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Krakowski A, Hoang N, Trost B, Summers J, Ambrozewicz P, Vorstman J. Global developmental delay and a de novo deletion of the 16p13.13 region. BMJ Case Rep 2024; 17:e251521. [PMID: 38423574 PMCID: PMC10910685 DOI: 10.1136/bcr-2022-251521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Many rare genetic variants are associated with the risk of atypical neurodevelopmental trajectories. In this study, we report a patient with developmental delay, autistic traits and multiple congenital anomalies, including congenital heart anomalies and orofacial cleft, with a 0.832 Mb de novo deletion of the 16p13.13 region classified as a variant of uncertain significance. Comparison of similar sized deletions and duplications overlapping the same genes in the DECIPHER database, revealed seven reports of copy number variants (CNVs), four duplications and three deletions. A neurodevelopmental phenotype including learning disability and intellectual disability was noted in some of the DECIPHER entries where phenotype was provided. Although the association between a deletion in this region and an atypical neurodevelopmental trajectory remains to be elucidated, the overlapping CNVs with neurodevelopmental phenotypes suggests possible candidate genes within the 16p13.13 region.
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Affiliation(s)
- Aneta Krakowski
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ny Hoang
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
- Autism Research Unit, Hospital For Sick Children, Toronto, Ontario, Canada
| | - Brett Trost
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
- Molecular Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jane Summers
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
- Autism Research Unit, Hospital For Sick Children, Toronto, Ontario, Canada
| | - Patricia Ambrozewicz
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
- Autism Research Unit, Hospital For Sick Children, Toronto, Ontario, Canada
| | - Jacob Vorstman
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
- Autism Research Unit, Hospital For Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, Hospital for Sick Children, Toronto, Ontario, Canada
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2
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Woodbury-Smith M, D'Abate L, Stavropoulos DJ, Howe J, Drmic I, Hoang N, Zarrei M, Trost B, Iaboni A, Anagnostou E, Scherer SW. The Phenotypic variability of 16p11.2 distal BP2-BP3 deletion in a transgenerational family and in neurodevelopmentally ascertained samples. J Med Genet 2023; 60:1153-1160. [PMID: 37290907 PMCID: PMC10715508 DOI: 10.1136/jmg-2022-108818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 05/03/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND We present genomic and phenotypic findings of a transgenerational family consisting of three male offspring, each with a maternally inherited distal 220 kb deletion at locus 16p11.2 (BP2-BP3). Genomic analysis of all family members was prompted by a diagnosis of autism spectrum disorder (ASD) in the eldest child, who also presented with a low body mass index. METHODS All male offspring underwent extensive neuropsychiatric evaluation. Both parents were also assessed for social functioning and cognition. The family underwent whole-genome sequencing. Further data curation was undertaken from samples ascertained for neurodevelopmental disorders and congenital abnormalities. RESULTS On medical examination, both the second and third-born male offspring presented with obesity. The second-born male offspring met research diagnostic criteria for ASD at 8 years of age and presented with mild attention deficits. The third-born male offspring was only noted as having motor deficits and received a diagnosis of developmental coordination disorder. Other than the 16p11.2 distal deletion, no additional contributing variants of clinical significance were observed. The mother was clinically evaluated and noted as having a broader autism phenotype. CONCLUSION In this family, the phenotypes observed are most likely caused by the 16p11.2 distal deletion. The lack of other overt pathogenic mutations identified by genomic sequencing reinforces the variable expressivity that should be heeded in a clinical setting. Importantly, distal 16p11.2 deletions can present with a highly variable phenotype even within a single family. Our additional data curation provides further evidence on the variable clinical presentation among those with pathogenetic 16p11.2 (BP2-BP3) mutations.
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Affiliation(s)
- Marc Woodbury-Smith
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lia D'Abate
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Dimitri J Stavropoulos
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genome Diagnostics, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer Howe
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Irene Drmic
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Ron Joyce Children's Health Centre, Autism Spectrum Disorder (ASD) Program and Child and Youth Mental Health Program, McMaster Autism Research Team, McMaster University, Hamilton, Hamilton, Ontario, Canada
| | - Ny Hoang
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mehdi Zarrei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brett Trost
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alana Iaboni
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Centre, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Holland Bloorview Kids Rehabilitation Centre, Toronto, Ontario, Canada
| | - Stephen W Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- McLaughlin Centre, University of Toronto, Toronto, Ontario, Canada
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Perlman P, Vorstman J, Hoang N, Summers J, Baribeau D, Cunningham J, Mulsant BH. Support to caregivers who have received genetic information about neurodevelopmental and psychiatric vulnerability in their young children: A narrative review. Clin Genet 2023. [PMID: 37098443 DOI: 10.1111/cge.14349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/27/2023]
Abstract
Diagnosis of pathogenic genetic variants associated with neurodevelopmental and psychiatric disorders (NPDs) is increasingly made early in life. This narrative review focuses on the need for, and provision of, psychological supports following genetic diagnosis. We conducted a literature search of publications on how caregivers are informed about the NPD vulnerability associated with genetic variants, challenges and unmet needs when receiving this information, and whether psychological supports are provided. Given its early recognition, the 22q11.2 deletion has been studied thoroughly for two decades, providing generalizable insights. This literature indicates the complex caregivers' needs related to learning about potential NPD vulnerabilities associated with a genetic variant, include how to communicate the diagnosis, how to identify early signs of NPDs, how to deal with stigma and a lack of medical expertise outside of specialized genetics clinics. With one exception, no publications describe psychotherapeutic support provided to parents. In the absence of support, caregivers struggle with several unmet needs regarding potential longer-term NPD implications of a genetic diagnosis. The field needs to go beyond explaining genetic diagnoses and associated vulnerabilities, and develop approaches to support caregivers with communicating and managing NPD implications across the child's lifespan.
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Affiliation(s)
- Polina Perlman
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Vorstman
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ny Hoang
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Jane Summers
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Danielle Baribeau
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jessie Cunningham
- SickKids Hospital Library, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Addition and Mental Health, Toronto, Ontario, Canada
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4
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Clarke S, Geczy R, Balgi A, Park S, Zhao R, Swaminathan M, Tieu R, Hoang N, Webb C, Watt E, Wong M, Fujisawa M, Jain N, Zhang A, Thomas A. Abstract 1785: Multi-step engineering of gene-edited CAR T cells using RNA lipid nanoparticles. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Autologous chimeric antigen receptor (CAR) T therapies utilize patient cells and can be limited by cell quality, and the high manufacturing burden of viral vectors. As such, there is a need for allogeneic, “off-the-shelf” CAR T cells to make these transformative treatments widely available. However, allogeneic therapies require multiple genetic engineering steps to express CAR and to delete proteins responsible for graft-versus-host disease. Messenger RNA (mRNA) is a promising approach for expression of therapeutic proteins and gene editing nucleases. In this work, we demonstrate a new method for multi-step engineering of gene-edited CAR T cells using RNA lipid nanoparticles (LNPs).
LNPs encapsulating Spy-Cas9 mRNA, TCR and CD52 guide RNA (sgRNA), and CAR mRNA were produced using microfluidics. The CAR construct contained an anti-CD19 scFv binding domain and CD3ζ/4-1BB co-stimulatory domains. Microgram quantities of RNA LNPs were produced to optimize LNP packaging, cargo ratios, and sgRNA combinations. Lead candidates were scaled to milligrams. Purified human primary T cells were cultured, activated, and expanded in serum-free media in plates, flasks and bioreactors. CAR+, TCR− or CD52− cells were generated by addition of the corresponding LNP to activated cells. Cytotoxic killing was determined by co-culture assays with leukemia cells. Gene knockout, CAR expression, viability and cell killing were measured using flow-cytometry.
CD19 CAR was selected as a relevant protein for expression, with TCR and CD52 proteins as gene knockout targets. Single-step addition of CAR LNPs to T cells resulted in transfection efficiencies of 95.0 ± 2.1% and high protein expression. Upon TCR or CD52 LNP addition to T cells, the onset of gene editing was within 48 hours, reaching single target knockout efficiencies of 92.3 ± 3.0% (TCR−), and double knockouts (TCR−/CD52−) of 74.5 ± 6.1%. Similar results were obtained when comparing different LNP batch sizes (microgram to milligram RNA) and cell culture vessels (125,000 to 45 million cells), demonstrating scalability of both the LNP production and cell treatment. Cell viabilities above 90% were maintained at all steps and for all RNA LNPs. Finally, as proof-of-concept for multi-step engineering, sequential addition of TCR LNPs and CAR LNPs resulted in simultaneous CAR expression and TCR gene knockout. These “off-the-shelf” gene-edited CAR T cells were functionally equivalent to non-edited cells in a B cell killing assay, efficiently clearing over 80% of leukemia target cells at a 1:1 ratio.
Our findings demonstrate the advantages of LNPs for RNA delivery to T cells. The simple and gentle nature of LNP cell treatment allows for multiple genetic engineering steps for simultaneous expression and deletion of proteins. Furthermore, LNPs can be easily manufactured using microfluidics, enabling small-scale screening of RNA libraries and rapid scale-up of lead candidates for clinical translation.
Citation Format: Samuel Clarke, R Geczy, A Balgi, S Park, R Zhao, M Swaminathan, R Tieu, N Hoang, C Webb, E Watt, M Wong, M Fujisawa, N Jain, Angela Zhang, Anitha Thomas. Multi-step engineering of gene-edited CAR T cells using RNA lipid nanoparticles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1785.
