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Bonati MT, Feresin A, Prontera P, Michieletto P, Gambacorta V, Ricci G, Orzan E. Contiguous Gene Syndromes and Hearing Loss: A Clinical Report of Xq21 Deletion and Comprehensive Literature Review. Genes (Basel) 2024; 15:677. [PMID: 38927613 PMCID: PMC11202778 DOI: 10.3390/genes15060677] [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: 04/29/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Given the crucial role of the personalized management and treatment of hearing loss (HL), etiological investigations are performed early on, and genetic analysis significantly contributes to the determination of most syndromic and nonsyndromic HL cases. Knowing hundreds of syndromic associations with HL, little comprehensive data about HL in genomic disorders due to microdeletion or microduplications of contiguous genes is available. Together with the description of a new patient with a novel 3.7 Mb deletion of the Xq21 critical locus, we propose an unreported literature review about clinical findings in patients and their family members with Xq21 deletion syndrome. We finally propose a comprehensive review of HL in contiguous gene syndromes in order to confirm the role of cytogenomic microarray analysis to investigate the etiology of unexplained HL.
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Affiliation(s)
- Maria Teresa Bonati
- Institute for Maternal and Child Health—Institute for Maternal and Child Health “Burlo Garofolo”, 34137 Trieste, Italy; (P.M.); (E.O.)
| | - Agnese Feresin
- Independent Researcher, 33059 Fiumicello Villa Vicentina, Italy
| | - Paolo Prontera
- Medical Genetics Unit, S. Maria della Misericordia Hospital, 06129 Perugia, Italy;
| | - Paola Michieletto
- Institute for Maternal and Child Health—Institute for Maternal and Child Health “Burlo Garofolo”, 34137 Trieste, Italy; (P.M.); (E.O.)
| | - Valeria Gambacorta
- Department of Medicine and Surgery, Section of Otorhinolaryngology, University of Perugia, 06129 Perugia, Italy; (V.G.)
| | - Giampietro Ricci
- Department of Medicine and Surgery, Section of Otorhinolaryngology, University of Perugia, 06129 Perugia, Italy; (V.G.)
| | - Eva Orzan
- Institute for Maternal and Child Health—Institute for Maternal and Child Health “Burlo Garofolo”, 34137 Trieste, Italy; (P.M.); (E.O.)
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2
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Kaufman R, Timmermans S, Raz A. Genomic uncertainty and genetic counsellors' professional authority. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:485-502. [PMID: 36424363 DOI: 10.1111/1467-9566.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Genomic tests regularly produce Variants of Uncertain Significance (VUS), mutations of which currently little is known but may turn out to be disease-causing. The communication of such variants in the United States is typically delegated to genetic counsellors. Based on in-depth interviews, we examined this communication as an indicator of the genetic counsellor's professional status: did they take a subordinate position by reporting out the results as provided by laboratories or did they assert professional authority by interpreting and possibly reducing the uncertainty of VUS results? We found that genetic counsellors put their professional spin on VUS results and they prepared patients for the full range of possible interpretations by normalising the existence of VUS results; intervened in the ecology of testing laboratories to stack the deck in favour of the expected results; and conducted their own research to reclassify a VUS. They marshalled organisational, technical, scientific and communication expertise to ease the sting of uncertainty but were ultimately limited by their role in the counselling encounter rather than in the basic research or laboratory community. We concluded that genetic counsellors use uncertainty to assert professional authority that interpreted genetic test results in light of the patient's symptoms and risk profile and uncertainty tolerance.
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Affiliation(s)
- Rebecca Kaufman
- Department of Sociology, University of California, Los Angeles, California, USA
| | - Stefan Timmermans
- Department of Sociology, University of California, Los Angeles, California, USA
| | - Aviad Raz
- Department of Sociology, Ben Gurion University, Beer-Sheva, Israel
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3
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Floriani MA, Santos AS, Diniz BL, Glaeser AB, Gazzola Zen PR, Machado Rosa RF. 22q11 Copy Number Variations in a Brazilian Cohort of Children with Congenital Heart Disorders. Mol Syndromol 2023; 14:1-10. [PMID: 36777701 PMCID: PMC9911999 DOI: 10.1159/000525247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/19/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Congenital heart disease (CHD) is the most common type of congenital defect reported to be one of the leading causes of mortality in the first year of life. Microdeletion and microduplication syndromes (MMS) are associated with cardiac malformations. Understanding which genetic factors are involved in these conditions directly impacts treatment decisions. We aimed to identify the occurrence of genetic alterations and their association with MMS in CHD pediatric patients evaluated in a reference service of Southern Brazil. Methods Participants were recruited during 2010 in the intensive care unit of a pediatric hospital. MMs and regions of chromosome 22 were screened by SALSA MLPA Probemix P245 Microdeletion Syndromes-1A kit for detection of copy number variations (CNVs). Results MMS were detected in 11 from 207 patients (5.3%). Heterozygous deletion in the 22q11.2 chromosome region was the most prevalent CNV (5 from 11 patients). Also, atypical RTDR1 deletion and 22q11.2 duplication were detected. MLPA was able to reveal microdeletions in SNRPN and NF1 genes in patients with a normal karyotype and FISH. Conclusion Our study reports the prevalence and variability of genomic alterations associated with MMS in CHD pediatric patients. The results by MLPA are of great help in planning and specialized care.
