Defining the clinical validity of genes reported to cause pulmonary arterial hypertension

dc.contributor.authorWelch, Carrie L.
dc.contributor.authorAldred, Micheala A.
dc.contributor.authorBalachandar, Srimmitha
dc.contributor.authorDooijes, Dennis
dc.contributor.authorEichstaedt, Christina A.
dc.contributor.authorGräf, Stefan
dc.contributor.authorHouweling, Arjan C.
dc.contributor.authorMachado, Rajiv D.
dc.contributor.authorPandya, Divya
dc.contributor.authorPrapa, Matina
dc.contributor.authorShaukat, Memoona
dc.contributor.authorSouthgate, Laura
dc.contributor.authorTenorio-Castano, Jair
dc.contributor.authorClinGen PH VCEP
dc.contributor.authorChung, Wendy K.
dc.contributor.authorInternational Consortium for Genetic Studies in Pulmonary Arterial Hypertension (PAH-ICON) at the Pulmonary Vascular Research Institute (PVRI)
dc.contributor.departmentMedicine, School of Medicine
dc.date.accessioned2024-12-13T15:21:50Z
dc.date.available2024-12-13T15:21:50Z
dc.date.issued2023
dc.description.abstractPurpose: Pulmonary arterial hypertension (PAH) is a rare, progressive vasculopathy with significant cardiopulmonary morbidity and mortality. Genetic testing is currently recommended for adults diagnosed with heritable, idiopathic, anorexigen-, hereditary hemorrhagic telangiectasia-, and congenital heart disease-associated PAH, PAH with overt features of venous/capillary involvement, and all children diagnosed with PAH. Variants in at least 27 genes have putative evidence for PAH causality. Rigorous assessment of the evidence is needed to inform genetic testing. Methods: An international panel of experts in PAH applied a semi-quantitative scoring system developed by the NIH Clinical Genome Resource to classify the relative strength of evidence supporting PAH gene-disease relationships based on genetic and experimental evidence. Results: Twelve genes (BMPR2, ACVRL1, ATP13A3, CAV1, EIF2AK4, ENG, GDF2, KCNK3, KDR, SMAD9, SOX17, and TBX4) were classified as having definitive evidence and 3 genes (ABCC8, GGCX, and TET2) with moderate evidence. Six genes (AQP1, BMP10, FBLN2, KLF2, KLK1, and PDGFD) were classified as having limited evidence for causal effects of variants. TOPBP1 was classified as having no known PAH relationship. Five genes (BMPR1A, BMPR1B, NOTCH3, SMAD1, and SMAD4) were disputed because of a paucity of genetic evidence over time. Conclusion: We recommend that genetic testing includes all genes with definitive evidence and that caution be taken in the interpretation of variants identified in genes with moderate or limited evidence. Genes with no known evidence for PAH or disputed genes should not be included in genetic testing.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationWelch CL, Aldred MA, Balachandar S, et al. Defining the clinical validity of genes reported to cause pulmonary arterial hypertension. Genet Med. 2023;25(11):100925. doi:10.1016/j.gim.2023.100925
dc.identifier.urihttps://hdl.handle.net/1805/45032
dc.language.isoen_US
dc.publisherElsevier
dc.relation.isversionof10.1016/j.gim.2023.100925
dc.relation.journalGenetics in Medicine
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectGenetics
dc.subjectGenomic medicine
dc.subjectMolecular diagnosis
dc.subjectPulmonary arterial hypertension
dc.titleDefining the clinical validity of genes reported to cause pulmonary arterial hypertension
dc.typeArticle
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