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Diagnosing Cornelia de Lange syndrome and related neurodevelopmental disorders using RNA sequencing.
Genetics in Medicine ( IF 6.6 ) Pub Date : 2020-01-08 , DOI: 10.1038/s41436-019-0741-5
Stefan Rentas 1 , Komal S Rathi 2 , Maninder Kaur 3 , Pichai Raman 2 , Ian D Krantz 3 , Mahdi Sarmady 1 , Ahmad Abou Tayoun 4, 5
Affiliation  

PURPOSE Neurodevelopmental disorders represent a frequent indication for clinical exome sequencing. Fifty percent of cases, however, remain undiagnosed even upon exome reanalysis. Here we show RNA sequencing (RNA-seq) on human B-lymphoblastoid cell lines (LCL) is highly suitable for neurodevelopmental Mendelian gene testing and demonstrate the utility of this approach in suspected cases of Cornelia de Lange syndrome (CdLS). METHODS Genotype-Tissue Expression project transcriptome data for LCL, blood, and brain were assessed for neurodevelopmental Mendelian gene expression. Detection of abnormal splicing and pathogenic variants in these genes was performed with a novel RNA-seq diagnostic pipeline and using a validation CdLS-LCL cohort (n = 10) and test cohort of patients who carry a clinical diagnosis of CdLS but negative genetic testing (n = 5). RESULTS LCLs share isoform diversity of brain tissue for a large subset of neurodevelopmental genes and express 1.8-fold more of these genes compared with blood (LCL, n = 1706; whole blood, n = 917). This enables testing of more than 1000 genetic syndromes. The RNA-seq pipeline had 90% sensitivity for detecting pathogenic events and revealed novel diagnoses such as abnormal splice products in NIPBL and pathogenic coding variants in BRD4 and ANKRD11. CONCLUSION The LCL transcriptome enables robust frontline and/or reflexive diagnostic testing for neurodevelopmental disorders.

中文翻译:

使用 RNA 测序诊断 Cornelia de Lange 综合征和相关的神经发育障碍。

目的 神经发育障碍是临床外显子组测序的常见适应症。然而,即使经过外显子组再分析,50% 的病例仍未得到诊断。在这里,我们展示了人类 B 淋巴母细胞系 (LCL) 上的 RNA 测序 (RNA-seq) 非常适用于神经发育孟德尔基因检测,并证明了这种方法在疑似 Cornelia de Lange 综合征 (CdLS) 病例中的实用性。方法 基因型-组织表达项目对 LCL、血液和大脑的转录组数据进行神经发育孟德尔基因表达评估。使用新的 RNA-seq 诊断流程并使用验证 CdLS-LCL 队列(n = 10)和进行 CdLS 临床诊断但基因检测阴性的患者的测试队列来检测这些基因中的异常剪接和致病变异。 n = 5)。结果 LCLs 共享脑组织中一大类神经发育基因的异构体多样性,与血液相比,表达的这些基因多 1.8 倍(LCL,n = 1706;全血,n = 917)。这可以测试超过 1000 种遗传综合征。RNA-seq 管道对检测致病事件具有 90% 的敏感性,并揭示了新的诊断,例如 NIPBL 中的异常剪接产物和 BRD4 和 ANKRD11 中的致病性编码变异。结论 LCL 转录组能够为神经发育障碍提供强大的前线和/或反射性诊断测试。RNA-seq 管道对检测致病事件具有 90% 的敏感性,并揭示了新的诊断,例如 NIPBL 中的异常剪接产物和 BRD4 和 ANKRD11 中的致病性编码变异。结论 LCL 转录组能够为神经发育障碍提供强大的前线和/或反射性诊断测试。RNA-seq 管道对检测致病事件具有 90% 的敏感性,并揭示了新的诊断,例如 NIPBL 中的异常剪接产物和 BRD4 和 ANKRD11 中的致病性编码变异。结论 LCL 转录组能够为神经发育障碍提供强大的前线和/或反射性诊断测试。
更新日期:2020-01-08
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