Genetic Profile of Epidermolysis Bullosa Cases in King Abdulaziz Medical City, Riyadh, Saudi Arabia

Raghad Alharthi; Muhannad A Alnahdi; Ahad Alharthi; Seba Almutairi; Sultan Al-Khenaizan; Mohammed A AlBalwi

doi:10.3389/fgene.2021.753229

Genetic Profile of Epidermolysis Bullosa Cases in King Abdulaziz Medical City, Riyadh, Saudi Arabia

Front Genet. 2022 Feb 10:12:753229. doi: 10.3389/fgene.2021.753229. eCollection 2021.

Authors

Raghad Alharthi^{1

2}, Muhannad A Alnahdi^{1

3}, Ahad Alharthi¹, Seba Almutairi^{1

4}, Sultan Al-Khenaizan^{1

2}, Mohammed A AlBalwi^{1

5

6}

Affiliations

¹ College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
² Department of Dermatology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
³ Department of Ophthalmology, Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
⁴ Department of Dermatology, King Fahad University Hospital, Al Khobar, Saudi Arabia.
⁵ Department of Pathology and Laboratory Medicine, Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
⁶ Medical Genomic Research Department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

Abstract

Epidermolysis bullosa (EB) is a rare heterogeneous genetic mechanobullous skin disorder that is characterized by increased skin fragility leading to blistering following minor trauma. EB may be inherited as an autosomal dominant or an autosomal recessive disorder and can be classified into dystrophic EB (DEB), junctional EB (JEB), and EB simplex (EBS). A total of 28 Saudi patients with EB were included in this observational, retrospective chart-review study. A consecutive non-probability sampling technique was used to approach all affected patients. Molecular analysis was done to test the patients' genomic DNA using a custom-designed AmpliSeq panel of suspected genes. All disease-causing variants were checked against available public databases. Twelve patients (42.9%) were found to have DEB, 6 patients (21.4%) with JEB, and 10 patients (35.7%) with EBS. The molecular genetic results revealed detections of 24 various homozygous genetic variations in the genes associated with EB, of which 14 were novel mutations. The most frequent variations were detected in COL7A1 in 12 cases (42.9%), followed by LAMB3 in 5 cases (17.9%), TGM5 in 4 cases (14.3%), and other genes. Furthermore, the majority (87.5%) of EB cases were confirmed to have homozygous mutations, and few were documented with positive consanguinity history. Only 3 cases (12.5%) were found to be autosomal dominant displaying heterozygous mutations. This is the first study to establish the EB genetic profile in Saudi Arabia where DEB is the most frequent type. A total of 14 novel mutations were identified that had not been previously reported. Consanguineous marriage is clearly recognized in the Saudi population; therefore, we propose a nationwide EB program that would help extend the spectrum of the genetic profile and help in the diagnosis and better understanding of this disease.

Keywords: Saudi Arabia; dystrophic epidermolysis bullosa; epidermolysis bullosa; epidermolysis bullosa simplex; junctional epidermolysis bullosa.