Publications by authors named "Lehalle D"

Introduction: Heterozygous pathogenic variants in NTRK2 (HGNC: 8032) have been associated with global developmental delay. However, only scattered cases have been described in small or general studies. The aim of our work was to consolidate our understanding of NTRK2-related disorders and to delineate the clinical presentation METHODS: We report extended cohort of 44 affected individuals, of whom 19 are from the literature and 25 were previously unreported.

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  • Researchers studied mutations in a gene that affects a key protein involved in cell signaling, which is linked to severe health issues like impaired immunity in patients.
  • The mutations were found to disrupt normal cell behavior by promoting excessive cell growth and responses to immune signals, specifically T cell receptor stimulation.
  • The mutant protein was shown to interfere with a regulatory protein, leading to heightened activity of important signaling pathways that contribute to cell growth and survival.
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CSMD1 (Cub and Sushi Multiple Domains 1) is a well-recognized regulator of the complement cascade, an important component of the innate immune response. CSMD1 is highly expressed in the central nervous system (CNS) where emergent functions of the complement pathway modulate neural development and synaptic activity. While a genetic risk factor for neuropsychiatric disorders, the role of CSMD1 in neurodevelopmental disorders is unclear.

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  • Variants of uncertain significance (VUS) present challenges in diagnosing rare diseases, and episignatures have emerged as potential biomarkers to help classify these variants.
  • A study analyzed DNA methylation data from different groups, including carriers of pathogenic variants and healthy controls, using a k-nearest-neighbour classifier to assess the predictive abilities of various episignatures.
  • Results revealed that while some signatures (ATRX, DNMT3A, KMT2D, NSD1) achieved 100% sensitivity, others (CREBBP-RSTS, CHD8) showed lower performance, indicating that not all episignatures are equally reliable for diagnostic use and highlighting the need for further validation with larger sample sizes.
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  • DYRK1A Syndrome is caused by mutations in the DYRK1A gene, leading to global developmental delays, intellectual disability, and common physical issues like low birth weight and microcephaly.
  • The study compiled growth data from 92 individuals with the syndrome, utilizing various sources including pediatric records and scientific literature.
  • New growth charts were created for key measurements (height, weight, BMI, occipitofrontal circumference) for children aged 0-5 years, providing a useful tool for managing patients with DYRK1A Syndrome.
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  • The PIK3CA-related overgrowth spectrum (PROS) includes conditions caused by mosaic variants in the PIK3CA gene, which can also lead to various cancers, including an increased risk of Wilms tumor (WT).
  • A study of 267 PROS patients found a low overall cancer development rate of 2.2%, with an estimated 5.6% probability of cancer by age 45, suggesting the risk of WT in these patients is relatively low.
  • The findings indicate that routine abdominal ultrasound for cancer detection in PROS might not be necessary, and more long-term studies are needed to better understand the risks of different cancers and their connection to PIK3CA variants.
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  • Exome sequencing has a high diagnostic yield (25%-70%) for rare diseases, revealing novel gene associations, but retrospective data reanalysis can be challenging for labs.
  • The study employed a systematic reanalysis strategy utilizing daily PubMed searches and the GREP command-line tool to track new disease-gene associations over 18 months.
  • From their queries, they identified 128 genes of interest and confirmed causal diagnoses in 21 individuals, showcasing that this efficient reanalysis method can enhance diagnostic outcomes in genetic research.
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  • This study introduces 31 new individuals with 22 unique genetic variants related to SYN1 disorders, detailing the prevalence of symptoms like autism, epilepsy, and intellectual disability across these cases.
  • The research also identifies specific triggers for seizures, such as water contact and routine activities, and suggests that the type of genetic mutation can influence the severity of symptoms, particularly the relationship between early seizure onset and greater intellectual challenges.
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Prenatal exome sequencing could be complex because of limited phenotypical data compared to postnatal/portmortem phenotype in fetuses affected by multiple congenital abnormalities (MCA). Here, we investigated limits of prenatal phenotype for ES interpretation thanks to a blindly reanalysis of postmortem ES data using prenatal data only in fetuses affected by MCA and harboring a (likely)pathogenic variant or a variant of unknown significance (VUS). Prenatal ES identified all causative variant previously reported by postmortem ES (22/24 (92%) and 2/24 (8%) using solo-ES and trio-ES respectively).

