RRID:AB_398558
DOI: 10.1111/bph.70722
Resource: (BD Biosciences Cat# 554468, RRID:AB_398558)
Curator: @scibot
SciCrunch record: RRID:AB_398558
RRID:AB_398558
DOI: 10.1111/bph.70722
Resource: (BD Biosciences Cat# 554468, RRID:AB_398558)
Curator: @scibot
SciCrunch record: RRID:AB_398558
RRID:AB_2892833
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-092-575, RRID:AB_2892833)
Curator: @scibot
SciCrunch record: RRID:AB_2892833
RRID:AB_2540675
DOI: 10.1111/bph.70722
Resource: (Thermo Fisher Scientific Cat# PA5-23148, RRID:AB_2540675)
Curator: @scibot
SciCrunch record: RRID:AB_2540675
RRID:AB_2660387
DOI: 10.1111/bph.70722
Resource: RRID:AB_2660387
Curator: @scibot
SciCrunch record: RRID:AB_2660387
RRID:AB_2660790
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-102-298, RRID:AB_2660790)
Curator: @scibot
SciCrunch record: RRID:AB_2660790
RRID:AB_2889697
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-125-220, RRID:AB_2889697)
Curator: @scibot
SciCrunch record: RRID:AB_2889697
RRID:AB_2660587
DOI: 10.1111/bph.70722
Resource: RRID:AB_2660587
Curator: @scibot
SciCrunch record: RRID:AB_2660587
RRID:AB_2659991
DOI: 10.1111/bph.70722
Resource: RRID:AB_2659991
Curator: @scibot
SciCrunch record: RRID:AB_2659991
RRID:AB_10896418
DOI: 10.1111/bph.70722
Resource: (BioLegend Cat# 141405, RRID:AB_10896418)
Curator: @scibot
SciCrunch record: RRID:AB_10896418
RRID:AB_2659917
DOI: 10.1111/bph.70722
Resource: RRID:AB_2659917
Curator: @scibot
SciCrunch record: RRID:AB_2659917
RRID:AB_2733492
DOI: 10.1111/bph.70722
Resource: RRID:AB_2733492
Curator: @scibot
SciCrunch record: RRID:AB_2733492
RRID:AB_2801756
DOI: 10.1111/bph.70722
Resource: RRID:AB_2801756
Curator: @scibot
SciCrunch record: RRID:AB_2801756
RRID:AB_2727574
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-116-499, RRID:AB_2727574)
Curator: @scibot
SciCrunch record: RRID:AB_2727574
RRID:AB_2660043
DOI: 10.1111/bph.70722
Resource: RRID:AB_2660043
Curator: @scibot
SciCrunch record: RRID:AB_2660043
RRID:AB_2652905
DOI: 10.1111/bph.70722
Resource: RRID:AB_2652905
Curator: @scibot
SciCrunch record: RRID:AB_2652905
RRID:AB_2659872
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-101-894, RRID:AB_2659872)
Curator: @scibot
SciCrunch record: RRID:AB_2659872
RRID:AB_2660516
DOI: 10.1111/bph.70722
Resource: RRID:AB_2660516
Curator: @scibot
SciCrunch record: RRID:AB_2660516
RRID:AB_396680
DOI: 10.1111/bph.70722
Resource: (BD Biosciences Cat# 557397, RRID:AB_396680)
Curator: @scibot
SciCrunch record: RRID:AB_396680
RRID:AB_2658180
DOI: 10.1111/bph.70722
Resource: RRID:AB_2658180
Curator: @scibot
SciCrunch record: RRID:AB_2658180
RRID:AB_2637419
DOI: 10.1111/bph.70722
Resource: (Thermo Fisher Scientific Cat# 17-2061-80, RRID:AB_2637419)
Curator: @scibot
SciCrunch record: RRID:AB_2637419
RRID:AB_2660747
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-102-558, RRID:AB_2660747)
Curator: @scibot
SciCrunch record: RRID:AB_2660747
RRID:AB_2659902
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-102-541, RRID:AB_2659902)
Curator: @scibot
SciCrunch record: RRID:AB_2659902
RRID:AB_2659884
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-102-807, RRID:AB_2659884)
Curator: @scibot
SciCrunch record: RRID:AB_2659884
RRID:AB_2727970
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-117-509, RRID:AB_2727970)
Curator: @scibot
SciCrunch record: RRID:AB_2727970
RRID:AB_468921
DOI: 10.1111/bph.70722
Resource: (Thermo Fisher Scientific Cat# 16-0281-82, RRID:AB_468921)
Curator: @scibot
SciCrunch record: RRID:AB_468921
RRID:AB_468847
DOI: 10.1111/bph.70722
Resource: (Thermo Fisher Scientific Cat# 16-0031-82, RRID:AB_468847)
Curator: @scibot
SciCrunch record: RRID:AB_468847
RRID:AB_2661142
DOI: 10.1111/bph.70722
Resource: (Miltenyi Biotec Cat# 130-102-339, RRID:AB_2661142)
Curator: @scibot
SciCrunch record: RRID:AB_2661142
RRID:MGI:8310058
DOI: 10.1111/bph.70720
Resource: RRID:MGI:8310058
Curator: @scibot
SciCrunch record: RRID:MGI:8310058
RRID:CVCL_Z831
DOI: 10.1111/acel.70721
Resource: (DGRC Cat# 150, RRID:CVCL_Z831)
Curator: @scibot
SciCrunch record: RRID:CVCL_Z831
RRID:SCR_018000
DOI: 10.1101/2025.03.28.646066
Resource: arivis Vision4D (RRID:SCR_018000)
Curator: @scibot
SciCrunch record: RRID:SCR_018000
RRID:SCR_002823
DOI: 10.1101/2025.03.28.646066
Resource: FSL (RRID:SCR_002823)
Curator: @scibot
SciCrunch record: RRID:SCR_002823
RRID:SCR_015246
DOI: 10.1101/2025.03.28.646066
Resource: Ilastik (RRID:SCR_015246)
Curator: @scibot
SciCrunch record: RRID:SCR_015246
RRID:SCR_021413
DOI: 10.1101/2025.03.28.646066
Resource: Simple Behavior Analysis (RRID:SCR_021413)
Curator: @scibot
SciCrunch record: RRID:SCR_021413
RRID:SCR_004757
DOI: 10.1101/2025.03.28.646066
Resource: ANTS - Advanced Normalization ToolS (RRID:SCR_004757)
Curator: @scibot
SciCrunch record: RRID:SCR_004757
RRID:SCR_021382
DOI: 10.1101/2025.03.28.646066
Resource: Social LEAP (RRID:SCR_021382)
Curator: @scibot
SciCrunch record: RRID:SCR_021382
RRID:SCR_014289
DOI: 10.1101/2025.03.28.646066
Resource: ANY-maze (RRID:SCR_014289)
Curator: @scibot
SciCrunch record: RRID:SCR_014289
RRID:SCR_003070
DOI: 10.1101/2025.03.28.646066
Resource: ImageJ (RRID:SCR_003070)
Curator: @scibot
SciCrunch record: RRID:SCR_003070
RRID:SCR_018361
DOI: 10.1101/2025.03.28.646066
Resource: Biorender (RRID:SCR_018361)
Curator: @scibot
SciCrunch record: RRID:SCR_018361
RRID:IMSR_JAX:030323
DOI: 10.1101/2025.03.28.646066
Resource: (IMSR Cat# JAX_030323,RRID:IMSR_JAX:030323)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:030323
RRID:SCR_002798
DOI: 10.1101/2025.03.28.646066
Resource: GraphPad Prism (RRID:SCR_002798)
Curator: @scibot
SciCrunch record: RRID:SCR_002798
RRID:IMSR_JAX:000664
DOI: 10.1101/2025.03.28.646066
Resource: RRID:IMSR_JAX:000664
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:000664
RRID:SCR_022328
DOI: 10.1101/2025.03.28.646066
Resource: Brainrender (RRID:SCR_022328)
Curator: @scibot
SciCrunch record: RRID:SCR_022328
RRID:SCR_016422
DOI: 10.1101/2025.03.28.646066
Resource: KiloSort (RRID:SCR_016422)
Curator: @scibot
SciCrunch record: RRID:SCR_016422
RRID:AB_2340696
DOI: 10.1101/2025.03.28.646066
Resource: (Jackson ImmunoResearch Labs Cat# 712-606-153, RRID:AB_2340696)
Curator: @scibot
SciCrunch record: RRID:AB_2340696
RRID:AB_2864765
DOI: 10.1101/2025.03.28.646066
Resource: (Synaptic Systems Cat# 226 017, RRID:AB_2864765)
