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BARDET-BIEDL Syndrome International Connecting people affected by the syndrome of Bardet-Biedl worldwide About BBS FOUNDATION BBS International is a federation that will enable us to collaborate together on a global scale, to unite efforts, to collect and publish information on the disease, to increase network cooperation, to improve research by avoiding unnecessary duplication. ​ Created on 03 October 2020 by 5 countries (France, USA, UK, Italy, Netherlands). Members are active national patient organisations representing patients and their families affected by BBS. Together, they are the voice of approximately 40,000 patients worldwide. « Bardet-Biedl syndrome is a rare disease, but many of you around the world are affected by it or one or more of your children. The announcement of such a diagnosis is hard and one can feel quite alone. Many countries in the world do not have a national association or the information to better understand the disease. This is also why the Federation was created, to break the isolation and answer your questions. You are not alone ! » ​ Join the community and get to know each other ! JOIN Our TEAM Véronique HELOIR Presidente Francis LESTEL Vice-President Patricia Dawn HATCHER Secretary Grégory BOUETEL Treasurer Contact US Send Thank you for your sending ! Bardet-Biedl Syndrome International 3 route des Essarts 26240 SAINT-UZE FRANCE

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Bardet-Biedl RESOURCES

Become a MEMBER The Federation accepts new members from BBS or similar associations in Europe and around the world. The applicant organisation can pay by bank transfer or credit card by following the links below. Becoming a member will make the Federation stronger and you will be involved in all the initiatives of the Federation. How to become A MEMBER : The fee of 100 € gives you the status of a full member and the right to vote at general meetings . It will contribute to all the operating costs of BBSI. It is an annual membership fee which can be paid by bank transfer or credit card. To become a full member, your organisation must be a properly constituted non-profit organisation in your home country. BY TRANSFER BY CREDIT CARD There is no association in your country ? ​ Register for free with our community and tell us your story. You will be able to send us a message and ask your questions and also attend our meetings. ​ Join us

связаться с нами Для этого заболевания характерна ассоциация с ожирением, пигментным ретинитом, постаксиальной полидактилией, поликистозом почек, гипогенитализмом и трудностями в обучении, которые обычно возникают через несколько лет после начала заболевания. Клиническая картина может быть различной, хотя у многих пациентов в течение болезни проявляются почти все признаки. Пигментный ретинит является единственным постоянным признаком после детского возраста. BBS также связан с другими тяжелыми признаками, включая диабет, гипертонию, врожденные пороки сердца и болезнь Гиршпрунга. ​ Синдром Барде-Бидля (СББ) описан на сайте :https://www.gsdinternational.com/ru/conditions/bardet-biedl-syndrome-bbs ​

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Bardet-Biedls Syndrom (BBS) kännetecknas av en kombination av synnedsättning, övervikt, extra fingrar och/eller tår, små könsorgan, nedsatt njurfunktion och inlärningssvårigheter. Andra symtom förekommer också. ​ Bardet-Biedls syndrom ingår i en grupp sjukdomar som kallas ciliopatier och orsakas av en skada i de primära cilierna. En primär cilie är ett orörligt utskott, ett slags antenn på cellytan som samordnar många funktioner som är av betydelse för cellfunktioner som rörelse, syn, känsel och cellsignalering. Störd ciliefunktion kan leda till avvikelser i fosterutvecklingen och ge missbildningar i många olika organ. Hos ungefär 80 procent av alla med Bardet-Biedls syndrom har det varit möjligt att påvisa en sjukdomsframkallande mutation. De vanligaste mutationerna finns i BBS1 (23 procent), BBS2 (8 procent) och BBS10 (20 procent). ​ Hittills (2022) finns mutationer rapporterade i 24 olika gener, som alla är inblandade i tillverkning eller reglering av proteiner som är av betydelse för normal cilieformation och funktion. ​ Kontakta oss

