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Bouchaala W, Laroussi S, Mzid Y, Maaloul I, Jallouli O, Zouari S, Ben Nsir S, Mnif Z, Kammoun F, Triki C. Moyamoya Angiopathy: An Underdiagnosed Cause of Ischemic Stroke in a Tunisian Pediatric Cohort. Pediatr Neurol 2024; 150:3-9. [PMID: 37925769 DOI: 10.1016/j.pediatrneurol.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Moyamoya angiopathy is a rare cerebral vasculopathy and an underdiagnosed cause of arterial ischemic stroke in children. We aim to report the clinical and radiological presentations in a Tunisian pediatric cohort. METHODS We identified moyamoya angiopathy in pediatric patients managed at the Child Neurology Department of Hedi Chaker Sfax University Hospital between 2008 and 2020 and reviewed their clinical and radiological data as well as their evolutionary profile. RESULTS We collected 14 patients with median age 40.6 months and a female predominance (sex ratio of 0.75). An arterial ischemic stroke (AIS) revealed the disease in all patients, with the major symptom being a motor deficit. Symptoms related to a transient ischemic attack before the diagnostic consultation were reported in four patients. Carotid territory was, clinically and radiologically, the most frequently involved. Brain magnetic resonance imaging with angiography was performed in 12 patients confirming the diagnosis by revealing the development of collateral vessels. All the investigations concluded to moyamoya disease in 57.2% and moyamoya syndrome in 42.8%. The latter was related to Down syndrome in five patients and neurofibromatosis type 1 in one patient. With a mean follow-up of 2.35 years, two patients had at least two more AISs during the first two years following diagnosis and 42.8% of patients were diagnosed with vascular or poststroke epilepsy. Full recovery was noted in 14.3% of cases. CONCLUSIONS Moyamoya angiopathy in children is a serious condition that needs to be recognized due to the high risk of recurrent ischemic strokes.
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Affiliation(s)
- Wafa Bouchaala
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Sirine Laroussi
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia.
| | - Yosra Mzid
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Imen Maaloul
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Olfa Jallouli
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Salma Zouari
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Sihem Ben Nsir
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Zeineb Mnif
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Fatma Kammoun
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
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Ben Said M, Jallouli O, Ben Aissa A, Souissi A, Kamoun F, Fakhfakh F, Masmoudi S, Ben Ayed I, Triki CC. Customized targeted massively parallel sequencing enables the identification of novel pathogenic variants in Tunisian patients with Developmental and Epileptic Encephalopathy. Epilepsia Open 2023. [PMID: 37867425 DOI: 10.1002/epi4.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVE To develop a high throughput sequencing panel for the diagnosis of developmental and epileptic encephalopathy in Tunisia and to clarify the frequency of disease-causing genes in this region. METHODS We developed a custom panel for next generation sequencing of the coding sequences of 116 genes in individuals with developmental and epileptic encephalopathy from the Tunisian population. Segregation analyses as well as in silico studies have been conducted to assess the identified variants' pathogenicity. RESULTS We report 12 pathogenic variants in SCN1A, CHD2, CDKL5, SZT2, KCNT1, GNAO1, PCDH19, MECP2, GRIN2A, and SYNGAP1 in patients with developmental and epileptic encephalopathy. Five of these variants are novel: "c.149delA, p.(Asn50MetfsTer26)" in CDKL5; "c.3616C>T, p.(Arg1206Ter)" in SZT2; "c.111_113del, p.(Leu39del)" in GNAO1; "c.1435G>C , p.(Asp479His)" in PCDH19; as well as "c.2143delC, p. (Arg716GlyfsTer10)"in SYNGAP1. Additionally, for four of our patients, the genetic result facilitated the choice of the appropriate treatment. SIGNIFICANCE This is the first report of a custom gene panel to identify genetic variants implicated in developmental and epileptic encephalopathy in the Tunisian population as well as the North African region (Tunisia, Egypt, Libya, Algeria, Morocco) with a diagnostic rate of 30%. This high-throughput sequencing panel has considerably improved the rate of positive diagnosis of developmental and epileptic encephalopathy in the Tunisian population, which was less than 15% using Sanger sequencing. The benefit of genetic testing in these patients was approved by both physicians and parents.
