1
|
Chen HK, Hsieh YW, Hsu HY, Liu TY, Zhang YT, Lin CD, Tsai FJ. Increased risk of hearing loss associated with MT-RNR1 gene mutations: a real-world investigation among Han Taiwanese Population. BMC Med Genomics 2024; 17:155. [PMID: 38840095 PMCID: PMC11155076 DOI: 10.1186/s12920-024-01921-8] [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: 04/14/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Previous studies have implicated inherited mutations in mitochondrial DNA (mtDNA) in sensorineural hearing loss (SNHL). However, the definitive association between mitochondrial 12S rRNA (MT-RNR1) variants and hearing loss in the population has not been well established, particularly in Asia. The objective of this retrospective cohort study was to assess the association between MT-RNR1 variants and the risk of SNHL in patients in Taiwan. METHODS The cohort included 306,068 participants from Taiwan between January 2003 and December 2020. Participants were classified based on genetic variants, particularly mitochondrial mutations (rs267606618, rs267606619, rs267606617). MT-RNR1 variant cases were matched 1:10 with non-mutant patients by age, gender, and visit year, excluding those with pre-existing hearing loss. The primary endpoint was SNHL, identified using specific ICD-TM codes with a 90% positive predictive value. Medication exposure history was determined via self-report or electronic medical records in the hospital. Cox proportional hazard regression models were used to assess the association between MT-RNR1 variants and hearing loss, adjusting for various covariates. Kaplan-Meier survival curves and log-rank tests compared hearing loss incidence between groups. RESULTS The mean age of the mtDNA variants group is 32.4 years, with a standard deviation of 19.2 years. The incidence density of hearing loss for the mutation group was 36.42 per 10,000 person-years (95% Confidence Interval [CI], 27.21-47.73), which was higher than the 23.77per 10,000 person-years (95% CI, 21.32-26.42) in the wild-type group (p = 0.0036). Additionally, diabetes mellitus was associated with an increased risk of developing SNHL in individuals with MT-RNR1 variants (adjusted hazard ratio = 1.76 [95% CI, 1.00-3.09], p < 0.05). CONCLUSION This study highlights the increased risk of hearing loss in patients carrying MT-RNR1 variants, particularly those with diabetes mellitus. Future research that integrates genetic and clinical data is crucial for developing more precise interventions to monitor and treat hearing loss in this vulnerable population.
Collapse
Affiliation(s)
- Hou-Kuang Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Yow-Wen Hsieh
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
- School of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Hsing-Yu Hsu
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Yuan Liu
- Million-person precision medicine initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Ting Zhang
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Der Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan.
| | - Fuu-Jen Tsai
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
- Division of Pediatric Genetics, Children's Hospital of China Medical University, Taichung, Taiwan.
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan.
| |
Collapse
|
2
|
Talotta R. COVID-19 mRNA vaccines as hypothetical epigenetic players: Results from an in silico analysis, considerations and perspectives. Vaccine 2023; 41:5182-5194. [PMID: 37453842 DOI: 10.1016/j.vaccine.2023.07.007] [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: 06/28/2022] [Revised: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES To investigate in silico the occurrence of epigenetic crosstalk by nucleotide sequence complementarity between the BNT162b2 mRNA vaccine and whole human genome, including coding and noncoding (nc)RNA genes. To correlate these results with those obtained with the original spike (S) gene of Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2). METHODS The publicly available FASTA sequence of the BNT162b2 mRNA vaccine and the SARS-CoV-2 isolate Wuhan-Hu-1 S gene (NC_045512.2) were used separately as key input to the Ensembl.org library to evaluate base pair match to human GRCh38 genome. Human coding and noncoding genes harboring hits were assessed for functional activity and health effects using bioinformatics tools and GWAS databases. RESULTS The BLAT analysis against the human GRCh38 genome revealed a total of 37 hits for BNT162b2 mRNA and no hits for the SARS-CoV-2 S gene. More specifically, BNT162b2 mRNA matched 19 human genes whose protein products are variously involved in enzyme reactions, nucleotide or cation binding, signaling, and carrier functions. In BLASTN analysis of ncRNA genes, BNT162b2 mRNA and SARS-CoV-2 S gene matched 17 and 24 different human genomic regions, respectively. Overall, characterization of the matched noncoding sequences revealed stronger interference with epigenetic pathways for BNT162b2 mRNA compared with the original S gene. CONCLUSION This pivotal in silico analysis shows that SARS-CoV-2 S gene and the BNT162b2 mRNA vaccine exhibit Watson-Crick nucleotide complementarity with human coding or noncoding genes. Although they do not share the same complementarity pattern, both may disrupt epigenetic mechanisms in target cells, potentially leading to long-term complications.
