Combining RSPH9 founder mutation screening and next-generation sequencing analysis is efficient for primary ciliary dyskinesia diagnosis in Saudi patients.

Primary ciliary dyskinesia (PCD) is a clinically and genetically heterogeneous ciliopathy. Dysfunction of motile respiratory and nodal cilia results in sinopulmonary symptoms associated with laterality defects (LD) found in half of the patients. The molecular basis of the disease is insufficiently investigated in patients originating from the Arabian Peninsula. In a group of 16 unrelated Saudi patients clinically suspected of PCD and among whom only 5 (31%) had LD, we first screened by PCR-RFLP two founder mutations, RSPH9 c.804_806del and CCDC39 c.2190del previously identified in patients from the Arabian Peninsula and Tunisia, respectively. When negative, targeted panel or whole-exome sequencing was performed. Three patients were homozygous for the mutation in RSPH9, which encodes an axonemal protein that is absent from nodal cilia. None of the patients carried the CCDC39 founder mutation frequent in Tunisia. NGS analysis showed that nine patients had homozygous mutations in PCD genes. In total, sequential RFLP and NGS analysis solved 75% (12/16) of cases and identified ten distinct mutations, among which six are novel, in nine different genes. These results, which highlight the genetic heterogeneity of PCD in Saudi Arabia, show that the RSPH9 c.804_806del mutation is a prevalent mutation among Saudi patients, whereas the CCDC39 c.2190del ancestral allele is most likely related to the Berber population. This study shows that RSPH9 founder mutation first-line screening and NGS analysis is efficient for the genetic exploration of PCD in Saudi patients. The RSPH9 founder mutation accounts for the low rate of LD among Saudi patients.

Primary ciliary dyskinesia gene contribution in Tunisia: Identification of a major Mediterranean allele.

Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disease of motile cilia. Even though PCD is widely studied, North-African patients have been rarely explored. In this study, we aim at confirming the clinical diagnosis and explore the genetic spectrum of PCD in a cohort of Tunisian patients. Forty clinically diagnosed patients with PCD belonging to 34 families were recruited from Tunisian pediatric departments. In each proband, targeted capture PCD panel sequencing of the 40 PCD genes was performed. PCD panel sequencing identified bi-allelic mutations in 82% of the families in eight PCD genes. Remarkably, 23.5% of patients carried the same c.2190del CCDC39 mutation. Single nucleotide polymorphism profiling in six unrelated patients carrying this mutation has revealed a founder effect in North-African patients. This mutation is estimated to date back at least 1,400-1,750 years ago. The identification of this major allele allowed us to suggest a cost-effective genetic diagnostic strategy in North-African patients with PCD.

Molecular characterization of multidrug resistant E. coli associated to urinary tract infection in Taif, Saudi Arabia.

Escherichia coli account approximately to 85% of the Urinary tract infection. UTI affect the different parts of the urinary tract and is considered as a common bacterial infection. The infection is caused as a consequence of the urinary tract bacterial invasion. E. coli were isolated from the urine of UTI patients referred to King Abdulaziz Specialist Hospital, Taif, Saudi Arabia. Antibiotics susceptibility was tested on 25 antibiotics using the disc diffusion method. The prevalence of antibiotics resistance genes was realized by Polymerase Chain Reaction (PCR). Results showed heterogenicity in the percentage of antibiotics resistance from 100% for penicillin to 2% for imipenem. 30% of the isolates appeared as for Extended-Spectrum Beta-Lactamase (ESBL) positive and 74% are multidrug resistance strains. Distribution of antibiotic resistance genes showed that aac(3)-IV and blaSHV genes were identified in 33.33% of isolates. In addition, qnrA, blaCMY and dfrA1 genes were founded in 37.25%, 19.60% and 17.64% of the isolates respectively. In total, 17 different genotypes were detected, and 12 isolates (24%) do not include any genes in their genomes. Multi-drug resistant E. coli have antibiotics profiles highly variable and the mechanism of resistance was not correlated to the investigated genes.

Prevention of autoimmunity and control of recall response to exogenous antigen by Fas death receptor ligand expression on T cells.