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Affiliation(s)
- Mariem Ben Said
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Olfa Jallouli
- Department of Child Neurology, Hedi Chaker Hospital, LR19ES15, University of Sfax, Sfax, Tunisia
| | - Abir Ben Aissa
- Department of Child Neurology, Hedi Chaker Hospital, LR19ES15, University of Sfax, Sfax, Tunisia
| | - Amal Souissi
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Fatma Kamoun
- Department of Child Neurology, Hedi Chaker Hospital, LR19ES15, University of Sfax, Sfax, Tunisia
| | - Faiza Fakhfakh
- Molecular Genetics and Functional Laboratory, Faculty of Science of Sfax, University of Sfax, Sfax, Tunisia
| | - Saber Masmoudi
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Ikhlas Ben Ayed
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Chahnez Charfi Triki
- Department of Child Neurology, Hedi Chaker Hospital, LR19ES15, University of Sfax, Sfax, Tunisia
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Kharrat M, Issa AB, Tlili A, Jallouli O, Alila-Fersi O, Maalej M, Chouchen J, Ghouylia Y, Kamoun F, Triki C, Fakhfakh F. A Novel Mutation in the MAP7D3 Gene in Two Siblings with Severe Intellectual Disability and Autistic Traits: Concurrent Assessment of BDNF Functional Polymorphism, X-Inactivation and Oxidative Stress to Explain Disease Severity. J Mol Neurosci 2023; 73:853-864. [PMID: 37817054 DOI: 10.1007/s12031-023-02163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023]
Abstract
Intellectual disabilities (ID) and autism spectrum disorders (ASD) are characterized by extreme genetic and phenotypic heterogeneity. However, understanding this heterogeneity is difficult due to the intricate interplay among multiple interconnected genes, epigenetic factors, oxidative stress, and environmental factors. Employing next-generation sequencing (NGS), we revealed the genetic cause of ID and autistic traits in two patients from a consanguineous family followed by segregation analysis. Furthermore, in silico prediction methods and 3D modeling were conducted to predict the effect of the variants. To establish genotype-phenotype correlation, X-chromosome inactivation using Methylation-specific PCR and oxidative stress markers were also investigated. By analyzing the NGS data of the two patients, we identified a novel frameshift mutation c.2174_2177del (p.Thr725MetfsTer2) in the MAP7D3 gene inherited from their mother along with the functional BDNF Val66Met polymorphism inherited from their father. The 3D modeling demonstrated that the p.Thr725MetfsTer2 variant led to the loss of the C-terminal tail of the MAP7D3 protein. This change could destabilize its structure and impact kinesin-1's binding to microtubules via an allosteric effect. Moreover, the analysis of oxidative stress biomarkers revealed an elevated oxidative stress in the two patients compared to the controls. To the best of our knowledge, this is the first report describing severe ID and autistic traits in familial cases with novel frameshift mutation c.2174_2177del in the MAP7D3 gene co-occurring with the functional polymorphism Val66M in the BDNF gene. Besides, our study underlines the importance of investigating combined genetic variations, X-chromosome inactivation (XCI) patterns, and oxidative stress markers for a better understanding of ID and autism etiology.
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Affiliation(s)
- Marwa Kharrat
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax University, Sfax, Tunisia.
| | - Abir Ben Issa
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Olfa Jallouli
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Olfa Alila-Fersi
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax University, Sfax, Tunisia
| | - Marwa Maalej
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax University, Sfax, Tunisia
| | - Jihen Chouchen
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Yosra Ghouylia
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Fatma Kamoun
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Faiza Fakhfakh
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax University, Sfax, Tunisia.
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Kamoun F, Laroussi S, Mellouli A, Jallouli O, Feki S, Ben Sassi S, Charfi Triki C. Juvenile Dermatomyositis Without Skin Lesions in an Antinuclear Matrix Protein 2 Antibody Seropositive Pediatric Case. J Clin Neuromuscul Dis 2023; 25:46-50. [PMID: 37611270 DOI: 10.1097/cnd.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
ABSTRACT We report a 5-year-old boy who presented with progressive weakness in 4 limbs and gait disorders over 7 months. No skin rash was observed on admission. A symmetrical proximodistal weakness was found. The creatine kinase level was normal with a slightly elevated lactate dehydrogenase level. Biopsy specimens showed infiltration of mononuclear cells, few necrotic fibers, and perifascicular atrophy. Screening for myositis-specific antibodies was positive for the antinuclear matrix protein 2 antibody, which is mainly associated with dermatomyositis. Symptoms improved on receiving corticosteroids. Our findings suggest that in cases where inflammatory muscle disease is suspected, antinuclear matrix protein 2 antibody analyses should be considered for precise diagnosis, even with the absence of dermatological symptoms. The case suggests consideration of juvenile dermatomyositis in children with no associated skin manifestations or elevated creatine kinase levels and highlights the importance of screening for myositis-specific antibodies in helping with the diagnosis, given the possible heterogeneity of its clinical presentations.
