Tobias B. Haack, Christian Staufner, Marlies G. Köpke, Beate K

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Biallelic Mutations in NBAS Cause Recurrent Acute Liver Failure with Onset in Infancy Tobias B. Haack, Christian Staufner, Marlies G. Köpke, Beate K. Straub, Stefan Kölker, Christian Thiel, Peter Freisinger, Ivo Baric, Patrick J. McKiernan, Nicola Dikow, Inga Harting, Flemming Beisse, Peter Burgard, Urania Kotzaeridou, Joachim Kühr, Urban Himbert, Robert W. Taylor, Felix Distelmaier, Jerry Vockley, Lina Ghaloul-Gonzalez, Johannes Zschocke, Laura S. Kremer, Elisabeth Graf, Thomas Schwarzmayr, Daniel M. Bader, Julien Gagneur, Thomas Wieland, Caterina Terrile, Tim M. Strom, Thomas Meitinger, Georg F. Hoffmann, Holger Prokisch The American Journal of Human Genetics Volume 97, Issue 1, Pages 163-169 (July 2015) DOI: 10.1016/j.ajhg.2015.05.009 Copyright © 2015 The Authors Terms and Conditions

Figure 1 Pedigrees of Investigated Families Pedigrees of ten families affected by RALF and mutations in NBAS. Mutation status of affected (closed symbols) and healthy (open symbols) family members. The American Journal of Human Genetics 2015 97, 163-169DOI: (10.1016/j.ajhg.2015.05.009) Copyright © 2015 The Authors Terms and Conditions

Figure 2 NBAS Structure and Conservation of Identified Mutations Gene structure of NBAS with known protein domains of the gene product and localization and conservation of amino acid residues affected by mutations. Mutation c.5741G>A (p.Arg1914His) in exon 45 in the C-terminal domain of unknown function is associated with SOPH syndrome.17 Amino acids 90–371 form a quinoprotein aminedehydrogenase, beta chain like domain (IPR011044) and amino acids 725–1,376 form a secretory pathway sec39 domain (IPR013244). Intronic regions are not drawn to scale. The American Journal of Human Genetics 2015 97, 163-169DOI: (10.1016/j.ajhg.2015.05.009) Copyright © 2015 The Authors Terms and Conditions

Figure 3 Quantification of NBAS and p31 Protein Levels Mutant and control fibroblast cell lines were cultivated at 37°C. 10 μg protein of collected cells were separated on a 4%–12% acrylamide gradient gel, transferred to a PVDF membrane, and immunodecorated with antibodies against NBAS, p31, and β-actin. The antibody for NBAS was detecting a single protein band at approximately 270 kDa corresponding to the predicted molecular weight of NBAS. β-actin was used as a loading control. The quantified protein levels are based on three independent experiments and expressed as percentages of a control cell line, corrected for β-actin. Five of the eight investigated subject cell lines are shown. NBAS and p31 protein levels were severely reduced in fibroblast cell lines of RALF-affected individuals to 21% and 33% of control subjects, respectively. Error bar indicates 1 SD. Protein amount in control 1 was set as 100%. The American Journal of Human Genetics 2015 97, 163-169DOI: (10.1016/j.ajhg.2015.05.009) Copyright © 2015 The Authors Terms and Conditions

Figure 4 Increased Expression of ER Stress Response Genes Quartiles (boxes) and 1.5 times the interquartile range (whiskers) of the fold change of normalized RNA-seq read counts from fibroblasts are displayed. Three individuals with pathogenic variants in NBAS (F1:II.1, F2:II.1, and F5:II.2) are compared against the median per gene over 12 control samples. We obtained interaction partners of the NBAS protein from the BioGrid database (v.3.3).18 The genes associated with the corresponding gene ontology terms were downloaded from UniProt (accessed March 2015).19 For every box, we computed a two-sided Wilcoxon test whether it is symmetric about 1. Single data points are shown for boxes with less than 50 genes. Gene ontology (GO) terms: GO 0034976, response to endoplasmic reticulum stress; GO 0001889, liver development; GO 0006259, DNA metabolic process; GO 0006119, oxidative phosphorylation. ns, p > 0.1. The American Journal of Human Genetics 2015 97, 163-169DOI: (10.1016/j.ajhg.2015.05.009) Copyright © 2015 The Authors Terms and Conditions