Whole-Genome Sequencing for Optimized Patient Management

被引:192
作者
Bainbridge, Matthew N. [1 ,2 ]
Wiszniewski, Wojciech [3 ]
Murdock, David R. [1 ]
Friedman, Jennifer [4 ,5 ,6 ]
Gonzaga-Jauregui, Claudia [3 ]
Newsham, Irene [1 ]
Reid, Jeffrey G. [1 ]
Fink, John K. [7 ,8 ]
Morgan, Margaret B. [1 ]
Gingras, Marie-Claude [1 ]
Muzny, Donna M. [1 ]
Hoang, Linh D. [9 ]
Yousaf, Shahed [9 ]
Lupski, James R. [1 ,3 ,10 ,11 ]
Gibbs, Richard A. [1 ,3 ]
机构
[1] Baylor Coll Med, Human Genome Sequencing Ctr, Houston, TX 77030 USA
[2] Baylor Coll Med, Dept Struct & Computat Biol & Mol Biophys, Houston, TX 77030 USA
[3] Baylor Coll Med, Dept Mol & Human Genet, Houston, TX 77030 USA
[4] Univ Calif San Diego, Dept Neurosci, San Diego, CA 92093 USA
[5] Univ Calif San Diego, Dept Pediat, San Diego, CA 92093 USA
[6] Rady Childrens Hosp, San Diego, CA 92123 USA
[7] Univ Michigan, Dept Neurol, Ann Arbor, MI 48109 USA
[8] Ann Arbor Vet Affairs Med Ctr, Geriatr Res Educ & Clin Ctr, Ann Arbor, MI 48105 USA
[9] Life Technol, Carlsbad, CA 92008 USA
[10] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
[11] Texas Childrens Hosp, Houston, TX 77030 USA
基金
加拿大自然科学与工程研究理事会;
关键词
DOPA-RESPONSIVE DYSTONIA; SEPIAPTERIN REDUCTASE DEFICIENCY; PROGRESSIVE DYSTONIA; DIURNAL-VARIATION; DIAGNOSIS; GENETICS; DATABASE;
D O I
10.1126/scitranslmed.3002243
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
Whole-genome sequencing of patient DNA can facilitate diagnosis of a disease, but its potential for guiding treatment has been under-realized. We interrogated the complete genome sequences of a 14-year-old fraternal twin pair diagnosed with dopa (3,4-dihydroxyphenylalanine)-responsive dystonia (DRD; Mendelian Inheritance in Man #128230). DRD is a genetically heterogeneous and clinically complex movement disorder that is usually treated with L-dopa, a precursor of the neurotransmitter dopamine. Whole-genome sequencing identified compound heterozygous mutations in the SPR gene encoding sepiapterin reductase. Disruption of SPR causes a decrease in tetrahydrobiopterin, a cofactor required for the hydroxylase enzymes that synthesize the neuro-transmitters dopamine and serotonin. Supplementation of L-dopa therapy with 5-hydroxytryptophan, a serotonin precursor, resulted in clinical improvements in both twins.
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页数:6
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