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Complete Sequence of the 22q11.2 Allele in 1,053 Subjects with 22q11.2 Deletion Syndrome Reveals Modifiers of Conotruncal Heart Defects.


ABSTRACT: The 22q11.2 deletion syndrome (22q11.2DS) results from non-allelic homologous recombination between low-copy repeats termed LCR22. About 60%-70% of individuals with the typical 3 megabase (Mb) deletion from LCR22A-D have congenital heart disease, mostly of the conotruncal type (CTD), whereas others have normal cardiac anatomy. In this study, we tested whether variants in the hemizygous LCR22A-D region are associated with risk for CTDs on the basis of the sequence of the 22q11.2 region from 1,053 22q11.2DS individuals. We found a significant association (FDR p < 0.05) of the CTD subset with 62 common variants in a single linkage disequilibrium (LD) block in a 350 kb interval harboring CRKL. A total of 45 of the 62 variants were associated with increased risk for CTDs (odds ratio [OR) ranges: 1.64-4.75). Associations of four variants were replicated in a meta-analysis of three genome-wide association studies of CTDs in affected individuals without 22q11.2DS. One of the replicated variants, rs178252, is located in an open chromatin region and resides in the double-elite enhancer, GH22J020947, that is predicted to regulate CRKL (CRK-like proto-oncogene, cytoplasmic adaptor) expression. Approximately 23% of patients with nested LCR22C-D deletions have CTDs, and inactivation of Crkl in mice causes CTDs, thus implicating this gene as a modifier. Rs178252 and rs6004160 are expression quantitative trait loci (eQTLs) of CRKL. Furthermore, set-based tests identified an enhancer that is predicted to target CRKL and is significantly associated with CTD risk (GH22J020946, sequence kernal association test (SKAT) p = 7.21 × 10-5) in the 22q11.2DS cohort. These findings suggest that variance in CTD penetrance in the 22q11.2DS population can be explained in part by variants affecting CRKL expression.

SUBMITTER: Zhao Y 

PROVIDER: S-EPMC7077921 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Complete Sequence of the 22q11.2 Allele in 1,053 Subjects with 22q11.2 Deletion Syndrome Reveals Modifiers of Conotruncal Heart Defects.

Zhao Yingjie Y   Diacou Alexander A   Johnston H Richard HR   Musfee Fadi I FI   McDonald-McGinn Donna M DM   McGinn Daniel D   Crowley T Blaine TB   Repetto Gabriela M GM   Swillen Ann A   Breckpot Jeroen J   Vermeesch Joris R JR   Kates Wendy R WR   Digilio M Cristina MC   Unolt Marta M   Marino Bruno B   Pontillo Maria M   Armando Marco M   Di Fabio Fabio F   Vicari Stefano S   van den Bree Marianne M   Moss Hayley H   Owen Michael J MJ   Murphy Kieran C KC   Murphy Clodagh M CM   Murphy Declan D   Schoch Kelly K   Shashi Vandana V   Tassone Flora F   Simon Tony J TJ   Shprintzen Robert J RJ   Campbell Linda L   Philip Nicole N   Heine-Suñer Damian D   García-Miñaúr Sixto S   Fernández Luis L   Bearden Carrie E CE   Vingerhoets Claudia C   van Amelsvoort Therese T   Eliez Stephan S   Schneider Maude M   Vorstman Jacob A S JAS   Gothelf Doron D   Zackai Elaine E   Agopian A J AJ   Gur Raquel E RE   Bassett Anne S AS   Emanuel Beverly S BS   Goldmuntz Elizabeth E   Mitchell Laura E LE   Wang Tao T   Morrow Bernice E BE  

American journal of human genetics 20191220 1


The 22q11.2 deletion syndrome (22q11.2DS) results from non-allelic homologous recombination between low-copy repeats termed LCR22. About 60%-70% of individuals with the typical 3 megabase (Mb) deletion from LCR22A-D have congenital heart disease, mostly of the conotruncal type (CTD), whereas others have normal cardiac anatomy. In this study, we tested whether variants in the hemizygous LCR22A-D region are associated with risk for CTDs on the basis of the sequence of the 22q11.2 region from 1,053  ...[more]

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