Rare DiseasesNCT06072079
Structural Chromosome Rearrangements and Brain Disorders
An observational study of Rare Diseases and Genetic Disease, run by Karolinska Institutet at 1 site in Sweden.
Trial summary
The project is focused on the detailed study of structural genomic variants (SVs). Such genetic mutations are in fact alterations in the DNA molecule structure and include copy number variants, inversions and translocations. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Rare Diseases, Genetic Disease, Chromosome Abnormality
- How many people
- 10,000 participants
- Where
- 1 siteSweden
- Study dates
- 20 Dec 2019to 31 Dec 2029
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: Individuals that have undergone genetic investigations due to a suspected rare disease
Who may be able to join
- Individual with a suspected rare disease and/or chromosomal abnormality
Who cannot join
- No suspected rare disease or chromosome abnormalities
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Studies of Structural Chromosome Rearrangements to Identify Genes Involved in Congenital Brain Disorders
The project is focused on the detailed study of structural genomic variants (SVs). Such genetic mutations are in fact alterations in the DNA molecule structure and include copy number variants, inversions and translocations. A single event may affect many genes as well as regulatory regions and the specific phenotypic consequences will depend on the location, genetic content and type of SV. Many times, the specific disease-causing mechanism is not known. Here, the plan is to study the molecular genetic behavior of structural variants as well as the underlying mutational mechanisms involved.
First, genome sequencing will be done to pinpoint the chromosomal breakpoints at the nucleotide level, characterize the genomic architecture at the breakpoints and study the relationship between structural variants and SNVs. Second, the aim is to study how structural variants impact gene expression. Finally, disease mechanisms will be functionally explored in vivo using zebrafish and in vitro using primary patient cells and induced pluripotent stem cells.
The studies will focus on the origin, structure and impact of structural variation on human disease. The results will directly lead to a higher mutation detection rate in genetic diagnostics. Through a better understanding of disease mechanisms the findings will also assist in the development of novel biomarkers and therapeutic strategies for patients with rare genetic disorders.
Read the detailed description
PROJECT DESCRIPTION Aim 1) What are the molecular mechanisms of formation for structural genomic variants?
There is already WGS data from more than 500 individual SVs. To understand underlying mutational and disease mechanisms, structural variant detection will be combined with positional information for the rearrangement. This will be particularly important for duplications (the location of the duplicated genomic segment is key to a correct clinical interpretation) and for complex rearrangements. Second, the exact breakpoint will be established and breakpoint junctions analyzed for sequence motifs.
Aim 2) What are the molecular mechanisms involved in disease pathology?
First WGS will be used to identify and characterize structural variants. Next, to understand how the candidate disease gene(s) affected by the SVs cause clinical symptoms, the cellular mechanisms involved in disease pathology will be studied in three ways:
Part 1. In vitro studies of primary cells: Effects on expression and splicing, will be evaluated in patient cells (fibroblasts or B cell lines) with RT-PCR, qPCR and Western blot.
Part 2. In vitro studies in patient-derived models: In selected cases, induced-pluripotent stem cells and neural progenitor cells (NES cells) will be generated, which will provide an opportunity to directly study the effects of early neurogenesis in cells from the patient and compare to cells derived from normal controls. The investigators are interested in studying both early neurogenesis in 2D culture using the NES cells, as well as generating another developmentally relevant model, brain organoids (mini brains), in 3D culture directly from iPS cell lines. Organoid 3D culture recapitulates development of various brain regions and is therefore a unique tool to investigate brain disorders. Furthermore, the 3D neural culture could improve cell maturity and stimulate expression of disease phenotypes that facilitate better understanding the disease mechanisms.
Part 3. In vivo studies in a zebrafish model: Zebrafish (Danio rerio) is a well-functioning in vivo system for studies of normal and abnormal embryological development. Duplications are simulated by RNA overexpression and deletion through CRISPR/Cas9 induced gene disruption or morpholino knock down. Assessment of the phenotypes is designed in accordance with the those observed in patients (e.g. head size, craniofacial defects, cardiovascular malformations, cilia defects).
Aim 3) How does structural genomic variants impact gene expression?
