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Soucy A, Potts C, Kaija A, Harrington A, McGilvrey M, Sutphin GL, Korstanje R, Tero B, Seeker J, Pinz I, Vary C, Ryzhova L, Liaw L. Effects of a Global Rab27a Null Mutation on Murine PVAT and Cardiovascular Function. Arterioscler Thromb Vasc Biol 2024; 44:1601-1616. [PMID: 38660803 PMCID: PMC11209784 DOI: 10.1161/atvbaha.124.320969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND RAB27A is a member of the RAS oncogene superfamily of GTPases and regulates cell secretory function. It, is expressed within blood vessels and perivascular adipose tissue. We hypothesized that loss of RAB27A would alter cardiovascular function. METHODS Body weight of Rab27aash mice was measured from 2 to 18 months of age, along with glucose resorption at 6 and 12 months of age and glucose sensitivity at 18 months of age. Body weight and cellular and molecular features of perivascular adipose tissue and aortic tissue were examined in a novel C57BL/6J Rab27a null strain. Analyses included morphometric quantification and proteomic analyses. Wire myography measured vasoreactivity, and echocardiography measured cardiac function. Comparisons across ages and genotypes were evaluated via 2-way ANOVA with multiple comparison testing. Significance for myography was determined via 4-parameter nonlinear regression testing. RESULTS Genome-wide association data linked rare human RAB27A variants with body mass index and glucose handling. Changes in glucose tolerance were observed in Rab27aash male mice at 18 months of age. In WT (wild-type) and Rab27a null male mice, body weight, adipocyte lipid area, and aortic area increased with age. In female mice, only body weight increased with age, independent of RAB27A presence. Protein signatures from male Rab27a null mice suggested greater associations with cardiovascular and metabolic phenotypes compared with female tissues. Wire myography results showed Rab27a null males exhibited increased vasoconstriction and reduced vasodilation at 8 weeks of age. Rab27a null females exhibited increased vasoconstriction and vasodilation at 20 weeks of age. Consistent with these vascular changes, male Rab27a null mice experienced age-related cardiomyopathy, with severe differences observed by 21 weeks of age. CONCLUSIONS Global RAB27A loss impacted perivascular adipose tissue and thoracic aorta proteomic signatures, altered vasocontractile responses, and decreased left ventricular ejection fraction in mice.
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Affiliation(s)
- Ashley Soucy
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME
| | - Christian Potts
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
| | - Abigail Kaija
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
| | - Anne Harrington
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
| | - Marissa McGilvrey
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME
| | - George L. Sutphin
- The Jackson Laboratory, Bar Harbor, ME
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, AZ (current affiliation)
| | - Ron Korstanje
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME
- The Jackson Laboratory, Bar Harbor, ME
| | - Benjamin Tero
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
| | - Jacob Seeker
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
| | - Ilka Pinz
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME
| | - Calvin Vary
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME
| | - Larisa Ryzhova
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
| | - Lucy Liaw
- MaineHealth Institute for Research, MaineHealth, Scarborough, ME
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME
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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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3
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Jiang F, Sun Y, Liu ZY, Fan SF, Xiao J, Chen J, Liu HY, Wu NH, Guo ZK. Haploidentical Hematopoietic Stem Cell Transplantation for Paediatric Patients with X-linked Lymphoproliferative Syndrome. Mediterr J Hematol Infect Dis 2024; 16:e2024036. [PMID: 38882453 PMCID: PMC11178043 DOI: 10.4084/mjhid.2024.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/02/2024] [Indexed: 06/18/2024] Open
Abstract
The aim of this study was to investigate the prognostic factors of haploid hematopoietic stem cell transplantation in the treatment of X-linked lymphoproliferative syndrome. Seven children with X-linked lymphoproliferative syndrome diagnosed by XIAP gene analysis were enrolled. The conditioning regimens were tolerated in all seven patients, and the median time of neutrophil engraftment was 10 days (8-13 days), and that of platelet engraftment was 21 days (14-24 days). STR-PCR analysis on the peripheral blood cells showed complete donor origins. Four cases developed Grade I acute graft versus host disease (aGVHD), one developed Grade III aGVHD (intestinal tract), and two cases had limited chronic GVHD. Four cases had cytomegalovirus (CMV) reactivation, and two cases had Epstein-Barr virus (EBV) reactivation. One case was diagnosed as pneumocystosis, and thrombotic microangiopathy (TMA) occurred in three cases. During the follow-up period (median time of 42 months), one patient died of TMA and six patients survived. Statistical analysis showed that the status of disease remission and the positive result of virus in blood before transplantation were independent prognostic factors. Haplo-HSCT might be a curative option for children with refractory X-linked lymphoproliferative syndrome. Low-intensity conditioning regimens may reduce transplant-related mortality and improve overall survival.