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Affiliation(s)
- Maiara A. Floriani
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | | | - Bruna L. Diniz
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Andressa B. Glaeser
- Graduate Program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Paulo R. Gazzola Zen
- Department of Internal Medicine, Clinical Genetics, UFCSPA, Porto Alegre, Brazil,Irmandade da Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil
| | - Rafael F. Machado Rosa
- Department of Internal Medicine, Clinical Genetics, UFCSPA, Porto Alegre, Brazil,Irmandade da Santa Casa de Misericórdia de Porto Alegre (ISCMPA), Porto Alegre, Brazil,*Rafael Fabiano Machado Rosa,
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Qiao J, Yuan J, Hu W, Li Q, Fang H, Xu Y, Dai Y. Combined diagnosis of QF-PCR and CNV-Seq in fetal chromosomal abnormalities: A new perspective on prenatal diagnosis. J Clin Lab Anal 2022; 36:e24311. [PMID: 35195919 PMCID: PMC8993611 DOI: 10.1002/jcla.24311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/18/2022] [Accepted: 02/16/2022] [Indexed: 11/06/2022] Open
Abstract
Objective This study aimed to evaluate the effect of QF‐PCR and CNV‐seq in diagnosing prenatal fetal chromosomal aberrations, explore the advantages and necessity of multimethod joint diagnosis. Methods We chose pregnant women with the indication of fetal chromosome examination in our hospital last year, collected 657 cases of amniotic fluid for QF‐PCR and CNV‐seq analyzes. Results While detecting aneuploidy, the coincidence rate of QF‐PCR and CNV‐seq was 100% (56/56). For all 46 chromosomes, 523 cases (79.60%, 523/657) coincided precisely, 128 cases (19.48%, 128/657) showed abnormality with CNV‐seq, 8 cases (1.22%, 8/657) revealed abnormality by QF‐PCR. In serological Down's syndrome screening, 328 cases showed a high risk of trisomy 21, of which CNV‐seq and QF‐PCR were consistent in 4 cases (1.22%, 4/328), CNV‐seq found 87 cases of CNVs in 78 samples except for chromosomal aneuploidy abnormalities, among these, 18 cases (20.69%, 18/87) were polymorphic, 7 cases (8.05%, 7/87) might cause disease, 13 cases (14.94%, 13/87) caused disease explicitly, 21 cases (24.14%, 21/87) were possibly benign, 17 cases (19.54%, 17/87) were explicitly benign, and the classification of 11 cases (12.64%, 11/87) was unclear. Conclusion QF‐PCR and CNV‐seq were highly consistent in diagnosing chromosomal aneuploidy. The high risk of serological Down's screening might not only due to the aneuploidy of chromosomes 21, 18, and NTD, but also the microdeletion or microduplication of all 46 chromosomes. So using CNV‐seq combined with QF‐PCR could effectively reduce the risk of missed diagnosis.
