nih-gov/www.ncbi.nlm.nih.gov/omim/612990

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Entry
- *612990 - ASXL TRANSCRIPTIONAL REGULATOR 1; ASXL1
- OMIM
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<span class="h4">*612990</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="#geneStructure">Gene Structure</a>
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<a href="#geneFunction">Gene Function</a>
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<a href="#molecularGenetics">Molecular Genetics</a>
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<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimProtein">
<span class="panel-title">
<span class="small">
<a href="#mimProteinLinksFold" id="mimProteinLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<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=16516&isoform_id=16516_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/ASXL1" 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/5912034,20521716,23094400,23270893,29570782,37998955,40674100,52545557,71681290,119596783,119596784,119596785,119596786,187950585,187952563,193783818,257195178,578835826,578835828,578835832,578835838,768016353,1375381502,1392111349,2217334594,2217334597,2217334599,2217334601,2217334603,2217334605,2217334608,2219556934,2219556940,2219556942,2219556944,2219556946,2219556948,2219556950,2462579671,2462579673,2462579675,2462579677,2462579679,2462579681,2462579683,2462579685,2462579687,2462579689" 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/Q8IXJ9" 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=171023" 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=ENSG00000171456;t=ENST00000375687" 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=ASXL1" 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=ASXL1" 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+171023" 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/ASXL1" 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:171023" 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/171023" 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=chr20&hgg_gene=ENST00000375687.10&hgg_start=32358331&hgg_end=32439319&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:18318" 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:18318" 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/asxl1" 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=612990[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=612990[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://www.deciphergenomics.org/gene/ASXL1/overview/clinical-info" class="mim-tip-hint" title="DECIPHER" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'DECIPHER', 'domain': 'DECIPHER'})">DECIPHER</a></div>
<div><a href="https://gnomad.broadinstitute.org/gene/ENSG00000171456" 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=ASXL1" 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=ASXL1" 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=ASXL1" 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="http://www.LOVD.nl/ASXL1" class="mim-tip-hint" title="A gene-specific database of variation." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Locus Specific DB', 'domain': 'locus-specific-db.org'})">Locus Specific DBs</a></div>
<div><a href="https://evs.gs.washington.edu/EVS/PopStatsServlet?searchBy=Gene+Hugo&target=ASXL1&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/PA25078" 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:18318" 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/FBgn0261823.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:2684063" 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/ASXL1#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:2684063" 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/171023/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=171023" 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://zfin.org/ZDB-GENE-091116-9" 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:171023" 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=ASXL1&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> 720565000<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>
612990
</span>
</span>
</div>
</div>
<div>
<a id="preferredTitle" class="mim-anchor"></a>
<h3>
<span class="mim-font">
ASXL TRANSCRIPTIONAL REGULATOR 1; ASXL1
</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">
ADDITIONAL SEX COMBS-LIKE 1<br />
KIAA0978
</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=ASXL1" class="mim-tip-hint" title="HUGO Gene Nomenclature Committee." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HGNC', 'domain': 'genenames.org'})">ASXL1</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/20/200?start=-3&limit=10&highlight=200">20q11.21</a>
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : <a href="https://genome.ucsc.edu/cgi-bin/hgTracks?db=hg38&position=chr20:32358331-32439319&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'})">20:32,358,331-32,439,319</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
<span class="hidden-sm hidden-xs pull-right">
<a href="/clinicalSynopsis/table?mimNumber=605039,614286" class="label label-warning" onclick="gtag('event', 'mim_link', {'source': 'Entry', 'destination': 'clinicalSynopsisTable'})">
View Clinical Synopses
</a>
</span>
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="2">
<span class="mim-font">
<a href="/geneMap/20/200?start=-3&limit=10&highlight=200">
20q11.21
</a>
</span>
</td>
<td>
<span class="mim-font">
Bohring-Opitz syndrome
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/605039"> 605039 </a>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="Autosomal dominant">AD</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>
<tr>
<td>
<span class="mim-font">
Myelodysplastic syndrome, somatic
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/614286"> 614286 </a>
</span>
</td>
<td>
<span class="mim-font">
</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/612990" target="_blank" onclick="gtag('event', 'mim_graph', {'destination': 'Linear'})"> Linear </a></li>
<li><a href="/graph/radial/612990" 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="description" class="mim-anchor"></a>
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<p>ASXL1 is a human homolog of the Drosophila asx gene. Drosophila asx is an enhancer of trithorax (see <a href="/entry/159555">159555</a>) and polycomb (see <a href="/entry/610231">610231</a>) (ETP) gene that encodes a chromatin protein required to maintain both activation and silencing of homeotic loci (summary by <a href="#4" class="mim-tip-reference" title="Fisher, C. L., Berger, J., Randazzo, F., Brock, H. W. &lt;strong&gt;A human homolog of Additional sex combs, ADDITIONAL SEX COMBS-LIKE 1, maps to chromosome 20q11.&lt;/strong&gt; Gene 306: 115-126, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12657473/&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;12657473&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/s0378-1119(03)00430-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="12657473">Fisher et al., 2003</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12657473" 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="cloning" class="mim-anchor"></a>
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<strong>Cloning and Expression</strong>
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<p>By sequencing clones obtained from a size-fractionated human brain cDNA library, <a href="#9" class="mim-tip-reference" title="Nagase, T., Ishikawa, K., Suyama, M., Kikuno, R., Hirosawa, M., Miyajima, N., Tanaka, A., Kotani, H., Nomura, N., Ohara, O. &lt;strong&gt;Prediction of the coding sequences of unidentified human genes. XIII. The complete sequences of 100 new cDNA clones from brain which code for large proteins in vitro.&lt;/strong&gt; DNA Res. 6: 63-70, 1999.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10231032/&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;10231032&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/dnares/6.1.63&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="10231032">Nagase et al. (1999)</a> obtained a partial ASXL1 clone, which they designated KIAA0978. RT-PCR ELISA detected low to moderate expression in all adult and fetal tissues and specific adult brain regions examined. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=10231032" 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>By searching EST databases for sequences similar to Drosophila asx and by screening an adult heart cDNA library, <a href="#4" class="mim-tip-reference" title="Fisher, C. L., Berger, J., Randazzo, F., Brock, H. W. &lt;strong&gt;A human homolog of Additional sex combs, ADDITIONAL SEX COMBS-LIKE 1, maps to chromosome 20q11.&lt;/strong&gt; Gene 306: 115-126, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12657473/&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;12657473&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/s0378-1119(03)00430-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="12657473">Fisher et al. (2003)</a> obtained overlapping clones covering the ASXL1 coding sequence. The deduced 1,541-amino acid protein has a calculated molecular mass of 165.5 kD. The N-terminal region of ASXL1 contains a serine-rich region, 3 nuclear localization signals, a PEST motif, a nuclear receptor-binding motif, and a region that shares high sequence identity with Drosophila asx, which <a href="#4" class="mim-tip-reference" title="Fisher, C. L., Berger, J., Randazzo, F., Brock, H. W. &lt;strong&gt;A human homolog of Additional sex combs, ADDITIONAL SEX COMBS-LIKE 1, maps to chromosome 20q11.&lt;/strong&gt; Gene 306: 115-126, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12657473/&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;12657473&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/s0378-1119(03)00430-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="12657473">Fisher et al. (2003)</a> called the asx homology domain (AHD). The AHD is followed by a glycine-rich region, 3 additional PEST sequences, and a C-terminal plant homeodomain (PHD). ASXL1 lacks the AT-hook motif and the nucleotide-binding motif of Drosophila asx. ASXL1 shares over 70% amino acid identity with mouse Asxl1 and 21% identity with Drosophila asx. Northern blot analysis detected variable expression of ASXL1 transcripts of 8.0 and 6.0 kb. Expression was highest in testis, moderate in thymus, ovary, lymph node, and appendix, very low in other tissues, and undetectable in adult liver and kidney. The 8.0-kb transcript was dominant in most tissues, but the 6.0-kb transcript was dominant in testis. Testis also expressed a 5.0-kb transcript that was not detected in other tissues. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12657473" 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="Fisher, C. L., Berger, J., Randazzo, F., Brock, H. W. &lt;strong&gt;A human homolog of Additional sex combs, ADDITIONAL SEX COMBS-LIKE 1, maps to chromosome 20q11.&lt;/strong&gt; Gene 306: 115-126, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12657473/&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;12657473&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/s0378-1119(03)00430-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="12657473">Fisher et al. (2003)</a> determined that the ASXL1 gene contains 13 exons and spans 81 kb. Exon 13 contains the entire 3-prime UTR and is almost 5 kb long. The smallest exon, exon 3, is 3 bp long. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12657473" 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>Mapping</strong>
