Avidity sequencing of whole genomes from retinal degeneration pedigrees identifies causal variants

Whole genome sequencing has been an effective tool in the discovery of variants that cause rare disease. In this study, we determined the suitability of a novel avidity sequencing approach for rare disease applications. We built a sample to results workflow, combining the novel sequencing technology with standard library preparation kits, analysis workflows, and interpretation tools. We applied the workflow to ten pedigrees with inherited retinal degeneration (IRD) phenotype. Candidate variants of interest identified through whole genome sequencing were further evaluated using segregation analysis. Mutations in known IRD genes were detected in five of the ten cases. Genes with identified high confidence variants associated with retinal degeneration included PEX6, ABCA4, CERKL, MAK , and RDH12 . Pending confirmatory clinical sequencing, we observed a 50% diagnostic yield, consistent with previously reported outcomes of IRD patient analysis. The study confirms that avidity sequencing is effective in detection of causal mutations when used for whole genome sequencing in rare disease applications. ### Competing Interest Statement Authors BJK, JM, JZ, BRL, and SK are current or former employees of Element Biosciences, which has commercialized the sequencing technology described in the paper ### Funding Statement Foundation Fighting Blindness (EGI-GE1218-0753-UCSD) The National Eye Institute RO1EY031663: P30EY022589 ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: IRB 121666: Biological Basis of Eye Diseases of University of California at San Diego gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors given the restrictions of dbGAP, where the data will reside