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用于广泛临床基因诊断的综合长读长测序平台的验证

Validation of a comprehensive long-read sequencing platform for broad clinical genetic diagnosis.

作者信息

Sen Siddhartha, Handler Hillary P, Victorsen Alec, Flaten Zach, Ellison Aidan, Knutson Todd P, Munro Sarah A, Martinez Ryan J, Billington Charles John, Laffin Jennifer J, Bray Sarah, Mroz Pawel, Yohe Sophia, Nelson Andrew C, Bower Matthew, Thyagarajan Bharat

机构信息

University of Minnesota Health Sciences, University of Minnesota Medical Center, Minneapolis, MN, United States.

Molecular Diagnostics Laboratory, Fairview Health, University of Minnesota Medical Center, Minneapolis, MN, United States.

出版信息

Front Genet. 2025 May 2;16:1499456. doi: 10.3389/fgene.2025.1499456. eCollection 2025.

Abstract

Though short read high-throughput sequencing, commonly known as Next-Generation Sequencing (NGS), has revolutionized genomics and genetic testing, there is no single genetic test that can accurately detect single nucleotide variants (SNVs), small insertions/deletions (indels), complex structural variants (SVs), repetitive genomic alterations, and variants in genes with highly homologous pseudogenes. The implementation of a unified comprehensive technique that can simultaneously detect a broad spectrum of genetic variation would substantially increase efficiency of the diagnostic process. The current study evaluated the clinical utility of long-read sequencing as a comprehensive genetic test for diagnosis of inherited conditions. Using Oxford Nanopore Technologies long read nanopore sequencing, we successfully developed and validated a clinically deployable integrated bioinformatics pipeline that utilizes a combination of eight publicly available variant callers. A concordance assessment comparing the known variant calls from a well-characterized, benchmarked sample called NA12878 from the National Institute of Standards and Technology (NIST) with the variants detected by our pipeline for this sample, determined that the analytical sensitivity of our pipeline was 98.87% and the analytical specificity exceeded 99.99%. We then evaluated our pipeline's ability to detect 167 clinically relevant variants from 72 clinical samples. This set of variants consisted of 80 SNVs, 26 indels, 32 SVs, and 29 repeat expansions, including 14 variants in genes with highly homologous pseudogenes. The overall detection concordance for these clinically relevant variants was 99.4% (95% CI: 99.7%-99.9%). Importantly, in addition to detecting known clinically relevant variants, in four cases, our pipeline yielded valuable additional information in support of clinical diagnoses that could not have been established using short-read NGS alone. Our findings suggest that long-read sequencing is successful in identifying diverse genomic alterations and that our pipeline functions well as the basis for a single diagnostic test for patients with suspected genetic disease.

摘要

尽管短读长高通量测序,即通常所说的下一代测序(NGS),已经彻底改变了基因组学和基因检测,但没有一种单一的基因检测方法能够准确检测单核苷酸变异(SNV)、小插入/缺失(indel)、复杂结构变异(SV)、重复性基因组改变以及具有高度同源假基因的基因中的变异。实施一种能够同时检测广泛遗传变异的统一综合技术将大幅提高诊断过程的效率。当前研究评估了长读长测序作为遗传性疾病诊断综合基因检测的临床效用。使用牛津纳米孔技术长读长纳米孔测序,我们成功开发并验证了一种可临床应用的综合生物信息学流程,该流程利用了八个公开可用的变异检测工具。通过将来自美国国家标准与技术研究院(NIST)的一个特征明确、经过基准测试的样本NA12878的已知变异与我们的流程针对该样本检测到的变异进行一致性评估,确定我们的流程的分析灵敏度为98.87%,分析特异性超过99.99%。然后我们评估了我们的流程从72个临床样本中检测167个临床相关变异的能力。这组变异包括80个SNV、26个indel、32个SV和29个重复扩增,其中包括14个具有高度同源假基因的基因中的变异。这些临床相关变异的总体检测一致性为99.4%(95%置信区间:99.7%-99.9%)。重要的是,除了检测已知的临床相关变异外,在四个案例中,我们的流程还产生了有价值的额外信息,支持了仅使用短读长NGS无法确立的临床诊断。我们的研究结果表明,长读长测序在识别多种基因组改变方面是成功的,并且我们的流程作为疑似遗传疾病患者单一诊断检测的基础运行良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2ea/12082127/3e86e555cb7d/fgene-16-1499456-g001.jpg

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