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Transcriptome analysis provides critical answers to the “variants of uncertain significance” conundrum
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  • Mackenzie Postel,
  • Julie O. Culver,
  • Charité Ricker,
  • David Craig
Mackenzie Postel
University of Southern California Keck School of Medicine

Corresponding Author:mpostel@usc.edu

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Julie O. Culver
University of Southern California Norris Comprehensive Cancer Center
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Charité Ricker
University of Southern California Norris Comprehensive Cancer Center
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David Craig
University of Southern California Keck School of Medicine
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Abstract

The vast volume of data that has been generated as a result of the next-generation sequencing revolution is overwhelming to sift through and interpret. Parsing functional vs. non-functional and benign vs. pathogenic variants continues to be a challenge. Out of three billion bases, the genomes of two given individuals will only differ by about 3 million variants (0.1%). Furthermore, only a small fraction of these are biologically-relevant and, of those that are functional, only a handful actually drive disease pathology. While whole genome and exome sequencing have transformed our collective understanding of the role that genetics plays in disease pathogenesis, there are certain conditions and populations for whom DNA-level data has failed to produce a molecular diagnosis. Patients of non-White race/non-European ancestry are disproportionately affected by “variants of unknown/uncertain significance” (VUS). This limits the scope of precision medicine for minority patients and perpetuates health disparities. VUS often include deep intronic and splicing variants which are difficult to interpret in DNA alone. RNA analysis is capable of illuminating the consequences of VUS thereby allowing for their reclassification as pathogenic vs. benign. Here we review the critical role, going forward, of transcriptome analysis for clarifying VUS in both neoplastic and non-neoplastic diseases.
21 Dec 2021Submitted to Human Mutation
22 Dec 2021Submission Checks Completed
22 Dec 2021Assigned to Editor
11 Jan 2022Reviewer(s) Assigned
06 Feb 2022Review(s) Completed, Editorial Evaluation Pending
15 Feb 2022Editorial Decision: Revise Minor
16 Mar 20221st Revision Received
17 Mar 2022Submission Checks Completed
17 Mar 2022Assigned to Editor
18 Apr 2022Reviewer(s) Assigned
23 Apr 2022Review(s) Completed, Editorial Evaluation Pending
26 Apr 2022Editorial Decision: Accept
Nov 2022Published in Human Mutation volume 43 issue 11 on pages 1590-1608. 10.1002/humu.24394