Соматический мозаицизм при нейрофиброматозе первого типа

Background. Neurofibromatosis type 1 is one of the most common monogenic disorders. A pathogenic mutation in NF1 is the etiological factor of neurofibromatosis type 1. Nevertheless, not all patients receive molecular genetic verification of the clinical diagnosis. We believe that this may be due to a somatic mosaicism with a small fraction of pathogenic allele, which is neglected by the NGS analysis software and/or is undetectable by Sanger sequencing due to noisy background. Objective. To detect pathogenic mosaic mutations in cases of neurofibromatosis type 1 without germline genetic variants. Material and methods. Two hundred seventy five peripheral blood lymphocyte DNA samples from patients with NF1 and without germline mutation were retrospectively analyzed. DNA samples were sequenced with Ion PGM and Ion S5 NGS systems. Gene panel design included NF1 and NF2 genes: exons, adjacent intron segments (20-70 b.p.), 3’UTRs and 5’UTRs. Samples were also tested using MLPA in order to exclude deletions in NF1 and NF2. We developed and implemented the pipeline to search mosaic cases using bioinformatics approaches. All newly detected mutations were evaluated by Sanger sequencing and by heteroduplex analysis. Result. We have identified new pathogenic mutations in NF1 for 12 patients (4.4%) and verified 8 of them using alternative methods. Conclusion. Dominant disorders, like neurofibromatosis type 1, require a detailed bioinformatic analysis of NGS results with respect to somatic mosaicism. Our approach makes it possible to identify genetic variants with low representation of a pathogenic allele without increasing the sequencing depth of the sample under study and can be used for retrospective analysis of NGS data in order to improve the quality of DNA diagnostics.