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PubMed2026

A multicenter randomized phase II/III trial of salvage treatment for refractory primary central nervous system lymphoma using tirabrutinib: JCOG2314 (ReSTART).

Primary central nervous system lymphoma (PCNSL) is an aggressive malignancy. Patients refractory to high-dose methotrexate-based induction therapy have an extremely poor prognosis. Although whole-brain radiotherapy (WBRT) is the standard salvage treatment and provides potent tumor control, early functional deterioration and late neurocognitive toxicity remain major concerns. A phase I/II trial on relapsed or refractory PCNSL demonstrated favorable efficacy and tolerability of tirabrutinib, a second-generation selective Bruton's tyrosine kinase inhibitor. Tirabrutinib's oral administration has enabled outpatient management. However, its clinical value for induction-refractory PCNSL remains uncertain. We designed a multicenter, randomized phase II/III trial (JCOG2314) to assess the non-inferiority of tirabrutinib to WBRT in overall survival and its potential to reduce functional deterioration and cognitive impairment. A total of 94 patients from 49 institutions will be enrolled over 4 years. The trial has been registered in the Japan Registry of Clinical Trials (study number: jRCT1031250645).

Humans↗

PubMed2026

Integrating genetic predictors into subsequent breast cancer risk prediction in survivors of childhood cancer.

PURPOSE: Female survivors of childhood cancer are at high risk for developing breast cancer. The contributions of most general population primary breast cancer genetic predictors to this risk have not been explored. METHODS: Analyses included females who survived ≥5 years after their childhood cancer diagnosis with available array (N = 2096, subsequent breast cancer [SBC]=218) or whole-genome sequencing (WGS; N = 3292, SBC=101) data from the Childhood Cancer Survivor Study and St. Jude Lifetime Cohort. We computed 99 externally-validated primary breast cancer polygenic risk scores (PRS). Using deep-coverage WGS, ClinVar-annotated pathogenic/likely pathogenic (P/LP) variants in breast cancer susceptibility genes were identified. Cox proportional hazards models assessed associations with SBC risk, adjusting for treatments and genetic ancestry. RESULTS: Among 5388 female survivors (genetic ancestry, European: N = 4,752; African: N = 444; East Asian: N = 192), 319 developed SBC. Most (90.9%) PRSs were nominally associated with SBC risk (P < 0.05), but effect sizes varied substantially. PRSs with superior discriminatory ability had greater genome-wide coverage (e.g., 6.4 million-variant PRS, HR per SD = 1.71, 95% CI = 1.43 to 2.05; P = 4.2x10-9) and 7.7-fold higher odds (P = 7.0x10-4) of including variants in multiple DNA damage repair pathways compared with PRSs with weaker risk associations. Among survivors with WGS, 1.6% carried P/LP variants in clinical testing panel genes, which was associated with a 7.4-fold greater risk (95% CI = 3.16 to 17.19). Including genetic factors improved SBC risk prediction by age 40 (P < 0.001) compared to treatment exposures alone. CONCLUSIONS: Externally-validated primary breast cancer genetic susceptibility predictors are relevant for SBC risk prediction and should be prioritized for risk stratification in survivors.

Journal Article↗

PubMed2026

Translating Flood-Tolerance Biology into Breeding: A 5D Framework for Next-Generation Rice Varieties.

Flooding is among the most devastating abiotic stresses limiting rice productivity. Although SUB1A introgression conferred submergence tolerance in several mega-varieties, this single-gene approach is insufficient for the diverse flood types-flash floods, stagnant floods, anaerobic germination, and deepwater inundation-progressively intensifying with climate change. Here, we review the physiological mechanisms and genetic architecture underlying tolerance to each flood type, emphasizing the dual role of reactive oxygen species (ROS) in signalling and damage, the management of elemental toxicities (Fe2+, Mn2+) under altered soil redox, and lessons from wetland species and lowland rice. We then examine why marker-assisted selection has failed for polygenic, multi-stress tolerance and identify persistent breeding bottlenecks. Building on this biological foundation, we outline an integrated 5D framework (Demand, Discovery, Design, Development, Deployment) that links gene-bank diversity, multi-omics discovery, predictive breeding and on-farm validation through continuous feedback. We discuss how connected breeding, the transition-from-trait-to-environment (TTE) strategy, and speed breeding can accelerate genetic gain, and we close with research priorities centred on the biology of multi-flood tolerance to develop climate-resilient rice.