Curator: @scibot
SciCrunch record: RRID:AB_2864765
RRID:AB_2209751
DOI: 10.1101/2025.03.28.646066
Resource: (Rockland Cat# 600-401-379, RRID:AB_2209751)
Curator: @scibot
SciCrunch record: RRID:AB_2209751
RRID:SCR_002978
DOI: 10.1101/2025.03.28.646066
Resource: Allen Mouse Brain Atlas (RRID:SCR_002978)
Curator: @scibot
SciCrunch record: RRID:SCR_002978
RRID:AB_2340625
DOI: 10.1101/2025.03.28.646066
Resource: (Jackson ImmunoResearch Labs Cat# 711-606-152, RRID:AB_2340625)
Curator: @scibot
SciCrunch record: RRID:AB_2340625
Addgene_122508
DOI: 10.1101/2024.10.03.616590
Resource: RRID:Addgene_122508
Curator: @scibot
SciCrunch record: RRID:Addgene_122508
Addgene_122507
DOI: 10.1101/2024.10.03.616590
Resource: RRID:Addgene_122507
Curator: @scibot
SciCrunch record: RRID:Addgene_122507
dentification of ACO2 variants in individuals with ION Cohorts including about 1000 molecularly undiagnosed ION individuals from France, Germany, Italy, Spain, Belgium and the UK were screened by targeted sequencing for the presence of ACO2 variants. Among individuals with a single ACO2 variant, we selected cases with an MAF lower than 0.0001, whereas in individuals with biallelic heterozygous composite or homozygous variants, we selected the cases with an MAF lower than 0.005 for each variant. This led to the identification of 50 individuals harbouring 1 of 43 different heterozygous mutations, among which 29 were novel, as well as 11 individuals with biallelic mutations, among which 8 were novel. A compilation of these variants and the associated amino acid changes are displayed on ACO2 primary sequence and 3D structure in Fig. 1A and C and listed in the Supplementary Table 1. Notably, four dominant variants p.(Arg474Gly), p.(Trp603Ser), p.(Ser669Leu) and p.(Arg671Trp) were identified in two unrelated individuals and p.(Arg671Gln) in four unrelated individuals, while one recessive variant, p.(Leu74Val), with an MAF value of 0.00369, was found in five unrelated ROA individuals, and also formerly described in eight individuals with syndromic ACO2 presentations. This p.(Leu74Val) variant was associated once with p.(Gly661Arg) in the P56 individual, a combination already reported in an ROA family.6 Segregation analysis was performed where available. In DOA cases, all affected relatives carried the variant, whereas some relatives in the families of patients P6, P8, P9, P13 and P33 carrying the variant were asymptomatic, as occasionally observed in families with OPA1 mutations.15,41 Moreover, segregation analysis revealed de novo mutations in the P15 and P18 index cases. Analysis of the types of mutations identified in ACO2 (Fig. 1B) revealed that two-third of all variants were missense mutations, irrespective of the dominant or recessive mode of inheritance, while nonsense, frame-shift, splice-site mutations and deletions accounted together for the third part of all mutations identified, without significant difference between the distribution of the mutation types between dominant and recessive cases (P-value: 0.80). Notably, the identification of null alleles in dominant cases suggests that ACO2 haploinsufficiency contributes mainly to DOA pathophysiology.
Case: Charif Patient #60, 7yo at report, 6yo at dx, male, European
CasePresentingHPOs:
CasePresentingHPOsFreeText: inherited optic neuropathy/dominant optic atrophy; BCVA= OD:0.25, OS:0.08; central scotoma; ODS: temporal atrophy
CaseNOTHPOs:
CaseNOTHPOSFreeText: other symptoms
CasePreviousTesting:
CaseGenotypingMethod: ACO2 mutations were screened using resequencing gene panels dedicated to the molecular diagnosis of IONs or of mitochondrial inherited diseases. All candidate pathogenic variants were validated by Sanger sequencing
Variant: NM_001098.2 c.525+1G>A; c.220C>G p.(Leu74Val) compound heterozygous
ClinVarID: or CAID: 1470169
AddCaseInfo: no segregation data
PreviouslyPublished: n/a
VariantEvidence: n/a
Identification of ACO2 variants in individuals with ION Cohorts including about 1000 molecularly undiagnosed ION individuals from France, Germany, Italy, Spain, Belgium and the UK were screened by targeted sequencing for the presence of ACO2 variants. Among individuals with a single ACO2 variant, we selected cases with an MAF lower than 0.0001, whereas in individuals with biallelic heterozygous composite or homozygous variants, we selected the cases with an MAF lower than 0.005 for each variant. This led to the identification of 50 individuals harbouring 1 of 43 different heterozygous mutations, among which 29 were novel, as well as 11 individuals with biallelic mutations, among which 8 were novel. A compilation of these variants and the associated amino acid changes are displayed on ACO2 primary sequence and 3D structure in Fig. 1A and C and listed in the Supplementary Table 1. Notably, four dominant variants p.(Arg474Gly), p.(Trp603Ser), p.(Ser669Leu) and p.(Arg671Trp) were identified in two unrelated individuals and p.(Arg671Gln) in four unrelated individuals, while one recessive variant, p.(Leu74Val), with an MAF value of 0.00369, was found in five unrelated ROA individuals, and also formerly described in eight individuals with syndromic ACO2 presentations. This p.(Leu74Val) variant was associated once with p.(Gly661Arg) in the P56 individual, a combination already reported in an ROA family.6 Segregation analysis was performed where available. In DOA cases, all affected relatives carried the variant, whereas some relatives in the families of patients P6, P8, P9, P13 and P33 carrying the variant were asymptomatic, as occasionally observed in families with OPA1 mutations.15,41 Moreover, segregation analysis revealed de novo mutations in the P15 and P18 index cases. Analysis of the types of mutations identified in ACO2 (Fig. 1B) revealed that two-third of all variants were missense mutations, irrespective of the dominant or recessive mode of inheritance, while nonsense, frame-shift, splice-site mutations and deletions accounted together for the third part of all mutations identified, without significant difference between the distribution of the mutation types between dominant and recessive cases (P-value: 0.80). Notably, the identification of null alleles in dominant cases suggests that ACO2 haploinsufficiency contributes mainly to DOA pathophysiology.
