PROJECT SUMMARY/ABSTRACT
Multiple cases of MEHMO syndrome, an X-linked intellectual disability syndrome
caused by mutations in EIF2S3 that encodes a core member of the cellular protein synthesis
machinery, have recently been identified. However, the causal links between mis-regulated
protein synthesis and human disease remain poorly understood. EIF2S3 encodes the γ subunit of
translation initiation factor 2 (eIF2γ) that, along with the eIF2 α and β subunits, GTP, and the
initiator Met-tRNAiMet, plays a critical role in selection of the translation start site. Thus, patients
with MEHMO syndrome are likely to experience changes in protein synthesis on both a global
and gene specific level. The acronym MEHMO denotes the symptoms of this syndrome: Mental
deficiency, Epilepsy, Hypogenitalism, Microcephaly, and Obesity. How changes in gene
expression incurred through mutations in eIF2γ result in the presentation of MEHMO syndrome
remains unknown. Thus, there is a critical need to determine the underlying molecular
mechanism governing the phenotype and symptoms of MEHMO patients. The long-term goal of
these studies is to identify key factors and gene expression changes that underlie MEHMO
syndrome in order to develop improved strategies for treating patients. The overall objective in
this application is to determine how mis-regulation of protein synthesis contributes to the
symptoms of MEHMO syndrome. In Aim 1 ribosome profiling, an informatics-based, genome-
wide approach, and additional validation techniques will be used to identify mRNAs subject to
changes in start codon selection and translational efficiency in MEHMO-patient derived iPSCs
expressing mutant eIF2γ or isogenic iPSCs expressing wild-type eIF2g. In Aim 2 wild-type and
eIF2γ mutant iPSCs will be differentiated into neurons that will be utilized in multidisciplinary
analyses, including electrophysiological readings, immunohistochemistry, and ribosome
profiling, geared toward understanding changes in neuronal biology and function caused by the
eIF2γ mutation. In Aim 3 CRISPR Cas9 genome editing will be used to generate isogenic iPSCs
with Vanishing White Matter disease-causing eIF2B mutations. Generation of eIF2B mutant
iPSCs from the isogenic wild-type control iPSCs utilized in Aim 1 will enable direct comparisons
of the protein synthesis changes caused by mutations in eIF2γ and its guanine-nucleotide
exchange factor eIF2B. These studies will enhance our understanding of how translation is mis-
regulated by alterations in eIF2 function, and ultimately provide critical knowledge for the
development of targeted strategies for the treatment of patients with MEHMO syndrome.