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Majed OAK, Majed FO, Almoamen NJ, Alsatrawi HB, Shehabi SD, Hrbková J, Libik M, Macek M. Distribution of pathogenic variants in the CFTR gene in a representative cohort of people with cystic fibrosis in the Kingdom of Bahrain. Mol Genet Genomics 2024; 299:52. [PMID: 38744777 PMCID: PMC11093839 DOI: 10.1007/s00438-024-02119-4] [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: 05/12/2023] [Accepted: 01/25/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Cystic fibrosis (CF) is a rare multi-systemic recessive disorder. The spectrum and the frequencies of CFTR mutations causing CF vary amongst different populations in Europe and the Middle East. In this study, we characterised the distribution of CF-causing mutations (i.e. pathogenic variants in the CFTR gene) in a representative CF cohort from the Kingdom of Bahrain based on a three-decade-long analysis at a single tertiary centre. We aim to improve CF genetic diagnostics, introduce of CF neonatal screening and provide CFTR modulator therapy (CFTRm). METHODS CFTR genotyping and associated clinical information were drawn from a longitudinal cohort. We sequenced 56 people with CF (pwCF) that had one or both CFTR mutations unidentified and carried out comprehensive bioinformatic- and family-based segregation analyses of detected variants, including genotype-phenotype correlations and disease incidence estimates. The study methodology could serve as a basis for other non-European CF populations with a high degree of consanguinity. RESULTS Altogether 18 CF-causing mutations were identified, 15 of which were not previously detected in Bahrain, accounting for close to 100% of all population-specific alleles. The most common alleles comprise c.1911delG [2043delG; 22.8%], c.2988+1G > A [3120+1G>A; 16.3%], c.2989-1G>A [3121-1G>A; 14.1%], c.3909C>G [N1303K; 13.0%], and c.1521_1523delCTT [p.PheF508del; 7.6%]. Although the proportion of 1st cousin marriages has decreased to 50%, the frequency of homozygosity in our pwCF is 67.4%, thereby indicating that CF still occurs in large, often related, families. pwCF in Bahrain present with faltering growth, pancreatic insufficiency and classical sino-pulmonary manifestations. Interestingly, two pwCF also suffer from sickle cell disease. The estimated incidence of CF in Bahrain based on data from the last three decades is 1 in 9,880 live births. CONCLUSION The most commonCF-causing mutations in Bahraini pwCF were identified, enabling more precise diagnosis, introduction of two-tier neonatal screening and fostering administration of CFTRm.
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Affiliation(s)
- Osama A Karim Majed
- Salmaniya Medical Complex, Rd. No. 2904, Manama, Kingdom of Bahrain.
- Royal University of Surgeons in Ireland, Medical University of Bahrain, Al Sayh Muharraq Governorate, Busaiteen, Kingdom of Bahrain.
| | - Fatema Osama Majed
- Royal University of Surgeons in Ireland, Medical University of Bahrain, Al Sayh Muharraq Governorate, Busaiteen, Kingdom of Bahrain
| | | | | | - Salma Dawood Shehabi
- Department of Pediatrics, University Hospital in Coventry and Warwickshire, Coventry, United Kingdom
| | - Jana Hrbková
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine and Motol University Hospital, Charles University, Prague, Czechia
| | - Malgorzata Libik
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine and Motol University Hospital, Charles University, Prague, Czechia
| | - Milan Macek
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine and Motol University Hospital, Charles University, Prague, Czechia
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Almaghamsi T, Attiyah WB, Bahasan M, Alotaibi BA, AlAhmadi SF, Hanbazazh M, Zakariyah A, Saleem RA, AlAnezi MK, Hawsawi Y. Identification of cystic fibrosis transmembrane conductance regulator gene (CFTR) variants: A retrospective study on the western and southern regions of Saudi Arabia. Saudi Med J 2023; 44:987-994. [PMID: 37777263 PMCID: PMC10541982 DOI: 10.15537/smj.2023.44.10.20230290] [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: 07/31/2023] [Accepted: 08/31/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVES To investigate the geographic distribution of common cystic fibrosis (CF) variants in the western and southern regions of Saudi Arabia. METHODS A retrospective study was conducted on 69 patients diagnosed with CF at King Faisal Specialist Hospital & Research Center, Jeddah. Patient data were collected retrospectively between June 2000 and November 2021. Various parameters were considered, including patient demographic information, CFTR variants, and respiratory cultures. RESULTS We identified 26 CFTR variants in 69 patients with CF, including one novel variant that had not been reported or published before (1549del G) in 2 patients with CF. The 6 most prevalentvariants were as follows: c.1521_1523delCTT (19%), c.1418delG (10.2%), c.579+1G>T (8.8%), c.2988+1G>A (8.8%), c.3419 T>A (7.2%), and c.4124A>C (5.8%). In addition, respiratory cultures revealed that Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae were highly common among patients with CF. CONCLUSION This study highlighted features of patients with CF residing in the Western and Southern regions of Saudi Arabia. Six of the 26 CFTR variants were common in these patients. We also report, for the first time, a novel variant and other CFTR variants that are yet to be reported in Saudi Arabia. These findings could help establish a foundation for cystic fibrosis screening in Saudi Arabia and may assist in clinical diagnosis and prognosis.
