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Artificial intelligence in medical genomics 医学基因组学中的人工智能。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-27 DOI: 10.1038/s10038-024-01282-1
Yoichiro Kamatani, Tadashi Kaname
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引用次数: 0
Healthy lifestyle practice correlates with decreased obesity prevalence in individuals with high polygenic risk: TMM CommCohort study. 健康生活方式与多基因高风险人群肥胖患病率下降相关:TMM社区队列研究。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-22 DOI: 10.1038/s10038-024-01280-3
Yoichi Sutoh, Tsuyoshi Hachiya, Yayoi Otsuka-Yamasaki, Shohei Komaki, Shiori Minabe, Hideki Ohmomo, Makoto Sasaki, Atsushi Shimizu

Obesity and overweight, fundamental components of the metabolic syndrome, predispose individuals to lifestyle-related diseases. The extent to which adopting healthy lifestyles can reduce obesity risk, even in those with a high genetic risk, remains uncertain. Our aim was to assess the extent to which lifestyle modifications can improve outcomes in individuals with a high polygenic score (PGS) for obesity. We quantified the genetic risk of obesity using PGSs. Four datasets from the Tohoku Medical Megabank Community-Based Cohort (TMM CommCohort) were employed in the study. One dataset (n = 9958) was used to select the best model for calculating PGS. The remaining datasets (total n = 69,341) were used in a meta-analysis to validate the model and to evaluate associated risks. The odds ratio (OR) for obesity risk in the intermediate (11th-90th percentiles in the dataset) and high PGS categories (91st-100th) was 2.27 [95% confidence intervals: 2.12-2.44] and 4.83 [4.45-5.25], respectively, compared to that in the low PGS category (1st-10th). Trend analysis showed that an increase in leisure-time physical activity was significantly associated with reduced obesity risk across all genetic risk categories, representing an OR of 0.9 [0.87-0.94] even among individuals in the high PGS category. Similarly, sodium intake displayed a positive association with obesity across all genetic risk categories, yielding an OR of 1.24 [1.17-1.31] in the high PGS category. The risk of obesity was linked to the adoption of healthy lifestyles, even in individuals with high PGS. Our results may provide perspectives for integrating PGSs into preventive medicine.

肥胖和超重是代谢综合征的基本组成部分,容易导致与生活方式相关的疾病。采用健康的生活方式能在多大程度上降低肥胖风险,即使是那些具有高遗传风险的人,这一点仍不确定。我们的目的是评估改变生活方式能在多基因评分(PGS)较高的肥胖症患者中改善预后的程度。我们利用多基因评分量化了肥胖的遗传风险。研究采用了来自东北医学巨型数据库社区队列(TMM CommCohort)的四个数据集。其中一个数据集(n = 9958)用于选择计算 PGS 的最佳模型。其余数据集(总 n = 69,341 个)用于荟萃分析,以验证模型并评估相关风险。与低PGS类别(第1-10位)相比,中PGS类别(数据集中第11-90百分位数)和高PGS类别(第91-100位)肥胖风险的几率比(OR)分别为2.27[95%置信区间:2.12-2.44]和4.83[4.45-5.25]。趋势分析表明,在所有遗传风险类别中,业余时间体育锻炼的增加与肥胖风险的降低有显著相关性,即使在高 PGS 类别中,OR 值也达到了 0.9 [0.87-0.94] 。同样,钠摄入量在所有遗传风险类别中都与肥胖呈正相关,在高 PGS 类别中,OR 值为 1.24 [1.17-1.31]。肥胖风险与采用健康的生活方式有关,即使在高 PGS 的个体中也是如此。我们的研究结果为将 PGS 纳入预防医学提供了新的视角。
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引用次数: 0
Hydrops fetalis due to loss of function of hNav1.4 channel via compound heterozygous variants. 通过复合杂合变体导致 hNav1.4 通道功能缺失引起的胎儿水肿。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-21 DOI: 10.1038/s10038-024-01284-z
Tomoya Kubota, Miho Nagata, Kazuko Takagi, Yasuki Ishihara, Kurumi Kojima, Yuka Uchikura, Reina Yamamoto, Ayumi Yonei, Erina Ozaki, Natsuki Kira, Satoe Takahashi, Kazuaki Homma, Yohei Miyashita, Minenori Eguchi-Ishimae, Norio Sakai, Yohihiro Asano, Yasushi Sakata, Keiichi Ozono, Mariko Eguchi, Masanori P Takahashi

