title: Mutations in the CHD7 gene: the experience of a commercial laboratory.
abstract: CHARGE syndrome is an autosomal dominant multisystem disorder caused by mutation in the CHD7 gene, encoding chromodomain helicase DNA-binding protein 7. Molecular diagnostic testing for CHD7 mutation has been available in a clinical setting since 2005. We report here the results from the first 642 unrelated proband samples submitted for testing. Thirty-two percent (n = 203) of patient samples had a heterozygous pathogenic variant identified. The lower mutation rate than that published for well-characterized clinical samples is likely due to referral bias, as samples submitted for clinical testing may be for "rule-out" diagnoses, rather than solely to confirm clinical suspicion. We identified 159 unique pathogenic mutations, and of these, 134 mutations were each seen in a single individual and 25 mutations were found in two to five individuals (n =69). Of the 203 mutations, only 9 were missense, with 107 nonsense, 69 frameshift, and 15 splice-site mutations likely leading to haploinsufficiency at the cellular level. An additional 72 variations identified in the 642 tested samples (11%) were considered to have unknown clinical significance. Copy number changes (deletion/duplication of the entire gene or one/several exons) were found to account for a very small number of cases (n = 3). This cohort represents the largest CHARGE syndrome sample size to date and is intended to serve as a resource for clinicians, genetic counselors, researchers, and other diagnostic laboratories.
authors.affiliation: Department of Genetics, Case Western Reserve University, Cleveland, Ohio 44016, USA.
authors.forename: Cynthia F
authors.initials: CF
authors.lastname: Bartels
authors.forename: Cheryl
authors.initials: C
authors.lastname: Scacheri
authors.forename: Lashonda
authors.initials: L
authors.lastname: White
authors.forename: Peter C
authors.initials: PC
authors.lastname: Scacheri
authors.forename: Sherri
authors.initials: S
authors.lastname: Bale
mesh_terms: D058747:CHARGE Syndrome / Q000175:diagnosis* / Q000235:genetics; D015331:Cohort Studies; D004265:DNA Helicases / Q000235:genetics*; D004252:DNA Mutational Analysis; D004268:DNA-Binding Proteins / Q000235:genetics*; D018628:Gene Dosage; D005820:Genetic Testing; D006801:Humans; D007755:Laboratories, Hospital; D009154:Mutation; D014481:United States
chemical_list: D004268:DNA-Binding Proteins; D004265:DNA Helicases; C491434:CHD7 protein, human