Diagnostic yield and clinical impact of exome sequencing in early-onset scoliosis (EOS)

BackgroundEarly-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 sc...

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Published inJournal of medical genetics Vol. 58; no. 1; pp. 41 - 47
Main Authors Zhao, Sen, Zhang, Yuanqiang, Chen, Weisheng, Li, Weiyu, Wang, Shengru, Wang, Lianlei, Zhao, Yanxue, Lin, Mao, Ye, Yongyu, Lin, Jiachen, Zheng, Yu, Liu, Jiaqi, Zhao, Hengqiang, Yan, Zihui, Yang, Yongxin, Huang, Yingzhao, Lin, Guanfeng, Chen, Zefu, Zhang, Zhen, Liu, Sen, Jin, Lichao, Wang, Zhaoyang, Chen, Jingdan, Niu, Yuchen, Li, Xiaoxin, Wu, Yong, Wang, Yipeng, Du, Renqian, Gao, Na, Zhao, Hong, Yang, Ying, Liu, Ying, Tian, Ye, Li, Wenli, Zhao, Yu, Liu, Jia, Yu, Bin, Zhang, Na, Yu, Keyi, Yang, Xu, Li, Shugang, Xu, Yuan, Hu, Jianhua, Liu, Zhe, Shen, Jianxiong, Zhang, Shuyang, Su, Jianzhong, Khanshour, Anas M, Kidane, Yared H, Ramo, Brandon, Rios, Jonathan J, Liu, Pengfei, Sutton, V. Reid, Posey, Jennifer E, Wu, Zhihong, Qiu, Guixing, Wise, Carol A, Zhang, Feng, Lupski, James R, Zhang, Jianguo, Wu, Nan
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.01.2021
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Summary:BackgroundEarly-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.MethodsIn 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.ResultsAfter 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.ConclusionES 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.
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These authors contributed equally to this work.
JianguoZ, NanW and SenZ conceived of the project and designed the study, SenZ, YuanqiangZ, WeishengC, WeiyuL, ShengruW, LianleiW, LichaoJ, ZhaoyangW, JingdanC and GuanfengL collected and interpreted the data, YanxueZ, YongyuY, JiachenL, HengqiangZ, ZihuiY, ZefuC and JianzhongS conducted the statistical analysis. SenZ, YuZ, YongW, MaoL, JiaqiL, YongxinY, YingzhaoH, ZhenZ, SenL, XiaoxinL, RenqianD, ZheL and YuchenN conducted the bioinformatic analyses. JianguoZ, GuixingQ, YipengW, NaG, HongZ, YingY, YingL, YeT, WenliL, YuZ, JiaL, BinY, NaZ, KeyiY, XuY, ShugangL, YuanX, JianhuaH, JiangxiongS and ShuyangZ recruited patients. SenZ, YuangqiangZ, ZhihongW and NanW wrote the first draft of the manuscript, and AMK, YK, BR, JJR, PengfeiL, VRS, JEP, CAW, FengZ and JRL critically revised the work for important intellectual content. All authors provided crucial input on several iterations of the manuscript and all authors have approved the final version.
Contributorship Statement
ISSN:0022-2593
1468-6244
1468-6244
DOI:10.1136/jmedgenet-2019-106823