Abstract
The objective of this study was to evaluate the efficacy of whole exome sequencing (WES) for the genetic diagnosis of cases presenting with fetal structural anomalies detected by ultrasonography. WES was performed on 19 cases with prenatal structural anomalies. Genomic DNA was extracted from umbilical cords or umbilical blood obtained shortly after birth. WES data were analyzed on prenatal phenotypes alone, and the data were re-analyzed after information regarding the postnatal phenotype was obtained. Based solely on the fetal phenotype, pathogenic, or likely pathogenic, single nucleotide variants were identified in 5 of 19 (26.3%) cases. Moreover, we detected trisomy 21 in two cases by WES-based copy number variation analysis. The overall diagnostic rate was 36.8% (7/19). They were all compatible with respective fetal structural anomalies. By referring to postnatal phenotype information, another candidate variant was identified by a postnatal clinical feature that was not detected in prenatal screening. As detailed phenotyping is desirable for better diagnostic rates in WES analysis, we should be aware that fetal phenotype is a useful, but sometimes limited source of information for comprehensive genetic analysis. It is important to amass more data of genotype–phenotype correlations, especially to appropriately assess the validity of WES in prenatal settings.
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References
Normand EA, Braxton A, Nassef S, Ward PA, Vetrini F, He W, et al. Clinical exome sequencing for fetuses with ultrasound abnormalities and a suspected Mendelian disorder. Genome Med. 2018;10:74.
Alamillo CL, Powis Z, Farwell K, Shahmirzadi L, Weltmer EC, Turocy J, et al. Exome sequencing positively identified relevant alterations in more than half of cases with an indication of prenatal ultrasound anomalies. Prenat Diagnosis. 2015;35:1073–8.
Wapner RJ, Martin CL, Levy B, Ballif BC, Eng CM, Zachary JM, et al. Chromosomal microarray versus karyotyping for prenatal diagnosis. N Engl J Med. 2012;367:2175–84.
Petrovski S, Aggarwal V, Giordano JL, Stosic M, Wou K, Bier L, et al. Whole-exome sequencing in the evaluation of fetal structural anomalies: a prospective cohort study. Lancet (Lond, Engl). 2019;393:758–67.
Best S, Wou K, Vora N, Van der Veyver IB, Wapner R, et al. Promises, pitfalls and practicalities of prenatal whole exome sequencing. Prenat Diagnosis. 2018;38:10–19.
Monaghan KG, Leach NT, Pekarek D, Prasad P, Rose NC. The use of fetal exome sequencing in prenatal diagnosis: a points to consider document of the American College of Medical Genetics and Genomics (ACMG). Genet Med: Off J Am Coll Med Genet. 2020;22:675–80.
Aoi H, Mizuguchi T, Ceroni JR, Kim VEH, Furquim I, Honjo RS, et al. Comprehensive genetic analysis of 57 families with clinically suspected Cornelia de Lange syndrome. J Hum Genet. 2019;64:967–78.
Fromer M, Moran JL, Chambert K, Banks E, Bergen SE, Ruderfer DM, et al. Discovery and statistical genotyping of copy-number variation from whole-exome sequencing depth. Am J Hum Genet. 2012;91:597–607.
Nord AS, Lee M, King MC, Walsh T. Accurate and exact CNV identification from targeted high-throughput sequence data. BMC Genomics. 2011;12:184.
Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med: Off J Am Coll Med Genet. 2015;17:405–24.
Bahi-Buisson N, Poirier K, Fourniol F, Saillour Y, Valence S, Lebrun N, et al. The wide spectrum of tubulinopathies: what are the key features for the diagnosis? Brain: A J Neurol. 2014;137:1676–700.
Rivière JB, Mirzaa GM, O’Roak BJ, Beddaoui M, Alcantara D, Conway RL, et al. De novo germline and postzygotic mutations in AKT3, PIK3R2 and PIK3CA cause a spectrum of related megalencephaly syndromes. Nat Genet. 2012;44:934–40.
Hjeij R, Lindstrand A, Francis R, Zariwala MA, Liu X, Li Y, et al. ARMC4 mutations cause primary ciliary dyskinesia with randomization of left/right body asymmetry. Am J Hum Genet. 2013;93:357–67.
Paulussen AD, Steyls A, Vanoevelen J, van Tienen FH, Krapels IP, Claes GR, et al. Rare novel variants in the ZIC3 gene cause X-linked heterotaxy. Eur J Hum Genet. 2016;24:1783–91.
