Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanks

Background: Autosomal recessive Gaucher disease (GD) is likely underdiagnosed in many countries. Because the number of diagnosed GD patients in Finland is relatively low, and the true prevalence is currently not known, it was hypothesized that undiagnosed GD patients may exist in Finland. Our previo...

Full description

Bibliographic Details
Main Authors: Minja Pehrsson, Hanna Heikkinen, Ulla Wartiovaara-Kautto, Sampo Mäntylahti, Pia Bäckström, Mariann I. Lassenius, Kristiina Uusi-Rauva, Olli Carpén, Kaisa Elomaa
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Molecular Genetics and Metabolism Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214426922000714
_version_ 1811299689863053312
author Minja Pehrsson
Hanna Heikkinen
Ulla Wartiovaara-Kautto
Sampo Mäntylahti
Pia Bäckström
Mariann I. Lassenius
Kristiina Uusi-Rauva
Olli Carpén
Kaisa Elomaa
author_facet Minja Pehrsson
Hanna Heikkinen
Ulla Wartiovaara-Kautto
Sampo Mäntylahti
Pia Bäckström
Mariann I. Lassenius
Kristiina Uusi-Rauva
Olli Carpén
Kaisa Elomaa
author_sort Minja Pehrsson
collection DOAJ
description Background: Autosomal recessive Gaucher disease (GD) is likely underdiagnosed in many countries. Because the number of diagnosed GD patients in Finland is relatively low, and the true prevalence is currently not known, it was hypothesized that undiagnosed GD patients may exist in Finland. Our previous study demonstrated the applicability of Gaucher Earlier Diagnosis Consensus point-scoring system (GED-C PSS; Mehta et al., 2019) and Finnish biobank data and specimens in the automated point scoring of large populations. An indicative point-score range for Finnish GD patients was determined, but undiagnosed patients were not identified partly due to high number of high-score subjects in combination with a lack of suitable samples for diagnostics in the assessed biobank population. The current study extended the screening to another biobank and evaluated the feasibility of utilising the automated GED-C PSS in conjunction with small nucleotide polymorphism (SNP) chip genotype data from the FinnGen study of biobank sample donors in the identification of undiagnosed GD patients in Finland. Furthermore, the applicability of FFPE tissues and DNA restoration in the next-generation sequencing (NGS) of the GBA gene were tested. Methods: Previously diagnosed Finnish GD patients eligible to the study, and up to 45,100 sample donors in Helsinki Biobank (HBB) were point scored. The GED-C point scoring, adjusted to local data, was automated, but also partly manually verified for GD patients. The SNP chip genotype data for rare GBA variants was visually assessed. FFPE tissues of GD patients were obtained from HBB and Biobank Borealis of Northern Finland (BB). Results: Three previously diagnosed GD patients and one patient previously treated for GD-related features were included. A genetic diagnosis was confirmed for the patient treated for GD-related features. The GED-C point score of the GD patients was 12.5–22.5 in the current study. The score in eight Finnish GD patients of the previous and the current study is thus 6–22.5 points per patient. In the automated point scoring of the HBB subpopulation (N ≈ 45,100), the overall scores ranged from 0 to 17.5, with 0.77% (346/45,100) of the subjects having ≥10 points. The analysis of SNP chip genotype data was able to identify the diagnosed GD patients, but potential undiagnosed patients with the GED-C score and/or the GBA genotype indicative of GD were not discovered. Restoration of the FFPE tissue DNA improved the quality of the GBA NGS, and pathogenic GBA variants were confirmed in five out of six unrestored and in all four restored FFPE DNA samples. Discussion: These findings imply that the prevalence of diagnosed patients (~1:325,000) may indeed correspond the true prevalence of GD in Finland. The SNP chip genotype data is a valuable tool that complements the screening with the GED-C PSS, especially if the genotyping pipeline is tuned for rare variants. These proof-of-concept biobank tools can be adapted to other rare genetic diseases.
first_indexed 2024-04-13T06:39:33Z
format Article
id doaj.art-b89df55e164e428891087e026837972c
institution Directory Open Access Journal
issn 2214-4269
language English
last_indexed 2024-04-13T06:39:33Z
publishDate 2022-12-01
publisher Elsevier
record_format Article
series Molecular Genetics and Metabolism Reports
spelling doaj.art-b89df55e164e428891087e026837972c2022-12-22T02:57:47ZengElsevierMolecular Genetics and Metabolism Reports2214-42692022-12-0133100911Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanksMinja Pehrsson0Hanna Heikkinen1Ulla Wartiovaara-Kautto2Sampo Mäntylahti3Pia Bäckström4Mariann I. Lassenius5Kristiina Uusi-Rauva6Olli Carpén7Kaisa Elomaa8Helsinki Biobank, Helsinki University Hospital, Haartmaninkatu 3, 00290 Helsinki, FinlandHelsinki Biobank, Helsinki University Hospital, Haartmaninkatu 3, 00290 Helsinki, FinlandDepartment of Hematology, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, FinlandHelsinki Biobank, Helsinki University Hospital, Haartmaninkatu 3, 00290 Helsinki, FinlandHelsinki Biobank, Helsinki University Hospital, Haartmaninkatu 3, 00290 Helsinki, FinlandMedaffcon Oy, Metsänneidonkuja 8, 02130 Espoo, FinlandMedaffcon Oy, Metsänneidonkuja 8, 02130 Espoo, FinlandHelsinki Biobank, Helsinki University Hospital, Haartmaninkatu 3, 00290 Helsinki, Finland; Department of Pathology, University of Helsinki, HUS Diagnostic Center, FinlandTakeda Oy, Ilmalantori 1, 00101 Helsinki, Finland; Corresponding author at: Nordic Innovation CoE Lead, Takeda, PO Box 1406, Ilmalantori 1, 00101 Helsinki, Finland.Background: Autosomal recessive Gaucher disease (GD) is likely underdiagnosed in many countries. Because the number of diagnosed GD patients in Finland is relatively low, and the true prevalence is currently not known, it was hypothesized that undiagnosed GD patients may exist in Finland. Our previous study demonstrated the applicability of Gaucher Earlier Diagnosis Consensus point-scoring system (GED-C PSS; Mehta et al., 2019) and Finnish biobank data and specimens in the automated point scoring of large populations. An indicative point-score range for Finnish GD patients was determined, but undiagnosed patients were not identified partly due to high number of high-score subjects in combination with a lack of suitable samples for diagnostics in the assessed biobank population. The current study extended the screening to another biobank and evaluated the feasibility of utilising the automated GED-C PSS in conjunction with small nucleotide polymorphism (SNP) chip genotype data from the FinnGen study of biobank sample donors in the identification of undiagnosed GD patients in Finland. Furthermore, the applicability of FFPE tissues and DNA restoration in the next-generation sequencing (NGS) of the GBA gene were tested. Methods: Previously diagnosed Finnish GD patients eligible to the study, and up to 45,100 sample donors in Helsinki Biobank (HBB) were point scored. The GED-C point scoring, adjusted to local data, was automated, but also partly manually verified for GD patients. The SNP chip genotype data for rare GBA variants was visually assessed. FFPE tissues of GD patients were obtained from HBB and Biobank Borealis of Northern Finland (BB). Results: Three previously diagnosed GD patients and one patient previously treated for GD-related features were included. A genetic diagnosis was confirmed for the patient treated for GD-related features. The GED-C point score of the GD patients was 12.5–22.5 in the current study. The score in eight Finnish GD patients of the previous and the current study is thus 6–22.5 points per patient. In the automated point scoring of the HBB subpopulation (N ≈ 45,100), the overall scores ranged from 0 to 17.5, with 0.77% (346/45,100) of the subjects having ≥10 points. The analysis of SNP chip genotype data was able to identify the diagnosed GD patients, but potential undiagnosed patients with the GED-C score and/or the GBA genotype indicative of GD were not discovered. Restoration of the FFPE tissue DNA improved the quality of the GBA NGS, and pathogenic GBA variants were confirmed in five out of six unrestored and in all four restored FFPE DNA samples. Discussion: These findings imply that the prevalence of diagnosed patients (~1:325,000) may indeed correspond the true prevalence of GD in Finland. The SNP chip genotype data is a valuable tool that complements the screening with the GED-C PSS, especially if the genotyping pipeline is tuned for rare variants. These proof-of-concept biobank tools can be adapted to other rare genetic diseases.http://www.sciencedirect.com/science/article/pii/S2214426922000714Biobank studyElectronic health record dataSmall nucleotide polymorphism chip genotype dataGaucher diseaseGaucher earlier diagnosis consensus point-scoring systemGBA
spellingShingle Minja Pehrsson
Hanna Heikkinen
Ulla Wartiovaara-Kautto
Sampo Mäntylahti
Pia Bäckström
Mariann I. Lassenius
Kristiina Uusi-Rauva
Olli Carpén
Kaisa Elomaa
Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanks
Molecular Genetics and Metabolism Reports
Biobank study
Electronic health record data
Small nucleotide polymorphism chip genotype data
Gaucher disease
Gaucher earlier diagnosis consensus point-scoring system
GBA
title Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanks
title_full Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanks
title_fullStr Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanks
title_full_unstemmed Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanks
title_short Screening for potential undiagnosed Gaucher disease patients: Utilisation of the Gaucher earlier diagnosis consensus point-scoring system (GED-C PSS) in conjunction with electronic health record data, tissue specimens, and small nucleotide polymorphism (SNP) genotype data available in Finnish biobanks
title_sort screening for potential undiagnosed gaucher disease patients utilisation of the gaucher earlier diagnosis consensus point scoring system ged c pss in conjunction with electronic health record data tissue specimens and small nucleotide polymorphism snp genotype data available in finnish biobanks
topic Biobank study
Electronic health record data
Small nucleotide polymorphism chip genotype data
Gaucher disease
Gaucher earlier diagnosis consensus point-scoring system
GBA
url http://www.sciencedirect.com/science/article/pii/S2214426922000714
work_keys_str_mv AT minjapehrsson screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT hannaheikkinen screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT ullawartiovaarakautto screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT sampomantylahti screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT piabackstrom screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT mariannilassenius screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT kristiinauusirauva screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT ollicarpen screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank
AT kaisaelomaa screeningforpotentialundiagnosedgaucherdiseasepatientsutilisationofthegaucherearlierdiagnosisconsensuspointscoringsystemgedcpssinconjunctionwithelectronichealthrecorddatatissuespecimensandsmallnucleotidepolymorphismsnpgenotypedataavailableinfinnishbiobank