pathogenic variants

致病性变异
  • 文章类型: Journal Article
    大约10%的乳腺癌(BC)病例是由遗传原因引起的。遗传检测已在BC护理中广泛实施,以确定遗传性癌症综合征和个性化医疗。因此,鉴定携带种系致病变异体的个体可用于为每种BC亚型提供适当的预防或筛查措施。然而,到目前为止,很少有正式的基因检测建议。在这项研究中,我们通过系统评价和荟萃分析,比较过表达HER2的亚型与其他临床公认的BC亚型,评估了一组特定基因中的罕见种系变异,以确定与富含人表皮生长因子2(HER2+)BC表型的相关性.这篇评论在PROSPERO注册(ID:CRD42023447571)。
    我们在PubMed(MEDLINE)进行了在线文献检索,Scopus,EMBASE数据库。我们纳入了研究HER2+BC患者种系变异的原始研究,并选择了仅报道罕见和/或致病性种系变异的研究。我们使用JoannaBriggs研究所关键评估清单和改良的Newcastle-Ottawa遗传研究量表评估了偏倚和研究质量的风险。分别。考虑到激素受体和HER2表达状态,我们比较了最初在HR-HER2-中基于基因的风险,HR+HER2-,HR+HER2+,和HR-HER2+组,对每个比较使用随机效应模型进行单独的荟萃分析,并在其中为每个基因。
    在总共36项描述种系变异的研究中,11项研究提供了有关不同临床相关BC亚型中变体患病率的信息,并进行了比较。8个基因内的种系变体在BC组之间进行meta分析时显示出显着差异:BRCA1,BRCA2,TP53,ATM,CHEK2,PALB2,RAD51C,和BARD1。值得注意的是,TP53,ATM,CHEK2种系变异体被鉴定为HER2+亚型的易感因素,而BRCA1,BRCA2,PALB2,RAD51C,和BARD1种系变异与低HER2表达倾向相关。对偏见和质量评估的主要关注是缺乏混杂因素控制;和可比性或结果评估,分别。
    我们的发现强调了种系变异与HER2蛋白和BC亚型差异表达之间的联系。
    https://www.crd.约克。AC.英国/PROSPERO,标识符CRD42023447571。
    UNASSIGNED: Approximately 10% of breast cancer (BC) cases result from hereditary causes. Genetic testing has been widely implemented in BC care to determine hereditary cancer syndromes and personalized medicine. Thus, identification of individuals carrying germline pathogenic variants could be useful to provide appropriate prophylactic or screening measures for each BC subtype, however, there are few formal recommendations for genetic testing in this sense so far. In this study, we assessed rare germline variants in a specific group of genes in order to determine the association with human epidermal growth factor 2 enriched (HER2+) BC phenotype through a systematic review and meta-analysis comparing subtypes overexpressing HER2 with other clinically recognized subtypes of BC. This review was registered with PROSPERO (ID: CRD42023447571).
    UNASSIGNED: We conducted an online literature search in PubMed (MEDLINE), Scopus, and EMBASE databases. We included original studies that investigated germline variants in HER2+ BC patients and selected the studies that reported only rare and/or pathogenic germline variants. We assessed the risk of bias and quality of the studies using the Joanna Briggs Institute Critical Appraisal checklists and the Modified Newcastle-Ottawa Scale for Genetic Studies, respectively. Considering hormone receptor and HER2 expression status, we compared gene-based risks initially in HR-HER2-, HR+HER2-, HR+HER2+, and HR-HER2+ groups, conducting separate meta-analyses using the random effects model for each comparison, and within them for each gene.
    UNASSIGNED: Of the total 36 studies describing germline variants, 11 studies provided information on the prevalence of variants in the different clinically relevant BC subtypes and allowed comparisons. Germline variants within eight genes showed significant differences when meta-analyzed between the BC groups: BRCA1, BRCA2, TP53, ATM, CHEK2, PALB2, RAD51C, and BARD1. Notably, TP53, ATM, and CHEK2 germline variants were identified as predisposing factors for HER2+ subtypes, whereas BRCA1, BRCA2, PALB2, RAD51C, and BARD1 germline variants were associated with a predisposition to low HER2 expression. Main concerns about bias and quality assessment were the lack of confounding factors control; and comparability or outcome assessment, respectively.
