Jamuar Saumya S, Lam Anh-Thu N, Kircher Martin, D'Gama Alissa M, Wang Jian, Barry Brenda J, Zhang Xiaochang, Hill Robert Sean, Partlow Jennifer N, Rozzo Aldo, Servattalab Sarah, Mehta Bhaven K, Topcu Meral, Amrom Dina, Andermann Eva, Dan Bernard, Parrini Elena, Guerrini Renzo, Scheffer Ingrid E, Berkovic Samuel F, Leventer Richard J, Shen Yiping, Wu Bai Lin, Barkovich A James, Sahin Mustafa, Chang Bernard S, Bamshad Michael, Nickerson Deborah A, Shendure Jay, Poduri Annapurna, Yu Timothy W, Walsh Christopher A
From the Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Howard Hughes Medical Institute (S.S.J., A.-T.N.L., A.M.D., B.J.B., X.Z., R.S.H., J.N.P., A.R., S.S., B.K.M., T.W.Y., C.A.W.), and the Departments of Laboratory Medicine (J.W., Y.S., B.L.W.) and Neurology (M.S., A.P.), Boston Children's Hospital, the Departments of Pediatrics (S.S.J., A.-T.N.L., A.M.D., B.J.B., X.Z., R.S.H., J.N.P., A.R., S.S., B.K.M., T.W.Y., C.A.W.), Neurology (S.S.J., A.-T.N.L., A.M.D., B.J.B., X.Z., R.S.H., J.N.P., A.R., S.S., B.K.M., T.W.Y., C.A.W., M.S., A.P.), and Pathology (Y.S., B.L.W.), Harvard Medical School, the Department of Neurology, Beth Israel Deaconess Medical Center (B.S.C.), and the Department of Neurology, Massachusetts General Hospital (T.W.Y.) - all in Boston; the Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore (S.S.J.); the Department of Genome Sciences, University of Washington, Seattle (M.K., M.B., D.A.N., J.S.); the Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai (J.W., Y.S.); the Division of Neurology, Department of Pediatrics, Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey (M.T.); the Neurogenetics Unit, Montreal Neurological Hospital and Institute, Department of Neurology and Neurosurgery (D.A., E.A.) and Department of Human Genetics (E.A.), McGill University, Montreal; the Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels (B.D.); the Pediatric Neurology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy (E.P., R.G.); the Department of Medicine, University of Melbourne, Austin Health, Heidelberg (I.E.S., S.F.B.), Department of Paediatrics, Royal Children's Hospital, University of Melbourne, and the Florey Institute of Neuroscience and Mental Health, Melbourne (I.E.S.), and the Department of Neurology, Royal Children's Hospital, Murdoch Children'
N Engl J Med. 2014 Aug 21;371(8):733-43. doi: 10.1056/NEJMoa1314432.
Although there is increasing recognition of the role of somatic mutations in genetic disorders, the prevalence of somatic mutations in neurodevelopmental disease and the optimal techniques to detect somatic mosaicism have not been systematically evaluated.
Using a customized panel of known and candidate genes associated with brain malformations, we applied targeted high-coverage sequencing (depth, ≥200×) to leukocyte-derived DNA samples from 158 persons with brain malformations, including the double-cortex syndrome (subcortical band heterotopia, 30 persons), polymicrogyria with megalencephaly (20), periventricular nodular heterotopia (61), and pachygyria (47). We validated candidate mutations with the use of Sanger sequencing and, for variants present at unequal read depths, subcloning followed by colony sequencing.
Validated, causal mutations were found in 27 persons (17%; range, 10 to 30% for each phenotype). Mutations were somatic in 8 of the 27 (30%), predominantly in persons with the double-cortex syndrome (in whom we found mutations in DCX and LIS1), persons with periventricular nodular heterotopia (FLNA), and persons with pachygyria (TUBB2B). Of the somatic mutations we detected, 5 (63%) were undetectable with the use of traditional Sanger sequencing but were validated through subcloning and subsequent sequencing of the subcloned DNA. We found potentially causal mutations in the candidate genes DYNC1H1, KIF5C, and other kinesin genes in persons with pachygyria.
Targeted sequencing was found to be useful for detecting somatic mutations in patients with brain malformations. High-coverage sequencing panels provide an important complement to whole-exome and whole-genome sequencing in the evaluation of somatic mutations in neuropsychiatric disease. (Funded by the National Institute of Neurological Disorders and Stroke and others.).
尽管体细胞突变在遗传疾病中的作用日益受到认可,但体细胞突变在神经发育疾病中的患病率以及检测体细胞镶嵌现象的最佳技术尚未得到系统评估。
我们使用了一组定制的与脑畸形相关的已知基因和候选基因,对158例脑畸形患者白细胞来源的DNA样本进行了靶向高覆盖测序(深度≥200×),这些患者包括双皮质综合征(皮质下带异位,30例)、巨脑回伴多小脑回畸形(20例)、室管膜下结节性异位(61例)和巨脑回(47例)。我们使用Sanger测序验证候选突变,对于读取深度不等的变异,进行亚克隆后再进行菌落测序。
在27例患者(17%;每种表型的范围为10%至30%)中发现了经过验证的致病突变。27例中的8例(30%)突变是体细胞突变,主要见于双皮质综合征患者(我们在其中发现了DCX和LIS1基因的突变)、室管膜下结节性异位患者(FLNA)和巨脑回患者(TUBB2B)。在我们检测到的体细胞突变中,5例(63%)使用传统Sanger测序无法检测到,但通过亚克隆及亚克隆DNA的后续测序得到了验证。我们在巨脑回患者的候选基因DYNC1H1、KIF5C和其他驱动蛋白基因中发现了潜在的致病突变。
发现靶向测序有助于检测脑畸形患者的体细胞突变。在评估神经精神疾病的体细胞突变时,高覆盖测序面板是对全外显子组测序和全基因组测序的重要补充。(由美国国立神经疾病与中风研究所及其他机构资助。)