{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T12:03:13Z","timestamp":1790424193157,"version":"4.1.0"},"reference-count":99,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["OMICS: A Journal of Integrative Biology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>\n                    Rett syndrome (RTT) is a severe neurodevelopmental disorder reported worldwide in diverse populations. RTT is diagnosed primarily in females, with clinical findings manifesting early in life. Despite the variable rates across populations, RTT has an estimated prevalence of \u223c1 in 10,000 live female births. Among 215 Saudi Arabian patients with neurodevelopmental and autism spectrum disorders, we identified 33 patients with RTT who were subsequently examined by genome-wide transcriptome and mitochondrial genome variations. To the best of our knowledge, this is the first in-depth molecular and multiomics analyses of a large cohort of Saudi RTT cases with a view to informing the underlying mechanisms of this disease that impact many patients and families worldwide. The patients were unrelated, except for 2 affected sisters, and comprised of 25 classic and eight atypical RTT cases. The cases were screened for methyl-CpG binding protein 2 (\n                    <jats:italic toggle=\"yes\">MECP2<\/jats:italic>\n                    ),\n                    <jats:italic toggle=\"yes\">CDKL5<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">FOXG1<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">NTNG1,<\/jats:italic>\n                    and mitochondrial DNA (mtDNA) variants, as well as copy number variations (CNVs) using a genome-wide experimental strategy. We found that 15 patients (13 classic and two atypical RTT) have\n                    <jats:italic toggle=\"yes\">MECP2<\/jats:italic>\n                    mutations, 2 of which were novel variants. Two patients had novel\n                    <jats:italic toggle=\"yes\">FOXG1<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">CDKL5<\/jats:italic>\n                    variants (both atypical RTT). Whole mtDNA sequencing of the patients who were MECP2 negative revealed two novel mtDNA variants in two classic RTT patients. Importantly, the whole-transcriptome analysis of our RTT patients' blood and further comparison with previous expression profiling of brain tissue from patients with RTT revealed 77 significantly dysregulated genes. The gene ontology and interaction network analysis indicated potentially critical roles of\n                    <jats:italic toggle=\"yes\">MAPK9<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">NDUFA5<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">ATR<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">SMARCA5<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">RPL23<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">SRSF3<\/jats:italic>\n                    , and mitochondrial dysfunction, oxidative stress response and MAPK signaling pathways in the pathogenesis of RTT genes. This study expands our knowledge on RTT disease networks and pathways as well as presents novel mutations and mtDNA alterations in RTT in a population sample that was not previously studied.\n                  <\/jats:p>","DOI":"10.1089\/omi.2019.0192","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T15:37:42Z","timestamp":1582817862000},"page":"160-171","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Rett Syndrome, a Neurodevelopmental Disorder, Whole-Transcriptome, and Mitochondrial Genome Multiomics Analyses Identify Novel Variations and Disease Pathways"],"prefix":"10.1177","volume":"24","author":[{"given":"Mazhor","family":"Aldosary","sequence":"first","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AlBandary","family":"Al-Bakheet","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesham","family":"Al-Dhalaan","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, and King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawan","family":"Almass","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maysoon","family":"Alsagob","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banan","family":"Al-Younes","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"AlQuait","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama Mufid","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Bulbul","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuhair","family":"Rahbeeni","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Alfadhel","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Centre, King Saud bin Abdulaziz University for Health Sciences, Genetics Division, Department of Pediatrics, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziza","family":"Chedrawi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, and King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuhair","family":"Al-Hassnan","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"AlDosari","sequence":"additional","affiliation":[{"name":"Center for Pediatric Neurosciences, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamad","family":"Al-Zaidan","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Al-Muhaizea","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, and King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moeenaldeen D.","family":"AlSayed","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa A.","family":"Salih","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, College of Medicine, King Saud University, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"AlShammari","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Faiyaz-Ul-Haque","sequence":"additional","affiliation":[{"name":"Department of Pathology and King Khalid Hospital, King Saud University, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Azhar","family":"Chishti","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, King Khalid Hospital, King Saud University, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olfat","family":"Al-Harazi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Al-Odaib","sequence":"additional","affiliation":[{"name":"Department of Genetics, King Faisal Specialist Hospital &amp; 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