@article {817, title = {Short stature and growth hormone deficiency in a subset of patients with Potocki-Lupski syndrome: Expanding the phenotype of PTLS.}, journal = {Am J Med Genet A}, volume = {182}, year = {2020}, month = {2020 09}, pages = {2077-2084}, abstract = {

Potocki-Lupski Syndrome (PTLS, MIM 610883), or duplication of chromosome 17p11.2, is a clinically recognizable condition characterized by infantile hypotonia, failure to thrive, developmental delay, intellectual disability, and congenital anomalies. Short stature, classified as greater than two standard deviations below the mean, has not previously been considered a major feature of PTLS. Retrospective chart review on a cohort of 37 individuals with PTLS was performed to investigate the etiology of short stature. Relevant data included anthropometric measurements, insulin growth factor-1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), growth hormone (GH) stimulation testing, blood glucose levels, brain MRI, and bone age. Approximately 25\% (9/37) of individuals with PTLS had short stature. Growth hormone deficiency (GHD) was definitively identified in two individuals. These two PTLS patients with growth hormone deficiency, as well as three others with short stature and no documented GHD, received growth hormone and obtained improvement in linear growth. One individual was identified to have pituitary abnormalities on MRI and had complications of hypoglycemia due to unrecognized GHD. Individuals with PTLS can benefit from undergoing evaluation for GHD should they present with short stature or hypoglycemia. Early identification of GHD could facilitate potential therapeutic benefit for individuals with PTLS, including linear growth, musculoskeletal, and in cases of hypoglycemia, potentially cognitive development as well.

}, issn = {1552-4833}, doi = {10.1002/ajmg.a.61741}, author = {Franciskovich, Rachel and Soler-Alfonso, Claudia and Neira-Fresneda, Juanita and Lupski, James R and McCann-Crosby, Bonnie and Potocki, Lorraine} } @article {539, title = {SVachra: a tool to identify genomic structural variation in mate pair sequencing data containing inward and outward facing reads.}, journal = {BMC Genomics}, volume = {18}, year = {2017}, month = {2017 Oct 03}, pages = {691}, abstract = {

BACKGROUND: Characterization of genomic structural variation (SV) is essential to expanding the research and clinical applications of genome sequencing. Reliance upon short DNA fragment paired end sequencing has yielded a wealth of single nucleotide variants and internal sequencing read insertions-deletions, at the cost of limited SV detection. Multi-kilobase DNA fragment mate pair sequencing has supplemented the void in SV detection, but introduced new analytic challenges requiring SV detection tools specifically designed for mate pair sequencing data. Here, we introduce SVachra - Structural Variation Assessment of CHRomosomal Aberrations, a breakpoint calling program that identifies large insertions-deletions, inversions, inter- and intra-chromosomal translocations utilizing both inward and outward facing read types generated by mate pair sequencing.

RESULTS: We demonstrate SVachra{\textquoteright}s utility by executing the program on large-insert (Illumina Nextera) mate pair sequencing data from the personal genome of a single subject (HS1011). An additional data set of long-read (Pacific BioSciences RSII) was also generated to validate SV calls from SVachra and other comparison SV calling programs. SVachra exhibited the highest validation rate and reported the widest distribution of SV types and size ranges when compared to other SV callers.

CONCLUSIONS: SVachra is a highly specific breakpoint calling program that exhibits a more unbiased SV detection methodology than other callers.

}, keywords = {Genetic Variation, Genomics, Sequence Analysis, DNA}, issn = {1471-2164}, doi = {10.1186/s12864-017-4021-y}, author = {Hampton, Oliver A and English, Adam C and Wang, Mark and Salerno, William J and Liu, Yue and Muzny, Donna M and Han, Yi and Wheeler, David A and Worley, Kim C and Lupski, James R and Gibbs, Richard A} } @article {76, title = {Somatic mosaicism underlies X-linked acrogigantism syndrome in sporadic male subjects.}, journal = {Endocr Relat Cancer}, volume = {23}, year = {2016}, month = {2016 04}, pages = {221-33}, abstract = {

