New workflow for classification of genetic variants' pathogenicity applied to hereditary recurrent fevers by the International Study Group for Systemic Autoinflammatory Diseases (INSAID)

Marielle E. Van Gijn, Isabella Ceccherini, Yael Shinar, Ellen C. Carbo, Mariska Slofstra, Juan I. Arostegui, Guillaume Sarrabay, Dorota Rowczenio, Ebun Omoylmnl, Banu Balci-Peynircioglu, Hal M. Hoffman, Florian Milhavet, Morris A. Swertz, Isabelle Touitou

Research output: Contribution to journalArticle

Abstract

Background Hereditary recurrent fevers (HRFs) are rare inflammatory diseases sharing similar clinical symptoms and effectively treated with anti-inflammatory biological drugs. Accurate diagnosis of HRF relies heavily on genetic testing. Objectives This study aimed to obtain an experts' consensus on the clinical significance of gene variants in four well-known HRF genes: MEFV, TNFRSF1A, NLRP3 and MVK. Methods We configured a MOLGENIS web platform to share and analyse pathogenicity classifications of the variants and to manage a consensus-based classification process. Four experts in HRF genetics submitted independent classifications of 858 variants. Classifications were driven to consensus by recruiting four more expert opinions and by targeting discordant classifications in five iterative rounds. Results Consensus classification was reached for 804/858 variants (94%). None of the unsolved variants (6%) remained with opposite classifications (eg, pathogenic vs benign). New mutational hotspots were found in all genes. We noted a lower pathogenic variant load and a higher fraction of variants with unknown or unsolved clinical significance in the MEFV gene. Conclusion Applying a consensus-driven process on the pathogenicity assessment of experts yielded rapid classification of almost all variants of four HRF genes. The high-throughput database will profoundly assist clinicians and geneticists in the diagnosis of HRFs. The configured MOLGENIS platform and consensus evolution protocol are usable for assembly of other variant pathogenicity databases. The MOLGENIS software is available for reuse at http://github.com/molgenis/molgenis; the specific HRF configuration is available at http://molgenis.org/said/. The HRF pathogenicity classifications will be published on the INFEVERS database at https://fmf.igh.cnrs.fr/ISSAID/infevers/.

Original languageEnglish
Pages (from-to)530-537
Number of pages8
JournalJournal of Medical Genetics
Volume55
Issue number8
DOIs
Publication statusPublished - Aug 1 2018

Keywords

  • genetic diagnosis
  • hereditary recurrent fever
  • infevers
  • molgenis
  • pathogenicity classification

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)

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    Van Gijn, M. E., Ceccherini, I., Shinar, Y., Carbo, E. C., Slofstra, M., Arostegui, J. I., Sarrabay, G., Rowczenio, D., Omoylmnl, E., Balci-Peynircioglu, B., Hoffman, H. M., Milhavet, F., Swertz, M. A., & Touitou, I. (2018). New workflow for classification of genetic variants' pathogenicity applied to hereditary recurrent fevers by the International Study Group for Systemic Autoinflammatory Diseases (INSAID). Journal of Medical Genetics, 55(8), 530-537. https://doi.org/10.1136/jmedgenet-2017-105216