Our TEAM Administrative OFFICE Véronique HELOIR Presidente ​ Véronique is the mother of a little boy of almost 12 years old who has BBS6 and lives in France in the Drôme Provençale. After a career in the press and then in Real Estate, Véronique had to give up her professional activity to stay close to her son with special needs. Appointed President of the Bardet Biedl France Association in 2018, she and her team are working to increase awareness of the syndrome and to raise funds and interact with the various French doctors in charge of research for BBS. Francis LESTEL Vice-President ​ Francis leaves in France, he is an engineer and has participated in several international medical congresses, preparing abstracts for those who were unable to attend. He understands 11 languages and is the father of a 30 years old girl with BBS10. Dawn HATCHER Secretary ​ Vice-president of BBS Italy. Association created in 2009 with 30 registered families.Patricia is a teacher, she is bilingual English/Italian and mother of Christopher, 31 years old, diagnosed with BBS 25 years ago by Phil Beales. Grégory BOUETEL Treasurer ​ Grégory is Treasurer of the association Bardet-Biedl France. He also suffers from the syndrome. ​ Grégory lives in France and has his own company specialising in the field of event organisation (weddings, birthdays, lighting, etc.). The Board OF DIRECTORS Tim OGDEN USA ​ Tim is Managing Director of the Financial Access Initiative. He is also Managing Director of the US Financial Diaries project. Tim is the President of the Bardet Biedl Association USA. He is the father of Nathanael, a 14-year-old carrier of the syndrome. Bendert DE GRAAF NETHERLAND ​ Operations Manager at CCIC EUROPE Food Test BV Kampen (Overijssel), Province of Flevoland, The Netherlands. Bendert is the president of the Bardet-Biedl Stichting Association and father of a little boy with the syndrome. Tonia HYMERS UK ​ Tonia is the Service Manager for BBS UK Clinics Ltd. Tonia has two grown-up children, Daniel and Connor and lives in Harwich in Essex. The family attended their first conference in 1998 following the diagnosis of their son, Daniel, and were so grateful to the young people and adults with the syndrome for enabling them to picture a positive future. Tonia was happily coerced onto the Committee, where she stayed for the next 15 years, taking on the role of Fundraising Co-ordinator and then Newsletter Editor. Tonia assisted with the inception and development of the specialised BBS Clinics and was Children’s Service Manager from 2010 to 2017, when she took on the role of Service Manager. Matthias KIMM GERMANY ​ ​ Kjell ARNE NORWAY ​ ​ The SCIENTIFIC ADVISORS Phil BEALES UK ​ Phil Beales is head of Genetics and Genomic Medicine at ICH, Director of the Centre for Translational Genomics (GOSGENE) and head of the Cilia Disorders Laboratory (CDL). His research interests centre on rare diseases, especially the ciliopathies, a class of disorders caused by defects in the formation or function of the cilium. Hélène DOLLFUS FRANCE ​ Hélèn e Dollfus is University Professor and Hospital Practitioner (PU-PH) in medical genetics and ophthalmology. Head of the Medical Genetics Department at the University Hospitals of Strasbourg (HUS), she coordinates the CARGO (Affections rares en génétique ophtalmologique) reference center, as well as the SENSGENE national rare disease network. Director of the Medical Genetics Laboratory (Inserm/Unistra), she is also the driving force behind the Institut de Génétique Médicale d'Alsace (IGMA). Chairwoman of the Scientific Advisory Board of the Retina France patients' association. Hélène Dollfus is also coordinator of ERN-EYE, the European reference network for rare eye diseases. ​

The DISEASE SWEDISH POLISH PORTUGUESE SPANISH RUSSIAN GERMANY Bardet-Biedl Syndrome is a genetic disease caused by a change (mutation) in a gene. To date, there are at least twenty-four different genes that may be responsible for this disease. These are genes BBS1 to BBS24. Bardet-Biedl most often combines obesity, vision problems, finger abnormalities, and in some cases kidney and genital abnormalities. Learning difficulties are often present. Other malformations (of the heart, for example) may be associated, but more rarely. Bardet-Biedl Syndrome affects both boys and girls and usually begins at birth and is not contagious. The manifestations and severity of the syndrome vary considerably from person to person. Bardet-Biedl syndrome is a rare disease whose prevalence (number of people affected in a population at a given time) is between 1 in 100,000 and 1 in 160,000 for the populations of Europe and North America. This syndrome is much more common in certain isolated populations such as the Bedouin populations of Kuwait where the prevalence is estimated at 1 in 13,500. TRANSMISSION In most cases of BBS, both parents carry a normal gene and a defective recessive gene. Although the parents have a copy of the defective gene and are called carriers of the disease, they are not affected by the presence of the defective gene. For a recessive disease to occur, the child must inherit two defective copies of the gene, one from each parent. The child from each pregnancy has a one in four chance of being affected. If a newborn child is not affected, there is a 2 in 3 chance that it will carry the defective BBS gene. Because the syndrome is rare, it is unlikely that a carrier will have affected children unless their partner is also a carrier. GENETIC To date (2022), mutations in 24 BBS genes have been identified in 85% of BBS patients. There are still more genes to be found, as 15% of patients do not have a mutation in one of the identified BBS genes. ​ Some genes are more common than others: 38% of patients have mutations in the BBS1 gene and in the BBS10 gene. However, patients with mutations in the same BBS gene can have very different symptoms of the syndrome: one person may be born with extra fingers, while another person with the same mutation may not have extra fingers at all. The genes involved in this syndrome 'control' the production of proteins that play a role in the cilia of cells. Cells have cilia that function like antennae, capturing and transmitting information about the state of their environment. When these cilia are defective (which is the case when genes are mutated), certain functions are also altered. ​ In particular, cilia play an important role in vision and kidney function, which explains the visual deficit and possible kidney abnormalities in Bardet-Biedl syndrome. Much research is underway to understand the role of the cilia in all manifestations of the disease. CLINICAL MANIFESTATIONS The clinical manifestations of Bardet-Biedl syndrome are multiple and vary considerably from person to person. Therefore, not all patients have all of the symptoms described below. Visual disturbance Learn more Overweight Learn more Abnormalities of toes and fingers Learn more Abnormalities of the genital organs Learn more Kidney and urinary tract deformities Learn more Intellectual deficiency and psychological disorders Learn more Other manifestations Learn more HOW CAN THE SYMPTOMS BE EXPLAINED The genes involved in this syndrome "control" the production of proteins that play a role in the cells' eyelashes. The cells have lashes that function like antennae, capturing and transmitting information about the state of their environment. When these cilia are defective (which is the case when genes are mutated), certain functions are also altered. In particular, cilia play an important role in vision and kidney function, which explains the visual deficit and possible kidney abnormalities in Bardet-Biedl syndrome. A great deal of research is underway to understand the role of the cilia in all manifestations of the disease. ​ If left untreated, the various manifestations can worsen, in particular kidney damage and obesity. Obesity, which is resistant to the usual diet and measures, can be complicated by diabetes and excess lipids in the blood (hyperlipidemia), heart and joint problems. In addition, retinal abnormality leads to a severe reduction in vision, and even blindness between the ages of 15 and 30. Indeed, the field of vision gradually reduces and central vision can sometimes end up being reduced. Early treatment can limit the worsening of symptoms. WHAT IS ITS EVOLUTION ?

