Rai Archana, Klonowski Jonathan, Yuan Bo, Coveler Karen J, Dardas Zain, Egab Iman, Xu Jiaoyang, Lupo Philip J, Agopian A J, Kostka Dennis, Lo Cecilia W, Yi S Stephen, Gelb Bruce D, Seidman Christine E, Boerwinkle Eric, Posey Jennifer E, Gibbs Richard A, Lupski James R, Morris Shaine A, Coban-Akdemir Zeynep
Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
Department of Developmental Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
Am J Hum Genet. 2025 Jul 3;112(7):1664-1680. doi: 10.1016/j.ajhg.2025.05.014. Epub 2025 Jun 20.
Laterality defects are defined by perturbations in the usual left-right asymmetry of organs. The genetic etiology that underlies congenital heart disease (CHD) is often unknown (less than 40%), so we used a digenic model approach for the identification of contributing variants in known laterality-defect-associated genes (n = 115) in the exome/genome sequencing (ES/GS) data from individuals with clinically diagnosed laterality defects. The unsolved ES/GS data were analyzed from three CHD cohorts: Baylor College of Medicine-Genomics Research to Elucidate the Genetics of Rare Diseases (BCM-GREGoR; n= 251 proband ES), Gabriella Miller Kids First Pediatric Research Program (Kids First; n = 158 trio GS), and Pediatric Cardiac Genomics Consortium (PCGC; n = 163 trio ES). trans-heterozygous digenic variants were identified in 2.8% (inherited digenic variants in 0.4%), 8.2%, and 13.5% of individuals, respectively; this was significantly higher than in 602 control trios provided by the 1000 Genomes Project (p = 0.001, 1.4e-07, and 8.9e-13, respectively). trans-heterozygous digenic variants were also identified in 0.4% and 1.4% of individuals with non-laterality CHD in Kids First and PCGC datasets, respectively, which was not statistically significant as compared to control trios (p = 1 and 0.059, respectively). Altogether, in laterality cohorts, 23% of digenic pairs were in the same structural complex of motile cilia. Out of 39 unique digenic pairs in laterality CHD, 29 are more likely to be potential digenic hits as predicted by the DiGePred tool. These findings provide further evidence that digenic epistatic interactions can contribute to the complex genetics of laterality defects.
左右侧缺陷是由器官通常的左右不对称性受到干扰所定义的。先天性心脏病(CHD)的遗传病因通常不明(不到40%),因此我们采用双基因模型方法,在临床诊断为左右侧缺陷个体的外显子组/基因组测序(ES/GS)数据中,识别已知的与左右侧缺陷相关基因(n = 115)中的致病变异。对来自三个先天性心脏病队列的未解决的ES/GS数据进行了分析:贝勒医学院-阐明罕见病遗传学基因组研究(BCM-GREGoR;n = 251先证者ES)、加布里埃拉·米勒儿童优先儿科研究项目(儿童优先;n = 158三联体GS)和儿科心脏基因组学联盟(PCGC;n = 163三联体ES)。分别在2.8%(0.4%为遗传双基因变异)、8.2%和13.5%的个体中鉴定出反式杂合双基因变异;这显著高于千人基因组计划提供的602个对照三联体(p值分别为0.001、1.4×10⁻⁷和8.9×10⁻¹³)。在儿童优先和PCGC数据集中,分别在0.4%和1.4%的非左右侧先天性心脏病个体中也鉴定出了反式杂合双基因变异,与对照三联体相比无统计学意义(p值分别为1和0.059)。总体而言,在左右侧队列中,23%的双基因对存在于运动纤毛的同一结构复合体中。在左右侧先天性心脏病的39个独特双基因对中,有29个更有可能是DiGePred工具预测的潜在双基因命中。这些发现进一步证明双基因上位性相互作用可能导致左右侧缺陷的复杂遗传学。