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全外显子组测序分析在儿童癫痫中的临床应用

Clinical application of whole-exome sequencing analysis in childhood epilepsy.

作者信息

Gavaz Meral, Aslan Elif S, Tekeş Selahattin

机构信息

Department of Molecular and Medical Genetics, Biruni University, Istanbul, Turkey.

Faculty of Medicine, Department of Medical Genetics, Dicle University, Diyarbakir, Turkey.

出版信息

J Neurogenet. 2024 Dec;38(4):187-194. doi: 10.1080/01677063.2024.2434869. Epub 2024 Dec 9.

Abstract

The swift updates of public databases and advancements in next-generation sequencing (NGS) technologies have enhanced the genetic identification capacities of epilepsy clinics. This study aimed to evaluate the diagnostic efficacy of NGS in pediatric epilepsy patients as a whole and to present the data obtained in the whole exome sequence analysis. We enrolled 40 children with suspected childhood epilepsy in this study. All patients underwent evaluation by a clinical geneticist or pediatric neurologist and the molecular genetic analysis of those children was performed by whole-exome sequencing (WES). Out of the 40 patients, 12 (30%) received a genetic diagnosis, involving 14 mutations across 13 genes. The cumulative positive diagnostic yield was 30%. Twelve of these patients were identified to have 5 variants previously documented as pathogenic, 9 variants classified as likely pathogenic, and 5 novel variants that have not been reported before. The outcomes indicate that whole-exome sequencing offers great benefits in clinical patient diagnosis, particularly in terms of detecting diagnostic variants. This study underscored the significance of whole exome sequencing (WES) studies, where only a broad gene set is examined in epilepsy patients. This approach has the potential to establish gene-specific phenotypic profiles, particularly by uncovering novel candidate genes in epilepsy patients with well-defined phenotypes. Additionally, conducting validation studies on variants of uncertain clinical significance could enhance the outcome yield.

摘要

公共数据库的迅速更新以及新一代测序(NGS)技术的进步提高了癫痫诊所的基因识别能力。本研究旨在评估NGS对小儿癫痫患者的整体诊断效果,并展示全外显子组序列分析所获得的数据。我们在本研究中纳入了40名疑似儿童癫痫的患儿。所有患者均接受了临床遗传学家或儿科神经科医生的评估,这些儿童的分子遗传学分析通过全外显子组测序(WES)进行。在这40例患者中,12例(30%)获得了基因诊断,涉及13个基因中的14个突变。累积阳性诊断率为30%。其中12例患者被鉴定出有5个先前记录为致病性的变异、9个被分类为可能致病性的变异以及5个以前未报道过的新变异。结果表明,全外显子组测序在临床患者诊断中具有很大益处,特别是在检测诊断性变异方面。本研究强调了全外显子组测序(WES)研究的重要性,在癫痫患者中仅检测一组广泛的基因。这种方法有可能建立基因特异性的表型谱,特别是通过在具有明确表型的癫痫患者中发现新的候选基因。此外,对临床意义不明确的变异进行验证研究可以提高诊断率。

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