We continue to make significant contributions to the field of genomic analysis through collaborative studies, innovative software solutions, and robust data interpretation methodologies. This blog highlights four recent contributions from our team and collaborators, showcasing the breadth of our research and its implications for clinical practice.
Analyzing Performance of Twist Bioscience Exome Enrichment with Spike-in CNV Backbone Panels at Various Probe Densities Leveraging Golden Helix VS-CNV Analysis Software
Clinical Whole Exome Sequencing (WES) offers a high diagnostic yield test by detecting pathogenic variants in all coding genes of the human genome. WES is poised to consolidate multiple genetic tests by accurately identifying Copy Number Variation (CNV) events, typically necessitating microarray analysis. However, standard commercial exome kits are typically limited to targeting exon coding regions, leaving significant gaps in coverage between genes, which could hinder comprehensive CNV detection. To convert microarray CNV calling with NGS, advances in both assay design and computational methods are needed.
Addressing the need for comprehensive coverage, Twist Bioscience has developed an enhanced Exome 2.0 Plus Comprehensive Exome Spike-in panel with added CNV “backbone” probes. These probes target common SNPs polymorphic in multiple populations and are evenly distributed in the intergenic and intronic regions, with three varying densities at 25 kb, 50 kb, and 100 kb intervals from highest to lowest resolution respectively. Concurrently, Golden Helix has developed a multi-modal CNV caller designed specifically for target-capture NGS data to detect single-exon to whole-chromosome aneuploidy CNV events. This study evaluates the combined efficacy of the backbone-probe enhanced exome capture kit and VS-CNV 2.6 in identifying known CNVs using the Coriell CNVPANEL01 reference set.
The integration of the enhanced capture kit with VS-CNV 2.6 achieved a 100% sensitivity rate for the detection of known CNV events at all three probe densities. The application of best-practice quality metrics, annotations, and filters was shown to have a minimal impact on this high sensitivity. These findings underscore the potential of the augmented Twist Exome in tandem with the VS-CNV caller and VarSeq’s annotation and filtering capabilities. This combination presents a promising alternative to conventional microarray assays, potentially consolidating WES and CNV into a single assay obviating the need for additional testing in clinical CNV detection. The study’s results advocate for the implementation of this integrated approach as a more efficient and equally sensitive method for CNV analysis in a clinical setting.
Rare host variants in ciliary expressed genes contribute to COVID-19 severity in Bulgarian patients
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a pneumonia with extremely heterogeneous clinical presentation, ranging from asymptomatic to severely ill patients. Previous studies have reported links between the presence of host genetic variants and the outcome of the COVID-19 infection. In our study, we used whole exome sequencing in a cohort of 444 SARS-CoV-2 patients, admitted to hospital in the period October-2020-April-2022, to search for associations between rare pathogenic/potentially pathogenic variants and COVID-19 progression. We used gene prioritization-based analysis in genes that have been reported by host genetic studies. Although we did not identify correlation between the presence of rare pathogenic variants and COVID-19 outcome, in critically ill patients we detected known mutations in a number of genes associated with severe disease related to cardiovascular disease, primary ciliary dyskinesia, cystic fibrosis, DNA damage repair response, coagulation, primary immune disorder, hemoglobin subunit β, and others. Additionally, we report 93 novel pathogenic variants found in severely infected patients who required intubation or died. A network analysis showed main component, consisting of 13 highly interconnected genes related to epithelial cilium. In conclusion, we have detected rare pathogenic host variants that may have influenced the COVID-19 outcome in Bulgarian patients.
Actionability and familial uptake following opportunistic genomic screening in a pediatric cancer cohort
The care for patients with serious conditions is increasingly guided by genomic medicine, and genomic medicine may equally transform care for healthy individual if genomic population screening is implemented. This study examines the medical impact of opportunistic genomic screening (OGS) in a cohort of patients undergoing comprehensive genomic germline DNA testing for childhood cancer, including the impact on their relatives. Medical actionability and uptake after cascade testing in the period following disclosure of OGS results was quantified. A secondary finding was reported to 19/595 (3.2%) probands primarily in genes related to cardiovascular and lipid disorders. After a mean follow up time of 1.6 years (Interquartile range (IQR): 0.57-1.92 yrs.) only 12 (63%) of these variants were found to be medically actionable. Clinical follow up or treatment was planned in 16 relatives, and as in the probands, the prescribed treatment was primarily betablockers or cholesterol lowering therapy. No invasive procedures or implantation of medical devices were performed in probands or relatives, and no reproductive counseling was requested. After an average of 1.6 years of follow-up 2.25 relatives per family with an actionable finding had been tested. This real-world experience of OGS grants new insight into the practical implementation effects and derived health care demands of genotype-first screening. The resulting health care effect and impact on demand for genetic counseling and workup in relatives extends beyond the effect in the probands.
Analysis of Molecular Mechanisms and Predictive Biomarkers of Disease Transformation in Polycythemia Vera
These recent studies and preprints from Golden Helix and collaborators underscore the transformative potential of genomic analysis in clinical settings. From enhancing CNV detection in WES to unraveling genetic factors in COVID-19 severity and implementing OGS in pediatric cancer care, our research continues to push the boundaries of precision medicine. We remain committed to developing innovative solutions that improve diagnostic accuracy and patient outcomes as we advance.