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Biallelic variation in the choline and ethanolamine transporter FLVCR1 underlies a severe developmental disorder spectrum. 胆碱和乙醇胺转运体FLVCR1的双叶变异是严重发育障碍谱系的基础。
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-19 DOI: 10.1016/j.gim.2024.101273
Daniel G Calame, Jovi Huixin Wong, Puravi Panda, Dat Tuan Nguyen, Nancy C P Leong, Riccardo Sangermano, Sohil G Patankar, Mohamed S Abdel-Hamid, Lama AlAbdi, Sylvia Safwat, Kyle P Flannery, Zain Dardas, Jawid M Fatih, Chaya Murali, Varun Kannan, Timothy E Lotze, Isabella Herman, Farah Ammouri, Brianna Rezich, Stephanie Efthymiou, Shahryar Alavi, David Murphy, Zahra Firoozfar, Mahya Ebrahimi Nasab, Amir Bahreini, Majid Ghasemi, Nourelhoda A Haridy, Hamid Reza Goldouzi, Fatemeh Eghbal, Ehsan Ghayoor Karimiani, Amber Begtrup, Houda Elloumi, Varunvenkat M Srinivasan, Vykuntaraju K Gowda, Haowei Du, Shalini N Jhangiani, Zeynep Coban-Akdemir, Dana Marafi, Lance Rodan, Sedat Isikay, Jill A Rosenfeld, Subhadra Ramanathan, Michael Staton, Kerby C Oberg, Robin D Clark, Catharina Wenman, Sam Loughlin, Ramy Saad, Tazeen Ashraf, Alison Male, Shereen Tadros, Reza Boostani, Ghada M H Abdel-Salam, Maha Zaki, Ali Mardi, Farzad Hashemi-Gorji, Ebtesam Abdalla, M Chiara Manzini, Davut Pehlivan, Jennifer E Posey, Richard A Gibbs, Henry Houlden, Fowzan S Alkuraya, Kinga Bujakowska, Reza Maroofian, James R Lupski, Long N Nguyen

Purpose: FLVCR1 encodes a solute carrier protein implicated in heme, choline, and ethanolamine transport. Although Flvcr1-/- mice exhibit skeletal malformations and defective erythropoiesis reminiscent of Diamond-Blackfan anemia (DBA), biallelic FLVCR1 variants in humans have previously only been linked to childhood or adult-onset ataxia, sensory neuropathy, and retinitis pigmentosa.

Methods: We identified individuals with undiagnosed neurodevelopmental disorders and biallelic FLVCR1 variants through international data sharing and characterized the functional consequences of their FLVCR1 variants.

Results: We ascertained 30 patients from 23 unrelated families with biallelic FLVCR1 variants and characterized a novel FLVCR1-related phenotype: severe developmental disorders with profound developmental delay, microcephaly (z-score -2.5 to -10.5), brain malformations, epilepsy, spasticity, and premature death. Brain malformations ranged from mild brain volume reduction to hydranencephaly. Severely affected patients share traits, including macrocytic anemia and skeletal malformations, with Flvcr1-/- mice and DBA. FLVCR1 variants significantly reduce choline and ethanolamine transport and/or disrupt mRNA splicing.

Conclusion: These data demonstrate a broad FLVCR1-related phenotypic spectrum ranging from severe multiorgan developmental disorders resembling DBA to adult-onset neurodegeneration. Our study expands our understanding of Mendelian choline and ethanolamine disorders and illustrates the importance of anticipating a wide phenotypic spectrum for known disease genes and incorporating model organism data into genome analysis to maximize genetic testing yield.

目的FLVCR1 编码一种溶质载体(SLC)蛋白,参与血红素、胆碱和乙醇胺的转运。Flvcr1-/-小鼠表现出骨骼畸形和红细胞生成缺陷,让人联想到钻石-贝克范贫血症(DBA),而人类的双侧FLVCR1变体以前只与儿童或成人发病的共济失调、感觉神经病变和视网膜色素变性有关:方法:我们通过国际数据共享发现了未确诊的神经发育障碍患者和双叶FLVCR1变异体,并描述了其FLVCR1变异体的功能性后果:我们确定了来自 23 个非亲缘关系家庭的 30 名 FLVCR1 双拷贝变异体患者,并描述了一种新型 FLVCR1 相关表型:严重发育障碍,包括深度发育迟缓、小头畸形(Z 值 -2.5 至 -10.5)、脑畸形、癫痫、痉挛和早逝。脑畸形的范围从轻度脑容量减少到脑积水。严重患者与Flvcr1-/-小鼠和DBA具有相同的特征,包括巨幼红细胞性贫血和骨骼畸形。FLVCR1变体会明显降低胆碱和乙醇胺的转运和/或破坏mRNA的剪接:这些数据显示了与 FLVCR1 相关的广泛表型谱,从类似 DBA 的严重多器官发育障碍到成年后发病的神经变性。我们的研究拓展了我们对孟德尔胆碱和乙醇胺疾病的理解,并说明了预测已知疾病基因的广泛表型谱以及将模式生物数据纳入基因组分析以最大限度提高基因测试收益的重要性。
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引用次数: 0
Utilization of a SNP microarray to detect uniparental disomy: Implications and outcomes 利用 SNP 微阵列检测单亲畸形:影响和结果。
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-19 DOI: 10.1016/j.gim.2024.101275

Purpose

To examine the utility of single-nucleotide polymorphisms (SNP) microarray analysis to detect uniparental disomy (UPD) by utilizing trios and duos (for which only 1 parent is available).

