nih-gov/www.ncbi.nlm.nih.gov/omim/610956

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<title>
Entry
- *610956 - ASPARTYL-tRNA SYNTHETASE 2; DARS2
- OMIM
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<span class="h4">*610956</span>
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<strong>Table of Contents</strong>
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<a href="#cloning">Cloning and Expression</a>
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<a href="#geneFunction">Gene Function</a>
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<a href="#geneStructure">Gene Structure</a>
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<a href="#mapping">Mapping</a>
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<a href="#molecularGenetics">Molecular Genetics</a>
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<a href="#animalModel">Animal Model</a>
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<span id="mimProteinLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5">&#9658;</span> Protein
</a>
</span>
</span>
</div>
<div id="mimProteinLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://hprd.org/summary?hprd_id=07677&isoform_id=07677_1&isoform_name=Isoform_1" class="mim-tip-hint" title="The Human Protein Reference Database; manually extracted and visually depicted information on human proteins." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HPRD', 'domain': 'hprd.org'})">HPRD</a></div>
<div><a href="https://www.proteinatlas.org/search/DARS2" class="mim-tip-hint" title="The Human Protein Atlas contains information for a large majority of all human protein-coding genes regarding the expression and localization of the corresponding proteins based on both RNA and protein data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HumanProteinAtlas', 'domain': 'proteinatlas.org'})">Human Protein Atlas</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/protein/7022598,10434343,34783643,40789249,74758347,119611366,119611367,119611368,158255182,1443145686,1443145690" class="mim-tip-hint" title="NCBI protein data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Protein', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Protein</a></div>
<div><a href="https://www.uniprot.org/uniprotkb/Q6PI48" class="mim-tip-hint" title="Comprehensive protein sequence and functional information, including supporting data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UniProt', 'domain': 'uniprot.org'})">UniProt</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimGeneInfo">
<span class="panel-title">
<span class="small">
<a href="#mimGeneInfoLinksFold" id="mimGeneInfoLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<div style="display: table-row">
<div id="mimGeneInfoLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Gene Info</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimGeneInfoLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="http://biogps.org/#goto=genereport&id=55157" class="mim-tip-hint" title="The Gene Portal Hub; customizable portal of gene and protein function information." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'BioGPS', 'domain': 'biogps.org'})">BioGPS</a></div>
<div><a href="https://www.ensembl.org/Homo_sapiens/Gene/Summary?db=core;g=ENSG00000117593;t=ENST00000649689" class="mim-tip-hint" title="Orthologs, paralogs, regulatory regions, and splice variants." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Ensembl', 'domain': 'ensembl.org'})">Ensembl</a></div>
<div><a href="https://www.genecards.org/cgi-bin/carddisp.pl?gene=DARS2" class="mim-tip-hint" title="The Human Genome Compendium; web-based cards integrating automatically mined information on human genes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GeneCards', 'domain': 'genecards.org'})">GeneCards</a></div>
<div><a href="http://amigo.geneontology.org/amigo/search/annotation?q=DARS2" class="mim-tip-hint" title="Terms, defined using controlled vocabulary, representing gene product properties (biologic process, cellular component, molecular function) across species." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GeneOntology', 'domain': 'amigo.geneontology.org'})">Gene Ontology</a></div>
<div><a href="https://www.genome.jp/dbget-bin/www_bget?hsa+55157" class="mim-tip-hint" title="Kyoto Encyclopedia of Genes and Genomes; diagrams of signaling pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'KEGG', 'domain': 'genome.jp'})">KEGG</a></div>
<dd><a href="http://v1.marrvel.org/search/gene/DARS2" class="mim-tip-hint" title="Model organism Aggregated Resources for Rare Variant ExpLoration." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MARRVEL', 'domain': 'marrvel.org'})">MARRVEL</a></dd>
<dd><a href="https://monarchinitiative.org/NCBIGene:55157" class="mim-tip-hint" title="Monarch Initiative." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Monarch', 'domain': 'monarchinitiative.org'})">Monarch</a></dd>
<div><a href="https://www.ncbi.nlm.nih.gov/gene/55157" class="mim-tip-hint" title="Gene-specific map, sequence, expression, structure, function, citation, and homology data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Gene', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Gene</a></div>
<div><a href="https://genome.ucsc.edu/cgi-bin/hgGene?db=hg38&hgg_chrom=chr1&hgg_gene=ENST00000649689.2&hgg_start=173824673&hgg_end=173858546&hgg_type=knownGene" class="mim-tip-hint" title="UCSC Genome Bioinformatics; gene-specific structure and function information with links to other databases." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UCSC', 'domain': 'genome.ucsc.edu'})">UCSC</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimClinicalResources">
<span class="panel-title">
<span class="small">
<a href="#mimClinicalResourcesLinksFold" id="mimClinicalResourcesLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<div style="display: table-row">
<div id="mimClinicalResourcesLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Clinical Resources</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimClinicalResourcesLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel" aria-labelledby="clinicalResources">
<div class="panel-body small mim-panel-body">
<div><a href="https://search.clinicalgenome.org/kb/gene-dosage/HGNC:25538" class="mim-tip-hint" title="A ClinGen curated resource of genes and regions of the genome that are dosage sensitive and should be targeted on a cytogenomic array." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinGen Dosage', 'domain': 'dosage.clinicalgenome.org'})">ClinGen Dosage</a></div>
<div><a href="https://search.clinicalgenome.org/kb/genes/HGNC:25538" class="mim-tip-hint" title="A ClinGen curated resource of ratings for the strength of evidence supporting or refuting the clinical validity of the claim(s) that variation in a particular gene causes disease." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinGen Validity', 'domain': 'search.clinicalgenome.org'})">ClinGen Validity</a></div>
<div><a href="https://medlineplus.gov/genetics/gene/dars2" class="mim-tip-hint" title="Consumer-friendly information about the effects of genetic variation on human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MedlinePlus Genetics', 'domain': 'medlineplus.gov'})">MedlinePlus Genetics</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/gtr/all/tests/?term=610956[mim]" class="mim-tip-hint" title="Genetic Testing Registry." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GTR', 'domain': 'ncbi.nlm.nih.gov'})">GTR</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimVariation">
<span class="panel-title">
<span class="small">
<a href="#mimVariationLinksFold" id="mimVariationLinksToggle" class=" mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<span id="mimVariationLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5">&#9660;</span> Variation
</a>
</span>
</span>
</div>
<div id="mimVariationLinksFold" class="panel-collapse collapse in mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.ncbi.nlm.nih.gov/clinvar?term=610956[MIM]" class="mim-tip-hint" title="ClinVar aggregates information about sequence variation and its relationship to human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">ClinVar</a></div>
<div><a href="https://gnomad.broadinstitute.org/gene/ENSG00000117593" class="mim-tip-hint" title="The Genome Aggregation Database (gnomAD), Broad Institute." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'gnomAD', 'domain': 'gnomad.broadinstitute.org'})">gnomAD</a></div>
<div><a href="https://www.ebi.ac.uk/gwas/search?query=DARS2" class="mim-tip-hint" title="GWAS Catalog; NHGRI-EBI Catalog of published genome-wide association studies." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GWAS Catalog', 'domain': 'gwascatalog.org'})">GWAS Catalog&nbsp;</a></div>
<div><a href="https://www.gwascentral.org/search?q=DARS2" class="mim-tip-hint" title="GWAS Central; summary level genotype-to-phenotype information from genetic association studies." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GWAS Central', 'domain': 'gwascentral.org'})">GWAS Central&nbsp;</a></div>
<div><a href="http://www.hgmd.cf.ac.uk/ac/gene.php?gene=DARS2" class="mim-tip-hint" title="Human Gene Mutation Database; published mutations causing or associated with human inherited disease; disease-associated/functional polymorphisms." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HGMD', 'domain': 'hgmd.cf.ac.uk'})">HGMD</a></div>
<div><a href="https://evs.gs.washington.edu/EVS/PopStatsServlet?searchBy=Gene+Hugo&target=DARS2&upstreamSize=0&downstreamSize=0&x=0&y=0" class="mim-tip-hint" title="National Heart, Lung, and Blood Institute Exome Variant Server." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NHLBI EVS', 'domain': 'evs.gs.washington.edu'})">NHLBI EVS</a></div>
<div><a href="https://www.pharmgkb.org/gene/PA142672015" class="mim-tip-hint" title="Pharmacogenomics Knowledge Base; curated and annotated information regarding the effects of human genetic variations on drug response." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PharmGKB', 'domain': 'pharmgkb.org'})">PharmGKB</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimAnimalModels">
<span class="panel-title">
<span class="small">
<a href="#mimAnimalModelsLinksFold" id="mimAnimalModelsLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<div style="display: table-row">
<div id="mimAnimalModelsLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Animal Models</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimAnimalModelsLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.alliancegenome.org/gene/HGNC:25538" class="mim-tip-hint" title="Search Across Species; explore model organism and human comparative genomics." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Alliance Genome', 'domain': 'alliancegenome.org'})">Alliance Genome</a></div>
<div><a href="https://flybase.org/reports/FBgn0051739.html" class="mim-tip-hint" title="A Database of Drosophila Genes and Genomes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'FlyBase', 'domain': 'flybase.org'})">FlyBase</a></div>
<div><a href="https://www.mousephenotype.org/data/genes/MGI:2442510" class="mim-tip-hint" title="International Mouse Phenotyping Consortium." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'IMPC', 'domain': 'knockoutmouse.org'})">IMPC</a></div>
