1
|
Guha S, Reddi HV, Aarabi M, DiStefano M, Wakeling E, Dungan JS, Gregg AR. Laboratory testing for preconception/prenatal carrier screening: A technical standard of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2024; 26:101137. [PMID: 38814327 DOI: 10.1016/j.gim.2024.101137] [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: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 05/31/2024] Open
Abstract
Carrier screening has historically assessed a relatively small number of autosomal recessive and X-linked conditions selected based on frequency in a specific subpopulation and association with severe morbidity or mortality. Advances in genomic technologies enable simultaneous screening of individuals for several conditions. The American College of Medical Genetics and Genomics recently published a clinical practice resource that presents a framework when offering screening for autosomal recessive and X-linked conditions during pregnancy and preconception and recommends a tier-based approach when considering the number of conditions to screen for and their frequency within the US population in general. This laboratory technical standard aims to complement the practice resource and to put forth considerations for clinical laboratories and clinicians who offer preconception/prenatal carrier screening.
Collapse
Affiliation(s)
| | - Honey V Reddi
- Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Mahmoud Aarabi
- UPMC Medical Genetics and Genomics Laboratories, UPMC Magee-Womens Hospital, Pittsburgh, PA; Departments of Pathology and Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | | | - Jeffrey S Dungan
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Anthony R Gregg
- Department of Obstetrics and Gynecology, Prisma Health, Columbia, SC
| |
Collapse
|
2
|
Fang Y, Li J, Zhang M, Cheng Y, Wang C, Zhu J. Clinical application value of expanded carrier screening in the population of childbearing age. Eur J Med Res 2023; 28:151. [PMID: 37031186 PMCID: PMC10082524 DOI: 10.1186/s40001-023-01112-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/30/2023] [Indexed: 04/10/2023] Open
Abstract
OBJECTIVE The objective of this study was to explore the clinical utility of the implementation of expanded carrier screening (ECS) in Chinese population of childbearing age. MATERIALS AND METHODS Based on capillary electrophoresis, a first-generation sequencing technology, a prospective screening study of carriers of 15 single-gene diseases was carried out in 327 subjects in Anhui Province, including 84 couples and 159 women of childbearing age, the disease carrier rate, types of screened pathogenic genes, and incidence of both partners carrying the same pathogenic genes were summarized and analyzed. RESULTS In 320 people with normal phenotypes who underwent ECS for 15 genetic diseases and 7 spouses who underwent targeted gene sequencing, 65 carriers of at least one disease were detected, with a total carrier rate of 20.31% (65/320). Among the 65 carriers, 81.54% (53/65) carried one genetic variant, 16.92% (11/65) carried two genetic variants, and 1.54% (1/65) carried three genetic variants. In this study, the three diseases with the highest carrier rates were hereditary deafness (8.13%, 26/320), Wilson's disease (4.06%, 13/320), and phenylketonuria (3.13%, 10/320). One high-risk couple (1.19%, 1/84) was detected. CONCLUSIONS It has certain clinical application value to implement ECS in the population of childbearing age in China.
Collapse
Affiliation(s)
- Yuqin Fang
- Affiliated Maternity and Child Health Hospital of Anhui Medical University, Hefei, China
- Maternity and Child Health Hospital of Anhui Province, Hefei, China
| | - Jingran Li
- Maternity and Child Health Hospital of Anhui Province, Hefei, China
| | - Miaomiao Zhang
- Maternity and Child Health Hospital of Anhui Province, Hefei, China
| | - Yuan Cheng
- Maternity and Child Health Hospital of Anhui Province, Hefei, China
| | - Chaohong Wang
- Maternity and Child Health Hospital of Anhui Province, Hefei, China
| | - Jiansheng Zhu
- Affiliated Maternity and Child Health Hospital of Anhui Medical University, Hefei, China.
- Maternity and Child Health Hospital of Anhui Province, Hefei, China.
| |
Collapse
|
3
|
Strovel ET, Cusmano-Ozog K, Wood T, Yu C. Measurement of lysosomal enzyme activities: A technical standard of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2022; 24:769-783. [PMID: 35394426 DOI: 10.1016/j.gim.2021.12.013] [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: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Assays that measure lysosomal enzyme activity are important tools for the screening and diagnosis of lysosomal storage disorders (LSDs). They are often ordered in combination with urine oligosaccharide and glycosaminoglycan analysis, additional biomarker assays, and/or DNA sequencing when an LSD is suspected. Enzyme testing in whole blood/leukocytes, serum/plasma, cultured fibroblasts, or dried blood spots demonstrating deficient enzyme activity remains a key component of LSD diagnosis and is often prompted by characteristic clinical findings, abnormal newborn screening, abnormal biochemical findings (eg, elevated glycosaminoglycans), or molecular results indicating pathogenic variants or variants of uncertain significance in a gene associated with an LSD. This document, which focuses on clinical enzyme testing for LSDs, provides a resource for laboratories to develop and implement clinical testing, to describe variables that can influence test performance and interpretation of results, and to delineate situations for which follow-up molecular testing is warranted.
