) expression [50][51][52][53][54][55]. Although ciprofloxacin, a fluoroquinolone inhibitor, was proven to be the best molecular scaffold to modulate MCM2-7 helicase activity, other analogs still need to be developed to achieve optimal MCM2-7 inhibition [56]. Meanwhile, the MCM PTM sites that are involved in promoting replication are likely potential targets for inhibitors or peptides and could ultimately have effective therapeutic implications in the context of human cancers.

MCM Phosphorylation
Phosphorylation is the best studied PTM to occur on MCM proteins in human cells. Phosphorylation occurs throughout the cell cycle, especially in G1 and S phase when replication is initiated and progressed ( Figure 1). MCM phosphorylation is mainly mediated by CDKs and cell division cycle 7-related protein kinase (CDC7) and regulated by the ATM/ATR checkpoint pathways (Table 3). Replicative helicases and polymerases have important roles in normal cell proliferation; thus, their abnormal expression or dysfunctional alterations may promote tumorigenesis. Many studies are focusing on searching for therapeutic targets and developing small molecules for cancer treatment, and MCM proteins are of great interest as potential targets. Seo et al. described nine small molecules-iovastatin, metformin, genistein, trichostatin A, bromodomain and extraterminal domain proteins inhibitor (BETi), breviscapine, heliquinomycin, ciprofloxacin, and widdrol-to target the MCMs via three main strategies [8]. The first strategy focuses on downregulating MCM expression to suppress tumor cell growth. The second strategy aims to inhibit MCM enzymatic activity [46]. The third strategy is based on developing a cancer vaccine. Of these nine molecules, heliquinomycin and ciprofloxacin inhibit MCM4/6/7 helicase activity [47][48][49], while the others negatively regulate the MCM2-7 complex or subunit (MCM2, MCM5, MCM7) expression [50][51][52][53][54][55]. Although ciprofloxacin, a fluoroquinolone inhibitor, was proven to be the best molecular scaffold to modulate MCM2-7 helicase activity, other analogs still need to be developed to achieve optimal MCM2-7 inhibition [56]. Meanwhile, the MCM PTM sites that are involved in promoting replication are likely potential targets for inhibitors or peptides and could ultimately have effective therapeutic implications in the context of human cancers.

MCM Phosphorylation
Phosphorylation is the best studied PTM to occur on MCM proteins in human cells. Phosphorylation occurs throughout the cell cycle, especially in G1 and S phase when replication is initiated and progressed ( Figure 1). MCM phosphorylation is mainly mediated by CDKs and cell division cycle 7-related protein kinase (CDC7) and regulated by the ATM/ATR checkpoint pathways (Table 3).

CDK-Dependent Phosphorylation of MCMs
CDKs are serine/threonine kinases that bind a specific cyclin to regulate different phases of the cell cycle; they phosphorylate multiple substrates to precisely control cell-cycle progression [57]. MCM2 Ser-139 and MCM3 Ser-711 are sites phosphorylated by CDK2 [58]. Lin et al. found CDK1 phosphorylated MCM3 at Ser-112, Ser-611, and Thr-719 [59]. Phosphorylation on Ser-112 promotes MCM2-7 complex formation and subsequent chromatin loading. Li et al. found that cyclin B/CDK1 phosphorylated MCM3 at Thr-722 to promote MCM3 chromatin loading [60]. Schumann et al. found that CDK1-mediated MCM3 phosphorylation at Ser-112 and Thr-722 is essential for peptidyl-prolyl cis-trans isomerase never in mitosis A (NIMA)-interacting 1 (Pin1) binding [61]. Pin1 is required for MCM3 chromatin loading in early S phase, and Pin1 depletion inhibits MCM3 disassembly from chromatin in gap 2 (G2)/mitosis (M) phase. These data reveal that a phosphorylation-dependent interaction between Pin1 and MCM3 regulates MCM3 chromatin binding and disassembly in a cell-cycle-dependent manner.
MCM7 phosphorylation at Ser-121, which is mediated by cyclin E/CDK2, also promotes its chromatin loading and proper mitotic exit in M phase [62]. Excessive levels of MCM3 or MCM7 can block S-phase entry and activate the checkpoint pathway [60,62]. MCM7 is also strongly phosphorylated at Ser-365 by CDK2, as shown in vivo [63], but the functional consequences of this phosphorylation on DNA replication are illusive.