5D breeding framework↗

PubMed2026

Acquisition and erosion of toxin-antitoxin systems in bacterial chromosomes.

Toxin-antitoxin systems (TAs) are widespread in bacterial genomes. Yet, their integration, persistence, and impact in chromosome dynamics remain unclear. Here, we identified 80 type II TAs in the single chromosome of Photorhabdus laumondii TT01, 50 of which were experimentally validated. Comparative analysis across the Photorhabdus genus revealed a highly heterogeneous distribution, with TAs frequently clustering within discrete genomic regions, either alone or associated with cointegrate-forming transposases and integrases. TAs rarely clustered with other putative defense systems and are preferentially associated with different types of recombinases, suggesting distinct pathways of acquisition for the two types of functions. Functional analyses showed that most validated TAs display addictive properties and stabilize plasmids. These addictive TAs are preferentially located in genomic regions characterized by high gene turnover, consistent with recent acquisition events. Despite their plasmid-stabilizing capacity, TAs do not promote long-term conservation of their immediate chromosomal neighborhoods. Instead, we observed frequent TA loss, either through complete deletion or toxin pseudogenization, indicating relaxed selection for their persistence in bacterial lineages. We propose a stepwise model for TA evolution in bacterial chromosomes: initial acquisition mediated by mobile genetic elements, preferential integration into permissive genomic regions, subsequent genetic streamlining of linked loci, and progressive gene loss. The short-lasting linkage between TAs and their genomic neighborhoods is consistent with the view that TA modules can behave as autonomous, selfish genetic elements.

Journal Article↗

PubMed2026

Long-read based detection of large copy number variants with potential functional significance using the ContextSV structural variant caller.

Long-read sequencing enables improved detection of structural variants (SVs) in the human genome due to its substantially increased read lengths. However, currently widely used long-read SV callers primarily rely on alignment-based evidence, limiting their ability to detect large and complex SVs and potentially missing disease-relevant events. To address these limitations, we developed ContextSV, a framework that integrates alignment evidence with copy number predictions derived from sequencing coverage and single-nucleotide variant allele frequencies to improve SV detection, particularly for large copy number variants (CNVs). We additionally developed ContextScore, a machine learning-based classification model to assign SV confidence scores based on genomic context features and integrated it within ContextSV. Through benchmarking analyses on both simulated and real datasets, we demonstrate that ContextSV improves detection of large CNVs and inversions that may be missed by existing long-read SV callers. We further illustrate its utility by identifying and experimentally validating multiple large SVs in the KOLF2.1J reference stem cell line that were not detected by other methods. Collectively, our results demonstrate that ContextSV serves as a valuable complement to existing long-read SV detection approaches by improving sensitivity for large and clinically relevant SVs.

Humans↗

PubMed2026

Global prevalence of metabolic syndrome in adults with obstructive sleep apnea: a systematic review and meta-analysis.

STUDY OBJECTIVES: Metabolic syndrome (MetS) is considered to exhibit increased prevalence among adults with obstructive sleep apnea (OSA), but the reported prevalence estimates among such patients vary. Thus, this systematic review and meta-analysis aimed to investigate the global prevalence of MetS in adults with confirmed OSA. MATERIALS AND METHODS: Ovid Medline, Embase, CINAHL, and the Cochrane Library databases were searched for all primary studies published in English that used standard polysomnography for OSA diagnosis and reported MetS estimates. At least two reviewers independently screened for eligible studies, extracted data, and graded the risk of bias using the Risk of Bias Assessment Tool for Non-randomised Studies. Three-level random-effects model was applied for the meta-analysis, reporting pooled prevalence estimate with 95% confidence intervals (CIs). Pre-specified subgroup analyses and meta-regression were also performed. Heterogeneity was quantified using I2 and chi-square statistics. RESULTS: A total of 102 studies were eligible for inclusion (34 013 adults with OSA from 28 countries). The combined MetS prevalence was 55.4% (95% CI: 51.0%, 59.8%). Considerable heterogeneity was noted among the included studies (I2 = 97.8%), whilst the risk of bias ranged from low to high. Subgroup analysis examining the effects of geographic region, study design, MetS definition, and apnea-hypopnea index threshold showed a significant variation in prevalence estimates across most subgroups (p < 0.0001). Meta-regression analysis indicated a positive association between mean body mass index (β = 0.0772, t = 4.56, p < 0.0001) and MetS prevalence. CONCLUSIONS: MetS has a high prevalence among adults with polysomnography-confirmed OSA, underscoring the need for prompt MetS screening in these patients. Future longitudinal and genetic/mechanistic studies should investigate the factors accounting for this association. PROSPERO REGISTRATION NUMBER: CRD420251073055.

