Jia Lijuan, Chen Yuanying, Hao Chanjuan, Guo Ruolan, Liu Yanjie, Li Wei, Guo Jun, Feng Yingjun
Department of Cardiology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan 450000,China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2021 Aug 10;38(8):731-734. doi: 10.3760/cma.j.cn511374-20200602-00406.
To identify the pathogenesis in two patients of restrictive cardiomyopathy (RCM) using high-throughput sequencing.
Peripheral blood samples from the two patients and their parents were collected and genomic DNAs were extracted to conduct targeted next generation sequencing or whole exome sequencing. Bioinformation analysis was performed to identify the pathogenic variants in genes associated with cardiomyopathy, which were further validated by Sanger sequencing.
By high throughput sequencing, we detected a de novo heterozygous variant c.549+1G>T in TNNI3 gene in patient 1. The variant has not been reported previously and was predicted to be pathogenic in line with American College of Medical Genetics and Genomics (ACMG) guidelines (PVS1+PS2+PM2). Another heterozygous variant c.433C>T (p.Arg145Trp) in TNNI3 gene was identified in patient 2 and his father. The variant had been reported as pathogenic variant in Clinvar and HGMD databases; based on ACMG guidelines, the variant was predicted to be likely pathogenic (PS3+PM1+PP3).
TNNI3 variants may be the causative gene responsible for restrictive cardiomyopathy in the two patients. High throughput sequencing results provide bases for the diagnosis of restrictive cardiomyopathy.
采用高通量测序技术鉴定两例限制型心肌病(RCM)患者的发病机制。
采集两名患者及其父母的外周血样本,提取基因组DNA,进行靶向二代测序或全外显子组测序。进行生物信息分析以鉴定与心肌病相关基因中的致病变异,并通过桑格测序进一步验证。
通过高通量测序,在患者1的TNNI3基因中检测到一个新发杂合变异c.549+1G>T。该变异此前未见报道,根据美国医学遗传学与基因组学学会(ACMG)指南预测为致病性变异(PVS1+PS2+PM2)。在患者2及其父亲中鉴定出TNNI3基因的另一个杂合变异c.433C>T(p.Arg145Trp)。该变异在Clinvar和HGMD数据库中已被报道为致病变异;根据ACMG指南,该变异预测可能致病(PS3+PM1+PP3)。
TNNI3变异可能是这两名患者限制型心肌病的致病基因。高通量测序结果为限制型心肌病的诊断提供了依据。