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<p>Using FISH and genomic sequence analysis, <a href="#4" class="mim-tip-reference" title="Fisher, C. L., Berger, J., Randazzo, F., Brock, H. W. &lt;strong&gt;A human homolog of Additional sex combs, ADDITIONAL SEX COMBS-LIKE 1, maps to chromosome 20q11.&lt;/strong&gt; Gene 306: 115-126, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12657473/&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;12657473&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/s0378-1119(03)00430-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="12657473">Fisher et al. (2003)</a> mapped the ASXL1 gene to chromosome 20q11.21, between the KIF3B gene (<a href="/entry/603754">603754</a>) and the DNMT3B gene (<a href="/entry/602900">602900</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12657473" 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>Using mouse and human cell lines, <a href="#10" class="mim-tip-reference" title="Park, U.-H., Yoon, S. K., Park, T., Kim, E.-J., Um, S.-J. &lt;strong&gt;Additional sex comb-like (ASXL) proteins 1 and 2 play opposite roles in adipogenesis via reciprocal regulation of peroxisome proliferator-activated receptor gamma.&lt;/strong&gt; J. Biol. Chem. 286: 1354-1363, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21047783/&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;21047783&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=21047783[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.M110.177816&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="21047783">Park et al. (2011)</a> showed that mouse Asxl1 and human ASXL2 (<a href="/entry/612991">612991</a>) interacted with PPAR-alpha (PPARA; <a href="/entry/170998">170998</a>) and PPAR-gamma (PPARG; <a href="/entry/601487">601487</a>) and played opposite roles in adipogenesis. Asxl1 suppressed transactivation activity of ligand-bound PPAR-gamma and blocked adipogenic differentiation in mouse 3T3-L1 cells, whereas ASXL2 promoted these activities. Mutation analysis revealed that the heterochromatin protein-1 (HP1; see <a href="/entry/604478">604478</a>)-binding domain of Asxl1 was required for its repressive activity. Without the HP1-binding domain, Asxl1 behaved like ASXL2 to promote PPAR-gamma activity and induce adipogenesis. In chromatin immunoprecipitation assays in 3T3-L1 cells, Asxl1 occupied the promoter of the endogenous PPAR-gamma target Ap2 (FABP4; <a href="/entry/600434">600434</a>) together with the inhibitory factors HP1-alpha (CBX5; <a href="/entry/604478">604478</a>) and lys9-methylated histone H3 (see <a href="/entry/602810">602810</a>), whereas ASXL2 occupied the Ap2 promoter together with the activating factors histone lysine N-methyltransferase MLL1 (<a href="/entry/159555">159555</a>) and lys9-acetylated and lys4-methylated H3 histones. Microarray analysis showed that Asxl1 repressed, whereas ASXL2 increased, the expression of a subset of adipogenic genes, most of which are PPAR-gamma targets. <a href="#10" class="mim-tip-reference" title="Park, U.-H., Yoon, S. K., Park, T., Kim, E.-J., Um, S.-J. &lt;strong&gt;Additional sex comb-like (ASXL) proteins 1 and 2 play opposite roles in adipogenesis via reciprocal regulation of peroxisome proliferator-activated receptor gamma.&lt;/strong&gt; J. Biol. Chem. 286: 1354-1363, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21047783/&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;21047783&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=21047783[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.M110.177816&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="21047783">Park et al. (2011)</a> concluded that ASXL1 is a PPAR-gamma corepressor and that ASXK2 is a PPAR-gamma coactivator. They proposed that ASXL1 and ASXL2 fine-tune adipogenesis via differential regulation of PPAR-gamma. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21047783" 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><strong><em>Somatic Mutations in Myeloid Malignancies</em></strong></p><p>
<a href="#5" class="mim-tip-reference" title="Gelsi-Boyer, V., Trouplin, V., Adelaide, J., Bonansea, J., Cervera, N., Carbuccia, N., Lagarde, A., Prebet, T., Nezri, M., Sainty, D., Olschwang, S., Xerri, L., Chaffanet, M., Mozziconacci, M.-J., Vey, N., Birnbaum, D. &lt;strong&gt;Mutations of polycomb-associated gene ASXL1 in myelodysplastic syndromes and chronic myelomonocytic leukaemia.&lt;/strong&gt; Brit. J. Haemat. 145: 788-800, 2009.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/19388938/&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;19388938&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1365-2141.2009.07697.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="19388938">Gelsi-Boyer et al. (2009)</a> presented evidence that the ASXL1 gene may act as a tumor suppressor in myeloid malignancies. They identified heterozygous somatic mutations in the ASXL1 gene in 5 (16%) of 38 myelodysplastic syndrome (MDS; <a href="/entry/614286">614286</a>)/acute myeloid leukemia (AML; <a href="/entry/601626">601626</a>) samples. Somatic ASXL1 mutations were also found in 19 (43%) of 44 chronic myelomonocytic leukemia (CMML; see <a href="/entry/607785">607785</a>) samples. All the mutations were in exon 12 and resulted in truncation of the C terminus PHD finger of the protein. The findings suggested that regulators of gene expression via DNA methylation, histone modification, and chromatin remodeling could be altered in myelodysplastic syndromes and some leukemias. The same group (<a href="#2" class="mim-tip-reference" title="Carbuccia, N., Murati, A., Trouplin, V., Brecqueville, M., Adelaide, J., Rey, J., Vainchenker, W., Bernard, O. A., Chaffanet, M., Vey, N., Birnbaum, D., Mozziconacci, M. J. &lt;strong&gt;Mutations of ASXL1 gene in myeloproliferative neoplasms. (Letter)&lt;/strong&gt; Leukemia 23: 2183-2186, 2009.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/19609284/&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;19609284&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/leu.2009.141&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="19609284">Carbuccia et al., 2009</a>) identified heterozygous somatic truncating ASXL1 mutations in 5 (7.8%) of 64 myeloproliferative neoplasms, including 1 essential thrombocythemia (<a href="/entry/187950">187950</a>), 3 primary myelofibrosis (<a href="/entry/254450">254450</a>), and 1 AML. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=19388938+19609284" 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="Chou, W.-C., Huang, H.-H., Hou, H.-A., Chen, C.-Y., Tang, J.-L., Yao, M., Tsay, W., Ko, B.-S., Wu, S.-J., Huang, S.-Y., Hsu, S.-C., Chen, Y.-C., Huang, Y.-N., Chang, Y.-C., Lee, F.-Y., Liu, M.-C., Liu, C.-W., Tseng, M.-H., Huang, C.-F., Tien, H.-F. &lt;strong&gt;Distinct clinical and biological features of de novo acute myeloid leukemia with additional sex comb-like 1 (ASXL1) mutations.&lt;/strong&gt; Blood 116: 4086-4094, 2010.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/20693432/&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;20693432&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1182/blood-2010-05-283291&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="20693432">Chou et al. (2010)</a> identified somatic mutations in exon 12 of the ASXL1 gene disrupting the PHD domain in 54 (10.8%) of 501 adults with de novo AML. There was a similar frequency of ASXL1 mutations in those with a normal karyotype (8.9%) and those with abnormal cytogenetics (12.9%), but 39 of the 54 patients with ASXL1 mutations had concurrent mutations in other genes. ASXL1 mutations were closely associated with older age, male sex, isolated trisomy 8, RUNX1 (<a href="/entry/151385">151385</a>) mutations, and expression of HLA-DR and CD34, but inversely associated with t(15;17), complex cytogenetics, FLT3-internal tandem duplication, NPM1 (<a href="/entry/164040">164040</a>) mutations, WT1 (<a href="/entry/607102">607102</a>) mutations, and expression of CD33 (<a href="/entry/159590">159590</a>) and CD15. Patients with ASXL1 mutations had a shorter overall survival than patients without mutations, but mutation status was not an independent adverse prognostic factor in multivariate analysis. Sequential analyses of patient samples showed that the original ASXL1 mutations were lost at relapse and/or refractory status in 2 of the 6 relapsed ASXL1-mutated patients studied, whereas 2 of the 109 ASXL1-wildtype patients acquired a novel ASXL1 mutation at relapse. <a href="#3" class="mim-tip-reference" title="Chou, W.-C., Huang, H.-H., Hou, H.-A., Chen, C.-Y., Tang, J.-L., Yao, M., Tsay, W., Ko, B.-S., Wu, S.-J., Huang, S.-Y., Hsu, S.-C., Chen, Y.-C., Huang, Y.-N., Chang, Y.-C., Lee, F.-Y., Liu, M.-C., Liu, C.-W., Tseng, M.-H., Huang, C.-F., Tien, H.-F. &lt;strong&gt;Distinct clinical and biological features of de novo acute myeloid leukemia with additional sex comb-like 1 (ASXL1) mutations.&lt;/strong&gt; Blood 116: 4086-4094, 2010.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/20693432/&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;20693432&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1182/blood-2010-05-283291&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="20693432">Chou et al. (2010)</a> suggested that AML with ASXL1 mutations showed distinct clinical and biologic features and that ASXL1 mutation status can change during disease evolution. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=20693432" 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>Bohring-Opitz Syndrome</em></strong></p><p>
