The review correctly separates two mechanisms for Barr body disappearance in tumors: (A) genetic loss/duplication of Xi (copy-number changes), and (B) epigenetic decompaction with possible sporadic gene reactivation. Empirical support since 2014 favors frequent genetic instability of Xi (e.g., hypermutation, idic(X) in myeloid cancers), while widespread epigenetic reactivation remains poorly supported by genome-wide allele-specific expression studies — so Chaligné & Heard's cautious stance is justified.
Chaligné & Heard (2014) is a solid, cautious, and well-referenced review that accurately summarizes knowledge up to 2014: Xist initiates XCI; PRC1/PRC2 and histone modifications are early events; DNA methylation, macroH2A and Smchd1 contribute to durable maintenance; escape is tissue- and species-dependent; cancer-associated Xi changes likely include genetic loss and sometimes focal epigenetic changes but genome-wide epigenetic Xi reactivation lacks convincing broad evidence in primary tumors. This conclusion would be falsified by large, allele-resolved tumor cohorts demonstrating frequent genome-wide Xi reactivation without Xi copy-number change.
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