Next Generation Sequencing of CFTR from dried blood spots using the Ion Torrent PGM

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Next Generation Sequencing of CFTR from dried blood spots using the Ion Torrent PGM Miyono Hendrix Newborn Screening & Genetic Testing Symposium October 27, 2014 National Center for Environmental Health Division of Laboratory Sciences

Study Objectives Evaluate Ion Torrent Next Gen Sequencing of CFTR on DBS DNA extracted from CDC s Newborn Screening Quality Assurance Program (NSQAP) PT samples Compare traditional Sanger sequencing data with the highly parallel sequencing data from Ion Torrent Determine if Ion Torrent Next Gen Sequencing assay can be used as a primary method with Sanger sequencing confirmation for PT specimen characterization

CF DNA Proficiency Testing Program PT pilot program began in early 2007 CF Patient and Family PT Samples Collaborations with Phil Farrell, U of WI School of Med, Marty Kharrazi, CA Dept. of PH and Charlene Sacramento, Sequoia Foundation 25 participants in 2007 and today 65 enrolled laboratories in 19 countries NSQAP Repository contains all of the ACMG 23 recommended mutations as well as 41 additional mutations

Advantages of the Ion Torrent Method Scalable sample throughput (different chip sizes) Multiplex up to 96 individuals on one chip Massively parallel sequencing to more easily evaluate small insertions or deletions (indels) Automated data analysis Potential for cost savings as multiplexing larger numbers of samples

Ion Torrent Technology Direct conversion of released H + into digital information A H + ion is released as each nucleotide is incorporated into the DNA strand causing a transient ph change Ion Torrent semiconductor sequencing chip is able to detect this change in ph and convert it directly to base calls Slide compliments of Life Technologies

Comparison of Sanger and Ion Torrent CFTR Sequencing Sanger Sequencing Requires >220 ng of gdna Single-plex 42 PCR rxns/sample followed by 86 seq rxns Manual Analysis using SeqScape software ~ 5 weeks to sequence and analyze 32 samples Ion Torrent Sequencing Requires 10 ng gdna per pool* Multiplex 8-96 library preps pooled for sequencing Automated Analysis (hotspot file contains 240 variants) <1 week to sequence and analyze 32 samples *note ~ 5 ng/pool was used in this study

Calling Indels - Sanger vs. Ion Torrent F508del/+ - causes a 3bp shift in the sequence SeqScape software (LifeTech/ThermoFisher) Roughly 50% of the sequences have a 3 bp deletion (TCT) Integrated Genome Viewer (Broad Institute) F508del/+ Sample

Automated Ion Torrent Mutation/Variant Calls G551D F508del Hotspot file contains 240 unique variants

CFTR Mutation/Variation Comparison Ion Torrent vs. Sanger Data Mut/ Var* N=108 Ion Torrent Precision Ion Torrent Sensitivity Ion Torrent Technical Issues Mutations 162 (57 unique) 100% 100% 2 Variants 539 (39 unique) 100% 99.3% 4 No-Calls *excludes IVS8 variant - TGxTy

Conclusions Ion Torrent is Faster than Sanger for CFTR <1 week vs 5 for sequencing 32 samples Automated data analysis significantly faster than manual Ion Torrent Precision and Sensitivity is >99% Mutation Detection Precision - 100%; Sensitivity 100% Variant Detection Precision - 100%; Sensitivity 99.3% IVS8 (TGxTy) 5T can be distinguished from the 7T and 9T Ion Torrent is Scalable from 8 96 samples 3 different density chip sizes allow flexibility Ion Torrent Can Save Money Cost savings over Sanger when using a 316 or 318 chip at 500x Ion Torrent Can Potentially Replace Sanger Sanger should be used for IVS8 characterization

Acknowledgements Thermo Fisher Scientific (Life Technology, Inc.) Clarence Lee Tim Harkins Warren Tom Shann-Ching Chen Jingwei Ni University of WI School of Medicine Phillip Farrell CA Dept of Public Health Marty Kharrazi Sequoia Foundation Charlene Sacramento Cystic Fibrosis Center at Johns Hopkins Peter J. Mogayzel, Jr Case Western Reserve University Michael Konstan CDC Suzanne Cordovado Marie Earley Carla Cuthbert

Thank you! Newborn Screening Saving Lives. Promoting Healthier Babies. Protecting our Future. For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for Environmental Health Division of Laboratory Sciences