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Unique or multiple congenital facial skin polyps are features of several rare syndromes, from the most well-known Pai syndrome (PS), to the less recognized oculoauriculofrontonasal syndrome (OAFNS), encephalocraniocutaneous lipomatosis (ECCL), or Sakoda complex (SC). We set up a research project aiming to identify the molecular bases of PS. We reviewed 27 individuals presenting with a syndromic frontonasal polyp and initially referred for PS.

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  • Auriculocondylar syndrome (ACS) is a rare craniofacial disorder featuring an underdeveloped jaw and a unique ear shape called "Question Mark Ear," along with possible additional features from other tissues.
  • The genetic basis of ACS includes mutations linked to the endothelin 1 signaling pathway and can be inherited in both dominant and recessive patterns.
  • A study of 14 new cases and a reassessment of 25 existing cases identified mutations in PLCB4, GNAI3, or EDN1, highlighting associated anomalies and offering recommendations for patient management.
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  • The study evaluated the effectiveness of exome sequencing (ES) to diagnose inherited metabolic disorders (IMDs) in 547 patients with non-specific developmental disorders.
  • Results showed that 12% (177 patients) received a causative diagnosis of IMDs through ES.
  • The findings highlight the advantages of using ES for diagnosing IMDs, especially when traditional biochemical tests are not available.
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Background: O'Donnell-Luria-Rodan syndrome (ODLURO) is an autosomal-dominant neurodevelopmental disorder caused by pathogenic, mostly truncating variants in . It was first described by O'Donnell-Luria in 2019 in a cohort of 38 patients. Clinical features encompass macrocephaly, mild intellectual disability (ID), autism spectrum disorder (ASD) susceptibility and seizure susceptibility.

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  • The CHD5 gene, found in the critical 1p36 microdeletion region, is part of the NuRD complex essential for brain development, and variants in this gene are linked to neurodevelopmental disorders.
  • A study identified 16 individuals with heterozygous CHD5 variants via exome sequencing, revealing that most had new (de novo) mutations associated with conditions such as speech delays and learning disabilities.
  • The most common issues among these patients included language deficits (81%), behavioral problems (69%), intellectual disabilities (64%), and epilepsy (62%), indicating that CHD5 variants lead to a varied spectrum of neurodevelopmental disorders.
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The structure of proline prevents it from adopting an optimal position for rapid protein synthesis. Poly-proline-tract (PPT) associated ribosomal stalling is resolved by highly conserved eIF5A, the only protein to contain the amino acid hypusine. We show that de novo heterozygous EIF5A variants cause a disorder characterized by variable combinations of developmental delay, microcephaly, micrognathia and dysmorphism.

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The genetic causes of multiple congenital anomalies are incompletely understood. Here, we report novel heterozygous predicted loss-of-function (LoF) and predicted damaging missense variants in the WW domain binding protein 11 (WBP11) gene in seven unrelated families with a variety of overlapping congenital malformations, including cardiac, vertebral, tracheo-esophageal, renal and limb defects. WBP11 encodes a component of the spliceosome with the ability to activate pre-messenger RNA splicing.

