Experience of a multidisciplinary task force with exome sequencing for Mendelian disorders

Background

In order to optimally integrate the use of high-throughput sequencing (HTS) as a tool in clinical diagnostics of likely monogenic disorders, we have created a multidisciplinary “Genome Clinic Task Force” at the University Hospitals of Geneva, which is composed of clinical and molecular geneticists, bioinformaticians, technicians, bioethicists, and a coordinator.

Methods and results

We have implemented whole exome sequencing (WES) with subsequent targeted bioinformatics analysis of gene lists for specific disorders. Clinical cases of heterogeneous Mendelian disorders that could potentially benefit from HTS are presented and discussed during the sessions of the task force. Debate concerning the interpretation of identified variants and the content of the final report constitutes a major part of the task force’s work. Furthermore, issues related to bioethics, genetic counseling, quality control, and reimbursement are also addressed.

Conclusions

This multidisciplinary task force has enabled us to create a platform for regular exchanges between all involved experts in order to deal with the multiple complex issues related to HTS in clinical practice and to continuously improve the diagnostic use of HTS. In addition, this task force was instrumental to formally approve the reimbursement of HTS for molecular diagnosis of Mendelian disorders in Switzerland.

     

Exome Sequencing in 53 Sporadic Cases of Schizophrenia Identifies 18 Putative Candidate Genes

Schizophrenia (SCZ) is a severe, debilitating mental illness which has a significant genetic component. The identification of genetic factors related to SCZ has been challenging and these factors remain largely unknown. To evaluate the contribution of de novo variants (DNVs) to SCZ, we sequenced the exomes of 53 individuals with sporadic SCZ and of their non-affected parents. We identified 49 DNVs, 18 of which were predicted to alter gene function, including 13 damaging missense mutations, 2 conserved splice site mutations, 2 nonsense mutations, and 1 frameshift deletion. The average number of exonic DNV per proband was 0.88, which corresponds to an exonic point mutation rate of 1.7×10⁻⁸ per nucleotide per generation. The non-synonymous-to-synonymous mutation ratio of 2.06 did not differ from neutral expectations. Overall, this study provides a list of 18 putative candidate genes for sporadic SCZ, and when combined with the results of similar reports, identifies a second proband carrying a non-synonymous DNV in the RGS12 gene.     

The role of caspases in photoreceptor cell death of the retinoschisin-deficient mouse

Early schisis cavities in the retinal bipolar cell layer accompanied by progressive loss of cone and rod photoreceptor cells are the hallmark of the retinoschisin-deficient (Rs1h(-/Y)) murine retina. With this study we aimed at elucidating the molecular events underlying the photoreceptor cell death in this established murine model of X-linked juvenile retinoschisis. We show that photoreceptor degeneration in the Rs1h(-/Y) mouse is due to apoptotic events peaking around postnatal day 18. Cell death is accompanied by increased expression of initiator and inflammatory caspases but not by downstream effector caspases. The strong induction of caspase-1 (Casp1) prompted us to explore its involvement in the apoptotic process. We therefore generated double knock-out mice deficient for both retinoschisin and Casp1. No direct influence of the Casp1 genotype on apoptosis could be identified although striking differences in the overall number of resident microglia were observed independent of the Rs1h genotype.     

Beta-amyloid treatment of two complementary P301L tau-expressing Alzheimer's disease models reveals similar deregulated cellular processes

Alzheimer's disease (AD) is characterized by Abeta peptide-containing plaques and tau-containing neurofibrillary tangles (NFTs). Both pathologies have been combined by crossing Abeta plaque-forming APP mutant mice with NFT-forming P301L tau mutant mice or by stereotaxically injecting beta-amyloid peptide 1-42 (Abeta42) into brains of P301L tau mutant mice. In cell culture, Abeta42 induces filamentous tau aggregates. To understand which processes are disrupted by Abeta42 in the presence of tau aggregates, we applied comparative proteomics to Abeta42-treated P301L tau-expressing neuroblastoma cells and the amygdala of P301L tau transgenic mice stereotaxically injected with Abeta42. Remarkably, a significant fraction of proteins altered in both systems belonged to the same functional categories, i.e. stress response and metabolism. We also identified model-specific effects of Abeta42 treatment such as differences in cell signaling proteins in the cellular model and of cytoskeletal and synapse associated proteins in the amygdala. By Western blotting (WB) and immunohistochemistry (IHC), we were able to show that 72% of the tested candidates were altered in human AD brain with a major emphasis on stress-related unfolded protein responsive candidates. These data highlight these processes as potentially important initiators in the Abeta42-mediated pathogenic cascade in AD and further support the role of unfolded proteins in the course of AD.     

