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Its occurrence at a single site in one cellular protein defines hypusine synthesis as one of the most specific post-translational modifications. Synthesis of hypusine involves two enzymatic steps: first, deoxyhypusine synthase (DHPS) cleaves the 4-aminobutyl moiety of spermidine and transfers it to the \u03b5-amino group of a specific lysine residue of the eIF5A precursor protein to form an intermediate, deoxyhypusine [N<jats:sup>\u03b5<\/jats:sup>-(4-aminobutyl)lysine]. This intermediate is subsequently hydroxylated by deoxyhypusine hydroxylase (DOHH) to form hypusine in eIF5A. eIF5A, DHPS, and DOHH are highly conserved in all eukaryotes, and both enzymes exhibit a strict specificity toward eIF5A substrates. eIF5A promotes translation elongation globally by alleviating ribosome stalling and it also facilitates translation termination. Hypusine is required for the activity of eIF5A, mammalian cell proliferation, and animal development. Homozygous knockout of any of the three genes, <jats:italic>Eif5a, Dhps,<\/jats:italic> or <jats:italic>Dohh<\/jats:italic>, leads to embryonic lethality in mice. eIF5A has been implicated in various human pathological conditions. A recent genetic study reveals that heterozygous germline <jats:italic>EIF5A<\/jats:italic> variants cause Faundes\u2013Banka syndrome, a craniofacial\u2013neurodevelopmental malformations in humans. Biallelic variants of <jats:italic>DHPS<\/jats:italic> were identified as the genetic basis underlying a rare inherited neurodevelopmental disorder. Furthermore, biallelic <jats:italic>DOHH<\/jats:italic> variants also appear to be associated with neurodevelopmental disorder. The clinical phenotypes of these patients include intellectual disability, developmental delay, seizures, microcephaly, growth impairment, and\/or facial dysmorphisms. Taken together, these findings underscore the importance of eIF5A and the hypusine modification pathway in neurodevelopment in humans.<\/jats:p>","DOI":"10.1007\/s00726-021-03023-6","type":"journal-article","created":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T06:03:26Z","timestamp":1626501806000},"page":"485-499","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Post-translational formation of hypusine in eIF5A: implications in human neurodevelopment"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5526-0617","authenticated-orcid":false,"given":"Myung Hee","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh Kumar","family":"Kar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Banka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alban","family":"Ziegler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy K.","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,17]]},"reference":[{"issue":"7","key":"3023_CR1","doi-asserted-by":"publisher","first-page":"3085","DOI":"10.1016\/S0021-9258(17)35750-2","volume":"261","author":"A Abbruzzese","year":"1986","unstructured":"Abbruzzese A, Park MH, Folk JE (1986) Deoxyhypusine hydroxylase from rat testis. 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