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Affiliation(s)
- Samuel Clarke
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - R Geczy
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - A Balgi
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - S Park
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - R Zhao
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - M Swaminathan
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - R Tieu
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - N Hoang
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - C Webb
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - E Watt
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - M Wong
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - M Fujisawa
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - N Jain
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - Angela Zhang
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
| | - Anitha Thomas
- 1Precision NanoSystems ULC, Vancouver, British Columbia, Canada
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5
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Trost B, Thiruvahindrapuram B, Chan AJS, Engchuan W, Higginbotham EJ, Howe JL, Loureiro LO, Reuter MS, Roshandel D, Whitney J, Zarrei M, Bookman M, Somerville C, Shaath R, Abdi M, Aliyev E, Patel RV, Nalpathamkalam T, Pellecchia G, Hamdan O, Kaur G, Wang Z, MacDonald JR, Wei J, Sung WWL, Lamoureux S, Hoang N, Selvanayagam T, Deflaux N, Geng M, Ghaffari S, Bates J, Young EJ, Ding Q, Shum C, D'Abate L, Bradley CA, Rutherford A, Aguda V, Apresto B, Chen N, Desai S, Du X, Fong MLY, Pullenayegum S, Samler K, Wang T, Ho K, Paton T, Pereira SL, Herbrick JA, Wintle RF, Fuerth J, Noppornpitak J, Ward H, Magee P, Al Baz A, Kajendirarajah U, Kapadia S, Vlasblom J, Valluri M, Green J, Seifer V, Quirbach M, Rennie O, Kelley E, Masjedi N, Lord C, Szego MJ, Zawati MH, Lang M, Strug LJ, Marshall CR, Costain G, Calli K, Iaboni A, Yusuf A, Ambrozewicz P, Gallagher L, Amaral DG, Brian J, Elsabbagh M, Georgiades S, Messinger DS, Ozonoff S, Sebat J, Sjaarda C, Smith IM, Szatmari P, Zwaigenbaum L, Kushki A, Frazier TW, Vorstman JAS, Fakhro KA, Fernandez BA, Lewis MES, Weksberg R, Fiume M, Yuen RKC, Anagnostou E, Sondheimer N, Glazer D, Hartley DM, Scherer SW. Genomic architecture of autism from comprehensive whole-genome sequence annotation. Cell 2022; 185:4409-4427.e18. [PMID: 36368308 PMCID: PMC10726699 DOI: 10.1016/j.cell.2022.10.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/30/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
Abstract
Fully understanding autism spectrum disorder (ASD) genetics requires whole-genome sequencing (WGS). We present the latest release of the Autism Speaks MSSNG resource, which includes WGS data from 5,100 individuals with ASD and 6,212 non-ASD parents and siblings (total n = 11,312). Examining a wide variety of genetic variants in MSSNG and the Simons Simplex Collection (SSC; n = 9,205), we identified ASD-associated rare variants in 718/5,100 individuals with ASD from MSSNG (14.1%) and 350/2,419 from SSC (14.5%). Considering genomic architecture, 52% were nuclear sequence-level variants, 46% were nuclear structural variants (including copy-number variants, inversions, large insertions, uniparental isodisomies, and tandem repeat expansions), and 2% were mitochondrial variants. Our study provides a guidebook for exploring genotype-phenotype correlations in families who carry ASD-associated rare variants and serves as an entry point to the expanded studies required to dissect the etiology in the ∼85% of the ASD population that remain idiopathic.
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Affiliation(s)
- Brett Trost
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | | | - Ada J S Chan
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Worrawat Engchuan
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Edward J Higginbotham
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jennifer L Howe
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Livia O Loureiro
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Miriam S Reuter
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; CGEn, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Delnaz Roshandel
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Joe Whitney
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Mehdi Zarrei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | | | - Cherith Somerville
- Ted Rogers Centre for Heart Research, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Rulan Shaath
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Mona Abdi
- Department of Human Genetics, Sidra Medicine, Doha, Qatar; College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Elbay Aliyev
- Department of Human Genetics, Sidra Medicine, Doha, Qatar
| | - Rohan V Patel
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Thomas Nalpathamkalam
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Giovanna Pellecchia
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Omar Hamdan
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Gaganjot Kaur
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Zhuozhi Wang
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jeffrey R MacDonald
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - John Wei
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Wilson W L Sung
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sylvia Lamoureux
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Ny Hoang
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Thanuja Selvanayagam
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Nicole Deflaux
- Verily Life Sciences, South San Francisco, CA 94080, USA
| | - Melissa Geng
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Siavash Ghaffari
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - John Bates
- Verily Life Sciences, South San Francisco, CA 94080, USA
| | - Edwin J Young
- Genome Diagnostics, Department of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Qiliang Ding
- Ted Rogers Centre for Heart Research, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Carole Shum
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Lia D'Abate
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Clarrisa A Bradley
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Annabel Rutherford
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Vernie Aguda
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Beverly Apresto
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Nan Chen
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sachin Desai
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Xiaoyan Du
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Matthew L Y Fong
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sanjeev Pullenayegum
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Kozue Samler
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Ting Wang
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Karen Ho
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Tara Paton
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sergio L Pereira
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Jo-Anne Herbrick
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Richard F Wintle
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | - Olivia Rennie
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON K7L 3N6, Canada; Department of Psychiatry, Queen's University, Kingston, ON K7L 7X3, Canada
| | - Nina Masjedi
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90024, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90024, USA
| | - Michael J Szego
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Ma'n H Zawati
- Department of Human Genetics, McGill University, Montreal, QC H3A 0C7, Canada
| | - Michael Lang
- Department of Human Genetics, McGill University, Montreal, QC H3A 0C7, Canada
| | - Lisa J Strug
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Statistical Sciences, University of Toronto, Toronto, ON M5S 3G3, Canada
| | - Christian R Marshall
- Genome Diagnostics, Department of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Gregory Costain
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Kristina Calli
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada; BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Alana Iaboni
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Afiqah Yusuf
- Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Patricia Ambrozewicz
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Psychology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Louise Gallagher
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Child, Youth and Family Services, The Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - David G Amaral
- MIND Institute, University of California, Davis, Sacramento, CA 95817, USA; Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA 95817, USA
| | - Jessica Brian
- Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada
| | | | - Sally Ozonoff
- MIND Institute, University of California, Davis, Sacramento, CA 95817, USA; Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA 95817, USA
| | - Jonathan Sebat
- Department of Psychiatry and Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Calvin Sjaarda
- Department of Psychiatry, Queen's University, Kingston, ON K7L 7X3, Canada; Queen's Genomics Lab at Ongwanada, Queen's University, Kingston, ON K7M 8A6, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada; IWK Health Centre, Halifax, NS B3K 6R8, Canada
| | - Peter Szatmari
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Azadeh Kushki
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Thomas W Frazier
- Autism Speaks, Princeton, NJ 08540, USA; Department of Psychology, John Carroll University, Cleveland, OH 44118, USA
| | - Jacob A S Vorstman
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Khalid A Fakhro
- Department of Human Genetics, Sidra Medicine, Doha, Qatar; College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar; Department of Genetic Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar
| | - Bridget A Fernandez
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA; Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
| | - M E Suzanne Lewis
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada; BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Rosanna Weksberg
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | | | - Ryan K C Yuen
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Evdokia Anagnostou
- Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Neal Sondheimer
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - David Glazer
- Verily Life Sciences, South San Francisco, CA 94080, USA
| | | | - Stephen W Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada; McLaughlin Centre, Toronto, ON M5G 0A4, Canada.
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6
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Baribeau DA, Hoang N, Selvanayagam T, Stavropoulos DJ, Costain G, Scherer SW, Vorstman J. Developmental implications of genetic testing for physical indications. Eur J Hum Genet 2022; 30:1297-1300. [PMID: 36068265 PMCID: PMC9626575 DOI: 10.1038/s41431-022-01181-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/12/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023] Open
Abstract
In children undergoing genetic testing for physical health concerns, we examined how often the results also revealed information about their risk for neurodevelopmental disorders. The study sample consisted of 3056 genetic tests (1686 chromosomal microarrays--CMAs, and 1378 next-generation sequencing--NGS panels) ordered at a tertiary pediatric hospital because of a physical/congenital health problem. Tests ordered to investigate developmental concerns were excluded. Pathogenic, or likely pathogenic variants were manually reviewed for diagnostic likelihood, and for evidence of an association with a neurodevelopmental disorder (e.g., autism or intellectual disability). A total of 169 CMAs (10%) and 232 NGS panels (17%) had likely diagnostic results. More than half (52%) of all diagnostic results had established evidence of a neurodevelopmental disorder association. In summary, there is a high prevalence of neurodevelopmental implications from genetic tests ordered for physical/congenital indications. This broad clinical utility suggests a growing need for genetics-first developmental care pathways.
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Affiliation(s)
- Danielle A Baribeau
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, The University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Ny Hoang
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- Genetics and Genome Biology, SickKids Research Institute, Toronto, ON, Canada
| | - Thanuja Selvanayagam
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON, Canada
- Genetics and Genome Biology, SickKids Research Institute, Toronto, ON, Canada
| | - D James Stavropoulos
- Department of Laboratory Medicine & Pathobiology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Gregory Costain
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- Genetics and Genome Biology, SickKids Research Institute, Toronto, ON, Canada
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephen W Scherer
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
- Genetics and Genome Biology, SickKids Research Institute, Toronto, ON, Canada
- The Centre for Applied Genomics, SickKids Research Institute, Toronto, ON, Canada
| | - Jacob Vorstman
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.