Collapse
Affiliation(s)
- Erin T Strovel
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD
| | | | - Tim Wood
- Section of Genetics and Metabolism, Department of Pediatrics, School of Medicine, Children's Hospital Colorado Anschutz Medical Campus, Aurora, CO
| | - Chunli Yu
- Department of Genetics and Genomics Science, Icahn School of Medicine at Mount Sinai, New York, NY; Sema4, Stamford, CT
| |
Collapse
|
4
|
Barlow-Stewart K, Bardsley K, Elan E, Fleming J, Berman Y, Fleischer R, Recsei K, Goldberg D, Tucker J, Burnett L. Evaluating the model of offering expanded genetic carrier screening to high school students within the Sydney Jewish community. J Community Genet 2021; 13:121-131. [PMID: 34846685 PMCID: PMC8799788 DOI: 10.1007/s12687-021-00567-8] [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: 08/02/2021] [Accepted: 11/15/2021] [Indexed: 10/31/2022] Open
Abstract
Programs offering reproductive genetic carrier screening (RGCS) to high school students within the Ashkenazi Jewish community in several countries including Canada and Australia have demonstrated high uptake and retention of educational messages over time. This study was undertaken to evaluate whether testing for an expanded number of conditions in a high school setting would impact the effectiveness of education. In this questionnaire-based study, genetic carrier testing for nine conditions was offered to 322 year 11 students from five high schools, with students attending a compulsory 1-h education session prior to voluntary testing. Comparison of pre- and post-education measures demonstrated a significant increase in knowledge, positive attitudes, and reduced concern immediately after the education session. Retention of knowledge, measures of positive attitude, and low concern over a 12-month period were significantly higher than baseline, although there was some reduction over time. In total, 77% of students exhibited informed choice regarding their intention to test. A significant increase in baseline knowledge scores and positive attitude was also demonstrated between our original 1995 evaluation (with testing for only one condition) and 2014 (testing for nine conditions) suggesting community awareness and attitudes to RGCS have increased. These findings validate the implementation of effective education programs as a key component of RGCS and are relevant as gene panels expand with the introduction of genomic technologies.
Collapse
Affiliation(s)
- Kristine Barlow-Stewart
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia
| | - Kayley Bardsley
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Genetic Medicine, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Elle Elan
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Jane Fleming
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia
| | - Yemima Berman
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Ron Fleischer
- Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia.,Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown, NSW, 2010, Australia
| | - Krista Recsei
- Pangolin Consulting, The Entrance, NSW, 2261, Australia
| | - Daniel Goldberg
- Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia
| | - John Tucker
- Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia
| | - Leslie Burnett
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia. .,Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia. .,Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia. .,St Vincent's Clinical School, UNSW Sydney, Darlinghurst, NSW, 2010, Australia.
| |
Collapse
|
5
|
Pan J, Zhang C, Teng Y, Zeng S, Chen S, Liang D, Li Z, Wu L. Detection of Spinal Muscular Atrophy Using a Duplexed Real-Time PCR Approach With Locked Nucleic Acid-Modified Primers. Ann Lab Med 2020; 41:101-107. [PMID: 32829585 PMCID: PMC7443528 DOI: 10.3343/alm.2021.41.1.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/24/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder mainly caused by homozygous deletions that include exon 7 of the survival motor neuron 1 (SMN1) gene. A nearby paralog gene, SMN2, obstructs the specific detection of SMN1. We optimized a duplexed real-time PCR approach using locked nucleic acid (LNA)-modified primers to specifically detect SMN1. METHODS An LNA-modified primer pair with 3' ends targeting SMN1 specific sites c.835-44g and c.840C was designed, and its specificity was examined by real-time PCR and Sanger Sequencing. A duplexed real-time PCR approach for amplifying SMN1 and control gene albumin (ALB) was developed. A randomized double-blind trial with 97 fresh peripheral blood samples and 25 dried blood spots (DBS) was conducted to evaluate the clinical efficacy of the duplexed approach. This new approach was then used to screen 753 newborn DBS. RESULTS The LNA-modified primers exhibited enhanced specificity and 6.8% increased efficiency for SMN1 amplification, compared with conventional primers. After stabilizing the SMN1 test by optimizing the duplexed real-time PCR approach, a clinical trial validated that the sensitivity and specificity of our new approach for detecting SMA patients and carriers was 100%. Using this new approach, 15 of the screened 753 newborns were identified as carriers via DBS, while the rest were identified as normal individuals. These data reveal a carrier rate of 1.99% in Hunan province, South Central China. CONCLUSIONS We have developed a novel, specific SMN1 detection approach utilizing real-time PCR with LNA-modified primers, which could be applied to both prenatal carrier and newborn screening.
