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+ [
2
+ {
3
+ "id": "AITX-00001",
4
+ "patient": {
5
+ "genotype": [
6
+ {
7
+ "gene": "DMD",
8
+ "transcript": "NM_004006.2",
9
+ "variant_hgvs": "c.7544_9286del",
10
+ "protein_hgvs": "p.(Thr2516_Ala3096del)",
11
+ "zygosity": "hemizygous"
12
+ }
13
+ ],
14
+ "clinical_info": "Progressive muscle weakness"
15
+ },
16
+ "question": "To which of the following targeted therapies would this variant be most likely amenable: Golodirsen, Viltolarsen, Eteplirsen, Casimersen, Ataluren, or None?",
17
+ "answer": "Eteplirsen",
18
+ "answer_type": "multipleChoice",
19
+ "category": "Established_Targeted",
20
+ "sub_category": "ASO",
21
+ "rationale": "Variant results in deletion of exons 52-63, which is listed as amenable to exon 51 skipping"
22
+ },
23
+ {
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+ "id": "AITX-00002",
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+ "patient": {
26
+ "genotype": [
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+ {
28
+ "gene": "DMD",
29
+ "transcript": "NM_004006.2",
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+ "variant_hgvs": "c.10453_10454delinsTA",
31
+ "protein_hgvs": "p.(Leu3485Ter)",
32
+ "zygosity": "hemizygous"
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+ }
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+ ],
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+ "clinical_info": "Progressive muscle weakness"
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+ },
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+ "question": "To which of the following targeted therapies would this variant be most likely amenable: Golodirsen, Viltolarsen, Eteplirsen, Casimersen, Ataluren, or None?",
38
+ "answer": "Ataluren",
39
+ "answer_type": "multipleChoice",
40
+ "category": "Established_Targeted",
41
+ "sub_category": "Small Molecule",
42
+ "rationale": "Variant results in a nonsense in exon 74, which is amenable to nonsense readthrough"
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+ },
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+ {
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+ "id": "AITX-00003",
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+ "patient": {
47
+ "genotype": [
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+ {
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+ "gene": "DMD",
50
+ "transcript": "NM_004006.2",
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+ "variant_hgvs": "c.70T>C",
52
+ "protein_hgvs": "p.(Trp24Arg)",
53
+ "zygosity": "hemizygous"
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+ }
55
+ ],
56
+ "clinical_info": "Progressive muscle weakness"
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+ },
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+ "question": "To which of the following targeted therapies would this variant be most likely amenable: Eteplirsen, Golodirsen, Viltolarsen, Casimersen, Ataluren, or None?",
59
+ "answer": "None",
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+ "answer_type": "multipleChoice",
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+ "category": "Established_Targeted",
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+ "sub_category": "ASOs",
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+ "rationale": "Results in a missense in exon 2, which is not amenable to nonsense readthrough and is upstream from skippable exons"
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+ },
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+ {
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+ "id": "AITX-00004",
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+ "patient": {
68
+ "genotype": [
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+ {
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+ "gene": "AGXT",
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+ "transcript": "NM_000030.3",
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+ "variant_hgvs": "c.508G>A",
73
+ "protein_hgvs": "p.(Gly170Arg)",
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+ "zygosity": "homozygous"
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+ }
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+ ],
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+ "clinical_info": "Recurrent nephrocalcinosis and chronic kidney disease"
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+ },
79
+ "question": "What targeted, small molecule therapy is available for this patient? Provide the generic name or None.",
80
+ "answer": "Pyridoxine",
81
+ "answer_type": "exactMatch",
82
+ "category": "Established_Targeted",
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+ "sub_category": "Small Molecule",
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+ "rationale": "Missense variants are amenable to pyridoxine treatment https://www.ncbi.nlm.nih.gov/books/NBK1283/"
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+ },
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+ {
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+ "id": "AITX-00005",
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+ "patient": {
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+ "genotype": [
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+ {
