通过外体序列测序检测到的马赛克变异的临床相关性
Rajarshi Ghosh1, Zeeshan Fazal2, Andrew J Oler2
1Centralized Sequencing Program | DIR | NIAID | NIH.
The Journal of allergy and clinical immunology
|February 22, 2026
概括
马赛克变异对于诊断免疫和血液学疾病至关重要,通常会被标准遗传测试遗漏. 检测这些低频变体可以改善分子诊断和预后.
科学领域:
- 遗传学和基因组学 遗传学和基因组学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 马赛克变体是癌症和免疫系统疾病等疾病的未被认可的原因.
- 检测马赛克变异是具有挑战性的,因为低变异性等位基因分数 (VAFs),组织特异性和临床异质性.
研究的目的:
- 调查患有免疫疾病的个体中马赛克变异的流行率,诊断影响和临床相关性.
主要方法:
- 从2655名参与者 (2064名受影响者) 的血液和/或唾液样本上进行了exome测序.
- 使用Lofreq2和Mutect2算法识别了马赛克变体,并对子集进行正交验证.
- 临床数据被追溯分析以确定检测到的变异的意义.
主要成果:
- 马赛克变异导致1.4%的受影响参与者患有免疫障碍的分子诊断,34%的受影响者在标准生殖线分析中错过了.
- 父母的马赛克主义在两个家庭中被确定,克隆性血液形成基因中的马赛克变异具有预后影响.
- 发现了化学疗法药物耐药性变体 (NRAS,KRAS,IDH2),突出显示了潜在的治疗策略影响.
结论:
- 马赛克变体对免疫和血液学疾病的分子诊断和预后有显著的贡献.
- 当前的生殖系变异调用工作流程经常错过临床相关的马赛克变异.
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