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Al-Allawi N, Atroshi SD, Sadullah RK, Eissa AA, Kriegshäuser G, Al-Zebari S, Qadir S, Khalil D, Oberkanins C. A Population-Oriented Genetic Scoring System to Predict Phenotype: A Pathway to Personalized Medicine in Iraqis With β-Thalassemia. Hemoglobin 2024:1-7. [PMID: 38390736 DOI: 10.1080/03630269.2024.2319733] [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: 11/20/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
To assess the roles of genetic modifiers in Iraqi β-thalassemia patients, and determine whether a genotype-based scoring system could be used to predict phenotype, a total of 224 Iraqi patients with molecularly characterized homozygous or compound heterozygous β-thalassemia were further investigated for α-thalassemia deletions as well as five polymorphisms namely: rs7482144 C > T at HBG2, rs1427407 G > T and rs10189857 A > G at BCL11A, and rs28384513 A > C and rs9399137 T > C at HMIP. The enrolled patients had a median age of 14 years, with 96 males and 128 females. They included 144 thalassemia major, and 80 thalassemia intermedia patients. Multivariate logistic regression analysis revealed that a model including sex and four of these genetic modifiers, namely: β+ alleles, HBG2 rs7482144, α-thalassemia deletions, and BCL11A rs1427407 could significantly predict phenotype (major versus intermedia) with an overall accuracy of 83.9%. Furthermore, a log odds genetic score based on these significant predictors had a highly significant area under curve of 0.917 (95% CI 0.882-0.953). This study underscores the notion that genetic scoring systems should be tailored to populations in question, since genetic modifiers (and/or their relative weight) vary between populations. The population-oriented genetic scoring system created by the current study to predict β-thalassemia phenotype among Iraqis may pave the way to personalized medicine in this patient's group.
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Affiliation(s)
- Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Duhok, Iraq
| | - Sulav D Atroshi
- Department of Pathology, College of Medicine, University of Duhok, Iraq
| | - Regir K Sadullah
- Medical Laboratory Technology Department, College of Health and Medical Technology, Duhok Polytechnic University, Shekhan, Iraq
| | | | | | - Shaima Al-Zebari
- Research Center, College of Science, University of Duhok, Duhok, Iraq
| | - Shatha Qadir
- Department of Hematology, Azadi Teaching Hospital, Duhok, Iraq
| | - Dilan Khalil
- Research Center, College of Science, University of Duhok, Duhok, Iraq
| | - Christian Oberkanins
- Department of Research and Development, ViennaLab Diagnostics GmbH, Vienna, Austria
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Rashid NW, Al-Allawi N, Tahir HI. Silent Cerebral Infarcts in Iraqi Patients with Sickle Cell Disease. Hemoglobin 2023; 47:198-201. [PMID: 37982216 DOI: 10.1080/03630269.2023.2282017] [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: 05/15/2023] [Accepted: 11/04/2023] [Indexed: 11/21/2023]
Abstract
Silent ischemic infarcts have been reported to be the most frequent neurological abnormalities in sickle cell disease (SCD) in several studies worldwide. However, no previous studies investigated this neurological disorder in Iraqi SCD patients. To address this issue, a total of 52 patients with a median age of 20 years (range 10-46) and including 46.2% males were enrolled. Patients were clinically evaluated and their records were reviewed. They had full blood and reticulocyte counts, hemoglobin F estimation, serum lactic dehydrogenase and bilirubin assayed, as well as brain magnetic resonance imaging (MRI) to screen for silent cerebral infarcts. Six out of the 52 patients (11.5%) had silent cerebral infarcts, all of which were in the deep white matter, ranging from 6 to 10 mm in their largest diameters. There were no significant differences in age, sex, or sickle cell genotype between those with silent cerebral infarcts and those without it. Those with silent cerebral infarcts had lower median hemoglobin, higher reticulocytes and lower pain frequencies than those without it, yet again this was not significant. Follow up MRI in four out of the six silent infarct patients showed no additional lesions and no increase in size of the original ones after six to eight months. In conclusion, it appears that the frequency of silent cerebral infarcts in Iraqi SCD patients is lower than the bulk of the literature from other populations. Further studies to screen for genetic polymorphisms that may explain this lower rate may be informative.