Collapse
Affiliation(s)
- Jianyan Pan
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Chunhua Zhang
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Yanling Teng
- Laboratory of Molecular Genetics, Hunan Jiahui Genetics Hospital, Changsha, Hunan, China
| | - Sijing Zeng
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Siyi Chen
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Desheng Liang
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Zhuo Li
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Lingqian Wu
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| |
Collapse
|
6
|
Unal C, Ozkara HA, Tanacan A, Fadiloglu E, Lay I, Topçu M, Cakar AN, Beksac MS. Prenatal enzymatic diagnosis of lysosomal storage diseases using cultured amniotic cells, uncultured chorionic villus samples, and fetal blood cells: Hacettepe experience. Prenat Diagn 2019; 39:1080-1085. [PMID: 31411753 DOI: 10.1002/pd.5547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/25/2019] [Accepted: 08/05/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Canan Unal
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | | | - Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Erdem Fadiloglu
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Incilay Lay
- Department of Medical Biochemistry, Hacettepe University, Ankara, Turkey
| | - Meral Topçu
- Division of Pediatric Neurology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Ayse Nur Cakar
- Department of Histology and Embryology, TOBB University of Economics and Technology, Ankara, Turkey
| | - Mehmet Sinan Beksac
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| |
Collapse
|
7
|
Yip T, Grinzaid KA, Bellcross C, Moore RH, Page PZ, Hardy MW. Patients' reactions and follow-up testing decisions related to Tay-Sachs (HEXA) variants of uncertain significance results. J Genet Couns 2019; 28:738-749. [PMID: 30843643 DOI: 10.1002/jgc4.1108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/16/2019] [Accepted: 02/02/2019] [Indexed: 11/10/2022]
Abstract
JScreen is a national public health initiative based out of Emory University that provides reproductive carrier screening through an online portal and follow-up genetic counseling services. In 2014, JScreen began reporting to patients variants of uncertain significance (VUSs) in the gene that causes Tay-Sachs disease (HEXA). Genetic counseling was provided to discuss the VUS and patients were offered hexosaminidase A (HEXA) blood enzyme testing to assist with VUS reclassification. To identify patient reactions and factors influencing their follow-up testing decisions after receiving these results, we conducted a retrospective quantitative study by administering online surveys to 62 patients with HEXA VUSs. Participants who pursued enzyme testing and those who did not both experienced low levels of distress when receiving the VUS results. Perceptions of HEXA carrier status after genetic counseling, decisional conflict levels, plans to have children in the near future, time available to pursue enzyme testing, and eligibility for research were significant factors influencing decision-making to pursue or not pursue enzyme testing. Genetic counseling played an important role in helping patients understand the VUS and follow-up testing options. When discussing VUSs with patients, it would be beneficial for genetic counselors to focus on the patient's perception of the VUS, anxiety related to the uncertainty of their results, and follow-up options, when available.
Collapse
Affiliation(s)
- Tiffany Yip
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Karen A Grinzaid
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Cecelia Bellcross
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Reneé H Moore
- Department of Public Health, Emory University, Atlanta, Georgia
| | - Patricia Z Page
- Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham School of Health Professions, Birmingham, Alabama
| | - Melanie W Hardy
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| |
Collapse
|
8
|
Standards and guidelines for canine clinical genetic testing laboratories. Hum Genet 2018; 138:493-499. [PMID: 30426199 PMCID: PMC6536461 DOI: 10.1007/s00439-018-1954-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 10/29/2018] [Indexed: 11/23/2022]
Abstract
This publication represents a proposed approach to quality standards and guidelines for canine clinical genetic testing laboratories. Currently, there are no guidelines for laboratories performing clinical testing on dogs. Thus, there is no consensus set of protocols that set the minimal standards of quality among these laboratories, potentially causing variable results between laboratories, inconsistencies in reporting, and the inability to share information that could impact testing among organizations. A minimal standard for quality in testing is needed as breeders use the information from genetic testing to make breeding choices and irreversible decisions regarding spay, neuter or euthanasia. Incorrect results can have significant impact on the health of the dogs being tested and on their subsequent progeny. Because of the potentially serious consequences of an incorrect result or incorrect interpretation, results should be reviewed by and reported by individuals who meet a minimum standard of qualifications. Quality guidelines for canine genetic testing laboratories should include not only the analytical phase, but also the preanalytical and postanalytical phases, as this document attempts to address.
