Aberrant left-right patterning in the developing human embryo can lead to a broad spectrum of congenital malformations. The causes of most laterality defects are not known, with variants in established genes accounting for <20% of cases. We sought to characterize the genetic spectrum of these conditions by performing whole-exome sequencing of 323 unrelated laterality cases. We investigated the role of rare, predicted-damaging variation in 1726 putative laterality candidate genes derived from model organisms, pathway analyses, and human phenotypes. We also evaluated the contribution of homo/hemizygous exon deletions and gene-based burden of rare variation. A total of 28 candidate variants (26 rare predicted-damaging variants and 2 hemizygous deletions) were identified, including variants in genes known to cause heterotaxy and primary ciliary dyskinesia (ACVR2B, NODAL, ZIC3, DNAI1, DNAH5, HYDIN, MMP21), and genes without a human phenotype association, but with prior evidence for a role in embryonic laterality or cardiac development. Sanger validation of the latter variants in probands and their parents revealed no de novo variants, but apparent transmitted heterozygous (ROCK2, ISL1, SMAD2), and hemizygous (RAI2, RIPPLY1) variant patterns. Collectively, these variants account for 7.1% of our study subjects. We also observe evidence for an excess burden of rare, predicted loss-of-function variation in PXDNL and BMS1-two genes relevant to the broader laterality phenotype. These findings highlight potential new genes in the development of laterality defects, and suggest extensive locus heterogeneity and complex genetic models in this class of birth defects.

BackgroundLeft-sided lesions (LSLs) account for an important fraction of severe congenital cardiovascular malformations (CVMs). The genetic contributions to LSLs are complex, and the mutations that cause these malformations span several diverse biological signaling pathways: TGFB, NOTCH, SHH, and more. Here, we use whole exome sequence data generated in 342 LSL cases to identify likely damaging variants in putative candidate CVM genes.MethodsUsing a series of bioinformatics filters, we focused on genes harboring population-rare, putative loss-of-function (LOF), and predicted damaging variants in 1760 CVM candidate genes constructed a priori from the literature and model organism databases. Gene variants that were not observed in a comparably sequenced control dataset of 5492 samples without severe CVM were then subjected to targeted validation in cases and parents. Whole exome sequencing data from 4593 individuals referred for clinical sequencing were used to bolster evidence for the role of candidate genes in CVMs and LSLs.ResultsOur analyses revealed 28 candidate variants in 27 genes, including 17 genes not previously associated with a human CVM disorder, and revealed diverse patterns of inheritance among LOF carriers, including 9 confirmed de novo variants in both novel and newly described human CVM candidate genes (ACVR1, JARID2, NR2F2, PLRG1, SMURF1) as well as established syndromic CVM genes (KMT2D, NF1, TBX20, ZEB2). We also identified two genes (DNAH5, OFD1) with evidence of recessive and hemizygous inheritance patterns, respectively. Within our clinical cohort, we also observed heterozygous LOF variants in JARID2 and SMAD1 in individuals with cardiac phenotypes, and collectively, carriers of LOF variants in our candidate genes had a four times higher odds of having CVM (odds ratio = 4.0, 95% confidence interval 2.5–6.5).ConclusionsOur analytical strategy highlights the utility of bioinformatic resources, including human disease records and model organism phenotyping, in novel gene discovery for rare human disease. The results underscore the extensive genetic heterogeneity underlying non-syndromic LSLs, and posit potential novel candidate genes and complex modes of inheritance in this important group of birth defects.Electronic supplementary materialThe online version of this article (doi:10.1186/s13073-017-0482-5) contains supplementary material, which is available to authorized users.

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Photocatalytic remediation represents a potential sustainable solution to the abatement of xenobiotic pollutants released within the water environment. Aeroxide® P25 titanium dioxide nanoparticles (TiO2 NPs) are well-known as one of the most efficient photocatalysts in several applications, and have also been investigated in water remediation as suspended powder. Recently, their application in the form of thin films has been revealed as a potential alternative to avoid time-consuming filtration processes. Polymers represent suitable substrates to immobilize TiO2 NPs, allowing further production of thin films that can be exploited as a photoactive coating for environmental remediation. Nevertheless, the methods adopted to immobilize TiO2 NPs on polymer matrix involve time-consuming procedures and the use of several reactants. Here, titanium dioxide-based nanocomposites (NCx) were obtained through a new approach based on Methyl Methacrylate in situ bulk polymerization and were compared with a blended mixture (BL). Their morphology and chemical–physical properties were investigated through Thermogravimetric Analysis (TGA), Differential Scanning Calorimetry (DSC), UV–Vis, and Raman spectroscopies. It was revealed that the in situ approach deeply influences the chemical–physical interactions between the polymer matrix and TiO2 NPs. Photocatalytic experiments revealed the boosted photodegradation activity of NCx thin films, induced by the in situ approach. The photodegradation of paraquat and acetaminophen was also ascertained.

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