Case: Charif Patient #1, 25yo at report, female, European
CasePresentingHPOs:
CasePresentingHPOsFreeText: inherited optic neuropathy/dominant optic atrophy; BCVA= OD:0.5, OS:0.63; ODS: diffuse loss;
CaseNOTHPOs:
CaseNOTHPOSFreeText: other symptoms
CasePreviousTesting:
CaseGenotypingMethod: ACO2 mutations were screened using resequencing gene panels dedicated to the molecular diagnosis of IONs or of mitochondrial inherited diseases. All candidate pathogenic variants were validated by Sanger sequencing
Variant: NM_001098.2 c.172C>T p.(Arg58*) heterozygous
ClinVarID: or CAID: 441075
AddCaseInfo: no segregation data
PreviouslyPublished: n/a
VariantEvidence: n/a
KMP 15
Case#: KMP 15, female, 82 yrs, East Slovakia
DiseaseAssertion: HCM
FamilyInfo: yes
CasePresentingHPOs: n/a
CaseHPOFreeText: symptomatic, LVOTO yes; LVEF 60%; NYHA III.; ICD yes; ECG; echocardiography;
CaseNotHPOs: n/a
CaseNotHPOFreeText: n/a
CasePreviousTesting: Additional Sanger sequencing of exons 12, 24, 25 of MYBPC3, exon 12 NEBL, exons 12, 20, 21 of SCN5A, exon 7 of TNNI3, and exon 9 of TNNT2 gene
CaseGenotypingMethod: Sanger sequencing;
Variant: NM_000257.4(MYH7):c.2734A>G (p.Lys912Glu)
ClinVar: 520267 https://www.ncbi.nlm.nih.gov/clinvar/variation/520267/
CAID: n/a
gnomAD: absent
RRID:SCR_002798
DOI: 10.1096/fj.202603540R
Resource: GraphPad Prism (RRID:SCR_002798)
Curator: @scibot
SciCrunch record: RRID:SCR_002798
RRID:AB_2722664
DOI: 10.1096/fj.202602013R
Resource: (Crystal Chem Cat# 90030, RRID:AB_2722664)
Curator: @scibot
SciCrunch record: RRID:AB_2722664
RRID:AB_3662574
DOI: 10.1096/fj.202602013R
Resource: (Crystal Chem Cat# 62100, RRID:AB_3662574)
Curator: @scibot
SciCrunch record: RRID:AB_3662574
SCR_018669
DOI: 10.1096/fba.2026-00277
Resource: Johns Hopkins University School of Medicine Genetic Resources Core Facility (RRID:SCR_018669)
Curator: @scibot
SciCrunch record: RRID:SCR_018669
UMU-36-513-s001.zip (35M)GUID: 06D923F1-8EE7-4CA8-96C3-FB1A004ACCF5
Variant not found in the supplemental data even though Mastermind says it is in S002.
HUMU-36-513-s001.zip (35M)GUID: 06D923F1-8EE7-4CA8-96C3-FB1A004ACCF5
Variant not found in the supplemental data even though Mastermind says it is in S002.
addgene_51133
DOI: 10.1093/stcltm/szag073
Resource: RRID:Addgene_51133
Curator: @scibot
SciCrunch record: RRID:Addgene_51133
addgene_112095
DOI: 10.1093/stcltm/szag073
Resource: RRID:Addgene_112095
Curator: @scibot
SciCrunch record: RRID:Addgene_112095
Case#: Consequence 7 Table 1 in Data Supplement (1 cases)
DiseaseAssertion: HCM
FamilyInfo: N/A
CasePresentingHPOs: N/A
CaseHPOFreeText: Cardiac magnetic resonance imaging, BSA, NYHA functional class, obstructive HCM, atrial fibrillation, coronary artery disease, NSVT, Syncope, SCD family hitory, wall thickness
CaseNotHPOs: N/A
CaseNotHPOFreeText: N/A
CasePreviousTesting: Additional oligonucleotide hybridization–based DNA sequencing and dideoxy-based DNA sequencing for MYBPC3, TMP1, TNNC1, TNNI2, TNNI3, TNNT2, ACTC1, MYL3
CaseGenotypingMethod: oligonucleotide hybridization–based DNA sequencing and dideoxy-based DNA sequencing
Variant: NM_000257.4(MYH7):c.1608G>T (p.Glu536Asp)
ClinVar: 177671 https://www.ncbi.nlm.nih.gov/clinvar/variation/177671/
CAID: n/a
gnomAD: absent
Case#: Consequence 16 Table 1 in Data Supplement (1 cases)
DiseaseAssertion: HCM
FamilyInfo: N/A
CasePresentingHPOs: N/A
CaseHPOFreeText: Cardiac magnetic resonance imaging, BSA, NYHA functional class, obstructive HCM, atrial fibrillation, coronary artery disease, NSVT, Syncope, SCD family hitory, wall thickness
CaseNotHPOs: N/A
CaseNotHPOFreeText: N/A
CasePreviousTesting: Additional oligonucleotide hybridization–based DNA sequencing and dideoxy-based DNA sequencing for MYBPC3, TMP1, TNNC1, TNNI2, TNNI3, TNNT2, ACTC1, MYL3
CaseGenotypingMethod: oligonucleotide hybridization–based DNA sequencing and dideoxy-based DNA sequencing
Variant: NM_000257.4(MYH7):c.5135G>A (p.Arg1712Gln)
ClinVar: 36642 https://www.ncbi.nlm.nih.gov/clinvar/variation/36642/
CAID: n/a
gnomAD: 0.00004657 European (non-Finnish) https://gnomad.broadinstitute.org/variant/14-23884860-C-T
Case#: Consequence 5 Table 1 in Data Supplement (1 cases)
DiseaseAssertion: HCM
FamilyInfo: N/A
CasePresentingHPOs: N/A
CaseHPOFreeText: Cardiac magnetic resonance imaging, BSA, NYHA functional class, obstructive HCM, atrial fibrillation, coronary artery disease, NSVT, Syncope, SCD family hitory, wall thickness
CaseNotHPOs: N/A
CaseNotHPOFreeText: N/A
CasePreviousTesting: Additional oligonucleotide hybridization–based DNA sequencing and dideoxy-based DNA sequencing for MYBPC3, TMP1, TNNC1, TNNI2, TNNI3, TNNT2, ACTC1, MYL3
CaseGenotypingMethod: oligonucleotide hybridization–based DNA sequencing and dideoxy-based DNA sequencing
Variant: NM_000257.4(MYH7):c.2198G>T (p.Gly733Val)
ClinVar: 181177 https://www.ncbi.nlm.nih.gov/clinvar/variation/181177/
CAID: n/a
gnomAD: absent
Addgene_53188
DOI: 10.1093/nar/gkag906
Resource: RRID:Addgene_53188
Curator: @scibot
SciCrunch record: RRID:Addgene_53188
Addgene_132777
DOI: 10.1093/nar/gkag906
Resource: RRID:Addgene_132777
Curator: @scibot
SciCrunch record: RRID:Addgene_132777
RRID:SCR_018986
DOI: 10.1093/nar/gkag890
Resource: Colorado University at Boulder Biochemistry Shared Instruments Pool Core Facility (RRID:SCR_018986)
Curator: @scibot
SciCrunch record: RRID:SCR_018986
RRID:SCR_026645
DOI: 10.1093/g3journal/jkag271
Resource: Breeding Insight (RRID:SCR_026645)
Curator: @scibot
SciCrunch record: RRID:SCR_026645
RRID:SCR_014431
DOI: 10.1093/aesa/saag043
Resource: Avizo 3D Software (RRID:SCR_014431)
Curator: @scibot
SciCrunch record: RRID:SCR_014431
c.172C > T
This variant is mentioned only in reference to a previous publication (PMID: 30689204)
RRID:SCR_021898
DOI: 10.1073/pnas.2536755123
Resource: University of Texas at Austin Biomedical Imaging Center Core Facility (RRID:SCR_021898)
Curator: @scibot
SciCrunch record: RRID:SCR_021898
RRID:SCR_005012
DOI: 10.1073/pnas.2529474123
Resource: Gene Expression Omnibus (GEO) (RRID:SCR_005012)
Curator: @scibot
SciCrunch record: RRID:SCR_005012
RRID:SCR_022924
DOI: 10.1039/d6sc07403k
Resource: RRID:SCR_022924
Curator: @scibot
SciCrunch record: RRID:SCR_022924
RRID:SCR_002798
DOI: 10.1038/s44341-026-00051-9
Resource: GraphPad Prism (RRID:SCR_002798)
Curator: @scibot
SciCrunch record: RRID:SCR_002798
RRID:Addgene_50526
DOI: 10.1038/s44341-026-00051-9
Resource: RRID:Addgene_50526
Curator: @scibot
SciCrunch record: RRID:Addgene_50526
RRID:CVCL_2765
DOI: 10.1038/s44341-026-00051-9
Resource: (RRID:CVCL_2765)
Curator: @scibot
SciCrunch record: RRID:CVCL_2765
Table 1
Ser112Arg is mentioned in this table in reference to previous publications
RRID:SCR_014601
DOI: 10.1038/s44321-026-00543-0
Resource: ggplot2 (RRID:SCR_014601)
Curator: @scibot
