Fig. 5

Pathogenic mechanism of missense variants in NHL domain of TRIM32 gene. Variants in the NHL domain of TRIM32 lead to impaired oligomerization and structural stability of the protein, subsequently hindering interaction and ubiquitination with critical substrates essential for maintaining muscle homeostasis. This cascade ultimately results in muscle atrophy and impaired muscle regeneration, with a clinical phenotype of proximal muscle weakness, and in severe cases, reliance on walking aids or wheelchairs for travel. NHL domain (purple on TRIM32): mediates oligomerization; TRIM32 (blue): interaction and ubiquitination with substrates; Substrate (yellow): related to muscle homeostasis. The material of the figure is provided by figdraw2.0