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Elgaali E, Mezzavilla M, Ahmed I, Elanbari M, Ali A, Abdelaziz G, Fakhro KA, Saleh A, Ben-Omran T, Almulla N, Cugno C. Genetic background of primary and familial HLH in Qatar: registry data and population study. Front Pediatr 2024; 12:1326489. [PMID: 38808104 PMCID: PMC11130942 DOI: 10.3389/fped.2024.1326489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/08/2024] [Indexed: 05/30/2024] Open
Abstract
Background Familial hemophagocytic lymphohistiocytosis (FHLH) is an inherited life-threatening disease. Five types are identified, with the addition of congenital immunodeficiency syndromes in which HLH is a typical manifestation. The literature on this disease is very scarce in the Middle East, with only a few scattered reports. Methods We report detailed demographic, clinical, and genomic data from 28 patients diagnosed with primary and familial HLH over the last decade in Qatar. An evaluation was performed of allele frequencies of deleterious variants from 12 primary and familial HLH causative genes on the Qatar Genome Programme (QGP) cohort of 14,669 Qatari individuals. Results The genetic diagnosis was obtained in 15 patients, and four novel mutations in Perforin 1 (PRF1), UNC13D, LYST, and RAB27A genes were found. We identified 22,945 low/high/moderate/modifier impact variants significantly enriched in the QGP in those 12 genes. The variants rs1271079313 in PRF1 and rs753966933 in RAB27A found in our patient cohort were significantly more prevalent in the QGP compared to the Genome Aggregation Database (gnomAD) database, with a high carrier frequency in the Qatari population. Conclusions We established the first primary and familial HLH Registry in the Gulf Region and identified novel possibly pathogenic variants present at higher frequency in the Qatari population, which could be used for screening purposes. Raising awareness about primary and familial HLH and implementing screening activities in the Qatari highly inbred population could stem into more comprehensive premarital and prenatal evaluations and faster diagnosis.
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Affiliation(s)
- Elkhansa Elgaali
- Pediatric Hematology and Oncology Department, Sidra Medicine, Doha, Qatar
| | | | - Ikhlak Ahmed
- Research Department, Sidra Medicine, Doha, Qatar
| | | | - Aesha Ali
- Research Department, Sidra Medicine, Doha, Qatar
| | | | | | - Ayman Saleh
- Pediatric Hematology and Oncology Department, Sidra Medicine, Doha, Qatar
| | - Tawfeg Ben-Omran
- Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar
| | - Naima Almulla
- Pediatric Hematology and Oncology Department, Sidra Medicine, Doha, Qatar
| | - Chiara Cugno
- Pediatric Hematology and Oncology Department, Sidra Medicine, Doha, Qatar
- Research Department, Sidra Medicine, Doha, Qatar
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Rusiñol L, Baselga E, Garcia-Garcia A, Armstrong J, Prat C, Vicente A, Ivars M. Silvery hair and neurologic impairment in a 21-month-old boy. J Dtsch Dermatol Ges 2023; 21:1043-1045. [PMID: 37293827 DOI: 10.1111/ddg.15109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/26/2023] [Indexed: 06/10/2023]
Affiliation(s)
- Lluís Rusiñol
- Department of Dermatology, Santa Creu i Sant Pau University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Eulàlia Baselga
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Ana Garcia-Garcia
- Department of Pediatrics, Unit of Clinical Immunology and Primary Immunodeficiencies, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Judith Armstrong
- Department of Molecular Genetics, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Carolina Prat
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Asunción Vicente
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Marta Ivars
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
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Rusiñol L, Baselga E, Garcia-Garcia A, Armstrong J, Prat C, Vicente A, Ivars M. Silbergraues Haar und neurologische Symptome bei einem 21 Monate alten Jungen. J Dtsch Dermatol Ges 2023; 21:1043-1045. [PMID: 37700401 DOI: 10.1111/ddg.15109_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/26/2023] [Indexed: 09/14/2023]
Affiliation(s)
- Lluís Rusiñol
- Department of Dermatology, Santa Creu i Sant Pau University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Eulàlia Baselga
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Ana Garcia-Garcia
- Department of Pediatrics, Unit of Clinical Immunology and Primary Immunodeficiencies, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Judith Armstrong
- Department of Molecular Genetics, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Carolina Prat
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Asunción Vicente
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Marta Ivars
- Department of Pediatric Dermatology, Barcelona Children´s hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
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Khorram E, Tabatabaiefar MA, Yaghini O, Khorrami M, Yazdani V, Fakhr F, Amini M, Kheirollahi M. Griscelli syndrome type 1: a novel pathogenic variant, and review of literature. Mol Genet Genomics 2023; 298:485-493. [PMID: 36651988 DOI: 10.1007/s00438-022-01971-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/28/2022] [Indexed: 01/19/2023]
Abstract
Griscelli syndrome type 1 (GS1) is a rare inherited autosomal recessive disease caused by a deleterious variant in the MYO5A gene and characterized by general hypopigmentation, neurological symptoms, motor disability, hypotonia, and vision abnormality. Only nine pathogenic variants in the MYO5A gene have been confirmed in association with the GS1. All of the reported pathogenic variants are truncating. Herein, two siblings from a consanguineous Iranian family with abnormal pigmentation and neurological symptoms were referred for genetic counseling. Whole-exome sequencing (WES) revealed a novel homozygous truncating variant c.1633_1634delAA (p.Asn545Glnfs*10) in the MYO5A gene, which was completely co-segregated with the phenotype in all affected and unaffected family members. Computational analysis and protein modeling demonstrated the deleterious effects of this variant on the structure and function of the protein. The variant, according to ACMG guidelines, was classified as pathogenic. Besides the novelty of the identified variant, our patients manifested more severe clinical symptoms and presented distal hyperlaxity in all four limbs, which was a new finding. In conclusion, we expanded the mutational and phenotypic spectrum of the GS1. Moreover, by studying clinical manifestations in all molecularly confirmed reported cases, provided a comprehensive overview of clinical presentation, and attempted to find a genotype-phenotype correlation.
