PRNP

gene
On this page

Also known as CD230PRPAltPrP

Summary

PRNP (prion protein (Kanno blood group), HGNC:9449) is a protein-coding gene on chromosome 20p13, encoding Alternative prion protein (F7VJQ1).

The protein encoded by this gene is a membrane glycosylphosphatidylinositol-anchored glycoprotein that tends to aggregate into rod-like structures. The encoded protein contains a highly unstable region of five tandem octapeptide repeats. This gene is found on chromosome 20, approximately 20 kbp upstream of a gene which encodes a biochemically and structurally similar protein to the one encoded by this gene. Mutations in the repeat region as well as elsewhere in this gene have been associated with Creutzfeldt-Jakob disease, fatal familial insomnia, Gerstmann-Straussler disease, Huntington disease-like 1, and kuru. An overlapping open reading frame has been found for this gene that encodes a smaller, structurally unrelated protein, AltPrp. Alternative splicing results in multiple transcript variants.

Source: NCBI Gene 5621 — RefSeq curated summary.

At a glance

  • Gene–disease (curated): inherited glutathione synthetase deficiency (Definitive, ClinGen) — +7 more curated relationships
  • GWAS associations: 63
  • Clinical variants (ClinVar): 681 total — 38 pathogenic, 28 likely-pathogenic
  • Phenotypes (HPO): 168
  • MANE Select transcript: NM_000311

Identifiers

Gene identifiers

FieldValue
HGNC IDHGNC:9449
Approved symbolPRNP
Nameprion protein (Kanno blood group)
Location20p13
Locus typegene with protein product
StatusApproved
AliasesCD230, PRP, AltPrP
Ensembl geneENSG00000171867
Ensembl biotypeprotein_coding
OMIM176640
Entrez5621

Gene structure

Transcript identifiers

Ensembl transcripts: 12 — 12 protein_coding

ENST00000379440, ENST00000424424, ENST00000430350, ENST00000457586, ENST00000882184, ENST00000882185, ENST00000882186, ENST00000882187, ENST00000882188, ENST00000967833, ENST00000967834, ENST00000967835

RefSeq mRNA: 6 — MANE Select: NM_000311 NM_000311, NM_001080121, NM_001080122, NM_001080123, NM_001271561, NM_183079

CCDS: CCDS13080

Canonical transcript exons

ENST00000379440 — 2 exons

ExonStartEnd
ENSE0000195734646864564686512
ENSE0000389216846992114701588

Expression profiles

Bgee: expression breadth ubiquitous, 294 present calls, max score 99.86.

FANTOM5 (CAGE): breadth ubiquitous, TPM avg 163.8198 / max 3287.9914, expressed in 1816 samples.

FANTOM5 promoters (8 alternative TSS)

Promoter IDTPM avgSamples expressed
183278148.00131814
18701233.84981820
18327713.27581452
1832921.1186563
1832800.7988511
1832790.6152386
1870110.00722
1870100.00301

Top tissues by expression

295 total, by Bgee expression score (0-100, higher = more expressed):

TissueAnatomy IDExpression scoreQuality
CA1 field of hippocampusUBERON:000388199.86gold quality
Brodmann (1909) area 23UBERON:001355499.86gold quality
pigmented layer of retinaUBERON:000178299.78gold quality
endothelial cellCL:000011599.76gold quality
orbitofrontal cortexUBERON:000416799.76gold quality
dorsal root ganglionUBERON:000004499.75gold quality
ponsUBERON:000098899.72gold quality
trigeminal ganglionUBERON:000167599.72gold quality
choroid plexus epitheliumUBERON:000391199.72gold quality
substantia nigra pars compactaUBERON:000196599.70gold quality
germinal epithelium of ovaryUBERON:000130499.68gold quality
lateral nuclear group of thalamusUBERON:000273699.68gold quality
cerebellar vermisUBERON:000472099.66gold quality
dorsal plus ventral thalamusUBERON:000189799.65gold quality
superior frontal gyrusUBERON:000266199.64gold quality
superior vestibular nucleusUBERON:000722799.64gold quality
parietal lobeUBERON:000187299.60gold quality
subthalamic nucleusUBERON:000190699.60gold quality
substantia nigra pars reticulataUBERON:000196699.59gold quality
lateral globus pallidusUBERON:000247699.59gold quality
adult organismUBERON:000702399.59gold quality
occipital lobeUBERON:000202199.58gold quality
postcentral gyrusUBERON:000258199.58gold quality
entorhinal cortexUBERON:000272899.58gold quality
olfactory bulbUBERON:000226499.56gold quality
primary visual cortexUBERON:000243699.53gold quality
Brodmann (1909) area 9UBERON:001354099.53gold quality
parietal pleuraUBERON:000240099.52gold quality
middle temporal gyrusUBERON:000277199.48gold quality
prefrontal cortexUBERON:000045199.47gold quality

Single-cell (SCXA)

Detected in 12 experiment(s), a significant marker in 8.

ExperimentMarker?Max mean expression
E-CURD-114yes81.57
E-HCAD-35yes51.35
E-HCAD-11yes38.00
E-GEOD-134144yes32.95
E-MTAB-8410yes28.77
E-CURD-46yes16.54
E-MTAB-8142yes15.84
E-GEOD-70580no872.25
E-MTAB-6142no312.17
E-CURD-112no2.81
E-MTAB-9543no2.37
E-ANND-3no0.00

Regulation

Is transcription factor: no

Upstream regulators (CollecTRI, top): FOXO3, HES1, HIF1A, MTF1, NFE2L2, NFKBIB, SP1, TP53, XBP1

miRNA regulators (miRDB)