By exome sequencing in combination with direct sequencing, <a href="#6" class="mim-tip-reference" title="Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others. &lt;strong&gt;De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.&lt;/strong&gt; Nature Genet. 43: 729-731, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21706002/&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;21706002&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng.868&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="21706002">Hoischen et al. (2011)</a> identified 7 different de novo heterozygous nonsense or truncating mutations in the ASXL1 gene (see, e.g., <a href="#0001">612990.0001</a>-<a href="#0005">612990.0005</a>) in 7 of 13 unrelated patients with Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), a severe developmental and malformation disorder characterized by intrauterine growth retardation, poor feeding, profound mental retardation, trigonocephaly, prominent metopic suture, exophthalmos, nevus flammeus of the face, upslanting palpebral fissures, hirsutism, and flexion of the elbows and wrists with deviation of the wrists and metacarpophalangeal joints. <a href="#6" class="mim-tip-reference" title="Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others. &lt;strong&gt;De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.&lt;/strong&gt; Nature Genet. 43: 729-731, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21706002/&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;21706002&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng.868&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="21706002">Hoischen et al. (2011)</a> postulated a loss-of-function mechanism. The ASXL1 gene is involved in the maintenance of both activation and silencing of the HOX genes, which are involved in body patterning, as well as in chromatin remodeling, although the patients did not have any specific homeotic transformations. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21706002" 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 2 unrelated patients with classic features of Bohring-Opitz syndrome, <a href="#8" class="mim-tip-reference" title="Magini, P., Della Monica, M., Uzielli, M. L. G., Mongelli, P., Scarselli, G., Gambineri, E., Scarano, G., Seri, M. &lt;strong&gt;Two novel patients with Bohring-Opitz syndrome caused by de novo ASXL1 mutations.&lt;/strong&gt; Am. J. Med. Genet. 158A: 917-921, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22419483/&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;22419483&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ajmg.a.35265&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="22419483">Magini et al. (2012)</a> identified 2 different de novo heterozygous truncating mutations in the ASXL1 gene (<a href="#0006">612990.0006</a> and <a href="#0007">612990.0007</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22419483" 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 patient with a mild case of Bohring-Opitz syndrome, <a href="#7" class="mim-tip-reference" title="Leon, E., Diaz, J., Castilla-Vallmanya, L., Grinberg, D., Balcells, S., Urreizti, R. &lt;strong&gt;Extending the phenotypic spectrum of Bohring-Opitz syndrome: mild case confirmed by functional studies.&lt;/strong&gt; Am. J. Med. Genet. 182A: 201-204, 2020.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/31692235/&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;31692235&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ajmg.a.61397&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="31692235">Leon et al. (2020)</a> identified heterozygosity for a de novo splicing mutation in the ASXL1 gene (<a href="#0008">612990.0008</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=31692235" 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="#1" class="mim-tip-reference" title="Abdel-Wahab, O., Gao, J., Adli, M., Dey, A., Trimarchi, T., Chung, Y. R., Kuscu, C., Hricik, T., Ndiaye-Lobry, D., LaFave, L. M., Koche, R., Shih, A. H., and 15 others. &lt;strong&gt;Deletion of Asxl1 results in myelodysplasia and severe developmental defects in vivo.&lt;/strong&gt; J. Exp. Med. 210: 2641-2659, 2013.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/24218140/&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;24218140&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=24218140[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1084/jem.20131141&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="24218140">Abdel-Wahab et al. (2013)</a> found that Asxl1-null mice had multiple developmental abnormalities, including anophthalmia, microcephaly, cleft palate, and mandibular malformation. Hemopoietic-specific deletion of Asxl1 in mice resulted in progressive, multilineage cytopenias and dysplasia with increased numbers of hemopoietic stem/progenitor cells, characteristic of human MDS. Serial transplantation of Asxl1-null hemopoietic cells caused a lethal myeloid disorder with a shorter latency than primary Asxl1-null mice. Deletion of Asxl1 reduced hemopoietic stem cell self-renewal, which was restored by concurrent deletion of Tet2 (<a href="/entry/612839">612839</a>), a gene frequently co-mutated with ASXL1 in MDS patients. Asxl1/Tet2 double-knockout mice had an MDS phenotype with more rapid mortality compared with single gene-knockout mice. Asxl1 loss resulted in a genomewide reduction of histone H3 lys27 trimethylation and dysregulated expression of known regulators of hemopoiesis. Chromosome immunoprecipitation of Asxl1 followed by DNA sequencing in mouse hemopoietic cells identified a subset of genes differentially regulated by Asxl1. <a href="#1" class="mim-tip-reference" title="Abdel-Wahab, O., Gao, J., Adli, M., Dey, A., Trimarchi, T., Chung, Y. R., Kuscu, C., Hricik, T., Ndiaye-Lobry, D., LaFave, L. M., Koche, R., Shih, A. H., and 15 others. &lt;strong&gt;Deletion of Asxl1 results in myelodysplasia and severe developmental defects in vivo.&lt;/strong&gt; J. Exp. Med. 210: 2641-2659, 2013.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/24218140/&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;24218140&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=24218140[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1084/jem.20131141&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="24218140">Abdel-Wahab et al. (2013)</a> concluded that ASXL1 is important in development and hemopoiesis. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=24218140" 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>8 Selected Examples</a>):</strong>
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<a href="/allelicVariants/612990" class="btn btn-default" role="button"> Table View </a>
&nbsp;&nbsp;<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=612990[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;BOHRING-OPITZ SYNDROME</strong>
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ASXL1, GLN925TER
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs387907077 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs387907077;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=rs387907077" 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=rs387907077" 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=RCV000023976 OR RCV004721246" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000023976, RCV004721246" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000023976...</a>
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<p>In a patient with Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), <a href="#6" class="mim-tip-reference" title="Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others. &lt;strong&gt;De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.&lt;/strong&gt; Nature Genet. 43: 729-731, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21706002/&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;21706002&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng.868&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="21706002">Hoischen et al. (2011)</a> identified a de novo heterozygous 2773C-T transition in the ASXL1 gene, resulting in a gln925-to-ter (Q925X) substitution. The patient died at age 6 years. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21706002" 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;BOHRING-OPITZ SYNDROME</strong>
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ASXL1, ARG404TER
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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> rs373145711 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs373145711;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/rs373145711?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=rs373145711" 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=rs373145711" 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=RCV000023977 OR RCV000414833 OR RCV000415151 OR RCV000627196 OR RCV001199371" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000023977, RCV000414833, RCV000415151, RCV000627196, RCV001199371" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000023977...</a>
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<div>
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<p>In a 7-year-old girl with Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), <a href="#6" class="mim-tip-reference" title="Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others. &lt;strong&gt;De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.&lt;/strong&gt; Nature Genet. 43: 729-731, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21706002/&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;21706002&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng.868&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="21706002">Hoischen et al. (2011)</a> identified a de novo heterozygous 1210C-T transition in the ASXL1 gene, resulting in an arg404-to-ter (R404X) substitution. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21706002" 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>
</span>
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<a id="0003" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0003&nbsp;BOHRING-OPITZ SYNDROME</strong>
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</h4>
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<div style="float: left;">
ASXL1, SER1028TER
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</span>
&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> rs200702600 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs200702600;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/rs200702600?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=rs200702600" 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=rs200702600" 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=RCV000023978" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000023978" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000023978</a>
</span>
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<div>
<span class="mim-text-font">
<p>In a 2.5-year-old girl with Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), <a href="#6" class="mim-tip-reference" title="Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others. &lt;strong&gt;De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.&lt;/strong&gt; Nature Genet. 43: 729-731, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21706002/&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;21706002&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng.868&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="21706002">Hoischen et al. (2011)</a> identified a de novo heterozygous 3083C-A transversion in the ASXL1 gene, resulting in a ser1028-to-ter (S1028X) substitution. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21706002" 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>