Methods

We established Mendelian Inheritance Error (MIE) values associated with either UPD or biparental inheritance in a cohort of 124 patients. In duos, the percentage of proband heterozygous (AB) SNPs contributed from the parent submitted was also used to detect UPD.

Results

Examination of 25 trios revealed UPD with a MIE = 0.02 +/− 0.02 and a range of 0.01 to 0.23 for the contributing parent and a MIE = 8.76 +/− 1.68 with a range of 5.96 to 11.14 for the noncontributing parent. Detailed examination of 13 duos (involving 16 chromosomes) showed an AB% = 52.0% +/− 4.85% consistent with biparental origin of the chromosome of interest. In 6 duos (6 chromosomes), the AB% = 97.2% +/− 2.6% and a range of 92.9% to 99.4% were consistent with UPD.

Conclusion

Our results demonstrate utility of a SNP microarray to detect UPD. Distinct MIE ranges were observed that defined UPD or biparental inheritance. In duos, the AB% calculation effectively detected UPD. The diagnostic yield for UPD testing is significantly decreased when large regions of homozygosity are not detected by routine microarray analysis, which has implications for UPD test ordering practices.
目的:研究单核苷酸多态性 (SNP)研究单核苷酸多态性(SNP)微阵列分析在检测单亲裂殖症(UPD)方面的实用性,方法是利用三联体和二联体(只有父母一方可用):我们在一组 124 名患者中确定了与 UPD 或双亲遗传相关的孟德尔遗传错误 (MIE) 值。在双亲遗传中,提交的父母所贡献的概率性杂合(AB)SNPs 的百分比也用于检测 UPD:结果:对 25 例三联病例进行检查后发现,有贡献的父或母的 UPD MIE = 0.02 +/- 0.02,范围为 0.01 - 0.23;无贡献的父或母的 UPD MIE = 8.76 +/- 1.68,范围为 5.96 - 11.14。对 13 个双生子(涉及 16 条染色体)的详细检查显示,AB% = 52.0% +/-4.85% 与相关染色体的双亲来源一致。6对(6条染色体)的AB% = 97.2% +/- 2.6%和92.9% - 99.4%的范围与UPD一致:我们的研究结果证明了 SNP 微阵列检测 UPD 的实用性。我们观察到了不同的 MIE 范围,这些范围确定了 UPD 或双亲遗传。在双亲中,AB%计算能有效检测出UPD。如果常规微阵列分析不能检测到大面积的同源性区域,那么UPD检测的诊断率就会明显下降,这对UPD检测的订购实践有一定的影响。
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引用次数: 0
The Australian Genomics Mitochondrial Flagship: A national program delivering mitochondrial diagnoses. 澳大利亚基因组学线粒体旗舰项目:提供线粒体诊断的国家计划。
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-19 DOI: 10.1016/j.gim.2024.101271
Rocio Rius, Alison G Compton, Naomi L Baker, Shanti Balasubramaniam, Stephanie Best, Kaustuv Bhattacharya, Kirsten Boggs, Tiffany Boughtwood, Jeffrey Braithwaite, Drago Bratkovic, Alessandra Bray, Marie-Jo Brion, Jo Burke, Sarah Casauria, Belinda Chong, David Coman, Shannon Cowie, Mark Cowley, Michelle G de Silva, Martin B Delatycki, Samantha Edwards, Carolyn Ellaway, Michael C Fahey, Keri Finlay, Janice Fletcher, Leah E Frajman, Ann E Frazier, Velimir Gayevskiy, Roula Ghaoui, Himanshu Goel, Ilias Goranitis, Matilda Haas, Daniella H Hock, Denise Howting, Matilda R Jackson, Maina P Kava, Madonna Kemp, Sarah King-Smith, Nicole J Lake, Phillipa J Lamont, Joy Lee, Janet C Long, Mandi MacShane, Evanthia O Madelli, Ellenore M Martin, Justine E Marum, Tessa Mattiske, Jim McGill, Alejandro Metke, Sean Murray, Julie Panetta, Liza K Phillips, Michael C J Quinn, Michael T Ryan, Sarah Schenscher, Cas Simons, Nicholas Smith, David A Stroud, Michel C Tchan, Melanie Tom, Mathew Wallis, Tyson L Ware, AnneMarie E Welch, Christine Wools, You Wu, John Christodoulou, David R Thorburn

Purpose: Families living with mitochondrial diseases (MD) often endure prolonged diagnostic journeys and invasive testing, yet many remain without a molecular diagnosis. The Australian Genomics Mitochondrial Flagship, comprising clinicians, diagnostic, and research scientists, conducted a prospective national study to identify the diagnostic utility of singleton genomic sequencing using blood samples.

