Genetics of prelingual isolated deafness and Usher syndrome in the Maghreb and Jordan: Harnessing the potential of homozygosity

Z Zied Riahi (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory) S Sophie Boucher (Department of ear, nose, throat, University Hospital Center in Angers) S Samia Abdi (Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé) F Fabienne Wong Jun Tai (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory) A Amrit Singh-Estivalet (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory) A Asadollah Aghaie (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory) M Magali Niasme-Grare (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory) J Jean-Pierre Hardelin (Brain Plasticity Unit, CNRS, École Supérieure de Physique et de Chimie Industrielles Paris, Paris Sciences et Lettres Research University, Sorbonne Université, Inserm, CNRS, Neuroscience Paris Seine-Institut de Biologie Paris Seine) A Asma Behlouli (Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé) M Malika Dahmani (Equipe de Génétique, Laboratoire de Biologie Cellulaire et Moléculaire, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumédiène) S Sonia Talbi (Equipe de Génétique, Laboratoire de Biologie Cellulaire et Moléculaire, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumédiène) Y Yosra Bouyacoub (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory) R Rahma Mkaouar (Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar) C Cherine Charfeddine (Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar) G Ghita Amalou (Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc) A Amina Bakhchane (Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc) A Amale Bousfiha (Laboratory of Integrative Biology, Faculty of Sciences Ain Chock, Hassan II University, BP 2693, Maarif) S Sara Salime (Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc) S Soukaina Elrharchi (Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc) M Malak Salame (Biomarker Research Unit for Mauritanian Populations, Nouakchott University) M Mouna Hadrami (Biomarker Research Unit for Mauritanian Populations, Nouakchott University) E Ely Boussaty (Division of Otolaryngology, Department of Surgery, University of California, 9500 Gilman Drive, Mail Code 0666, La Jolla) H Hicham Charoute (Genomic Sequencing Laboratory, Institut Pasteur du Maroc) M Mustapha Detsouli (Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc) K Khalid Snoussi (Mohammed VI University of Sciences and Health (UM6SS)) H Hassan Rouba (Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc) H Hala El Hachmi (Biomarker Research Unit for Mauritanian Populations, Nouakchott University) F Fatimetou Veten (Biomarker Research Unit for Mauritanian Populations, Nouakchott University) G Ghlana Meiloud (Biomarker Research Unit for Mauritanian Populations, Nouakchott University) J Jihene Marrakchi (Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar) R Rim Zainine (Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar) H Houda Chahed (Department of Otorhinolaryngology and Maxilofacial Surgery, La Rabta Hospital in Tunis) G Ghazi Besbes (Department of Otorhinolaryngology and Maxilofacial Surgery, La Rabta Hospital in Tunis) M Mediha Trabelsi (Department of Congenital and Hereditary Diseases, Charles Nicolle Hospital in Tunis) R Ridha Mrad (Department of Congenital and Hereditary Diseases, Charles Nicolle Hospital in Tunis) I Ichraf Kraoua (Child and Adolescent Neurology Department of Neurology, National Institute of Neurology) S Sofiane Ouhab (Otorhinolaryngology Department, Etablissement Public Hospitalier Bachir Mentouri) D Djamel Djennaoui (Otorhinolaryngology Department, Mustapha Pacha Hospital) F Farid Boudjenah (Otorhinolaryngology Department, Tizi Ouzou University Hospital Center) E Eliane Chouery (Department of Human Genetics, Gilbert and Rose-Mary Chagoury School of Medicine, Lebanese American University) M Mirna Mustapha (Department of Biomedical Science, University of Sheffield) A Ahmed Houmeida (Biomarker Research Unit for Mauritanian Populations, Nouakchott University) A Abdelhamid Barakat (Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc) F Fatima Ammar Khodja (Equipe de Génétique, Laboratoire de Biologie Cellulaire et Moléculaire, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumédiène) M Mohamed Makrelouf (Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé) A Akila Zenati (Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé) N Najeh Beltaief (Department of Otorhinolaryngology and Maxilofacial Surgery, La Rabta Hospital in Tunis) S Sonia Abdelhak (Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar) C Christine Petit (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory) C Crystel Bonnet (Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory)

Abstract

The molecular genetic diagnosis of prelingual sensorineural hearing impairment (HI) is essential for genetic counseling and patient management. Effective diagnosis requires a knowledge of the genetic architecture of HI, which is often lacking. We established a cohort of 450 unrelated patients with familial (at least two affected relatives) severe-to-profound bilateral prelingual HI in five countries with high consanguinity rates: Tunisia, Jordan, Algeria, Morocco, and Mauritania (the TJAMM cohort). Recessive and dominant inheritance were observed in 92% and 8% of cases, respectively; 14% were syndromic. Genome analysis detected 211 different mutations (36% not reported before) in 49 deafness genes, and fully resolved 90% of cases of autosomal recessive isolated deafness (DFNB forms), 89% of the mutations being homozygous. The deafness genes involved were similar in different countries, but their mutations, except a few in GJB2 and LRTOMT , differed considerably, suggesting an overrepresentation of private mutations. Biallelic missense mutations in MYO7A , CDH23 , PCDH15 , USH1C cause either DFNB forms or Usher syndrome type 1 (USH1) ( USH1/DFNB genes). Such mutations were overrepresented (13% of patients), highlighting the importance of distinguishing between these two mutation classes. We hypothesized that current difficulties might stem from the misclassification of certain mutations. By studying the 65 USH1/DFNB missense mutations reported to cause DFNB in the homozygous state, we identified some that, when associated with a loss-of-function mutation, resulted in USH1, a characteristic pattern of some recessive hypomorphic mutations. This reappraised classification of USH1/DFNB mutations has the potential to improve molecular diagnosis and patient management significantly.