</span>
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<a id="0004" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0004&nbsp;BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
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<span class="mim-text-font">
<div style="float: left;">
ASLX1, 1-BP DUP, NT2535
</div>
</span>
&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> rs750170870 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs750170870;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/rs750170870?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=rs750170870" 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=rs750170870" 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=RCV000023979" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000023979" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000023979</a>
</span>
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<div>
<span class="mim-text-font">
<p>In a 24-year-old woman with Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), <a href="#6" class="mim-tip-reference" title="Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others. &lt;strong&gt;De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.&lt;/strong&gt; Nature Genet. 43: 729-731, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21706002/&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;21706002&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng.868&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="21706002">Hoischen et al. (2011)</a> identified a de novo heterozygous 1-bp duplication at nucleotide 2535 in the ASXL1 gene, resulting in a frameshift and premature termination (Ser846GlnfsTer5). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21706002" 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>
</span>
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<a id="0005" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0005&nbsp;BOHRING-OPITZ SYNDROME</strong>
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</h4>
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<div>
<span class="mim-text-font">
<div style="float: left;">
ASLX1, GLN733TER
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</span>
&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> rs387907078 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs387907078;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/rs387907078?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=rs387907078" 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=rs387907078" 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=RCV000023980" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000023980" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000023980</a>
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a female infant with Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), <a href="#6" class="mim-tip-reference" title="Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others. &lt;strong&gt;De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.&lt;/strong&gt; Nature Genet. 43: 729-731, 2011.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/21706002/&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;21706002&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng.868&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="21706002">Hoischen et al. (2011)</a> identified a de novo heterozygous 2197C-T transition in the ASXL1 gene, resulting in a gln733-to-ter (Q733X) substitution. The patient died 23 hours after birth. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21706002" 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>
</span>
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<br />
</div>
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<a id="0006" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0006&nbsp;BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
<div style="float: left;">
ASLX1, 5-BP DEL, NT2407
</div>
</span>
&nbsp;&nbsp;
<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs1600588199 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs1600588199;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=rs1600588199" 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=rs1600588199" 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=RCV000032664" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000032664" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000032664</a>
</span>
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<div>
<span class="mim-text-font">
<p>In a 3-year-old girl with typical features of Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), <a href="#8" class="mim-tip-reference" title="Magini, P., Della Monica, M., Uzielli, M. L. G., Mongelli, P., Scarselli, G., Gambineri, E., Scarano, G., Seri, M. &lt;strong&gt;Two novel patients with Bohring-Opitz syndrome caused by de novo ASXL1 mutations.&lt;/strong&gt; Am. J. Med. Genet. 158A: 917-921, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22419483/&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;22419483&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ajmg.a.35265&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="22419483">Magini et al. (2012)</a> identified a de novo heterozygous 5-bp deletion in the ASLX1 gene (2407_2411del), resulting in a frameshift and premature termination (Gln803ThrfsTer17). The mutation was not found in 2 large databases. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22419483" 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>
</span>
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<div>
<br />
</div>
</div>
<div>
<div>
<a id="0007" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0007&nbsp;BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
<div style="float: left;">
ASLX1, ARG965TER
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</span>
&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> rs397515401 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs397515401;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/rs397515401?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=rs397515401" 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=rs397515401" 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=RCV000032665 OR RCV000255108" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000032665, RCV000255108" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000032665...</a>
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a 7-year-old boy with typical features of Bohring-Opitz syndrome (<a href="/entry/605039">605039</a>), <a href="#8" class="mim-tip-reference" title="Magini, P., Della Monica, M., Uzielli, M. L. G., Mongelli, P., Scarselli, G., Gambineri, E., Scarano, G., Seri, M. &lt;strong&gt;Two novel patients with Bohring-Opitz syndrome caused by de novo ASXL1 mutations.&lt;/strong&gt; Am. J. Med. Genet. 158A: 917-921, 2012.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/22419483/&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;22419483&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ajmg.a.35265&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="22419483">Magini et al. (2012)</a> identified a de novo heterozygous 2893C-T transition in the ASLX1 gene, resulting in an arg965-to-ter (R965X) substitution. The mutation was not found in 2 large databases. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22419483" 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>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<a id="0008" class="mim-anchor"></a>
<h4>
<span class="mim-font">
<strong>.0008&nbsp;BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
<div style="float: left;">
ASLX1, IVS12, A-G, -2
</div>
</span>
&nbsp;&nbsp;
<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs2011649912 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs2011649912;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=rs2011649912" 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=rs2011649912" 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=RCV002275470" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV002275470" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV002275470</a>
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<p>By whole-exome sequencing in a 5-year-old girl with a mild case of Bohring-Opitz syndrome (BOPS; <a href="/entry/605039">605039</a>), <a href="#7" class="mim-tip-reference" title="Leon, E., Diaz, J., Castilla-Vallmanya, L., Grinberg, D., Balcells, S., Urreizti, R. &lt;strong&gt;Extending the phenotypic spectrum of Bohring-Opitz syndrome: mild case confirmed by functional studies.&lt;/strong&gt; Am. J. Med. Genet. 182A: 201-204, 2020.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/31692235/&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;31692235&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/ajmg.a.61397&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="31692235">Leon et al. (2020)</a> identified a de novo heterozygous c.1720A-G transition (ENST00000375687) in the ASLX1 gene at the canonical splice acceptor site of intron 12, resulting in a frameshift and a premature stop codon after 21 residues (Ile574ValfsTer22). Analysis of the mRNA splicing pattern on patient fibroblasts by Sanger sequencing showed that the mutation leads to full retention of intron 12. The resulting protein is predicted to lack the C terminus end of the protein. The patient had previously been reported by <a href="#11" class="mim-tip-reference" title="Yuan, B., Neira, J., Pehlivan, D., Santiago-Sim, T., Song, X., Rosenfeld, J., Posey, J. E., Patel, V., Jin, W., Adam, M. P., Baple, E. L., Dean, J., and 34 others. &lt;strong&gt;Clinical exome sequencing reveals locus heterogeneity and phenotypic variability of cohesinopathies.&lt;/strong&gt; Genet. Med. 21: 663-675, 2019.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/30158690/&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;30158690&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=30158690[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/s41436-018-0085-6&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="30158690">Yuan et al. (2019)</a> as patient 3 with a Cornelia de Lange-like phenotype. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=30158690+31692235" 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>REFERENCES</strong>
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<div id="mimReferencesFold" class="collapse in mimTextToggleFold">
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<a id="1" class="mim-anchor"></a>
<a id="Abdel-Wahab2013" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Abdel-Wahab, O., Gao, J., Adli, M., Dey, A., Trimarchi, T., Chung, Y. R., Kuscu, C., Hricik, T., Ndiaye-Lobry, D., LaFave, L. M., Koche, R., Shih, A. H., and 15 others.
