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Chermakani P, Gowri P, Mahesh Kumar S, Sundaresan P. Exploring mito-nuclear genetic factors in Leber's hereditary optic neuropathy: insights from comprehensive profiling of unique cases. EXCLI JOURNAL 2023; 22:1077-1091. [PMID: 38054206 PMCID: PMC10694345 DOI: 10.17179/excli2023-6297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/06/2023] [Indexed: 12/07/2023]
Abstract
Leber's hereditary optic neuropathy (LHON) is a mitochondrial complex I disorder and causes inexorable painless vision loss. Recent studies from India reported that a significant proportion of LHON patients lack primary mitochondrial DNA mutations, suggesting that alternative genetic factors contribute to disease development. Therefore, this study investigated the genetic profile of LHON-affected individuals in order to understand the role of mito-nuclear genetic factors in LHON. A total of thirty probands displaying symptoms consistent with LHON have undergone whole mitochondrial and whole exome sequencing. Interestingly, whole mtDNA sequencing revealed primary mtDNA mutations in 30 % of the probands (n=9), secondary mtDNA mutations in 40 % of the probands (n=12) and no mitochondrial changes in 30 % of individuals (n=9). Further, WES analysis determined pathogenic mutations in 11 different nuclear genes, especially in cases with secondary mtDNA mutations (n=6) or no mtDNA mutations (n=6). These findings provide valuable insight into LHON genetic predisposition, particularly in cases lacking primary mtDNA mutations. See also Figure 1(Fig. 1).
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Affiliation(s)
- Prakash Chermakani
- Department of Molecular Genetics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
- Department of Molecular Biology, Aravind Medical Research Foundation - Affiliated to Alagappa University, Karaikudi, Tamil Nadu, India
| | - Poigaialwar Gowri
- Department of Molecular Genetics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
- Department of Molecular Biology, Aravind Medical Research Foundation - Affiliated to Alagappa University, Karaikudi, Tamil Nadu, India
| | | | - Periasamy Sundaresan
- Department of Molecular Genetics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
- Department of Molecular Biology, Aravind Medical Research Foundation - Affiliated to Alagappa University, Karaikudi, Tamil Nadu, India
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Neuhann TM, Neuhann L. [Human genetic diagnostics in hereditary eye diseases : What does the ophthalmologist need to know]. DIE OPHTHALMOLOGIE 2023:10.1007/s00347-023-01878-6. [PMID: 37266672 DOI: 10.1007/s00347-023-01878-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/03/2023]
Abstract
Hereditary eye disorders can affect all ocular structures and can be accompanied by structural malformations (e.g. coloboma) or functional disorders (e.g. retinal dystrophy). Ocular phenotypes can also be the presenting symptom of many complex syndromic disorders. The majority of hereditary eye disorders are extremely heterogeneous but can be routinely diagnosed by modern high-throughput sequencing technologies. Molecular testing is highly important not only in in the evaluation of differential diagnoses but is also of increasing relevance due to individual treatment options.
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Affiliation(s)
- Teresa M Neuhann
- MGZ - Medizinisch genetisches Zentrum, Bayerstr. 3-5, 80335, München, Deutschland.
| | - Lukas Neuhann
- MVZ Prof. Neuhann, Helene-Weber-Allee 19, 80637, München, Deutschland
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Han J, Li Y, You Y, Fan K, Lei B. Autosomal dominant optic atrophy caused by six novel pathogenic OPA1 variants and genotype-phenotype correlation analysis. BMC Ophthalmol 2022; 22:322. [PMID: 35883160 PMCID: PMC9327245 DOI: 10.1186/s12886-022-02546-0] [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: 08/28/2021] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To describe the genetic and clinical features of nineteen patients from eleven unrelated Chinese pedigrees with OPA1-related autosomal dominant optic atrophy (ADOA) and define the phenotype-genotype correlations. METHODS Detailed ophthalmic examinations were performed. Targeted next-generation sequencing (NGS) was conducted in the eleven probands using a custom designed panel PS400. Sanger sequencing and cosegregation were used to verify the identified variants. The pathogenicity of gene variants was evaluated according to American College of Medical Genetics and Genomics (ACMG) guidelines. RESULTS Nineteen patients from the eleven unrelated Chinese ADOA pedigrees had impaired vision and optic disc pallor. Optical coherence tomography showed significant thinning of the retinal nerve fiber layer. The visual field showed varying degrees of central or paracentral scotoma. The onset of symptoms occurred between 3 and 24 years of age (median age 6 years). Eleven variants in OPA1 were identified in the cohort, and nine novel variants were identified. Among the novel variants, two splicing variants c.984 + 1_984 + 2delGT, c.1194 + 2 T > C, two stop-gain variants c.1937C > G, c.2830G > T, and one frameshift variant c.2787_2794del8, were determined to be pathogenic based on ACMG. A novel splicing variant c.1316-10 T > G was determined to be likely pathogenic. In addition, a novel missense c.1283A > C (p.N428T) and two novel splicing variants c.2496G > A and c.1065 + 5G > C were of uncertain significance. CONCLUSIONS Six novel pathogenic variants were identified. The findings will facilitate genetic counselling by expanding the pathogenic mutation spectrum of OPA1.
