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Aguech A, Sfaihi L, Alila-Fersi O, Kolsi R, Tlili A, Kammoun T, Fendri A, Fakhfakh F. A novel homozygous PIGO mutation associated with severe infantile epileptic encephalopathy, profound developmental delay and psychomotor retardation: structural and 3D modelling investigations and genotype-phenotype correlation. Metab Brain Dis 2023; 38:2665-2678. [PMID: 37656370 DOI: 10.1007/s11011-023-01276-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/07/2023] [Indexed: 09/02/2023]
Abstract
The PIGO gene encodes the GPI-ethanolamine phosphate transferase 3, which is crucial for the final synthetic step of the glycosylphosphatidylinositol-anchor serving to attach various proteins to their cell surface. These proteins are intrinsic for normal neuronal and embryonic development. In the current research work, a clinical investigation was conducted on a patient from a consanguineous family suffering from epileptic encephalopathy, characterized by severe seizures, developmental delay, hypotonia, ataxia and hyperphosphatasia. Molecular analysis was performed using Whole Exome Sequencing (WES). The molecular investigation revealed a novel homozygous variant c.1132C > T in the PIGO gene, in which a highly conserved Leucine was changed to a Phenylalanine (p.L378F). To investigate the impact of the non-synonymous mutation, a 3D structural model of the PIGO protein was generated using the AlphaFold protein structure database as a resource for template-based tertiary structure modeling. A structural analysis by applying some bioinformatic tools on both variants 378L and 378F models predicted the pathogenicity of the non-synonymous mutation and its potential functional and structural effects on PIGO protein. We also discussed the phenotypic and genotypic variability associated with the PIGO deficiency. To our best knowledge, this is the first report of a patient diagnosed with infantile epileptic encephalopathy showing a high elevation of serum alkaline phosphatase level. Our findings, therefore, widen the genotype and phenotype spectrum of GPI-anchor deficiencies and broaden the cohort of patients with PIGO associated epileptic encephalopathy with an elevated serum alkaline phosphatase level.
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Affiliation(s)
- Ameni Aguech
- Molecular Genetics and Functional Laboratory, Faculty of Sciences of Sfax, University of Sfax, Sfax, Tunisia.
| | - Lamia Sfaihi
- Pediatrics Department, Hedi Chaker University Hospital, 3029, Sfax, Tunisia
- Faculty of Medecine of Sfax, University of Sfax, Avenue Magida Boulila, 3029, Sfax, Tunisia
| | - Olfa Alila-Fersi
- Molecular Genetics and Functional Laboratory, Faculty of Sciences of Sfax, University of Sfax, Sfax, Tunisia
| | - Roeya Kolsi
- Pediatrics Department, Hedi Chaker University Hospital, 3029, Sfax, Tunisia
- Faculty of Medecine of Sfax, University of Sfax, Avenue Magida Boulila, 3029, Sfax, Tunisia
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Thouraya Kammoun
- Pediatrics Department, Hedi Chaker University Hospital, 3029, Sfax, Tunisia
- Faculty of Medecine of Sfax, University of Sfax, Avenue Magida Boulila, 3029, Sfax, Tunisia
| | - Ahmed Fendri
- Laboratory of Biochemistry and Enzymatic Engineering of Lipases, Engineering National School of Sfax (ENIS), University of Sfax, Sfax, Tunisia
| | - Faiza Fakhfakh
- Molecular Genetics and Functional Laboratory, Faculty of Sciences of Sfax, University of Sfax, Sfax, Tunisia.
