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ResearchIn-Press PreviewGeneticsNeuroscience Open Access | 10.1172/jci.insight.197941

KIF5A downregulation in spinal muscular atrophy links axonal regeneration defects with ALS

Tetsuya Akiyama,1 Yi Zeng,1 Caiwei Guo,1 Olivia Gautier,1 Lauren Koepke,2 Heankel Lyons,1 Elana Molotsky,3 Juliane S. Bombosch,1 Odilia Sianto,1 Jay P. Ross,1 Phuong Hoang,1 Luke Zhao,1 Cole Spencer,1 Charlotte J. Sumner,3 Michelle Monje,2 John W. Day,4 and Aaron D. Gitler1

1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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1Department of Genetics, Stanford University School of Medicine, Stanford, United States of America

2Department of Neurology and Neurological Sciences, Stanford University, Stanford, United States of America

3Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, United States of America

4Department of Neurology and Clinical Neurosciences, Stanford University, Stanford, United States of America

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Published March 26, 2026 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.197941.
Copyright © 2026, Akiyama et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published March 26, 2026 - Version history
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Abstract

Spinal muscular atrophy (SMA) is a devastating neuromuscular disorder caused by mutations in the survival motor neuron 1 (SMN1) gene leading to decreased SMN protein levels and motor neuron dysfunction. SMN-restoring therapies offer clinical benefit, but the downstream molecular consequences of SMN reduction remain incompletely understood. SMN deficiency resulted in downregulation of kinesin heavy chain isoform 5A (KIF5A) in human neurons and in a mouse model of SMA. SMN associated with KIF5A mRNA and contributed to its stability. Reduced SMN levels impaired axon regeneration, which was rescued by KIF5A overexpression. Because KIF5A has also been connected to ALS, these findings provide evidence of a molecular link between SMA and ALS pathophysiology, highlighting KIF5A as an SMN regulated factor. Our findings suggest SMN-independent interventions targeting KIF5A could represent a complementary therapeutic approach for SMA and other motor neuron diseases.

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