81 targeting PRNP, top 30 by miRDB confidence (max_score; target_count = how many genes the miRNA targets in total — lower means more specific):

miRNAMax scoreAvg scoremiRNA target_count
HSA-MIR-190A-3P100.0080.355520
HSA-MIR-4673100.0066.641490
HSA-MIR-5011-5P100.0083.465820
HSA-MIR-188-3P100.0068.761240
HSA-MIR-4645-5P99.9865.811284
HSA-MIR-520D-5P99.9873.344883
HSA-MIR-524-5P99.9873.434882
HSA-MIR-314899.9775.066478
HSA-MIR-590-3P99.9674.346478
HSA-MIR-548AT-5P99.9670.832666
HSA-MIR-568899.9673.234504
HSA-MIR-495-3P99.9672.814197
HSA-MIR-55999.9572.283609
HSA-MIR-548AB99.9571.313488
HSA-MIR-548A-5P99.9471.273482
HSA-MIR-548AD-5P99.9471.233502
HSA-MIR-548AE-5P99.9471.233502
HSA-MIR-548AK99.9471.243488
HSA-MIR-548AM-5P99.9471.243488
HSA-MIR-548AP-5P99.9471.143489
HSA-MIR-548AQ-5P99.9471.343426
HSA-MIR-548AR-5P99.9471.283515
HSA-MIR-548AS-5P99.9471.223482
HSA-MIR-548AU-5P99.9471.243488
HSA-MIR-548AY-5P99.9471.233502
HSA-MIR-548B-5P99.9471.233502
HSA-MIR-548BB-5P99.9471.273509
HSA-MIR-548C-5P99.9471.243488
HSA-MIR-548D-5P99.9471.233502
HSA-MIR-548H-5P99.9471.243488

Literature-anchored findings (GeneRIF, showing 40)

  • fibrillogenesis of PrP (195-213) (PMID:11559357)
  • Huntington disease phenocopy is a familial prion disease (PMID:11593450)
  • sporadic–but not variant–Creutzfeldt-Jakob disease is associated with polymorphisms upstream of PRNP exon 1 (PMID:11704923)
  • Three novel PrP mutants were examined employing this model system and compared with wild type as well as known mutant PrPs (PMID:11756421)
  • Molecular dynamics simulations of wild-type and point mutation human prion protein at normal and elevated temperature. (PMID:11775001)
  • colocalized with CBP70 in the nuclear compartment of NB4 cells (PMID:11787070)
  • expressed on endothelial cells and is released during apoptosis on membrane microparticles in human plasma (PMID:11961239)
  • All-trans retinoic acid down-regulates prion protein expression independently of granulocyte maturation. (PMID:11986958)
  • Resting paroxysmal nocturnal hemoglobinuria (CD55(-)) platelets were devoid of surface PrPc, but activation of platelets resulted in the surface expression of PrPc. (PMID:12070046)
  • PrP was detected on all major human blood cells types except eosinophils, but was not detected as ubiquitously or uniformly on major blood cell types of different animal species. (PMID:12084159)
  • PRPc acquires Proteinase K resistance with structural rearrangement, which can be promoted by the presence of a PrP(Sc) template (PMID:12161431)
  • Cell-surface prion protein interacts with glycosaminoglycans (PMID:12186633)
  • Spontaneous mutations in the prion protein gene causing transmissible spongiform encephalopathy. (PMID:12205650)
  • examined the kinetics of folding and unfolding reactions for the recombinant human prion protein C-terminal fragment 90-231; data provide clear evidence for the population of an intermediate on the refolding pathway of the prion protein (PMID:12356762)
  • PrP(C) transfer required the GPI anchor and direct cell to cell contact (PMID:12359724)
  • Cellular stress up-regulates both the transcription and translation of PrP through interaction with the HSEs on the PrP gene promoter, resulting in an increase in protein synthesis. (PMID:12392052)
  • PRNP missense mutations causing familial Creutzfeldt-Jakob disease recapitulate conserved residues in Doppel: a case of molecular mimicry? (PMID:12459456)
  • CD34+ cells from paroxysmal nocturnal hemoglobinuria (PNH) patients are deficient in surface expression of cellular prion protein (PrPc). This may be a suitable system to explore the function of membrane PrP(c) in the hematopoietic system. (PMID:12543108)
  • NMR structure of the globular domain with residues 121-230 of a variant human prion protein with two disulfide bonds, hPrP(M166C/E221C), shows the same global fold as wild-type hPrP(121-230) (PMID:12547204)
  • detail the schematic construction of PrP(Sc) monomeric and dimeric models (PMID:12568340)
  • Mutant PrP is associated with neurodegeneration in prion diseases. (PMID:12590162)
  • Review. PrPC is a membrane glycoprotein expressed by most tissues and is attached on the cell membrane by a glycosyl-phosphatidylinositol anchor which would be consistent with roles in cell adhesion, ligand uptake, or transmembrane signaling. (PMID:12645301)
  • has different biological properties than linked GPI-anchored protein DAF (PMID:12659837)
  • Polymorphism of the codon 129 of the prion protein (PrP) gene and neuropathology of cerebral ageing. (PMID:12679875)
  • Neuropathological features of a case with schizophrenia and prion protein gene P102L mutation before onset of Gerstmann-Straussler-Scheinker disease. (PMID:12682740)
  • Abbreviated incubation times for human prions in mice expressing a chimeric mouse-human prion protein transgene. (PMID:12684540)
  • Kuru imposed strong balancing selection on the Fore, essentially eliminating PRNP 129 homozygotes; worldwide PRNP haplotype diversity and coding allele frequencies suggest strong balancing selection at this locus occurred during evolution of modern humans (PMID:12690204)
  • observed that PrP106-126 is a chemoattractant for monocyte-derived immature but not mature dendritic cells; results suggest transactivation of sphingosine-1-phosphate-dependent cell motility by prion protein (PMID:12692258)
  • findings highlight the role of PrP in copper homeostasis and hint at its possible role as a modulator of synapses regulated by this trace metal (PMID:12694397)
  • plasmin cleaves PrP(c) in vitro and the liberated NH(2)-terminal fragment accelerates plasminogen activation (PMID:12719777)
  • The 129 codon polymorphism of the prion protein gene influences earlier cognitive performance in Down syndrome subjects. (PMID:12796830)
  • a specific prion protein fragment has a role in disulfide stability by retarding the rate of fibril formation (PMID:12805563)
  • proteinase K-resistant C-terminal fragments of PrP are identified in Creutzfeldt-Jakob disease brains (PMID:12917418)
  • endoplasmic reticulum-associated degradation PrP is not converted naturally into a form reminiscent of scrapie PrP and that PrP located in the cytosol retains its protective function against Bax (PMID:12917444)
  • interactions between small, highly structured RNAs and human recombinant prion protein (PrP) suggest possible roles of RNAs in the modulation of PrP structure and perhaps disease development (PMID:12946346)
  • interconversion of helix 1 of the prion protein is rather representing a barrier than a nucleus for the PrPC–>PrPSc conversion (PMID:12952977)
  • the intrinsic properties of PrP-(82-146) are dependent upon the integrity of the C-terminal region and account for the massive deposition of PrP amyloid in GSS (PMID:12970341)
  • spontaneous conversion of the recombinant polypeptide corresponding to the Y145Stop variant (huPrP23-144) from a monomeric unordered state to a fibrillar form (PMID:14519851)
  • PrPc has a role in the signaling of cell-cell contacts in epithelial cells (PMID:14576159)
  • association of a common genetic variation in the prion protein gene with cognitive performance (PMID:14593432)

