De Novo and Bi-allelic Pathogenic Variants in NARS1 Cause Neurodevelopmental Delay Due to Toxic Gain-of-Function and Partial Loss-of-Function Effects

Andreea Manole1, Stephanie Efthymiou1, Emer O’Connor1, Marisa I Mendes2, Matthew Jennings 3, Reza Maroofian1, Indran Davagnanam4, Kshitij Mankad5, Maria Rodriguez Lopez6, Vincenzo Salpietro1, Ricardo Harripaul7, Lauren Badalato8, Jagdeep Walia8, Christopher S Francklyn9, Alkyoni Athanasiou-Fragkouli 1, Roisin Sullivan1, Sonal Desai10, Kristin Baranano10, Faisal Zafar 11, Nuzhat Rana11, Muhammed Ilyas12, Alejandro Horga1, Majdi Kara 13, Francesca Mattioli14, Alice Goldenberg15, Helen Griffin3, Amelie Piton14, Lindsay B Henderson16, Benyekhlef Kara17, Ayca Dilruba Aslanger17, Joost Raaphorst18, Rolph Pfundt19, Ruben Portier20, Marwan Shinawi 21, Amelia Kirby22, Katherine M Christensen22, Lu Wang23, Rasim O Rosti23, Sohail A Paracha24, Muhammad T Sarwar24, Dagan Jenkins25, SYNAPS Study Group; Jawad Ahmed24, Federico A Santoni26, Emmanuelle Ranza27, Justyna Iwaszkiewicz28, Cheryl Cytrynbaum29, Rosanna Weksberg29, Ingrid M Wentzensen16, Maria J Guillen Sacoto16, Yue Si16, Aida Telegrafi16, Marisa V Andrews21, Dustin Baldridge21, Heinz Gabriel30, Julia Mohr30, Barbara Oehl-Jaschkowitz31, Sylvain Debard32, Bruno Senger32, Frédéric Fischer32, Conny van Ravenwaaij 33, Annemarie J M Fock33, Servi J C Stevens34, Jürg Bähler6, Amina Nasar8, John F Mantovani35, Adnan Manzur25, Anna Sarkozy25, Desirée E C Smith2, Gajja S Salomons2,Zubair M Ahmed36, Shaikh Riazuddin37, Saima Riazuddin36,Muhammad A Usmani36, Annette Seibt38, Muhammad Ansar39, Stylianos E Antonarakis40, John B Vincent7, Muhammad Ayub8,Mona Grimmel41, Anne Marie Jelsig42,Tina Duelund Hjortshøj42, Helena Gásdal Karstensen42, Marybeth Hummel43, Tobias B Haack44, Yalda Jamshidi45, Felix Distelmaier38, Rita Horvath3, Joseph G Gleeson23, Gleeson23, Hubert Becker32, Jean-Louis Mandel 14, David A Koolen19, Henry Houlden46.
  1. Department of Neuromuscular Disorders, University College London (UCL) Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
  2. Metabolic Unit, Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam Gastroenterology and Metabolism, Amsterdam, 1081 the Netherlands.
  3. Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ UK.
  4. Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
  5. Department of Neuroradiology, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.
  6. Institute of Healthy Ageing, Department of Genetics, Evolution and Environment, University College London (UCL), London, WC1E 6BT, UK.
  7. Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, ON, M5T 1R8, Canada; Institute of Medical Science and Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.
  8. Department of Pediatrics, Queen’s University, Kingston, ON, K7L 2V7, Canada.
  9. Department of Biochemistry, University of Vermont College of Medicine, Burlington, VT 05405, USA.
  10. Department of Neurology and Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
  11. Department of Pediatrics, Multan Hospital, Multan, 60000, Pakistan.
  12. University of Islamabad, Islamabad, 45320, Pakistan.
  13. Department of Pediatrics, Tripoli Children’s Hospital, Tripoli, Libya.
  14. Institute for Genetics and Molecular and Cellular Biology (IGBMC), University of Strasbourg, CNRS UMR7104, INSERM U1258, Illkirch, 67404, France.
