A severe clinical phenotype of Noonan syndrome with neonatal hypertrophic cardiomyopathy in the second case worldwide with RAF1 S259Y neomutation

International audienceNoonan syndrome and related disorders are a group of clinically and genetically heterogeneous conditions caused by mutations in genes of the RAS/MAPK pathway. Noonan syndrome causes multiple congenital anomalies, which are frequently accompanied by hypertrophic cardiomyopathy (HCM). We report here a Tunisian patient with a severe phenotype of Noonan syndrome including neonatal HCM, facial dysmorphism, severe failure to thrive, cutaneous abnormalities, pectus excavatum and severe stunted growth, who died in her eighth month of life. Using whole exome sequencing, we identified a de novo mutation in exon 7 of the RAF1 gene: c.776C > A (p.Ser259Tyr). This mutation affects a highly conserved serine residue, a main mediator of Raf-1 inhibition via phosphorylation. To our knowledge the c.776C > A mutation has been previously reported in only one case with prenatally diagnosed Noonan syndrome. Our study further supports the striking correlation of RAF1 mutations with HCM and highlights the clinical severity of Noonan syndrome associated with a RAF1 p.Ser259Tyr mutation

Chemical composition, antioxidant, and antimicrobial activities of Leaves of Ajuga iva

The main objective of this research was to study the biological characteristics in terms of antioxidant and antimicrobial activities of Ajuga iva and determine the best analytical and extraction methods applicable to this specie and studied compounds. A short screening of its nutritional value in terms of chemical composition is also included. A. iva leaves were analyzed for crude protein (CP), cell wall [neutral detergent fiber (NDF), acid detergent fiber (ADF), and acid detergent lignin (ADL)], minerals, fatty acids, essential oils, and phenolic compounds. Mature aerial parts of A. iva were randomly collected during the Spring season from Mograne-Zaghouan, Tunisia. Leaves of A. iva contained 13.4 ± 0.4% CP, 26.3 ± 0.35% NDF, 20.2 ± 0.42% ADF, and 5.13 ± 0.21% ADL. Mineral content (13.0 ± 0.45%) was mainly composed of potassium (4.5% g DM) and magnesium (4.25% DM). Leaves of A. iva had linolenic (26.29 ± 0.760%) and linoleic (37.66 ± 2.35%) acids as the main components of the acid profile. Thymol was found to be the most dominant (23.43%) essential oil, followed by 4-vinylguaiacol (14.27%) and linalool (13.66%). HPLC-PDA-ESI-MS/MS analysis pointed out the presence of phytoecdysteroids. Phenolic acids and flavonoids, such as glycosylated derivatives of naringenin, eriodyctiol, and apigenin, were detected in the methanol extract of A. iva leaves. Our results underline the importance of choosing proper extraction methods and solvents to extract and characterize the described compounds profile of A. iva leaves. Results also show A. iva leaves as a potential source of functional ingredients with beneficial health-promoting properties. Overall, leaves of A. iva have low biological activities (antioxidant and antimicrobial activities) with a chemical composition suitable as a feed for ruminants in rangeland pasture. It also has low-grade antibacterial or medicinal characteristics when fed to ruminants

Differentiation of Phenolic Composition Among Tunisian Thymus algeriensis Boiss. et Reut. (Lamiaceae) Populations: Correlation to Bioactive Activities

Twelve Tunisian Thymus algeriensis populations growing wild in different bioclimatic zones, extending from the subhumid to the upper-arid bioclimates, were compared regarding their phenolic composition and their ability to serve as antioxidant, anti-acetylcholinesterase, and antibacterial agents. A significant variation of phenol profile was observed between the analyzed populations, as assessed by ultra-high-performance liquid chromatography coupled with a diode array detector and an electrospray mass spectrometer (UHPLC-DAD-ESI/MSn) technique. Rosmarinic acid was the main phenolic compound in most populations (383.8–1157.8 µg/mL extract), but still, those from the upper-arid bioclimatic zone were distinguished by the presence of carvacrol (1374.7 and 2221.6 µg/mL extract), which was absent in the remaining ones. T. algeriensis methanolic extracts were found to possess a substantial antioxidant and anti-acetylcholinesterase activities, with significant variation observed between populations, which were correlated to their phenolic contents. The antibacterial activity of the extracts tested against seven bacteria was revealed only by populations collected from upper-arid bioclimate and mainly associated with the presence of carvacrol. Extracts revealed a bacteriostatic effect against all bacteria (MIC = 1.4 mg/mL). Yet, the bactericidal activity (MBC = 1.4mg/mL) was restricted to the gram-negative bacteria Escherchia coli

Polyphenolic Profiling, Quantitative Assessment and Biological Activities of Tunisian Native Mentha rotundifolia (L.) Huds.