Humans↗

PubMed2026

Daridorexant in severe obstructive sleep apnea: effects on sleep-disordered breathing and sleep.

STUDY OBJECTIVES: To evaluate the effect of daridorexant on nighttime respiratory function and sleep in adults with severe obstructive sleep apnea (OSA) without insomnia. MATERIALS AND METHODS: This randomized, double-blind, placebo-controlled, two-period, crossover trial was conducted at a single sleep center in 16 adults (≥18 years) with severe OSA without insomnia. In each period, daridorexant 50 mg or placebo was administered every evening for 5 days. Primary and secondary endpoints were the treatment differences (daridorexant-placebo) for apnea/hypopnea index (AHI) and oxygen saturation (SpO2) during total sleep time (TST), respectively, after last dosing. A mean increase in AHI ≥10 events/h and mean decrease in nocturnal SpO2 ≤-2% were the minimum changes considered to be clinically meaningful negative effects. Other endpoints included TST, latency to persistent sleep (LPS), and wake after sleep onset (WASO). RESULTS: Mean baseline AHI was 51.2 events/h (range 30.8, 82.2) and mean SpO2 during TST was 92.1% (range 88.5, 94.3). No clinically meaningful effect of daridorexant on AHI or SpO2 during TST was detected. Treatment differences were -3.7 events/h (one-sided 95% CI ≤ +4.2) and - 0.12 % (one-sided 95% CI ≥ -0.6), respectively. Compared with placebo, daridorexant increased TST by 32.5 min (90% CI: 6.9, 58.2), associated with shorter LPS (-10.3 min [90% CI: -20.6, -0.02]) and a trend towards reduced WASO (-15.2 min [-31.2, 0.9]). Four adverse events were reported (daridorexant n = 3; placebo n = 1), all of mild intensity and none related to respiratory function. CONCLUSION: Short-term treatment with daridorexant does not impair sleep-disordered breathing and may improve sleep in patients with severe OSA. CLINICAL TRIAL: ClinicalTrials.gov, https://clinicaltrials.gov/study/NCT05458193, NCT05458193. Statement of Significance Obstructive sleep apnea (OSA) is highly prevalent and associated, in 30%-50% of cases, with insomnia-related symptoms, yet the safety of insomnia medications in OSA remains unclear. Daridorexant, a dual orexin receptor antagonist for the treatment of adults with insomnia disorder, previously showed no negative effect on sleep-disordered breathing in participants with mild/moderate OSA. This randomized, double-blind, placebo-controlled, crossover trial evaluates daridorexant 50 mg (maximum therapeutic dose) in participants with severe OSA without insomnia. Repeated dosing (5 nights) did not impair nighttime respiratory function, as assessed by apnea/hypopnea index and nocturnal oxygen saturation. Moreover, improvements in sleep characteristics were observed with daridorexant, extending evidence that daridorexant 50 mg is safe and well-tolerated and may improve sleep in adults with severe OSA.

Humans↗

PubMed2026

USleep: efficacy of app-based audio interventions to improve sleep disturbance in working adults, a multi-arm randomized controlled trial.