Hydrops fetalis, characterized by abnormal fluid accumulation in fetuses, presents a significant risk of stillbirth and neonatal mortality. Although the etiology of nonimmune hydrops fetalis (NIHF) is multifaceted, recent studies have highlighted genetic factors as crucial determinants. This study focused on a family with three consecutive stillbirths, each with pronounced hydrops fetalis. Using whole-exome sequencing (WES), we identified compound heterozygous variants of the SCN4A gene encoding the voltage-gated sodium channel of the skeletal muscle (hNav1.4), c.2429T>A p.L810Q and c.4556T>C p.F1519S, in all three deceased infants. A functional analysis conducted using the whole-cell patch-clamp technique revealed loss-of-function defects in both variant channels, with F1519S exhibiting a complete loss of ionic current and L810Q showing a reduced channel opening. These findings support the pathogenicity of SCN4A variants in NIHF and underscore the significance of functional studies in elucidating genotype-phenotype correlations. Furthermore, our study emphasizes the diagnostic value of WES in cases of NIHF in where standard genetic testing fails to identify causative variants.

胎儿水肿(Hydrops fetalis)以胎儿体内异常液体积聚为特征,是死胎和新生儿死亡的重要风险因素。虽然非免疫性胎儿水肿(NIHF)的病因是多方面的,但最近的研究强调遗传因素是关键的决定因素。本研究的重点是一个连续出现三例死胎的家庭,每个死胎都伴有明显的胎儿水肿。通过全外显子组测序(WES),我们在所有三名死亡婴儿中发现了编码骨骼肌电压门控钠通道(hNav1.4)的 SCN4A 基因的复合杂合变异:c.2429T>A p.L810Q 和 c.4556T>C p.F1519S。利用全细胞膜片钳技术进行的功能分析显示,这两种变异通道均存在功能缺失缺陷,其中 F1519S 表现为离子电流完全丧失,而 L810Q 则表现为通道开放度降低。这些发现支持了 SCN4A 变异在 NIHF 中的致病性,并强调了功能研究在阐明基因型与表型相关性方面的重要性。此外,我们的研究还强调了 WES 在标准基因检测无法确定致病变异的 NIHF 病例中的诊断价值。
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引用次数: 0
Contribution of rare variants to heritability of a disease is much greater than conventionally estimated: modification of allele distribution model. 罕见变异对疾病遗传性的贡献远大于传统估计:等位基因分布模型的修正。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-20 DOI: 10.1038/s10038-024-01281-2
Yoshiro Nagao

"Missing heritability" is a current problem in human genetics. I previously reported a method to estimate heritability of a polymorphism (hp2) for a common disease without calculating the genetic variance under dominant and the recessive models. Here, I extend the method to the co-dominant model and carry out trial calculations of hp2. I also calculate hp2 applying the allele distribution model originally reported by Pawitan et al. for comparison as a conventional method. But unexpectedly, hp2 calculated for rare variants with high odds ratios was much higher than the calculated values with the allele distribution model. Also, while examining the basis for the difference in calculated hp2, I noticed that conventional methods use the allele frequency (AF) of a variant in the general population to calculate the genetic variance of that variant. However, this implicitly assumes that the unaffected are included among the phenotypes of the disease - an assumption that is inconsistent with case-control studies in which unaffected individuals belong to the control (unaffected) group. Therefore, I modified the allele distribution model by using the AF in the patient population. Consequently, the hp2 of rare variants calculated with the modified allele distribution model was quite high. Recalculating hp2 of several rare variants reported in the literature with the modified allele distribution model yielded results were 3.2 - 53.7 times higher than the hp2 calculated with the original allele distribution model. These results suggest that the contribution of rare variants to heritability of a disease has been considerably underestimated.

