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Distinctive genetic variation of long‐segment Hirschsprung's disease in Taiwan
Author(s) -
Yang Wendy,
Chen SzuChieh,
Lai JinYao,
Ming YungChing,
Chen JengChang,
Chen PeiLung
Publication year - 2019
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13665
Subject(s) - frameshift mutation , penetrance , sanger sequencing , genetics , exon , biology , hirschsprung's disease , gene , allele , medicine , dna sequencing , disease , phenotype , pathology
Background Hirschsprung's disease (HSCR) is a congenital disorder with the absence of myenteric and submucosal ganglion cells within distal gut. Due to multigenic inheritance and interactions, we employed next‐generation sequencing (NGS) to investigate genetic backgrounds of long‐segment HSCR (L‐HSCR) in Taiwan. Methods Genomic DNA extracted from peripheral blood of L‐HSCR patients was subjected to capture‐based NGS, based on a 31‐gene panel. The variants with allele frequency <0.05 and predicted by computational methods as deleterious were further validated by Sanger sequencing in patients and their family as well to tell de novo from inherited variants. Results Between 2015/04 and 2018/05, this study enrolled 23 L‐HSCR patients, including 15 (65.2%) sporadic cases and 8 (34.8%) familial patients in 4 different families. Six sporadic and seven familial cases showed possible harmful variants across eight different genes, accounting for an overall detection rate of 56.5%. These variants mainly resided in SEMA3C, followed by RET, NRG1, and NTRK1 . Three sporadic and 2 familial cases exhibited strong pathogenic variants as a deletional frameshift or stop codon in RET, L1CAM or NRG1 . In a HSCR family, the father passed on a pathogenic RET frameshift to two daughters; however, only one developed HSCR. Conclusion Using NGS, we disclosed deleterious mutations such as a frameshift or stop codon in either familial or sporadic patients. Our cases with isolated L‐HSCR or even total colonic aganglionosis appeared to exhibit complex patterns of inheritance and incomplete penetrance even in families with the same genetic variants, reflecting the possible effects of environmental factors and genetic modifiers.