[en] PURPOSE: Neurodevelopmental disorders (NDDs), such as intellectual disability (ID) and autism spectrum disorder (ASD), exhibit genetic and phenotypic heterogeneity, making them difficult to differentiate without a molecular diagnosis. The Clinical Genome Resource Intellectual Disability/Autism Gene Curation Expert Panel (GCEP) uses systematic curation to distinguish ID/ASD genes that are appropriate for clinical testing (ie, with substantial evidence supporting their relationship to disease) from those that are not.
METHODS: Using the Clinical Genome Resource gene-disease validity curation framework, the ID/Autism GCEP classified genes frequently included on clinical ID/ASD testing panels as Definitive, Strong, Moderate, Limited, Disputed, Refuted, or No Known Disease Relationship.
RESULTS: As of September 2021, 156 gene-disease pairs have been evaluated. Although most (75%) were determined to have definitive roles in NDDs, 22 (14%) genes evaluated had either Limited or Disputed evidence. Such genes are currently not recommended for use in clinical testing owing to the limited ability to assess the effect of identified variants.
CONCLUSION: Our understanding of gene-disease relationships evolves over time; new relationships are discovered and previously-held conclusions may be questioned. Without periodic re-examination, inaccurate gene-disease claims may be perpetuated. The ID/Autism GCEP will continue to evaluate these claims to improve diagnosis and clinical care for NDDs.
Disciplines :
Genetics & genetic processes Laboratory medicine & medical technology
Author, co-author :
Riggs, Erin Rooney ; Autism & Developmental Medicine Institute, Geisinger, Danville, PA
Bingaman, Taylor I; Autism & Developmental Medicine Institute, Geisinger, Danville, PA
Barry, Carrie-Ann; Drexel University College of Medicine, Philadelphia, PA
Behlmann, Andrea; Invitae, San Francisco, CA
Bluske, Krista; Illumina, Inc, San Diego, CA
Bostwick, Bret; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
Bright, Alison; Natera, San Carlos, CA
Chen, Chun-An; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
Clause, Amanda R; Illumina, Inc, San Diego, CA
Dharmadhikari, Avinash V; Department of Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Los Angeles, CA, Keck School of Medicine, University of Southern California, Los Angeles, CA
Ganapathi, Mythily; Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
Gonzaga-Jauregui, Claudia; Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Juriquilla, Querétaro, Mexico
Grant, Andrew R; Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, New York Medical College, Valhalla, NY
Hughes, Madeline Y; University of Illinois Chicago, Chicago, IL
Kim, Se Rin; National Human Genome Research Institute, Bethesda, MD
Krause, Amanda; Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Liao, Jun; Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY
Lumaka Zola, Aimé; CHU Liège - Central University Hospital of Liege [BE] > Génétique Humaine
Mah, Michelle; Trillium Health Partners, Mississauga, Ontario, Canada
Maloney, Caitlin M; University of Washington, Seattle, WA
Mohan, Shruthi; University of North Carolina, Chapel Hill, NC
Osei-Owusu, Ikeoluwa A; Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA
Reble, Emma; St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
Rennie, Olivia; Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
Savatt, Juliann M; Autism & Developmental Medicine Institute, Geisinger, Danville, PA
Shimelis, Hermela; Autism & Developmental Medicine Institute, Geisinger, Danville, PA
Siegert, Rebecca K; Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA
Sneddon, Tam P; Department of Pathology and Laboratory Medicine, School of Medicine, The University of North Carolina, Chapel Hill, NC
Thaxton, Courtney; Department of Pathology and Laboratory Medicine, School of Medicine, The University of North Carolina, Chapel Hill, NC
Toner, Kelly A; Drexel University College of Medicine, Philadelphia, PA
Tran, Kien Trung; Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
Webb, Ryan; Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA
Wilcox, Emma H; The Warren Alpert Medical School of Brown University, Providence, RI
Yin, Jiani; Department of Neurology, University of California Los Angeles, Los Angeles, CA
Zhuo, Xinming; The Jackson Laboratory for Genomic Medicine, Farmington, CT
Znidarsic, Masa; University Medical Center Ljubljana, Ljubljana, Slovenia
Martin, Christa Lese; Autism & Developmental Medicine Institute, Geisinger, Danville, PA
Betancur, Catalina; Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Institut de Biologie Paris Seine, Paris, France
Vorstman, Jacob A S; Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
Miller, David T; Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA
Schaaf, Christian P; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
Lumaka Zola, Aimé ; Centre Hospitalier Universitaire de Liège - CHU ; Université de Liège - ULiège > GIGA > GIGA Cancer - Human Genetics
NHGRI - National Human Genome Research Institute NIH - National Institutes of Health
Funding text :
A.Br. is a shareholder of and employed by Natera. A.Br. has also been an employee of Invitae and Quest Diagnostics commercial laboratories. A.R.C. and K.B. are shareholders of and employed by Illumina, Inc. A.Be. is a shareholder of and is employed by Invitae. B.B. has received research support from Biomarin Pharmaceuticals Inc. He is currently employed by and is a shareholder of Alnylam Pharmaceuticals, Inc. All other authors declare no conflicts of interest.This work was supported by the National Human Genome Research Institute of the National Institutes of Health under award number U24HG006834. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Clark, M.M., Stark, Z., Farnaes, L., et al. Meta-analysis of the diagnostic and clinical utility of genome and exome sequencing and chromosomal microarray in children with suspected genetic diseases. NPJ Genom Med, 3, 2018, 16, 10.1038/s41525-018-0053-8.
