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Walsh C, Durst AL, Ortiz D, Miller RG, Alabek M. Genetic counselors' awareness and attitudes regarding gene therapies. J Genet Couns 2024. [PMID: 39039945 DOI: 10.1002/jgc4.1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024]
Abstract
There are 10 gene therapies (GTs) for hereditary conditions that are currently approved by the Food and Drug Administration (FDA). While prior research demonstrates that the majority of healthcare providers lack knowledge regarding GTs, this has not been explored within the genetic counseling profession. The authors hypothesize that the availability of GTs impacts the genetic counseling profession and that there is variable awareness on this topic among genetic counselors (GCs). We conducted a survey to assess GCs' familiarity with, comfort with, and frequency of discussing FDA-approved GTs at the time of the survey, as well as GCs' perceived impact of and educational experiences related to GT. The survey was distributed through listservs and word of mouth from January through March 2021. One hundred of the 109 responses met eligibility criteria. Respondents were more familiar with onasemnogene abeparvovec-xioi (ZOLGENSMA; Novartis Gene Therapies, Inc., Durham, NC, USA) than voretigene neparvovec-rzyl (LUXTURNA; Spark Therapeutics, Inc., Philadelphia, PA, USA; p < 0.001). Familiarity with, comfort with, and frequency of discussing both GTs varied by specialty but not by years of experience. Fifty-nine percent of respondents (58/98) reported that GTs impact their work, with differences by specialty but not by years of experience. The majority of respondents (93%; 90/97) felt that GCs should be comfortable discussing GTs with patients, and most respondents (83%; 79/95) were interested in additional GT training. Only 38% of respondents (36/95) recalled GT being included in their genetic counseling training program's curriculum, which may be skewed by recent growth of this field. Our results suggest that GCs feel that GTs impact their practice, have discrepant awareness and comfort in this area, and desire additional training on this topic. Further investigation into the actual impact and models for addressing training is warranted and will be critical as the number of approved GTs increases.
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Affiliation(s)
- Chelsey Walsh
- Department of Human Genetics, Graduate School of Public Health, Genetic Counseling Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Northwestern Medicine, Winfield, Illinois, USA
| | - Andrea L Durst
- Department of Human Genetics, Graduate School of Public Health, Genetic Counseling Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Damara Ortiz
- Department of Human Genetics, Graduate School of Public Health, Genetic Counseling Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rachel G Miller
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michelle Alabek
- Department of Human Genetics, Graduate School of Public Health, Genetic Counseling Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- UPMC Vision Institute, Pittsburgh, Pennsylvania, USA
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Sun H, Zheng J, Zhang Q, Ying F, Fu Y, Guan Y, Wu J, Zhou Y, Dong J, Xu M, Yang F, An N, Shi N, Zhang L, Zhu S, Liu J, Li M. Screening of Spinal Muscular Atrophy Carriers and Prenatal Diagnosis in Pregnant Women in Yancheng, China. Biochem Genet 2024:10.1007/s10528-024-10775-9. [PMID: 38581475 DOI: 10.1007/s10528-024-10775-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/06/2024] [Indexed: 04/08/2024]
Abstract
Spinal muscular atrophy (SMA) is a neuromuscular disorder with an autosomal recessive inheritance pattern. Patients with severe symptoms may suffer respiratory failure, leading to death. The homozygous deletion of exon 7 in the SMN1 gene accounts for nearly 95% of all cases. Population carrier screening for SMA and prenatal diagnosis by amniocentesis for high-risk couples can assist in identifying the risk of fetal disease. We provided the SMA carrier screening process to 55,447 pregnant women in Yancheng from October 2020 to December 2022. Among them, 8185 participated in this process, with a participation rate of around 14.76% (95% CI 14.47-15.06%). Quantitative real-time polymerase chain reaction (qPCR) was used to detect deletions of SMN1 exons 7 and 8 (E7, E8) in screened pregnant women. 127 were identified as carriers (111 cases of E7 and E8 heterozygous deletions, 15 cases of E7 heterozygous deletions, and 1 case of E7 heterozygous deletions and E8 homozygous deletions), resulting in a carrying rate of around 1.55% (95% CI 1.30-1.84%). After genetic counseling, 114 spouses of pregnant women who tested positive underwent SMA carrier screening; three of them were screened as SMA carriers. Multiplexed ligation-dependent probe amplification (MLPA) was used for the prenatal diagnosis of the fetuses of high-risk couples. Two of them exhibited two copies of SMN1 exon 7 (normal), and the pregnancy was continued; one exhibited no copies of SMN1 exon 7 and exon 8 (SMA patient), and the pregnancy was terminated. Analyzing SMN1 mutations in Yancheng and provide clinical evidence for SMA genetic counseling and birth defect prevention. Interventional prenatal diagnosis for high-risk families can promote informed reproductive selection and prepare for the fetus's early treatment.
