genetic screening

基因筛查
  • 文章类型: Case Reports
    先天性全身性脂肪营养不良2型(CGL2)是一种罕见的常染色体隐性遗传疾病,其特征是脂肪组织几乎完全缺失,导致各种代谢并发症。我们介绍了一名一岁男性从六个月大开始表现出进行性腹胀的情况。体格检查显示出独特的特征,包括三角相,超端粒,瘦弱的外观,没有口腔脂肪,和肝脾肿大.实验室调查显示转氨酶升高和血脂紊乱,而影像学检查证实肝脾肿大无全身异常。肝活检提示大泡性脂肪变性和即将发生的肝硬化。基因检测揭示了BSCL2基因的纯合致病变异(c.603C>T),确认CGL2。孩子正在接受定期随访,向父母提供遗传咨询。这个案例强调了早期识别的重要性,基因诊断,并定期监测管理这种罕见的情况。
    Congenital generalized lipodystrophy type 2 (CGL2) is a rare autosomal recessive disorder characterized by the near-total absence of adipose tissue, leading to various metabolic complications. We present the case of a one-year-old male who exhibited progressive abdominal distension from six months of age. Physical examination revealed distinctive features including triangular facies, hypertelorism, an emaciated appearance with absent buccal fat, and hepatosplenomegaly. Laboratory investigations showed elevated transaminases and a deranged lipid profile, while imaging confirmed hepatosplenomegaly without systemic anomalies. A liver biopsy indicated macrovesicular steatosis and impending cirrhosis. Genetic testing revealed a homozygous pathogenic variant in the BSCL2 gene (c.604C>T), confirming CGL2. The child is under regular follow-up, with genetic counseling provided to the parents. This case underscores the importance of early recognition, genetic diagnosis, and regular monitoring in managing this rare condition.
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  • 文章类型: Journal Article
    由拷贝数变异(CNVs)引起的基因组紊乱在肾病患者中很普遍;然而,他们对病因不明(uKF)的慢性肾衰竭(KF)的贡献尚不清楚。我们筛选了50岁或以下的uKF患者,以确定致病性CNV的患病率。
    我们招募了KF发病年龄≤50年的患者,以初步审查病历,排除明确临床或组织病理学肾脏诊断的患者或已经确定的遗传性肾脏疾病患者。接下来,我们进行了基于单核苷酸多态性(SNP)阵列的CNV筛查.对所有检测到的CNV进行系统分类,并评估患者肾脏疾病的可能原因。另外使用全基因组测序在540个基因中筛选具有不能解释肾脏表型的CNV的患者的因果变异。
    我们招募了172名患者,其中123人接受了SNP阵列。在12名患者(9.8%)中鉴定出对应于已知基因组疾病的致病性CNV。确定的基因组疾病为三名患者提供了致病性肾脏诊断,所有这些人在18岁时都达到了KF。其余9例患者的CNV与肾脏疾病因果关系不明确。随后,全基因组测序在另外四名患者中提供了致病基因诊断,包括与检测到的CNV无关的两个诊断序列变体。
    基因组疾病在uKF队列中很普遍,在123例患者中,有5例被鉴定为致病性CNV。需要结合CNV和序列变体分析的进一步研究来阐明基因组疾病在肾脏疾病中的因果作用。
    UNASSIGNED: Genomic disorders caused by copy number variations (CNVs) are prevalent in patients with kidney disease; however, their contribution to chronic kidney failure (KF) of undetermined aetiology (uKF) is unclear. We screened patients with uKF aged 50 years or younger to establish the prevalence of causative CNVs.
    UNASSIGNED: We enrolled patients with an onset of KF ≤50 years from suspected undetermined aetiology for initial review of medical records to exclude patients with clear-cut clinical or histopathological kidney diagnoses or patients with already established genetic kidney diseases. Next, we performed single nucleotide polymorphism (SNP) array-based CNV screening. All the detected CNVs were systematically classified and evaluated as possible causes of the patient\'s kidney disease. Patients with CNVs not explaining the kidney phenotype were additionally screened for causal variants in 540 genes using whole-genome sequencing.
    UNASSIGNED: We enrolled 172 patients, of whom 123 underwent SNP-array. Pathogenic CNVs corresponding to known genomic disorders were identified in 12 patients (9.8%). The identified genomic disorders provided a causative kidney diagnosis in three patients, all of whom had reached KF by age 18 years. The remaining nine patients had CNVs with unclear kidney disease causality. Subsequently, whole-genome sequencing provided a causative genetic diagnosis in an additional four patients, including two diagnostic sequence variants unrelated to the detected CNVs.
