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Clinical presentation and genetic profiles of Chinese patients with velocardiofacial syndrome in a large referral centre

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Abstract

Diagnosis and treatment of velocardiofacial syndrome (VCFS) with variable genotypes and phenotypes are considered to be very complicated. Establishing an exact correlation between the phenotypes and genotypes of VCFS is still a challenging. In this paper, 88 Chinese VCFS patients were divided into five groups based on palatal anomalies and one or two of other four common phenotypes, and copy number variations (CNVs) were detected using multiplex ligation-dependent probe amplification (MLPA), array comparative genomic hybridization (aCGH) and quantitative polymerase chain reaction. The findings showed that palatal anomalies and characteristic malformation of face were important indicators for 22q11.2 microdeletion, and there was difference in the phenotypic spectrum between the duplication and deletion of 22q11.2. MLPA was a highly cost-effective, sensitive and preferred method for patients with 22q11.2 deletion or duplication. Our results also firstly reported that all three patients who simultaneously exhibited palatal anomalies and cognitive disorder, without other phenotypes, have Top3b duplication, which strongly suggested that Top3b may be a pathogenic gene for these patients. Further, the findings showed that patients with palatal anomalies and congenital heart disease or immune deficiency, with or without other uncommon phenotypes, exhibited heterogeneity in CNVs, including 4q34.1-qter, 6q25.3, 4q23, Xp11.4, 13q21.1, 17q23.2, 7p21.3, 2p11.2, 11q24.3 and 16q23.3, and some possible pathogenic genes, including BCOR, PRR20A, TBX2, SMYD1, KLKB1 and TULP4 have been suggested. For these patients, aCGH, whole genomic sequencing, combined with references and phenomics database to find pathogenic gene, may be choices of priority. Taking these findings together, we offered an alternative method for diagnosis of Chinese VCFS patients based on this phenotypic strategy.

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Acknowledgements

This work was supported by the Interdisciplinary Program of Shanghai Jiaotong University (nos. YG2016MS08 and YG2016QN11), the National Key Research and Development Program of China (no. 2016YFC1000502), the National Natural Science Foundation of China (no. 81300842) and Morning Star Rewarding Fund of Shanghai Jiaotong University.

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Correspondence to Guoming Wang, Jinguang He, Li Huang or Jiewen Dai.

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Corresponding Editor: Indrajit Nanda

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Wu, D., Chen, Y., Chen, Q. et al. Clinical presentation and genetic profiles of Chinese patients with velocardiofacial syndrome in a large referral centre. J Genet 98, 42 (2019). https://doi.org/10.1007/s12041-019-1090-5

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