<div><a href="http://v1.marrvel.org/search/gene/DARS2#HomologGenesPanel" class="mim-tip-hint" title="Model organism Aggregated Resources for Rare Variant ExpLoration." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MARRVEL', 'domain': 'marrvel.org'})">MARRVEL</a></div>
<div><a href="http://www.informatics.jax.org/marker/MGI:2442510" class="mim-tip-hint" title="Mouse Genome Informatics; international database resource for the laboratory mouse, including integrated genetic, genomic, and biological data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MGI Mouse Gene', 'domain': 'informatics.jax.org'})">MGI Mouse Gene</a></div>
<div><a href="https://www.mmrrc.org/catalog/StrainCatalogSearchForm.php?search_query=" class="mim-tip-hint" title="Mutant Mouse Resource & Research Centers." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MMRRC', 'domain': 'mmrrc.org'})">MMRRC</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/gene/55157/ortholog/" class="mim-tip-hint" title="Orthologous genes at NCBI." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Orthologs', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Orthologs</a></div>
<div><a href="https://www.orthodb.org/?ncbi=55157" class="mim-tip-hint" title="Hierarchical catalogue of orthologs." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'OrthoDB', 'domain': 'orthodb.org'})">OrthoDB</a></div>
<div><a href="https://wormbase.org/db/gene/gene?name=WBGene00001095;class=Gene" class="mim-tip-hint" title="Database of the biology and genome of Caenorhabditis elegans and related nematodes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name'{'name': 'Wormbase Gene', 'domain': 'wormbase.org'})">Wormbase Gene</a></div>
<div><a href="https://zfin.org/ZDB-GENE-070912-443" class="mim-tip-hint" title="The Zebrafish Model Organism Database." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ZFin', 'domain': 'zfin.org'})">ZFin</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimCellularPathways">
<span class="panel-title">
<span class="small">
<a href="#mimCellularPathwaysLinksFold" id="mimCellularPathwaysLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<div style="display: table-row">
<div id="mimCellularPathwaysLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Cellular Pathways</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimCellularPathwaysLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.genome.jp/dbget-bin/get_linkdb?-t+pathway+hsa:55157" class="mim-tip-hint" title="Kyoto Encyclopedia of Genes and Genomes; diagrams of signaling pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'KEGG', 'domain': 'genome.jp'})">KEGG</a></div>
<div><a href="https://reactome.org/content/query?q=DARS2&species=Homo+sapiens&types=Reaction&types=Pathway&cluster=true" class="definition" title="Protein-specific information in the context of relevant cellular pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {{'name': 'Reactome', 'domain': 'reactome.org'}})">Reactome</a></div>
</div>
</div>
</div>
</div>
</div>
</div>
<span>
<span class="mim-tip-bottom" qtip_title="<strong>Looking for this gene or this phenotype in other resources?</strong>" qtip_text="Select a related resource from the dropdown menu and click for a targeted link to information directly relevant.">
&nbsp;
</span>
</span>
</div>
<div class="col-lg-8 col-lg-pull-2 col-md-8 col-md-pull-2 col-sm-8 col-sm-pull-2 col-xs-12">
<div>
<a id="title" class="mim-anchor"></a>
<div>
<a id="number" class="mim-anchor"></a>
<div class="text-right">
<a href="#" class="mim-tip-icd" qtip_title="<strong>ICD+</strong>" qtip_text="
<strong>SNOMEDCT:</strong> 703537008, 735421004<br />
">ICD+</a>
</div>
<div>
<span class="h3">
<span class="mim-font mim-tip-hint" title="Gene description">
<span class="text-danger"><strong>*</strong></span>
610956
</span>
</span>
</div>
</div>
<div>
<a id="preferredTitle" class="mim-anchor"></a>
<h3>
<span class="mim-font">
ASPARTYL-tRNA SYNTHETASE 2; DARS2
</span>
</h3>
</div>
<div>
<br />
</div>
<div>
<a id="alternativeTitles" class="mim-anchor"></a>
<div>
<p>
<span class="mim-font">
<em>Alternative titles; symbols</em>
</span>
</p>
</div>
<div>
<h4>
<span class="mim-font">
ASPARTYL-tRNA SYNTHETASE, MITOCHONDRIAL<br />
MT-ASPRS
</span>
</h4>
</div>
</div>
<div>
<br />
</div>
</div>
<div>
<a id="approvedGeneSymbols" class="mim-anchor"></a>
<p>
<span class="mim-text-font">
<strong><em>HGNC Approved Gene Symbol: <a href="https://www.genenames.org/tools/search/#!/genes?query=DARS2" class="mim-tip-hint" title="HUGO Gene Nomenclature Committee." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HGNC', 'domain': 'genenames.org'})">DARS2</a></em></strong>
</span>
</p>
</div>
<div>
<a id="cytogeneticLocation" class="mim-anchor"></a>
<p>
<span class="mim-text-font">
<strong>
<em>
Cytogenetic location: <a href="/geneMap/1/1438?start=-3&limit=10&highlight=1438">1q25.1</a>
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : <a href="https://genome.ucsc.edu/cgi-bin/hgTracks?db=hg38&position=chr1:173824673-173858546&dgv=pack&knownGene=pack&omimGene=pack" class="mim-tip-hint" title="UCSC Genome Browser; reference sequences and working draft assemblies for a large collection of genomes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UCSC Genome Browser', 'domain': 'genome.ucsc.edu'})">1:173,824,673-173,858,546</a> </span>
</em>
</strong>
<a href="https://www.ncbi.nlm.nih.gov/" target="_blank" class="small"> (from NCBI) </a>
</span>
</p>
</div>
<div>
<br />
</div>
<div>
<a id="geneMap" class="mim-anchor"></a>
<div style="margin-bottom: 10px;">
<span class="h4 mim-font">
<strong>Gene-Phenotype Relationships</strong>
</span>
</div>
<div>
<table class="table table-bordered table-condensed table-hover small mim-table-padding">
<thead>
<tr class="active">
<th>
Location
</th>
<th>
Phenotype
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="1">
<span class="mim-font">
<a href="/geneMap/1/1438?start=-3&limit=10&highlight=1438">
1q25.1
</a>
</span>
</td>
<td>
<span class="mim-font">
Leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/611105"> 611105 </a>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="Autosomal recessive">AR</abbr>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="3 - The molecular basis of the disorder is known">3</abbr>
</span>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div>
<div class="btn-group">
<button type="button" class="btn btn-success dropdown-toggle" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false">
PheneGene Graphics <span class="caret"></span>
</button>
<ul class="dropdown-menu" style="width: 17em;">
<li><a href="/graph/linear/610956" target="_blank" onclick="gtag('event', 'mim_graph', {'destination': 'Linear'})"> Linear </a></li>
<li><a href="/graph/radial/610956" target="_blank" onclick="gtag('event', 'mim_graph', {'destination': 'Radial'})"> Radial </a></li>
</ul>
</div>
<span class="glyphicon glyphicon-question-sign mim-tip-hint" title="OMIM PheneGene graphics depict relationships between phenotypes, groups of related phenotypes (Phenotypic Series), and genes.<br /><a href='/static/omim/pdf/OMIM_Graphics.pdf' target='_blank'>A quick reference overview and guide (PDF)</a>"></span>
<div>
<p />
</div>
</div>
<div>
<br />
</div>
<div>
<a id="text" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<span class="mim-tip-floating" qtip_title="<strong>Looking For More References?</strong>" qtip_text="Click the 'reference plus' icon &lt;span class='glyphicon glyphicon-plus-sign'&gt;&lt;/span&gt at the end of each OMIM text paragraph to see more references related to the content of the preceding paragraph.">
<strong>TEXT</strong>
</span>
</span>
</h4>
<div>
<a id="cloning" class="mim-anchor"></a>
<h4 href="#mimCloningFold" id="mimCloningToggle" class="mimTriangleToggle" style="cursor: pointer;" data-toggle="collapse">
<span id="mimCloningToggleTriangle" class="small mimTextToggleTriangle">&#9660;</span>
<span class="mim-font">
<strong>Cloning and Expression</strong>
</span>
</h4>
</div>
<div id="mimCloningFold" class="collapse in mimTextToggleFold">
<span class="mim-text-font">
<p>By searching a database for tRNA synthetases, <a href="#1" class="mim-tip-reference" title="Bonnefond, L., Fender, A., Rudinger-Thirion, J., Giege, R., Florentz, C., Sissler, M. &lt;strong&gt;Toward the full set of human mitochondrial aminoacyl-tRNA synthetases: characterization of AspRS and TyrRS.&lt;/strong&gt; Biochemistry 44: 4805-4816, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/15779907/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;15779907&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1021/bi047527z&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="15779907">Bonnefond et al. (2005)</a> identified DARS2, which they called MT-ASPRS. The deduced 645-amino acid protein has a 47-amino acid mitochondrial targeting signal, resulting in a mature protein of 598 amino acids. DARS2 contains conserved residues involved in ATP binding, tRNA binding, and aspartic acid recognition, as well as catalytic site motifs characteristic of amino acid tRNA synthetases. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=15779907" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="geneFunction" class="mim-anchor"></a>
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<p><a href="#1" class="mim-tip-reference" title="Bonnefond, L., Fender, A., Rudinger-Thirion, J., Giege, R., Florentz, C., Sissler, M. &lt;strong&gt;Toward the full set of human mitochondrial aminoacyl-tRNA synthetases: characterization of AspRS and TyrRS.&lt;/strong&gt; Biochemistry 44: 4805-4816, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/15779907/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;15779907&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1021/bi047527z&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="15779907">Bonnefond et al. (2005)</a> found that recombinant DARS2 aminoacylated purified E. coli tRNA-asp and in vitro transcribed human mitochondrial tRNA-asp (MTTD; <a href="/entry/590015">590015</a>). Gel-filtration chromatography showed that recombinant DARS2 formed dimers. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=15779907" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="geneStructure" class="mim-anchor"></a>
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<strong>Gene Structure</strong>
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<p><a href="#1" class="mim-tip-reference" title="Bonnefond, L., Fender, A., Rudinger-Thirion, J., Giege, R., Florentz, C., Sissler, M. &lt;strong&gt;Toward the full set of human mitochondrial aminoacyl-tRNA synthetases: characterization of AspRS and TyrRS.&lt;/strong&gt; Biochemistry 44: 4805-4816, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/15779907/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;15779907&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1021/bi047527z&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="15779907">Bonnefond et al. (2005)</a> determined that the DARS2 gene contains 17 exons and spans 32.5 kb. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=15779907" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="mapping" class="mim-anchor"></a>