Collapse
|
9
|
|
10
|
Vaz-de-Macedo C, Harper J. A closer look at expanded carrier screening from a PGD perspective. Hum Reprod 2017; 32:1951-1956. [DOI: 10.1093/humrep/dex272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 08/12/2017] [Indexed: 01/28/2023] Open
|
11
|
Mehta N, Lazarin GA, Spiegel E, Berentsen K, Brennan K, Giordano J, Haque IS, Wapner R. Tay-Sachs Carrier Screening by Enzyme and Molecular Analyses in the New York City Minority Population. Genet Test Mol Biomarkers 2016; 20:504-9. [PMID: 27362553 PMCID: PMC5314723 DOI: 10.1089/gtmb.2015.0302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Carrier screening for Tay-Sachs disease is performed by sequence analysis of the HEXA gene and/or hexosaminidase A enzymatic activity testing. Enzymatic analysis (EA) has been suggested as the optimal carrier screening method, especially in non-Ashkenazi Jewish (non-AJ) individuals, but its utilization and efficacy have not been fully evaluated in the general population. This study assesses the reliability of EA in comparison with HEXA sequence analysis in non-AJ populations. Methods: Five hundred eight Hispanic and African American patients (516 samples) had EA of their leukocytes performed and 12 of these patients who tested positive by EA (“carriers”) had subsequent HEXA gene sequencing performed. Results: Of the 508 patients, 25 (4.9%) were EA positive and 40 (7.9%) were inconclusive. Of the 12 patients who were sequenced, 11 did not carry a pathogenic variant and one carried a likely deleterious mutation (NM_000520.4(HEXA):c.1510C>T). Conclusions: High inconclusive rates and poor correlation between positive/inconclusive enzyme results and identification of pathogenic mutations suggest that ethnic-specific recalibration of reference ranges for EA may be necessary. Alternatively, HEXA gene sequencing could be performed.
Collapse
Affiliation(s)
| | | | - Erica Spiegel
- 2 Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| | | | - Kelly Brennan
- 2 Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| | - Jessica Giordano
- 1 Counsyl , South San Francisco, California.,2 Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center , New York, New York.,3 Department of OBGYN-MFM, Columbia Doctors Midtown , New York, New York
| | | | - Ronald Wapner
- 2 Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| |
Collapse
|
12
|
Abstract
Whether all adult Ashkenazi women should be offered population screening for recurrent [...]
Collapse
Affiliation(s)
- S E Plon
- Departments of Pediatrics/Hematology-Oncology and Molecular and Human Genetics, Baylor College of Medicine; Human Genome Sequencing Center, Baylor College of Medicine; and Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX, U.S.A
| |
Collapse
|
13
|
Perreault-Micale C, Davie J, Breton B, Hallam S, Greger V. A rigorous approach for selection of optimal variant sets for carrier screening with demonstration of clinical utility. Mol Genet Genomic Med 2015; 3:363-73. [PMID: 26247052 PMCID: PMC4521971 DOI: 10.1002/mgg3.148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/24/2015] [Accepted: 03/24/2015] [Indexed: 11/29/2022] Open
Abstract
Carrier screening for certain diseases is recommended by major medical and Ashkenazi Jewish (AJ) societies. Most carrier screening panels test only for common, ethnic-specific variants. However, with formerly isolated ethnic groups becoming increasingly intermixed, this approach is becoming inadequate. Our objective was to develop a rigorous process to curate all variants, for relevant genes, into a database and then apply stringent clinical validity classification criteria to each in order to retain only those with clear evidence for pathogenicity. The resulting variant set, in conjunction with next-generation DNA sequencing (NGS), then affords the capability for an ethnically diverse, comprehensive, highly specific carrier-screening assay. The clinical utility of our approach was demonstrated by screening a pan-ethnic population of 22,864 individuals for Bloom syndrome carrier status using a BLM variant panel comprised of 50 pathogenic variants. In addition to carriers of the common AJ founder variant, we identified 57 carriers of other pathogenic BLM variants. All variants reported had previously been curated and their clinical validity documented, or were of a type that met our stringent, preassigned validity criteria. Thus, it was possible to confidently report an increased number of Bloom’s syndrome carriers compared to traditional, ethnicity-based screening, while not reducing the specificity of the screening due to reporting variants of unknown clinical significance.
