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Epilepsy is one of the most common neurological disorders. The cost to the health system and the impact on quality of life for patients with intractable epilepsies and associated comorbidities is significant. Disease etiology and pathogenesis are still not well understood. Genetic mutations have been shown to be associated with 70% of epilepsies, with the majority being non-monogenic, and the remaining 30% enigmatic. This knowledge gap necessitates further research. The goal of this study is to partially bridge this gap through the genetic analysis of a cohort of patients with epilepsy from an understudied and highly consanguineous population, primarily of ethnicities from the Middle East and North Africa region. Whole exome sequencing was carried out in 81 patients with epilepsy and their family members at a tertiary center in Qatar. We used the data to identify pathogenic variants and type HLA alleles for 13 class I & II genes. We associated the resulting alleles with disease status, using controls of a closely related ethnicity. The genetic yield was approximately 22% for known epilepsy genes. We also suggest a list of 20 genes that could be culprits. Analysis of the biological pathways in which these genes are involved show that focal and generalized epilepsy genes are highly interwound. HLA analysis revealed that class II HLA genes are associated with disease status, particularly DRB4*03:01N, which plays a strong protective role. Our findings suggest that an immune etiology may contribute to the disease together with a genetic culprit, emphasizing the complexity of the etiology of the disease.

Summary Cytotoxic T lymphocyte antigen 4 (CTLA-4) haploinsufficiency (CHAI) and lipopolysaccharide-responsive beige-like anchor (LRBA) deficiency (LATAIE) are newly identified inborn errors of immunity with shared molecular pathomechanisms and clinical manifestations. In this review, we aimed to provide differential comparisons regarding demographic, clinical, immunological and molecular characteristics between these two similar conditions. A literature search was conducted in PubMed, Web of Science and Scopus databases and included studies were systematically evaluated. Overall, 434 (222 CHAI and 212 LATAIE) patients were found in 101 eligible studies. The CHAI patients were mainly reported from North America and western Europe, while LATAIE patients were predominantly from Asian countries. In CHAI, positive familial history (P

SARS‐CoV‐2 is a novel human coronavirus responsible for the Coronavirus disease 2019 (COVID‐19) pandemic. Pneumonia and acute respiratory distress syndrome are the major complications of COVID‐19. SARS‐CoV‐2 infection can activate innate and adaptive immune responses and result in massive inflammatory responses later in the disease. These uncontrolled inflammatory responses may lead to local and systemic tissue damage. In patients with severe COVID‐19, eosinopenia and lymphopenia with a severe reduction in the frequency of CD4+ and CD8+ T cells, B cells and natural killer (NK) cells are a common feature. COVID‐19 severity hinges on the development of cytokine storm characterized by elevated serum levels of pro‐inflammatory cytokines. Moreover, IgG‐, IgM‐ and IgA‐specific antibodies against SARS‐CoV‐2 can be detected in most patients, along with the viral RNA, forming the basis for assays that aid in patient diagnosis. Elucidating the immunopathological outcomes due to COVID‐19 could provide potential targets for immunotherapy and are important for choosing the best clinical management by consultants. Currently, along with standard supportive care, therapeutic approaches to COVID‐19 treatment involve the use of antiviral agents that interfere with the SARS‐CoV‐2 lifecycle to prevent further viral replication and utilizing immunomodulators to dampen the immune system in order to prevent cytokine storm and tissue damage. While current therapeutic options vary in efficacy, there are several molecules that were either shown to be effective against other viruses such as HIV or show promise in vitro that could be added to the growing arsenal of agents used to control COVID‐19 severity and spread.