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Schubert T, Schaaf CP. MAGEL2 (patho-)physiology and Schaaf-Yang syndrome. Dev Med Child Neurol 2024. [PMID: 38950199 DOI: 10.1111/dmcn.16018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/19/2024] [Accepted: 06/11/2024] [Indexed: 07/03/2024]
Abstract
Schaaf-Yang syndrome (SYS) is a complex neurodevelopmental disorder characterized by autism spectrum disorder, joint contractures, and profound hypothalamic dysfunction. SYS is caused by variants in MAGEL2, a gene within the Prader-Willi syndrome (PWS) locus on chromosome 15. In this review, we consolidate decades of research on MAGEL2 to elucidate its physiological functions. Moreover, we synthesize current knowledge on SYS, suggesting that while MAGEL2 loss-of-function seems to underlie several SYS and PWS phenotypes, additional pathomechanisms probably contribute to the distinct and severe phenotype observed in SYS. In addition, we highlight recent therapeutic advances and identify promising avenues for future investigation.
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Affiliation(s)
- Tim Schubert
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
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2
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Thomas Q, Vitobello A, Tran Mau-Them F, Duffourd Y, Fromont A, Giroud M, Daubail B, Jacquin-Piques A, Hervieu-Begue M, Moreau T, Osseby GV, Garret P, Nambot S, Delanne J, Bruel AL, Sorlin A, Callier P, Denomme-Pichon AS, Faivre L, Béjot Y, Philippe C, Thauvin-Robinet C, Moutton S. High efficiency and clinical relevance of exome sequencing in the daily practice of neurogenetics. J Med Genet 2021; 59:445-452. [PMID: 34085946 DOI: 10.1136/jmedgenet-2020-107369] [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: 07/24/2020] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To assess the efficiency and relevance of clinical exome sequencing (cES) as a first-tier or second-tier test for the diagnosis of progressive neurological disorders in the daily practice of Neurology and Genetic Departments. METHODS Sixty-seven probands with various progressive neurological disorders (cerebellar ataxias, neuromuscular disorders, spastic paraplegias, movement disorders and individuals with complex phenotypes labelled 'other') were recruited over a 4-year period regardless of their age, gender, familial history and clinical framework. Individuals could have had prior genetic tests as long as it was not cES. cES was performed in a proband-only (60/67) or trio (7/67) strategy depending on available samples and was analysed with an in-house pipeline including software for CNV and mitochondrial-DNA variant detection. RESULTS In 29/67 individuals, cES identified clearly pathogenic variants leading to a 43% positive yield. When performed as a first-tier test, cES identified pathogenic variants for 53% of individuals (10/19). Difficult cases were solved including double diagnoses within a kindred or identification of a neurodegeneration with brain iron accumulation in a patient with encephalopathy of suspected mitochondrial origin. CONCLUSION This study shows that cES is a powerful tool for the daily practice of neurogenetics offering an efficient (43%) and appropriate approach for clinically and genetically complex and heterogeneous disorders.
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Affiliation(s)
- Quentin Thomas
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France .,Genetics Center, FHU-TRANSLAD, Dijon University Hospital, Dijon, Burgundy, France.,Neurology Department, Dijon University Hospital, Dijon, Burgundy, France
| | - Antonio Vitobello
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Frederic Tran Mau-Them
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Yannis Duffourd
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Agnès Fromont
- Neurology Department, Dijon University Hospital, Dijon, Burgundy, France
| | - Maurice Giroud
- Neurology Department, Dijon University Hospital, Dijon, Burgundy, France.,Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy and Franche-Comté, Dijon, Burgundy, France
| | - Benoit Daubail
- Department of Adult Neurophysiology, Dijon University Hospital, Dijon, Burgundy, France
| | - Agnès Jacquin-Piques
- Department of Adult Neurophysiology, Dijon University Hospital, Dijon, Burgundy, France
| | | | - Thibault Moreau
- Neurology Department, Dijon University Hospital, Dijon, Burgundy, France
| | - Guy-Victor Osseby
- Neurology Department, Dijon University Hospital, Dijon, Burgundy, France
| | - Philippine Garret
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Sophie Nambot
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Genetics Center, FHU-TRANSLAD, Dijon University Hospital, Dijon, Burgundy, France
| | - Julian Delanne
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Genetics Center, FHU-TRANSLAD, Dijon University Hospital, Dijon, Burgundy, France
| | - Ange-Line Bruel