- Department of Psychiatry, The University of Toronto, Toronto, ON, Canada.
- Genetics and Genome Biology, SickKids Research Institute, Toronto, ON, Canada.
- Autism Research Unit, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
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7
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Drmic IE, MacKinnon Modi B, McConnell B, Jilderda S, Hoang N, Noor A, Bassett AS, Speevak M, Stavropoulos DJ, Carter MT. Neurodevelopmental functioning in probands and non-proband carriers of 22q11.2 microduplication. Am J Med Genet A 2022; 188:2999-3008. [PMID: 35899837 DOI: 10.1002/ajmg.a.62916] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/01/2022] [Accepted: 07/07/2022] [Indexed: 01/31/2023]
Abstract
Microduplication of the LCR22-A to LCR22-D region on chromosome 22q11.2 is a recurrent copy number variant found in clinical populations undergoing chromosomal microarray, and at lower frequency in controls. Often inherited, there is limited data on intellectual (IQ) and psychological functioning, particularly in those individuals ascertained through a family member rather than because of neurodevelopmental disorders. To investigate the range of cognitive-behavioral phenotypes associated with 22q11.2 duplication, we studied both probands and their non-proband carrier relatives. Twenty-two individuals with 22q11.2 duplication (10 probands, 12 non-proband carriers) were prospectively assessed with a battery of neuropsychological tests, physical examination, and medical record review. Assessment measures with standardized norms included IQ, academic, adaptive, psychiatric, behavioral, and social functioning. IQ and academic skills were within the average range, with a trend toward lower scores in probands versus non-probands. Adaptive skills were within age expectations. Prevalence of attention deficits (probands only) and anxiety (both groups) was high compared with norms. The prevalence of autism spectrum disorder was relatively low (5% of total sample). Assessment of both probands and non-probands with 22q11.2 duplication suggests that the phenotypic spectrum with respect to neurodevelopment overlaps significantly with the general population. IQ and academic abilities are in the average range for most of the individuals with 22q11.2 duplication in our study, regardless of ascertainment as a proband or non-proband relative. Symptoms of attention deficit and anxiety were identified, which require further study. Results of this study further clarify the phenotype of individuals with 22q11.2 duplication, and provides important information for genetic counseling regarding this recurrent copy number variant.
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Affiliation(s)
- Irene E Drmic
- McMaster Children's Hospital Autism Program, Ron Joyce Children's Health Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Beth McConnell
- Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sanne Jilderda
- Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Ny Hoang
- Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Abdul Noor
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | - Marsha Speevak
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Credit Valley Site, Toronto, Ontario, Canada
| | - Dimitri J Stavropoulos
- Genome Diagnostics, Department of Pathology and Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Melissa T Carter
- Regional Genetics Program, The Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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8
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Hoang N, Yuen RKC, Howe J, Drmic I, Ambrozewicz P, Russell C, Vorstman J, Weiss SK, Anagnostou E, Malow BA, Scherer SW. Sleep phenotype of individuals with autism spectrum disorder bearing mutations in the PER2 circadian rhythm gene. Am J Med Genet A 2021; 185:1120-1130. [PMID: 33474825 DOI: 10.1002/ajmg.a.62086] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/26/2020] [Accepted: 01/02/2021] [Indexed: 02/05/2023]
Abstract
The Per family of genes functions as a primary circadian rhythm maintenance in the brain. Mutations in PER2 are associated with familial advanced sleep-phase syndrome 1 (FASPS1), and recently suggested in delayed sleep phase syndrome and idiopathic hypersomnia. The detection of PER2 variants in individuals with autism spectrum disorder (ASD) and without reported sleep disorders, has suggested a role of circadian-relevant genes in the pathophysiology of ASD. It remains unclear whether these individuals may have, in addition to ASD, an undiagnosed circadian rhythm sleep disorder. The MSSNG database was used to screen whole genome sequencing data of 5,102 individuals with ASD for putative mutations in PER2. Families identified were invited to complete sleep phenotyping consisting of a structured interview and two standardized sleep questionnaires: the Pittsburgh Sleep Quality Index and the Morningness-Eveningness Questionnaire. From 5,102 individuals with ASD, two nonsense, one frameshift, and one de novo missense PER2 variants were identified (0.08%). Of these four, none had a diagnosed sleep disorder. Three reported either a history of, or ongoing sleep disturbances, and one had symptoms highly suggestive of FASPS1 (as did a mutation carrier father without ASD). The individual with the missense variant did not report sleep concerns. The ASD and cognitive profiles of these individuals varied in severity and symptoms. The results support a possible role of PER2-related circadian rhythm disturbances in the dysregulation of sleep overall and sometimes FASPS1. The relationship between dysregulated sleep and the pathophysiology of ASD require further exploration.
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Affiliation(s)
- Ny Hoang
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada.,Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ryan K C Yuen
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Howe
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Irene Drmic
- McMaster Children's Hospital Autism Program, Ron Joyce Children's Health Centre, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Patricia Ambrozewicz
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Carolyn Russell
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Jacob Vorstman
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Shelly K Weiss
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Beth A Malow
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Stephen W Scherer
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.,The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada.,McLaughlin Centre, University of Toronto, Toronto, ON, Canada
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9
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10
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Jibbe A, Hoang N, Jibbe N, Wang T. Hypertrichosis lanuginosa acquisita preceding the diagnosis of breast cancer. Dermatol Online J 2020; 26:13030/qt5rc548m6. [PMID: 33147678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 06/11/2023] Open
Affiliation(s)
- A Jibbe
- Division of Dermatology, University of Kansas Medical Center, Kansas City, KS
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11
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Trost B, Engchuan W, Nguyen CM, Thiruvahindrapuram B, Dolzhenko E, Backstrom I, Mirceta M, Mojarad BA, Yin Y, Dov A, Chandrakumar I, Prasolava T, Shum N, Hamdan O, Pellecchia G, Howe JL, Whitney J, Klee EW, Baheti S, Amaral DG, Anagnostou E, Elsabbagh M, Fernandez BA, Hoang N, Lewis MES, Liu X, Sjaarda C, Smith IM, Szatmari P, Zwaigenbaum L, Glazer D, Hartley D, Stewart AK, Eberle MA, Sato N, Pearson CE, Scherer SW, Yuen RKC. Genome-wide detection of tandem DNA repeats that are expanded in autism. Nature 2020; 586:80-86. [PMID: 32717741 PMCID: PMC9348607 DOI: 10.1038/s41586-020-2579-z] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 06/05/2020] [Indexed: 12/31/2022]
Abstract
Tandem DNA repeats vary in the size and sequence of each unit (motif). When expanded, these tandem DNA repeats have been associated with more than 40 monogenic disorders1. Their involvement in disorders with complex genetics is largely unknown, as is the extent of their heterogeneity. Here we investigated the genome-wide characteristics of tandem repeats that had motifs with a length of 2-20 base pairs in 17,231 genomes of families containing individuals with autism spectrum disorder (ASD)2,3 and population control individuals4. We found extensive polymorphism in the size and sequence of motifs. Many of the tandem repeat loci that we detected correlated with cytogenetic fragile sites. At 2,588 loci, gene-associated expansions of tandem repeats that were rare among population control individuals were significantly more prevalent among individuals with ASD than their siblings without ASD, particularly in exons and near splice junctions, and in genes related to the development of the nervous system and cardiovascular system or muscle. Rare tandem repeat expansions had a prevalence of 23.3% in children with ASD compared with 20.7% in children without ASD, which suggests that tandem repeat expansions make a collective contribution to the risk of ASD of 2.6%. These rare tandem repeat expansions included previously undescribed ASD-linked expansions in DMPK and FXN, which are associated with neuromuscular conditions, and in previously unknown loci such as FGF14 and CACNB1. Rare tandem repeat expansions were associated with lower IQ and adaptive ability. Our results show that tandem DNA repeat expansions contribute strongly to the genetic aetiology and phenotypic complexity of ASD.
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Affiliation(s)
- Brett Trost
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Worrawat Engchuan
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Charlotte M Nguyen
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Bhooma Thiruvahindrapuram
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Ian Backstrom
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mila Mirceta
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Bahareh A Mojarad
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Yue Yin
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alona Dov
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Induja Chandrakumar
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tanya Prasolava
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Natalie Shum
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Omar Hamdan
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giovanna Pellecchia
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer L Howe
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joseph Whitney
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eric W Klee
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Saurabh Baheti
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - David G Amaral
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute and Azrieli Centre for Autism Research, McGill University, Montreal, Quebec, Canada
| | - Bridget A Fernandez
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Ny Hoang
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - M E Suzanne Lewis
- Medical Genetics, University of British Columbia (UBC), Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Xudong Liu
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Calvin Sjaarda
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - David Glazer
- Verily Life Sciences, South San Francisco, CA, USA
| | | | - A Keith Stewart
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Nozomu Sato
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christopher E Pearson
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Stephen W Scherer
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- McLaughlin Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ryan K C Yuen
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada.
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada.