SciCrunch record: RRID:SCR_014601
RRID:SCR_022035
DOI: 10.1038/s44321-026-00543-0
Resource: University of Colorado Anschutz Medical Campus Cancer Center Flow Cytometry Shared Resource Core Facility (RRID:SCR_022035)
Curator: @scibot
SciCrunch record: RRID:SCR_022035
RRID:SCR_016884
DOI: 10.1038/s44321-026-00543-0
Resource: clusterProfiler (RRID:SCR_016884)
Curator: @scibot
SciCrunch record: RRID:SCR_016884
RRID:SCR_021984
DOI: 10.1038/s44321-026-00543-0
Resource: University of Colorado Anschutz Medical Campus Cancer Center Genomics Shared Resource Core Facility (RRID:SCR_021984)
Curator: @scibot
SciCrunch record: RRID:SCR_021984
RRID:SCR_000432
DOI: 10.1038/s44321-026-00543-0
Resource: RStudio (RRID:SCR_000432)
Curator: @scibot
SciCrunch record: RRID:SCR_000432
RRID:SCR_016167
DOI: 10.1038/s44321-026-00543-0
Resource: OlyVIA (RRID:SCR_016167)
Curator: @scibot
SciCrunch record: RRID:SCR_016167
RRID:SCR_001905
DOI: 10.1038/s44321-026-00543-0
Resource: R Project for Statistical Computing (RRID:SCR_001905)
Curator: @scibot
SciCrunch record: RRID:SCR_001905
RRID:SCR_018257
DOI: 10.1038/s44321-026-00543-0
Resource: QuPath (RRID:SCR_018257)
Curator: @scibot
SciCrunch record: RRID:SCR_018257
RRID:SCR_017344
DOI: 10.1038/s44321-026-00543-0
Resource: Cell Ranger (RRID:SCR_017344)
Curator: @scibot
SciCrunch record: RRID:SCR_017344
RRID:SCR_008520
DOI: 10.1038/s44321-026-00543-0
Resource: FlowJo (RRID:SCR_008520)
Curator: @scibot
SciCrunch record: RRID:SCR_008520
RRID:SCR_016341
DOI: 10.1038/s44321-026-00543-0
Resource: Seurat (RRID:SCR_016341)
Curator: @scibot
SciCrunch record: RRID:SCR_016341
RRID:SCR_022206
DOI: 10.1038/s44321-026-00543-0
Resource: Harmony (RRID:SCR_022206)
Curator: @scibot
SciCrunch record: RRID:SCR_022206
RRID:SCR_002798
DOI: 10.1038/s44321-026-00543-0
Resource: GraphPad Prism (RRID:SCR_002798)
Curator: @scibot
SciCrunch record: RRID:SCR_002798
JAX:000664
DOI: 10.1038/s44321-026-00543-0
Resource: RRID:IMSR_JAX:000664
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:000664
JAX:032127
DOI: 10.1038/s44321-026-00543-0
Resource: (IMSR Cat# JAX_032127,RRID:IMSR_JAX:032127)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:032127
JAX:000651
DOI: 10.1038/s44321-026-00543-0
Resource: (IMSR Cat# JAX_000651,RRID:IMSR_JAX:000651)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:000651
Q380RR628PA8, A20, L14Mild, survival beyond age 35, no mental retardation
Case#: Patient #17, Brazilian
DiseaseAssertion: MPS1, mild
FamilyInfo:
CasePresentingHPOs:
CaseHPOFreeText: survival beyond age 35
CaseNotHPOs:
CaseNotHPOFreeText: mental retardation
GenotypingMethod:
PreviouslyPublished:
Variant: Q380R; R628P (also A8, A20, L14)
ClinVar: 1064675
CAID:
SupplementalData:
hree families (F1-P1/P2, F2-P1/P2/P3, F3-P1/P2) were of Arab origin,
Another family has this variant in homozygosity, but they are also of Arab origin and are said to be from the same village, so conservatively not scoring for PM3 since this is a founder variant. Could add to segregation data, but PP1 is already at the maximum weight
The institutional review board of the University of Michigan (IRBMED) approved this retrospective study. Patients who were referred to the Michigan Medicine Pediatric Genetics clinic for any reason and who underwent CES as part of their diagnostic workup were consecutively included in this study. Clinical evaluations of patients were performed in the comprehensive Pediatrics Genetics Clinic, and included detailed evaluation of each individual and construction of a pedigree. Patients were clinically assessed by a physician (medical geneticist) who reviewed prior history and medical workup, performed a patient interview and physical exam, and ordered diagnostic testing. Patients selected for this cohort included all consecutive patients in whom CES was deemed clinically indicated by the assessing physician who presented for evaluation during from October 1, 2012 through April 30, 2018. Based on physician clinical evaluation and reviews of prior workup and diagnostic testing, a binary yes/no phenotype dataset was curated for all patients across all body systems and other developmental / neurodevelopmental categories. This phenotyping was performed by the Medical Geneticist and then entered into the phenotype database. This was done upon the patient’s initial presentation to clinic before results from genetic testing had returned. The database was created in Excel format, and data were entered by genetic counsellors after the patient had been evaluated in clinic. The database was subsequently updated with results of genetic testing when available. The clinical system phenotypes assessed for abnormalities were: ear/nose/throat (Oto), ophthalmologic, neuromuscular, cardiac, pulmonary, gastrointestinal, renal, skeletal/connective tissue/vascular, skin/hair/teeth, endocrine, hematologic/immunologic (hem/imm), disorders of sexual development (DSD)/ambiguous genitalia, metabolic/inborn errors of metabolism (IEM). A number of other non-body system categories were also assessed in a similar binary way: multiple congenital anomalies (MCA), dysmorphic features, cancer, developmental delay, autism spectrum disorder or autism-like features, and any other behavioral phenotype not otherwise specified. In addition to these binary-curated features, all patients had a descriptive phenotypic summary, as well as demographic information (age, sex) and collation of any prior genetic/molecular testing including karyotype, CMA, or other single gene or panel based molecular testing. Each clinical phenotype was assigned its corresponding Human Phenotype Ontology (HPO) term (Supplementary Table 2). All patients included in this study underwent CES as part of their clinical workup, based on physician clinical decision making. All patients were also required to have a separate genetic counselling appointment for pre-test counselling performed by a certified genetic counselor. Clinical exome sequencing was performed in a ‘send-out’ manner, with 424 to GeneDx, 96 to Ambry, 2 to UCLA, and one to Fulgent. Clinical CES results were reported using the ACMG classification scheme; however, for research purposes, we modified reporting for analysis here by collapsing pathogenic and likely pathogenic variants into the same category (pathogenic variants). We have also included genes of uncertain significance (GUS)—i.e. genes whose biologic function is not known or disease association has not been established—as these may be informative for future gene discovery research. Clinical phenotype data were analyzed by comparing summative analysis of the binary phenotypes. Analysis of variance (ANOVA) was used to compare differences between groups, with p-value < 0.05 considered significant.
