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Whole-transcriptome sequencing–based concomitant detection of viral and human genetic determinants of cutaneous lesions
Amir Hossein Saeidian, Leila Youssefian, Charles Y. Huang, Fahimeh Palizban, Mahtab Naji, Zahra Saffarian, Hamidreza Mahmoudi, Azadeh Goodarzi, Soheila Sotoudeh, Fatemeh Vahidnezhad, Maliheh Amani, Narjes Tavakoli, Ali Ajami, Samaneh Mozafarpoor, Mehrdad Teimoorian, Saeed Dorgaleleh, Sima Shokri, Mohammad Shenagari, Nima Abedi, Sirous Zeinali, Paolo Fortina, Vivien Béziat, Emmanuelle Jouanguy, Jean-Laurent Casanova, Jouni Uitto, Hassan Vahidnezhad
Amir Hossein Saeidian, Leila Youssefian, Charles Y. Huang, Fahimeh Palizban, Mahtab Naji, Zahra Saffarian, Hamidreza Mahmoudi, Azadeh Goodarzi, Soheila Sotoudeh, Fatemeh Vahidnezhad, Maliheh Amani, Narjes Tavakoli, Ali Ajami, Samaneh Mozafarpoor, Mehrdad Teimoorian, Saeed Dorgaleleh, Sima Shokri, Mohammad Shenagari, Nima Abedi, Sirous Zeinali, Paolo Fortina, Vivien Béziat, Emmanuelle Jouanguy, Jean-Laurent Casanova, Jouni Uitto, Hassan Vahidnezhad
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Resource and Technical Advance Genetics Infectious disease

Whole-transcriptome sequencing–based concomitant detection of viral and human genetic determinants of cutaneous lesions

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Abstract

Severe viral infections of the skin can occur in patients with inborn errors of immunity (IEI). We report an all-in-one whole-transcriptome sequencing–based method by RNA-Seq on a single skin biopsy for concomitantly identifying the cutaneous virome and the underlying IEI. Skin biopsies were obtained from healthy and lesional skin from patients with cutaneous infections suspected to be of viral origin. RNA-Seq was utilized as the first-tier strategy for unbiased human genome-wide rare variant detection. Reads unaligned to the human genome were utilized for the exploration of 926 viruses in a viral genome catalog. In 9 families studied, the patients carried pathogenic variants in 6 human IEI genes, including IL2RG, WAS, CIB1, STK4, GATA2, and DOCK8. Gene expression profiling also confirmed pathogenicity of the human variants and permitted genome-wide homozygosity mapping, which assisted in identification of candidate genes in consanguineous families. This automated, online, all-in-one computational pipeline, called VirPy, enables simultaneous detection of the viral triggers and the human genetic variants underlying skin lesions in patients with suspected IEI and viral dermatosis.

Authors

Amir Hossein Saeidian, Leila Youssefian, Charles Y. Huang, Fahimeh Palizban, Mahtab Naji, Zahra Saffarian, Hamidreza Mahmoudi, Azadeh Goodarzi, Soheila Sotoudeh, Fatemeh Vahidnezhad, Maliheh Amani, Narjes Tavakoli, Ali Ajami, Samaneh Mozafarpoor, Mehrdad Teimoorian, Saeed Dorgaleleh, Sima Shokri, Mohammad Shenagari, Nima Abedi, Sirous Zeinali, Paolo Fortina, Vivien Béziat, Emmanuelle Jouanguy, Jean-Laurent Casanova, Jouni Uitto, Hassan Vahidnezhad

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Figure 4

Concomitant detection of the causal single-gene defect and skin virome in a patient with IEI and EV.

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Concomitant detection of the causal single-gene defect and skin virome i...
(A) Family pedigree of an 8-year-old patient initially diagnosed with EV (indicated by the arrowhead). (B) Widespread flat warts on the trunk. (C) (Upper panel) Histopathology of a flat wart on acral skin showed epidermal thickening with hyperkeratosis, acanthosis, hypergranulosis, and the presence of koilocytes with the large cytoplasmic halo. Original magnification, 10× and 40×. (Lower panel) Bone marrow histopathology at the age of 6 years showed hypercellularity with mild dysmyelopoiesis and megaloblastic changes (lower left panel), which progressively became hypocellular (cell/fat ratio 50:50) during the subsequent 3 years (right panel). (D) RNA-Seq analysis by VirPy detected HPV5 and HPV14 in wart samples but also insignificant levels in the patient’s normal skin. (E) HM performed on RNA-Seq data identified several regions of homozygosity (ROHs) (blue vertical blocks). The STK4 gene was present within an ROH in chromosome 20. (F) Variants called from RNA-Seq were filtered by the indicated steps, which identified STK4 as the pathogenic candidate gene. (G) Sanger sequencing of genomic DNA confirmed the presence of a homozygous mutation STK4: c.878_882del5 in the proband, and the parents were heterozygous carriers. (H) Sashimi plots showed that the mutation in STK4 resulted in aberrant mRNA splicing, including retention of intron 8 sequences. Note the position of the mutation in the middle of exon 8 (arrow). (I) Heatmap visualization of transcriptome analysis revealed STK4 was highly downregulated in comparison with the randomly selected housekeeping genes. The figure was generated in BioRender. CADD, combined annotation dependent depletion; MAF, minor allele frequency.

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