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Affiliation(s)
- Noor W Rashid
- Department of Hematology, Azadi Teaching Hospital, Duhok, Iraq
| | - Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
| | - Hamdy I Tahir
- Department of Radiology, Azadi Teaching Hospital, Duhok, Iraq
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Atroshi SD, Al-Allawi N, Chui DHK, Najmabadi H, Khailany RA. A Novel β 0-Thalassemia Mutation, HBB: c.356_357delTT [Codon 118 (-TT)] in an Iraqi Kurd. Hemoglobin 2021; 45:212-214. [PMID: 34167424 DOI: 10.1080/03630269.2021.1941082] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We report a novel frameshift β-thalassemia (β-thal) mutation due to a two-nucleotide deletion at codon 118 of the β-globin gene (HBB: c.356_357delTT) in a 4-year-old Iraqi Kurd female presenting as transfusion-dependent β-thal. This frameshift mutation, unlike many others involving the third exon, behaved as a recessive β0 defect and not as dominant β-thal mutation.
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Affiliation(s)
- Sulav D Atroshi
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
| | - Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
| | - David H K Chui
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Hossein Najmabadi
- Department of Genetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Rozhgar A Khailany
- Department of Biology, College of Science, University of Salahaddin, Erbil, Iraq
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Hasan KH, Sofijanova A, Hassan L, Al-Allawi N. Deferasirox Effect on Serum Ferritin in Iraq Patients with Hemoglobinopathies: A Single Center Experience. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The introduction of deferasirox as an oral iron chelator for hemoglobinopathies has been hailed by many as an important milestone in the management of iron overload in the latter disorders.
AIM: The objectives of the study were to evaluate the effectiveness of deferasirox in patients with hemoglobinopathies and to assess predictors of response.
METHODS: In this cross-sectional study, 160 patients diagnosed with hemoglobinopathies were included retrospectively from Jin hematology and oncology center in Duhok city, Iraqi Kurdistan. The Jin center offers patients with hemoglobinopathies clinical advice, examination, follow-up, treatment, and blood transfusions.
RESULTS: The median age of enrolled patients was 12 years (range 3–34 years), and included 86 females and 74 males. All patients were on deferasirox with a compliance rate of 77.5%. Furthermore, 32.3% were on concomitant deferoxamine at their last follow-up. After a median follow-up of 2.1 years (range 1–4 years), there was a mean reduction of serum ferritin level of −478.7 overall and −821.1 ng/ml in complaint patients (both being significant at p of 0.042 and 0.001, respectively). Univariate analysis revealed that older age at enrollment, and older age at starting therapy, and initial serum ferritin (>3000 ng/ml) were all significantly associated with more mean reduction in serum ferritin; while only the latter remained so by multivariate analysis (p = 0.04).
CONCLUSIONS: Deferasirox was found to be effective in reducing the level of serum ferritin among this cohort of hemoglobinopathy patients, to a degree comparable to that reported in other studies worldwide. Furthermore, there were significant associations between the reduction of serum ferritin level and age, age at starting treatment, drug compliance, and the initial serum ferritin levels.
