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Helsmoortel C, Vandeweyer G, Ordoukhanian P, Van Nieuwerburgh F, Van der Aa N, Kooy RF. Challenges and opportunities in the investigation of unexplained intellectual disability using family-based whole-exome sequencing. Clin Genet 2014; 88:140-8. [PMID: 25081361 DOI: 10.1111/cge.12470] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 05/29/2014] [Revised: 07/22/2014] [Accepted: 07/25/2014] [Indexed: 12/25/2022]
Abstract
Intellectual disability (ID), characterized by an intellectual performance of at least 2 SD (standard deviations) below average is a frequent, lifelong disorder with a prevalence of 2-3%. Today, only for at most half of patients a diagnosis is made. Knowing the cause of the ID is important for patients and their relatives, as it allows for appropriate medical care, prognosis on further development of the disorder, familial counselling or access to support groups. Whole-exome sequencing (WES) now offers the possibility to identify the genetic cause for patients for which all previously available genetic tests, including karyotyping, specific gene analysis, or microarray analysis did not reveal causative abnormalities. However, data analysis of WES experiments is challenging. Here we present an analysis workflow implementable in any laboratory, requiring no bioinformatics knowledge. We demonstrated its feasibility on a cohort of 10 patients, in which we found a conclusive diagnosis in 3 and a likely diagnosis in 2 more patients. Of the three conclusive diagnoses, one was a clinically suspected mutation missed by Sanger sequencing, and one was an atypical presentation of a known monogenic disorder, highlighting two essential strengths of WES-based diagnostics.
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Affiliation(s)
- C Helsmoortel
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - G Vandeweyer
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Biomedical Informatics Research Center Antwerpen (Biomina), Department of Mathematics and Computer Science, University of Antwerp, Antwerp, Belgium
| | - P Ordoukhanian
- Next Generation Sequencing Core, The Scripps Research Institute, La Jolla, CA, USA
| | - F Van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - N Van der Aa
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Department of Medical Genetics, University Hospital Antwerp, Antwerp, Belgium
| | - R F Kooy
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
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Peeters DJE, Kumar P, Van der Aa N, Rothé F, Theunis K, Op de Beeck K, Van Laere SJ, Vermeulen PB, van Dam PA, Vincent D, Desmedt C, Sotiriou C, Dirix LY, Ignatiadis M, Voet T. Abstract P1-04-03: Genome-wide analysis of copy number variations and mutation profiles of single circulating tumour cells using massively parallel paired-end sequencing. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-04-03] [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: 11/16/2022]
Abstract
Abstract
INTRODUCTION
Recent advances in single cell isolation techniques and next generation sequencing (NGS) have paved the way for the genome-wide molecular analysis of individual circulating tumour cells (CTCs) in patients with metastatic carcinomas. Here we present the results of a pilot study evaluating the feasibility and reliability of NGS of single CTC from whole blood samples.
MATERIALS & METHODS
Single cells of the human breast cancer cell line HCC38 were harvested from spiked blood samples in a semi-automated workflow consisting of immunomagnetic enrichment using the CellSearch system and dielectrophoretic cell sorting using the DEPArray system. DNA was isolated and amplified using the Ampli1 whole genome amplification (WGA) kit and subjected to low-coverage genome-wide paired-end sequencing for copy number variation (CNV) analysis and targeted re-sequencing of 200 cancer-related genes for somatic mutation analysis.
RESULTS
Single-cell WGA products of four HCC38 cells were subjected to whole genome sequencing for CNV analysis. Average coverage depth was 0,68x. At a binning window of 50 kb, detection results of CNVs in single-cell samples were highly consistent (>81% copy number concordance per bin genome wide) with CNV profiles from non-amplified multi-cell samples of the same cell line. We could demonstrate that part of the discordance was due to the acquisition of novel DNA-rearrangements in the single cells. Three of the single-cell WGA products were additionally subjected to targeted re-sequencing for mutation analysis of 200 selected genes, of which the analysis is currently ongoing.
DISCUSSION
Our study demonstrates the feasibility of a comprehensive genome-wide CNV analysis and targeted mutation analysis using NGS of single tumour cells isolated from whole blood samples in a highly automated isolation workflow. This approach provides a robust framework for the study of intercellular heterogeneity within the CTC population in blood samples of patients with (metastatic) breast cancer. In addition, our results document the extent of WGA-induced bias of a recently commercialized PCR-based WGA kit.
