Non-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testing

Abstract Individuals with heritable thoracic aortic disease (HTAD) face a high risk of deadly aortic dissections, but genetic testing identifies causative variants in only a minority of cases. We explored the contribution of non-canonical splice variants (NCVAS) to thoracic aortic disease (TAD) usin...

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Main Authors: David R. Murdock, Dong-chuan Guo, John S. DePaolo, Ulrike Schwarze, Xue-yan Duan, Alana C. Cecchi, Isabella C. Marin, YingYing Tang, Jessica X. Chong, Michael J. Bamshad, Kathleen A. Leppig, Peter H. Byers, Scott M. Damrauer, Dianna M. Milewicz
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:npj Genomic Medicine
Online Access:https://doi.org/10.1038/s41525-025-00472-w
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author David R. Murdock
Dong-chuan Guo
John S. DePaolo
Ulrike Schwarze
Xue-yan Duan
Alana C. Cecchi
Isabella C. Marin
YingYing Tang
Jessica X. Chong
Michael J. Bamshad
Kathleen A. Leppig
Peter H. Byers
Scott M. Damrauer
Dianna M. Milewicz
author_facet David R. Murdock
Dong-chuan Guo
John S. DePaolo
Ulrike Schwarze
Xue-yan Duan
Alana C. Cecchi
Isabella C. Marin
YingYing Tang
Jessica X. Chong
Michael J. Bamshad
Kathleen A. Leppig
Peter H. Byers
Scott M. Damrauer
Dianna M. Milewicz
author_sort David R. Murdock
collection DOAJ
description Abstract Individuals with heritable thoracic aortic disease (HTAD) face a high risk of deadly aortic dissections, but genetic testing identifies causative variants in only a minority of cases. We explored the contribution of non-canonical splice variants (NCVAS) to thoracic aortic disease (TAD) using SpliceAI and sequencing data from diverse cohorts, including 551 early-onset sporadic dissection cases and 437 HTAD probands with exome sequencing, 57 HTAD pedigrees with whole genome sequencing, and select sporadic cases with clinical panel testing. NCVAS were identified in syndromic HTAD genes such as FBN1, SMAD3, and COL3A1, including intronic variants in FBN1 in two Marfan syndrome (MFS) families. Validation in the Penn Medicine BioBank and UK Biobank showed enrichment of NCVAS in HTAD-associated genes among dissections. These findings suggest NCVAS are an underrecognized contributor to TAD, particularly in sporadic dissection and unsolved MFS cases, highlighting the potential of advanced splice prediction tools in genetic diagnostics.
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spelling doaj-art-4afefe527bb44a42bf708c4df94b991b2025-08-20T03:41:50ZengNature Portfolionpj Genomic Medicine2056-79442025-03-011011910.1038/s41525-025-00472-wNon-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testingDavid R. Murdock0Dong-chuan Guo1John S. DePaolo2Ulrike Schwarze3Xue-yan Duan4Alana C. Cecchi5Isabella C. Marin6YingYing Tang7Jessica X. Chong8Michael J. Bamshad9Kathleen A. Leppig10Peter H. Byers11Scott M. Damrauer12Dianna M. Milewicz13Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)Department of Surgery, University of Pennsylvania Perelman School of MedicineDepartment of Laboratory Medicine and Pathology, University of WashingtonDepartment of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)Molecular Genetics Laboratory, New York City Office of Chief Medical ExaminerDivision of Genetic Medicine, Department of Pediatrics, University of WashingtonDivision of Genetic Medicine, Department of Pediatrics, University of WashingtonDivision of Medical Genetics, Department of Medicine, University of WashingtonDepartment of Laboratory Medicine and Pathology, University of WashingtonDepartment of Surgery, University of Pennsylvania Perelman School of MedicineDepartment of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)Abstract Individuals with heritable thoracic aortic disease (HTAD) face a high risk of deadly aortic dissections, but genetic testing identifies causative variants in only a minority of cases. We explored the contribution of non-canonical splice variants (NCVAS) to thoracic aortic disease (TAD) using SpliceAI and sequencing data from diverse cohorts, including 551 early-onset sporadic dissection cases and 437 HTAD probands with exome sequencing, 57 HTAD pedigrees with whole genome sequencing, and select sporadic cases with clinical panel testing. NCVAS were identified in syndromic HTAD genes such as FBN1, SMAD3, and COL3A1, including intronic variants in FBN1 in two Marfan syndrome (MFS) families. Validation in the Penn Medicine BioBank and UK Biobank showed enrichment of NCVAS in HTAD-associated genes among dissections. These findings suggest NCVAS are an underrecognized contributor to TAD, particularly in sporadic dissection and unsolved MFS cases, highlighting the potential of advanced splice prediction tools in genetic diagnostics.https://doi.org/10.1038/s41525-025-00472-w
spellingShingle David R. Murdock
Dong-chuan Guo
John S. DePaolo
Ulrike Schwarze
Xue-yan Duan
Alana C. Cecchi
Isabella C. Marin
YingYing Tang
Jessica X. Chong
Michael J. Bamshad
Kathleen A. Leppig
Peter H. Byers
Scott M. Damrauer
Dianna M. Milewicz
Non-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testing
npj Genomic Medicine
title Non-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testing
title_full Non-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testing
title_fullStr Non-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testing
title_full_unstemmed Non-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testing
title_short Non-canonical splice variants in thoracic aortic dissection cases and Marfan syndrome with negative genetic testing
title_sort non canonical splice variants in thoracic aortic dissection cases and marfan syndrome with negative genetic testing
url https://doi.org/10.1038/s41525-025-00472-w
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