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Mohammad AM, Dawad MM, Kashmoola MA, Al-Allawi N. Doppler-defined pulmonary hypertension in β-thalassemia major in Kurdistan, Iraq. PLoS One 2020; 15:e0243648. [PMID: 33301537 PMCID: PMC7728223 DOI: 10.1371/journal.pone.0243648] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/24/2020] [Indexed: 01/19/2023] Open
Abstract
Cardiopulmonary complications are among the most important complications of thalassemia major. Pulmonary hypertension is among these complications and studies addressing its frequency and associations in the latter disorder are sparse from Iraq. For this purpose a total 100 thalassemia major patients (≥ 8 years old) were enrolled from a main thalassemia center in Kurdistan, Northern Iraq. All patients had a full history and clinical examination. Full blood count, biochemical tests and viral screen including hepatitis B surface antigen and hepatitis C virus antibody, in addition to transthoracic Doppler echocardiography for tricuspid regurgitation jet velocity (TRV). The enrolled patients had a mean (SD) age of 17.6 (5.5) years, and included 52 males and 48 females. Pulmonary hypertension as defined by TRV> 2.8 m/s coupled with both exertional dyspnea and an absence of left sided heart failure, was identified in nine patients (9%). The latter subgroup of patients had significantly higher reticulocyte counts, S. LDH, S. ferritin, and hepatitis C sero-positivity compared to those without this complication by univariate analysis. While by multivariate logistic regression only reticulocytes and hepatitis C sero-positivity remained significant. Furthermore, TRV as a continuous variable was positively correlated with reticulocytes, S. bilirubin and LDH (p<0.001, p = 0.002 and p<0.001 respectively), but not with age or S. ferritin (p = 0.77, and p = 0.93 respectively). In conclusion, pulmonary hypertension is not uncommon in Iraqi patients with thalassemia major, and it appears to be linked to chronic hemolysis rather than iron overload.
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Affiliation(s)
- Ameen M. Mohammad
- Department of Internal Medicine, College of Medicine, University of Duhok, Duhok, Iraq
- * E-mail:
| | | | - Muna A. Kashmoola
- Department of Pathology, College of Medicine, University of Mousel, Mousel, Iraq
| | - Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
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Mohammad AM, Othman GO, Saeed CH, Al Allawi S, Gedeon GS, Qadir SM, Al-Allawi N. Genetic polymorphisms in early-onset myocardial infarction in a sample of Iraqi patients: a pilot study. BMC Res Notes 2020; 13:541. [PMID: 33228791 PMCID: PMC7686715 DOI: 10.1186/s13104-020-05367-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/30/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Early-onset myocardial infarction constitutes nearly one third of cases of myocardial infarction among Iraqis, which is rather higher than the proportions reported in many Western countries. Thus this study was initiated to investigate the role of some genetic polymorphisms, as well as acquired risk factors in this condition. RESULTS A total of 102 Iraqi patients with first myocardial infarction aged 50 years, and 77 matched controls were enrolled. The DNAs of participants were screened for nine polymorphisms, namely: β-Fibrinogen (- 455G > A), Factor XIII (V34L), Plasminogen Activator inhibitor-1 (PAI-1, 4G/5G), Human Platelet Antigen-1 (HPA1a/b), 5,10-Methylenetetrahydrofolate Reductase MTHFR (C677T) and MTHFR (A1298C), Angiotensin-Converting Enzyme (ACE) 287 bp insertion/deletion (I/D), Apolipoprotein-B (ApoB: R3500Q), and Apolipoprotein-E (Apo E: E2/E3/E4), using PCR and reverse hybridization technique. Among traditional risk factors, univariate analysis revealed that smoking (OR 2.86 [95%CI 1.53-5.34]), hyperlipidemia (OR 5.23 [95%CI 2.66-10.29]), and diabetes mellitus (OR 4.05 [95% CI 1.57-10.41]) were significantly higher among patients compared to controls (P<0.001, <0.001 and 0.002 respectively), while none of the nine genetic polymorphisms reached significance. Multivariate Logistic regression, however, revealed that only smoking and hyperlipidemia retained significance (P of < 0.001 each). The need to initiate further studies on larger cohorts is paramount to understand the higher than expected frequency of early-onset myocardial infarction in our population.
