Investigation of Genetic Defects in Severe Combined Immunodeficiency Patients from Turkey by Targeted Sequencing

Scand J Immunol. 2017 Mar;85(3):227-234. doi: 10.1111/sji.12523.

Abstract

Primary immunodeficiencies (PIDs) represent a large group of disorders with an increased susceptibility to infections. Severe combined immunodeficiency (SCID) is the most severe form of primary immunodeficiencies (PIDs) with marked T-cell lymphopenia. Investigation of the genetic aetiology using classical Sanger sequencing is associated with considerable diagnostic delay. We here established a custom-designed, next-generation sequencing (NGS)-based panel to efficiently identify disease-causing genetic defects in PID patients and applied this method in SCID patients of Turkish origin with previously undefined genetic aetiology. We used HaloPlex enrichment technology, a targeted, NGS-based method which was designed to diagnose patients with SCID and other PIDs. Our HaloPlex panel included a total of 356 PID-related genes, and we searched disease-causing mutations in 19 Turkish SCID patients without a genetic diagnosis. The coverage of targeted regions ranged from 97.47% to 99.62% with an average of 98.31% for all patients. All known SCID genes were covered with a percentage of at least 97.3%. We made a genetic diagnosis in six of 19 (33%) patients, including four novel disease-causing mutations identified in RAG1, JAK3 and IL2RG, respectively. We showed that this NGS-based method can provide rapid genetic diagnosis for patients suffering from SCID, potentially facilitating clinical treatment decisions.

MeSH terms

  • Base Sequence
  • Cytidine Deaminase / genetics
  • Female
  • Genetic Predisposition to Disease*
  • High-Throughput Nucleotide Sequencing
  • Homeodomain Proteins / genetics
  • Humans
  • Infant
  • Interleukin Receptor Common gamma Subunit / genetics
  • Interleukin-10 Receptor alpha Subunit / genetics
  • Interleukin-10 Receptor beta Subunit / genetics
  • Janus Kinase 3 / genetics
  • Male
  • Sequence Analysis, DNA
  • Severe Combined Immunodeficiency / genetics*
  • Telomerase / genetics
  • Turkey

Substances

  • Homeodomain Proteins
  • IL10RB protein, human
  • IL2RG protein, human
  • Interleukin Receptor Common gamma Subunit
  • Interleukin-10 Receptor alpha Subunit
  • Interleukin-10 Receptor beta Subunit
  • RAG-1 protein
  • JAK3 protein, human
  • Janus Kinase 3
  • TERT protein, human
  • Telomerase
  • AICDA (activation-induced cytidine deaminase)
  • Cytidine Deaminase