Browsing by Author "Cardoso, Manuela"
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- Citogenética de Próxima Geração: Implementação e primeiros resultados em PortugalPublication . David, Dezső; Oliva-Teles, Natália; Freixo, João; Fonseca e Silva, ML; Fortuna, Ana; Tkachenko, Natália; Carvalho, Inês; Marques, Mariana; Cardoso, Manuela; Fino, Joana; Marques, Bárbara; Alves, Ana Cristina; Dória, Sófia; Pinto de Moura, Carla; Marques Carreira, Isabel; Correia, Hildeberto; Gonçalves, Rui Miguel; Lavinha, João; Kay, Teresa; Talkowski, Michael; Morton, CynthiaIntrodução: As alterações cromossómicas estruturais provocam doenças de severidade variável que acarretam sofrimento individual e familiar signifi cativo. Para compreensão da sua etiologia e estabelecimento de um possível prognóstico, uma adequada correlação fenótipo-genótipo é fundamental. O presente estudo faz parte do projeto intitulado àCitogenética de Próxima Geração Irrompe nos Cuidados de Saúde e Contribui para Anotação do Genoma Humanoà, que visa a introdu- ção da sequenciação de próxima geração (NGS) na citogené- tica clínica, tirando partido dessa inovação única na deteção de variantes estruturais, com uma resolução de um nucleótido para a criação de uma citogenética de alto rendimento, catalisadora de notáveis avanços no diagnóstico clínico e resulta da colaboração entre seis Instituições nacionais e a Harvard Medical School. Estima-se que exista um número considerável de indivíduos portadores de diversas patologias, incluindo algumas de início tardio associadas a rearranjos genómicos por identifi car. Assim, é fundamental a identifi cação e a referência destes indivíduos com possíveis rearranjos cromossómicos associados a doenças.
- Comprehensive clinically oriented workflow for nucleotide level resolution and interpretation in prenatal diagnosis of de novo apparently balanced chromosomal translocations in their genomic landscapePublication . David, Dezső; Freixo, João P.; Fino, Joana; Carvalho, Inês; Marques, Mariana; Cardoso, Manuela; Piña-Aguilar, Raul E.; Morton, Cynthia C.We present a comprehensive clinically oriented workflow for large-insert genome sequencing (liGS)-based nucleotide level resolution and interpretation of de novo (dn) apparently balanced chromosomal abnormalities (BCA) in prenatal diagnosis (PND). Retrospective or concomitant with conventional PND and liGS, molecular and newly developed clinically inspired bioinformatic tools (TAD-GConTool and CNV-ConTool) are applied to analyze and assess the functional and phenotypic outcome of dn structural variants (dnSVs). Retrospective analysis of four phenotype-associated dnSVs identified during conventional PND precisely reveal the genomic elements disrupted by the translocation breakpoints. Identification of autosomal dominant disease due to the disruption of ANKS1B and WDR26 by t(12;17)(q23.1;q21.33)dn and t(1;3)(q24.11;p25.3)dn breakpoints, respectively, substantiated the proposed workflow. We then applied this workflow to two ongoing prenatal cases with apparently balanced dnBCAs: 46,XX,t(16;17)(q24;q21.3)dn referred for increased risk on combined first trimester screening and 46,XY,t(2;19)(p13;q13.1)dn referred due to a previous trisomy 21 pregnancy. Translocation breakpoints in the t(16;17) involve ANKRD11 and WNT3 and disruption of ANKRD11 resulted in KBG syndrome confirmed in postnatal follow-up. Breakpoints in the t(2;19) are within ATP6V1B1 and the 3' UTR of CEP89, and are not interpreted to cause disease. Genotype-phenotype correlation confirms the causative role of WDR26 in the Skraban-Deardorff and 1q41q42 microdeletion phenocopy syndromes, and that disruption of ANKS1B causes ANKS1B haploinsufficiency syndrome. In sum, we show that an liGS-based approach can be realized in PND care providing additional information concerning clinical outcomes of dnBCAs in patients with such rearrangements.
- Early results of next-gen cytogenetics implementation in PortugalPublication . David, Dezső; Freixo, João; Marques, Bárbara; Carvalho, Inês; Tkachenko, Natália; Oliva-Teles, Natália; Marques, Mariana; Cardoso, Manuela; Fino, Joana; Alves, Cristina; Fortuna, Ana; Sófia, Dória; Pinto de Moura, Carla; Correia, Hildeberto; Marques Carreira, Isabel; Sá, Joaquim; Gonçalves, Rui Miguel; Lavinha, João; Kay, Teresa; Talkowski, Michael; Morton, CynthiaBackground: Most approaches are insensitive to the full mutational spectrum of chromosome rearrangements associated with human developmental abnormalities. Therefore, our aim is to introduce next-generation sequencing (NGS) into clinical cytogenetics, creating a sequence-based NextGen Cytogenetics to catalyze a dramatic advancement in clinical diagnostics. Methods: Twenty families with chromosome rearrangement-associated diseases, including two prenatal (PN) cases, have been enrolled. Fourteen of these were also analyzed by NGS using large-insert paired-end libraries. Results: The majority of these cases were confirmed to be balanced reciprocal rearrangements, whereas 4 were complex chromosomal rearrangements including 1 of chromothripsis. Thus far, over 50 breakpoints were identified disrupting protein coding genes, lncRNAs, or intergenic regions, thus revealing candidate genes or genomic loci. These cases are further assessed for pathogenicity from positional effects on genes located within topological domains (TADs) containing the breakpoints using DECIPHER predictions of haploinsufficiency. In one PN case, the 16q24 breakpoint disrupts ANKRD11, etiologic in the autosomal dominant KBG syndrome (OMIM #148050), predicting an abnormal phenotype. The chromothripsis case, submitted as 46,XY,t(7;14)(q22;q32.1),inv(15)(q21.2q26.1), proved by NGS to carry two further deletions, at 3p12 (5.3 Mb) and 15q14 (488 kb), as well as an insertion of 644.4 kb from 15q14 into 3p14. The inv(15) is in fact a complex rearrangement of 15q with eight breakpoints. Conclusions: We demonstrate that NGS-based chromosomal rearrangement characterization leads to major improvements in identification of chromosomal aberrations and in prediction of clinical outcomes of postnatally and prenatally detected genomic rearrangements, and to contributions to human genome annotation.