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Affiliation(s)
- Jinfeng Han
- Department of Ophthalmology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou University, Zheng-zhou, 450003, China.,Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000, China
| | - Ya Li
- Department of Ophthalmology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou University, Zheng-zhou, 450003, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Ya You
- Department of Ophthalmology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou University, Zheng-zhou, 450003, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Ke Fan
- Department of Ophthalmology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou University, Zheng-zhou, 450003, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Bo Lei
- Department of Ophthalmology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou University, Zheng-zhou, 450003, China. .,Academy of Medical Sciences, Zhengzhou University, Zhengzhou, 450000, China. .,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China.
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Hereditary Optic Neuropathies: Induced Pluripotent Stem Cell-Based 2D/3D Approaches. Genes (Basel) 2021; 12:genes12010112. [PMID: 33477675 PMCID: PMC7831942 DOI: 10.3390/genes12010112] [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: 12/14/2020] [Revised: 01/10/2021] [Accepted: 01/14/2021] [Indexed: 12/12/2022] Open
Abstract
Inherited optic neuropathies share visual impairment due to the degeneration of retinal ganglion cells (RGCs) as the hallmark of the disease. This group of genetic disorders are caused by mutations in nuclear genes or in the mitochondrial DNA (mtDNA). An impaired mitochondrial function is the underlying mechanism of these diseases. Currently, optic neuropathies lack an effective treatment, and the implementation of induced pluripotent stem cell (iPSC) technology would entail a huge step forward. The generation of iPSC-derived RGCs would allow faithfully modeling these disorders, and these RGCs would represent an appealing platform for drug screening as well, paving the way for a proper therapy. Here, we review the ongoing two-dimensional (2D) and three-dimensional (3D) approaches based on iPSCs and their applications, taking into account the more innovative technologies, which include tissue engineering or microfluidics.
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Haploinsufficiency due to a novel ACO2 deletion causes mitochondrial dysfunction in fibroblasts from a patient with dominant optic nerve atrophy. Sci Rep 2020; 10:16736. [PMID: 33028849 PMCID: PMC7541502 DOI: 10.1038/s41598-020-73557-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 09/02/2020] [Indexed: 01/20/2023] Open
Abstract
ACO2 is a mitochondrial protein, which is critically involved in the function of the tricarboxylic acid cycle (TCA), the maintenance of iron homeostasis, oxidative stress defense and the integrity of mitochondrial DNA (mtDNA). Mutations in the ACO2 gene were identified in patients suffering from a broad range of symptoms, including optic nerve atrophy, cortical atrophy, cerebellar atrophy, hypotonia, seizures and intellectual disabilities. In the present study, we identified a heterozygous 51 bp deletion (c.1699_1749del51) in ACO2 in a family with autosomal dominant inherited isolated optic atrophy. A complementation assay using aco1-deficient yeast revealed a growth defect for the mutant ACO2 variant substantiating a pathogenic effect of the deletion. We used patient-derived fibroblasts to characterize cellular phenotypes and found a decrease of ACO2 protein levels, while ACO2 enzyme activity was not affected compared to two age- and gender-matched control lines. Several parameters of mitochondrial function, including mitochondrial morphology, mitochondrial membrane potential or mitochondrial superoxide production, were not changed under baseline conditions. However, basal respiration, maximal respiration, and spare respiratory capacity were reduced in mutant cells. Furthermore, we observed a reduction of mtDNA copy number and reduced mtDNA transcription levels in ACO2-mutant fibroblasts. Inducing oxidative stress led to an increased susceptibility for cell death in ACO2-mutant fibroblasts compared to controls. Our study reveals that a monoallelic mutation in ACO2 is sufficient to promote mitochondrial dysfunction and increased vulnerability to oxidative stress as main drivers of cell death related to optic nerve atrophy.
