Application value of whole exome sequencing in critically ill neonates with inherited diseases

CHEN Yu-Lan, ZHANG You-Xiang, YANG Xiu-Fang, CHEN Jian, LI Xiao-Tong, HUANG Mu-Hua, RUAN Jing-Wei, LIN Qiang

Chinese Journal of Contemporary Pediatrics ›› 2020, Vol. 22 ›› Issue (12) : 1261-1266.

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Chinese Journal of Contemporary Pediatrics ›› 2020, Vol. 22 ›› Issue (12) : 1261-1266. DOI: 10.7499/j.issn.1008-8830.2007109
CLINICAL RESEARCH

Application value of whole exome sequencing in critically ill neonates with inherited diseases

  • CHEN Yu-Lan1,2, ZHANG You-Xiang1,3, YANG Xiu-Fang2, CHEN Jian2, LI Xiao-Tong2, HUANG Mu-Hua2, RUAN Jing-Wei2, LIN Qiang2
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Abstract

Objective To study the application value of whole exome sequencing (WES) in critically ill neonates with inherited diseases. Methods A total of 66 critically ill neonates with suspected inherited diseases or unclear clinical diagnosis who were admitted to the neonatal intensive care unit were enrolled as subjects. The clinical data of the neonates were collected, and venous blood samples were collected from the neonates and their parents for WES. The clinical manifestations of the neonates were observed to search for related pathogenic gene mutations. Results Among the 66 critically ill neonates with suspected inherited diseases or unclear clinical diagnosis (34 boys and 32 girls), 14 (21%) were found to have gene mutations by WES. One neonate had no gene mutation detected by WES but was highly suspected of pigment incontinence based on clinical manifestations, and multiplex ligation-dependent probe amplification detected a heterozygous deletion mutation in exons 4-10 of the IKBKG gene. Among the 15 neonates with gene mutations, 10 (67%) had pathogenic gene mutation, 1 (7%) was suspected of pathogenic gene mutation, and 4 (27%) had gene mutations with unknown significance. Among the 15 neonates, 13 underwent chromosome examination, and only 1 neonate was found to have chromosome abnormality. Conclusions Chromosome examination cannot be used as a diagnostic method for inherited diseases, and WES detection technology is an important tool to find inherited diseases in critically ill neonates with suspected inherited diseases or unclear clinical diagnosis; however WES technology has some limitation and it is thus necessary to combine with other sequencing methods to achieve an early diagnosis.

Key words

Inherited disease / Whole exome sequencing / Chromosome / Neonate

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CHEN Yu-Lan, ZHANG You-Xiang, YANG Xiu-Fang, CHEN Jian, LI Xiao-Tong, HUANG Mu-Hua, RUAN Jing-Wei, LIN Qiang. Application value of whole exome sequencing in critically ill neonates with inherited diseases[J]. Chinese Journal of Contemporary Pediatrics. 2020, 22(12): 1261-1266 https://doi.org/10.7499/j.issn.1008-8830.2007109

References

[1] 孙丽雅, 邢清和, 贺林. 中国出生缺陷遗传学研究的回顾与展望[J]. 遗传, 2018, 40(10):800-813.
[2] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 第5版. 北京:人民卫生出版社, 2019:940-978.
[3] 王慧君, 周文浩. 精准医疗时代新生儿遗传病临床干预面临的机遇与挑战[J]. 中华儿科杂志, 2018, 56(4):244-246.
[4] 中国医师协会医学遗传医师分会, 中华医学会儿科学分会内分泌遗传代谢学组, 中国医师协会青春期医学专业委员会临床遗传学组, 等. 全基因组测序在遗传病检测中的临床应用专家共识[J]. 中华儿科杂志, 2019, 57(6):419-423.
[5] 齐志业, 段江, 贺湘英, 等. 全组测序在危重症新生儿单基因遗传病中的临床应用[J]. 中国当代儿科杂志, 2019, 21(7):640-643.
[6] Choi M, Scholl UI, Ji WZ, et al. Genetic diagnosis by whole exome capture and massively parallel DNA sequencing[J]. Proc Natl Acad Sci U S A, 2009, 106(45):19096-19101.
[7] 饶书权, 杜廷福, 许琪. 外显子组测序在人类疾病中的应用[J]. 遗传, 2014, 36(11):1077-1086.
[8] 杨琳, 董辰, 魏泽峻, 等. 基于快速和常规全外显子组分析技术对遗传性疾病的诊断程序比较[J]. 中国循证儿科杂志, 2016, 11(2):131-136.
[9] 谢华, 吕凌云, 高志杰, 等. 探索全外显子测序在儿童神经发育障碍中的诊断价值[J]. 中华检验医学杂志, 2017, 40(8):623-629.
[10] Meng LY, Pammi M, Saronwala A, et al. Use of exome sequencing for infants in intensive care units:ascertainment of severe single-gene disorders and effect on medical management[J]. JAMA Pediatr, 2017, 171(12):e173438.
[11] Smith LD, Willig LK, Kingsmore SF. Whole-exome sequencing and whole-genome sequencing in critically ill neonates suspected to have single-gene disorders[J]. Cold Spring Harb Perspect Med, 2015, 6(2):a023168.
[12] Miller NA, Farrow EG, Gibson M, et al. A 26-hour system of highly sensitive whole genome sequencing for emergency management of genetic diseases[J]. Genome Med, 2015, 7:100.
[13] Zhang W, Cui H, Wong LJ. Comprehensive one-step molecular analyses of mitochondrial genome by massively parallel sequencing[J]. Clin Chem, 2012, 58(9):1322-1331.
[14] Feng YM, Ge XY, Meng LY, et al. The next generation of population-based spinal muscular atrophy carrier screening:comprehensive pan-ethnic SMN1 copy-number and sequence variant analysis by massively parallel sequencing[J]. Genet Med, 2017, 19(8):936-944.
[15] Basel-Salmon L, Orenstein N, Markus-Bustani K, et al. Improved diagnostics by exome sequencing following raw data reevaluation by clinical geneticists involved in the medical care of the individuals tested[J]. Genet Med, 2019, 21(6):1443-1451.
[16] Lionel AC, Costain G, Monfared N, et al. Improved diagnostic yield compared with targeted gene sequencing panels suggests a role for whole-genome sequencing as a first-tier genetic test[J]. Genet Med, 2018, 20(4):435-443.

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