Collapse
Affiliation(s)
- Rossella Talotta
- Department of Clinical and Experimental Medicine, Rheumatology Unit, AOU "Gaetano Martino", University of Messina, Messina, Italy.
| |
Collapse
|
3
|
Wittwer NL, Meier CR, Huber CA, Meyer zu Schwabedissen HE, Allemann S, Schneider C. Utilization of Drugs with Pharmacogenetic Dosing Recommendations in Switzerland: A Descriptive Study Using the Helsana Database. Pharmgenomics Pers Med 2022; 15:967-976. [DOI: 10.2147/pgpm.s382214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/21/2022] [Indexed: 11/24/2022] Open
|
4
|
Induced Pluripotent Stem Cells, a Stepping Stone to In Vitro Human Models of Hearing Loss. Cells 2022; 11:cells11203331. [PMID: 36291196 PMCID: PMC9600035 DOI: 10.3390/cells11203331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/28/2022] Open
Abstract
Hearing loss is the most prevalent sensorineural impairment in humans. Yet despite very active research, no effective therapy other than the cochlear implant has reached the clinic. Main reasons for this failure are the multifactorial nature of the disorder, its heterogeneity, and a late onset that hinders the identification of etiological factors. Another problem is the lack of human samples such that practically all the work has been conducted on animals. Although highly valuable data have been obtained from such models, there is the risk that inter-species differences exist that may compromise the relevance of the gathered data. Human-based models are therefore direly needed. The irruption of human induced pluripotent stem cell technologies in the field of hearing research offers the possibility to generate an array of otic cell models of human origin; these may enable the identification of guiding signalling cues during inner ear development and of the mechanisms that lead from genetic alterations to pathology. These models will also be extremely valuable when conducting ototoxicity analyses and when exploring new avenues towards regeneration in the inner ear. This review summarises some of the work that has already been conducted with these cells and contemplates future possibilities.
Collapse
|
5
|
Jones SW, Ball AL, Chadwick AE, Alfirevic A. The Role of Mitochondrial DNA Variation in Drug Response: A Systematic Review. Front Genet 2021; 12:698825. [PMID: 34484295 PMCID: PMC8416105 DOI: 10.3389/fgene.2021.698825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/14/2021] [Indexed: 01/11/2023] Open
Abstract
Background: The triad of drug efficacy, toxicity and resistance underpins the risk-benefit balance of all therapeutics. The application of pharmacogenomics has the potential to improve the risk-benefit balance of a given therapeutic via the stratification of patient populations based on DNA variants. A growth in the understanding of the particulars of the mitochondrial genome, alongside the availability of techniques for its interrogation has resulted in a growing body of literature examining the impact of mitochondrial DNA (mtDNA) variation upon drug response. Objective: To critically evaluate and summarize the available literature, across a defined period, in a systematic fashion in order to map out the current landscape of the subject area and identify how the field may continue to advance. Methods: A systematic review of the literature published between January 2009 and December 2020 was conducted using the PubMed database with the following key inclusion criteria: reference to specific mtDNA polymorphisms or haplogroups, a core objective to examine associations between mtDNA variants and drug response, and research performed using human subjects or human in vitro models. Results: Review of the literature identified 24 articles reporting an investigation of the association between mtDNA variant(s) and drug efficacy, toxicity or resistance that met the key inclusion criteria. This included 10 articles examining mtDNA variations associated with antiretroviral therapy response, 4 articles examining mtDNA variants associated with anticancer agent response and 4 articles examining mtDNA variants associated with antimicrobial agent response. The remaining articles covered a wide breadth of medications and were therefore grouped together and referred to as "other." Conclusions: Investigation of the impact of mtDNA variation upon drug response has been sporadic to-date. Collective assessment of the associations identified in the articles was inconclusive due to heterogeneous methods and outcomes, limited racial/ethnic groups, lack of replication and inadequate statistical power. There remains a high degree of idiosyncrasy in drug response and this area has the potential to explain variation in drug response in a clinical setting, therefore further research is likely to be of clinical benefit.
