The accumulation of orphan ribosomal proteins is a hallmark of ALS

Summary Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of poor prognosis, for which age is the strongest risk factor. Despite significant progress in the discovery of ALS-associated mutations, no model explains how such a diversity of mutations converges in a common pathology. In addition, most ALS cases are sporadic and lack known genetic drivers. We recently reported that arginine-rich peptides arising from the C9ORF72 mutation trigger a widespread accumulation of orphan ribosomal proteins (oRP). Here, we show that oRP accumulation is also observed upon expression of other RNA-related ALS mutations, such as hnRNPA2 D290V and TDP-43 A315T , as well as upon exposure to the ALS-related neurotoxin β-N-methylamino-L-alanine (BMAA). Furthermore, the transcriptional signature of patients with sporadic ALS resembles that of Diamond-Blackfan anemia (DBA), a known ribosomopathy. Supporting the usefulness of our in vitro data, a transcriptional signature defined from these models provides diagnostic and prognostic value in ALS patients. We propose that the accumulation of oRPs due to dysfunctional ribosome biogenesis is a molecular hallmark of ALS that can contribute to the progressive loss of motor neurons in the disease.