Patient 2 in the supplemental info has the same genotype, phenotype, and gender as from PMID: 30689204, so it seems likely that this is the same individual.
4
Case4: Male, 45 years report, 44 years diagnosis, Germany
CasePresentingHPOs:
HPOsFreeText: 6-min walk test at 510 (m)
CaseNotHPOs: HP:0002878 (Respiratory failure)
NotHPOsFreeText: Not wheelchair bound
CaseAddInfo: 0 years on ERT
Exon 2 c.172C>T r.(?) p.(Arg58*) Pathogenic (dominant) — 1 ACO2_000050 5
This variant is mentioned only in reference to a previous publication (PMID: 34056600)
ACO2 614559 2/3 TR20* [34] Intellectual disability, truncal hypotonia, strabismus NM_001098.3:c.336C>G: p.(Ser112Arg) hom Known variant [35], pathogenic, AR
Previously published in PMID 30689204
RRID:SCR_014601
DOI: 10.1038/s42003-026-10750-7
Resource: ggplot2 (RRID:SCR_014601)
Curator: @scibot
SciCrunch record: RRID:SCR_014601
RRID:SCR_022813
DOI: 10.1038/s42003-026-10750-7
Resource: stringr (RRID:SCR_022813)
Curator: @scibot
SciCrunch record: RRID:SCR_022813
RRID:SCR_026117
DOI: 10.1038/s42003-026-10750-7
Resource: data.table (RRID:SCR_026117)
Curator: @scibot
SciCrunch record: RRID:SCR_026117
RRID:SCR_001905
DOI: 10.1038/s42003-026-10750-7
Resource: R Project for Statistical Computing (RRID:SCR_001905)
Curator: @scibot
SciCrunch record: RRID:SCR_001905
RRID:SCR_024826
DOI: 10.1038/s42003-026-10750-7
Resource: patchwork (RRID:SCR_024826)
Curator: @scibot
SciCrunch record: RRID:SCR_024826
RRID:SCR_026470
DOI: 10.1038/s42003-026-10750-7
Resource: ggtext (RRID:SCR_026470)
Curator: @scibot
SciCrunch record: RRID:SCR_026470
RRID:SCR_008394
DOI: 10.1038/s42003-026-10750-7
Resource: Python Programming Language (RRID:SCR_008394)
Curator: @scibot
SciCrunch record: RRID:SCR_008394
RRID:SCR_018315
DOI: 10.1038/s42003-026-10750-7
Resource: Jupyter Notebook (RRID:SCR_018315)
Curator: @scibot
SciCrunch record: RRID:SCR_018315
RRID:SCR_017870
DOI: 10.1038/s41598-026-76779-0
Resource: Northwestern University Mouse Histology and Phenotyping Laboratory Core Facility (RRID:SCR_017870)
Curator: @scibot
SciCrunch record: RRID:SCR_017870
RRID:CVCL_0063
DOI: 10.1038/s41596-026-01454-7
Resource: (RRID:CVCL_0063)
Curator: @scibot
SciCrunch record: RRID:CVCL_0063
RRID:AB_2210370
DOI: 10.1038/s41596-026-01433-y
Resource: (Abcam Cat# ab6046, RRID:AB_2210370)
Curator: @scibot
SciCrunch record: RRID:AB_2210370
RRID:CVCL_0030
DOI: 10.1038/s41596-026-01433-y
Resource: (ICLC Cat# HTL95023, RRID:CVCL_0030)
Curator: @scibot
SciCrunch record: RRID:CVCL_0030
RRID:AB_725655
DOI: 10.1038/s41596-026-01433-y
Resource: (Abcam Cat# ab32370, RRID:AB_725655)
Curator: @scibot
SciCrunch record: RRID:AB_725655
RRID:CVCL_0125
DOI: 10.1038/s41596-026-01433-y
Resource: (ATCC Cat# CRL-2539, RRID:CVCL_0125)
Curator: @scibot
SciCrunch record: RRID:CVCL_0125
RRID:CVCL_0493
DOI: 10.1038/s41596-026-01433-y
Resource: (ATCC Cat# TIB-71, RRID:CVCL_0493)
Curator: @scibot
SciCrunch record: RRID:CVCL_0493
RRID:AB_955447
DOI: 10.1038/s41596-026-01433-y
Resource: (Abcam Cat# ab6721, RRID:AB_955447)
Curator: @scibot
SciCrunch record: RRID:AB_955447
RRID:SCR_017788
DOI: 10.1038/s41594-026-01916-2
Resource: Stanford University Shared FACS Core Facility (RRID:SCR_017788)
Curator: @scibot
SciCrunch record: RRID:SCR_017788
RRID:Addgene_119741
DOI: 10.1038/s41593-026-02491-x
Resource: RRID:Addgene_119741
Curator: @scibot
SciCrunch record: RRID:Addgene_119741
RRID:SCR_023772
DOI: 10.1038/s41591-026-04721-y
Resource: Akoya PhenoImager (RRID:SCR_023772)
Curator: @scibot
SciCrunch record: RRID:SCR_023772
RRID:SCR_008567
DOI: 10.1038/s41591-026-04721-y
Resource: Statistical Analysis System (RRID:SCR_008567)
Curator: @scibot
SciCrunch record: RRID:SCR_008567
RRID:SCR_019155
DOI: 10.1038/s41591-026-04721-y
Resource: inForm (RRID:SCR_019155)
Curator: @scibot
SciCrunch record: RRID:SCR_019155
RRID:CVCL_6910
DOI: 10.1038/s41589-026-02359-y
Resource: (RRID:CVCL_6910)
Curator: @scibot
SciCrunch record: RRID:CVCL_6910
RRID:SCR_018206
DOI: 10.1038/s41586-026-11181-4
Resource: University of California San Francisco Parnassus Flow Cytometry Core Facility (RRID:SCR_018206)
Curator: @scibot
SciCrunch record: RRID:SCR_018206
JAX:008863
DOI: 10.1038/s41564-026-02521-1
Resource: RRID:IMSR_JAX:008863
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:008863
RRID:IMSR_JAX:004781
DOI: 10.1038/s41564-026-02521-1
Resource: (IMSR Cat# JAX_004781,RRID:IMSR_JAX:004781)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:004781
RRID:IMSR_JAX:019099
DOI: 10.1038/s41564-026-02521-1
Resource: (IMSR Cat# JAX_019099,RRID:IMSR_JAX:019099)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:019099
RRID:IMSR_JAX:032410
DOI: 10.1038/s41564-026-02521-1
Resource: (IMSR Cat# JAX_032410,RRID:IMSR_JAX:032410)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:032410
RRID:IMSR_JAX:022071
DOI: 10.1038/s41564-026-02521-1
Resource: (IMSR Cat# JAX_022071,RRID:IMSR_JAX:022071)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:022071
A p.Ser112Arg missense mutation was first identified in 2 families with infantile cerebellar-retinal degeneration.28 Affected individuals exhibited developmental delay including severe psychomotor retardation, with an age at onset between 2 and 6 months. Brain MRI revealed cerebellar degeneration and white matter abnormalities (dysmyelination). Optic atrophy and retinal degeneration were readily identifiable in the setting of progressively severe visual impairment. Mitochondrial aconitase enzymatic activity was significantly reduced in lymphoblasts.
