“…Moreover, in skin fibroblasts from patients, the level of both functional a-dystroglycan glycosylation, examined by Western blot and flow cytometry (Stevens et al, 2013b), and its ability to bind laminin ( Fig 2B and Appendix Fig S5B) were normal, unlike known secondary dystroglycanopathies, which usually result in decreased functional a-dystroglycan glycosylation in both muscle and the skin fibroblasts (Willer et al, 2012;Carss et al, 2013;Stevens et al, 2013a). Finally, although basement membrane defects are commonly observed in dystroglycanopathies (Yamamoto et al, 1997;Goddeeris et al, 2013), transmission electron microscopy showed normal muscle ultrastructure in patients, with no alterations in basement membrane compaction (Fig 2C and Appendix Fig S5C). A The family pedigree, where circles denote female members, squares male members, solid symbols affected members, and white symbols asymptomatic members with normal physical exam; the dots indicate heterozygous carriers, and double line denotes a consanguineous marriage.…”