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Browsing by Subject "Whole-genome sequencing"
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Item Esophageal Atresia With or Without Tracheoesophageal Fistula: Comorbidities, Genetic Evaluations, and Neonatal Outcomes(Springer Nature, 2023-02-08) Khattar, Divya; Suhrie, Kristen R.; Pediatrics, School of MedicineObjective: Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) has a reported incidence of 1 in 3500 live births and requires intensive care and surgery. To evaluate the prevalence of a molecularly confirmed genetic etiology of EA/TEF in a level IV neonatal intensive care unit (NICU), focusing on genetic evaluation, diagnostic yield, and clinical outcomes of these neonates. Study design: A retrospective cohort study over a period of seven years was performed for all patients admitted with a diagnosis of EA/TEF. Automated data was extracted for demographic information and manual extraction was done to evaluate the frequency of associated anomalies, type of genetic evaluations and diagnoses, and outcomes at NICU discharge. Results: Sixty-eight infants met the inclusion criteria. The majority were male (n=42; 62%), born at >37 weeks' gestation (n=36; 53%), and had EA with distal TEF (n=54; 79%). Most (n=53; 78%) had additional associated congenital anomalies, but only 47 (69%) patients had a genetics evaluation performed and genetic testing was sent for 44 (65%) of those patients. The most common genetic testing performed was chromosomal microarray analysis (n=40; 59%), followed by chromosome analysis (n=11; 16%), and whole exome/genome sequencing (n=7; 10%). Five unique genetic diagnoses including CHARGE Syndrome, Fanconi Syndrome, EFTUD2-related mandibulofacial dysostosis, and two different chromosomal deletion syndromes were made for a total of nine (13%) patients in our cohort. The cohort suffered a high rate of morbidity and mortality during their NICU stay with important differences noted in isolated vs non-isolated EA/TEF. Twelve infants (18%) died prior to NICU discharge. Of those surviving, 40 (71%) infants had a primary repair, 37 (66%) infants required G or GJ feedings at NICU discharge, and eight (14%) patients were discharged on some type of respiratory support. Conclusion: In this high-risk cohort of EA/TEF patients cared for at a quaternary NICU, a majority were non-isolated and had some form of a genetic evaluation, but a minority underwent exome or genome sequencing. Given the high prevalence of associated anomalies, high mortality, and genetic disease prevalence in this cohort, we recommend standardization of phenotyping and genetic evaluation to allow for precision care and appropriate risk stratification.Item Genomic Investigation of Methicillin-Resistant Staphylococcus aureus ST113 Strains Isolated from Tertiary Care Hospitals in Pakistan(MDPI, 2021-09-17) Ullah, Nimat; Dar, Hamza Arshad; Naz, Kanwal; Andleeb, Saadia; Rahman, Abdur; Saeed, Muhammad Tariq; Hanan, Fazal; Bae, Taeok; Ali, Amjad; Microbiology and Immunology, School of MedicineMethicillin-resistant Staphylococcus aureus (MRSA) is a multi-drug resistant and opportunistic pathogen. The emergence of new clones of MRSA in both healthcare settings and the community warrants serious attention and epidemiological surveillance. However, epidemiological data of MRSA isolates from Pakistan are limited. We performed a whole-genome-based comparative analysis of two (P10 and R46) MRSA strains isolated from two provinces of Pakistan to understand the genetic diversity, sequence type (ST), and distribution of virulence and antibiotic-resistance genes. The strains belong to ST113 and harbor the SCCmec type IV encoding mecA gene. Both the strains contain two plasmids, and three and two complete prophage sequences are present in P10 and R46, respectively. The specific antibiotic resistance determinants in P10 include two aminoglycoside-resistance genes, aph(3')-IIIa and aad(6), a streptothrin-resistance gene sat-4, a tetracycline-resistance