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+ "gene": "AGXT",
92
+ "transcript": "NM_000030.3",
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+ "variant_hgvs": "c.33dup",
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+ "protein_hgvs": "p.(Lys12GlnfsTer156)",
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+ "zygosity": "homozygous"
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+ }
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+ ],
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+ "clinical_info": "Recurrent nephrocalcinosis and chronic kidney disease"
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+ },
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+ "question": "Is this patient predicted to be responsive to pyridoxine? Answer yes or no.",
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+ "answer": "No",
102
+ "answer_type": "exactMatch",
103
+ "category": "Established_Targeted",
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+ "sub_category": "Small Molecule",
105
+ "rationale": "Pyridoxine is not effective for patients with null variants https://www.ncbi.nlm.nih.gov/books/NBK1283/"
106
+ },
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+ {
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+ "id": "AITX-00006",
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+ "patient": {
110
+ "genotype": [
111
+ {
112
+ "gene": "AGXT",
113
+ "transcript": "NM_000030.3",
114
+ "variant_hgvs": "c.33dup",
115
+ "protein_hgvs": "p.(Lys12GlnfsTer156)",
116
+ "zygosity": "homozygous"
117
+ }
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+ ],
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+ "clinical_info": "7 year old with recurrent nephrocalcinosis and chronic kidney disease"
120
+ },
121
+ "question": "What targeted, genetic therapies are approved for this patient in the US? Provide the generic name.",
122
+ "answer": "Lumasiran",
123
+ "answer_type": "exactMatch",
124
+ "category": "Established_Targeted",
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+ "sub_category": "siRNA",
126
+ "rationale": "Lumasiran is approved for patients of all ages whereas Nedosiran is only approved for patients age >9. https://www.ncbi.nlm.nih.gov/books/NBK1283/"
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+ },
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+ {
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+ "id": "AITX-00007",
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+ "patient": {
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+ "genotype": [
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+ {
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+ "gene": "DDC",
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+ "transcript": "NM_001082971.2",
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+ "variant_hgvs": "c.286G>A",
136
+ "protein_hgvs": "p.(Gly96Arg)",
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+ "zygosity": "homozygous"
138
+ }
139
+ ],
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+ "clinical_info": "Global developmental delay"
141
+ },
142
+ "question": "What is the youngest age for which a gene therapy is approved for this patient's genetic condition in the united kingdom? Answer with the format \"X months\".",
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+ "answer": "18 months",
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+ "answer_type": "exactMatch",
145
+ "category": "Established_Targeted",
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+ "sub_category": "Gene Therapy",
147
+ "rationale": "https://www.ncbi.nlm.nih.gov/books/NBK595821/"
148
+ },
149
+ {
150
+ "id": "AITX-00008",
151
+ "patient": {
152
+ "genotype": [
153
+ {
154
+ "gene": "COL1A1",
155
+ "transcript": "NM_000088.4",
156
+ "variant_hgvs": "c.1678G>A",
157
+ "protein_hgvs": "p.(Gly560Ser)",
158
+ "zygosity": "heterozygous"
159
+ }
160
+ ],
161
+ "clinical_info": "joint hypermobility, skin hyperextensibility, and easy bruising"
162
+ },
163
+ "question": "What two medications are most established for decreasing bruising? List generic names in alphabetical order",
164
+ "answer": "ascorbic acid, desmopressin",
165
+ "answer_type": "exactMatch",
166
+ "category": "Established_Supportive",
167
+ "sub_category": "Treatment_Identification",
168
+ "rationale": "https://www.ncbi.nlm.nih.gov/books/NBK1244/#eds.Management"
169
+ },
170
+ {
171
+ "id": "AITX-00009",
172
+ "patient": {
173
+ "genotype": [
174
+ {
175
+ "gene": "SLC35A2",
176
+ "transcript": "NM_005660.3",
177
+ "variant_hgvs": "c.3G>A",
178
+ "protein_hgvs": "p.Met1Ile",
179
+ "zygosity": "heterozygous"
180
+ }
181
+ ],
182
+ "clinical_info": "Patient with SLC35A2-CDG who is experiencing seizures and global developmental delay"
183
+ },
184
+ "question": "What clinical trial developing a new therapeutic for this condition is recruiting or listed as upcoming/not yet recruiting? Return a clinical trials ID",
185
+ "answer": "NCT05402384",
186
+ "answer_type": "exactMatch",
187
+ "category": "Clinical_Trials",
188
+ "sub_category": "Trial_Identification",
189
+ "rationale": "https://clinicaltrials.gov/study/NCT05402384"
190
+ },
191
+ {
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+ "id": "AITX-00010",
193
+ "patient": {