Collapse
Affiliation(s)
| | - Jocelyn Davie
- Good Start Genetics, Inc. 237 Putnam Avenue, Cambridge, Massachusetts, 02139
| | - Benjamin Breton
- Good Start Genetics, Inc. 237 Putnam Avenue, Cambridge, Massachusetts, 02139
| | - Stephanie Hallam
- Good Start Genetics, Inc. 237 Putnam Avenue, Cambridge, Massachusetts, 02139
| | - Valerie Greger
- Good Start Genetics, Inc. 237 Putnam Avenue, Cambridge, Massachusetts, 02139
| |
Collapse
|
14
|
Zlotogora J, Grotto I, Kaliner E, Gamzu R. The Israeli national population program of genetic carrier screening for reproductive purposes. Genet Med 2015; 18:203-6. [PMID: 25880436 DOI: 10.1038/gim.2015.55] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 03/17/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The Israeli population genetic screening program for reproductive purposes, launched in January 2013, includes all known, nationally frequent severe diseases (carrier frequency 1:60 and/or disease frequency 1 in 15,000 live births). The carrier screening program is free of charge and offers testing for cystic fibrosis, fragile X syndrome, and spinal muscular atrophy for nearly the entire population, according to disease frequency among the different groups within the population. We report the results of the first year of the program. METHODS Data on the tests performed over a 12-month period were collected from laboratories nationwide. RESULTS More than 62,000 individuals were examined. The carrier frequency was within the expected range for most of the diseases. The few exceptions included lower carrier rates for cystic fibrosis among Muslim Arabs (1:236) and Druze (1:1,021) and Niemann-Pick type A among Muslim Arabs in a delineated region of Israel (1:229). CONCLUSION The national population genetic carrier screening is aimed toward providing couples with knowledge of the existing options for the prevention of serious genetic conditions when it is relevant for them. It is still too early to determine whether this aim has been achieved.
Collapse
Affiliation(s)
- Joël Zlotogora
- Department of Community Genetics.,Public Health Services.,Ministry of Health, Jerusalem, Israel.,Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Itamar Grotto
- Public Health Services.,Ministry of Health, Jerusalem, Israel.,Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ehud Kaliner
- Public Health Services.,Ministry of Health, Jerusalem, Israel
| | | |
Collapse
|
15
|
Lew RM, Burnett L, Proos AL, Barlow-Stewart K, Delatycki MB, Bankier A, Aizenberg H, Field MJ, Berman Y, Fleischer R, Fietz M. Ashkenazi Jewish population screening for Tay-Sachs disease: the international and Australian experience. J Paediatr Child Health 2015; 51:271-9. [PMID: 24923490 DOI: 10.1111/jpc.12632] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 12/13/2022]
Abstract
Internationally, Tay-Sachs disease (TSD) preconception screening of Ashkenazi Jewish (AJ) individuals and couples has led to effective primary prevention of TSD. In Australia, adolescent preconception genetic screening programs operate mainly in Jewish community high schools. These existing programs offer an effective means of primary prevention of TSD, are cost effective and safe. However, in the broader Australian community TSD screening is not systematically performed and cases still occur in unscreened AJ individuals. In order to improve the effectiveness of Australian screening, there is a need for definitive guidelines for healthcare professionals to facilitate extension of the proven benefits of preconception TSD screening to all AJ individuals at risk. We performed a systematic review of the relevant literature relating to AJ pre-conception and antenatal screening for TSD. The evidence was assessed using an established National Health and Medical Research Council evidence grading system. Evaluations of efficacy of TSD screening programs design and execution, cost-benefit and cost-utility health economic evaluation, and population outcomes were undertaken. The results have been used to propose a model for universal AJ TSD preconception and antenatal screening for the primary care setting.
