В кратком сообщении представлены результаты анализа генетического разнообразия и структуры неравновесия по сцеплению в двух популяциях южных алтайцев: теленгитов и алтай-кижи. Анализ проводился с использованием мультиплексного набора TYPER X-19, включающего 18 STR-маркеров, локализованных на X-хромосоме. Продемонстрирована специфичность генетической структуры двух этносов, Выявлены различия в структуре неравновесия по сцеплению. Проведена оценка уровня исключающей способности 18 X-STR для ДНК-идентификации.

Введение. Наряду с известными факторами риска сердечно-сосудистых заболеваний, такими как мужской пол, артериальная гипертензия и курение, предрасположенность к развитию аневризмы восходящей аорты (АВА) в значительной степени определяют и генетические факторы. Зачастую генетическая предрасположенность обусловлена вариантами в генах компонентов соединительной ткани, функционирования гладкомышечных клеток, сигнального пути TGF-β. Однако на сегодняшний день не разработана панель генетических маркеров, рекомендованная для оценки риска развития спорадических случаев АВА. Цель: поиск клинически значимых генетических вариантов у пациента со спорадической формой АВА методом массового параллельного секвенирования. Методы. У пациента (48 лет, диаметр восходящей части аорты 50 мм) проведен поиск редких генетических вариантов (частота минорного аллеля <1%), локализованных в экзонах 53 генов наследственных и синдромальных форм АВА. Секвенирование клинического экзома выполнено на платформе SOPHiA GENETICS. Аннотация вариантов была выполнена с использованием программы ANNOVAR. Классификацию вариантов по степени патогенности проводили согласно стандартам и рекомендациям Американской коллегии медицинской генетики и геномики (ACMG) с использованием инструмента VarSome. Валидацию идентифицированных вариантов осуществляли методом секвенирования по Сэнгеру. Результаты. У пациента выявлено три варианта с неясной клинической значимостью в генах FBN1 − c.C7841T (p.A2614V), COL3A1 − c.A2498T (p.K833I), и PLOD3 − c.G833A (rs1041461490, p.G278D). Все найденные варианты идентифицированы при данной патологии впервые. Два варианта локализованы в генах с доказанным максимальным эффектом мутаций на развитие патологии (FBN1, COL3A1). Третий ген PLOD3 связан с заболеваниями восходящей аорты на основании экспериментальных исследований, однако в клинической практике его роль в развитии АВА до сих пор не установлена. Выводы. Спорадические АВА развиваются с вовлечением тех же патогенетических путей, что наследственные и синдромальные формы. Тем не менее, паттерн найденных генетических вариантов при спорадических случаях уникален. Для выявления этих особенностей у больных со спорадическими АВА требуется генетическое тестирование по расширенной панели, разработка которой является актуальной прикладной задачей современной медицины. 

The problem of diagnosing hereditary neuromuscular diseases is one of the most difficult in the medical specialists’ practice. Molecular genetic diagnostics is one of the fundamental aspects in the classification and subsequent approaches to the treatment and prevention of hereditary diseases. Pathogenic variants identification leads to the formation of separate subtypes and phenotypically identical diseases syndromes. This review examines modern diagnostic methods and algorithmization of patients with neuromuscular diseases. Despite enormous research and clinical efforts, the molecular causes remain unknown for almost half of patients with neuromuscular diseases due to genetic heterogeneity and molecular diagnostics based on a gene-by-gene approach. Next-generation sequencing (NGS) is an effective and cost-effective strategy for accelerating patient diagnosis. However, the diagnostic value of conducting and prescribing whole-exome or whole-genome sequencing is largely dependent on the clinical picture of the disease and the professional competence of the doctor. Hereditary neuromuscular diseases have similar initial symptoms, and molecular genetic diagnostics can pinpoint the cause and pathogenesis of the observed disorders in the patient. Conclusion. The molecular diagnostics algorithm is based on sequential analysis, starting with the search for the most common pathogenic variants using inexpensive and rapid methods, and progressing to the search for rare, previously undescribed pathogenic variants using whole-genome/whole-exome studies. The phasing allows science and medicine to uncover previously unknown causes of severe disease in patients with neuromuscular diseases, which often leading to disability or premature death. Earlier genetic diagnosis should provide more effective treatment of the disease and better genetic counseling for families and will also allow access to pathogenetic therapy for neuromuscular diseases.