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Affiliation(s)
- Ameen M. Mohammad
- Department of Internal Medicine, College of Medicine, University of Duhok, 9 Azadi Hospital Rd, Duhok, 1014AM Iraq
| | - Galawezh O. Othman
- Department of Biology, Education College, Salahaddin University, Erbil, Iraq
| | - Chiman H. Saeed
- Medical Research Center, Hawler Medical University, Erbil, Iraq
| | | | - George S. Gedeon
- Consultant Clinical Biochemist, Gedeon Medical Laboratories, Amman, Jordan
| | - Shatha M. Qadir
- Department of Hematology, Azadi Teaching Hospital, Duhok, Iraq
| | - Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
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Albarawi DJ, Balatay AA, Al-Allawi N. HBG2 -158 (C>T) polymorphism and its contribution to fetal hemoglobin variability in Iraqi Kurds with beta-thalassemia minor. J Lab Physicians 2020; 10:370-373. [PMID: 30498305 PMCID: PMC6210847 DOI: 10.4103/jlp.jlp_22_18] [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] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Hemoglobin (Hb) F% is increased in up to half of beta-thalassemia (β-thal) carriers. Several polymorphisms have been linked to such variability in different populations, including HBG2 - 158(C>T) (Xmn I polymorphism) on chromosome 11. To determine the role of this polymorphism in such variability among Iraqi Kurds, the current study was initiated. MATERIALS AND METHODS A total of 102 consecutive patients diagnosed as β-thal minor were enrolled. The enrollees had their diagnosis based on peripheral blood counts and high-performance liquid chromatography to determine HbA2 and HbF. All enrollees had their DNA extracted by phenol-chloroform method and Xmn I polymorphism detected by restriction fragment length polymorphism-polymerase chain reaction. RESULTS The mean age (standard deviation [SD]) of the 102 enrollees was 25.4 (14.0) years, and the enrollees included 48 males and 54 females. Xmn I polymorphism was identified in heterozygous state in 46 (45.1%) patients and in homozygous state in one patient (0.98%). Thus, the minor allele frequency of this polymorphism was 0.235 in the studied group. There were no significant differences in red cell indices and HbA2% in carriers of the minor allele compared to noncarriers, while HbF% and absolute HbF concentrations were significantly higher in the former subgroup (P = 0.032 and 0.014, respectively). This polymorphism's contribution to HbF variability was found to be 5.8% in the studied sample. Furthermore, those with HbF ≥2% were 3.2 folds more likely to carry the minor allele. CONCLUSIONS Xmn I polymorphism is frequently encountered in Iraqi Kurds with β-thal minor, and it is significantly associated with higher fetal hemoglobin in these patients.
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Affiliation(s)
- Dilan J Albarawi
- Scientific Research Center, College of Science, University of Duhok, Duhok, Iraq
| | - Amer A Balatay
- Department of Pathology, College of Pharmacy, University of Duhok, Duhok, Iraq
| | - Nasir Al-Allawi
- Department of Pathology and Scientific Research Center, College of Medicine, University of Duhok, Duhok, Iraq
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Al-Allawi N, Qadir SMA, Puehringer H, Chui DHK, Farrell JJ, Oberkanins C. The association of HBG2, BCL11A, and HMIP polymorphisms with fetal hemoglobin and clinical phenotype in Iraqi Kurds with sickle cell disease. Int J Lab Hematol 2018; 41:87-93. [PMID: 30216683 DOI: 10.1111/ijlh.12927] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 06/11/2018] [Revised: 07/14/2018] [Accepted: 08/14/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Fetal hemoglobin (HbF) is the major modifier for sickle cell disease (SCD) severity. HbF is modulated mainly by three major quantitative trait loci (QTL) on chromosomes 2, 6, and 11. METHODS Five SNPs in the three QTLs (HBG2, rs7482144; BCL11A, rs1427407 and rs10189857; and HBS1L-MYB intergenic region, rs28384513 and rs9399137) were investigated by multiplex PCR and reverse hybridization, and their roles in HbF and clinical phenotype variability in Iraqi Kurds with SCD were assessed. RESULTS HBG2 rs7482144 with minor allele frequency (MAF) of 0.133 was the most significant contributor to HbF variability, contributing 18.1%, followed by rs1427407 (MAF of 0.266) and rs9399137 (MAF of 0.137) at 14.3% and 8.8%, respectively. The other two SNPs were not significant contributors. Furthermore, when the cumulative numbers of minor alleles in the three contributing SNPs were assessed, HbF% and hemoglobin concentration increased with increasing number of minor alleles (P < 0.0005 and 0.001, respectively), while serum lactic dehydrogenase, reticulocytes, leukocytes, transfusion, and pain frequencies decreased (P = 0.003, 0.004, <0.0005, <0.0005, and 0.017, respectively). CONCLUSIONS It was demonstrated that SNPs in all three major HbF QTLs contribute significantly to HbF and clinical variability in Iraqi Kurds with SCD and that the cumulative number of minor alleles at contributing SNPs may serve as a better predictor of such variability in this population.