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<strong>Mapping</strong>
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<p><a href="#6" class="mim-tip-reference" title="Stumpf, A. M. &lt;strong&gt;Personal Communication.&lt;/strong&gt; Baltimore, Md. 08/30/2022."None>Stumpf (2022)</a> mapped the DARS2 gene to chromosome 1q25.1 based on an alignment of the DARS2 sequence (GenBank <a href="https://www.ncbi.nlm.nih.gov/search/all/?term=BC045173" target="_blank" onclick="gtag(\'event\', \'mim_outbound\', {\'name\': \'GENBANK\', \'domain\': \'ncbi.nlm.nih.gov\'})">BC045173</a>) with the genomic sequence (GRCh38).</p>
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<a id="molecularGenetics" class="mim-anchor"></a>
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<strong>Molecular Genetics</strong>
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<p>Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) was defined by <a href="#9" class="mim-tip-reference" title="van der Knaap, M. S., van der Voorn, P., Barkhof, F., Van Coster, R., Krageloh-Mann, I., Feigenbaum, A., Blaser, S., Vles, J. S. H., Rieckmann, P., Pouwels, P. J. W. &lt;strong&gt;A new leukoencephalopathy with brainstem and spinal cord involvement and high lactate.&lt;/strong&gt; Ann. Neurol. 53: 252-258, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12557294/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12557294&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ana.10456&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12557294">van der Knaap et al. (2003)</a> on the basis of the highly characteristic constellation of abnormalities observed by magnetic resonance imaging and spectroscopy. Affected individuals develop slowly progressive cerebellar ataxia, spasticity, and dorsal column dysfunction, sometimes with a mild cognitive deficit or decline. <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a> sequenced genes in the candidate region on chromosome 1 linked to LBSL and identified compound heterozygous mutations in the DARS2 gene in affected individuals from all 30 families studied. Enzyme activities of mutant proteins were decreased. Surprisingly, activities of mitochondrial complexes from fibroblasts and lymphoblasts derived from affected individuals were normal, as determined by different assays. LBSL was the first example of a disorder caused by mutations in a gene encoding a mitochondrial aminoacetyl-tRNA synthetase. On the other hand, mutations in genes encoding mitochondrial tRNAs had been found in several human diseases. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=17384640+12557294" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>In the study of <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, almost all participants with LBSL were found to carry 1 mutation involving a stretch of T and C residues just upstream of exon 3 (<a href="#0001">610956.0001</a>). In 400 control chromosomes, <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a> invariably found either 3 T residues preceding 11 C residues or 4 T residues preceding 10 C residues. In 6 affected individuals, 1 of the C residues was altered, whereas 22 other affected individuals had 1 allele with only 2 T residues preceding the C stretch. Such changes were predicted to affect splicing of exon 3, leading to a frameshift and truncation of the protein. cDNA analysis confirmed the presence of this frameshift variant, although in a low concentration, probably as a result of nonsense-mediated decay of the mRNA. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#2" class="mim-tip-reference" title="Isohanni, P., Linnankivi, T., Buzkova, J., Lonnqvist, T., Pihko, H., Valanne, L., Tienari, P. J., Elovaara, I., Pirttila, T., Reunanen, M., Koivisto, K., Marjavaara, S., Suomalainen, A. &lt;strong&gt;DARS2 mutations in mitochondrial leucoencephalopathy and multiple sclerosis.&lt;/strong&gt; J. Med. Genet. 47: 66-70, 2010.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/19592391/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;19592391&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1136/jmg.2009.068221&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="19592391">Isohanni et al. (2010)</a> found that all 8 patients with LBSL were compound heterozygous for mutations in the DARS2 gene, suggesting that homozygosity for a DARS2 mutation may be lethal in humans. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19592391" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#3" class="mim-tip-reference" title="Miyake, N., Yamashita, S., Kurosawa, K., Miyatake, S., Tsurusaki, Y., Doi, H., Saitsu, H., Matsumoto, N. &lt;strong&gt;A novel homozygous mutation of DARS2 may cause a severe LBSL variant. (Letter)&lt;/strong&gt; Clin. Genet. 80: 293-296, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21815884/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;21815884&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1399-0004.2011.01644.x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="21815884">Miyake et al. (2011)</a> reported 3 Japanese sibs, born of consanguineous parents, with a severe form of LBSL due to a homozygous mutation in the DARS2 gene (<a href="#0012">610956.0012</a>). <a href="#3" class="mim-tip-reference" title="Miyake, N., Yamashita, S., Kurosawa, K., Miyatake, S., Tsurusaki, Y., Doi, H., Saitsu, H., Matsumoto, N. &lt;strong&gt;A novel homozygous mutation of DARS2 may cause a severe LBSL variant. (Letter)&lt;/strong&gt; Clin. Genet. 80: 293-296, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21815884/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;21815884&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1399-0004.2011.01644.x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="21815884">Miyake et al. (2011)</a> noted that homozygosity for pathogenic mutations in the DARS2 gene had not previously been reported. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21815884" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>In a German woman with a mild form of LBSL, <a href="#7" class="mim-tip-reference" title="Synofzik, M., Schicks, J., Lindig, T., Biskup, S., Schmidt, T., Hansel, J., Lehmann-Horn, F., Schols, L. &lt;strong&gt;Acetazolamide-responsive exercise-induced episodic ataxia associated with a novel homozygous DARS2 mutation. (Letter)&lt;/strong&gt; J. Med. Genet. 48: 713-715, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21749991/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;21749991&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1136/jmg.2011.090282&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="21749991">Synofzik et al. (2011)</a> identified a homozygous missense mutation in the DARS gene (<a href="#0013">610956.0013</a>). The unaffected parents were heterozygous for the mutation. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21749991" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#8" class="mim-tip-reference" title="van Berge, L., Hamilton, E. M., Linnankivi, T., Uziel, G., Steenweg, M. E., Isohanni, P., Wolf, N. I., Krageloh-Mann, I., Brautaset, N. J., Andrews, P. I., de Jong, B. A., al Ghamdi, M., and 11 others. &lt;strong&gt;Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation: clinical and genetic characterization and target for therapy.&lt;/strong&gt; Brain 137: 1019-29, 2014.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/24566671/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;24566671&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/brain/awu026&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="24566671">Van Berge et al. (2014)</a> reviewed mutations in the DARS2 gene in 120 patients with LBSL. Overall, 60 different mutations were identified, which were located throughout the gene. One hundred and sixteen patients had compound heterozygous mutations and 4 had homozygous mutations. Ninety-four percent (113/120) of the patients were heterozygous for a mutation in the polypyrimidine tract in intron 2, which is just upstream of exon 3. Thirteen different mutations were identified in this region, with 228-20_-21delTTinsC (<a href="#0001">610956.0001</a>) as the most common, in 88 patients. Mutations in the polypyrimidine tract in intron 2 were identified in only compound heterozygous state. <a href="#8" class="mim-tip-reference" title="van Berge, L., Hamilton, E. M., Linnankivi, T., Uziel, G., Steenweg, M. E., Isohanni, P., Wolf, N. I., Krageloh-Mann, I., Brautaset, N. J., Andrews, P. I., de Jong, B. A., al Ghamdi, M., and 11 others. &lt;strong&gt;Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation: clinical and genetic characterization and target for therapy.&lt;/strong&gt; Brain 137: 1019-29, 2014.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/24566671/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;24566671&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/brain/awu026&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="24566671">Van Berge et al. (2014)</a> also measured aspartyl-synthetase activity in lymphoblasts from 4 patients with LBSL and all showed a significant loss of activity compared to controls. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=24566671" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><strong><em>Exclusion Studies</em></strong></p><p>
<a href="#2" class="mim-tip-reference" title="Isohanni, P., Linnankivi, T., Buzkova, J., Lonnqvist, T., Pihko, H., Valanne, L., Tienari, P. J., Elovaara, I., Pirttila, T., Reunanen, M., Koivisto, K., Marjavaara, S., Suomalainen, A. &lt;strong&gt;DARS2 mutations in mitochondrial leucoencephalopathy and multiple sclerosis.&lt;/strong&gt; J. Med. Genet. 47: 66-70, 2010.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/19592391/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;19592391&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1136/jmg.2009.068221&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="19592391">Isohanni et al. (2010)</a> found no association between variation in the DARS2 gene among 321 patients with multiple sclerosis (MS; <a href="/entry/126200">126200</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19592391" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p><a href="#4" class="mim-tip-reference" title="Rumyantseva, A., Motori, E., Trifunovic, A. &lt;strong&gt;DARS2 is indispensable for Purkinje cell survival and protects against cerebellar ataxia.&lt;/strong&gt; Hum. Molec. Genet. 29: 2845-2854, 2020.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/32766765/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;32766765&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/hmg/ddaa176&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="32766765">Rumyantseva et al. (2020)</a> created a Purkinje cell (PC)-specific knockout Dars2 mouse model and observed that the animals developed a motor impairment phenotype at around 15 weeks of age. At that time the mice also displayed a 50% decrease in PC numbers. PCs in the knockout mice showed strong mitochondrial respiratory chain dysfunction characterized by diminished cytochrome C oxidase and increased succinate dehydrogenase, measures of complex IV and complex II activities. The loss of PCs was accompanied by an increase in activated microglia and hypertrophic Bergmann glia, both indicators of neuroinflammation. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=32766765" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>ALLELIC VARIANTS (<a href="/help/faq#1_4"></strong>
