Personalized genetic counseling for Stargardt disease: Offspring risk estimates based on variant severity

被引:31
作者
Cornelis, Stephanie S. [1 ,2 ]
Runhart, Esmee H. [2 ,3 ]
Bauwens, Miriam [4 ,5 ,6 ]
Corradi, Zelia [1 ,2 ]
De Baere, Elfride [4 ,5 ,6 ]
Roosing, Susanne [1 ,2 ]
Haer-Wigman, Lonneke [1 ,2 ]
Dhaenens, Claire-Marie [7 ]
Vulto-van Silfhout, Anneke T. [1 ,2 ]
Cremers, Frans P. M. [1 ,2 ]
机构
[1] Radboud Univ Nijmegen, Dept Human Genet, Med Ctr, NL-6525 Nijmegen, Netherlands
[2] Radboud Univ Nijmegen, Donders Inst Brain Cognit & Behav, Med Ctr, NL-6525 Nijmegen, Netherlands
[3] Radboud Univ Nijmegen, Dept Ophthalmol, Med Ctr, NL-6525 Nijmegen, Netherlands
[4] Univ Ghent, Ctr Med Genet Ghent, B-9000 Ghent, Belgium
[5] Univ Ghent, Dept Biomol Med, B-9000 Ghent, Belgium
[6] Ghent Univ Hosp, B-9000 Ghent, Belgium
[7] Univ Lille, INSERM, CHU Lille, U1172LilNCog Lille Neurosci & Cognit, F-59000 Lille, France
基金
欧盟地平线“2020”;
关键词
CONE-ROD DYSTROPHY; ABCA4; DISEASE; COMPLEX INHERITANCE; MUTATIONS; MILD; FREQUENT; ALLELES; ASSOCIATION; PROGRESSION;
D O I
10.1016/j.ajhg.2022.01.008
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Recurrence risk calculations in autosomal recessive diseases are complicated when the effect of genetic variants and their population frequencies and penetrances are unknown. An example of this is Stargardt disease (STGD1), a frequent recessive retinal disease caused by bi-allelic pathogenic variants in ABCA4. In this cross-sectional study, 1,619 ABCA4 variants from 5,579 individuals with STGD1 were collected and categorized by (1) severity based on statistical comparisons of their frequencies in STGD1-affected individuals versus the general population, (2) their observed versus expected homozygous occurrence in STGD1-affected individuals, (3) their occurrence in combination with established mild alleles in STGD1-affected individuals, and (4) previous functional and clinical studies. We used the sum allele frequencies of these severity categories to estimate recurrence risks for offspring of STGD1-affected individuals and carriers of pathogenic ABCA4 variants. The risk for offspring of an STGD1-affected individual with the "severe vertical bar severe"genotype or a "severe vertical bar mild with complete penetrance"genotype to develop STGD1 at some moment in life was estimated at 2.8%-3.1% (1 in 36-32 individuals) and 1.6%-1.8% (1 in 62-57 individuals), respectively. The risk to develop STGD1 in childhood was estimated to be 2-to 4-fold lower: 0.68%-0.79% (1 in 148-126) and 0.34%-0.39% (1 in 296-252), respectively. In conclusion, we established personalized recurrence risk calculations for STGD1-affected individuals with different combinations of variants. We thus propose an expanded genotype-based personalized counseling to appreciate the variable recurrence risks for STGD1-affected individuals. This represents a conceptual breakthrough because risk calculations for STGD1 may be exemplary for many other inherited diseases.
引用
收藏
页码:498 / 507
页数:11
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