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Affiliation(s)
- Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq
| | | | | | - David H K Chui
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - John J Farrell
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, Massachusetts
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Hamamy H, Makrythanasis P, Al-Allawi N, Muhsin AA, Antonarakis SE. Recessive thrombocytopenia likely due to a homozygous pathogenic variant in the FYB gene: case report. BMC Med Genet 2014; 15:135. [PMID: 25516138 PMCID: PMC4411870 DOI: 10.1186/s12881-014-0135-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/08/2014] [Indexed: 11/23/2022]
Abstract
Background Inherited thrombocytopenias (IT) are a heterogeneous group of rare diseases characterized by a reduced number of blood platelets. The frequency of IT is probably underestimated because of diagnostic difficulties and because not all the existing forms have as yet been identified, with some patients remaining without a definitive diagnosis. Exome Sequencing has made possible the identification of almost all variants in the coding regions of protein-coding genes, thereby providing the opportunity to identify the disease causing gene in a number of patients with indefinite diagnoses, specifically in consanguineous families. Case presentation Familial thrombocytopenia with small size platelets was present in several members of a highly consanguineous family from Northern Iraq. Genotyping of all affected, their unaffected siblings and parents, followed by exome sequencing revealed a strong candidate loss of function variant in a homozygous state: a frameshift mutation in the FYB gene. The protein encoded by this gene is known to be a cytosolic adaptor molecule expressed by T, natural killer (NK), myeloid cells and platelets, and is involved in platelet activation and controls the expression of interleukin-2. Knock-out mice were reported to show isolated thrombocytopenia. Conclusion Inherited thrombocytopenias differ in their presentation, associated features, and molecular etiologies. An accurate diagnosis is needed to provide appropriate management as well as counseling for the individuals and their family members. Exome sequencing may become a first diagnostic tool to identify the molecular basis of undiagnosed familial IT. In this report, the clinical evaluation combined with the power and efficiency of genomic analysis defined the FYB gene as the possible underlying cause of autosomal recessive thrombocytopenia with small platelet size. This is the first report linking pathogenic variants in FYB and thrombocytopenia in humans.
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Affiliation(s)
- Hanan Hamamy
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland.
| | - Periklis Makrythanasis
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland.
| | - Nasir Al-Allawi
- Department of Pathology, College of Medicine, University of Dohuk, Dohuk, Iraq.
| | | | - Stylianos E Antonarakis
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland. .,Service of Genetic Medicine, University Hospitals of Geneva, Geneva, Switzerland.