STUDY OBJECTIVES: To evaluate the efficacy of three categories of standalone, audio-based sleep interventions (Bedtime Stories, Sleep Sounds, Sleep Skills) delivered via mental health application (MHapp) in improving sleep among working adults with sleep disturbance. METHODS: A multi-arm, parallel randomized controlled trial was conducted. Adults with self-reported sleep disturbances were recruited online and randomly allocated to Bedtime Stories, Sleep Sounds, Sleep Skills, or digital control. Participants completed self-report questionnaires on sleep disturbance and other related outcomes at baseline (t0) and after the 4-week intervention (t1). The primary analysis followed an intention-to-treat approach using mixed-effects models. RESULTS: A total of 495 working adults (mean age = 32.7 years; 55.8% female) were randomized. For sleep disturbance (primary outcome), the between-group Hedges' g effect sizes were very small and not statistically significant (Bedtimes stories vs. control: g = 0.12, 95% CI -0.13 to 0.37, Sleep Sounds vs. control: g = 0.14, 95% CI -0.11 to 0.39, Sleep Skills 0.07, 95% CI -0.07 to 0.29), with slightly greater reductions in sleep disturbance for the intervention groups than control. The same pattern was observed for sleep-related impairment, mental health, well-being, and pre-sleep arousal. CONCLUSION: Audio-based sleep interventions delivered via a MHapp did not demonstrate superior efficacy over a digital control condition in reducing self-reported sleep disturbance among working adults. Although safe and well-tolerated, their use as standalone treatments for sleep disturbance is not supported by these findings. Future research should explore effectiveness in real-world settings, including user content choice across categories, and use objective sleep measures. CLINICAL TRIAL REGISTRATION: Registered at https://www.isrctn.com/ under "Evaluating the efficacy of audio-based digital tools to improve sleep on the Unmind workplace well-being platform"; https://www.isrctn.com/ISRCTN13426045; registration number: 13426045.

Humans↗

PubMed2026

A Leucine-Rich Repeat Receptor-Like Protein Associated with a QTL for Septoria Stem Canker in Populus trichocarpa × Populus deltoides Hybrid Poplar.

The fungal plant pathogen Sphaerulina musiva (Ascomycota) causes Septoria stem canker, the most economically damaging disease of Populus plantations in North America, yet the genetic determinants of host resistance remain uncharacterized in hybrid poplar. Using an inoculation experiment with the 52-124 pseudo-backcross family of Populus trichocarpa × Populus deltoides (TD × D) hybrid poplar, a single significant QTL was identified on Chromosome 16 (LOD = 4.93) associated with both stem canker count and disease severity score. Transcriptomic analysis of two resistant and two susceptible genotypes across a 72-hour infection time course identified a single differentially expressed gene within the QTL candidate gene window: Podel.16G125900, a putative leucine-rich repeat receptor-like protein (LRR-RLP) with homology to receptor-like protein 33 in Arabidopsis thaliana. Podel.16G125900 is located 3001 bp (0.019 cM) upstream of the QTL peak and showed a strong infection-induced upregulation in susceptible genotype 852 (log2 fold-change = 20.47) and higher baseline expression in resistant genotypes relative to susceptible genotypes across all infection time points, consistent with a resistance mechanism in which expression level contributes to the degree of resistance conferred. Two P. trichocarpa homologs were not differentially expressed and differ substantially in sequence content, suggesting the resistance function is specific to the resistant P. deltoides lineage. These findings identify Podel.16G125900 as a strong candidate gene underlying quantitative resistance mechanisms modulating Septoria stem canker resistance in the 52-124 family of TD × D hybrid poplar and provide a target for future functional validation and marker-assisted resistance breeding.

Disease Resistance↗

PubMed2026

Genomic Regions Associated with Resistance to Soybean Cyst Nematode (Heterodera glycines Ichinohe) Population HG Type 1.2.5.7 in Dry Beans (Phaseolus vulgaris L.).

