CMTDIC

YARS1 | 2006

What Is CMTDIC?

CMTDIC is a type of CMT caused by mutations in the YARS1 gene. This gene provides instructions for making tyrosyl-tRNA synthetase (TyrRS), an enzyme that attaches the amino acid tyrosine to its cognate (corresponding) transfer RNA during protein synthesis. Mutations in the YARS1 gene are thought to cause nerve damage through a toxic gain-of-function mechanism, where the malfunctioning enzyme acquires harmful properties that progressively damage peripheral nerve axons.

CMTDIC is autosomal dominant, meaning that just one of the gene’s two copies needs a mutation to cause this subtype.

Clinical Features

CMTDID symptom onset is variable, ranging from early childhood to adulthood. Nerve conduction studies usually show conduction velocities and reduced amplitudes that fall between a demyelinating and an axonal form of CMT.

CMTDID symptoms may include:

  • Weakness in the feet and lower legs
  • Muscle atrophy
  • Foot drop
  • steppage-style walking pattern
  • Foot deformities, including high arches and hammertoes (clawed toes)
  • Reduced sensation
  • Muscle cramping
  • Reduced or absent reflexes
  • Enlarged peripheral nerves (hypertrophic nerves)
  • Clawing of the fingers
  • Additional symptoms not listed here

Disease Course

CMTDIC shows wide variability in severity and progression. Some individuals remain mildly affected, while others develop a more severe disease. Progression is generally slow, and life expectancy is not reduced.

Clinical Basics

Subtype
CMTDIC

Classification
CMTDI

Neuropathy Type
Intermediate

Inheritance Pattern
autosomal dominant

Genetic Context

HGNC-Approved Gene Symbol
YARS1

Gene Full Name
Tyrosyl-tRNA Synthetase 1

HGNC Gene Alias(es)
YTS, YARS, YRS, tyrRS

Chromosome
1p35.1

Zygosity of Responsible Variant
Heterozygous

Mitochondrial Involvement
No

Variant Mechanism

Toxic Gain of Function (GoF)

Details

Mechanistic basis:
Neomorphic

Confidence:
Medium

Prediction:
The literature predicts a toxic gain-of-function mechanism for CMTDIC: heterozygous YARS1 variants acquire neomorphic properties, an aberrant conformational opening, axonal mislocalization, and novel interactions demonstrated in Drosophila and yeast models, that damage peripheral axons beyond any loss of aminoacylation. Because loss of catalytic activity is necessary but not sufficient and the toxicity is intrinsic to the mutant, the evidence supports a neomorphic gain rather than haploinsufficiency, holding confidence at medium.

Rationale:
Heterozygous YARS1 alleles acquire an aberrant open conformation and novel interactions, with wild-type failing to rescue and toxicity dissociable from aminoacylation loss, pointing to a toxic neomorphic gain rather than disruption of wild-type. Because the precise neomorphic partner and the residual role of catalytic loss remain debated, confidence holds at medium.

ClinVar Pathogenic Variants

View CMTDIC ClinVar Variants

CMTDIC OMIM Entry

CMTDIC OMIM

YARS1 OMIM Entry

YARS1 OMIM

More Info

CMTDIC Research Opportunity

CMT Natural History Study

Original Discovery Publication

Publication Title

Disrupted Function and Axonal Distribution of Mutant Tyrosyl-tRNA Synthetase in Dominant Intermediate Charcot-Marie-Tooth Neuropathy

Authors

Jordanova, A., Irobi, J., Thomas, F. P., Van Dijck, P., Meerschaert, K., Dewil, M., Dierick, I., Jacobs, A., De Vriendt, E., Guergueltcheva, V., Rao, C. V., Tournev, I., Gondim, F. A., D’Hooghe, M., Van Gerwen, V., Callaerts, P., Van Den Bosch, L., Timmermans, J. P., Robberecht, W., Gettemans, J., Thevelein, J.M., De Jonghe, P., Kremensky, I., Timmerman, V.

Publication Date
January 22, 2006

Updated: May 9, 2026 | By: K. Raymond

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