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Ganapathy A, Mishra A, Soni MR, Kumar P, Sadagopan M, Kanthi AV, Patric IRP, George S, Sridharan A, Thyagarajan TC, Aswathy SL, Vidya HK, Chinnappa SM, Nayanala S, Prakash MB, Raghavendrachar VG, Parulekar M, Gowda VK, Nampoothiri S, Menon RN, Pachat D, Udani V, Naik N, Kamate M, Devi ARR, Mohammed Kunju PA, Nair M, Hegde AU, Kumar MP, Sundaram S, Tilak P, Puri RD, Shah K, Sheth J, Hasan Q, Sheth F, Agrawal P, Katragadda S, Veeramachaneni V, Chandru V, Hariharan R, Mannan AU. Multi-gene testing in neurological disorders showed an improved diagnostic yield: data from over 1000 Indian patients. J Neurol 2019; 266:1919-1926. [PMID: 31069529 DOI: 10.1007/s00415-019-09358-1] [Citation(s) in RCA: 20] [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: 01/21/2019] [Revised: 04/25/2019] [Accepted: 05/03/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Neurological disorders are clinically heterogeneous group of disorders and are major causes of disability and death. Several of these disorders are caused due to genetic aberration. A precise and confirmatory diagnosis in the patients in a timely manner is essential for appropriate therapeutic and management strategies. Due to the complexity of the clinical presentations across various neurological disorders, arriving at an accurate diagnosis remains a challenge. METHODS We sequenced 1012 unrelated patients from India with suspected neurological disorders, using TruSight One panel. Genetic variations were identified using the Strand NGS software and interpreted using the StrandOmics platform. RESULTS We were able to detect mutations in 197 genes in 405 (40%) cases and 178 mutations were novel. The highest diagnostic rate was observed among patients with muscular dystrophy (64%) followed by leukodystrophy and ataxia (43%, each). In our cohort, 26% of the patients who received definitive diagnosis were primarily referred with complex neurological phenotypes with no suggestive diagnosis. In terms of mutations types, 62.8% were truncating and in addition, 13.4% were structural variants, which are also likely to cause loss of function. CONCLUSION In our study, we observed an improved performance of multi-gene panel testing, with an overall diagnostic yield of 40%. Furthermore, we show that NGS (next-generation sequencing)-based testing is comprehensive and can detect all types of variants including structural variants. It can be considered as a single-platform genetic test for neurological disorders that can provide a swift and definitive diagnosis in a cost-effective manner.
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Affiliation(s)
- Aparna Ganapathy
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Avshesh Mishra
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Megha Rani Soni
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Priyanka Kumar
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Mukunth Sadagopan
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Anil Vittal Kanthi
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Irene Rosetta Pia Patric
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Sobha George
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Aparajit Sridharan
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - T C Thyagarajan
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - S L Aswathy
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - H K Vidya
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Swathi M Chinnappa
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Swetha Nayanala
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Manasa B Prakash
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Vijayashree G Raghavendrachar
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Minothi Parulekar
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | | | | | - Ramshekhar N Menon
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | | | - Vrajesh Udani
- P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - Neeta Naik
- EN1 Neuro Services Pvt. Ltd., Mumbai, India
| | | | | | | | | | | | | | - Soumya Sundaram
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Preetha Tilak
- St. Johns Medical College Hospital, Bangalore, India
| | | | - Krati Shah
- ONE-Centre for Rheumatology and Genetics, Vadodara, India
| | - Jayesh Sheth
- FRIGE'S Institute of Human Genetics, Ahmedabad, India
| | | | - Frenny Sheth
- FRIGE'S Institute of Human Genetics, Ahmedabad, India
| | - Pooja Agrawal
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Shanmukh Katragadda
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Vamsi Veeramachaneni
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India
| | - Vijay Chandru
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India.,Indian Institute of Science, Bangalore, India
| | - Ramesh Hariharan
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India.,Indian Institute of Science, Bangalore, India
| | - Ashraf U Mannan
- Strand Center for Genomics and Personalized Medicine, Strand Life Sciences, Bellary Road, Hebbal, Bangalore, 560024, India.