North Dakota, the largest dry bean (Phaseolus vulgaris L.) producing state in the U.S., faces an emerging production threat caused by the soybean cyst nematode (SCN; Heterodera glycines Ichinohe, 1952). Host resistance is an effective management strategy, yet resistance to the virulent SCN population HG type 1.2.5.7 has not been genetically characterized in dry beans. In this study, 170 dry bean genotypes (113 breeding lines/cultivars and 57 germplasm accessions) were evaluated for response to HG type 1.2.5.7 under controlled conditions using female index (FI) as the resistance phenotype. FI values ranged from 4.1% to 78.1%, with one genotype (PI 313733) classified as resistant, 35 moderately resistant, 104 moderately susceptible, and 30 susceptible. Genome-wide association analysis using 2,044 single-nucleotide polymorphism (SNP) markers from the 3.8K Bean Panel chip and the BLINK model identified four significant marker-trait associations on chromosomes Pv02, Pv05, Pv07, and Pv11. Linkage disequilibrium-defined candidate intervals spanned 108 kb (Pv02), 1.50 Mb (Pv05), 798 kb (Pv07), and 1.45 Mb (Pv11), collectively containing 126 annotated genes: 20 on Pv02, 39 on Pv05, 35 on Pv07, and 32 on Pv11. The intervals contained putative genes annotated for signaling and transcriptional regulation, cell wall and carbohydrate metabolism, transport, and secondary metabolism. Together, these findings indicate that the response to HG type 1.2.5.7 in dry bean is quantitative and associated with multiple genomic regions. The identified intervals provide candidate targets for independent validation, fine mapping, functional analysis, and future marker development to support breeding for SCN resistance.

Disease Resistance↗

PubMed2026

Trade-Offs Associated with Virulence of Soybean Cyst Nematode on the Broad-Spectrum Resistance Source PI 437654.

The soybean cyst nematode (SCN; Heterodera glycines) poses a major challenge to soybean production, intensified by the declining effectiveness of natural resistance against this pathogen. Although the use of resistant soybean varieties can be effective, their widespread and repeated use ultimately results in the emergence of virulent nematode populations that can successfully attack these resistant hosts. To assess for potential trade-offs between virulence and fitness, we investigated the hatch response, penetration rate, and reproductive potential of SCN adapted to overcome the broad-spectrum resistance source PI 437654. The hatching process is a critical phase in the life cycle of the SCN, influencing its ability to infect hosts and complete its life cycle. Our results indicated that SCN populations exhibit preferential and heightened hatch responses to their adapted host compared to alternative hosts, regardless of their virulence profile. Additionally, we found that SCN populations adapted to overcome broad-spectrum resistance showed reduced reproductive success on susceptible hosts compared to unadapted populations. This reduction in reproductive success was not attributed to differences in hatch response or penetration rates. The results from our study highlight the potential trade-offs associated with SCN virulence adaptation and emphasize the importance of considering these evolutionary dynamics in developing sustainable management strategies.

Disease Control and Pest Management↗

PubMed2026

Validation of the LD-526 brachial blood pressure monitor according to the International Organization for Standardization protocol (ISO 81060-2:2018/AMD 1:2020/AMD 2:2024).

OBJECTIVE: The LD-526 oscillometric upper-arm blood pressure (BP) monitor is intended for self-measurement of BP in adults. The aim of this study was to evaluate the accuracy of LD-526 oscillometric upper-arm BP monitor in the general population according to the International Organization for Standardization (ISO) universal standard (ISO 81060-2 : 2018/AMD 1 : 2020/AMD 2 : 2024). METHOD: Subjects were recruited to fulfill the age, gender, BP, and cuff distributions of the ISO universal standard in the general population using the same-arm sequential BP measurement method. The test device was used with one universal cuff for arm circumferences of 22-42 cm. Reference BP measurements were obtained using a calibrated mercury sphygmomanometer, with two cuffs (inflatable bladder sizes of 12 × 24 and 16 × 32 cm, respectively). RESULTS: Of the 98 recruited subjects, 85 [women/men: 46/39; mean (±SD) age: 52.2 ± 17.4 years] were analyzed, and 13 were excluded from the final analysis: 10 because of reference BP variability and three because of cardiac arrhythmias. For validation of criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 1.34 ± 5.56/-0.31 ± 4.36 mmHg (systolic/diastolic). For criterion 2, the SD of the average BP differences between the test device and reference BP per subject was 4.51/3.77 mmHg (systolic/diastolic). CONCLUSION: The LD-526 BP monitor fulfilled all the requirements of the ISO universal standard (ISO 81060-2 : 2018/AMD 1 : 2020/AMD 2 : 2024) in the general population and can be recommended for self-measurement.

blood pressure monitor↗

PubMed2026

Immune dysregulatory disorders: perspective from solving a diagnostic odyssey.

