The alternative polyadenylation (APA) of mRNAs is the use of multiple polyadenylation sites in primary transcripts and in conjunction with alternative splicing. APA expands cellular transcriptomic diversity by generating distinct mRNA isoforms [
21]. Depending on the location of polyadenylation sites (PASs), APA can be classified into two types: UTR-APA and coding region-APA (CR-APA) [
22]. The presence of APA sites in 3′-UTRs of mRNAs generates transcript isoforms with the same coding region but with different lengths of 3′-UTR regions, thus giving rise to distinct interactions of mRNA isoforms with RNA-binding proteins and non-coding RNAs like microRNA and lncRNAs [
21]. On the other hand, CR-APA directly affects the coding region and leads to the generation of proteins with different C-termini [
23,
24]. APA is found in all eukaryotes, and in mammals, about 70% of all mRNA-encoding genes undergo APA [
25,
26,
27]. APA events can be tissue-specific to a great extent; for example, in the case of 3′-UTR APA isoforms, distal PASs are enriched in neurons, while blood cells and testis tissue favor the use of proximal PASs [
28,
29]. The functional consequences of APA sites in 3′-UTR of pre-mRNAs are diverse. For example, 3′-UTR-APAs participate in post-transcriptional gene regulation through various methods, such as modification of mRNA stability, translation, nuclear export and cellular localization. The influence of 3′-APA upon stability of mRNAs can be exemplified through altered effects of miRNA functions. For example, about 10% of all miRNAs targeting two cell types can be influenced by expression of APA isoforms [
30]. Another way through which 3′-UTR APA events can modulate mRNA stability is differential binding of various RNA binding factors as well as lncRNAs that can affect the mRNA decay process [
21]. The localization of mRNAs can also be influenced by 3′-UTR APA events, which is best exemplified in the case of
BDNF transcripts, where the short isoform is restricted to the cell body while the long isoform is predominantly found in the dendrites [
31]. Lastly, 3′-UTR APA events can directly influence protein localization, as evidenced in the case of proteins like CD47, CD44, α1 integrin (ITGA1) and TNF receptor superfamily member 13C (TNFRSF13C) [
32]. CR-APA events are known to contribute to protein diversification, as seen in the case of transcripts encoded by genes like calcitonin-related polypeptide-α (
CALCA) and immunoglobulin M heavy chain (
IgM) [
21]. CR-APA can also repress gene expression by generating severely truncated transcripts through utilization of PAS proximal to the promoter, as observed in the case of transcripts encoded by the mammalian polyadenylation factor cleavage stimulation factor 77 kDa subunit (
CstF-77) gene [
33].
Effect of neurodevelopmental diseases: Neuronal commitment at the early stages of neurodevelopment is heavily influenced by the transcriptome repertoire of neural stem cells. During neurodevelopment, APA contributes significantly to the specification of neuronal lineage in association with other mechanisms such as microRNA networks, alternative splicing, non-sense mediated RNA decay, etc., that shape the transcriptome diversity of neural stem cells. APA events are known to be enriched in specific neuronal cell types [
34,
35]. Additionally, single-cell RNA sequencing data analysis identified cell type-specific APA landscapes in different GABAergic interneurons in the mouse cerebral cortex. Interestingly, genes with cell type-specific APA events are enriched in biological processes like synaptic vesicle recycling, neurotransmitter release, ion transport etc., which implies a significant role of APA in synaptic communication and neuronal identity determination [
36]. Furthermore, the role of APA during early stages of neurodevelopment, such as the commitment and differentiation of neural progenitors, has been investigated by Grassi et al. where transcriptome-wide changes of 3′-UTR lengths were observed during differentiation of mouse-adherent neural stem cells into GABAergic inhibitory neurons [
37]. A group of studies have linked APA events and 3′-UTR in specific genes like
MeCP2,
FMR1 to disorders with autistic phenotypes such as Rett syndrome, Fragile X-associated syndrome, autism, schizophrenia and other psychiatric diseases [
38,
39,
40,
41,
42]. Since ASDs have been correlated with aberrations of calcium signaling, the dysregulation of APA events in the autistic brains, as found by analyzing RNA sequencing data from publicly available databases, are linked with dysregulation of calcium ion homeostasis by Szkop et al. [
43]. The effect of APA in the regulation of MeCP2 protein levels and concomitant development of neuropsychiatric diseases has been studied by Gennarino et al., where copy-number variation of the
NUDT21 gene that encodes a subunit of pre-mRNA cleavage factor Im is reported to regulate the length of
MeCP2 transcript 3′-UTR [
44].
Effect of neurodegenerative diseases: The ability of APA events to generate transcripts with varying lengths of 3′-UTR gives rise to their intimate association with the regulation of gene expression. Since significant alterations of gene expression have been observed in neurodegenerative disorders [
45,
46], APA can be viewed as a potentially important regulatory mechanism operating during the development and progression of different neurodegenerative diseases. Analysis of RNA sequencing data from AD, PD and ALS patients and matched healthy controls, available in public databases, revealed disease-specific changes of APA profiles in a subset of genes among each disease [
47]. Although this study found APA profile changes in relatively small subset of genes, and affected genes differ among RNA-sequencing datasets, they found, in all three disease-associated datasets, overrepresentation of genes associated with protein turnover and mitochondrial function. Usage of the distal PAS site in α-synuclein mRNA generates an extended transcript isoform which is shown to be associated with PD development, and the presence of this extended 3′-UTR promotes accumulation of the α-synuclein protein, which gets redirected away from the synaptic terminal towards mitochondria [
48]. Genome-wide usage of proximal PAS within 3′-UTR regions or PAS within introns leads to transcriptome-wide shortening of 3′-UTR regions, and that may underlie the development of neurological disorders like oculopharyngeal muscular dystrophy (OPMD) [
49].