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Arthur Sorlin
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Patrick Callier
- Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Anne-Sophie Denomme-Pichon
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Laurence Faivre
- Genetics Center, FHU-TRANSLAD, Dijon University Hospital, Dijon, Burgundy, France
| | - Yannick Béjot
- Neurology Department, Dijon University Hospital, Dijon, Burgundy, France.,Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy and Franche-Comté, Dijon, Burgundy, France
| | - Christophe Philippe
- Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Christel Thauvin-Robinet
- Genetics Center, FHU-TRANSLAD, Dijon University Hospital, Dijon, Burgundy, France.,Functional Unity of innovative diagnosis for rare diseases, Dijon Bourgogne University Hospital, Dijon, Burgundy, France
| | - Sébastien Moutton
- Inserm UMR1231 team GAD, University of Burgundy and Franche-Comté, Dijon, France.,Genetics Center, FHU-TRANSLAD, Dijon University Hospital, Dijon, Burgundy, France
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A head-to-head evaluation of the diagnostic efficacy and costs of trio versus singleton exome sequencing analysis. Eur J Hum Genet 2019; 27:1791-1799. [PMID: 31320747 DOI: 10.1038/s41431-019-0471-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/24/2019] [Accepted: 07/02/2019] [Indexed: 01/22/2023] Open
Abstract
Diagnostic exome sequencing (ES) can be performed on the proband only (singleton; sES) or with additional samples, often including both biological parents with the proband (trio; tES). In this study we sought to compare the efficiencies of exome sequencing (ES) by trio (tES) versus singleton (sES) approach, determine costs, and identify factors to consider when deciding on optimal implementation strategies for the diagnosis of monogenic disorders. We undertook ES in 30 trios and analysed each proband's sES and tES data in parallel. Two teams were randomly allocated to either sES or tES analysis for each case and blinded to each other's work. Each task was timed and cost analyses were based on time taken and diagnostic yield. We modelled three scenarios to determine the factors to consider in the implementation of tES. sES diagnosed 11/30 (36.7%) cases and tES identified one additional diagnosis (12/30 (40.0%)). tES obviated the need for Sanger segregation, reduced the number of variants for curation, and had lower cost-per-diagnosis when considering analysis alone. When sequencing costs were included, tES nearly doubled the cost of sES. Reflexing to tES in those who remain undiagnosed after sES was cost-saving over tES in all as first-line. This approach requires a large differential in diagnostic yield between sES and tES for maximal benefit given current sequencing costs. tES may be preferable when scaling up laboratory throughput due to efficiency gains and opportunity cost considerations. Our findings are relevant to clinicians, laboratories and health services considering tES over sES.
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Bodian DL, Kothiyal P, Hauser NS. Pitfalls of clinical exome and gene panel testing: alternative transcripts. Genet Med 2018; 21:1240-1245. [DOI: 10.1038/s41436-018-0319-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 09/14/2018] [Indexed: 11/09/2022] Open
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Abstract
PURPOSE OF REVIEW The development of massively parallel sequencing (MPS) has revolutionized molecular genetic diagnostics in monogenic disorders. The present review gives a brief overview of different MPS-based approaches used in clinical diagnostics of neuromuscular disorders (NMDs) and highlights their advantages and limitations. RECENT FINDINGS MPS-based approaches like gene panel sequencing, (whole) exome sequencing, (whole) genome sequencing, and RNA sequencing have been used to identify the genetic cause in NMDs. Although gene panel sequencing has evolved as a standard test for heterogeneous diseases, it is still debated, mainly because of financial issues and unsolved problems of variant interpretation, whether genome sequencing (and to a lesser extent also exome sequencing) of single patients can already be regarded as routine diagnostics. However, it has been shown that the inclusion of parents and additional family members often leads to a substantial increase in the diagnostic yield in exome-wide/genome-wide MPS approaches. In addition, MPS-based RNA sequencing just enters the research and diagnostic scene. SUMMARY Next-generation sequencing increasingly enables the detection of the genetic cause in highly heterogeneous diseases like NMDs in an efficient and affordable way. Gene panel sequencing and family-based exome sequencing have been proven as potent and cost-efficient diagnostic tools. Although clinical validation and interpretation of genome sequencing is still challenging, diagnostic RNA sequencing represents a promising tool to bypass some hurdles of diagnostics using genomic DNA.