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<strong>13 Selected Examples</a>):</strong>
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<a href="/allelicVariants/610956" class="btn btn-default" role="button"> Table View </a>
&nbsp;&nbsp;<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=610956[MIM]" class="btn btn-default mim-tip-hint" role="button" title="ClinVar aggregates information about sequence variation and its relationship to human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">ClinVar</a>
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<strong>.0001&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, 2-BP DEL/1-BP INS
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs1553201258 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs1553201258;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs1553201258" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs1553201258" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001112 OR RCV000415026 OR RCV000626945 OR RCV003332072" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001112, RCV000415026, RCV000626945, RCV003332072" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001112...</a>
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<p>Almost all of the 28 unrelated patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) studied by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a> were compound heterozygous for a mutation involving a stretch of T and C residues just upstream of exon 3, designated 228-20_-21delTTinsC. The mutation was predicted to lead to frameshift and premature termination (Arg76SerfsTer5). A variety of mutations were partnered with this indel mutation: L626V (<a href="#0002">610956.0002</a>) in 1 of the original patients from the Netherlands, R263X (<a href="#0003">610956.0003</a>) in a patient from Belgium, R263Q (<a href="#0004">610956.0004</a>) in sibs of German/Kazakhstani extraction, C152F (<a href="#0005">610956.0005</a>) in patients from Russia, Canada, Italy, and Germany, M134_K165del due to splice site mutation 492+2T-C (<a href="#0006">610956.0006</a>), S45G (<a href="#0007">610956.0007</a>) in a patient from Portugal, and R179H (<a href="#0008">610956.0008</a>) in patients from the Netherlands and Norway. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#2" class="mim-tip-reference" title="Isohanni, P., Linnankivi, T., Buzkova, J., Lonnqvist, T., Pihko, H., Valanne, L., Tienari, P. J., Elovaara, I., Pirttila, T., Reunanen, M., Koivisto, K., Marjavaara, S., Suomalainen, A. &lt;strong&gt;DARS2 mutations in mitochondrial leucoencephalopathy and multiple sclerosis.&lt;/strong&gt; J. Med. Genet. 47: 66-70, 2010.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/19592391/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;19592391&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1136/jmg.2009.068221&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="19592391">Isohanni et al. (2010)</a> determined that the frequency of this mutation was 1 in 95 among Finnish controls. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19592391" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0002&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, LEU626VAL
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs121918205 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918205;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918205" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918205" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001113" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001113" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001113</a>
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<p>For discussion of the leu626-to-val (L626V) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0001">610956.0001</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The L626V substitution results from a 1875C-G transversion in exon 3 of the DARS2 gene.</p>
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<strong>.0003&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, ARG263TER
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs121918206 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918206;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918206" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918206" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001114 OR RCV002512634" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001114, RCV002512634" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001114...</a>
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<p>For discussion of the arg263-to-ter (R263X) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0001">610956.0001</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The R263X substitution results from a 787C-T transition in exon 9.</p>
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<strong>.0004&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, ARG263GLN
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs121918207 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918207;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs121918207?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918207" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918207" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001115 OR RCV002243611" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001115, RCV002243611" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001115...</a>
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<p>For discussion of the arg263-to-gln (R263Q) mutation in the DARS2 gene that was found in compound heterozygous state in sibs with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0001">610956.0001</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The R263Q substitution results from a 788G-A transition in exon 9.</p>
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<strong>.0005&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, CYS152PHE
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs121918208 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918208;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs121918208?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918208" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918208" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001116 OR RCV000676393 OR RCV002254674 OR RCV003934791" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001116, RCV000676393, RCV002254674, RCV003934791" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001116...</a>
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<p>For discussion of the cys152-to-phe (C152F) mutation in the DARS2 gene that was found in compound heterozygous state in patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0001">610956.0001</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The C152F substitution results from a 455G-T transversion in exon 5.</p>
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<a id="0006" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0006&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, IVS5DS, T-C, +2
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs142433332 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs142433332;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs142433332?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs142433332" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs142433332" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001117 OR RCV000255444 OR RCV000415333 OR RCV000626946 OR RCV002464975 OR RCV002512635" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001117, RCV000255444, RCV000415333, RCV000626946, RCV002464975, RCV002512635" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001117...</a>
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<p>For discussion of the splice site mutation in the DARS2 gene (492+2T-C) that was found in compound heterozygous state in patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0001">610956.0001</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>This splice site mutation results in exon skipping without a frameshift (met134_lys165del).</p><p><a href="#2" class="mim-tip-reference" title="Isohanni, P., Linnankivi, T., Buzkova, J., Lonnqvist, T., Pihko, H., Valanne, L., Tienari, P. J., Elovaara, I., Pirttila, T., Reunanen, M., Koivisto, K., Marjavaara, S., Suomalainen, A. &lt;strong&gt;DARS2 mutations in mitochondrial leucoencephalopathy and multiple sclerosis.&lt;/strong&gt; J. Med. Genet. 47: 66-70, 2010.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/19592391/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;19592391&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1136/jmg.2009.068221&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="19592391">Isohanni et al. (2010)</a> identified the 492+2T-C splice site mutation as a founder mutation in the Finnish population. Seven patients of Finnish origin with LBSL were compound heterozygous for this mutation and the indel mutation (<a href="#0001">610956.0001</a>). The carrier frequency of the 492+2T-C mutation among controls was 1 in 380. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19592391" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="0007" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0007&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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</h4>
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<div style="float: left;">
DARS2, SER45GLY
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs121918209 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918209;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918209" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918209" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001118" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001118" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001118</a>
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<p>For discussion of the ser45-to-gly (S45G) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0001">610956.0001</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The S45G substitution results from a 133A-G transition in exon 2.</p>
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<a id="0008" class="mim-anchor"></a>
<h4>
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<strong>.0008&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, ARG179HIS
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs121918210 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918210;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs121918210?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918210" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918210" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001119 OR RCV001268501" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001119, RCV001268501" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001119...</a>