    UNASSIGNED: Genomic disorders were prevalent in this cohort with uKF, and causative CNVs were identified in 5 of 123 patients. Further studies combining the analysis of CNVs and sequence variants are needed to clarify the causal role of genomic disorders in kidney disease.
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  • 文章类型: Case Reports
    心律失常性心肌病(ACM)是一种与心室组织的纤维脂肪组织置换相关的遗传性心肌病。该疾病可引起心室功能障碍和心律失常,并可增加心源性猝死的风险。这种心肌病可以有不同的临床表现,尤其是在儿童和年轻的成年人群。在这份报告中,我们描述了一名18岁女性心肌炎的病例作为ACM的初始表现。她因室性心律失常而出现心脏骤停。抵达后,心肌水肿和延迟钆增强出现在心脏磁共振成像,没有观察到心室变化,使诊断与心肌炎一致。基因检测显示desmoplakin基因中的致病性突变与ACM一致。鉴于该患者疾病的非常规初始表现,早期考虑基因检测可能有助于年轻患者ACM的早期诊断和治疗.
    Arrhythmogenic cardiomyopathy (ACM) is an inherited cardiomyopathy associated with fibrofatty tissue replacement of the ventricular tissue. The disease can cause ventricular dysfunction and arrhythmias and can increase the risk of sudden cardiac death. This cardiomyopathy can have variable clinical presentations, especially in the pediatric and young adult populations. In this report, we describe the case of an 18-year-old female with myocarditis as the initial presentation of ACM. She presented following a resuscitated cardiac arrest due to ventricular arrhythmia. On arrival, myocardial edema and delayed gadolinium enhancement were present on cardiac magnetic resonance imaging, with no ventricular changes observed, making the diagnosis consistent with myocarditis. Genetic testing revealed a pathogenic mutation in the desmoplakin gene consistent with ACM. Given the unconventional initial presentation of this patient\'s disease, early consideration of genetic testing may be beneficial to aid in the early diagnosis and management of ACM in young patients.
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  • 文章类型: Journal Article
    细菌参与感染期间和宿主相关微生物群体之间的许多相互作用。肠沙门氏菌是一种非常重要的食源性病原体,也是研究微生物群落内相互作用的模型生物。在这项研究中,我们发现,当与乳杆菌共培养时,鼠伤寒沙门氏菌对阿奇霉素具有耐受性。同样,酸化介质,例如,从乳酸菌培养物的无细胞上清液中,还诱导了鼠伤寒沙门氏菌对阿奇霉素的耐受性。添加膜破坏剂恢复了酸化培养基中对阿奇霉素的正常敏感性,但不是在有乳酸杆菌的时候.这些结果表明,培养基的酸化导致了包膜稳态的改变,但是,在存在乳杆菌的情况下,不同的机制促进了对阿奇霉素的耐受性。为了进一步了解乳杆菌菌株如何改变鼠伤寒沙门氏菌对阿奇霉素的敏感性,使用鼠伤寒沙门氏菌(1)与鼠李糖乳杆菌共培养和(2)无菌酸性条件(仅pH5.5培养基)的单基因缺失集合进行高通量测定.不出所料,两次筛选都确定了与包膜稳态和膜通透性有关的基因。我们的结果还表明,鼠伤寒沙门氏菌代谢的变化会诱导在鼠李糖乳杆菌存在下观察到的耐受性。因此,我们的结果强调了乳杆菌诱导鼠伤寒沙门氏菌对阿奇霉素耐受的两种不同机制。重要意义本研究为感染过程中细菌与宿主相关微生物群落之间的复杂相互作用提供了有价值的见解。具体来说,它揭示了乳杆菌在诱导肠道沙门氏菌伤寒中的抗生素耐受性中的重要作用,一种重要的食源性病原体和微生物群落研究的模型生物。研究结果不仅揭示了这种抗生素耐受性的潜在机制,而且揭示了两个不同的途径,通过这些途径,乳杆菌菌株可能会影响沙门氏菌对抗生素的反应。了解这些机制有可能增强我们对细菌感染的认识,并可能对制定对抗病原体抗生素耐药性的策略产生影响。比如沙门氏菌。此外,我们的结果强调了探索抗生素直接抗菌作用之外的必要性,强调更广泛的微生物群落背景。
    Bacteria are involved in numerous interactions during infection and among host-associated microbial populations. Salmonella enterica serovar Typhimurium is a foodborne pathogen of great importance as well as a model organism to study interactions within a microbial community. In this study, we found that S. Typhimurium becomes tolerant to azithromycin when co-cultured with lactobacilli strains. Similarly, acidified media, from cell-free supernatant of lactobacilli cultures for instance, also induced the tolerance of S. Typhimurium to azithromycin. The addition of membrane disruptors restored the normal sensitivity to azithromycin in acidified media, but not when lactobacilli were present. These results suggested that the acidification of the media led to modification in envelope homeostasis, but that a different mechanism promoted the tolerance to azithromycin in the presence of lactobacilli strains. To further understand how lactobacilli strains modify the sensitivity of S. Typhimurium to azithromycin, a high-throughput assay was performed using the single-gene deletion collection of the S. Typhimurium (1) in co-culture with Lacticaseibacillus rhamnosus and (2) in sterile acidic conditions (pH 5.5 media only). As expected, both screens identified genes involved in envelope homeostasis and membrane permeability. Our