Epilepsia. 2024 Mar;65(3):792-804. doi: 10.1111/epi.17860. Epub 2024 Jan 20.
OBJECTIVE: Copy number variants (CNVs) contribute to genetic risk and genetic etiology of both rare and common epilepsies. Whereas many studies have explored the role of CNVs in sporadic or severe cases, fewer have been done in familial generalized and focal epilepsies. METHODS: We analyzed exome sequence data from 267 multiplex families and 859 first-degree relative pairs with a diagnosis of genetic generalized epilepsies or nonacquired focal epilepsies to predict CNVs. Validation and segregation studies were performed using an orthogonal method when possible. RESULTS: We identified CNVs likely to contribute to epilepsy risk or etiology in the probands of 43 of 1116 (3.9%) families, including known recurrent CNVs (16p13.11 deletion, 15q13.3 deletion, 15q11.2 deletion, 16p11.2 duplication, 1q21.1 duplication, and 5-Mb duplication of 15q11q13). We also identified CNVs affecting monogenic epilepsy genes, including four families with CNVs disrupting the DEPDC5 gene, and a de novo deletion of HNRNPU in one affected individual from a multiplex family. Several large CNVs (>500 kb) of uncertain clinical significance were identified, including a deletion in 18q, a large duplication encompassing the SCN1A gene, and a 15q13.3 duplication (BP4-BP5). SIGNIFICANCE: The overall CNV landscape in common familial epilepsies is similar to that of sporadic epilepsies, with large recurrent deletions at 15q11, 15q13, and 16p13 contributing in 2.5%-3% of families. CNVs that interrupt known epilepsy genes and rare, large CNVs were also identified. Multiple etiologies were found in a subset of families, emphasizing the importance of genetic testing for multiple affected family members. Rare CNVs found in a single proband remain difficult to interpret and require larger cohorts to confirm their potential role in disease. Overall, our work indicates that CNVs contribute to the complex genetic architecture of familial generalized and focal epilepsies, supporting the role for clinical testing in affected individuals.
目的:拷贝数变异(CNVs)是导致罕见和常见癫痫的遗传风险和遗传病因的因素之一。虽然许多研究已经探讨了 CNVs 在散发性或严重病例中的作用,但在家族性全面性和局灶性癫痫中进行的研究较少。
方法:我们分析了 267 个多基因家族和 859 对一级亲属的外显子组序列数据,这些家族或亲属被诊断为遗传性全面性癫痫或后天获得性局灶性癫痫,以预测 CNVs。当可能时,使用正交方法进行验证和分离研究。
结果:我们在 1116 个家庭的 43 个先证者中发现了可能导致癫痫风险或病因的 CNVs,包括已知的反复 CNVs(16p13.11 缺失、15q13.3 缺失、15q11.2 缺失、16p11.2 重复、1q21.1 重复和 15q11q13 的 5-Mb 重复)。我们还发现了影响单基因癫痫基因的 CNVs,包括 4 个家族的 CNVs 破坏 DEPDC5 基因,以及一个多基因家族中一个受影响个体的 HNRNPU 新生缺失。还鉴定了几个具有不确定临床意义的大 CNVs(>500kb),包括 18q 的缺失、包含 SCN1A 基因的大重复和 15q13.3 重复(BP4-BP5)。
意义:常见家族性癫痫的总体 CNV 图谱与散发性癫痫相似,15q11、15q13 和 16p13 的大反复缺失在 2.5%-3%的家族中起作用。还鉴定了中断已知癫痫基因的 CNVs 和罕见的大 CNVs。在一部分家庭中发现了多种病因,强调了对多个受影响家庭成员进行基因检测的重要性。在单个先证者中发现的罕见 CNVs 仍然难以解释,需要更大的队列来证实它们在疾病中的潜在作用。总体而言,我们的工作表明 CNVs 导致了家族性全面性和局灶性癫痫的复杂遗传结构,支持对受影响个体进行临床检测的作用。
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