Toward the clinical application of long-read sequencing in repeat-expansion disorders

Benarroch, Louise, Pešović, Jovan, Rossato, Marzia, Chen, Zhongbo, Lucas, Morghan C. and Dion, Vincent ORCID: https://orcid.org/0000-0003-4953-7637 2026. Toward the clinical application of long-read sequencing in repeat-expansion disorders. Nature Genetics 58 , pp. 2087-2103. 10.1038/s41588-026-02694-9

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Abstract

Repeat-expansion disorders (REDs) are a mechanistically and clinically well-defined subgroup of rare diseases caused by the expansion of short tandem repeats (STRs). These expansions can exceed several kilobases and show complex features, such as noncanonical secondary structures, somatic instability, repeat interruptions and allele-specific methylation. These characteristics are highly relevant for understanding disease mechanisms, clinical variability, prognosis and potentially therapeutic decision-making, but cannot be fully resolved using traditional diagnostic methods or short-read sequencing technologies. By contrast, long-read sequencing (LRS) enables accurate investigation of STR complexity in a single assay, facilitates the discovery of new pathogenic repeat expansions and drives advances in diagnostics, clinical and basic research, which may allow for better patient stratification in future clinical trials. This Perspective discusses recent LRS-driven discoveries, methodological and bioinformatic advances, and emerging diagnostic applications to illustrate the potential of LRS in reshaping both research and clinical practice.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Additional Information:	Full author list available at DOI
Publisher:	Nature Research
ISSN:	1061-4036
Date of Acceptance:	25 June 2026
Last Modified:	06 Oct 2026 10:22
URI:	https://orca.cardiff.ac.uk/id/eprint/189174

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