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Affiliation(s)
- Jinping Qiao
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jing Yuan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wenjun Hu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qin Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Huiqin Fang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yaqian Dai
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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5
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Dasouki MJ, Wakil SM, Al-Harazi O, Alkorashy M, Muiya NP, Andres E, Hagos S, Aldusery H, Dzimiri N, Colak D. New Insights into the Impact of Genome-Wide Copy Number Variations on Complex Congenital Heart Disease in Saudi Arabia. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2019; 24:16-28. [PMID: 31855513 DOI: 10.1089/omi.2019.0165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Congenital heart diseases (CHDs) are complex traits that manifest in diverse clinical phenotypes such as the Tetralogy of Fallot (TOF), valvular and ventricular/atrial septal defects. Genetic mechanisms of CHDs have remained largely unclear to date. Copy number variations (CNVs) have been implicated in many complex diseases but their impact has not been examined extensively in various forms of CHD lesions. We report in this study, to the best of our knowledge, the largest cohort of Saudi Arab CHD patients to date who were evaluated using genome-wide CNV analysis. In a sample of 134 Saudi Arab patients with CHD, 66 exhibited pathogenic or likely pathogenic CNVs. Notably, 21 copy number gains and 11 copy number losses were detected that encompassed 141 genes and 146 genes, respectively. The most frequent gains were on 17q21.31, 8p11.21, and 22q11.23, whereas the losses were primarily localized to 16p11.2. Interestingly, all lesions have had gains at 17q21.31. Septal defects had also gains at 8p11.21 and 22q11.23, valvular lesions at 8p11.21, 22q11.23, and 2q13, and TOF at 16p11.2. Functional and network analyses demonstrated that cardiovascular and nervous system development and function as well as cell death/survival were most significantly associated with CNVs, thus highlighting the potentially important genes likely to be involved in CHD, including NPHP1, PLCB1, KANSL1, and NR3C1. In conclusion, this genome-wide analysis identifies a high frequency of CNVs mostly in patients with septal defects, primarily influencing cardiovascular developmental and functional pathways, thereby offering a deeper insight into the complex networks involved in CHD pathogenesis.
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Affiliation(s)
- Majed J Dasouki
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Salma M Wakil
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Olfat Al-Harazi
- Departments Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Maarab Alkorashy
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Nzioka P Muiya
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Editha Andres
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Samya Hagos
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Haya Aldusery
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Nduna Dzimiri
- Departments Genetics and Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Dilek Colak
- Departments Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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7
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Kumar R, Corbett MA, Van Bon BWM, Gardner A, Woenig JA, Jolly LA, Douglas E, Friend K, Tan C, Van Esch H, Holvoet M, Raynaud M, Field M, Leffler M, Budny B, Wisniewska M, Badura-Stronka M, Latos-Bieleńska A, Batanian J, Rosenfeld JA, Basel-Vanagaite L, Jensen C, Bienek M, Froyen G, Ullmann R, Hu H, Love MI, Haas SA, Stankiewicz P, Cheung SW, Baxendale A, Nicholl J, Thompson EM, Haan E, Kalscheuer VM, Gecz J. Increased STAG2 dosage defines a novel cohesinopathy with intellectual disability and behavioral problems. Hum Mol Genet 2015; 24:7171-81. [PMID: 26443594 DOI: 10.1093/hmg/ddv414] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/28/2015] [Indexed: 11/13/2022] Open
Abstract
Next generation genomic technologies have made a significant contribution to the understanding of the genetic architecture of human neurodevelopmental disorders. Copy number variants (CNVs) play an important role in the genetics of intellectual disability (ID). For many CNVs, and copy number gains in particular, the responsible dosage-sensitive gene(s) have been hard to identify. We have collected 18 different interstitial microduplications and 1 microtriplication of Xq25. There were 15 affected individuals from 6 different families and 13 singleton cases, 28 affected males in total. The critical overlapping region involved the STAG2 gene, which codes for a subunit of the cohesin complex that regulates cohesion of sister chromatids and gene transcription. We demonstrate that STAG2 is the dosage-sensitive gene within these CNVs, as gains of STAG2 mRNA and protein dysregulate disease-relevant neuronal gene networks in cells derived from affected individuals. We also show that STAG2 gains result in increased expression of OPHN1, a known X-chromosome ID gene. Overall, we define a novel cohesinopathy due to copy number gain of Xq25 and STAG2 in particular.