El síndrome de Bardet-Biedl (SBB) es una enfermedad genética multisistémica poco frecuente en población caucásica (está estimada 1/150.000), caracterizada por una pronunciada variabilidad fenotípica y una gran heterogeneidad genética. Pertenece al grupo de las ciliopatías, causadas por defectos en la estructura y/o función ciliar. El trastorno se trasmite principalmente de manera autosómica recesiva pero se ha detectado herencia oligogénica en algunos casos. Hasta ahora, se han identificado mutaciones en 24 genes diferentes. Este trastorno está caracterizado por una combinación de síntomas clínicos: obesidad, retinopatía pigmentaria, polidactilia post-axial, riñones poliquísticos, hipogenitalismo y trastornos de aprendizaje, muchos de los cuales aparecen muchos años después de la aparición de la enfermedad. La expresión clínica es variable pero muchos de los pacientes manifiestan la mayoría de los síntomas clínicos durante el curso de enfermedad. La retinopatía pigmentaria es el único síntoma clínico constante después la infancia. El SBB puede también estar asociado con otras manifestaciones graves incluida diabetes, hipertensión, cardiopatía congénita y enfermedad de Hirschsprung . El amplio espectro clínico observado en el SBB está asociado a una significativa heterogeneidad genética. Contactador

Contacto A síndrome de Bardet- Biedl, caracteriza-se pela associação de défice visual progressivo, obesidade, polidactilia, problemas renais, hipogenitalismo nos homens e anomalias genito-urinárias na mulher e dificuldades de aprendizagem. Transmite-se de forma autossómica recessiva e foram identificados 24 genes associados a BBS, mas em cerca de 20% a causa ainda é desconhecida. Estima-se uma prevalência de 1/150.000. As manifestações mais frequentes são: Retinite pigmentar de tipo cone e bastonete (>90%). Esta alteração pode não ser identificável até por volta dos 8 anos, quando se inicia diminuição da visão nocturna; aos 20 anos 75% dos doentes perderam completamente a visão. Polidactilia postaxial (dedo supranumerário na metade externa das mãos e /ou pés) ocorre em cerca de 80%. Obesidade (90%) inicia-se na infância e é essencialmente do tronco. Ao nascer o peso é habitualmente normal. Não controlada, podem surgir outros problemas associados: diabetes, hipertensão, hiperlipidemia. Dificuldades de aprendizagem são frequentes (60%), embora na maioria não exista um défice cognitivo significativo. Défice de atenção, processamento lento e traços obsessivos, compulsivos são comuns. Anomalias genitais (60-90%). No sexo masculino manifesta-se por hipogonadismo com pénis e testículos pequenos, criptorquidia, ausência de caracteres sexuais secundários, atraso pubertário, infertilidade. No sexo feminino podem existir malformações genito-urinárias como ausência ou hipoplasia da vagina, útero, trompas, ovários, imperfuração vaginal, fistulas….e também atraso pubertário, amenorreia, diminuição da fertilidade, mas há casos de gravidez Alterações renais (displasia, doença quística…) ocorrem em 50 a 70% dos casos e podem conduzir a falência renal. Foi sugerido como critério de diagnóstico clínico de BBS a presença de 4 das manifestações acima referidas ou 3 delas e mais duas das seguintes: cardiopatia, diabetes, alterações dentárias, hepáticas, intestinais (hirshprung), anosmia (ausência de cheiro),braquidactilia/sindactilia (dedos curtos/unidos), descoordenação motora/ ataxia, atraso global de desenvolvimento, atraso da linguagem