<strong>Deletion of Asxl1 results in myelodysplasia and severe developmental defects in vivo.</strong>
J. Exp. Med. 210: 2641-2659, 2013.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/24218140/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">24218140</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/?term=24218140[PMID]&report=imagesdocsum" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Image', 'domain': 'ncbi.nlm.nih.gov'})">images</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=24218140" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1084/jem.20131141" target="_blank">Full Text</a>]
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<a id="2" class="mim-anchor"></a>
<a id="Carbuccia2009" class="mim-anchor"></a>
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Carbuccia, N., Murati, A., Trouplin, V., Brecqueville, M., Adelaide, J., Rey, J., Vainchenker, W., Bernard, O. A., Chaffanet, M., Vey, N., Birnbaum, D., Mozziconacci, M. J.
<strong>Mutations of ASXL1 gene in myeloproliferative neoplasms. (Letter)</strong>
Leukemia 23: 2183-2186, 2009.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/19609284/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">19609284</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19609284" 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/leu.2009.141" target="_blank">Full Text</a>]
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<a id="3" class="mim-anchor"></a>
<a id="Chou2010" class="mim-anchor"></a>
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<p class="mim-text-font">
Chou, W.-C., Huang, H.-H., Hou, H.-A., Chen, C.-Y., Tang, J.-L., Yao, M., Tsay, W., Ko, B.-S., Wu, S.-J., Huang, S.-Y., Hsu, S.-C., Chen, Y.-C., Huang, Y.-N., Chang, Y.-C., Lee, F.-Y., Liu, M.-C., Liu, C.-W., Tseng, M.-H., Huang, C.-F., Tien, H.-F.
<strong>Distinct clinical and biological features of de novo acute myeloid leukemia with additional sex comb-like 1 (ASXL1) mutations.</strong>
Blood 116: 4086-4094, 2010.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/20693432/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">20693432</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=20693432" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1182/blood-2010-05-283291" target="_blank">Full Text</a>]
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<a id="Fisher2003" class="mim-anchor"></a>
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Fisher, C. L., Berger, J., Randazzo, F., Brock, H. W.
<strong>A human homolog of Additional sex combs, ADDITIONAL SEX COMBS-LIKE 1, maps to chromosome 20q11.</strong>
Gene 306: 115-126, 2003.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/12657473/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">12657473</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12657473" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1016/s0378-1119(03)00430-x" target="_blank">Full Text</a>]
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<a id="Gelsi-Boyer2009" class="mim-anchor"></a>
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Gelsi-Boyer, V., Trouplin, V., Adelaide, J., Bonansea, J., Cervera, N., Carbuccia, N., Lagarde, A., Prebet, T., Nezri, M., Sainty, D., Olschwang, S., Xerri, L., Chaffanet, M., Mozziconacci, M.-J., Vey, N., Birnbaum, D.
<strong>Mutations of polycomb-associated gene ASXL1 in myelodysplastic syndromes and chronic myelomonocytic leukaemia.</strong>
Brit. J. Haemat. 145: 788-800, 2009.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/19388938/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">19388938</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=19388938" 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.1365-2141.2009.07697.x" target="_blank">Full Text</a>]
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<a id="Hoischen2011" class="mim-anchor"></a>
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Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others.
<strong>De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.</strong>
Nature Genet. 43: 729-731, 2011.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/21706002/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">21706002</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21706002" 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/ng.868" target="_blank">Full Text</a>]
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<a id="Leon2020" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Leon, E., Diaz, J., Castilla-Vallmanya, L., Grinberg, D., Balcells, S., Urreizti, R.
<strong>Extending the phenotypic spectrum of Bohring-Opitz syndrome: mild case confirmed by functional studies.</strong>
Am. J. Med. Genet. 182A: 201-204, 2020.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/31692235/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">31692235</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=31692235" 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/ajmg.a.61397" target="_blank">Full Text</a>]
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<a id="Magini2012" class="mim-anchor"></a>
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Magini, P., Della Monica, M., Uzielli, M. L. G., Mongelli, P., Scarselli, G., Gambineri, E., Scarano, G., Seri, M.
<strong>Two novel patients with Bohring-Opitz syndrome caused by de novo ASXL1 mutations.</strong>
Am. J. Med. Genet. 158A: 917-921, 2012.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/22419483/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">22419483</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=22419483" 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/ajmg.a.35265" target="_blank">Full Text</a>]
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<a id="Nagase1999" class="mim-anchor"></a>
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Nagase, T., Ishikawa, K., Suyama, M., Kikuno, R., Hirosawa, M., Miyajima, N., Tanaka, A., Kotani, H., Nomura, N., Ohara, O.
<strong>Prediction of the coding sequences of unidentified human genes. XIII. The complete sequences of 100 new cDNA clones from brain which code for large proteins in vitro.</strong>
DNA Res. 6: 63-70, 1999.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/10231032/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">10231032</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=10231032" 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/dnares/6.1.63" target="_blank">Full Text</a>]
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<a id="Park2011" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Park, U.-H., Yoon, S. K., Park, T., Kim, E.-J., Um, S.-J.
<strong>Additional sex comb-like (ASXL) proteins 1 and 2 play opposite roles in adipogenesis via reciprocal regulation of peroxisome proliferator-activated receptor gamma.</strong>
J. Biol. Chem. 286: 1354-1363, 2011.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/21047783/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">21047783</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/?term=21047783[PMID]&report=imagesdocsum" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Image', 'domain': 'ncbi.nlm.nih.gov'})">images</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=21047783" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1074/jbc.M110.177816" target="_blank">Full Text</a>]
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<a id="Yuan2019" class="mim-anchor"></a>
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Yuan, B., Neira, J., Pehlivan, D., Santiago-Sim, T., Song, X., Rosenfeld, J., Posey, J. E., Patel, V., Jin, W., Adam, M. P., Baple, E. L., Dean, J., and 34 others.
