Accurate classification of BRCA1 variants with saturation genome editing.

Accurate classification of BRCA1 variants with saturation genome editing.
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DOI:
10.1038/s41586-018-0461-z
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发表时间:
2018-10
期刊:
影响因子:
64.8
通讯作者:
Shendure J
Shendure J
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Findlay GM;Daza RM;Martin B;Zhang MD;Leith AP;Gasperini M;Janizek JD;Huang X;Starita LM;Shendure J

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不确定意义的变异(VUS)从根本上限制了遗传信息的临床应用。BRCA1是一种肿瘤抑制因子,其生殖系功能丧失变异使女性易患乳腺癌和卵巢癌。虽然BRCA1已经在数百万女性中进行了测序,但与大多数新观察到的变异相关的风险无法明确分配。在这里,我们采用饱和基因组编辑来检测BRCA1功能关键结构域编码的13个外显子中96.5%的所有可能的单核苷酸变体(SNV)。近4,000个SNV的功能效应呈双峰分布,几乎与已建立的致病性评估完全一致。鉴定了超过400种非功能性错义SNV,以及约300种破坏表达的SNV。我们预测,这些结果将立即用于BRCA1变体的临床解释,并且这种模式可以扩展到克服VUS在其他临床可操作基因中的挑战。
Variants of uncertain significance (VUS) fundamentally limit the clinical utility of genetic information. The challenge they pose is epitomized by BRCA1, a tumor suppressor in which germline loss-of-function variants predispose women to breast and ovarian cancer. Although BRCA1 has been sequenced in millions of women, the risk associated with most newly observed variants cannot be definitively assigned. Here, we employ saturation genome editing to assay 96.5% of all possible single nucleotide variants (SNVs) in 13 exons encoding functionally critical domains of BRCA1. Functional effects for nearly 4,000 SNVs are bimodally distributed and almost perfectly concordant with established assessments of pathogenicity. Over 400 non-functional missense SNVs are identified, as well as ~300 SNVs that disrupt expression. We predict that these results will be immediately useful for clinical interpretation of BRCA1 variants, and that this paradigm can be extended to overcome the challenge of VUS in additional clinically actionable genes.
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