Targeted long-read sequencing enables comprehensive analysis of the genetic and epigenetic landscape of inherited myopathies

D Dennis Yeow A Andre L. M. Reis I Igor Stevanovski N Neysa Njo L Laura I. Rudaks B Bianca R. Grosz J Joanne S. Sy L Leah Kemp S Sanjog R. Chintalaphani M Michael Chin M Marion Stoll D Danqing Zhu C Christina Liang K Katrina A. Morris A Andrew Hannaford E Ehsan Shandiz K Kate E. Ahmad S Shadi El-Wahsh S Stephen W. Reddel R Robert Boland-Freitas R Roula Ghaoui S Stephanie Barnes J Jonathan Sturm A Anna Willard M Mahi Jasinarachchi S Simon Hawke N Neil G. Simon L Lisa Worgan D David Manser M Michel Tchan N Neil C. Griffith R Ryan L. Davis M Michael C. Fahey C Carolyn M. Sue P Pamela A. McCombe K Karl Ng M Marina L. Kennerson P Pak Leng Cheong K Kishore R. Kumar I Ira W. Deveson

Abstract

Abstract The genetic variants that cause inherited myopathies vary widely in type, size and sequence context, encompassing small sequence variants, large structural variants, repeat expansions, and more complex events, such as the D4Z4 macrosatellite contraction and hypomethylation that causes facioscapulohumeral muscular dystrophy. Many of these are challenging to characterise using next-generation sequencing and other older molecular technologies. To address this, we developed a targeted long-read sequencing assay and bioinformatics analysis framework that captures the full suite of genes, variants and epigenetic signatures currently implicated in inherited myopathies. Applying this to a cohort of myopathy patients, we demonstrate the analytical validity of our approach and its improved accuracy and resolution compared to existing methods. Our assay led to new genetic diagnoses in 35.5% (11/31) of patients who remained undiagnosed after standard clinical genetic testing. This methodology constitutes a single streamlined assay for comprehensive genetic and epigenetic characterisation of inherited myopathies.

Article Details

Volume / Issue Vol. 1, Issue 1
Published July 04, 2026
ISSN 2041-1723
Publisher Nature Portfolio

Journal Info

Nature Communications

Nature Portfolio

ISSN: 2041-1723 Open Access Life Sciences

Authors (40)

D

Dennis Yeow

A

Andre L. M. Reis

I

Igor Stevanovski

N

Neysa Njo

L

Laura I. Rudaks

B

Bianca R. Grosz

J

Joanne S. Sy

L

Leah Kemp

S

Sanjog R. Chintalaphani

M

Michael Chin

M

Marion Stoll

D

Danqing Zhu

C

Christina Liang

K

Katrina A. Morris

A

Andrew Hannaford

E

Ehsan Shandiz

K

Kate E. Ahmad

S

Shadi El-Wahsh

S

Stephen W. Reddel

R

Robert Boland-Freitas

R

Roula Ghaoui

S

Stephanie Barnes

J

Jonathan Sturm

A

Anna Willard

M

Mahi Jasinarachchi

S

Simon Hawke

N

Neil G. Simon

L

Lisa Worgan

D

David Manser

M

Michel Tchan

N

Neil C. Griffith

R

Ryan L. Davis

M

Michael C. Fahey

C

Carolyn M. Sue

P

Pamela A. McCombe

K

Karl Ng

M

Marina L. Kennerson

P

Pak Leng Cheong

K

Kishore R. Kumar

I

Ira W. Deveson