Dominant Mutations in KAT6A Cause Intellectual Disability with Recognizable Syndromic Features  Emma Tham, Anna Lindstrand, Avni Santani, Helena Malmgren,

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Dominant Mutations in KAT6A Cause Intellectual Disability with Recognizable Syndromic Features  Emma Tham, Anna Lindstrand, Avni Santani, Helena Malmgren, Addie Nesbitt, Holly A. Dubbs, Elaine H. Zackai, Michael J. Parker, Francisca Millan, Kenneth Rosenbaum, Golder N. Wilson, Ann Nordgren  The American Journal of Human Genetics  Volume 96, Issue 3, Pages 507-513 (March 2015) DOI: 10.1016/j.ajhg.2015.01.016 Copyright © 2015 The American Society of Human Genetics Terms and Conditions

Figure 1 Facial Characteristics of the Individuals with KAT6A Mutations Individuals with KAT6A mutations show distinct facial features. Subject 2 at 22 months (A) and 9 years (B); subject 3 at 22 months (C) and 9 years (D); subject 4 at 4 months (E) and 12 months of age (F); subject 5 at 10 months (G) and 4 years 4 months of age (H); subject 6 at 5 months (I) and 3.5 years (J); and subject 7 at 17 years (K and L). There are common features in all affected individuals, e.g., bitemporal narrowing, broad nasal tip, low-set ears, thin upper lip, and/or tented mouth, although other features such as ptosis, downturned corners of the mouth, micrognathia, and smooth philtrum can only be seen in a subset of the subjects. See Table S1 for more details. The American Journal of Human Genetics 2015 96, 507-513DOI: (10.1016/j.ajhg.2015.01.016) Copyright © 2015 The American Society of Human Genetics Terms and Conditions

Figure 2 Pedigrees of the Families with KAT6A Mutations with Individual Results of Sanger Sequencing Pedigrees and KAT6A Sanger sequencing traces (A–E; with reverse strand in B) or array-CGH findings (F) in all families with KAT6A mutations. Squares denote males and circles denote females. Blackened symbols represent the affected children. The generation numbers are shown to the left and individual identification numbers are shown underneath the symbols. The American Journal of Human Genetics 2015 96, 507-513DOI: (10.1016/j.ajhg.2015.01.016) Copyright © 2015 The American Society of Human Genetics Terms and Conditions

Figure 3 Genetic Location and Functional Consequences of Detected KAT6A Mutations (A) Schematic human chromosome 8. A vertical red line indicates the position of KAT6A at 8p11.21. (B) A zoomed depiction of the KAT6A locus with a schematic illustration of exons (vertical black bars). The genetic position of all of the five KAT6A point mutations is marked by black arrows. (C) A schematic illustration of the main functional units of human KAT6A: the nuclear localization domain (H15), a double-plant homeodomain finger (PHD), a histone-acetyl-transferase domain (HAT) containing a C2H2 zinc-finger domain (light blue), and an Acetyl-coenzyme-A-binding domain (yellow); an acidic glutamate/aspartate-rich domain and a transactivation domain with both a serine-rich (red) and a methionine-rich (green) region are also shown. The truncated KAT6A forms are shown below. (D) The relative position of the truncated KAT6A in mutant mouse (MozΔ).11 The American Journal of Human Genetics 2015 96, 507-513DOI: (10.1016/j.ajhg.2015.01.016) Copyright © 2015 The American Society of Human Genetics Terms and Conditions