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Makrythanasis P, Nelis M, Santoni FA, Guipponi M, Vannier A, Béna F, Gimelli S, Stathaki E, Temtamy S, Mégarbané A, Masri A, Aglan MS, Zaki MS, Bottani A, Fokstuen S, Gwanmesia L, Aliferis K, Bustamante Eduardo M, Stamoulis G, Psoni S, Kitsiou-Tzeli S, Fryssira H, Kanavakis E, Al-Allawi N, Sefiani A, Al Hait S, Elalaoui SC, Jalkh N, Al-Gazali L, Al-Jasmi F, Bouhamed HC, Abdalla E, Cooper DN, Hamamy H, Antonarakis SE. Diagnostic exome sequencing to elucidate the genetic basis of likely recessive disorders in consanguineous families. Hum Mutat 2014; 35:1203-10. [PMID: 25044680 DOI: 10.1002/humu.22617] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [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: 01/30/2014] [Accepted: 06/30/2014] [Indexed: 01/19/2023]
Abstract
Rare, atypical, and undiagnosed autosomal-recessive disorders frequently occur in the offspring of consanguineous couples. Current routine diagnostic genetic tests fail to establish a diagnosis in many cases. We employed exome sequencing to identify the underlying molecular defects in patients with unresolved but putatively autosomal-recessive disorders in consanguineous families and postulated that the pathogenic variants would reside within homozygous regions. Fifty consanguineous families participated in the study, with a wide spectrum of clinical phenotypes suggestive of autosomal-recessive inheritance, but with no definitive molecular diagnosis. DNA samples from the patient(s), unaffected sibling(s), and the parents were genotyped with a 720K SNP array. Exome sequencing and array CGH (comparative genomic hybridization) were then performed on one affected individual per family. High-confidence pathogenic variants were found in homozygosity in known disease-causing genes in 18 families (36%) (one by array CGH and 17 by exome sequencing), accounting for the clinical phenotype in whole or in part. In the remainder of the families, no causative variant in a known pathogenic gene was identified. Our study shows that exome sequencing, in addition to being a powerful diagnostic tool, promises to rapidly expand our knowledge of rare genetic Mendelian disorders and can be used to establish more detailed causative links between mutant genotypes and clinical phenotypes.
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Affiliation(s)
- Periklis Makrythanasis
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland; Service of Genetic Medicine, University Hospitals of Geneva, Geneva, Switzerland
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Novarino G, Fenstermaker AG, Zaki MS, Hofree M, Silhavy JL, Heiberg AD, Abdellateef M, Rosti B, Scott E, Mansour L, Masri A, Kayserili H, Al-Aama JY, Abdel-Salam GMH, Karminejad A, Kara M, Kara B, Bozorgmehri B, Ben-Omran T, Mojahedi F, El Din Mahmoud IG, Bouslam N, Bouhouche A, Benomar A, Hanein S, Raymond L, Forlani S, Mascaro M, Selim L, Shehata N, Al-Allawi N, Bindu PS, Azam M, Gunel M, Caglayan A, Bilguvar K, Tolun A, Issa MY, Schroth J, Spencer EG, Rosti RO, Akizu N, Vaux KK, Johansen A, Koh AA, Megahed H, Durr A, Brice A, Stevanin G, Gabriel SB, Ideker T, Gleeson JG. Exome sequencing links corticospinal motor neuron disease to common neurodegenerative disorders. Science 2014; 343:506-511. [PMID: 24482476 DOI: 10.1126/science.1247363] [Citation(s) in RCA: 397] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Hereditary spastic paraplegias (HSPs) are neurodegenerative motor neuron diseases characterized by progressive age-dependent loss of corticospinal motor tract function. Although the genetic basis is partly understood, only a fraction of cases can receive a genetic diagnosis, and a global view of HSP is lacking. By using whole-exome sequencing in combination with network analysis, we identified 18 previously unknown putative HSP genes and validated nearly all of these genes functionally or genetically. The pathways highlighted by these mutations link HSP to cellular transport, nucleotide metabolism, and synapse and axon development. Network analysis revealed a host of further candidate genes, of which three were mutated in our cohort. Our analysis links HSP to other neurodegenerative disorders and can facilitate gene discovery and mechanistic understanding of disease.