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Affiliation(s)
- Fan Jiang
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Yuan Sun
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Zhou-Yang Liu
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Shi-Fen Fan
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Juan Xiao
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Jiao Chen
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Hong-Yan Liu
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Nan-Hai Wu
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
| | - Zi-Kuan Guo
- Department of Hematology and Oncology, Beijing Jingdu Children's Hospital, China
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4
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Pehlivan UA, Oktay K, Cay U, Onan HB, Sezgin G, Zorludemir S. Griscelli Syndrome Type 2 Presenting with Isolated Neurologic Disorder. Neurol India 2023; 71:1042-1043. [PMID: 37929462 DOI: 10.4103/0028-3886.388096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
| | - Kadir Oktay
- Department of Neurosurgery, Cukurova University School of Medicine, Adana, Turkey
| | - Ummuhan Cay
- Department of Pediatric Infectious Diseases, Cukurova University School of Medicine, Adana, Turkey
| | - Hasan Bilen Onan
- Department of Radiology, Cukurova University School of Medicine, Adana, Turkey
| | - Gulay Sezgin
- Department of Pediatric Hematology and Oncology, Cukurova University School of Medicine, Adana, Turkey
| | - Suzan Zorludemir
- Department of Pathology, Cukurova University School of Medicine, Adana, Turkey
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5
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Inflammation in pediatric epilepsies: Update on clinical features and treatment options. Epilepsy Behav 2022; 131:107959. [PMID: 33867302 DOI: 10.1016/j.yebeh.2021.107959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 02/08/2023]
Abstract
The role of inflammation is increasingly recognized in triggering or sustaining epileptic activity. In the last decades, increasing research has provided definite evidence to support the link between immunity, inflammatory process, and epilepsy. Neuro- and systemic inflammation play a pivotal role in driving epileptogenesis through different pathogenetic mechanisms: the activation of innate immunity in glia, neurons, and microvasculature, the brain mediated by blood-brain barrier (BBB) impairment, and the imbalance of pro- and anti-inflammatory molecules produced by both arms of immunity. More recently, research has focused on the adverse effects of maternal or early-life immune activation and cytokine imbalance on fetal neurodevelopment and postnatal epilepsy. A complex crosstalk between the immune and nervous system, and a crucial interplay of genetic, epigenetic, and environmental factors may influence structures and functions of the developing brain. A better understanding of the inflammatory process in promoting epilepsy implies that targeting specific pathways may be effective in seizure control. Multiple targets have been identified so far, and several antiseizure interventions are obtained by inhibiting inflammatory signaling or protecting/restoring BBB. All this evidence has changed the field of epilepsy research and neuropharmacology. Further developments and new treatments will rapidly emerge to improve seizure management in inflammation-related epilepsies. This article is part of the Special Issue "Severe Infantile Epilepsies".
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Ortiz JF, Ruxmohan S, Alzamora IM, Patel A, Eissa-Garcés A. Refractory Seizure in a Patient With Griscelli Syndrome: A Unique Case With One Mutation and a Novel Deletion. Cureus 2021; 13:e14402. [PMID: 33981514 PMCID: PMC8109045 DOI: 10.7759/cureus.14402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Griscelli syndrome (GS) is a rare syndrome characterized by hypopigmentation, immunodeficiency, and neurological features. The genes Ras-related protein (RAB27A) and Myosin-Va (MYO5A) are involved in this condition's pathogenesis. We present a GS type 1 (GS1) case with developmental delay, hypotonia, and refractory seizures despite multiple medications, which included clobazam, cannabinol, zonisamide, and a ketogenic diet. Lacosamide and levetiracetam were added to the treatment regimen, which decreased the seizures' frequency from 10 per day to five per day. The patient had an MYO5A mutation and, remarkably, a deletion on 18p11.32p11.31. The deletion was previously reported in a patient with refractory seizures and developmental delay. We reviewed all cases of GS that presented with seizures. We reviewed other cases of GS and seizures described in the literature and explored possible seizure mechanisms in GS. Seizure in GS1 seems to be related directly to the MYO5A mutation. The neurological manifestations in GS2 seem to be caused indirectly by the accelerated phase of Hemophagocytic syndrome (HPS), which is characteristic of GS2. By having the MYO5A gene mutation combined with the 18p11.32p11.31 deletion, the prognosis and severity of the patient's condition are poor. This is the first report of GS1 with a deletion in 18p11.32p11.31.
