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Fournier H, Hasdenteufel M, Garrouteigt C, Perie M, Gliksohn A, Jouanne B, Hadj-Rabia S, Arveiler B, Morice-Picard F, Quintard B. The experience of albinism in France: a qualitative study on dyads of parents and their adult child with albinism. BMC Med 2024; 22:40. [PMID: 38281904 PMCID: PMC10823752 DOI: 10.1186/s12916-024-03251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND To date, almost no research on the psychosocial implications of albinism has been conducted in France and an exploration of albinism-related experiences could be beneficial, in order to better understand this condition. The aim of this study was to examine how French people with albinism and their parents live with and adapt to this condition in all the areas of their lives. METHODS Semi-structured phone interviews were conducted with 9 parent-child dyads, each participating separately. Participants were recruited by convenience sampling, thanks to the combined efforts of a patient association (Genespoir) and professionals from the partner medical referral centers involved in the project. Dyads in which the individual with albinism had any comorbidity were excluded. The interviews were then transcribed and subjected to in-depth thematic analysis. Two codebooks were constructed in a mirrored process: one for people with albinism; the other for their parents. They were finally merged at the end of the coding step. RESULTS Four main categories were identified: personal perceptions and social representations of albinism, difficulties and obstacles encountered by people with albinism, resources and facilitators, and the importance of parent-child functioning. The results indicated that experiences of stigmatization during childhood and adolescence are common and that people with albinism face challenges in adapting to certain obstacles related to their visual impairments (VI) (e.g., inability to drive a car; eye strain...). Parents emerged as one, if not as the main, source of support for people with albinism throughout their development. Although external support systems exist to assist them in various aspects of their lives, some of them primarily rely on their own personal resources to cope. CONCLUSIONS This research highlights the importance of a systemic and transdisciplinary approach to make sure families receive the support that best meets their needs.
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Affiliation(s)
- Hugo Fournier
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France.
| | - Marie Hasdenteufel
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France
| | - Constance Garrouteigt
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France
| | - Mathieu Perie
- National Institute for Research in Digital Science and Technology, Talence, F-33405, France
| | - Antoine Gliksohn
- Genespoir Association, Rennes, F-35000, France
- Global Albinism Alliance, Fontenay-sous-Bois, F-94120, France
| | | | | | - Benoit Arveiler
- CHU Bordeaux, Bordeaux, F-33404, France
- Laboratory of Rare Diseases: Genetics and Metabolism (MRGM) INSERM U1211, University of Bordeaux, Bordeaux, F-33076, France
| | | | - Bruno Quintard
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France
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Nagy N, Pal M, Kun J, Galik B, Urban P, Medvecz M, Fabos B, Neller A, Abdolreza A, Danis J, Szabo V, Yang Z, Fenske S, Biel M, Gyenesei A, Adam E, Szell M. Missing Heritability in Albinism: Deep Characterization of a Hungarian Albinism Cohort Raises the Possibility of the Digenic Genetic Background of the Disease. Int J Mol Sci 2024; 25:1271. [PMID: 38279271 PMCID: PMC10817051 DOI: 10.3390/ijms25021271] [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: 11/10/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024] Open
Abstract
Albinism is characterized by a variable degree of hypopigmentation affecting the skin and the hair, and causing ophthalmologic abnormalities. Its oculocutaneous, ocular and syndromic forms follow an autosomal or X-linked recessive mode of inheritance, and 22 disease-causing genes are implicated in their development. Our aim was to clarify the genetic background of a Hungarian albinism cohort. Using a 22-gene albinism panel, the genetic background of 11 of the 17 Hungarian patients was elucidated. In patients with unidentified genetic backgrounds (n = 6), whole exome sequencing was performed. Our investigations revealed a novel, previously unreported rare variant (N687S) of the two-pore channel two gene (TPCN2). The N687S variant of the encoded TPC2 protein is carried by a 15-year-old Hungarian male albinism patient and his clinically unaffected mother. Our segregational analysis and in vitro functional experiments suggest that the detected novel rare TPCN2 variant alone is not a disease-causing variant in albinism. Deep genetic analyses of the family revealed that the patient also carries a phenotype-modifying R305W variant of the OCA2 protein, and he is the only family member harboring this genotype. Our results raise the possibility that this digenic combination might contribute to the observed differences between the patient and the mother, and found the genetic background of the disease in his case.
