Mutations in KARS, Encoding Lysyl-tRNA Synthetase, Cause Autosomal-Recessive Nonsyndromic Hearing Impairment DFNB89 Regie Lyn P. Santos-Cortez, Kwanghyuk.

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Mutations in KARS, Encoding Lysyl-tRNA Synthetase, Cause Autosomal-Recessive Nonsyndromic Hearing Impairment DFNB89 Regie Lyn P. Santos-Cortez, Kwanghyuk Lee, Zahid Azeem, Patrick J. Antonellis, Lana M. Pollock, Saadullah Khan, Irfanullah, Paula B. Andrade-Elizondo, Ilene Chiu, Mark D. Adams, Sulman Basit, Joshua D. Smith, Deborah A. Nickerson, Brian M. McDermott, Wasim Ahmad, Suzanne M. Leal The American Journal of Human Genetics Volume 93, Issue 1, Pages 132-140 (July 2013) DOI: 10.1016/j.ajhg.2013.05.018 Copyright © 2013 The American Society of Human Genetics Terms and Conditions

Figure 1 Pedigree Drawings, Clinical Data, and Mutation Information for Families Affected by KARS Variants (A–C) Family 4338 (A), affected by the c.1129G>A (p.Asp377Asn) variant, and families 4406 (B) and 4284 (C), affected by the c.517T>C (p.Tyr173His) variant segregating with hearing impairment. Each family has a unique haplotype within the DFNB89 locus. (D) Air-conduction audiograms for individuals V-6 of family 4338 (black solid), IV-2 of family 4406 (gray), and IV-2 of family 4284 (black dotted). Circles are for the right ear, and crosses are for the left ear. All three individuals have symmetric, moderate-to-profound impairment across all frequencies. (E) Multiple-sequence alignment showing evolutionary conservation of amino acid residues Asp377 and Tyr173 (black arrows) in humans, chickens, mice, and zebrafish. (F) Chromatograms comparing an HI individual who is homozygous for each KARS variant, a heterozygous carrier, and an individual with normal hearing. (G) Auditory brainstem response (ABR) tracings at 80–100 dB from two individuals from family 4406. Red lines are for the right ear, and blue lines are for the left ear. Crosses mark the latency peaks at waves I, III, and V. ABR waveforms were well formed in both individuals but showed unilateral delay in interpeak latencies I-III or I-V and a difference > 0.2 ms in the interaural latencies of wave V. For individual IV-2, the delay in interpeak I-III or I-V was seen only at 100 dB, but not at 90 dB. Additionally, individual IV-7 had an absent compliance peak from tympanometry on the left ear, suggesting otitis media or middle-ear effusion at the time of testing, which could explain the latency delays on the left ear compared to the right ear. Otoacoustic emissions (OAEs) were bilaterally absent in both individuals, ruling out auditory neuropathy. The American Journal of Human Genetics 2013 93, 132-140DOI: (10.1016/j.ajhg.2013.05.018) Copyright © 2013 The American Society of Human Genetics Terms and Conditions

Figure 2 Expression of KARS in Chicken Hair Cells Expression of KARS in purified chicken hair cells was detected by RNA-seq. The alignment of reads was visualized with the Integrative Genomics Viewer; blue read color represents forward orientation relative to the reference genome, and red color represents reverse reads. The American Journal of Human Genetics 2013 93, 132-140DOI: (10.1016/j.ajhg.2013.05.018) Copyright © 2013 The American Society of Human Genetics Terms and Conditions

Figure 3 Expression and Localization of Kars in Zebrafish and Mice RT-PCR analyses of zebrafish (A) and mouse (B) Kars mRNAs with the use of three separate primer sets for each species (Table S2). Tick marks in (A) and (B) correspond to molecular weights of 500 bp (upper) and 400 bp (lower). Confocal images of whole-mount mouse vestibular tissue (C and D) and cochlear cryosections (E–H) are displayed. Scale bars represent 1 μm in (A) and (B) and 10 μm in (C)–(H). (A) Agarose gel confirms the expected amplicon size with the use of primer set 1, directed toward kars cDNA with zebrafish hair cell (HC), macula (M), and whole fish (WF) cDNA templates (lanes 1, 2, and 3, respectively). No product was observed without the template (–) (lane 4). The same pattern of template cDNAs was repeated for primer sets 2 (lanes 5–8) and 3 (lanes 9–12). (B) Agarose gel confirms the expected Kars amplicon size with the use of primer set 1 and mouse macula cDNA (lane 1), but no product was observed without the template (lane 2). The same pattern of template cDNA was used for primer sets 2 (lanes 3–4) and 3 (lanes 5–6). (C) Mouse vestibular tissue labeled with KARS polyclonal antibody (green) and phalloidin (red) reveals the broad distribution of KARS in hair cells and supporting cells. (D) Control mouse vestibular tissue labeled with only secondary antibody and phalloidin. (E) Mouse organ of Corti section labeled with KARS antibody and phalloidin demonstrates KARS localization to inner hair cells, outer hair cells, and supporting cells. Hair cell nuclei are denoted by asterisks. (F) Control organ of Corti tissue labeled exclusively with secondary antibody. (G) A cochlear section reveals KARS localization to an area that contains otic fibrocytes (arrowhead). Localization to this area was observed in 41% (n = 21) of sections. (H) Control, cochlear section labeled with only secondary antibody and phalloidin. The American Journal of Human Genetics 2013 93, 132-140DOI: (10.1016/j.ajhg.2013.05.018) Copyright © 2013 The American Society of Human Genetics Terms and Conditions