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Affiliation(s)
- Raman Kumar
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Mark A Corbett
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia
| | | | - Alison Gardner
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Joshua A Woenig
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Lachlan A Jolly
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Evelyn Douglas
- Genetics and Molecular Pathology, SA Pathology, North Adelaide, SA 5006, Australia
| | - Kathryn Friend
- Genetics and Molecular Pathology, SA Pathology, North Adelaide, SA 5006, Australia
| | - Chuan Tan
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Hilde Van Esch
- Center for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Maureen Holvoet
- Center for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Martine Raynaud
- Centre Hospitalier Régional Universitaire, Service de Génétique, 37000 Tours, France
| | - Michael Field
- Genetics of Learning Disability Service, Hunter Genetics, Waratah, NSW 2298, Australia
| | - Melanie Leffler
- Genetics of Learning Disability Service, Hunter Genetics, Waratah, NSW 2298, Australia
| | - Bartłomiej Budny
- Department of Endocrinology, Metabolism and Internal Diseases and
| | - Marzena Wisniewska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | | | - Anna Latos-Bieleńska
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | | | - Jill A Rosenfeld
- Signature Genomic Laboratories, Spokane, WA 99207, USA, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lina Basel-Vanagaite
- Raphael Recanati Genetic Institute and Felsenstein Medical Research Center, Rabin Medical Center, Beilinson Campus, Petah Tikva 49100, Israel
| | | | | | - Guy Froyen
- Human Genome Laboratory, Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium and
| | - Reinhard Ullmann
- Department of Human Molecular Genetics and, Bundeswehr Institute of Radiobiology, 80937 Munich, Germany
| | - Hao Hu
- Department of Human Molecular Genetics and
| | - Michael I Love
- Department of Computational Molecular Biology, Max Planck Institute for Molecular Genetics, Ihnestrasse 73, 14195 Berlin, Germany
| | - Stefan A Haas
- Department of Computational Molecular Biology, Max Planck Institute for Molecular Genetics, Ihnestrasse 73, 14195 Berlin, Germany
| | - Pawel Stankiewicz
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sau Wai Cheung
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Anne Baxendale
- South Australian Clinical Genetics Service, SA Pathology, North Adelaide, SA 5006, Australia
| | - Jillian Nicholl
- Genetics and Molecular Pathology, SA Pathology, North Adelaide, SA 5006, Australia
| | - Elizabeth M Thompson
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia, South Australian Clinical Genetics Service, SA Pathology, North Adelaide, SA 5006, Australia
| | - Eric Haan
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia, South Australian Clinical Genetics Service, SA Pathology, North Adelaide, SA 5006, Australia
| | | | - Jozef Gecz
- School of Medicine, and the Robinson Research Institute, The University of Adelaide, Adelaide, SA 5000, Australia,
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8
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Riley KN, Catalano LM, Bernat JA, Adams SD, Martin DM, Lalani SR, Patel A, Burnside RD, Innis JW, Rudd MK. Recurrent deletions and duplications of chromosome 2q11.2 and 2q13 are associated with variable outcomes. Am J Med Genet A 2015; 167A:2664-73. [PMID: 26227573 DOI: 10.1002/ajmg.a.37269] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 07/17/2015] [Indexed: 12/21/2022]
Abstract
Copy number variation (CNV) in the long arm of chromosome 2 has been implicated in developmental delay (DD), intellectual disability (ID), autism spectrum disorder (ASD), congenital anomalies, and psychiatric disorders. Here we describe 14 new subjects with recurrent deletions and duplications of chromosome 2q11.2, 2q13, and 2q11.2-2q13. Though diverse phenotypes are associated with these CNVs, some common features have emerged. Subjects with 2q11.2 deletions often exhibit DD, speech delay, and attention deficit hyperactivity disorder (ADHD), whereas those with 2q11.2 duplications have DD, gastroesophageal reflux, and short stature. Congenital heart defects (CHDs), hypotonia, dysmorphic features, and abnormal head size are common in those with 2q13 deletions. In the 2q13 duplication cohort, we report dysmorphic features, DD, and abnormal head size. Two individuals with large duplications spanning 2q11.2-2q13 have dysmorphic features, hypotonia, and DD. This compilation of clinical features associated with 2q CNVs provides information that will be useful for healthcare providers and for families of affected children. However, the reduced penetrance and variable expressivity associated with these recurrent CNVs makes genetic counseling and prediction of outcomes challenging. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Kacie N Riley
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia.,Department of Cytogenetics, Laboratory Corporation of America Holdings, Center for Molecular Biology and Pathology, Research Triangle Park, North Carolina
| | - Lisa M Catalano
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - John A Bernat
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
| | - Stacie D Adams
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
| | - Donna M Martin
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.,Department of Human Genetics, University of Michigan, Ann Arbor, Michigan
| | - Seema R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Ankita Patel
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Rachel D Burnside
- Department of Cytogenetics, Laboratory Corporation of America Holdings, Center for Molecular Biology and Pathology, Research Triangle Park, North Carolina
| | - Jeffrey W Innis
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.,Department of Human Genetics, University of Michigan, Ann Arbor, Michigan
| | - M Katharine Rudd