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Affiliation(s)
- Fatma Kamoun
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- LR19ES15 University of Sfax, Tunisia
| | - Sirine Laroussi
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Azza Mellouli
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Olfa Jallouli
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- LR19ES15 University of Sfax, Tunisia
| | - Sawsan Feki
- Autoimmunity, Cancer and Immunogenetics Research Laboratory (LR18SP12), Immunology Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Samia Ben Sassi
- Neurology Department, National Institute of Neurology, Tunis, Tunisia; and
- Faculty of Medicine of Tunis, Neurosciences Department, University of Tunis El Manar, Tunis, Tunisia
| | - Chahnez Charfi Triki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- LR19ES15 University of Sfax, Tunisia
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Zouari Mallouli S, Jallouli O, Bouchaala W, Ben Nsir S, Kamoun Feki F, Charfi Triki C. Challenges to associate early onset epilepsy with COVID-19 autoimmune encephalitis: A case report. World J Immunol 2023; 13:1-10. [DOI: 10.5411/wji.v13.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/14/2023] [Accepted: 02/02/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Diagnosis of coronavirus disease 2019 (COVID-19)-related neurological events in the pediatric population is challenging. Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism, in addition to the frequency of asymptomatic COVID-19 cases, pose the main challenges for diagnosis. Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis (AIE) is reported.
CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE. Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal. Neither the immunological assessment, including viral serologies, antinuclear antibodies, autoimmune antibodies (NMDA, AMPA, CASPR2, LG11, GABARB, Hu, Yo, Ri, CV2, PNMA2, SOX1, Titin, amphiphysin, Recoverin), nor the metabolic assessment for lactate and pyruvate showed significant anomaly. Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE. A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veino-globulin and high dose of intravenous Corticosteroid.
CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.
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Affiliation(s)
- Salma Zouari Mallouli
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Olfa Jallouli
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Wafa Bouchaala
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Sihem Ben Nsir
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Fatma Kamoun Feki
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Chahnez Charfi Triki
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
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Ben Issa A, Ben Ayed I, Jallouli O, Souissi A, Bouchaalla W, Ben Said M, Mallouli S, Masmoudi S, Charfi Triki C, Hadj Kacem H, Kammoun F. A new case with the recurrent PURA p.(Phe233del) pathogenic variant: Expansion of the phenotype and review of the literature. Int J Dev Neurosci 2023. [PMID: 37204304 DOI: 10.1002/jdn.10266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
In the process of neuronal development, the protein Purα (encoded by the PURA gene) is essential for neuronal proliferation, dendritic maturation, and the transportation of mRNA to translation sites. Mutations in the PURA gene may alter normal brain development and impair neuronal function, contributing to developmental delays and seizures. Recently, PURA syndrome is described as developmental encephalopathy with or without epilepsy, neonatal hypotonia, feeding difficulties, global developmental delay, and severe intellectual disability. In our study, we aimed to perform a genetic analysis by whole exome sequencing (WES) in a Tunisian patient presented with developmental and epileptic encephalopathy to provide a molecular explanation for the developed phenotype. We collected, also, clinical data of all PURA p.(Phe233del) patients reported yet and compared the clinical features with those of our patient. Results revealed the presence of the known PURA c.697_699del, p.(Phe233del) variant. Our studied case shares some clinical features including hypotonia, feeding difficulties, severe developmental delay, epilepsy, and language delay (nonverbal) but presents a radiological finding undescribed before. Our finding defines and expands the phenotypic and genotypic spectrum of the PURA syndrome supporting the absence of reliable genotype-phenotype correlations and the existence of a highly variable, wide-ranging clinical spectrum.