Collapse
Affiliation(s)
- Samantha W. Jones
- Department of Pharmacology and Therapeutics, MRC Centre for Drug Safety Science, University of Liverpool, Liverpool, United Kingdom
| | - Amy L. Ball
- Department of Pharmacology and Therapeutics, MRC Centre for Drug Safety Science, University of Liverpool, Liverpool, United Kingdom
| | - Amy E. Chadwick
- Department of Pharmacology and Therapeutics, MRC Centre for Drug Safety Science, University of Liverpool, Liverpool, United Kingdom
| | - Ana Alfirevic
- Department of Pharmacology and Therapeutics, Wolfson Centre for Personalised Medicine, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
6
|
Cai L, Liu Y, Xu Y, Yang H, Lv L, Li Y, Chen Q, Lin X, Yang Y, Hu G, Zheng G, Zhou J, Qian Q, Xu MA, Fang J, Ding J, Chen W, Gao J. Multi-Center in-Depth Screening of Neonatal Deafness Genes: Zhejiang, China. Front Genet 2021; 12:637096. [PMID: 34276761 PMCID: PMC8282931 DOI: 10.3389/fgene.2021.637096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose The conventional genetic screening for deafness involves 9-20 variants from four genes. This study expands screening to analyze the mutation types and frequency of hereditary deafness genes in Zhejiang, China, and explore the significance of in-depth deafness genetic screening in newborns. Methods This was a multi-centre study conducted in 5,120 newborns from 12 major hospitals in the East-West (including mountains and islands) of Zhejiang Province. Concurrent hearing and genetic screening was performed. For genetic testing, 159 variants of 22 genes were screened, including CDH23, COL11A1, DFNA5, DFNB59, DSPP, GJB2, GJB3, KCNJ10, MT-RNR1, MT-TL1, MT-TS1, MYO15A, MYO7A, OTOF, PCDH15, SLC26A4, SOX10, TCOF1, TMC1, USH1G, WFS1, and WHRN using next-generation sequencing. Newborns who failed to have genetic mutations or hearing screening were diagnosed audiologically at the age of 6 months. Results A total of 4,893 newborns (95.57%) have passed the initial hearing screening, and 7 (0.14%) have failed in repeated screening. Of these, 446 (8.71%) newborns carried at least one genetic deafness-associated variant. High-risk pathogenic variants were found in 11 newborns (0.21%) (nine homozygotes and two compound heterozygotes), and eight of these infants have passed the hearing screening. The frequency of mutations in GJB2, GJB3, SLC26A4, 12SrRNA, and TMC1 was 5.43%, 0.59%, 1.91%, 0.98%, and 0.02%, respectively. The positive rate of in-depth screening was significantly increased when compared with 20 variants in four genes of traditional testing, wherein GJB2 was increased by 97.2%, SLC26A4 by 21% and MT-RNR1 by 150%. The most common mutation variants were GJB2c.235delC and SLC26A4c.919-2A > G, followed by GJB2c.299_300delAT. Homoplasmic mutation in MT-RNR1 was the most common, including m.1555A > G, m.961T > C, m.1095T > C. All these infants have passed routine hearing screening. The positive rate of MT-RNR1 mutation was significantly higher in newborns with high-risk factors of maternal pregnancy. Conclusion The positive rate of deafness gene mutations in the Zhejiang region is higher than that of the database, mainly in GJB2c.235delC, SLC26A4 c.919-2A > G, and m.1555A > G variants. The expanded genetic screening in the detection rate of diseasecausing variants was significantly improved. It is helpful in identifying high-risk children for follow-up intervention.