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
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12
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Zarrei M, Burton CL, Engchuan W, Young EJ, Higginbotham EJ, MacDonald JR, Trost B, Chan AJS, Walker S, Lamoureux S, Heung T, Mojarad BA, Kellam B, Paton T, Faheem M, Miron K, Lu C, Wang T, Samler K, Wang X, Costain G, Hoang N, Pellecchia G, Wei J, Patel RV, Thiruvahindrapuram B, Roifman M, Merico D, Goodale T, Drmic I, Speevak M, Howe JL, Yuen RKC, Buchanan JA, Vorstman JAS, Marshall CR, Wintle RF, Rosenberg DR, Hanna GL, Woodbury-Smith M, Cytrynbaum C, Zwaigenbaum L, Elsabbagh M, Flanagan J, Fernandez BA, Carter MT, Szatmari P, Roberts W, Lerch J, Liu X, Nicolson R, Georgiades S, Weksberg R, Arnold PD, Bassett AS, Crosbie J, Schachar R, Stavropoulos DJ, Anagnostou E, Scherer SW. A large data resource of genomic copy number variation across neurodevelopmental disorders. NPJ Genom Med 2019; 4:26. [PMID: 31602316 PMCID: PMC6779875 DOI: 10.1038/s41525-019-0098-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/05/2019] [Indexed: 12/29/2022] Open
Abstract
Copy number variations (CNVs) are implicated across many neurodevelopmental disorders (NDDs) and contribute to their shared genetic etiology. Multiple studies have attempted to identify shared etiology among NDDs, but this is the first genome-wide CNV analysis across autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), schizophrenia (SCZ), and obsessive-compulsive disorder (OCD) at once. Using microarray (Affymetrix CytoScan HD), we genotyped 2,691 subjects diagnosed with an NDD (204 SCZ, 1,838 ASD, 427 ADHD and 222 OCD) and 1,769 family members, mainly parents. We identified rare CNVs, defined as those found in <0.1% of 10,851 population control samples. We found clinically relevant CNVs (broadly defined) in 284 (10.5%) of total subjects, including 22 (10.8%) among subjects with SCZ, 209 (11.4%) with ASD, 40 (9.4%) with ADHD, and 13 (5.6%) with OCD. Among all NDD subjects, we identified 17 (0.63%) with aneuploidies and 115 (4.3%) with known genomic disorder variants. We searched further for genes impacted by different CNVs in multiple disorders. Examples of NDD-associated genes linked across more than one disorder (listed in order of occurrence frequency) are NRXN1, SEH1L, LDLRAD4, GNAL, GNG13, MKRN1, DCTN2, KNDC1, PCMTD2, KIF5A, SYNM, and long non-coding RNAs: AK127244 and PTCHD1-AS. We demonstrated that CNVs impacting the same genes could potentially contribute to the etiology of multiple NDDs. The CNVs identified will serve as a useful resource for both research and diagnostic laboratories for prioritization of variants.
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Affiliation(s)
- Mehdi Zarrei
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Christie L Burton
- 3Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON Canada
| | - Worrawat Engchuan
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Edwin J Young
- 4Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON Canada
| | - Edward J Higginbotham
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,5Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Jeffrey R MacDonald
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Brett Trost
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Ada J S Chan
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,5Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Susan Walker
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Sylvia Lamoureux
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Tracy Heung
- 6Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Bahareh A Mojarad
- 2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Barbara Kellam
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Tara Paton
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Muhammad Faheem
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Karin Miron
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Chao Lu
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Ting Wang
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Kozue Samler
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Xiaolin Wang
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Gregory Costain
- 7Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON Canada.,8Medical Genetics Residency Training Program, University of Toronto, Toronto, ON Canada
| | - Ny Hoang
- 2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,5Department of Molecular Genetics, University of Toronto, Toronto, ON Canada.,9Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON Canada
| | - Giovanna Pellecchia
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - John Wei
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Rohan V Patel
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | | | - Maian Roifman
- 7Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON Canada.,10The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON Canada.,11Department of Paediatrics, University of Toronto, Toronto, ON Canada
| | - Daniele Merico
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,Deep Genomics Inc., Toronto, ON Canada
| | - Tara Goodale
- 3Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON Canada
| | - Irene Drmic
- Hamilton Health Sciences, Ron Joyce Children's Health Centre, Hamilton, On Canada
| | - Marsha Speevak
- 14Trillium Health Partners Credit Valley Site, Mississauga, Ontario Canada
| | - Jennifer L Howe
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Ryan K C Yuen
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Janet A Buchanan
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Jacob A S Vorstman
- 15Department of Psychiatry, University of Toronto, Toronto, ON Canada.,16Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Christian R Marshall
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,4Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON Canada.,17Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Richard F Wintle
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - David R Rosenberg
- 18Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI USA.,19The Children's Hospital of Michigan, Detroit, MI United States
| | - Gregory L Hanna
- 20Department of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Marc Woodbury-Smith
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,21Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Cheryl Cytrynbaum
- 2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,5Department of Molecular Genetics, University of Toronto, Toronto, ON Canada.,7Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON Canada.,22Dalla Lana School of Public Health and the Department of Family and Community Medicine, University of Toronto, Toronto, ON Canada
| | | | - Mayada Elsabbagh
- 24Montreal Neurological Institute, McGill University, Montreal, QC Canada
| | - Janine Flanagan
- 11Department of Paediatrics, University of Toronto, Toronto, ON Canada
| | - Bridget A Fernandez
- 25Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL Canada
| | - Melissa T Carter
- 26Regional Genetics Program, The Children's Hospital of Eastern Ontario, Ottawa, ON Canada
| | - Peter Szatmari
- 15Department of Psychiatry, University of Toronto, Toronto, ON Canada.,27Centre for Addiction and Mental Health, Toronto, ON Canada.,28Department of Psychiatry, The Hospital for Sick Children, Toronto, ON Canada
| | - Wendy Roberts
- 16Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Jason Lerch
- 29Mouse Imaging Centre, Hospital for Sick Children, Toronto, ON Canada.,30Department of Medical Biophysics, The University of Toronto, Toronto, ON Canada
| | - Xudong Liu
- 31Department of Psychiatry, Queen's University, Kinston, ON Canada
| | - Rob Nicolson
- 32Children's Health Research Institute, London, ON Canada.,33Western University, London, ON Canada
| | - Stelios Georgiades
- 34Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Rosanna Weksberg
- 2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,7Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON Canada.,5Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Paul D Arnold
- 2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,35Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB Canada.,36Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Anne S Bassett
- 6Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON Canada.,15Department of Psychiatry, University of Toronto, Toronto, ON Canada.,37The Dalglish Family 22q Clinic, Toronto General Hospital, Toronto, ON Canada
| | - Jennifer Crosbie
- 3Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON Canada.,15Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Russell Schachar
- 3Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON Canada.,15Department of Psychiatry, University of Toronto, Toronto, ON Canada.,38Institute of Medical Science, University of Toronto, Toronto, ON Canada
| | - Dimitri J Stavropoulos
- 4Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON Canada
| | - Evdokia Anagnostou
- 39Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON Canada
| | - Stephen W Scherer
- 1The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,2Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,5Department of Molecular Genetics, University of Toronto, Toronto, ON Canada.,40Department of Molecular Genetics and McLaughlin Centre, University of Toronto, Toronto, ON Canada
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13
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Srivastava S, Love-Nichols JA, Dies KA, Ledbetter DH, Martin CL, Chung WK, Firth HV, Frazier T, Hansen RL, Prock L, Brunner H, Hoang N, Scherer SW, Sahin M, Miller DT. Meta-analysis and multidisciplinary consensus statement: exome sequencing is a first-tier clinical diagnostic test for individuals with neurodevelopmental disorders. Genet Med 2019; 21:2413-2421. [PMID: 31182824 PMCID: PMC6831729 DOI: 10.1038/s41436-019-0554-6] [Citation(s) in RCA: 300] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/15/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose For neurodevelopmental disorders (NDDs), etiological evaluation can
be a diagnostic odyssey involving numerous genetic tests, underscoring the need
to develop a streamlined algorithm maximizing molecular diagnostic yield for
this clinical indication. Our objective was to compare the yield of exome
sequencing (ES) with that of chromosomal microarray (CMA), the current
first-tier test for NDDs. Methods We performed a PubMed scoping review and meta-analysis investigating
the diagnostic yield of ES for NDDs as the basis of a consensus development
conference. We defined NDD as global developmental delay, intellectual
disability, and/or autism spectrum disorder. The consensus development
conference included input from genetics professionals, pediatric neurologists,
and developmental behavioral pediatricians. Results After applying strict inclusion/exclusion criteria, we identified 30
articles with data on molecular diagnostic yield in individuals with isolated
NDD, or NDD plus associated conditions (such as Rett-like features). Yield of ES
was 36% overall, 31% for isolated NDD, and 53% for the NDD plus associated
conditions. ES yield for NDDs is markedly greater than previous studies of CMA
(15–20%). Conclusion Our review demonstrates that ES consistently outperforms CMA for
evaluation of unexplained NDDs. We propose a diagnostic algorithm placing ES at
the beginning of the evaluation of unexplained NDDs.
