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Guidelines for splicing analysis in molecular diagnosis derived from a set of 327 combined in silico/in vitro studies on BRCA1 and BRCA2 variants
Abstract
Assessing the impact of variants of unknown significance (VUS) on splicing is a key issue in molecular diagnosis. This impact can be predicted by in silico tools, but proper evaluation and user guidelines are lacking. To fill this gap, we embarked upon the largest BRCA1 and BRCA2 splice study to date by testing 272 VUSs (327 analyses) within the BRCA splice network of Unicancer. All these VUSs were analyzed by using six tools (splice site prediction by neural network, splice site finder (SSF), MaxEntScan (MES), ESE finder, relative enhancer and silencer classification by unanimous enrichment, and human splicing finder) and the predictions obtained were compared with transcript analysis results. Combining MES and SSF gave 96% sensitivity and 83% specificity for VUSs occurring in the vicinity of consensus splice sites, that is, the surrounding 11 and 14 bases for the 5' and 3' sites, respectively. This study was also an opportunity to define guidelines for transcript analysis along with a tentative classification of splice variants. The guidelines drawn from this large series should be useful for the whole community, particularly in the context of growing sequencing capacities that require robust pipelines for variant interpretation.
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“In general, splice site prediction tools have increased sensitivity (~90-100%) relative to specificity (~60-80%) in predicting splice site abnormalities. 23,24”
Citations
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Items 201–227 of 227
Data Analysis in Rare Disease Diagnostics
Veeramachaneni, V. (2020) · Journal of the Indian Institute of Science · doi:10.1007/s41745-020-00189-y · Cited by 2
Spliceogenic analysis of BRCA1 c.439T>C (rs794727800) variant by High Resolution Melting Analysis
Minucci, A., Mazzuccato, G., D'Indinosante, M., Nardo, L. D., Concolino, P., Bonis, M. D. D., Urbani, A., Scambia, G., Fagotti, A., & Capoluongo, E. (2019) · Molecular Biology Reports · doi:10.1007/s11033-019-05199-3 · Cited by 2
Incorporating calibrated functional assay data into the BRCA1 Ex-UV databasePreprint
Thompson, B., Bell, R., Welm, B., Burn, J., & Tavtigian, S. (2016) · bioRxiv · doi:10.1101/079418 · Cited by 2
Llinares-Burguet, I., Sanoguera-Miralles, L., Bueno-Martínez, E., Esteban-Sánchez, A., Romano-Medina, D., Ramadane-Morchadi, L., García-Álvarez, A., Pérez-Segura, P., Easton, D., Devilee, P., et al. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27020765 · Cited by 1
do Nascimento, R. R. N. R., Quaio, C. R. D. C., Chung, C. H., Vasconcelos, D. D. M., Sztajnbok, F., Neto, N. S. R., & Perazzio, S. F. (2024) · Revista Brasileira de Reumatologia · doi:10.1186/s42358-024-00400-z · Cited by 1
“Meta-predictors that utilize machine learning algorithms and integrate different sources of data, such as REVEL (rare exome variant ensemble learner) and BeyesDel, have gained prominence [22, 38, 39].”
MethodIdentification of novel single-nucleotide variants altering RNA splicing of PKD1 and PKD2
Xie, S., Leng, X.-Y., Tao, D.-C., Zhang, Y.-W., Wang, Z.-K., Zhang, X., He, T., Tan, X.-L., Liu, Y.-Q., & Yang, Y. (2021) · Journal of Human Genetics · doi:10.1038/s10038-021-00959-1 · Cited by 1
“Studies using a large dataset indicated that MaxEntScan scoresplice is the best performing method with the highest sensitivity and AUC (area under the curve) for prediction of an impact on splicing [22–24], and the method has been extensively used in splice-site prediction [10, 25, 26].”