Collapse
Affiliation(s)
- Luhang Cai
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ya Liu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaping Xu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hang Yang
- Department of Otorhinolaryngology, Jiangshan People's Hospital, Quzhou, China
| | - Lihui Lv
- Department of Otorhinolaryngology, Fenghua People's Hospital, Ningbo, China
| | - Yang Li
- Department of Obstetrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiongqiong Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojiang Lin
- Department of Otorhinolaryngology, Kaihua People's Hospital, Quzhou, China
| | - Yihui Yang
- Department of Otorhinolaryngology, Ningbo Women and Children's Hospital, Ningbo, China
| | - Guangwei Hu
- Department of Otorhinolaryngology, Zhoushan Hospital, Zhoushan, China
| | - Guofeng Zheng
- Department of Otorhinolaryngology, Shaoxing Second Hospital, Shaoxing, China
| | - Jing Zhou
- Department of Otorhinolaryngology, Ruian People's Hospital, Wenzhou, China
| | - Qiyong Qian
- Department of Otorhinolaryngology, Shengzhou People's Hospital, Shaoxing, China
| | - Mei-Ai Xu
- Department of Otorhinolaryngology, Sanmen People's Hospital, Taizhou, China
| | - Jin Fang
- Department of Otorhinolaryngology, Zhejiang Xin'an International Hospital, Jiaxing, China
| | - Jianjun Ding
- Department of Otorhinolaryngology, Linhai First People's Hospital, Taizhou, China
| | - Wei Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiong Gao
- Beijing Genomics Institute, Shenzhen, China
| |
Collapse
|
7
|
Bernard PS, Wooderchak-Donahue W, Wei M, Bray SM, Wood KC, Parikh B, McMillin GA. Potential Utility of Pre-Emptive Germline Pharmacogenetics in Breast Cancer. Cancers (Basel) 2021; 13:cancers13061219. [PMID: 33799547 PMCID: PMC7998388 DOI: 10.3390/cancers13061219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 12/14/2022] Open
Abstract
Patients with breast cancer often receive many drugs to manage the cancer, side effects associated with cancer treatment, and co-morbidities (i.e., polypharmacy). Drug-drug and drug-gene interactions contribute to the risk of adverse events (AEs), which could lead to non-adherence and reduced efficacy. Here we investigated several well-characterized inherited (germline) pharmacogenetic (PGx) targets in 225 patients with breast cancer. All relevant clinical, pharmaceutical, and PGx diplotype data were aggregated into a single unifying informatics platform to enable an exploratory analysis of the cohort and to evaluate pharmacy ordering patterns. Of the drugs recorded, there were 38 for which high levels of evidence for clinical actionability with PGx was available from the US FDA and/or the Clinical Pharmacogenetics Implementation Consortium (CPIC). These data were associated with 10 pharmacogenes: DPYD, CYP2C9, CYP2C19, CYP2D6, CYP3A5, CYP4F2, G6PD, MT-RNR1, SLCO1B1, and VKORC1. All patients were taking at least one of the 38 drugs and had inherited at least one actionable PGx variant that would have informed prescribing decisions if this information had been available pre-emptively. The non-cancer drugs with PGx implications that were common (prescribed to at least one-third of patients) included anti-depressants, anti-infectives, non-steroidal anti-inflammatory drugs, opioids, and proton pump inhibitors. Based on these results, we conclude that pre-emptive PGx testing may benefit patients with breast cancer by informing drug and dose selection to maximize efficacy and minimize AEs.
Collapse
Affiliation(s)
- Philip S. Bernard
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA; (P.S.B.); (W.W.-D.)
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA;
| | - Whitney Wooderchak-Donahue
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA; (P.S.B.); (W.W.-D.)
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
| | - Mei Wei
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA;
- Division of Oncology, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84112, USA
| | - Steven M. Bray
- LifeOmic Inc., Indianapolis, IN 46202, USA; (S.M.B.); (K.C.W.); (B.P.)
| | - Kevin C. Wood
- LifeOmic Inc., Indianapolis, IN 46202, USA; (S.M.B.); (K.C.W.); (B.P.)
| | - Baiju Parikh
- LifeOmic Inc., Indianapolis, IN 46202, USA; (S.M.B.); (K.C.W.); (B.P.)
| | - Gwendolyn A. McMillin
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA; (P.S.B.); (W.W.-D.)
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
- Correspondence: ; Tel.: +1-801-583-2787 (ext. 2671)
| |
Collapse
|
8
|
Yang H, Luo H, Zhang G, Zhang J, Peng Z, Xiang J. A multiplex PCR amplicon sequencing assay to screen genetic hearing loss variants in newborns. BMC Med Genomics 2021; 14:61. [PMID: 33639928 PMCID: PMC7913202 DOI: 10.1186/s12920-021-00906-1] [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: 11/25/2020] [Accepted: 02/16/2021] [Indexed: 12/30/2022] Open
Abstract
Background Congenital hearing loss is one of the most common birth defects. Early identification and management play a crucial role in improving patients’ communication and language acquisition. Previous studies demonstrated that genetic screening complements newborn hearing screening in clinical settings. Methods We developed a multiplex PCR amplicon sequencing assay to sequence the full coding region of the GJB2 gene, the most pathogenic variants of the SLC26A4 gene, and hotspot variants in the MT-RNR1 gene. The sensitivity, specificity, and reliability were validated via samples with known genotypes. Finally, a pilot study was performed on 300 anonymous dried blood samples. Results Of 103 samples with known genotypes, the multiplex PCR amplicon sequencing assay accurately identified all the variants, demonstrating a 100% sensitivity and specificity. The consistency is high in the analysis of the test–retest reliability and internal consistency reliability. In the pilot study, 12.3% (37/300) of the newborns were found to carry at least one pathogenic variant, including 24, 10, and 3 from the GJB2, SLC26A4, and MT-RNR1 gene, respectively. With an allele frequency of 2.2%, the NM_004004.6(GJB2):c.109G>A was the most prevalent variant in the study population. Conclusion The multiplex PCR amplicon sequencing assay is an accurate and reliable test to detect hearing loss variants in the GJB2, SLC26A4, and MT-RNR1 genes. It can be used to screen genetic hearing loss in newborns.
