Evidence map›Paper›PMID 32004447›Full record

ArticleAmerican journal of human genetics2020

Bi-allelic Variants in RALGAPA1 Cause Profound Neurodevelopmental Disability, Muscular Hypotonia, Infantile Spasms, and Feeding Abnormalities.

Matias Wagner, Yuliya Skorobogatko, Ben Pode-Shakked, Cynthia M Powell, Bader Alhaddad, Annette Seibt, Ortal Barel, Gali Heimer, Chen Hoffmann, Laurie A Demmer and 15 more

Open access · bronzeAbstract read
In one paragraph

Article in American journal of human genetics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
1.9field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 34 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 11 institutions in 4 countries.

Matias WagnerInstitute of Human Genetics, Technical University München, 81675 Munich, Germany; Institute of Human Genetics, Helmholtz Zentrum München, 85764 Neuherberg, Germany; Institute for Neurogenomics, Helmholtz Zentrum München, 85764 Neuherberg, Germany. Electronic address: Matias.Wagner@mri.tum.de.
Yuliya SkorobogatkoDepartment of Medicine, University of California, San Diego School of Medicine, La Jolla, CA 92093, USA.
Ben Pode-ShakkedMetabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621 Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, 6997801 Tel-Aviv, Israel.
Cynthia M PowellDepartment of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, 27599, USA.
Bader AlhaddadInstitute of Human Genetics, Technical University München, 81675 Munich, Germany.
Annette SeibtDepartment of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany.
Ortal BarelGenomics Unit, Sheba Cancer Research Center, Sheba Medical Center, 52621 Tel-Hashomer, Israel.
Gali HeimerSackler Faculty of Medicine, Tel-Aviv University, 6997801 Tel-Aviv, Israel; Pediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621 Tel-Hashomer, Israel.
Chen HoffmannSackler Faculty of Medicine, Tel-Aviv University, 6997801 Tel-Aviv, Israel; Department of Radiology, Sheba Medical Center, 52621 Tel-Hashomer, Israel.
Laurie A DemmerMedical Genetics, Atrium Health Levine Children's Hospital, Charlotte, NC, 28203, USA.
Yezmin Perilla-YoungDepartment of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, 27599, USA.
Marc RemkeDepartment of Pediatric Oncology, Hematology, and Clinical Immunology, Medical Faculty, University Hospital Düsseldorf, 40225 Düsseldorf, Germany.
Dagmar WieczorekInstitute of Human Genetics, Medical Faculty, Heinrich Heine University, 40225 Düsseldorf, Germany.
Tharsini NavaratnarajahDepartment of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany.
Peter LichtnerInstitute of Human Genetics, Helmholtz Zentrum München, 85764 Neuherberg, Germany.
Dirk KleeDepartment of Diagnostic and Interventional Radiology, Heinrich-Heine University, 40225 Düsseldorf, Germany.
Hanan E ShamseldinDepartment of Genetics, King Faisal Specialist Hospital and Research Center, 12713 Riyadh, Saudi Arabia.
Fuad Al MutairiDivision of Genetics, Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, 12713 Riyadh, Saudi Arabia.
Ertan MayatepekDepartment of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany.
Tim StromInstitute of Human Genetics, Technical University München, 81675 Munich, Germany.
Thomas MeitingerInstitute of Human Genetics, Technical University München, 81675 Munich, Germany; Institute of Human Genetics, Helmholtz Zentrum München, 85764 Neuherberg, Germany.
Fowzan S AlkurayaDepartment of Genetics, King Faisal Specialist Hospital and Research Center, 12713 Riyadh, Saudi Arabia.
Yair AniksterMetabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621 Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, 6997801 Tel-Aviv, Israel.
Alan R SaltielDepartment of Medicine, University of California, San Diego School of Medicine, La Jolla, CA 92093, USA.
Felix DistelmaierDepartment of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany. Electronic address: felix.distelmaier@med.uni-duesseldorf.de.
Düsseldorf University Hospital · DETel Aviv University · ILHelmholtz Zentrum München · DEHeinrich Heine University Düsseldorf · DEKing Faisal Specialist Hospital & Research Centre · SATechnical University of Munich · DEUniversity of California San Diego · USUniversity of North Carolina at Chapel Hill · USKing Saud bin Abdulaziz University for Health Sciences · SALevine Children's Hospital · USSheba Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ral (Ras-like) GTPases play an important role in the control of cell migration and have been implicated in Ras-mediated tumorigenicity. Recently, variants in RALA were also described as a cause of intellectual disability and developmental delay, indicating the relevance of this pathway to neuropediatric diseases. Here, we report the identification of bi-allelic variants in RALGAPA1 (encoding Ral GTPase activating protein catalytic alpha subunit 1) in four unrelated individuals with profound neurodevelopmental disability, muscular hypotonia, feeding abnormalities, recurrent fever episodes, and infantile spasms . Dysplasia of corpus callosum with focal thinning of the posterior part and characteristic facial features appeared to be unifying findings. RalGAPA1 was absent in the fibroblasts derived from two affected individuals suggesting a loss-of-function effect of the RALGAPA1 variants. Consequently, RalA activity was increased in these cell lines, which is in keeping with the idea that RalGAPA1 deficiency causes a constitutive activation of RalA. Additionally, levels of RalGAPB, a scaffolding subunit of the RalGAP complex, were dramatically reduced, indicating a dysfunctional RalGAP complex. Moreover, RalGAPA1 deficiency clearly increased cell-surface levels of lipid raft components in detached fibroblasts, which might indicate that anchorage-dependence of cell growth signaling is disturbed. Our findings indicate that the dysregulation of the RalA pathway has an important impact on neuronal function and brain development. In light of the partially overlapping phenotype between RALA- and RALGAPA1-associated diseases, it appears likely that dysregulation of the RalA signaling pathway leads to a distinct group of genetic syndromes that we suggest could be named RALopathies.

Indexed as

MutationAllelesCell MovementCell ProliferationChild, PreschoolFamilyFeeding and Eating DisordersFemaleGTPase-Activating ProteinsHumansInfantMaleMuscle HypotoniaNerve Tissue ProteinsNeurodevelopmental DisordersPhenotypeGTPase-Activating ProteinsNerve Tissue ProteinsRALGAPA1 protein, humanepilepsyGARNL1muscular hypotonianeurodevelopmental disorderRalA signalingTULIP1West syndrome

Identifiers

PMID32004447
PMCPMC7010976
OpenAlexW3004341876

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.