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Halachev, M.

Publications and source records attributed to Halachev, M..

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VEP-G2P: A Tool for Efficient, Flexible and Scalable Diagnostic Filtering of Genomic Variants

PurposeWe aimed to develop an efficient, flexible, scalable and evidence-based approach to sequence-based diagnostic analysis/re-analysis of conditions with very large numbers of different causative genes. We then wished to define the expected rate of plausibly causative variants coming through strict filtering in control in comparison to disease populations to quantify background diagnostic \"noise\".\n\nMethodsWe developed G2P (www.ebi.ac.uk/gene2phenotype) as an online system to facilitate the development, validation, curation and distribution of large-scale, evidence-based datasets for use in diagnostic variant filtering. Each locus-genotype-mechanism-disease-evidence thread (LGMDET) associates an allelic requirement and a mutational consequence at a defined locus with a disease entity and a confidence level and evidence links. We then developed an extension to Ensembl Variant Effect Predictor (VEP), VEP-G2P, which can filter based on G2P other widely used gene panel curation systems. We compared the output of disease-associated and control whole exome sequence (WES) using Developmental Disorders G2P (G2PDD; 2044 LGMDETs) and constitutional cancer predisposition G2P (G2PCancer; 128 LGMDETs).\n\nResultsWe have shown a sensitivity/precision of 97.3%/33% and 81.6%/22.7% for causative de novo and inherited variants respectively using VEP-G2PDD in DDD study probands WES. Many of the apparently diagnostic genotypes \"missed\" are likely false-positive reports with lower minor allele frequencies and more severe predicted consequences being diagnostically-discriminative features.\n\nConclusionCase:control comparisons using VEP-G2PDD established an observed:expected ratio of 1:30,000 plausibly causative variants in proband WES to ~1:40,000 reportable but presumed-benign variants in controls. At least half the filtered variants in probands represent background \"noise\". Supporting phenotypic evidence is, therefore, necessary in genetically-heterogeneous disorders. G2P and VEP-G2P provides a practical approach to optimize disease-specific filtering parameters in diagnostic genetic research.

genetics

ITPase Deficiency Causes Martsolf Syndrome With a Lethal Infantile Dilated Cardiomyopathy

Martsolf syndrome is characterized by congenital cataracts, postnatal microcephaly, developmental delay, hypotonia, short stature and biallelic hypomorphic mutations in either RAB3GAP1 or RAB3GAP2. Through genetic analysis of 85 unrelated \"mutation negative\" probands referred with Martsolf syndrome we identified two individuals with different homozygous null mutations in ITPA, the gene encoding inosine triphosphate pyrophosphatase (ITPase). The probands reported here each presented with a lethal and highly distinctive disorder; Martsolf syndrome with infantile-onset dilated cardiomyopathy. Severe ITPase-deficiency has been previously reported with infantile epileptic encephalopathy (MIM 616647). ITPase acts to prevent incorporation of inosine bases (rl/dl) into RNA and DNA. In Itpa-null cells, dI was undetectable in genomic DNA. dI could be identified at a low level in mtDNA but this was not associated with detectable mitochondrial genome instability, mtDNA depletion or biochemical dysfunction of the mitochondria. rI accumulation was detectable in lymphoblastoid RNA from an affected individual. In Itpa-null mouse embryos rI was detectable in the brain and kidney with the highest level seen in the embryonic heart (rI at 1 in 385 bases). Transcriptome and proteome analysis in mutant cells revealed no major differences with controls. The rate of transcription and the total amount of cellular RNA also appeared normal. rI accumulation in RNA - and by implication rI production - correlates with the severity of organ dysfunction in ITPase deficiency but the basis of the cellulopathy remains cryptic. While we cannot exclude cumulative minor effects, there are no major anomalies in the production, processing, stability and/or translation of mRNA.\n\nAuthor SummaryNucleotide triphosphate bases containing inosine, ITP and dITP, are continually produced within the cell as a consequence of various essential biosynthetic reactions. The enzyme inosine triphosphate pyrophosphatase (ITPase) scavenges ITP and dITP to prevent their incorporation into RNA and DNA. Here we describe two unrelated families with complete loss of ITPase function as a consequence of disruptive mutations affecting both alleles of ITPA, the gene that encodes this protein. Both of the families have a very distinctive and severe combination of clinical problems, most notably a failure of heart muscle that was lethal in infancy or early childhood. They also have features of another rare genetic disorder affecting the brain and the eyes called Martsolf syndrome. We could not detect any evidence of dITP accumulation in genomic DNA from the affected individuals. A low but detectable level of inosine was present in the mitochondrial DNA but this did not have any obvious detrimental effect. The inosine accumulation in RNA was detectable in the patient cells. We made both cellular and animal models that were completely deficient in ITPase. Using these reagents we could show that the highest level of inosine accumulation into RNA was seen in the embryonic mouse heart. In this tissue more than 1 in 400 bases in all RNA in the cell was inosine. In normal tissues inosine is almost undetectable using very sensitive assays. The inosine accumulation did not seem to be having a global effect on the balance of RNA molecules or proteins.

genetics