Framework From a Multidisciplinary Approach for Transitioning Variants of Unknown Significance From Clinical Genetic Testing in Kidney Disease to a Definitive Classification

Autor: Uyenlinh L. Mirshahi, Ahana Bhan, Lotte E. Tholen, Brian Fang, Guoli Chen, Bryn Moore, Adam Cook, Prince Mohan Anand, Kashyap Patel, Mary E. Haas, Luca A. Lotta, Peter Igarashi, Jeroen H.F. de Baaij, Silvia Ferrè, Joost G.J. Hoenderop, David J. Carey, Alexander R. Chang
Rok vydání: 2022
Předmět:
Zdroj: Kidney International Reports, 7, 9, pp. 2047-2058
Kidney International Reports, 7, 2047-2058
ISSN: 2468-0249
DOI: 10.1016/j.ekir.2022.06.014
Popis: Monogenic causes in over 300 kidney-associated genes account for approximately 12% of end stage kidney disease (ESKD) cases. Advances in sequencing and large customized panels enable the noninvasive diagnosis of monogenic kidney disease at relatively low cost, thereby allowing for more precise management for patients and their families. A major challenge is interpreting rare variants, many of which are classified as variants of unknown significance (VUS). We present a framework in which we thoroughly evaluated and provided evidence of pathogenicity forA blueprint was designed by a multidisciplinary team of clinicians, molecular biologists, and diagnostic geneticists. The blueprint included using a health system-based cohort with genetic and clinical information to perform deep phenotyping of VUS heterozygotes to identify the candidate VUS and rule out other VUS, examination of existing genetic databases, as well as functional testing.Our approach demonstrated evidence for pathogenicity forDetermination of a molecular diagnosis for the example family allows for proper surveillance and management of
Databáze: OpenAIRE