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<p>In patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) from the Netherlands, Germany, and Norway, <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a> identified compound heterozygosity for the arg179-to-his (R179H) mutation in the DARS2 gene. In sibs from Norway, it was combined with the Arg76SerfsTer5 mutation (<a href="#0001">610956.0001</a>); in a patient from the Netherlands, it was combined with the nonsense mutation E425X (<a href="#0009">610956.0009</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<br />
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<a id="0009" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0009&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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</h4>
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<div>
<span class="mim-text-font">
<div style="float: left;">
DARS2, GLU425TER
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&nbsp;&nbsp;
<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs121918211 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918211;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs121918211?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918211" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918211" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001120 OR RCV001794426" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001120, RCV001794426" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001120...</a>
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<p>For discussion of the glu425-to-ter (E425X) mutation in the DARS2 gene that was found in compound heterozygous state in patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0008">610956.0008</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The E425X substitution results from a 1273G-T transversion in exon 13.</p>
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<strong>.0010&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, LEU613PHE
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs121918212 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918212;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs121918212?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918212" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918212" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001121" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001121" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001121</a>
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<p>In a Belgian patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>), <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a> found compound heterozygosity for 2 missense mutations in the DARS2 gene: L613F, brought about by a 1837C-T transition in exon 17, and L626Q (<a href="#0011">610956.0011</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0011&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, LEU626GLN
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs121918213 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121918213;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121918213" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121918213" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000001122" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000001122" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000001122</a>
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<p>For discussion of the leu626-to-gln (L626Q) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>) by <a href="#5" class="mim-tip-reference" title="Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S. &lt;strong&gt;Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.&lt;/strong&gt; Nature Genet. 39: 534-539, 2007.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/17384640/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;17384640&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng2013&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="17384640">Scheper et al. (2007)</a>, see <a href="#0010">610956.0010</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The L626Q substitution results from a 1876T-A transversion in exon 17.</p>
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<strong>.0012&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
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DARS2, IVS2, T-A, -22
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs1557853625 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs1557853625;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs1557853625" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs1557853625" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000023847" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000023847" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000023847</a>
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<p>In 3 Japanese sibs, born of consanguineous parents, with a severe form of leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>), <a href="#3" class="mim-tip-reference" title="Miyake, N., Yamashita, S., Kurosawa, K., Miyatake, S., Tsurusaki, Y., Doi, H., Saitsu, H., Matsumoto, N. &lt;strong&gt;A novel homozygous mutation of DARS2 may cause a severe LBSL variant. (Letter)&lt;/strong&gt; Clin. Genet. 80: 293-296, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21815884/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;21815884&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1399-0004.2011.01644.x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="21815884">Miyake et al. (2011)</a> identified a homozygous T-to-A transversion 22 basepairs upstream of exon 3 of the DARS2 gene. Each unaffected parent was heterozygous for the mutation, which was not found in 395 controls. RT-PCR analysis of patient lymphoblastoid cells showed a fragment lacking all of exon 3. Wildtype DARS2 mRNA transcript and protein was significantly decreased in patient cells. The 21-year-old proband developed truncal ataxia at age 3 years, followed by nystagmus, slurred speech, tremor, spasticity, and mental retardation; he could speak only 1 or 2 words. His 2 sibs, who showed onset before age 12 months, died in childhood of respiratory disease. Brain imaging showed leukoencephalopathy of the cerebrum, cerebellum, brainstem, and spinal cord. <a href="#3" class="mim-tip-reference" title="Miyake, N., Yamashita, S., Kurosawa, K., Miyatake, S., Tsurusaki, Y., Doi, H., Saitsu, H., Matsumoto, N. &lt;strong&gt;A novel homozygous mutation of DARS2 may cause a severe LBSL variant. (Letter)&lt;/strong&gt; Clin. Genet. 80: 293-296, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21815884/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;21815884&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1399-0004.2011.01644.x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="21815884">Miyake et al. (2011)</a> noted that homozygosity for pathogenic mutations in the DARS2 gene had not previously been reported. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21815884" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="0013" class="mim-anchor"></a>
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<strong>.0013&nbsp;LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION, MILD</strong>
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DARS2, ARG609TRP
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs200670286 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs200670286;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs200670286?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs200670286" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs200670286" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
<span class="mim-text-font">
<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000023848 OR RCV001762056" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000023848, RCV001762056" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000023848...</a>
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<p>In a 25-year-old German woman with a mild form of leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; <a href="/entry/611105">611105</a>), <a href="#7" class="mim-tip-reference" title="Synofzik, M., Schicks, J., Lindig, T., Biskup, S., Schmidt, T., Hansel, J., Lehmann-Horn, F., Schols, L. &lt;strong&gt;Acetazolamide-responsive exercise-induced episodic ataxia associated with a novel homozygous DARS2 mutation. (Letter)&lt;/strong&gt; J. Med. Genet. 48: 713-715, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21749991/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;21749991&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1136/jmg.2011.090282&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="21749991">Synofzik et al. (2011)</a> identified a homozygous 1825C-T transition in exon 17 of the DARS2 gene, resulting in an arg609-to-trp (R609W) substitution in a highly conserved residue in mammals. Each unaffected parent was heterozygous for the mutation, which was not found in 338 controls. Functional analysis was not performed. She presented with paroxysmal exercise-induced gait ataxia that first occurred up to 5 times a day and lasted for a few seconds to 5 minutes, but increased in frequency over a few years. Other features included mild distal deficits in position and vibration sense, mild leg spasticity, and hyperreflexia, but she never had permanent cerebellar ataxia or gait spasticity. Serum lactate was intermittently increased, and brain MRI showed T2 hyperintense lesions in the cerebellar white matter, deep cerebral white matter, and periventricular region, with some involvement of the pyramidal tracts and dorsal columns. Treatment with acetazolamide resulted in significantly decreased frequency of the attacks. The findings indicated that this disorder can have a milder phenotype and even present with episodic ataxia. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21749991" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<span id="mimReferencesToggleTriangle" class="small mimTextToggleTriangle">&#9660;</span>
<strong>REFERENCES</strong>
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<a id="Bonnefond2005" class="mim-anchor"></a>
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Bonnefond, L., Fender, A., Rudinger-Thirion, J., Giege, R., Florentz, C., Sissler, M.
<strong>Toward the full set of human mitochondrial aminoacyl-tRNA synthetases: characterization of AspRS and TyrRS.</strong>
Biochemistry 44: 4805-4816, 2005.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/15779907/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">15779907</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=15779907" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1021/bi047527z" target="_blank">Full Text</a>]
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<a id="Isohanni2010" class="mim-anchor"></a>
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Isohanni, P., Linnankivi, T., Buzkova, J., Lonnqvist, T., Pihko, H., Valanne, L., Tienari, P. J., Elovaara, I., Pirttila, T., Reunanen, M., Koivisto, K., Marjavaara, S., Suomalainen, A.
