Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Med Genet. 2024 Jun 20;61(7):613-620. doi: 10.1136/jmg-2023-109750.
As gene-specific therapy for inherited retinal dystrophy (IRD) advances, unified variant interpretation across institutes is becoming increasingly important. This study aims to update the genetic findings of 86 retinitis pigmentosa (RP)-related genes in a large number of Japanese patients with RP by applying the standardised variant interpretation guidelines for Japanese patients with IRD (J-IRD-VI guidelines) built upon the American College of Medical Genetics and Genomics and the Association for Molecular Pathology rules, and assess the contribution of these genes in RP-allied diseases.
We assessed 2325 probands with RP (n=2155, including n=1204 sequenced previously with the same sequencing panel) and allied diseases (n=170, newly analysed), including Usher syndrome, Leber congenital amaurosis and cone-rod dystrophy (CRD). Target sequencing using a panel of 86 genes was performed. The variants were interpreted according to the J-IRD-VI guidelines.
A total of 3564 variants were detected, of which 524 variants were interpreted as pathogenic or likely pathogenic. Among these 524 variants, 280 (53.4%) had been either undetected or interpreted as variants of unknown significance or benign variants in our earlier study of 1204 patients with RP. This led to a genetic diagnostic rate in 38.6% of patients with RP, with accounting for 46.7% of the genetically solved patients, showing a 9% increase in diagnostic rate from our earlier study. The genetic diagnostic rate for patients with CRD was 28.2%, with RP-related genes significantly contributing over other allied diseases.
A large-scale genetic analysis using the J-IRD-VI guidelines highlighted the population-specific genetic findings for Japanese patients with IRD; these findings serve as a foundation for the clinical application of gene-specific therapies.
随着针对遗传性视网膜营养不良(IRD)的基因特异性治疗的发展,不同机构之间统一的变异解释变得越来越重要。本研究旨在通过应用基于美国医学遗传学与基因组学学会和分子病理学协会规则为日本IRD 患者建立的标准化变异解释指南(J-IRD-VI 指南),更新大量日本 RP 患者 86 个与视网膜色素变性(RP)相关基因的遗传发现,并评估这些基因在与 RP 相关疾病中的作用。
我们评估了 2325 名 RP 患者(n=2155,包括之前使用相同测序面板测序的 n=1204)和相关疾病(n=170,新分析),包括 Usher 综合征、先天性黑矇和 Cone-Rod 营养不良(CRD)。使用 86 个基因的面板进行靶向测序。根据 J-IRD-VI 指南对变体进行解释。
共检测到 3564 个变体,其中 524 个变体被解释为致病性或可能致病性。在这 524 个变体中,280 个(53.4%)在我们之前对 1204 名 RP 患者的研究中未被检测到或被解释为未知意义的变体或良性变体。这导致 38.6%的 RP 患者具有遗传诊断率,其中 46.7%的遗传解决患者归因于这一发现,与我们之前的研究相比,诊断率提高了 9%。CRD 患者的遗传诊断率为 28.2%,RP 相关基因明显比其他相关疾病贡献更大。
使用 J-IRD-VI 指南进行的大规模遗传分析突出了日本 IRD 患者的人群特异性遗传发现;这些发现为基因特异性治疗的临床应用奠定了基础。