Whole-genome sequencing for optimized patient management

Matthew N. Bainbridge, Wojciech Wiszniewski, David R. Murdock, Jennifer Friedman, Claudia Gonzaga-Jauregui, Irene Newsham, Jeffrey G. Reid, John K. Fink, Margaret B. Morgan, Marie Claude Gingras, Donna M. Muzny, Linh D. Hoang, Shahed Yousaf, James R. Lupski, Richard A. Gibbs

Research output: Contribution to journalArticle

200 Scopus citations

Abstract

Whole-genome sequencing of patient DNA can facilitate diagnosis of a disease, but its potential for guiding treatment has been under-realized. We interrogated the complete genome sequences of a 14-year-old fraternal twin pair diagnosed with dopa (3,4-dihydroxyphenylalanine)-responsive dystonia (DRD; Mendelian Inheritance in Man #128230). DRD is a genetically heterogeneous and clinically complex movement disorder that is usually treated with L-dopa, a precursor of the neurotransmitter dopamine. Whole-genome sequencing identified compound heterozygous mutations in the SPR gene encoding sepiapterin reductase. Disruption of SPR causes a decrease in tetrahydrobiopterin, a cofactor required for the hydroxylase enzymes that synthesize the neurotransmitters dopamine and serotonin. Supplementation of L-dopa therapy with 5-hydroxytryptophan, a serotonin precursor, resulted in clinical improvements in both twins.

Original languageEnglish (US)
Article number87re3
JournalScience translational medicine
Volume3
Issue number87
DOIs
StatePublished - Jun 15 2011

ASJC Scopus subject areas

  • Medicine(all)

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    Bainbridge, M. N., Wiszniewski, W., Murdock, D. R., Friedman, J., Gonzaga-Jauregui, C., Newsham, I., Reid, J. G., Fink, J. K., Morgan, M. B., Gingras, M. C., Muzny, D. M., Hoang, L. D., Yousaf, S., Lupski, J. R., & Gibbs, R. A. (2011). Whole-genome sequencing for optimized patient management. Science translational medicine, 3(87), [87re3]. https://doi.org/10.1126/scitranslmed.3002243