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Affiliation(s)
- Nikoletta Nagy
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary; (M.P.); (A.N.); (A.A.); (E.A.); (M.S.)
- HUN-REN-SZTE Functional Clinical Genetic Research Group, 6720 Szeged, Hungary
| | - Margit Pal
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary; (M.P.); (A.N.); (A.A.); (E.A.); (M.S.)
- HUN-REN-SZTE Functional Clinical Genetic Research Group, 6720 Szeged, Hungary
| | - Jozsef Kun
- Hungarian Centre for Genomics and Bioinformatics, Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary; (J.K.); (B.G.); (P.U.); (A.G.)
| | - Bence Galik
- Hungarian Centre for Genomics and Bioinformatics, Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary; (J.K.); (B.G.); (P.U.); (A.G.)
| | - Peter Urban
- Hungarian Centre for Genomics and Bioinformatics, Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary; (J.K.); (B.G.); (P.U.); (A.G.)
| | - Marta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1095 Budapest, Hungary;
- ERN-Skin Reference Centre, Semmelweis University, 1095 Budapest, Hungary
| | - Beata Fabos
- Mor Kaposi Teaching Hospital of Somogy County, 7400 Kaposvar, Hungary;
| | - Alexandra Neller
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary; (M.P.); (A.N.); (A.A.); (E.A.); (M.S.)
| | - Aliasgari Abdolreza
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary; (M.P.); (A.N.); (A.A.); (E.A.); (M.S.)
| | - Judit Danis
- HUN-REN-SZTE Dermatological Research Group, 6720 Szeged, Hungary;
- Department of Immunology, University of Szeged, 6720 Szeged, Hungary
| | - Viktoria Szabo
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary
| | - Zhuo Yang
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München, 81377 Munich, Germany (M.B.)
| | - Stefanie Fenske
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München, 81377 Munich, Germany (M.B.)
| | - Martin Biel
- Department of Pharmacy, Center for Drug Research, Ludwig-Maximilians-Universität München, 81377 Munich, Germany (M.B.)
| | - Attila Gyenesei
- Hungarian Centre for Genomics and Bioinformatics, Szentagothai Research Centre, University of Pecs, 7624 Pecs, Hungary; (J.K.); (B.G.); (P.U.); (A.G.)
| | - Eva Adam
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary; (M.P.); (A.N.); (A.A.); (E.A.); (M.S.)
- HUN-REN-SZTE Functional Clinical Genetic Research Group, 6720 Szeged, Hungary
| | - Marta Szell
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary; (M.P.); (A.N.); (A.A.); (E.A.); (M.S.)