BackgroundMethodSignificance of intronic and synonymous MYBPC3 gene variations in hypertrophic cardiomyopathy
Rangaraju, A., Matsa, L. S., Calambur, N., & Nallari, P. (2017) · Gene Reports · doi:10.1016/j.genrep.2017.06.004 · Cited by 1
Titin: an analysis of genetic variation and cardiac phenotype
Roberts, A. M. (2014) · Spiral (Imperial College London) · doi:10.25560/26990
Houweling, & van Tintelen, J. V. (2020) · doi:10.1007/978-3-030-45457-9 · Cited by 1
Bioinformatics for Precision Medicine in Oncology
Servant, N., & Hupé, P. (2015) · Springer eBooks · doi:10.1007/978-3-319-22189-2_6 · Cited by 1
Domènech-Vivó, J., Tubeuf, H., Mesman, R. L. S., Drouet, A., Girardi, M., Alonso-Cerezo, M. C., Baralle, D., Boutry-Kryza, N., Bunyan, D., Byers, H., et al. (2026) · American Journal of Human Genetics · doi:10.1016/j.ajhg.2026.08.001
Self-citationCeleghin, R., Tosato, G., Pinci, S., Zanna, F. D., Marinas, M. B., Cason, M., Basso, C., & Pilichou, K. (2026) · Journal of Translational Medicine · doi:10.1186/s12967-026-08496-1
Unveiling splicing disruptions due to common somatic variants in acute myeloid leukemia
Morote-Faubel, M., Guaita-Céspedes, M., Fernández-Blanco, B., Martínez-Valiente, C., Ibáñez, M., Santiago-Balsera, M., Such, E., de la Rubia, J., Liquori, A., & Cervera, J. (2025) · Human Genomics · doi:10.1186/s40246-025-00842-6
“Variants were flagged as splice-associated if they met specific thresholds: MaxEntScan scores above 3 with a 10% score change between wild-type and mutant sequences [16, 19], and SpliceAI scores above 0.2 [15].”
InfluentialMarchis, L. D., Gelibter, A., Mammone, G., Madaio, R., Aretini, P., Bonis, M. D. D., Zampatti, S., Peconi, C., Guadagnolo, D., Vestri, A., et al. (2025) · Cancers · doi:10.3390/cancers17121906
“The BRCA2 c.7007G>C is a missense variant in the last nucleotide of exon 13, demonstrated in the literature to promote abnormal splicing [29,30].”
Wang, L.-Y., Zeng, W., Qian, Y.-Q., Sun, Y.-X., Chen, M., Liu, B., Hu, J., Yu, P., & Dong, M.-Y. (2024) · Molecular Genetics & Genomic Medicine · doi:10.1002/mgg3.2492
“The guidelines do not recommend using prediction results as the sole source of evidence for evaluating the pathogenicity of missense or splicing variants at other sites, despite the high sensitivity of prediction software analysis (Houdayer et al., 2012; Thusberg et al., 2011).”
BackgroundPrivat, M., Ponelle-Chachuat, F., Viala, S., Uhrhammer, N., Lepage, M., Cayre, A., Bidet, Y., Bignon, Y., Gay-Bellile, M., & Cavaillé, M. (2024) · Human Mutation · doi:10.1155/2024/4830045
“Thus, di ff erent methods for studying RNA have been reported, but they all can be di ffi cult to apply in routine diagnostics [9].”
Alimohamed, M., Boven, L. G., van Dijk, K. K., Vos, Y., Hoedemaekers, Y., van der Zwaag, P. A., Sijmons, R., Jongbloed, J., Sikkema-Raddatz, B., & Westers, H. (2022) · Gene · doi:10.1016/j.gene.2022.146984
Case report: Antenatal diagnostic of a polymalformative syndrome due to biallelic BRCA2 mutations
Anquetil, A., Khung-Savatovsky, S., Gavard, L., Bazin, A., Guimiot, F., Dubourg, C., Mandelbrot, L., & Picone, O. (2021) · Clinical Case Reports · doi:10.1002/ccr3.4838
Jourdy, Y. (2017) · theses.fr (ABES) · doi:10.70675/45473a2fz4310z429fzb4b3z559274d80403
“ont comparé de nombreuses prédictions in silico à l’analyses in vitro des ARNm pour 272 variations d’épissage (variations situées en dehors des dinucléotides AG/GT) affectant les gènes BRCA1 et BRCA2 (227).”