Fetal growth restriction is a complication of pregnancy that is defined as the inability of the fetus to realize its genetically determined growth potential. Despite the high social and medical significance of this problem the exact pathogenesis of fetal growth restriction is not known. Therefore, the analysis of the molecular genetics mechanisms of this pathology within the framework of approaches using modern high-performance technologies of next generation sequencing is of undoubted interest. In this review we focused on the analysis of data obtained in studies of the genetics component of fetal growth restriction. The authors of these studies used next generation sequencing technologies and carried out whole transcriptome profiling. The results of the gene expression genome-wide analysis in placental tissue allow us to identify 1430 differentially expressed genes between fetal growth restriction and normal pregnancy, of which only 1% were found in at least two studies. These differentially expressed genes are involved in the Wnt/β-catenin signaling pathway, which plays an important role in cell migration, neural pattern formation and organogenesis during embryonic development. Common genes are associated with both obstetric and gynecological diseases, as well as with various somatic conditions from the groups of neurodegenerative, cardiovascular diseases and mental disorders, which probably reflects their involvement in the development of postnatal consequences of fetal growth restriction. The results of our work do not only point to potential molecular mechanisms and key genes underlying fetal growth restriction, but also indicate the important role of gene–gene communications in this pathology: about 30% of all identified differentially expressed genes products interact with each other within the same gene network. In general, genome-wide RNA sequencing combined with the analysis of protein–protein interactions represents a promising direction in research in the development and functioning of the placenta, as well as the identification of genetic mechanisms of placental insufficiency diseases, including fetal growth restriction.

Abstract: Objective: This study assessed the patterns and clinical significance of potential drug–drug interactions (pDDIs) in patients with diseases of the cardiovascular system. Methods: Electronic health records (EHRs), established in 2018–2023, were selected using the probability serial nested sampling method (n = 1030). Patients were aged 27 to 95 years (65.0% men). Primary diagnosis of COVID-19 was present in 17 EHRs (1.7%). Medscape Drug Interaction Checker was used to characterize pDDIs. The Mann–Whitney U test and chi-square test were used for statistical analysis. Results: Drug numbers per record ranged from 1 to 23 in T-List and from 1 to 20 in P-List. In T-List, 567 drug combinations resulted in 3781 pDDIs. In P-List, 584 drug combinations resulted in 5185 pDDIs. Polypharmacy was detected in 39.0% of records in T-List versus 65.9% in P-List (p-value < 0.05). The rates of serious and monitor-closely pDDIs due to ‘aspirin + captopril’ combinations were significantly higher in P-List than in T-List (p-value < 0.05). The rates of serious pDDIs due to ‘aspirin + enalapril’ and ‘aspirin + lisinopril’ combinations were significantly lower in P-List compared with the corresponding rates in T-List (p-value < 0.05). Serious pDDIs due to administration of aspirin with fosinopril, perindopril, and ramipril were detected less frequently in T-List (p-value < 0.05). Conclusions: Obtained data may suggest better patient adherence to ‘aspirin + enalapril’ and ‘aspirin + lisinopril’ combinations, which are potentially superior to the combinations of aspirin with fosinopril, perindopril, and ramipril. An abundance of high-order pDDIs in real-world clinical practice warrants the development of a decision support system aimed at reducing pharmacotherapy-associated risks while integrating patient pharmacokinetic, pharmacodynamic, and pharmacogenetic information.

