Application of Whole Exome Sequencing in Mutational Analysis of Patients with Ohtahara Syndrome

Nguyen Thi Quynh Mai, Nguyen Le Trung Hieu, Le Thi Khanh Van, Nguyen Thuy Minh Thu, Le Tran Anh Ngan, Huynh Thi Dieu Hien, Do Thi Thu Hang
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Abstract

Ohtahara syndrome is one of the earliest and most severe forms of developmental and epileptic encephalopathy. Over the last decade, the rapid advances in molecular techniques, especially in high-throughput sequencing (HTS), have revealed that a majority of Ohtahara patients have genetic etiology. About 20 genes have been found to be related to this syndrome so far, and Next Generation Sequencing (NGS) technique is now an important genetic test for this syndrome. This study was conducted on 4 patients with Ohtahara syndrome referred to Children’s Hospital 2, Ho Chi Minh City. Whole-exome sequencing (WES) following targeted analysis on 283 epileptic encephalopathy–related genes was performed to identify disease-causing variants of the patients. Following multi-step bioinformatics analysis, trio-based Sanger sequencing confirmation, and variant classification according to standards of The American College of Medical Genetics and Genomics – 2015, we have identified 2 pathogenic mutations in 2 patients: OH3 (KCNQ2, c.868G>A, p.G290S) and OH4 (SCN2A, c.788C>T, p.A263V). The results of this study contribute to verifying the role of genetic factors in Ohtahara syndrome in Vietnamese patients. This study also confirms that NGS in general and WES, in particular, are reliable and useful in detecting genetic causes of Ohtahara syndrome, thereby, assisting in diagnosis and treatment of this syndrome.    
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全外显子组测序在大田原综合征患者突变分析中的应用
大田原综合征是发育性和癫痫性脑病的最早和最严重的形式之一。在过去的十年中,分子技术的快速发展,特别是高通量测序(HTS),揭示了大多数大田原患者具有遗传病因。到目前为止,已经发现了大约20个与该综合征相关的基因,而下一代测序(NGS)技术现在是该综合征的重要基因检测。本研究以4名到胡志明市第二儿童医院就诊的大田原综合征患者为研究对象。对283个癫痫性脑病相关基因进行靶向分析后进行全外显子组测序(WES),以确定患者的致病变异。经过多步骤的生物信息学分析,基于三组的Sanger测序确认,并根据美国医学遗传与基因组学学院- 2015的标准进行变异分类,我们在2例患者中发现了2个致病突变:OH3 (KCNQ2, c.868G>A, p.G290S)和OH4 (SCN2A, c.788C>T, p.A263V)。本研究结果有助于验证遗传因素在越南患者大田原综合征中的作用。本研究还证实了一般的NGS,特别是WES在检测大田原综合征的遗传原因方面是可靠和有用的,从而有助于该综合征的诊断和治疗。
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