<strong>DARS2 mutations in mitochondrial leucoencephalopathy and multiple sclerosis.</strong>
J. Med. Genet. 47: 66-70, 2010.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/19592391/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">19592391</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19592391" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1136/jmg.2009.068221" target="_blank">Full Text</a>]
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<a id="Miyake2011" class="mim-anchor"></a>
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Miyake, N., Yamashita, S., Kurosawa, K., Miyatake, S., Tsurusaki, Y., Doi, H., Saitsu, H., Matsumoto, N.
<strong>A novel homozygous mutation of DARS2 may cause a severe LBSL variant. (Letter)</strong>
Clin. Genet. 80: 293-296, 2011.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/21815884/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">21815884</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21815884" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1111/j.1399-0004.2011.01644.x" target="_blank">Full Text</a>]
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</li>
<li>
<a id="4" class="mim-anchor"></a>
<a id="Rumyantseva2020" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Rumyantseva, A., Motori, E., Trifunovic, A.
<strong>DARS2 is indispensable for Purkinje cell survival and protects against cerebellar ataxia.</strong>
Hum. Molec. Genet. 29: 2845-2854, 2020.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/32766765/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">32766765</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=32766765" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1093/hmg/ddaa176" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="5" class="mim-anchor"></a>
<a id="Scheper2007" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S.
<strong>Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.</strong>
Nature Genet. 39: 534-539, 2007.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/17384640/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">17384640</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=17384640" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1038/ng2013" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="6" class="mim-anchor"></a>
<a id="Stumpf2022" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Stumpf, A. M.
<strong>Personal Communication.</strong>
Baltimore, Md. 08/30/2022.
</p>
</div>
</li>
<li>
<a id="7" class="mim-anchor"></a>
<a id="Synofzik2011" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Synofzik, M., Schicks, J., Lindig, T., Biskup, S., Schmidt, T., Hansel, J., Lehmann-Horn, F., Schols, L.
<strong>Acetazolamide-responsive exercise-induced episodic ataxia associated with a novel homozygous DARS2 mutation. (Letter)</strong>
J. Med. Genet. 48: 713-715, 2011.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/21749991/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">21749991</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21749991" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1136/jmg.2011.090282" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="8" class="mim-anchor"></a>
<a id="van Berge2014" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
van Berge, L., Hamilton, E. M., Linnankivi, T., Uziel, G., Steenweg, M. E., Isohanni, P., Wolf, N. I., Krageloh-Mann, I., Brautaset, N. J., Andrews, P. I., de Jong, B. A., al Ghamdi, M., and 11 others.
<strong>Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation: clinical and genetic characterization and target for therapy.</strong>
Brain 137: 1019-29, 2014.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/24566671/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">24566671</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=24566671" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1093/brain/awu026" target="_blank">Full Text</a>]
</p>
</div>
</li>
<li>
<a id="9" class="mim-anchor"></a>
<a id="van der Knaap2003" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
van der Knaap, M. S., van der Voorn, P., Barkhof, F., Van Coster, R., Krageloh-Mann, I., Feigenbaum, A., Blaser, S., Vles, J. S. H., Rieckmann, P., Pouwels, P. J. W.
<strong>A new leukoencephalopathy with brainstem and spinal cord involvement and high lactate.</strong>
Ann. Neurol. 53: 252-258, 2003.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/12557294/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">12557294</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12557294" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1002/ana.10456" target="_blank">Full Text</a>]
</p>
</div>
</li>
</ol>
<div>
<br />
</div>
</div>
</div>
<div>
<a id="contributors" class="mim-anchor"></a>
<div class="row">
<div class="col-lg-2 col-md-2 col-sm-4 col-xs-4">
<span class="mim-text-font">
<a href="#mimCollapseContributors" role="button" data-toggle="collapse"> Contributors: </a>
</span>
</div>
<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Hilary J. Vernon - updated : 10/06/2022
</span>
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<div class="row collapse" id="mimCollapseContributors">
<div class="col-lg-offset-2 col-md-offset-4 col-sm-offset-4 col-xs-offset-2 col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Anne M. Stumpf- updated : 08/30/2022<br>Alan F. Scott - updated : 08/30/2022<br>Cassandra L. Kniffin - updated : 10/26/2011<br>Cassandra L. Kniffin - updated : 10/4/2011<br>Cassandra L. Kniffin - updated : 6/15/2010<br>Patricia A. Hartz - updated : 5/21/2009<br>Victor A. McKusick - updated : 6/6/2007
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<div>
<a id="creationDate" class="mim-anchor"></a>
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<div class="col-lg-2 col-md-2 col-sm-4 col-xs-4">
<span class="text-nowrap mim-text-font">
Creation Date:
</span>
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<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Patricia A. Hartz : 4/23/2007
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<a id="editHistory" class="mim-anchor"></a>
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<a href="#mimCollapseEditHistory" role="button" data-toggle="collapse"> Edit History: </a>
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<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
carol : 10/06/2022
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<div class="row collapse" id="mimCollapseEditHistory">
<div class="col-lg-offset-2 col-md-offset-2 col-sm-offset-4 col-xs-offset-4 col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
carol : 09/24/2022<br>carol : 09/09/2022<br>carol : 08/31/2022<br>alopez : 08/30/2022<br>alopez : 08/30/2022<br>carol : 04/27/2018<br>mcolton : 07/31/2015<br>carol : 9/24/2013<br>carol : 10/27/2011<br>ckniffin : 10/26/2011<br>carol : 10/11/2011<br>ckniffin : 10/4/2011<br>wwang : 6/25/2010<br>ckniffin : 6/15/2010<br>mgross : 5/26/2009<br>terry : 5/21/2009<br>mgross : 5/8/2008<br>alopez : 6/11/2007<br>terry : 6/6/2007<br>mgross : 4/23/2007
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<h3>
<span class="mim-font">
<strong>*</strong> 610956
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<h3>
<span class="mim-font">
ASPARTYL-tRNA SYNTHETASE 2; DARS2
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<p>
<span class="mim-font">
<em>Alternative titles; symbols</em>
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<h4>
<span class="mim-font">
ASPARTYL-tRNA SYNTHETASE, MITOCHONDRIAL<br />
MT-ASPRS
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<span class="mim-text-font">
<strong><em>HGNC Approved Gene Symbol: DARS2</em></strong>
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<span class="mim-text-font">
<strong>SNOMEDCT:</strong> 703537008, 735421004; &nbsp;
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<p>
<span class="mim-text-font">
<strong>
<em>
Cytogenetic location: 1q25.1
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : 1:173,824,673-173,858,546 </span>
</em>
</strong>
<span class="small">(from NCBI)</span>
</span>
</p>
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<h4>
<span class="mim-font">
<strong>Gene-Phenotype Relationships</strong>
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</h4>
<div>
<table class="table table-bordered table-condensed small mim-table-padding">
<thead>
<tr class="active">
<th>
Location
</th>
<th>
Phenotype
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="1">
<span class="mim-font">
1q25.1
</span>
</td>
<td>
<span class="mim-font">
Leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation
</span>
</td>
<td>
<span class="mim-font">
611105
</span>
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<td>
<span class="mim-font">
Autosomal recessive
</span>
</td>
<td>
<span class="mim-font">
3
</span>
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<h4>
<span class="mim-font">
<strong>TEXT</strong>
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<h4>
<span class="mim-font">
<strong>Cloning and Expression</strong>
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</h4>
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<span class="mim-text-font">
<p>By searching a database for tRNA synthetases, Bonnefond et al. (2005) identified DARS2, which they called MT-ASPRS. The deduced 645-amino acid protein has a 47-amino acid mitochondrial targeting signal, resulting in a mature protein of 598 amino acids. DARS2 contains conserved residues involved in ATP binding, tRNA binding, and aspartic acid recognition, as well as catalytic site motifs characteristic of amino acid tRNA synthetases. </p>
