Yamamoto Toshiyuki, Imaizumi Taichi, Yamamoto-Shimojima Keiko, Lu Yongping, Yanagishita Tomoe, Shimada Shino, Chong Pin Fee, Kira Ryutaro, Ueda Riyo, Ishiyama Akihiko, Takeshita Eri, Momosaki Ken, Ozasa Shiro, Akiyama Tomoyuki, Kobayashi Katsuhiro, Oomatsu Hiroo, Kitahara Hikaru, Yamaguchi Tokito, Imai Katsumi, Kurahashi Hirokazu, Okumura Akihisa, Oguni Hirokazu, Seto Toshiyuki, Okamoto Nobuhiko
Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan; Tokyo Women's Medical University Institute of Integrated Medical Sciences, Tokyo, Japan.
Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan; Department of Pediatrics, St. Mariannna University School of Medicine, Kawasaki, Japan.
Brain Dev. 2019 Oct;41(9):776-782. doi: 10.1016/j.braindev.2019.05.007. Epub 2019 Jun 4.
Recently, many genes related to neurodevelopmental disorders have been identified by high-throughput genomic analysis; however, a comprehensive understanding of the mechanism underlying neurodevelopmental disorders remains to be established. To further understand these underlying mechanisms, we performed a comprehensive genomic analysis of patients with undiagnosed neurodevelopmental disorders.
Genomic analysis using next-generation sequencing with a targeted panel was performed for a total of 133 Japanese patients (male/female, 81/52) with previously undiagnosed neurodevelopmental disorders, including developmental delay (DD), intellectual disability (ID), autism spectrum disorder (ASD), and epilepsy. Genomic copy numbers were also analyzed using the eXome Hidden Markov Model (XHMM).
Thirty-nine patients (29.3%) exhibited pathogenic or likely pathogenic findings with single-gene variants or chromosomal aberrations. Among them, 20 patients were presented here. Pathogenic or likely pathogenic variants were identified in 18 genes, including ACTG1, CACNA1A, CHD2, CDKL5, DNMT3A, EHMT1, GABRB3, GABRG2, GRIN2B, KCNQ3, KDM5C, MED13L, SCN2A, SHANK3, SMARCA2, STXBP1, SYNGAP1, and TBL1XR1.
A diagnostic yield of 29.3% in this study was nearly the same as that previously reported from other countries. Thus, we suggest that there is no difference in genomic backgrounds in Japanese patients with undiagnosed neurodevelopmental disabilities. Although most of the patients possessed de novo variants, one of the patients showed an X-linked inheritance pattern. As X-linked recessive disorders exhibit the possibility of recurrent occurrence in the family, comprehensive molecular diagnosis is important for genetic counseling.
最近,通过高通量基因组分析已鉴定出许多与神经发育障碍相关的基因;然而,对神经发育障碍潜在机制的全面理解仍有待确立。为了进一步了解这些潜在机制,我们对未确诊的神经发育障碍患者进行了全面的基因组分析。
对总共133名日本患者(男/女,81/52)进行了使用靶向panel的下一代测序的基因组分析,这些患者患有先前未确诊的神经发育障碍,包括发育迟缓(DD)、智力残疾(ID)、自闭症谱系障碍(ASD)和癫痫。还使用外显子隐马尔可夫模型(XHMM)分析了基因组拷贝数。
39名患者(29.3%)表现出单基因变异或染色体畸变的致病或可能致病结果。其中,本文介绍了20名患者。在18个基因中鉴定出致病或可能致病的变异,包括ACTG1、CACNA1A、CHD2、CDKL5、DNMT3A、EHMT1、GABRB3、GABRG2、GRIN2B、KCNQ3、KDM5C、MED13L、SCN2A、SHANK3、SMARCA2、STXBP1、SYNGAP1和TBL1XR1。
本研究中29.3%的诊断率与其他国家先前报道的几乎相同。因此,我们认为未确诊的神经发育障碍日本患者的基因组背景没有差异。虽然大多数患者具有新生变异,但其中一名患者表现出X连锁遗传模式。由于X连锁隐性疾病在家族中有复发的可能性,全面的分子诊断对遗传咨询很重要。