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2
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Messina M, Manea E, Cullup T, Tuschl K, Batzios S. Hyperphosphatasia with mental retardation syndrome 3: Cerebrospinal fluid abnormalities and correction with pyridoxine and Folinic acid. JIMD Rep 2023; 64:42-52. [PMID: 36636587 PMCID: PMC9830023 DOI: 10.1002/jmd2.12347] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/16/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
Glycosylphosphatidylinositol anchored proteins (GPI-APs) represent a class of molecules attached to the external leaflet of the plasma membrane by the GPI anchor where they play important roles in numerous cellular processes including neurogenesis, cell adhesion, immune response and signalling. Within the group of GPI anchor defects, six present with the clinical phenotype of Hyperphosphatasia with Mental Retardation Syndrome (HPMRS, Mabry Syndrome) characterized by moderate to severe intellectual disability, dysmorphic features, hypotonia, seizures and persistent hyperphosphatasia. We report the case of a 5-year-old female with global developmental delay associated with precocious puberty and persistently raised plasma alkaline phosphatase. Targeted next generation sequencing analysis of the HPMRS genes identified novel compound heterozygous variants in the PGAP2 gene (c.103del p.(Leu35Serfs*90)and c.134A > Gp.(His45Arg)) consistent with the diagnosis of HPMRS type 3. Cerebrospinal fluid (CSF) neurotransmitter analysis showed low levels of pyridoxal phosphate and 5-methyltetrahydrofolate and raised homovanillic acid. Supplementation with pyridoxine and folinic acid led to normalization of biochemical abnormalities. The patient continues to make developmental progress with significant improvement in speech and fine motor skills. Our reported case expands the clinical spectrum of HPMRS3 in which multisystem involvement is being increasingly recognized. Furthermore, it shows that miss-targeting GPI-APs and the effect on normal cellular function could provide a physiopathologic explanation for the CSF biochemical abnormalities with management implications for a group of disorders that currently has no treatment that can lead possibly to improved clinical outcomes.
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Affiliation(s)
- Martina Messina
- Metabolic Medicine DepartmentGreat Ormond Street Hospital for ChildrenLondonUK
| | - Emanuela Manea
- Metabolic Medicine DepartmentGreat Ormond Street Hospital for ChildrenLondonUK
| | - Thomas Cullup
- North Thames Genomic Laboratory HubGreat Ormond Street Hospital for ChildrenLondonUK
| | - Karin Tuschl
- Metabolic Medicine DepartmentGreat Ormond Street Hospital for ChildrenLondonUK
- University College London Great Ormond Street Institute for ChildrenLondonUK
| | - Spyros Batzios
- Metabolic Medicine DepartmentGreat Ormond Street Hospital for ChildrenLondonUK
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3
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Kuwayama R, Suzuki K, Nakamura J, Aizawa E, Yoshioka Y, Ikawa M, Nabatame S, Inoue KI, Shimmyo Y, Ozono K, Kinoshita T, Murakami Y. Establishment of mouse model of inherited PIGO deficiency and therapeutic potential of AAV-based gene therapy. Nat Commun 2022; 13:3107. [PMID: 35661110 PMCID: PMC9166810 DOI: 10.1038/s41467-022-30847-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/20/2022] [Indexed: 11/09/2022] Open
Abstract
Inherited glycosylphosphatidylinositol (GPI) deficiency (IGD) is caused by mutations in GPI biosynthesis genes. The mechanisms of its systemic, especially neurological, symptoms are not clarified and fundamental therapy has not been established. Here, we report establishment of mouse models of IGD caused by PIGO mutations as well as development of effective gene therapy. As the clinical manifestations of IGD are systemic and lifelong lasting, we treated the mice with adeno-associated virus for homology-independent knock-in as well as extra-chromosomal expression of Pigo cDNA. Significant amelioration of neuronal phenotypes and growth defect was achieved, opening a new avenue for curing IGDs.
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Affiliation(s)
- Ryoko Kuwayama
- Yabumoto Department of Intractable disease research, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keiichiro Suzuki
- Graduate School of Frontier Bioscience, Osaka University, Osaka, Japan.,Graduate School of Engineering Science, Osaka University, Osaka, Japan.,Institute for Advanced Co-Creation Studies, Osaka University, Osaka, Japan
| | - Jun Nakamura
- Graduate School of Frontier Bioscience, Osaka University, Osaka, Japan
| | - Emi Aizawa
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Yoshichika Yoshioka
- Graduate School of Frontier Bioscience, Osaka University, Osaka, Japan.,Center for Information and Neural Networks, National Institute of Information and Communications Technology (NICT) and Osaka University, Osaka, Japan.,Center for Quantum Information and Quantum Biology, Osaka University, Osaka, Japan
| | - Masahito Ikawa
- Department of Experimental Genome Research, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Shin Nabatame
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ken-Ichi Inoue
- Systems Neuroscience Section, Department of Neuroscience, Primate Research Institute, Kyoto University, Kyoto, Japan
| | | | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Taroh Kinoshita
- Yabumoto Department of Intractable disease research, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.,Immunoglycobiology, WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Yoshiko Murakami
- Yabumoto Department of Intractable disease research, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
