Epigenetic disorders of development (EDD) are associated with a range of clinical complications including developmental delay, growth and congenital anomalies, endocrine and others. EDDs include both congenital imprinting disorders (CIDs) and conditions caused by germline pathogenic variants (GPVs; mutations) in genes that regulate chromatin structure /function (chromatin disorders=CD). The genetics of CDs are complex and genetic heterogeneity and variable genotype-phenotype relationships make the interpretation of variants of uncertain significance (VUS) in CD genes challenging. However, GPVs causing CDs are frequently associated with altered patterns of DNA methylation (episigntures) that can be detected in blood. Episignature analysis can resolve the pathogenicity of variants of uncertain significance (VUSs) but further algorithm development is required for full-scale clinical application. We have demonstrated that episignature analysis can inform VUS interpretation, have identified novel episignatures and demonstrated that episignatures might inform prognosis and insights into the mechanisms of disease. This project will extend these pilot findings by applying a novel state-of-the-art sequencing technique that provides both DNA sequence and CpG methylation status (Illumina 5-base sequencing) to CDs. This provides much more detailed analysis of methylation status than the methods currently used for episignature analysis and promises to improve the sensitivity and accuracy of episignature detection with the potential for direct translation into clinical diagnostics.
Relevant literature:
Lee S, Menzies L, Hay E et al. Epigenotype-genotype-phenotype correlations in SETD1A and SETD2 chromatin disorders. Hum Mol Genet. 2023;32:3123-3134
Lee S, Ochoa E, Badura-Stronka M, Donnelly D et al. Germline pathogenic variants in HNRNPU are associated with alterations in blood methylome. Eur J Hum Genet. 2023;31:1040-1047
Ochoa E, Zvetkova I, Lee S et al. Germline variants in UHRF1 are associated with multilocus imprinting disturbance in humans and mice. Proc Natl Acad Sci U S A. 2025;122):e2505884122