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Affiliation(s)
- Talal Almaghamsi
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Wejdan Ba Attiyah
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Mona Bahasan
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Badi A. Alotaibi
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Shahad F. AlAhmadi
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Mehenaz Hanbazazh
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Abeer Zakariyah
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Rimah A. Saleem
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Munaifah K. AlAnezi
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
| | - Yousef Hawsawi
- From the Department of Pediatrics (Almaghamsi, Ba Attiyah, Bahasan), King Faisal Specialist Hospital and Research Center; from the Department of Pathology (Hanbazazh), Faculty of Medicine, University of Jeddah; from the Department of Medical Genetics (Zakariyah), Faculty of Medicine, University of Jeddah; from the Research Center (AlAnezi, Hawsawi), King Faisal Specialist Hospital and Research, Jeddah; from the Department of Clinical Laboratory Sciences (Alotaibi), College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences; from the Department of Clinical Laboratory Sciences (Alotaibi), King Abdullah International Medical Research Center; from the College of Medicine (Saleem, Hawsawi), Al-Faisal University, Riyadh; from the Pharmacy Department (AlAhmadi), Muhammed Saleh Basharhil Hospital, Makkah, Kingdom of Saudi Arabia.
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Abu Sirhan M, Kalinin M, Cohen L, Gurevich E. Uncommon Presentation of Cystic Fibrosis: A Case Report and Literature Review. Cureus 2023; 15:e45186. [PMID: 37842418 PMCID: PMC10575793 DOI: 10.7759/cureus.45186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Cystic fibrosis (CF) is a multiorgan disease, caused by autosomal recessive (AR) mutations in the cystic fibrosis transmembrane regulator (CFTR) acting primarily as a chloride channel. CF is most commonly diagnosed in Caucasian populations. Common clinical presentations in pediatric patients include chronic cough, respiratory tract infections such as pneumonia, digestive symptoms, and stunted growth, and malnutrition due to gastrointestinal malabsorption and pancreatic insufficiency. Excessive sweat sodium chloride losses due to dysfunctional sweat glands in CFTR result in volume contraction and secondary hyperaldosteronism leading to renal potassium losses and metabolic alkalosis. Hypokalemic hypochloremic metabolic alkalosis is a known but uncommon presenting sign of the disease, documented as pseudo Bartter syndrome. Common mutations in the CFTR gene are now included in prenatal genetic screening programs. We describe the case of an infant of African descent with normal prenatal screening who presented with severe hypokalemic hypochloremic metabolic alkalosis and was diagnosed with CF with further genetic confirmation of the diagnosis.