Objective: Epidermolysis bullosa simplex (EBS) is a common, well-characterized type of epidermolysis bullosa. However, some rare syndromic EBS phenotypes are not well described. The accumulation of clinical descriptions of patients with syndromic subtypes of EBS is important for understanding the natural history of the disease and assessing genotype-phenotype correlations.
Case summary: We present a series of case reports of the syndromic subtype of EBS associated with mutations in the KLHL24 gene in seven patients from four unrelated families. The clinical features of this rare phenotype in children and adult patients are described in detail. In two families, we revealed pathogenic variant c.1A > G (p.Met1?) in the KLHL24 gene. The third family had c.3G > A (p.Met1?) mutation, and the fourth family had a novel de novo variant c.23del (p.Arg8AsnfsTer2).
Conclusion: The description of the clinical manifestations of the disease in two generations of EBS families with different genetic variants allows the assessment and prediction of the natural course and severity of the disease in these families, the risk of complications, and the planning of the amount of medical care necessary.

Nonsyndromic sporadic thoracic aortic aneurysm (nssTAA) is characterized by diverse genetic variants that may vary in different populations. Our aim was to identify clinically relevant variants in genes implicated in hereditary aneurysms in Russian patients with nssTAA. Forty-one patients with nssTAA without dissection were analyzed. Using massive parallel sequencing, we searched for variants in exons of 53 known disease-causing genes. Patients were found to have no (likely) pathogenic variants in the genes of hereditary TAA. Six variants of uncertain significance (VUSs) were identified in four (9.8%) patients. Three VUSs [FBN1 c.7841C>T (p.Ala2614Val), COL3A1 c.2498A>T (p.Lys833Ile), and MYH11 c.4993C>T (p.Arg1665Cys)] are located in genes with “definitive” disease association (ClinGen). The remaining variants are in “potentially diagnostic” genes or genes with experimental evidence of disease association [NOTCH1 c.964G>A (p.Val322Met), COL4A5 c.953C>G (p.Pro318Arg), and PLOD3 c.833G>A (p.Gly278Asp)]. Russian patients with nssTAA without dissection examined in this study have ≥1 VUSs in six known genes of hereditary TAA (FBN1, COL3A1, MYH11, NOTCH1, COL4A5, or PLOD3). Experimental studies expanded genetic testing, and clinical examination of patients and first/second-degree relatives may shift VUSs to the pathogenic (benign) category or to a new class of rare “predisposing” low-penetrance variants causing the pathology if combined with other risk factors.

Обоснование. Белок UBE2A относится к семейству E2 убиквитин-связывающих ферментов, которые участвуют в процессе убиквитинирования белков-субстратов. Известно, что мутации гена UBE2A связаны с синдромом врождённой Х-сцепленной умственной отсталости типа Насименто. До сих пор остаётся неизвестным, каким образом дисфункция гена UBE2A приводит к нарушению развития центральной нервной системы. Цель исследования - создание клеточной модели на основе индуцированных плюрипотентных стволовых клеток (ИПСК) для изучения молекулярных и клеточных функций гена UBE2A в нейрогенезе.

Методы. Используя геномное CRISPR-Cas9-редактирование и лентивирусную трансдукцию, мы создали клеточную модель на основе ИПСК двух здоровых доноров, включающую изогенные ИПСК с нокаутом и индуцибельной гиперэкспрессией гена UBE2A. Дополнительно к изогенным системам мы получили линию ИПСК путём репрограммирования мононуклеаров периферической крови пациента, которому поставлен диагноз Х-сцепленной умственной отсталости типа Насименто и у которого выявлена делеция, целиком захватывающая локус гена UBE2A.

Результаты. Полученные ИПСК демонстрируют морфологию, подобную эмбриональным стволовым клеткам. Они экспрессируют маркёры плюрипотентных клеток OCT4, SOX2, SSEA-4 и TRA-1-81 и имеют нормальный кариотип. Обнаружено, что у ИПСК с нокаутом или гиперэкспрессией гена UBE2A происходит статистически значимое увеличение размера клеточного ядра по сравнению с изогенным контролем.