Methods: A total of 140 children and adults living with suspected MD were recruited using modified Nijmegen criteria (MNC) and randomized to either exome + mitochondrial DNA (mtDNA) sequencing or genome sequencing.

Results: Diagnostic yield was 55% (n = 77) with variants in nuclear (n = 37) and mtDNA (n = 18) MD genes, as well as phenocopy genes (n = 22). A nuclear gene etiology was identified in 77% of diagnoses, irrespective of disease onset. Diagnostic rates were higher in pediatric-onset (71%) than adult-onset (31%) cases and comparable in children with non-European (78%) vs European (67%) ancestry. For children, higher MNC scores correlated with increased diagnostic yield and fewer diagnoses in phenocopy genes. Additionally, 3 adult patients had a mtDNA deletion discovered in skeletal muscle that was not initially identified in blood.

Conclusion: Genomic sequencing from blood can simplify the diagnostic pathway for individuals living with suspected MD, especially those with childhood onset diseases and high MNC scores.

目的:患有线粒体疾病(MD)的家庭往往要经历漫长的诊断过程和侵入性检测,但许多家庭仍无法获得分子诊断。由临床医生、诊断和研究科学家组成的澳大利亚基因组学线粒体旗舰组织开展了一项前瞻性全国研究,以确定使用血液样本进行单胎基因组测序的诊断效用。方法:根据修改后的奈梅亨标准(MNC)招募了140名疑似线粒体病的儿童和成人,并随机进行外显子组+mtDNA测序(ES+mtDNAseq)或基因组测序(GS):诊断率为 55%(n=77),变异涉及核基因(n=37)和 mtDNA(n=18)MD 基因以及表型基因(n=22)。77%的诊断结果确定了核基因病因,与发病时间无关。儿科发病病例的诊断率(71%)高于成人发病病例(31%),非欧洲血统儿童的诊断率(78%)与欧洲血统儿童的诊断率(67%)相当。对于儿童来说,MNC 分数越高,诊断率越高,表型基因的诊断率越低。此外,有三名成年患者在骨骼肌中发现了mtDNA缺失,而这一缺失最初并未在血液中发现:结论:血液基因组测序可简化疑似 MD 患者的诊断途径,尤其是那些儿童期发病且 MNC 得分较高的患者。
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引用次数: 0
Evaluation of Bayesian point-based system on the variant classification of hereditary cancer predisposition genes 对基于贝叶斯点的遗传性癌症易感基因变异分类系统的评估
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-18 DOI: 10.1016/j.gim.2024.101276

Purpose

To assess the differences in variant classifications using the American College of Medical Genetics and Genomics and the Association for Molecular Pathology 2015 guidelines and the Bayesian point-based classification system (here referred to as the point system) in 115 hereditary cancer predisposition genes and explore variant sub-tiering by the point system.

Methods

Germline variant classifications for 721 pediatric patients from an in-house panel were retrospectively evaluated using the 2 scoring systems.

Results

A total of 2376 unique variants were identified, with ∼23.5% exhibiting discordant classifications. Unique variants classified by the point system demonstrated a lower rate of variants of uncertain significance (VUS; ∼15%) compared with American College of Medical Genetics and Genomics and the Association for Molecular Pathology 2015 guidelines (∼36%). This change is attributed to unique variants with 1 benign supporting evidence (∼12%) or 1 benign strong evidence (∼4%) being classified as likely benign by the point system. Additionally, variants with conflicting/modified evidence (∼5% of 2376) are also resolved by the point system. Sub-tiering unique variants classified by the point system as VUS (n = 354) indicates ∼77.4% were VUS-Low (0-1 points), whereas the remaining ∼22.6% were VUS-Mid (2-3 points) and VUS-High (4-5 points).