Cross-species orthologs

2 orthologs

OrganismSymbolGene ID
mus_musculusPrnpENSMUSG00000079037
rattus_norvegicusPrnpENSRNOG00000021259

Protein

Protein identifiers

Alternative prion proteinF7VJQ1 (reviewed: F7VJQ1, P04156)

Alternative names: AltPrP

All UniProt accessions (4): P04156, A2A2V1, Q53YK7, X6RKS3

UniProt curated annotations — full annotation on UniProt →

Subcellular location. Mitochondrion outer membrane.

Tissue specificity. Detected in brain homogenate, primary neurons, and peripheral blood mononuclear cells (at protein level).

Induction. Up-regulated by endoplasmic reticulum stress and proteasomal inhibition.

Miscellaneous. This protein is produced by a bicistronic gene which also produces the major prion protein/PRNP from an overlapping reading frame. The alternative prion protein/AltPrP and PRNP (AC P04156) have no apparent direct functional relation since a mutation that removes the start codon of the AltPrP has no apparent effect on the biology of PRNP. In mouse and hamster, the alternative initiation AUG codon is absent and is replaced by a GUG codon.

Isoforms (2)

UniProt IDNamesCanonical?
F7VJQ1-13, AltPrPyes
P04156-11, PrP

RefSeq proteins (6): NP_000302, NP_001073590, NP_001073591, NP_001073592, NP_001258490, NP_898902 (=MANE)

Domains & families (InterPro)

IDNameType
IPR000817PrionFamily
IPR020949Prion_copper_b_octapeptideRepeat
IPR022416Prion/Doppel_prot_b-ribbon_domDomain
IPR025860Prion_NDomain
IPR036924Prion/Doppel_b-ribbon_dom_sfHomologous_superfamily

Pfam: PF00377, PF03991, PF11587

UniProt features (89 total): sequence variant 27, strand 19, binding site 12, turn 6, repeat 5, region of interest 4, sequence conflict 3, helix 3, chain 2, glycosylation site 2, transmembrane region 1, signal peptide 1, compositionally biased region 1, propeptide 1, lipid moiety-binding region 1, disulfide bond 1

Structure

Experimental structures (PDB)

70 structures, top 30 by resolution.

PDBMethodResolution (Å)
2OL9X-RAY DIFFRACTION0.85
7RVEELECTRON CRYSTALLOGRAPHY0.85
7RVJELECTRON CRYSTALLOGRAPHY1
7RVKELECTRON CRYSTALLOGRAPHY1
7RVLELECTRON CRYSTALLOGRAPHY1
7RVCELECTRON CRYSTALLOGRAPHY1
3MD4X-RAY DIFFRACTION1.15
3MD5X-RAY DIFFRACTION1.4
4E1HX-RAY DIFFRACTION1.4
6PQAX-RAY DIFFRACTION1.46
4KMLX-RAY DIFFRACTION1.5
4N9OX-RAY DIFFRACTION1.5
6PQ5X-RAY DIFFRACTION1.5
3NHCX-RAY DIFFRACTION1.57
3HAKX-RAY DIFFRACTION1.8
3HEQX-RAY DIFFRACTION1.8
3NVFX-RAY DIFFRACTION1.8
3HERX-RAY DIFFRACTION1.85
3NHDX-RAY DIFFRACTION1.92
1I4MX-RAY DIFFRACTION2
3HESX-RAY DIFFRACTION2
3HJXX-RAY DIFFRACTION2
4E1IX-RAY DIFFRACTION2.03
3HAFX-RAY DIFFRACTION2.26
6SV2X-RAY DIFFRACTION2.3
6DU9X-RAY DIFFRACTION2.33
4DGIX-RAY DIFFRACTION2.4
6SUZX-RAY DIFFRACTION2.5
6LNIELECTRON MICROSCOPY2.7
7RL4ELECTRON MICROSCOPY2.86

Predicted structure (AlphaFold)

ModelpLDDTFraction very-high
AF-F7VJQ1-F168.180.00
AF-P04156-F166.120.09

Antibody-complex structures (SAbDab): 62W9E, 4DGI, 4KML, 4N9O, 6SUZ, 6SV2

Functional residue map

Curated UniProt residues grouped by drug-discovery relevance — catalytic, ligand-binding, modification, and mutation-validated positions. Source: UniProtKB sequence features.

Ligand- & substrate-binding residues (12): 61; 62; 63; 69; 70; 71; 77; 78; 79; 85; 86; 87

Post-translational modifications (1): 230

Disulfide bonds (1): 179–214

Glycosylation sites (2): 181, 197

Function

Pathways and Gene Ontology

Reactome pathways

2 pathways

IDPathway
R-HSA-419037NCAM1 interactions
R-HSA-9609523Insertion of tail-anchored proteins into the endoplasmic reticulum membrane

MSigDB gene sets: 967 (showing top): GOBP_POTASSIUM_ION_TRANSPORT, GOBP_REGULATION_OF_T_CELL_RECEPTOR_SIGNALING_PATHWAY, WAMUNYOKOLI_OVARIAN_CANCER_LMP_DN, GOBP_MEMORY, GOBP_REGULATION_OF_CELL_ACTIVATION, GOBP_REGULATION_OF_ANTIGEN_RECEPTOR_MEDIATED_SIGNALING_PATHWAY, GOBP_RESPONSE_TO_NITROGEN_COMPOUND, GOBP_REGULATION_OF_LEUKOCYTE_PROLIFERATION, REACTOME_BIOLOGICAL_OXIDATIONS, GOBP_NEGATIVE_REGULATION_OF_PROTEOLYSIS, GOBP_COGNITION, GOBP_BEHAVIOR, GOBP_REGULATION_OF_CALCIUM_MEDIATED_SIGNALING, YAGI_AML_WITH_INV_16_TRANSLOCATION, GOBP_NEGATIVE_REGULATION_OF_LEUKOCYTE_PROLIFERATION

