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在西波利尼西亚发现一种新的 IFNAR1 缺陷病例,该病例中 DOCK8 存在常见的经典剪接位点变异:在代表性不足的血统中验证意义不明的变异的重要性。

A Novel Case of IFNAR1 Deficiency Identified a Common Canonical Splice Site Variant in DOCK8 in Western Polynesia: The Importance of Validating Variants of Unknown Significance in Under-Represented Ancestries.

机构信息

Queensland Paediatric Immunology and Allergy Service, Children's Health Queensland, Brisbane, QLD, 4101, Australia.

Clinical Immunogenomics Research Consortium, Australasia, Australia.

出版信息

J Clin Immunol. 2024 Aug 5;44(8):170. doi: 10.1007/s10875-024-01774-x.

Abstract

Advanced genomic technologies such as whole exome or whole genome sequencing have improved diagnoses and disease outcomes for individuals with genetic diseases. Yet, variants of unknown significance (VUS) require rigorous validation to establish disease causality or modification, or to exclude them from further analysis. Here, we describe a young individual of Polynesian ancestry who in the first 13 mo of life presented with SARS-CoV-2 pneumonia, severe enterovirus meningitis and adenovirus gastroenteritis, and severe adverse reaction to MMR vaccination. Genomic analysis identified a previously reported pathogenic homozygous variant in IFNAR1 (c.1156G > T, p.Glu386* LOF), which is common in Western Polynesia. Moreover, a new and putatively deleterious canonical splice site variant in DOCK8 was also found in homozygosity (c.3234 + 2T > C). This DOCK8 variant is common in Polynesians and other under-represented ancestries in large genomic databases. Despite in silico bioinformatic predictions, extensive in vitro and ex vivo analysis revealed the DOCK8 variant likely be neutral. Thus, our study reports a novel case of IFNAR1 deficiency, but also highlights the importance of functional validation of VUS, including those predicted to be deleterious, and the pressing need to expand our knowledge of the genomic architecture and landscape of under-represented populations and ancestries.

摘要

先进的基因组技术,如全外显子或全基因组测序,提高了患有遗传疾病的个体的诊断和疾病结果。然而,意义不明的变异(VUS)需要严格的验证来确定疾病的因果关系或修饰,或排除它们进行进一步分析。在这里,我们描述了一个具有波利尼西亚血统的年轻人,他在生命的前 13 个月中出现了 SARS-CoV-2 肺炎、严重的肠道病毒脑膜炎和腺病毒肠胃炎,以及对 MMR 疫苗的严重不良反应。基因组分析确定了 IFNAR1 中一个先前报道的致病性纯合变异(c.1156G>T,p.Glu386* 无义突变),该变异在西方波利尼西亚人中很常见。此外,还在 DOCK8 中发现了一个新的、推测具有致病性的经典剪接位点变异(c.3234+2T>C),呈纯合状态。这种 DOCK8 变异在波利尼西亚人和其他在大型基因组数据库中代表性不足的人群中很常见。尽管进行了计算机生物信息学预测,但广泛的体外和离体分析表明,DOCK8 变异可能是中性的。因此,我们的研究报告了一个新的 IFNAR1 缺陷病例,但也强调了对 VUS 的功能验证的重要性,包括那些预测为有害的 VUS,以及迫切需要扩大我们对代表性不足的人群和血统的基因组结构和景观的了解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7547/11298505/1b75ec0cea38/10875_2024_1774_Fig1_HTML.jpg

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