Wkład mapowania genomu optycznego (OGM) w diagnozowanie mnogich wad wrodzonych z lub bez niepełnosprawności intelektualnej bez nieprawidłowości genetycznej (CARTOGEN-N)
CARTOGEN-N_Wkład Optycznego Mapowania Genomu (OGM) w Diagnostykę Wielorakich Wrodzonych Wad Rozwojowych z Upośledzeniem Umysłowym lub bez Niego, Bez Wykrytych Nieprawidłowości Genetycznych w Badaniu Sekwencjonowania Całego Genomu
Congenital malformations result from an embryonic or foetal developmental disorder (DD) affecting one or more systems (cardiac, skeletal, nervous, etc.). These are referred to as multiple congenital anomalies (MCAs). They may be associated with an intellectual disability (ID)1.
Chromosomal analysis on Chromosomal Microarray Analysis (CMA) and gene panels or exome sequencing are the respective gold standard methods for chromosomal and molecular diagnosis of DD respectively2. In cases where no diagnosis is established after these first-line tests, short-read whole genome sequencing (WGS), via the Plan France Medicine Genomic 2020-2025 (AURAGEN), may be considered. This approach allows for diagnosis in nearly 40% of patients with DD3,4. However, many patients remain in diagnostic deadlock, likely due to the technical limitations of these methods, which potentially be overcome by emerging methodologies such as optical genome mapping (OGM)5,6,7,8,9. The investigators propose to systematically perform OGM in 30 patients presenting with MCA+/-ID who have inconclusive WGS result10.
The main objective is to assess the contribution of OGM in identifying structural variants not detected or poorly characterised by WGS in this clinical context. This work will also contribute to the ongoing of OGM in routine diagnostics and determine its role in the overall genetic diagnosis of MCA+/-ID. Additionally it may lead to the identification of new candidate genes and/or mechanisms of pathogenicity. If the results are promising, further clinical could expand this preliminary work into a larger-scale project. Improving the genetic diagnosis of DD should enhance the medical management of patients, currently in diagnostic deadlock, and their families.
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Szczegółowy opis
Study Workflow
Pre-analytical Phase
Participation in the study will be offered to all patients meeting the inclusion and non-inclusion criteria by an investigator from the Department of Genetics, during a medical consultation in which the non-contributive whole-genome sequencing (WGS) result will have been communicated (Figure 1). Information regarding the study procedures and objectives will be provided at that time. The information sheet and consent form will be given to the patient (if an adult) or to the holders of parental authority (if the patient is a minor). After obtaining consent for both the genetic investigations and participation in the research project, the patient may be enrolled in the study. Blood samples required for the study will be collected, transferred to the laboratory, and secured for analysis according to the following protocol:
Patient > 20 kg:
2 × 5 mL EDTA blood tubes
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× 5 mL heparinized blood tube
Patient 12-20 kg:
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× 5 mL EDTA blood tubes
Patient 5-12 kg:
1 × 5 mL EDTA blood tube
Samples will be sent to the Cytogenetics Department, where they will be pseudonymized and secured. At least three aliquots of 1.5 mL EDTA blood and the remaining volume will be frozen at -80 °C for DNA extraction and long-fragment DNA extraction. A cell culture (peripheral blood lymphocytes) will also be performed to obtain a fixed chromosomal pellet from the heparinized tube, when available. If the heparinized sample is not available and the results of optical genome mapping require confirmation of a chromosomal abnormality by karyotype or FISH (i.e., contributive result), a second blood draw will be proposed during the clinical results-return consultation.
Analysis Frozen samples from the Cytogenetics Department of Clermont-Ferrand University Hospital (one per patient) will be transferred via TSE to the Department of Genetics at Reims University Hospital, designated to perform optical genome mapping while awaiting installation of the Saphyr scanner at Clermont-Ferrand University Hospital (DAN 2025 application).
Extraction, labeling, and imaging of long DNA molecules will be performed using the manufacturer's kits, following the provided instructions.
Results and Interpretation
Raw data will be analyzed and validated by cytogeneticists at Reims University Hospital using Bionano Access and Solve® software. Data will also be securely shared with the project lead, responsible for:
Performing a second independent analysis (with Bionano Access and Solve, available in the Cytogenetics Department), leveraging expertise acquired through participation in previous projects.
Providing final interpretation of results and disseminating clinically relevant findings for patient management.
Each sample will therefore benefit from dual review and dual expertise, ensuring the reliability of the results.
Parental segregation studies may be proposed to facilitate biological interpretation. If needed, collection of parental samples and consent procedures will be coordinated by the Department of Medical Genetics at Clermont-Ferrand University Hospital. Conclusive results will be communicated to the clinician who prescribed the WGS for patient management and genetic counselling.
