Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Department for Cell and Developmental Biology, Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.
Eur Arch Otorhinolaryngol. 2024 Jul;281(7):3577-3586. doi: 10.1007/s00405-024-08492-5. Epub 2024 Feb 24.
Hearing loss (HL) is often monogenic. The clinical importance of genetic testing in HL may further increase when gene therapy products become available. Diagnoses are, however, complicated by a high genetic and allelic heterogeneity, particularly of autosomal dominant (AD) HL. This work aimed to characterize the mutational spectrum of AD HL in Austria.
In an ongoing prospective study, 27 consecutive index patients clinically diagnosed with non-syndromic AD HL, including 18 previously unpublished cases, were analyzed using whole-exome sequencing (WES) and gene panels. Novel variants were characterized using literature and bioinformatic means. Two additional Austrian medical centers provided AD HL mutational data obtained with in-house pipelines. Other Austrian cases of AD HL were gathered from literature.
The solve rate (variants graded as likely pathogenic (LP) or pathogenic (P)) within our cohort amounted to 59.26% (16/27). MYO6 variants were the most common cause. One third of LP/P variants were truncating variants in haploinsufficiency genes. Ten novel variants in HL genes were identified, including six graded as LP or P. In one cohort case and one external case, the analysis uncovered previously unrecognized syndromic presentations.
More than half of AD HL cases analyzed at our center were solved with WES. Our data demonstrate the importance of genetic testing, especially for the diagnosis of syndromic presentations, enhance the molecular knowledge of genetic HL, and support other laboratories in the interpretation of variants.
听力损失(HL)通常是单基因的。当基因治疗产品问世时,基因检测在 HL 中的临床重要性可能会进一步增加。然而,由于遗传和等位基因高度异质性,尤其是常染色体显性(AD)HL,诊断变得复杂。这项工作旨在描述奥地利 AD HL 的突变谱。
在一项正在进行的前瞻性研究中,对 27 例临床诊断为非综合征性 AD HL 的连续索引患者(包括 18 例以前未发表的病例)进行了全外显子组测序(WES)和基因面板分析。使用文献和生物信息学方法对新发现的变体进行了特征描述。另外两个奥地利医疗中心提供了使用内部管道获得的 AD HL 突变数据。从文献中收集了其他奥地利 AD HL 病例。
我们队列中的解决率(评为可能致病性(LP)或致病性(P)的变体)为 59.26%(16/27)。MYO6 变体是最常见的原因。三分之一的 LP/P 变体是半合子不足基因中的截断变体。在 HL 基因中发现了 10 个新的变体,其中 6 个被评为 LP 或 P。在一个队列病例和一个外部病例中,分析发现了以前未被认识到的综合征表现。
我们中心分析的超过一半的 AD HL 病例通过 WES 得到解决。我们的数据证明了基因检测的重要性,特别是对综合征表现的诊断,增强了对遗传性 HL 的分子认识,并为其他实验室解释变体提供了支持。