Müller, E. (2017) · theses.fr (ABES) · doi:10.70675/dae59909zdc29z472fzad91z2c2805e11ff6
Deciphering splicing with sparse regression techniques in the era of high-throughput RNA sequencing.
Bernard, E. (2016) · theses.fr (ABES) · doi:10.70675/1074a190z4aa6z4e52zb386z0491fcaff5f3
Rendu, J. (2014) · doi:10.70675/53a1e4aazcc6dz4277z99b6z4afcf8e2f764
“L’étude de Houdayer et al. (Houdayer et al. 2012) sur les mutations d’épissage de BRCA1/BRCA2 estimait qu’il fallait utiliser deux algorithmes différents: MAXENT suivi d'un logiciel utilisant un algorithme SSF-like pour avoir une sensibilité supérieure { 85%.”
BackgroundFunctional evidence (I) transcripts and RNA-splicing outline
Colombo, M., Radice, P., & de la Hoya, M. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-820519-8.00004-1
Introduction to Molecular Genetics
Jongbloed, J. D. H., Deprez, R. H. L., & Vatta, M. (2016) · Springer eBooks · doi:10.1007/978-3-319-44203-7_1
Classification of Genetic Variants
Genuardi, M., Holinski-Feder, E., Laner, A., & Martins, A. (2018) · Springer eBooks · doi:10.1007/978-3-319-74259-5_18
Assessment of Biomarkers’ Predictive Value of Efficacy
Rouleau, E., Callens, C., Pierron, G., & Bièche, I. (2015) · Springer eBooks · doi:10.1007/978-3-319-22189-2_7
Self-citation
Metadata
- Authors
- Houdayer, C., Caux-Moncoutier, V., Krieger, S., Barrois, M., Bonnet, F., Bourdon, V., Bronner, M., Buisson, M., Coulet, F., Gaildrat, P., Lefol, C., Léone, M., Mazoyer, S., Muller, D., Remenieras, A., Révillion, F., Rouleau, E., Sokolowska, J., Vert, J.-P., Lidereau, R., Soubrier, F., Sobol, H., Sevenet, N., Bressac-de Paillerets, B., Hardouin, A., Tosi, M., Sinilnikova, O. M., & Stoppa-Lyonnet, D.
- Affiliations
- Sorbonne Paris Cité (FR)
- Centre François Baclesse (FR)
- Institut Gustave Roussy (FR)
- Inserm (FR)
- Institut Paoli-Calmettes (FR)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- Lyon 1 Université (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Hôpital René Huguenin (FR)
- Institut Strauss (FR)
- Corresponding author
- Houdayer, Claude
- ORCID
- Venue
- Human Mutation
- Publisher
- Hindawi Limited
- Published
- 2012-05-11
- Volume
- 33
- Issue
- 8
- Pages
- 1228-1238
- ISSN
- 1059-7794 (ISSN-L)
- OpenAlex
- W1975196485
- Cited by
- 239
- References
- 0
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 11 · 2023: 6 · 2022: 25 · 2021: 27 · 2020: 22 · 2019: 23 · 2018: 27 · 2017: 23 · 2016: 14 · 2015: 22 · 2014: 11 · 2013: 17 · 2012: 3
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Mutation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Research and Splicing
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Keywords
- BRCA1, BRCA2, variants of uncertain significance, splicing, splice site prediction, in silico tools, transcript analysis, variant interpretation, molecular diagnosis
- MeSH terms
- Exons, Female, Humans, RNA Splicing, BRCA1 Protein, BRCA2 Protein, Pathology, Molecular
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