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Recurrent
de novo
(DN) and likely gene-disruptive (LGD) mutations contribute significantly to autism spectrum disorders (ASDs) but have been primarily investigated in European cohorts. Here, we sequence 189 risk genes in 1,543 Chinese ASD probands (1,045 from trios). We report an 11-fold increase in the odds of DN LGD mutations compared with expectation under an exome-wide neutral model of mutation. In aggregate, ∼4% of ASD patients carry a DN mutation in one of just 29 autism risk genes. The most prevalent gene for recurrent DN mutations is
SCN2A
(1.1% of patients) followed by
CHD8
,
DSCAM
,
MECP2
,
POGZ
,
WDFY3
and
ASH1L
. We identify novel DN LGD recurrences (
GIGYF2
,
MYT1L
,
CUL3
,
DOCK8
and
ZNF292
) and DN mutations in previous ASD candidates (
ARHGAP32
,
NCOR1
,
PHIP
,
STXBP1
,
CDKL5
and
SHANK1
). Phenotypic follow-up confirms potential subtypes and highlights how large global cohorts might be leveraged to prove the pathogenic significance of individually rare mutations.
Recurrent sporadic mutations are important risk factors for autism spectrum disorders (ASDs) but have been primarily investigated in European cohorts. Here, Eichler, Xia and colleagues analyse risk genes in a large Chinese ASD cohort and find novel recurrences of potential pathogenic significance.