Du Xiujuan, Gao Xueren, Liu Xin, Shen Lixiao, Wang Kai, Fan Yanjie, Sun Yu, Luo Xiaomei, Liu Huili, Wang Lili, Wang Yu, Gong Zhuwen, Wang Jianguo, Yu Yongguo, Li Fei
Developmental and Behavioral Pediatric Department - Child Primary Care Department, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research and MOE Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pediatric Endocrinology and Genetics, Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Genet. 2018 Nov 30;9:594. doi: 10.3389/fgene.2018.00594. eCollection 2018.
Autism spectrum disorder (ASD) is a group of clinically and genetically heterogeneous neurodevelopmental disorders. Recent tremendous advances in the whole exome sequencing (WES) enable rapid identification of variants associated with ASD including single nucleotide variations (SNVs) and indels. To further explore genetic etiology of ASD in Chinese children with negative findings of copy number variants (CNVs), we applied WES in 80 simplex families with a single affected offspring with ASD or suspected ASD, and validated variations predicted to be damaging by Sanger sequencing. The results showed that an overall diagnostic yield of 8.8% (9.2% in the group of ASD and 6.7% in the group of suspected ASD) was observed in our cohort. Among patients with diagnosed ASD, developmental delay or intellectual disability (DD/ID) was the most common comorbidity with a diagnostic yield of 13.3%, followed by seizures (50.0%) and craniofacial anomalies (40.0%). All of identified SNVs and indels among patients with ASD were loss of function (LOF) variations and were slightly more frequent among female (male vs. female: 7.3% vs. 8.5%). A total of seven presumed causative genes (, and ) were identified in this study. In conclusion, WES is an efficient diagnostic tool for diagnosed ASD especially those with negative findings of CNVs and other neurological disorders in clinical practice, enabling early identification of disease related genes and contributing to precision and personalized medicine.
自闭症谱系障碍(ASD)是一组临床和遗传异质性的神经发育障碍。全外显子组测序(WES)最近取得了巨大进展,能够快速识别与ASD相关的变异,包括单核苷酸变异(SNV)和插入缺失。为了进一步探索在中国儿童中拷贝数变异(CNV)检测结果为阴性的ASD的遗传病因,我们对80个单基因家庭进行了WES检测,这些家庭中有一个患有ASD或疑似ASD的患病后代,并通过桑格测序验证了预测具有损害性的变异。结果显示,我们的队列中总体诊断率为8.8%(ASD组为9.2%,疑似ASD组为6.7%)。在确诊为ASD的患者中,发育迟缓或智力残疾(DD/ID)是最常见的合并症,诊断率为13.3%,其次是癫痫(50.0%)和颅面畸形(40.0%)。在ASD患者中鉴定出的所有SNV和插入缺失均为功能丧失(LOF)变异,在女性中略为常见(男性与女性:7.3%对8.5%)。本研究共鉴定出7个推定的致病基因(、和)。总之,WES是临床实践中诊断ASD尤其是CNV检测结果为阴性的ASD以及其他神经系统疾病的有效诊断工具,能够早期识别疾病相关基因,有助于精准和个性化医疗。