- Molecular pathogenesis of a malformation syndrome associated with a pericentric chromosome 2 inversionPublication . Cardoso, Manuela; David, Dezso; Dias, Deodália Maria AntunesCongenital malformation syndromes can be caused by genomic and/or chromosome rearrangements. It is difficult to establish the underlying causes of malformations because of their high level of complexity. Although balanced chromosome inversions are in most cases subclinical, those disrupting transcripts or affecting the genomic architecture at breakpoint regions may well be pathogenic. Currently, the lack of a fully annotated human genome hinders the predictability of the phonotypic consequences of such rearrangements. The aim of this study is the identification of potential candidate genes for a malformation syndrome in an individual with an apparently balanced maternally inherited pericentric chromosome inversion inv(2)(p16.1;q14.3)mat. The proband has severe congenital malformation with multiple psychomotor and developmental anomalies, dismorphism and autistic features. The parents are phenotypically normal. Classical cytogenetic methods are of low resolution, often in the magnitude of a 5 to 10 Mb. Whole-genome Next-Generation Sequencing (NGS) of large-insert sequencing library (liWGS) has the capability to detect structural rearrangements with incomparably higher resolution, including cryptic alterations. As consequence, it was applied for the identification of inv(2)(p16.1;q14.3) breakpoints in the proband. Familial segregation analysis and definition of the inversion breakpoints at a nucleotide resolution were performed by amplification of junction fragments and Sanger sequencing. Genome and transcriptome array analysis were also carried out, for detection of additional genomic alterations and for gene expression profiling, respectively. Additionally, a possibly polymorphic duplication at 2q21.1, inherited from his father, was found. No apparent pathogenic genomic imbalances were identified in the proband. The inversion breakpoints are located at chr2:55,935,064 and chr2:123,767,685 (GRCh37), respectively, in 2p16.1 and 2q14.3. The inv2p16.1 breakpoint is flanked 14 kb proximal by the gene polyribonucleotide nucleotidyltransferase 1 (PNPT1; chr2:55,861,198-55,921,045, GRCh37; OMIM *610316) and 172 kb distal by EGF containing fibulin-like extracellular matrix protein 1 (EFEMP1; chr2:56,093,097-56,151,298, GRCh37; OMIM *601548). PNPT1, highly expressed in mice cochlea, has been associated with deafness (OMIM #614934) and with combined oxidative phosphorylation deficiency (OMIM #614932), both autosomal recessive. Meanwhile, the autosomal dominant Doyne honeycomb retinal dystrophy (OMIM #126600) is reported to be associated with mutations in EFEMP1. This gene is essential for the formation of elastic fibers in connective tissue. The 2q14.3 breakpoint is in a gene-poor region. Located 1.2 Mb proximal to the breakpoint is translin (TSN; chr2:122,513,120-122,525,428, GRCh37; OMIM *600575). Involved in DNA damage repair and RNA trafficking in neurons, TSN codes for a protein that specifically binds to breakpoint junctions of translocations in acute leukemia. The gene contactin-associated protein-like 5 (CNTNAP5; chr2:124,782,863-125,672,953, GRCh37; OMIM *610519) is localized 1 Mb, distal. CNTNAP5 is involved in cell adhesion and intercellular communication. Susceptibility to autistic syndromes has been suspected. The above described breakpoints at nucleotide resolution are the same in the proband’s mother, and did not directly disrupt any gene. Publicly available clinical information on alterations affecting the inversion flanking genes revealed no major similarity with the proband’s phenotype. Furthermore, no significant alteration in their expression level was observed. In-depth analysis of genome-wide expression data is in progress. Based on these findings, the causal relationship between clinical phenotype and the inv(2)(p16.1;q14.3) is most likely excluded, since the inversion is most likely non-pathogenic. Therefore it is not yet possible to identity the underlying genetic cause of the malformation syndrome reported in this subject. Whole-exome sequencing is proposed as a future task to detect the disease causing alteration. This study highlights the application of NGS-based methodology, with its capability in mapping chromosome inversion breakpoints at a very high resolution. Large scale application of this approach will represent a hallmark in the characterization of congenital malformations associated with structural chromosomal abnormalities.