1
|
Chen DM, Dong R, Kachuri L, Hoffmann TJ, Jiang Y, Berndt SI, Shelley JP, Schaffer KR, Machiela MJ, Freedman ND, Huang WY, Li SA, Lilja H, Justice AC, Madduri RK, Rodriguez AA, Van Den Eeden SK, Chanock SJ, Haiman CA, Conti DV, Klein RJ, Mosley JD, Witte JS, Graff RE. Transcriptome-wide association analysis identifies candidate susceptibility genes for prostate-specific antigen levels in men without prostate cancer. HGG ADVANCES 2024; 5:100315. [PMID: 38845201 PMCID: PMC11262184 DOI: 10.1016/j.xhgg.2024.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/18/2024] Open
Abstract
Deciphering the genetic basis of prostate-specific antigen (PSA) levels may improve their utility for prostate cancer (PCa) screening. Using genome-wide association study (GWAS) summary statistics from 95,768 PCa-free men, we conducted a transcriptome-wide association study (TWAS) to examine impacts of genetically predicted gene expression on PSA. Analyses identified 41 statistically significant (p < 0.05/12,192 = 4.10 × 10-6) associations in whole blood and 39 statistically significant (p < 0.05/13,844 = 3.61 × 10-6) associations in prostate tissue, with 18 genes associated in both tissues. Cross-tissue analyses identified 155 statistically significantly (p < 0.05/22,249 = 2.25 × 10-6) genes. Out of 173 unique PSA-associated genes across analyses, we replicated 151 (87.3%) in a TWAS of 209,318 PCa-free individuals from the Million Veteran Program. Based on conditional analyses, we found 20 genes (11 single tissue, nine cross-tissue) that were associated with PSA levels in the discovery TWAS that were not attributable to a lead variant from a GWAS. Ten of these 20 genes replicated, and two of the replicated genes had colocalization probability of >0.5: CCNA2 and HIST1H2BN. Six of the 20 identified genes are not known to impact PCa risk. Fine-mapping based on whole blood and prostate tissue revealed five protein-coding genes with evidence of causal relationships with PSA levels. Of these five genes, four exhibited evidence of colocalization and one was conditionally independent of previous GWAS findings. These results yield hypotheses that should be further explored to improve understanding of genetic factors underlying PSA levels.
Collapse
Affiliation(s)
- Dorothy M Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Ruocheng Dong
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA
| | - Linda Kachuri
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA; Stanford Cancer Institute, Stanford University, Stanford, CA 94305, USA
| | - Thomas J Hoffmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20814, USA
| | - John P Shelley
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Kerry R Schaffer
- Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Mitchell J Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20814, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20814, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20814, USA
| | - Shengchao A Li
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20814, USA
| | - Hans Lilja
- Departments of Pathology and Laboratory Medicine, Surgery, Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Translational Medicine, Lund University, 21428 Malmö, Sweden
| | | | | | | | | | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20814, USA
| | - Christopher A Haiman
- Center for Genetic Epidemiology, Department of Population and Preventive Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - David V Conti
- Center for Genetic Epidemiology, Department of Population and Preventive Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Robert J Klein
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jonathan D Mosley
- Departments of Internal Medicine and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - John S Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA; Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA; Departments of Biomedical Data Science and Genetics (by courtesy), Stanford University, Stanford, CA 94305, USA.
| | - Rebecca E Graff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, USA.
| |
Collapse
|
2
|
Mazzola S, Schreiber A. Genetics evaluation outcomes of patients with pediatric hearing loss: 2008-2022 retrospective study. Am J Otolaryngol 2024; 45:104196. [PMID: 38134852 DOI: 10.1016/j.amjoto.2023.104196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE This study aims to explore how genetics evaluation and testing for patients with pediatric onset hearing loss affects their diagnosis and management. METHODS Retrospective chart review was completed for patients with pediatric hearing loss that were evaluated by a genetic counselor from 2008 to 2022 with data entry into a REDCap database. Descriptive statistical analysis was completed. RESULTS Four hundred twenty-nine patients with pediatric onset hearing loss were evaluated by genetics. Majority of patients presented with bilateral (67 %) and sensorineural (83 %) hearing loss. Genetic testing was recommended for 76 % of patients with pediatric hearing loss evaluated by a genetic counselor with 70 % completing some or all recommended tests. Overall genetic testing diagnostic rate was 34 %, with 41 % of diagnoses syndromic. Yearly trends noted an increasing number of patients evaluated, tests ordered, and subsequently an increased number of diagnoses overtime. For diagnostic results, management recommendations were made for 45 % of patients (35/78) and for 92 % of family members (72/78). This compared to total management recommendations for all patients (82/429, 19 %) and family members (110/429, 26 %). CONCLUSION This study identified a genetic testing diagnostic rate for pediatric hearing loss of 34 % over 14 years. This study notes the beneficial outcomes of patients with hearing loss and their families meeting with a genetic counselor and the importance of collaboration with hearing loss management colleagues. It highlights the value a genetic counselor consult can add to a patient's diagnostic journey, in addition to how genetic testing impacts management for patients and their families.
Collapse
Affiliation(s)
- Sarah Mazzola
- Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH, United States of America.
| | - Allison Schreiber
- Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH, United States of America
| |
Collapse
|
3
|
Yu FF, Feltrin FS, Bathla G, Raj K, Agarwal A, Lee WC, Booth T, Singh A. Imaging Guide to Inner Ear Malformations: An Illustrative Review. Curr Probl Diagn Radiol 2023; 52:576-585. [PMID: 37500297 DOI: 10.1067/j.cpradiol.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/29/2023]
Abstract
Inner ear malformation (IEM) with associated sensoryneural hearing loss (SNHL) is a major cause of childhood disability. Computed tomography (CT) and magnetic resonance imaging (MRI) imaging play important and often complementary roles in diagnosing underlying structural abnormalities and surgical planning allows for direct visualization of the cochlear nerve and is the preferred imaging modality prior to cochlear implantation. CT is helpful to assess osseous anatomy and when evaluating children with mixed hearing loss or syndromic associations. When reviewing these cases, it is important for the radiologist to be familiar with the key imaging features. In this article, we will present the imaging findings associated with different inner ear malformations associated with congenital sensorineural hearing loss.
Collapse
Affiliation(s)
- Fang Frank Yu
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | | | - Girish Bathla
- Department of Radiology, University of Iowa Hospital and Clinics, Iowa City, IA
| | - Karuna Raj
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | - Amit Agarwal
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | - Wan-Ching Lee
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, TX
| | - Timothy Booth
- Department of Radiology, Children's Hospital, University of Texas Southwestern, Dallas, TX
| | - Achint Singh
- Department of Radiology, University of Texas Health Science Center at San Antonio, Dallas, TX
| |
Collapse
|
4
|
Carlson RJ, Walsh T, Mandell JB, Aburayyan A, Lee MK, Gulsuner S, Horn DL, Ou HC, Sie KCY, Mancl L, Rubinstein J, King MC. Association of Genetic Diagnoses for Childhood-Onset Hearing Loss With Cochlear Implant Outcomes. JAMA Otolaryngol Head Neck Surg 2023; 149:212-222. [PMID: 36633841 PMCID: PMC9857764 DOI: 10.1001/jamaoto.2022.4463] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/10/2022] [Indexed: 01/13/2023]
Abstract
Importance In the US, most childhood-onset bilateral sensorineural hearing loss is genetic, with more than 120 genes and thousands of different alleles known. Primary treatments are hearing aids and cochlear implants. Genetic diagnosis can inform progression of hearing loss, indicate potential syndromic features, and suggest best timing for individualized treatment. Objective To identify the genetic causes of childhood-onset hearing loss and characterize severity, progression, and cochlear implant success associated with genotype in a single large clinical cohort. Design, Setting, and Participants This cross-sectional analysis (genomics) and retrospective cohort analysis (audiological measures) were conducted from 2019 to 2022 at the otolaryngology and audiology clinics of Seattle Children's Hospital and the University of Washington and included 449 children from 406 families with bilateral sensorineural hearing loss with an onset younger than 18 years. Data were analyzed between January and June 2022. Main Outcomes and Measures Genetic diagnoses based on genomic sequencing and structural variant analysis of the DNA of participants; severity and progression of hearing loss as measured by audiologic testing; and cochlear implant success as measured by pediatric and adult speech perception tests. Hearing thresholds and speech perception scores were evaluated with respect to age at implant, months since implant, and genotype using a multivariate analysis of variance and covariance. Results Of 406 participants, 208 (51%) were female, 17 (4%) were African/African American, 32 (8%) were East Asian, 219 (54%) were European, 53 (13%) were Latino/Admixed American, and 16 (4%) were South Asian. Genomic analysis yielded genetic diagnoses for 210 of 406 families (52%), including 55 of 82 multiplex families (67%) and 155 of 324 singleton families (48%). Rates of genetic diagnosis were similar for children of all ancestries. Causal variants occurred in 43 different genes, with each child (with 1 exception) having causative variant(s) in only 1 gene. Hearing loss severity, affected frequencies, and progression varied by gene and, for some genes, by genotype within gene. For children with causative mutations in MYO6, OTOA, SLC26A4, TMPRSS3, or severe loss-of-function variants in GJB2, hearing loss was progressive, with losses of more than 10 dB per decade. For all children with cochlear implants, outcomes of adult speech perception tests were greater than preimplanted levels. Yet the degree of success varied substantially by genotype. Adjusting for age at implant and interval since implant, speech perception was highest for children with hearing loss due to MITF or TMPRSS3. Conclusions and Relevance The results of this cross-sectional study suggest that genetic diagnosis is now sufficiently advanced to enable its integration into precision medical care for childhood-onset hearing loss.