Collapse
Affiliation(s)
- Raelia M Lew
- Department of Obstetrics and Gynaecology, QEII Research Institute for Mothers and Infants, University of Sydney, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Mathijssen IB, Henneman L, van Eeten-Nijman JMC, Lakeman P, Ottenheim CPE, Redeker EJW, Ottenhof W, Meijers-Heijboer H, van Maarle MC. Targeted carrier screening for four recessive disorders: high detection rate within a founder population. Eur J Med Genet 2015; 58:123-8. [PMID: 25641760 DOI: 10.1016/j.ejmg.2015.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/07/2015] [Indexed: 12/13/2022]
Abstract
In a genetically isolated community in the Netherlands four severe recessive genetic disorders occur at relatively high frequency (pontocerebellar hypoplasia type 2 (PCH2), fetal akinesia deformation sequence (FADS), rhizomelic chondrodysplasia punctata type 1 (RCDP1), and osteogenesis imperfecta (OI) type IIB/III. Over the past decades multiple patients with these disorders have been identified. This warranted the start of a preconception outpatient clinic, in 2012, aimed at couples planning a pregnancy. The aim of our study was to evaluate the offer of targeted genetic carrier screening as a method to identify high-risk couples for having affected offspring in this high-risk subpopulation. In one year, 203 individuals (92 couples and 19 individuals) were counseled. In total, 65 of 196 (33.2%) tested individuals were carriers of at least one disease, five (7.7%) of them being carriers of two diseases. Carrier frequencies of PCH2, FADS, RCDP1, and OI were 14.3%, 11.2%, 6.1%, and 4.1% respectively. In individuals with a positive family history for one of the diseases, the carrier frequency was 57.8%; for those with a negative family history this was 25.8%. Four PCH2 carrier-couples were identified. Thus, targeted (preconception) carrier screening in this genetically isolated population in which a high prevalence of specific disorders occurs detects a high number of carriers, and is likely to be more effective compared to cascade genetic testing. Our findings and set-up can be seen as a model for carrier screening in other high-risk subpopulations and contributes to the discussion about the way carrier screening can be offered and organized in the general population.
Collapse
Affiliation(s)
- Inge B Mathijssen
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands.
| | - Lidewij Henneman
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Phillis Lakeman
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Cecile P E Ottenheim
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Egbert J W Redeker
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Winnie Ottenhof
- Waterland Oost Midwifery Practice, Volendam, The Netherlands
| | - Hanne Meijers-Heijboer
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands; Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Merel C van Maarle
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
17
|
Lew RM, Burnett L, Proos AL, Delatycki MB. Tay-Sachs disease: current perspectives from Australia. APPLICATION OF CLINICAL GENETICS 2015; 8:19-25. [PMID: 25653550 PMCID: PMC4309774 DOI: 10.2147/tacg.s49628] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Tay-Sachs disease (TSD) is a fatal, recessively inherited neurodegenerative condition of infancy and early childhood. Although rare in most other populations, the carrier frequency is one in 25 in Ashkenazi Jews. Australian high-school-based TSD preconception genetic screening programs aim to screen, educate, and optimize reproductive choice for participants. These programs have demonstrated high uptake, low psychological morbidity, and have been shown to result in fewer than expected Jewish TSD-affected births over 18 years of operation. The majority of Jewish individuals of reproductive age outside of the high school screening program setting in Australia have not accessed screening. Recent recommendations advocate supplementing the community high school screening programs with general practitioner- and obstetrician-led genetic screening of Ashkenazi Jewish individuals for TSD and other severe recessive diseases for which this group is at risk. Massively parallel DNA sequencing is expected to become the testing modality of choice over the coming years.
Collapse
Affiliation(s)
- Raelia M Lew
- Department of Obstetrics and Gynecology, QEII Research Institute for Mothers and Infants, The University of Sydney, Australia ; Department of Obstetrics and Gynaecology, Dentistry and Health Sciences, Faculty of Medicine, The University of Melbourne, Melbourne, Australia
| | - Leslie Burnett
- NSW Health Pathology North, Royal North Shore Hospital, St Leonards, Australia ; SEALS, Prince of Wales Hospital, Randwick, Australia ; Sydney Medical School-Northern, Royal North Shore Hospital E25, University of Sydney, Sydney, Australia
| | - Anné L Proos
- NSW Health Pathology North, Royal North Shore Hospital, St Leonards, Australia
| | - Martin B Delatycki