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4
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Wang M, Lin Y, Zhou S, Cui Y, Feng Q, Yan W, Xiang H. Genetic Mapping of Climbing and Mimicry: Two Behavioral Traits Degraded During Silkworm Domestication. Front Genet 2020; 11:566961. [PMID: 33391338 PMCID: PMC7773896 DOI: 10.3389/fgene.2020.566961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/17/2020] [Indexed: 11/13/2022] Open
Abstract
Behavioral changes caused by domestication in animals are an important issue in evolutionary biology. The silkworm, Bombyx mori, is an ideal fully domesticated insect model for studying both convergent domestication and behavior evolution. We explored the genetic basis of climbing for foraging and mimicry, two degraded behaviors during silkworm domestication, in combination of bulked segregant analysis (BSA) and selection sweep screening. One candidate gene, ASNA1, located in the 3-5 Mb on chromosome 19, harboring a specific non-synonymous mutation in domestic silkworm, might be involved in climbing ability. This mutation was under positive selection in Lepidoptera, strongly suggesting its potential function in silkworm domestication. Nine candidate domesticated genes related to mimicry were identified on chromosomes 13, 21, and 27. Most of the candidate domesticated genes were generally expressed at higher levels in the brain of the wild silkworm. This study provides valuable information for deciphering the molecular basis of behavioral changes associated with silkworm domestication.
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Affiliation(s)
- Man Wang
- Guangdong Provincial Key Laboratory of Insect Developmental Biology and Applied Technology, Institute of Insect Science and Technology, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Yongjian Lin
- Guangdong Provincial Key Laboratory of Insect Developmental Biology and Applied Technology, Institute of Insect Science and Technology, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Shiyi Zhou
- Guangdong Provincial Key Laboratory of Insect Developmental Biology and Applied Technology, Institute of Insect Science and Technology, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Yong Cui
- Guangdong Provincial Key Laboratory of Insect Developmental Biology and Applied Technology, Institute of Insect Science and Technology, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Qili Feng
- Guangdong Provincial Key Laboratory of Insect Developmental Biology and Applied Technology, Institute of Insect Science and Technology, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Wei Yan
- Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Hui Xiang
- Guangdong Provincial Key Laboratory of Insect Developmental Biology and Applied Technology, Institute of Insect Science and Technology, School of Life Sciences, South China Normal University, Guangzhou, China
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5
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Wu T, Yin F, Guang S, He F, Yang L, Peng J. The Glycosylphosphatidylinositol biosynthesis pathway in human diseases. Orphanet J Rare Dis 2020; 15:129. [PMID: 32466763 PMCID: PMC7254680 DOI: 10.1186/s13023-020-01401-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/06/2020] [Indexed: 01/15/2023] Open
Abstract
Glycosylphosphatidylinositol biosynthesis defects cause rare genetic disorders characterised by developmental delay/intellectual disability, seizures, dysmorphic features, and diverse congenital anomalies associated with a wide range of additional features (hypotonia, hearing loss, elevated alkaline phosphatase, and several other features). Glycosylphosphatidylinositol functions as an anchor to link cell membranes and protein. These proteins function as enzymes, adhesion molecules, complement regulators, or co-receptors in signal transduction pathways. Biallelic variants involved in the glycosylphosphatidylinositol anchored proteins biosynthetic pathway are responsible for a growing number of disorders, including multiple congenital anomalies-hypotonia-seizures syndrome; hyperphosphatasia with mental retardation syndrome/Mabry syndrome; coloboma, congenital heart disease, ichthyosiform dermatosis, mental retardation, and ear anomalies/epilepsy syndrome; and early infantile epileptic encephalopathy-55. This review focuses on the current understanding of Glycosylphosphatidylinositol biosynthesis defects and the associated genes to further understand its wide phenotype spectrum.
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Affiliation(s)
- Tenghui Wu
- Department of Pediatrics, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China.,Hunan Children's Mental Disorders Research Center, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Fei Yin
- Department of Pediatrics, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China.,Hunan Children's Mental Disorders Research Center, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Shiqi Guang
- Department of Pediatrics, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China.,Hunan Children's Mental Disorders Research Center, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Fang He
- Department of Pediatrics, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China.,Hunan Children's Mental Disorders Research Center, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Li Yang
- Department of Pediatrics, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China.,Hunan Children's Mental Disorders Research Center, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China
| | - Jing Peng
- Department of Pediatrics, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China. .,Hunan Children's Mental Disorders Research Center, XiangYa Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan Province, China.