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Affiliation(s)
- Majed Abu Sirhan
- Pediatric Department, Barzilai University Medical Center, Ashqelon, ISR
| | - Michael Kalinin
- Pediatric Intensive Care Unit, Barzilai University Medical Center, Ashqelon, ISR
| | - Lior Cohen
- Genetics Institute, Barzilai University Medical Center, Ashqelon, ISR
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, ISR
| | - Evgenia Gurevich
- Pediatric Department, Barzilai University Medical Center, Ashqelon, ISR
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheva, ISR
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Hosseini Nami A, Kabiri M, Zafarghandi Motlagh F, Shirzadeh T, Fakhari N, Karimi A, Bagherian H, Jamali M, Younesikhah S, Shadman S, Zeinali R, Zeinali S. Genetic attributes of Iranian cystic fibrosis patients: the diagnostic efficiency of CFTR mutations in over a decade. Front Genet 2023; 14:1140034. [PMID: 37274793 PMCID: PMC10234504 DOI: 10.3389/fgene.2023.1140034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/10/2023] [Indexed: 06/07/2023] Open
Abstract
Objectives: Cystic fibrosis (CF) is the most prevalent autosomal recessive disorder among Caucasians. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene cause this pathology. We, therefore, aimed to describe the CFTR mutations and their geographical distribution in Iran. Method: The mutation spectrum for 87 families from all Iranian ethnicities was collected using ARMS PCR, Sanger sequencing, and MLPA. Results: Mutations were identified in 95.8% of cases. This dataset revealed that the most frequent mutations in the Iranian population were F508del, c.1000C>T, c.1397C>G, c.1911delG, and c.1393-1G>A. In addition, we found weak evidence for Turkey being the possible geographical pathway for introducing CFTR mutations into Iran by mapping the frequency of CFTR mutations. Conclusion: Our descriptive results will facilitate the genetic detection and prenatal diagnosis of cystic fibrosis within the Iranian population.
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Affiliation(s)
- Amin Hosseini Nami
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Mahboubeh Kabiri
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran
| | | | - Tina Shirzadeh
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Negar Fakhari
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Ali Karimi
- Max Planck Institute for Brain Research, Frankfurt am Main, Germany
| | - Hamideh Bagherian
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Mojdeh Jamali
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Shahrzad Younesikhah
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Sara Shadman
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Razie Zeinali
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Sirous Zeinali
- Dr. Zeinali’s Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran
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Moni SS, Al Basheer A. Molecular targets for cystic fibrosis and therapeutic potential of monoclonal antibodies. Saudi Pharm J 2022; 30:1736-1747. [PMID: 36601503 PMCID: PMC9805982 DOI: 10.1016/j.jsps.2022.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/01/2022] [Indexed: 12/24/2022] Open
Abstract
Cystic fibrosis (CF) is a genetic disease that affects the exocrine glands and is caused by cystic fibrosis transmembrane conductance regulator gene (CFTR) mutations. Lung disease is the leading cause of morbidity in patients. Target-specific treatment of CF has been achieved using monoclonal antibodies (mAbs). The purpose of this article is to discuss the possibility of treating CF with mAbs through their significant target specificity. We searched electronic databases in Web of Science, PubMed, EMBASE, Scopus, and Google Scholar from 1984 to 2021. We discussed the critical role of targeted therapy in cystic fibrosis, as it will be more effective at suppressing the molecular networks. After conducting a critical review of the available literature, we concluded that it is critical to understand the fundamental molecular mechanisms underlying CF prior to incorporating biologics into the therapy regimen. Omalizumab, Mepolizumab, Benralizumab, Dupilumab and KB001-A have been successfully screened for asthma-complicated CF, and their efficacies have been well reported. Despite the availability of effective targeted biologics, treating CF has remained a difficult task, particularly when it comes to reduction of secondary inflammatory mediators. This review emphasizes the overall views on CF, the immunological mechanism of CF, and the prospective therapeutic use of mAbs as potential targeted biologics for enhancing the overall status of human health.
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Clinical and Genetic Characterisation of Cystic Fibrosis Patients in Latvia: A Twenty-Five-Year Experience. Diagnostics (Basel) 2022; 12:diagnostics12112893. [PMID: 36428953 PMCID: PMC9689702 DOI: 10.3390/diagnostics12112893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Cystic fibrosis (CF) is the most common life-limiting genetic disorder in European descent populations. It is caused by pathogenic variants in the CFTR gene, and inheritance is autosomal recessive. This study provides an up-to-date, comprehensive estimation of the distribution of CFTR pathogenic variants in Latvia and their phenotypic characteristics. It also reports the first results of the CF newborn screening programme following its implementation in 2019. We analysed the clinical and molecular data of CF patients treated at the only tertiary hospital in Latvia providing specialised healthcare for the disorder. Between 1997 and 2022, 66 CF patients from 62 families were diagnosed based on symptoms or a molecular confirmation (six patients were diagnosed through the CF newborn screening programme). F508del was identified in 70.5% of all CF chromosomes. Known variants were identified in more than one family: dele2,3, R1006H, L1335P, W57R, R553X, 2143delT and 3849+10kb C>T (legacy names used). Furthermore, two novel variants were identified, namely, c.503C>A p.(Ser168Ter) and c.(743+1_744-1)_(1584+1_1585-1)del p.(?). The available follow-up results indicated that Latvian CF patients demonstrated similar tendencies to CF patients worldwide. The oldest age at diagnosis prior to the implementation of the CF newborn screening programme was 14 years. We provide here, for the first time, a comprehensive description of Latvian CF patients. An improvement in the healthcare of CF patients over time, including access to diagnosis, is evident. Two novel CF-causing variants are reported, and F508del is the most frequently occurring variant in the population, thus suggesting that F508del screening should be followed by the testing of the full CFTR gene.
