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Rare variants found in clinical gene panels illuminate the genetic and allelic architecture of orofacial clefting
Journal article   Open access   Peer reviewed

Rare variants found in clinical gene panels illuminate the genetic and allelic architecture of orofacial clefting

Kimberly K. Diaz Perez, Sarah W. Curtis, Alba Sanchis-Juan, Xuefang Zhao, Taylor Head, Samantha Ho, Bridget Carter, Toby McHenry, Madison R. Bishop, Luz C. Valencia-Ramirez, …
Genetics in medicine, Vol.25(10), pp.100918-100918
10/01/2023
DOI: 10.1016/j.gim.2023.100918
PMCID: PMC10592535
PMID: 37330696
url
https://doi.org/10.1016/j.gim.2023.100918View
Published (Version of record) Open Access

Abstract

Orofacial clefts (OFCs) are common birth defects including cleft lip, cleft lip and palate, and cleft palate. OFCs have heterogeneous etiologies, complicating clinical diagnostics because it is not always apparent if the cause is Mendelian, environmental, or multifactorial. Sequencing is not currently performed for isolated or sporadic OFCs; therefore, we estimated the diagnostic yield for 418 genes in 841 cases and 294 controls. We evaluated 418 genes using genome sequencing and curated variants to assess their pathogenicity using American College of Medical Genetics criteria. 9.04% of cases and 1.02% of controls had “likely pathogenic” variants (P < .0001), which was almost exclusively driven by heterozygous variants in autosomal genes. Cleft palate (17.6%) and cleft lip and palate (9.09%) cases had the highest yield, whereas cleft lip cases had a 2.80% yield. Out of 39 genes with likely pathogenic variants, 9 genes, including CTNND1 and IRF6, accounted for more than half of the yield (4.64% of cases). Most variants (61.8%) were “variants of uncertain significance”, occurring more frequently in cases (P = .004), but no individual gene showed a significant excess of variants of uncertain significance. These results underscore the etiological heterogeneity of OFCs and suggest sequencing could reduce the diagnostic gap in OFCs.
Cleft lip Cleft palate Congenital anomaly Exome Genome

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