- HUN-REN-SZTE Functional Clinical Genetic Research Group, 6720 Szeged, Hungary
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Psychosocial implications of rare genetic skin diseases affecting appearance on daily life experiences, emotional state, self-perception and quality of life in adults: a systematic review. Orphanet J Rare Dis 2023; 18:39. [PMID: 36823650 PMCID: PMC9951542 DOI: 10.1186/s13023-023-02629-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Since the beginning of human genetic research, there are very few publications sharing insights of the negative impact of rare genetic skin diseases (RGSD) on patients' experiences. This systematic review assessed the psychosocial implications of these conditions in terms of daily life experiences, emotional state, self-perception, and Quality of Life (QoL). METHODOLOGY A systematic review was carried out on albinism, neurofibromatosis type 1 (NF1), birthmarks and inherited ichthyosis. The PubMed, Scopus, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection, and SOCindex databases were queried. Inclusion criteria were adult patients with one of these RGSDs. Simple descriptive statistics and qualitative content analysis were conducted to summarize the main results reported by the authors. RESULTS Of the 9987 articles retrieved, 48 articles were included: albinism (16), NF1 (16), inherited ichthyosis (10), birthmarks (6). The majority of the studies on albinism were conducted in Africa. Twenty-seven studies quantitatively assessed diverse psychological parameters: 13 showed a significant impact of the disease on QoL, five on emotional state, two on self-representation and two others on psychiatric comorbidities. Disease severity and visibility were good predictors of QoL (except for albinism). Body image and appearance concerns were also associated with QoL and emotional state. The 19 qualitative studies highlighted recurring themes across each of these diseases: discrimination and stigma during childhood and adolescence, discomfort in social interactions, guilt of transmission, the importance of social support from family and friends, altered daily life functioning, altered romantic and sex life, limited academic and professional aspirations, lack of interest and support from the medical field, and the unpredictability of the evolution of the disease. The only two mixed-method studies in this review were unable to contribute to any inferential analyses but could corroborate some of the qualitative findings. CONCLUSION These results showed that RGSDs have a significant impact on different aspects of patients' lives. This review has demonstrated that there is a real need for support systems for patients with these diseases. Such systems should be developed to provide them with necessary information and to guide them through an appropriate care pathway.
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Oculo-Cutaneous Albinism Type 4 (OCA4): Phenotype-Genotype Correlation. Genes (Basel) 2022; 13:genes13122198. [PMID: 36553465 PMCID: PMC9777904 DOI: 10.3390/genes13122198] [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: 10/02/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022] Open
Abstract
Albinism is a genetic disorder, present worldwide, caused by mutations in genes affecting melanin production or transport in the skin, hair and eyes. To date, mutations in at least 20 different genes have been identified. Oculo-cutaneous Albinism type IV (OCA4) is the most frequent form in Asia but has been reported in all populations, including Europeans. Little is known about the genotype-phenotype correlation. We identified two main phenotypes via the analysis of 30 OCA4 patients with a molecularly proven diagnosis. The first, found in 20 patients, is clinically indistinguishable from the classical OCA1 phenotype. The genotype-to-phenotype correlation suggests that this phenotype is associated with homozygous or compound heterozygous nonsense or deletion variants with frameshift leading to translation interruption in the SLC45A2 gene. The second phenotype, found in 10 patients, is characterized by very mild hypopigmentation of the hair (light brown or even dark hair) and skin that is similar to the general population. In this group, visual acuity is variable, but it can be subnormal, foveal hypoplasia can be low grade or even normal, and nystagmus may be lacking. These mild to moderate phenotypes are associated with at least one missense mutation in SLC45A2.
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Pediatric Cutaneous Oncology. Dermatol Clin 2022; 41:175-185. [DOI: 10.1016/j.det.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Zamani Varkaneh M, Khodabakhshi-Koolaee A, Sheikhi MR. Identifying psychosocial challenges and introducing coping strategies for people with albinism. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221099155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Albinism refers to a group of genetic disorders that, following genetic mutations, lead to impaired melanin production, resulting in skin allergies and visual impairment in affected people. Visual impairment brings not only physical limitations and challenges but also many social problems, including psychosocial challenges, leading to different experiences in the lives of these people. To this end, using a qualitative content analysis approach, the present study aimed to identify psychosocial challenges and introduce coping strategies for people with albinism living in Tehran in 2021. The participants were people with albinism aged 20 to 40 years in Tehran. The participants were selected from among members of the Iranian Albinism Association (AMAL) using purposive sampling. The data were saturated through semi-structured interviews with 20 participants in the research sample. The collected data were analyzed using conventional content analysis. Analysis of the participants’ experiences revealed three main themes: (1) The challenges and difficulties of living with albinism, (2) welfare, specialized facilities, and support seeking, and (3) strategies for coping with psychosocial challenges. According to the findings, albinism, due to its limitations, brings many bitter and painful experiences in education, job finding, and marriage for affected patients. The condition is also associated with some limitations such as visual impairment affecting various aspects of the patient’s life and different developmental periods. Each person may have different interpretations of their challenges and thus seek unique strategies for coping with the challenges. The findings of this study can have some implications for mental health professionals and managers of relevant institutions and to become aware of the nature and complications of albinism, the challenges faced by people with albinism, and the special needs of these people. Findings from this study can be used to identify the relationship between albinism, the challenges of living with albinism, and the special needs of these individuals, by mental health professionals, related institutions, and psychosocial environments.
