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International Clinical Evidence-based Guideline for Kleefstra Syndrome. Kleefstra综合征国际临床循证指南。
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-20 DOI: 10.1016/j.gim.2026.102070
Arianne Bouman, Charlotte M W Gaasterland, Carla Sloof-Enthoven, Tanja Zdolsek Draksler, Dmitrijs Rots, Joyce M Geelen, Lottie D Morison, Angela T Morgan, Dorota Wicher, Sabrina Rivero, Inés Fernández-Ulibarri, Julie Drake, Anne O'Donnell Luria, Laura Pickup, Carolyn Shalhoub, Donatella Milani, Raoul C Hennekam, Birute Tumiene, Kira A Dies, Livia Garavelli, Maria Francesca Bedeschi, Alberto Danieli, Lara V van Renssen, Elizabeth E Palmer, Isabelle Grosdemouge, Kinga Hadzsiev, Lilian Bomme Ousager, Zoë Frazier, Maya Chopra, Katalin Szakszon, Lisa Ewans, Siddharth Srivastava, Nicoletta Balbo, Ettore Caterino, Annette Schenck, Ryan Smith, F Nienke Boonstra, Sietske A L van Till, Sunil K Vasireddi, Hon-Yin Brian Chung, Mirthe J Klein Haneveld, Klea Vyshka, Tjitske Kleefstra

Kleefstra syndrome (KLEFS1) is a rare monogenic neurodevelopmental disorder (mNDD) with multisystem involvement, caused by disruption of EHMT1 function, resulting in significant burden on affected individuals and their families. The current shortage of and globally scattered syndrome-specific knowledge has led to significant disparities in the access to and provision of evidence-based and individual-centered expert care. To address the challenges and improve outcomes for individuals with KLEFS1, an international KLEFS1 guideline consortium was formed consisting of 43 participants, both clinical experts and patient-representatives, from 15 different countries. The primary goal of the consortium was to develop a comprehensive and high-quality guideline for KLEFS1, aiming to enhance patient care, establish a uniform minimum international standard of care, and support decision-making. The current clinical guideline is evidence-based and includes 66 tailored recommendations to improve KLEFS1 care. The comprehensive methodological approach ensures broad consensus and supports effective implementation. Furthermore, this guideline serves as a valuable methodological model for guideline development in the context of rare disorders.

Kleefstra综合征(KLEFS1)是一种罕见的单基因神经发育障碍(mNDD),涉及多系统,由EHMT1功能破坏引起,给患者及其家庭带来重大负担。目前缺乏和全球分散的综合征特异性知识导致在获得和提供循证和以个人为中心的专家护理方面存在重大差异。为了应对挑战并改善KLEFS1患者的预后,一个由来自15个不同国家的43名临床专家和患者代表组成的国际KLEFS1指南联盟成立了。该联盟的主要目标是为KLEFS1制定一个全面和高质量的指南,旨在加强患者护理,建立统一的最低国际护理标准,并支持决策。目前的临床指南是基于证据的,包括66项量身定制的建议,以改善KLEFS1的护理。全面的方法方法确保广泛的协商一致意见,并支持有效的执行。此外,本指南在罕见疾病的背景下为指南的制定提供了有价值的方法模型。
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引用次数: 0
Correspondence on "Deep phenotyping of 11 individuals with pathogenic variants in RNU4-2 Reveals a clinically recognizable syndrome" by Valenzuela et al. Valenzuela等人对“11例RNU4-2致病性变异个体的深度表型分析揭示了一种临床可识别的综合征”的对应。
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-19 DOI: 10.1016/j.gim.2026.101686
Zarnab Saleem, Jawairya Muhammad Hussain, Qurat-Ul-Ain Siddiqui, Sarah Zuberi
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引用次数: 0
Response to Saleem et al. 对Saleem等人的回应
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-19 DOI: 10.1016/j.gim.2026.101687
Irene Valenzuela, Marta Codina-Solà, Eduardo F Tizzano
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引用次数: 0
A comprehensive approach to evaluating the clinical utility of genome sequencing in rare disease: A large prospective Canadian cohort. 评估罕见疾病基因组测序临床应用的综合方法:一项大型加拿大前瞻性队列研究。
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-10 DOI: 10.1016/j.gim.2026.101684
Salma Shickh, Katharine Fooks, Viji Venkataramanan, Meryl Acker, Karen V MacDonald, Trevor A Seeger, Meredith Gillespie, Taila Hartley, Kym M Boycott, Francois Bernier, Deborah A Marshall, Robin Z Hayeems

Purpose: We characterized dimensions of clinical utility in a prospective, observational cohort of patients with rare diseases undergoing genome sequencing (GS).