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Affiliation(s)
- Siddharth Srivastava
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jamie A Love-Nichols
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kira A Dies
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - David H Ledbetter
- Autism & Developmental Medicine Institute, Geisinger, Danville, PA, USA
| | - Christa L Martin
- Autism & Developmental Medicine Institute, Geisinger, Danville, PA, USA
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA.,SFARI, Simons Foundation, New York, NY, USA
| | - Helen V Firth
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK.,East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Robin L Hansen
- MIND Institute, Department of Pediatrics, University of California Davis, Sacramento, CA, USA
| | - Lisa Prock
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Developmental Medicine Center, Boston Children's Hospital, Boston, MA, USA
| | - Han Brunner
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,The Netherlands; Department of Clinical Genetics and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ny Hoang
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON, Canada.,Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Stephen W Scherer
- Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.,The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada.,McLaughlin Centre and Department of Molecular Genetics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mustafa Sahin
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - David T Miller
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA
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14
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Chan AJS, Cytrynbaum C, Hoang N, Ambrozewicz PM, Weksberg R, Drmic I, Ritzema A, Schachar R, Walker S, Uddin M, Zarrei M, Yuen RKC, Scherer SW. Expanding the neurodevelopmental phenotypes of individuals with de novo KMT2A variants. NPJ Genom Med 2019; 4:9. [PMID: 31044088 PMCID: PMC6486600 DOI: 10.1038/s41525-019-0083-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/20/2019] [Indexed: 01/07/2023] Open
Abstract
De novo loss-of-function (LoF) variants in the KMT2A gene are associated with Wiedemann-Steiner Syndrome (WSS). Recently, de novo KMT2A variants have been identified in sequencing studies of cohorts of individuals with neurodevelopmental disorders (NDDs). However, most of these studies lack the detailed clinical information required to determine whether those individuals have isolated NDDs or WSS (i.e. syndromic NDDs). We performed thorough clinical and neurodevelopmental phenotyping on six individuals with de novo KMT2A variants. From these data, we found that all six patients met clinical criteria for WSS and we further define the neurodevelopmental phenotypes associated with KMT2A variants and WSS. In particular, we identified a subtype of Autism Spectrum Disorder (ASD) in five individuals, characterized by marked rigid, repetitive and inflexible behaviours, emotional dysregulation, externalizing behaviours, but relative social motivation. To further explore the clinical spectrum associated with KMT2A variants, we also conducted a meta-analysis of individuals with KMT2A variants reported in the published literature. We found that de novo LoF or missense variants in KMT2A were significantly more prevalent than predicted by a previously established statistical model of de novo mutation rate for KMT2A. Our genotype-phenotype findings better define the clinical spectrum associated with KMT2A variants and suggest that individuals with de novo LoF and missense variants likely have a clinically unrecognized diagnosis of WSS, rather than isolated NDD or ASD alone. This highlights the importance of a clinical genetic and neurodevelopmental assessment for individuals with such variants in KMT2A.
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Affiliation(s)
- Ada J. S. Chan
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Cheryl Cytrynbaum
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON Canada
| | - Ny Hoang
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON Canada
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Patricia M. Ambrozewicz
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
- Department of Psychology, The Hospital for Sick Children, Toronto, ON Canada
| | - Rosanna Weksberg
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- Institute of Medical Science, University of Toronto, Toronto, ON Canada
- Department of Paediatrics, University of Toronto, Toronto, ON Canada
| | - Irene Drmic
- Ron Joyce Children’s Health Centre, Hamilton Health Services, Hamilton, ON Canada
| | - Anne Ritzema
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
- Department of Psychology, The Hospital for Sick Children, Toronto, ON Canada
| | - Russell Schachar
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Susan Walker
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Mohammed Uddin
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mehdi Zarrei
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Ryan K. C. Yuen
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
| | - Stephen W. Scherer
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada
- Institute of Medical Science, University of Toronto, Toronto, ON Canada
- McLaughin Centre, University of Toronto, Toronto, ON Canada
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15
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Hoang N, Buchanan JA, Scherer SW. Heterogeneity in clinical sequencing tests marketed for autism spectrum disorders. NPJ Genom Med 2018; 3:27. [PMID: 30275975 PMCID: PMC6145925 DOI: 10.1038/s41525-018-0066-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
- Ny Hoang
- 1Department of Genetic Counselling, The Hospital for Sick Children, Toronto, ON Canada.,2Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,3Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Janet A Buchanan
- 4The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Stephen W Scherer
- 2Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON Canada.,3Department of Molecular Genetics, University of Toronto, Toronto, ON Canada.,4The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,5McLaughlin Centre and Department of Molecular Genetics, Faculty of Medicine, University of Toronto, Toronto, ON Canada
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16
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Hoang N, Khalaf M, Reposar A, Kwofie J, Sze D. 3:36 PM Abstract No. 145 Quantification of activity lost to delivery-system residual and decay in Yttrium-90 radioembolization. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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17
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Hoang N, Cytrynbaum C, Scherer SW. Communicating complex genomic information: A counselling approach derived from research experience with Autism Spectrum Disorder. Patient Educ Couns 2018; 101:352-361. [PMID: 28803755 DOI: 10.1016/j.pec.2017.07.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 06/07/2023]
Abstract
Individuals with Autism Spectrum Disorder (ASD) share characteristics (impairments in socialization and communication, and repetitive interests and behaviour), but differ in their developmental course, pattern of symptoms, and cognitive and language abilities. The development of standardized phenotyping has revealed ASD to clinically be vastly heterogeneous, ranging from milder presentations to more severe forms associated with profound intellectual disability. Some 100 genes have now been implicated in the etiology of ASD, and advances in genome-wide testing continue to yield new data at an unprecedented rate. As the translation of this data is incorporated into clinical care, genetic professionals/counsellors, as well as other health care providers, will benefit from guidelines and tools to effectively communicate such genomic information. Here, we present a model to facilitate communication regarding the complexities of ASD, where clinical and genetic heterogeneity, as well as overlapping neurological conditions are inherent. We outline an approach for counselling families about their genomic results grounded in our direct experience from counselling families participating in an ASD research study, and supported by rationale from the literature.
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Affiliation(s)
- Ny Hoang
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Canada; Autism Research Unit, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada.
| | - Cheryl Cytrynbaum
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada.
| | - Stephen W Scherer
- Department of Molecular Genetics, University of Toronto, Toronto, Canada; Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada; The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Canada; McLaughlin Centre, University of Toronto, Toronto, Canada.
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18
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Dale B, Modi BM, Jilderda S, McConnell B, Hoang N, Swaroop P, Falcon J, Thiruvahindrapuram B, Walker S, Scherer SW, Stavropoulos DJ, Drmic IE, Carter MT. Atypical autism in a boy with double duplication of 22q11.2: implications of increasing dosage. NPJ Genom Med 2017; 2:28. [PMID: 29263838 PMCID: PMC5677976 DOI: 10.1038/s41525-017-0031-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 06/30/2017] [Accepted: 07/26/2017] [Indexed: 12/04/2022] Open
Abstract
Duplication of chromosome 22q11.2 (LCR A-D) has been reported at higher frequencies in clinical samples than the general population, but phenotypes vary widely. Triplication (4 copies) is rare, but studying the associated phenotype may provide insight into dosage-sensitivity of the genes in this chromosomal interval. We describe a proband with a triplication, specifically a “double duplication” (two copies per chromosome) of the 22q11.2 region, while his parents and two siblings each have a single duplication (3 copies). The proband had a heart malformation, dysmorphic features, and learning and socialization deficits, whereas the other family members did not. This family illustrates that while duplication of the 22q11.2 may not be sufficient to cause clinically significant neurodevelopmental or health-related phenotypes, triplication of the same region may result in a phenotype characterized by a mild neurodevelopmental disorder, facial dysmorphism, and possibly cardiac anomalies.
