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. 2022 Aug;11(3):120-124.
doi: 10.5582/irdr.2022.01067.

Need for revision of the ACMG/AMP guidelines for interpretation of X-linked variants

Yoko Inoue  1   2 , Osamu Machida  1   3 , Yosuke Kita  4 , Toshiyuki Yamamoto  1   2
Affiliations

Need for revision of the ACMG/AMP guidelines for interpretation of X-linked variants

Yoko Inoue et al. Intractable Rare Dis Res. 2022 Aug.

Abstract

The guidelines provided by American College of Medical Genetics and Genomics (ACMG) and the Association of Molecular Pathology (AMP) (ACMG/AMP guidelines) suggest a framework for the classification of clinical variants. However, the interpretations can be inconsistent, with each definition sometimes proving to be ambiguous. In particular, there can be difficulty with interpretation of variants related to the X-linked recessive trait. To confirm whether there are biases in the interpretation of inherited traits, we reanalyzed variants reported prior to the release of the ACMG/AMP guidelines. As expected, the interpretation ratio as pathogenic or likely pathogenic was significantly lower for variants related to the X-linked recessive trait. Evaluation of variants related to the X-linked recessive trait, hence, need to consider whether the variant is identified only in males in accordance with the X-linked recessive trait. The ACMG/AMP guidelines should be revised to eliminate the bias revealed in this study.

Keywords: ACMG/AMP guidelines; X-linked recessive; diagnostic odyssey; interpretation; sequence variant.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Distribution of the interpretation of the variants for each inheritance trait represented by a 100% stacked chart. The numbers in the boxes indicate the corresponding numbers of the variants. *, Statistically significant (p < 0.05); #, no significant difference.
See this image and copyright information in PMC

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