Evaluation of DNA Methylation Episignatures for Diagnosis and Phenotype Correlations in 42 Mendelian Neurodevelopmental Disorders

Genetic syndromes frequently present with overlapping clinical features and inconclusive or ambiguous genetic findings which can confound accurate diagnosis and clinical management. An expanding number of genetic syndromes have been shown to have unique genomic DNA methylation patterns (called “epis...

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Published inAmerican journal of human genetics Vol. 106; no. 3; pp. 356 - 370
Main Authors Aref-Eshghi, Erfan, Kerkhof, Jennifer, Pedro, Victor P., Barat-Houari, Mouna, Ruiz-Pallares, Nathalie, Andrau, Jean-Christophe, Lacombe, Didier, Van-Gils, Julien, Fergelot, Patricia, Dubourg, Christèle, Cormier-Daire, Valerie, Rondeau, Sophie, Lecoquierre, François, Saugier-Veber, Pascale, Nicolas, Gaël, Lesca, Gaetan, Chatron, Nicolas, Sanlaville, Damien, Vitobello, Antonio, Faivre, Laurence, Thauvin-Robinet, Christel, Laumonnier, Frederic, Raynaud, Martine, Alders, Mariëlle, Mannens, Marcel, Henneman, Peter, Hennekam, Raoul C., Velasco, Guillaume, Francastel, Claire, Ulveling, Damien, Ciolfi, Andrea, Pizzi, Simone, Tartaglia, Marco, Heide, Solveig, Héron, Delphine, Mignot, Cyril, Keren, Boris, Whalen, Sandra, Afenjar, Alexandra, Bienvenu, Thierry, Campeau, Philippe M., Rousseau, Justine, Levy, Michael A., Brick, Lauren, Kozenko, Mariya, Balci, Tugce B., Siu, Victoria Mok, Stuart, Alan, Kadour, Mike, Masters, Jennifer, Takano, Kyoko, Kleefstra, Tjitske, de Leeuw, Nicole, Field, Michael, Shaw, Marie, Gecz, Jozef, Ainsworth, Peter J., Lin, Hanxin, Rodenhiser, David I., Friez, Michael J., Tedder, Matt, Lee, Jennifer A., DuPont, Barbara R., Stevenson, Roger E., Skinner, Steven A., Schwartz, Charles E., Genevieve, David, Sadikovic, Bekim
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 05.03.2020
Elsevier (Cell Press)
Elsevier
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Abstract Genetic syndromes frequently present with overlapping clinical features and inconclusive or ambiguous genetic findings which can confound accurate diagnosis and clinical management. An expanding number of genetic syndromes have been shown to have unique genomic DNA methylation patterns (called “episignatures”). Peripheral blood episignatures can be used for diagnostic testing as well as for the interpretation of ambiguous genetic test results. We present here an approach to episignature mapping in 42 genetic syndromes, which has allowed the identification of 34 robust disease-specific episignatures. We examine emerging patterns of overlap, as well as similarities and hierarchical relationships across these episignatures, to highlight their key features as they are related to genetic heterogeneity, dosage effect, unaffected carrier status, and incomplete penetrance. We demonstrate the necessity of multiclass modeling for accurate genetic variant classification and show how disease classification using a single episignature at a time can sometimes lead to classification errors in closely related episignatures. We demonstrate the utility of this tool in resolving ambiguous clinical cases and identification of previously undiagnosed cases through mass screening of a large cohort of subjects with developmental delays and congenital anomalies. This study more than doubles the number of published syndromes with DNA methylation episignatures and, most significantly, opens new avenues for accurate diagnosis and clinical assessment in individuals affected by these disorders.