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
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9
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Next-generation sequencing of duplication CNVs reveals that most are tandem and some create fusion genes at breakpoints. Am J Hum Genet 2015; 96:208-20. [PMID: 25640679 DOI: 10.1016/j.ajhg.2014.12.017] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/15/2014] [Indexed: 11/23/2022] Open
Abstract
Interpreting the genomic and phenotypic consequences of copy-number variation (CNV) is essential to understanding the etiology of genetic disorders. Whereas deletion CNVs lead obviously to haploinsufficiency, duplications might cause disease through triplosensitivity, gene disruption, or gene fusion at breakpoints. The mutational spectrum of duplications has been studied at certain loci, and in some cases these copy-number gains are complex chromosome rearrangements involving triplications and/or inversions. However, the organization of clinically relevant duplications throughout the genome has yet to be investigated on a large scale. Here we fine-mapped 184 germline duplications (14.7 kb-25.3 Mb; median 532 kb) ascertained from individuals referred for diagnostic cytogenetics testing. We performed next-generation sequencing (NGS) and whole-genome sequencing (WGS) to sequence 130 breakpoints from 112 subjects with 119 CNVs and found that most (83%) were tandem duplications in direct orientation. The remainder were triplications embedded within duplications (8.4%), adjacent duplications (4.2%), insertional translocations (2.5%), or other complex rearrangements (1.7%). Moreover, we predicted six in-frame fusion genes at sequenced duplication breakpoints; four gene fusions were formed by tandem duplications, one by two interconnected duplications, and one by duplication inserted at another locus. These unique fusion genes could be related to clinical phenotypes and warrant further study. Although most duplications are positioned head-to-tail adjacent to the original locus, those that are inverted, triplicated, or inserted can disrupt or fuse genes in a manner that might not be predicted by conventional copy-number assays. Therefore, interpreting the genetic consequences of duplication CNVs requires breakpoint-level analysis.
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10
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Reiff M, Mueller R, Mulchandani S, Spinner NB, Pyeritz RE, Bernhardt BA. A qualitative study of healthcare providers' perspectives on the implications of genome-wide testing in pediatric clinical practice. J Genet Couns 2014; 23:474-88. [PMID: 24037030 PMCID: PMC3955216 DOI: 10.1007/s10897-013-9653-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 08/22/2013] [Indexed: 12/20/2022]
Abstract
The utilization of genome-wide chromosomal microarray analysis (CMA) in pediatric clinical practice provides an opportunity to consider how genetic diagnostics is evolving, and to prepare for the clinical integration of genome-wide sequencing technologies. We conducted semi-structured interviews with 15 healthcare providers (7 genetic counselors, 4 medical geneticists, and 4 non-genetics providers) to investigate the impact of CMA on clinical practice, and implications for providers, patients and families. Interviews were analyzed qualitatively using content analysis. Most providers reported that genomic testing enhanced their professional experience and was beneficial to patients, primarily due to the improved diagnostic rate compared with earlier chromosomal studies. Other effects on practice included moving towards genotype-first diagnosis and broadening indications for chromosomal testing. Opinions varied concerning informed consent and disclosure of results. The duty to disclose incidental findings (IFs) was noted; however concerns were raised about potential psychosocial harms of disclosing pre-symptomatic findings. Tensions were revealed between the need for comprehensive informed consent for all families and the challenges of communicating time-consuming and potentially anxiety-provoking information regarding uncertain and incidental findings that may be relevant only in rare cases. Genetic counselors can play an important role in liaising with families, health professionals and testing laboratories, providing education and guidance to non-genetics providers, and enabling families to receive adequate pre-and post-test information and follow-up care.
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Affiliation(s)
- Marian Reiff
- Center for the Integration of Genetic Health Care Technologies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,
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11
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Nevado J, Mergener R, Palomares-Bralo M, Souza KR, Vallespín E, Mena R, Martínez-Glez V, Mori MÁ, Santos F, García-Miñaur S, García-Santiago F, Mansilla E, Fernández L, de Torres ML, Riegel M, Lapunzina P. New microdeletion and microduplication syndromes: A comprehensive review. Genet Mol Biol 2014; 37:210-9. [PMID: 24764755 PMCID: PMC3983590 DOI: 10.1590/s1415-47572014000200007] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Several new microdeletion and microduplication syndromes are emerging as disorders that have been proven to cause multisystem pathologies frequently associated with intellectual disability (ID), multiple congenital anomalies (MCA), autistic spectrum disorders (ASD) and other phenotypic findings. In this paper, we review the "new" and emergent microdeletion and microduplication syndromes that have been described and recognized in recent years with the aim of summarizing their main characteristics and chromosomal regions involved. We decided to group them by genomic region and within these groupings have classified them into those that include ID, MCA, ASD or other findings. This review does not intend to be exhaustive but is rather a quick guide to help pediatricians, clinical geneticists, cytogeneticists and/or molecular geneticists.