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Affiliation(s)
- Gaia Novarino
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Ali G Fenstermaker
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Maha S Zaki
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Center, Cairo 12311, Egypt
| | - Matan Hofree
- Department of Computer Science and Engineering and Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Jennifer L Silhavy
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Andrew D Heiberg
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Mostafa Abdellateef
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Basak Rosti
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Eric Scott
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Lobna Mansour
- Department of Pediatric Neurology, Neurometabolic Unit, Cairo University Children's Hospital, Cairo 406, Egypt
| | - Amira Masri
- Division of Child Neurology, Department of Pediatrics, University of Jordan, Amman 11942, Jordan
| | - Hulya Kayserili
- Istanbul University, Istanbul Medical Faculty, Medical Genetics Department, 34093 Istanbul, Turkey
| | - Jumana Y Al-Aama
- Department of Genetic Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ghada M H Abdel-Salam
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Center, Cairo 12311, Egypt
| | | | - Majdi Kara
- Department of Pediatrics, Tripoli Children's Hospital, Tripoli, Libya
| | - Bulent Kara
- Kocaeli University, Medical Faculty, Department of Pediatric Neurology, 41380 Umuttepe, Kocaeli, Turkey
| | - Bita Bozorgmehri
- Kariminejad-Najmabadi Pathology and Genetics Center, Tehran, Iran
| | - Tawfeg Ben-Omran
- Clinical and Metabolic Genetics Division, Department of Pediatrics, Hamad Medical Corporation, Doha 3050, Qatar
| | - Faezeh Mojahedi
- Mashhad Medical Genetic Counseling Center, 91767 Mashhad, Iran
| | - Iman Gamal El Din Mahmoud
- Department of Pediatric Neurology, Neurometabolic Unit, Cairo University Children's Hospital, Cairo 406, Egypt
| | - Naima Bouslam
- Université Mohammed V Souissi, Equipe de Recherchéde Maladies Neurodégéneratives (ERMN) and Centre de Recherche en Épidémiologie Clinique et Essais Thérapeutiques (CRECET), 6402 Rabat, Morocco
| | - Ahmed Bouhouche
- Université Mohammed V Souissi, Equipe de Recherchéde Maladies Neurodégéneratives (ERMN) and Centre de Recherche en Épidémiologie Clinique et Essais Thérapeutiques (CRECET), 6402 Rabat, Morocco
| | - Ali Benomar
- Université Mohammed V Souissi, Equipe de Recherchéde Maladies Neurodégéneratives (ERMN) and Centre de Recherche en Épidémiologie Clinique et Essais Thérapeutiques (CRECET), 6402 Rabat, Morocco
| | - Sylvain Hanein
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, INSERM U1127, CNRS UMR7225; UPMC Univ Paris VI UMR_S975, 75013 Paris, France
| | - Laure Raymond
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, INSERM U1127, CNRS UMR7225; UPMC Univ Paris VI UMR_S975, 75013 Paris, France
| | - Sylvie Forlani
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, INSERM U1127, CNRS UMR7225; UPMC Univ Paris VI UMR_S975, 75013 Paris, France
| | - Massimo Mascaro
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Laila Selim
- Department of Pediatric Neurology, Neurometabolic Unit, Cairo University Children's Hospital, Cairo 406, Egypt
| | - Nabil Shehata
- Department of Pediatrics and Neonatology, Saudi German Hospital, Post Office Box 84348, Riyadh, Kingdom of Saudi Arabia
| | - Nasir Al-Allawi
- Department of Pathology, School of Medicine, University of Dohuk, Dohuk, Iraq
| | - P S Bindu
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Matloob Azam
- Department of Pediatrics and Child Neurology, Wah Medical College, Wah Cantt, Pakistan
| | - Murat Gunel
- Department of Genetics and Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Ahmet Caglayan
- Department of Genetics and Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Kaya Bilguvar
- Department of Genetics and Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Aslihan Tolun
- Department of Molecular Biology and Genetics, Bogazici University, 34342 Istanbul, Turkey
| | - Mahmoud Y Issa
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Center, Cairo 12311, Egypt
| | - Jana Schroth