This variant is mentioned only in reference to a previous report.
RRID:SCR_017697
DOI: 10.1038/s41556-026-02097-2
Resource: McGill University Advanced BioImaging Core Facility (RRID:SCR_017697)
Curator: @scibot
SciCrunch record: RRID:SCR_017697
RRID:MMRRC_046712-UCD
DOI: 10.1038/s41556-026-02096-3
Resource: RRID:MMRRC_046712-UCD
Curator: @scibot
SciCrunch record: RRID:MMRRC_046712-UCD
RRID:Addgene_54563
DOI: 10.1038/s41556-026-02096-3
Resource: RRID:Addgene_54563
Curator: @scibot
SciCrunch record: RRID:Addgene_54563
RRID:Addgene_26475
DOI: 10.1038/s41556-026-02096-3
Resource: RRID:Addgene_26475
Curator: @scibot
SciCrunch record: RRID:Addgene_26475
athogenic variants in mitochondrial aconitase were originally described in two families of Middle Eastern descent. The resulting defects in ACO2 activity were associated with a relatively severe clinical course that included optic and cerebellar atrophy associated with hearing loss and severe to profound developmental delay (8). Subsequent to that original report (preceding the results on our patient), Metodiev et al. described an additional five subjects in three families (two consanguineous) from France and Algeria with other ACO2 pathogenic variants (9). In that cohort, although the core symptoms of ataxia, optic nerve involvement and developmental delay were again noted, the severity of the associated symptoms varied widely. Our report therefore serves to further expand the phenotype associated with ACO2 deficiency in a similar manner – our patient falls outside of the ethnic groups so far described, and did not have evidence of cerebellar atrophy on MRI or of significant optic nerve involvement at the time of evaluation. However, the aconitase activity is within the range of previously reported patient’s with infantile cerebellar-retinal degeneration syndrome, and the ACO2 protein activity is similar to at least one other patient (Figure 5).
This variant is only mentioned in reference to a previous report.
RRID:CVCL_1685
DOI: 10.1038/s41368-026-00467-y
Resource: (ATCC Cat# CRL-1629, RRID:CVCL_1685)
Curator: @scibot
SciCrunch record: RRID:CVCL_1685
CVCL_1107
DOI: 10.1038/s41368-026-00467-y
Resource: (BCRJ Cat# 0326, RRID:CVCL_1107)
Curator: @scibot
SciCrunch record: RRID:CVCL_1107
RRID:CVCL_0063
DOI: 10.1038/s41368-026-00467-y
Resource: (RRID:CVCL_0063)
Curator: @scibot
SciCrunch record: RRID:CVCL_0063
RRID:CVCL_1681
DOI: 10.1038/s41368-026-00467-y
Resource: (ATCC Cat# CRL-1623, RRID:CVCL_1681)
Curator: @scibot
SciCrunch record: RRID:CVCL_1681
RRID:CVCL_1682
DOI: 10.1038/s41368-026-00467-y
Resource: (BCRC Cat# 60516, RRID:CVCL_1682)
Curator: @scibot
SciCrunch record: RRID:CVCL_1682
RRID:SCR_027587
DOI: 10.1021/jasms.6c00325
Resource: RRID:SCR_027587
Curator: @scibot
SciCrunch record: RRID:SCR_027587
RRID:SCR_026360
DOI: 10.1021/jacs.6c14729
Resource: Northwestern University Keck Interdisciplinary Surface Science Core Facility (RRID:SCR_026360)
Curator: @scibot
SciCrunch record: RRID:SCR_026360
RRID:SCR_026361
DOI: 10.1021/jacs.6c14729
Resource: Northwestern University Electron Probe Instrumentation Center EPIC Core Facility (RRID:SCR_026361)
Curator: @scibot
SciCrunch record: RRID:SCR_026361
RRID:SCR_017773
DOI: 10.1021/jacs.6c14729
Resource: RRID:SCR_017773
Curator: @scibot
SciCrunch record: RRID:SCR_017773
RRID:SCR_026695
DOI: 10.1021/jacs.6c11841
Resource: nano@stanford (RRID:SCR_026695)
Curator: @scibot
SciCrunch record: RRID:SCR_026695
RRID:SCR_026324
DOI: 10.1021/jacs.6c11513
Resource: Montana State University Cryo-EM Core Facility (RRID:SCR_026324)
Curator: @scibot
SciCrunch record: RRID:SCR_026324
RRID:SCR_012482
DOI: 10.1021/jacs.6c11513
Resource: Montana State University Mass Spectrometry Core Facility (RRID:SCR_012482)
Curator: @scibot
SciCrunch record: RRID:SCR_012482
RRID:SCR_017773
DOI: 10.1021/acsptsci.6c00191
Resource: RRID:SCR_017773
Curator: @scibot
SciCrunch record: RRID:SCR_017773
RRID:SCR_022687
DOI: 10.1021/acs.langmuir.6c04797
Resource: Purdue Electron Microscopy Center (RRID:SCR_022687)
Curator: @scibot
SciCrunch record: RRID:SCR_022687
RRID:SCR_026360
DOI: 10.1021/acs.chemmater.6c02075
Resource: Northwestern University Keck Interdisciplinary Surface Science Core Facility (RRID:SCR_026360)
Curator: @scibot
SciCrunch record: RRID:SCR_026360
RRID:SCR_022884
DOI: 10.1021/acsapm.6c03447
Resource: University of Arizona W.M. Keck Center for Nano Scale Imaging Core Facility (RRID:SCR_022884)
Curator: @scibot
SciCrunch record: RRID:SCR_022884
SCR_021713
DOI: 10.1016/j.yhbeh.2026.106016
Resource: University of Texas at Austin Genomic Sequencing and Analysis Core Facility (RRID:SCR_021713)
Curator: @scibot
SciCrunch record: RRID:SCR_021713
RRID:AB_2797933
DOI: 10.1016/j.yexmp.2026.105095
Resource: (Cell Signaling Technology Cat# 12480, RRID:AB_2797933)
Curator: @scibot
SciCrunch record: RRID:AB_2797933
RRID:AB_2888320
DOI: 10.1016/j.yexmp.2026.105095
Resource: (GeneTex Cat# GTX632602, RRID:AB_2888320)
Curator: @scibot
SciCrunch record: RRID:AB_2888320
RRID:SCR_011036
DOI: 10.1016/j.yexmp.2026.105095
Resource: RRID:SCR_011036
Curator: @scibot
SciCrunch record: RRID:SCR_011036
RRID:CVCL_0302
DOI: 10.1016/j.yexmp.2026.105095
Resource: (KCLB Cat# 22190, RRID:CVCL_0302)
Curator: @scibot
SciCrunch record: RRID:CVCL_0302
RRID:CVCL_0063
DOI: 10.1016/j.yexmp.2026.105095
Resource: (RRID:CVCL_0063)
Curator: @scibot
SciCrunch record: RRID:CVCL_0063
RRID:SCR_022642
DOI: 10.1016/j.ydbio.2026.10.013
Resource: Cincinnati Children's Hospital Transgenic Animal and Genome Editing Core Facility (RRID:SCR_022642)
Curator: @scibot
SciCrunch record: RRID:SCR_022642
RRID:SCR_006809
DOI: 10.1016/j.xgen.2026.101398
Resource: G:Profiler (RRID:SCR_006809)
Curator: @scibot
SciCrunch record: RRID:SCR_006809
RRID:SCR_005227
DOI: 10.1016/j.xgen.2026.101398
Resource: SAMtools/BCFtools (RRID:SCR_005227)
Curator: @scibot
SciCrunch record: RRID:SCR_005227
RRID:SCR_005780
DOI: 10.1016/j.xgen.2026.101398
Resource: UCSC Genome Browser (RRID:SCR_005780)
Curator: @scibot
SciCrunch record: RRID:SCR_005780
RRID:SCR_016739
DOI: 10.1016/j.xgen.2026.101398
Resource: PrediXcan (RRID:SCR_016739)
Curator: @scibot
SciCrunch record: RRID:SCR_016739
RRID:SCR_005223
DOI: 10.1016/j.xgen.2026.101398
Resource: STRING (RRID:SCR_005223)
Curator: @scibot
SciCrunch record: RRID:SCR_005223
RRID:SCR_024805
DOI: 10.1016/j.xgen.2026.101398
Resource: Enformer (RRID:SCR_024805)
Curator: @scibot
SciCrunch record: RRID:SCR_024805