Collapse
Affiliation(s)
- Haiyan Yang
- BGI College, Zhengzhou University, Zhengzhou, 450001, China.,School of Life Sciences, Zhengzhou University, Zhengzhou, 450001, China.,BGI Education Center, University of Chinese Academy of Sciences, BGI Park, No.21 Hongan 3rd Street, Yantian District, Shenzhen, 518083, China
| | - Hongyu Luo
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China
| | - Guiwei Zhang
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China
| | - Junqing Zhang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, 300308, China
| | - Zhiyu Peng
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China
| | - Jiale Xiang
- BGI Education Center, University of Chinese Academy of Sciences, BGI Park, No.21 Hongan 3rd Street, Yantian District, Shenzhen, 518083, China. .,BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, China.
| |
Collapse
|
9
|
Kam H, Jeong H. Pharmacogenomic Biomarkers and Their Applications in Psychiatry. Genes (Basel) 2020; 11:genes11121445. [PMID: 33266292 PMCID: PMC7760818 DOI: 10.3390/genes11121445] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/27/2020] [Accepted: 11/27/2020] [Indexed: 12/13/2022] Open
Abstract
Realizing the promise of precision medicine in psychiatry is a laudable and beneficial endeavor, since it should markedly reduce morbidity and mortality and, in effect, alleviate the economic and social burden of psychiatric disorders. This review aims to summarize important issues on pharmacogenomics in psychiatry that have laid the foundation towards personalized pharmacotherapy and, in a broader sense, precision medicine. We present major pharmacogenomic biomarkers and their applications in a variety of psychiatric disorders, such as depression, attention-deficit/hyperactivity disorder (ADHD), narcolepsy, schizophrenia, and bipolar disorder. In addition, we extend the scope into epilepsy, since antiepileptic drugs are widely used to treat psychiatric disorders, although epilepsy is conventionally considered to be a neurological disorder.
Collapse
|
10
|
Lanillos J, Santos M, Carcajona M, Roldan-Romero JM, Martinez AM, Calsina B, Monteagudo M, Leandro-García LJ, Montero-Conde C, Cascón A, Maietta P, Alvarez S, Robledo M, Rodriguez-Antona C. A Novel Approach for the Identification of Pharmacogenetic Variants in MT-RNR1 through Next-Generation Sequencing Off-Target Data. J Clin Med 2020; 9:jcm9072082. [PMID: 32630724 PMCID: PMC7408883 DOI: 10.3390/jcm9072082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Specific genetic variants in the mitochondrially encoded 12S ribosomal RNA gene (MT-RNR1) cause aminoglycoside-induced irreversible hearing loss. Mitochondrial DNA is usually not included in targeted sequencing experiments; however, off-target data may deliver this information. Here, we extract MT-RNR1 genetic variation, including the most relevant ototoxicity variant m.1555A>G, using the off-target reads of 473 research samples, sequenced through a capture-based, custom-targeted panel and whole exome sequencing (WES), and of 1245 diagnostic samples with clinical WES. Sanger sequencing and fluorescence-based genotyping were used for genotype validation. There was a correlation between off-target reads and mitochondrial coverage (rcustomPanel = 0.39, p = 2 × 10−13 and rWES = 0.67, p = 7 × 10−21). The median read depth of MT-RNR1 m.1555 was similar to the average mitochondrial genome coverage, with saliva and blood samples giving comparable results. The genotypes from 415 samples, including three m.1555G carriers, were concordant with fluorescence-based genotyping data. In clinical WES, median MT-RNR1 coverage was 56×, with 90% of samples having ≥20 reads at m.1555 position, and one m.1494T and three m.1555G carriers were identified with no evidence for heteroplasmy. Altogether, this study shows that obtaining MT-RNR1 genotypes through off-target reads is an efficient strategy that can impulse preemptive pharmacogenetic screening of this mitochondrial gene.
