VarSeq Annotation and Filtering Use Cases

         September 3, 2024

The following customer publications showcase the ability of VarSeq. Each study demonstrates the abilities of VarSeq’s annotation and filtering of variants and the ease of identifying with our software.

Rare host variants in ciliary expressed genes contribute to COVID-19 severity in Bulgarian patients

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a pneumonia with extremely heterogeneous clinical presentation, ranging from asymptomatic to severely ill patients. Previous studies have reported links between the presence of host genetic variants and the outcome of the COVID-19 infection. In our study, we used whole exome sequencing in a cohort of 444 SARS-CoV-2 patients, admitted to hospital in the period October-2020–April-2022, to search for associations between rare pathogenic/potentially pathogenic variants and COVID-19 progression. We used gene prioritization-based analysis in genes that have been reported by host genetic studies. Although we did not identify correlation between the presence of rare pathogenic variants and COVID-19 outcome, in critically ill patients we detected known mutations in a number of genes associated with severe disease related to cardiovascular disease, primary ciliary dyskinesia, cystic fibrosis, DNA damage repair response, coagulation, primary immune disorder, hemoglobin subunit β, and others. Additionally, we report 93 novel pathogenic variants found in severely infected patients who required intubation or died. A network analysis showed main component, consisting of 13 highly interconnected genes related to epithelial cilium. In conclusion, we have detected rare pathogenic host variants that may have influenced the COVID-19 outcome in Bulgarian patients.

“For WES analysis we applied a locally maintained DRAGEN (Illumina) secondary analysis pipeline for mapping to the GRCh37/hg19 human genome single nucleotide variants calling and quality filtering. Annotations and variant filtering were performed using VarSeq software (version 2.2.1, Golden Helix, Inc.) and as we have described previously21.”

Kamenarova, K., Kachakova-Yordanova, D., Baymakova, M. et al. Rare host variants in ciliary expressed genes contribute to COVID-19 severity in Bulgarian patients. Sci Rep 14, 19487 (2024). https://doi.org/10.1038/s41598-024-70514-3

Comprehensive Screening of Genetic Variants in the Coding Region of F8 in Severe Hemophilia A Reveals a Relationship with Disease Severity in a Colombian Cohort

Hemophilia A is an X-linked disorder characterized by quantitative deficiency of coagulation factor VIII (FVIII) caused by pathogenic variants in the factor 8 (F8) gene. Our study’s primary objective was to identify genetic variants within the exonic region of F8 in 50 Colombian male participants with severe hemophilia A (HA). Whole-exome sequencing and bioinformatics analyses were performed, and bivariate analysis was used to evaluate the relationship between identified variants, disease severity, and inhibitor risk formation. Out of the 50 participants, 21 were found to have 17 different pathogenic F8 variants (var). It was found that 70% (var = 12) of them were premature truncation variants (nonsense, frameshift), 17.6% (var = 3) were missense mutations, and 11.7% (var = 2) were splice-site variants. Interestingly, 35% (var = 6) of the identified variants have not been previously reported in the literature. All patients with a history of positive inhibitors (n = 4) were found to have high-impact genetic variants (nonsense and frameshift). When investigating the relationship between variant location (heavy versus light chain) and specific inhibitor risk, 75% (n = 3) of the inhibitor participants were found to have variants located in the F8 light chain (p = 0.075), suggesting that conserved domains are associated with higher inhibitor risk. In summary, we identified genetic variants within the F8 that can possibly influence inhibitor development in Colombian patients with severe HA. Our results provide a basis for future studies and the development of further personalized treatment strategies in this population.