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Affiliation(s)
- Huilin Sun
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Jianli Zheng
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Qing'e Zhang
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Feifei Ying
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Yadong Fu
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Yongjuan Guan
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Jing Wu
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Yueyun Zhou
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Jingjing Dong
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Mengjun Xu
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Fangfang Yang
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Ning An
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Ning Shi
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Lu Zhang
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Shu Zhu
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China
| | - Jianbing Liu
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China.
| | - Min Li
- The Affiliated Yancheng Maternity&Child Health Hospital of Yangzhou University Medical School, Yancheng, 224001, China.
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Lashgari NA, Roudsari NM, Shayan M, Eshraghi S, Momtaz S, Jamialahmadi T, Abdolghaffari AH, Sahebkar A. Spinal Muscular Atrophy Treatment: The MTOR Regulatory Intervention. Curr Med Chem 2024; 31:1512-1522. [PMID: 36788689 DOI: 10.2174/0929867330666230213114909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/29/2022] [Accepted: 12/29/2022] [Indexed: 02/16/2023]
Abstract
Spinal muscular atrophy (SMA) is a hereditary disorder affecting neurons and muscles, resulting in muscle weakness and atrophy. Most SMA cases are diagnosed during infancy or early childhood, the most common inherited cause of infant mortality without treatment. Still, SMA might appear at older ages with milder symptoms. SMA patients demonstrate progressive muscle waste, movement problems, tremors, dysphagia, bone and joint deformations, and breathing difficulties. The mammalian target of rapamycin (mTOR), the mechanistic target of rapamycin, is a member of the phosphatidylinositol 3-kinase-related kinase family of protein kinases encoded by the mTOR gene in humans. The mTOR phosphorylation, deregulation, and autophagy have shown dissimilarity amongst SMA cell types. Therefore, exploring the underlying molecular process in SMA therapy could provide novel insights and pave the way for finding new treatment options. This paper provides new insight into the possible modulatory effect of mTOR/ autophagy in SMA management.
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Affiliation(s)
- Naser-Aldin Lashgari
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nazanin Momeni Roudsari
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Shayan
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf Eshraghi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Saeideh Momtaz
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Tannaz Jamialahmadi
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hossein Abdolghaffari
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Medicine, The University of Western Australia, Perth, Australia
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Jensen A, Greisen G, Stensballe LG. Socioeconomic background affects mortality in Danish children with severe chronic disease. Acta Paediatr 2022; 111:2393-2399. [PMID: 36093628 PMCID: PMC9825841 DOI: 10.1111/apa.16540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 01/11/2023]
Abstract
AIM To assess the association between socioeconomic factors and mortality in Danish children diagnosed with different types of severe chronic disease, including cancer. METHODS National cohort study 1994-2020 including Danish children with chronic disease. Inclusion was based on diagnoses in The National Patient Register, socioeconomic information was obtained from Statistics Denmark and mortality was ascertained from the Cause of Death Register. Hazard ratios (HR) with 95% confidence intervals (CIs) were based on Cox regression. The factors were combined in one common risk score and the association with disease-specific mortality was analysed overall and by ethnicity status. RESULTS Overall, non-Danish ethnicity (HR = 1.96 (95% CI 1.69-2.28)) was associated with all-cause mortality in 128 129 children (69 435 male and 58 694 female) with chronic disease. Median age at first diagnosis was 1.42 years (range 0-18 years). Low family income was associated with mortality regardless of ethnicity status, and young maternal age was also a notable risk factor across ethnicities. The socioeconomic association was more pronounced in children with cancer. CONCLUSION In the high-income setting of Denmark, ethnicity and differences in socioeconomic background were associated with child mortality even among children with severe chronic disease. The pattern was more pronounced in paediatric cancer patients.
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Affiliation(s)
- Andreas Jensen
- Department of Paediatrics and Adolescent MedicineRigshospitalet, Copenhagen University HospitalCopenhagenDenmark
| | - Gorm Greisen
- Department of Intensive Care of Newborns and Small ChildrenRigshospitalet, Copenhagen University HospitalCopenhagenDenmark,Institute of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Lone Graff Stensballe
- Department of Paediatrics and Adolescent MedicineRigshospitalet, Copenhagen University HospitalCopenhagenDenmark
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