"遗传率缺失 "是人类遗传学目前面临的一个问题。我曾报告过一种方法,无需计算显性和隐性模型下的遗传变异,即可估算常见疾病多态性的遗传率(hp2)。在此,我将该方法扩展到了共显模式,并对 hp2 进行了试算。作为一种常规方法,我还应用 Pawitan 等人最初报告的等位基因分布模型计算 hp2,以进行比较。但出乎意料的是,计算出的高几率罕见变异的 hp2 远远高于等位基因分布模型的计算值。此外,在研究 hp2 计算值差异的基础时,我注意到传统方法使用变异体在普通人群中的等位基因频率(AF)来计算该变异体的遗传变异。然而,这暗含了一个假设,即未受影响的个体包含在疾病的表型中--这一假设与病例对照研究中未受影响的个体属于对照(未受影响)组的假设不一致。因此,我修改了等位基因分布模型,使用了患者群体中的 AF。结果,用修改后的等位基因分布模型计算出的罕见变异的 hp2 相当高。用修改后的等位基因分布模型重新计算文献中报道的几种罕见变异的 hp2,结果是用原始等位基因分布模型计算的 hp2 的 3.2 - 53.7 倍。这些结果表明,罕见变异对疾病遗传性的贡献被大大低估了。
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引用次数: 0
A novel homozygous nonsense variant of STX2 underlies non-obstructive azoospermia in a consanguineous Chinese family. 一个近亲结婚的中国家庭中,STX2 的新型同源无义变体是导致非梗阻性无精子症的原因。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-19 DOI: 10.1038/s10038-024-01288-9
Qi Fang, Lanxi Ran, Xinying Bi, Jianyong Di, Ye Liu, Fengqin Xu, Binbin Wang

Male infertility is a widespread population health concern, causing various degrees of adverse fertility outcomes. We determined the genetic cause of an infertile male from a consanguineous family, expanding the mutant spectrum of male infertility. A non-obstructive azoospermia (NOA) patient was recruited, and histological type of human testicular tissue of the patient categorized as maturation arrest. We identified a novel loss-of-function variant of syntaxin 2 (STX2) (c.142C>T:p.Gln48*) by performing Whole-exome sequencing (WES) on the NOA patient from a consanguineous Chinese family. Sanger sequencing confirmed the p.Gln48* variant was maternally and paternally inherited. The variant was predicted to be deleterious and resulted in aberrant changes to structure and function of STX2 by In silico analysis. In summary, we reported for the first time that a nonsense variant occurred in the exon region of STX2 in an infertile male presenting with NOA, which was beneficial for diagnosis and therapies of NOA.

男性不育是一个普遍的人口健康问题,会造成不同程度的不良生育后果。我们确定了一名近亲结婚男性不育症患者的遗传原因,扩大了男性不育症的突变谱。我们招募了一名非梗阻性无精子症(NOA)患者,并将其人类睾丸组织的组织学类型归类为成熟停滞。我们通过对这名来自中国近亲家庭的无精子症患者进行全外显子组测序(WES),发现了一个新的句法蛋白2(STX2)功能缺失变体(c.142C>T:p.Gln48*)。桑格测序证实,p.Gln48*变异为母系遗传和父系遗传。硅学分析预测该变异为有害变异,会导致 STX2 的结构和功能发生异常变化。总之,我们首次报道了一名患有NOA的不育男性的STX2外显子区域出现了无义变异,这有利于NOA的诊断和治疗。
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引用次数: 0
A 3000-year-old founder variant in the DRC1 gene causes primary ciliary dyskinesia in Japan and Korea. 日本和韩国的原发性睫状肌运动障碍是由具有 3000 年历史的 DRC1 基因创始人变异引起的。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-16 DOI: 10.1038/s10038-024-01289-8
Ryotaro Hashizume, Yifei Xu, Makoto Ikejiri, Shimpei Gotoh, Kazuhiko Takeuchi