ATM/ATR-Dependent Phosphorylation of MCMs
Many studies showed that the MCM complex is involved in the ATM/ATR signaling pathways [7,71]. Cortez et al. found that MCM3 is phosphorylated by ATM at Ser-535 upon irradiation, while MCM2 phosphorylation at Ser-108 is partially mediated by ATR upon ultraviolet (UV) light exposure or hydroxyurea treatment [71]. Further, Matsuoka et al. screened for irradiation-induced phosphorylation at potential serine/threonine-glutarnine (S/TQ) sites within MCM3 (Ser-681, Ser-728, Ser-734), MCM6 (Thr-791), and MCM7 (Ser-549) [73]. These data suggest that ATM/ATR-dependent phosphorylation of the MCM complex may serve as a platform to connect the checkpoint kinases to DNA replication.
Han et al. found that MCM3 is phosphorylated by CHK1 at Ser-205, which negatively regulates DNA replication [74]. An S205A mutant overexpressed in MCM3-depleted cells increased replication protein a foci formation compared to wild-type cells upon exposure to the DNA polymerase inhibitor, aphidicolin [74]. This finding indicates that MCM3 phosphorylation at Ser-205 also has a negative role in checkpoint signaling. Finally, Blasius et al. identified that MCM5 Thr-633 is a potential phosphorylation site for CHK1, but the impact of this phosphorylation mark awaits further investigation [75].

Other Kinase-Dependent Phosphorylation of MCMs
Casein kinase II (CK2) is a ubiquitous serine/threonine kinase that participates in multiple pathways, such as apoptosis and cell survival [76]. Montagnoli et al. found that casein kinase II subunit α (CSNK2A1) specifically phosphorylates MCM2 at Ser-139 [69]. Because hydroxyurea and etoposide treatments have no impact on Ser-139 phosphorylation, Ser139 may not regulate checkpoint signaling. Death-associated protein kinase (DAPK) is a serine/threonine kinase involved in caspase-dependent cell death, cell adhesion, and migration. DAPK1 phosphorylates MCM3 at Ser-160 but has no impact on MCM3 chromatin loading [74,77]. Drissi [78]. The function of these phosphorylation marks in the DNA damage response and replication requires further investigation.

MCM Ubiquitination
The ubiquitination system is involved in various cellular processes, such as protein stability, cell-cycle progression, DNA replication, and cellular metabolism [100][101][102]. Ubiquitin is a small peptide (8.6 kDa) that can covalently conjugate with a lysine residue of a substrate protein through three enzymatic steps: activation by ubiquitin-activating enzymes (E1s), conjugation by ubiquitin-conjugating enzymes (E2s), and ligation by ubiquitin ligases (E3s). Ubiquitination can be monomeric or polymeric (Figure 2) [103]. Linkage type through different lysine residues in ubiquitin (Lys-6, Lys-11, Lys-27, Lys-29, Lys-33, Lys-48, Lys-63) and the first methionine defines different poly-ubiquitination chains and function. All the human MCM proteins are ubiquitylated in human cells [104][105][106], and the ubiquitination status of some MCM proteins changes upon DNA damage and replication stress [78] ( Table 4). This finding suggests that MCM ubiquitination may have an important role in regulating replication progression and genome stability.