Collapse
Affiliation(s)
- Javier Lanillos
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | - María Santos
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | | | - Juan María Roldan-Romero
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | - Angel M. Martinez
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | - Bruna Calsina
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | - María Monteagudo
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | - Luis Javier Leandro-García
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | - Cristina Montero-Conde
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
| | - Alberto Cascón
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
| | - Paolo Maietta
- Nimgenetics, 28049 Madrid, Spain; (M.C.); (P.M.); (S.A.)
| | - Sara Alvarez
- Nimgenetics, 28049 Madrid, Spain; (M.C.); (P.M.); (S.A.)
| | - Mercedes Robledo
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
| | - Cristina Rodriguez-Antona
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (J.L.); (M.S.); (J.M.R.-R.); (A.M.M.); (B.C.); (M.M.); (L.J.L.-G.); (C.M.-C.); (A.C.); (M.R.)
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-91-732-8000 (ext. 3321)
| |
Collapse
|
11
|
Concurrent hearing and genetic screening in a general newborn population. Hum Genet 2020; 139:521-530. [PMID: 32002660 DOI: 10.1007/s00439-020-02118-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/17/2020] [Indexed: 01/21/2023]
Abstract
Newborn hearing screening is not designed to detect delayed-onset prelingual hearing loss or aminoglycoside-antibiotic-induced ototoxicity. Cases with severe to profound hearing loss have been reported to have been missed by newborn hearing screens. The aim of this study was to evaluate the efficacy of concurrent hearing and genetic screening in the general population and demonstrate its benefits in practice. Enrolled newborns received concurrent hearing and genetic screens between September 1, 2015 and January 31, 2018. Of the 239,636 eligible infants (median age, 19 months), 548 (0.23%) had prelingual hearing loss. Genetic screening identified 14 hearing loss patients with positive genotypes and 27 patients with inconclusive genotypes who had passed the hearing screens. In addition, the genetic screen identified 0.23% (570/239,636) of the newborns and their family members as at-risk for ototoxicity, which is undetectable by hearing screens. In conclusion, genetic screening complements newborn hearing screening by improving the detection of infants at risk of hereditary hearing loss and ototoxicity, and by informing genotype-based clinical management for affected infants and their family members. Our findings suggest that the practice should be further validated in other populations and rigorous cost-effectiveness analyses are warranted.
Collapse
|
12
|
Wang Q, Xiang J, Sun J, Yang Y, Guan J, Wang D, Song C, Guo L, Wang H, Chen Y, Leng J, Wang X, Zhang J, Han B, Zou J, Yan C, Zhao L, Luo H, Han Y, Yuan W, Zhang H, Wang W, Wang J, Yang H, Xu X, Yin Y, Morton CC, Zhao L, Zhu S, Shen J, Peng Z. Nationwide population genetic screening improves outcomes of newborn screening for hearing loss in China. Genet Med 2019; 21:2231-2238. [PMID: 30890784 DOI: 10.1038/s41436-019-0481-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/27/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The benefits of concurrent newborn hearing and genetic screening have not been statistically proven due to limited sample sizes and outcome data. To fill this gap, we analyzed outcomes of newborns with genetic screening results. METHODS Newborns in China were screened for 20 hearing-loss-related genetic variants from 2012 to 2017. Genetic results were categorized as positive, at-risk, inconclusive, or negative. Hearing screening results, risk factors, and up-to-date hearing status were followed up via phone interviews. RESULTS Following up 12,778 of 1.2 million genetically screened newborns revealed a higher rate of hearing loss by three months of age among referrals from the initial hearing screening (60% vs. 5.0%, P < 0.001) and a lower rate of lost-to-follow-up/documentation (5% vs. 22%, P < 0.001) in the positive group than in the inconclusive group. Importantly, genetic screening detected 13% more hearing-impaired infants than hearing screening alone and identified 2,638 (0.23% of total) newborns predisposed to preventable ototoxicity undetectable by hearing screening. CONCLUSION Incorporating genetic screening improves the effectiveness of newborn hearing screening programs by elucidating etiologies, discerning high-risk subgroups for vigilant management, identifying additional children who may benefit from early intervention, and informing at-risk newborns and their maternal relatives of increased susceptibility to ototoxicity.