Mice with mutations in the gene encoding Fas ligand (FasL) develop lymphoproliferation and systemic autoimmune diseases. However, the cellular subset responsible for the prevention of autoimmunity in FasL-deficient mice remains undetermined. Here, we show that mice with FasL loss on either B or T cells had identical life span as littermates, and both genotypes developed signs of autoimmunity. In addition, we show that T cell-dependent death was vital for the elimination of aberrant T cells and for controlling the numbers of B cells and dendritic cells that dampen autoimmune responses. Furthermore, we show that the loss of FasL on T cells affected the follicular dentritic cell network in the germinal centers, leading to an impaired recall response to exogenous antigen. These results disclose the distinct roles of cellular subsets in FasL-dependent control of autoimmunity and provide further insight into the role of FasL in humoral immunity.

Overexpression of yeast thioredoxin TRX2 reduces p53-mediated cell death in yeast.

We have previously shown that overexpression of the human tumor suppressor protein P53 causes cell death of the yeast Saccharomyces cerevisiae. P53 overproduction led to transcriptional downregulation of some yeast genes, such as the TRX1/2 thioredoxin system, which plays a key role in cell protection against various oxidative stresses induced by reactive oxygen species (ROS). In the present work, the impact of TRX2 overexpression on apoptosis mediated by p53 overexpression in yeast is investigated. In yeast cells expressing P53 under an inducible promoter together with TRX2 under a strong constitutive promoter, we showed that Tr2p overproduction reduced the apoptotic effect exerted by P53 and increased the viability of the P53-overproducing cells. Furthermore, measurements of ROS amounts by flow cytometry and fluorescence microscopy indicated that the TRX2 protein acted probably through its increased detoxifying activity on the P53-generated ROS. The steady-state level and activity of P53 were not affected by TRX2 overexpression, as shown by western blotting and functional analysis of separated alleles in yeast (FASAY), respectively. The growth inhibitory effect of P53 was partially reversed by the antioxidant N-acetylcysteine. Our data strengthen the idea that overexpression of a single gene (trx2) decreases the p53-mediated cell death by decreasing ROS accumulation.

Expression of the human tumor suppressor p53 induces cell death in Pichia pastoris.

The human tumor suppressor p53 is known as guardian of genome because of its involvement in many signals related to cell life or death. In this work, we report that human p53 induces cell death in the yeast Pichia pastoris. We showed a growth inhibition effect, which increased with the p53 protein expression level in recombinant Mut(s) (methanol utilization slow) strain of Pichia. However, no effect of p53 was observed in recombinant strain of Mut(+) (methanol utilization plus) phenotype. Interestingly, human p53 induces cell death in recombinant strains Mut(s) with characteristic markers of apoptosis such as DNA fragmentation, exposure of phosphatidylserine, and reactive oxygen species generation. Taken together, our results strongly suggest that human p53 is biologically active in this heterologous context. Thus, we propose that P. pastoris could be a useful tool to better understand the biological function of human p53.

Molecular characterization of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from King Abdulaziz Specialist Hospital at Taif City, Saudi Arabia.

Klebsiella pneumoniae is an opportunistic pathogen responsible for a significant proportion of nosocomial and community-acquired infections. Genotypic variation in K. pneumoniae populations is a major barrier to control public health risk associated with pathogen. In this work, thirty K. pneumoniae were recovered from hospital and were tested for their resistance to antibiotics. Genetic variability of the isolates was performed using PCR based on genes coding for porins and efflux pumps, (GTG)5 and BOX repetitive sequences. K. pneumoniae showed heterogenicity of resistance to antibiotics based on gender or specimen type. Further, out of 30 isolates, 25 different profiles were found and 83.33% are multidrug-resistant. PCR detection of genes coding for porins and efflux pumps revealed seven different genotypes and strong correlation between antibiotics resistance profiles and investigated genes. PCR genomic fingerprinting showed high genetic diversity of K. pneumoniae. BOX-PCR and (GTG)5 generated 18 and 19 clusters with discriminatory indexes 0.97 and 0.98, respectively at 80% of similarity. K. pneumoniae clinical isolates showed high phenotypic and genetic variability, and many strains can be circulating simultaneously. This genetic variability should be taken into consideration when designing strategies for controlling K. pneumoniae outbreaks. In addition, a significant correlation, was detected for the first time, between (GTG)5-genotyping and antibiotic resistance patterns of K. pneumoniae and could be valuable in the prediction of antibiotic resistance profiles of K. pneumoniae.