AbstractList Genetic syndromes frequently present with overlapping clinical features and inconclusive or ambiguous genetic findings which can confound accurate diagnosis and clinical management. An expanding number of genetic syndromes have been shown to have unique genomic DNA methylation patterns (called “episignatures”). Peripheral blood episignatures can be used for diagnostic testing as well as for the interpretation of ambiguous genetic test results. We present here an approach to episignature mapping in 42 genetic syndromes, which has allowed the identification of 34 robust disease-specific episignatures. We examine emerging patterns of overlap, as well as similarities and hierarchical relationships across these episignatures, to highlight their key features as they are related to genetic heterogeneity, dosage effect, unaffected carrier status, and incomplete penetrance. We demonstrate the necessity of multiclass modeling for accurate genetic variant classification and show how disease classification using a single episignature at a time can sometimes lead to classification errors in closely related episignatures. We demonstrate the utility of this tool in resolving ambiguous clinical cases and identification of previously undiagnosed cases through mass screening of a large cohort of subjects with developmental delays and congenital anomalies. This study more than doubles the number of published syndromes with DNA methylation episignatures and, most significantly, opens new avenues for accurate diagnosis and clinical assessment in individuals affected by these disorders.
Genetic syndromes frequently present with overlapping clinical features and inconclusive or ambiguous genetic findings which can confound accurate diagnosis and clinical management. An expanding number of genetic syndromes have been shown to have unique genomic DNA methylation patterns (called "episignatures"). Peripheral blood episignatures can be used for diagnostic testing as well as for the interpretation of ambiguous genetic test results. We present here an approach to episignature mapping in 42 genetic syndromes, which has allowed the identification of 34 robust disease-specific episignatures. We examine emerging patterns of overlap, as well as similarities and hierarchical relationships across these episignatures, to highlight their key features as they are related to genetic heterogeneity, dosage effect, unaffected carrier status, and incomplete penetrance. We demonstrate the necessity of multiclass modeling for accurate genetic variant classification and show how disease classification using a single episignature at a time can sometimes lead to classification errors in closely related episignatures. We demonstrate the utility of this tool in resolving ambiguous clinical cases and identification of previously undiagnosed cases through mass screening of a large cohort of subjects with developmental delays and congenital anomalies. This study more than doubles the number of published syndromes with DNA methylation episignatures and, most significantly, opens new avenues for accurate diagnosis and clinical assessment in individuals affected by these disorders.Genetic syndromes frequently present with overlapping clinical features and inconclusive or ambiguous genetic findings which can confound accurate diagnosis and clinical management. An expanding number of genetic syndromes have been shown to have unique genomic DNA methylation patterns (called "episignatures"). Peripheral blood episignatures can be used for diagnostic testing as well as for the interpretation of ambiguous genetic test results. We present here an approach to episignature mapping in 42 genetic syndromes, which has allowed the identification of 34 robust disease-specific episignatures. We examine emerging patterns of overlap, as well as similarities and hierarchical relationships across these episignatures, to highlight their key features as they are related to genetic heterogeneity, dosage effect, unaffected carrier status, and incomplete penetrance. We demonstrate the necessity of multiclass modeling for accurate genetic variant classification and show how disease classification using a single episignature at a time can sometimes lead to classification errors in closely related episignatures. We demonstrate the utility of this tool in resolving ambiguous clinical cases and identification of previously undiagnosed cases through mass screening of a large cohort of subjects with developmental delays and congenital anomalies. This study more than doubles the number of published syndromes with DNA methylation episignatures and, most significantly, opens new avenues for accurate diagnosis and clinical assessment in individuals affected by these disorders.
Author Raynaud, Martine
de Leeuw, Nicole
Aref-Eshghi, Erfan
Skinner, Steven A.
Tartaglia, Marco
Henneman, Peter
Barat-Houari, Mouna
Ciolfi, Andrea
Kadour, Mike
Hennekam, Raoul C.
Genevieve, David
Pedro, Victor P.
Alders, Mariëlle
Mignot, Cyril
Kerkhof, Jennifer
Whalen, Sandra
Schwartz, Charles E.
Ulveling, Damien
Afenjar, Alexandra
Lin, Hanxin
Keren, Boris
Dubourg, Christèle
Sanlaville, Damien
Vitobello, Antonio
Mannens, Marcel
Gecz, Jozef
Tedder, Matt
Ainsworth, Peter J.
Siu, Victoria Mok
Shaw, Marie
Cormier-Daire, Valerie
Friez, Michael J.
Balci, Tugce B.