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Affiliation(s)
- Breanne Dale
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | | | - Sanne Jilderda
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Beth McConnell
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Ny Hoang
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada.,The Centre for Applied Genomics, Hospital for Sick Children and McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Pooja Swaroop
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Jhoan Falcon
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada
| | - Bhooma Thiruvahindrapuram
- The Centre for Applied Genomics, Hospital for Sick Children and McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Susan Walker
- The Centre for Applied Genomics, Hospital for Sick Children and McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - Stephen W Scherer
- The Centre for Applied Genomics, Hospital for Sick Children and McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
| | - D James Stavropoulos
- Department of Pathology and Laboratory Medicine, Genome Diagnostics, The Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Irene E Drmic
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada.,The Centre for Applied Genomics, Hospital for Sick Children and McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, ON Canada.,Department of Pediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON Canada
| | - Melissa T Carter
- Regional Genetics Program, The Children's Hospital of Eastern Ontario, Ottawa, ON Canada
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19
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Morales L, Griffith G, Wright V, Fleming E, Umberger W, Hoang N. Branding fresh food: Who is willing to pay more for beef? Acta Alimentaria 2017. [DOI: 10.1556/066.2016.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- L.E. Morales
- UNE Business School, W40 EBL Building, Armidale Campus, University of New England, Armidale, New South Wales 2351. Australia
| | - G. Griffith
- UNE Business School, W40 EBL Building, Armidale Campus, University of New England, Armidale, New South Wales 2351. Australia
- Faculty of Veterinary and Agricultural Sciences, 142 University of Melbourne, University Street, Parkville, Victoria 3053. Australia
- Global Food Studies Program, Faculty of the Professions, 5.05 NEXUS 10 Tower, The University of Adelaide, South Australia 5005. Australia
| | - V. Wright
- UNE Business School, W40 EBL Building, Armidale Campus, University of New England, Armidale, New South Wales 2351. Australia
| | - E. Fleming
- UNE Business School, W40 EBL Building, Armidale Campus, University of New England, Armidale, New South Wales 2351. Australia
| | - W. Umberger
- Global Food Studies Program, Faculty of the Professions, 5.05 NEXUS 10 Tower, The University of Adelaide, South Australia 5005. Australia
| | - N. Hoang
- UNE Business School, W40 EBL Building, Armidale Campus, University of New England, Armidale, New South Wales 2351. Australia
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20
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Woodbury-Smith M, Deneault E, Yuen RKC, Walker S, Zarrei M, Pellecchia G, Howe JL, Hoang N, Uddin M, Marshall CR, Chrysler C, Thompson A, Szatmari P, Scherer SW. Mutations in RAB39B in individuals with intellectual disability, autism spectrum disorder, and macrocephaly. Mol Autism 2017; 8:59. [PMID: 29152164 PMCID: PMC5679329 DOI: 10.1186/s13229-017-0175-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 10/16/2017] [Indexed: 12/14/2022] Open
Abstract
Background Autism spectrum disorder (ASD), a developmental disorder of early childhood onset, affects males four times more frequently than females, suggesting a role for the sex chromosomes. In this study, we describe a family with ASD in which a predicted pathogenic nonsense mutation in the X-chromosome gene RAB39B segregates with ASD phenotype. Methods Clinical phenotyping, microarray, and whole genome sequencing (WGS) were performed on the five members of this family. Maternal and female sibling X inactivation ratio was calculated, and phase was investigated. Mutant-induced pluripotent stem cells engineered for an exon 2 nonsense mutation were generated and differentiated into cortical neurons for expression and pathway analyses. Results Two males with an inherited RAB39B mutation both presented with macrocephaly, intellectual disability (ID), and ASD. Their female sibling with the same mutation presented with ID and a broad autism phenotype. In contrast, their transmitting mother has no neurodevelopmental diagnosis. Our investigation of phase indicated maternal preferential inactivation of the mutated allele, with no such bias observed in the female sibling. We offer the explanation that this bias in X inactivation may explain the absence of a neurocognitive phenotype in the mother. Our cellular knockout model of RAB39B revealed an impact on expression in differentiated neurons for several genes implicated in brain development and function, supported by our pathway enrichment analysis. Conclusions Penetrance for ASD is high among males but more variable among females with RAB39B mutations. A critical role for this gene in brain development and function is demonstrated.
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Affiliation(s)
- Marc Woodbury-Smith
- Institute of Neuroscience, Newcastle University, c/o Sir James Spence Institute, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP UK.,Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Eric Deneault
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Ryan K C Yuen
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Susan Walker
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Mehdi Zarrei
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Giovanna Pellecchia
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Jennifer L Howe
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Ny Hoang
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON Canada.,Centre for Addiction and Mental Health, The Hospital for Sick Children and University of Toronto, Toronto, ON Canada
| | - Mohammed Uddin
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Christian R Marshall
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada
| | - Christina Chrysler
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Ann Thompson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, The Hospital for Sick Children and University of Toronto, Toronto, ON Canada
| | - Stephen W Scherer
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON Canada.,McLaughlin Centre, University of Toronto, Toronto, ON Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON Canada
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21
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Woodbury-Smith M, Nicolson R, Zarrei M, Yuen RKC, Walker S, Howe J, Uddin M, Hoang N, Buchanan JA, Chrysler C, Thompson A, Szatmari P, Scherer SW. Variable phenotype expression in a family segregating microdeletions of the NRXN1 and MBD5 autism spectrum disorder susceptibility genes. NPJ Genom Med 2017. [PMID: 28649445 PMCID: PMC5482711 DOI: 10.1038/s41525-017-0020-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Autism spectrum disorder is a developmental condition of early childhood onset, which impacts socio-communicative functioning and is principally genetic in etiology. Currently, more than 50 genomic loci are deemed to be associated with susceptibility to autism spectrum disorder, showing de novo and inherited unbalanced copy number variants and smaller insertions and deletions (indels), more complex structural variants, as well as single-nucleotide variants deemed of pathological significance. However, the phenotypes associated with many of these genes are variable, and penetrance is largely unelaborated in clinical descriptions. This case report describes a family harboring two copy number variant microdeletions, which affect regions of NRXN1 and MBD5—each well-established in association with risk of autism spectrum disorder and other neurodevelopmental disorders. Although each copy number variant would likely be categorized as pathologically significant, both genomic alterations are transmitted in this family from an unaffected father to the proband, and shared by an unaffected sibling. This family case illustrates the importance of recognizing that phenotype can vary among exon overlapping variants of the same gene, and the need to evaluate penetrance of such variants in order to properly inform on risks.
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Affiliation(s)
- Marc Woodbury-Smith
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - Mehdi Zarrei
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ryan K C Yuen
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Susan Walker
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer Howe
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mohammed Uddin
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ny Hoang
- Autism Research Unit, The Hospital for Sick Children, Toronto, ON, Canada
| | - Janet A Buchanan
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Christina Chrysler
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ann Thompson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, The Hospital for Sick Children & University of Toronto, Toronto, ON, Canada
| | - Stephen W Scherer
- Program in Genetics and Genome Biology, The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, ON, Canada.,McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
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22
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Hoang N, Hayeems R, Davies J, Pu S, Wasim S, Velsher L, Aw J, Chénier S, Stavropoulos DJ, Babul-Hirji R, Weksberg R, Shuman C. Does personal genome testing drive service utilization in an adult preventive medicine clinic? J Community Genet 2017; 8:151-158. [PMID: 28374280 DOI: 10.1007/s12687-017-0297-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 03/02/2017] [Indexed: 11/26/2022] Open
Abstract
Personal genome testing (PGT) that assesses risk for common diseases may influence the use of preventive health services, but outcome data are limited. We aimed to assess health service utilization following PGT. We conducted a retrospective matched cohort study at an adult health clinic. Medical records of clients who pursued PGT at their comprehensive health assessment (CHA) over a 1-year period (N = 388) were reviewed and compared to age- and sex-matched clients who underwent CHA but not PGT (N = 388). We measured condition-specific health services used post CHA up to two subsequent visits while accounting for confounding factors (e.g., family history, health status, and age). A relatively equal number of post CHA services were used by clients who pursued PGT and those who did not pursue PGT (52% and 48%, respectively). Overall and across the majority of conditions examined, clients' service utilization was significantly associated with health status, e.g., clients identified as "at risk" on CHA for heart attack used 2.86 times more services than clients not at risk. Pursuing PGT was not significantly associated with increased use of services post CHA overall or for most of the conditions examined. Our data demonstrate that health status rather than pursuing PGT is the strongest driver of service utilization in this population. Overall, pursuit of PGT and PGT results does not appear to significantly drive the utilization of downstream health services.
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Affiliation(s)
- Ny Hoang
- Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada.
- Molecular Genetics, The University of Toronto, Toronto, Canada.
| | - Robin Hayeems
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | | | - Shuye Pu
- Molecular Structure and Function, The Hospital for Sick Children, Toronto, Canada
| | - Syed Wasim
- Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada
| | | | - James Aw
- Genetics, Medcan Clinic, Toronto, Canada
| | - Sébastien Chénier
- Département de pédiatrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada
| | - Dimitri J Stavropoulos
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Riyana Babul-Hirji
- Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada
- Molecular Genetics, The University of Toronto, Toronto, Canada
| | - Rosanna Weksberg
- Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada
- Molecular Genetics, The University of Toronto, Toronto, Canada
| | - Cheryl Shuman
- Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada
- Molecular Genetics, The University of Toronto, Toronto, Canada
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23
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C Yuen RK, Merico D, Bookman M, L Howe J, Thiruvahindrapuram B, Patel RV, Whitney J, Deflaux N, Bingham J, Wang Z, Pellecchia G, Buchanan JA, Walker S, Marshall CR, Uddin M, Zarrei M, Deneault E, D'Abate L, Chan AJS, Koyanagi S, Paton T, Pereira SL, Hoang N, Engchuan W, Higginbotham EJ, Ho K, Lamoureux S, Li W, MacDonald JR, Nalpathamkalam T, Sung WWL, Tsoi FJ, Wei J, Xu L, Tasse AM, Kirby E, Van Etten W, Twigger S, Roberts W, Drmic I, Jilderda S, Modi BM, Kellam B, Szego M, Cytrynbaum C, Weksberg R, Zwaigenbaum L, Woodbury-Smith M, Brian J, Senman L, Iaboni A, Doyle-Thomas K, Thompson A, Chrysler C, Leef J, Savion-Lemieux T, Smith IM, Liu X, Nicolson R, Seifer V, Fedele A, Cook EH, Dager S, Estes A, Gallagher L, Malow BA, Parr JR, Spence SJ, Vorstman J, Frey BJ, Robinson JT, Strug LJ, Fernandez BA, Elsabbagh M, Carter MT, Hallmayer J, Knoppers BM, Anagnostou E, Szatmari P, Ring RH, Glazer D, Pletcher MT, Scherer SW. Whole genome sequencing resource identifies 18 new candidate genes for autism spectrum disorder. Nat Neurosci 2017; 20:602-611. [PMID: 28263302 DOI: 10.1038/nn.4524] [Citation(s) in RCA: 505] [Impact Index Per Article: 72.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 02/01/2017] [Indexed: 12/13/2022]
Abstract
We are performing whole-genome sequencing of families with autism spectrum disorder (ASD) to build a resource (MSSNG) for subcategorizing the phenotypes and underlying genetic factors involved. Here we report sequencing of 5,205 samples from families with ASD, accompanied by clinical information, creating a database accessible on a cloud platform and through a controlled-access internet portal. We found an average of 73.8 de novo single nucleotide variants and 12.6 de novo insertions and deletions or copy number variations per ASD subject. We identified 18 new candidate ASD-risk genes and found that participants bearing mutations in susceptibility genes had significantly lower adaptive ability (P = 6 × 10-4). In 294 of 2,620 (11.2%) of ASD cases, a molecular basis could be determined and 7.2% of these carried copy number variations and/or chromosomal abnormalities, emphasizing the importance of detecting all forms of genetic variation as diagnostic and therapeutic targets in ASD.