Article Details

Volume / Issue Vol. 122, Issue 50
Published December 16, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (50)

Z

Zied Riahi

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory

S

Sophie Boucher

Department of ear, nose, throat, University Hospital Center in Angers

S

Samia Abdi

Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé

F

Fabienne Wong Jun Tai

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory

A

Amrit Singh-Estivalet

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory

A

Asadollah Aghaie

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory

M

Magali Niasme-Grare

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory

J

Jean-Pierre Hardelin

Brain Plasticity Unit, CNRS, École Supérieure de Physique et de Chimie Industrielles Paris, Paris Sciences et Lettres Research University, Sorbonne Université, Inserm, CNRS, Neuroscience Paris Seine-Institut de Biologie Paris Seine

A

Asma Behlouli

Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé

M

Malika Dahmani

Equipe de Génétique, Laboratoire de Biologie Cellulaire et Moléculaire, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumédiène

S

Sonia Talbi

Equipe de Génétique, Laboratoire de Biologie Cellulaire et Moléculaire, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumédiène

Y

Yosra Bouyacoub

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory

R

Rahma Mkaouar

Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar

C

Cherine Charfeddine

Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar

G

Ghita Amalou

Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc

A

Amina Bakhchane

Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc

A

Amale Bousfiha

Laboratory of Integrative Biology, Faculty of Sciences Ain Chock, Hassan II University, BP 2693, Maarif

S

Sara Salime

Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc

S

Soukaina Elrharchi

Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc

M

Malak Salame

Biomarker Research Unit for Mauritanian Populations, Nouakchott University

M

Mouna Hadrami

Biomarker Research Unit for Mauritanian Populations, Nouakchott University

E

Ely Boussaty

Division of Otolaryngology, Department of Surgery, University of California, 9500 Gilman Drive, Mail Code 0666, La Jolla

H

Hicham Charoute

Genomic Sequencing Laboratory, Institut Pasteur du Maroc

M

Mustapha Detsouli

Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc

K

Khalid Snoussi

Mohammed VI University of Sciences and Health (UM6SS)

H

Hassan Rouba

Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc

H

Hala El Hachmi

Biomarker Research Unit for Mauritanian Populations, Nouakchott University

F

Fatimetou Veten

Biomarker Research Unit for Mauritanian Populations, Nouakchott University

G

Ghlana Meiloud

Biomarker Research Unit for Mauritanian Populations, Nouakchott University

J

Jihene Marrakchi

Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar

R

Rim Zainine

Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar

H

Houda Chahed

Department of Otorhinolaryngology and Maxilofacial Surgery, La Rabta Hospital in Tunis

G

Ghazi Besbes

Department of Otorhinolaryngology and Maxilofacial Surgery, La Rabta Hospital in Tunis

M

Mediha Trabelsi

Department of Congenital and Hereditary Diseases, Charles Nicolle Hospital in Tunis

R

Ridha Mrad

Department of Congenital and Hereditary Diseases, Charles Nicolle Hospital in Tunis

I

Ichraf Kraoua

Child and Adolescent Neurology Department of Neurology, National Institute of Neurology

S

Sofiane Ouhab

Otorhinolaryngology Department, Etablissement Public Hospitalier Bachir Mentouri

D

Djamel Djennaoui

Otorhinolaryngology Department, Mustapha Pacha Hospital

F

Farid Boudjenah

Otorhinolaryngology Department, Tizi Ouzou University Hospital Center

E

Eliane Chouery

Department of Human Genetics, Gilbert and Rose-Mary Chagoury School of Medicine, Lebanese American University

M

Mirna Mustapha

Department of Biomedical Science, University of Sheffield

A

Ahmed Houmeida

Biomarker Research Unit for Mauritanian Populations, Nouakchott University

A

Abdelhamid Barakat

Genomics and Human Genetics Laboratory, Institut Pasteur du Maroc

F

Fatima Ammar Khodja

Equipe de Génétique, Laboratoire de Biologie Cellulaire et Moléculaire, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumédiène

M

Mohamed Makrelouf

Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé

A

Akila Zenati

Laboratoire de Recherche Biochimie Génétique, Université des sciences de la santé

N

Najeh Beltaief

Department of Otorhinolaryngology and Maxilofacial Surgery, La Rabta Hospital in Tunis

S

Sonia Abdelhak

Laboratory of Biomedical Genomics and Oncogenetics LR16IPT05, Pasteur Institute in Tunis, University of Tunis El Manar

C

Christine Petit

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory

C

Crystel Bonnet

Université Paris Cité, Institut Pasteur, Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Fondation Pour l’Audition, Institut de l’Audition, Institut Hospitalo-Universitaire reConnect, Auditory Therapies Innovation Laboratory