Collapse
Affiliation(s)
- Qiuju Wang
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
| | | | - Jun Sun
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
- Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Yun Yang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Jing Guan
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
| | - Dayong Wang
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
| | - Cui Song
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ling Guo
- Jining Maternal and Child Health Care Service Center, Jining, China
| | - Hongyang Wang
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
| | - Yaqiu Chen
- Tianjin Women and Children's Health Centre, Tianjing, China
| | - Junhong Leng
- Tianjin Women and Children's Health Centre, Tianjing, China
| | - Xiaman Wang
- BGI Clinical Laboratory, BGI-Shenzhen, Shenzhen, China
| | - Junqing Zhang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Bing Han
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
| | - Jing Zou
- MGI, BGI-Shenzhen, Shenzhen, China
| | | | - Lidong Zhao
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China
| | - Hongyu Luo
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Yuan Han
- Wuhan BGI Clinical Laboratory, BGI-Shenzhen, Wuhan, China
| | - Wen Yuan
- Wuhan BGI Clinical Laboratory, BGI-Shenzhen, Wuhan, China
| | - Hongyun Zhang
- BGI Clinical Laboratory, BGI-Shenzhen, Shenzhen, China
| | - Wei Wang
- BGI-Beijing, BGI-Shenzhen, Beijing, China
| | - Jian Wang
- BGI-Shenzhen, Shenzhen, China
- James D. Watson Institute of Genome Sciences, Hangzhou, China
| | - Huanming Yang
- BGI-Shenzhen, Shenzhen, China
- James D. Watson Institute of Genome Sciences, Hangzhou, China
| | - Xun Xu
- BGI-Shenzhen, Shenzhen, China
- China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Ye Yin
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Cynthia C Morton
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Manchester Center for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Lijian Zhao
- BGI Clinical Laboratory, BGI-Shenzhen, Shenzhen, China.
| | - Shida Zhu
- BGI-Shenzhen, Shenzhen, China.
- China National GeneBank, BGI-Shenzhen, Shenzhen, China.
- Shenzhen Engineering Laboratory for Innovative Molecular Diagnostics, Shenzhen, China.
| | - Jun Shen
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Zhiyu Peng
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.
| |
Collapse
|
13
|
Miscio G, Paroni G, Bisceglia P, Gravina C, Urbano M, Lozupone M, Piccininni C, Prisciandaro M, Ciavarella G, Daniele A, Bellomo A, Panza F, Di Mauro L, Greco A, Seripa D. Pharmacogenetics in the clinical analysis laboratory: clinical practice, research, and drug development pipeline. Expert Opin Drug Metab Toxicol 2019; 15:751-765. [PMID: 31512953 DOI: 10.1080/17425255.2019.1658742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Over the last decade, the spread of next-generation sequencing technology along with the rising cost in health management in national health systems has led to widespread use/abuse of pharmacogenetic tests (PGx) in the practice of many clinical disciplines. However, given their clinical significance, it is important to standardize these tests for having an interaction with the clinical analysis laboratory (CAL), in which a PGx service can meet these requirements. Areas covered: A diagnostic test must meet the criteria of reproducibility and validity for its utility in the clinical routine. This present review mainly describes the utility of introducing PGx tests in the CAL routine to produce correct results useful for setting up personalized drug treatments. Expert opinion: With a PGx service, CALs can provide the right tool to help clinicians to make better choices about different categories of drugs and their dosage and to manage the economic impact both in hospital-based settings and in National Health Services, throughout electronic health records. Advances in PGx also allow a new approach for pharmaceutical companies in order to improve drug development and clinical trials. As a result, CALs can achieve a powerful source of epidemiological, clinical, and research findings from PGx tests.
