Interpreting variants from whole-exome sequencing remains a major challenge, particularly for heterogeneous disorders such as mitochondrial diseases (MDs). To address this, we have developed Variant prIoritizatiOn using Latent spAce (VIOLA), a pipeline designed to help find a diagnosis for complex cases. VIOLA uses a variational autoencoder to embed functional annotations into a low-dimensional space, followed by DBSCAN-based outlier detection to identify potential pathogenic variants. Filtering steps and phenotype integration via HPO terms are then applied. The VIOLA score (Vscore) combines variant outlierness, transcriptomic co-expression data, and MD-specific annotations. Two rankings are derived: the VIOLA rank (all variants) and the ARrank (variants compatible with autosomal recessive inheritance). The VIOLA Aggregated score (VAscore) merges Vscore with Exomiser's pathogenicity score. Applied to 20 patients (four diagnosed), VIOLA reduced the variant list by >99% and ranked causal variants within the top 5 using ARrank, outperforming existing methods. Overall, VIOLA is a patient-specific strategy for variant prioritization, helping to resolve challenging MD cases and uncover novel disease mechanisms.

Noninvasive prenatal testing (NIPT) consists of determining fetal aneuploidies by quantifying copy number alteration from the sequencing of cell-free DNA (cfDNA) from maternal blood. Due to the presence of cfDNA of fetal origin in maternal blood, in silico approaches have been developed to accurately predict fetal aneuploidies. Although NIPT is becoming a new standard in prenatal screening of chromosomal abnormalities, there are no integrated pipelines available to allow rapid, accurate and standardized data analysis in any clinical setting. Several tools have been developed, however often optimized only for research purposes or requiring enormous amount of retrospective data, making hard their implementation in a clinical context. Furthermore, no guidelines have been provided on how to accomplish each step of the data analysis to achieve reliable results. Finally, there is no integrated pipeline to perform all steps of NIPT analysis. To address these needs, we tested several tools for performing NIPT data analysis. We provide extensive benchmark of tools performances but also guidelines for running them. We selected the best performing tools that we benchmarked and gathered them in a computational pipeline. NiPTUNE is an open source python package that includes methods for fetal fraction estimation, a novel method for accurate gender prediction, a principal component analysis based strategy for quality control and fetal aneuploidies prediction. NiPTUNE is constituted by seven modules allowing the user to run the entire pipeline or each module independently. Using two cohorts composed by 1439 samples with 31 confirmed aneuploidies, we demonstrated that NiPTUNE is a valuable resource for NIPT analysis.

MOTIVATION: Current advances in omics technologies are paving the diagnosis of rare diseases proposing a complementary assay to identify the responsible gene. The use of transcriptomic data to identify aberrant gene expression (AGE) has demonstrated to yield potential pathogenic events. However, popular approaches for AGE identification are limited by the use of statistical tests that imply the choice of arbitrary cut-off for significance assessment and the availability of several replicates not always possible in clinical contexts. RESULTS: Hence, we developed ABerrant Expression Identification empLoying machine LEarning from sequencing data (ABEILLE) a variational autoencoder (VAE)-based method for the identification of AGEs from the analysis of RNA-seq data without the need for replicates or a control group. ABEILLE combines the use of a VAE, able to model any data without specific assumptions on their distribution, and a decision tree to classify genes as AGE or non-AGE. An anomaly score is associated with each gene in order to stratify AGE by the severity of aberration. We tested ABEILLE on a semi-synthetic and an experimental dataset demonstrating the importance of the flexibility of the VAE configuration to identify potential pathogenic candidates. AVAILABILITY AND IMPLEMENTATION: ABEILLE source code is freely available at: https://github.com/UCA-MSI/ABEILLE. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.