Fryns syndrome (FS) is a multiple malformations syndrome with major features of congenital diaphragmatic hernia, pulmonary hypoplasia, craniofacial dysmorphic features, distal digit hypoplasia, and a range of other lower frequency malformations. FS is typically lethal in the fetal or neonatal period. Inheritance is presumed autosomal recessive. Although no major genetic cause has been identified for FS, biallelic truncating variants in PIGN, encoding a component of the glycosylphosphatidylinositol (GPI)-anchor biosynthesis pathway, have been identified in a limited number of cases with a phenotype compatible with FS. Biallelic variants in PIGN, typically missense or compound missense with truncating, also cause multiple congenital anomalies-hypotonia-seizures syndrome 1 (MCAHS1). Here we report six further patients with FS with or without congenital diaphragmatic hernia and recessive loss of function PIGN alleles, including an intragenic deletion with a likely founder effect in La Réunion and other Indian Ocean islands. Our results support the hypothesis that a spectrum of phenotypic severity is associated with recessive PIGN variants, ranging from FS at the extreme end, caused by complete loss of function, to MCAHS1, in which some residual PIGN function may remain. Our data add FS resulting from PIGN variants to the catalog of inherited GPI deficiencies caused by the disruption of the GPI-anchor biosynthesis pathway.

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A continuous emulsion/solvent diffusion process was designed for the preparation of polysaccharide-covered poly(D,L-lactide) (PLA) microparticles. The emulsification step was carried out in a flow-focusing junction where ethyl acetate containing dissolved PLA was dispersed into an aqueous solution of hydrophobically modified dextran. It was demonstrated that poly(dimethylsiloxane) devices could be used for oil-in-water emulsion preparation provided that the microfluidic devices were preconditioned by simply circulating the aqueous phase containing the amphiphilic polysaccharide during a sufficient time (30 h). The adsorption of the polymers at the surface of the channel walls permitted the wetting by the aqueous phase with a hydrophilic character maintained at least throughout 2 months. The preconditioning time was significantly reduced by pretreating the microfluidic device with piranha solution and KOH solution during 15 min each before the circulation of the aqueous solution of dextran derivative. Dextran-covered PLA microparticle aqueous suspensions were produced with well-controlled size distribution. The suspensions could be lyophilized and reconstituted by retrieving the initial size distribution without adding any cryoprotectant. The reported procedure was used for preparing octyl gallate-loaded PLA microparticles.