GO Biological Process (38): negative regulation of transcription by RNA polymerase II (GO:0000122), intracellular copper ion homeostasis (GO:0006878), response to oxidative stress (GO:0006979), learning or memory (GO:0007611), long-term memory (GO:0007616), negative regulation of protein processing (GO:0010955), protein destabilization (GO:0031648), negative regulation of type II interferon production (GO:0032689), negative regulation of interleukin-17 production (GO:0032700), negative regulation of interleukin-2 production (GO:0032703), intracellular signal transduction (GO:0035556), negative regulation of apoptotic process (GO:0043066), positive regulation of neuron apoptotic process (GO:0043525), negative regulation of activated T cell proliferation (GO:0046007), response to cadmium ion (GO:0046686), positive regulation of calcium-mediated signaling (GO:0050850), negative regulation of T cell receptor signaling pathway (GO:0050860), protein homooligomerization (GO:0051260), regulation of cell cycle (GO:0051726), negative regulation of calcineurin-NFAT signaling cascade (GO:0070885), cellular response to copper ion (GO:0071280), cellular response to xenobiotic stimulus (GO:0071466), positive regulation of protein targeting to membrane (GO:0090314), dendritic spine maintenance (GO:0097062), negative regulation of long-term synaptic potentiation (GO:1900272), regulation of glutamate receptor signaling pathway (GO:1900449), positive regulation of glutamate receptor signaling pathway (GO:1900451), regulation of potassium ion transmembrane transport (GO:1901379), negative regulation of amyloid-beta formation (GO:1902430), negative regulation of dendritic spine maintenance (GO:1902951), negative regulation of amyloid precursor protein catabolic process (GO:1902992), positive regulation of protein localization to plasma membrane (GO:1903078), response to amyloid-beta (GO:1904645), cellular response to amyloid-beta (GO:1904646), regulation of calcium ion import across plasma membrane (GO:1905664), neuron projection maintenance (GO:1990535), regulation of protein localization (GO:0032880), response to copper ion (GO:0046688)

GO Molecular Function (22): amyloid-beta binding (GO:0001540), protease binding (GO:0002020), copper ion binding (GO:0005507), lamin binding (GO:0005521), glycosaminoglycan binding (GO:0005539), microtubule binding (GO:0008017), tubulin binding (GO:0015631), aspartic-type endopeptidase inhibitor activity (GO:0019828), type 5 metabotropic glutamate receptor binding (GO:0031802), signaling receptor activity (GO:0038023), identical protein binding (GO:0042802), ATP-dependent protein binding (GO:0043008), transmembrane transporter binding (GO:0044325), protein-containing complex binding (GO:0044877), protein-folding chaperone binding (GO:0051087), molecular adaptor activity (GO:0060090), molecular function activator activity (GO:0140677), molecular condensate scaffold activity (GO:0140693), cupric ion binding (GO:1903135), cuprous ion binding (GO:1903136), protein binding (GO:0005515), metal ion binding (GO:0046872)

GO Cellular Component (19): mitochondrial outer membrane (GO:0005741), cytoplasm (GO:0005737), endoplasmic reticulum (GO:0005783), Golgi apparatus (GO:0005794), cytosol (GO:0005829), plasma membrane (GO:0005886), external side of plasma membrane (GO:0009897), cell surface (GO:0009986), postsynaptic density (GO:0014069), inclusion body (GO:0016234), extrinsic component of membrane (GO:0019898), dendrite (GO:0030425), nuclear membrane (GO:0031965), terminal bouton (GO:0043195), membrane raft (GO:0045121), extracellular exosome (GO:0070062), postsynapse (GO:0098794), membrane (GO:0016020), side of membrane (GO:0098552)

Reactome top-level categories

Rollup of top-2 pathways:

CategoryPathways
NCAM signaling for neurite out-growth1
Protein localization1

GO top-level categories

Rollup of top GO terms by namespace:

CategoryTerms
cellular anatomical structure7
protein binding5
negative regulation of cytokine production3
intracellular anatomical structure3
cytoplasm3
membrane3
binding2
copper ion binding2
endomembrane system2
intracellular membrane-bounded organelle2
regulation of transcription by RNA polymerase II1
transcription by RNA polymerase II1
negative regulation of DNA-templated transcription1
intracellular monoatomic cation homeostasis1
copper ion homeostasis1
response to stress1
behavior1
cognition1
memory1
protein processing1
negative regulation of proteolysis1
regulation of protein processing1
negative regulation of protein maturation1
regulation of protein stability1
type II interferon production1
regulation of type II interferon production1
interleukin-17 production1
regulation of interleukin-17 production1
interleukin-2 production1
regulation of interleukin-2 production1
signal transduction1
apoptotic process1
regulation of apoptotic process1
negative regulation of programmed cell death1
positive regulation of apoptotic process1
regulation of neuron apoptotic process1
neuron apoptotic process1
negative regulation of T cell proliferation1
regulation of activated T cell proliferation1
activated T cell proliferation1

Protein interactions and networks

STRING

0 interactions, top by confidence (×1000):

IntAct

0 interactions, top by confidence:

BioGRID (2594): PRNP (PCA), PRNP (Affinity Capture-Western), ARF1 (Affinity Capture-Western), PRNP (Two-hybrid), CSNK2A1 (Affinity Capture-MS), ZBED3 (Affinity Capture-MS), YWHAQ (Affinity Capture-MS), PABPC1 (Affinity Capture-MS), PABPC4 (Affinity Capture-MS), HSPD1 (Affinity Capture-MS), CYLD (Affinity Capture-MS), HSP90AA1 (Affinity Capture-MS), RPSA (Affinity Capture-MS), PSMD2 (Affinity Capture-MS), CYLD (Affinity Capture-Western)

ESM2 similar proteins: A0A1D9BZF0, A0A1M6T247, A6QL64, B0Y8Y8, C6UYI3, E9Q6E9, F7VJQ1, F7VJQ2, F8W0I5, O77733, P04672, P09125, P0CL27, P0CL28, P0CL29, P0CL30, P0CL31, P0DI83, P0DJ88, P0DJ89, P12347, P13492, P20466, P43537, P49170, P58150, P83059, P83060, P84729, P84730, P84976, Q01456, Q196Z8, Q4WW98, Q4ZJZ1, Q4ZJZ3, Q5JPF3, Q5MJ10, Q5SF96, Q69577

Diamond homologs: F7VJQ1, F7VJQ2, F7VJQ3

SIGNOR signaling

2 interactions.