- Department of Clinical Genetics, Austin Health, Heidelberg, Australia ; Bruce Lefroy Centre for Genetic Health Research, Murdoch Childrens Research Institute, Parkville, Australia
| |
Collapse
|
18
|
Lebo RV, Tonk VS. Analyzing the most frequent disease loci in targeted patient categories optimizes disease gene identification and test accuracy worldwide. J Transl Med 2015; 13:16. [PMID: 25604770 PMCID: PMC4312458 DOI: 10.1186/s12967-014-0333-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 11/14/2014] [Indexed: 11/10/2022] Open
Abstract
Background Our genomewide studies support targeted testing the most frequent genetic diseases by patient category: (1) pregnant patients, (2) at-risk conceptuses, (3) affected children, and (4) abnormal adults. This approach not only identifies most reported disease causing sequences accurately, but also minimizes incorrectly identified additional disease causing loci. Methods Diseases were grouped in descending order of occurrence from four data sets: (1) GeneTests 534 listed population prevalences, (2) 4129 high risk prenatal karyotypes, (3) 1265 affected patient microarrays, and (4) reanalysis of 25,452 asymptomatic patient results screened prenatally for 108 genetic diseases. These most frequent diseases are categorized by transmission: (A) autosomal recessive, (B) X-linked, (C) autosomal dominant, (D) microscopic chromosome rearrangements, (E) submicroscopic copy number changes, and (F) frequent ethnic diseases. Results Among affected and carrier patients worldwide, most reported mutant genes would be identified correctly according to one of four patient categories from at-risk couples with <64 tested genes to affected adults with 314 tested loci. Three clinically reported patient series confirmed this approach. First, only 54 targeted chromosomal sites would have detected all 938 microscopically visible unbalanced karyotypes among 4129 karyotyped POC, CVS, and amniocentesis samples. Second, 37 of 48 reported aneuploid regions were found among our 1265 clinical microarrays confirming the locations of 8 schizophrenia loci and 20 aneuploidies altering intellectual ability, while also identifying 9 of the most frequent deletion syndromes. Third, testing 15 frequent genes would have identified 124 couples with a 1 in 4 risk of a fetus with a recessive disease compared to the 127 couples identified by testing all 108 genes, while testing all mutations in 15 genes could have identified more couples. Conclusion Testing the most frequent disease causing abnormalities in 1 of 8 reported disease loci [~1 of 84 total genes] will identify ~7 of 8 reported abnormal Caucasian newborn genotypes. This would eliminate ~8 to 10 of ~10 Caucasian newborn gene sequences selected as abnormal that are actually normal variants identified when testing all ~2500 diseases looking for the remaining 1 of 8 disease causing genes. This approach enables more accurate testing within available laboratory and reimbursement resources. Electronic supplementary material The online version of this article (doi:10.1186/s12967-014-0333-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Roger V Lebo
- Department of Pathology and Laboratory Medicine, Akron Children's Hospital, One Perkins Square, Akron, OH, 44308-1062, USA. .,Northeast Ohio Medical University, Rootstown, OH, USA.
| | - Vijay S Tonk
- Department of Pediatrics, Texas Tech University Health Science Center, 4th Street 3601, Lubbock, TX, 79416, USA. .,Texas Tech University Health Sciences Center, El Paso, TX, USA.
| |
Collapse
|
19
|
Fedick AM, Jalas C, Treff NR, Knowles MR, Zariwala MA. Carrier frequencies of eleven mutations in eight genes associated with primary ciliary dyskinesia in the Ashkenazi Jewish population. Mol Genet Genomic Med 2014; 3:137-42. [PMID: 25802884 PMCID: PMC4367086 DOI: 10.1002/mgg3.124] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/19/2014] [Accepted: 10/24/2014] [Indexed: 12/02/2022] Open
Abstract
Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, autosomal recessive disorder that results from functional and ultrastructural abnormalities of motile cilia. Patients with PCD have diverse clinical phenotypes that include chronic upper and lower respiratory tract infections, situs inversus, heterotaxy with or without congenital heart disease, and male infertility, among others. In this report, the carrier frequencies for eleven mutations in eight PCD-associated genes (DNAI1, DNAI2, DNAH5, DNAH11, CCDC114, CCDC40, CCDC65, and C21orf59) that had been found in individuals of Ashkenazi Jewish descent were investigated in order to advise on including them in existing clinical mutation panels for this population. Results showed relatively high carrier frequencies for the DNAH5 c.7502G>C mutation (0.58%), the DNAI2 c.1304G>A mutation (0.50%), and the C21orf59 c.735C>G mutation (0.48%), as well as lower frequencies for mutations in DNAI1, CCDC65, CCDC114, and DNAH11 (0.10–0.29%). These results suggest that several of these genes should be considered for inclusion in carrier screening panels in the Ashkenazi Jewish population.