MCM Ubiquitination
The ubiquitination system is involved in various cellular processes, such as protein stability, cellcycle progression, DNA replication, and cellular metabolism [100][101][102]. Ubiquitin is a small peptide (8.6 kDa) that can covalently conjugate with a lysine residue of a substrate protein through three enzymatic steps: activation by ubiquitin-activating enzymes (E1s), conjugation by ubiquitinconjugating enzymes (E2s), and ligation by ubiquitin ligases (E3s). Ubiquitination can be monomeric or polymeric (Figure 2) [103]. Linkage type through different lysine residues in ubiquitin (Lys-6, Lys-11, Lys-27, Lys-29, Lys-33, Lys-48, Lys-63) and the first methionine defines different polyubiquitination chains and function. All the human MCM proteins are ubiquitylated in human cells [104][105][106], and the ubiquitination status of some MCM proteins changes upon DNA damage and replication stress [78] (Table 4). This finding suggests that MCM ubiquitination may have an important role in regulating replication progression and genome stability.  [107]. KEAP1 binds to MCM3 throughout the cell cycle and serves as an adaptor protein to link MCM3 to the CUL3-based E3 ligase. The researchers identified several sites (Lys-229, Lys-270, Lys-283, Lys-351, Lys-435, Lys-748) that are responsive to KEAP1-dependent ubiquitination. Unexpectedly, it was determined that KEAP1-mediated ubiquitination confers little impact on total MCM3 protein stability or subcellular localization [107]. Additional specific ubiquitination sites of MCM3 (Lys-315, Lys-655, Lys-656) were found to increase upon etoposide treatment, indicating a link between MCM3 and the DNA damage response [78].
MCM7 ubiquitination mostly serves to ensure replication termination and replicative helicase disassembly [108][109][110]; any replication stress will block this termination-specific polyubiquitylation [108]. In budding yeast, SCFDia2 (Skp1/Cullin/F-box protein) ubiquitinates MCM7 in vivo and in vitro to promote CMG disassembly [109,111]. Although MCM7 polyubiquitination mostly occurs on lysine 48 (K48) of ubiquitin, it does not cause MCM7 proteolysis [108]. K48-linked poly-ubiquitinated MCM7 is recognized by the p97 complex; then, the CMG complex and other replisome components are removed from chromatin [108,110,112,113]. These events terminate DNA replication. Recently, Wu et al. identified a E3 ubiquitin protein ligase: tumor necrosis factor receptor-associated factor-interacting protein (TRAIP) in Xenopus egg extracts, which ubiquitinates MCM7 when the replication fork is stalled at the inter-strand crosslink (ICL) sites [114]. This TRAIP-mediated MCM7 ubiquitination leads to two different ICL-repair pathways; the short ubiquitin chains trigger direct cleavage by recruiting endonuclease 8-like protein 3 (NEIL3) glycosylase, while the long ubiquitin chains are recognized by the p97 complex, and the crosslinks undergo Fanconi anemia repair pathway [114].
Although many studies showed that MCM ubiquitination is involved in regulating replication progression and genome stability, research on MCM ubiquitination in human cells is scarce. More research is now needed into the biological function of MCM ubiquitination on DNA replication and genome stability.  [107]; ※ involved in proteasomal degradation, refers to Reference [106]; other sites refer to References [104,105]. K, lysine.
Global screening of UFMylation substrates identified MCM3 and MCM7 as potential substrates [129,133]. Our lab is actively involved in investigating MCM UFMylation and its potential roles in DNA replication under unperturbed conditions and in the replication stress response.
In Saccharomyces cerevisiae, MCM2 and MCM3 are sumoylated by the SUMO ligase Mms21, and MCM6 is sumoylated by the SUMO ligases Siz1 and Siz2 [139]. Decreased MCM sumoylation enhances the accumulation of gross chromosome rearrangements [139]. Wei and Zhao found that only the chromatin-bound MCM subunits are sumoylated [140]. Here, MCM sumoylation is enriched in G1 phase and decreased at the entry to S phase when MCM phosphorylation is increased, suggesting that sumoylation may have an inhibitory role to prevent replication initiation in G1 phase. Reduced sumoylation activity during S phase depends on DDK and the GINS subunit, Psf2. Conversely, increased MCM sumoylation promotes protein phosphatase 1 (PP1) recruitment to the MCM complex, which leads to decreased CMG protein levels and subsequently inhibited DNA replication initiation [140]. MCM sumoylation is also responsible for DNA damage signaling and the cellular response to cytotoxic stress [136,138]. In yeast, upon DNA damage induced by the DNA methylation agent methyl methanesulfonate, MCM4 and MCM5 monosumoylation and MCM2 and MCM6 polysumoylation levels significantly increase [136]. In human cells, sumoylated MCM2, MCM3, MCM4, and MCM7 are responsive to a heat shock, indicating that MCM sumoylation may have a role in the cellular response to cytotoxic stress [138].