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Li JK, Li W, Gao FJ, Qu SF, Hu FY, Zhang SH, Li LL, Wang ZW, Qiu Y, Wang LS, Huang J, Wu JH, Chen F. Mutation Screening of mtDNA Combined Targeted Exon Sequencing in a Cohort With Suspected Hereditary Optic Neuropathy. Transl Vis Sci Technol 2020; 9:11. [PMID: 32855858 PMCID: PMC7422818 DOI: 10.1167/tvst.9.8.11] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/23/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (ADOA) are the two commonest forms of hereditary optic neuropathy. The aim of this study was to comprehensively investigate the incidence and spectrum of mutations in patients with suspected hereditary optic neuropathy by combining mitochondrial DNA (mtDNA) genome-wide and targeted exon sequencing. Methods A cohort of 1101 subjects were recruited to participate in the study, comprising 177 families (177 probands and their family members, a total of 537 subjects, including 254 patients) and 164 sporadic cases with suspected hereditary optic neuropathy, and 400 unrelated control subjects for genetic analysis: all subjects (including control subjects) underwent a comprehensive ophthalmologic examination and were subjected to sequencing analysis of mtDNA genome-wide and targeted exon. Overall, targeted exon sequencing was used to screen 792 genes associated with common hereditary eye diseases, and the mtDNA genome-wide were screened by next-generation sequencing. Results We found variants detected in 168 (40.2%, 168/418) of the 418 patients screened. Among these, 132 cases (78.6%, 132/168) were detected with known LHON disease-causing mtDNA variants; 40 cases (23.8%, 40/168) were detected with nuclear DNA (ntDNA) variants, which included 36 cases (21.4%, 36/168) with detected OPA1 mutations, 4 patients (2.4%, 4/168) with detected OPA3 mutations, and 2 patients (1.2%, 2/168) with detected TMEM126A homozygous mutation. Coexistence variation (mtDNA/mtDNA [n = 16], ntDNA/ntDNA [n = 4], mtDNA/ntDNA [n = 7]) was found in 27 patients (16.4%, 27/165), including mtDNA/ntDNA coexistence variation that was detected in seven patients. Among these ntDNA mutations, 38 distinct disease-causing variants, including autosomal recessive heterozygous mutations, were detected, which included 22 novel variants and two de novo variants. Total haplogroup distribution showed that 34.5% (29/84) and 28.6% (24/84) of the affected subjects with m.11778G>A belonged to haplogroup D and M, with a high frequency of subhaplogroups D4, D5, and M7. Conclusions The LHON-mtDNA mutations are the commonest genetic defects in this Chinese cohort, followed by the OPA1 mutations. To our knowledge, this is the first comprehensive study of LHON, ADOA, and autosomal recessive optic atrophy combined with mtDNA genome-wide and targeted exon sequencing, as well as haplogroup analysis, in a large cohort of Chinese patients with suspected hereditary optic neuropathy. Our findings provide a powerful basis for genetic counseling in patients with suspected hereditary optic neuropathy. Translational Relevance We applied mtDNA genome-wide sequencing combined with panel-based targeted exon sequencing to explore the pathogenic variation spectrum and genetic characteristics of patients with suspected hereditary optic neuropathy, providing a comprehensive research strategy for clinical assistant diagnosis, treatment, and genetic counseling.