Collapse
Affiliation(s)
- Ryan J. Carlson
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Tom Walsh
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Jessica B. Mandell
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Amal Aburayyan
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Ming K. Lee
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Suleyman Gulsuner
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - David L. Horn
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Henry C. Ou
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Kathleen C. Y. Sie
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Lisa Mancl
- Center on Human Development and Disability, University of Washington Medical Center, Seattle
| | - Jay Rubinstein
- Department of Otolaryngology–Head & Neck Surgery, University of Washington School of Medicine, Seattle
- Division of Pediatric Otolaryngology–Head and Neck Surgery, Seattle Children’s Hospital, Seattle, Washington
| | - Mary-Claire King
- Department of Genome Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| |
Collapse
|
5
|
Fitzpatrick EM, Nassrallah F, Gaboury I, Whittingham J, Vos B, Coyle D, Durieux-Smith A, Pigeon M, Olds J. Trajectory of hearing loss in children with unilateral hearing loss. Front Pediatr 2023; 11:1149477. [PMID: 37114003 PMCID: PMC10126436 DOI: 10.3389/fped.2023.1149477] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction The aim of this study was to quantify the amount of deterioration in hearing and to document the trajectory of hearing loss in early identified children with unilateral hearing loss (UHL). We also examined whether clinical characteristics were associated with the likelihood of having progressive hearing loss. Methods As part of the Mild and Unilateral Hearing Loss Study, we followed a population-based cohort of 177 children diagnosed with UHL from 2003 to 2018. We applied linear mixed models to examine hearing trends over time including the average amount of change in hearing. Logistic regression models were used to examine the relationship between age and severity at diagnosis, etiology, and the likelihood of progressive loss and amount of deterioration in hearing. Results The median age of the children at diagnosis was 4.1 months (IQR 2.1, 53.9) and follow-up time was 58.9 months (35.6, 92.0). Average hearing loss in the impaired ear was 58.8 dB HL (SD 28.5). Over the 16-year period, 47.5% (84/177) of children showed deterioration in hearing in one or both ears from their initial diagnostic assessment to most recent assessment including 21 (11.9%) who developed bilateral hearing loss. Average deterioration in the impaired ear ranged from 27 to 31 dB with little variation across frequencies. Deterioration resulted in a change in category of severity for 67.5% (52/77) of the children. Analysis for children who were followed for at least 8 years showed that most lost a significant amount of hearing rapidly in the first 4 years, with the decrease stabilizing and showing a plateau in the last 4 years. Age and severity at diagnosis were not significantly associated with progressive/stable loss after adjusting for time since diagnosis. Etiologic factors (ENT external/middle ear anomalies, inner ear anomalies, syndromic hearing loss, hereditary/genetic) were found to be positively associated with stable hearing loss. Conclusion Almost half of children with UHL are at risk for deterioration in hearing in one or both ears. Most deterioration occurs within the first 4 years following diagnosis. Most children did not experience sudden "large" drops in hearing but more gradual decrease over time. These results suggest that careful monitoring of UHL especially in the early years is important to ensure optimal benefit from early hearing loss detection.
Collapse
Affiliation(s)
- Elizabeth M. Fitzpatrick
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, ON, Canada
- Correspondence: Elizabeth M. Fitzpatrick
| | - Flora Nassrallah
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, ON, Canada
| | - Isabelle Gaboury
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - JoAnne Whittingham
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, ON, Canada
- Audiology Clinic, CHEO, Ottawa, ON, Canada
| | - Bénédicte Vos
- School of Public Health, Université libre de Bruxelles (ULB), Brussells, Belgium
| | - Doug Coyle
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Andrée Durieux-Smith
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, ON, Canada
| | | | - Janet Olds
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, ON, Canada
- Audiology Clinic, CHEO, Ottawa, ON, Canada
| |
Collapse
|
6
|
Elander J, McCormick EM, Värendh M, Stenfeldt K, Ganetzky RD, Goldstein A, Zolkipli-Cunningham Z, MacMullen LE, Xiao R, Falk MJ, Ehinger JK. Pathogenic mtDNA variants, in particular single large-scale mtDNA deletions, are strongly associated with post-lingual onset sensorineural hearing loss in primary mitochondrial disease. Mol Genet Metab 2022; 137:230-238. [PMID: 36182714 PMCID: PMC9881581 DOI: 10.1016/j.ymgme.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 01/31/2023]
Abstract
In this retrospective cohort study of 193 consecutive subjects with primary mitochondrial disease (PMD) seen at the Children's Hospital of Philadelphia Mitochondrial Medicine Frontier Program, we assessed prevalence, severity, and time of onset of sensorineural hearing loss (SNHL) for PMD cases with different genetic etiologies. Subjects were grouped by genetic diagnosis: mitochondrial DNA (mtDNA) pathogenic variants, single large-scale mtDNA deletions (SLSMD), or nuclear DNA (nDNA) pathogenic variants. SNHL was audiometrically confirmed in 27% of PMD subjects (20% in mtDNA pathogenic variants, 58% in SLSMD and 25% in nDNA pathogenic variants). SLSMD had the highest odds ratio for SNHL. SNHL onset was post-lingual in 79% of PMD cases, interestingly including all cases with mtDNA pathogenic variants and SLSMD, which was significantly different from PMD cases caused by nDNA pathogenic variants. SNHL onset during school age was predominant in this patient population. Regular audiologic assessment is important for PMD patients, and PMD of mtDNA etiology should be considered as a differential diagnosis in pediatric patients and young adults with post-lingual SNHL onset, particularly in the setting of multi-system clinical involvement. Pathogenic mtDNA variants and SLSMD are less likely etiologies in subjects with congenital, pre-lingual onset SNHL.
Collapse
Affiliation(s)
- Johanna Elander
- Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, 221 85 Lund, Sweden
| | - Elizabeth M McCormick
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA
| | - Maria Värendh
- Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, 221 85 Lund, Sweden
| | - Karin Stenfeldt
- Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, 221 85 Lund, Sweden; Logopedics, Phoniatrics and Audiology, Department of Clinical Sciences Lund, Lund University, 221 85 Lund, Sweden
| | - Rebecca D Ganetzky
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, PA, USA
| | - Amy Goldstein
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, PA, USA
| | - Zarazuela Zolkipli-Cunningham
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, PA, USA
| | - Laura E MacMullen
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA
| | - Rui Xiao
- Division of Biostatistics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, 19146, PA, USA
| | - Marni J Falk
- Mitochondrial Medicine Frontier Program, Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, PA, USA.
| | - Johannes K Ehinger
- Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, 221 85 Lund, Sweden; Mitochondrial Medicine, Department of Clinical Sciences Lund, Lund University, 221 84 Lund, Sweden.
| |
Collapse
|
7
|
Elander J, Ullmark T, Ehrencrona H, Jonson T, Piccinelli P, Samuelsson S, Löwgren K, Falkenius-Schmidt K, Ehinger J, Stenfeldt K, Värendh M. Extended genetic diagnostics for children with profound sensorineural hearing loss by implementing massive parallel sequencing. Diagnostic outcome, family experience and clinical implementation. Int J Pediatr Otorhinolaryngol 2022; 159:111218. [PMID: 35779349 DOI: 10.1016/j.ijporl.2022.111218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/12/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The aim of this study was to investigate genetic outcomes, analyze the family experience, and describe the process of implementing genetic sequencing for children with profound sensorineural hearing loss (SNHL) at a tertial audiological center in southern Sweden. DESIGN This is a prospective pilot study including eleven children with profound bilateral SNHL who underwent cochlear implant surgery. Genetic diagnostic investigation was performed with whole exome sequencing (WES) complemented with XON-array to identify copy number variants, using a manually curated gene panel incorporating 179 genes associated with non-syndromic and syndromic SNHL. Mitochondrial DNA (mtDNA) from blood was examined separately. A patient reported experience measures (PREM) questionnaire was used to evaluate parental experience. We also describe here the process of implementing WES in an audiology department. RESULTS Six female and five male children (mean 3.4 years, SD 3.5 years), with profound bilateral SNHL were included. Genetic variants of interest were found in six subjects (55%), where three (27%) could be classified as pathogenic or likely pathogenic. Among the six cases, one child was found to have a homozygous pathogenic variant in MYO7A and two children had homozygous likely pathogenic variants in SLC26A4 and PCDH15, respectively. One was carrying a compound heterozygote frameshift variant of uncertain significance (VUS) on one allele and in trans, a likely pathogenic deletion on the other allele in PCDH15. Two subjects had homozygous VUS in PCDH15 and ADGRV1, respectively. In five of the cases the variants were in genes associated with Usher syndrome. For one of the likely pathogenic variants, the finding was related to Pendred syndrome. No mtDNA variants related to SNHL were found. The PREM questionnaire revealed that the families had difficulty in fully understanding the results of the genetic analysis. However, the parents of all eleven (100%) subjects still recommended that other families with children with SNHL should undergo genetic testing. Specifically addressed referrals for prompt complementary clinical examination and more individualized care were possible, based on the genetic results. Close clinical collaboration between different specialists, including physicians of audiology, audiologists, clinical geneticists, ophthalmologists, pediatricians, otoneurologists, physiotherapists and hearing habilitation teams was initiated during the implementation of the new regime. For all professionals involved, a better knowledge of the diversity of the genetic background of hearing loss was achieved. CONCLUSIONS Whole exome sequencing and XON-array using a panel of genes associated with SNHL had a high diagnostic yield, added value to the families, and provided guidance for further examinations and habilitation for the child. Great care should be taken to thoroughly inform parents about the genetic test result. Collaborations between departments were intensified and knowledge of hearing genomics was increased among the staff.
