Abstract

Abstract Objectives Next generation sequencing (NGS) technology has allowed cost-effective massive parallel DNA sequencing. To evaluate the utility of NGS for newborn screening (NBS) of inborn errors of metabolism (IEM), a custom panel was designed to target 87 disease-related genes. The pilot study was primarily proposed for second-tier testing under the NBSIEM program in Hong Kong. Methods The validation of the panel was performed with two reference genomes and an external quality assurance (EQA) sample. Sequencing libraries were synthesized with amplicon-based approach. The libraries were pooled, spiked-in with 2% PhiX DNA as technical control, for 16-plex sequencing runs. Sequenced reads were analyzed using a commercially available pipeline. Results The average target region coverage was 208× and the fraction of region with target depth ≥20× was 95.7%, with a sensitivity of 91.2%. There were 85 out of 87 genes with acceptable coverage, and EQA result was satisfactory. The turnaround time from DNA extraction to completion of variant calling and quality control (QC) procedures was 2.5 days. Conclusions The NGS approach with the amplicon-based panel has been validated for analytical performance and is suitable for second-tier NBSIEM test.

Highlights

  • A newborn screening (NBS) program is an effective mean to find out conditions which are not clinically evident on physical examination in neonatal period to allow early diagnosis and intervention to prevent disability or death

  • Many countries carry out screening program for inborn errors of metabolism (IEM) conditions utilizing dried blood spot (DBS) [1]

  • During an 18-month pilot study of expanded NBS for 26 IEM conditions conducted in Hong Kong since 2015, nine confirmed IEM cases was found among 15,138 babies screened, with a collective incidence of one in 1,682 newborns [4], compared to incidence reported in other places such as 1/2,920 in Germany [5], 1/3,165 in Singapore [6], and 1/901 in Qatar [7]

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Summary

Introduction

A newborn screening (NBS) program is an effective mean to find out conditions which are not clinically evident on physical examination in neonatal period to allow early diagnosis and intervention to prevent disability or death. Many countries carry out screening program for inborn errors of metabolism (IEM) conditions utilizing dried blood spot (DBS) [1]. Individual IEM is rare, the collective incidence could be up to one in 500 to 4,000, posing severe public health problem [3]. During an 18-month pilot study of expanded NBS for 26 IEM conditions conducted in Hong Kong since 2015, nine confirmed IEM cases was found among 15,138 babies screened, with a collective incidence of one in 1,682 newborns [4], compared to incidence reported in other places such as 1/2,920 in Germany [5], 1/3,165 in Singapore [6], and 1/901 in Qatar [7]. Incidence rate may vary due to reasons such as panel selection, ethnic composition and scope of the study

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