Next-generation phenotyping integrated in a national framework for patients with ultrarare disorders improves genetic diagnostics and yields new molecular findings

Author:

Schmidt AxelORCID,Danyel Magdalena,Grundmann Kathrin,Brunet TheresaORCID,Klinkhammer HannahORCID,Hsieh Tzung-ChienORCID,Engels HartmutORCID,Peters Sophia,Knaus AlexejORCID,Moosa ShahidaORCID,Averdunk Luisa,Boschann Felix,Sczakiel Henrike Lisa,Schwartzmann Sarina,Mensah Martin Atta,Pantel Jean ToriORCID,Holtgrewe Manuel,Bösch Annemarie,Weiß ClaudiaORCID,Weinhold Natalie,Suter Aude-Annick,Stoltenburg Corinna,Neugebauer JuliaORCID,Kallinich Tillmann,Kaindl Angela M.,Holzhauer Susanne,Bührer Christoph,Bufler Philip,Kornak UweORCID,Ott Claus-EricORCID,Schülke MarkusORCID,Nguyen Hoa Huu Phuc,Hoffjan Sabine,Grasemann Corinna,Rothoeft Tobias,Brinkmann Folke,Matar Nora,Sivalingam SugirthanORCID,Perne Claudia,Mangold Elisabeth,Kreiss Martina,Cremer Kirsten,Betz Regina C.ORCID,Mücke Martin,Grigull Lorenz,Klockgether Thomas,Spier Isabel,Heimbach André,Bender Tim,Brand Fabian,Stieber Christiane,Morawiec Alexandra Marzena,Karakostas Pantelis,Schäfer Valentin S.ORCID,Bernsen SarahORCID,Weydt Patrick,Castro-Gomez SergioORCID,Aziz AhmadORCID,Grobe-Einsler Marcus,Kimmich Okka,Kobeleva Xenia,Önder Demet,Lesmann Hellen,Kumar Sheetal,Tacik Pawel,Basin Meghna Ahuja,Incardona Pietro,Lee-Kirsch Min Ae,Berner Reinhard,Schuetz Catharina,Körholz Julia,Kretschmer Tanita,Di Donato NataliyaORCID,Schröck EvelinORCID,Heinen André,Reuner Ulrike,Hanßke Amalia-Mihaela,Kaiser Frank J.,Manka Eva,Munteanu Martin,Kuechler Alma,Cordula Kiewert,Hirtz Raphael,Schlapakow Elena,Schlein ChristianORCID,Lisfeld Jasmin,Kubisch Christian,Herget Theresia,Hempel Maja,Weiler-Normann Christina,Ullrich Kurt,Schramm Christoph,Rudolph Cornelia,Rillig Franziska,Groffmann Maximilian,Muntau Ania,Tibelius Alexandra,Schwaibold Eva M. C.ORCID,Schaaf Christian P.,Zawada Michal,Kaufmann Lilian,Hinderhofer Katrin,Okun Pamela M.ORCID,Kotzaeridou Urania,Hoffmann Georg F.,Choukair Daniela,Bettendorf Markus,Spielmann MalteORCID,Ripke Annekatrin,Pauly MartjeORCID,Münchau Alexander,Lohmann KatjaORCID,Hüning Irina,Hanker Britta,Bäumer Tobias,Herzog RebeccaORCID,Hellenbroich Yorck,Westphal Dominik S.ORCID,Strom Tim,Kovacs Reka,Riedhammer Korbinian M.ORCID,Mayerhanser Katharina,Graf Elisabeth,Brugger MelanieORCID,Hoefele Julia,Oexle Konrad,Mirza-Schreiber NazaninORCID,Berutti RiccardoORCID,Schatz Ulrich,Krenn Martin,Makowski Christine,Weigand Heike,Schröder Sebastian,Rohlfs Meino,Vill Katharina,Hauck FabianORCID,Borggraefe IngoORCID,Müller-Felber Wolfgang,Kurth IngoORCID,Elbracht MiriamORCID,Knopp Cordula,Begemann MatthiasORCID,Kraft FlorianORCID,Lemke Johannes R.ORCID,Hentschel Julia,Platzer KonradORCID,Strehlow Vincent,Abou Jamra RamiORCID,Kehrer Martin,Demidov GermanORCID,Beck-Wödl Stefanie,Graessner Holm,Sturm MarcORCID,Zeltner Lena,Schöls Ludger J.,Magg Janine,Bevot Andrea,Kehrer Christiane,Kaiser Nadja,Turro ErnestORCID,Horn Denise,Grüters-Kieslich Annette,Klein ChristophORCID,Mundlos Stefan,Nöthen MarkusORCID,Riess OlafORCID,Meitinger ThomasORCID,Krude Heiko,Krawitz Peter M.ORCID,Haack TobiasORCID,Ehmke Nadja,Wagner Matias

Abstract

AbstractIndividuals with ultrarare disorders pose a structural challenge for healthcare systems since expert clinical knowledge is required to establish diagnoses. In TRANSLATE NAMSE, a 3-year prospective study, we evaluated a novel diagnostic concept based on multidisciplinary expertise in Germany. Here we present the systematic investigation of the phenotypic and molecular genetic data of 1,577 patients who had undergone exome sequencing and were partially analyzed with next-generation phenotyping approaches. Molecular genetic diagnoses were established in 32% of the patients totaling 370 distinct molecular genetic causes, most with prevalence below 1:50,000. During the diagnostic process, 34 novel and 23 candidate genotype–phenotype associations were identified, mainly in individuals with neurodevelopmental disorders. Sequencing data of the subcohort that consented to computer-assisted analysis of their facial images with GestaltMatcher could be prioritized more efficiently compared with approaches based solely on clinical features and molecular scores. Our study demonstrates the synergy of using next-generation sequencing and phenotyping for diagnosing ultrarare diseases in routine healthcare and discovering novel etiologies by multidisciplinary teams.

Publisher

Springer Science and Business Media LLC

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