Somatic mosaicism has been implicated as a causative mechanism in a number of genetic and genomic disorders. X-linked acrogigantism (XLAG) syndrome is a recently characterized genomic form of pediatric gigantism due to aggressive pituitary tumors that is caused by submicroscopic chromosome Xq26.3 duplications that include GPR101 We studied XLAG syndrome patients (n= 18) to determine if somatic mosaicism contributed to the genomic pathophysiology. Eighteen subjects with XLAG syndrome caused by Xq26.3 duplications were identified using high-definition array comparative genomic hybridization (HD-aCGH). We noted that males with XLAG had a decreased log2ratio (LR) compared with expected values, suggesting potential mosaicism, whereas females showed no such decrease. Compared with familial male XLAG cases, sporadic males had more marked evidence for mosaicism, with levels of Xq26.3 duplication between 16.1 and 53.8\%. These characteristics were replicated using a novel, personalized breakpoint junction-specific quantification droplet digital polymerase chain reaction (ddPCR) technique. Using a separate ddPCR technique, we studied the feasibility of identifying XLAG syndrome cases in a distinct patient population of 64 unrelated subjects with acromegaly/gigantism, and identified one female gigantism patient who had had increased copy number variation (CNV) threshold for GPR101 that was subsequently diagnosed as having XLAG syndrome on HD-aCGH. Employing a combination of HD-aCGH and novel ddPCR approaches, we have demonstrated, for the first time, that XLAG syndrome can be caused by variable degrees of somatic mosaicism for duplications at chromosome Xq26.3. Somatic mosaicism was shown to occur in sporadic males but not in females with XLAG syndrome, although the clinical characteristics of the disease were similarly severe in both sexes.

}, keywords = {Adult, Female, Genetic Diseases, X-Linked, Gigantism, Humans, Male, Middle Aged, Mosaicism, Polymerase Chain Reaction, Syndrome, Young Adult}, issn = {1479-6821}, doi = {10.1530/ERC-16-0082}, author = {Daly, Adrian F and Yuan, Bo and Fina, Frederic and Caberg, Jean-Hubert and Trivellin, Giampaolo and Rostomyan, Liliya and de Herder, Wouter W and Naves, Luciana A and Metzger, Daniel and Cuny, Thomas and Rabl, Wolfgang and Shah, Nalini and Jaffrain-Rea, Marie-Lise and Zatelli, Maria Chiara and Faucz, Fabio R and Castermans, Emilie and Nanni-Metellus, Isabelle and Lodish, Maya and Muhammad, Ammar and Palmeira, Leonor and Potorac, Iulia and Mantovani, Giovanna and Neggers, Sebastian J and Klein, Marc and Barlier, Anne and Liu, Pengfei and Ouafik, L{\textquoteright}Houcine and Bours, Vincent and Lupski, James R and Stratakis, Constantine A and Beckers, Albert} } @article {143, title = {Secondary findings and carrier test frequencies in a large multiethnic sample.}, journal = {Genome Med}, volume = {7}, year = {2015}, month = {2015}, pages = {54}, abstract = {

BACKGROUND: Besides its growing importance in clinical diagnostics and understanding the genetic basis of Mendelian and complex diseases, whole exome sequencing (WES) is a rich source of additional information of potential clinical utility for physicians, patients and their families. We analyzed the frequency and nature of single nucleotide variants (SNVs) considered secondary findings and recessive disease allele carrier status in the exomes of 8554 individuals from a large, randomly sampled cohort study and 2514 patients from a study of presumed Mendelian disease having undergone WES.

METHODS: We used the same sequencing platform and data processing pipeline to analyze all samples and characterized the distributions of reported pathogenic (ClinVar, Human Gene Mutation Database (HGMD)) and predicted deleterious variants in the pre-specified American College of Medical Genetics and Genomics (ACMG) secondary findings and recessive disease genes in different ethnic groups.

RESULTS: In the 56 ACMG secondary findings genes, the average number of predicted deleterious variants per individual was 0.74, and the mean number of ClinVar reported pathogenic variants was 0.06. We observed an average of 10 deleterious and 0.78 ClinVar reported pathogenic variants per individual in 1423 autosomal recessive disease genes. By repeatedly sampling pairs of exomes, 0.5~\% of the randomly generated couples were at 25~\% risk of having an affected offspring for an autosomal recessive disorder based on the ClinVar variants.

CONCLUSIONS: By investigating reported pathogenic and novel, predicted deleterious variants we estimated the lower and upper limits of the population fraction for which exome sequencing may reveal additional medically relevant information. We suggest that the observed wide range for the lower and upper limits of these frequency numbers will be gradually reduced due to improvement in classification databases and prediction algorithms.

}, issn = {1756-994X}, doi = {10.1186/s13073-015-0171-1}, author = {Gambin, Tomasz and Jhangiani, Shalini N and Below, Jennifer E and Campbell, Ian M and Wiszniewski, Wojciech and Muzny, Donna M and Staples, Jeffrey and Morrison, Alanna C and Bainbridge, Matthew N and Penney, Samantha and McGuire, Amy L and Gibbs, Richard A and Lupski, James R and Boerwinkle, Eric} } @article {169, title = {Somatic mosaicism: implications for disease and transmission genetics.}, journal = {Trends Genet}, volume = {31}, year = {2015}, month = {2015 Jul}, pages = {382-92}, abstract = {

Nearly all of the genetic material among cells within an organism is identical. However, single-nucleotide variants (SNVs), small insertions/deletions (indels), copy-number variants (CNVs), and other structural variants (SVs) continually accumulate as cells divide during development. This process results in an organism composed of countless cells, each with its own unique personal genome. Thus, every human is undoubtedly mosaic. Mosaic mutations can go unnoticed, underlie genetic disease or normal human variation, and may be transmitted to the next generation as constitutional variants. We review the influence of the developmental timing of mutations, the mechanisms by which they arise, methods for detecting mosaic variants, and the risk of passing these mutations on to the next generation.