    UNASSIGNED: Our findings underscore the connection between germline variants and differential expression of the HER2 protein and BC subtypes.
    UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023447571.
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  • 文章类型: Journal Article
    目的:本研究旨在分析6例由溶质载体家族38成员8(SLC38A8)变异体引起的中央凹发育不全(FH)的临床和遗传特征,并从以前的文献中描述SLC38A8变体的基因型和表型。
    方法:所有受试者都接受了全面的眼科检查。进行光学相干断层扫描(OCT)以评估FH的结构等级。使用基于小组的下一代测序和直接Sanger测序技术鉴定SLC38A8基因的致病变体。Further,之前报道的所有SLC38A8变异病例均与本研究中发现的新病例一起进行了重新分析.
    结果:有6例SLC38A8基因变异的患者存在眼球震颤和FH,伴有正常的前节。在4名患者中确定了4级FH。共鉴定出12种SLC38A8基因变异体,包括9种新颖的变体。系统分析显示一半的变异(30/60)是错义的,其中大部分(23/30)分布在跨膜(TM)结构域中。在大多数患者中检测到4级FH(66%,23/35).0、1和2个错义变异的患者亚组之间的临床特点无统计学差别。
    结论:在具有SLC38A8变异体的患者中发现了严重的中央凹发育停滞。本研究提供了致病性SLC38A8变异的临床和遗传特征的简要总结,有助于FH的鉴别诊断。
    OBJECTIVE: This study aimed to analyze the clinical and genetic characteristics of 6 Chinese patients with foveal hypoplasia (FH) caused by the variants of solute carrier family 38 member 8 (SLC38A8), and to describe the genotype and phenotype of SLC38A8 variants from previous literature.
    METHODS: All subjects underwent comprehensive ophthalmic examinations. Optical coherence tomography (OCT) was performed to evaluate the structural grade of FH. Pathogenic variants of SLC38A8 gene were identified using panel-based next-generation sequencing and direct Sanger sequencing techniques. Further, all previously reported cases of SLC38A8 variants were re-analyzed together with the novel ones identified in this study.
    RESULTS: Nystagmus and FH were present in 6 patients with variants of SLC38A8 gene, accompanied by a normal anterior segment. Grade 4 FH was identified in 4 patients. A total of 12 variants of SLC38A8 gene were identified, including 9 novel variants. Systematical analysis revealed that half of the variants (30/60) were missense, the majority of which (23/30) were distributed in the transmembrane (TM) domains. Grade 4 FH was detected in the majority of patients (66%, 23/35). There was no statistical difference in the clinical features between the subgroups of patients with 0, 1 and 2 missense variants.
    CONCLUSIONS: Severe arrest of foveal development was identified in patients with variants of SLC38A8. This study provides a brief summary of the clinical and genetic characteristics of the pathogenic SLC38A8 variants, which is helpful in the differentiation diagnosis of FH.
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  • 文章类型: Journal Article
    我们的大多数遗传性乳腺癌基因不仅增加了患乳腺癌的风险,也增加了其他恶性肿瘤的风险。了解个体是否在遗传性乳腺癌基因中携带致病性变异不仅会影响对患者的筛查,也会影响对他或她的家庭成员的筛查。通过多基因小组识别和适当测试个体可以降低风险并在有风险的个体中进行早期监测。放射科医生可以作为女性的一线识别者,这些女性有患乳腺癌遗传倾向的风险,因为他们正在与所有接受常规筛查乳房X光检查的女性互动,并收集提示突变存在的家族史。我们在这里概述了国家综合癌症网络遗传/家族高风险:乳腺和卵巢(版本3.2019)中讨论的与高乳腺癌风险相关的11个基因,作为年度乳房X线照相术之外的额外乳腺癌筛查建议,作为乳腺癌筛查和降低风险的指南。以及非乳腺癌监测的建议。
    The majority of our hereditary breast cancer genes incur not only an increased risk for breast cancer but for other malignancies as well. Knowing whether an individual carries a pathogenic variant in a hereditary breast cancer gene can affect not only screening for the patient but for his or her family members as well. Identifying and appropriately testing individuals via multigene panels allows for risk reduction and early surveillance in at-risk individuals. Radiologists can serve as first-line identifiers of women who are at risk of having an inherited predisposition to breast cancer because they are interacting with all women receiving routine screening mammograms, and collecting family history suggestive of the presence of a mutation. We outline here the 11 genes associated with high breast cancer risk discussed in the National Comprehensive Cancer Network Genetic/Familial High-Risk: Breast and Ovarian (version 3.2019) as having additional breast cancer screening recommendations outside of annual mammography to serve as a guide for breast cancer screening and risk reduction, as well as recommendations for surveillance of nonbreast cancers.