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Tong W, Wang Y, Lu Y, Ye T, Song C, Xu Y, Li M, Ding J, Duan Y, Zhang L, Gu W, Zhao X, Yang XA, Jin D. Whole-exome Sequencing Helps the Diagnosis and Treatment in Children with Neurodevelopmental Delay Accompanied Unexplained Dyspnea. Sci Rep 2018; 8:5214. [PMID: 29581464 PMCID: PMC5980106 DOI: 10.1038/s41598-018-23503-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/12/2018] [Indexed: 12/31/2022] Open
Abstract
Neurodevelopmental delay accompanied unexplained dyspnea is a highly lethal disease in clinic. This study is to investigate the performance characteristics of trio whole exome sequencing (Trio-WES) in a pediatric setting by presenting our patient cohort and displaying the diagnostic yield. A total of 31 pediatric patients showing neurodevelopmental delay accompanied unexplained dyspnea were admitted to our hospital and referred for molecular genetic testing using Trio-WES. Eight genes namely MMACHC, G6PC, G6PT, ETFDH, OTC, NDUFAF5, SLC22A5, and MAGEL2 were suspected to be responsible for the onset of the clinical symptoms and 6 variants were novel. Standard interpretation according to ACMG guideline showed that the variants were pathogenic. Finally, diagnosis of methylmalonic aciduria and homocystinuria, glycogen storage disease, ornithine transcarbamylase deficiency, glutaric acidemia II, mitochondrial complex 1 deficiency, carnitine deficiency, and Schaaf-Yang syndrome was made in 12 out of the 31 patients. Trio-WES is an effective means for molecular diagnosis of infantile neurodevelopmental delay accompanied unexplained dyspnea. As for molecular etiology identification, when routine potential monogenetic inheritance patterns including de novo, autosomal recessive, autosomal dominant, and X-linked recessive inheritance analysis is negative, physicians should take into account imprinted genes.
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Affiliation(s)
- Wenjia Tong
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Yajian Wang
- Joy Orient Translational Medicine Research Center Co., Ltd, Beijing, 100875, P.R. China
| | - Yun Lu
- Department of Nephrology, Affiliated Hospital of Hebei University of Engineering, Handan, 056002, P.R. China
| | - Tongsheng Ye
- Neonatal Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Conglei Song
- Department of Neurology, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Yuanyuan Xu
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Min Li
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Jie Ding
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Yuanyuan Duan
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Le Zhang
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Weiyue Gu
- Joy Orient Translational Medicine Research Center Co., Ltd, Beijing, 100875, P.R. China
| | - Xiaoling Zhao
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China
| | - Xiu-An Yang
- Beijing Scientific Operation Biotechnology Co., Ltd., Beijing, 100121, P.R. China. .,Cardiac Center Beijing Chest Hospital, Capital Medical University, Beijing, 101149, P.R. China.
| | - Danqun Jin
- Pediatric Intensive Care Unit, Anhui Provincial Children's Hospital, Hefei, 230029, P.R. China.
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Palomares-Bralo M, Vallespín E, Del Pozo Á, Ibañez K, Silla JC, Galán E, Gordo G, Martínez-Glez V, Alba-Valdivia LI, Heath KE, García-Miñaúr S, Lapunzina P, Santos-Simarro F. Pitfalls of trio-based exome sequencing: imprinted genes and parental mosaicism-MAGEL2 as an example. Genet Med 2017. [PMID: 28640240 DOI: 10.1038/gim.2017.42] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- María Palomares-Bralo
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Elena Vallespín
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Ángela Del Pozo
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Kristina Ibañez
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Juan Carlos Silla
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Enrique Galán
- CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain.,Departamento de Pediatria, Hospital Materno Infantil, Badajoz, Spain
| | - Gema Gordo
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Víctor Martínez-Glez
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Lázaro I Alba-Valdivia
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - Karen E Heath
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Sixto García-Miñaúr
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Pablo Lapunzina
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Fernando Santos-Simarro
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, IdiPaz, Madrid, Spain.,CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
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