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Affiliation(s)
- Ryan K C Yuen
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Daniele Merico
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Deep Genomics Inc., Toronto, Canada
| | - Matt Bookman
- Google, Mountain View, California, USA.,Verily Life Sciences, South San Francisco, California, USA
| | - Jennifer L Howe
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Bhooma Thiruvahindrapuram
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Rohan V Patel
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Joe Whitney
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Nicole Deflaux
- Google, Mountain View, California, USA.,Verily Life Sciences, South San Francisco, California, USA
| | - Jonathan Bingham
- Google, Mountain View, California, USA.,Verily Life Sciences, South San Francisco, California, USA
| | - Zhuozhi Wang
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Giovanna Pellecchia
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Janet A Buchanan
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Susan Walker
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Christian R Marshall
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Mohammed Uddin
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Mehdi Zarrei
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Eric Deneault
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Lia D'Abate
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Ada J S Chan
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Stephanie Koyanagi
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Tara Paton
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Sergio L Pereira
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Ny Hoang
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Canada
| | - Worrawat Engchuan
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Edward J Higginbotham
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Karen Ho
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Sylvia Lamoureux
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Weili Li
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Jeffrey R MacDonald
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Thomas Nalpathamkalam
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Wilson W L Sung
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Fiona J Tsoi
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - John Wei
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Lizhen Xu
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Anne-Marie Tasse
- Public Population Project in Genomics and Society, McGill University, Montreal, Canada
| | - Emily Kirby
- Public Population Project in Genomics and Society, McGill University, Montreal, Canada
| | | | | | - Wendy Roberts
- Autism Research Unit, The Hospital for Sick Children, Toronto, Canada
| | - Irene Drmic
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Canada
| | - Sanne Jilderda
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Canada
| | - Bonnie MacKinnon Modi
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Canada
| | - Barbara Kellam
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - Michael Szego
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Dalla Lana School of Public Health and the Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cheryl Cytrynbaum
- Department of Molecular Genetics, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health and the Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.,Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada
| | - Rosanna Weksberg
- Department of Molecular Genetics, University of Toronto, Toronto, Canada.,Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada
| | | | - Marc Woodbury-Smith
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Jessica Brian
- Bloorview Research Institute, University of Toronto, Toronto, Canada.
| | - Lili Senman
- Bloorview Research Institute, University of Toronto, Toronto, Canada.
| | - Alana Iaboni
- Bloorview Research Institute, University of Toronto, Toronto, Canada.
| | | | - Ann Thompson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Christina Chrysler
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Jonathan Leef
- Bloorview Research Institute, University of Toronto, Toronto, Canada.
| | | | - Isabel M Smith
- Departments of Pediatrics and of Psychology &Neuroscience, Dalhousie University and Autism Research Centre, IWK Health Centre, Halifax, Canada
| | - Xudong Liu
- Department of Psychiatry, Queen's University, Kinston, Canada
| | - Rob Nicolson
- Children's Health Research Institute, London, Ontario, Canada.,Western University, London, Ontario, Canada
| | | | | | - Edwin H Cook
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Louise Gallagher
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Beth A Malow
- Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
| | - Sarah J Spence
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jacob Vorstman
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Brendan J Frey
- Deep Genomics Inc., Toronto, Canada.,Department of Electrical and Computer Engineering and Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, Canada
| | - James T Robinson
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Lisa J Strug
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Bridget A Fernandez
- Disciplines of Genetics and Medicine, Memorial University of Newfoundland and Provincial Medical Genetic Program, Eastern Health, St. John's, Canada
| | | | - Melissa T Carter
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada.,Regional Genetics Program, The Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Joachim Hallmayer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | | | | | - Peter Szatmari
- Child Youth and Family Services, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Robert H Ring
- Department of Pharmacology &Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - David Glazer
- Google, Mountain View, California, USA.,Verily Life Sciences, South San Francisco, California, USA
| | | | - Stephen W Scherer
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada.,McLaughlin Centre, University of Toronto, Toronto, Canada
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24
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Hayeems RZ, Hoang N, Chenier S, Stavropoulos DJ, Pu S, Weksberg R, Shuman C. Capturing the clinical utility of genomic testing: medical recommendations following pediatric microarray. Eur J Hum Genet 2014; 23:1135-41. [PMID: 25491637 PMCID: PMC4538218 DOI: 10.1038/ejhg.2014.260] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 10/01/2014] [Accepted: 10/21/2014] [Indexed: 01/08/2023] Open
Abstract
Interpretation of pediatric chromosome microarray (CMA) results presents diagnostic and medical management challenges. Understanding management practices triggered by CMA will inform clinical utility and resource planning. Using a retrospective cohort design, we extracted clinical and management-related data from the records of 752 children with congenital anomalies and/or developmental delay who underwent CMA in an academic pediatric genetics clinic (2009–2011). Frequency distributions and relative rates (RR) of post-CMA medical recommendations in children with reportable and benign CMA results were calculated. Medical recommendations were provided for 79.6% of children with reportable results and 62.0% of children with benign results. Overall, recommendations included specialist consultation (40.8%), imaging (32.5%), laboratory investigations (17.2%), surveillance (4.6%), and family investigations (4.9%). Clinically significant variants and variants of uncertain clinical significance were associated with higher and slightly higher rates of management recommendations, respectively, compared with benign/no variants (RR=1.34; 95% CI (1.22–1.47); RR=1.23; 95% CI (1.09–1.38)). Recommendation rates for clinically significant versus uncertain results depended upon how uncertainty was classified (RRbroad=1.09; 95% CI (0.99–1.2); RRnarrow=1.12; 95% CI (1.02–1.24)). Recommendation rates also varied by the child's age and provider type. In conclusion, medical recommendations follow CMA for the majority of children. Compared with benign CMA results, clinically significant CMA variants are a significant driver of pediatric medical recommendations. Variants of uncertain clinical significance drive recommendations, but to a lesser extent. As a broadening range of specialists will need to respond to CMA results, targeted capacity building is warranted.
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Affiliation(s)
- Robin Z Hayeems
- 1] Program in Child Health Evaluative, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada [2] Institute of Health Policy Management and Evaluation, The University of Toronto, Toronto, ON, Canada
| | - Ny Hoang
- 1] Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada [2] Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sebastien Chenier
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Dimitri J Stavropoulos
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children and The University of Toronto, Toronto, ON, Canada
| | - Shuye Pu
- Terrence Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, ON, Canada
| | - Rosanna Weksberg
- 1] Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada [2] Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada [3] Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada [4] Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Cheryl Shuman
- 1] Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada [2] Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada [3] Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
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25
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Garg N, Hoang N, Wong C, Ali Z, Patel R, Suarez A. 381 Characteristics of Patients Requiring Automatic Implantable Cardioverter Defibrillator or Permanent Pacemaker Implantation During the Hospital Stay in Patients Without Evidence of Ventricular Tachycardia on Presentation to the Emergency Department. Ann Emerg Med 2014. [DOI: 10.1016/j.annemergmed.2014.07.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Garg N, Radeos M, Ali Z, Wong C, Hoang N, Suarez A. Identification of Characteristics of Adult Patients in the Emergency Department Who Develop Ventricular Tachycardia or Ventricular Fibrillation During Hospital Stay. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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27
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Zhan L, Featherstone J, Lo J, Krupansky C, Hoang N, DenBesten P, Huynh T. Clinical Efficacy and Effects of Xylitol Wipes on Bacterial Virulence. Adv Dent Res 2012; 24:117-22. [DOI: 10.1177/0022034512449835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the study was to investigate whether xylitol-wipe use in young children prevented caries by affecting bacterial virulence. In a double-blinded randomized controlled clinical trial, 44 mother-child pairs were randomized to xylitol-wipe or placebo-wipe groups. Salivary mutans streptococci levels were enumerated at baseline, 6 months, and one year. Ten mutans streptococci colonies were isolated and genotyped from each saliva sample. Genotype-colonization stability, xylitol sensitivity, and biofilm formation of these isolates were studied. Despite a significant reduction in new caries at one year in the xylitol-wipe group, no significant differences were found between the two groups in levels of mutans streptococci. Children in the xylitol-wipe group had significantly fewer retained genotypes (p = 0.06) and more transient genotypes of mutans streptococci (p = 0.05) than those in the placebo-wipe group. At one year, there was no significant difference in the prevalence of xylitol-resistant genotypes or in biofilm formation ability of mutans streptococci isolates between the two groups. The mechanism of the caries-preventive effect of xylitol-wipe use may be related to the stability of mutans streptococci colonization. Further studies with genomic characterization methods are needed to determine specific gene(s) that account for the caries-preventive effect of xylitol.