Заключение. Созданная клеточная модель на основе ИПСК может быть использована для фундаментальных исследований функций гена UBE2A в нейрогенезе.

The gene pool of the Koryaks was studied in comparison with other Far Eastern and Siberian peoples using a genome-wide panel of autosomal single-nucleotide polymorphic markers and Y-chromosome markers. The results of analyzing the frequencies of autosomal SNPs using various methods, the similarity in the composition of Y-chromosome haplogroups and YSTR haplotypes indicate that the gene pool of the Koryaks is as close as possible to the Chukchi one and was formed as a result of the unification of several groups whose ancestors had moved from the territory of modern Yakutia and the Amur region. The two dominant Y-chromosome haplogroups of the Koryaks with different sublines of haplotype clusters demonstrate their contacts with the Chukchi, Evens, Yukaghirs, and Eskimos. Analysis of the composition of genetic components and IBD blocks on autosomes indicates the maximum genetic proximity of the Koryaks to the Chukchi. Among the Siberian populations, the Chukchi, Koryaks, and Nivkhs form a cluster separate from the main group of Siberian populations, while the Chukchi and Koryaks are more closely related. Far Eastern populations are divided in full accordance with geographic localization into the northern group (Chukchi and Koryaks) and the southern group, including the Nivkhs and Udege. A more detailed analysis of the component composition of gene pools in some populations reveals components specific to them. The isolation of such components is associated with founder effects and a shift in allele frequencies for these populations. The Koryaks and Chukchi represent one of the most striking examples of long-standing genetic kinship. Their populations demonstrate maximum values of the level of genomic inbreeding FROH > 1.5 (0.0422, 0.0409), which is natural due to their relative isolation.

Цель – исследование патогенного эффекта варианта в сайте сплайсинга MYBPC3 у пациента с гипертрофической кардиомиопатией. Материалы и методы. Исследование проведено с использованием образца ДНК пациентки с гипертрофической кардиомиопатией, у которой был выявлен ранее не описанный вариант в донорном сайте сплайсинга интрона 21. Применены методы конструирования и клонирования мини-генов (вектор pSpl3- Flu2-TKdel), трансфекции культуры клеток человека (HEK293T), с последующим выделением мРНК, получением кДНК, ПЦР участка мини-гена, содержащего анализируемый фрагмент, электрофореза в агарозном геле, секвенирования по Сэнгеру. Результаты. Вариант chr11:47339649-A-C (hg38), нарушающий донорный сайт сплайсинга в интроне 21 (NM_000256.3: c.2067+2T>G), был выявлен у пациентки 23 лет с обструктивной формой гипертрофической кардиомиопатии. Для прямого анализа влияния этого варианта на сплайсинг был получен вектор, содержащий экзон 21, интрон 21, экзон 22, частично интроны 20 и 22 MYBPC3. Сравнение мРНК, полученных для мини-генов, содержащих или несодержащих исследуемый вариант, показало, что замена chr11:47339649-A-C приводит к пропуску экзонов 21 и 22 в процессе сплайсинга. Заключение. В результате исследования установлена функциональная значимость ранее не описанного варианта c.2067+2T>G в гене MYBPC3, приводящего к нарушению механизма сплайсинга мРНК у пациента с гипертрофической кардиомиопатией. Данный вариант может быть классифицирован как патогенный.

We found hypomethylation of five CpG sites in the 5' region of TBX20 gene (7p14.2) in the tissues of atherosclerotic aortic plaque compared to dilated part of aorta in patients with ascending aortic aneurysm. Using GEO database, we found that the DNA methylation level in the chr7:35253926-35262250 region changes in opposite direction in aortic dissection and aortic atherosclerosis. The results suggest an alteration in epigenetic regulation both in aortic atherosclerosis and aortic aneurysm.