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6
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Holtz AM, Harrington AW, McNamara ER, Kielian A, Soul JS, Martinez-Ojeda M, Levy PT. Expanding the phenotypic spectrum of Mabry Syndrome with novel PIGO gene variants associated with hyperphosphatasia, intractable epilepsy, and complex gastrointestinal and urogenital malformations. Eur J Med Genet 2019; 63:103802. [PMID: 31698102 DOI: 10.1016/j.ejmg.2019.103802] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/05/2019] [Accepted: 10/30/2019] [Indexed: 11/30/2022]
Abstract
Mabry syndrome is a glycophosphatidylinositol (GPI) deficiency characterized by intellectual disability, distinctive facial features, intractable seizures, and hyperphosphatasia. We expand the phenotypic spectrum of inherited GPI deficiencies with novel bi-allelic phosphatidylinositol glycan anchor biosynthesis class O (PIGO) variants in a neonate who presented with intractable epilepsy and complex gastrointestinal and urogenital malformations.
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Affiliation(s)
- Alexander M Holtz
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Amanda W Harrington
- Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Erin R McNamara
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Agnieszka Kielian
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Janet S Soul
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Mayra Martinez-Ojeda
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Philip T Levy
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
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7
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Brooks JK. A review of syndromes associated with blue sclera, with inclusion of malformations of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:252-263. [DOI: 10.1016/j.oooo.2018.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/09/2018] [Accepted: 05/21/2018] [Indexed: 11/30/2022]
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8
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Abstract
Biallelic mutations in the post-GPI attachment to proteins 3 (PGAP3) gene cause hyperphosphatasia with mental retardation syndrome 4 (HPMRS4), which is characterized by elevated serum alkaline phosphatase, severe psychomotor developmental delay, seizures, and facial dysmorphism. To date, 15 PGAP3 mutations have been reported in humans. Here we report a novel homozygous PGAP3 mutation (c.314C>A, p.Pro105Gln) in a Croatian patient and fully describe the clinical features.
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9
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Knaus A, Pantel JT, Pendziwiat M, Hajjir N, Zhao M, Hsieh TC, Schubach M, Gurovich Y, Fleischer N, Jäger M, Köhler S, Muhle H, Korff C, Møller RS, Bayat A, Calvas P, Chassaing N, Warren H, Skinner S, Louie R, Evers C, Bohn M, Christen HJ, van den Born M, Obersztyn E, Charzewska A, Endziniene M, Kortüm F, Brown N, Robinson PN, Schelhaas HJ, Weber Y, Helbig I, Mundlos S, Horn D, Krawitz PM. Characterization of glycosylphosphatidylinositol biosynthesis defects by clinical features, flow cytometry, and automated image analysis. Genome Med 2018; 10:3. [PMID: 29310717 PMCID: PMC5759841 DOI: 10.1186/s13073-017-0510-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 12/11/2017] [Indexed: 12/17/2022] Open
Abstract
Background Glycosylphosphatidylinositol biosynthesis defects (GPIBDs) cause a group of phenotypically overlapping recessive syndromes with intellectual disability, for which pathogenic mutations have been described in 16 genes of the corresponding molecular pathway. An elevated serum activity of alkaline phosphatase (AP), a GPI-linked enzyme, has been used to assign GPIBDs to the phenotypic series of hyperphosphatasia with mental retardation syndrome (HPMRS) and to distinguish them from another subset of GPIBDs, termed multiple congenital anomalies hypotonia seizures syndrome (MCAHS). However, the increasing number of individuals with a GPIBD shows that hyperphosphatasia is a variable feature that is not ideal for a clinical classification. Methods We studied the discriminatory power of multiple GPI-linked substrates that were assessed by flow cytometry in blood cells and fibroblasts of 39 and 14 individuals with a GPIBD, respectively. On the phenotypic level, we evaluated the frequency of occurrence of clinical symptoms and analyzed the performance of computer-assisted image analysis of the facial gestalt in 91 individuals. Results We found that certain malformations such as Morbus Hirschsprung and diaphragmatic defects are more likely to be associated with particular gene defects (PIGV, PGAP3, PIGN). However, especially at the severe end of the clinical spectrum of HPMRS, there is a high phenotypic overlap with MCAHS. Elevation of AP has also been