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Affiliation(s)
| | | | - Mohammad Reza Sheikhi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Dufresne H, de Longcamp A, Compain S, Morice-Picard F, Deladrière E, Bekel L, Godot C, Rateaux M, Godeau M, Jouanne B, Bodemer C, Bremond-Gignac D, Robert MP, Hadj-Rabia S. Development and co-construction of a therapeutic patient education program for albinism. Ann Dermatol Venereol 2021; 148:246-250. [PMID: 34217528 DOI: 10.1016/j.annder.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/07/2021] [Accepted: 03/03/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Long-term and ongoing support in accordance with the changing needs of patients and their families is one of the main components of patient care, including therapeutic patient education (TPE). OBJECTIVE To co-construct a TPE program for albinism with all those involved in the management of albinism patients. METHODS Eight steps have been defined for the co-construction process: 1) identify all the relevant experts and invite them to participate in the construction of a TPE program to improve care for and support of patients with albinism, 2) review and analyse all publications regarding TPE for albinism, 3) conduct semi-structured interviews with the patients' parents, 4) conduct brainstorming meetings with the participating experts for an exchange of experience and expertise, 5) elaborate the program's concrete content with the experts, 6) draw up a TPE skills checklist, 7) create TPE educational tools to facilitate learning, 8) review and summarize each step of the co-construction protocol. RESULTS Co-construction of a TPE program for children, adolescents, and young adults with albinism, and their parents. CONCLUSION Strengths and advantages of the co-construction process include: i) highlighting of the experiential knowledge mentioned in the repository, ii) multiplicity of points of view and perspectives, iii) rapid improvement in TPE training both for the association and the patients, iv) awareness of the shift caregivers' position with regards to TPE and recognition of the polysemy of their discourse. The TPE program for albinism has been authorized since 2018.
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Affiliation(s)
- H Dufresne
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Pediatric Social Services, hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - A de Longcamp
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - S Compain
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Cross-disciplinary Therapeutic Education Unit, hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - F Morice-Picard
- Pediatric Dermatology Unit, National Center for Rare Skin Disorders, hôpital Pellegrin-Enfants, CHU de Bordeaux, 33000 Bordeaux, France
| | - E Deladrière
- Department of Physical Medicine, hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - L Bekel
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - C Godot
- Cross-disciplinary Therapeutic Education Unit, hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - M Rateaux
- Reference Center for Rare Ocular Diseases (OPHTARA) and Department of Ophthalmology, hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - M Godeau
- French Association for Albinism (GENESPOIR), 3, rue de la Paix, 35000 Rennes, France
| | - B Jouanne
- French Association for Albinism (GENESPOIR), 3, rue de la Paix, 35000 Rennes, France
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Institut Imagine, 24, boulevard du Montparnasse, 75015 Paris, France; Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France
| | - D Bremond-Gignac
- Reference Center for Rare Ocular Diseases (OPHTARA) and Department of Ophthalmology, hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Institut Imagine, 24, boulevard du Montparnasse, 75015 Paris, France; Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France
| | - M P Robert
- Reference Center for Rare Ocular Diseases (OPHTARA) and Department of Ophthalmology, hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Institut Imagine, 24, boulevard du Montparnasse, 75015 Paris, France; Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France
| | - S Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC) hôpital universitaire Necker-Enfants malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Institut Imagine, 24, boulevard du Montparnasse, 75015 Paris, France; Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France.
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