Phenolic profiling of ten plant samples of Mentha rotundifolia (L.) Huds. collected from different bioclimatic areas of Tunisia, was for the first time carried out by using a fast ultra-high-performance liquid chromatography (UHPLC)-high resolution tandem mass spectrometry (HRMS/MS) method on a Q Exactive platform equipped with an electrospray ionization (ESI) source. An intraspecific, interpopulation variability was evidenced and a total of 17 polyphenolic metabolites were identified and quantified by using the UHPLC-HRESIMS/MS method, here validated for specificity, linearity, limit of detection, limit of quantitation, accuracy and precision. The quantitative method resulted sensitive at the nM level and reliable for rapid polyphenol quantification in vegetal matrices. The metabolomic study allowed us to identify a new compound, named salvianolic acid W, which was isolated and characterized mainly by NMR and MS analysis. A statistical correlation of the phenolic composition with antioxidant and anti-acetylcholinesterase activities was provided

Novel ALPK3 mutation in a Tunisian patient with pediatric cardiomyopathy and facio-thoraco-skeletal features.

International audiencePediatric cardiomyopathy is a complex disease with clinical and genetic heterogeneity. Recently, the ALPK3 gene was described as a new hereditary cardiomyopathy gene underlying pediatric cardiomyopathies. Only eight patients carrying mutations in ALPK3 have been reported to date. Here, we report a 3-year-old male patient with both hypertrophic and dilated cardiomyopathy. The patient presented dysmorphic features and skeletal deformities of hands and feet, pectus excavatum, and cleft palate. The genetic investigation was performed by whole-exome sequencing in the patient and his parents. We identified a novel homozygous mutation in ALPK3 (c.1531_1532delAA; p.Lys511Argfs*12). Our work extends the phenotypic spectrum of the ALPK3-associated cardiomyopathy by reporting additional clinical features. This is the first study of a Tunisian patient with mutation in the ALPK3 gene. In conclusion, ALPK3 should be included in the list of genes to be considered in genetic studies for patients affected with pediatric syndromic cardiomyopathy

Multiallelic rare variants support an oligogenic origin of sudden cardiac death in the young

International audienceUngeklärte plötzliche Todesfälle bei jungen Menschen sind in den meisten Fällen kardiovaskulärer Natur. Struktur- und Leitungsstörungen auf Basis von kardialen Gendefekten können im Zusammenspiel dem plötzlichen Herztod zugrunde liegen. Im vorliegenden Beitrag wird die klinische und ausführliche genetische Untersuchung einer tunesischen Familie mit plötzlichem Herztod junger Angehöriger beschrieben. Mit dem Ziel, die familiäre genetische Basis des plötzlichen Herztods zu identifizieren, wurden eine Exomsequenzierung („whole exome sequencing [WES]“), ein Read-depth-copy-number-variation(CNV)-Screening und eine Segregationsanalyse durchgeführt. Sechs äußerst seltene pathogene heterozygote Varianten in den Genen OBSCN, RYR2, DSC2, AKAP9, CACNA1C, RBM20 und eine homozygote Spleicingvariante im TECRL-Gen, die mit einem oligogenischen Vererbungsmodell vereinbar waren, wurden identifiziert. Die CNV-Analyse ergab keine ursächliche CNV im Einklang mit dem Familienphänotyp. Insgesamt deuten die Ergebnisse stark auf einen kumulativen Effekt heterozygoter Missense-Varianten als Krankheitsursache hin, wodurch sich der höhere Schweregrad der Erkrankung unter den Nachkommen erklärt. Die vorliegende Studie bestätigt erneut die Komplexität der Vererbung des plötzlichen Herztods und unterstreicht den Nutzen der familienbasierten WES und Segregationsanalyse bei der Identifikation familienspezifischer Mutationen in verschiedenen kardialen genetischen Mechanismen.Unexplained sudden death in the young is cardiovascular in most cases. Structural and conduction defects in cardiac-related genes can conspire to underlie sudden cardiac death. Here we report a clinical investigation and an extensive genetic assessment of a Tunisian family with sudden cardiac death in young members. In order to identify the family-genetic basis of sudden cardiac death, we performed Whole Exome Sequencing (WES), read depth copy-number-variation (CNV) screening and segregation analysis. We identify 6 ultra-rare pathogenic heterozygous variants in OBSCN, RYR2, DSC2, AKAP9, CACNA1C and RBM20 genes, and one homozygous splicing variant in TECRL gene consistent with an oligogenic model of inheritance. CNV analysis did not reveal any causative CNV consistent with the family phenotype. Overall, our results are highly suggestive for a cumulative effect of heterozygous missense variants as disease causation and to account for a greater disease severity among offspring. Our study further confirms the complexity of the inheritance of sudden cardiac death and highlights the utility of family-based WES and segregation analysis in the identification of family specific mutations within different cardiac genes pathways