Methods: Clinical utility data (diagnostic, clinical management, and research recommended, avoided, or pursued for index cases and relatives) were collected from medical records and summarized using descriptive statistics. A multivariable regression model characterized factors associated with each type of utility, reported as odds ratios with 95% confidence intervals.

Results: Among 715 cases who underwent GS, results triggered diagnostic investigations in 17.5%, clinical management activities in 35.8%, research opportunities in 30.8%, and genetic counseling/testing for relatives in 19.0%. Results also limited diagnostic investigations in 87.9%. Regression analyses identified clinical, geographic, and ethnicity-related factors as significantly associated with utility. Diagnostic/potentially diagnostic results increased odds of changes in diagnostic investigations, management, and genetic testing recommendations for relatives. Patients from larger sites had higher odds of management or research recommendations and patients of non-European ethnicity were less likely to pursue recommendations.

Conclusion: Our findings provide evidence that GS has clinical utility beyond diagnostic care, including management, research, as well as familial care and preventing unnecessary medical activity. To determine which factors are associated with utility, multiple dimensions of care and broad sociodemographic factors warrant consideration.

目的:我们对一组接受基因组测序(GS)的罕见病患者进行前瞻性观察性队列研究,以确定临床效用的维度。方法:从病历资料中收集临床效用资料(诊断、临床管理和研究推荐、避免、追求),并采用描述性统计方法进行汇总。多变量回归模型描述了与每种效用相关的因素,以95%置信区间的比值比报告。结果:在715例GS患者中,有17.5%的患者进行了诊断调查,35.8%的患者进行了临床管理活动,30.8%的患者进行了研究,19.0%的患者进行了亲属遗传咨询/检测。结果还限制了87.9%的诊断调查。回归分析确定临床、地理和种族相关因素与效用显著相关。诊断/潜在诊断结果增加了诊断调查、管理和对亲属的基因检测建议发生改变的几率。来自较大地区的患者接受治疗或研究建议的几率较高,非欧洲种族的患者不太可能接受建议。结论:我们的研究结果提供了证据,证明GS在诊断护理之外具有临床效用,包括管理、研究、家庭护理和预防不必要的医疗活动。为了确定哪些因素与效用有关,需要考虑多方面的护理和广泛的社会人口因素。
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引用次数: 0
Phenylalanine hydroxylase deficiency diagnosis and management: A 2023 evidence-based clinical guideline of the American College of Medical Genetics and Genomics (ACMG) 苯丙氨酸羟化酶缺乏症的诊断和治疗:美国医学遗传与基因组学学会(ACMG) 2023循证临床指南
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-01 Epub Date: 2026-01-06 DOI: 10.1016/j.gim.2025.101602
Wendy E. Smith, Susan A. Berry, Kaitlyn Bloom, Christine Brown, Barbara K. Burton, Olivia M. Demarest, Gabrielle P. Jenkins, Jennifer Malinowski, Kim L. McBride, H. Joel Mroczkowski, Curt Scharfe, Jerry Vockley, ACMG Board of Directors
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引用次数: 0
Correspondence on “What’s in a name? Issues to consider when naming Mendelian disorders” by Rasmussen et al 关于“名字有什么意义?”Rasmussen等人在命名孟德尔障碍时要考虑的问题。
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-01 Epub Date: 2026-01-06 DOI: 10.1016/j.gim.2025.101627
Joël Zlotogora
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引用次数: 0
Operationalizing the Wilson-Jungner principles for the genomics era: Consensus recommendations from the International Consortium on Newborn Sequencing 为基因组学时代实施威尔逊-荣纳原则:来自新生儿测序国际联盟的共识建议
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-01 Epub Date: 2025-10-24 DOI: 10.1016/j.gim.2025.101618
Lilian Downie , Julie Yeo , Thomas Minten , Rose Heald , Derek Ansel , Mei Baker , Jorune Balciuniene , Jonathan S. Berg , François Boemer , Wendy K. Chung , Heidi L. Cope , David J. Eckstein , Nicolas Encina , Laurence Faivre , Alessandra Ferlini , Judit García-Villoria , Michael H. Gelb , José Manuel González De Aledo-Castillo , Katie Golden-Grant , Richard B. Parad , Nina B. Gold

Purpose

For decades, the selection of disorders included in newborn screening (NBS) programs has been guided by principles published by Wilson and Jungner in 1968. As research explores the expansion of conditions included in NBS through genomic sequencing, there is a critical need for updated recommendations to address the opportunities and complexities of genomic data.