  15. Département de Génétique, centre de référence anomalies du développement et syndromes malformatifs, CHU de Rouen, Inserm U1245, UNIROUEN, Normandie Université, Centre Normand de Génomique et de Médecine Personnalisée, Rouen, 76031, France.
  16. GeneDx, 207 Perry Parkway Gaithersburg, MD 20877, USA.
  17. Bezmiâlem Vakıf Üniversitesi, Istanbul, 34093, Turkey.
  18. Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6500HB Nijmegen, the Netherlands; Department of Neurology, Amsterdam Neuroscience Institute, Amsterdam University Medical Center, 1105AZ Amsterdam, the Netherlands.
  19. Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6500HB Nijmegen, the Netherlands.
  20. Department of Neurology, Medisch Spectrum Twente, 7512KZ Enschede, the Netherlands.
  21. Department of Pediatrics, Divisions of Genetics and Genomic Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA.
  22. Division of Medical Genetics, SSM Health Cardinal Glennon Children’s Hospital, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
  23. Howard Hughes Medical Institute, University of California San Diego and Rady Children’s Hospital, La Jolla, CA 92130, USA.
  24. Institute of Basic Medical Sciences, Khyber Medical University, 25100 Peshawar, Pakistan.
  25. Institute of Child Health, Guilford Street and Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.
  26. Department of Genetic Medicine and Development, University of Geneva, 1206 Geneva, Switzerland; Department of Endocrinology, Diabetes, and Metabolism, University Hospital of Lausanne, 1011 Lausanne, Switzerland.
  27. Department of Genetic Medicine and Development, University of Geneva, 1206 Geneva, Switzerland; Service of Genetic Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; Medigenome, The Swiss Institute of Genomic Medicine, Geneva, CH-1207, Switzerland.
  28. Swiss Institute of Bioinformatics, Molecular Modeling Group, Batiment Genopode, Unil Sorge, Lausanne, CH-1015, Switzerland.
  29. Hospital for Sick Children, Division of Clinical and Metabolic Genetics, 555 University Ave., Toronto, M5G 1X8, Canada.
  30. CeGaT GmbH and Praxis für Humangenetik Tuebingen, Tuebingen, 72076, Germany.
  31. Biomedical Centre Cardinal-Wendel-Straße 14, 66424 Hamburg, Germany.
  32. University of Strasbourg, CNRS, GMGM UMR 7156, Strasbourg, 67083, France.
  33. University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, 9713, the Netherlands.
  34. Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, 6211, the Netherlands..
  35. Division of Child Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
  36. Department of Biochemistry and Molecular Biology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
  37. Jinnah Burn and Reconstructive Surgery Center, Allama Iqbal Medical College, University of Health Sciences, Lahore 54550, Pakistan.
  38. Department of General Pediatrics, Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf, Germany.
  39. Department of Genetic Medicine and Development, University of Geneva, 1206 Geneva, Switzerland; Institute of Molecular and Clinical Ophthalmology Basel, Basel Switzerland.
  40. Department of Genetic Medicine and Development, University of Geneva, 1206 Geneva, Switzerland; Service of Genetic Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; iGE3 Institute of Genetics and Genomics of Geneva, 1211 Geneva, Switzerland.
  41. Institute of Medical Genetics and Applied Genomics, University of Tuebingen, 72076 Tübingen, Germany.
  42. Department of Clinical Genetics, University Hospital of Copenhagen, Rigshospitalet, 2100, Denmark.
  43. Department of Pediatrics, Section of Medical Genetics, West Virginia University, Morgantown, WV 26506-9600, USA.
  44. Institute of Medical Genetics and Applied Genomics, University of Tuebingen, 72076 Tübingen, Germany; Centre for Rare Diseases, University of Tuebingen, 72076 Tübingen, Germany.
  45. Genetics Centre, Molecular and Clinical Sciences Institute, St George’s University of London, London, SW17 0RE, UK.
  46. Department of Neuromuscular Disorders, University College London (UCL) Institute of Neurology, Queen Square, London, WC1N 3BG, UK. Electronic address: h.houlden@ucl.ac.uk.