Primary ciliary dyskinesia (PCD) is a genetic disorder characterized by ciliary structural abnormalities and dysfunction, leading to chronic rhinosinusitis, otitis media with effusion, bronchiectasis, and infertility. Approximately half of Japanese PCD cases are attributed to variants in the dynein regulatory complex subunit 1 (DRC1) gene, predominantly featuring homogeneous deletions of exons 1-4 spanning 27,748 base pairs on chromosome 2. Here, we report 10 new PCD cases (9 families) in addition to 29 previously reported cases (24 families) caused by DRC1 variants. Among these 39 cases, biallelic DRC1 exon 1-4 deletions were detected in 38 (97.4%). These DRC1 deletions exhibited an identical breakpoint in all PCD cases in the Japanese and Korean populations, strongly suggesting a founder effect. In this study, we performed haplotype analysis, using a whole-exome sequencing dataset of 18 Japanese PCD patients harboring large biallelic DRC1 deletions. We estimated that the founder allele likely emerged 115.1 generations ago (95% confidence interval: 33.7-205.1), suggesting an origin of approximately 3050 years ago, coinciding with the transition from the Jomon period to the early Yayoi period in Japan. Considering the formation of the modern Japanese population, the founder with the DRC1 exon 1-4 deletion likely lived on the Korean peninsula, with the allele later transmitted to Japan through migration. This study provides insights into the origin of the DRC1 copy number variant, the most frequent PCD variant in the Japanese and Korean populations, highlighting the importance of understanding population-specific genetic variations in the context of human migration and disease prevalence.

原发性睫状肌运动障碍(PCD)是一种以睫状肌结构异常和功能障碍为特征的遗传性疾病,可导致慢性鼻炎、中耳炎伴渗出液、支气管扩张和不育症。在日本的 PCD 病例中,约有一半归因于动力蛋白调节复合体亚基 1(DRC1)基因的变异,主要表现为第 1-4 号外显子的同质缺失,跨度为 27,748 碱基对,位于第 2 号染色体上。在此,我们报告了 10 例新的 PCD 病例(9 个家庭),以及之前报告的 29 例由 DRC1 基因变异引起的病例(24 个家庭)。在这 39 个病例中,有 38 个病例(97.4%)检测到 DRC1 第 1-4 号外显子双重复缺失。在日本和韩国人群中的所有 PCD 病例中,这些 DRC1 基因缺失都表现出相同的断点,这有力地表明这是一种奠基效应。在本研究中,我们利用全外显子组测序数据集对 18 例携带大型双侧 DRC1 缺失的日本 PCD 患者进行了单倍型分析。我们估计创始等位基因可能出现在 115.1 代以前(95% 置信区间:33.7-205.1),这表明其起源于大约 3050 年前,与日本从绳文时代向弥生时代早期的过渡相吻合。考虑到现代日本人口的形成,带有 DRC1 外显子 1-4 缺失的始祖很可能生活在朝鲜半岛,后来通过移民将等位基因传到了日本。这项研究深入揭示了日本和韩国人群中最常见的 PCD 变异--DRC1 拷贝数变异的起源,强调了在人类迁徙和疾病流行的背景下了解人群特异性遗传变异的重要性。
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引用次数: 0
The genetic architecture of age at menarche and its causal effects on other traits. 月经初潮年龄的遗传结构及其对其他特征的因果效应。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-15 DOI: 10.1038/s10038-024-01287-w
Gui-Juan Feng, Qian Xu, Qi-Gang Zhao, Bai-Xue Han, Shan-Shan Yan, Jie Zhu, Yu-Fang Pei

