Mutations in the CHD7 gene: the experience of a commercial laboratory

• Published in: Genetic testing and molecular biomarkers Vol. 14; no. 6; p. 881
• Main Authors: Bartels, Cynthia F, Scacheri, Cheryl, White, Lashonda, Scacheri, Peter C, Bale, Sherri
• Format: Journal Article
• Language: English
• Published: United States 01.12.2010
• Subjects: CHARGE Syndrome - diagnosis; CHARGE Syndrome - genetics; Cohort Studies; DNA Helicases - genetics; DNA Mutational Analysis; DNA-Binding Proteins - genetics; Gene Dosage; Genetic Testing; Humans; Laboratories, Hospital; Mutation; United States; United States
• ISSN: 1945-0257
• DOI: 10.1089/gtmb.2010.0101

CHARGE syndrome is an autosomal dominant multisystem disorder caused by mutation in the CHD7 gene, encoding chromodomain helicase DNA-binding protein 7. Molecular diagnostic testing for CHD7 mutation has been available in a clinical setting since 2005. We report here the results from the first 642 unrelated proband samples submitted for testing. Thirty-two percent (n = 203) of patient samples had a heterozygous pathogenic variant identified. The lower mutation rate than that published for well-characterized clinical samples is likely due to referral bias, as samples submitted for clinical testing may be for "rule-out" diagnoses, rather than solely to confirm clinical suspicion. We identified 159 unique pathogenic mutations, and of these, 134 mutations were each seen in a single individual and 25 mutations were found in two to five individuals (n =69). Of the 203 mutations, only 9 were missense, with 107 nonsense, 69 frameshift, and 15 splice-site mutations likely leading to haploinsufficiency at the cellular level. An additional 72 variations identified in the 642 tested samples (11%) were considered to have unknown clinical significance. Copy number changes (deletion/duplication of the entire gene or one/several exons) were found to account for a very small number of cases (n = 3). This cohort represents the largest CHARGE syndrome sample size to date and is intended to serve as a resource for clinicians, genetic counselors, researchers, and other diagnostic laboratories.