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Affiliation(s)
- Jian-Kang Li
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, China.,Department of Computer Science, City University of Hong Kong, Kowloon, Hong Kong.,BGI-Shenzhen, Shenzhen, China
| | - Wei Li
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, China.,BGI-Shenzhen, Shenzhen, China
| | - Feng-Juan Gao
- Eye Institute, Eye, Ear, Nose and Throat Hospital, College of Medicine, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China
| | - Shou-Fang Qu
- National Institutes for Food and Drug Control, Tiantan Xili Dongcheng District, Beijing, China
| | - Fang-Yuan Hu
- Eye Institute, Eye, Ear, Nose and Throat Hospital, College of Medicine, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China
| | - Sheng-Hai Zhang
- Eye Institute, Eye, Ear, Nose and Throat Hospital, College of Medicine, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China
| | - Li-Li Li
- National Institutes for Food and Drug Control, Tiantan Xili Dongcheng District, Beijing, China
| | - Zi-Wei Wang
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, China.,BGI-Shenzhen, Shenzhen, China
| | - Yong Qiu
- BGI-Shenzhen, Shenzhen, China.,MGI, BGI-Shenzhen, Shenzhen, China
| | - Lu-Sheng Wang
- Department of Computer Science, City University of Hong Kong, Kowloon, Hong Kong.,BGI-Shenzhen, Shenzhen, China
| | - Jie Huang
- National Institutes for Food and Drug Control, Tiantan Xili Dongcheng District, Beijing, China
| | - Ji-Hong Wu
- Eye Institute, Eye, Ear, Nose and Throat Hospital, College of Medicine, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China
| | - Fang Chen
- BGI-Shenzhen, Shenzhen, China.,MGI, BGI-Shenzhen, Shenzhen, China
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Kelman JC, Kamien BA, Murray NC, Goel H, Fraser CL, Grigg JR. A sibling study of isolated optic neuropathy associated with novel variants in the ACO2 gene. Ophthalmic Genet 2018; 39:648-651. [PMID: 30118607 DOI: 10.1080/13816810.2018.1509353] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Inherited optic neuropathy is a rare cause of debilitating vision loss. It may occur in constellation with other syndromic features of neurological impairment, or present as an isolated finding. We describe a sibling pair, without a family history of vision loss, who developed visual impairment in early childhood consistent with optic neuropathy. Genetic testing identified novel compound heterozygous variants in the aconitase 2 (ACO2) gene. To date, seven families hosting ACO2 variants have been described in the literature. We describe the second family with ACO2 variants to have an isolated optic neuropathy highlighting the importance of including this gene in genomic panels assessing inherited optic neuropathies.
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Affiliation(s)
| | | | - Natalia C Murray
- b Hunter Genetics , Waratah , NSW , Australia.,c The University of Newcastle, University Dr , Callaghan , NSW , Australia
| | - Himanshu Goel
- b Hunter Genetics , Waratah , NSW , Australia.,c The University of Newcastle, University Dr , Callaghan , NSW , Australia
| | | | - John R Grigg
- a Save Sight Institute , Sydney , NSW , Australia
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Genetic and Clinical Analyses of DOA and LHON in 304 Chinese Patients with Suspected Childhood-Onset Hereditary Optic Neuropathy. PLoS One 2017; 12:e0170090. [PMID: 28081242 PMCID: PMC5230780 DOI: 10.1371/journal.pone.0170090] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/28/2016] [Indexed: 02/08/2023] Open
Abstract
Leber hereditary optic neuropathy (LHON) and dominant optic atrophy (DOA), the most common forms of hereditary optic neuropathy, are easily confused, and it is difficult to distinguish one from the other in the clinic, especially in young children. The present study was designed to survey the mutation spectrum of common pathogenic genes (OPA1, OPA3 and mtDNA genes) and to analyze the genotype-phenotype characteristics of Chinese patients with suspected childhood-onset hereditary optic neuropathy. Genomic DNA and clinical data were collected from 304 unrelated Chinese probands with suspected hereditary optic neuropathy with an age of onset below 14 years. Sanger sequencing was used to screen variants in the coding and adjacent regions of OPA1, OPA3 and the three primary LHON-related mutation sites in mitochondrial DNA (mtDNA) (m.3460G>A, m.11778G>A and m.14484T>C). All patients underwent a complete ophthalmic examination and were compared with age-matched controls. We identified 89/304 (29.3%) primary mtDNA mutations related to LHON in 304 probands, including 76 mutations at m.11778 (76/89, 85.4% of all mtDNA mutations), four at m.3460 (4/89, 4.5%) and nine at m.14484 (9/89, 10.1%). This result was similar to the mutation frequency among Chinese patients with LHON of any age. Screening of OPA1 revealed 23 pathogenic variants, including 11 novel and 12 known pathogenic mutations. This study expanded the OPA1 mutation spectrum, and our results showed that OPA1 mutation is another common cause of childhood-onset hereditary optic neuropathy in Chinese pediatric patients, especially those with disease onset during preschool age.