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  • 文章类型: Systematic Review
    铁抗性缺铁性贫血是一种罕见的常染色体隐性遗传疾病,其特征是低色素性小细胞性贫血。低转铁蛋白饱和度和不适当的高铁调素水平。这种情况的病因植根于跨膜丝氨酸蛋白酶6(TMPRSS6)基因内的遗传变异,负责编码matriptase-2,铁调素的关键负调节因子。我们在四个电子数据库中进行了系统的搜索,总共产生538篇文章,其中25篇最终被纳入,并在进一步之前,旨在预测流行的单核苷酸多态性(SNP)和有害的遗传改变。这篇综述旨在阐明各种SNP和致病突变对血液和生化参数的影响。以及他们潜在的民族间关系。利用生物信息学工具,我们对100多个SNP进行了审查,辨别它们潜在的功能后果。我们发现rs1373272804,rs1430692214和rs855791变体最常见,并对血液学和生化特征产生重大影响。我们发现,与其他种族相比,欧洲血统的个体更容易出现这些变体。总之,本综述不仅阐明了TMPRSS6多态性与铁抗性缺铁性贫血(IRIDA)的关系,但也强调了对涉及全球更大样本量和更多样化种族群体的进一步调查的迫切需要。这些未来的研究对于获得更强大,更可靠的理解这些遗传差异如何与IRIDA的发展有关至关重要。
    Iron resistance iron deficiency anaemia is a rare autosomal recessive disorder characterized by hypochromic microcytic anaemia, low transferrin saturation and inappropriately high hepcidin levels. The aetiology of this condition is rooted in genetic variations within the transmembrane serine protease 6 (TMPRSS6) genes, responsible for encoding matriptase-2, a pivotal negative regulator of hepcidin. We conducted a systematic search across four electronic databases, yielding 538 articles in total out of which 25 were finally included and were preceded further, aiming to prognosticate prevalent single nucleotide polymorphisms (SNPs) and detrimental genetic alterations. This review aims to elucidate the effects of various SNPs and pathogenic mutations on both haematological and biochemical parameters, as well as their potential interethnic correlation. Employing bioinformatics tools, we subjected over 100 SNPs to scrutiny, discerning their potential functional ramifications. We found rs1373272804, rs1430692214 and rs855791 variants to be most frequent and were having a significant impact on haematological and biochemical profile. We found that individuals of European ancestry were more prone to have these variants compared to other ethnic groups. In conclusion, this review not only sheds light on the association of TMPRSS6 polymorphism in iron resistance iron deficiency anaemia (IRIDA), but also highlights the critical need for further investigations involving larger sample size and more diverse ethnic groups around the globe. These future studies will be vital for gaining a stronger and more reliable understanding of how these genetic differences are linked to the development of IRIDA.
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  • 文章类型: Systematic Review
    Personalized information is paramount to patient-centered communication and decision-making regarding risk management in hereditary cancer syndromes. This systematic review identified information needs of individuals from families harboring BRCA pathogenic variants and compared findings based on gender (women vs men) and clinical characteristics (patients with cancer vs previvors and BRCA heterozygotes vs untested relatives).
    We screened 8115 studies identified from databases and citation searching. The quality of selected studies was assessed using the Mixed Methods Appraisal Tool. Narrative synthesis was conducted based on content analysis.
    From 18 selected studies including 1063 individuals, we identified 9 categories of information needs. Risk of bias in the selected studies was moderate. Men, untested relatives, and racial and ethnic minorities were underrepresented. Frequently required information was personalized cancer risk and risk-reducing strategies, including decision-making, family implications of hereditary cancers, psychological issues, and cascade testing. Subgroup analyses showed that information needs depended on gender, personal cancer history, and cascade testing in relatives.
    We identified comprehensive and detailed informational needs of individuals from families harboring BRCA pathogenic variants and gaps in international guidelines. Needs for personalized information varied based on gender, health, and genetic testing status. Findings of this study have implications for genetic counseling, tailoring educational materials, and personalizing interventions.