Atherosclerosis and aneurysm of the aorta are relatively common pathological conditions that remain asymptomatic for a long period of time and have life-threatening and disabling complications. DNA methylation profiling in several regions (a dilated area, a nondilated area, and an atherosclerotic plaque) of the ascending aorta was carried out in patients with aortic aneurysm. DNA methylation was analyzed by reduced representation bisulfite sequencing (RRBS). Differences in methylation level between dilated and normal aortic tissues were detected for two CpG sites of the NR2F1-AS1 gene (|Δβ| ≥ 0.2 and FDR < 0.05). In total, 586/480 differentially methylated CpG sites (DMSs) were identified by comparing atherosclerotic plaque samples with dilated/normal aortic tissues; 323/234 of the DMSs were hypermethylated and 263/246 were hypomethylated in atherosclerotic plaques. Most DMSs were in introns and intergenic regions; 88.2% of the DMSs were in the binding sites of transcription factors, among which ZNf263, ZFP148, PATZ1, NRF1, TCF12, and EGR1 play a role in the pathogenesis of atherosclerosis of various arteries and ELK1, ETS1, and KLF15 play a role in aortic aneurysms. Sixteen DMSs were found in the regions of the genes CMIP, RPH3AL, XRCC1, GATA5, EXD3, KCNC2, HIVEP3, ADCY9, CDCP2, FOLR1, WT1, MGMT, GAS2, CA1, PRSS16, and ANK3, whose protein products are involved in both aortic dissection and atherosclerosis in various arterial circulation regions. The protein products of the genes are involved in a wide range of biological processes, including mesenchyme development (GO:0060485; FOLR1, WT1, GATA5, HIVEP3, and KCNC2) and positive regulation of DNA metabolic processes (GO:0051054; MGMT, WT1, and XRCC1).

Aortic aneurysm (AA) is a life-threatening condition, and aortic rupture that is the complication of AA in the absence of emergency surgery leads to death. Genetic (more often in thoracic AA—TAA) and environmental factors (in TAA and abdominal AA—AAA) contribute to the development of AA. This review summarizes the data of scientific publications devoted to the study of DNA methylation under the influence of AA risk factors, as well as in the cells of different parts of the aorta (thoracic, abdominal) in normal and pathological conditions. Changes in DNA methylation are observed in aortic and/or blood cells in the presence of AA risk factors (arterial hypertension, smoking, age, and comorbidities). Studies of DNA methylation in TAA and AAA are few and have been conducted using different approaches to sample formation, cell sample selection, and experimental methods. However, they provide convincing evidence of the altered DNA methylation status of genes selected for study using a candidate approach (in the AAA study), as well as of different genomic regions in genome-wide DNA methylation analysis (mainly in TAA studies). Genes localized in differentially methylated regions are associated with the functioning of the cardiovascular system and are involved in cellular and metabolic processes pathogenetically significant for the development of AA. In a number of cases, the association of DNA methylation levels with clinical parameters in AA has been established. These results indicate the prospect of expanding the studies of DNA methylation in AA, including the identification of new pathogenetically significant links in AA development.

The effects of the demographic history of mankind have led to the fact that the indigenous peoples of Dagestan and Siberia are inferior in terms of genetic diversity to the populations of Europe, which affects the level of identification informativeness of standard forensic autosomal markers in these populations. In our study, we evaluated the effectiveness of two standard sets of autosomal STRs (13 CODIS, 20 CODIS, Combined DNA Index System) for the genetic examination of parent–child relationship in four highly inbred populations of the Russian Federation and the Russian population, using two types of reference frequencies. The results of the study confirmed the assumption that the level of identification informativity of standard autosomal markers in highly inbred populations of Siberia and Dagestan is lower than in the Russian population. The total information content of markers of the new CODIS standard exceeds the threshold values required in the order of the Ministry of Health and Social Development of the Russian Federation (no. 346n). At the same time, the probability of a false positive result increases with an increase in the inbreeding coefficient in the population.