Age at menarche (AAM) is a sign of puberty of females. It is a heritable trait associated with various adult diseases. However, the genetic mechanism that determines AAM and links it to disease risk is poorly understood. Aiming to uncover the genetic basis for AAM, we conducted a joint association study in up to 438,089 women from 3 genome-wide association studies of European and East Asian ancestries. A series of bioinformatical analyses and causal inference were then followed to explore in-depth annotations at the associated loci and infer the causal relationship between AAM and other complex traits/diseases. This largest meta-analysis identified a total of 21 novel AAM associated loci at the genome wide significance level (P < 5.0  × 10-8), 4 of which were European ancestry-specific loci. Functional annotations prioritized 33 candidate genes at newly identified loci. Significant genetic correlations were observed between AAM and 67 complex traits. Further causal inference demonstrated the effects of AAM on 13 traits, including forced vital capacity (FVC), high blood pressure, age at first live birth, etc, indicating that earlier AAM causes lower FVC, worse lung function, hypertension and earlier age at first (last) live birth. Enrichment analysis identified 5 enriched tissues, including the hypothalamus middle, hypothalamo hypophyseal system, neurosecretory systems, hypothalamus and retina. Our findings may provide useful insights that elucidate the mechanisms determining AAM and the genetic interplay between AAM and some traits of women.

初潮年龄(AAM)是女性青春期的标志。它是一种与各种成人疾病相关的遗传性状。然而,人们对决定月经初潮年龄并将其与疾病风险联系起来的遗传机制知之甚少。为了揭示 AAM 的遗传基础,我们对来自欧洲和东亚血统的 3 项全基因组关联研究的多达 438,089 名女性进行了联合关联研究。随后,我们进行了一系列生物信息学分析和因果推断,以探索相关基因位点的深度注释,并推断 AAM 与其他复杂性状/疾病之间的因果关系。这项规模最大的荟萃分析在全基因组显著性水平(P -8)上共发现了21个新的AAM相关位点,其中4个是欧洲血统特异性位点。功能注释优先考虑了新发现位点上的 33 个候选基因。AAM与67个复杂性状之间存在显著的遗传相关性。进一步的因果推断表明,AAM对13个性状有影响,包括强迫生命容量(FVC)、高血压、首次活产年龄等,表明较早的AAM会导致较低的FVC、较差的肺功能、高血压和较早的首次(最后)活产年龄。富集分析确定了 5 个富集组织,包括下丘脑中部、下丘脑下叶系统、神经分泌系统、下丘脑和视网膜。我们的研究结果可能会为阐明AAM的决定机制以及AAM与女性某些特征之间的遗传相互作用提供有用的见解。
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引用次数: 0
Japanese Public Health Insurance System's new genomic strategic action to shorten the "diagnostic odyssey" for patients with rare and intractable diseases. 日本公共健康保险制度的新基因组战略行动,以缩短罕见病和疑难杂症患者的 "诊断奥德赛"。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-15 DOI: 10.1038/s10038-024-01285-y
Jiro Ezaki, Yukari Takahashi, Harutaka Saijo, Fuyuki Miya, Kenjiro Kosaki

In June 2024, the Japanese government introduced a new genomic strategic action to shorten the "diagnostic odyssey" for patients with rare and intractable diseases: Six groups of rare diseases, (i) Muscle weakness group, (ii) Growth retardation, intellectual disability, and characteristic facial features group, (iii) Intellectual disability/epilepsy group, (iv) Cardiomyopathy group (mainly adult onset) (v) Proteinuria group, (vi) Fever, inflammation, skin rash, osteoarthritis group, have been newly recognized as "difficult-to-differentiate disorders" and comprehensive genomic testing can be reimbursed when patients belong to one of the six groups and certain requirements are met. The introduction of comprehensive genomic testing will improve the diagnosis rate of diseases and have significant potential to enhance Japan's rare and intractable disease policy. The new strategy in Japan and its rationale will be a reference for insurance reimbursement of comprehensive genomic testing in other countries that have universal health coverage supported by the public health insurance system.

