The use of next-generation sequencing in clinical diagnosis of familial hypercholesterolemia

Jana Vandrovcova, Ellen R A Thomas, Santosh Atanur, Penny J Norsworthy, Clare Neuwirth, Yvonne Tan, Dalia Kasperaviciute, Jennifer Biggs, Laurence Game, Michael Mueller, Anne K Soutar, Timothy J Aitman

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

PURPOSE: Familial hypercholesterolemia is a common Mendelian disorder associated with early-onset coronary heart disease that can be treated by cholesterol-lowering drugs. The majority of cases in the United Kingdom are currently without a molecular diagnosis, which is partly due to the cost and time associated with standard screening techniques. The main purpose of this study was to test the sensitivity and specificity of two next-generation sequencing protocols for genetic diagnosis of familial hypercholesterolemia.

METHODS: Libraries were prepared for next-generation sequencing by two target enrichment protocols; one using the SureSelect Target Enrichment System and the other using the PCR-based Access Array platform.

RESULTS: In the validation cohort, both protocols showed 100% specificity, whereas the sensitivity for short variant detection was 100% for the SureSelect Target Enrichment and 98% for the Access Array protocol. Large deletions/duplications were only detected using the SureSelect Target Enrichment protocol. In the prospective cohort, the mutation detection rate using the Access Array was highest in patients with clinically definite familial hypercholesterolemia (67%), followed by patients with possible familial hypercholesterolemia (26%).

CONCLUSION: We have shown the potential of target enrichment methods combined with next-generation sequencing for molecular diagnosis of familial hypercholesterolemia. Adopting these assays for patients with suspected familial hypercholesterolemia could improve cost-effectiveness and increase the overall number of patients with a molecular diagnosis.

Original languageEnglish
Pages (from-to)948-57
Number of pages10
JournalGenetics in Medicine
Issue number12
Publication statusPublished - Dec 2013

Keywords / Materials (for Non-textual outputs)

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • DNA Copy Number Variations
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Hyperlipoproteinemia Type II
  • Middle Aged
  • Molecular Diagnostic Techniques
  • Mutation Rate
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sequence Analysis, DNA
  • Young Adult


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