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<h4>
<span class="mim-font">
<strong>Gene Function</strong>
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</h4>
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<span class="mim-text-font">
<p>Bonnefond et al. (2005) found that recombinant DARS2 aminoacylated purified E. coli tRNA-asp and in vitro transcribed human mitochondrial tRNA-asp (MTTD; 590015). Gel-filtration chromatography showed that recombinant DARS2 formed dimers. </p>
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<h4>
<span class="mim-font">
<strong>Gene Structure</strong>
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</h4>
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<span class="mim-text-font">
<p>Bonnefond et al. (2005) determined that the DARS2 gene contains 17 exons and spans 32.5 kb. </p>
</span>
<div>
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<h4>
<span class="mim-font">
<strong>Mapping</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Stumpf (2022) mapped the DARS2 gene to chromosome 1q25.1 based on an alignment of the DARS2 sequence (GenBank BC045173) with the genomic sequence (GRCh38).</p>
</span>
<div>
<br />
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<div>
<h4>
<span class="mim-font">
<strong>Molecular Genetics</strong>
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</h4>
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<span class="mim-text-font">
<p>Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) was defined by van der Knaap et al. (2003) on the basis of the highly characteristic constellation of abnormalities observed by magnetic resonance imaging and spectroscopy. Affected individuals develop slowly progressive cerebellar ataxia, spasticity, and dorsal column dysfunction, sometimes with a mild cognitive deficit or decline. Scheper et al. (2007) sequenced genes in the candidate region on chromosome 1 linked to LBSL and identified compound heterozygous mutations in the DARS2 gene in affected individuals from all 30 families studied. Enzyme activities of mutant proteins were decreased. Surprisingly, activities of mitochondrial complexes from fibroblasts and lymphoblasts derived from affected individuals were normal, as determined by different assays. LBSL was the first example of a disorder caused by mutations in a gene encoding a mitochondrial aminoacetyl-tRNA synthetase. On the other hand, mutations in genes encoding mitochondrial tRNAs had been found in several human diseases. </p><p>In the study of Scheper et al. (2007), almost all participants with LBSL were found to carry 1 mutation involving a stretch of T and C residues just upstream of exon 3 (610956.0001). In 400 control chromosomes, Scheper et al. (2007) invariably found either 3 T residues preceding 11 C residues or 4 T residues preceding 10 C residues. In 6 affected individuals, 1 of the C residues was altered, whereas 22 other affected individuals had 1 allele with only 2 T residues preceding the C stretch. Such changes were predicted to affect splicing of exon 3, leading to a frameshift and truncation of the protein. cDNA analysis confirmed the presence of this frameshift variant, although in a low concentration, probably as a result of nonsense-mediated decay of the mRNA. </p><p>Isohanni et al. (2010) found that all 8 patients with LBSL were compound heterozygous for mutations in the DARS2 gene, suggesting that homozygosity for a DARS2 mutation may be lethal in humans. </p><p>Miyake et al. (2011) reported 3 Japanese sibs, born of consanguineous parents, with a severe form of LBSL due to a homozygous mutation in the DARS2 gene (610956.0012). Miyake et al. (2011) noted that homozygosity for pathogenic mutations in the DARS2 gene had not previously been reported. </p><p>In a German woman with a mild form of LBSL, Synofzik et al. (2011) identified a homozygous missense mutation in the DARS gene (610956.0013). The unaffected parents were heterozygous for the mutation. </p><p>Van Berge et al. (2014) reviewed mutations in the DARS2 gene in 120 patients with LBSL. Overall, 60 different mutations were identified, which were located throughout the gene. One hundred and sixteen patients had compound heterozygous mutations and 4 had homozygous mutations. Ninety-four percent (113/120) of the patients were heterozygous for a mutation in the polypyrimidine tract in intron 2, which is just upstream of exon 3. Thirteen different mutations were identified in this region, with 228-20_-21delTTinsC (610956.0001) as the most common, in 88 patients. Mutations in the polypyrimidine tract in intron 2 were identified in only compound heterozygous state. Van Berge et al. (2014) also measured aspartyl-synthetase activity in lymphoblasts from 4 patients with LBSL and all showed a significant loss of activity compared to controls. </p><p><strong><em>Exclusion Studies</em></strong></p><p>
Isohanni et al. (2010) found no association between variation in the DARS2 gene among 321 patients with multiple sclerosis (MS; 126200). </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Animal Model</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Rumyantseva et al. (2020) created a Purkinje cell (PC)-specific knockout Dars2 mouse model and observed that the animals developed a motor impairment phenotype at around 15 weeks of age. At that time the mice also displayed a 50% decrease in PC numbers. PCs in the knockout mice showed strong mitochondrial respiratory chain dysfunction characterized by diminished cytochrome C oxidase and increased succinate dehydrogenase, measures of complex IV and complex II activities. The loss of PCs was accompanied by an increase in activated microglia and hypertrophic Bergmann glia, both indicators of neuroinflammation. </p>
</span>
<div>
<br />
</div>
</div>
<div>
<h4>
<span class="mim-font">
<strong>ALLELIC VARIANTS</strong>
</span>
<strong>13 Selected Examples):</strong>
</span>
</h4>
<div>
<p />
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0001 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, 2-BP DEL/1-BP INS
<br />
SNP: rs1553201258,
ClinVar: RCV000001112, RCV000415026, RCV000626945, RCV003332072
</span>
</div>
<div>
<span class="mim-text-font">
<p>Almost all of the 28 unrelated patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) studied by Scheper et al. (2007) were compound heterozygous for a mutation involving a stretch of T and C residues just upstream of exon 3, designated 228-20_-21delTTinsC. The mutation was predicted to lead to frameshift and premature termination (Arg76SerfsTer5). A variety of mutations were partnered with this indel mutation: L626V (610956.0002) in 1 of the original patients from the Netherlands, R263X (610956.0003) in a patient from Belgium, R263Q (610956.0004) in sibs of German/Kazakhstani extraction, C152F (610956.0005) in patients from Russia, Canada, Italy, and Germany, M134_K165del due to splice site mutation 492+2T-C (610956.0006), S45G (610956.0007) in a patient from Portugal, and R179H (610956.0008) in patients from the Netherlands and Norway. </p><p>Isohanni et al. (2010) determined that the frequency of this mutation was 1 in 95 among Finnish controls. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0002 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, LEU626VAL
<br />
SNP: rs121918205,
ClinVar: RCV000001113
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the leu626-to-val (L626V) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0001. </p><p>The L626V substitution results from a 1875C-G transversion in exon 3 of the DARS2 gene.</p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0003 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, ARG263TER
<br />
SNP: rs121918206,
ClinVar: RCV000001114, RCV002512634
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the arg263-to-ter (R263X) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0001. </p><p>The R263X substitution results from a 787C-T transition in exon 9.</p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0004 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, ARG263GLN
<br />
SNP: rs121918207,
gnomAD: rs121918207,
ClinVar: RCV000001115, RCV002243611
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the arg263-to-gln (R263Q) mutation in the DARS2 gene that was found in compound heterozygous state in sibs with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0001. </p><p>The R263Q substitution results from a 788G-A transition in exon 9.</p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0005 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, CYS152PHE
<br />
SNP: rs121918208,
gnomAD: rs121918208,
ClinVar: RCV000001116, RCV000676393, RCV002254674, RCV003934791
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the cys152-to-phe (C152F) mutation in the DARS2 gene that was found in compound heterozygous state in patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0001. </p><p>The C152F substitution results from a 455G-T transversion in exon 5.</p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0006 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, IVS5DS, T-C, +2
<br />
SNP: rs142433332,
gnomAD: rs142433332,
ClinVar: RCV000001117, RCV000255444, RCV000415333, RCV000626946, RCV002464975, RCV002512635
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the splice site mutation in the DARS2 gene (492+2T-C) that was found in compound heterozygous state in patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0001. </p><p>This splice site mutation results in exon skipping without a frameshift (met134_lys165del).</p><p>Isohanni et al. (2010) identified the 492+2T-C splice site mutation as a founder mutation in the Finnish population. Seven patients of Finnish origin with LBSL were compound heterozygous for this mutation and the indel mutation (610956.0001). The carrier frequency of the 492+2T-C mutation among controls was 1 in 380. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0007 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, SER45GLY
