The genetic profile of Leber congenital amaurosis in an Australian cohort

Mol Genet Genomic Med. 2017 Nov;5(6):652-667. doi: 10.1002/mgg3.321. Epub 2017 Aug 22.

Abstract

Background: Leber congenital amaurosis (LCA) is a severe visual impairment responsible for infantile blindness, representing ~5% of all inherited retinal dystrophies. LCA encompasses a group of heterogeneous disorders, with 24 genes currently implicated in pathogenesis. Such clinical and genetic heterogeneity poses great challenges for treatment, with personalized therapies anticipated to be the best treatment candidates. Unraveling the individual genetic etiology of disease is a prerequisite for personalized therapies, and could identify potential treatment candidates, inform patient management, and discriminate syndromic forms of disease.

Methods: We have genetically analyzed 45 affected and 82 unaffected individuals from 34 unrelated LCA pedigrees using predominantly next-generation sequencing and Array CGH technology.

Results: We present the molecular findings for an Australian LCA cohort, sourced from the Australian Inherited Retinal Disease Registry & DNA Bank. CEP290 and GUCY2D mutations, each represent 19% of unrelated LCA cases, followed by NMNAT1 (12%). Genetic subtypes were consistent with other reports, and were resolved in 90% of this cohort.

Conclusion: The high resolution rate achieved, equivalent to recent findings using whole exome/genome sequencing, reflects the progression from hypothesis (LCA Panel) to non-hypothesis (RD Panel) testing and, coupled with Array CGH analysis, is a highly effective first-tier test for LCA.

Keywords: Genetic variants; Leber congenital amaurosis; inherited retinal dystrophies; next-generation sequencing; personalized therapies; retinal disease.

MeSH terms

  • Antigens, Neoplasm / genetics
  • Australia / epidemiology
  • Cell Cycle Proteins
  • Cohort Studies
  • Cytoskeletal Proteins
  • DNA Mutational Analysis
  • Databases, Genetic
  • Eye Proteins / genetics
  • Guanylate Cyclase / genetics
  • Heterozygote
  • High-Throughput Nucleotide Sequencing
  • Homozygote
  • Humans
  • Leber Congenital Amaurosis / diagnosis
  • Leber Congenital Amaurosis / epidemiology
  • Leber Congenital Amaurosis / genetics*
  • Microtubule-Associated Proteins / genetics
  • Native Hawaiian or Other Pacific Islander / genetics*
  • Neoplasm Proteins / genetics
  • Nicotinamide-Nucleotide Adenylyltransferase / genetics
  • Pedigree
  • Phenotype
  • Prevalence
  • Receptors, Cell Surface / genetics

Substances

  • Antigens, Neoplasm
  • Cell Cycle Proteins
  • Cep290 protein, human
  • Cytoskeletal Proteins
  • Eye Proteins
  • LCA5 protein, human
  • Microtubule-Associated Proteins
  • Neoplasm Proteins
  • Receptors, Cell Surface
  • guanylate cyclase 1
  • NMNAT1 protein, human
  • Nicotinamide-Nucleotide Adenylyltransferase
  • Guanylate Cyclase