Enhancer architecture sensitizes cell specific responses to gene dose via a bind and discard mechanism.

Notch pathway haploinsufficiency can cause severe developmental syndromes with highly variable penetrance. Currently, we have a limited mechanistic understanding of phenotype variability due to gene dosage. Here, we unexpectedly found that inserting an enhancer containing pioneer transcription factor sites coupled to Notch dimer sites can induce a subset of haploinsufficiency phenotypes in with wild type gene dose.