PURPOSE OF REVIEW: Inborn errors of immunity (IEIs), once considered rare disorders characterized primarily by recurrent infections, are now recognized as a rapidly expanding group of diseases encompassing autoimmunity, autoinflammation, allergy, malignancy, and immune dysregulation. Advances in next-generation sequencing, functional immunology, and systems biology have revealed overlap between traditionally distinct disease categories and highlighted the complexity of genotype-phenotype relationships. RECENT FINDINGS: While this evolution has led to the discovery of hundreds of previously unrecognized disorders, it has also challenged conventional diagnostic paradigms and demonstrated how patients may have care spread across multiple specialties, without a clear medical home. These discoveries have also highlighted ongoing challenges translating scientific findings to the clinic including difficulties in accessing genomic testing, interpretation of variants of uncertain significance, impacts of incomplete penetrance and somatic mosaicism, and limited availability of specialized functional assays. Emerging computational approaches, including artificial intelligence, offer opportunities to accelerate diagnosis but cannot replace comprehensive clinical evaluation or longitudinal physician-patient relationships. SUMMARY: This perspective examines how the diagnostic odyssey for immune dysregulatory disorders has evolved, side-by-side with the changing framework for diagnosing rare immune diseases. We propose an integrated approach combining clinical phenotyping, genomics, functional validation, and multidisciplinary expertise to unite ongoing discovery between clinicians and scientists, diagnostics, and patient outcomes.

diagnostic odyssey↗

PubMed2026

Sparse Logistic Regression on Genomic Data for Prediction of Tumour Pathological Subtype.

The correct prediction of tumour subtype is critical for the treatment of cancer patients to maximise the chance of survival. The patients' genomic information, such as copy number alterations (CNA) profile, has increasingly become an important factor in the prediction to supplement the traditional pathological subtyping. The incorporation of the CNA information in a prediction model, such as logistic regression, faces two major statistical challenges: first, how to estimate the model parameters in the thousands and, second, how to deal with the correlation of CNA between genomic regions. To address them, we propose a sparse logistic regression model with random effects where some of its parameters are estimated to zero while the other parameters are non-zero. In effect, a variable selection is embedded in the modelling. To deal with the correlation of CNA across genomic regions, we extend further the model to incorporate an additional penalty in the corresponding likelihood function in the logistic regression. The results show that we can identify selected genomic regions that are informative to distinguish different tumour subtypes, while giving a good prediction ability. We illustrate the methodology using CNA dataset from a lung cancer cohort.

Journal Article↗

PubMed2026

Comparisons Between Large-Scale Genomic Variants and SNPs in Driving Population Divergence and Local Adaptation.

Genomic variations, such as indels (2-49 bp) and structural variants (SVs, ≥50 bp), are larger-scale mutations than single nucleotide polymorphisms (SNPs) and can substantially impact evolutionary processes, including speciation, adaptation, and phenotypes. Despite their functional importance, integrative population genetic analyses that jointly consider genome-wide SNPs, indels, and SVs remain under-explored. The ground tit (Pseudopodoces humilis), an endemic species to the Qinghai-Tibet Plateau (QTP), exhibits divergence across distinct glacial refugia, accompanied by habitat and morphological divergence, making it an excellent example for investigating how different types of genomic variants contribute to population divergence and local adaptation. Here, by retrieving 81 whole-genome sequence data, over 13 million SNPs, 2 million indels, and 22,101 SVs were identified. Variants were unevenly distributed across the genome, characterized by distinct hotspot regions. Indels and SVs revealed four genetic clusters consistent with previous SNP-based results, thereby validating the reliability of our variant datasets. FST and genotype-environment association (GEA) analyses independently revealed numerous candidate indels and SVs; each showed minimal overlap with previously identified SNPs, and were enriched in similar functional pathways such as signal transduction, skeletal muscle development, water transport, DNA repair, reproduction, nervous system development, and immunity. Collectively, our results demonstrated that indels and SVs could capture additional signatures besides SNPs. Furthermore, similar but distinct gene functions among different types of genomic variants collectively and complementarily drive genomic divergence across environmental gradients in such a high-elevation endemic species, underscoring its evolutionary relevance in local adaptation.