Collapse
Affiliation(s)
- Johanna Elander
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Otorhinolaryngology, Head and Neck Surgery, 221 84, Lund, Sweden.
| | - Tove Ullmark
- Department of Clinical Genetics and Pathology, Office for Medical Services, Region Skåne, 221 85, Lund, Sweden
| | - Hans Ehrencrona
- Department of Clinical Genetics and Pathology, Office for Medical Services, Region Skåne, 221 85, Lund, Sweden; Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, 221 85, Lund, Sweden
| | - Tord Jonson
- Department of Clinical Genetics and Pathology, Office for Medical Services, Region Skåne, 221 85, Lund, Sweden
| | - Paul Piccinelli
- Department of Clinical Genetics and Pathology, Office for Medical Services, Region Skåne, 221 85, Lund, Sweden
| | - Sofie Samuelsson
- Department of Clinical Genetics and Pathology, Office for Medical Services, Region Skåne, 221 85, Lund, Sweden
| | - Karolina Löwgren
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Otorhinolaryngology, Head and Neck Surgery, 221 84, Lund, Sweden
| | - Karolina Falkenius-Schmidt
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Otorhinolaryngology, Head and Neck Surgery, 221 84, Lund, Sweden
| | - Johannes Ehinger
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Otorhinolaryngology, Head and Neck Surgery, 221 84, Lund, Sweden
| | - Karin Stenfeldt
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Otorhinolaryngology, Head and Neck Surgery, 221 84, Lund, Sweden; Lund University, Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, 221 84, Lund, Sweden
| | - Maria Värendh
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Otorhinolaryngology, Head and Neck Surgery, 221 84, Lund, Sweden
| |
Collapse
|
8
|
Etiology, Comorbidities, and Health Service Use in a Clinical Cohort of Children With Hearing Loss. Ear Hear 2022; 43:1836-1844. [DOI: 10.1097/aud.0000000000001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Kim YS, Kim Y, Jeon HW, Yi N, Lee SY, Kim Y, Han JH, Kim MY, Kim BH, Choi HY, Carandang M, Koo JW, Kim BJ, Bae YJ, Choi BY. Full etiologic spectrum of pediatric severe to profound hearing loss of consecutive 119 cases. Sci Rep 2022; 12:12335. [PMID: 35853923 PMCID: PMC9296524 DOI: 10.1038/s41598-022-16421-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 07/11/2022] [Indexed: 12/03/2022] Open
Abstract
Determining the etiology of severe-to-profound sensorineural hearing loss (SP-SNHL) in pediatric subjects is particularly important in aiding the decision for auditory rehabilitation. We aimed to update the etiologic spectrum of pediatric SP-SNHL by combining internal auditory canal (IAC)-MRI with comprehensive and state-of-the-art genetic testings. From May 2013 to September 2020, 119 cochlear implantees under the age of 15 years with SP-SNHL were all prospectively recruited. They were subjected to genetic tests, including exome sequencing, and IAC-MRI for etiologic diagnosis. Strict interpretation of results were made based on ACMG/AMP guidelines and by an experienced neuroradiologist. The etiology was determined in of 65.5% (78/119) of our cohort. If only one of the two tests was done, the etiologic diagnostic rate would be reduced by at least 21.8%. Notably, cochlear nerve deficiency (n = 20) detected by IAC-MRI topped the etiology list of our cohort, followed by DFNB4 (n = 18), DFNB1 (n = 10), DFNB9 (n = 10) and periventricular leukomalacia associated with congenital CMV infection (n = 8). Simultaneous application of state-of-the-art genetic tests and IAC-MRI is essential for etiologic diagnosis, and if lesions of the auditory nerve or central nerve system are carefully examined on an MRI, we can identify the cause of deafness in more than 65% of pediatric SP-SNHL cases.
Collapse
Affiliation(s)
- Young Seok Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea
| | - Yoonjoong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea
| | - Hyoung Won Jeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea
| | - Nayoung Yi
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Sejong Hospital, Sejong, South Korea
- College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Yehree Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea
| | - Jin Hee Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea
- College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Min Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea
| | - Bo Hye Kim
- College of Medicine, Seoul National University, Seoul, South Korea
| | - Hyeong Yun Choi
- Information Science Major, University of Maryland, College Park, MD, USA
| | - Marge Carandang
- Department of Otorhinolaryngology-Head and Neck Surgery, East Avenue Medical Center, Metro Manila, Philippines
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea
| | - Bong Jik Kim
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Sejong Hospital, Sejong, South Korea
- College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Yun Jung Bae
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyunggi-do, 463-707, South Korea.
| |
Collapse
|
10
|
Evaluation of copy number variants for genetic hearing loss: a review of current approaches and recent findings. Hum Genet 2021; 141:387-400. [PMID: 34811589 DOI: 10.1007/s00439-021-02365-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/02/2021] [Indexed: 01/22/2023]
Abstract
Structural variation includes a change in copy number, orientation, or location of a part of the genome. Copy number variants (CNVs) are a common cause of genetic hearing loss, comprising nearly 20% of diagnosed cases. While large deletions involving the gene STRC are the most common pathogenic CNVs, a significant proportion of known hearing loss genes also contain pathogenic CNVs. In this review, we provide an overview of currently used methods for detection of CNVs in genes known to cause hearing loss including molecular techniques such as multiplex ligation probe amplification (MLPA) and digital droplet polymerase chain reaction (ddPCR), array-CGH and single-nucleotide polymorphism (SNP) arrays, as well as techniques for detection of CNVs using next-generation sequencing data analysis including targeted gene panel, exome, and genome sequencing data. In addition, in this review, we compile published data on pathogenic hearing loss CNVs to provide an up-to-date overview. We show that CNVs have been identified in 29 different non-syndromic hearing loss genes. An understanding of the contribution of CNVs to genetic hearing loss is critical to the current diagnosis of hearing loss and is crucial for future gene therapies. Thus, evaluation for CNVs is required in any modern pipeline for genetic diagnosis of hearing loss.
Collapse
|
11
|
Han S, Zhang D, Guo Y, Fu Z, Guan G. Prevalence and Characteristics of STRC Gene Mutations (DFNB16): A Systematic Review and Meta-Analysis. Front Genet 2021; 12:707845. [PMID: 34621290 PMCID: PMC8491653 DOI: 10.3389/fgene.2021.707845] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mutations in the STRC (MIM 606440) gene, inducing DFNB16, are considered a major cause of mild–moderate autosomal recessive non-syndromic hearing loss (ARNSHL). We conducted a systematic review and meta-analysis to determine the global prevalence and characteristics of STRC variations, important information required for genetic counseling. Methods: PubMed, Google Scholar, Medline, Embase, and Web of Science were searched for relevant articles published before January 2021. Results: The pooled prevalence of DFNB16 in GJB2-negative patients with hearing loss was 4.08% (95% CI: 0.0289–0.0573), and the proportion of STRC variants in the mild–moderate hearing loss group was 14.36%. Monoallelic mutations of STRC were 4.84% (95% CI: 0.0343–0.0680) in patients with deafness (non-GJB2) and 1.36% (95% CI: 0.0025–0.0696) in people with normal hearing. The DFNB16 prevalence in genetically confirmed patients (non-GJB2) was 11.10% (95% CI: 0.0716–0.1682). Overall pooled prevalence of deafness–infertility syndrome (DIS) was 36.75% (95% CI: 0.2122–0.5563) in DFNB16. The prevalence of biallelic deletions in STRC gene mutations was 70.85% (95% CI: 0.5824–0.8213). Conclusion: Variants in the STRC gene significantly contribute to mild–moderate hearing impairment. Moreover, biallelic deletions are a main feature of STRC mutations. Copy number variations associated with infertility should be seriously considered when investigating DFNB16.
