CENTOGENE GmbH, Rostock, Germany.
Serviço de Genética Médica. Hospital de Santa Maria. Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal.
Genet Med. 2021 Aug;23(8):1551-1568. doi: 10.1038/s41436-021-01159-0. Epub 2021 Apr 19.
Within this study, we aimed to discover novel gene-disease associations in patients with no genetic diagnosis after exome/genome sequencing (ES/GS).
We followed two approaches: (1) a patient-centered approach, which after routine diagnostic analysis systematically interrogates variants in genes not yet associated to human diseases; and (2) a gene variant centered approach. For the latter, we focused on de novo variants in patients that presented with neurodevelopmental delay (NDD) and/or intellectual disability (ID), which are the most common reasons for genetic testing referrals. Gene-disease association was assessed using our data repository that combines ES/GS data and Human Phenotype Ontology terms from over 33,000 patients.
We propose six novel gene-disease associations based on 38 patients with variants in the BLOC1S1, IPO8, MMP15, PLK1, RAP1GDS1, and ZNF699 genes. Furthermore, our results support causality of 31 additional candidate genes that had little published evidence and no registered OMIM phenotype (56 patients). The phenotypes included syndromic/nonsyndromic NDD/ID, oral-facial-digital syndrome, cardiomyopathies, malformation syndrome, short stature, skeletal dysplasia, and ciliary dyskinesia.
Our results demonstrate the value of data repositories which combine clinical and genetic data for discovering and confirming gene-disease associations. Genetic laboratories should be encouraged to pursue such analyses for the benefit of undiagnosed patients and their families.
在这项研究中,我们旨在发现外显子组/基因组测序(ES/GS)后无遗传诊断的患者中的新的基因-疾病关联。
我们遵循两种方法:(1)以患者为中心的方法,在常规诊断分析后系统地检测尚未与人类疾病相关的基因中的变体;(2)以基因变异为中心的方法。对于后者,我们专注于具有神经发育迟缓(NDD)和/或智力障碍(ID)的患者中的新生变体,这是遗传测试转诊的最常见原因。使用我们的数据库评估基因-疾病关联,该数据库结合了来自 33,000 多名患者的 ES/GS 数据和人类表型本体论术语。
我们提出了六个新的基因-疾病关联,涉及 38 名具有 BLOC1S1、IPO8、MMP15、PLK1、RAP1GDS1 和 ZNF699 基因变异的患者。此外,我们的结果支持了另外 31 个候选基因的因果关系,这些基因的证据很少,且 OMIM 表型尚未注册(56 名患者)。表型包括综合征/非综合征性 NDD/ID、口腔-面部-数字综合征、心肌病、畸形综合征、身材矮小、骨骼发育不良和纤毛运动障碍。
我们的结果证明了结合临床和遗传数据的数据存储库对于发现和确认基因-疾病关联的价值。应该鼓励遗传实验室进行此类分析,以为未确诊的患者及其家人带来益处。