Role of the cytoplasmic C terminus of the FliF motor protein in flagellar assembly and rotation

Twenty-six FliF monomers assemble into the MS ring, a central motor component of the bacterial flagellum that anchors the structure in the inner membrane. Approximately 100 amino acids at the C terminus of FliF are exposed to the cytoplasm and, through the interaction with the FliG switch protein, a component of the flagellar C ring, are essential for the assembly of the motor. In this study, we have dissected the entire cytoplasmic C terminus of the Caulobacter crescentus FliF protein by high-resolution mutational analysis and studied the mutant forms with regard to the assembly, checkpoint control, and function of the flagellum. Only nine amino acids at the very C terminus of FliF are essential for flagellar assembly. Deletion or substitution of about 10 amino acids preceding the very C terminus of FliF resulted in assembly-competent but nonfunctional flagella, making these the first fliF mutations described so far with a Fla(+) but Mot(-) phenotype. Removal of about 20 amino acids further upstream resulted in functional flagella, but cells carrying these mutations were not able to spread efficiently on semisolid agar plates. At least 61 amino acids located between the functionally relevant C terminus and the second membrane-spanning domain of FliF were not required for flagellar assembly and performance. A strict correlation was found between the ability of FliF mutant versions to assemble into a flagellum, flagellar class III gene expression, and a block in cell division. Motile suppressors could be isolated for nonmotile mutants but not for mutants lacking a flagellum. Several of these suppressor mutations were localized to the 5' region of the fliG gene. These results provide genetic support for a model in which only a short stretch of amino acids at the immediate C terminus of FliF is required for flagellar assembly through stable interaction with the FliG switch protein.     

Cladogram of Panamanian Clusia Based on Nuclear DNA: Implications for the Origins of Crassulacean Acid Metabolism

Abstract: The internal transcribed spacer (ITS) region of 18-26S nuclear ribosomal DNA repeat was sequenced for 31 of the approximately 40 species of Clusia known to occur in Panama. Several species from other genera of the Clusiaceae were used as outgroups in the phylogenetic calculation. High sequence alignment and minimal length variation among ITS-1, 5.8S and ITS-2 sequences facilitated determination of positional homology of nucleotide sizes. Sequence alignment was evaluated with character state (Maximum Parsimony) and distance methods (Neighbour Joining). Phylogenetic trees obtained with the two methods were largely concordant and revealed three main groups that roughly correspond to previous arrangements of species into three large morphological groups, the C. flava group, the C. minor group and the C. multiflora group. Because species of Clusia are either regular C₃ plants or exhibit crassulacean acid metabolism (CAM) involving varying proportions of CO₂ fixation in the dark versus the light, we mapped photosynthetic pathways onto the cladograms. Photosynthetic pathway classification was based on measurements of ¹³C/¹²C ratios of plant carbon and also on information available from the literature. Both the C. flava and C. minor group contained species exhibiting CAM, distributed on distinct branches of the cladograms, whereas the third group ( C. multiflora group) was composed of species which are not known to use CAM.     

Pollen monitoring: minimum requirements and reproducibility of analysis

Training, quality assurance (QA) and quality control (QC) play an important role in building competence in monitoring and research in aerobiology. The main goals of this paper were to: (a) formulate an updated Minimum Requirements Report for pollen monitoring; (b) carry out a pilot QC exercise of staff involved in pollen counting from various national networks in order to examine between analysts reproducibility and develop a methodology that can be used in future QC exercises. A questionnaire survey was sent to coordinators of participating pollen monitoring networks. In addition, a total of 45 technicians from 15 European countries participated in the pilot QC exercise. All technicians were instructed to analyse two slides containing the following pollen types: (a) Poaceae and Betula pollen grains in the north of Europe; (b) Poaceae and Olea pollen grains in the south of Europe. Minimum Recommendations were produced based on the results of the questionnaire survey, published literature, and the outcomes of a workshop. In the QC exercise, it was noticed that technicians who followed the Minimum Recommendations and examined at least 10 % of the slide tended to have better indicators of precision and accuracy than those technicians who did not follow the Minimum Recommendations. The proposed Minimum Recommendations will help to improve the quality of scientific work, particularly for those who are considering the setting up of new monitoring sites. The results of the pilot QC exercise will help to develop a methodology that can be used again in the future, thereby ensuring data quality.     