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Reporting Two Novel Mutations in Two Iranian Families with Cystic Fibrosis, Molecular and Bioinformatic Analysis. IRANIAN BIOMEDICAL JOURNAL 2022; 26:398-405. [PMID: 35468710 PMCID: PMC9763878 DOI: 10.52547/ibj.3713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Cystic fibrosis (CF) is the most common heredity disease among the Caucasian population. More than 350 known pathogenic variations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene (NM_000492.4) cause CF. Herein, we report the outcome of our investigation in two unrelated Iranian families with CF patients. Methods We conducted phenotypic examination, segregation, linkage analysis, and CFTR gene sequencing to define causative mutations. Results We found two novel mutations in the present study. The first one was a deletion causing frameshift, c.299delT p.(Leu100Profs*7), and the second one was a missense mutation, c.1857G>T, at nucleotide binding domain 1 of the CFTR protein. Haplotype segregation data supported our new mutation findings. Conclusion Findings of this study expand the spectrum of CFTR pathogenic variations and can improve prenatal diagnosis and genetic counseling for CF.
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Banjar H, AbdulAziz N, Khader J, Ghomraoui F, Alansari A, Al-Hoshan A, AlKaf S, Aldakheel W. Liver disease in cystic fibrosis patients in a tertiary care center in Saudi Arabia. Int J Pediatr Adolesc Med 2022; 9:78-82. [PMID: 35663788 PMCID: PMC9152554 DOI: 10.1016/j.ijpam.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/26/2021] [Accepted: 06/13/2021] [Indexed: 11/21/2022]
Abstract
Background Internationally, Cystic fibrosis-associated liver disease (CFLD) is considered the third leading cause of death, following lung disease and transplantation complications. Aims To identify the prevalence of CFLD in cystic fibrosis (CF) patients. Methodology A retrospective chart review for all patients with CF liver disease from a tertiary care center. Result A total of 341 CF patients were included. The mean age at the diagnosis of liver disease is 13.5 (7.6) years.The first elevated ALT was reported in 190/341 patients (56%), elevated AST in 124 patients (36%), elevated alkaline phosphatase (ALP) in 166 patients (49.1%), elevated GGT in 57 patients (23%), and elevated bilirubin in 24 patients (7%). There was an improvement of the liver enzyme values during the follow-up period, P-value = (<0.05).Ultrasound liver assessments were performed in 258/341 patients (75.7%). One hundred and twelve patients (43%) had abnormal findings. In 14 patients (5.4%), assessment exhibited advanced liver disease (liver cirrhosis and periportal fibrosis). Out of 190 patients, who were given ursodeoxycholic acid for elevated liver enzymes, 180 (94.7%) exhibited improvement. One patient underwent liver transplant at the age of 12. Four patients were submitted for liver biopsy; periportal fibrosis was observed in 4 patients (1.6%), and liver cirrhosis by ultrasound (US) in 10 patients (4%). Conclusion Patients with CF should be screened early for liver enzymes, and should undergo the US study to detect liver disease at early stages and to prevent its progression.