gene tet(K), a mupirocin-resistance gene mupA, a point mutation in fusA conferring resistance to fusidic acid, and in strain R46 a specific plasmid associated gene ant(4')-Ib. The strains harbor many virulence factors common to MRSA. However, no Panton-Valentine leucocidin (lukF-PV/lukS-PV) or toxic shock syndrome toxin (tsst) genes were detected in any of the genomes. The phylogenetic relationship of P10 and R46 with other prevailing MRSA strains suggests that ST113 strains are closely related to ST8 strains and ST113 strains are a single-locus variant of ST8. These findings provide important information concerning the emerging MRSA clone ST113 in Pakistan and the sequenced strains can be used as reference strains for the comparative genomic analysis of other MRSA strains in Pakistan and ST113 strains globally.Item Rare variants in long non-coding RNAs are associated with blood lipid levels in the TOPMed Whole Genome Sequencing Study(medRxiv, 2023-06-29) Wang, Yuxuan; Selvaraj, Margaret Sunitha; Li, Xihao; Li, Zilin; Holdcraft, Jacob A.; Arnett, Donna K.; Bis, Joshua C.; Blangero, John; Boerwinkle, Eric; Bowden, Donald W.; Cade, Brian E.; Carlson, Jenna C.; Carson, April P.; Chen, Yii-Der Ida; Curran, Joanne E.; de Vries, Paul S.; Dutcher, Susan K.; Ellinor, Patrick T.; Floyd, James S.; Fornage, Myriam; Freedman, Barry I.; Gabriel, Stacey; Germer, Soren; Gibbs, Richard A.; Guo, Xiuqing; He, Jiang; Heard-Costa, Nancy; Hildalgo, Bertha; Hou, Lifang; Irvin, Marguerite R.; Joehanes, Roby; Kaplan, Robert C.; Kardia, Sharon Lr.; Kelly, Tanika N.; Kim, Ryan; Kooperberg, Charles; Kral, Brian G.; Levy, Daniel; Li, Changwei; Liu, Chunyu; Lloyd-Jone, Don; Loos, Ruth Jf.; Mahaney, Michael C.; Martin, Lisa W.; Mathias, Rasika A.; Minster, Ryan L.; Mitchell, Braxton D.; Montasser, May E.; Morrison, Alanna C.; Murabito, Joanne M.; Naseri, Take; O'Connell, Jeffrey R.; Palmer, Nicholette D.; Preuss, Michael H.; Psaty, Bruce M.; Raffield, Laura M.; Rao, Dabeeru C.; Redline, Susan; Reiner, Alexander P.; Rich, Stephen S.; Ruepena, Muagututi'a Sefuiva; Sheu, Wayne H-H; Smith, Jennifer A.; Smith, Albert; Tiwari, Hemant K.; Tsai, Michael Y.; Viaud-Martinez, Karine A.; Wang, Zhe; Yanek, Lisa R.; Zhao, Wei; NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium; Rotter, Jerome I.; Lin, Xihong; Natarajan, Pradeep; Peloso, Gina M.; Biostatistics and Health Data Science, School of MedicineLong non-coding RNAs (lncRNAs) are known to perform important regulatory functions. Large-scale whole genome sequencing (WGS) studies and new statistical methods for variant set tests now provide an opportunity to assess the associations between rare variants in lncRNA genes and complex traits across the genome. In this study, we used high-coverage WGS from 66,329 participants of diverse ancestries with blood lipid levels (LDL-C, HDL-C, TC, and TG) in the National Heart, Lung, and Blood Institute (NHLBI) Trans-Omics for Precision Medicine (TOPMed) program to investigate the role of lncRNAs in lipid variability. We aggregated rare variants for 165,375 lncRNA genes based on their genomic locations and conducted rare variant aggregate association tests using the STAAR (variant-Set Test for Association using Annotation infoRmation) framework. We performed STAAR conditional analysis adjusting for common variants in known lipid GWAS loci and rare coding variants in nearby protein coding genes. Our analyses revealed 83 rare lncRNA variant sets significantly associated with blood lipid levels, all of which were located in known lipid GWAS loci (in a ±500 kb window of a Global Lipids Genetics Consortium index variant). Notably, 61 out of 83 signals (73%) were conditionally independent of common regulatory variations and rare protein coding variations at the same loci. We replicated 34 out of 61 (56%) conditionally independent associations using the independent UK Biobank WGS data. Our results expand the genetic architecture of blood lipids to rare variants in lncRNA, implicating new therapeutic opportunities.