Alpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.

Alpha-Mannosidosis (AM) is an ultra-rare storage disorder caused by a deficiency of lysosomal alpha-mannosidase encoded by the MAN2B1 gene. Clinical presentation of AM includes mental retardation, recurrent infections, hearing loss, dysmorphic features, and motor dysfunctions. AM has never been repo...

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Autores principales: Rahma Mkaouar, Zied Riahi, Cherine Charfeddine, Imen Chelly, Hela Boudabbous, Hamza Dallali, Crystel Bonnet, Meriem Hechmi, Soumeya Bekri, Nadia Zitouna, Lotfi Zekri, Amel Tounsi, Rym Kefi, Jihene Marrakchi, Olfa Messaoud, Ichraf Kraoua, Sonia Maalej, Ilhem Turki Ben Youssef, Ahlem Ben Hmid, Fabrice Giraudet, Sami Bouchoucha, Neji Tebib, Ghazi Besbes, Christine Petit, Ridha Mrad, Sonia Abdelhak, Mediha Trabelsi
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:569f864a04af411d83938661f56801312021-12-02T20:17:17ZAlpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.1932-620310.1371/journal.pone.0258202https://doaj.org/article/569f864a04af411d83938661f56801312021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258202https://doaj.org/toc/1932-6203Alpha-Mannosidosis (AM) is an ultra-rare storage disorder caused by a deficiency of lysosomal alpha-mannosidase encoded by the MAN2B1 gene. Clinical presentation of AM includes mental retardation, recurrent infections, hearing loss, dysmorphic features, and motor dysfunctions. AM has never been reported in Tunisia. We report here the clinical and genetic study of six patients from two Tunisian families with AM. The AM diagnosis was confirmed by an enzymatic activity assay. Genetic investigation was conducted by Sanger sequencing of the mutational hotspots for the first family and by ES analysis for the second one. In the first family, a frameshift duplication p.(Ser802GlnfsTer129) was identified in the MAN2B1 gene. For the second family, ES analysis led to the identification of a missense mutation p.(Arg229Trp) in the MAN2B1 gene in four affected family members. The p.(Ser802GlnfsTer129) mutation induces a premature termination codon which may trigger RNA degradation by the NMD system. The decrease in the levels of MAN2B1 synthesis could explain the severe phenotype observed in the index case. According to the literature, the p.(Arg229Trp) missense variant does not have an impact on MAN2B1 maturation and transportation, which correlates with a moderate clinical sub-type. To explain the intra-familial variability of cognitive impairment, exome analysis allowed the identification of two likely pathogenic variants in GHR and SLC19A3 genes potentially associated to cognitive decline. The present study raises awareness about underdiagnosis of AM in the region that deprives patients from accessing adequate care. Indeed, early diagnosis is critical in order to prevent disease progression and to propose enzyme replacement therapy.Rahma MkaouarZied RiahiCherine CharfeddineImen ChellyHela BoudabbousHamza DallaliCrystel BonnetMeriem HechmiSoumeya BekriNadia ZitounaLotfi ZekriAmel TounsiRym KefiJihene MarrakchiOlfa MessaoudIchraf KraouaSonia MaalejIlhem Turki Ben YoussefAhlem Ben HmidFabrice GiraudetSami BouchouchaNeji TebibGhazi BesbesChristine PetitRidha MradSonia AbdelhakMediha TrabelsiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258202 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Rahma Mkaouar
Zied Riahi
Cherine Charfeddine
Imen Chelly
Hela Boudabbous
Hamza Dallali
Crystel Bonnet
Meriem Hechmi
Soumeya Bekri
Nadia Zitouna
Lotfi Zekri
Amel Tounsi
Rym Kefi
Jihene Marrakchi
Olfa Messaoud
Ichraf Kraoua
Sonia Maalej
Ilhem Turki Ben Youssef
Ahlem Ben Hmid
Fabrice Giraudet
Sami Bouchoucha
Neji Tebib
Ghazi Besbes
Christine Petit
Ridha Mrad
Sonia Abdelhak
Mediha Trabelsi
Alpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.
description Alpha-Mannosidosis (AM) is an ultra-rare storage disorder caused by a deficiency of lysosomal alpha-mannosidase encoded by the MAN2B1 gene. Clinical presentation of AM includes mental retardation, recurrent infections, hearing loss, dysmorphic features, and motor dysfunctions. AM has never been reported in Tunisia. We report here the clinical and genetic study of six patients from two Tunisian families with AM. The AM diagnosis was confirmed by an enzymatic activity assay. Genetic investigation was conducted by Sanger sequencing of the mutational hotspots for the first family and by ES analysis for the second one. In the first family, a frameshift duplication p.(Ser802GlnfsTer129) was identified in the MAN2B1 gene. For the second family, ES analysis led to the identification of a missense mutation p.(Arg229Trp) in the MAN2B1 gene in four affected family members. The p.(Ser802GlnfsTer129) mutation induces a premature termination codon which may trigger RNA degradation by the NMD system. The decrease in the levels of MAN2B1 synthesis could explain the severe phenotype observed in the index case. According to the literature, the p.(Arg229Trp) missense variant does not have an impact on MAN2B1 maturation and transportation, which correlates with a moderate clinical sub-type. To explain the intra-familial variability of cognitive impairment, exome analysis allowed the identification of two likely pathogenic variants in GHR and SLC19A3 genes potentially associated to cognitive decline. The present study raises awareness about underdiagnosis of AM in the region that deprives patients from accessing adequate care. Indeed, early diagnosis is critical in order to prevent disease progression and to propose enzyme replacement therapy.
format article
author Rahma Mkaouar
Zied Riahi
Cherine Charfeddine
Imen Chelly
Hela Boudabbous
Hamza Dallali
Crystel Bonnet
Meriem Hechmi
Soumeya Bekri
Nadia Zitouna
Lotfi Zekri
Amel Tounsi
Rym Kefi
Jihene Marrakchi
Olfa Messaoud
Ichraf Kraoua
Sonia Maalej
Ilhem Turki Ben Youssef
Ahlem Ben Hmid
Fabrice Giraudet
Sami Bouchoucha
Neji Tebib
Ghazi Besbes
Christine Petit
Ridha Mrad
Sonia Abdelhak
Mediha Trabelsi
author_facet Rahma Mkaouar
Zied Riahi
Cherine Charfeddine
Imen Chelly
Hela Boudabbous
Hamza Dallali
Crystel Bonnet
Meriem Hechmi
Soumeya Bekri
Nadia Zitouna
Lotfi Zekri
Amel Tounsi
Rym Kefi
Jihene Marrakchi
Olfa Messaoud
Ichraf Kraoua
Sonia Maalej
Ilhem Turki Ben Youssef
Ahlem Ben Hmid
Fabrice Giraudet
Sami Bouchoucha
Neji Tebib
Ghazi Besbes
Christine Petit
Ridha Mrad
Sonia Abdelhak
Mediha Trabelsi
author_sort Rahma Mkaouar
title Alpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.
title_short Alpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.
title_full Alpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.
title_fullStr Alpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.
title_full_unstemmed Alpha-mannosidosis in Tunisian consanguineous families: Potential involvement of variants in GHR and SLC19A3 genes in the variable expressivity of cognitive impairment.
title_sort alpha-mannosidosis in tunisian consanguineous families: potential involvement of variants in ghr and slc19a3 genes in the variable expressivity of cognitive impairment.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/569f864a04af411d83938661f5680131
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