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11.5 The Era of Whole-Genome Sequencing   387


                       New Techniques Sequence Millions of                 combination of these three innovations allows sequencing
                       Individual DNA Molecules in Parallel                machines to record the successive addition of nucleotides to
                                                                           each of millions of growing DNA molecules in real time.
                       The major technical advances that are making exome and   Figure 11.24 outlines only one of many ingenious tech-
                       genome sequencing fast and cheap enough for use in iden-  nologies for inexpensive high-throughput sequencing cur-
                       tifying disease genes permit millions of individual DNA   rently under development. Other prototype systems are
                       molecules to be sequenced simultaneously. Many creative   based on very different ideas; for example, the figure at the
                       methods have been invented to perform so-called  high-  beginning of this chapter illustrates a novel method in
                       throughput or massively parallel sequencing.        which individual DNA molecules are threaded through
                          Several of these high-throughput methods for sequenc-  small channels called  nanopores. It is not clear which
                       ing human genomes are straightforward extensions of the   methods will become standard in the future as costs are
                       Sanger sequencing by synthesis approach you already   steadily driven lower. But you should have no doubt that
                       learned in Chapter 9, but three things are new. First, indi-  the era of whole-genome sequencing has already arrived.
                       vidual DNA molecules being synthesized by DNA poly-
                       merase are anchored in one place. Second, these methods
                       control base addition temporally so that each base can be   Disease‑Causing Mutations
                       identified before the next one is added. Third, in some sys-  Are Hidden in a Sea of Variation
                       tems the sensitivity of detection is so high that a single mol-
                       ecule of DNA can be monitored without the need for cloning   A patient’s whole-exome or whole-genome sequence
                       or PCR amplification steps. As shown in Fig. 11.24, the   should include the sequence difference(s) responsible for


                       Figure 11.24  One method for high-throughput, single molecule DNA sequencing. (a) Millions of single-stranded genomic
                       DNA fragments, to which poly-A has been enzymatically added at the 3′ end, are hybridized to oligo-dT molecules attached to the surface of
                       a special microarray called a flowcell. (b) Using the genomic fragment as template and the oligo-dT as primer, DNA polymerase synthesizes
                       new DNA containing nucleotides with colored, base-specific fluorescent tags. These nucleotides are also blocked at their 3′ ends so that only
                       one nucleotide can be added at a time. (c) After a high-resolution camera photographs the fluorescence, chemicals applied to the flowcell
                       remove the tag and the blocking group from the just-added nucleotide. (d) Each subsequent cycle begins by infusing the flowcell with a new
                       dose of tagged nucleotides and polymerase, and then step (c) is iterated. The sequencing machine takes about 100 pictures that record a
                       sequence of colored flashes at each of the millions of spots where a single DNA molecule is being synthesized. A computer rearranges the
                       data into millions of short sequence reads of about 100 nucleotides and then assembles the genome sequence.
                             (a)               Flow cell surface          (c)
                                         5'                                           5'
                                         T      5'                                    T     5'
                                         T      C     5'                              T     C      5'
                                         C      G     G                               C     G      G
                                         C  DNA fragment 1  A  A                      C     A      A
                                         A      G  DNA fragment 2  A                  A     G      A
                                         G      C     T  DNA fragment 3              C G    C      T
                                        T A     T     T                              T A   A T     T
                             Oligo(dT)  T  A  T A     C                              T  A  T A   G C
                                        T  A  T  A   T A                             T  A  T  A  T A
                                        T     T  A   T  A  Poly-A                    T     T  A  T  A
                                              T                                            T
                                                     T  A                                        T  A
                                                     T                                           T
                                                Add DNA polymerase +                        Add DNA polymerase +
                                                  labeled, blocked                             labeled, blocked
                                                  deoxynucleotides                            deoxynucleotides
                             (b)                                          (d)
                                         5'                                           5'
                                         T      5'                                    T     5'
                                         T      C     5'                              T     C      5'
                                         C      G     G                               C     G      G
                                         C      A     A                               C     A      A
                              Blocking   A      G     A                              T  A  G  G    A
                               group    C G     C     T                              C G    C      T
                                        T A   A T     T                              T A   A T   A T
                                        T  A  T A    G C                             T  A  T A   G C
                                        T  A  T  A   T A                             T  A  T  A  T A
                                        T     T  A   T  A                            T     T  A  T  A
                                              T      T  A                                  T     T  A
                                                             Photograph
                                                                                                         Photograp
                                                     T       Photograph                          T       Photographh
                                                             fluorescent
                                                             fluorescent                                  fluorescentfluorescent
                                                              flashes                                       flashes
                                                Remove fluorescent
                                                tags and blocking
                                                    groups                             ~100 Rounds
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