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Affiliation(s)
- Juan Fernando Ortiz
- Neurology, Universidad San Francisco de Quito, Quito, ECU.,Neurology, Larkin Community Hospital, Miami, USA
| | - Samir Ruxmohan
- Neurology, Larkin Community Hospital, Miami, Florida, USA
| | | | - Amrapali Patel
- Public Health, George Washington University, Washington, USA
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Al-Sulaiman R, Othman A, El-Akouri K, Fareed S, AlMulla H, Sukik A, Al-Mureikhi M, Shahbeck N, Ali R, Al-Mesaifri F, Musa S, Al-Mulla M, Ibrahim K, Mohamed K, Al-Nesef MA, Ehlayel M, Ben-Omran T. A founder RAB27A variant causes Griscelli syndrome type 2 with phenotypic heterogeneity in Qatari families. Am J Med Genet A 2020; 182:2570-2580. [PMID: 32856792 DOI: 10.1002/ajmg.a.61829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/13/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022]
Abstract
Griscelli syndrome type 2 (GS2) is a rare autosomal recessive disorder caused by pathogenic variants in the RAB27A gene and characterized by partial albinism, immunodeficiency, and occasional hematological and neurological involvement. We reviewed and analyzed the medical records of 12 individuals with GS2 from six families belonging to a highly consanguineous Qatari tribe and with a recurrent pathogenic variant in the RAB27A gene (NM_004580.4: c.244C > T, p.Arg82Cys). Detailed demographic, clinical, and molecular data were collected. Cutaneous manifestations were the most common presentation (42%), followed by neurological abnormalities (33%) and immunodeficiency (25%). The most severe manifestation was HLH (33%). Among the 12 patients, three patients (25%) underwent HSCT, and four (33%) died. The cause of death in all four patients was deemed HLH, providing evidence for this complication's fatal nature. Interestingly, two affected patients (16%) were asymptomatic. This report highlights the broad spectrum of clinical presentations of GS2 associated with a founder variant in the RAB27A gene (c.244C > T, p.Arg82Cys). Early suspicion of GS2 among Qatari patients with cutaneous manifestations, neurological findings, immunodeficiency, and HLH would shorten the diagnostic odyssey, guide early and appropriate treatment, and prevent fatal outcomes.
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Affiliation(s)
- Reem Al-Sulaiman
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Department of Adult Hematology/Oncology, Hamad Medical Corporation, Doha, Qatar
| | - Amna Othman
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
| | - Karen El-Akouri
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
| | - Shehab Fareed
- Department of Adult Hematology/Oncology, Hamad Medical Corporation, Doha, Qatar
| | - Hajer AlMulla
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Department of Adult Hematology/Oncology, Hamad Medical Corporation, Doha, Qatar
| | - Aseel Sukik
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mariam Al-Mureikhi
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
| | - Noora Shahbeck
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
| | - Rehab Ali
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
| | - Fatma Al-Mesaifri
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
| | - Sara Musa
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar
| | - Mariam Al-Mulla
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
| | - Khalid Ibrahim
- Division of Pediatric Neurology, Sidra Medicine, Doha, Qatar
| | - Khalid Mohamed
- Division of Pediatric Neurology, Sidra Medicine, Doha, Qatar
| | | | - Mohammad Ehlayel
- Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medical College, Doha, Qatar
| | - Tawfeg Ben-Omran
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar.,Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar.,Weill Cornell Medical College, Doha, Qatar
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8
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Tewari N, Rajwar A, Mathur VP, Chaudhari PK. Oral features of Griscelli syndrome type II: A rare case report. SPECIAL CARE IN DENTISTRY 2018; 38:421-425. [PMID: 30207398 DOI: 10.1111/scd.12328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/20/2018] [Accepted: 07/28/2018] [Indexed: 11/28/2022]
Abstract
Griscelli syndrome (GS) is an autosomal-recessive disorder of the vesicle transport and membrane trafficking system first identified by Griscelli et al in 1978. The three types of GS have specific genetic defects and systemic manifestations apart from classic partial pigmentary dilution, resulting in hypopigmentation of skin and silvery hair. GS-II occurs due to a defect in the Rab27a gene and is characterized by primary immune deficiency along with accelerated phases of a hemophagocytic lymphohistiocytosis (HLH) crisis. This rare disorder has been widely studied for dermatological, hematological, and neurological manifestations; however, the oral features and presentations have not been elucidated in detail. This report presents a case of a 4-year-old male with known mutation c.550C > T or p.R184X mutation (ENST00000396307) in Rab27a with oral features.