Methods

The International Consortium on Newborn Sequencing includes leaders from over 16 research projects investigating genomic NBS across the United Kingdom, Europe, United States, and Oceania. Consortium members were invited to participate in a modified Delphi study, aggregating opinion on the selection of conditions for genomic NBS through 3 rounds of online questionnaires, with feedback provided to participants between rounds.

Results

In round 1, 94 participants completed the questionnaire, and 10 of 43 statements reached consensus. In round 2, 81 participants completed the questionnaire, and 14 of 27 statements reached consensus. In round 3, 68 participants completed the questionnaire, and all 10 statements reached 72% or more consensus.

Conclusion

The 10 consensus recommendations developed in this study can guide future research and public health programs performing genomic NBS. This process also identified key areas of participant discordance, highlighting important topics for future research.
几十年来,新生儿筛查(NBS)项目中疾病的选择一直以Wilson和Jungner在1968年发表的原则为指导。随着研究探索通过基因组测序扩大NBS所包含的条件,迫切需要更新建议,以解决基因组数据的机会和复杂性。方法国际新生儿测序联盟包括来自英国、欧洲、美国和大洋洲超过16个研究项目的负责人。联盟成员被邀请参加一项改进的德尔菲研究,通过3轮在线问卷收集对基因组NBS条件选择的意见,并在两轮之间向参与者提供反馈。结果共194人完成问卷调查,43项意见中有10项意见一致。在第2轮中,81名参与者完成了问卷,27个陈述中有14个达成了共识。在第3轮,68名参与者完成了问卷调查,所有10项陈述都达到了72%或更多的共识。结论本研究提出的10项共识建议可指导未来开展基因组NBS的研究和公共卫生项目。该过程还确定了参与者不一致的关键领域,突出了未来研究的重要主题。
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引用次数: 0
A recurrent missense variant in the PPIB gene encoding peptidylprolyl isomerase B underlies adult-onset autosomal dominant optic atrophy 编码肽基脯氨酸异构酶B的PPIB基因的复发性错义变异是成人发病的常染色体显性视神经萎缩的基础。
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-01 Epub Date: 2025-10-01 DOI: 10.1016/j.gim.2025.101595
Katharina Valentin , Monika Kustermann , Mona R. Schneider , Haleh Aminfar , Kathrin Vollnhofer , Andreas Wedrich , Christoph Stapf , Martin Bertich , Markus Ritter , Theresa Mendrina , Daniel Valcanover , Walter Berger , Margret Eckhard , Andy Sombke , Stephanie V. Lilja , Amina Paquay , Bernhard Rosensteiner , Iris Schmidt , Reginald E. Bittner , Thomas P. Georgi , Wolfgang M. Schmidt

Purpose

Hereditary optic atrophy (OA) represents one of the leading causes of blindness. A relatively large number of genes, many of which are implicated in mitochondrial function, are known to be involved in OA. For many affected individuals, however, a genetic cause still cannot be identified.

Methods

In a large pedigree and additional families, exome sequencing was used to identify a genetic cause in individuals with so far genetically unresolved OA. Subsequently, mitochondrial function was studied in cultured dermal fibroblasts.

Results

Exome sequencing revealed a heterozygous missense variant in PPIB [NM_000942.5:c.538C>T p.(Arg180Trp)], encoding peptidylprolyl isomerase B, which segregated with clinically isolated OA in 19 individuals from 9 families. PPIB-associated OA involves an insidious reduction in visual acuity, central scotoma, and inner retinal layer thinning consistent with other autosomal dominant OAs. Age of symptom onset was mostly in adulthood (median: 36 years), and severity of clinical manifestation was variable. Patient-derived fibroblasts revealed altered mitochondrial morphology, as well as subtle respiratory chain defects.