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Key Words
- AST to platelet ratio index FIB-4, Fibrosis-4 scoring system US
- CF, Cystic Fibrosis (CFTR) = Cystic Fibrosis Transmembrane Conductance Regulator Gene, Mutations.CFLD
- CFTR
- Cholestasis
- Cystic fibrosis
- Cystic fibrosis liver diseaseLD, Liver diseaseALT
- Liver cirrhosis, Arabs
- Liver disease
- Liver function tests,INR, International normalized ratio
- Ultrasound SD, Standard Deviation ALP
- Ursodeoxycholic acid
- alanine aminotransferaseAST, aspartate aminotransferase APRi
- alkaline phosphatase GGT, gamma glutamyl transpeptidase, LFTs
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Affiliation(s)
- Hanaa Banjar
- Department of Pediatrics, King Specialist Hospital and Research Center (KFSHRC), Riyadh, Saudi Arabia
| | - Najlaa AbdulAziz
- Department of Pediatrics, King Specialist Hospital and Research Center (KFSHRC), Riyadh, Saudi Arabia
| | - Jumana Khader
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
| | | | - AbdulAziz Alansari
- Department of Pediatrics, King Specialist Hospital and Research Center (KFSHRC), Riyadh, Saudi Arabia
| | | | - Sara AlKaf
- Biostatistics, Epidemiology, and Scientific Computing Department, King Specialist Hospital and Research Center (KFSHRC), Riyadh. Saudi Arabia
| | - Wajeeh Aldakheel
- Department of Pediatrics, King Specialist Hospital and Research Center (KFSHRC), Riyadh, Saudi Arabia
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Alibakhshi R, Mohammadi A, Khamooshian S, Kazeminia M, Moradi K. CFTR gene mutation spectrum among 735 Iranian patients with cystic fibrosis: A comprehensive systematic review. Pediatr Pulmonol 2021; 56:3644-3656. [PMID: 34525262 DOI: 10.1002/ppul.25647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/06/2021] [Accepted: 08/25/2021] [Indexed: 01/17/2023]
Abstract
In this study, the spectrum and frequency of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations previously reported among Iranian cystic fibrosis (CF) patients have been reviewed and discussed. Using the keywords of Cystic Fibrosis, CF, CFTR, and Iran, along with their Persian equivalents, a comprehensive search was performed on the online databases. After applying the inclusion and exclusion criteria, 16 articles with an overall sample of 735 Iranian patients with CF, were included in this systematic review. A total of 101 different CFTR gene variants had been reported. The mutation of p.Phe508del (c.1521_1523delCTT) (21.22%) was the most frequent one among Iranian patients with CF. In conclusion, due to the fact that in many provinces of Iran no specific study has been done so far, it seems that the CFTR gene mutation spectrum in patients with CF from Iran is much wider.
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Affiliation(s)
- Reza Alibakhshi
- Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aboozar Mohammadi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahand Khamooshian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Kazeminia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Keivan Moradi
- Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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AbdulWahab A, AlNaimi A, Habra B, Janahi I. First report of the cystic fibrosis transmembrane conductance regulator mutation c.1521_1523delCTT (p. Phe508del) in two Qatari patients with cystic fibrosis. Qatar Med J 2021; 2021:24. [PMID: 34377682 PMCID: PMC8314207 DOI: 10.5339/qmj.2021.24] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/07/2021] [Indexed: 11/03/2022] Open
Abstract
We report two cases of Qatari children with cystic fibrosis (CF) from different families presenting the homozygous CFTR 1521_1523delCTT (p. Phe508del) mutation with classic CF phenotypes. This gene mutation is considered the second CF mutation identified in Qatar. Herein, we review the frequency and distribution of this mutation in Arab countries.