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Allen KF, Gaier ED, Wiggs JL. Genetics of Primary Inherited Disorders of the Optic Nerve: Clinical Applications. Cold Spring Harb Perspect Med 2015; 5:a017277. [PMID: 26134840 DOI: 10.1101/cshperspect.a017277] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Inherited disorders of the optic nerve significantly impact vision in children and adults. The optic nerve disorders most commonly encountered clinically are glaucoma and primary optic neuropathy including Leber's hereditary optic neuropathy (LHON) and autosomal dominant or Kjer's optic atrophy. Current knowledge of the genetics of optic neuropathy and glaucoma makes it possible to test for mutations in disease-causing genes allowing for presymptomatic testing and risk assessment, and recent advances have revealed important disease mechanisms that may suggest potential therapeutic targets. In this perspective, we describe the current approaches and limitations to genetic testing for these disorders and provide an update on the development of gene-based therapies.
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Affiliation(s)
- Keri F Allen
- Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114
| | - Eric D Gaier
- Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114
| | - Janey L Wiggs
- Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114
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Panel-based genetic diagnostic testing for inherited eye diseases is highly accurate and reproducible, and more sensitive for variant detection, than exome sequencing. Genet Med 2014; 17:253-261. [PMID: 25412400 PMCID: PMC4572572 DOI: 10.1038/gim.2014.172] [Citation(s) in RCA: 180] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/23/2014] [Indexed: 12/16/2022] Open
Abstract
Purpose Next-generation sequencing (NGS) based methods are being adopted broadly for genetic diagnostic testing, but the performance characteristics of these techniques have not been fully defined with regard to test accuracy and reproducibility. Methods We developed a targeted enrichment and NGS approach for genetic diagnostic testing of patients with inherited eye disorders, including inherited retinal degenerations, optic atrophy and glaucoma. In preparation for providing this Genetic Eye Disease (GEDi) test on a CLIA-certified basis, we performed experiments to measure the sensitivity, specificity, reproducibility as well as the clinical sensitivity of the test. Results The GEDi test is highly reproducible and accurate, with sensitivity and specificity for single nucleotide variant detection of 97.9% and 100%, respectively. The sensitivity for variant detection was notably better than the 88.3% achieved by whole exome sequencing (WES) using the same metrics, due to better coverage of targeted genes in the GEDi test compared to commercially available exome capture sets. Prospective testing of 192 patients with IRDs indicated that the clinical sensitivity of the GEDi test is high, with a diagnostic rate of 51%. Conclusion The data suggest that based on quantified performance metrics, selective targeted enrichment is preferable to WES for genetic diagnostic testing.
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Hereditäre Optikusatrophien. MED GENET-BERLIN 2014. [DOI: 10.1007/s11825-014-0435-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Zusammenfassung
Bei hereditären Optikusatrophien werden 2 Untergruppen differenziert: isolierte hereditäre Optikusatrophien und hereditäre Optikusatrophien als Teil von syndromalen Erkrankungen. In der 1. Gruppe ist die Beeinträchtigung des N. opticus typischerweise die einzige Manifestation. Diese Gruppe umfasst insbesondere autosomal-dominante und autosomal-rezessive Optikusatrophien, darüber hinaus auch die mitochondrial vererbte hereditäre Leber-Optikusneuropathie (LHON).
In der 2. Gruppe, die die syndromalen Erkrankungen umfasst, wird eine Vielzahl neurologischer und anderer systemischer Auffälligkeiten beobachtet. Am häufigsten sind hier Veränderungen der mitochondrialen DNA (mtDNA) ursächlich. Weiterhin ist eine Optikusatrophie Symptom von einigen erblichen peripheren Neuropathien bzw. Charcot-Marie-Tooth-Erkrankungen (CMT2A2, CMTX5), hereditären sensorischen Neuropathie Typ 3 (HSAN3), Friedreich-Ataxie, Leukodystrophien, Sphingolipidosen, Zeroidlipofuszinosen und Eisenspeichererkrankungen („neurodegeneration with brain iron accumulation“, NBIA). Im vorliegenden Beitrag werden die zugrundeliegenden genetischen Prädispositionen und die klinischen Phänotypen erläutert.
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