胶原基因相关关节过度活动序列变异的 ACMG/AMP 临床解读标准的制定和验证
Specifications and validation of the ACMG/AMP criteria for clinical interpretation of sequence variants in collagen genes associated with joint hypermobility.
机构信息
Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy.
Medical Genetics Unit, Department of Clinical and Biological Sciences, University of Turin, AOU 'S. Luigi Gonzaga', Orbassano, Turin, Italy.
出版信息
Hum Genet. 2023 Jun;142(6):785-808. doi: 10.1007/s00439-023-02547-z. Epub 2023 Apr 20.
Deleterious variants in collagen genes are the most common cause of hereditary connective tissue disorders (HCTD). Adaptations of the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) criteria are still lacking. A multidisciplinary team was set up for developing specifications of the ACMG/AMP criteria for COL1A1, COL1A2, COL2A1, COL3A1, COL5A1, COL5A2, COL11A1, COL11A2 and COL12A1, associated with various forms of HCTD featuring joint hypermobility, which is becoming one of the most common reasons of referral for molecular testing in this field. Such specifications were validated against 209 variants, and resulted effective for classifying as pathogenic and likely pathogenic null alleles without downgrading of the PVS1 level of strength and recurrent Glycine substitutions. Adaptations of selected criteria reduced uncertainties on private Glycine substitutions, intronic variants predicted to affect the splicing, and null alleles with a downgraded PVS1 level of strength. Segregation and multigene panel sequencing data mitigated uncertainties on non-Glycine substitutions by the attribution of one or more benignity criteria. These specifications may improve the clinical utility of molecular testing in HCTD by reducing the number of variants with neutral/conflicting interpretations. Close interactions between laboratory and clinicians are crucial to estimate the a priori utility of molecular test and to improve medical reports.
胶原基因中的有害变异是遗传性结缔组织疾病(HCTD)最常见的原因。美国医学遗传学与基因组学学会/分子病理学协会(ACMG/AMP)标准的适应性仍然缺乏。成立了一个多学科团队,为与关节过度活动相关的各种形式的 HCTD 相关的 COL1A1、COL1A2、COL2A1、COL3A1、COL5A1、COL5A2、COL11A1、COL11A2 和 COL12A1 基因的 ACMG/AMP 标准制定规范,关节过度活动是该领域分子检测最常见的转诊原因之一。这些规范针对 209 个变体进行了验证,并有效地用于对无功能等位基因进行致病性和可能致病性分类,而不会降低 PVS1 强度等级和反复出现的甘氨酸取代的致病性。选定标准的适应性降低了对私人甘氨酸取代、预测影响剪接的内含子变体以及 PVS1 强度等级降低的无功能等位基因的不确定性。分离和多基因组测序数据通过归因于一个或多个良性标准,减轻了对非甘氨酸取代的不确定性。这些规范可以通过减少具有中性/冲突解释的变异数量,提高 HCTD 分子检测的临床实用性。实验室和临床医生之间的密切互动对于评估分子检测的先验实用性和改进医学报告至关重要。