Long range effects will be studied in three ways. Part 1. To assess the clinical impact of TAD disruptions, CNV data from the Clinical Genetics array database (data from over 6200 children with rare NDDs), LocusDB SV (SV calls from >1000 patients with rare diseases analyzed by WGS at Clinical Genomics SciLifeLab) and publicly available databases (DECIPHER, ICCG and SWEGEN) will be analysed. The Bioinformatic analysis will combine information on phenotypic overlap between known-disease genes surrounding the SV and the patients' characteristics, as well as on physical overlap with tissue-specific enhancers and TAD regions. Novel computational approaches will be designed for the discovery of genes disrupted by similar mechanisms. Follow-up studies will involve further patient characterization and customized RNA studies.
Part 2. Transcriptome analysis of patient samples is done by RNA-seq. Since not every gene is transcriptionally active in every cell, a key to successfully achieving this aim is access to biologically relevant samples. Often biopsies are not available therefore, in those cases, iPS cells are an alternative way to study biologically relevant effects on RNA expression. In cases with paired WGS and RNA-seq data, we will integrate changes in transcription levels and ASE as a readout for the SVs effect on neighboring genes.
Part 3. Cell and animal studies: Introduction of specific SVs with CRISPR/Cas9 in human cell lines will be done when the primary cells are unavailable and zebrafish lines created under goal 2 may also be used to evaluate global effects of SVs on an organism level.
- Conditions
- Rare Diseases, Genetic Disease, Chromosome Abnormality
- Keywords
- genome sequencing, structural variants
- Medical subject headings
- Rare Diseases, Genetic Diseases, Inborn, Chromosome Aberrations
What is being measured
The primary outcome is the main question the study is designed to answer.
Understanding disease mechanisms
Measured: 10 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Oct 2023
- Study start20 Dec 2019
- Primary completion31 Dec 2029 (estimated)
- Study completion31 Dec 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Rare DiseasesStudies of the same condition, open and under way.
- More trials run by Karolinska InstitutetThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Other
- Enrolment
- 10,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Karolinska Institutet
- Sponsor type
- University, hospital or other
- Collaborators
- Karolinska University Hospital
- Responsible party
- Principal investigator, Anna Lindstrand, Karolinska Institutet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06072079
- Sponsor's protocol ID
- 2019-02078
- Other IDs
- 2019
- Status last verified
- Aug 2025
- First submitted
- 2 Oct 2023
- Last updated
- 4 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 4 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Studies of Structural Chromosome Rearrangements to Identify Genes Involved in Congenital Brain Disorders
- ClinicalTrials.gov ID
- NCT06072079
- Acronym / sponsor ID
- 2019-02078
- Conditions
- Rare Diseases, Genetic Disease, Chromosome Abnormality
- Keywords
- genome sequencing, structural variants
- Study type
- Observational
- Recruitment status
- Enrolling by invitation
- Enrolment
- 10,000 participants (estimated)
- Lead sponsor
- Karolinska InstitutetUniversity, hospital or other
- Collaborators
- Karolinska University Hospital
- Study start
- 20 Dec 2019 (actual)
- Primary completion
- 31 Dec 2029 (estimated)
- Study completion
- 31 Dec 2029 (estimated)
- First posted
- 10 Oct 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The project is focused on the detailed study of structural genomic variants (SVs). Such genetic mutations are in fact alterations in the DNA molecule structure and include copy number variants, inversions and translocations. A single event may affect many genes as well as regulatory regions and the specific phenotypic consequences will depend on the location, genetic content and type of SV. Many times, the specific disease-causing mechanism is not known. Here, the plan is to study the molecular genetic behavior of structural variants as well as the underlying mutational mechanisms involved.
First, genome sequencing will be done to pinpoint the chromosomal breakpoints at the nucleotide level, characterize the genomic architecture at the breakpoints and study the relationship between structural variants and SNVs. Second, the aim is to study how structural variants impact gene expression. Finally, disease mechanisms will be functionally explored in vivo using zebrafish and in vitro using primary patient cells and induced pluripotent stem cells.
The studies will focus on the origin, structure and impact of structural variation on human disease. The results will directly lead to a higher mutation detection rate in genetic diagnostics. Through a better understanding of disease mechanisms the findings will also assist in the development of novel biomarkers and therapeutic strategies for patients with rare genetic disorders.
