Short Tandem Repeat expansion genotyping in wf-human-variation

By Sirisha Hesketh
Published in How Tos
March 08, 2023
2 min read
Short Tandem Repeat expansion genotyping in wf-human-variation

Our human variation workflow, wf-human-variation, gives users the ability to call a range of different variant types from Oxford Nanopore Technologies sequencing data, offering: SNP, SV, methylation, and CNV sub-workflows. In this blog post we introduce the newest sub-workflow, which enables genotyping of STR expansions.

Our colleagues in the ONT Applications Team are actively investigating best practice for human STR genotyping, and this sub-workflow builds on their extensive work to make this functionality available to the community.

STR expansion genotyping

Short tandem repeats (STRs) are short DNA sequence motifs, typically 2-6bp, which are repeated consecutively at given positions in the genome. An abnormal number of copies of these motifs at certain loci have been shown to cause human disease, for example trinucleotide repeat expansion disorders such as Huntington’s disease (HTT) and Fragile X syndrome (FMR1). As long-read ONT sequencing data has the potential to cover the whole expanded region, it is particularly well-suited to both identification of expansions as well as calculating their size - a critical aspect of determining repeat instability and a notable advantage over short-read sequencing platforms.

Running the workflow

The STR workflow implemented within wf-human-variation accepts BAM as input along with a (optionally gzipped) FASTA reference sequence, and uses a fork of Straglr to genotype STRs and generate a VCF, followed by annotation via Stranger and SnpSift. Genotyping is based on a BED file of repeats, available here.

Example command

Please note, this workflow is only compatible with human genome build 38.

nextflow run epi2me-labs/wf-human-variation --str --bam <PATH_TO_BAM> --ref <PATH_TO_REFERENCE> --sex <male|female>

The STR workflow triggers a modified version of the SNP workflow to create a haplotagged BAM, as phased alignments are required to genotype STR expansions, enabling the enumeration of repeat units and their corresponding lengths for each allele. A haplotagged BAM is only generated if the user selects the --str option, and won’t be generated if --snp is selected on its own. The STR workflow also takes a required --sex parameter (male or female) which determines the number of calls on chrX. The output HTML report contains a list of each repeat, divided into ‘normal’, ‘pre-mutation’ and ‘pathogenic’ tabs, depending on the number of copies of the repeat observed in each haplotype (Figure 1). A summary table is also presented which gives an at-a-glance overview of the total number of each repeat, again colour-coded according to whether the repeat number falls into the normal, pre-mutation or pathogenic ranges (Figure 2). These examples have been observed following an analysis of sequence data from the Coriell NA07063 cell line.

As well as the HTML report, the workflow also produces as output the final haplotagged BAM used for STR genotyping, an annotated VCF of calls, and a tab-delimited file output by Straglr which lists the reads spanning STR sites, and includes read identifiers and strand information.

FMR1 expansion plot
Figure 1 - Here we show data from an individual carrying an FMR1 expansion on one allele. The blue area of the plot represents those repeats which are within the size range that is considered normal. The red area indicates repeat sizes that are in the pathogenic range. Triangles under the plots indicate median counts for each allele.

FMR1 summary table
Figure 2 - The STR module reports its observations to a summary table, in addition to the VCF file output. Analysis results can be easily reviewed through clear colour coding of the repeat counts – the colours indicate if a repeat count is considered within the normal, pre-mutation, or mutation ranges.


Chiu, R., Rajan-Babu, IS., Friedman, J.M. et al. Straglr: discovering and genotyping tandem repeat expansions using whole genome long-read sequences. Genome Biol 22, 224 (2021).

The following cell line samples were obtained from the NIGMS Human Genetic Cell Repository at the Coriell Institute for Medical Research: NA07063




Sirisha Hesketh

Clinical Bioinformatician

Table Of Contents

STR expansion genotyping
Running the workflow

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