<strong>Clinical exome sequencing reveals locus heterogeneity and phenotypic variability of cohesinopathies.</strong>
Genet. Med. 21: 663-675, 2019.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/30158690/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">30158690</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/?term=30158690[PMID]&report=imagesdocsum" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Image', 'domain': 'ncbi.nlm.nih.gov'})">images</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=30158690" 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/s41436-018-0085-6" target="_blank">Full Text</a>]
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Sonja A. Rasmussen - updated : 08/16/2022
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Paul J. Converse - updated : 6/11/2014<br>Cassandra L. Kniffin - updated : 1/10/2013<br>Cassandra L. Kniffin - updated : 8/18/2011<br>Cassandra L. Kniffin - updated : 8/1/2011<br>Patricia A. Hartz - updated : 2/25/2011<br>Cassandra L. Kniffin - updated : 10/6/2009
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Patricia A. Hartz : 8/31/2009
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carol : 08/16/2022
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carol : 01/08/2020<br>mgross : 07/02/2014<br>mcolton : 6/11/2014<br>carol : 9/12/2013<br>mgross : 2/5/2013<br>alopez : 1/22/2013<br>ckniffin : 1/10/2013<br>carol : 10/25/2011<br>ckniffin : 10/24/2011<br>alopez : 8/22/2011<br>ckniffin : 8/18/2011<br>wwang : 8/9/2011<br>ckniffin : 8/1/2011<br>wwang : 5/19/2011<br>mgross : 3/14/2011<br>terry : 2/25/2011<br>alopez : 1/28/2010<br>wwang : 10/14/2009<br>ckniffin : 10/6/2009<br>mgross : 8/31/2009
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<strong>*</strong> 612990
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ASXL TRANSCRIPTIONAL REGULATOR 1; ASXL1
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<em>Alternative titles; symbols</em>
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ADDITIONAL SEX COMBS-LIKE 1<br />
KIAA0978
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<strong><em>HGNC Approved Gene Symbol: ASXL1</em></strong>
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<strong>SNOMEDCT:</strong> 720565000; &nbsp;
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Cytogenetic location: 20q11.21
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : 20:32,358,331-32,439,319 </span>
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</strong>
<span class="small">(from NCBI)</span>
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<strong>Gene-Phenotype Relationships</strong>
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Location
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Phenotype
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="2">
<span class="mim-font">
20q11.21
</span>
</td>
<td>
<span class="mim-font">
Bohring-Opitz syndrome
</span>
</td>
<td>
<span class="mim-font">
605039
</span>
</td>
<td>
<span class="mim-font">
Autosomal dominant
</span>
</td>
<td>
<span class="mim-font">
3
</span>
</td>
</tr>
<tr>
<td>
<span class="mim-font">
Myelodysplastic syndrome, somatic
</span>
</td>
<td>
<span class="mim-font">
614286
</span>
</td>
<td>
<span class="mim-font">
</span>
</td>
<td>
<span class="mim-font">
3
</span>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>TEXT</strong>
</span>
</h4>
<div>
<h4>
<span class="mim-font">
<strong>Description</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>ASXL1 is a human homolog of the Drosophila asx gene. Drosophila asx is an enhancer of trithorax (see 159555) and polycomb (see 610231) (ETP) gene that encodes a chromatin protein required to maintain both activation and silencing of homeotic loci (summary by Fisher et al., 2003). </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Cloning and Expression</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>By sequencing clones obtained from a size-fractionated human brain cDNA library, Nagase et al. (1999) obtained a partial ASXL1 clone, which they designated KIAA0978. RT-PCR ELISA detected low to moderate expression in all adult and fetal tissues and specific adult brain regions examined. </p><p>By searching EST databases for sequences similar to Drosophila asx and by screening an adult heart cDNA library, Fisher et al. (2003) obtained overlapping clones covering the ASXL1 coding sequence. The deduced 1,541-amino acid protein has a calculated molecular mass of 165.5 kD. The N-terminal region of ASXL1 contains a serine-rich region, 3 nuclear localization signals, a PEST motif, a nuclear receptor-binding motif, and a region that shares high sequence identity with Drosophila asx, which Fisher et al. (2003) called the asx homology domain (AHD). The AHD is followed by a glycine-rich region, 3 additional PEST sequences, and a C-terminal plant homeodomain (PHD). ASXL1 lacks the AT-hook motif and the nucleotide-binding motif of Drosophila asx. ASXL1 shares over 70% amino acid identity with mouse Asxl1 and 21% identity with Drosophila asx. Northern blot analysis detected variable expression of ASXL1 transcripts of 8.0 and 6.0 kb. Expression was highest in testis, moderate in thymus, ovary, lymph node, and appendix, very low in other tissues, and undetectable in adult liver and kidney. The 8.0-kb transcript was dominant in most tissues, but the 6.0-kb transcript was dominant in testis. Testis also expressed a 5.0-kb transcript that was not detected in other tissues. </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Gene Structure</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Fisher et al. (2003) determined that the ASXL1 gene contains 13 exons and spans 81 kb. Exon 13 contains the entire 3-prime UTR and is almost 5 kb long. The smallest exon, exon 3, is 3 bp long. </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Mapping</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Using FISH and genomic sequence analysis, Fisher et al. (2003) mapped the ASXL1 gene to chromosome 20q11.21, between the KIF3B gene (603754) and the DNMT3B gene (602900). </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Gene Function</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Using mouse and human cell lines, Park et al. (2011) showed that mouse Asxl1 and human ASXL2 (612991) interacted with PPAR-alpha (PPARA; 170998) and PPAR-gamma (PPARG; 601487) and played opposite roles in adipogenesis. Asxl1 suppressed transactivation activity of ligand-bound PPAR-gamma and blocked adipogenic differentiation in mouse 3T3-L1 cells, whereas ASXL2 promoted these activities. Mutation analysis revealed that the heterochromatin protein-1 (HP1; see 604478)-binding domain of Asxl1 was required for its repressive activity. Without the HP1-binding domain, Asxl1 behaved like ASXL2 to promote PPAR-gamma activity and induce adipogenesis. In chromatin immunoprecipitation assays in 3T3-L1 cells, Asxl1 occupied the promoter of the endogenous PPAR-gamma target Ap2 (FABP4; 600434) together with the inhibitory factors HP1-alpha (CBX5; 604478) and lys9-methylated histone H3 (see 602810), whereas ASXL2 occupied the Ap2 promoter together with the activating factors histone lysine N-methyltransferase MLL1 (159555) and lys9-acetylated and lys4-methylated H3 histones. Microarray analysis showed that Asxl1 repressed, whereas ASXL2 increased, the expression of a subset of adipogenic genes, most of which are PPAR-gamma targets. Park et al. (2011) concluded that ASXL1 is a PPAR-gamma corepressor and that ASXK2 is a PPAR-gamma coactivator. They proposed that ASXL1 and ASXL2 fine-tune adipogenesis via differential regulation of PPAR-gamma. </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Molecular Genetics</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p><strong><em>Somatic Mutations in Myeloid Malignancies</em></strong></p><p>