Detailed description
PROJECT DESCRIPTION Aim 1) What are the molecular mechanisms of formation for structural genomic variants?
There is already WGS data from more than 500 individual SVs. To understand underlying mutational and disease mechanisms, structural variant detection will be combined with positional information for the rearrangement. This will be particularly important for duplications (the location of the duplicated genomic segment is key to a correct clinical interpretation) and for complex rearrangements. Second, the exact breakpoint will be established and breakpoint junctions analyzed for sequence motifs.
Aim 2) What are the molecular mechanisms involved in disease pathology?
First WGS will be used to identify and characterize structural variants. Next, to understand how the candidate disease gene(s) affected by the SVs cause clinical symptoms, the cellular mechanisms involved in disease pathology will be studied in three ways:
Part 1. In vitro studies of primary cells: Effects on expression and splicing, will be evaluated in patient cells (fibroblasts or B cell lines) with RT-PCR, qPCR and Western blot.
Part 2. In vitro studies in patient-derived models: In selected cases, induced-pluripotent stem cells and neural progenitor cells (NES cells) will be generated, which will provide an opportunity to directly study the effects of early neurogenesis in cells from the patient and compare to cells derived from normal controls. The investigators are interested in studying both early neurogenesis in 2D culture using the NES cells, as well as generating another developmentally relevant model, brain organoids (mini brains), in 3D culture directly from iPS cell lines. Organoid 3D culture recapitulates development of various brain regions and is therefore a unique tool to investigate brain disorders. Furthermore, the 3D neural culture could improve cell maturity and stimulate expression of disease phenotypes that facilitate better understanding the disease mechanisms.
Part 3. In vivo studies in a zebrafish model: Zebrafish (Danio rerio) is a well-functioning in vivo system for studies of normal and abnormal embryological development. Duplications are simulated by RNA overexpression and deletion through CRISPR/Cas9 induced gene disruption or morpholino knock down. Assessment of the phenotypes is designed in accordance with the those observed in patients (e.g. head size, craniofacial defects, cardiovascular malformations, cilia defects).
Aim 3) How does structural genomic variants impact gene expression?
Long range effects will be studied in three ways. Part 1. To assess the clinical impact of TAD disruptions, CNV data from the Clinical Genetics array database (data from over 6200 children with rare NDDs), LocusDB SV (SV calls from >1000 patients with rare diseases analyzed by WGS at Clinical Genomics SciLifeLab) and publicly available databases (DECIPHER, ICCG and SWEGEN) will be analysed. The Bioinformatic analysis will combine information on phenotypic overlap between known-disease genes surrounding the SV and the patients' characteristics, as well as on physical overlap with tissue-specific enhancers and TAD regions. Novel computational approaches will be designed for the discovery of genes disrupted by similar mechanisms. Follow-up studies will involve further patient characterization and customized RNA studies.
Part 2. Transcriptome analysis of patient samples is done by RNA-seq. Since not every gene is transcriptionally active in every cell, a key to successfully achieving this aim is access to biologically relevant samples. Often biopsies are not available therefore, in those cases, iPS cells are an alternative way to study biologically relevant effects on RNA expression. In cases with paired WGS and RNA-seq data, we will integrate changes in transcription levels and ASE as a readout for the SVs effect on neighboring genes.
Part 3. Cell and animal studies: Introduction of specific SVs with CRISPR/Cas9 in human cell lines will be done when the primary cells are unavailable and zebrafish lines created under goal 2 may also be used to evaluate global effects of SVs on an organism level.
Study design
- Observational model
- Cohort
- Time perspective
- Other
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Individuals that have undergone genetic investigations due to a suspected rare disease
Key inclusion criteria (1 listed)
- Individual with a suspected rare disease and/or chromosomal abnormality
Key exclusion criteria (1 listed)
- No suspected rare disease or chromosome abnormalities
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Understanding disease mechanisms
Time frame: 10 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Sep 2025.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Rare Diseases and Genetic Disease, run by Karolinska Institutet at 1 site in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 4 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Understanding disease mechanisms (time frame: 10 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Sep 2025.