Comprehensive genetic screening for vascular Ehlers-Danlos syndrome through an amplification-based next-generation sequencing system

Am J Med Genet A. 2023 Jan;191(1):37-51. doi: 10.1002/ajmg.a.62982. Epub 2022 Oct 3.

Abstract

Vascular Ehlers-Danlos syndrome (vEDS) is a hereditary connective tissue disorder (HCTD) characterized by arterial dissection/aneurysm/rupture, sigmoid colon rupture, or uterine rupture. Diagnosis is confirmed by detecting heterozygous variants in COL3A1. This is the largest Asian case series and the first to apply an amplification-based next-generation sequencing through custom panels of causative genes for HCTDs, including a specific method of evaluating copy number variations. Among 429 patients with suspected HCTDs analyzed, 101 were suspected to have vEDS, and 33 of them (32.4%) were found to have COL3A1 variants. Two patients with a clinical diagnosis of Loeys-Dietz syndrome and/or familial thoracic aortic aneurysm and dissection were also found to have COL3A1 variants. Twenty cases (57.1%) had missense variants leading to glycine (Gly) substitutions in the triple helical domain, one (2.9%) had a missense variant leading to non-Gly substitution in this domain, eight (22.9%) had splice site alterations, three (8.6%) had nonsense variants, two (5.7%) had in-frame deletions, and one (2.9%) had a multi-exon deletion, including two deceased patients analyzed with formalin-fixed and paraffin-embedded samples. This is a clinically useful system to detect a wide spectrum of variants from various types of samples.

Keywords: COL3A1; amplification-based next-generation sequencing; copy number variations; formalin-fixed and paraffin-embedded (FFPE) samples; hereditary connective tissue disorders (HCTDs); vascular Ehlers-Danlos syndrome (vEDS).

MeSH terms

  • Collagen Type III / genetics
  • DNA Copy Number Variations
  • Ehlers-Danlos Syndrome* / diagnosis
  • Ehlers-Danlos Syndrome* / genetics
  • Ehlers-Danlos Syndrome, Type IV*
  • Female
  • Genetic Testing
  • Humans
  • Pregnancy

Substances

  • Collagen Type III