Collapse
Affiliation(s)
- Shuang Han
- Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Dejun Zhang
- Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Yingyuan Guo
- Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Zeming Fu
- Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Guofang Guan
- Department of Otolaryngology Head and Neck Surgery, The Second Hospital of Jilin University, Changchun, China
| |
Collapse
|
12
|
Kılıç S, Bouzaher MH, Cohen MS, Lieu JEC, Kenna M, Anne S. Comprehensive medical evaluation of pediatric bilateral sensorineural hearing loss. Laryngoscope Investig Otolaryngol 2021; 6:1196-1207. [PMID: 34667865 PMCID: PMC8513426 DOI: 10.1002/lio2.657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/08/2022] Open
Abstract
Children with bilateral sensorineural hearing loss (SNHL) should undergo a comprehensive medical evaluation to determine the underlying etiology and help guide treatment and counseling. In this article, we review the indications and rationale for medical evaluation of pediatric bilateral SNHL, including history and physical examination, imaging, genetic testing, specialist referrals, cytomegalovirus (CMV) testing, and other laboratory tests. Workup begins with a history and physical examination, which can provide clues to the etiology of SNHL, particularly with syndromic causes. If SNHL is diagnosed within the first 3 weeks of life, CMV testing should be performed to identify patients that may benefit from antiviral treatment. If SNHL is diagnosed after 3 weeks, testing can be done using dried blood spots samples, if testing capability is available. Genetic testing is oftentimes successful in identifying causes of hearing loss as a result of recent technological advances in testing and an ever-increasing number of identified genes and genetic mutations. Therefore, where available, genetic testing should be performed, ideally with next generation sequencing techniques. Ophthalmological evaluation must be done on all children with SNHL. Imaging (high-resolution computed tomography and/or magnetic resonance imaging) should be performed to assess for anatomic causes of hearing loss and to determine candidacy for cochlear implantation when indicated. Laboratory testing is indicated for certain etiologies, but should not be ordered indiscriminately since the yield overall is low.
Collapse
Affiliation(s)
- Suat Kılıç
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| | | | - Michael S. Cohen
- Department of Otolaryngology, Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Judith E. C. Lieu
- Department of Otolaryngology‐Head and Neck SurgeryWashington University in St. LouisSt. LouisMissouriUSA
| | - Margaret Kenna
- Department of Otolaryngology and Communication EnhancementBoston Children's HospitalBostonMassachusettsUSA
| | - Samantha Anne
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| |
Collapse
|
13
|
Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K. Hearing impairment among children in Sweden with foreign-born parents and natives: A national Swedish study. Acta Paediatr 2021; 110:2817-2824. [PMID: 34139033 DOI: 10.1111/apa.15990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 01/07/2023]
Abstract
AIM We aimed to estimate the risk of hearing impairment in children and adolescents with foreign-born parents, compared to natives. METHODS A nationwide study of 1,923,590 (51.4% boys) individuals aged 0-17 years of age in Sweden. Hearing impairment was defined as at least one registered diagnosis in the National Patient Register between 1 January 1998 and 31 December 2015. We used Cox regression analysis to estimate relative risk (hazard ratios with 99% confidence intervals) of incident hearing impairment in children with foreign-born parents compared to Swedish-born natives. Cox regression models were stratified by sex and adjusted for age, co-morbidities and socioeconomic status. RESULTS A total of 20,514 cases (53.7% boys) with extended sensorineural hearing impairment were registered, also including noise-induced hearing impairment and that from other causes, and 6172 cases (50.0% boys) with conductive hearing impairment. The risk of extended sensorineural hearing impairment was higher in boys with parents from Asia, especially from Iraq, fully adjusted HR (99% CI) 1.30 (1.17-1.4), and lower in boys with parents from Nordic countries, South Europe, and North America. CONCLUSION The risk of extended sensorineural hearing impairment was higher in boys with parents from Asia, in particular Iraq.
Collapse
Affiliation(s)
- Per Wändell
- Department of Neurobiology, Care Sciences and Society Division of Family Medicine and Primary Care Karolinska Institutet Huddinge Sweden
| | - Xinjun Li
- Center for Primary Health Care Research Lund University Malmö Sweden
| | - Axel C. Carlsson
- Department of Neurobiology, Care Sciences and Society Division of Family Medicine and Primary Care Karolinska Institutet Huddinge Sweden
- Academic Primary Health Care Centre Stockholm Region Stockholm Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research Lund University Malmö Sweden
- Department of Family Medicine and Community Health Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Functional Pathology Center for Community‐based Healthcare Research and Education (CoHRE) School of Medicine Shimane University Matsue Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research Lund University Malmö Sweden
- Department of Family Medicine and Community Health Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Functional Pathology Center for Community‐based Healthcare Research and Education (CoHRE) School of Medicine Shimane University Matsue Japan
| |
Collapse
|
14
|
Guan J, Li J, Chen G, Shi T, Lan L, Wu X, Zhao C, Wang D, Wang H, Wang Q. Family trio-based sequencing in 404 sporadic bilateral hearing loss patients discovers recessive and De novo genetic variants in multiple ways. Eur J Med Genet 2021; 64:104311. [PMID: 34416374 DOI: 10.1016/j.ejmg.2021.104311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/07/2021] [Accepted: 08/15/2021] [Indexed: 11/29/2022]
Abstract
Hereditary hearing loss (HL) has high genetic and phenotypical heterogeneity including the overlapping and variable phenotypic features. For sporadic HL without a family history, it is more difficult to indicate the contribution of genetic factors to define a pattern of inheritance. We assessed the contribution of genetic variants and patterns of inheritance by a family trio-based sequencing and provided new insight into genetics. We conducted an analysis of data from unrelated sporadic patients with HL (n = 404) who underwent trio-based whole-exome sequencing (trio-WES) or proband-only WES (p-WES) or targeted exome sequencing (TES), and the samples of their unaffected-parents (n = 808)were validated. A molecular diagnosis was rendered for 191 of 404 sporadic HL patients (47.3%) in multiple modes of inheritance, including autosomal recessive (AR), autosomal dominant (AD) caused by de novo variants, copy-number variants (CNVs), X-linked recessive, and dual genetic diagnosis. Among these patients, 83 (43.5%) cases were diagnosed with variants in rare genes. Sporadic HL patients were identified by multiple modes of transmission. Observed variations in rare genes and multiple modes of inheritance can strikingly emphasize the important etiological contribution of recessive and de novo genetic variants to a large cohort of sporadic HL cases plus their parents.
Collapse
Affiliation(s)
- Jing Guan
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Jin Li
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Guohui Chen
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Tao Shi
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Lan Lan
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Xiaonan Wu
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Cui Zhao
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Dayong Wang
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Hongyang Wang
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| | - Qiuju Wang
- College of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxing Road, Beijing, 100853, China; National Clinical Research Center for Otolaryngologic Diseases, State Key Lab of Hearing Science, Ministry of Education, China & Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, 100853, China.
| |
Collapse
|
15
|
Performance and characteristics of the Newborn Hearing Screening Program in Campania region (Italy) between 2013 and 2019. Eur Arch Otorhinolaryngol 2021; 279:1221-1231. [PMID: 33768315 PMCID: PMC8897375 DOI: 10.1007/s00405-021-06748-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/11/2021] [Indexed: 11/06/2022]
Abstract
Purpose Universal newborn hearing screening (UNHS) in the first month of life is crucial for facilitating both early hearing detection and intervention (EHDI) of significant permanent hearing impairment (PHI). In Campania region, UNHS has been introduced in 2003 by the Regional Council Resolution and started on January 2007. The aim of this paper is to update a previous article describing the performance of the program since its implementation in the period between 2013 and 2019. Methods A longitudinal retrospective study was carried at the Regional Reference Center III on 350,178 babies born in the analysis period. The paper reports the main results of overall coverage, referral rate, lost-to-follow-up rate,yield for PHI and shall determine various risk factor associations with hearing impairment Results In Campania region, 318,878 newborns were enrolled at I level, with a coverage rate of 91.06%, 301,818 (86.18%) Well Infant Nurseries (WIN) and 17,060 (5.35%) Neonatal Intensive Care Unit (NICU) babies. PHI was identified in 413 children, 288 (69.73%) bilaterally and 125 (30.26%) unilaterally. The overall cumulative incidence rate of PHI was 1.29 per 1000 live-born infants (95% CI 1.17–1.42) with a quite steady tendency during the whole study period. Conclusions This study confirms the feasibility and effectiveness of UNHS in Campania region also in a setting with major socioeconomic and health organization restrictions.The program meets quality benchmarks to evaluate the progress of UNHS. Nowadays, it is possible to achieve an early diagnosis of all types of HL avoiding the consequences of hearing deprivation.
Collapse
|
16
|
Laurent S, Gehrig C, Nouspikel T, Amr SS, Oza A, Murphy E, Vannier A, Béna FS, Carminho-Rodrigues MT, Blouin JL, Cao Van H, Abramowicz M, Paoloni-Giacobino A, Guipponi M. Molecular characterization of pathogenic OTOA gene conversions in hearing loss patients. Hum Mutat 2021; 42:373-377. [PMID: 33492714 DOI: 10.1002/humu.24167] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/02/2020] [Accepted: 12/16/2020] [Indexed: 11/11/2022]
Abstract
Bi-allelic loss-of-function variants of OTOA are a well-known cause of moderate-to-severe hearing loss. Whereas non-allelic homologous recombination-mediated deletions of the gene are well known, gene conversions to pseudogene OTOAP1 have been reported in the literature but never fully described nor their pathogenicity assessed. Here, we report two unrelated patients with moderate hearing-loss, who were compound heterozygotes for a converted allele and a deletion of OTOA. The conversions were initially detected through sequencing depths anomalies at the OTOA locus after exome sequencing, then confirmed with long range polymerase chain reactions. Both conversions lead to loss-of-function by introducing a premature stop codon in exon 22 (p.Glu787*). Using genomic alignments and long read nanopore sequencing, we found that the two probands carry stretches of converted DNA of widely different lengths (at least 9 kbp and around 900 bp, respectively).