AEffectBMechanism
“ER stress”up-regulatesPRNP
CDK5“up-regulates quantity”PRNPphosphorylation

Disease & clinical

Clinical variants and AI predictions

ClinVar

681 variants total. Per-class counts are floors (≥ shown; pagination cap):

ClassificationCount (floor)
Pathogenic38
Likely pathogenic28
Uncertain significance236
Likely benign263
Benign36

Top pathogenic / likely-pathogenic (30)

Variant IDHGVSClassification
1076084NM_000178.4(GSS):c.922C>T (p.Gln308Ter)Pathogenic
13394NM_000311.5(PRNP):c.154_177[6_13]Pathogenic
13395NM_000311.5(PRNP):c.305C>T (p.Pro102Leu)Pathogenic
13396NM_000311.5(PRNP):c.350C>T (p.Ala117Val)Pathogenic
13398NM_000311.5(PRNP):c.598G>A (p.Glu200Lys)Pathogenic
13401NM_000311.5(PRNP):c.593T>C (p.Phe198Ser)Pathogenic
13404NM_000311.5(PRNP):c.314C>T (p.Pro105Leu)Pathogenic
13407NM_000311.5(PRNP):c.547A>G (p.Thr183Ala)Pathogenic
13412NM_000311.5(PRNP):c.560A>G (p.His187Arg)Pathogenic
13413NM_000311.5(PRNP):c.313C>A (p.Pro105Thr)Pathogenic
13414NM_000311.5(PRNP):c.398C>T (p.Ala133Val)Pathogenic
21147NM_000311.5(PRNP):c.435T>G (p.Tyr145Ter)Pathogenic
21148NM_000311.5(PRNP):c.478C>T (p.Gln160Ter)Pathogenic
2702032NM_000178.4(GSS):c.1045del (p.Gln349fs)Pathogenic
2714497NM_000178.4(GSS):c.1103_1104del (p.Glu368fs)Pathogenic
2716943NM_000178.4(GSS):c.325C>T (p.Gln109Ter)Pathogenic
2725232NM_000178.4(GSS):c.882C>A (p.Cys294Ter)Pathogenic
2736963NM_000178.4(GSS):c.374G>A (p.Arg125His)Pathogenic
2756529NM_000178.4(GSS):c.527del (p.Ala176fs)Pathogenic
2792061NM_000178.4(GSS):c.587G>A (p.Trp196Ter)Pathogenic
2793305NM_000178.4(GSS):c.658C>T (p.Gln220Ter)Pathogenic
2815837NM_000311.5(PRNP):c.350_351inv (p.Ala117Val)Pathogenic
2858234NM_000178.4(GSS):c.547_550del (p.Asn183fs)Pathogenic
2877418NM_000178.4(GSS):c.49G>T (p.Glu17Ter)Pathogenic
2903932NM_000178.4(GSS):c.588G>A (p.Trp196Ter)Pathogenic
2976093NM_000178.4(GSS):c.105del (p.Ser36fs)Pathogenic
3014333NM_000178.4(GSS):c.1020dup (p.Leu341fs)Pathogenic
3248261NC_000020.10:g.(?33516631)(33517413_?)delPathogenic
3637395NM_000178.4(GSS):c.37C>T (p.Gln13Ter)Pathogenic
3699755NM_000178.4(GSS):c.14G>A (p.Trp5Ter)Pathogenic

SpliceAI

328 predictions. Top by Δscore:

VariantEffectΔscore
20:4699210:GAGCA:Gacceptor_gain1.0000
20:4686512:GGT:Gdonor_loss0.9900
20:4686513:G:GAdonor_loss0.9900
20:4686514:T:Gdonor_loss0.9900
20:4699209:A:AGacceptor_gain0.9900
20:4699210:G:GGacceptor_gain0.9900
20:4699210:GA:Gacceptor_gain0.9900
20:4699210:GAGC:Gacceptor_gain0.9900
20:4691890:G:Cacceptor_gain0.9800
20:4699205:TTGCA:Tacceptor_loss0.9700
20:4699208:CA:Cacceptor_loss0.9700
20:4699208:CAG:Cacceptor_gain0.9700
20:4699209:AGA:Aacceptor_gain0.9700
20:4699209:AGAGC:Aacceptor_loss0.9700
20:4699210:G:GTacceptor_loss0.9700
20:4699210:GAG:Gacceptor_gain0.9700
20:4686509:GCAG:Gdonor_gain0.9400
20:4691895:T:Gacceptor_gain0.9400
20:4693185:T:TAdonor_gain0.9400
20:4693187:T:TGdonor_gain0.9300
20:4699202:A:AGacceptor_gain0.9100
20:4693184:GTCT:Gdonor_gain0.9000
20:4699206:TGCAG:Tacceptor_gain0.9000
20:4686513:G:GGdonor_gain0.8900
20:4699206:T:TAacceptor_gain0.8800
20:4697449:A:Tdonor_gain0.8700
20:4699203:T:Gacceptor_gain0.8700
20:4693186:C:Adonor_gain0.8400
20:4686508:GGCAG:Gdonor_gain0.8300
20:4686509:GCAGG:Gdonor_gain0.8300

AlphaMissense

1678 scored. Top likely-pathogenic:

VariantProtein changeam_pathogenicity
20:4699756:G:AC179Y1.000
20:4699757:C:GC179W1.000
20:4699860:T:AC214S1.000
20:4699861:G:CC214S1.000
20:4699862:T:GC214W1.000
20:4699744:T:CF175S0.999
20:4699744:T:GF175C0.999
20:4699755:T:AC179S0.999
20:4699755:T:CC179R0.999
20:4699756:G:CC179S0.999
20:4699756:G:TC179F0.999
20:4699768:C:TT183I0.999
20:4699860:T:CC214R0.999
20:4699861:G:AC214Y0.999
20:4699861:G:TC214F0.999
20:4699573:C:AA118D0.998
20:4699743:T:CF175L0.998
20:4699745:T:AF175L0.998
20:4699745:T:GF175L0.998
20:4699768:C:AT183K0.998
20:4699768:C:GT183R0.998
20:4699849:T:AV210D0.998
20:4699642:T:CF141S0.997
20:4699642:T:GF141C0.997
20:4699668:T:GY150D0.997
20:4699825:A:TD202V0.997
20:4699611:G:AG131R0.996
20:4699611:G:CG131R0.996
20:4699641:T:CF141L0.996
20:4699643:C:AF141L0.996

dbSNP variants (sampled 300 via entrez): RS1000275839 (20:4697290 A>G), RS1000293454 (20:4690134 C>T), RS1000601097 (20:4687193 C>T), RS1000896399 (20:4694011 C>A), RS1000904029 (20:4700987 TTC>T), RS1000933016 (20:4701353 G>A), RS1001063640 (20:4701992 A>G), RS1001167786 (20:4686844 C>T), RS1001546486 (20:4687274 T>C,G), RS1001848976 (20:4698429 G>A), RS1002121529 (20:4695820 T>G), RS1002155235 (20:4697310 A>G), RS1002155642 (20:4684855 G>C,T), RS1002366211 (20:4691454 T>C), RS1002553096 (20:4698718 G>A)

