Capasso Dalila, Zeuli Roberta, Arno Gavin, Kwint Michael, Timmermans Raoul, Ruiz-Ceja Karla A, Karali Marianthi, Simonelli Francesca, Signorini Sabrina, Valente Enza Maria, Cremers Frans P M, Banfi Sandro, Roosing Susanne, Panneman Daan M, de Bruijn Suzanne E
Telethon Institute of Genetics and Medicine, Pozzuoli, Italy; Scuola Superiore Meridionale (SSM, School of Advanced Studies), Genomic and Experimental Medicine Program, Naples, Italy.
Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy.
HGG Adv. 2025 Apr 18;6(3):100442. doi: 10.1016/j.xhgg.2025.100442.
Splice-altering variants are suggested to be responsible for part of the missing heritability of inherited retinal diseases (IRDs). The interpretation of these variants is challenging as functional evidence is required to validate pathogenicity. We explored the diagnostic value of a targeted long-read cDNA sequencing (lrcDNA-seq) approach to investigate IRD-associated splicing defects. For each affected individual, RNA was isolated from blood, and for each candidate gene, cDNA amplicons, spanning the complete open reading frame or multiple exons, were generated and subjected to long-read sequencing. We validated our approach by assessing previously described pathogenic splice-altering variants in IRD-associated genes. Next, we investigated six genetically unexplained affected individuals, each carrying pathogenic variant(s) in NMNAT1. In two probands, we provided functional validation for previously identified variants of uncertain significance present on the second allele. In four other subjects, lrcDNA-seq revealed the partial inclusion of an SVA_F retrotransposon in the NMNAT1 mRNA, predicted to introduce a premature stop codon. We showed that targeted lrcDNA-seq is effective in characterizing splice defects and in identifying novel splice-altering variants and uncovered the IRD genetic basis for six previously unexplained subjects. We believe that the implementation of this technique has the potential to contribute to an increased diagnostic rate of IRDs.
剪接改变变体被认为是遗传性视网膜疾病(IRD)部分缺失遗传力的原因。由于需要功能证据来验证致病性,这些变体的解释具有挑战性。我们探索了靶向长读长cDNA测序(lrcDNA-seq)方法在研究IRD相关剪接缺陷方面的诊断价值。对于每个受影响个体,从血液中分离RNA,对于每个候选基因,生成跨越完整开放阅读框或多个外显子的cDNA扩增子,并进行长读长测序。我们通过评估先前描述的IRD相关基因中的致病性剪接改变变体来验证我们的方法。接下来,我们研究了6名遗传原因不明的受影响个体,每个个体在NMNAT1中携带致病性变体。在两名先证者中,我们为先前在第二个等位基因上鉴定的意义不确定的变体提供了功能验证。在其他四名受试者中,lrcDNA-seq显示NMNAT1 mRNA中部分包含SVA_F逆转录转座子,预计会引入提前终止密码子。我们表明,靶向lrcDNA-seq在表征剪接缺陷和识别新的剪接改变变体方面是有效的,并揭示了6名先前原因不明受试者的IRD遗传基础。我们认为,这项技术的应用有可能提高IRD的诊断率。