Department of Clinical Genetics, Helsinki University Hospital, Helsinki, Finland.
Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland.
Acta Ophthalmol. 2018 Mar;96(2):183-191. doi: 10.1111/aos.13551. Epub 2017 Oct 25.
To study the genetic aetiology of retinal dystrophies (RD) in Finnish patients.
A targeted next-generation sequencing (NGS) panel of 105 retinal dystrophy genes was used in a cohort of 55 RD patients.
The overall diagnostic yield was 60% demonstrating the power of this approach. Interestingly, a missense mutation c.375C>G p.(Cys125Trp) in the CERKL gene was found in 18% of the patients in either a homozygous or compound heterozygous state. Data from Exome Aggregation Consortium (ExAC) Browser show that the CERKL c.375C>G p.(Cys125Trp) allele is enriched in the Finnish population and thus is a founder mutation. Furthermore, we report the clinical picture of 18 patients with mutations in the CERKL gene. CERKL mutations cause a macular-onset disease, in which symptoms first become apparent at the second decade. We also detected other novel founder mutations in the CERKL, EYS, RP1, ABCA4 and GUCY2D genes.
Our report indicates that the first diagnostic test for Finnish patients with sporadic or autosomal recessive RD should be a targeted test for founder mutations in the CERKL, EYS, RP1, ABCA4 and GUCY2D genes. These results confirm the utility of NGS-based gene panels as a powerful method for mutation identification in RD, thus enabling improved genetic counselling for these families.
研究芬兰患者视网膜营养不良(RD)的遗传病因。
在 55 名 RD 患者的队列中使用了针对 105 种视网膜营养不良基因的靶向下一代测序(NGS)面板。
总体诊断率为 60%,证明了这种方法的有效性。有趣的是,在 18%的患者中发现了 CERKL 基因中的错义突变 c.375C>G p.(Cys125Trp),无论是纯合子还是复合杂合子状态。来自外显子组聚合联盟(Exome Aggregation Consortium,ExAC)浏览器的数据显示,CERKL c.375C>G p.(Cys125Trp)等位基因在芬兰人群中丰富,因此是一个创始人突变。此外,我们报告了 18 名 CERKL 基因突变患者的临床特征。CERKL 突变导致黄斑起始疾病,症状在第二十年开始出现。我们还在 CERKL、EYS、RP1、ABCA4 和 GUCY2D 基因中检测到其他新的创始人突变。
我们的报告表明,对于散发性或常染色体隐性 RD 的芬兰患者,第一个诊断测试应该是针对 CERKL、EYS、RP1、ABCA4 和 GUCY2D 基因中创始人突变的靶向测试。这些结果证实了基于 NGS 的基因面板作为 RD 中突变识别的有力方法的有效性,从而为这些家庭提供了更好的遗传咨询。