癫痫和发育障碍儿童的全基因组测序

E. D. Belousova, O. Groznova, V. Voinova
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摘要

基因诊断方法的进步和下一代测序(NGS)质量的显著提高引发了癫痫遗传学研究的一场革命。全基因组测序(PSG)是癫痫遗传学研究的 "黄金标准"。对 168 名年龄在 1 个月至 18 岁之间的疑似遗传性癫痫患者进行了全基因组测序。PSG适用于除癫痫外还伴有智力/语言发育迟缓和/或运动障碍和行为障碍的患者。根据 PSG 的结果,168 名儿童中有 137 名(81.5%)发现了与疾病表型相关的基因变异,168 名患者中有 14 名(8.3%)发现了 DNA 拷贝数的变异。137名患者中有35名(25.54%)存在临床意义不明的变异。在 137 例患者中的其余 102 例(74.45%)中,已确定的致病基因变异被描述为可能致病和致病。在 37/137 例(占患者总数的 27%)患者中发现了单基因发育性癫痫性脑病(DEE),而这些遗传性脑病的病谱极为广泛(从 DEE 1 型到 DEE 97 型)。在 52/137 例(37.9%)患儿中,确认了在 DEE 框架之外存在一种特定的遗传综合征,并在 OMIM 中进行了分类。研究结果证实,全基因组测序在一组合并癫痫、智力、语言、运动和行为障碍的儿童中具有很高的信息价值。在大多数情况下,这些结果可以用于以基因型为导向的对症治疗(较少用于病因治疗),或合理地证明进一步观察和检查的策略是正确的,还可以提高医疗和遗传咨询的有效性。作者衷心感谢医疗和社会基因援助项目慈善基金会 "生命基因组 "在对大部分上述患者进行全基因组测序方面提供的帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Genome-wide sequencing in children with epilepsy and developmental disorders
The progress of genetic diagnostic methods and a significant improvement in the quality of next-generation sequencing (NGS) have led to a revolution in the study of the genetics of epilepsy. Genome-wide sequencing (PSG) is the «gold standard» in genetic research in epilepsy.Material and methods. Genome-wide sequencing was performed in 168 probands aged from 1 month to 18 years with a suspected diagnosis of genetic epilepsy. PSG was prescribed to patients who, alongside with epilepsy, had delayed intellectual/speech development and/or motor disorders and behavioral disorders.Results. According to the results of PSG, genetic variants related to the phenotype of the disease were detected in 137 out of 168 (81.5%) children, variations in the number of DNA copies were noted in 14 out of 168 (8.3%) patients. Variants with unclear clinical significance were described in 35 of 137 (25.54%). In the remaining 102 out of 137 (74.45%) patients, the identified causative genetic variants were described as probably pathogenic and pathogenic. Monogenic developmental and epileptic encephalopathies (DEE) were detected in 37/137 or 27% of all patients, while the spectrum of these genetic encephalopathies was extremely wide (from DEE type 1 to DEE type 97). In 52/137 (37.9%) children, the presence of a specific genetic syndrome outside the framework of the DEE, classified in OMIM, was confirmed.Conclusion. The results confirm the high informative value of genome-wide sequencing in a group of children with a combination of epilepsy, intellectual, speech, motor and behavioral disorders. In most cases, the results allow either to prescribe a genotype-oriented symptomatic (less often pathogenetic) treatment, or rationally justify the tactics of further observation and examination, as well as to increase the effectiveness of medical and genetic counseling. The authors express their sincere gratitude to the Charity foundation for medical and social genetic aid projects «Life Genome” for assistance in conducting genome-wide sequencing of most of the described patients.
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