Collapse
Affiliation(s)
- Sacha Laurent
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Corinne Gehrig
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Thierry Nouspikel
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Sami S Amr
- Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine, Cambridge, Massachusetts, USA
| | - Andrea Oza
- Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine, Cambridge, Massachusetts, USA
| | - Elissa Murphy
- Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine, Cambridge, Massachusetts, USA
| | - Anne Vannier
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Frédérique Sloan Béna
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | | | - Jean-Louis Blouin
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Hélène Cao Van
- Department of Otorhinolaryngology, Head and Neck Surgery, Pediatric Otolaryngology Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Marc Abramowicz
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Ariane Paoloni-Giacobino
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Michel Guipponi
- Department of Diagnostic, Genetic Medicine Unit, University Hospitals of Geneva, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| |
Collapse
|
17
|
Belcher R, Virgin F, Duis J, Wootten C. Genetic and Non-genetic Workup for Pediatric Congenital Hearing Loss. Front Pediatr 2021; 9:536730. [PMID: 33829002 PMCID: PMC8020033 DOI: 10.3389/fped.2021.536730] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 02/25/2021] [Indexed: 01/06/2023] Open
Abstract
Hearing loss is one of the most common concerns for presentation for a geneticist. Presentation prior to the age of one (congenital hearing loss), profound sensorineural hearing loss (SNHL), and bilateral hearing loss are sensitive and should raise concern for genetic causes of hearing loss and prompt referral for genetic testing. Genetic testing particularly in this instance offers the opportunity for anticipatory guidance including possible course of the hearing loss over time and also connection and evaluation for additional congenital anomalies that may be associated with an underlying syndrome vs. isolated genetic hearing loss.
Collapse
Affiliation(s)
- Ryan Belcher
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
| | - Frank Virgin
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
| | - Jessica Duis
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
| | - Christopher Wootten
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
| |
Collapse
|
18
|
Downie L, Amor DJ, Halliday J, Lewis S, Martyn M, Goranitis I. Exome Sequencing for Isolated Congenital Hearing Loss: A Cost-Effectiveness Analysis. Laryngoscope 2020; 131:E2371-E2377. [PMID: 33382469 DOI: 10.1002/lary.29356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES/HYPOTHESIS To assess the relative cost-effectiveness of exome sequencing for isolated congenital deafness compared with standard care. STUDY DESIGN Incremental cost-effectiveness and cost-benefit analyses were undertaken from the perspective of the Australian healthcare system using an 18-year time horizon. METHODS A decision tree was used to model the costs and outcomes associated with exome sequencing and standard care for infants presenting with isolated congenital deafness. RESULTS Exome sequencing resulted in an incremental cost of AU$1,000 per child and an additional 30 diagnoses per 100 children tested. The incremental cost-effectiveness ratio was AU$3,333 per additional diagnosis. The mean societal willingness to pay for exome sequencing was estimated at AU$4,600 per child tested relative to standard care, resulting in a positive net benefit of AU$3,600. Deterministic and probabilistic sensitivity analyses confirmed the cost-effectiveness of exome sequencing. CONCLUSIONS Our findings demonstrate the cost-effectiveness of exome sequencing in congenital hearing loss, through increased diagnostic rate and consequent improved process of care by reducing or ceasing diagnostic investigation or facilitating targeted further investigation. We recommend equitable funding for exome sequencing in infants presenting with isolated congenital hearing loss. LEVEL OF EVIDENCE N/A. Laryngoscope, 131:E2371-E2377, 2021.
Collapse
Affiliation(s)
- Lilian Downie
- Victorian Clinical Genetics Services, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Amor
- Victorian Clinical Genetics Services, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Halliday
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Sharon Lewis
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Melissa Martyn
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Melbourne Genomics Health Alliance, Melbourne, Victoria, Australia
| | - Ilias Goranitis
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Health Policy, University of Melbourne, Melbourne, Victoria, Australia.,Australian Genomics Health Alliance, Melbourne, Victoria, Australia
| |
Collapse
|
19
|
Sohal K, Moshy J, Owibingire S, Shuaibu I. Hearing loss in children: A review of literature. JOURNAL OF MEDICAL SCIENCES 2020. [DOI: 10.4103/jmedsci.jmedsci_166_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
20
|
Downie L, Halliday J, Burt R, Lunke S, Lynch E, Martyn M, Poulakis Z, Gaff C, Sung V, Wake M, Hunter MF, Saunders K, Rose E, Lewis S, Jarmolowicz A, Phelan D, Rehm HL, Amor DJ. Exome sequencing in infants with congenital hearing impairment: a population-based cohort study. Eur J Hum Genet 2019; 28:587-596. [PMID: 31827275 DOI: 10.1038/s41431-019-0553-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/30/2019] [Accepted: 11/07/2019] [Indexed: 12/11/2022] Open
Abstract
Congenital hearing impairment (HI) is the most common sensory impairment and can be isolated or part of a syndrome. Diagnosis through newborn hearing screening and management through early intervention, hearing aids and cochlear implantation is well established in the Australian setting; however understanding the genetic basis of congenital HI has been missing. This population-derived cohort comprised infants with moderate-profound bilateral HI born in the 2016-2017 calendar years, detected through newborn hearing screening. Participants were recruited through an integrated paediatric, otolaryngology and genetics HI clinic and offered whole exome sequencing (WES) on a HiSeq4000 or NextSeq500 (Illumina) platform with a targeted average sequencing depth of 100x and chromosome microarray on the Illumina Infinium core exome-24v1.2 platform. Of those approached, 68% (106/156) consented to participate. The rate of genetic diagnosis was 56% (59/106), significantly higher than standard of care (GJB2/6 sequencing only), 21% (22/106). There were clinical implications for the 106 participants: 36% required no further screening, 9% had tailored screening initiated, 2% were offered treatment and 4% had informed care for a complex neurodevelopmental syndrome. WES in this cohort demonstrates the range of diagnoses associated with congenital HI and confirms the genetic heterogeneity of congenital HI. The high diagnostic yield and clinical implications emphasises the need for genomic sequencing to become standard of care.
Collapse
Affiliation(s)
- Lilian Downie
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Royal Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Jane Halliday
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Rachel Burt
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sebastian Lunke
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Elly Lynch
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Melbourne Genomics Health Alliance, Melbourne, VIC, Australia
| | - Melissa Martyn
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Genomics Health Alliance, Melbourne, VIC, Australia
| | - Zeffie Poulakis
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Royal Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Clara Gaff
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Genomics Health Alliance, Melbourne, VIC, Australia
| | - Valerie Sung
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Royal Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Matthew F Hunter
- Monash Health, Melbourne, VIC, Australia.,Monash University, Melbourne, VIC, Australia
| | - Kerryn Saunders
- Monash Health, Melbourne, VIC, Australia.,Monash University, Melbourne, VIC, Australia
| | - Elizabeth Rose
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Royal Children's Hospital, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sharon Lewis
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Anna Jarmolowicz
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Dean Phelan
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Heidi L Rehm
- Massachusetts General Hospital and the Broad Institute of MIT and Harvard, Boston, MA, USA
| | | | - David J Amor
- Victorian Clinical Genetics Services, Melbourne, VIC, Australia. .,Murdoch Children's Research Institute, Melbourne, VIC, Australia. .,Royal Children's Hospital, Melbourne, VIC, Australia. .,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
| |
Collapse
|
21
|
Welling DB, Jackler RK. Reflections on the Last 25 Years of the American Otological Society and Thoughts on its Future. Otol Neurotol 2019. [PMID: 29533378 DOI: 10.1097/mao.0000000000001760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To review contributions of the American Otological Society (AOS) over the most recent quarter century (1993-2018) and to comment on possible future evolution of the field during the quarter century to come. METHODS Retrospective review of selected topics from the AOS transactions, distinguished lectureships over the past 25 years, and selective reflection by the authors. Speculation on potential advances of the next quarter century derived from emerging topics in the current literature and foreseeable trends in science and technology are also proffered for consideration (and possible future ridicule). RESULTS Integration of multiple disciplines including bioengineering, medical imaging, genetics, molecular biology, physics, and evidence based medicine have substantially benefitted the practice of otology over the past quarter century. The impact of the contributions of members of the AOS in these developments cannot be over estimated. CONCLUSIONS Further scientific advancement will certainly accelerate change in the practice of otologic surgery and medicine over the coming decade in ways that will be marvelous to behold.