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Affiliation(s)
- Julián Nevado
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Functional and Structural Genomics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Rafaella Mergener
- Programa de Pós-graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre,RS, Brazil
| | - María Palomares-Bralo
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Functional and Structural Genomics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Karen Regina Souza
- Programa de Pós-graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre,RS, Brazil
| | - Elena Vallespín
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Functional and Structural Genomics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Rocío Mena
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Functional and Structural Genomics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Víctor Martínez-Glez
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Functional and Structural Genomics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - María Ángeles Mori
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Functional and Structural Genomics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Fernando Santos
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Clinical Genetics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Sixto García-Miñaur
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Clinical Genetics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Fé García-Santiago
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Cytogenetics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Elena Mansilla
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Cytogenetics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Luis Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Preanalytics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - María Luisa de Torres
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Cytogenetics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
| | - Mariluce Riegel
- Programa de Pós-graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre,RS, Brazil . ; Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Pablo Lapunzina
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain . ; Section of Clinical Genetics, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain . ; Section of Molecular Endocrinology, Overgrowth Disordes Laboratory, Instituto de Genética Médica y Molecular, Hospital Universitario la Paz, Madrid, Spain
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Abstract
The field of cytogenetics has focused on studying the number, structure, function and origin of chromosomal abnormalities and the evolution of chromosomes. The development of fluorescent molecules that either directly or via an intermediate molecule bind to DNA has led to the development of fluorescent in situ hybridization (FISH), a technology linking cytogenetics to molecular genetics. This technique has a wide range of applications that increased the dimension of chromosome analysis. The field of cytogenetics is particularly important for medical diagnostics and research as well as for gene ordering and mapping. Furthermore, the increased application of molecular biology techniques, such as array-based technologies, has led to improved resolution, extending the recognized range of microdeletion/microduplication syndromes and genomic disorders. In adopting these newly expanded methods, cytogeneticists have used a range of technologies to study the association between visible chromosome rearrangements and defects at the single nucleotide level. Overall, molecular cytogenetic techniques offer a remarkable number of potential applications, ranging from physical mapping to clinical and evolutionary studies, making a powerful and informative complement to other molecular and genomic approaches. This manuscript does not present a detailed history of the development of molecular cytogenetics; however, references to historical reviews and experiments have been provided whenever possible. Herein, the basic principles of molecular cytogenetics, the technologies used to identify chromosomal rearrangements and copy number changes, and the applications for cytogenetics in biomedical diagnosis and research are presented and discussed.
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Affiliation(s)
- Mariluce Riegel
- Serviço de Genética Médica, Hospital de Clínicas, Porto Alegre, RS, Brazil . ; Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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13
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Bug S, Schmitz F, Nevinny-Stickel-Hinzpeter C. The correct genetic diagnosis has already been determined more often than we think, let's report it to the parents! Clin Pediatr (Phila) 2014; 53:8-10. [PMID: 23613176 DOI: 10.1177/0009922813485811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Stefanie Bug
- 1synlab Medizinisches Versorgungszentrum Humane Genetik München, Munich, Germany
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14
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Beunders G, Voorhoeve E, Golzio C, Pardo L, Rosenfeld J, Talkowski M, Simonic I, Lionel A, Vergult S, Pyatt R, van de Kamp J, Nieuwint A, Weiss M, Rizzu P, Verwer L, van Spaendonk R, Shen Y, Wu BL, Yu T, Yu Y, Chiang C, Gusella J, Lindgren A, Morton C, van Binsbergen E, Bulk S, van Rossem E, Vanakker O, Armstrong R, Park SM, Greenhalgh L, Maye U, Neill N, Abbott K, Sell S, Ladda R, Farber D, Bader P, Cushing T, Drautz J, Konczal L, Nash P, de Los Reyes E, Carter M, Hopkins E, Marshall C, Osborne L, Gripp K, Thrush D, Hashimoto S, Gastier-Foster J, Astbury C, Ylstra B, Meijers-Heijboer H, Posthuma D, Menten B, Mortier G, Scherer S, Eichler E, Girirajan S, Katsanis N, Groffen A, Sistermans E. Exonic deletions in AUTS2 cause a syndromic form of intellectual disability and suggest a critical role for the C terminus. Am J Hum Genet 2013; 92:210-20. [PMID: 23332918 PMCID: PMC3567268 DOI: 10.1016/j.ajhg.2012.12.011] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/06/2012] [Accepted: 12/20/2012] [Indexed: 01/15/2023] Open
Abstract
Genomic rearrangements involving AUTS2 (7q11.22) are associated with autism and intellectual disability (ID), although evidence for causality is limited. By combining the results of diagnostic testing of 49,684 individuals, we identified 24 microdeletions that affect at least one exon of AUTS2, as well as one translocation and one inversion each with a breakpoint within the AUTS2 locus. Comparison of 17 well-characterized individuals enabled identification of a variable syndromic phenotype including ID, autism, short stature, microcephaly, cerebral palsy, and facial dysmorphisms. The dysmorphic features were more pronounced in persons with 3'AUTS2 deletions. This part of the gene is shown to encode a C-terminal isoform (with an alternative transcription start site) expressed in the human brain. Consistent with our genetic data, suppression of auts2 in zebrafish embryos caused microcephaly that could be rescued by either the full-length or the C-terminal isoform of AUTS2. Our observations demonstrate a causal role of AUTS2 in neurocognitive disorders, establish a hitherto unappreciated syndromic phenotype at this locus, and show how transcriptional complexity can underpin human pathology. The zebrafish model provides a valuable tool for investigating the etiology of AUTS2 syndrome and facilitating gene-function analysis in the future.