results also suggest that changes in the metabolism of S. Typhimurium induce the tolerance observed in the presence of L. rhamnosus. Our results thus highlight two different mechanisms by which lactobacilli induce the tolerance of S. Typhimurium to azithromycin.IMPORTANCEThis study provides valuable insights into the intricate interactions between bacteria during infections and within host-associated microbial communities. Specifically, it sheds light on the significant role of lactobacilli in inducing antibiotic tolerance in Salmonella enterica serovar Typhimurium, a critical foodborne pathogen and model organism for microbial community studies. The findings not only uncover the mechanisms underlying this antibiotic tolerance but also reveal two distinct pathways through which strains of lactobacilli might influence Salmonella\'s response to antibiotics. Understanding these mechanisms has the potential to enhance our knowledge of bacterial infections and may have implications for the development of strategies to combat antibiotic resistance in pathogens, such as Salmonella. Furthermore, our results underscore the necessity to explore beyond the direct antimicrobial effects of antibiotics, emphasizing the broader microbial community context.
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  • 文章类型: Journal Article
    新生儿筛查(NBS)是一项公共卫生措施,用于在出生后的第一天内识别患有可治疗疾病的儿童,允许进行症状前治疗。它是全球许多国家最成功的二级医疗预防措施,也是公共卫生计划的一部分。在NBS中应用第二层策略允许增加的特异性和连续更高的阳性预测值。第二层策略可以包括针对目标病症的特定生物标志物的分析或可以基于分子遗传分析。提高国家统计局的质量,例如,通过第二层策略,对于保持家庭对NBS的高度接受度至关重要-特别是随着越来越多的目标疾病被连续纳入NBS计划。
    Newborn screening (NBS) is a public health measure to identify children with treatable disorders within the first days of life allowing presymptomatic treatment. It is the most successful measure of secondary medical prevention and part of public health programs in many countries worldwide. Application of second-tier strategies in NBS allows for increased specificity and consecutively a higher positive predictive value. Second-tier strategies can include analysis of specific biomarkers for a target disorder or may be based on molecular genetic analyses. Improving the quality of NBS, for example by second-tier strategies, is of utmost importance to maintain the high acceptance of NBS by families - especially as an increasing number of target disorders is being consecutively included into NBS programs.
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  • 文章类型: Journal Article
    肝癌,主要是肝细胞癌,随着发病率上升和治疗选择有限,仍然是全球健康挑战。遗传因素在肝癌的发生发展中起着关键作用。这篇最先进的论文对肝癌遗传筛查策略的现状进行了全面的回顾。我们讨论肝癌的遗传基础,强调与风险相关的遗传变异的关键作用,体细胞突变,和表观遗传改变。我们还探讨了环境因素和遗传学之间复杂的相互作用,强调基因筛查如何通过使用液体活检来帮助风险分层和早期检测,以及高通量测序技术的进步。综合最新的研究成果,我们的目标是全面概述最先进的肝癌基因筛查方法,揭示了它们彻底改变早期检测的潜力,风险评估,和有针对性的治疗来对抗这种毁灭性的疾病。
    Liver cancer, primarily hepatocellular carcinoma, remains a global health challenge with rising incidence and limited therapeutic options. Genetic factors play a pivotal role in the development and progression of liver cancer. This state-of-the-art paper provides a comprehensive review of the current landscape of genetic screening strategies for liver cancer. We discuss the genetic underpinnings of liver cancer, emphasizing the critical role of risk-associated genetic variants, somatic mutations, and epigenetic alterations. We also explore the intricate interplay between environmental factors and genetics, highlighting how genetic screening can aid in risk stratification and early detection via using liquid biopsy, and advancements in high-throughput sequencing technologies. By synthesizing the latest research findings, we aim to provide a comprehensive overview of the state-of-the-art genetic screening methods for liver cancer, shedding light on their potential to revolutionize early detection, risk assessment, and targeted therapies in the fight against this devastating disease.