MCM Sumoylation
The small ubiquitin-like modifier (SUMO) protein belongs to the ubiquitin-like protein family. SUMOs are covalently attached to or detached from substrates, regulating various cellular processes [134]. In human cells, SUMOs have four isoforms: SUMO-1, SUMO-2, SUMO-3, and SUMO-4. The SUMO precursor undergoes cleavage by the Sentrin-specific protease (SENP) to remove extra C-terminal amino acids before it becomes mature. Like ubiquitination, sumoylation needs three enzymatic steps (E1 activation, E2 conjugation, E3 ligation) to covalently add SUMO moieties onto a substrate (Figure 4) [135]. MCM sumoylation is highly conserved across different species [136][137][138].  Together, these findings reveal that sumoylation may have an important safeguarding role to maintain genome stability and tolerate cytotoxic stress by inactivating helicase to negatively regulate DNA replication. As most of the MCM sumoylation sites (Table 5) are also potential ubiquitination sites, this complicated relationship may induce a different MCM "status" that helps to precisely control replication progression.   In Saccharomyces cerevisiae, MCM2 and MCM3 are sumoylated by the SUMO ligase Mms21, and MCM6 is sumoylated by the SUMO ligases Siz1 and Siz2 [139]. Decreased MCM sumoylation enhances the accumulation of gross chromosome rearrangements [139]. Wei and Zhao found that only the chromatin-bound MCM subunits are sumoylated [140]. Here, MCM sumoylation is enriched in G1 phase and decreased at the entry to S phase when MCM phosphorylation is increased, suggesting that sumoylation may have an inhibitory role to prevent replication initiation in G1 phase. Reduced sumoylation activity during S phase depends on DDK and the GINS subunit, Psf2. Conversely, increased MCM sumoylation promotes protein phosphatase 1 (PP1) recruitment to the MCM complex, which leads to decreased CMG protein levels and subsequently inhibited DNA replication initiation [140]. MCM sumoylation is also responsible for DNA damage signaling and the cellular response to cytotoxic stress [136,138]. In yeast, upon DNA damage induced by the DNA methylation agent methyl methanesulfonate, MCM4 and MCM5 monosumoylation and MCM2 and MCM6 polysumoylation levels significantly increase [136]. In human cells, sumoylated MCM2, MCM3, MCM4, and MCM7 are responsive to a heat shock, indicating that MCM sumoylation may have a role in the cellular response to cytotoxic stress [138].
Together, these findings reveal that sumoylation may have an important safeguarding role to maintain genome stability and tolerate cytotoxic stress by inactivating helicase to negatively regulate DNA replication. As most of the MCM sumoylation sites (Table 5) are also potential ubiquitination sites, this complicated relationship may induce a different MCM "status" that helps to precisely control replication progression.

MCM Acetylation
Protein acetylation covalently introduces an acetyl functional group into a substrate ( Figure 6) and modulates varieties of cellular activities through acetylation of histones and non-histone proteins [151]. Several studies revealed that MCM proteins are substrates for acetylation (Table 7) [152][153][154]. Takei et al. identified MCM3-associated protein (MCM3AP) as an acetyltransferase for chromatin-bound MCM3 acetylation that inhibits the initiation of DNA replication [155]. Fatoba et al. found that the p300 histone acetyltransferase (HAT) acetylates MCM10 in both the DNA binding domain internal domain (ID) and the C-terminal domain (CTD) [156], but its acetylation elicits different biological functions in vivo; acetylation in the ID promotes MCM10 DNA binding, while acetylation in the CTD suppresses DNA binding. Meanwhile, some of the acetylation sites (Table 7) can be directly deacetylated by the nicotinamide adenine dinucleotide (NAD)-dependent protein deacetylase sirtuin-1 (SIRT1) [156]. SIRT1 depletion promotes MCM10 chromatin loading and retention during S phase and increases the replication speed. Simultaneous depletion of SIRT1 and MCM10 slows down the replication speed and fired origin distance, which suggests that MCM10 and SIRT1 synergistically modulate DNA replication progress [156]. These findings suggest that MCM protein acetylation has an important role in replication.     [152][153][154]156]. K, lysine; M, methionine. * Refers to lysine residues acetylated by p300 [156]. # Refers to lysine residues deacetylated by SIRT1 [156].

Other PTMs of the MCM Proteins
Merbl et al. identified MCM10 as a substrate of other ubiquitin-like modifiers, such as neural precursor cell-expressed developmentally downregulated 8 (NEDD8) and interferon-stimulated gene 15 (ISG15) [129]. The biological functions of these modifications to MCM10 are unknown.

Conclusions
In sum, MCM subunits are modified by various PTMs during DNA replication under unperturbed conditions and in response to replication stress and DNA damage. Here, we summarize the functional modification sites (Table 8). Among the MCM PTMs, phosphorylation is an important replication initiation event but is also needed when replication is progressed. Most of the MCM phosphorylation sites are well understood in yeast and other model systems, but less so in human cells. Ubiquitination is also a common PTM, but its function is poorly investigated in human cells. The replication termination model mediated by MCM7 ubiquitination is, however, well delineated in yeast and Xenopus eggs. The biological function of other PTMs and cross-talk among different PTMs of MCM complex is largely unknown and warrants further investigation. Finally, MCMs are tightly involved in different cancers due to various gene alterations, and some MCM subunits already serve as diagnostic biomarkers. It will take time to fully understand the biological functions of the modified MCM sites that have been found thus far; however, once understood, these may open up new opportunities to develop small molecules for cancer therapy.  MCM6 Phosphorylation S13, S762 Response to DNA damage [78] MCM7 Phosphorylation S121 Promotes chromatin loading and proper mitotic exit [62] Ubiquitination K159 Response to DNA damage [78] Author Contributions: X.X. conceived and scientifically edited the review and Z.L. wrote the draft, while both authors contributed to defining the content of this review.