1. Antiepileptic Drug Teratogenicity and De Novo Genetic Variation Load.
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Perucca, Piero, Anderson, Alison, Jazayeri, Dana, Hitchcock, Alison, Graham, Janet, Todaro, Marian, Tomson, Torbjörn, Battino, Dina, Perucca, Emilio, Ferri, Meritxell Martinez, Rochtus, Anne, Lagae, Lieven, Canevini, Maria Paola, Zambrelli, Elena, Campbell, Ellen, Koeleman, Bobby P. C., Scheffer, Ingrid E., Berkovic, Samuel F., Kwan, Patrick, and Sisodiya, Sanjay M.
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GENETIC load , *ANTICONVULSANTS , *DNA copy number variations , *FISHER exact test , *CATEGORIES (Mathematics) , *RESEARCH , *GENETICS , *DNA , *RESEARCH methodology , *GENETIC polymorphisms , *EVALUATION research , *MEDICAL cooperation , *TERATOGENIC agents , *COMPARATIVE studies , *DRUG-induced abnormalities , *GENOMES , *PATERNAL age effect ,SIDE effects of anticonvulsants - Abstract
Objective: The mechanisms by which antiepileptic drugs (AEDs) cause birth defects (BDs) are unknown. Data suggest that AED-induced BDs may result from a genome-wide increase of de novo variants in the embryo, a mechanism that we investigated.Methods: Whole exome sequencing data from child-parent trios were interrogated for de novo single-nucleotide variants/indels (dnSNVs/indels) and de novo copy number variants (dnCNVs). Generalized linear models were applied to assess de novo variant burdens in children exposed prenatally to AEDs (AED-exposed children) versus children without BDs not exposed prenatally to AEDs (AED-unexposed unaffected children), and AED-exposed children with BDs versus those without BDs, adjusting for confounders. Fisher exact test was used to compare categorical data.Results: Sixty-seven child-parent trios were included: 10 with AED-exposed children with BDs, 46 with AED-exposed unaffected children, and 11 with AED-unexposed unaffected children. The dnSNV/indel burden did not differ between AED-exposed children and AED-unexposed unaffected children (median dnSNV/indel number/child [range] = 3 [0-7] vs 3 [1-5], p = 0.50). Among AED-exposed children, there were no significant differences between those with BDs and those unaffected. Likely deleterious dnSNVs/indels were detected in 9 of 67 (13%) children, none of whom had BDs. The proportion of cases harboring likely deleterious dnSNVs/indels did not differ significantly between AED-unexposed and AED-exposed children. The dnCNV burden was not associated with AED exposure or birth outcome.Interpretation: Our study indicates that prenatal AED exposure does not increase the burden of de novo variants, and that this mechanism is not a major contributor to AED-induced BDs. These results can be incorporated in routine patient counseling. ANN NEUROL 2020;87:897-906. [ABSTRACT FROM AUTHOR]- Published
- 2020
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