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Updated: Sep 3, 2025

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation
Published on: January 16, 2019
Study of variants associated with ventricular septal defects (VSDs) highlights the unique genetic structure of the
Sumbal Sarwar1, Shabana2, Amna Tahir3
1Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan. sumbal.sarwar@ymail.com.
Insights
Genetic variants in ISL1, NFATc1, TBX5, and MTHFR genes are associated with congenital heart defects (ventricular septal defects) in Pakistani children. This finding aids in understanding the genetic basis of VSDs and potential screening strategies.
Area of Science:
- Cardiovascular Genetics
- Pediatric Cardiology
- Molecular Biology
Background:
- Ventricular septal defects (VSDs) are a leading cause of infant mortality from cardiac anomalies, affecting up to 4% of neonates.
- The complex interplay of genetic and environmental factors in VSD etiology remains incompletely understood.
Purpose of the Study:
- To investigate the association between specific gene variants and the occurrence of VSDs in a Pakistani pediatric cohort.
- To identify potential genetic markers for VSD risk in the Pakistani population.
Main Methods:
- Genotyping of six gene variants (ISL1, NFATc1, VEGF, HEY2, TBX5, MTHFR) in 200 VSD children and 150 healthy controls using tetra-ARMS PCR and PCR-RFLP.
- Collection of pediatric clinical and demographic data.
Main Results:
- Significant associations were found between VSD and variants in ISL1 (rs1017), NFATc1 (rs7240256), TBX5 (rs11067075), and MTHFR (rs1801133) in the Pakistani cohort.
- VEGF and HEY2 gene variants were not detected in the study population.
- Allele and genotype frequencies differed significantly between VSD cases and controls for the associated genes.
Conclusions:
- ISL1, NFATc1, TBX5, and MTHFR gene variants are implicated in the pathogenesis of VSDs in Pakistani children.
- Wider genetic screening programs targeting these markers could help reduce VSD risk in the Pakistani population.
Background:
Ventricular septal defects (VSDs) are one of the leading causes of death due to cardiac anomalies during the first months of life. The prevalence of VSD in neonates is reported up to 4%. Despite the remarkable progress in medication, treatment and surgical procedure for VSDs, the genetic etiology of VSDs is still in infancy because of the complex genetic and environmental interactions.
Methods:
Three hundred fifty subjects (200 VSD children and 150 healthy controls) were recruited from different pediatric cardiac units. Pediatric clinical and demographic data were collected. A total of six variants, rs1017 (ISL1), rs7240256 (NFATc1), rs36208048 (VEGF), variant of HEY2, rs11067075 (TBX5) and rs1801133 (MTHFR) genes were genotyped by tetra-ARMS PCR and PCR-RFLP methods.
Results:
The results showed that in cases, the rs1017 (g.16138A > T) variant in the ISL1 gene has an allele frequency of 0.42 and 0.58 respectively for the T and A alleles, and 0.75 and 0.25 respectively in the controls. The frequencies of the AA, TA and TT genotypes were, 52%, 11% and 37% in cases versus 21%, 8% and 71% respectively in the controls. For the NFATc1 variant rs7240256, minor allele frequency (MAF) was 0.43 in cases while 0.23 in controls. For the variant in the VEGF gene, genotype frequencies were 0% (A), 32% (CA) and 68% (CC) in cases and 0.0%, 33% and 67% respectively in controls. The allele frequency of C and A were 0.84 and 0.16 in cases and 0.83 and 0.17 respectively in controls. The TBX5 polymorphism rs11067075 (g.51682G > T) had an allelic frequency of 0.44 and 0.56 respectively for T and G alleles in cases, versus 0.26 and 0.74 in the controls. We did not detect the presence of the HEY2 gene variant (g.126117350A > C) in our pediatric cohort. For the rs1801133 (g.14783C > T) variant in the MTHFR gene, the genotype frequencies were 25% (CC), 62% (CT) and 13% (TT) in cases, versus 88%, 10% and 2% in controls. The ISL1, NFATc1, TBX5 and MTHFR variants were found to be in association with VSD in the Pakistani pediatric cohort whilst the VEGF and HEY2 variants were completely absent in our cohort.
Conclusion:
We propose that a wider programme of genetic screening of the Pakistani population for genetic markers in heart development genes would be helpful in reducing the risk of VSDs.
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