Medical Genomics Flashcards

1
Q

When was the human genome mapped?

A

2003

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2
Q

When did next generation sequencing begin?

A

2010->

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3
Q

What is NGS?

A

Next generation sequencing

The rapidly advancing technology that makes it economically viable to sequence individuals rather than species

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4
Q

What % of the genome is the exome?

A

1%

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5
Q

What does studying the transcriptome RNA allow us to study?

A

Gene expression
Gene fusions
Splice variants

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6
Q

How many base pairs in a genome?

A

About 3200 million

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7
Q

How many base pairs in an exome?

A

5–70million

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8
Q

Negatives of exome sequencing

A

Only picks up 85% of disease causing variants
Requires additional sample prep
No assessment of non coding regions
Simple repeats, GC rich and highly homologous regions are poorly captured
Clinical exome develops over time

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9
Q

Negatives of genome sequencing

A

Much more expensive
Massive data (storage?)
Interpretation more expensive and difficult

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10
Q

Steps in exome sequencing

A
Genomic DNA
Shotgun library-> fragments
Rehybridisation
Pull down and wash
Captured DNA is sequenced
Mapping, alignment and variant calling
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11
Q

What does variant calling rely on?

A

Accurate alignment to a reference sequence from the Human Genome Reference
No read is the full gene

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12
Q

Who should be sequenced?

A

Distantly related concordantly affected individuals (share very few mutations)
Closely related discordant individuals (very few differences)

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13
Q

What is a compound heterozygote?

A

The presence of two different mutant alleles at a particular gene locus, one on each chromosome of a pair
Different mutations in mum and dad but on same allele
Offspring has no functioning copies of that gene

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14
Q

What does consanguineous mean?

A

The quality of being descended from the same ancestor as another person.

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15
Q

What are the 6 main types of mutations?

A

Inherited (autosomal recessive, autosomal dominant, X linked recessive, consanguineous autosomal recessive)
De novo
Mosaic

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16
Q

What is needed for bioinformatics?

A

4Gb data for each sample
Biologists skilled in programming
IRIDIS4 supercomputer

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17
Q

What affects the quality of sequencing?

A

Read depths
Standard bias
PCR duplicates

18
Q

What is tiered analysis?

A

Prioritised analysis on basis of clinical presentation
Use known targeted gene panels
Top candidate genes first then pathway, system, others
Minimises incidental findings

19
Q

How can you filter data?

A

Mode of inheritance
Variant type
Concordance/discordance to affected relatives
Frequency in control populations

20
Q

Give an example of an ‘in silico’ tool

A

Computerised predictors
Logit
Mutationtaster

21
Q

Name 2 reference databases

A

UK10K, in-house, ESV

22
Q

What do genetic libertarians believe about incidental findings in genome analysis?

A

“Return comprehensive data”
Patient has right to know
Return all data on known and unknown risk variants

23
Q

What does the ACMG recommend about incidental findings in genome analysis?

A

“Return data on a limited number of conditions and genes”

20 diseases, 60 genes

24
Q

What do genetic empiricists believe about incidental findings in genome analysis?

A

“Only return data that is truly significant”
Don’t create burden of ‘patient in waiting’
Penetrance for most variants is unknown

25
Q

Who is involved in a medical genomics/bioinformatics MDT?

A
Genomicists
Clinicians
Immunologists
Bioinformaticians
Lab techs
Registrars
Research nurses
PhD students
Molecular biologists
Pathologists
26
Q

What are the issues with big data?

A

Storage space
Safety/confidentiality of data
Identifiable data refreshed for clinical life-course registry
Need data on cancer registries, rare diseases, mortality data
All data needs to be kept behind a firewall until processed
Then it can be given to clinicians, academics and industry

27
Q

What are the options for a patient when they get their data back?

A

Info about patient’s main condition
Info about ‘serious and actionable’ conditions (optional)
Info on carrier status for non-affected parents of children with rare diseases (optional)

28
Q

What can genomics be used for?

A

Making diagnoses
Identifying people and increased risk of developing a condition
Diagnosing infections and tracking epidemics
Personalising drug treatments
Identifying appropriate cancer treatments
Developing new therapies

29
Q

How can genomics be used to personalise drug treatments?

A

Genetic variation can impact drug metabolism.

  • > dosage
  • > frequency
  • > SEs
  • > adverse reactions
30
Q

How can NGS be used for monitoring of disease?

A

Measure minimal residual disease by liquid biopsy-> quantifies disease, monitors remission and detects relapse

31
Q

How does a mutation become heritable?

A

If it is germline (egg/sperm)

Then all cells are affected in offspring

32
Q

What do are proto-oncogenes?

A

Proto-oncogenes code for proteins that help to regulate cell growth and differentiation.
Could become an oncogene due to mutations or increased expression

33
Q

What do tumour-suppressor genes usually do?

A

Prevent cell division and check cells for mutations before allowing them to progress in mitosis

34
Q

What happens if a tumour-suppressor gene is mutated?

A

Loses function

Tumours are not suppressed

35
Q

Apart from tumour-suppressor genes and proto-oncogenes, what other genes do we worry about mutations?

A

DNA repair genes
Mutation may lead to decreased repair of damaged genes
Increased likelihood of damaging mutations

36
Q

What are the 2 types of mutation in cancer?

A

Drivers (give clones a selective advantage)

Passengers (have no effect)

37
Q

What can be used for NGS samples?

A

Fresh frozen tissue biopsies
Formalin fixed paraffin embedded samples
Peripheral blood cells
Saliva

38
Q

What does ‘cancer is clonal’ mean?

A

Cells are from one common ancestor cell characterised by one or more somatic driver mutations

39
Q

What are targeted gene panels good for?

A
Cheap, quick, higher read depth
Can estimate clonality
Best for rare variants
Restricted based on current knowledge
Can predict prognosis
40
Q

What are the 4 Ps of personalised healthcare?

A

Personalise
Predict
Prevent
Participate

41
Q

How will clinical genomics stratify disease?

A

Classify disease based on causative pathways instead of signs and symptoms