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Affiliation(s)
- L. Zhan
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, USA
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, USA
| | - J.D.B. Featherstone
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, USA
| | - J. Lo
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, USA
| | - C. Krupansky
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, USA
| | - N. Hoang
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, USA
| | - P. DenBesten
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, USA
| | - T. Huynh
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, USA
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Marin F, Hoang N, Aufaure P, Ho Ba Tho MC. In vivo intersegmental motion of the cervical spine using an inverse kinematics procedure. Clin Biomech (Bristol, Avon) 2010; 25:389-96. [PMID: 20334962 DOI: 10.1016/j.clinbiomech.2010.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 02/03/2010] [Accepted: 02/08/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND The main functions of the cervical spine are the stabilization and the orientation of the head. Pathologies are complex and difficult to diagnose. The first sign of the dysfunction is an abnormal intervertebral motion. It is the purpose of this feasibility study to determine the intersegmental motions and loading conditions of the cervical spine in vivo with standard clinical investigation methods. METHODS We propose a new approach which merges full flexion-extension X-ray images, and continuous motion of the whole cervical spine obtained with a tracking motion system. These data were used as input for a subject-specific rigid body model of the cervical spine computed with the software MSC.Adams. This model simulates the cervical spine extension/flexion, the intervertebral motions are deduced using an inverse kinematics procedure. FINDINGS Subject-specific rigid body models were computed from data of two subjects. The intersegmental motion and loading conditions were calculated. We found that the loading amplitudes depended on the intervertebral level, and that subject specific patterns were highlighted. We noticed an unsymmetrical behavior in flexion and extension. Furthermore intervertebral rotations were correlated with the global motion of the cervical spine. INTERPRETATION A subject-specific rigid body model merged data from classical flexion-extension radiographs and noninvasive external motion capture. Our approach is based on inverse kinematics allowing the estimation of the intervertebral motion and mechanical behavior of the cervical spine in vivo, which gives valuable information concerning biomechanics of the cervical spine in vivo for cervical spine clinical investigation.
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Affiliation(s)
- F Marin
- Biomécanique et Bioingénierie UMR CNRS 6600, Université de Technologie de Compiègne, Compiègne, France.
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Elias E, Hoang N, Sommer J, Schramm B. Die zweiten Virialkoeffizienten von Helium-Gasmischungen im Bereich unterhalb Zimmertemperatur. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bbpc.19860900406] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Marin F, Hoang N, Ho Ba Tho M. Influence of the localisation of the intersegmental joint position on the musculo-skeletal model of the cervical spine. Comput Methods Biomech Biomed Engin 2009. [DOI: 10.1080/10255840903091486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schurr C, Burghartz M, Miethke T, Kesting M, Hoang N, Staudenmaier R. Management of facial necrotizing fasciitis. Eur Arch Otorhinolaryngol 2008; 266:325-31. [PMID: 19043730 DOI: 10.1007/s00405-008-0870-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2008] [Accepted: 11/10/2008] [Indexed: 10/21/2022]
Abstract
Necrotizing fasciitis is a progressive, life-threatening, bacterial infection of the skin, the subcutaneous tissue and the underlying fascia, in most cases caused by ss-hemolytic group A streptococcus. Only early diagnosis and aggressive therapy including broad spectrum antibiotics and surgical intervention can avoid systemic toxicity with a high mortality rate. This uncommon disease generally occurs in the lower extremities and trunk, and only rarely affects the head and neck region. When located in the face necrotizing fasciitis is associated with severe cosmetic and functional restrictions due to the invasive infection and often to the necessary surgical treatment. Generally surgical intervention cannot be performed in the face as aggressively as in the extremities and trunk, since a lot of vital structures are found in a relatively small area. In the following article, we present the successful diagnostic and therapeutic management of an isolated facial necrotizing fasciitis as a consequence of a nasal bone fracture with a minor dermal cut.
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Affiliation(s)
- Christian Schurr
- Klinik für Hals-Nasen-Ohren-Heilkunde, Technische Universität München, Munich, Germany.
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Hoang N, Marin F, Ho Ba Tho MC. The intersegmental motion of cervical spine with the in vivomeasurement and a rigid body model. Comput Methods Biomech Biomed Engin 2008. [DOI: 10.1080/10255840802297044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hoang N, Marin F, Ho ba tho MC. Rigid body model to determine the in vivointersegmental motions of the cervical spine. Comput Methods Biomech Biomed Engin 2007. [DOI: 10.1080/10255840701479081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hoang N, Ho Ba Tho MC, Dürselen L, Marin F. Development of a rigid body model to determine the in vivo intersegmental motions of the cervical spine. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)83317-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Choi JK, Hoang N, Vilardi AM, Conrad P, Emerson SG, Gewirtz AM. Hybrid HIV/MSCV LTR enhances transgene expression of lentiviral vectors in human CD34(+) hematopoietic cells. Stem Cells 2001; 19:236-46. [PMID: 11359949 DOI: 10.1634/stemcells.19-3-236] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
HIV-based lentiviral vectors can transduce nondividing cells, an important advantage over murine leukemia virus (MLV)-based vectors when transducing slowly dividing hematopoietic stem cells. However, we find that in human CD34(+) hematopoietic cells, the HIV-based vectors with an internal cytomegalovirus (CMV) promoter express transgenes 100- to 1,000-fold less than the MLV-based retroviral vector murine stem cell virus (MSCV). To increase the expression of the integrated lentivirus, we replaced CMV promoter with that of the Rous sarcoma virus or MSCV and obtained a modest augmentation in expression. A more dramatic effect was seen when the CMV enhancer/promoter was removed and the HIV long-terminal repeat (LTR) was replaced by a novel HIV/MSCV hybrid LTR. This vector retains the ability to transduce nondividing cells but now expresses its transgene (enhanced green fluorescent protein) 10- to 100-fold greater than the original HIV-based vector. When compared under identical conditions, the HIV vector with the hybrid LTR transduced a higher percentage of CD34(+) cells than the MSCV-based retroviral vector (19.4% versus 2.4%). The number of transduced cells and level of transgene expression remain constant over 5-8 weeks as determined by long-term culture-initiating cells, fluoresence-activated cell sorting, and nonobese diabetic/severe combined immunodeficiency repopulation assay.
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Affiliation(s)
- J K Choi
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia 19104, USA.
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Huynh DP, Figueroa K, Hoang N, Pulst SM. Nuclear localization or inclusion body formation of ataxin-2 are not necessary for SCA2 pathogenesis in mouse or human. Nat Genet 2000; 26:44-50. [PMID: 10973246 DOI: 10.1038/79162] [Citation(s) in RCA: 220] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Instability of CAG DNA trinucleotide repeats is the mutational mechanism for several neurodegenerative diseases resulting in the expansion of a polyglutamine (polyQ) tract. Proteins with long polyQ tracts have an increased tendency to aggregate, often as truncated fragments forming ubiquitinated intranuclear inclusion bodies. We examined whether similar features define spinocerebellar ataxia type 2 (SCA2) pathogenesis using cultured cells, human brains and transgenic mouse lines. In SCA2 brains, we found cytoplasmic, but not nuclear, microaggregates. Mice expressing ataxin-2 with Q58 showed progressive functional deficits accompanied by loss of the Purkinje cell dendritic arbor and finally loss of Purkinje cells. Despite similar functional deficits and anatomical changes observed in ataxin-1[Q80] transgenic lines, ataxin-2[Q58] remained cytoplasmic without detectable ubiquitination.
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Affiliation(s)
- D P Huynh
- Rose Moss Laboratory for Parkinson's and Neurodegenerative Diseases, CSMC Burns and Allen Research Institute, and Division of Neurology, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, California, USA
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Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, Guo L, Jacob S, Regenstein FG, Zimmerman R, Everhart JE, Wasserfall C, Maclaren NK, Perrillo RP. Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology 1999; 29:328-33. [PMID: 9918906 DOI: 10.1002/hep.510290235] [Citation(s) in RCA: 467] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
While patients with liver disease are known to have a higher prevalence of glucose intolerance, preliminary studies suggest that hepatitis C virus (HCV) infection may be an additional risk factor for the development of diabetes mellitus. To further study the correlation of HCV infection and diabetes, we performed a retrospective analysis of 1,117 patients with chronic viral hepatitis and analyzed whether age, sex, race, hepatitis B virus (HBV) infection, HCV infection, and cirrhosis were independently associated with diabetes. In addition, a case-control study was conducted to determine the seroprevalence of HCV infection in a cohort of 594 diabetics and 377 clinic patients assessed for thyroid disease. In the former study after the exclusion of patients with conditions predisposing to hyperglycemia, diabetes was observed in 21% of HCV-infected patients compared with 12% of HBV-infected subjects (P =.0004). Multivariate analysis revealed that HCV infection (P =.02) and age (P =.01) were independent predictors of diabetes. In the diabetes cohort, 4.2% of patients were found to be infected with HCV compared with 1.6% of control patients (P =.02). HCV genotype 2a was observed in 29% of HCV-RNA-positive diabetic patients versus 3% of local HCV-infected controls (P <.005). In conclusion, the data suggest a relatively strong association between HCV infection and diabetes, because diabetics have an increased frequency of HCV infection, particularly with genotype 2a. Furthermore, it is possible that HCV infection may serve as an additional risk factor for the development of diabetes, beyond that attributable to chronic liver disease alone.
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Affiliation(s)
- A L Mason
- Section of Gastroenterology and Hepatology, Alton Ochsner Medical Institutions, New Orleans, LA, USA.
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