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Affiliation(s)
- Gea Beunders
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Els Voorhoeve
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Christelle Golzio
- Center for Human Disease Modeling, Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA
| | - Luba M. Pardo
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Jill A. Rosenfeld
- Signature Genomic Laboratories, Perkin Elmer, Spokane, WA 99207, USA
| | - Michael E. Talkowski
- Center for Human Genetic Research, Massachusetts General Hospital, affiliated with Departments of Genetics and Neurology, Harvard Medical School, Harvard University, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
| | - Ingrid Simonic
- East Anglian Medical Genetics Service, Addenbrooke’s Hospital, Cambridge University Hospitals, National Health Service Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Anath C. Lionel
- The Centre for Applied Genomics and Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
- Department of Molecular Genetics and the McLaughlin Centre, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Sarah Vergult
- Center for Medical Genetics, University Hospital Ghent, Ghent 9000, Belgium
| | - Robert E. Pyatt
- Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Jiddeke van de Kamp
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Aggie Nieuwint
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Marjan M. Weiss
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Patrizia Rizzu
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Lucilla E.N.I. Verwer
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | | | - Yiping Shen
- Center for Human Genetic Research, Massachusetts General Hospital, affiliated with Departments of Genetics and Neurology, Harvard Medical School, Harvard University, Boston, MA 02114, USA
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA 02114, USA
- Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Bai-lin Wu
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA 02114, USA
- Children’s Hospital and Institutes of Biomedical Science, Fudan University, Shanghai 200032, China
| | - Tingting Yu
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA 02114, USA
- Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Yongguo Yu
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA 02114, USA
- Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Colby Chiang
- Center for Human Genetic Research, Massachusetts General Hospital, affiliated with Departments of Genetics and Neurology, Harvard Medical School, Harvard University, Boston, MA 02114, USA
| | - James F. Gusella
- Center for Human Genetic Research, Massachusetts General Hospital, affiliated with Departments of Genetics and Neurology, Harvard Medical School, Harvard University, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
| | - Amelia M. Lindgren
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Cynthia C. Morton
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142, USA
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Ellen van Binsbergen
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht 3508 AB, The Netherlands
| | - Saskia Bulk
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht 3508 AB, The Netherlands
| | | | - Olivier Vanakker
- Center for Medical Genetics, University Hospital Ghent, Ghent 9000, Belgium
| | - Ruth Armstrong
- East Anglian Medical Genetics Service, Addenbrooke’s Hospital, Cambridge University Hospitals, National Health Service Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Soo-Mi Park
- East Anglian Medical Genetics Service, Addenbrooke’s Hospital, Cambridge University Hospitals, National Health Service Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Lynn Greenhalgh
- Clinical Genetics, Royal Liverpool Children’s Hospital, Eaton Road, Alder Hey, Liverpool L12 2AP, Great Britain
| | - Una Maye
- Clinical Genetics, Royal Liverpool Children’s Hospital, Eaton Road, Alder Hey, Liverpool L12 2AP, Great Britain
| | - Nicholas J. Neill
- Signature Genomic Laboratories, Perkin Elmer, Spokane, WA 99207, USA
| | - Kristin M. Abbott
- East Anglian Medical Genetics Service, Addenbrooke’s Hospital, Cambridge University Hospitals, National Health Service Foundation Trust, Cambridge, CB2 0QQ, UK
| | - Susan Sell
- Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Roger Ladda
- Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Darren M. Farber
- Department of Neurology, University of Louisville, Louisville, KY 40222, USA
| | - Patricia I. Bader
- Northeast Indiana Genetic Counseling Center, Ft. Wayne, IN 46804, USA
| | - Tom Cushing
- Pediatric Genetics Division, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USA
| | - Joanne M. Drautz
- Pediatric Genetics Division, Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USA
| | - Laura Konczal
- University Hospitals, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Patricia Nash
- Department of Behavioral Pediatrics, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Emily de Los Reyes
- Department of Pediatrics and Neurology, The Ohio State University, Columbus, OH 43210, USA