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  • 文章类型: Journal Article
    帕金森病(PD)是一种异质性神经退行性疾病。遗传因素起着重要的作用,尤其是早期发病和家族性病例。突变通常在LRRK2基因中发现,但它们的重要性各不相同。一些突变,例如p.Arg1441Cys或1441密码子中的其他改变,与PD有明显的相关性,而另一些是健康人群中也发现的危险因素,或者具有可忽略的后果。它们在不同人群中也表现出不同的患病率。本文的目的是总结有关LRRK2突变的流行病学和致病性的现有知识,除了完善的p.Gly2019Ser.我们使用PubMed数据库对文献进行了回顾。103份出版物符合我们的纳入标准。p.Arg1441Cys,p.Arg1441Gly,p.Arg1441His,p.Arg1441Ser是欧洲人群中最常见的致病突变,尤其是西班牙裔。p.Asn1437His是致病性的,主要发生在斯堪的纳维亚人。p.Asn1437Ser和p.Asn1437Asp分别在德国和中国队列中报道。p.Ile20Thr是仅在日本队列中描述的罕见致病性突变。p.Met1869Thr仅在白种人中报道。p.Tyr1699Cys,p.Ile1122Val仅在每个家庭中发现。仅在一名患者中描述了p.Glu1874Ter。我们没有发现有关p.Gln416Ter突变的参考文献。我们还报告了第一例波兰PD家庭,其成员携带p.Asn1437His。
    Parkinson\'s disease (PD) is a heterogenous neurodegenerative disorder. Genetic factors play a significant role, especially in early onset and familial cases. Mutations are usually found in the LRRK2 gene, but their importance varies. Some mutations, such as p.Arg1441Cys or other alterations in the 1441 codon, show clear correlation with PD, whereas others are risk factors found also in healthy populations or have neglectable consequences. They also exhibit various prevalence among different populations. The aim of this paper is to sum up the current knowledge regarding the epidemiology and pathogenicity of LRRK2 mutations, other than the well-established p.Gly2019Ser. We performed a review of the literature using PubMed database. 103 publications met our inclusion criteria. p.Arg1441Cys, p.Arg1441Gly, p.Arg1441His, p.Arg1441Ser are the most common pathogenic mutations in European populations, especially Hispanic. p.Asn1437His is pathogenic and occurs mostly in the Scandinavians. p.Asn1437Ser and p.Asn1437Asp have been reported in German and Chinese cohorts respectively. p.Ile2020Thr is a rare pathogenic mutation described only in a Japanese cohort. p.Met1869Thr has only been reported in Caucasians. p.Tyr1699Cys, p.Ile1122Val have only been found in one family each. p.Glu1874Ter has been described in just one patient. We found no references concerning mutation p.Gln416Ter. We also report the first case of a Polish PD family whose members carried p.Asn1437His.
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  • 文章类型: Case Reports
    背景:SCARB2基因的双等位基因致病变异与行动肌阵挛性肾衰竭(AMRF)综合征有关。尽管据报道SCARB2相关表型包括典型的神经系统特征,根据致病变体的定位和特征,临床过程和演示文稿已被证明是不同的。
    方法:全外显子组测序(WES)分析揭示了纯合截短变体(p。N45MfsX88)在SCARB2基因中的指标情况下,随后的sanger测序分析验证了该变异体在一个土耳其家庭的所有受影响的家庭成员中具有与AMRF和相关疾病相关的临床特征.家族内临床异质性的共同特征包括构音障碍,震颤和蛋白尿,和独特的特征,如周围神经病变(PNP),受影响病例之间的肌阵鸣和癫痫发作,在家庭中观察到。深入的文献综述能够详细研究与AMRF相关的已报道的变异,并表明虽然变异的类型对临床特征的过程没有重大影响,只有致病性变异体的C末端定位显着影响临床表现,特别是疾病的发病年龄(AO)。
    结论:在这项研究中,我们表明双等位基因SCARB2致病变异可能导致一系列与AMRF相关的共同和独特特征。在这些特征中,常见特征包括肌阵挛症(100%),共济失调(96%),强直阵挛性癫痫发作(82%),构音障碍(68%),震颤(65%),肾损害(62%),不常见的特征涉及PNP(17%),听力损失(6.8%),和认知障碍(13.7%)。已发现AO在p.G462DfsX34致病变体的携带者中明显更高。SCARB2致病变异不仅与AMRF有关,而且与帕金森病(PD)和戈谢病(GD)的发病机制有关。提示遗传和功能研究在临床和诊断环境中的重要性。鉴于SCARB2基因在AMRF发病机制中的作用,PD和GD具有广泛的临床症状,调查可能的修饰符,如前颗粒蛋白和HSP7,具有很大的重要性。
    BACKGROUND: Biallelic pathogenic variants in the SCARB2 gene have been associated with action myoclonus-renal failure (AMRF) syndrome. Even though SCARB2 associated phenotype has been reported to include typical neurological characteristics, depending on the localization and the feature of the pathogenic variants, clinical course and the presentations have been shown to differ.