These authors contributed equally to the data presented in this abstract.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-04-03.
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Affiliation(s)
- DJE Peeters
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - P Kumar
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - N Van der Aa
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - F Rothé
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - K Theunis
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - K Op de Beeck
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - SJ Van Laere
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - PB Vermeulen
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - PA van Dam
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - D Vincent
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - C Desmedt
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - C Sotiriou
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - LY Dirix
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - M Ignatiadis
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
| | - T Voet
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University of Antwerp/Antwerp University Hospital, Antwerp, Belgium; Laboratory of Reproductive Genomics, KU Leuven, Leuven, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Single-Cell Genomics Centre, Wellcome Trust Sanger Institute, Hinxton-Cambridge, United Kingdom; These authors contributed equally to the data presented in this abstract; Joint Senior Authors
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Alders M, Mendola A, Adès L, Al Gazali L, Bellini C, Dallapiccola B, Edery P, Frank U, Hornshuh F, Huisman SA, Jagadeesh S, Kayserili H, Keng WT, Lev D, Prada CE, Sampson JR, Schmidtke J, Shashi V, van Bever Y, Van der Aa N, Verhagen JM, Verheij JB, Vikkula M, Hennekam RC. Evaluation of Clinical Manifestations in Patients with Severe Lymphedema with and without CCBE1 Mutations. Mol Syndromol 2012; 4:107-13. [PMID: 23653581 DOI: 10.1159/000342486] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2012] [Indexed: 11/19/2022] Open
Abstract
The lymphedema-lymphangiectasia-intellectual disability (Hennekam) syndrome (HS) is characterised by a widespread congenital lymph vessel dysplasia manifesting as congenital lymphedema of the limbs and intestinal lymphangiectasia, accompanied by unusual facial morphology, variable intellectual disabilities and infrequently malformations. The syndrome is heterogeneous as mutations in the gene CCBE1 have been found responsible for the syndrome in only a subset of patients. We investigated whether it would be possible to predict the presence of a CCBE1 mutation based on phenotype by collecting clinical data of patients diagnosed with HS, with or without a CCBE1 mutation. We report here the results of 13 CCBE1 positive patients, 16 CCBE1 negative patients, who were clinically found to have classical HS, and 8 patients in whom the diagnosis was considered possible, but not certain, and in whom no CCBE1 mutation was identified. We found no statistically significant phenotypic differences between the 2 groups with the clinical HS phenotype, although the degree of lymphatic dysplasia tended to be more pronounced in the mutation positive group. We also screened 158 patients with less widespread and less pronounced forms of lymphatic dysplasia for CCBE1 mutations, and no mutation was detected in this group. Our results suggest that (1) CCBE1 mutations are present only in patients with a likely clinical diagnosis of HS, and not in patients with less marked forms of lymphatic dysplasia, and (2) that there are no major phenotypic differences between HS patients with or without CCBE1 mutations.
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Affiliation(s)
- M Alders
- Department of Clinical Genetics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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van Bon BWM, Mefford HC, Menten B, Koolen DA, Sharp AJ, Nillesen WM, Innis JW, de Ravel TJL, Mercer CL, Fichera M, Stewart H, Connell LE, Ounap K, Lachlan K, Castle B, Van der Aa N, van Ravenswaaij C, Nobrega MA, Serra-Juhé C, Simonic I, de Leeuw N, Pfundt R, Bongers EM, Baker C, Finnemore P, Huang S, Maloney VK, Crolla JA, van Kalmthout M, Elia M, Vandeweyer G, Fryns JP, Janssens S, Foulds N, Reitano S, Smith K, Parkel S, Loeys B, Woods CG, Oostra A, Speleman F, Pereira AC, Kurg A, Willatt L, Knight SJL, Vermeesch JR, Romano C, Barber JC, Mortier G, Pérez-Jurado LA, Kooy F, Brunner HG, Eichler EE, Kleefstra T, de Vries BBA. Further delineation of the 15q13 microdeletion and duplication syndromes: a clinical spectrum varying from non-pathogenic to a severe outcome. J Med Genet 2009; 46:511-23. [PMID: 19372089 PMCID: PMC3395372 DOI: 10.1136/jmg.2008.063412] [Citation(s) in RCA: 210] [Impact Index Per Article: 14.0] [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] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recurrent 15q13.3 microdeletions were recently