Conclusion

The PPIB variant segregates with OA, which might be caused by compromised mitochondrial function. Although future studies are needed to study the exact pathomechanistic role of PPIB, insights from this work broaden the knowledge of genes implicated in autosomal dominant OA.
目的:遗传性视神经萎缩(OA)是致盲的主要原因之一。已知相对大量的基因,其中许多与线粒体功能有关,与OA有关。然而,对于许多受影响的个体来说,遗传原因仍然无法确定。方法:在大型家系和其他家庭中,外显子组测序(ES)用于确定迄今为止遗传上未解决的OA个体的遗传原因。随后,在培养的真皮成纤维细胞中研究线粒体功能。结果:ES在PPIB中发现一个杂合错义变异[NM_000942.5:c]。538C>T p.(Arg180Trp)],编码肽基脯氨酸异构酶B,在9个家族的19个个体中分离到临床分离的OA。ppib相关的OA与其他常染色体显性OA一致,包括视力下降、中心暗斑和视网膜内层变薄。症状发病年龄多在成年期(中位:36岁),临床表现严重程度各不相同。患者来源的成纤维细胞显示线粒体形态改变以及轻微的呼吸链缺陷。结论:PPIB变异与OA分离,可能由线粒体功能受损引起。虽然未来的研究需要研究PPIB的确切病理机制作用,但这项工作的见解拓宽了对常染色体显性OA相关基因的认识。
{"title":"A recurrent missense variant in the PPIB gene encoding peptidylprolyl isomerase B underlies adult-onset autosomal dominant optic atrophy","authors":"Katharina Valentin ,&nbsp;Monika Kustermann ,&nbsp;Mona R. Schneider ,&nbsp;Haleh Aminfar ,&nbsp;Kathrin Vollnhofer ,&nbsp;Andreas Wedrich ,&nbsp;Christoph Stapf ,&nbsp;Martin Bertich ,&nbsp;Markus Ritter ,&nbsp;Theresa Mendrina ,&nbsp;Daniel Valcanover ,&nbsp;Walter Berger ,&nbsp;Margret Eckhard ,&nbsp;Andy Sombke ,&nbsp;Stephanie V. Lilja ,&nbsp;Amina Paquay ,&nbsp;Bernhard Rosensteiner ,&nbsp;Iris Schmidt ,&nbsp;Reginald E. Bittner ,&nbsp;Thomas P. Georgi ,&nbsp;Wolfgang M. Schmidt","doi":"10.1016/j.gim.2025.101595","DOIUrl":"10.1016/j.gim.2025.101595","url":null,"abstract":"<div><h3>Purpose</h3><div>Hereditary optic atrophy (OA) represents one of the leading causes of blindness. A relatively large number of genes, many of which are implicated in mitochondrial function, are known to be involved in OA. For many affected individuals, however, a genetic cause still cannot be identified.</div></div><div><h3>Methods</h3><div>In a large pedigree and additional families, exome sequencing was used to identify a genetic cause in individuals with so far genetically unresolved OA. Subsequently, mitochondrial function was studied in cultured dermal fibroblasts.</div></div><div><h3>Results</h3><div>Exome sequencing revealed a heterozygous missense variant in <em>PPIB</em> [NM_000942.5:c.538C&gt;T p.(Arg180Trp)], encoding peptidylprolyl isomerase B, which segregated with clinically isolated OA in 19 individuals from 9 families. <em>PPIB</em>-associated OA involves an insidious reduction in visual acuity, central scotoma, and inner retinal layer thinning consistent with other autosomal dominant OAs. Age of symptom onset was mostly in adulthood (median: 36 years), and severity of clinical manifestation was variable. Patient-derived fibroblasts revealed altered mitochondrial morphology, as well as subtle respiratory chain defects.</div></div><div><h3>Conclusion</h3><div>The <em>PPIB</em> variant segregates with OA, which might be caused by compromised mitochondrial function. Although future studies are needed to study the exact pathomechanistic role of <em>PPIB</em>, insights from this work broaden the knowledge of genes implicated in autosomal dominant OA.</div></div>","PeriodicalId":12717,"journal":{"name":"Genetics in Medicine","volume":"28 1","pages":"Article 101595"},"PeriodicalIF":6.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225233","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
Response to Kane and Coleman 对凯恩和科尔曼的回应。
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-01 Epub Date: 2026-01-06 DOI: 10.1016/j.gim.2025.101616
Sanjana Basava , William B. Dobyns
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引用次数: 0
Response to Burgard et al 对Burgard等人的回应。
IF 6.2 1区 医学 Q1 GENETICS & HEREDITY Pub Date : 2026-01-01 Epub Date: 2026-01-06 DOI: 10.1016/j.gim.2025.101601
Wendy E. Smith , Barbara K. Burton , Christine Brown , Jennifer Malinowski , Kim L. McBride , Jerry Vockley
{"title":"Response to Burgard et al","authors":"Wendy E. Smith ,&nbsp;Barbara K. Burton ,&nbsp;Christine Brown ,&nbsp;Jennifer Malinowski ,&nbsp;Kim L. McBride ,&nbsp;Jerry Vockley","doi":"10.1016/j.gim.2025.101601","DOIUrl":"10.1016/j.gim.2025.101601","url":null,"abstract":"","PeriodicalId":12717,"journal":{"name":"Genetics in Medicine","volume":"28 1","pages":"Article 101601"},"PeriodicalIF":6.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933001","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
期刊
Genetics in Medicine
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