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Radha Rama Devi A, Ramesh VA, Nagarajaram HA, Satish SPS, Jayanthi U, Lingappa L. Spectrum of mutations in Glutaryl-CoA dehydrogenase gene in glutaric aciduria type I--Study from South India. Brain Dev 2016; 38:54-60. [PMID: 26071121 DOI: 10.1016/j.braindev.2015.05.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 05/25/2015] [Accepted: 05/26/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Glutaric aciduria type I is an autosomal recessive organic acid disorder. The primary defect is the deficiency of Glutaryl-CoA dehydrogenase (EC number 1.3.99.7) enzyme that is involved in the catabolic pathways of the amino acids l-lysine, l-hydroxylysine, and l-tryptophan. It is a treatable neuro-metabolic disorder. Early diagnosis and treatment helps in preventing brain damage. METHODS The Glutaryl-CoA dehydrogenase gene (GCDH) gene was sequenced to identify disease causing mutations by direct sequencing of all the exons in twelve patients who were biochemically confirmed with GA I. RESULTS We identified eleven mutations of which nine are homozygous mutations, one heterozygous and two synonymous mutations. Among the eleven mutations, four mutations p.Q162R, p.P286S, p.W225X in two families and p.V410M are novel. A milder clinical presentation is observed in those families who are either heterozygous or with a benign synonymous SNP. Multiple sequence alignment (MSA) of GCDH with its homologues revealed that the observed novel mutations are not tolerated by protein structure and function. CONCLUSIONS The present study indicates genetic heterogeneity in GCDH gene mutations among South Indian population. Genetic analysis is useful in prenatal diagnosis and prevention. Mutation analysis is a useful tool in the absence of non-availability of enzyme assay in GA I.
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Affiliation(s)
- A Radha Rama Devi
- Genetic Metabolic Unit, Rainbow Children Hospital, India; Sandor Life Sciences, India.
| | - Vakkalagadda A Ramesh
- Laboratory of Computational Biology, CDFD, Gruhakalpa, Nampally, Hyderabad, India; Graduate Studies, Manipal University, India
| | - H A Nagarajaram
- Laboratory of Computational Biology, CDFD, Gruhakalpa, Nampally, Hyderabad, India
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Bidchol AM, Dalal A, Shah H, S S, Nampoothiri S, Kabra M, Gupta N, Danda S, Gowrishankar K, Phadke SR, Kapoor S, Kamate M, Verma IC, Puri RD, Sankar VH, Devi ARR, Patil SJ, Ranganath P, Jain SJMN, Agarwal M, Singh A, Mishra P, Tamhankar PM, Gopinath PM, Nagarajaram HA, Satyamoorthy K, Girisha KM. GALNS mutations in Indian patients with mucopolysaccharidosis IVA. Am J Med Genet A 2014; 164A:2793-801. [PMID: 25252036 DOI: 10.1002/ajmg.a.36735] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 10/26/2013] [Accepted: 06/27/2014] [Indexed: 01/20/2023]
Abstract
Mucopolysaccharidosis IV A (Morquio syndrome A, MPS IVA) is a lysosomal storage disease caused by the deficiency of N-acetylgalactosamine-6-sulfatase (GALNS). The mutation spectrum in this condition is yet to be determined in Indians. We aimed to analyze the mutations in the GALNS gene in Asian Indians with MPS IVA. All the exons and the adjacent intronic regions of the gene were amplified and sequenced in sixty-eight unrelated Indian families. We identified 136 mutant alleles comprising of 40 different mutations. We report twenty-two novel mutations that comprise of seventeen missense (p.Asn32Thr, p.Leu36Arg, p.Pro52Leu, p.Pro77Ser, p.Cys79Arg, p.His142Pro, p.Tyr191Asp, p.Asn204Thr, p.Gly188Ser, p.Phe216Ser, p.Trp230Cys, p.Ala291Ser, p.Gly317Arg, p.His329Pro, p.Arg386Ser, p.Glu450Gly, p.Cys501Ser), three splice-site variants (c.120+1G>C, c.1003-3C>G, c.1139+1G>A), one nonsense mutation (p.Gln414*) and one frameshift mutation (p.Pro420Leufs*440). Eighteen mutations have been reported earlier. Among these p.Ser287Leu (8.82%), p.Phe216Ser (7.35%), p.Asn32Thr (6.61%) and p.Ala291Ser (5.88%) were the most frequent mutations in Indian patients but were rare in the mutational profiles reported in other populations. These results indicate that the Indian patients may have a distinct mutation spectrum compared to those of other populations. Mutant alleles in exon 1, 7 and 8 accounted for 44.8% of the mutations, and sequencing of these exons initially may be a cost-effective approach in Asian Indian patients. This is the largest study on molecular analysis of patients with MPS IVA reported in the literature, and the first report from India.
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Affiliation(s)
- Abdul Mueed Bidchol
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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