Improving molecular diagnosis of aniridia and WAGR syndrome using customized targeted array-based CGH

PLoS One. 2017 Feb 23;12(2):e0172363. doi: 10.1371/journal.pone.0172363. eCollection 2017.

Abstract

Chromosomal deletions at 11p13 are a frequent cause of congenital Aniridia, a rare pan-ocular genetic disease, and of WAGR syndrome, accounting up to 30% of cases. First-tier genetic testing for newborn with aniridia, to detect 11p13 rearrangements, includes Multiplex Ligation-dependent Probe Amplification (MLPA) and karyotyping. However, neither of these approaches allow obtaining a complete picture of the high complexity of chromosomal deletions and breakpoints in aniridia. Here, we report the development and validation of a customized targeted array-based comparative genomic hybridization, so called WAGR-array, for comprehensive high-resolution analysis of CNV in the WAGR locus. Our approach increased the detection rate in a Spanish cohort of 38 patients with aniridia, WAGR syndrome and other related ocular malformations, allowing to characterize four undiagnosed aniridia cases, and to confirm MLPA findings in four additional patients. For all patients, breakpoints were accurately established and a contiguous deletion syndrome, involving a large number of genes, was identified in three patients. Moreover, we identified novel microdeletions affecting 3' PAX6 regulatory regions in three families with isolated aniridia. This tool represents a good strategy for the genetic diagnosis of aniridia and associated syndromes, allowing for a more accurate CNVs detection, as well as a better delineation of breakpoints. Our results underline the clinical importance of performing exhaustive and accurate analysis of chromosomal rearrangements for patients with aniridia, especially newborns and those without defects in PAX6 after diagnostic screening.

MeSH terms

  • Aniridia / genetics*
  • Chromosome Deletion
  • Chromosomes, Human, Pair 11 / genetics*
  • Comparative Genomic Hybridization / methods*
  • Female
  • Humans
  • Male
  • Oligonucleotide Array Sequence Analysis / methods
  • PAX6 Transcription Factor / genetics
  • WAGR Syndrome / genetics*

Substances

  • PAX6 Transcription Factor
  • PAX6 protein, human

Supplementary concepts

  • Chromosome 11p, partial deletion

Grants and funding

This work was supported by several grants from the Spanish Centre for Biomedical Network Research on Rare Diseases (CIBERER) (06/07/0036 and INTRA/07/704.1), Instituto de Salud Carlos III (Spanish Ministry of Health)/FEDER (CP12/03256), RETICS (RD09/0076/00101 and RD12/0034/0010), Ministry of Economy and Competitiveness/FEDER (MINECO, SAF2013-46943-R), and the Cátedra de Patrocinio HU-FJD-UAM "Medicina Genómica" and Fundación Mutua Madrileña. MC is sponsored by the Miguel Servet Program (CP12/03256) from Instituto de Salud Carlos III (Spanish Ministry of Health). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.