CMT-DARS2

DARS2 | 2025

What Is CMT-DARS2?

CMT-DARS2 is a type of CMT caused by autosomal recessive mutations in the DARS2 gene. This gene provides instructions for making the mitochondrial aspartyl-tRNA synthetase, an enzyme required for building proteins inside mitochondria. Mutations in the DARS2 gene disrupt mitochondrial protein synthesis, leading to impaired nerve signal transmission.

CMT-DARS2 is autosomal recessive, meaning that both copies of the gene must have a mutation to cause this subtype.

Clinical Features

The age of symptom onset in CMT-DARS2 is variable, ranging from childhood to adulthood. Symptoms typically begin in the lower extremities and progress over time to involve the upper limbs. Nerve conduction studies usually show somewhat slowed conduction velocities and reduced amplitudes, consistent with an axonal form of CMT.

CMT-DARS2 symptoms may include:

  • Weakness in the feet and lower legs
  • Muscle atrophy
  • Foot drop
  • Reduced or absent reflexes
  • Reduced sensation
  • A steppage-style walking pattern
  • Foot deformities, including high arches, and hammertoes (clawed toes)
  • Progressive involvement of the hands and forearms
  • Difficulty with fine motor skills and manual dexterity
  • Additional symptoms not listed here

Disease Course

CMT-DARS2 shows wide variability in severity and progression. Some individuals are mildly affected, while others develop a more severe disease. Disease progression is generally slow, and life expectancy is not reduced.

Clinical Basics

Subtype
CMT-DARS2

Classification
Unclassified Subtypes

Neuropathy Type
Axonal

Inheritance Pattern
autosomal recessive

Genetic Context

HGNC-Approved Gene Symbol
DARS2

Gene Full Name
Aspartyl-tRNA Synthetase 2, Mitochondrial

HGNC Gene Alias(es)
FLJ10514

Chromosome
1q25.1

Zygosity of Responsible Variant
Compound Heterozygous

Mitochondrial Involvement
Yes

Variant Mechanism

Loss of Function (LoF)

Details

Mechanistic basis:
Biallelic

Confidence:
High

Prediction:
The literature predicts a biallelic loss-of-function mechanism for CMT-DARS2: recessive, typically compound-heterozygous hypomorphic DARS2 variants partially reduce mitochondrial aspartyl-tRNA synthetase activity, impairing mitochondrial translation in peripheral nerve. Because these are partial-loss variants that restored wild-type enzyme is predicted to rescue, the evidence supports biallelic loss rather than a dominant-negative or gain-of-function effect.

Rationale:
Biallelic hypomorphic DARS2 variants, classically a leaky intron-2 splice allele paired with a more severe allele, preserve residual mitochondrial aspartyl-tRNA synthetase activity, so restored wild-type is predicted to rescue: a recessive loss of function.

ClinVar Pathogenic Variants

View CMT-DARS2 ClinVar Variants

DARS2 OMIM Entry

DARS2 OMIM

More Info

CMT-DARS2 Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Biallelic Variants in the DARS2 Gene as a Novel Cause of Axonal Charcot-Marie-Tooth Disease

Authors

Estévez-Arias, B., Sarv, S., Bonello-Palot, N., Carrera-García, L., Ortez, C., Expósito-Escudero, J., Yubero, D., Muchart, J., Delmont, E., Õiglane-Shlik, E., Meren, T., Puusepp, S., Murumets, Ü., Salomons, G. S., Udd, B., Väli, L., Cantarero, L., Bönnemann, C. G., Nascimento, A., Ramón-Maiques, S., Õunap, K., Hoenicka, J., Natera-de Benito, D., Palau, F.

Publication Date
August 15, 2025

Updated: July 18, 2026 | By: K. Raymond

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