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Lise Laclautre
- Numer telefonu: +33473754963
- E-mail: promo_interne_drci@chu-clermontferrand.fr
Lokalizacje studiów
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-
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Clermont-Ferrand, Francja
- Rekrutacyjny
- CHU clermont-Ferrand
-
Kontakt:
- Lise Laclautre
- Numer telefonu: +33473754963
- E-mail: promo_interne_drci@chu-clermontferrand.fr
-
Główny śledczy:
- Céline PEBREL-RICHARD
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dziecko
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria
- Patients presenting with at least two congenital anomalies, with or without intellectual disability, and weighing more than 5 kg.
- Whole-genome sequencing performed by the AURAGEN laboratory deemed non-contributive (absence of class 4 or 5 variants, or identification of a VUS, or identification of only one variant in the context of a recessive disorder).
- Patient covered by a social security scheme.
- Patient able to understand and to oppose participation in the study.
- Written informed consent for genetic analyses, signed either by the patient or by their legal representatives (for minors), after clear and fair information about the study has been provided.
Non-Inclusion Criteria
- Patients for whom a non-genetic cause (infectious, environmental, or toxic) has been previously identified.
- Inability to obtain a compliant sample.
- Patient or holder of parental authority under guardianship or legal protection, deprived of liberty, or placed under court-ordered protection.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Diagnostyczny
- Przydział: Nie dotyczy
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
|
Eksperymentalny: jednoramienny z pacjentami z wrodzonymi wadami rozwojowymi
|
A blood sample will be collected after obtaining consent from the patient and/or their legal guardians. The number of tubes required (1 to 3) will be determined according to the patient's weight, for the purpose of performing optical genome mapping and any necessary confirmatory analyses in the event that a structural variant is identified. |
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
diagnostic yield of optical genome mapping (OGM) in multiple congenital anomalies with or without intellectual disability when whole-genome sequencing (WGS) is non-contributive
Ramy czasowe: day 1 (inclusion and blood collection)
|
Assessing the diagnostic yield of optical genome mapping (OGM) in multiple congenital anomalies with or without intellectual disability when whole-genome sequencing (WGS) is non-contributive (absence of causal genetic variation or detection of a variant of uncertain significance (VUS) or a single variant in a recessive disorder). |
day 1 (inclusion and blood collection)
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Liczba pacjentów, u których zidentyfikowano nowy gen kandydat/szkodliwy mechanizm
Ramy czasowe: dzień 1 (włączenie do badania i pobranie krwi)
|
dzień 1 (włączenie do badania i pobranie krwi)
|
|
|
Number of reclassified variants intially considered as VUS (Variants of Uncertain/Unknown Signification)
Ramy czasowe: day 1 (inclusion and blood collection)
|
Assessment of the number of variants initially classified as VUS (variants of uncertain/unknown significance) that were reclassified as benign or pathogenic variants |
day 1 (inclusion and blood collection)
|
|
Evaluation of the feasibility (duration) of the technique in current practice in 1st-line, 2nd-line (after routine tests such as chromosomal microarray, exome sequencing…), or 3rd-line in the case of non-contributive WGS based on several criteria
Ramy czasowe: day 1 (inclusion and blood collection)
|
Evaluation of technical duration (hours) |
day 1 (inclusion and blood collection)
|
|
Evaluation of the feasibility of the technique (failure) in current practice in 1st-line, 2nd-line (after routine tests such as chromosomal microarray, exome sequencing…), or 3rd-line in the case of non-contributive WGS based on several criteria
Ramy czasowe: day 1 (inclusion and blood collection)
|
failure rate number |
day 1 (inclusion and blood collection)
|
|
Evaluation of the feasibility of the technique (reprocessing) in current practice in 1st-line, 2nd-line (after routine tests such as chromosomal microarray, exome sequencing…), or 3rd-line in the case of non-contributive WGS based on several criteria
Ramy czasowe: day 1 (inclusion and blood collection)
|
reprocessing rate number |
day 1 (inclusion and blood collection)
|
|
Evaluation of the feasibility of the technique (interpretation) in current practice in 1st-line, 2nd-line (after routine tests such as chromosomal microarray, exome sequencing…), or 3rd-line in the case of non-contributive WGS based on several criteria
Ramy czasowe: day 1 (inclusion and blood collection)
|
Evaluation of biological interpretation time (hours) |
day 1 (inclusion and blood collection)
|
|
Assess the impact of using these new technologies on patient management.
Ramy czasowe: day 1 (inclusion and blood collection)
|
Percentage of patients for whom the OGM results led to a change in clinical management. |
day 1 (inclusion and blood collection)
|
Współpracownicy i badacze
Sponsor
Sponsor
Śledczy
Śledczy
- Krzesło do nauki: Lise LACLAUTRE, University Hospital, Clermont-Ferrand
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- AOI 2024 PEBREL-RICHARD
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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