RRID:SCR_006828
DOI: 10.1016/j.xgen.2026.101398
Resource: 1000 Genomes: A Deep Catalog of Human Genetic Variation (RRID:SCR_006828)
Curator: @scibot
SciCrunch record: RRID:SCR_006828
RRID:SCR_010881
DOI: 10.1016/j.xgen.2026.101398
Resource: HOMER (RRID:SCR_010881)
Curator: @scibot
SciCrunch record: RRID:SCR_010881
RRID:SCR_000242
DOI: 10.1016/j.xgen.2026.101398
Resource: Galaxy Cistrome (RRID:SCR_000242)
Curator: @scibot
SciCrunch record: RRID:SCR_000242
RRID:SCR_018160
DOI: 10.1016/j.xgen.2026.101398
Resource: liftOver (RRID:SCR_018160)
Curator: @scibot
SciCrunch record: RRID:SCR_018160
RRID:SCR_017579
DOI: 10.1016/j.xgen.2026.101398
Resource: Michigan Imputation Server (RRID:SCR_017579)
Curator: @scibot
SciCrunch record: RRID:SCR_017579
BL168
DOI: 10.1016/j.xcrm.2026.103127
Resource: RRID:BDSC_168
Curator: @scibot
SciCrunch record: RRID:BDSC_168
RRID:AB_467256
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Thermo Fisher Scientific Cat# 14-0452-86, RRID:AB_467256)
Curator: @scibot
SciCrunch record: RRID:AB_467256
RRID:AB_2889890
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Abcam Cat# ab263899, RRID:AB_2889890)
Curator: @scibot
SciCrunch record: RRID:AB_2889890
RRID:IMSR_JAX:005557
DOI: 10.1016/j.xcrm.2026.103127
Resource: (IMSR Cat# JAX_005557,RRID:IMSR_JAX:005557)
Curator: @scibot
SciCrunch record: RRID:IMSR_JAX:005557
RRID:AB_331692
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Cell Signaling Technology Cat# 9452, RRID:AB_331692)
Curator: @scibot
SciCrunch record: RRID:AB_331692
RRID:AB_2794426
DOI: 10.1016/j.xcrm.2026.103127
Resource: (SouthernBiotech Cat# 1071-05, RRID:AB_2794426)
Curator: @scibot
SciCrunch record: RRID:AB_2794426
RRID:AB_560835
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Cell Signaling Technology Cat# 2855, RRID:AB_560835)
Curator: @scibot
SciCrunch record: RRID:AB_560835
RRID:AB_315009
DOI: 10.1016/j.xcrm.2026.103127
Resource: (BioLegend Cat# 405306, RRID:AB_315009)
Curator: @scibot
SciCrunch record: RRID:AB_315009
RRID:AB_331676
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Cell Signaling Technology Cat# 9202, RRID:AB_331676)
Curator: @scibot
SciCrunch record: RRID:AB_331676
RRID:AB_3083002
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Easybio Cat# BE0101 (also BE0101-100), RRID:AB_3083002)
Curator: @scibot
SciCrunch record: RRID:AB_3083002
RRID:AB_2269803
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Cell Signaling Technology Cat# 9234, RRID:AB_2269803)
Curator: @scibot
SciCrunch record: RRID:AB_2269803
RRID:AB_2737588
DOI: 10.1016/j.xcrm.2026.103127
Resource: (Proteintech Cat# HRP-60004, RRID:AB_2737588)
Curator: @scibot
SciCrunch record: RRID:AB_2737588
RRID:AB_10901166
DOI: 10.1016/j.xcrm.2026.103127
Resource: (BioLegend Cat# 141704, RRID:AB_10901166)
Curator: @scibot
SciCrunch record: RRID:AB_10901166
RRID:AB_2632899
DOI: 10.1016/j.xcrm.2026.103127
Resource: (BioLegend Cat# 152604, RRID:AB_2632899)
Curator: @scibot
SciCrunch record: RRID:AB_2632899
RRID:AB_2561697
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The differential diagnosis of neurodegenerative disorders with atrophy of the cerebral and cerebellar cortex and cerebellar vermis is broad even in young age groups; concomitant occurrence of degeneration of the retina points to lysosomal storage disorders, mitochondrial disorders, defects of carbohydrate glycosylation, and infantile neuroaxonal dystrophy.1–4 We hereby report on the identification of a tricarboxylic acid (TCA) cycle defect manifesting in infancy by the degeneration of the cerebrum, cerebellum, and retina. The subjects of this study were eight individuals, two males and six females, originating from two unrelated families of Arab Muslim origin (Figure 1). Their clinical data are summarized in Table 1. All were born following an uneventful pregnancy and delivery and had normal birth weights, head circumferences, and Apgar scores. Symptoms were first noted at 2–6 months of age and included variable appearance of truncal hyptonia, head bobbing, athetosis, generalized seizures, and ophthalmologic abnormalities that included strabismus, nystagmus, abnormal eye movements, and abnormal pursuit. The course was characterized by failure to thrive, gradual evolution of severe muscle wasting despite satisfactory oral intake, worsening of the hypotonia, attenuating deep tendon reflexes until complete areflexia was reached, progressive microcephaly, variable forms of seizures that were typically triggered by intercurrent febrile illnesses and were partly responsive to anticonvulsants, and failure to gain developmental milestones, culminating in profound psychomotor retardation. A distinctive feature was the appearance of head bobbing and athetoid movements of the upper limbs along with horizontal nystagmus when the individuals were held at the upright position. Visual tracking, normal at the newborn period, steadily deteriorated with the gradual evolution of bilateral optic atrophy. Visual evoked potentials in early infancy were normal, but the electroretinogram responses became critically reduced over the first two years of life, indicating severe retinal dystrophy. Similarly, auditory brain responses declined steadily, reflecting sensorineural hearing loss of variable severity. EEG disclosed generalized or focal spike and wave activity and slow background compatible with nonspecific encephalopathy. Electrophysiologic assessment of peripheral muscles and nerves performed in individual V-2 at 2 years revealed a normal electromyogram and a mild decrease of peripheral sensory and motor velocity suggesting demyelination. Taken together with the gradual disappearance of tendon reflexes, this finding indicates an evolving peripheral demyelinating neuropathy. Figure 1. Open in a new tab Pedigrees of the Two Families (A) Family A and (B) Family B. Affected individuals are represented by filled symbols.Table 1. Clinical Features of Affected Individuals Family A Family B IV-3 IV-5 V-2 V-5 V-7 III-1 III-2 III-3 Sex m f f f m f f f Current age (years) 18 13 7 3 0.5 9 8 2 Birth weight (centile) 2,900 g (10) 3,700 g (75) 2,700 g (10) 2,800 g (15) 3,700 g (75) 3,220 g (25) 3,450 g (50) 2,750 g (10) Birth head circumference (centile) 35 cm (40) 35 cm (50) 35 cm (50) 34 cm (25) 35 cm (40) 34.5 cm (40) 35 cm (50) 34 cm (25) Initial manifestations (age at presentation) H, A (5 months) H, A (6 months) H, A (2 months) H, E (4 months) H, E (3 months) H, S (3 months) A, H (5 months) A, E (5 months) Current weight (centile) 25 kg (−5 SD) 26 kg (−4 SD) 11 kg (−5 SD) 9 kg (−4 SD) 7.7 kg (25) 13 kg (−6 SD) 12 kg (−6 SD) 8 kg (−4 SD) Current head circumference (centile) 47 cm (−5 SD) 49.5 cm (−3 SD) 46.5 cm (−3.5 SD) 46.5 cm (5) 42.7 cm (25) 48.5 cm (−2.5 SD) 48 cm (3) 45.5 cm (5) Global DD/MR profound severe profound profound moderate profound profound severe Current motor skills no intentional movements crawls, rolls sits with support does not roll rolls, does not sit lift head when supine does not role does not role roles both sides Current cognitive skills vegetative state, no smile smile, recognize family smile, recognize family smile, recognize family smile, recognize family no eye contact, does not recognize family no eye contact, responds to auditory stimuli smile, recognize family Ataxia yes yes yes yes very mild yes yes yes Seizures generalized generalized focal and generalized focal and generalized no generalized myoclonic and focal focal and generalized no Retinal dystrophy (age at diagnosis) not evaluated severe (4 years) severe (1 year) severe (1 year) not evaluated profound (2 years) profound (1.5 years) moderate (1.5 years) ophthalmology optic atrophy, strabismus optic atrophy, strabismus optic atrophy, nystagmus optic atrophy, nystagmus, strabismus strabismus optic atrophy, nystagmus optic atrophy, nystagmus optic atrophy, nystagmus, strabismus Initial MR scan (age) not done normal (11 months) mild CoA (3 months) mild CoA (frontal and temporal) (11 months) normal (in utero, 30 weeks) CoA (frontal and temporal) mild thinning of CC (7 months) CoA abnormal WM (16 months) normal (in utero, 31 weeks) Last MR scan (age) not done severe CeA, moderate CoA (frontal and temporal), abnormal periventricular WM signal (12 years) severe CeA, moderate CoA (frontal and temporal), thin CC abnormal WM signal (4 years) severe CeA, moderate CoA (frontal and temporal), thin CC, abnormal WM signal (2.5 years) not done not done mild CoA and CeA (1y) Tendon reflexes absent brisk absent absent normal absent decreased absent Other severe scoliosis moderate SNHL severe SNHL (hearing aids) Open in a new tab The following abbreviations are used: A, ataxia/athetoid movements; H, hypotonia; E, eye abnormalities; S, seizures; HC, head circumference; DD, developmental delay; MR, mental retardation; CoA, cortical atrophy; CeA, cerebellar atrophy; WM, white matter; CC, corpus callosum; SNHL, sensorineural hearing loss.During gestation and throughout the first 6 months, brain MRI was typically normal. Thereafter, repeated MR scans (Figure 2) displayed progressive cerebellar atrophy of both hemispheres and the vermis. In addition, symmetric cortical atrophy gradually evolved, affecting mainly the frontal and temporal lobes along with a striking thinning of the corpus callosum. White matter abnormalities, indicated by T2 and fluid-attenuated inversion recovery (FLAIR) periventricular hyperintense signals, were first noted during the second year of life. Taken together, these serial MR scans revealed generalized progressive brain atrophy affecting primarily the cerebellum and to a lesser extent the white matter and the frontal and parietal lobes of the cerebral cortex. Figure 2. Open in a new tab Representative MRI Findings (A) T2-weighted, coronal section image of individual V-2 at 3 months shows a normal cerebellum and mild cortical atrophy. (B) T1-weighted, coronal section scan of the same individual at 4 years displays severe atrophy of the cerebellar hemispheres (arrowheads) and the vermis (arrows). (C) T1-weighted, coronal section image of individual IV-5 at 12 years shows enlarged cerebellar folia and reduced volume indicating generalized (vermian and hemispheral) atrophy. Note also the mild cortical atrophy and visible sulci. (D) Cortical atrophy and white matter abnormal signals (arrows) demonstrated by FLAIR image of coronal section in the same individual. (E) Moderate cortical atrophy, very thin corpus callosum (arrow), and cerebellar atrophy (arrowhead) in a T1-weighted, sagital section of individual V-5 at 2.5 years. (F) FLAIR image, axial section of individual V-5 displaying frontal and temporal cortical atrophy compared with relatively preserved occipital cortex. The abnormal periventricular white matter signal (arrow) is consistent with dysmyelination.
Case#: Spiegel Patient V-2 (proband not designated, so was chosen), female, 7yo at report, Arab Muslin origin
DiseaseAssertion: Infantile Cerebellar-Retinal Degeneration
FamilyInfo: All eight individuals were homozygous for the mutation; ten parents and one of the healthy sibs were heterozygous, and three healthy sibs were homozygous for the normal allele. 3 additional affected individuals are deceased, so it is possible that they were not genotyped and that may be the reason for the discrepancy in the count.
CasePresentingHPOs: HP:0000648, HP:0000639, HP:0012736, HP:0001252, HP:0001251, HP:0002194, HP:0100543, HP:0007359, HP:0002197, HP:0000556, HP:0002120, HP:0001272, HP:0033725, HP:0002500, HP:0001284, HP:0000407
CaseHPOFreeText: birth weight= 2,700 g (10th centile); birth head circumference= 35 cm (50th centile); initial manifestations: hypotonia and ataxia at 2 months; current weight= 11 kg (−5 SD); current head circumference= 46.5 cm (−3.5 SD); current motor skills= does not roll; current cognitive skills= smile, recognize family; focal and generalized seizures; severe retinal dystrophy dx at 1yo; mild cortical atrophy on MR scan at 3mo; severe cerebellar atrophy, moderate cortical atrophy (frontal and temporal), thin corpus callosum, abnormal white matter signal last MR scan at 4 yo; moderate sensorineural hearing loss
CaseNotHPOs:
CaseNotHPOFreeText:
GenotypingMethod: homozygosity mapping, WES
PreviouslyPublished: n/a
Variant: c.336C>G in ACO2 [MIM 100850] (NM_001098.2), which causes p.Ser112Arg (NP_001089.1). homozygous
ClinVar: 29584
FunctionalEvidence: Specific aconitase activity in the individuals' lymphoblasts was severely reduced. Under restrictive conditions, the mutant human ACO2 failed to complement a yeast ACO1 deletion strain, whereas the wild-type human ACO2 succeeded,
AdditionalInfo: 2 "unrelated" families reported, but "Affected individuals of both unrelated clans shared a similar homozygous haplotype, indicating that Ser112Arg is a founder mutation in this population" so will count the segregations as one family
SupplementalData: n/a