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Affiliation(s)
| | | | - Basel Habra
- Department of Paediatric Medicine, Hamad Medical Corporation, Doha, Qatar
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11
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Banjar H, Qeretli R, Ramadan A, Al-Ibraheem A, Bnatig F. The first report on CFTR mutations of meconium ileus in cystic fibrosis population in Saudi Arabia: A single center review. INTERNATIONAL JOURNAL OF PEDIATRICS AND ADOLESCENT MEDICINE 2021; 9:32-35. [PMID: 35573065 PMCID: PMC9072234 DOI: 10.1016/j.ijpam.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 03/16/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Meconium ileus (MI) is one of the most common causes of intestinal obstruction in newborns. It is the earliest clinical manifestation of cystic fibrosis (CF). MI is suspected if a baby fails to pass meconium shortly after birth and develops symptoms of bowel obstruction, such as distention of the abdomen or vomiting. MI can lead to bowel perforation, a twisting of the bowel, or inflammation and infection of the abdominal cavity. Objectives To find the incidence and prevalence of meconium ileus in cystic fibrosis patients and to report on the most common gene mutation of MI in CF patients. Methodology Retrospective review of the medical documentations of all MI patients during the period of 1989–2018. Results A total of 40 CF confirmed patients were presented with MI. Twenty-nine patients (71%) are alive and 11 patients (29%) died or lost to follow-up. The following CFTR mutations were found: Eight patients (20%) with c.2988+1G>A; Intron 18. Seven patients (17.5%) with c.1418delG; Exon 11. Five patients (12.5%) with c.579+1G>T; Intron 5. Four patients (10%) with c.1911delG; Exon 14. Four patients (10%) with c.1521_1523delCTT; Exon 11. Four patients (10%) with c.416A>T; Exon 13. Three patients (7.5%) with c.2421A>G; Exon 14. Two patients (5%) with c.3908A>C; Exon 21. One patient (2.5%) with c.3889dupT; Exon 24. One patient (2.5%) with c.1657C>T; Exon 12. One patient (2.5%) with c.2547C>A; Exon 14a. Eighteen patients (45%) were presented with vomiting, 38 patients (95%) had postnatal radiological findings, 7 patients (17.5%) had electrolytes imbalance. Five patients (12.5%) had cholestasis and 4 patients (10%) developed chronic liver disease. Thirty-five patients (79.5%) underwent surgical repair and 9 patients (20.5%) were treated medically. Mean age of operation was 2.25 (2) days. Of 9 patients, 6 (66.6%) were treated with gastrograffin enema, 2 patients (22.2%) with oral N-acetylcysteine and 1 patient (11.1%) with saline rectal wash. Thirteen patients (31.5%) required TPN. Five patients had recurrent operation. Conclusion CF and meconium ileus are commonly present in CF patients in Saudi Arabia. Prognosis is similar to other CFs without MI, if treated early. Thirty percent of our CF/MI patients have intronic mutations.
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Current Status of Genetic Diagnosis Laboratories and Frequency of Genetic Variants Associated with Cystic Fibrosis through a Newborn-Screening Program in Turkey. Genes (Basel) 2021; 12:genes12020206. [PMID: 33572515 PMCID: PMC7910984 DOI: 10.3390/genes12020206] [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] [Received: 12/15/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Cystic fibrosis (CF) is the most common worldwide, life-shortening multisystem hereditary disease, with an autosomal recessive inheritance pattern caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The national newborn screening (NBS) program for CF has been initiated in Turkey since 2015. If the immunoreactive trypsinogen (IRT) is elevated (higher than 70 μg/L in the second control) and confirmed by sweat test or clinical findings, genetic testing is performed. The aims of this study are to emphasize the effect of NBS on the status of genetic diagnosis centers with the increasing numbers of molecular testing methods, and to determine the numbers and types of CFTR mutations in Turkey. Methods: The next-generation sequencing (NGS) and multiplex ligation-dependent probe amplification (MLPA) results of 1595 newborns, who were referred to Cukurova University Adana Genetic Diseases Diagnosis and Treatment Center (AGENTEM) for molecular genetic testing, were evaluated with positive CF NBS program results since 2017. Results: According to the results; 560 (35.1%) of the 1595 patients carried at least 1 (one) CF-related variant, while 1035 patients (64.9%) had no mutation. Compound heterozygosity for two mutations was the most common in patients, while two detected variants were homozygote in 14 patients. A total of 161 variants were detected in 561 patients with mutations. Fifteen novel variants that have not been previously reported were found. Moreover, p.L997F was identified as the most frequent pathogenic mutation that might affect the IRT measurements used for the NBS. The distribution of mutation frequencies in our study showed a difference from those previously reported; for example, the well-known p.F508del was the third most common (n = 42 alleles), rather than the first. The most striking finding is that 313 cases had a pathogenic variant together with the V470M variant, which might have a cumulative effect on CF perpetuation. Conclusion: This study is the first to determine the mutational spectrum of CFTR in correlation with the NBS program in the Turkish population. NBS for CF raises issues regarding screening in diverse populations, both medical and non-medical benefits, and carrier identification. Through the lens of NBS, we focused on the integrated diagnostic algorithms and their effect on the results of genetic testing.
