Genetic Disorder Clinical Trial
Official title:
Delineation of Novel Monogenic Disorders in the United Arab Emirates
The study aims to identify novel monogenic phenotypes from specific pedigrees and discover the underlying causal genetic variant using genetic sequencing (Sanger and/or Next Generation Sequencing - Panel/WES/WGS) methodologies in families across the United Arab Emirates (UAE).
Monogenic disorders result from a single defective gene and are inherited according to
Mendel's Laws (Mendelian disorders). Such gene defects arise from a mutation that can either
be inherited or occur spontaneously; both may occur in the absence of a previous family
history. Inherited mutations can be dominant or recessive, and autosomal or sex-linked.
According to WHO, although individually rare, collectively monogenic disorders affect
millions of people worldwide. Currently, over 10,000 human diseases are estimated to be
monogenic. Until recently the identification of the genetic causes, especially of extremely
rare phenotypes, has not been possible or cost effective due to the scientific challenges of
identifying causative mutations through linkage analysis. The advent of cost effective next
generation sequencing now facilitates the identification of all rare variants across the
whole genome, in turn allowing mutation identification in small families and, if de novo,
even in single cases.
The clinical application of single gene sequencing potentially provides tangible benefits to
patients, informing diagnosis and prognosis, and may guide treatment choice. Next generation
sequencing (NGS) panels sequence multiple genes in parallel and are now entering the clinical
domain. NGS provides significant advantages over single gene sequencing for conditions which
are genetically heterogeneous, such as the epilepsies. However, as more genes are included in
an NGS panel, the possibility of incidental findings rises significantly, with associated
challenges in result interpretation. Since many conditions are phenotypically as well as
genetically heterogeneous, acquisition of detailed phenotypic information is essential for
meaningful interpretation of NGS results.
Monogenic (Mendelian) disorders have historically provided the clearest means of elucidating
human gene function. The linkage of a rare DNA variant to altered protein function or dose to
discrete phenotype has important implications for fundamental biology, monogenic disease
pathogenesis, complex traits, diagnostics and therapy. By representing the most readily
interpretable component of human genetics in defining a clear, high-penetrance phenotype
arising from alteration in function of a single gene, study of monogenic disorders can
identify the genetic basis for novel or existing phenotypes and provide insights into
non-redundant biological pathways that may inform therapeutic targeting for both the specific
rare variant and common diseases. Accordingly the primary purpose of this programme is to
identify novel monogenic phenotypes and discover underlying causal genetic variants by
genetic sequencing in families across the UAE.
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