| | - Melissa T. Carter
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Elizabeth Hopkins
- Division of Medical Genetics, Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA
| | - Christian R. Marshall
- The Centre for Applied Genomics and Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
- Department of Molecular Genetics and the McLaughlin Centre, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Lucy R. Osborne
- Departments of Medicine and Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Karen W. Gripp
- Division of Medical Genetics, Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA
| | - Devon Lamb Thrush
- Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Sayaka Hashimoto
- Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Julie M. Gastier-Foster
- Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Caroline Astbury
- Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Bauke Ylstra
- Department of Pathology, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Hanne Meijers-Heijboer
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Danielle Posthuma
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Amsterdam 1081 HV, The Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus University Rotterdam, Rotterdam 3000 CB, The Netherlands
| | - Björn Menten
- Center for Medical Genetics, University Hospital Ghent, Ghent 9000, Belgium
| | - Geert Mortier
- Department of Medical Genetics, Antwerp University, Edegem 2650, Belgium
| | - Stephen W. Scherer
- The Centre for Applied Genomics and Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON M5G 1L7, Canada
- Department of Molecular Genetics and the McLaughlin Centre, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Evan E. Eichler
- Department of Genome Sciences and Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Santhosh Girirajan
- Department of Genome Sciences and Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
- Department of Biochemistry and Molecular Biology Department of Anthropology, Pennsylvania State University, Pennsylvania, PA 16803, USA
| | - Nicholas Katsanis
- Center for Human Disease Modeling, Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA
| | - Alexander J. Groffen
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Amsterdam 1081 HV, The Netherlands
| | - Erik A. Sistermans
- Department of Clinical Genetics, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
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15
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Genetic counseling, activism and 'genotype-first' diagnosis of developmental disorders. J Genet Couns 2012; 21:770-6. [PMID: 22820968 DOI: 10.1007/s10897-012-9515-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 06/14/2012] [Indexed: 01/20/2023]
Abstract
This paper presents a sociological examination of the role of genetic counselors as advocates, not only for patients and their families, but also for genetic conditions themselves. In becoming activists for new disorders, genetic counselors are helping to create new categories that will shape expectations and treatment regimens for both existing patients and those who are yet to be diagnosed. By virtue of their expertise and their position at the intersection of several key professions and constituencies, genetic counselors are likely to play a central role in the way the genetic testing technologies, and especially 'genotype-first' diagnosis, impacts the way we understand and categorize developmental difference. I outline some of the promises and dangers that this kind of activism holds for people with developmental disabilities, and particularly the challenge presented by systemic ascertainment bias in the face of genotype-phenotype uncertainty. I argue that new testing techniques like microarray analysis that do not need to be targeted on the basis of clinical presentation throw these challenges into sharp relief, and that the genetic counseling community should consider how to marry advocacy for new genetic conditions with an emphasis on the indeterminate developmental potential of every child.
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16
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Abstract
Zusammenfassung
Die molekulare Karyotypisierung durch Array-CGH („comparative genomic hybridization“) und SNP-Arrays (SNP: „single nucleotide polymorphism“) ermöglicht die hochauflösende Untersuchung des gesamten Genoms, um so Gewinne und/oder Verluste (Kopienzahlvarianten, „copy number variants“, CNVs) zu detektieren, die die Ursache einer genetischen Erkrankung sein können. Diese Technik wird in erster Linie zur Ursachenklärung bei syndromalen und nichtsyndromalen (geistigen) Entwicklungsstörungen und zur genetischen Charakterisierung von Tumoren eingesetzt. Auch in der pränatalen Diagnostik könnte die molekulare Karyotypisierung bei auffälligem sonographischem Befund zur Klärung der Ursachen hilfreich sein. Der Artikel gibt eine kurze Übersicht über die grundlegenden Methoden, deren Grenzen und Stärken sowie einen Ausblick in die Zukunft.
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