Gelsi-Boyer et al. (2009) presented evidence that the ASXL1 gene may act as a tumor suppressor in myeloid malignancies. They identified heterozygous somatic mutations in the ASXL1 gene in 5 (16%) of 38 myelodysplastic syndrome (MDS; 614286)/acute myeloid leukemia (AML; 601626) samples. Somatic ASXL1 mutations were also found in 19 (43%) of 44 chronic myelomonocytic leukemia (CMML; see 607785) samples. All the mutations were in exon 12 and resulted in truncation of the C terminus PHD finger of the protein. The findings suggested that regulators of gene expression via DNA methylation, histone modification, and chromatin remodeling could be altered in myelodysplastic syndromes and some leukemias. The same group (Carbuccia et al., 2009) identified heterozygous somatic truncating ASXL1 mutations in 5 (7.8%) of 64 myeloproliferative neoplasms, including 1 essential thrombocythemia (187950), 3 primary myelofibrosis (254450), and 1 AML. </p><p>Chou et al. (2010) identified somatic mutations in exon 12 of the ASXL1 gene disrupting the PHD domain in 54 (10.8%) of 501 adults with de novo AML. There was a similar frequency of ASXL1 mutations in those with a normal karyotype (8.9%) and those with abnormal cytogenetics (12.9%), but 39 of the 54 patients with ASXL1 mutations had concurrent mutations in other genes. ASXL1 mutations were closely associated with older age, male sex, isolated trisomy 8, RUNX1 (151385) mutations, and expression of HLA-DR and CD34, but inversely associated with t(15;17), complex cytogenetics, FLT3-internal tandem duplication, NPM1 (164040) mutations, WT1 (607102) mutations, and expression of CD33 (159590) and CD15. Patients with ASXL1 mutations had a shorter overall survival than patients without mutations, but mutation status was not an independent adverse prognostic factor in multivariate analysis. Sequential analyses of patient samples showed that the original ASXL1 mutations were lost at relapse and/or refractory status in 2 of the 6 relapsed ASXL1-mutated patients studied, whereas 2 of the 109 ASXL1-wildtype patients acquired a novel ASXL1 mutation at relapse. Chou et al. (2010) suggested that AML with ASXL1 mutations showed distinct clinical and biologic features and that ASXL1 mutation status can change during disease evolution. </p><p><strong><em>Bohring-Opitz Syndrome</em></strong></p><p>
By exome sequencing in combination with direct sequencing, Hoischen et al. (2011) identified 7 different de novo heterozygous nonsense or truncating mutations in the ASXL1 gene (see, e.g., 612990.0001-612990.0005) in 7 of 13 unrelated patients with Bohring-Opitz syndrome (605039), a severe developmental and malformation disorder characterized by intrauterine growth retardation, poor feeding, profound mental retardation, trigonocephaly, prominent metopic suture, exophthalmos, nevus flammeus of the face, upslanting palpebral fissures, hirsutism, and flexion of the elbows and wrists with deviation of the wrists and metacarpophalangeal joints. Hoischen et al. (2011) postulated a loss-of-function mechanism. The ASXL1 gene is involved in the maintenance of both activation and silencing of the HOX genes, which are involved in body patterning, as well as in chromatin remodeling, although the patients did not have any specific homeotic transformations. </p><p>In 2 unrelated patients with classic features of Bohring-Opitz syndrome, Magini et al. (2012) identified 2 different de novo heterozygous truncating mutations in the ASXL1 gene (612990.0006 and 612990.0007). </p><p>In a patient with a mild case of Bohring-Opitz syndrome, Leon et al. (2020) identified heterozygosity for a de novo splicing mutation in the ASXL1 gene (612990.0008). </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Animal Model</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Abdel-Wahab et al. (2013) found that Asxl1-null mice had multiple developmental abnormalities, including anophthalmia, microcephaly, cleft palate, and mandibular malformation. Hemopoietic-specific deletion of Asxl1 in mice resulted in progressive, multilineage cytopenias and dysplasia with increased numbers of hemopoietic stem/progenitor cells, characteristic of human MDS. Serial transplantation of Asxl1-null hemopoietic cells caused a lethal myeloid disorder with a shorter latency than primary Asxl1-null mice. Deletion of Asxl1 reduced hemopoietic stem cell self-renewal, which was restored by concurrent deletion of Tet2 (612839), a gene frequently co-mutated with ASXL1 in MDS patients. Asxl1/Tet2 double-knockout mice had an MDS phenotype with more rapid mortality compared with single gene-knockout mice. Asxl1 loss resulted in a genomewide reduction of histone H3 lys27 trimethylation and dysregulated expression of known regulators of hemopoiesis. Chromosome immunoprecipitation of Asxl1 followed by DNA sequencing in mouse hemopoietic cells identified a subset of genes differentially regulated by Asxl1. Abdel-Wahab et al. (2013) concluded that ASXL1 is important in development and hemopoiesis. </p>
</span>
<div>
<br />
</div>
</div>
<div>
<h4>
<span class="mim-font">
<strong>ALLELIC VARIANTS</strong>
</span>
<strong>8 Selected Examples):</strong>
</span>
</h4>
<div>
<p />
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0001 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASXL1, GLN925TER
<br />
SNP: rs387907077,
ClinVar: RCV000023976, RCV004721246
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a patient with Bohring-Opitz syndrome (605039), Hoischen et al. (2011) identified a de novo heterozygous 2773C-T transition in the ASXL1 gene, resulting in a gln925-to-ter (Q925X) substitution. The patient died at age 6 years. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0002 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASXL1, ARG404TER
<br />
SNP: rs373145711,
gnomAD: rs373145711,
ClinVar: RCV000023977, RCV000414833, RCV000415151, RCV000627196, RCV001199371
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a 7-year-old girl with Bohring-Opitz syndrome (605039), Hoischen et al. (2011) identified a de novo heterozygous 1210C-T transition in the ASXL1 gene, resulting in an arg404-to-ter (R404X) substitution. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0003 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASXL1, SER1028TER
<br />
SNP: rs200702600,
gnomAD: rs200702600,
ClinVar: RCV000023978
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a 2.5-year-old girl with Bohring-Opitz syndrome (605039), Hoischen et al. (2011) identified a de novo heterozygous 3083C-A transversion in the ASXL1 gene, resulting in a ser1028-to-ter (S1028X) substitution. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0004 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASLX1, 1-BP DUP, NT2535
<br />
SNP: rs750170870,
gnomAD: rs750170870,
ClinVar: RCV000023979
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a 24-year-old woman with Bohring-Opitz syndrome (605039), Hoischen et al. (2011) identified a de novo heterozygous 1-bp duplication at nucleotide 2535 in the ASXL1 gene, resulting in a frameshift and premature termination (Ser846GlnfsTer5). </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0005 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASLX1, GLN733TER
<br />
SNP: rs387907078,
gnomAD: rs387907078,
ClinVar: RCV000023980
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a female infant with Bohring-Opitz syndrome (605039), Hoischen et al. (2011) identified a de novo heterozygous 2197C-T transition in the ASXL1 gene, resulting in a gln733-to-ter (Q733X) substitution. The patient died 23 hours after birth. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0006 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASLX1, 5-BP DEL, NT2407
<br />
SNP: rs1600588199,
ClinVar: RCV000032664
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a 3-year-old girl with typical features of Bohring-Opitz syndrome (605039), Magini et al. (2012) identified a de novo heterozygous 5-bp deletion in the ASLX1 gene (2407_2411del), resulting in a frameshift and premature termination (Gln803ThrfsTer17). The mutation was not found in 2 large databases. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0007 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASLX1, ARG965TER
<br />
SNP: rs397515401,
gnomAD: rs397515401,
ClinVar: RCV000032665, RCV000255108
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a 7-year-old boy with typical features of Bohring-Opitz syndrome (605039), Magini et al. (2012) identified a de novo heterozygous 2893C-T transition in the ASLX1 gene, resulting in an arg965-to-ter (R965X) substitution. The mutation was not found in 2 large databases. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0008 &nbsp; BOHRING-OPITZ SYNDROME</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
ASLX1, IVS12, A-G, -2
<br />
SNP: rs2011649912,
ClinVar: RCV002275470
</span>
</div>
<div>
<span class="mim-text-font">
<p>By whole-exome sequencing in a 5-year-old girl with a mild case of Bohring-Opitz syndrome (BOPS; 605039), Leon et al. (2020) identified a de novo heterozygous c.1720A-G transition (ENST00000375687) in the ASLX1 gene at the canonical splice acceptor site of intron 12, resulting in a frameshift and a premature stop codon after 21 residues (Ile574ValfsTer22). Analysis of the mRNA splicing pattern on patient fibroblasts by Sanger sequencing showed that the mutation leads to full retention of intron 12. The resulting protein is predicted to lack the C terminus end of the protein. The patient had previously been reported by Yuan et al. (2019) as patient 3 with a Cornelia de Lange-like phenotype. </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">
Abdel-Wahab, O., Gao, J., Adli, M., Dey, A., Trimarchi, T., Chung, Y. R., Kuscu, C., Hricik, T., Ndiaye-Lobry, D., LaFave, L. M., Koche, R., Shih, A. H., and 15 others.