Srivastava, S., Love-Nichols, J.A., Dies, K.A., et al. Meta-analysis and multidisciplinary consensus statement: exome sequencing is a first-tier clinical diagnostic test for individuals with neurodevelopmental disorders. Genet Med 21:11 (2019), 2413–2421 Published correction appears in Genet Med. 2020;22(10):1731-1732 https://doi.org/10.1038/s41436-019-0554-6.
Bilkey, G.A., Burns, B.L., Coles, E.P., et al. Genomic testing for human health and disease across the life cycle: applications and ethical, legal, and social challenges. Front Public Health, 7, 2019, 40, 10.3389/fpubh.2019.00040.
Hayeems, R.Z., Babul-Hirji, R., Hoang, N., Weksberg, R., Shuman, C., Parents’ experience with pediatric microarray: transferrable lessons in the era of genomic counseling. J Genet Couns 25:2 (2016), 298–304, 10.1007/s10897-015-9871-3.
Iglesias, A., Anyane-Yeboa, K., Wynn, J., et al. The usefulness of whole-exome sequencing in routine clinical practice. Genet Med 16:12 (2014), 922–931, 10.1038/gim.2014.58.
Srivastava, S., Cohen, J.S., Vernon, H., et al. Clinical whole exome sequencing in child neurology practice. Ann Neurol 76:4 (2014), 473–483, 10.1002/ana.24251.
Finucane, B., Challman, T.D., Martin, C.L., Ledbetter, D.H., Shift happens: family background influences clinical variability in genetic neurodevelopmental disorders. Genet Med 18:4 (2016), 302–304, 10.1038/gim.2015.92.
Erger, F., Schaaf, C.P., Netzer, C., Which genes to assess in the NGS diagnostics of intellectual disability? The case for a consensus database-driven and expert-curated approach. Mol Cell Probes 45 (2019), 84–88, 10.1016/j.mcp.2019.03.006.
Hoang, N., Buchanan, J.A., Scherer, S.W., Heterogeneity in clinical sequencing tests marketed for autism spectrum disorders. NPJ Genom Med, 3, 2018, 27, 10.1038/s41525-018-0066-3.
Richards, S., Aziz, N., Bale, S., et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 17:5 (2015), 405–424, 10.1038/gim.2015.30.
Mahon, S.M., Management of patients with a genetic variant of unknown significance. Oncol Nurs Forum 42:3 (2015), 316–318, 10.1188/15.ONF.316-318.
Rehm, H.L., Berg, J.S., Brooks, L.D., et al. ClinGen—the clinical genome resource. N Engl J Med 372:23 (2015), 2235–2242, 10.1056/NEJMsr1406261.
Strande, N.T., Riggs, E.R., Buchanan, A.H., et al. Evaluating the clinical validity of gene-disease associations: an evidence-based framework developed by the clinical genome resource. Am J Hum Genet 100:6 (2017), 895–906, 10.1016/j.ajhg.2017.04.015.
Rubinstein, W.S., Maglott, D.R., Lee, J.M., et al. The NIH genetic testing registry: a new, centralized database of genetic tests to enable access to comprehensive information and improve transparency. Nucleic Acids Res 41:Database issue (2013), D925–D935, 10.1093/nar/gks1173.
Hopkins University, Johns, OMIM: Online Mendelian Inheritance in Man. https://omim.org/.
INSERM. Orphanet. https://www.orpha.net/consor/cgi-bin/index.php. (Accessed 30 December 2021)
Shefchek, K.A., Harris, N.L., Gargano, M., et al. The Monarch Initiative in 2019: an integrative data and analytic platform connecting phenotypes to genotypes across species. Nucleic Acids Res 48:D1 (2020), D704–D715, 10.1093/nar/gkz997.