2024 年 6 月,日本政府推出了一项新的基因组战略行动,以缩短罕见难治疾病患者的 "诊断之路":六类罕见病:(i) 肌无力组;(ii) 生长迟缓、智力障碍和特征性面容组;(iii) 智力障碍/癫痫组;(iv) 心肌病组(主要是成人发病);(v) 蛋白尿组;(vi) 发烧、炎症、皮疹、骨关节炎组,被新认定为 "难以区分的疾病",如果患者属于这六类疾病之一,并满足一定条件,可报销综合基因组检测费用。全面基因组检测的引入将提高疾病的诊断率,对加强日本的罕见病和疑难病政策具有重大潜力。日本的新战略及其合理性将为其他由公共医疗保险系统支持的全民医保国家的综合基因组检测保险报销提供参考。
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引用次数: 0
Reciprocal chromosome translocation t(3;4)(q27;q31.2) with deletion of 3q27 and reduced FBXW7 expression in a patient with developmental delay, hypotonia, and seizures. 一名发育迟缓、肌张力低下和癫痫发作患者的染色体互变t(3;4)(q27;q31.2),伴有3q27缺失和FBXW7表达减少。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-09 DOI: 10.1038/s10038-024-01286-x
Takeaki Tamura, Keiko Shimojima Yamamoto, Jun Tohyama, Ichiro Morioka, Hitoshi Kanno, Toshiyuki Yamamoto

Reciprocal chromosomal translocation is one of genomic variations. When cytogenetically de novo reciprocal translocations are identified in patients with some clinical manifestations, the genes in the breakpoints are considered to be related to the clinical features. In this study, we encountered a patient with severe developmental delay, intractable epilepsy, growth failure, distinctive features, and skeletal manifestations. Conventional karyotyping revealed a de novo translocation described as 46,XY,t(3;4)(q27;q31.2). Chromosomal microarray testing detected a 1.25-Mb microdeletion at 3q27.3q28. Although the skeletal manifestations may have been affected by this deletion, the neurological features of this patient were severe and could not be fully explained by this deletion. Since no genomic copy number aberration was detected on chromosome 4, long-read whole-genome sequencing analysis was performed and a precise breakpoint was confirmed. A 460-bp deletion was detected between the two breakpoints; however, no gene was disrupted. FBXW7, the gene responsible for developmental delay, hypotonia, and impaired language, is in the 0.5-Mb telomeric region. Most of the patient's clinical features were considered consistent with symptoms of FBXW7-related disorders, but were more severe. FBXW7 expression in the immortalized lymphoblasts of the patient was reduced compared to that in controls. Based on these findings, we suspect that FBXW7 is affected by downstream position effects of chromosomal translocations. The severe neurological features of the patient may have been affected not only by the 3q27-q28 deletion but also by impaired expression of FBXW7 derived from the breakage of chromosome 4.

