Aminoacyl-Trna Synthetase Deficiencies in Search of Common Themes
© American College of Medical Genetics and Genomics ARTICLE Aminoacyl-tRNA synthetase deficiencies in search of common themes Sabine A. Fuchs, MD, PhD1, Imre F. Schene, MD1, Gautam Kok, BSc1, Jurriaan M. Jansen, MSc1, Peter G. J. Nikkels, MD, PhD2, Koen L. I. van Gassen, PhD3, Suzanne W. J. Terheggen-Lagro, MD, PhD4, Saskia N. van der Crabben, MD, PhD5, Sanne E. Hoeks, MD6, Laetitia E. M. Niers, MD, PhD7, Nicole I. Wolf, MD, PhD8, Maaike C. de Vries, MD9, David A. Koolen, MD, PhD10, Roderick H. J. Houwen, MD, PhD11, Margot F. Mulder, MD, PhD12 and Peter M. van Hasselt, MD, PhD1 Purpose: Pathogenic variations in genes encoding aminoacyl- with unreported compound heterozygous pathogenic variations in tRNA synthetases (ARSs) are increasingly associated with human IARS, LARS, KARS, and QARS extended the common phenotype disease. Clinical features of autosomal recessive ARS deficiencies with lung disease, hypoalbuminemia, anemia, and renal tubulo- appear very diverse and without apparent logic. We searched for pathy. common clinical patterns to improve disease recognition, insight Conclusion: We propose a common clinical phenotype for recessive into pathophysiology, and clinical care. ARS deficiencies, resulting from insufficient aminoacylation activity Methods: Symptoms were analyzed in all patients with recessive to meet translational demand in specific organs or periods of life. ARS deficiencies reported in literature, supplemented with Assuming residual ARS activity, adequate protein/amino acid supply unreported patients evaluated in our hospital. seems essential instead of the traditional replacement of protein by Results: In literature, we identified 107 patients with AARS, glucose in patients with metabolic diseases. DARS, GARS, HARS, IARS, KARS, LARS, MARS, RARS, SARS, VARS, YARS, and QARS deficiencies.
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