Mungall, C.J., McMurry, J.A., Köhler, S., et al. The Monarch Initiative: an integrative data and analytic platform connecting phenotypes to genotypes across species. Nucleic Acids Res 45:D1 (2017), D712–D722, 10.1093/nar/gkw1128.
Myers, S.M., Challman, T.D., Bernier, R., et al. Insufficient evidence for “autism-specific” genes. Am J Hum Genet 106:5 (2020), 587–595, 10.1016/j.ajhg.2020.04.004.
Bean, L.J.H., Funke, B., Carlston, C.M., et al. Diagnostic gene sequencing panels: from design to report-a technical standard of the American College of Medical Genetics and Genomics (ACMG). Genet Med 22:3 (2020), 453–461, 10.1038/s41436-019-0666-z.
Karczewski, K.J., Francioli, L.C., Tiao, G., et al. The mutational constraint spectrum quantified from variation in 141,456 humans. Nature 581:7809 (2020), 434–443 Published correction appears in Nature. 2021;590(7846):E53. Published correction appears in Nature. 2021;597(7874):E3-E4 https://doi.org/10.1038/s41586-020-2308-7.
de Ligt, J., Willemsen, M.H., van Bon, B.W., et al. Diagnostic exome sequencing in persons with severe intellectual disability. N Engl J Med 367:20 (2012), 1921–1929, 10.1056/NEJMoa1206524.
Neale, B.M., Kou, Y., Liu, L., et al. Patterns and rates of exonic de novo mutations in autism spectrum disorders. Nature 485:7397 (2012), 242–245, 10.1038/nature11011.
Savatt, J.M., Azzariti, D.R., Faucett, W.A., et al. ClinGen's GenomeConnect registry enables patient-centered data sharing. Hum Mutat 39:11 (2018), 1668–1676, 10.1002/humu.23633.
Kirkpatrick, B.E., Riggs, E.R., Azzariti, D.R., et al. GenomeConnect: matchmaking between patients, clinical laboratories, and researchers to improve genomic knowledge. Hum Mutat 36:10 (2015), 974–978, 10.1002/humu.22838.
Mirzaa, G.M., Chong, J.X., Piton, A., et al. De novo and inherited variants in ZNF292 underlie a neurodevelopmental disorder with features of autism spectrum disorder. Genet Med 22:3 (2020), 538–546, 10.1038/s41436-019-0693-9.
Martin, A.R., Williams, E., Foulger, R.E., et al. PanelApp crowdsources expert knowledge to establish consensus diagnostic gene panels. Nat Genet 51:11 (2019), 1560–1565, 10.1038/s41588-019-0528-2.
Stark, Z., Foulger, R.E., Williams, E., et al. Scaling national and international improvement in virtual gene panel curation via a collaborative approach to discordance resolution. Am J Hum Genet 108:9 (2021), 1551–1557, 10.1016/j.ajhg.2021.06.020.
Thormann, A., Halachev, M., McLaren, W., et al. Flexible and scalable diagnostic filtering of genomic variants using G2P with Ensembl VEP. Nat Commun, 10(1), 2019, 2373, 10.1038/s41467-019-10016-3.
Schaaf, C.P., Betancur, C., Yuen, R.K.C., et al. A framework for an evidence-based gene list relevant to autism spectrum disorder. Nat Rev Genet 21:6 (2020), 367–376, 10.1038/s41576-020-0231-2.
Belmadani, M., Jacobson, M., Holmes, N., et al. VariCarta: A comprehensive database of harmonized genomic variants found in autism spectrum disorder sequencing studies. Autism Res 12:12 (2019), 1728–1736, 10.1002/aur.2236.
Turner, T.N., Yi, Q., Krumm, N., et al. denovo-db: a compendium of human de novo variants. Nucleic Acids Res 45:D1 (2017), D804–D811, 10.1093/nar/gkw865.
Gonzalez-Mantilla, A.J., Moreno-De-Luca, A., Ledbetter, D.H., Martin, C.L., A cross-disorder method to identify novel candidate genes for developmental brain disorders. JAMA Psychiatry 73:3 (2016), 275–283, 10.1001/jamapsychiatry.2015.2692.
Abrahams, B.S., Arking, D.E., Campbell, D.B., et al. SFARI Gene 2.0: a community-driven knowledgebase for the autism spectrum disorders (ASDs). Mol Autism, 4(1), 2013, 36, 10.1186/2040-2392-4-36.