Collapse
Affiliation(s)
- D Bradley Welling
- Harvard Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Robert K Jackler
- Department of Otolaryngology Head and Neck Surgery, Stanford University, Stanford, California
| |
Collapse
|
22
|
|
23
|
Abstract
BACKGROUND The field of otology is increasingly at the forefront of innovation in science and medicine. The inner ear, one of the most challenging systems to study, has been rendered much more open to inquiry by recent developments in research methodology. Promising advances of potential clinical impact have occurred in recent years in biological fields such as auditory genetics, ototoxic chemoprevention and organ of Corti regeneration. The interface of the ear with digital technology to remediate hearing loss, or as a consumer device within an intelligent ecosystem of connected devices, is receiving enormous creative energy. Automation and artificial intelligence can enhance otological medical and surgical practice. Otology is poised to enter a new renaissance period, in which many previously untreatable ear diseases will yield to newly introduced therapies. OBJECTIVE This paper speculates on the direction otology will take in the coming decades. CONCLUSION Making predictions about the future of otology is a risky endeavour. If the predictions are found wanting, it will likely be because of unforeseen revolutionary methods.
Collapse
|
24
|
Huttunen K, Erixon E, Löfkvist U, Mäki-Torkko E. The impact of permanent early-onset unilateral hearing impairment in children - A systematic review. Int J Pediatr Otorhinolaryngol 2019; 120:173-183. [PMID: 30836274 DOI: 10.1016/j.ijporl.2019.02.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development. OBJECTIVES This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life. METHODS Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA ≥40 dB averaged over frequencies 0.5 to 2 or 0.5-4 kHz, hearing in the contralateral ear had to have PTA0.5-2 kHz or PTA0.5-4 kHz ≤ 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on. Four researchers independently screened 1618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results. Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. RESULTS Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise. CONCLUSIONS No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.
Collapse
Affiliation(s)
- Kerttu Huttunen
- Faculty of Humanities, Logopedics, and Child Language Research Center, University of Oulu, Finland; PEDEGO Research Unit, University of Oulu, Finland; MRC Oulu, Oulu, Finland; Oulu University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Oulu, Finland.
| | - Elsa Erixon
- Uppsala University, Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala, Sweden.
| | - Ulrika Löfkvist
- University of Oslo, Department of Special Needs Education, Oslo, Norway; Karolinska Institute, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden.
| | - Elina Mäki-Torkko
- Örebro University, School of Medical Sciences, Örebro, Sweden; Örebro University Hospital, Audiological Research Center, Örebro, Sweden.
| |
Collapse
|
25
|
Towerman AS, Hayashi SS, Hayashi RJ, Hulbert ML. Prevalence and nature of hearing loss in a cohort of children with sickle cell disease. Pediatr Blood Cancer 2019; 66:e27457. [PMID: 30207054 DOI: 10.1002/pbc.27457] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/16/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) may cause injury to any organ, including the auditory system. Although the association of SCD and hearing loss has been described, the nature of this complication is unknown. We sought to establish the prevalence and nature of hearing loss in a referred cohort of children with SCD and to identify correlating disease- or treatment-associated factors. PROCEDURE We conducted a retrospective review of patients with SCD < 22 years of age who had hearing evaluations between August 1990 and December 2014. Demographics, audiograms, and disease and treatment variables were analyzed. RESULTS Two hundred and ten audiograms among 81 patients were reviewed, and 189 were evaluable. Seventy-two children constituted the referred cohort. Fourteen (19.4%) had hearing loss documented on at least one audiogram. Seven (9.7%) patients had only conductive hearing loss, and the loss persisted for up to 10.3 years. The median age of first identification was eight years. Six (8.3%) patients had hearing loss that was at least partially sensorineural. One patient's hearing loss was ambiguous. All sensorineural hearing losses were unilateral and 4/6 patients had prior documented normal hearing, indicating acquired loss. No correlations were identified. CONCLUSIONS Both conductive and sensorineural hearing losses are more prevalent in our study population than those observed in the general pediatric population. In children with SCD, sensorineural hearing loss appears to be acquired and unilateral. Conductive hearing loss was identified in older children and can persist. Serial screening is needed for early detection and more prompt intervention in this population.
Collapse
Affiliation(s)
- Alison S Towerman
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Susan S Hayashi
- Department of Audiology, St. Louis Children's Hospital, St. Louis, Missouri
| | - Robert J Hayashi
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Monica L Hulbert
- Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| |
Collapse
|
26
|
van Beeck Calkoen EA, Engel MSD, van de Kamp JM, Yntema HG, Goverts S, Mulder M, Merkus P, Hensen EF. The etiological evaluation of sensorineural hearing loss in children. Eur J Pediatr 2019; 178:1195-1205. [PMID: 31152317 PMCID: PMC6647487 DOI: 10.1007/s00431-019-03379-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/27/2022]
Abstract
This study aims to evaluate the etiology of pediatric sensorineural hearing loss (SNHL). A total of 423 children with SNHL were evaluated, with the focus on the determination of causative genetic and acquired etiologies of uni- and bilateral SNHL in relation to age at diagnosis and severity of the hearing loss. We found that a stepwise diagnostic approach comprising of imaging, genetic, and/or pediatric evaluation identified a cause for SNHL in 67% of the children. The most common causative finding in children with bilateral SNHL was causative gene variants (26%), and in children with unilateral SNHL, a structural anomaly of the temporal bone (27%). The probability of finding an etiologic diagnosis is significantly higher in children under the age of 1 year and children with profound SNHL.Conclusions: With our stepwise diagnostic approach, we found a diagnostic yield of 67%. Bilateral SNHL often has a genetic cause, whereas in unilateral SNHL structural abnormalities of the labyrinth are the dominant etiologic factor. The diagnostic yield is associated with the age at detection and severity of hearing loss: the highest proportion of causative abnormalities is found in children with a young age at detection or a profound hearing loss. What is Known: • Congenital sensorineural hearing loss is one of the most common congenital disorders • Determination of the cause is important for adequate management and prognosis and may include radiology, serology, and DNA analysis What is New: • Using a stepwise diagnostic approach, causative abnormalities are found in 67% both in uni- and bilateral SNHL, with the highest diagnostic yield in very young children and those suffering from profound hearing loss • Bilateral SNHL often has a genetic cause, whereas in unilateral SNHL structural abnormalities of the labyrinth are the dominant etiologic factor.
Collapse
Affiliation(s)
- E. A. van Beeck Calkoen
- Department of Otolaryngology/Head and Neck Surgery, Section Ear and Hearing, VU University Medical Center, Amsterdam, Netherlands ,Amsterdam Public Health research institute, Amsterdam, Netherlands ,Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, Netherlands
| | - M. S. D. Engel
- Department of Otolaryngology/Head and Neck Surgery, Section Ear and Hearing, VU University Medical Center, Amsterdam, Netherlands ,Amsterdam Public Health research institute, Amsterdam, Netherlands ,Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, Netherlands
| | - J. M. van de Kamp
- Amsterdam Public Health research institute, Amsterdam, Netherlands ,Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, Netherlands ,Department of Clinical Genetics, VU University Medical Center, Amsterdam, Netherlands
| | - H. G. Yntema
- Department of Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - S.T. Goverts
- Department of Otolaryngology/Head and Neck Surgery, Section Ear and Hearing, VU University Medical Center, Amsterdam, Netherlands ,Amsterdam Public Health research institute, Amsterdam, Netherlands ,Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, Netherlands
| | - M.F. Mulder
- Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, Netherlands ,Department of Pediatrics, VU University Medical Center, Amsterdam, Netherlands
| | - P. Merkus
- Department of Otolaryngology/Head and Neck Surgery, Section Ear and Hearing, VU University Medical Center, Amsterdam, Netherlands ,Amsterdam Public Health research institute, Amsterdam, Netherlands ,Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, Netherlands
| | - E. F. Hensen
- Department of Otolaryngology/Head and Neck Surgery, Section Ear and Hearing, VU University Medical Center, Amsterdam, Netherlands ,Amsterdam Public Health research institute, Amsterdam, Netherlands ,Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, Netherlands ,Department of Otolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, Netherlands
| |
Collapse
|
27
|
Vona B, Hofrichter MAH, Schröder J, Shehata-Dieler W, Nanda I, Haaf T. Hereditary hearing loss SNP-microarray pilot study. BMC Res Notes 2018; 11:391. [PMID: 29903040 PMCID: PMC6003021 DOI: 10.1186/s13104-018-3466-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 06/01/2018] [Indexed: 02/08/2023] Open
Abstract
Objectives Despite recent advancements in diagnostic tools, the genomic landscape of hereditary hearing loss remains largely uncharacterized. One strategy to understand genome-wide aberrations includes the analysis of copy number variation that can be mapped using SNP-microarray technology. A growing collection of literature has begun to uncover the importance of copy number variation in hereditary hearing loss. This pilot study underpins a larger effort that involves the stage-wise analysis of hearing loss patients, many of whom have advanced to high-throughput sequencing analysis. Data description Our data originate from the Infinium HumanOmni1-Quad v1.0 SNP-microarrays (Illumina) that provide useful markers for genome-wide association studies and copy number variation analysis. This dataset comprises a cohort of 108 individuals (99 with hearing loss, 9 normal hearing family members) for the purpose of understanding the genetic contribution of copy number variations to hereditary hearing loss. These anonymized SNP-microarray data have been uploaded to the NCBI Gene Expression Omnibus and are intended to benefit other investigators interested in aggregating platform-matched array patient datasets or as part of a supporting reference tool for other laboratories to better understand recurring copy number variations in other genetic disorders.
