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土耳其人群神经发育障碍中多基因致病性变异的高患病率。

High prevalence of multilocus pathogenic variation in neurodevelopmental disorders in the Turkish population.

机构信息

Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.

Department of Pediatric Neurology, Faculty of Medicine, University of Gaziantep, Gaziantep 27310, Turkey.

出版信息

Am J Hum Genet. 2021 Oct 7;108(10):1981-2005. doi: 10.1016/j.ajhg.2021.08.009. Epub 2021 Sep 28.

Abstract

Neurodevelopmental disorders (NDDs) are clinically and genetically heterogenous; many such disorders are secondary to perturbation in brain development and/or function. The prevalence of NDDs is > 3%, resulting in significant sociocultural and economic challenges to society. With recent advances in family-based genomics, rare-variant analyses, and further exploration of the Clan Genomics hypothesis, there has been a logarithmic explosion in neurogenetic "disease-associated genes" molecular etiology and biology of NDDs; however, the majority of NDDs remain molecularly undiagnosed. We applied genome-wide screening technologies, including exome sequencing (ES) and whole-genome sequencing (WGS), to identify the molecular etiology of 234 newly enrolled subjects and 20 previously unsolved Turkish NDD families. In 176 of the 234 studied families (75.2%), a plausible and genetically parsimonious molecular etiology was identified. Out of 176 solved families, deleterious variants were identified in 218 distinct genes, further documenting the enormous genetic heterogeneity and diverse perturbations in human biology underlying NDDs. We propose 86 candidate disease-trait-associated genes for an NDD phenotype. Importantly, on the basis of objective and internally established variant prioritization criteria, we identified 51 families (51/176 = 28.9%) with multilocus pathogenic variation (MPV), mostly driven by runs of homozygosity (ROHs) - reflecting genomic segments/haplotypes that are identical-by-descent. Furthermore, with the use of additional bioinformatic tools and expansion of ES to additional family members, we established a molecular diagnosis in 5 out of 20 families (25%) who remained undiagnosed in our previously studied NDD cohort emanating from Turkey.

摘要

神经发育障碍 (NDD) 在临床上和遗传学上具有异质性;许多此类疾病继发于大脑发育和/或功能的紊乱。NDD 的患病率>3%,给社会带来了重大的社会文化和经济挑战。随着基于家系的基因组学、稀有变异分析以及对 Clan Genomics 假说的进一步探索,神经遗传学“疾病相关基因”的分子病因学和生物学在 NDD 方面呈指数级爆炸式增长;然而,大多数 NDD 仍然无法从分子上进行诊断。我们应用了全基因组筛选技术,包括外显子组测序 (ES) 和全基因组测序 (WGS),以确定 234 名新入组的受试者和 20 个以前未解决的土耳其 NDD 家系的分子病因学。在所研究的 234 个家庭中的 176 个家庭 (75.2%) 中,确定了一种合理且遗传简约的分子病因学。在已解决的 176 个家庭中,在 218 个不同的基因中发现了有害变异,进一步证明了 NDD 所涉及的人类生物学中存在巨大的遗传异质性和多样化的紊乱。我们提出了 86 个候选疾病特征相关基因,用于 NDD 表型。重要的是,基于客观的和内部建立的变异优先级标准,我们确定了 51 个家庭 (51/176 = 28.9%) 具有多基因致病性变异 (MPV),主要由纯合子连续状态 (ROH) 驱动-反映了同源的基因组片段/单倍型。此外,我们使用了额外的生物信息学工具,并将 ES 扩展到额外的家庭成员,在我们以前研究的来自土耳其的 NDD 队列中,有 5 个仍然无法诊断的家庭 (25%) 建立了分子诊断。

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