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Affiliation(s)
- Abir Ben Issa
- Research Laboratory "Neuropédiatrie" (LR19ES15), Sfax Faculty of Medicine, Sfax University, Sfax, Tunisia
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Ikhlas Ben Ayed
- Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax University, Sfax, Tunisia
- Medical Genetic Department, Hédi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Olfa Jallouli
- Research Laboratory "Neuropédiatrie" (LR19ES15), Sfax Faculty of Medicine, Sfax University, Sfax, Tunisia
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
| | - Amal Souissi
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax University, Sfax, Tunisia
| | - Wafa Bouchaalla
- Research Laboratory "Neuropédiatrie" (LR19ES15), Sfax Faculty of Medicine, Sfax University, Sfax, Tunisia
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
| | - Mariem Ben Said
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax University, Sfax, Tunisia
| | - Salma Mallouli
- Research Laboratory "Neuropédiatrie" (LR19ES15), Sfax Faculty of Medicine, Sfax University, Sfax, Tunisia
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
| | - Saber Masmoudi
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax University, Sfax, Tunisia
| | - Chahnez Charfi Triki
- Research Laboratory "Neuropédiatrie" (LR19ES15), Sfax Faculty of Medicine, Sfax University, Sfax, Tunisia
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
| | - Hassen Hadj Kacem
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma Kammoun
- Research Laboratory "Neuropédiatrie" (LR19ES15), Sfax Faculty of Medicine, Sfax University, Sfax, Tunisia
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
- Faculty of Medicine of Sfax, Sfax University, Sfax, Tunisia
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Ben Ayed I, Jallouli O, Murakami Y, Souissi A, Mallouli S, Bouzid A, Kamoun F, Elloumi I, Frikha F, Tlili A, Weckhuysen S, Kinoshita T, Triki CC, Masmoudi S. Case report: Functional analysis of the p.Arg507Trp variant of the PIGT gene supporting the moderate epilepsy phenotype of mutations in the C-terminal region. Front Neurol 2023; 14:1092887. [PMID: 36970549 PMCID: PMC10034188 DOI: 10.3389/fneur.2023.1092887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/01/2023] [Indexed: 03/29/2023] Open
Abstract
Pathogenic germline variants in the PIGT gene are associated with the "multiple congenital anomalies-hypotonia-seizures syndrome 3" (MCAHS3) phenotype. So far, fifty patients have been reported, most of whom suffer from intractable epilepsy. Recently, a comprehensive analysis of a cohort of 26 patients with PIGT variants has broadened the phenotypical spectrum and indicated that both p.Asn527Ser and p.Val528Met are associated with a milder epilepsy phenotype and less severe outcomes. Since all reported patients are of Caucasian/Polish origin and most harbor the same variant (p.Val528Met), the ability to draw definitive conclusions regarding the genotype-phenotype correlation remains limited. We report a new case with a homozygous variant p.Arg507Trp in the PIGT gene, detected on clinical exome sequencing. The North African patient in question displays a predominantly neurological phenotype with global developmental delay, hypotonia, brain abnormalities, and well-controlled epileptic seizures. Homozygous and heterozygous variants in codon 507 have been reported to cause PIGT deficiency without biochemical confirmation. In this study, FACS analysis of knockout HEK293 cells that had been transfected with wild-type or mutant cDNA constructs demonstrated that the p.Arg507Trp variant leads to mildly reduced activity. Our result confirm the pathogenicity of this variant and strengthen recently reported evidence on the genotype-phenotype correlation of the PIGT variant.