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Affiliation(s)
- Erfan Khorram
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Amin Tabatabaiefar
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Yaghini
- Department of Pediatrics, School of Medicine, Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Khorrami
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vida Yazdani
- Department of Biology, Islamic Azad University, East Tehran Branch, Tehran, Iran
| | - Fatemeh Fakhr
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoomeh Amini
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Kheirollahi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Association of rare variants in genes of immune regulation with pediatric autoimmune CNS diseases. J Neurol 2022; 269:6512-6529. [PMID: 35960392 PMCID: PMC9372976 DOI: 10.1007/s00415-022-11325-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/27/2022]
Abstract
Background There is a gap in the literature regarding genetic underpinnings of pediatric autoimmune CNS diseases. This study explored rare gene variants implicated in immune dysregulation within these disorders. Methods This was a single-center observational study of children with inflammatory CNS disorder who had genetic testing through next generation focused exome sequencing targeting 155 genes associated with innate or adaptive immunity. For in silico prediction of functional effects of single-nucleotide variants, Polymorphism Phenotyping v2, and Sorting Intolerant from Tolerant were used, and Combined Annotation Dependent Depletion (CADD) scores were calculated. Identified genes were analyzed using Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Results Of 54 patients, 42 (77.8%) carried variant(s), among which 12 (22.2%) had 3–8 variants. Eighty-eight unique single-nucleotide variants of 55 genes were identified. The most variants were detected in UNC13D, LRBA, LYST, NOD2, DOCK8, RNASEH2A, STAT5B, and AIRE. The majority of variants (62, 70.4%) had CADD > 10. KEGG pathway analysis revealed seven genes associated with primary immunodeficiency (Benjamini 1.40E − 06), six genes with NOD-like receptor signaling (Benjamini 4.10E − 04), five genes with Inflammatory Bowel Disease (Benjamini 9.80E − 03), and five genes with NF-kappa B signaling pathway (Benjamini 1.90E − 02). Discussion We observed a high rate of identification of rare and low-frequency variants in immune regulatory genes in pediatric neuroinflammatory CNS disorders. We identified 88 unique single-nucleotide variants of 55 genes with pathway analysis revealing an enrichment of NOD2-receptor signaling, consistent with involvement of the pathway within other autoinflammatory conditions and warranting further investigation. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11325-2.
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Lee Y, Park HJ, Kang HJ, Ko JM, Kim B, Chang YH, Kim HK, Lee JS, Kim MJ, Park SS, Seong MW. The First Korean Case of Griscelli Syndrome Type 2 With Hemophagocytic Lymphohistiocytosis and Partial Albinism. Ann Lab Med 2022; 42:384-388. [PMID: 34907113 PMCID: PMC8677482 DOI: 10.3343/alm.2022.42.3.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/10/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Youngeun Lee
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Jin Park
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Min Ko
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Boram Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Hwan Chang
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Kyung Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jee-Soo Lee
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Man Jin Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
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DInur-Schejter Y, Stepensky P. Social determinants of health and primary immunodeficiency. Ann Allergy Asthma Immunol 2021; 128:12-18. [PMID: 34628007 DOI: 10.1016/j.anai.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Inborn errors of immunity (IEI) are rare genetic conditions affecting the immune system. The rate of IEI and their presentation, course, and treatment are all affected by a multitude of social determinants, eventually affecting prognosis. This review summarizes the current knowledge of the social determinants affecting infectious susceptibility, genetic predisposition, diagnosis, and treatment of IEI. DATA SOURCES PubMed. STUDY SELECTIONS Search terms included "consanguinity," "social determinants," and "founder effect." Further studies were selected based on relevant citations. RESULTS Changes in climate and human behavior have modulated the spread of disease vectors and infectious organisms. Consanguinity increases the rate of autosomal recessive conditions, changes the distribution, and affects the severity of IEI. Access to sophisticated genetic and immunologic diagnostic modalities affects genetic counseling and timely diagnosis. Effective genetic counseling should address to the patient's genetic background and ethical code. Access to appropriate and timely treatment of immunodeficiencies is scarce in some regions of the world. CONCLUSION High consanguinity rate and reduced access to prophylactic measures increase the burden of immunodeficiencies in many low- and medium-income countries. Furthermore, poor access to diagnostic and treatment modalities in these regions adversely affects patients' prognosis. Increased awareness among health care professionals and the public and increased collaboration with Western countries aid in diagnosis of these conditions. Further advancements require improved public funding to the prevention, diagnosis, and treatment of IEI.
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Affiliation(s)
- Yael DInur-Schejter
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Ein Kerem Medical Center, Jerusalem, Israel.
| | - Polina Stepensky
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
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