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MALFAIT LAB
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MALFAIT LAB

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Integrative Translational Research on the Ehlers-Danlos Syndromes

Connective tissue is a complex three-dimensional network consisting of a cellular base which produces an extracellular matrix (ECM) made up of secreted macromolecules. It provides structural support, enhances tissue integrity, and plays important roles in cell-to-cell communication, differentiation, and tissue homeostasis. In heritable connective tissue disorders (HCTD), genetic defects in ECM-associated genes lead to disrupted production, secretion, organization, and/or homeostasis of the ECM in a wide range of organs. Because connective tissue is ubiquitous in the human body, HCTD affect many tissues and organs, leading to multisystemic disorders with important morbidity and mortality. Although individually rare, together the HCTD constitute a significant proportion of genetic diseases. As for most rare diseases, the diagnosis of HCTD is not straightforward, and effective, targeted treatment is mostly lacking. As such, improvements in diagnosis and clinical management of these conditions will have a direct impact on patient well-being and healthcare economics. In addition, understanding the mechanisms underlying the disease processes in these rare monogenic disorders is predicted to have a much larger indirect impact by informing the management of more common, multifactorial disorders sharing similar molecular pathways.
The Center for Medical Genetics Ghent (CMGG) at Ghent University Hospital, in which the Malfait Lab is embedded, has a strong reputation as an internationally recognized center of expertise for research, diagnostics and clinical management related to a range of HCTD, including, among others, the Ehlers-Danlos Syndromes (EDS) and osteogenesis imperfecta.


At the Malfait Lab, PI prof. dr. Fransiska Malfait (MD PhD) and Postdoctoral Fellow dr. Delfien Syx (PhD) lead studies in the following areas of interest:
  • Unraveling the molecular basis of HCTD, with a special focus on EDS and other hypermobility-related disorders, and studying their natural history and genotype-phenotype correlations
  • Elucidating molecular and physiological mechanisms underlying HCTD pathogenesis, using an integrated approach of in vitro and in vivo techniques, on tissue samples of humans and animal models (zebrafish, mice)
  • Studying prevalence, nature and pathophysiologic mechanisms of pain in EDS individuals and in relevant animal models.

Key publications of the last five years
Pain research

Front Mol Neurosci. Vroman R, Hunter RS, Wood MJ, Davis OC, Malfait Z, George DS, Ren D, Tavares- Ferreira D, Price TJ, Miller RJ, Malfait AM, Malfait F, Miller RE, Syx D. Analysis of matrisome expression patterns in murine and human dorsal root ganglia. 2023 Aug 17;16:1232447. doi: 10.3389/fnmol.2023.1232447. PMID: 37664243; PMCID: PMC10471487.


Sensory Profiling in Classical Ehlers- Danlos Syndrome: A Case-Control Study Revealing Pain Characteristics, Somatosensory Changes, and Impaired Pain Modulation. Colman M, Syx D, De Wandele I, Rombaut L, Wille D, Malfait Z, Meeus M, Malfait AM, Van Oosterwijck J, Malfait F. J Pain. 2023 Jun 26:S1526-5900(23)00450-9. doi: 10.1016/j.jpain.2023.06.015. Epub ahead of print. PMID: 37380025.


Exploring pain mechanisms in hypermobile Ehlers-Danlos syndrome: A case-control study. De Wandele I, Colman M, Hermans L, Van Oosterwijck J, Meeus M, Rombaut L, Brusselmans G, Syx D, Calders P, Malfait F. Eur J Pain. 2022 Apr 20. doi: 10.1002/ejp.1956. Epub ahead of print. PMID: 35442549.


Pain in the Ehlers-Danlos syndromes: Mechanisms, models, and challenges. Malfait F, Colman M, Vroman R, De Wandele I, Rombaut L, Miller RE, Malfait AM, Syx D. Am J Med Genet C Semin Med Genet. 2021 Dec;187(4):429-445. doi: 10.1002/ajmg.c.31950. Epub 2021 Nov 19. PMID: 34797601.


Pain-related behaviors and abnormal cutaneous innervation in a murine model of classical Ehlers-Danlos syndrome. Syx D, Miller RE, Obeidat AM, Tran PB, Vroman R, Malfait Z, Miller RJ, Malfait F, Malfait AM. Pain. 2020 Oct;161(10):2274-2283. doi: 10.1097/j.pain.0000000000001935. PMID: 32483055; PMCID: PMC7967806.


Zebrafish research

b3galt6 Knock-Out Zebrafish Recapitulate β3GalT6-Deficiency Disorders in Human and Reveal a Trisaccharide Proteoglycan Linkage Region. Delbaere S, De Clercq A, Mizumoto S, Noborn F, Bek JW, Alluyn L, Gistelinck C, Syx D, Salmon PL, Coucke PJ, Larson G, Yamada S, Willaert A, Malfait F. Front Cell Dev Biol. 2020 Dec 10;8:597857. doi: 10.3389/fcell.2020.597857. PMID: 33363150; PMCID: PMC7758351.


Hypomorphic zebrafish models mimic the musculoskeletal phenotype of β4GalT7-deficient Ehlers-Danlos syndrome. Delbaere S, Van Damme T, Syx D, Symoens S, Coucke P, Willaert A, Malfait F. Matrix Biol. 2020 Jul;89:59-75. doi: 10.1016/j.matbio.2019.12.002. Epub 2019 Dec 17. PMID: 31862401.


Reviews

Pathogenic mechanisms in genetically defined Ehlers-Danlos syndromes. Syx D, Malfait F. Trends Mol Med. 2024 Sep;30(9):824-843. doi: 10.1016/j.molmed.2024.06.001. Epub 2024 Aug 14. PMID: 39147618.


The Ehlers-Danlos Syndromes against the Backdrop of Inborn Errors of Metabolism. Van Damme T, Colman M, Syx D, Malfait F. Genes (Basel). 2022 Jan 29;13(2):265. doi: 10.3390/genes13020265. PMID: 35205310; PMCID: PMC8872221.


Animal Models of Ehlers- Danlos Syndromes: Phenotype, Pathogenesis, and Translational Potential. Vroman R, Malfait AM, Miller RE, Malfait F, Syx D. Front Genet. 2021 Oct 12;12:726474. doi: 10.3389/fgene.2021.726474. PMID: 34712265; PMCID: PMC8547655.


The Ehlers-Danlos syndromes. Malfait F, Castori M, Francomano CA, Giunta C, Kosho T, Byers PH. Nat Rev Dis Primers. 2020 Jul 30;6(1):64. doi: 10.1038/s41572-020-0194-9. PMID: 32732924.


The 2017 international classification of the Ehlers-Danlos syndromes. Malfait F, Francomano C, Byers P, Belmont J, Berglund B, Black J, Bloom L, Bowen JM, Brady AF, Burrows NP, Castori M, Cohen H, Colombi M, Demirdas S, De Backer J, De Paepe A, Fournel-Gigleux S, Frank M, Ghali N, Giunta C, Grahame R, Hakim A, Jeunemaitre X, Johnson D, Juul-Kristensen B, Kapferer-Seebacher I, Kazkaz H, Kosho T, Lavallee ME, Levy H, Mendoza-Londono R, Pepin M, Pope FM, Reinstein E, Robert L, Rohrbach M, Sanders L, Sobey GJ, Van Damme T, Vandersteen A, van Mourik C, Voermans N, Wheeldon N, Zschocke J, Tinkle B. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):8-26. doi: 10.1002/ajmg.c.31552. PMID: 28306229.


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