Missense Mutation ADNP p.C687R Disrupts Chromatin Regulation and GABAergic Differentiation in HVDAS

Activity-dependent neuroprotective protein (ADNP) is a key regulator of neurodevelopment and a high-risk gene for autism spectrum disorder (ASD). Most pathogenic variants cause loss-of-function in Helsmoortel-Van der Aa syndrome (HVDAS), yet the impact of missense mutations remains unclear. Here, we characterized a ADNP missense mutation (p.C687R) identified from a HVDAS patient, predicted to disrupt its ninth zinc finger domain. Overexpression of p.C687R altered subnuclear localization and affected wild-type ADNP distribution. In utero electroporation revealed impaired neuronal migration and cortical branching. CUT&Tag profiling showed mutant- specific chromatin binding, preferentially targeting histone modification genes through both direct and distal interactions. Patient-derived iPSCs carrying p.C687R exhibited upregulated bivalent histone marks (H3K4me3 and H3K27me3) on neurodevelopmental genes, including regulators of GABAergic differentiation, which became transcriptionally activated in neural progenitors. These findings reveal a gain-of-function mechanism by which ADNP p.C687R perturbs chromatin regulation and disrupts GABAergic lineage specification, expanding the molecular framework of ADNP pathogenesis. The Paper Explained ProblemMutations in the gene ADNP cause Helsmoortel-Van der Aa syndrome (HVDAS), a severe neurodevelopmental disorder, and also increase the risk for autism spectrum disorder (ASD). While most known ADNP mutations lead to loss of protein function, many missense mutations that alter a single amino acid remain poorly understood regarding their effects on brain development and disease contribution. ResultsWe characterized a specific missense mutation, ADNP p.C687R, from a patient diagnosed with HVDAS, and found that it does not simply inactivate the protein but instead confers a disruptive new function. Across multiple models, from cells to mice, the p.C687R mutant exhibits abnormal chromatin binding, altered subnuclear localization, and impaired neuronal migration and differentiation. Importantly, in patient-derived iPSCs, it marks distinct neurodevelopmental genes with bivalent histone modifications, which become aberrantly activated during differentiation into GABAergic neural progenitor cells. ImpactThese findings confirm the pathogenicity of the missense mutation ADNP p.C687R in HVDAS, reveal a gain-of-function mechanism whereby the mutant disrupts chromatin regulation and GABAergic lineage specification, and advance our understanding of ADNP-related neurodevelopmental disorders.