Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, United Kingdom.
Eur J Hum Genet. 2024 Oct;32(10):1291-1298. doi: 10.1038/s41431-023-01513-7. Epub 2023 Dec 20.
The contribution of de novo variants as a cause of intellectual disability (ID) is well established in several cohorts reported from the developed world. However, the genetic landscape as well as the appropriate testing strategies for identification of de novo variants of these disorders remain largely unknown in low-and middle-income countries like India. In this study, we delineate the clinical and genotypic spectrum of 54 families (55 individuals) with syndromic ID harboring rare de novo variants. We also emphasize on the effectiveness of singleton exome sequencing as a valuable tool for diagnosing these disorders in resource limited settings. Overall, 46 distinct disorders were identified encompassing 46 genes with 51 single-nucleotide variants and/or indels and two copy-number variants. Pathogenic variants were identified in CREBBP, TSC2, KMT2D, MECP2, IDS, NIPBL, NSD1, RIT1, SOX10, BRWD3, FOXG1, BCL11A, KDM6B, KDM5C, SETD5, QRICH1, DCX, SMARCD1, ASXL1, ASXL3, AKT3, FBN2, TCF12, WASF1, BRAF, SMARCA4, SMARCA2, TUBG1, KMT2A, CTNNB1, DLG4, MEIS2, GATAD2B, FBXW7, ANKRD11, ARID1B, DYNC1H1, HIVEP2, NEXMIF, ZBTB18, SETD1B, DYRK1A, SRCAP, CASK, L1CAM, and KRAS. Twenty-four of these monogenic disorders have not been previously reported in the Indian population. Notably, 39 out of 53 (74%) disease-causing variants are novel. These variants were identified in the genes mainly encoding transcriptional and chromatin regulators, serine threonine kinases, lysosomal enzymes, molecular motors, synaptic proteins, neuronal migration machinery, adhesion molecules, structural proteins and signaling molecules.
在发达国家的多个队列报告中,新生变异作为智力障碍(ID)的一个病因已得到充分证实。然而,在印度等中低收入国家,这些疾病的新生变异的遗传图谱以及适当的检测策略仍知之甚少。在这项研究中,我们描绘了 54 个有综合征性智力障碍的家系(共 55 名个体)的临床和基因型谱,这些家系携带有罕见的新生变异。我们还强调了单体外显子组测序作为在资源有限的环境中诊断这些疾病的有效工具的重要性。总的来说,我们鉴定了 46 种不同的疾病,涉及 46 个基因,其中包括 51 种单核苷酸变异和/或插入缺失和两种拷贝数变异。在 CREBBP、TSC2、KMT2D、MECP2、IDS、NIPBL、NSD1、RIT1、SOX10、BRWD3、FOXG1、BCL11A、KDM6B、KDM5C、SETB5、QRICH1、DCX、SMARCD1、ASXL1、ASXL3、AKT3、FBN2、TCF12、WASF1、BRAF、SMARCA4、SMARCA2、TUBG1、KMT2A、CTNNB1、DLG4、MEIS2、GATAD2B、FBXW7、ANKRD11、ARID1B、DYNC1H1、HIVEP2、NEXMIF、ZBTB18、SETD1B、DYRK1A、SRCAP、CASK、L1CAM 和 KRAS 中鉴定出了致病性变异。其中 24 种单基因疾病在印度人群中尚未有报道。值得注意的是,39 种(74%)致病性变异是新的。这些变异存在于主要编码转录和染色质调节因子、丝氨酸/苏氨酸激酶、溶酶体酶、分子马达、突触蛋白、神经元迁移机制、黏附分子、结构蛋白和信号分子的基因中。