<Emphasis Type="Italic">δ</Emphasis><Superscript>13</Superscript>C values and crassulacean acid metabolism in <Emphasis Type="Italic">Clusia</Emphasis> species from Panama

The genus Clusia is notable in that it contains arborescent crassulacean acid metabolism (CAM) plants. As part of a study of CAM in Clusia, titratable acidities were measured in 25 species and ¹³C values were measured for 38 species from Panamá, including seven undescribed species, and 11 species from Colombia, Costa Rica and Honduras. CAM was detected in 12 species. Clusia flava, C. rosea and C. uvitana exhibited ¹³C values or diurnal fluctuations in acidity indicative of strong CAM. In C. croatii, C. cylindrica, C. fructiangusta, C. lineata, C. odorata, C. pratensis, C. quadrangula, C. valerioi and C. sp. D diurnal fluctuations in acidity were consistent with weak CAM but the ¹³C values were C₃-like. All of the species that exhibited strong or weak CAM were in the C. flava or C. minor species groups. CAM was not detected in any member of the C. multiflora species group. Strong CAM species were not collected at altitudes above 680 m a.s.l. On the basis of ¹³C values, the expression of CAM was similar in terrestrial, hemi-epiphytic and epiphytic species and did not differ between individuals of the same species that exhibited different life-forms. This study indicates that phylogenetic affiliation may be a predictor of an ability to exhibit CAM in Clusia species from the Panamanian region, and that weak CAM is probably a common photosynthetic option in many Clusia species. ¹³C value is not a particularly good indicator of a potential of Clusia species growing in the field to exhibit CAM because it appears that the contribution in most species of CAM to carbon gain is generally rather small when integrated over the life-time of leaves.     

Facilitating the restoration of aquatic plant communities in a Ramsar wetland

Human activities such as land clearing and intensive land use around water bodies, particularly wetlands, have a detrimental impact on water quality and quantity, aquatic plant communities, and associated wetland fauna. Lake Alexandrina and Lake Albert are internationally significant Ramsar wetlands located at the terminus of the Murray River, Australia's longest river system. Agriculture, water regulation, and extraction and droughts have had a detrimental impact on native plant communities in the lakes. We studied the influence of young (<1–3 years) and old (8–11 years) plantings of a native sedge (bulrush), Schoenoplectus tabernaemontani, to facilitate the establishment of aquatic plant communities in comparison with remnant and control sites. We also measured how planting structure (height, stand width, and stem density) changed with age in comparison with remnant sites. Results suggest that as plantings age they get substantially wider and have a greater maximum height, although do not reach similar stand widths by 11 years when compared to remnant areas. However, old plantings do not differ from remnant habitats in relation to aquatic plant species richness, counts of aquatic plants, and community composition. Young plantings have substantially less abundant and diverse plant communities, but are developing on a similar trajectory to old plantings. It is likely that planting sedges along lake shorelines causes a breakwater effect that facilitates the recolonization of wetland plants between the planted area and the water's edge. Management agencies should consider restoring native sedges to increase aquatic biodiversity, and potentially reduce erosion.     

Discovery of a multispecies shark aggregation and parturition area in the Ba Estuary,Fiji Islands

Population declines in shark species have been reported on local and global scales, with overfishing, habitat destruction and climate change posing severe threats. The lack of species‐specific baseline data on ecology and distribution of many sharks, however, makes conservation measures challenging. Here, we present a fisheries‐independent shark survey from the Fiji Islands, where scientific knowledge on locally occurring elasmobranchs is largely still lacking despite the location's role as a shark hotspot in the Pacific. Juvenile shark abundance in the fishing grounds of the Ba Estuary (north‐western Viti Levu) was assessed with a gillnet‐ and longline‐based survey from December 2015 to April 2016. A total of 103 juvenile sharks identified as blacktip Carcharhinus limbatus (n = 57), scalloped hammerhead Sphyrna lewini (n = 35), and great hammerhead Sphyrna mokarran (n = 11) sharks were captured, tagged, and released. The condition of umbilical scars (68% open or semihealed), mean sizes of individuals (±SD) (C. limbatus: 66.5 ± 3.8 cm, S. lewini: 51.8 ± 4.8 cm, S. mokarran 77.4 ± 2.8 cm), and the presence of these species over recent years (based on fishermen interviews), suggest that the Ba Estuary area is a critical habitat for multiple species that are classified as “Near Threatened” or “Endangered.” Specifically, the area likely acts as a parturition ground over the studied period, and potentially as a subsequent nursery area. We identified subareas of high abundance and found that temperature, salinity and depth acted as small‐scale environmental drivers of shark abundance. The data suggests a tendency for species‐specific spatial use, both horizontally (i.e., between sampling areas) and vertically (i.e., across the water column). These results enhance the understanding of shark ecology in Fiji and provide a scientific basis for the implementation of local conservation strategies that contribute to the protection of these threatened species.