Targeted long-read sequencing enables comprehensive analysis of the genetic and epigenetic landscape of inherited myopathies

Таргетное секвенирование с длинными чтениями позволяет всесторонне анализировать генетический и эпигенетический ландшафт наследственных миопатий
Michael Fahey, Danqing Zhu, Stephanie L. Barnes, Igor Stevanovski, Sanjog R. Chintalaphani, Michel Tchan, Karl Ng, Marina Kennerson, Kishore R. Kumar, Ira W. Deveson, Andre L. M. Reis, Pamela McCombe, Carolyn M. Sue, Stephen Reddel, Neil G. Simon, Simon Hawke, Katrina Morris, Christina Liang, Kate Ahmad, Ryan L. Davis, Dennis Yeow, Neysa Njo, Laura Ivete Rudaks, Bianca R. Grosz, Joanne Sy, Leah Kemp, Michael T. Chin, Marion Stoll, Andrew Hannaford, Ehsan Esmaili Shandiz, Shadi El‐Wahsh, Robert Boland‐Freitas, Roula Ghaoui, Jonathan Sturm, Anna Willard, Mahi Jasinarachchi, Lisa Worgan, David Manser, Neil Griffith, Pak Leng Cheong
2026-07-04

epigenetic signaturesinherited myopathiesrepeat expansionsstructural variantstargeted long-read sequencing
Abstract The genetic variants that cause inherited myopathies vary widely in type, size and sequence context, encompassing small sequence variants, large structural variants, repeat expansions, and more complex events, such as the D4Z4 macrosatellite contraction and hypomethylation that causes facioscapulohumeral muscular dystrophy. Many of these are challenging to characterise using next-generation sequencing and other older molecular technologies. To address this, we developed a targeted long-read sequencing assay and bioinformatics analysis framework that captures the full suite of genes, variants and epigenetic signatures currently implicated in inherited myopathies. Applying this to a cohort of myopathy patients, we demonstrate the analytical validity of our approach and its improved accuracy and resolution compared to existing methods. Our assay led to new genetic diagnoses in 35.5% (11/31) of patients who remained undiagnosed after standard clinical genetic testing. This methodology constitutes a single streamlined assay for comprehensive genetic and epigenetic characterisation of inherited myopathies.
1
A targeted long-read sequencing assay and bioinformatics framework was developed to capture genes, variants, and epigenetic signatures implicated in inherited myopathies.
2
Applied to a cohort of myopathy patients, the method demonstrated analytical validity and improved accuracy and resolution compared to existing methods.
3
The assay can characterize a wide spectrum of variant types difficult for short-read NGS, including small sequence variants, large structural variants, repeat expansions, and complex events like D4Z4 macrosatellite contraction and hypomethylation.
4
The assay provided new genetic diagnoses in 35.5% (11/31) of patients who were undiagnosed after standard clinical genetic testing.
5
This single streamlined assay enables comprehensive genetic and epigenetic characterization of inherited myopathies within one workflow.

Targeted long-read sequencing assay and bioinformatics analysis framework for genes implicated in inherited myopathies

Comprehensive detection and characterisation of genetic variants (small variants, large structural variants, repeat expansions, complex events) and epigenetic signatures (e.g., methylation/D4Z4 hypomethylation) underlying inherited myopathies, and the assay's analytical validity and diagnostic yield versus standard methods

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2026-07-04
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Authors
Michael Fahey
Danqing Zhu
Stephanie L. Barnes
Igor Stevanovski
Sanjog R. Chintalaphani
Michel Tchan
Karl Ng
Marina Kennerson
Kishore R. Kumar
Ira W. Deveson
Andre L. M. Reis
Pamela McCombe
Carolyn M. Sue
Stephen Reddel
Neil G. Simon
Simon Hawke
Katrina Morris
Christina Liang
Kate Ahmad
Ryan L. Davis
Dennis Yeow
Neysa Njo
Laura Ivete Rudaks
Bianca R. Grosz
Joanne Sy
Leah Kemp
Michael T. Chin
Marion Stoll
Andrew Hannaford
Ehsan Esmaili Shandiz
Shadi El‐Wahsh
Robert Boland‐Freitas
Roula Ghaoui
Jonathan Sturm
Anna Willard
Mahi Jasinarachchi
Lisa Worgan
David Manser
Neil Griffith
Pak Leng Cheong
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