Disease associations

OMIM: gene MIM:176640 | disease phenotypes: MIM:266130, MIM:603218, MIM:231900, MIM:137440, MIM:600072, MIM:123400, MIM:606688, MIM:245300, MIM:181500

GenCC curated gene-disease

DiseaseClassificationInheritance
Gerstmann-Straussler-Scheinker syndromeDefinitiveAutosomal dominant
inherited glutathione synthetase deficiencyDefinitiveAutosomal recessive
inherited Creutzfeldt-Jakob diseaseStrongAutosomal dominant
Huntington disease-like 1StrongAutosomal dominant
glutathione synthetase deficiency with 5-oxoprolinuriaStrongAutosomal recessive
familial Alzheimer-like prion diseaseSupportiveAutosomal dominant
PrP systemic amyloidosisSupportiveAutosomal dominant
fatal familial insomniaSupportiveAutosomal dominant

ClinGen Gene-Disease Validity (1)

Expert-panel classifications — Definitive > Strong > Moderate > Limited > Disputed > Refuted.

DiseaseClassificationInheritance
inherited glutathione synthetase deficiencyDefinitiveAR

Mondo (15): glutathione synthetase deficiency with 5-oxoprolinuria (MONDO:0009947), Huntington disease-like 1 (MONDO:0011299), inherited glutathione synthetase deficiency (MONDO:0017909), glutathione synthetase deficiency without 5-oxoprolinuria (MONDO:0009284), vascular dementia (MONDO:0004648), Gerstmann-Straussler-Scheinker syndrome (MONDO:0007656), fatal familial insomnia (MONDO:0010808), inherited Creutzfeldt-Jakob disease (MONDO:0007403), spongiform encephalopathy with neuropsychiatric features (MONDO:0011703), autism spectrum disorder (MONDO:0005258), kuru, susceptibility to (MONDO:0009500), congenital portosystemic shunt (MONDO:0018811), schizophrenia (MONDO:0005090), familial Alzheimer-like prion disease (MONDO:0017233), PrP systemic amyloidosis (MONDO:0018339)

Orphanet (14): Glutathione synthetase deficiency with 5-oxoprolinuria (Orphanet:289846), Huntington disease-like 1 (Orphanet:157941), Glutathione synthetase deficiency (Orphanet:32), Glutathione synthetase deficiency without 5-oxoprolinuria (Orphanet:289849), Gerstmann-Straussler-Scheinker syndrome (Orphanet:356), Fatal familial insomnia (Orphanet:466), Sporadic Creutzfeldt-Jakob disease (Orphanet:204), Inherited human prion disease (Orphanet:280400), Inherited Creutzfeldt-Jakob disease (Orphanet:282166), Acquired Creutzfeldt-Jakob disease (Orphanet:454700), Kuru (Orphanet:454745), Congenital portosystemic shunt (Orphanet:480531), NON RARE IN EUROPE: Autism (Orphanet:106), NON RARE IN EUROPE: Schizophrenia (Orphanet:3140)

HPO phenotypes

168 total (30 of 168 shown, HPO-id order):

HPOTerm
HP:0000006Autosomal dominant inheritance
HP:0000007Autosomal recessive inheritance
HP:0000016Urinary retention
HP:0000298Mask-like facies
HP:0000496Abnormality of eye movement
HP:0000504Abnormality of vision
HP:0000505Visual impairment
HP:0000514Slow saccadic eye movements
HP:0000570Abnormal saccadic eye movements
HP:0000580Pigmentary retinopathy
HP:0000605Supranuclear gaze palsy
HP:0000617Abnormality of ocular smooth pursuit
HP:0000639Nystagmus
HP:0000651Diplopia
HP:0000708Atypical behavior
HP:0000709Psychosis
HP:0000710Hyperorality
HP:0000711Restlessness
HP:0000712Emotional lability
HP:0000716Depression
HP:0000718Aggressive behavior
HP:0000726Dementia
HP:0000736Short attention span
HP:0000737Irritability
HP:0000738Hallucinations
HP:0000739Anxiety
HP:0000741Apathy
HP:0000746Delusion
HP:0000750Delayed speech and language development
HP:0000751Personality changes

GWAS associations

63 associations (top):

StudyTraitp-value
GCST000294_2Creutzfeldt-Jakob disease2.000000e-21
GCST000693_6Platelet aggregation2.000000e-06
GCST001334_1Creutzfeldt-Jakob disease (variant)3.000000e-18
GCST001334_2Creutzfeldt-Jakob disease (variant)5.000000e-07
GCST001366_1Prion diseases7.000000e-07
GCST001378_9Hemostatic factors and hematological phenotypes4.000000e-34
GCST002878_1Creutzfeldt-Jakob disease (sporadic)8.000000e-09
GCST003871_13QRS complex (Cornell)5.000000e-11
GCST004501_125Waist circumference adjusted for BMI (joint analysis main effects and smoking interaction)3.000000e-06
GCST004502_1Waist circumference adjusted for BMI (smoking interaction)2.000000e-06
GCST005956_31Waist-to-hip ratio adjusted for BMI8.000000e-08
GCST005958_16Waist-to-hip ratio adjusted for BMI (age >50)6.000000e-06
GCST005962_40Waist-to-hip ratio adjusted for BMI x sex x age interaction (4df test)3.000000e-08
GCST007948_1KANNO antigen negativity3.000000e-08
GCST008058_164Estimated glomerular filtration rate1.000000e-44
GCST008103_149Bipolar disorder3.000000e-06
GCST008163_394Height2.000000e-06
GCST010142_10Fish- and plant-related diet8.000000e-12
GCST010796_3401Electrocardiogram morphology (amplitude at temporal datapoints)3.000000e-21
GCST010796_3402Electrocardiogram morphology (amplitude at temporal datapoints)1.000000e-20
GCST010796_3403Electrocardiogram morphology (amplitude at temporal datapoints)9.000000e-21
GCST010796_3404Electrocardiogram morphology (amplitude at temporal datapoints)2.000000e-21
GCST010796_3405Electrocardiogram morphology (amplitude at temporal datapoints)2.000000e-21
GCST010796_3406Electrocardiogram morphology (amplitude at temporal datapoints)9.000000e-22
GCST010796_3407Electrocardiogram morphology (amplitude at temporal datapoints)8.000000e-22
GCST010796_3408Electrocardiogram morphology (amplitude at temporal datapoints)6.000000e-22
GCST010796_3409Electrocardiogram morphology (amplitude at temporal datapoints)8.000000e-23
GCST010796_3410Electrocardiogram morphology (amplitude at temporal datapoints)1.000000e-22
GCST010796_3411Electrocardiogram morphology (amplitude at temporal datapoints)8.000000e-23
GCST010796_3412Electrocardiogram morphology (amplitude at temporal datapoints)1.000000e-22

