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Using VAAST to identify an X-linked disorder resulting in lethality in male infants due to N-terminal acetyltransferase deficiency.

We have identified two families with a previously undescribed lethal X-linked disorder of infancy; the disorder comprises a distinct combination of an aged appearance, craniofacial anomalies, hypotonia, global developmental delays, cryptorchidism, and cardiac arrhythmias. Using X chromosome exon sequencing and a recently developed probabilistic algorithm aimed at discovering disease-causing variants, we identified in one family a c.109T>C (p.Ser37Pro) variant in NAA10, a gene encoding the catalytic subunit of the major human N-terminal acetyltransferase (NAT). A parallel effort on a second unrelated family converged on the same variant. The absence of this variant in controls, the amino acid conservation of this region of the protein, the predicted disruptive change, and the co-occurrence in two unrelated families with the same rare disorder suggest that this is the pathogenic mutation. We confirmed this by demonstrating a significantly impaired biochemical activity of the mutant hNaa10p, and from this we conclude that a reduction in acetylation by hNaa10p causes this disease. Here we provide evidence of a human genetic disorder resulting from direct impairment of N-terminal acetylation, one of the most common protein modifications in humans.

Pubmed ID: 21700266


  • Rope AF
  • Wang K
  • Evjenth R
  • Xing J
  • Johnston JJ
  • Swensen JJ
  • Johnson WE
  • Moore B
  • Huff CD
  • Bird LM
  • Carey JC
  • Opitz JM
  • Stevens CA
  • Jiang T
  • Schank C
  • Fain HD
  • Robison R
  • Dalley B
  • Chin S
  • South ST
  • Pysher TJ
  • Jorde LB
  • Hakonarson H
  • Lillehaug JR
  • Biesecker LG
  • Yandell M
  • Arnesen T
  • Lyon GJ


American journal of human genetics

Publication Data

July 15, 2011

Associated Grants

  • Agency: NHGRI NIH HHS, Id: 1RC2HG005619
  • Agency: NHGRI NIH HHS, Id: 5R01HG5692
  • Agency: NHGRI NIH HHS, Id: K99HG005846
  • Agency: NCI NIH HHS, Id: P30CA042014
  • Agency: NHGRI NIH HHS, Id: R01 HG005692
  • Agency: NHGRI NIH HHS, Id: R01 HG005692-02
  • Agency: NHGRI NIH HHS, Id: R44 HG006579
  • Agency: NCRR NIH HHS, Id: UL1 RR025774
  • Agency: NCRR NIH HHS, Id: UL1RR025764

Mesh Terms

  • Acetylation
  • Acetyltransferases
  • Chromosomes, Human, X
  • Exons
  • Genes, X-Linked
  • Haplotypes
  • Humans
  • Infant, Newborn
  • Male
  • Mutation
  • N-Terminal Acetyltransferase A
  • N-Terminal Acetyltransferase E
  • Pedigree
  • Phenotype