Conclusion

The point system reduces the VUS rate and facilitates their sub-tiering. Future large-scale studies are warranted to explore the impact of the point system on improving VUS reporting and/or VUS clinical management.
目的:评估在115个遗传性癌症易感基因中使用ACMG/AMP 2015指南和贝叶斯点式分类系统(以下简称点式系统)进行变异分类的差异,并探讨点式系统对变异的分层:结果:共鉴定出2376个独特变异,其中23.5%的变异分类不一致。与 ACMG/AMP 2015(∼36%)相比,按评分系统分类的独特变异中,意义不确定变异(VUS;∼15%)的比例较低。这一变化归因于具有一个良性支持证据(∼12%)或一个良性强证据(∼4%)的独特变异被积分系统归类为可能良性。此外,具有冲突/修改证据的变异体(2376 个变异体中的 5%)也可通过计分制解决。对积分系统归类为VUS的独特变异体(n=354)进行细分,结果显示77.4%的变异体为VUS-低(0-1分),其余22.6%的变异体为VUS-中(2-3分)和VUS-高(4-5分):结论:积分制降低了 VUS 的发生率,有利于对其进行分层。结论:积分系统降低了 VUS 的发生率,并有助于对其进行分级。今后有必要开展大规模研究,探讨积分系统对改善 VUS 报告和/或 VUS 临床管理的影响。
{"title":"Evaluation of Bayesian point-based system on the variant classification of hereditary cancer predisposition genes","authors":"","doi":"10.1016/j.gim.2024.101276","DOIUrl":"10.1016/j.gim.2024.101276","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the differences in variant classifications using the American College of Medical Genetics and Genomics and the Association for Molecular Pathology 2015 guidelines and the Bayesian point-based classification system (here referred to as the point system) in 115 hereditary cancer predisposition genes and explore variant sub-tiering by the point system.</div></div><div><h3>Methods</h3><div>Germline variant classifications for 721 pediatric patients from an in-house panel were retrospectively evaluated using the 2 scoring systems.</div></div><div><h3>Results</h3><div>A total of 2376 unique variants were identified, with ∼23.5% exhibiting discordant classifications. Unique variants classified by the point system demonstrated a lower rate of variants of uncertain significance (VUS; ∼15%) compared with American College of Medical Genetics and Genomics and the Association for Molecular Pathology 2015 guidelines (∼36%). This change is attributed to unique variants with 1 benign supporting evidence (∼12%) or 1 benign strong evidence (∼4%) being classified as likely benign by the point system. Additionally, variants with conflicting/modified evidence (∼5% of 2376) are also resolved by the point system. Sub-tiering unique variants classified by the point system as VUS (<em>n</em> = 354) indicates ∼77.4% were VUS-Low (0-1 points), whereas the remaining ∼22.6% were VUS-Mid (2-3 points) and VUS-High (4-5 points).</div></div><div><h3>Conclusion</h3><div>The point system reduces the VUS rate and facilitates their sub-tiering. Future large-scale studies are warranted to explore the impact of the point system on improving VUS reporting and/or VUS clinical management.</div></div>","PeriodicalId":12717,"journal":{"name":"Genetics in Medicine","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Persistent growth-promoting effects of vosoritide in children with achondroplasia are accompanied by improvements in physical and social aspects of health-related quality of life 沃索利肽对软骨发育不全儿童具有持续的生长促进作用,同时还能改善与健康相关的生活质量的身体和社会方面。
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-18 DOI: 10.1016/j.gim.2024.101274

Purpose

: Evaluate the impact of vosoritide on health-related quality of life in children with achondroplasia.

Methods

Participants received vosoritide (15 μg/kg/day) in an extension trial (NCT03424018) after having participated in a placebo-controlled trial (NCT03197766).

Results

The population comprised 119 participants (mean [SD] age 9.7 [2.6] years). Mean treatment duration was 4 (0.78) years. At year 3, the largest mean (SD) changes were observed in the Quality of Life of Short Stature Youth physical score (5.99 [19.41], caregiver reported; 6.32 [20.15], self-reported) and social score (2.85 [8.29] and 6.76 [22.64], respectively). Changes were greatest in participants with ≥1 SD increase in height z-score (physical: 11.36 [19.51], caregiver-reported [n = 38]; 8.48 [21.83], self-reported [n = 28]) (social: 5.84 [15.45] and 9.79 [22.80], respectively). To determine how domain scores may change with age in untreated persons, models were produced using observational/untreated-person data. A 1-year increase in age was associated with a change of 0.16 (SE, 0.55) and 0.16 (0.50), for caregiver-reported physical and social domain scores, respectively. Self-reported scores changed by 1.45 (0.71) and 1.92 (0.77), respectively.