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  • A study screened 80 fetuses with congenital heart defects (CHDs) or heterotaxy, revealing a 12.5% pathogenic variant rate, especially higher in those with heterotaxy.
  • Most fetuses were male, and a significant portion had additional anomalies beyond heart defects.
  • The study found that genetic counseling for future pregnancies is more effective with these results, highlighting unexpected consanguinity in 20% of cases with identified variants.
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  • Molecular diagnosis using singleton exome sequencing (sES) in fetuses with multiple congenital abnormalities (MCA) shows a lower diagnostic yield (20%) compared to live births with developmental issues (30%), indicating potential underestimation of genetic variant impact in fetal cases.
  • In a study of 95 fetuses with MCA, a genotype-first strategy was employed, blending variant analysis and bioinformatics with reverse phenotyping to determine the clinical significance of genetic variations.
  • The results revealed causal variants in 25% of fetuses, unknown significance variants in 8%, and identified six novel candidate genes, highlighting the importance of prenatal genetic studies for understanding complex disorders.
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  • The study examined the effectiveness of chromosomal microarray (CMA) and exome sequencing (ES) for diagnosing genetic causes in fetuses with abnormal corpus callosum (AbnCC), both isolated (iAbnCC) and nonisolated (niAbnCC).
  • Out of 65 fetuses tested, 23% had identifiable genetic variants associated with AbnCC and intellectual disabilities, providing crucial data for predicting developmental outcomes.
  • The findings emphasize the importance of genetic testing in guiding parents’ decisions about pregnancy outcomes and highlight the need for further research to refine counseling practices, especially following negative test results.
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Introduction: Pigmentary mosaicism (PM) manifests by pigmentation anomalies along Blaschko's lines and represents a clue toward the molecular diagnosis of syndromic intellectual disability (ID). Together with new insights on the role for lysosomal signalling in embryonic stem cell differentiation, mutations in the X-linked transcription factor 3 () have recently been reported in five patients. Functional analysis suggested these mutations to result in ectopic nuclear gain of functions.

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Developmental disorders (DD), characterized by malformations/dysmorphism and/or intellectual disability, affecting around 3% of worldwide population, are mostly linked to genetic anomalies. Despite clinical exome sequencing (cES) centered on genes involved in human genetic disorders, the majority of patients affected by DD remain undiagnosed after solo-cES. Trio-based strategy is expected to facilitate variant selection thanks to rapid parental segregation.

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  • X-linked intellectual disability (XLID) is a complex condition with over 100 related genes, with KDM5C variants identified as a significant cause of moderate to severe cases.
  • The study analyzed 19 females with novel KDM5C variants, finding that while some were asymptomatic, most exhibited learning disabilities, behavioral disorders, and some expressive language impairments.
  • The findings emphasize the role of KDM5C in females affected by XLID, suggesting that genetic counseling should consider the potential for disease expression in female carriers, even in sporadic cases.
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  • Lamb-Shaffer syndrome (LAMSHF) is a rare neurodevelopmental disorder linked to genetic changes in the SOX5 gene, primarily through microdeletions, affecting brain development and function.
  • The study analyzed data from 41 new patients with different SOX5 alterations to better understand the genetic variations and their impact on clinical symptoms.
  • Findings revealed that while most genetic changes disrupt SOX5's ability to bind DNA, leading to varying degrees of intellectual disability and language delays, the severity of symptoms doesn't strongly correlate with specific genetic alterations.
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Congenital limb malformations (CLM) comprise many conditions affecting limbs and more than 150 associated genes have been reported. Due to this large heterogeneity, a high proportion of patients remains without a molecular diagnosis. In the last two decades, advances in high throughput sequencing have allowed new methodological strategies in clinical practice.

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Objective: Heterozygous variants in or, more rarely, genes are responsible for early-onset developmental/epileptic disorders characterized by heterogeneous clinical presentation and course, genetic transmission, and prognosis. While familial forms mostly include benign epilepsies with seizures starting in the neonatal or early-infantile period, de novo variants in or have been described in sporadic cases of early-onset encephalopathy (EOEE) with pharmacoresistant seizures, various age-related pathological EEG patterns, and moderate/severe developmental impairment. All pathogenic variants in or occur in heterozygosity.

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