“The sequencer applied was a NovaSeq6000 platform (Illumina, San Diego, CA, USA), following the manufacturer’s instructions. Variant prioritization was given for the filtering algorithm in Varseq 2.3.0, applying the following strategy: quality (PASS and Missing); depth ≥ 20×; genotype quality ≥ 20.2; type of variant and frequency, filtered via zygosity; effect: (LOF, Missense); and a pseudocontrol population frequency ≤ 1% according to gnomAD exomes, gnomAD genomes, 1000G, ESP, Kaviar, Beacoz, and Bravo. Pathogenicity prediction was performed by filtering using the threshold CADD ≥ 14 phred and Revel ≥ 0.75 to identify variants predicted to be damaging using in silico bioinformatics tools (Figure 1). Pathogenicity assignment for the remaining variants after filtering was performed according to the 2015 American College of Medical Genetics and Genomics (ACMG) recommendations. Only those variants that were likely to be pathogenic and/or variants of unknown significance (VUS) were reported. To analyze copy number variation (CNV), our filtering strategy included deletions, duplications, p-value < 0.05, a Span of 10,0000 pb, and clinical interpretations of “likely pathogenic” and “pathogenic”.”

Sarmiento Doncel, S.; Peláez, R.G.; Lapunzina, P.; Corrales-Medina, F.F.; Díaz Mosquera, G.A.; Bonanad, S.; Cortes, J.M.; Cazalla, M.; Gallego, N.; Querol-Giner, F.; et al. Comprehensive Screening of Genetic Variants in the Coding Region of F8 in Severe Hemophilia A Reveals a Relationship with Disease Severity in a Colombian Cohort. Life 2024, 14, 1041. https://doi.org/10.3390/life14081041

Whole exome sequencing of patients with varicella-zoster virus and herpes simplex virus induced acute retinal necrosis reveals rare disease-associated genetic variants

Purpose: Herpes simplex virus (HSV) and varicella-zoster virus (VZV) are neurotropic human alphaherpesviruses endemic worldwide. Upon primary infection, both viruses establish lifelong latency in neurons and reactivate intermittently to cause a variety of mild to severe diseases. Acute retinal necrosis (ARN) is a rare, sight-threatening eye disease induced by ocular VZV or HSV infection. The virus and host factors involved in ARN pathogenesis remain incompletely described. We hypothesize an underlying genetic defect in at least part of ARN cases. Methods: We collected blood from 17 patients with HSV-or VZV-induced ARN, isolated DNA and performed Whole Exome Sequencing by Illumina followed by analysis in Varseq with criteria of CADD score > 15 and frequency in GnomAD < 0.1% combined with biological filters. Gene modifications relative to healthy control genomes were filtered according to high quality and read-depth, low frequency, high deleteriousness predictions and biological relevance. Results: We identified a total of 50 potentially disease-causing genetic variants, including missense, frameshift and splice site variants and on in-frame deletion in 16 of the 17 patients. The vast majority of these genes are involved in innate immunity, followed by adaptive immunity, autophagy, and apoptosis; in several instances variants within a given gene or pathway was identified in several patients. Discussion: We propose that the identified variants may contribute to insufficient viral control and increased necrosis ocular disease presentation in the patients and serve as a knowledge base and starting point for the development of improved diagnostic, prophylactic, and therapeutic applications.

“The virus and host factors involved in ARN pathogenesis remain incompletely described. We hypothesize an underlying genetic defect in at least part of ARN cases. Methods: We collected blood from 17 patients with HSV-or VZV-induced ARN, isolated DNA and performed Whole Exome Sequencing by Illumina followed by analysis in Varseq with criteria of CADD score > 15 and frequency in GnomAD < 0.1% combined with biological filters.”

Heinz, J. L., Swagemakers, S. M. A., von Hofsten, J., Helleberg, M., Thomsen, M. M., De Keukeleere, K., de Boer, J. H., Ilginis, T., Verjans, G. M. G. M., van Hagen, P. M., van der Spek, P. J., & Mogensen, T. H. (2023). Whole exome sequencing of patients with varicella-zoster virus and herpes simplex virus induced acute retinal necrosis reveals rare disease-associated genetic variants. Frontiers in Molecular Neuroscience, 16, Artikel 1253040. https://doi.org/10.3389/fnmol.2023.1253040

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