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Emily G Spencer
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Rasim O Rosti
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Naiara Akizu
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Keith K Vaux
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Anide Johansen
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Alice A Koh
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
| | - Hisham Megahed
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Center, Cairo 12311, Egypt
| | - Alexandra Durr
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, INSERM U1127, CNRS UMR7225; UPMC Univ Paris VI UMR_S975, 75013 Paris, France.,Assistance Publique-Hôpitaux de Paris, Fédération de Génétique, Pitié-Salpêtrière Hospital, 75013 Paris, France
| | - Alexis Brice
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, INSERM U1127, CNRS UMR7225; UPMC Univ Paris VI UMR_S975, 75013 Paris, France.,Assistance Publique-Hôpitaux de Paris, Fédération de Génétique, Pitié-Salpêtrière Hospital, 75013 Paris, France.,Institut du Cerveau et de la Moelle Épinière, 75013 Paris, France
| | - Giovanni Stevanin
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, INSERM U1127, CNRS UMR7225; UPMC Univ Paris VI UMR_S975, 75013 Paris, France.,Assistance Publique-Hôpitaux de Paris, Fédération de Génétique, Pitié-Salpêtrière Hospital, 75013 Paris, France.,Institut du Cerveau et de la Moelle Épinière, 75013 Paris, France.,Laboratoire de Neurogénétique, Ecole Pratique des Hautes Etudes, Institut du Cerveau et de la Moelle Épinière, 75013 Paris, France
| | - Stacy B Gabriel
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Trey Ideker
- Department of Computer Science and Engineering and Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Joseph G Gleeson
- Howard Hughes Medical Institute, University of California, San Diego, La Jolla, CA 92093, USA
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Al-Musawi BM, Al-Allawi N, Abdul-Majeed BA, Eissa AA, Jubrael JM, Hamamy H. Molecular characterization of glucose-6-phosphate dehydrogenase deficient variants in Baghdad city - Iraq. BMC Blood Disord 2012; 12:4. [PMID: 22452742 PMCID: PMC3323424 DOI: 10.1186/1471-2326-12-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 03/27/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although G6PD deficiency is the most common genetically determined blood disorder among Iraqis, its molecular basis has only recently been studied among the Kurds in North Iraq, while studies focusing on Arabs in other parts of Iraq are still absent. METHODS A total of 1810 apparently healthy adult male blood donors were randomly recruited from the national blood transfusion center in Baghdad. They were classified into G6PD deficient and non-deficient individuals based on the results of methemoglobin reduction test (MHRT), with confirmation of deficiency by subsequent enzyme assays. DNA from deficient individuals was studied using a polymerase chain reaction-Restriction fragment length polymorphism (PCR-RFLP) for four deficient molecular variants, namely G6PD Mediterranean (563 C→T), Chatham (1003 G→A), A- (202 G→A) and Aures (143 T→C). A subset of those with the Mediterranean variant, were further investigated for the 1311 (C→T) silent mutation. RESULTS G6PD deficiency was detected in 109 of the 1810 screened male individuals (6.0%). Among 101 G6PD deficient males molecularly studied, the Mediterranean mutation was detected in 75 cases (74.3%), G6PD Chatham in 5 cases (5.0%), G6PD A- in two cases (2.0%), and G6PD Aures in none. The 1311 silent mutation was detected in 48 out of the 51 G6PD deficient males with the Mediterranean variant studied (94.1%). CONCLUSIONS Three polymorphic variants namely: the Mediterranean, Chatham and A-, constituted more than 80% of G6PD deficient variants among males in Baghdad. Iraq. This observation is to some extent comparable to other Asian Arab countries, neighboring Turkey and Iran.
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Affiliation(s)
- Bassam Ms Al-Musawi
- Department of Pathology, College of Medicine, University of Dohuk, Azadi Hospital road, 1014 AM Dohuk, Iraq.
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