EFO canonical traits (14, from GWAS)

EFO IDTrait name
EFO:0004503hematological measurement
EFO:0004633protein C measurement
EFO:1000656sporadic Creutzfeld Jacob disease
EFO:0005054QRS complex
EFO:0007742QRS amplitude
EFO:0004318smoking behavior
EFO:0007789BMI-adjusted waist circumference
EFO:0007788BMI-adjusted waist-hip ratio
EFO:0008007age at assessment
EFO:0008343sex interaction measurement
EFO:0009949KANNO antigen measurement
EFO:0008111diet measurement
EFO:0004327electrocardiography
EFO:0008039BMI-adjusted hip circumference

MeSH disease descriptors (6)

DescriptorNameTree numbers
D015140Dementia, VascularC10.228.140.300.400; C10.228.140.300.510.800.500; C10.228.140.380.230; C10.228.140.695.500; C14.907.137.126.372.500; C14.907.253.560.350.500; F03.615.400.350
D034062Insomnia, Fatal FamilialC01.207.800.392; C10.228.228.800.392; C10.574.843.512; C10.886.425.800.800.400
C535800Amyloidosis, Cerebral, with Spongiform Encephalopathy (supp.)
C536835Glutathione synthetase deficiency (supp.)
C566398Huntington Disease-Like 1 (supp.)
C564678Spongiform Encephalopathy with Neuropsychiatric Features (supp.)

Drugs & pharmacology

Drug and pharmacology data

Is drug target: no

PharmGKB: 1 entry (VIP=true, CPIC=false)

PharmGKB variants

1 variants.

VariantGenesLevelScore#Clin annotsDrugs
rs17309872ACSS2, GSS33.001carboplatin;cisplatin;docetaxel;gemcitabine;paclitaxel

PubChem BioAssay actives

7 with measured affinity, of 167 total; 7 most potent distinct compounds. Largely complementary to BindingDB; screening values are coarse (µM, 4 dp), so sub-nM hits tie at the floor.

CompoundAssayTypeValueUnit
4-N-(6-chloro-2-methoxyacridin-9-yl)-1-N,1-N-diethylpentane-1,4-diamine161627: Half maximal inhibition of Prion protein PrPsc formation was assayed in ScN2a cellsec500.3000uM
Chlorpromazine161627: Half maximal inhibition of Prion protein PrPsc formation was assayed in ScN2a cellsec502.0000uM
Chloroquine161627: Half maximal inhibition of Prion protein PrPsc formation was assayed in ScN2a cellsec504.0000uM
N,N-dimethyl-3-phenothiazin-10-ylpropan-1-amine161627: Half maximal inhibition of Prion protein PrPsc formation was assayed in ScN2a cellsec505.0000uM
Acepromazine161627: Half maximal inhibition of Prion protein PrPsc formation was assayed in ScN2a cellsec505.0000uM
Promethazine161627: Half maximal inhibition of Prion protein PrPsc formation was assayed in ScN2a cellsec508.0000uM
Imipramine161627: Half maximal inhibition of Prion protein PrPsc formation was assayed in ScN2a cellsec5010.0000uM

CTD chemical–gene interactions

112 total (human), top 30 by PubMed support.

ChemicalActions (top 5)PubMed papers
Copperaffects folding, affects reaction, affects binding, increases reduction, affects cotreatment (+6 more)15
Valproic Acidaffects cotreatment, increases expression8
sodium arseniteaffects cotreatment, increases abundance, increases expression, affects expression, decreases expression7
bisphenol Aincreases expression, affects expression, decreases expression4
Tretinoindecreases expression, increases expression4
trichostatin Aaffects cotreatment, increases expression3
Acetaminophenincreases expression3
Air Pollutantsincreases expression, affects expression, increases abundance3
Estradiolaffects expression, affects cotreatment, increases expression3
Tobacco Smoke Pollutionaffects expression, increases expression3
Copper Sulfateaffects binding, increases expression, affects localization, increases uptake, decreases reaction3
methylmercuric chlorideincreases expression2
perfluorooctanoic acidincreases expression2
mercuric bromideincreases expression, affects cotreatment2
entinostatincreases expression, affects cotreatment2
Panobinostataffects cotreatment, increases expression2
Aerosolsincreases expression2
Oxygendecreases reaction, increases expression, decreases expression2
Phenylmercuric Acetateaffects cotreatment, increases expression2
Cyclosporineincreases expression2
Cadmium Chlorideincreases abundance, increases expression2
graphene oxidedecreases expression1
ethylbenzeneincreases expression1
methylselenic acidincreases expression1
3,4-dichloroanilinedecreases expression1
beta-lapachoneincreases expression1
arseniteaffects binding, increases reaction1
mono-(2-ethylhexyl)phthalateincreases expression1
tris(1,3-dichloro-2-propyl)phosphateincreases expression1
zinc chromateincreases expression, increases abundance1

Cellosaurus cell lines

22 cell lines: 18 induced pluripotent stem cell, 3 cancer cell line, 1 transformed cell line

First 10 cell lines (id-ordered, not curated):

CellosaurusNameCategorySex
CVCL_0N79AG09950Transformed cell lineMale
CVCL_D2WCCJD2Induced pluripotent stem cellFemale
CVCL_D3BKCJD2CRInduced pluripotent stem cellFemale
CVCL_D3BLCJD13Induced pluripotent stem cellFemale
CVCL_D3BMCJD13CRInduced pluripotent stem cellFemale
CVCL_D3BPCJD29Induced pluripotent stem cellFemale
CVCL_D3BQCJD3Induced pluripotent stem cellFemale
CVCL_D3BRCJD4Induced pluripotent stem cellMale
CVCL_D3BSCJD40Induced pluripotent stem cellFemale
CVCL_D3BTCJD5Induced pluripotent stem cellFemale

Clinical trials (associated diseases)

300 trials via MONDO — disease-level, not drug-specific.