194
+ "genotype": [
195
+ {
196
+ "gene": "SLC35A2",
197
+ "transcript": "NM_005660.3",
198
+ "variant_hgvs": "c.3G>A",
199
+ "protein_hgvs": "p.Met1Ile",
200
+ "zygosity": "heterozygous"
201
+ }
202
+ ],
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+ "clinical_info": "seizures and global developmental delay. Age 2 months, Hemoglobin 5, Normal liver labs, Not enrolled in other trials"
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+ },
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+ "question": "Is this patient eligible for clinical trial NCT05402384? Answer yes or no.",
206
+ "answer": "No",
207
+ "answer_type": "exactMatch",
208
+ "category": "Clinical_Trials",
209
+ "sub_category": "Eligibility",
210
+ "rationale": "Exclusion criteria lists hemoglobin <7 https://clinicaltrials.gov/study/NCT05402384"
211
+ },
212
+ {
213
+ "id": "AITX-00011",
214
+ "patient": {
215
+ "genotype": [
216
+ {
217
+ "gene": "KCNT1",
218
+ "transcript": "NM_020822.3",
219
+ "variant_hgvs": "c.2849G>A",
220
+ "protein_hgvs": "p.Arg950Gln",
221
+ "zygosity": "heterozygous"
222
+ }
223
+ ],
224
+ "clinical_info": "early-onset seizures and developmental delays"
225
+ },
226
+ "question": "For which clinical trials evaluating new therapeutics is this patient eligible? Provide a clinical trial ID or answer None.",
227
+ "answer": "None",
228
+ "answer_type": "exactMatch",
229
+ "category": "Clinical_Trials",
230
+ "sub_category": "Trial_Identification",
231
+ "rationale": "Only a natural history study is listed. Source: https://clinicaltrials.gov/search?cond=KCNT1"
232
+ },
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+ {
234
+ "id": "AITX-00012",
235
+ "patient": {
236
+ "genotype": [
237
+ {
238
+ "gene": "GRIN2B",
239
+ "transcript": "NM_000834.5",
240
+ "variant_hgvs": "c.2755C>T",
241
+ "protein_hgvs": "p.Gln919Ter",
242
+ "zygosity": "heterozygous"
243
+ }
244
+ ],
245
+ "clinical_info": "intellectual disability, seizures, and developmental delays"
246
+ },
247
+ "question": "Is it more likely amenable to treatment with Memantine, L-serine, or Radiprodil",
248
+ "answer": "L-Serine",
249
+ "answer_type": "exactMatch",
250
+ "category": "Drug_Development_and_Repurposing",
251
+ "sub_category": "Mechanism_Of_Action",
252
+ "rationale": "Variant is a LOF variant. L-serine is being used for LOF variants whereas the others are being used for GOF variants https://academic.oup.com/brain/article/147/5/1653/7611854?login=false"
253
+ },
254
+ {
255
+ "id": "AITX-00013",
256
+ "patient": {
257
+ "genotype": [
258
+ {
259
+ "gene": "ANO10",
260
+ "transcript": "NM_018075.5",
261
+ "variant_hgvs": "c.289del",
262
+ "protein_hgvs": "p.(Met97Ter)",
263
+ "zygosity": "homozygous"
264
+ }
265
+ ],
266
+ "clinical_info": "progressive cerebellar ataxia and peripheral neuropathy"
267
+ },
268
+ "question": "How many amino acids are coded for by the exon in which this variant occurs? Answer with a number",
269
+ "answer": "66",
270
+ "answer_type": "exactMatch",
271
+ "category": "Variant_Assessment",
272
+ "sub_category": "Exon_Evaluation",
273
+ "rationale": "Source: Ensembl"
274
+ },
275
+ {
276
+ "id": "AITX-00014",
277
+ "patient": {
278
+ "genotype": [
279
+ {
280
+ "gene": "ANO10",
281
+ "transcript": "NM_018075.5",
282
+ "variant_hgvs": "c.289del",
283
+ "protein_hgvs": "p.(Met97Ter)",
284
+ "zygosity": "homozygous"
285
+ }
286
+ ],
287
+ "clinical_info": "progressive cerebellar ataxia and peripheral neuropathy"
288
+ },
289
+ "question": "What percentage of the total coding transcript for this gene are encoded by the exon in which this variant occurs? Answer with a decimal to nearest tenth.",
290
+ "answer": "0.1",
291
+ "answer_type": "exactMatch",
292
+ "category": "Variant_Assessment",
293
+ "sub_category": "Exon_Evaluation",
294
+ "rationale": "66/660 = 0.1 Source: Ensembl"
295
+ },
296
+ {
297
+ "id": "AITX-00015",
298
+ "patient": {
299
+ "genotype": [
300
+ {
301
+ "gene": "KMT2B",
302
+ "transcript": "NM_014727.3",
303
+ "variant_hgvs": "c.8079delC",
304
+ "protein_hgvs": "p.(Ile2694SerfsTer44)",
305
+ "zygosity": "heterozygous"
306
+ }
307
+ ],
308
+ "clinical_info": "childhood-onset generalized dystonia"
309
+ },
310
+ "question": "Based on typical prediction rules, is this variant likely to result in nonsense mediated decay? Answer yes or no.",
311
+ "answer": "No",
312
+ "answer_type": "exactMatch",
313
+ "category": "Variant_Assessment",
314
+ "sub_category": "Nonsense_Mediated_Decay",
315
+ "rationale": "At the end of the last exon, after the main domain"
316
+ },
317
+ {
318
+ "id": "AITX-00016",
319
+ "patient": {
320
+ "genotype": [
321
+ {
322
+ "gene": "NF1",
323
+ "transcript": "NM_001042492.3",
324
+ "variant_hgvs": "c.3728T>C",
325
+ "protein_hgvs": "p.(Leu1243Pro)",
326
+ "zygosity": "heterozygous"
327
+ }
328
+ ],
329
+ "clinical_info": "Malignant Peripheral Nerve Sheath Tumor and Pheochromocytoma"
330
+ },
331
+ "question": "In which functional domain does this variant occur? Answer choices: CSRD, TBD, GRD, Sec14-PH, HLR, NLS, SBR.",
332
+ "answer": "GRD",
333
+ "answer_type": "exactMatch",
334
+ "category": "Variant_Assessment",
335
+ "sub_category": "Functional_Domains",
336
+ "rationale": "GRD, GAP related domain (1198–1549 residues) https://www.mdpi.com/2073-4425/13/7/1130#"
337
+ }
338
+ ]