indels↗

PubMed2026

A Novel De Novo STAG1 Variant at the RAD21 Binding Interface Is Associated With Hypoglycemia, Recurrent Fever, Immunodeficiency and Features of Classical Cohesinopathies.

The cohesin complex, composed of SMC1, SMC3, RAD21, and STAG1/STAG2, is essential for chromosome cohesion, DNA repair, and transcriptional regulation. Pathogenic variants in cohesin components cause cohesinopathies. The classical characteristics of cohesinopathies include developmental delay (DD), intellectual disability (ID), feeding difficulties, hypotonia, short stature, hearing loss, and dysmorphic features. Here, we present a 5-year-old boy with classical cohesinopathy features, including DD/ID and feeding difficulties, along with non-classical features such as hypoglycemia, recurrent fever, and immunodeficiency. Trio exome sequencing identified a novel de novo missense variant of uncertain significance (NM_005862.3:c.643G>A(p.Val215Ile)) in the STAG1 gene. The variant localizes to the RAD21 interaction interface, and molecular dynamics (MD) simulations revealed conformational changes comparable to other STAG1 variants reported as likely pathogenic in patients, supporting a deleterious effect which may disrupt the STAG1-RAD21 interaction interface. This case expands the phenotypic and molecular spectrum of STAG1-related cohesinopathy and advances our understanding of the disease mechanism.

STAG1↗

PubMed2026

Genetic Testing Unveils a Novel Thrombospondin-1 Domain Containing Protein 1 Gene Variant as the Cause of Chronic Edema in a 79-Year-Old Woman.

Edema requires management tailored to its underlying etiology; however, in some cases the cause remains elusive. We describe a 79-year-old woman with lifelong unexplained peripheral edema. Comprehensive evaluation excluded common etiologies such as heart failure, renal dysfunction, and venous thrombosis. Whole-genome sequencing identified a novel homozygous splice-site variant (NM_018676.4:c.58+2T>G) in the thrombospondin-1 domain-containing protein 1 (THSD1) gene, which has previously been associated with non-immune hydrops fetalis (NIHF). This report describes, to our knowledge, the first elderly patient with chronic peripheral edema harboring a likely pathogenic THSD1 variant, suggesting that THSD1-related disease may, in rare instances, persist beyond the perinatal period and present into late adulthood. Although causality cannot be established definitively from a single case, the findings highlight the potential utility of genetic testing in adults with chronic unexplained edema.

chronic edema↗

PubMed2026

Transketolase promotes RNF20-dependent H2BK120 ubiquitination and DNA repair through a non-enzymatic adaptor function.

Efficient repair of DNA double-strand breaks (DSBs) is essential for maintaining genome stability and conferring tumor radioresistance. Histone H2B monoubiquitination at lysine 120 (H2BK120ub), catalyzed by the RNF20/RNF40 E3 ligase complex, promotes DSB repair by coordinating chromatin remodeling and repair factor recruitment. Here we identify transketolase (TKT) as a non-enzymatic regulator of DNA damage repair in colorectal cancer cells. TKT enhances DNA repair efficiency and radioresistance independently of its catalytic activity by facilitating RNF20-dependent H2BK120ub. Mechanistically, TKT interacts with both the RNF20/RNF40 complex and the FACT chromatin remodeling complex, functioning as a non-enzymatic adaptor that facilitates FACT-RNF20 association and RNF20 foci formation following DNA damage. Disruption of this TKT-FACT-RNF20 axis impairs RNF20 foci formation and H2BK120ub induction, increases DNA damage, and enhances radiosensitivity. These findings reveal a previously unrecognized non-enzymatic adaptor function of TKT in DNA damage repair and highlight a potential vulnerability in radioresistant tumors.

DNA repair↗