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Affiliation(s)
- Nitesh Tewari
- Pedodontics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Anju Rajwar
- Pedodontics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Pedodontics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhat Kumar Chaudhari
- Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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9
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Ettinger M, Schreml J, Wirsching K, Berneburg M, Schreml S. Skin signs of primary immunodeficiencies: how to find the genes to check. Br J Dermatol 2018; 178:335-349. [DOI: 10.1111/bjd.15870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2017] [Indexed: 12/11/2022]
Affiliation(s)
- M. Ettinger
- Department of Dermatology; University Medical Center Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - J. Schreml
- Department of Otorhinolaryngology; University Medical Center Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - K. Wirsching
- Institute of Human Genetics; University Hospital of Cologne; Cologne Germany
| | - M. Berneburg
- Department of Dermatology; University Medical Center Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
| | - S. Schreml
- Department of Dermatology; University Medical Center Regensburg; Franz-Josef-Strauss-Allee 11 93053 Regensburg Germany
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10
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Lee J, Eldeeb M, Hsu CK, Saito R, Abouzeid S, McGrath J. Further evidence for genotype-phenotype disparity in Griscelli syndrome. Br J Dermatol 2017; 176:1086-1089. [DOI: 10.1111/bjd.14866] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J.Y.W. Lee
- St John's Institute of Dermatology; King's College London; London U.K
| | - M.S. Eldeeb
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Alexandria University; Alexandria Egypt
| | - C.-K. Hsu
- St John's Institute of Dermatology; King's College London; London U.K
- Department of Dermatology; College of Medicine; National Cheng Kung University; Tainan Taiwan
- Institute of Clinical Medicine; College of Medicine; National Cheng Kung University; Tainan Taiwan
| | - R. Saito
- St John's Institute of Dermatology; King's College London; London U.K
- Department of Dermatology; Hiroshima University; Hiroshima Japan
| | - S.A. Abouzeid
- Department of Dermatology, Venereology and Andrology; Faculty of Medicine; Alexandria University; Alexandria Egypt
| | - J.A. McGrath
- St John's Institute of Dermatology; King's College London; London U.K
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11
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Bonilla FA, Khan DA, Ballas ZK, Chinen J, Frank MM, Hsu JT, Keller M, Kobrynski LJ, Komarow HD, Mazer B, Nelson RP, Orange JS, Routes JM, Shearer WT, Sorensen RU, Verbsky JW, Bernstein DI, Blessing-Moore J, Lang D, Nicklas RA, Oppenheimer J, Portnoy JM, Randolph CR, Schuller D, Spector SL, Tilles S, Wallace D. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol 2015; 136:1186-205.e1-78. [PMID: 26371839 DOI: 10.1016/j.jaci.2015.04.049] [Citation(s) in RCA: 400] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/18/2015] [Accepted: 04/23/2015] [Indexed: 02/07/2023]
Abstract
The American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI) have jointly accepted responsibility for establishing the "Practice parameter for the diagnosis and management of primary immunodeficiency." This is a complete and comprehensive document at the current time. The medical environment is a changing environment, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by pharmaceutical companies in drug promotion.
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12
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Mishra K, Singla S, Sharma S, Saxena R, Batra VV. Griscelli syndrome type 2: a novel mutation in RAB27A gene with different clinical features in 2 siblings: a diagnostic conundrum. KOREAN JOURNAL OF PEDIATRICS 2014; 57:91-5. [PMID: 24678334 PMCID: PMC3965801 DOI: 10.3345/kjp.2014.57.2.91] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 03/11/2013] [Accepted: 05/28/2013] [Indexed: 11/27/2022]
Abstract
Griscelli syndrome type 2 (GS2) is a rare autosomal recessive disease caused by mutations in the RAB27A gene. It is characterized by cutaneous hypopigmentation, immunodeficiency, and hemophagocytic lymphohistiocytosis. We describe 2 brothers who had GS2 with clinically diverse manifestations. The elder brother presented with a purely neurological picture, whereas the younger one presented with fever, pancytopenia, hepatosplenomegaly, and erythema nodosum. Considering that cutaneous hypopigmentation was a common feature between the brothers, genetic analysis for Griscelli syndrome was performed. As the elder sibling had died, mutation analysis was only performed on the younger sibling, which revealed a novel homozygous mutation in the RAB27A gene on chromosome 15 showing a single-base substitution (c.136T>A p.F46I). Both parents were heterozygous for the same mutation. This confirmed the diagnosis of GS2 in the accelerated phase in both siblings. The atypical features of GS2 in these cases are a novel mutation, isolated neurological involvement in one sibling, association with erythema nodosum, and 2 distinct clinical presentations in siblings with the same genetic mutation.
