Abstract

Usher syndrome (USH) is a leading cause of deaf-blindness in autosomal recessive trait. Phenotypic and genetic heterogeneities in USH make molecular diagnosis much difficult. This is a pilot study aiming to develop an approach based on next-generation sequencing to determine the genetic defects in patients with USH or allied diseases precisely and effectively. Eight affected patients and twelve unaffected relatives from five unrelated Chinese USH families, including 2 pseudo-dominant ones, were recruited. A total of 144 known genes of inherited retinal diseases were selected for deep exome resequencing. Through systematic data analysis using established bioinformatics pipeline and segregation analysis, a number of genetic variants were released. Eleven mutations, eight of them were novel, in the USH2A gene were identified. Biparental mutations in USH2A were revealed in 2 families with pseudo-dominant inheritance. A proband was found to have triple mutations, two of them were supposed to locate in the same chromosome. In conclusion, this study revealed the genetic defects in the USH2A gene and demonstrated the robustness of targeted exome sequencing to precisely and rapidly determine genetic defects. The methodology provides a reliable strategy for routine gene diagnosis of USH.

Highlights

  • Usher syndrome (USH) is an autosomal recessive disorder characterized by visual loss due to retinitis pigmentosa (RP), sensorineural hearing impairment and variable vestibular dysfunction, with remarkable clinical and genetic heterogeneity [1]

  • Usher syndrome is a severe disease with significant vision and hearing impairments

  • Seven loci (USH1B-H) have been mapped and five genes have been identified for type 1, four loci (USH2A-D) have been mapped and three genes have been identified for type 2, and two genes (USH3A, USH3B) have been identified for type 3

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Summary

Introduction

Usher syndrome (USH) is an autosomal recessive disorder characterized by visual loss due to retinitis pigmentosa (RP), sensorineural hearing impairment and variable vestibular dysfunction, with remarkable clinical and genetic heterogeneity [1]. Type I (USH1) is the most severe form characterized by prepubertal onset of RP, profound hearing loss, and vestibular dysfunction. Type II (USH2) is characterized by postpuberal onset RP and moderate deafness without vestibular dysfunction. At least 12 loci have been mapped for the three types of USH in human chromosomes and 10 genes have been identified [2]. These genes totally comprise 321 coding exons spanning a length of 59,430-nt (Table S1). Targeted or whole exome sequencing has been proved to be a powerful tool to discover novel disease-related genes or genetic mutations in large genomic regions [3]. We utilized targeted exome sequencing (TES) to study genetic defects in five USH families and attempted to establish a strategy useful for genetic diagnosis of USH patients

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