互易染色体易位是基因组变异的一种。当在具有某些临床表现的患者中发现细胞遗传学上的从头互变时,断点上的基因被认为与临床特征有关。在本研究中,我们遇到了一名患有严重发育迟缓、难治性癫痫、生长发育障碍、特征明显和骨骼表现的患者。常规核型检查发现了一个新发易位,描述为46,XY,t(3;4)(q27;q31.2)。染色体微阵列检测在 3q27.3q28 处发现了一个 1.25-Mb 的微缺失。虽然该患者的骨骼表现可能受此缺失的影响,但其神经系统特征非常严重,无法完全用此缺失来解释。由于在 4 号染色体上没有检测到基因组拷贝数畸变,因此进行了长线程全基因组测序分析,并确认了一个精确的断点。在两个断点之间检测到了一个 460 碱基对的缺失,但没有基因被破坏。导致发育迟缓、肌张力低下和语言障碍的基因 FBXW7 位于 0.5-Mb 端粒区。该患者的大多数临床特征被认为与FBXW7相关疾病的症状一致,但更为严重。与对照组相比,患者永生化淋巴母细胞中的FBXW7表达量减少。基于这些发现,我们怀疑 FBXW7 受染色体易位的下游位置效应影响。该患者严重的神经系统特征可能不仅受到 3q27-q28 缺失的影响,还受到 4 号染色体断裂导致的 FBXW7 表达受损的影响。
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引用次数: 0
Exploring unsolved cases of lissencephaly spectrum: integrating exome and genome sequencing for higher diagnostic yield. 探索无脑畸形谱系的未决病例:整合外显子组和基因组测序以提高诊断率。
IF 2.6 3区 生物学 Q2 GENETICS & HEREDITY Pub Date : 2024-08-09 DOI: 10.1038/s10038-024-01283-0
Shogo Furukawa, Mitsuhiro Kato, Akihiko Ishiyama, Tomohiro Kumada, Takeshi Yoshida, Eri Takeshita, Pin Fee Chong, Hideo Yamanouchi, Yuko Kotake, Takayoshi Kyoda, Toshihiro Nomura, Yohane Miyata, Mitsuko Nakashima, Hirotomo Saitsu

Lissencephaly is a rare brain malformation characterized by abnormal neuronal migration during cortical development. In this study, we performed a comprehensive genetic analysis using next-generation sequencing in 12 unsolved Japanese lissencephaly patients, in whom PAFAH1B1, DCX, TUBA1A, and ARX variants were excluded using the Sanger method. Exome sequencing (ES) was conducted on these 12 patients, identifying pathogenic variants in CEP85L, DYNC1H1, LAMC3, and DCX in four patients. Next, we performed genome sequencing (GS) on eight unsolved patients, and structural variants in PAFAH1B1, including an inversion and microdeletions involving several exons, were detected in three patients. Notably, these microdeletions in PAFAH1B1 could not to be detected by copy number variation (CNV) detection tools based on the depth of coverage methods using ES data. The density of repeat sequences, including Alu sequences or segmental duplications, which increase the susceptibility to structural variations, is very high in some lissencephaly spectrum genes (PAFAH1B1, TUBA1A, DYNC1H1). These missing CNVs were due to the limitations of detecting repeat sequences in ES-based CNV detection tools. Our study suggests that a combined approach integrating ES with GS can contribute to a higher diagnostic yield and a better understanding of the genetic landscape of the lissencephaly spectrum.

脑裂畸形是一种罕见的脑畸形,其特征是大脑皮层发育过程中神经元迁移异常。在本研究中,我们使用新一代测序技术对 12 例尚未解决的日本脑裂患者进行了全面的遗传分析,其中使用 Sanger 方法排除了 PAFAH1B1、DCX、TUBA1A 和 ARX 变体。我们对这12名患者进行了外显子组测序(ES),在4名患者中发现了CEP85L、DYNC1H1、LAMC3和DCX的致病变异。接下来,我们对 8 例未解决的患者进行了基因组测序(GS),在 3 例患者中检测到 PAFAH1B1 的结构变异,包括倒位和涉及多个外显子的微缺失。值得注意的是,基于ES数据覆盖深度方法的拷贝数变异(CNV)检测工具无法检测到PAFAH1B1中的这些微缺失。在一些脑裂谱基因(PAFAH1B1、TUBA1A、DYNC1H1)中,重复序列(包括 Alu 序列或片段重复)的密度非常高,这增加了结构变异的易感性。这些缺失的 CNV 是由于基于 ES 的 CNV 检测工具在检测重复序列方面的局限性造成的。我们的研究表明,将 ES 与 GS 相结合的方法有助于提高诊断率,并更好地了解无脑畸形谱系的遗传情况。
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Journal of Human Genetics
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