Molecular Investigation of Multidrug-Resistant Escherichia coli Clinical Isolates from Patients with Urinary Tract Infections.

<b>Background and Objective:</b> Urinary tract infections believe to be one of the main acquainted infections by <i>Escherichia coli</i> in hospitals with an excessive incidence of illness. This study aimed to analyze the antibiotic resistance profile and molecular characteristics of <i>E. coli</i> isolates recovered from patients with urinary tract infection at different hospitals in Taif Governorate, Saudi Arabia. <b>Materials and Methods:</b> Out of 143 isolates collected for 11 months, from February-December 2019, 24 isolates were identified as <i>E. coli</i> by API system and 16S rRNA sequences techniques. An antibiotic sensitivity test was performed using the disk diffusion method. Besides, the repetitive sequence repeat-PCR (Rep-PCR) technique was used for genotyping the 24 isolates. <b>Results:</b> Almost all isolates were resistant to most tested antibiotics such as ampicillin, ceftazidime, cefepime, trimethoprim/sulfamethoxazole, amox/clavulanic. The PCR results show that virulence genes <i>kpsII</i> and <i>yaiO</i> were detected in all <i>E. coli</i> isolates. <i>Stx1</i>, <i>fimH</i>, <i>hly</i> and <i>uidA</i> were moderate detected in all isolates. <b>Conclusion:</b> The high frequencies of antibiotic-resistant <i>E. coli</i> isolates in patients with urinary tract infections in the current study suggest that continuous surveillance of the use of appropriate antibiotics is required and that control of infections is necessary.

A novel DNAH5 variant in a Tunisian patient with primary ciliary dyskinesia.

Primary ciliary dyskinesia (PCD) is a genetically heterogeneous hereditary disease caused by the structural abnormalities and dysfunction of motile cilia. The DNAH5 is the most frequently mutated gene in PCD patients and hot spot exons were reported in this gene. Here, we aim to screen mutations in a set of five hot spot exons of DNAH5 gene in a cohort of 10 clinically diagnosed Tunisian PCD patients using an optimized polymerase chain reaction-single-strand conformational polymorphism screening technique. Only one patient harboured a novel heterozygous variant in exon 63 (c.10767A>G), which was inherited from his father. This variant activates a cryptic splicing site. No deleterious mutation has been identified while screening the exons of the remaining patients. Our results show that the reported hot spot exons of DNAH5 gene are not mutated in Tunisian PCD patients. This is probably due to the differences of ethnical background of the previously reported patients. Further investigations should be performed to identify the mutations underlying PCD in this group of patients.

A more accurate detection of codon 72 polymorphism and LOH of the TP53 gene.

The polymorphism at codon 72 of the TP53 gene has been extensively studied for its involvement in cancerogenesis and loss of heterozygosity (LOH) detection. Usually, the exon 4 of the TP53 gene is amplified by polymerase chain reaction (PCR) on DNA extracted from blood and tumor tissues, then digested by AccII. In the case of heterozygosity, the comparison of AccII profile from blood and tumor DNA PCR products allowed the identification of a potential LOH in the TP53 locus. This method can be hindered by a partial AccII digestion and/or DNA contamination of non-tumor cells. To circumvent these problems, we have developed a new approach by using the AccII restriction site between exon 4 and exon 6. The PCR amplification of exon 4-6, followed by AccII digestion allowed us to detect without ambiguity any LOH case.

No evidence of correlation between p53 codon 72 polymorphism and risk of bladder or breast carcinoma in Tunisian patients.

The TP53 gene, frequently mutated in human cancers, carries several polymorphisms. The one most informative and studied concerns codon 72; a single base changes the CGC (arginine) to CCC (proline). The arginine form was considered to be a significant risk factor in the development of cancer. However, various reports on this polymorphism are controversial. We carried out the same investigation in two groups of patients, a group with bladder cancer and another with breast cancer, and in healthy controls in two regions of our country, using an improved PCR-RFLP method. The number of Arg/Arg, Arg/Pro, and Pro/Pro genotypes was as follows: 21, 23, 3 and 13, 19, 2 for patients (total 47) and controls (34), respectively, in the first group; 18, 9, 3 and 19, 26, 4 for patients (30) and controls (49), respectively, in the second group. Statistical analysis of the genotype and allele frequencies did not reveal any difference between patients and controls in both groups except for a weak difference between the homozygotes to heterozygotes in the second group with a chi square of 4.1 (P = 0.045); the number of breast cancer patients is actually low (30) and should be increased in order to assess such a conclusion. Our overall results are therefore not consistent with a high risk associated with TP53 codon 72 polymorphism in breast and in bladder cancers.