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  • 文章类型: Journal Article
    在许多国家,向全部或部分人口提供某种形式的遗传筛查,要么以组织良好的筛选程序的形式,要么以不太形式化的方式。筛查可以在生命的不同阶段提供,比如先入为主,产前,新生儿和以后的生活。只有在利大于弊的情况下,才应提供筛查。检测和治疗的技术创新正在推动产前和新生儿筛查领域的变化,许多司法管辖区都组织了基于人群的筛查计划。因此,计划中添加了更多数量和更广泛的条件,这可以使夫妇的生殖自主性(孕前和产前筛查)受益,并改善早期诊断,以防止儿童(新生儿筛查)和成人(癌症和级联筛查)的不可逆转的健康损害。虽然筛查的许多发展都是技术驱动的,公民也可能表达对筛选创新的需求,与非侵入性产前检测一样。相对新出现的基因筛查问题,特别是如果使用DNA测序进行测试,与组织有关,数据存储和解释,利害比和分配正义,信息提供和后续行动,所有这些都与当前医疗保健系统的可接受性有关。
    In many countries, some form of genetic screening is offered to all or part of the population, either in the form of well-organized screening programs or in a less formalized way. Screening can be offered at different phases of life, such as preconception, prenatal, neonatal and later in life. Screening should only be offered if the advantages outweigh the disadvantages. Technical innovations in testing and treatment are driving changes in the field of prenatal and neonatal screening, where many jurisdictions have organized population-based screening programs. As a result, a greater number and wider range of conditions are being added to the programs, which can benefit couples\' reproductive autonomy (preconception and prenatal screening) and improve early diagnosis to prevent irreversible health damage in children (neonatal screening) and in adults (cancer and cascade screening). While many developments in screening are technology-driven, citizens may also express a demand for innovation in screening, as was the case with non-invasive prenatal testing. Relatively new emerging issues for genetic screening, especially if testing is performed using DNA sequencing, relate to organization, data storage and interpretation, benefit-harm ratio and distributive justice, information provision and follow-up, all connected to acceptability in current healthcare systems.
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  • 文章类型: Journal Article
    植入前基因检测(PGT)已成为辅助生殖技术(ART)不可或缺的组成部分,在体外受精(IVF)期间,为夫妇提供在植入胚胎之前筛查遗传异常的机会。这篇全面的综述探讨了PGT在IVF中的进展和应用,涵盖其各种类型,技术发展,临床应用,功效,挑战,监管方面,和未来的方向。PGT技术的发展,包括下一代测序(NGS)和比较基因组杂交(CGH),大大提高了胚胎基因检测的准确性和可靠性。PGT通过提高IVF成功率对ART的未来具有深远的意义,减少遗传性疾病的发病率,减轻与怀孕失败和遗传疾病相关的情感和经济负担。对临床医生的建议,研究人员,政策制定者包括保持最新的PGT技术和指南,探索创新技术,建立明确的监管框架,并促进合作,以最大限度地提高PGT在辅助生殖中的潜在利益。总的来说,这篇综述为PGT的现状及其对生殖医学领域的影响提供了有价值的见解。
    Preimplantation genetic testing (PGT) has become an integral component of assisted reproductive technology (ART), offering couples the opportunity to screen embryos for genetic abnormalities before implantation during in vitro fertilization (IVF). This comprehensive review explores the advancements and applications of PGT in IVF, covering its various types, technological developments, clinical applications, efficacy, challenges, regulatory aspects, and future directions. The evolution of PGT techniques, including next-generation sequencing (NGS) and comparative genomic hybridization (CGH), has significantly enhanced the accuracy and reliability of genetic testing in embryos. PGT holds profound implications for the future of ART by improving IVF success rates, reducing the incidence of genetic disorders, and mitigating the emotional and financial burdens associated with failed pregnancies and genetic diseases. Recommendations for clinicians, researchers, and policymakers include staying updated on the latest PGT techniques and guidelines, exploring innovative technologies, establishing clear regulatory frameworks, and fostering collaboration to maximize the potential benefits of PGT in assisted reproduction. Overall, this review provides valuable insights into the current state of PGT and its implications for the field of reproductive medicine.