<strong>Deletion of Asxl1 results in myelodysplasia and severe developmental defects in vivo.</strong>
J. Exp. Med. 210: 2641-2659, 2013.
[PubMed: 24218140]
[Full Text: https://doi.org/10.1084/jem.20131141]
</p>
</li>
<li>
<p class="mim-text-font">
Carbuccia, N., Murati, A., Trouplin, V., Brecqueville, M., Adelaide, J., Rey, J., Vainchenker, W., Bernard, O. A., Chaffanet, M., Vey, N., Birnbaum, D., Mozziconacci, M. J.
<strong>Mutations of ASXL1 gene in myeloproliferative neoplasms. (Letter)</strong>
Leukemia 23: 2183-2186, 2009.
[PubMed: 19609284]
[Full Text: https://doi.org/10.1038/leu.2009.141]
</p>
</li>
<li>
<p class="mim-text-font">
Chou, W.-C., Huang, H.-H., Hou, H.-A., Chen, C.-Y., Tang, J.-L., Yao, M., Tsay, W., Ko, B.-S., Wu, S.-J., Huang, S.-Y., Hsu, S.-C., Chen, Y.-C., Huang, Y.-N., Chang, Y.-C., Lee, F.-Y., Liu, M.-C., Liu, C.-W., Tseng, M.-H., Huang, C.-F., Tien, H.-F.
<strong>Distinct clinical and biological features of de novo acute myeloid leukemia with additional sex comb-like 1 (ASXL1) mutations.</strong>
Blood 116: 4086-4094, 2010.
[PubMed: 20693432]
[Full Text: https://doi.org/10.1182/blood-2010-05-283291]
</p>
</li>
<li>
<p class="mim-text-font">
Fisher, C. L., Berger, J., Randazzo, F., Brock, H. W.
<strong>A human homolog of Additional sex combs, ADDITIONAL SEX COMBS-LIKE 1, maps to chromosome 20q11.</strong>
Gene 306: 115-126, 2003.
[PubMed: 12657473]
[Full Text: https://doi.org/10.1016/s0378-1119(03)00430-x]
</p>
</li>
<li>
<p class="mim-text-font">
Gelsi-Boyer, V., Trouplin, V., Adelaide, J., Bonansea, J., Cervera, N., Carbuccia, N., Lagarde, A., Prebet, T., Nezri, M., Sainty, D., Olschwang, S., Xerri, L., Chaffanet, M., Mozziconacci, M.-J., Vey, N., Birnbaum, D.
<strong>Mutations of polycomb-associated gene ASXL1 in myelodysplastic syndromes and chronic myelomonocytic leukaemia.</strong>
Brit. J. Haemat. 145: 788-800, 2009.
[PubMed: 19388938]
[Full Text: https://doi.org/10.1111/j.1365-2141.2009.07697.x]
</p>
</li>
<li>
<p class="mim-text-font">
Hoischen, A., van Bon, B. W. M., Rodriguez-Santiago, B., Gilissen, C., Vissers, L. E. L. M., de Vries, P., Janssen, I., van Lier, B., Hastings, R., Smithson, S. F., Newbury-Ecob, R., Kjaergaard, S., and 11 others.
<strong>De novo nonsense mutations in ASXL1 cause Bohring-Opitz syndrome.</strong>
Nature Genet. 43: 729-731, 2011.
[PubMed: 21706002]
[Full Text: https://doi.org/10.1038/ng.868]
</p>
</li>
<li>
<p class="mim-text-font">
Leon, E., Diaz, J., Castilla-Vallmanya, L., Grinberg, D., Balcells, S., Urreizti, R.
<strong>Extending the phenotypic spectrum of Bohring-Opitz syndrome: mild case confirmed by functional studies.</strong>
Am. J. Med. Genet. 182A: 201-204, 2020.
[PubMed: 31692235]
[Full Text: https://doi.org/10.1002/ajmg.a.61397]
</p>
</li>
<li>
<p class="mim-text-font">
Magini, P., Della Monica, M., Uzielli, M. L. G., Mongelli, P., Scarselli, G., Gambineri, E., Scarano, G., Seri, M.
<strong>Two novel patients with Bohring-Opitz syndrome caused by de novo ASXL1 mutations.</strong>
Am. J. Med. Genet. 158A: 917-921, 2012.
[PubMed: 22419483]
[Full Text: https://doi.org/10.1002/ajmg.a.35265]
</p>
</li>
<li>
<p class="mim-text-font">
Nagase, T., Ishikawa, K., Suyama, M., Kikuno, R., Hirosawa, M., Miyajima, N., Tanaka, A., Kotani, H., Nomura, N., Ohara, O.
<strong>Prediction of the coding sequences of unidentified human genes. XIII. The complete sequences of 100 new cDNA clones from brain which code for large proteins in vitro.</strong>
DNA Res. 6: 63-70, 1999.
[PubMed: 10231032]
[Full Text: https://doi.org/10.1093/dnares/6.1.63]
</p>
</li>
<li>
<p class="mim-text-font">
Park, U.-H., Yoon, S. K., Park, T., Kim, E.-J., Um, S.-J.
<strong>Additional sex comb-like (ASXL) proteins 1 and 2 play opposite roles in adipogenesis via reciprocal regulation of peroxisome proliferator-activated receptor gamma.</strong>
J. Biol. Chem. 286: 1354-1363, 2011.
[PubMed: 21047783]
[Full Text: https://doi.org/10.1074/jbc.M110.177816]
</p>
</li>
<li>
<p class="mim-text-font">
Yuan, B., Neira, J., Pehlivan, D., Santiago-Sim, T., Song, X., Rosenfeld, J., Posey, J. E., Patel, V., Jin, W., Adam, M. P., Baple, E. L., Dean, J., and 34 others.
<strong>Clinical exome sequencing reveals locus heterogeneity and phenotypic variability of cohesinopathies.</strong>
Genet. Med. 21: 663-675, 2019.
[PubMed: 30158690]
[Full Text: https://doi.org/10.1038/s41436-018-0085-6]
</p>
</li>
</ol>
<div>
<br />
</div>
</div>
</div>
<div>
<div class="row">
<div class="col-lg-1 col-md-1 col-sm-2 col-xs-2">
<span class="text-nowrap mim-text-font">
Contributors:
</span>
</div>
<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Sonja A. Rasmussen - updated : 08/16/2022<br>Paul J. Converse - updated : 6/11/2014<br>Cassandra L. Kniffin - updated : 1/10/2013<br>Cassandra L. Kniffin - updated : 8/18/2011<br>Cassandra L. Kniffin - updated : 8/1/2011<br>Patricia A. Hartz - updated : 2/25/2011<br>Cassandra L. Kniffin - updated : 10/6/2009
</span>
</div>
</div>
</div>
<div>
<br />
</div>
<div>
<div class="row">
<div class="col-lg-1 col-md-1 col-sm-2 col-xs-2">
<span class="text-nowrap mim-text-font">
Creation Date:
</span>
</div>
<div class="col-lg-6 col-md-6 col-sm-6 col-xs-6">
<span class="mim-text-font">
Patricia A. Hartz : 8/31/2009
</span>
</div>
</div>
</div>
<div>
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</div>
<div>
<div class="row">
<div class="col-lg-1 col-md-1 col-sm-2 col-xs-2">
<span class="text-nowrap mim-text-font">
Edit History:
</span>
</div>
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