}, keywords = {Animals, Genetic Diseases, Inborn, Genome, Human, Humans, Mosaicism, Mutagenesis, Insertional, Mutation, Polymorphism, Single Nucleotide, Risk, Trinucleotide Repeat Expansion}, issn = {0168-9525}, doi = {10.1016/j.tig.2015.03.013}, author = {Campbell, Ian M and Shaw, Chad A and Stankiewicz, Pawel and Lupski, James R} } @article {175, title = {Structural variation mutagenesis of the human genome: Impact on disease and evolution.}, journal = {Environ Mol Mutagen}, volume = {56}, year = {2015}, month = {2015 06}, pages = {419-36}, abstract = {

Watson-Crick base-pair changes, or single-nucleotide variants (SNV), have long been known as a source of mutations. However, the extent to which DNA structural variation, including duplication and deletion copy number variants (CNV) and copy number neutral inversions and translocations, contribute to human genome variation and disease has been appreciated only recently. Moreover, the potential complexity of structural variants (SV) was not envisioned; thus, the frequency of complex genomic rearrangements and how such events form remained a mystery. The concept of genomic disorders, diseases due to genomic rearrangements and not sequence-based changes for which genomic architecture incite genomic instability, delineated a new category of conditions distinct from chromosomal syndromes and single-gene Mendelian diseases. Nevertheless, it is the mechanistic understanding of CNV/SV formation that has promoted further understanding of human biology and disease and provided insights into human genome and gene evolution. Environ. Mol. Mutagen. 56:419-436, 2015. {\textcopyright} 2015 Wiley Periodicals, Inc.

}, keywords = {Animals, Evolution, Molecular, Gene Dosage, Genetic Predisposition to Disease, Genome, Human, Genomic Structural Variation, Humans, Mutagenesis}, issn = {1098-2280}, doi = {10.1002/em.21943}, author = {Lupski, James R} } @article {245, title = {Structural variation and missense mutation in SBDS associated with Shwachman-Diamond syndrome.}, journal = {BMC Med Genet}, volume = {15}, year = {2014}, month = {2014 Jun 04}, pages = {64}, abstract = {

BACKGROUND: Shwachman-Diamond syndrome (SDS) is an autosomal recessive ribosomopathy caused mainly by compound heterozygous mutations in SBDS. Structural variation (SV) involving the SBDS locus has been rarely reported in association with the disease. We aimed to determine whether an SV contributed to the pathogenesis of a case lacking biallelic SBDS point mutations.

CASE PRESENTATION: Whole exome sequencing was performed in a patient with SDS lacking biallelic SBDS point mutations. Array comparative genomic hybridization and Southern blotting were used to seek SVs across the SBDS locus. Locus-specific polymerase chain reaction (PCR) encompassing flanking intronic sequence was also performed to investigate mutation within the locus. RNA expression and Western blotting were performed to analyze allele and protein expression. We found the child harbored a single missense mutation in SBDS (c.98A > C; p.K33T), inherited from the mother, and an SV in the SBDS locus, inherited from the father. The missense allele and SV segregated in accordance with Mendelian expectations for autosomal recessive SDS. Complementary DNA and western blotting analysis and locus specific PCR support the contention that the SV perturbed SBDS protein expression in the father and child.

CONCLUSION: Our findings implicate genomic rearrangements in the pathogenesis of some cases of SDS and support patients lacking biallelic SBDS point mutations be tested for SV within the SBDS locus.

}, keywords = {Abdomen, Alleles, Bone Marrow Diseases, Cell Line, Transformed, Child, Preschool, Comparative Genomic Hybridization, DNA Mutational Analysis, Exocrine Pancreatic Insufficiency, Female, Gene Order, Humans, Lipomatosis, Mutagenesis, Insertional, Mutation, Mutation, Missense, Pedigree, Proteins, Radiography, Abdominal, Ultrasonography}, issn = {1471-2350}, doi = {10.1186/1471-2350-15-64}, author = {Carvalho, Claudia M B and Zuccherato, Luciana W and Williams, Christopher L and Neill, Nicholas J and Murdock, David R and Bainbridge, Matthew and Jhangiani, Shalini N and Muzny, Donna M and Gibbs, Richard A and Ip, Wan and Guillerman, Robert Paul and Lupski, James R and Bertuch, Alison A} }