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Affiliation(s)
- Kirtisudha Mishra
- Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India
| | - Shilpy Singla
- Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India
| | - Suvasini Sharma
- Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India
| | - Renu Saxena
- Department of Molecular Genetics, Sir Ganga Ram Hospital, New Delhi, India
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13
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Animal models of human genetic diseases: do they need to be faithful to be useful? Mol Genet Genomics 2011; 286:1-20. [DOI: 10.1007/s00438-011-0627-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 04/21/2011] [Indexed: 12/18/2022]
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14
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Mitra S, Cheng KW, Mills GB. Rab GTPases implicated in inherited and acquired disorders. Semin Cell Dev Biol 2010; 22:57-68. [PMID: 21147240 DOI: 10.1016/j.semcdb.2010.12.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 12/06/2010] [Accepted: 12/06/2010] [Indexed: 01/05/2023]
Abstract
The endocytotic machinery imports, transports and exports receptors and associated molecules between the plasma membrane and various cytoplasmic chambers resulting in selective recycling, degradation, or secretion of molecules and signaling complexes. Trafficking of receptors, growth factors, nutrients, cytokines, integrins as well as pathogens dictates the kinetics and magnitude of signal transduction cascades. Understandably, alterations in the 'fate' of such cargo complexes have profound physiologic and pathophysiologic implications. Rab GTPases regulate endocytosis by decorating intracellular vesicles and targeting these vesicles along with their cargoes to appropriate subcellular compartments. In the last decade, the number of genetic diseases driven by germline mutations in Rab GTPases or their interacting proteins, has increased and there is growing evidence of aberrant Rab GTPase function in acquired pathophysiologies such as immune deficiency, infection, obesity, diabetes and cancer.
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Affiliation(s)
- Shreya Mitra
- Department of Systems Biology, The University of Texas, MD Anderson Cancer Center, Houston, TX 77054-1942, USA.
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Ohbayashi N, Mamishi S, Ishibashi K, Maruta Y, Pourakbari B, Tamizifar B, Mohammadpour M, Fukuda M, Parvaneh N. Functional characterization of two RAB27A missense mutations found in Griscelli syndrome type 2. Pigment Cell Melanoma Res 2010; 23:365-74. [PMID: 20370853 DOI: 10.1111/j.1755-148x.2010.00705.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Human Griscelli syndrome type 2 (GS-2) is characterized by partial albinism and a severe immunologic disorder as a result of RAB27A mutations. In melanocytes, Rab27A forms a tripartite complex with a specific effector Slac2-a/melanophilin and myosin Va, and the complex regulates melanosome transport. Here, we report a novel homozygous missense mutation of Rab27A, i.e. K22R, in a Persian GS-2 patient and the results of analysis of the impact of the K22R mutation and the previously reported I44T mutation on protein function. Both mutations completely abolish Slac2-a/melanophilin binding activity but they affect the biochemical properties of Rab27A differently. The Rab27A(K22R) mutant lacks the GTP binding ability and exhibits cytosolic localization in melanocytes. By contrast, neither intrinsic GTPase activity nor melanosomal localization of Rab27A is affected by the I44T mutation, but the Rab27A(I44T) mutant is unable to recruit Slac2-a/melanophilin. Interestingly, the two mutations differently affect binding to other Rab27A effectors, Slp2-a, Slp4-a/granuphilin-a, and Munc13-4. The Rab27A(K22R) mutant normally binds Munc13-4, but not Slp2-a or Slp4-a, whereas the Rab27A(I44T) mutant shows reduced binding activity to Slp2-a and Munc13-4 but normally binds Slp4-a.
