Sequenciamento de nova geração : explorando aplicações clínicas de dados de Targeted Gene Panel e Whole Exome Sequencing

A tecnologia de sequenciamento de nova geração (next-generation sequencing – NGS) e suas aplicações tem sido cada vez mais utilizada na prática médica para elucidar a base molecular de doenças Mendelianas. Embora seja uma poderosa ferramenta de pesquisa, ainda existe uma importante transição quanto à análise dos dados entre as tecnologias tradicionais de sequenciamento e o NGS. A primeira parte deste trabalho aborda aspectos analíticos envolvidos nesta mudança, com foco na plataforma Ion Torrent Personal Genome Machine. Esta é uma plataforma amplamente utilizada para sequenciar painéis de genes, já que esta aplicação requer menor rendimento de dados. Este trabalho demonstra indicadores adequados para avaliar a qualidade de corridas de sequenciamento e também uma estratégia baseada em valores de profundidade de cobertura para avaliar a performance de amplicons em diferentes cenários. Por outro lado, o NGS permitiu a realização de estudos populacionais em larga escala que estão mudando nossa compreensão sobre as variações genéticas humanas. Um desses exemplos são as mutações até então chamadas de silenciosas, que estão sendo implicadas como causadoras de doenças humanas. A segunda parte deste trabalho investiga a patogenicidade de polimorfismos de núcleotídeo único sinônimos (synonymous single nucleotide polymorphisms – sSNP) baseado em dados públicos obtidos do Exome Aggregation Consortium (ExAC) (exac.broadinstitute.org/) utilizando o software Silent Variant Analysis (SilVA) (compbio.cs.toronto.edu/silva/) e outros recursos para reunir informações adicionais sobre consequências funcionais visando fornecer um panorama dos efeitos patogênicos de sSNP em mais de 60.000 exomas humanos. Nós demonstramos que de 1,691,045 variantes sinônimas, um total de 26,034 foram classificadas como patogênicas pelo SilVA, com frequência alélica menor que 0,05. Análises funcionais in silico revelaram que as variantes sinônimas patogênicas estão envolvidas em processos biológicos importantes, como regulação celular, metabolismo e transporte. Ao expor um cenário de variações sinônimas patogênicas em exomas humanos, nós concluímos que filtrar sSNP em workflows de priorização é razoável, no entanto em situações específicas os sSNP podem ser considerados. Pesquisas futuras neste campo poderão fornecer uma imagem clara do papel de tais variações em doenças genéticas.Next-generation sequencing (NGS) technologies and its applications are increasingly used in medicine to elucidate the molecular basis of Mendelian diseases. Although it is a powerful research tool, there is still an important transition regarding data analysis between traditional sequencing techniques and NGS. The first part of this work addresses analytical aspects involved on this switch-over, focusing on the Ion Torrent Personal Genome Machine platform. This is a widely used platform for sequencing gene panels, as this application demands lower throughput of data. We present indicators suitable to evaluate quality of sequencing runs and also a strategy based on depth of coverage values to evaluate amplicon performance on different scenarios. On the other hand, NGS enabled large-scale population studies that are changing our understanding about human genetic variations. One of these examples are the so-called silent mutations, that are being implied as causative of human diseases. The second part of this work investigates the pathogenicity of synonymous single nucleotide polymorphisms (sSNP) based on public data obtained from the Exome Aggregation Consortium (ExAC) (exac.broadinstitute.org/) using the software Silent Variant Analysis (SilVA) (compbio.cs.toronto.edu/silva/) and other sources to gather additional information about affected protein domains, mRNA folding and functional consequences aiming to provide a landscape of harmfulness of sSNP on more than 60,000 human exomes. We show that from 1,691,045 synonymous variants a total of 26,034 were classified as pathogenic and by SilVA, with allele frequency lower than 0.05. In silico functional analysis revealed that pathogenic synonymous variants found are involved in important biological process, such as cellular regulation, metabolism and transport. By exposing a scenario of pathogenic synonymous variants on human exomes we conclude that filtering out sSNP on prioritization workflows is reasonable, although in some specific cases sSNP should be considered. Future research on this field will provide a clear picture of such variations on genetic diseases

Phenotype-oriented NGS panels for mucopolysaccharidoses : validation and potential use in the diagnostic flowchart

Mucopolysaccharidosis (MPS) are a group of rare genetic disorders caused by deficiency in the activity of specific lysosomal enzymes required for the degradation of glycosaminoglycans (GAGs). A defect in the activity of these enzymes will result in the abnormal accumulation of GAGs inside the lysosomes of most cells, inducing progressive cellular damage and multiple organ failure. DNA samples from 70 patients with biochemical diagnosis of different MPSs genotypes confirmed by Sanger sequencing were used to evaluate a Next Generation Sequencing (NGS) protocol. Eleven genes related to MPSs were divided into three different panels according to the clinical phenotype. This strategy led to the identification of several pathogenic mutations distributed across all exons of MPSs-related genes. We were able to identify 96% of all gene variants previously identified by Sanger sequencing, showing high sensitivity in detecting different types of mutations. Furthermore, new variants were not identified, representing 100% specificity of the NGS protocol. The use of this NGS approach for genotype identification in MPSs is an attractive option for diagnosis of patients. In addition, the MPS diagnosis workflow could be divided in a two-tier approach: NGS as a first-tier followed by biochemical confirmation as a second-tier