Collapse
Affiliation(s)
- Barbara Vona
- Institute of Human Genetics, Julius Maximilians University, Würzburg, Germany.
| | | | - Jörg Schröder
- Institute of Human Genetics, Julius Maximilians University, Würzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of ORL, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, Würzburg, Germany
| | - Indrajit Nanda
- Institute of Human Genetics, Julius Maximilians University, Würzburg, Germany
| | - Thomas Haaf
- Institute of Human Genetics, Julius Maximilians University, Würzburg, Germany
| |
Collapse
|
28
|
AUDIOME: a tiered exome sequencing-based comprehensive gene panel for the diagnosis of heterogeneous nonsyndromic sensorineural hearing loss. Genet Med 2018; 20:1600-1608. [PMID: 29595809 DOI: 10.1038/gim.2018.48] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/13/2018] [Indexed: 01/25/2023] Open
Abstract
PURPOSE Hereditary hearing loss is highly heterogeneous. To keep up with rapidly emerging disease-causing genes, we developed the AUDIOME test for nonsyndromic hearing loss (NSHL) using an exome sequencing (ES) platform and targeted analysis for the curated genes. METHODS A tiered strategy was implemented for this test. Tier 1 includes combined Sanger and targeted deletion analyses of the two most common NSHL genes and two mitochondrial genes. Nondiagnostic tier 1 cases are subjected to ES and array followed by targeted analysis of the remaining AUDIOME genes. RESULTS ES resulted in good coverage of the selected genes with 98.24% of targeted bases at >15 ×. A fill-in strategy was developed for the poorly covered regions, which generally fell within GC-rich or highly homologous regions. Prospective testing of 33 patients with NSHL revealed a diagnosis in 11 (33%) and a possible diagnosis in 8 cases (24.2%). Among those, 10 individuals had variants in tier 1 genes. The ES data in the remaining nondiagnostic cases are readily available for further analysis. CONCLUSION The tiered and ES-based test provides an efficient and cost-effective diagnostic strategy for NSHL, with the potential to reflex to full exome to identify causal changes outside of the AUDIOME test.
Collapse
|
29
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to review the evaluation and management of children with syndromic hearing loss. Specific syndromes and the impact of those syndromes on managing hearing loss will be discussed. RECENT FINDINGS Improved molecular testing has increased the ability to identify syndromes-associated hearing loss. Accurate diagnosis of syndromic hearing loss can guide discussions regarding prognosis and appropriate management options for the hearing impairment. SUMMARY A significant portion of childhood hearing loss is associated with a syndrome. Depending on the syndrome, surgical intervention including a bone-anchored hearing aid or cochlear implant may be helpful. In the future, targeted gene therapies may become a viable option for treating syndromic hearing loss.
Collapse
|
30
|
Likar T, Hasanhodžić M, Teran N, Maver A, Peterlin B, Writzl K. Diagnostic outcomes of exome sequencing in patients with syndromic or non-syndromic hearing loss. PLoS One 2018; 13:e0188578. [PMID: 29293505 PMCID: PMC5749682 DOI: 10.1371/journal.pone.0188578] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/09/2017] [Indexed: 12/30/2022] Open
Abstract
Hereditary hearing loss (HL) is a common sensory disorder, with an incidence of 1–2 per 1000 newborns, and has a genetic etiology in over 50% of cases. It occurs either as part of a syndrome or in isolation and is genetically very heterogeneous which poses a challenge for clinical and molecular diagnosis. We used exome sequencing to seek a genetic cause in a group of 56 subjects (49 probands) with HL: 32 with non-syndromic non-GJB2 HL and 17 with syndromic HL. Following clinical examination and clinical exome sequencing, an etiological diagnosis was established in 15 probands (15/49; 30%); eight (8/17;47%) from the syndromic group and seven (7/32; 21%) from the non-syndromic non-GJB2 subgroup. Fourteen different (half of them novel) non-GJB2 variants causing HL were found in 10 genes (CHD7, HDAC8, MITF, NEFL, OTOF, SF3B4, SLC26A4, TECTA, TMPRSS3, USH2A) among 13 probands, confirming the genetic heterogeneity of hereditary HL. Different genetic causes for HL were found in a single family while three probands with apparent syndromic HL were found to have HL as a separate clinical feature, distinct from the complex phenotype. Clinical exome sequencing proved to be an effective tool used to comprehensively address the genetic heterogeneity of HL, to detect clinically unrecognized HL syndromes, and to decipher complex phenotypes in which HL is a separate feature and not part of a syndrome.
Collapse
Affiliation(s)
- Tina Likar
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Mensuda Hasanhodžić
- Policlinic of Medical Genetics with Genetic Counseling for Out-Patient Care, Department of Paediatrics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Nataša Teran
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Aleš Maver
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Karin Writzl
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
- * E-mail:
| |
Collapse
|
31
|
Baux D, Vaché C, Blanchet C, Willems M, Baudoin C, Moclyn M, Faugère V, Touraine R, Isidor B, Dupin-Deguine D, Nizon M, Vincent M, Mercier S, Calais C, García-García G, Azher Z, Lambert L, Perdomo-Trujillo Y, Giuliano F, Claustres M, Koenig M, Mondain M, Roux AF. Combined genetic approaches yield a 48% diagnostic rate in a large cohort of French hearing-impaired patients. Sci Rep 2017; 7:16783. [PMID: 29196752 PMCID: PMC5711943 DOI: 10.1038/s41598-017-16846-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/17/2017] [Indexed: 11/22/2022] Open
Abstract
Hearing loss is the most common sensory disorder and because of its high genetic heterogeneity, implementation of Massively Parallel Sequencing (MPS) in diagnostic laboratories is greatly improving the possibilities of offering optimal care to patients. We present the results of a two-year period of molecular diagnosis that included 207 French families referred for non-syndromic hearing loss. Our multi-step strategy involved (i) DFNB1 locus analysis, (ii) MPS of 74 genes, and (iii) additional approaches including Copy Number Variations, in silico analyses, minigene studies coupled when appropriate with complete gene sequencing, and a specific assay for STRC. This comprehensive screening yielded an overall diagnostic rate of 48%, equally distributed between DFNB1 (24%) and the other genes (24%). Pathogenic genotypes were identified in 19 different genes, with a high prevalence of GJB2, STRC, MYO15A, OTOF, TMC1, MYO7A and USH2A. Involvement of an Usher gene was reported in 16% of the genotyped cohort. Four de novo variants were identified. This study highlights the need to develop several molecular approaches for efficient molecular diagnosis of hearing loss, as this is crucial for genetic counselling, audiological rehabilitation and the detection of syndromic forms.
Collapse
Affiliation(s)
- D Baux
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France
| | - C Vaché
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France
| | - C Blanchet
- Service ORL, CHU Montpellier, Montpellier, France.,Centre National de Référence Maladies Rares "Affections Sensorielles Génétiques", CHU Montpellier, Montpellier, France
| | - M Willems
- Génétique Médicale, CHU Montpellier, Montpellier, France
| | - C Baudoin
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France
| | - M Moclyn
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France
| | - V Faugère
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France
| | - R Touraine
- Service de Génétique, CHU-Hôpital Nord, Saint-Etienne, France
| | - B Isidor
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - D Dupin-Deguine
- Service de Génétique Médicale, CHU Toulouse, Toulouse, France.,Service d'ORL, Otoneurologie et ORL pédiatrique CHU Toulouse, Toulouse, France
| | - M Nizon
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - M Vincent
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - S Mercier
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - C Calais
- Service d'ORL, CHU Nantes, Nantes, France
| | - G García-García
- Laboratoire de Génétique de Maladies Rares (LGMR) EA7402, Université de Montpellier, Montpellier, France
| | - Z Azher
- Laboratoire de Génétique de Maladies Rares (LGMR) EA7402, Université de Montpellier, Montpellier, France
| | - L Lambert
- Génétique Médicale, Centre de Compétence des Surdités Génétiques, site constitutif du Centre de Référence des Anomalies du Développement et Syndromes Malformatifs de l'Est, CHRU Nancy, Nancy, France
| | - Y Perdomo-Trujillo
- Service de Génétique Médicale, Centre de Référence pour les Affections Rares en Génétique Ophtalmologique (CARGO), Hôpital Civil, Strasbourg, France
| | - F Giuliano
- Service de Génétique Médicale, CHU Nice, Nice, France
| | - M Claustres
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France.,Laboratoire de Génétique de Maladies Rares (LGMR) EA7402, Université de Montpellier, Montpellier, France
| | - M Koenig
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France.,Laboratoire de Génétique de Maladies Rares (LGMR) EA7402, Université de Montpellier, Montpellier, France
| | - M Mondain
- Service ORL, CHU Montpellier, Montpellier, France.,Centre National de Référence Maladies Rares "Affections Sensorielles Génétiques", CHU Montpellier, Montpellier, France
| | - A F Roux
- Laboratoire de Génétique Moléculaire, CHU Montpellier, Montpellier, France. .,Laboratoire de Génétique de Maladies Rares (LGMR) EA7402, Université de Montpellier, Montpellier, France.