A proposed mouse model to study male infertility provoked by genital serovar E, Chlamydia trachomatis.

Chlamydia trachomatis is a common sexually transmitted pathogen. The impact of chlamydial infection on male infertility is controversial. The aim of this study was to assess the role of C trachomatis human genital serovar E on sperm function, induction of apoptosis in spermatozoa, and reproductive performance, using the Swiss male mice model. Fertile mice were inoculated in the meatus urethra with 10(6) C trachomatis inclusion-forming units at day 0. The studied parameters were evaluated 7, 15, 21, and 30 days postinoculation (pi) in infected and sham-infected controls. Semen parameters of the infected mice groups were significantly lower than those of the control groups at the different days pi. DNA fragmentation study indicated that the mean percentages of apoptotic spermatozoa in the infected mice groups were significantly higher than those in the control groups 7 and 15 days pi, whereas the mean percentages of necrotic spermatozoa in the infected mice groups were significantly higher than those in the control group on the 30th day pi. A decrease in reproductive performance was observed at different days pi in infected male mice groups when compared to the control groups. Furthermore, a statistically significant decrease in the mean number of infant mice was observed at 21 and 30 days pi. In conclusion, our data showed that inoculation of fertile male Swiss mice in the meatus urethra with C trachomatis could lead to alteration of semen parameters, induction of apoptosis in spermatozoa, and decrease of the reproductive performance of male mice.

Haplotype analysis of p53 polymorphisms: Arg72Pro, Ins16bp and G13964C in Tunisian patients with familial or sporadic breast cancer.

BACKGROUND: The p53 polymorphisms have been extensively studied as putative breast cancer susceptibility variants. The present study was undertaken to investigate the association of p53 Arg72Pro, Ins16bp and G13964C polymorphisms and their haplotypes with breast cancer risk in Tunisian women. METHODS: Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on 159 patients and 132 controls. RESULTS: The G13964C intronic variant was significantly associated with familial breast cancer risk (p=0.0018) while the genotypic distribution was similar for p53 Arg72Pro and Ins16bp in patients and controls. Moreover, the (NoIns-C), (Arg-C) and (NoIns-Arg-C) haplotypes were significantly associated with familial breast cancer risk (p=0.0021, p=0.0096 and p=0.0084, respectively) while there was a trend of association between the (Ins-Arg) and (Ins-Arg-G) haplotypes and the risk of sporadic breast cancer. Only the G/C genotype as well as the (NoIns-C) haplotype remained significant after correction for multiple testing. CONCLUSION: Our data revealed an association between the G/C genotype and the (NoIns-C) haplotype and the risk of familial breast cancer in Tunisian women. However, these observations need to be confirmed due to the limited statistical power of our study and the small number of cases.

Human p53 induces cell death and downregulates thioredoxin expression in Saccharomyces cerevisiae.

The p53 tumour suppressor protein has a crucial role in controlling cell cycle and apoptosis in human cells and its inactivation by selective point mutations is associated with human cancers. Here we show that overexpression of the human wild-type (wt) p53 in Saccharomyces cerevisiae completely inhibits yeast growth under minimal media conditions. In contrast, the R248W 'hot spot' p53 mutant (one of the most frequent p53 mutations encountered in human cancers) does not impair yeast growth. Moreover, we report, for the first time, that the human wt p53 induces yeast cell death with characteristic markers of apoptosis: exposure of phosphatidylserine and DNA strand cleavage as shown by Annexin V staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling assay, respectively. In addition, p53 also has an impact on the expression of yeast genes. Using differential display and Northern blot analysis, we demonstrated that human wt p53 expression in yeast leads to gene repression of thioredoxin (TRX1/2), a highly conserved multifunctional antioxidative and antiapoptotic protein family. Accordingly, we demonstrated that reactive oxygen species (ROS) are highly produced in p53 yeast induced cell death as shown by dihydrorhodamine 123 staining. These results suggest that the generation of ROS is a key event in p53 yeast induced cell death.