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Benabdelkamel H, Alamri H, Okla M, Masood A, Abdel Jabar M, Alanazi IO, Alfadda AA, Nizami I, Dasouki M, Abdel Rahman AM. Serum-Based Proteomics Profiling in Adult Patients with Cystic Fibrosis. Int J Mol Sci 2020; 21:ijms21197415. [PMID: 33050003 PMCID: PMC7582405 DOI: 10.3390/ijms21197415] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/16/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022] Open
Abstract
Cystic fibrosis (CF), the most common lethal autosomal recessive disorder among Caucasians, is caused by mutations in the CF transmembrane conductance regulator (CFTR) chloride channel gene. Despite significant advances in the management of CF patients, novel disease-related biomarkers and therapies must be identified. We performed serum proteomics profiling in CF patients (n = 28) and healthy subjects (n = 10) using the 2D-DIGE MALDI-TOF proteomic approach. Out of a total of 198 proteins identified, 134 showed a statistically significant difference in abundance and a 1.5-fold change (ANOVA, p < 0.05), including 80 proteins with increased abundance and 54 proteins with decreased abundance in CF patients. A multiple reaction monitoring-mass spectrometry analysis of six differentially expressed proteins identified by a proteomic approach (DIGE-MALD-MS) showed a significant increase in C3 and CP proteins and a decrease in APOA1, Complement C1, Hp, and RBP4proteins compared with healthy controls. Fifteen proteins were identified as potential biomarkers for CF diagnosis. An ingenuity pathway analysis of the differentially regulated proteins indicates that the central nodes dysregulated in CF subjects involve pro-inflammatory cytokines, ERK1/2, and P38 MAPK, which are primarily involved in catalytic activities and metabolic processes. The involved canonical pathways include those related to FXR/RXR, LXR/RXR, acute phase response, IL12, nitric oxide, and reactive oxygen species in macrophages. Our data support the current efforts toward augmenting protease inhibitors in patients with CF. Perturbations in lipid and vitamin metabolism frequently observed in CF patients may be partly due to abnormalities in their transport mechanism.
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Affiliation(s)
- Hicham Benabdelkamel
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh 11461, Saudi Arabia; (H.B.); (A.M.); (A.A.A.)
| | - Hanadi Alamri
- Department of Biochemistry and Molecular Medicine, College of Medicine, Al Faisal University, Riyadh 11533, Saudi Arabia;
| | - Meshail Okla
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, 183T11, Riyadh 11495, Saudi Arabia;
| | - Afshan Masood
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh 11461, Saudi Arabia; (H.B.); (A.M.); (A.A.A.)
| | - Mai Abdel Jabar
- Department of Genetics, King Faisal Specialist Hospital and Research Centre (KFSHRC), Zahrawi Street, Al Maather, Riyadh 11211, Saudi Arabia;
| | - Ibrahim O. Alanazi
- The National Center for Biotechnology (NCB), Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 12354, Saudi Arabia;
| | - Assim A. Alfadda
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh 11461, Saudi Arabia; (H.B.); (A.M.); (A.A.A.)
- Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh 11461, Saudi Arabia
| | - Imran Nizami
- Lung Transplant Section, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Zahrawi Street, Al Maather, Riyadh 11211, Saudi Arabia;
| | - Majed Dasouki
- Department of Genetics, King Faisal Specialist Hospital and Research Centre (KFSHRC), Zahrawi Street, Al Maather, Riyadh 11211, Saudi Arabia;
- Correspondence: (M.D.); (A.M.A.R.); Tel.: +966-114647272 (ext. 24081) (M.D.); +966-114647272 (ext. 36481) (A.M.A.R.)
| | - Anas M. Abdel Rahman
- Department of Biochemistry and Molecular Medicine, College of Medicine, Al Faisal University, Riyadh 11533, Saudi Arabia;
- Department of Genetics, King Faisal Specialist Hospital and Research Centre (KFSHRC), Zahrawi Street, Al Maather, Riyadh 11211, Saudi Arabia;
- Department of Chemistry, Memorial University of Newfoundland, St. John’s, NL A1B 3X7, Canada
- Correspondence: (M.D.); (A.M.A.R.); Tel.: +966-114647272 (ext. 24081) (M.D.); +966-114647272 (ext. 36481) (A.M.A.R.)
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