| |
Collapse
|
32
|
Farzal Z, Walsh J, Ahmad FI, Roberts J, Ferns SJ, Zdanski CJ. Electrocardiogram Screening in Children with Congenital Sensorineural Hearing Loss: Prevalence and Follow-up of Abnormalities. Otolaryngol Head Neck Surg 2017; 158:553-558. [PMID: 29160150 DOI: 10.1177/0194599817738975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The purpose is to determine the prevalence of electrocardiogram (ECG) abnormalities, including borderline and prolonged QT, among screened children with sensorineural hearing loss (SNHL) and to analyze their subsequent medical workup. Study Design Institutional Review Board-approved case series with chart review. Setting Tertiary academic center. Subjects and Methods Cases from 1996 to 2014 involving pediatric patients (N = 1994) with SNHL were analyzed. Abnormal ECGs were categorized as borderline/prolonged QT or other. A board-certified pediatric cardiologist retrospectively determined the clinical significance of ECG changes. For follow-up analysis, children with heart disease, known syndromes, or inaccessible records were excluded. Results Among 772 children who had ECGs, 215 (27.8%) had abnormal results: 35 (4.5%) with QT abnormalities and 180 (23.3%) with other abnormalities. For children with QT abnormalities meeting inclusion criteria (n = 30), follow-up measures included cardiology referral (46.6%), repeat ECG by ear, nose, and throat (ENT) specialist (20%), clearance by ENT specialist with clinical correlation and/or comparison with old ECGs (20%), and pediatrician follow-up (6.7%). Documentation of further workup by ENT or referral was absent for 6.7%. For children with other ECG changes meeting inclusion criteria (n = 136), abnormalities were documented for 57 (41.9%); normal QT without other abnormality was documented for 18 (13.2%). The most common follow-up referrals were to pediatricians (16.9%) and cardiologists (10.3%). Among patients with clinically significant non-QT abnormalities mandating further evaluation (n = 122), 38 (31.1%) had documented follow-up in medical records. Conclusion There is a high prevalence of ECG abnormalities among children with congenital SNHL. If findings are confirmed by future studies, screening should be considered for congenital unilateral or bilateral SNHL, regardless of severity. We describe a standardized protocol for ECG screening/follow-up.
Collapse
Affiliation(s)
- Zainab Farzal
- 1 Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jonathan Walsh
- 2 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Faisal I Ahmad
- 3 Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Jason Roberts
- 4 Asheville Head, Neck, and Ear Surgeons, Asheville, North Carolina, USA
| | - Sunita J Ferns
- 5 Department of Pediatric Cardiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Carlton J Zdanski
- 1 Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
33
|
Rohacek AM, Bebee TW, Tilton RK, Radens CM, McDermott-Roe C, Peart N, Kaur M, Zaykaner M, Cieply B, Musunuru K, Barash Y, Germiller JA, Krantz ID, Carstens RP, Epstein DJ. ESRP1 Mutations Cause Hearing Loss due to Defects in Alternative Splicing that Disrupt Cochlear Development. Dev Cell 2017; 43:318-331.e5. [PMID: 29107558 PMCID: PMC5687886 DOI: 10.1016/j.devcel.2017.09.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 08/15/2017] [Accepted: 08/26/2017] [Indexed: 12/30/2022]
Abstract
Alternative splicing contributes to gene expression dynamics in many tissues, yet its role in auditory development remains unclear. We performed whole-exome sequencing in individuals with sensorineural hearing loss (SNHL) and identified pathogenic mutations in Epithelial Splicing-Regulatory Protein 1 (ESRP1). Patient-derived induced pluripotent stem cells showed alternative splicing defects that were restored upon repair of an ESRP1 mutant allele. To determine how ESRP1 mutations cause hearing loss, we evaluated Esrp1-/- mouse embryos and uncovered alterations in cochlear morphogenesis, auditory hair cell differentiation, and cell fate specification. Transcriptome analysis revealed impaired expression and splicing of genes with essential roles in cochlea development and auditory function. Aberrant splicing of Fgfr2 blocked stria vascularis formation due to erroneous ligand usage, which was corrected by reducing Fgf9 gene dosage. These findings implicate mutations in ESRP1 as a cause of SNHL and demonstrate the complex interplay between alternative splicing, inner ear development, and auditory function.
Collapse
Affiliation(s)
- Alex M Rohacek
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Clinical Research Building, Room 463, 415 Curie Boulevard, Philadelphia, PA 19104, USA
| | - Thomas W Bebee
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard K Tilton
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Caleb M Radens
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Clinical Research Building, Room 463, 415 Curie Boulevard, Philadelphia, PA 19104, USA
| | - Chris McDermott-Roe
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Natoya Peart
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Maninder Kaur
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael Zaykaner
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Benjamin Cieply
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kiran Musunuru
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yoseph Barash
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Clinical Research Building, Room 463, 415 Curie Boulevard, Philadelphia, PA 19104, USA
| | - John A Germiller
- Division of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ian D Krantz
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Clinical Research Building, Room 463, 415 Curie Boulevard, Philadelphia, PA 19104, USA; Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Russ P Carstens
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Douglas J Epstein
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Clinical Research Building, Room 463, 415 Curie Boulevard, Philadelphia, PA 19104, USA.
| |
Collapse
|
34
|
Sampaio‐Silva J, Batissoco AC, Jesus‐Santos R, Abath‐Neto O, Scarpelli LC, Nishimura PY, Galindo LT, Bento RF, Oiticica J, Lezirovitz K. Exome Sequencing Identifies a Novel Nonsense Mutation of
MYO6
as the Cause of Deafness in a Brazilian Family. Ann Hum Genet 2017; 82:23-34. [DOI: 10.1111/ahg.12213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/16/2017] [Indexed: 02/04/2023]
Affiliation(s)
- Juliana Sampaio‐Silva
- Laboratório de Otorrinolaringologia/LIM32 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brasil
| | - Ana Carla Batissoco
- Laboratório de Otorrinolaringologia/LIM32 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brasil
| | - Rafaela Jesus‐Santos
- Laboratório de Otorrinolaringologia/LIM32 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brasil
| | - Osório Abath‐Neto
- Departamento de Neurologia Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo SP Brasil
| | | | | | - Layla Testa Galindo
- Setor de Biologia Molecular Grupo DASA – Diagnósticos da América Barueri SP Brasil
| | - Ricardo Ferreira Bento
- Laboratório de Otorrinolaringologia/LIM32 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brasil
| | - Jeanne Oiticica
- Laboratório de Otorrinolaringologia/LIM32 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brasil
| | - Karina Lezirovitz
- Laboratório de Otorrinolaringologia/LIM32 Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brasil
| |
Collapse
|
35
|
Sengillo JD, Cabral T, Schuerch K, Duong J, Lee W, Boudreault K, Xu Y, Justus S, Sparrow JR, Mahajan VB, Tsang SH. Electroretinography Reveals Difference in Cone Function between Syndromic and Nonsyndromic USH2A Patients. Sci Rep 2017; 7:11170. [PMID: 28894305 PMCID: PMC5593892 DOI: 10.1038/s41598-017-11679-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 08/15/2017] [Indexed: 11/23/2022] Open
Abstract
Usher syndrome is an inherited and irreversible disease that manifests as retinitis pigmentosa (RP) and bilateral neurosensory hearing loss. Mutations in Usherin 2A (USH2A) are not only a frequent cause of Usher syndrome, but also nonsyndromic RP. Although gene- and cell-based therapies are on the horizon for RP and Usher syndrome, studies characterizing natural disease are lacking. In this retrospective analysis, retinal function of USH2A patients was quantified with electroretinography. Both groups had markedly reduced rod and cone responses, but nonsyndromic USH2A patients had 30 Hz-flicker electroretinogram amplitudes that were significantly higher than syndromic patients, suggesting superior residual cone function. There was a tendency for Usher syndrome patients to have a higher distribution of severe mutations, and alleles in this group had a higher odds of containing nonsense or frame-shift mutations. These data suggest that the previously reported severe visual phenotype seen in syndromic USH2A patients could relate to a greater extent of cone dysfunction. Additionally, a genetic threshold may exist where mutation burden relates to visual phenotype and the presence of hearing deficits. The auditory phenotype and allelic hierarchy observed among patients should be considered in prospective studies of disease progression and during enrollment for future clinical trials.
Collapse
Affiliation(s)
- Jesse D Sengillo
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Thiago Cabral
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,Department of Ophthalmology, Federal University of Espírito Santo, Vitoria, Brazil.,Department of Ophthalmology, Federal University of São Paulo, Sao Paulo, Brazil
| | - Kaspar Schuerch
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA
| | - Jimmy Duong
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Winston Lee
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA
| | - Katherine Boudreault
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,Department of Ophthalmology, University of Montreal, Montreal, Canada
| | - Yu Xu
- Department of Ophthalmology, Xin Hua Hospital affiliate of Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sally Justus
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA
| | - Janet R Sparrow
- Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,Department of Pathology & Cell Biology, Stem Cell Initiative (CSCI), Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Vinit B Mahajan
- Omics Laboratory, Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA
| | - Stephen H Tsang
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA. .,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA. .,Department of Pathology & Cell Biology, Stem Cell Initiative (CSCI), Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| |
Collapse
|