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Affiliation(s)
- Ikhlas Ben Ayed
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia
| | - Olfa Jallouli
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia
- Research Laboratory “Neuropédiatrie” LR19ES15, Sfax University, Sfax, Tunisia
| | - Yoshiko Murakami
- Laboratory of Immunoglycobiology, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Amal Souissi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Salma Mallouli
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia
- Research Laboratory “Neuropédiatrie” LR19ES15, Sfax University, Sfax, Tunisia
| | - Amal Bouzid
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Fatma Kamoun
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia
- Research Laboratory “Neuropédiatrie” LR19ES15, Sfax University, Sfax, Tunisia
| | - Ines Elloumi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Fakher Frikha
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Human Genetics and Stem Cell Laboratory, Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Taroh Kinoshita
- Laboratory of Immunoglycobiology, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
- Center for Infectious Disease Education and Research, Osaka University, Suita, Japan
| | - Chahnez Charfi Triki
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia
- Research Laboratory “Neuropédiatrie” LR19ES15, Sfax University, Sfax, Tunisia
| | - Saber Masmoudi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
- *Correspondence: Saber Masmoudi
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Kharrat M, Triki CC, Alila-Fersi O, Jallouli O, Khemakham B, Mallouli S, Maalej M, Ammar M, Frikha F, Kamoun F, Fakhfakh F. Combined in Silico Prediction Methods, Molecular Dynamic Simulation, and Molecular Docking of FOXG1 Missense Mutations: Effect on FoxG1 Structure and Its Interactions with DNA and Bmi-1 Protein. J Mol Neurosci 2022; 72:1695-1705. [PMID: 35654936 DOI: 10.1007/s12031-022-02032-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
FoxG1 encoded by FOXG1 gene is a transcriptional factor interacting with the DNA of targeted genes as well as with several proteins to regulate the forebrain development. Mutations in the FOXG1 gene have been shown to cause a wide spectrum of brain disorders, including the congenital variant of Rett syndrome. In this study, the direct sequencing of FOXG1 gene revealed a novel c.645C > A (F215L) variant in the patient P1 and a de novo known one c.755G > A (G252D) in the patient P2. To investigate the putative impact of FOXG1 missense variants, a computational pipeline by the application of in silico prediction methods, molecular dynamic simulation, and molecular docking approaches was used. Bioinformatics analysis and molecular dynamics simulation have demonstrated that F215L and G252D variants found in the DNA binding domain are highly deleterious mutations that may cause the protein structure destabilization. On the other hand, molecular docking revealed that F215L mutant is likely to have a great impact on destabilizing the protein structure and the disruption of the Bmi-1 binding site quite significantly. Regarding G252D mutation, it seems to abolish the ability of FoxG1 to bind DNA target, affecting the transcriptional regulation of targeted genes. Our study highlights the usefulness of combined computational approaches, molecular dynamic simulation, and molecular docking for a better understanding of the dysfunctional effects of FOXG1 missense mutations and their role in the etiopathogenesis as well as in the genotype-phenotype correlation.
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Affiliation(s)
- Marwa Kharrat
- Laboratory of Molecular and Functional Genetics, Faculty of Science, Sfax University, Sfax, Tunisia.
| | - Chahnez Charfi Triki
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia.,Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Olfa Alila-Fersi
- Laboratory of Molecular and Functional Genetics, Faculty of Science, Sfax University, Sfax, Tunisia
| | - Olfa Jallouli
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia.,Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Bassem Khemakham
- Laboratory of Plant Biotechnology, Faculty of Sciences of Sfax, Sfax University, Sfax, Tunisia
| | - Salma Mallouli
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia.,Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Marwa Maalej
- Laboratory of Molecular and Functional Genetics, Faculty of Science, Sfax University, Sfax, Tunisia
| | - Marwa Ammar
- Laboratory of Molecular and Functional Genetics, Faculty of Science, Sfax University, Sfax, Tunisia
| | - Fakher Frikha
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Fatma Kamoun
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia.,Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Faiza Fakhfakh
- Laboratory of Molecular and Functional Genetics, Faculty of Science, Sfax University, Sfax, Tunisia.
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Ben Ayed I, Bouzid A, Kammoun F, Souissi A, Jallouli O, Mallouli S, Guidara S, Loukil S, Aloulou H, Jbeli F, Aouichaoui S, Abid D, Abdelhedi F, Triki C, Kamoun H, Masmoudi S. 8q21.11 microdeletion syndrome: Delineation of HEY1 as a candidate gene in neurodevelopmental and cardiac defects. Mol Genet Genomic Med 2021; 9:e1811. [PMID: 34549899 PMCID: PMC8606210 DOI: 10.1002/mgg3.1811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/13/2021] [Accepted: 09/02/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND 8q21.11 microdeletion syndrome is a rare chromosomal disorder characterized by recurrent dysmorphic features, a variable degree of intellectual disability and ocular, cardiac and hand/feet abnormalities. To date, ZFHX4 is the only candidate gene implicated in the ocular findings. In this study, we evaluated a patient with a de novo 8q21.13-21.3 deletion to define a new small region of overlap (SRO) for this entity. METHODS We conducted a clinical evaluation and comparative genomic hybridization (CGH) 4x44K microarrays in a patient with de novo unbalanced translocation t(8;16)(q21; q11.2). RESULTS The case, a 6-year-old boy, presented dysmorphic features including an elongated face, brachycephaly with a high forehead, an underdeveloped ala, thin upper lip, micrognathia, low-set ears, hypotonia, mild intellectual disability, cortical atrophy with thin corpus callosum defect, and an atrial septal defect. No ocular abnormalities were found. Microarray analysis revealed a 9.6 Mb interstitial 8q21.11-21.3 deletion, not including the ZFHX4 gene. This microdeletion was confirmed in our patient through qPCR analysis, and both parents had a normal profile. Alignment analysis of our case defined a new SRO encompassing five genes. Among them, the HEY1 gene is involved in the embryonic development of the heart, central nervous system, and vascular system. Hrt1/Hey1 null mice show perinatal lethality due to congenital malformations of the aortic arch and its branch arteries. HEY1 has also been linked to the maintenance of neural stem cells, inhibition of oligodendrocyte differentiation, and myelin gene expression. CONCLUSION HEY1 is a candidate gene for both neurological and cardiac features of the 8q21.11 microdeletion syndrome and might, therefore, explain specific components of its pathophysiology.