<br />
SNP: rs121918209,
ClinVar: RCV000001118
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the ser45-to-gly (S45G) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0001. </p><p>The S45G substitution results from a 133A-G transition in exon 2.</p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0008 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, ARG179HIS
<br />
SNP: rs121918210,
gnomAD: rs121918210,
ClinVar: RCV000001119, RCV001268501
</span>
</div>
<div>
<span class="mim-text-font">
<p>In patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) from the Netherlands, Germany, and Norway, Scheper et al. (2007) identified compound heterozygosity for the arg179-to-his (R179H) mutation in the DARS2 gene. In sibs from Norway, it was combined with the Arg76SerfsTer5 mutation (610956.0001); in a patient from the Netherlands, it was combined with the nonsense mutation E425X (610956.0009). </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0009 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, GLU425TER
<br />
SNP: rs121918211,
gnomAD: rs121918211,
ClinVar: RCV000001120, RCV001794426
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the glu425-to-ter (E425X) mutation in the DARS2 gene that was found in compound heterozygous state in patients with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0008. </p><p>The E425X substitution results from a 1273G-T transversion in exon 13.</p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0010 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, LEU613PHE
<br />
SNP: rs121918212,
gnomAD: rs121918212,
ClinVar: RCV000001121
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a Belgian patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105), Scheper et al. (2007) found compound heterozygosity for 2 missense mutations in the DARS2 gene: L613F, brought about by a 1837C-T transition in exon 17, and L626Q (610956.0011). </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0011 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, LEU626GLN
<br />
SNP: rs121918213,
ClinVar: RCV000001122
</span>
</div>
<div>
<span class="mim-text-font">
<p>For discussion of the leu626-to-gln (L626Q) mutation in the DARS2 gene that was found in compound heterozygous state in a patient with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105) by Scheper et al. (2007), see 610956.0010. </p><p>The L626Q substitution results from a 1876T-A transversion in exon 17.</p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0012 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, IVS2, T-A, -22
<br />
SNP: rs1557853625,
ClinVar: RCV000023847
</span>
</div>
<div>
<span class="mim-text-font">
<p>In 3 Japanese sibs, born of consanguineous parents, with a severe form of leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105), Miyake et al. (2011) identified a homozygous T-to-A transversion 22 basepairs upstream of exon 3 of the DARS2 gene. Each unaffected parent was heterozygous for the mutation, which was not found in 395 controls. RT-PCR analysis of patient lymphoblastoid cells showed a fragment lacking all of exon 3. Wildtype DARS2 mRNA transcript and protein was significantly decreased in patient cells. The 21-year-old proband developed truncal ataxia at age 3 years, followed by nystagmus, slurred speech, tremor, spasticity, and mental retardation; he could speak only 1 or 2 words. His 2 sibs, who showed onset before age 12 months, died in childhood of respiratory disease. Brain imaging showed leukoencephalopathy of the cerebrum, cerebellum, brainstem, and spinal cord. Miyake et al. (2011) noted that homozygosity for pathogenic mutations in the DARS2 gene had not previously been reported. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0013 &nbsp; LEUKOENCEPHALOPATHY WITH BRAINSTEM AND SPINAL CORD INVOLVEMENT AND LACTATE ELEVATION, MILD</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
DARS2, ARG609TRP
<br />
SNP: rs200670286,
gnomAD: rs200670286,
ClinVar: RCV000023848, RCV001762056
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a 25-year-old German woman with a mild form of leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL; 611105), Synofzik et al. (2011) identified a homozygous 1825C-T transition in exon 17 of the DARS2 gene, resulting in an arg609-to-trp (R609W) substitution in a highly conserved residue in mammals. Each unaffected parent was heterozygous for the mutation, which was not found in 338 controls. Functional analysis was not performed. She presented with paroxysmal exercise-induced gait ataxia that first occurred up to 5 times a day and lasted for a few seconds to 5 minutes, but increased in frequency over a few years. Other features included mild distal deficits in position and vibration sense, mild leg spasticity, and hyperreflexia, but she never had permanent cerebellar ataxia or gait spasticity. Serum lactate was intermittently increased, and brain MRI showed T2 hyperintense lesions in the cerebellar white matter, deep cerebral white matter, and periventricular region, with some involvement of the pyramidal tracts and dorsal columns. Treatment with acetazolamide resulted in significantly decreased frequency of the attacks. The findings indicated that this disorder can have a milder phenotype and even present with episodic ataxia. </p>
</span>
</div>
<div>
<br />
</div>
</div>
</div>
<div>
<h4>
<span class="mim-font">
<strong>REFERENCES</strong>
</span>
</h4>
<div>
<p />
</div>
<div>
<ol>
<li>
<p class="mim-text-font">
Bonnefond, L., Fender, A., Rudinger-Thirion, J., Giege, R., Florentz, C., Sissler, M.
<strong>Toward the full set of human mitochondrial aminoacyl-tRNA synthetases: characterization of AspRS and TyrRS.</strong>
Biochemistry 44: 4805-4816, 2005.
[PubMed: 15779907]
[Full Text: https://doi.org/10.1021/bi047527z]
</p>
</li>
<li>
<p class="mim-text-font">
Isohanni, P., Linnankivi, T., Buzkova, J., Lonnqvist, T., Pihko, H., Valanne, L., Tienari, P. J., Elovaara, I., Pirttila, T., Reunanen, M., Koivisto, K., Marjavaara, S., Suomalainen, A.
<strong>DARS2 mutations in mitochondrial leucoencephalopathy and multiple sclerosis.</strong>
J. Med. Genet. 47: 66-70, 2010.
[PubMed: 19592391]
[Full Text: https://doi.org/10.1136/jmg.2009.068221]
</p>
</li>
<li>
<p class="mim-text-font">
Miyake, N., Yamashita, S., Kurosawa, K., Miyatake, S., Tsurusaki, Y., Doi, H., Saitsu, H., Matsumoto, N.
<strong>A novel homozygous mutation of DARS2 may cause a severe LBSL variant. (Letter)</strong>
Clin. Genet. 80: 293-296, 2011.
[PubMed: 21815884]
[Full Text: https://doi.org/10.1111/j.1399-0004.2011.01644.x]
</p>
</li>
<li>
<p class="mim-text-font">
Rumyantseva, A., Motori, E., Trifunovic, A.
<strong>DARS2 is indispensable for Purkinje cell survival and protects against cerebellar ataxia.</strong>
Hum. Molec. Genet. 29: 2845-2854, 2020.
[PubMed: 32766765]
[Full Text: https://doi.org/10.1093/hmg/ddaa176]
</p>
</li>
<li>
<p class="mim-text-font">
Scheper, G. C., van der Klok, T., van Andel, R. J., van Berkel, C. G. M., Sissler, M., Smet, J., Muravina, T. I., Serkov, S. V., Uziel, G., Bugiani, M., Schiffmann, R., Krageloh-Mann, I., Smeitink, J. A. M., Florentz, C., Van Coster, R., Pronk, J. C., van der Knaap, M. S.
<strong>Mitochondrial aspartyl-tRNA synthetase deficiency causes leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation.</strong>
Nature Genet. 39: 534-539, 2007.
[PubMed: 17384640]
[Full Text: https://doi.org/10.1038/ng2013]
</p>
</li>
<li>
<p class="mim-text-font">
Stumpf, A. M.
<strong>Personal Communication.</strong>
Baltimore, Md. 08/30/2022.
</p>
</li>
<li>
<p class="mim-text-font">
Synofzik, M., Schicks, J., Lindig, T., Biskup, S., Schmidt, T., Hansel, J., Lehmann-Horn, F., Schols, L.
<strong>Acetazolamide-responsive exercise-induced episodic ataxia associated with a novel homozygous DARS2 mutation. (Letter)</strong>
J. Med. Genet. 48: 713-715, 2011.
[PubMed: 21749991]
[Full Text: https://doi.org/10.1136/jmg.2011.090282]
</p>
</li>
<li>
<p class="mim-text-font">
van Berge, L., Hamilton, E. M., Linnankivi, T., Uziel, G., Steenweg, M. E., Isohanni, P., Wolf, N. I., Krageloh-Mann, I., Brautaset, N. J., Andrews, P. I., de Jong, B. A., al Ghamdi, M., and 11 others.
<strong>Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation: clinical and genetic characterization and target for therapy.</strong>
Brain 137: 1019-29, 2014.
[PubMed: 24566671]
[Full Text: https://doi.org/10.1093/brain/awu026]
</p>
</li>
<li>
<p class="mim-text-font">
van der Knaap, M. S., van der Voorn, P., Barkhof, F., Van Coster, R., Krageloh-Mann, I., Feigenbaum, A., Blaser, S., Vles, J. S. H., Rieckmann, P., Pouwels, P. J. W.
<strong>A new leukoencephalopathy with brainstem and spinal cord involvement and high lactate.</strong>
Ann. Neurol. 53: 252-258, 2003.
[PubMed: 12557294]
[Full Text: https://doi.org/10.1002/ana.10456]
</p>
</li>
</ol>
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Hilary J. Vernon - updated : 10/06/2022<br>Anne M. Stumpf- updated : 08/30/2022<br>Alan F. Scott - updated : 08/30/2022<br>Cassandra L. Kniffin - updated : 10/26/2011<br>Cassandra L. Kniffin - updated : 10/4/2011<br>Cassandra L. Kniffin - updated : 6/15/2010<br>Patricia A. Hartz - updated : 5/21/2009<br>Victor A. McKusick - updated : 6/6/2007
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