Conclusion

These data suggest that after 3 years of treatment, vosoritide demonstrates a positive effect on physical and social functioning among children with achondroplasia, particularly in children with a more pronounced change in height z-score.
目的:评估伏索利特对软骨发育不全儿童健康相关生活质量的影响:参与者在参加安慰剂对照试验(NCT03197766)后,在一项扩展试验(NCT03424018)中接受伏索利特(15 μg/kg/天):共有 119 名参与者(平均 [SD] 年龄为 9.7 [2.6] 岁)。平均治疗时间为 4 (0.78) 年。第 3 年时,QoLISSY 体力评分(5.99 [19.41],护理人员报告;6.32 [20.15],自我报告)和社交评分(分别为 2.85 [8.29] 和 6.76 (22.64))的平均(标清)变化最大。身高 Z 值增长≥1 SD 的参与者的变化最大(体能:11.36 [19.51],护理人员报告[n=38];8.48 [21.83],自我报告[n=28])(社交:分别为 5.84 [15.45] 和 9.79 [22.80])。为了确定未接受治疗者的领域得分会如何随年龄变化,我们使用观察/未接受治疗者的数据制作了模型。年龄每增加 1 岁,护理人员报告的身体和社交领域得分分别会发生 0.16 (SE, 0.55) 和 0.16 (0.50) 的变化。自我报告的分数分别变化了 1.45 (0.71) 和 1.92 (0.77):这些数据表明,经过3年的治疗,沃索利肽对软骨发育不全儿童的身体和社会功能有积极影响,尤其是对身高Z-score变化更明显的儿童。
{"title":"Persistent growth-promoting effects of vosoritide in children with achondroplasia are accompanied by improvements in physical and social aspects of health-related quality of life","authors":"","doi":"10.1016/j.gim.2024.101274","DOIUrl":"10.1016/j.gim.2024.101274","url":null,"abstract":"<div><h3>Purpose</h3><div>: Evaluate the impact of vosoritide on health-related quality of life in children with achondroplasia.</div></div><div><h3>Methods</h3><div>Participants received vosoritide (15 μg/kg/day) in an extension trial (NCT03424018) after having participated in a placebo-controlled trial (NCT03197766).</div></div><div><h3>Results</h3><div>The population comprised 119 participants (mean [SD] age 9.7 [2.6] years). Mean treatment duration was 4 (0.78) years. At year 3, the largest mean (SD) changes were observed in the Quality of Life of Short Stature Youth physical score (5.99 [19.41], caregiver reported; 6.32 [20.15], self-reported) and social score (2.85 [8.29] and 6.76 [22.64], respectively). Changes were greatest in participants with ≥1 SD increase in height <em>z</em>-score (physical: 11.36 [19.51], caregiver-reported [<em>n</em> = 38]; 8.48 [21.83], self-reported [<em>n</em> = 28]) (social: 5.84 [15.45] and 9.79 [22.80], respectively). To determine how domain scores may change with age in untreated persons, models were produced using observational/untreated-person data. A 1-year increase in age was associated with a change of 0.16 (SE, 0.55) and 0.16 (0.50), for caregiver-reported physical and social domain scores, respectively. Self-reported scores changed by 1.45 (0.71) and 1.92 (0.77), respectively.</div></div><div><h3>Conclusion</h3><div>These data suggest that after 3 years of treatment, vosoritide demonstrates a positive effect on physical and social functioning among children with achondroplasia, particularly in children with a more pronounced change in height <em>z</em>-score.</div></div>","PeriodicalId":12717,"journal":{"name":"Genetics in Medicine","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Genomic Counseling Model for Population-Based Sequencing: A Pre-Post Intervention Study 基于人口的测序基因组咨询模式:事后干预研究
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-17 DOI: 10.1016/j.gim.2024.101272

Purpose

Novel uses of genome sequencing (GS) present an opportunity for return of results to healthy individuals, prompting the need for scalable genetic counseling strategies. We evaluate the effectiveness of a genomic counseling model (GCM) and explore preferences for GS findings in the general population.

Methods

Participants (N = 466) completed GS and our GCM (digital genomics platform and group-based webinar) and indicated results preferences. Surveys were administered before (T0) and after (T1) GCM. Change in knowledge and decisional conflict (DC) were evaluated using paired-sample T and Wilcoxon tests. Factors influencing knowledge and results preferences were evaluated using linear and logistic regression models.

Results

Participants were 56% female, 58% white, and 53% ≥40 years of age. Mean knowledge scores increased (Limitations: 3.73 to 5.63; Benefits: 4.34 to 5.48, P < .0001), and DC decreased (−21.9, P < .0001) at T1 versus T0. Eighty-six percent of participants wished to learn all GS findings at T1 vs 78% at T0 (P < .0001). Older age, negative/mixed attitudes toward genetics and greater DC were associated with change in preferences after intervention.

Conclusion

In a population-based cohort undergoing GS interested in learning GS findings, our GCM increased knowledge and reduced DC, illustrating the GCM’s potential effectiveness for GS counseling in the general population.
背景:基因组测序(GS)的新用途为将测序结果返还给健康个体提供了机会,促使人们需要可扩展的遗传咨询策略。我们评估了基因组咨询模型(GCM)的有效性,并探讨了普通人群对 GS 结果的偏好:方法:参与者(N=466)完成了 GS 和我们的 GCM(数字基因组学平台和基于小组的网络研讨会),并表明了对结果的偏好。调查在 GCM 前(T0)和后(T1)进行。使用配对样本 T 检验和 Wilcoxon 检验评估了知识和决策冲突 (DC) 的变化。使用线性和逻辑回归模型评估了影响知识和结果偏好的因素:结果:56%的参与者为女性,58%为白人,53%年龄≥40岁。平均知识得分有所提高(局限性:3.73 至 5.63 分;不确定性:3.73 至 5.63 分):限制:3.73 分至 5.63 分;益处:3.73 分至 5.48 分:P结论:在对学习 GS 研究结果感兴趣的接受 GS 的人群中,我们的 GCM 增加了知识,减少了 DC,说明了 GCM 在普通人群中进行 GS 咨询的潜在有效性。
{"title":"A Genomic Counseling Model for Population-Based Sequencing: A Pre-Post Intervention Study","authors":"","doi":"10.1016/j.gim.2024.101272","DOIUrl":"10.1016/j.gim.2024.101272","url":null,"abstract":"<div><h3>Purpose</h3><div>Novel uses of genome sequencing (GS) present an opportunity for return of results to healthy individuals, prompting the need for scalable genetic counseling strategies. We evaluate the effectiveness of a genomic counseling model (GCM) and explore preferences for GS findings in the general population.</div></div><div><h3>Methods</h3><div>Participants (<em>N</em> = 466) completed GS and our GCM (digital genomics platform and group-based webinar) and indicated results preferences. Surveys were administered before (T0) and after (T1) GCM. Change in knowledge and decisional conflict (DC) were evaluated using paired-sample T and Wilcoxon tests. Factors influencing knowledge and results preferences were evaluated using linear and logistic regression models.</div></div><div><h3>Results</h3><div>Participants were 56% female, 58% white, and 53% ≥40 years of age. Mean knowledge scores increased (Limitations: 3.73 to 5.63; Benefits: 4.34 to 5.48, <em>P</em> &lt; .0001), and DC decreased (−21.9, <em>P</em> &lt; .0001) at T1 versus T0. Eighty-six percent of participants wished to learn all GS findings at T1 vs 78% at T0 (<em>P</em> &lt; .0001). Older age, negative/mixed attitudes toward genetics and greater DC were associated with change in preferences after intervention.</div></div><div><h3>Conclusion</h3><div>In a population-based cohort undergoing GS interested in learning GS findings, our GCM increased knowledge and reduced DC, illustrating the GCM’s potential effectiveness for GS counseling in the general population.</div></div>","PeriodicalId":12717,"journal":{"name":"Genetics in Medicine","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mapping the genetic landscape of treatable inherited metabolic disorders in a large Middle Eastern biobank 在一个大型中东生物库中绘制可治疗的遗传性代谢紊乱的基因图谱。
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-14 DOI: 10.1016/j.gim.2024.101268