Clinical MANIFESTATIONS visual disturbance Yeux Almost all children with Bardet-Biedl Syndrome suffer from decreased vision, most often starting around the age of 5-6 years. It starts with a decrease and then a gradual loss of vision at night or when the light is a little dim. The child sees very little in the dark, but this may go unnoticed when he is small. ​ The field of vision gradually narrows at the sides, giving the impression of looking through an increasingly narrow tube (so-called "tubular vision"). The quality of vision deteriorates greatly during adolescence. Sometimes, other ocular manifestations may be associated with it: blurred distance vision (myopia) or distorted vision (astigmatism), both of which can be corrected with glasses, opacification of the crystalline lens (cataract) leading to a progressive decrease in vision, the appearance of abnormal jerky eye movements (nystagmus), problems with colour distinction, etc. Eventually, central vision can also be affected, making the patient visually impaired. ​ The visual disturbances characteristic of Bardet-Biedl syndrome are due to an impairment of the retina, called retinopathy pigmentosa. The retina is the surface of the back of the eye that receives images, much like a photographic film, and transmits them to the brain in the form of electrical signals. OVERWEIGHT Poids Despite a normal birth weight, affected children are almost always significantly overweight from the first year of life. This overweight often evolves into severe obesity, especially in the trunk area. Sometimes the height is smaller than average. ABNORMALITIES OF TOES & FINGERS Doigts There are often, but not in all cases, malformations of the toes and fingers that are smaller than normal (brachydactyly). There are often six fingers and/or six toes instead of five, with the supernumerary finger(s) located next to the fifth finger (the little finger). This is called postaxial polydactyly. In addition, some children have two or more fingers joined together, i.e. not well separated, and connected by a membrane (webbed fingers or syndactyly). ABNORMALITIES OF the genital organs Organes génitaux In boys, the genitals, penis and testicles, are often abnormally small (hypogonadism). In girls, malformations of the genital organs are also possible. The vagina may be closed by a partition, which causes the uterus to expand, often detected before birth (hydrometrocolpos). KIDNEY AND URINARY DEFORMITIES Reins Malformations of the kidneys and urinary tract are very common. They can be serious and, in a significant number of cases, lead to malfunction of the kidneys, whose function is to filter the blood and allow waste products to be eliminated through urine. ​ In people with Bardet-Biedl syndrome, the progressive reduction in kidney function, known as chronic kidney failure, may require the use of an artificial kidney and lead to a kidney transplant. One of the consequences of this kidney damage is an increase in blood pressure (hypertension), which occurs in more than half of adults. Even if there are no kidney malformations, problems can occur in regulating the amount of water in the body. This is manifested by an increase in the volume of urine (regardless of the volume of liquid absorbed), with a frequent need to urinate, as well as by intense thirst (this is called diabetes insipidus). intellectual deficiency & PSYCHOLOGICAL DISORDERS Intellect The intellectual deficit is not always present. When it does exist, it is moderate or rarely severe. Most often, it is limited to learning difficulties that can be aggravated by vision problems. Affected children may also have a delay in language acquisition (they speak later than others), as well as phonation disorders (abnormal way of producing sounds). There may also be hearing loss (hearing loss), which is often mild and goes unnoticed. Psychological or behavioural disorders may appear in some people in the course of their lives. These disorders include emotional instability, frequent tantrums, inappropriate or uninhibited behaviour (with no idea of what is or is not done), with more rarely obsessive-compulsive behaviour (i.e. repetitive actions, such as washing hands very frequently). However, these disorders only affect a few patients and it is not always clear whether they are directly linked to the syndrome. OTHER MANIFESTATIONS Autres Diabetes (too high blood sugar levels) can also set in, as in many obese people. It initially manifests itself by intense tiredness, thirst and hunger, but over time it can lead to serious complications such as kidney failure, an increased risk of heart attacks and infections, nerve damage that can cause loss of feeling in the hands and feet, etc. It can be treated with medication. Very rarely, incoordination of movements can occur, manifesting itself as abnormalities in staggering gait or poorly coordinated hand movements. In rare cases there are malformations of the heart, in particular communication between the different chambers (atria or ventricles) or narrowing of the heart valves (valvular stenoses). Long-term (chronic) constipation, when present, may be due to Hirschsprung's disease, which is a lack of contraction of the large intestine (colon) which leads to its dilation.