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Affiliation(s)
- Ikhlas Ben Ayed
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia.,Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia
| | - Amal Bouzid
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia.,Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Fatma Kammoun
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia.,Research Laboratory, Sfax University, Sfax, Tunisia
| | - Amal Souissi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Olfa Jallouli
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia.,Research Laboratory, Sfax University, Sfax, Tunisia
| | - Salma Mallouli
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia.,Research Laboratory, Sfax University, Sfax, Tunisia
| | - Souhir Guidara
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia.,Laboratory of Human Molecular Genetics, LR33ES99, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Salma Loukil
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Hajer Aloulou
- Pediatric Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Fida Jbeli
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Sahar Aouichaoui
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia
| | - Dorra Abid
- Cardiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Fatma Abdelhedi
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia.,Laboratory of Human Molecular Genetics, LR33ES99, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia.,Research Laboratory, Sfax University, Sfax, Tunisia
| | - Hassen Kamoun
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Sfax, Tunisia.,Laboratory of Human Molecular Genetics, LR33ES99, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Saber Masmoudi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
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Allaya F, Kammoun I, Masmoudi D, Haddar A, Kammoun R, Jallouli O, Triki L, Zouari HG, Masmoudi K. Y a-t-il une particularité du syndrome du canal carpien chez le diabétique ? Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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11
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Kammoun R, Kammoun I, Haddar A, Jallouli O, Ellouze E, Triki L, Zouari HG, Masmoudi K. Quand l’electroneuromyogramme est l’examen clé lors d’une paralysie brachiale post luxation de l’épaule. Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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12
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Allaya F, Kammoun I, Masmoudi D, Haddar A, Jallouli O, Kammoun R, Triki L, Zouari HG, Masmoudi K. Is there a correlation between sensory and motor axonal damage of the median nerve during carpal tunnel syndrome? Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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13
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Kammoun R, Kammoun I, Jallouli O, Haddar A, Triki L, Masmoudi D, Allaya F, Zouari HG, Masmoudi K. La physiopathologie du trouble du langage chez les enfants avec trait du spectre autistique : atteinte corticale ou du tronc cérébral ? Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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14
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Kammoun R, Kammoun I, Haddar A, Triki L, Masmoudi D, Allaya F, Jallouli O, Zouari HG, Masmoudi K. Quel est l’apport de l’EEG dans Le syndrome du chromosome 20 en anneau ? À propos d’un cas. Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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15
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Haddar A, Zouari HG, Triki L, Jallouli O, Allaya F, Masmoudi D, Kammoun R, Kammoun I, Masmoudi K. Vitesse de conduction motrice comme marqueur de l’activité de la pompe Na + /K + ATPase neuronale au cours de la neuropathie diabétique. Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Kidar A, Abboud A, Henchiri R, Essahbi I, Chelbi F, Kidar I, Ludmila A, Bouallegue A, Othmani F, Saidi N, Yahyaoui M, Hamdi S, Jallouli O, Kidar O, Diouani F, Laouini D, Kourda M, Turki H, Denguezli M, Babba H, Bensalah A, Mokni M. La thermothérapie : une alternative séduisante et efficace dans le traitement de la leishmaniose cutanée à L. major en Tunisie. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Kidar A, Abboud A, Jaouadi K, Sahbi I, Chaara D, Haouas N, Gorcii M, Kidar O, Daly L, Jallouli O, Bouallegue A, Augot D, Pratlong F, Dedet J, Tlijani S, Kourda M, Baaba H. La leishmaniose cutanée à Leishmania killicki : une anthroponose ou une zoonose ? Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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