Frontiers in Genetics (Jun 2025)
Diagnostic yield of 1000 trio analyses with exome and genome sequencing in a clinical setting
- Helena Malmgren,
- Helena Malmgren,
- Malin Kvarnung,
- Malin Kvarnung,
- Peter Gustafsson,
- Peter Gustafsson,
- Britt-Marie Anderlid,
- Britt-Marie Anderlid,
- Cecilia Arthur,
- Cecilia Arthur,
- Jonas Carlsten,
- Jonas Carlsten,
- Karl De Geer,
- Karl De Geer,
- Emma Ehn,
- Emma Ehn,
- Giedre Grigelioniené,
- Giedre Grigelioniené,
- Anna Hammarsjö,
- Anna Hammarsjö,
- Hafdis T. Helgadottir,
- Hafdis T. Helgadottir,
- Maritta Hellström-Pigg,
- Maritta Hellström-Pigg,
- Erik Iwarsson,
- Erik Iwarsson,
- Ekaterina Kuchinskaya,
- Ekaterina Kuchinskaya,
- Hillevi Lindelöf,
- Hillevi Lindelöf,
- Maria Mannila,
- Maria Mannila,
- Daniel Nilsson,
- Daniel Nilsson,
- Maria Pettersson,
- Maria Pettersson,
- Eva Rudd,
- Eva Rudd,
- Ellika Sahlin,
- Ellika Sahlin,
- Bianca Tesi,
- Bianca Tesi,
- Emma Tham,
- Emma Tham,
- Håkan Thonberg,
- Håkan Thonberg,
- Eini Westenius,
- Eini Westenius,
- Johanna Winberg,
- Johanna Winberg,
- Max Winerdal,
- Max Winerdal,
- Magnus Nordenskjöld,
- Magnus Nordenskjöld,
- Maria Johansson-Soller,
- Maria Johansson-Soller,
- Valtteri Wirta,
- Valtteri Wirta,
- Ann Nordgren,
- Ann Nordgren,
- Anna Lindstrand,
- Anna Lindstrand,
- Kristina Lagerstedt-Robinson,
- Kristina Lagerstedt-Robinson
Affiliations
- Helena Malmgren
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Helena Malmgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Malin Kvarnung
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Malin Kvarnung
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Peter Gustafsson
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Peter Gustafsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Britt-Marie Anderlid
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Britt-Marie Anderlid
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Cecilia Arthur
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Cecilia Arthur
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Jonas Carlsten
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Jonas Carlsten
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Karl De Geer
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Karl De Geer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Emma Ehn
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Emma Ehn
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Giedre Grigelioniené
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Giedre Grigelioniené
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Anna Hammarsjö
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Anna Hammarsjö
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Hafdis T. Helgadottir
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Hafdis T. Helgadottir
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Maritta Hellström-Pigg
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Maritta Hellström-Pigg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Erik Iwarsson
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Erik Iwarsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Ekaterina Kuchinskaya
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Ekaterina Kuchinskaya
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Hillevi Lindelöf
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Hillevi Lindelöf
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Maria Mannila
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Maria Mannila
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Daniel Nilsson
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Daniel Nilsson
- Science for Life Laboratory, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Maria Pettersson
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Maria Pettersson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Eva Rudd
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Eva Rudd
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Ellika Sahlin
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Ellika Sahlin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Bianca Tesi
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Bianca Tesi
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Emma Tham
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Emma Tham
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Håkan Thonberg
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Håkan Thonberg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Eini Westenius
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Eini Westenius
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Johanna Winberg
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Johanna Winberg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Max Winerdal
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Max Winerdal
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Magnus Nordenskjöld
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Magnus Nordenskjöld
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Maria Johansson-Soller
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Maria Johansson-Soller
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Valtteri Wirta
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Valtteri Wirta
- Genomic Medicine Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden
- Ann Nordgren
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Ann Nordgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Anna Lindstrand
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Anna Lindstrand
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Kristina Lagerstedt-Robinson
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Kristina Lagerstedt-Robinson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- DOI
- https://doi.org/10.3389/fgene.2025.1580879
- Journal volume & issue
-
Vol. 16
Abstract
IntroductionA trio analysis refers to the strategy of exome or genome sequencing of DNA from a patient, as well as parents, in order to identify the genetic cause of a disorder or syndrome.MethodsDuring the last 10 years, we have successfully applied exome or genome sequencing and performed trio analysis for 1,000 patients.ResultsOverall, 39% of the patients were diagnosed, with the detection of causative variant(s). The variants were located in 308 different genes. Autosomal dominant de novo variants were detected in 46% of the solved cases. Detection rates were highest in patients with a syndromic neurodevelopmental disorder (46%) and in patients with known consanguinity (59%). Even for patients previously analyzed as singletons, using a pre-defined gene panel, a consecutive trio analysis resulted in the detection of a causative variant in 30%.DiscussionA major advantage of trio analysis is the immediate identification of de novo variants as well as confirmation of compound heterozygosity. Additionally, inherited variants from a healthy parent can be dismissed as non-disease causing. The trio strategy enables analysis of a high number of genes–or even the whole genome–simultaneously. The strengths of a trio analysis, in combination with analysis of genome sequence data, allows for the detection of a wide range of genetic aberrations. This enables a high diagnostic yield, even in previously analyzed patients. Our current protocol for trio analysis is based on genome sequencing data, which allows for simultaneous detection of single nucleotide variants, insertion/deletions, structural variants, expanded short tandem repeats, as well as a copy number analysis corresponding to an array-CGH, and analysis regarding SMN1 gene copies.
Keywords