Purpose

To date, approximately 1400 inherited metabolic disorders (IMDs) have been described, some of which are treatable. It is estimated that 2% to 3% of live births worldwide are affected by treatable IMDs. Roughly 80% of IMDs are autosomal recessive, leading to a potentially higher incidence in regions with high consanguinity.

Methodology

The study utilized genome sequencing data from 14,060 adult Qatari participants who were recruited by the Qatar Biobank and sequenced by the Qatar Genome Program. The genome sequencing data were analyzed for 125 nuclear genes known to be associated with 115 treatable IMDs.

Results

Our study identified 253 pathogenic/likely pathogenic single-nucleotide variations associated with 69 treatable IMDs, including 211 known and 42 novel predicted loss-of-function variants. We estimated that approximately 1 in 13 unrelated individuals (8%) carry a heterozygous pathogenic variant for at least 1 of 46 treatable IMDs. Notably, phenylketonuria/hyperphenylalaninemia and homocystinuria had among the highest carrier frequencies (1 in 68 and 1 in 85, respectively).

Conclusion

Population-based studies of treatable IMDs, particularly in globally under-studied populations, can identify high-frequency alleles segregating in the community and inform public health policies, including carrier and newborn screening.
背景迄今为止,已描述了约 1400 种遗传代谢病(IMD),其中一些是可以治疗的。据估计,全球有 2%-3% 的活产婴儿患有可治疗的遗传代谢病。约 80% 的 IMD 为常染色体隐性遗传,因此在近亲结婚率较高的地区发病率可能更高。 研究利用了来自 14,060 名卡塔尔成年参与者的基因组测序(GS)数据,这些参与者由卡塔尔生物库(QBB)招募,并由卡塔尔基因组计划(QGP)进行测序。结果我们的研究发现了 253 个致病/可能致病的 SNVs,它们与 69 种可治疗的 IMDs 有关,其中包括 211 个已知变异和 42 个新的预测功能缺失变异。我们估计,在 46 种可治疗的 IMDs 中,每 13 个无关个体中就有 1 个(8%)携带至少一种杂合致病变体。值得注意的是,苯丙酮尿症/高苯丙氨酸血症和高胱氨酸尿症的携带者频率最高(分别为 68 分之 1 和 85 分之 1)。结论对可治疗的 IMDs 进行基于人群的研究,尤其是在全球研究不足的人群中进行研究,可以确定社区中的高频等位基因分离,并为公共卫生政策提供信息,包括携带者和新生儿筛查。
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引用次数: 0
Ethical, legal, and social issues related to genetics and genomics in cancer: A scoping review and narrative synthesis 与癌症遗传学和基因组学有关的伦理、法律和社会问题:范围综述和叙述性综述。
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-13 DOI: 10.1016/j.gim.2024.101270
Genomics is increasingly being incorporated into models of care for cancer. Understanding the ethical, legal, and social issues (ELSI) in this domain is important for successful and equitable implementation. We aimed to identify ELSI scholarship specific to cancer control and genomics. To do this, we undertook a scoping literature review and narrative synthesis, identifying 46 articles that met inclusion criteria. Eighteen ELSI themes were developed, including (1) equity of access, which included structural barriers to testing and research, access to preventive and follow-up care, and engagement with health systems; (2) family considerations, such as an ethical obligation to disseminate relevant genomic information to at-risk family members; (3) legal considerations, including privacy and confidentiality, genetic discrimination, and the prospective duty to reclassify variants; and (4) optimizing consent processes in clinical care and research. Gaps in the literature were identified with respect to equity for people living in rural or remote areas, and how to provide ethical care within culturally, linguistically, and ethnically diverse communities, including First Nations peoples. Our findings suggest a need for a multidisciplinary approach to examining ELSI in cancer genomics beyond initial test indication and within the broader context of the mainstreaming of genomics in health care.
基因组学正越来越多地被纳入癌症治疗模式。了解这一领域的伦理、法律和社会影响(ELSI)对于成功和公平地实施非常重要。我们的目标是确定专门针对癌症控制和基因组学的 ELSI 奖学金。为此,我们进行了范围界定文献综述和叙述性综述,确定了 46 篇符合纳入标准的文章。我们制定了 18 个 ELSI 主题,包括:(i) 公平获取,其中包括检测和研究的结构性障碍、预防和后续护理的获取以及与卫生系统的接触;(ii) 家庭因素,如向高风险家庭成员传播相关基因组信息的道德义务;(iii) 法律因素,包括隐私和保密、基因歧视以及重新分类变异的预期责任;以及 (iv) 优化临床护理和研究中的同意程序。在农村或偏远地区居民的公平性方面,以及如何在文化、语言和种族多样化的社区(包括原住民)中提供符合伦理的护理方面,我们发现了文献中的空白。我们的研究结果表明,有必要采用多学科方法来研究癌症基因组学中的ELSI,而不仅仅局限于最初的测试适应症,并将基因组学纳入医疗保健的主流。
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引用次数: 0
Clinical and genetic delineation of autosomal recessive and dominant ACTL6B-related developmental brain disorders. 常染色体隐性和显性 ACTL6B 相关脑发育疾病的临床和遗传学划分。
IF 8.8 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-10 DOI: 10.1016/j.gim.2024.101251