identified with identical proximal (BP4) and distal (BP5) breakpoints and associated with mild to moderate mental retardation and epilepsy. METHODS To assess further the clinical implications of this novel 15q13.3 microdeletion syndrome, 18 new probands with a deletion were molecularly and clinically characterised. In addition, we evaluated the characteristics of a family with a more proximal deletion between BP3 and BP4. Finally, four patients with a duplication in the BP3-BP4-BP5 region were included in this study to ascertain the clinical significance of duplications in this region. RESULTS The 15q13.3 microdeletion in our series was associated with a highly variable intra- and inter-familial phenotype. At least 11 of the 18 deletions identified were inherited. Moreover, 7 of 10 siblings from four different families also had this deletion: one had a mild developmental delay, four had only learning problems during childhood, but functioned well in daily life as adults, whereas the other two had no learning problems at all. In contrast to previous findings, seizures were not a common feature in our series (only 2 of 17 living probands). Three patients with deletions had cardiac defects and deletion of the KLF13 gene, located in the critical region, may contribute to these abnormalities. The limited data from the single family with the more proximal BP3-BP4 deletion suggest this deletion may have little clinical significance. Patients with duplications of the BP3-BP4-BP5 region did not share a recognisable phenotype, but psychiatric disease was noted in 2 of 4 patients. CONCLUSIONS Overall, our findings broaden the phenotypic spectrum associated with 15q13.3 deletions and suggest that, in some individuals, deletion of 15q13.3 is not sufficient to cause disease. The existence of microdeletion syndromes, associated with an unpredictable and variable phenotypic outcome, will pose the clinician with diagnostic difficulties and challenge the commonly used paradigm in the diagnostic setting that aberrations inherited from a phenotypically normal parent are usually without clinical consequences.
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Affiliation(s)
- B W M van Bon
- Department of Human Genetics, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands
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Koolen DA, Sharp AJ, Hurst JA, Firth HV, Knight SJL, Goldenberg A, Saugier-Veber P, Pfundt R, Vissers LELM, Destrée A, Grisart B, Rooms L, Van der Aa N, Field M, Hackett A, Bell K, Nowaczyk MJM, Mancini GMS, Poddighe PJ, Schwartz CE, Rossi E, De Gregori M, Antonacci-Fulton LL, McLellan MD, Garrett JM, Wiechert MA, Miner TL, Crosby S, Ciccone R, Willatt L, Rauch A, Zenker M, Aradhya S, Manning MA, Strom TM, Wagenstaller J, Krepischi-Santos AC, Vianna-Morgante AM, Rosenberg C, Price SM, Stewart H, Shaw-Smith C, Brunner HG, Wilkie AOM, Veltman JA, Zuffardi O, Eichler EE, de Vries BBA. Clinical and molecular delineation of the 17q21.31 microdeletion syndrome. J Med Genet 2008; 45:710-20. [PMID: 18628315 DOI: 10.1136/jmg.2008.058701] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The chromosome 17q21.31 microdeletion syndrome is a novel genomic disorder that has originally been identified using high resolution genome analyses in patients with unexplained mental retardation. AIM We report the molecular and/or clinical characterisation of 22 individuals with the 17q21.31 microdeletion syndrome. RESULTS We estimate the prevalence of the syndrome to be 1 in 16,000 and show that it is highly underdiagnosed. Extensive clinical examination reveals that developmental delay, hypotonia, facial dysmorphisms including a long face, a tubular or pear-shaped nose and a bulbous nasal tip, and a friendly/amiable behaviour are the most characteristic features. Other clinically important features include epilepsy, heart defects and kidney/urologic anomalies. Using high resolution oligonucleotide arrays we narrow the 17q21.31 critical region to a 424 kb genomic segment (chr17: 41046729-41470954, hg17) encompassing at least six genes, among which is the gene encoding microtubule associated protein tau (MAPT). Mutation screening of MAPT in 122 individuals with a phenotype suggestive of 17q21.31 deletion carriers, but who do not carry the recurrent deletion, failed to identify any disease associated variants. In five deletion carriers we identify a <500 bp rearrangement hotspot at the proximal breakpoint contained within an L2 LINE motif and show that in every case examined the parent originating the deletion carries a common 900 kb 17q21.31 inversion polymorphism, indicating that this inversion is a necessary factor for deletion to occur (p<10(-5)). CONCLUSION Our data establish the 17q21.31 microdeletion syndrome as a clinically and molecularly well recognisable genomic disorder.
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Affiliation(s)
- D A Koolen
- Department of Human Genetics, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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