    METHODS: Whole exome sequencing (WES) analysis revealed a homozygous truncating variant (p.N45MfsX88) in SCARB2 gene in the index case, and subsequent sanger sequencing analysis validated the variant in all affected family members from a Turkish family with the clinical characteristics associated with AMRF and related disorders. Intrafamilial clinical heterogeneity with common features including dysarthria, tremor and proteinuria, and distinct features such as peripheral neuropathy (PNP), myoclonus and seizures between the affected cases, was observed in the family. In-depth literature review enabled the detailed investigation of the reported variants associated with AMRF and suggested that while the type of the variant did not have a major impact on the course of the clinical characteristics, only the C terminal localization of the pathogenic variant significantly affected the clinical presentation, particularly the age at onset (AO) of the disease.
    CONCLUSIONS: In this study we showed that biallelic SCARB2 pathogenic variants might cause a spectrum of common and distinct features associated with AMRF. Of those features while the common features include myoclonus (100%), ataxia (96%), tonic clonic seizures (82%), dysarthria (68%), tremor (65%), and renal impairment (62%), the uncommon features involve PNP (17%), hearing loss (6.8%), and cognitive impairment (13.7%). AO has been found to be significantly higher in the carriers of the p.G462DfsX34 pathogenic variant. SCARB2 pathogenic variants have not been only implicated in AMRF but also in the pathogenesis of Parkinson\'s disease (PD) and Gaucher disease (GD), suggesting the importance of genetic and functional studies in the clinical and the diagnostic settings. Given the proven role of SCARB2 gene in the pathogenesis of AMRF, PD and GD with a wide spectrum of clinical symptoms, investigation of the possible modifiers, such as progranulin and HSP7, has a great importance.
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  • 文章类型: Journal Article
    Duchenne muscular dystrophy (DMD) is associated with progressive muscle weakness, loss of ambulation (LOA), and early mortality. In this review we have synthesized published data on the clinical course of DMD by genotype. Using a systematic search implemented in Medline and Embase, 53 articles were identified that describe the clinical course of DMD, with pathogenic variants categorizable by exon skip or stop-codon readthrough amenability and outcomes presented by age. Outcomes described included those related to ambulatory, cardiac, pulmonary, or cognitive function. Estimates of the mean (95% confidence interval) age at LOA ranged from 9.1 (8.7-9.6) years among 90 patients amenable to skipping exon 53 to 11.5 (9.5-13.5) years among three patients amenable to skipping exon 8. Although function worsened with age, the impact of genotype was less clear for other outcomes (eg, forced vital capacity and left ventricular ejection fraction). Understanding the distribution of pathogenic variants is important for studies in DMD, as this research suggests major differences in the natural history of disease. In addition, specific details of the use of key medications, including corticosteroids, antisense oligonucleotides, and cardiac medications, should be reported.
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  • 文章类型: Case Reports
    BACKGROUND: Large intracranial dissecting aneurysm (IDA) in the anterior cerebral circulation is rare in children. There has been no consensus on the diagnosis and treatment for IDA in children.
    METHODS: We report a 3-year-old boy with a large ruptured IDA in the right middle cerebral artery (16 mm × 14 mm). The IDA was successfully managed with clipping and angioplasty. Next-generation sequencing of the blood sample followed by bioinformatics analysis suggested that the rs78977446 variant of the ADAMTS13 gene is a risk for pediatric IDA. Three years after surgery, the boy was develop-mentally normal.
    CONCLUSIONS: Clipping and angioplasty are effective treatments for ruptured IDA in the anterior cerebral circulation. ADAMTS13 rs78977446 is a risk factor for pediatric IDA.
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