Elisa Cali,Tania Quirin,Clarissa Rocca,Stephanie Efthymiou,Antonella Riva,Dana Marafi,Maha S Zaki,Mohnish Suri,Roberto Dominguez,Hasnaa M Elbendary,Shahryar Alavi,Mohamed S Abdel-Hamid,Heba Morsy,Frederic Tran Mau-Them,Mathilde Nizon,Pavel Tesner,Lukáš Ryba,Faisal Zafar,Nuzhat Rana,Nebal W Saadi,Zahra Firoozfar,Pinar Gencpinar,Bulent Unay,Canan Ustun,Ange-Line Bruel,Christine Coubes,Jennifer Stefanich,Ozlem Sezer,Emanuele Agolini,Antonio Novelli,Gessica Vasco,Donatella Lettori,Mathieu Milh,Laurent Villard,Shimriet Zeidler,Henry Opperman,Vincent Strehlow,Mahmoud Y Issa,Hebatallah El Khassab,Prem Chand,Shahnaz Ibrahim,Ali Nejad-Rashidi,Mohammad Miryounesi,Pegah Larki,Jennifer Morrison,Ingrid Cristian,Isabelle Thiffault,Nicole L Bertsch,Grace J Noh,John Pappas,Ellen Moran,Nikolaos M Marinakis,Joanne Traeger-Synodinos,Susan Hosseini,Mohammad Reza Abbaszadegan,Roseline Caumes,Lisenka E L M Vissers,Maedeh Neshatdoust,Mostafa Zohour Montazer,Elmostafa El Fahime,Christin Canavati,Lara Kamal,Moien Kanaan,Omar Askander,Victoria Voinova,Olga Levchenko,Shahzhad Haider,Sara S Halbach,Elias Rayana Maia,Salehi Mansoor,Jain Vivek,Sanjukta Tawde,Viveka Santhosh R Challa,Vykuntaraju K Gowda,Varunvenkat M Srinivasan,Lucas Alves Victor,Benito Pinero-Banos,Jennifer Hague,Heba Ahmed Ei-Awady,Adelia Maria de Miranda Henriques-Souza,Huma Arshad Cheema,Muhammad Nadeem Anjum,Sara Idkaidak,Firas Alqarajeh,Osama Atawneh,Hagar Mor-Shaked,Tamar Harel,Giovanni Zifarelli,Peter Bauer,Fernando Kok,Joao Paulo Kitajima,Fabiola Monteiro,Juliana Josahkian,Gaetan Lesca,Nicolas Chatron,Dorothe Ville,David Murphy,Jeffrey L Neul,Sureni V Mullegama,Amber Begtrup,Isabella Herman,Tadahiro Mitani,Jennifer E Posey,Chee Geap Tay,Iram Javed,Lucinda Carr,Farah Kanani,Fiona Beecroft,Lee Hane,Elsayed Abdelkreem,Milan Macek,Luciana Bispo,Marwa Abd Elmaksoud,Farzad Hashemi-Gorji,Davut Pehlivan,David J Amor,Rami Abou Jamra,Wendy K Chung,Eshan Karimiani Ghayoor,Philippe Campeau,Fowzan S Alkuraya,Alistair T Pagnamenta,Joseph Gleeson,James R Lupski,Pasquale Striano,Andres Moreno-De-Luca,Denis L J Lafontaine,Henry Houlden,Reza Maroofian
PURPOSEThis study aims to comprehensively delineate the phenotypic spectrum of ACTL6B-related disorders, previously associated with both autosomal recessive and autosomal dominant neurodevelopmental disorders. Molecularly, the role of the nucleolar protein ACTL6B in contributing to the disease has remained unclear.METHODSWe identified 105 affected individuals, including 39 previously reported cases, and systematically analysed detailed clinical and genetic data for all individuals. Additionally, we conducted knockdown experiments in neuronal cells to investigate the role of ACTL6B in ribosome biogenesis.RESULTSBiallelic variants in ACTL6B are associated with severe-to-profound global developmental delay/intellectual disability (GDD/ID), infantile intractable seizures, absent speech, autistic features, dystonia, and increased lethality. De novo monoallelic variants result in moderate-to-severe GDD/ID, absent speech, and autistic features, while seizures and dystonia were less frequently observed. Dysmorphic facial features and brain abnormalities, including hypoplastic corpus callosum, parenchymal volume loss/atrophy, are common findings in both groups. We reveal that in the nucleolus, ACTL6B plays a crucial role in ribosome biogenesis, in particular in pre-rRNA processing.CONCLUSIONThis study provides a comprehensive characterization of the clinical spectrum of both autosomal recessive and dominant forms of ACTL6B-associated disorders. It offers a comparative analysis of their respective phenotypes provides a plausible molecular explanation and suggests their inclusion within the expanding category of 'ribosomopathies'.
目的本研究旨在全面描述 ACTL6B 相关疾病的表型谱,该疾病以前与常染色体隐性和常染色体显性神经发育障碍有关。在分子学上,核小体蛋白 ACTL6B 在该疾病中的作用仍不清楚。方法 我们确定了 105 例受影响的个体,其中包括 39 例先前报道的病例,并系统分析了所有个体的详细临床和遗传数据。此外,我们还在神经元细胞中进行了基因敲除实验,以研究 ACTL6B 在核糖体生物发生过程中的作用。结果ACTL6B 的单倍变异与严重至确诊的全球发育迟缓/智力障碍(GDD/ID)、婴儿期顽固性癫痫发作、失语、自闭症特征、肌张力障碍和致死率增高有关。新出现的单倍变异会导致中度至重度 GDD/ID、失语和自闭症特征,而癫痫发作和肌张力障碍则较少见。面部畸形和大脑异常,包括胼胝体发育不全、脑实质体积减小/萎缩,是两组患者的共同发现。我们发现,在核仁中,ACTL6B 在核糖体生物发生过程中,尤其是在前 RNA 处理过程中发挥着至关重要的作用。它对这两种疾病各自的表型进行了比较分析,提供了合理的分子解释,并建议将它们纳入不断扩大的 "核糖体病 "类别。
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引用次数: 0
RPL26 variants: A rare cause of Diamond-Blackfan anemia syndrome with multiple congenital anomalies at the forefront RPL26变体:菱形-黑方贫血综合征的罕见病因,多种先天性畸形并存。
IF 6.6 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2024-09-10 DOI: 10.1016/j.gim.2024.101266