Pizzi, Simone
Rondeau, Sophie
Lacombe, Didier
Héron, Delphine
Masters, Jennifer
Andrau, Jean-Christophe
Fergelot, Patricia
Laumonnier, Frederic
Lesca, Gaetan
Thauvin-Robinet, Christel
Brick, Lauren
Rousseau, Justine
Kleefstra, Tjitske
Lee, Jennifer A.
Lecoquierre, François
Saugier-Veber, Pascale
Francastel, Claire
Rodenhiser, David I.
DuPont, Barbara R.
Heide, Solveig
Kozenko, Mariya
Levy, Michael A.
Takano, Kyoko
Field, Michael
Chatron, Nicolas
Sadikovic, Bekim
Nicolas, Gaël
Van-Gils, Julien
Stuart
AuthorAffiliation Groupe DI, French Rare Disease Network filière AnDDI-Rare France
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– name: 36 Greenwood Genetic Center, Greenwood, SC 29646, USA
– name: 13 Centre Hospitalier Universitaire de Tours, Service de Genetique, 37000 Tours, France
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  givenname: Tugce B.
  surname: Balci
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  givenname: Victoria Mok
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  givenname: Tjitske
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  givenname: Nicole
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  givenname: Michael
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  givenname: Marie
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– sequence: 56
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  surname: Gecz
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  givenname: Peter J.
  surname: Ainsworth
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– sequence: 58
  givenname: Hanxin
  surname: Lin
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– sequence: 59
  givenname: David I.
  surname: Rodenhiser
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– sequence: 60
  givenname: Michael J.
  surname: Friez
  fullname: Friez, Michael J.
  organization: Greenwood Genetic Center, Greenwood, SC 29646, USA
– sequence: 61
  givenname: Matt
  surname: Tedder
  fullname: Tedder, Matt
  organization: Greenwood Genetic Center, Greenwood, SC 29646, USA
– sequence: 62
  givenname: Jennifer A.
  surname: Lee
  fullname: Lee, Jennifer A.
  organization: Greenwood Genetic Center, Greenwood, SC 29646, USA
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  organization: Greenwood Genetic Center, Greenwood, SC 29646, USA
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  organization: Greenwood Genetic Center, Greenwood, SC 29646, USA
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  surname: Schwartz
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  organization: Greenwood Genetic Center, Greenwood, SC 29646, USA
– sequence: 67
  givenname: David
  surname: Genevieve
  fullname: Genevieve, David
  organization: Medical Genetic Department for Rare Diseases and Personalized Medicine, Reference Center AD SOOR, AnDDI-RARE, Groupe DI, Inserm U1183—Institute for Regenerative Medicine and Biotherapy, Montpellier University, Centre Hospitalier Universitaire de Montpellier, 34090 Montpellier, France
– sequence: 68
  givenname: Bekim
  surname: Sadikovic
  fullname: Sadikovic, Bekim
  email: Bekim.Sadikovic@lhsc.on.ca
  organization: Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, ON N6A5W9, Canada
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2020 American Society of Human Genetics. 2020 American Society of Human Genetics
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Issue 3
Keywords EpiSign
DNA methylation
molecular diagnostics
VUS classification
episignature
uncertain clinical cases
Molecular diagnostics
Episignature
Uncertain clinical cases
Language English
License Copyright © 2020 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.
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Snippet Genetic syndromes frequently present with overlapping clinical features and inconclusive or ambiguous genetic findings which can confound accurate diagnosis...
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SubjectTerms Cohort Studies
DNA Methylation
EpiSign
episignature
Genetic Heterogeneity
Humans
Life Sciences
molecular diagnostics
Neurodevelopmental Disorders - genetics
Phenotype
Syndrome
uncertain clinical cases
VUS classification
Title Evaluation of DNA Methylation Episignatures for Diagnosis and Phenotype Correlations in 42 Mendelian Neurodevelopmental Disorders
URI https://dx.doi.org/10.1016/j.ajhg.2020.01.019
https://www.ncbi.nlm.nih.gov/pubmed/32109418
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https://normandie-univ.hal.science/hal-02538107
https://pubmed.ncbi.nlm.nih.gov/PMC7058829
Volume 106
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