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  • 文章类型: Journal Article
    单倍体细胞是一种只有一组染色体的细胞。与传统的二倍体细胞相比,单倍体细胞在基因筛选和药物靶向治疗方面具有独特的优势,由于它们的表型等于基因型。胚胎干细胞是一种具有很强分化潜能的细胞,在体外特定条件下可以分化为各种类型的细胞。因此,单倍体胚胎干细胞同时具有单倍体细胞和胚胎干细胞的特性,这使得它们在许多方面都有显著的优势,如生殖发育机制研究,遗传筛选,和药物靶向治疗。因此,建立单倍体胚胎干细胞系具有重要意义。本文综述了单倍体胚胎干细胞的研究进展,并简要讨论了单倍体胚胎干细胞的应用。
    Haploid cells are a kind of cells with only one set of chromosomes. Compared with traditional diploid cells, haploid cells have unique advantages in gene screening and drug-targeted therapy, due to their phenotype being equal to the genotype. Embryonic stem cells are a kind of cells with strong differentiation potential that can differentiate into various types of cells under specific conditions in vitro. Therefore, haploid embryonic stem cells have the characteristics of both haploid cells and embryonic stem cells, which makes them have significant advantages in many aspects, such as reproductive developmental mechanism research, genetic screening, and drug-targeted therapy. Consequently, establishing haploid embryonic stem cell lines is of great significance. This paper reviews the progress of haploid embryonic stem cell research and briefly discusses the applications of haploid embryonic stem cells.
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  • 文章类型: Journal Article
    罕见疾病(RD)是一个术语,用于描述许多,在地理上不同的异质性疾病。全球约有4亿人生活在RD中,相当于大约十分之一的人。71.9%的RD具有遗传起源。RD对罕见疾病患者(PLWRD)提出了一系列独特的挑战,他们的家人,医疗保健专业人员(HCP),医疗保健系统,和整个社会。遗传遗传疾病的可能性对受影响的家庭产生重大的社会和心理影响。除了其他问题,PLWRD及其家人可能会感到污名化,经历内疚,感到责备,以及将疾病传给后代的压力。污名会影响PLWRD及其家人旅程的所有阶段,从诊断前到治疗准入,关心和支持,和合规。它不利地影响RD患者的生活质量。为了更好地探索与RD基因检测相关的污名的影响,我们在PubMed和Embase数据库上进行了文献检索,以确定2013年1月至2023年2月发表的关于污名和RD的文章.缺乏研究污名和RD基因测试动态的文献。作者观察到,在低收入和中等收入国家(LMICs)和潜在干预措施中,污名对患者预后的影响的研究是有限的。在这里,作者对已发表的关于污名的文献进行了综述,重点是RD基因检测,相关的挑战,以及解决这些问题的可能方法。
    Rare disease (RD) is a term used to describe numerous, heterogeneous diseases that are geographically disparate. Approximately 400 million people worldwide live with an RD equating to roughly 1 in 10 people, with 71.9% of RDs having a genetic origin. RDs present a distinctive set of challenges to people living with rare diseases (PLWRDs), their families, healthcare professionals (HCPs), healthcare system, and societies at large. The possibility of inheriting a genetic disease has a substantial social and psychological impact on affected families. In addition to other concerns, PLWRDs and their families may feel stigmatized, experience guilt, feel blamed, and stress about passing the disease to future generations. Stigma can affect all stages of the journey of PLWRDs and their families, from pre-diagnosis to treatment access, care and support, and compliance. It adversely impacts the quality of life of RD patients. To better explore the impact of stigma associated with genetic testing for RDs, we conducted a literature search on PubMed and Embase databases to identify articles published on stigma and RDs from January 2013 to February 2023. There is a dearth of literature investigating the dynamics of stigma and RD genetic testing. The authors observed that the research into the implications of stigma for patient outcomes in low- and middle-income countries (LMICs) and potential interventions is limited. Herein, the authors present a review of published literature on stigma with a focus on RD genetic testing, the associated challenges, and possible ways to address these.
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