Collapse
Affiliation(s)
- Giuseppe Miscio
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Giulia Paroni
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Paola Bisceglia
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Carolina Gravina
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Maria Urbano
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari , Italy
| | - Carla Piccininni
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia , Foggia , Italy
| | - Michele Prisciandaro
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Grazia Ciavarella
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart , Rome , Italy.,Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia , Foggia , Italy
| | - Francesco Panza
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy.,Neurodegenerative Disease Unit, Department of Basic Medical Sciences, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari , Italy
| | - Lazzaro Di Mauro
- Clinical Laboratory Analysis and Transfusional Medicine, Laboratory and Transfusional Diagnostics, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Antonio Greco
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| | - Davide Seripa
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza , Foggia , Italy
| |
Collapse
|
14
|
Igumnova V, Veidemane L, Vīksna A, Capligina V, Zole E, Ranka R. The prevalence of mitochondrial mutations associated with aminoglycoside-induced deafness in ethnic Latvian population: the appraisal of the evidence. J Hum Genet 2018; 64:199-206. [PMID: 30523288 DOI: 10.1038/s10038-018-0544-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/02/2018] [Accepted: 11/02/2018] [Indexed: 11/09/2022]
Abstract
Aminoglycosides are potent antibiotics which are used to treat severe gram-negative infections, neonatal sepsis, and multidrug-resistant tuberculosis. Ototoxicity is a well-known side effect of aminoglycosides, and a rapid, profound, and irreversible hearing loss can occur in predisposed individuals. MT-RNR1 gene encoding the mitochondrial ribosomal 12S subunit is a hot spot for aminoglycoside-induced hearing loss mutations, however, a variability in the nature and frequency of genetic changes in different populations exists. The objective of this study was to analyze MT-RNR1 gene mutations in a Baltic-speaking Latvian population, and to estimate the prevalence of such genetic changes in the population-specific mitochondrial haplogroups. In the cohort of 191 ethnic non-related Latvians, the presence of two deafness-associated mutations, m.1555A>G and m.827A>G, three potentially pathogenic variations, m.961insC(n), m.961T>G and m.951G>A, and one unknown substitution, m961T>A was detected, and the aggregate frequency of all variants was 7.3%. All genetic changes were detected in samples belonged to the haplogroups H, U, T, and J. The presence of several aminoglycoside ototoxicity-related MT-RNR1 gene mutations in Baltic-speaking Latvian population indicates the necessity to include ototoxicity-related mutation analysis in the future studies in order to determine the feasibility of DNA screening for patients before administration of aminoglycoside therapy.
Collapse
Affiliation(s)
- Viktorija Igumnova
- Latvian Biomedical Research and Study Centre, Ratsupites Str. 1, Riga, LV-1067, Latvia.,Department of Pharmaceutical Chemistry, Rīga Stradinš University, Dzirciema Str. 16, Riga, LV-1007, Latvia
| | - Lauma Veidemane
- Latvian Biomedical Research and Study Centre, Ratsupites Str. 1, Riga, LV-1067, Latvia
| | - Anda Vīksna
- Centre of Tuberculosis and Lung Diseases, Riga East University Hospital, Stopiņi region, Upeslejas, LV-2118, Latvia
| | - Valentina Capligina
- Latvian Biomedical Research and Study Centre, Ratsupites Str. 1, Riga, LV-1067, Latvia
| | - Egija Zole
- Latvian Biomedical Research and Study Centre, Ratsupites Str. 1, Riga, LV-1067, Latvia
| | - Renate Ranka
- Latvian Biomedical Research and Study Centre, Ratsupites Str. 1, Riga, LV-1067, Latvia. .,Department of Pharmaceutical Chemistry, Rīga Stradinš University, Dzirciema Str. 16, Riga, LV-1007, Latvia.
| |
Collapse
|
15
|
Whole sequence of the mitochondrial DNA genome of Kearns Sayre Syndrome patients: Identification of deletions and variants. Gene 2018; 688:171-181. [PMID: 30528267 DOI: 10.1016/j.gene.2018.11.085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/04/2018] [Accepted: 11/28/2018] [Indexed: 02/07/2023]
Abstract
Mitochondria both produce the energy of the cell as ATP via respiration and regulate cellular metabolism. Accordingly, any deletion or mutation in the mitochondrial DNA (mtDNA) may result in a disease. One of these diseases is Kearns Sayre syndrome (KSS), described for the first time in 1958, where different large-scale deletions of different sizes and at different positions have been reported in the mitochondrial genome of patients with similar clinical symptoms. In this study, sequences of the mitochondrial genome of three patients with clinic features of KSS were analyzed. Our results revealed the position, heteroplasmy percentage, size of deletions, and their haplogroups. Two patients contained deletions reported previously and one patient showed a new deletion not reported previously. These results display for the first time a systematic analysis of mtDNA variants in the whole mtDNA genome of patients with KSS to help to understand their association with the disease.
Collapse
|