Gos M, Fahiminiya S, Poznański J, Klapecki J, Obersztyn E, Piotrowicz M, et al. Contribution of RIT1 mutations to the pathogenesis of Noonan syndrome: four new cases and further evidence of heterogeneity. Am J Med Genet Part A. 2014;164a:2310–6.
Aoki Y, Niihori T, Banjo T, Okamoto N, Mizuno S, Kurosawa K, et al. Gain-of-function mutations in RIT1 cause Noonan syndrome, a RAS/MAPK pathway syndrome. Am J Hum Genet. 2013;93:173–80.
Koenighofer M, Hung CY, McCauley JL, Dallman J, Back EJ, Mihalek I, et al. Mutations in RIT1 cause Noonan syndrome—additional functional evidence and expanding the clinical phenotype. Clin Genet. 2016;89:359–66.
Kouz K, Lissewski C, Spranger S, Mitter D, Riess A, Lopez-Gonzalez V, et al. Genotype and phenotype in patients with Noonan syndrome and a RIT1 mutation. Genet Med: Off J Am Coll Med Genet. 2016;18:1226–34.
Stum M, Davoine CS, Vicart S, Guillot-Noël L, Topaloglu H, Carod-Artal FJ, et al. Spectrum of HSPG2 (Perlecan) mutations in patients with Schwartz-Jampel syndrome. Hum Mutat. 2006;27:1082–91.
Yan W, Dai J, Shi D, Xu X, Han X, Xu Z, et al. Novel HSPG2 mutations causing Schwartz‑Jampel syndrome type 1 in a Chinese family: a case report. Mol Med Rep. 2018;18:1761–65.
Ferretti L, Mellis R, Chitty LS. Update on the use of exome sequencing in the diagnosis of fetal abnormalities. Eur J Med Genet. 2019;62:103663.
Lord J, McMullan DJ, Eberhardt RY, Rinck G, Hamilton SJ, Quinlan-Jones E, et al. Prenatal exome sequencing analysis in fetal structural anomalies detected by ultrasonography (PAGE): a cohort study. Lancet (Lond, Engl). 2019;393:747–57.
Aymelek HS, Oğur G, Tosun M, Abur Ü, Altundağ E, Çelik H, et al. Genetic burden and outcome of cystic hygromas detected antenatally: results of 93 pregnancies from a single center in the northern region of Turkey. J Med Ultrasound. 2019;27:181–6.
Graesslin O, Derniaux E, Alanio E, Gaillard D, Vitry F, Quéreux C, et al. Characteristics and outcome of fetal cystic hygroma diagnosed in the first trimester. Acta Obstet Gynecol Scand. 2007;86:1442–6.
Gedikbasi A, Oztarhan K, Aslan G, Demirali O, Akyol A, Sargin A, et al. Multidisciplinary approach in cystic hygroma: prenatal diagnosis, outcome, and postnatal follow up. Pediatr Int. 2009;51:670–7.
Munteanu O, Cîrstoiu MM, Filipoiu FM, BohîlŢea RE, Bulescu IA, Berceanu C. Morphological and ultrasonographic study of fetuses with cervical hygroma. A cases series. Rom J Morphol Embryol. 2016;57:1421–7.
Acknowledgements
We would like to thank the patients and their families for participating in this study. We also thank N. Watanabe, T. Miyama, M. Sato, S. Sugimoto, and K. Takabe for their technical assistance. This work was supported by Japan Agency for Medical Research and Development (AMED) under grant numbers JP19ek0109280, JP19dm0107090, JP19ek0109301, JP19ek0109348, and JP19kk0205001; by Japan Society for the Promotion of Science (JSPS) KAKENHI under grant numbers JP17H01539, JP16H05357, JP16H06254, JP17K16132, JP17K10080, JP17K15630, and JP17H06994; by the Ministry of Health, Labour and Welfare under intramural grant numbers 30-6 and 30-7; and by the Takeda Science Foundation. We thank Edanz Group (www.edanzediting.com) for editing a draft of this manuscript.
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Aoi, H., Mizuguchi, T., Suzuki, T. et al. Whole exome sequencing of fetal structural anomalies detected by ultrasonography. J Hum Genet 66, 499–507 (2021). https://doi.org/10.1038/s10038-020-00869-8
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DOI: https://doi.org/10.1038/s10038-020-00869-8
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