Long-read HiFi genome sequencing allows for accurate detection and direct phasing of single nucleotide variants, indels, and structural variants. Recent algorithmic development enables simultaneous detection of CpG methylation for analysis of regulatory element activity directly in HiFi reads. We present a comprehensive haplotype resolved 5-base HiFi genome sequencing dataset from a rare disease cohort of 276 samples in 152 families to identify rare (~0.5%) hypermethylation events. We find that 80% of these events are allele-specific and predicted to cause loss of regulatory element activity. We demonstrate heritability of extreme hypermethylation including rare cis variants associated with short (~200 bp) and large hypermethylation events (>1 kb), respectively. We identify repeat expansions in proximal promoters predicting allelic gene silencing via hypermethylation and demonstrate allelic transcriptional events downstream. On average 30–40 rare hypermethylation tiles overlap rare disease genes per patient, providing indications for variation prioritization including a previously undiagnosed pathogenic allele in DIP2B causing global developmental delay. We propose that use of HiFi genome sequencing in unsolved rare disease cases will allow detection of unconventional diseases alleles due to loss of regulatory element activity.
Long-read HiFi genome sequencing (GS) allows for accurate detection and direct phasing of single nucleotide variants (SNV), indels, and structural variants (SV). Recent algorithmic development enables simultaneous detection of CpG methylation (mCpG) for analysis of regulatory element (RE) activity directly in HiFi-GS. We generated a comprehensive haplotyperesolved HiFi-GS dataset from a rare disease cohort of 276 samples in 152 families to identify rare (~0.5%) hyper-mCpG events. We found that 81% of these events are allele-specific and predicted to cause loss of RE (LRE). We demonstrated heritability of extreme hyper-mCpG including rare cis SNVs and SVs causing short (~200bp) and large hyper-mCpG events (>1 kb), respectively. We identified novel repeat expansions in proximal promoters predicting allelic gene silencing via hyper-mCpG and demonstrated allelic transcriptional events downstream. On average 30-40 LREs overlapped rare disease genes per patient, providing indications for variation prioritization. LRE led to a previously undiagnosed pathogenic allele in DIP2B causing global developmental delay. We propose that use of HiFi-GS in unsolved rare disease cases will allow detection of unconventional diseases alleles due to LRE.
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