@article {789, title = {Diagnostic yield and clinical impact of exome sequencing in early-onset scoliosis (EOS).}, journal = {J Med Genet}, volume = {58}, year = {2021}, month = {2021 Jan}, pages = {41-47}, abstract = {

BACKGROUND: Early-onset scoliosis (EOS), defined by an onset age of scoliosis less than 10 years, conveys significant health risk to affected children. Identification of the molecular aetiology underlying patients with EOS could provide valuable information for both clinical management and prenatal screening.

METHODS: In this study, we consecutively recruited a cohort of 447 Chinese patients with operative EOS. We performed exome sequencing (ES) screening on these individuals and their available family members (totaling 670 subjects). Another cohort of 13 patients with idiopathic early-onset scoliosis (IEOS) from the USA who underwent ES was also recruited.

RESULTS: After ES data processing and variant interpretation, we detected molecular diagnostic variants in 92 out of 447 (20.6\%) Chinese patients with EOS, including 8 patients with molecular confirmation of their clinical diagnosis and 84 patients with molecular diagnoses of previously unrecognised diseases underlying scoliosis. One out of 13 patients with IEOS from the US cohort was molecularly diagnosed. The age at presentation, the number of organ systems involved and the Cobb angle were the three top features predictive of a molecular diagnosis.

CONCLUSION: ES enabled the molecular diagnosis/classification of patients with EOS. Specific clinical features/feature pairs are able to indicate the likelihood of gaining a molecular diagnosis through ES.

}, issn = {1468-6244}, doi = {10.1136/jmedgenet-2019-106823}, author = {Zhao, Sen and Zhang, Yuanqiang and Chen, Weisheng and Li, Weiyu and Wang, Shengru and Wang, Lianlei and Zhao, Yanxue and Lin, Mao and Ye, Yongyu and Lin, Jiachen and Zheng, Yu and Liu, Jiaqi and Zhao, Hengqiang and Yan, Zihui and Yang, Yongxin and Huang, Yingzhao and Lin, Guanfeng and Chen, Zefu and Zhang, Zhen and Liu, Sen and Jin, Lichao and Wang, Zhaoyang and Chen, Jingdan and Niu, Yuchen and Li, Xiaoxin and Wu, Yong and Wang, Yipeng and Du, Renqian and Gao, Na and Zhao, Hong and Yang, Ying and Liu, Ying and Tian, Ye and Li, Wenli and Zhao, Yu and Liu, Jia and Yu, Bin and Zhang, Na and Yu, Keyi and Yang, Xu and Li, Shugang and Xu, Yuan and Hu, Jianhua and Liu, Zhe and Shen, Jianxiong and Zhang, Shuyang and Su, Jianzhong and Khanshour, Anas M and Kidane, Yared H and Ramo, Brandon and Rios, Jonathan J and Liu, Pengfei and Sutton, V Reid and Posey, Jennifer E and Wu, Zhihong and Qiu, Guixing and Wise, Carol A and Zhang, Feng and Lupski, James R and Zhang, Jianguo and Wu, Nan} } @article {774, title = {TBX6 missense variants expand the mutational spectrum in a non-Mendelian inheritance disease.}, journal = {Hum Mutat}, volume = {41}, year = {2020}, month = {2020 01}, pages = {182-195}, abstract = {

Congenital scoliosis (CS) is a birth defect with variable clinical and anatomical manifestations due to spinal malformation. The genetic etiology underlying about 10\% of CS cases in the Chinese population is compound inheritance by which the gene dosage is reduced below that of haploinsufficiency. In this genetic model, the trait manifests as a result of the combined effect of a rare variant and common pathogenic variant allele at a locus. From exome sequencing (ES) data of 523 patients in Asia and two patients in Texas, we identified six TBX6 gene-disruptive variants from 11 unrelated CS patients via ES and in vitro functional testing. The in trans mild hypomorphic allele was identified in 10 of the 11 subjects; as anticipated these 10 shared a similar spinal deformity of hemivertebrae. The remaining case has a homozygous variant in TBX6 (c.418C>T) and presents a more severe spinal deformity phenotype. We found decreased transcriptional activity and abnormal cellular localization as the molecular mechanisms for TBX6 missense loss-of-function alleles. Expanding the mutational spectrum of TBX6 pathogenic alleles enabled an increased molecular diagnostic detection rate, provided further evidence for the gene dosage-dependent genetic model underlying CS, and refined clinical classification.

}, keywords = {Alleles, Cell Line, Female, Gene Expression, Genes, Reporter, Genetic Association Studies, Genetic Predisposition to Disease, Genotype, Haplotypes, Humans, Inheritance Patterns, Male, Models, Molecular, Molecular Diagnostic Techniques, Mutation, Missense, Phenotype, Protein Conformation, Radiography, Sequence Analysis, DNA, Spine, Structure-Activity Relationship, T-Box Domain Proteins, Whole Exome Sequencing}, issn = {1098-1004}, doi = {10.1002/humu.23907}, author = {Chen, Weisheng and Lin, Jiachen and Wang, Lianlei and Li, Xiaoxin and Zhao, Sen and Liu, Jiaqi and Akdemir, Zeynep C and Zhao, Yanxue and Du, Renqian and Ye, Yongyu and Song, Xiaofei and Zhang, Yuanqiang and Yan, Zihui and Yang, Xinzhuang and Lin, Mao and Shen, Jianxiong and Wang, Shengru and Gao, Na and Yang, Ying and Liu, Ying and Li, Wenli and Liu, Jia and Zhang, Na and Yang, Xu and Xu, Yuan and Zhang, Jianguo and Delgado, Mauricio R and Posey, Jennifer E and Qiu, Guixing and Rios, Jonathan J and Liu, Pengfei and Wise, Carol A and Zhang, Feng and Wu, Zhihong and Lupski, James R and Wu, Nan} }