documented in some of the individuals with MCAHS, namely those with PIGA mutations. Although the impairment of GPI-linked substrates is supposed to play the key role in the pathophysiology of GPIBDs, we could not observe gene-specific profiles for flow cytometric markers or a correlation between their cell surface levels and the severity of the phenotype. In contrast, it was facial recognition software that achieved the highest accuracy in predicting the disease-causing gene in a GPIBD. Conclusions Due to the overlapping clinical spectrum of both HPMRS and MCAHS in the majority of affected individuals, the elevation of AP and the reduced surface levels of GPI-linked markers in both groups, a common classification as GPIBDs is recommended. The effectiveness of computer-assisted gestalt analysis for the correct gene inference in a GPIBD and probably beyond is remarkable and illustrates how the information contained in human faces is pivotal in the delineation of genetic entities. Electronic supplementary material The online version of this article (doi:10.1186/s13073-017-0510-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexej Knaus
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany.,Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany.,Berlin-Brandenburg School for Regenerative Therapies, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany.,Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127, Bonn, Germany
| | - Jean Tori Pantel
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Manuela Pendziwiat
- Department of Neuropediatrics, University Medical Center Schleswig Holstein, 24105, Kiel, Germany
| | - Nurulhuda Hajjir
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Max Zhao
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Tzung-Chien Hsieh
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany.,Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127, Bonn, Germany
| | - Max Schubach
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), 10178, Berlin, Germany
| | | | | | - Marten Jäger
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), 10178, Berlin, Germany
| | - Sebastian Köhler
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Hiltrud Muhle
- Department of Neuropediatrics, University Medical Center Schleswig Holstein, 24105, Kiel, Germany
| | - Christian Korff
- Unité de Neuropédiatrie, Université de Genève, CH-1211, Genève, Switzerland
| | - Rikke S Møller
- Danish Epilepsy Centre, DK-4293, Dianalund, Denmark.,Institute for Regional Health Services Research, University of Southern Denmark, DK-5000, Odense, Denmark
| | - Allan Bayat
- Department of Pediatrics, University Hospital of Hvidovre, 2650, Hvicovre, Denmark
| | - Patrick Calvas
- Service de Génétique Médicale, Hôpital Purpan, CHU, 31059, Toulouse, France
| | - Nicolas Chassaing
- Service de Génétique Médicale, Hôpital Purpan, CHU, 31059, Toulouse, France
| | | | | | | | - Christina Evers
- Genetische Poliklinik, Universitätsklinik Heidelberg, 69120, Heidelberg, Germany
| | - Marc Bohn
- St. Bernward Krankenhaus, 31134, Hildesheim, Germany
| | - Hans-Jürgen Christen
- Kinderkrankenhaus auf der Bult, Hannoversche Kinderheilanstalt, 30173, Hannover, Germany
| | | | - Ewa Obersztyn
- Institute of Mother and Child Department of Molecular Genetics, 01-211, Warsaw, Poland
| | - Agnieszka Charzewska
- Institute of Mother and Child Department of Molecular Genetics, 01-211, Warsaw, Poland
| | - Milda Endziniene
- Neurology Department, Lithuanian University of Health Sciences, 50009, Kaunas, Lithuania
| | - Fanny Kortüm
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Natasha Brown
- Victorian Clinical Genetics Services, Royal Children's Hospital, MCRI, Parkville, Australia.,Department of Clinical Genetics, Austin Health, Heidelberg, Australia
| | - Peter N Robinson
- The Jackson Laboratory for Genomic Medicine, 06032, Farmington, USA
| | - Helenius J Schelhaas
- Departement of Neurology, Academic Center for Epileptology, 5590, Heeze, The Netherlands
| | - Yvonne Weber
- Department of Neurology and Epileptology and Hertie Institute for Clinical Brain Research, University Tübingen, 72076, Tübingen, Germany
| | - Ingo Helbig
- Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127, Bonn, Germany.,Pediatric Neurology, Children's Hospital of Philadelphia, 3401, Philadelphia, USA
| | - Stefan Mundlos
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany.,Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany
| | - Denise Horn
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany.
| | - Peter M Krawitz
- Institut für Medizinische Genetik und Humangenetik, Charité Universitätsmedizin Berlin, 13353, Berlin, Germany. .,Max Planck Institute for Molecular Genetics, 14195, Berlin, Germany. .,Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127, Bonn, Germany.
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