Purpose

Diamond-Blackfan anemia syndrome (DBS) is a rare congenital disorder originally characterized by bone marrow failure with or without various congenital anomalies. At least 24 genes are implicated, the vast majority encoding for ribosomal proteins. RPL26 (ribosomal protein L26) is an emerging candidate (DBA11, MIM#614900). We aim to further delineate this rare condition.

Methods

Patients carrying heterozygous RPL26 variants were recruited. In one of them, erythroid proliferation and differentiation from peripheral blood CD34+ cells were studied by flow cytometry, and RPL26 expression by quantitative reverse transcription polymerase chain reaction and immunoblotting.

Results

We report on 8 affected patients from 4 families. Detailed phenotyping reveals that RPL26 is mainly associated with multiple congenital anomalies (particularly radial ray anomalies), albeit with variable expression. Mandibulofacial dysostosis and neural tube defects are potential features in DBA11, expanding the growing list of DBS abnormalities. In 1 individual, we showed that RPL26 haploinsufficiency was responsible for subclinical impairment in erythroid proliferation and enucleation. The absence of hematological involvement in 4 adults from this series contributes to the mounting evidence that bone marrow failure is not universally central to all DBS genes.

Conclusion

We confirm RPL26 as a DBS gene and expand the phenotypic spectrum of the gene and the disease.
目的:钻石-布莱克范贫血综合征(DBS)是一种罕见的先天性疾病,最初以骨髓衰竭为特征,伴有或不伴有各种先天性异常。至少有 24 个基因与此病有关,其中绝大多数为核糖体蛋白编码。RPL26(核糖体蛋白 L26)是一个新出现的候选基因(DBA11,MIM#614900)。方法招募了携带杂合子 RPL26 变体的患者。其中一人的外周血 CD34+ 细胞的红细胞增殖和分化情况通过流式细胞术进行了研究,RPL26 的表达情况通过 qRT-PCR 和免疫印迹法进行了研究。详细的表型分析表明,RPL26 主要与多种先天性畸形(尤其是桡骨射线畸形)有关,但其表达可变。下颌骨面部发育不良和神经管缺陷是 DBA11 的潜在特征,从而扩大了 DBS 异常的范围。在一个个体中,我们发现 RPL26 单倍体缺失是导致红细胞增殖和去核的亚临床损害的原因。我们证实 RPL26 是一种 DBS 基因,并扩大了该基因和该疾病的表型范围。
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引用次数: 0
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Genetics in Medicine
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