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Affiliation(s)
- Norihiko Ohbayashi
- Laboratory of Membrane Trafficking Mechanisms, Department of Developmental Biology and Neurosciences, Graduate School of Life Sciences, Tohoku University, Aobayama, Aoba-ku, Sendai, Miyagi, Japan
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Meeths M, Bryceson YT, Rudd E, Zheng C, Wood SM, Ramme K, Beutel K, Hasle H, Heilmann C, Hultenby K, Ljunggren HG, Fadeel B, Nordenskjöld M, Henter JI. Clinical presentation of Griscelli syndrome type 2 and spectrum of RAB27A mutations. Pediatr Blood Cancer 2010; 54:563-72. [PMID: 19953648 DOI: 10.1002/pbc.22357] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Griscelli syndrome type 2 (GS2) is an autosomal-recessive immunodeficiency caused by mutations in RAB27A, clinically characterized by partial albinism and haemophagocytic lymphohistocytosis (HLH). We evaluated the frequency of RAB27A mutations in 21 unrelated patients with haemophagocytic syndromes without mutations in familial HLH (FHL) causing genes or an established diagnosis of GS2. In addition, we report three patients with known GS2. Moreover, neurological involvement and RAB27A mutations in previously published patients with genetically verified GS2 are reviewed. PROCEDURE Mutation analysis of RAB27A was performed by direct DNA sequencing. NK cell activity was evaluated and microscopy of the hair was performed to confirm the diagnosis. RESULTS RAB27A mutations were found in 1 of the 21 families. This Swedish family had three affected children with heterozygous compound mutations consisting of a novel splice error mutation, [c.239G>C], and a nonsense mutation, [c.550C>T], p.R184X. The three additional children all carried homozygous RAB27A mutations, one of which is a novel splice error mutation, [c.240-2A>C]. Of note, five of the six patients displayed neurological symptoms, while three out of six patients displayed NK cell activity within normal reference values, albeit low. A literature review revealed that 67% of GS2 patients have been reported with neurological manifestations. CONCLUSIONS Identification of RAB27A mutations can facilitate prompt diagnosis and treatment, and aid genetic counselling and prenatal diagnosis. Since five of six patients studied herein initially were diagnosed as having FHL, we conclude that the diagnosis of GS2 may be overlooked, particularly in fair-haired patients with haemophagocytic syndromes.
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Affiliation(s)
- Marie Meeths
- Childhood Cancer Research Unit, Department of Woman and Child Health, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden.
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Meschede IP, Santos TO, Izidoro-Toledo TC, Gurgel-Gianetti J, Espreafico EM. Griscelli syndrome-type 2 in twin siblings: case report and update on RAB27A human mutations and gene structure. Braz J Med Biol Res 2009; 41:839-48. [PMID: 19030707 DOI: 10.1590/s0100-879x2008001000002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Accepted: 10/09/2008] [Indexed: 11/22/2022] Open
Abstract
Griscelli syndrome (GS) is a rare autosomal recessive disorder caused by mutation in the MYO5A (GS1, Elejalde), RAB27A (GS2) or MLPH (GS3) genes. Typical features of all three subtypes of this disease include pigmentary dilution of the hair and skin and silvery-gray hair. Whereas the GS3 phenotype is restricted to the pigmentation dysfunction, GS1 patients also show primary neurological impairment and GS2 patients have severe immunological deficiencies that lead to recurrent infections and hemophagocytic syndrome. We report here the diagnosis of GS2 in 3-year-old twin siblings, with silvery-gray hair, immunodeficiency, hepatosplenomegaly and secondary severe neurological symptoms that culminated in multiple organ failure and death. Light microscopy examination of the hair showed large, irregular clumps of pigments characteristic of GS. A homozygous nonsense mutation, C-T transition (c.550C>T), in the coding region of the RAB27A gene, which leads to a premature stop codon and prediction of a truncated protein (R184X), was found. In patient mononuclear cells, RAB27A mRNA levels were the same as in cells from the parents, but no protein was detected. In addition to the case report, we also present an updated summary on the exon/intron organization of the human RAB27A gene, a literature review of GS2 cases, and a complete list of the human mutations currently reported in this gene. Finally, we propose a flow chart to guide the early diagnosis of the GS subtypes and Chédiak-Higashi syndrome.
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Affiliation(s)
- I P Meschede
- Departamento de Biologia Celular e Molecular e Bioagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Van Gele M, Dynoodt P, Lambert J. Griscelli syndrome: a model system to study vesicular trafficking. Pigment Cell Melanoma Res 2009; 22:268-82. [DOI: 10.1111/j.1755-148x.2009.00558.x] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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