TrialPhaseStatusTitle
NCT00165763PHASE4COMPLETEDEfficacy and Safety of Donepezil Hydrochloride (Aricept) in Vascular Dementia
NCT00847860PHASE4COMPLETEDCilostazol Verse Asprin for Vascular Dementia in Poststroke Patients With White Matter Lesions
NCT00947531PHASE4COMPLETEDA Clinical Trial to Evaluate the Safety and Efficacy of 20 ml Cerebrolysin in Patients With Vascular Dementia
NCT00950430PHASE4ENROLLING_BY_INVITATIONImaging of Brain Amyloid Plaques in the Aging Population
NCT00391261PHASE4COMPLETEDAn Open-label Trial of Metformin for Weight Control of Pediatric Patients on Antipsychotic Medications.
NCT01028820PHASE4COMPLETEDFMRI Brain Activation of Aripiprazole Treatment in Autism Spectrum Disorders
NCT01333865PHASE4COMPLETEDA Study of Memantine Hydrochloride (Namenda®) for Cognitive and Behavioral Impairment in Adults With Autism Spectrum Disorders
NCT01337700PHASE4COMPLETEDMilnacipran in Autism and the Functional Locus Coeruleus and Noradrenergic Model of Autism
NCT01695200PHASE4COMPLETEDOmega-3 Fatty Acids in Autism Spectrum Disorders
NCT02096952PHASE4COMPLETEDMethylphenidate ER Liquid Formulation in Adults With ASD and ADHD
NCT02235467PHASE4COMPLETEDMultisite Study: Parental Training Using Video Modelling to Develop Social Skills in Children With Autism
NCT02940574PHASE4COMPLETEDNeural and Behavioral Effects of Oxytocin in Autism Spectrum Disorders
NCT03333629PHASE4COMPLETEDPromoting Positive Outcomes for Individuals With ASD: Linking Early Detection, Treatment, and Long-term Outcomes
NCT03337646PHASE4COMPLETEDEvaluation of the Effect and Safety of Lisdexamfetamine in Children Aged 6-12 With ADHD and Autism
NCT03538431PHASE4COMPLETEDImproving Driving in Young People With Autism Spectrum Disorders
NCT03757585PHASE4COMPLETEDNatural Treatments for the Management of Emotional Dysregulation in Youth With Non-verbal Learning Disability (NVLD) and/or Autism Spectrum Disorders (ASD)
NCT04903353PHASE4COMPLETEDPragmatic Trial Comparing Weight Gain in Children With Autism Taking Risperidone Versus Aripiprazole
NCT05063656PHASE4COMPLETEDBiomarker-Driven Pharmacological Treatment of Adolescents With Autism Spectrum Disorder With Gabapentin
NCT05146245PHASE4UNKNOWNSafety and Pharmacokinetics of Antipsychotics in Children 2: Studying TDM in an RCT
NCT05916339PHASE4RECRUITINGAWARE: Management of ADHD in Autism Spectrum Disorder
NCT05954052PHASE4TERMINATEDA Study of Glutathione in Children With Autism Spectrum Disorder
NCT06853665PHASE4RECRUITINGThe TEAM Study - Treatment Efficacy for Autism/Attention Using Mixed Amphetamine
NCT07054697PHASE4COMPLETEDPilot-RCT With Individualized Homeopathic Treatment in the Children With Autism Spectrum Disorder
NCT07161804PHASE4COMPLETEDPilot RCT Using Homeopathic Medicines in ASD
NCT07439042PHASE4NOT_YET_RECRUITINGBuspirone for Anxiety in Autistic Youth
NCT07482085PHASE3NOT_YET_RECRUITINGEfavirenz for the Treatment of Creutzfeldt-Jakob Disease
NCT00099216PHASE3COMPLETEDEfficacy and Safety of Rivastigmine Capsules in Patients With Probable Vascular Dementia
NCT00130338PHASE3COMPLETEDRivastigmine Capsules in Patients With Probable Vascular Dementia
NCT00209456PHASE3COMPLETEDDopamine Transporter Scintigraphy Imaging (DAT-Imaging) in Patients With Lewy Body Dementia
NCT00249158PHASE3COMPLETEDA Study of the Effectiveness and Safety of Risperidone in the Treatment of Behavioral Disturbances in Patients With Dementia
NCT00261573PHASE3COMPLETEDA Study of the Safety and Effectiveness of Galantamine Versus Placebo in the Treatment of Patients With Vascular Dementia or Mixed Dementia
NCT00621647PHASE3COMPLETEDSeroquel- Agitation Associated With Dementia
NCT02453932PHASE3COMPLETEDEfficacy and Safety of Tianzhi Granule in Mild to Moderate Vascular Dementia
NCT03682185PHASE3COMPLETEDThe Healthy Patterns Sleep Study
NCT03789760PHASE3COMPLETEDThe Clinical Trial of Chinese Herbal Medicine (SaiLuoTong) Capsule
NCT03804229PHASE3ACTIVE_NOT_RECRUITINGEfficacy and Safety of Butylphthalide Soft Capsule for the Treatment of Vascular Dementia
NCT03986424PHASE3COMPLETEDLocal Study of Akatinol Memantine in VaD in Russia
NCT04552041PHASE3COMPLETEDProspekta in the Treatment of Cognitive, Behavioral and Psychiatric Disorders in Patients With Vascular Dementia.
NCT01302964PHASE3COMPLETEDMirtazapine Treatment of Anxiety in Children and Adolescents With Pervasive Developmental Disorders
NCT01706523PHASE3TERMINATEDOpen Label Extension Study of STX209 (Arbaclofen) in Autism Spectrum Disorders