Collapse
Affiliation(s)
- Anastasia M Fedick
- Department of Microbiology and Molecular Genetics, Rutgers-Robert Wood Johnson Medical School Piscataway, New Jersey ; Reproductive Medicine Associates of New Jersey Basking Ridge, New Jersey
| | - Chaim Jalas
- Bonei Olam, Center for Rare Jewish Genetic Disorders Brooklyn, New Jersey
| | - Nathan R Treff
- Department of Microbiology and Molecular Genetics, Rutgers-Robert Wood Johnson Medical School Piscataway, New Jersey ; Reproductive Medicine Associates of New Jersey Basking Ridge, New Jersey
| | - Michael R Knowles
- Department of Medicine, University of North Carolina School of Medicine Chapel Hill, North Carolina
| | - Maimoona A Zariwala
- Department of Pathology/Lab Medicine, University of North Carolina School of Medicine Chapel Hill, North Carolina
| |
Collapse
|
20
|
Fedick AM, Shi L, Jalas C, Treff NR, Ekstein J, Kornreich R, Edelmann L, Mehta L, Savage SA. Carrier screening of RTEL1 mutations in the Ashkenazi Jewish population. Clin Genet 2014; 88:177-81. [PMID: 25047097 DOI: 10.1111/cge.12459] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/09/2014] [Accepted: 07/14/2014] [Indexed: 11/26/2022]
Abstract
Hoyeraal-Hreidarsson syndrome (HH) is a clinically severe variant of dyskeratosis congenita (DC), characterized by cerebellar hypoplasia, microcephaly, intrauterine growth retardation, and severe immunodeficiency in addition to features of DC. Germline mutations in the RTEL1 gene have recently been identified as causative of HH. In this study, the carrier frequency for five RTEL1 mutations that occurred in individuals of Ashkenazi Jewish descent was investigated in order to advise on including them in existing clinical mutation panels for this population. Our screening showed that the carrier frequency for c.3791G>A (p.R1264H) was higher than expected, 1% in the Ashkenazi Orthodox and 0.45% in the general Ashkenazi Jewish population. Haplotype analyses suggested the presence of a common founder. We recommend that the c.3791G>A RTEL1 mutation be considered for inclusion in carrier screening panels in the Ashkenazi population.
Collapse
Affiliation(s)
- A M Fedick
- Department of Microbiology and Molecular Genetics, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA.,Reproductive Medicine Associates of New Jersey, Basking Ridge, NJ, USA
| | - L Shi
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C Jalas
- Bonei Olam, Center for Rare Jewish Genetic Disorders, Brooklyn, NY, USA
| | - N R Treff
- Department of Microbiology and Molecular Genetics, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA.,Reproductive Medicine Associates of New Jersey, Basking Ridge, NJ, USA
| | - J Ekstein
- Dor Yeshorim, The Committee for Prevention of Jewish Diseases, Brooklyn, NY, USA
| | - R Kornreich
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Edelmann
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Mehta
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S A Savage
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| |
Collapse
|
21
|
Hoffman JD, Park JJ, Schreiber-Agus N, Kornreich R, Tanner AK, Keiles S, Friedman KJ, Heim RA. The Ashkenazi Jewish carrier screening panel: evolution, status quo, and disparities. Prenat Diagn 2014; 34:1161-7. [DOI: 10.1002/pd.4446] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 06/18/2014] [Accepted: 06/27/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Jodi D. Hoffman
- Division of Genetics; Floating Hospital for Children, Tufts Medical Center; Boston MA USA
| | - Jessica J. Park
- Medical School; Tufts University School of Medicine; Boston MA USA
| | - Nicole Schreiber-Agus
- Program for Jewish Genetic Health; Albert Einstein College of Medicine; Bronx NY USA
| | - Ruth Kornreich
- Mount Sinai Genetic Testing Laboratory; Icahn School of Medicine at Mount Sinai; New York NY USA
| | | | | | | | - Ruth A. Heim
- Integrated Genetics, Laboratory Corporation of America® Holdings; Westborough MA USA
| |
Collapse
|
22
|
Hoffman JD, Greger V, Strovel ET, Blitzer MG, Umbarger MA, Kennedy C, Bishop B, Saunders P, Porreca GJ, Schienda J, Davie J, Hallam S, Towne C. Next-generation DNA sequencing of HEXA: a step in the right direction for carrier screening. Mol Genet Genomic Med 2013; 1:260-8. [PMID: 24498621 PMCID: PMC3865593 DOI: 10.1002/mgg3.37] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 07/30/2013] [Accepted: 08/02/2013] [Indexed: 11/12/2022] Open
Abstract
Tay-Sachs disease (TSD) is the prototype for ethnic-based carrier screening, with a carrier rate of ∼1/27 in Ashkenazi Jews and French Canadians. HexA enzyme analysis is the current gold standard for TSD carrier screening (detection rate ∼98%), but has technical limitations. We compared DNA analysis by next-generation DNA sequencing (NGS) plus an assay for the 7.6 kb deletion to enzyme analysis for TSD carrier screening using 74 samples collected from participants at a TSD family conference. Fifty-one of 74 participants had positive enzyme results (46 carriers, five late-onset Tay-Sachs [LOTS]), 16 had negative, and seven had inconclusive results. NGS + 7.6 kb del screening of HEXA found a pathogenic mutation, pseudoallele, or variant of unknown significance (VUS) in 100% of the enzyme-positive or obligate carrier/enzyme-inconclusive samples. NGS detected the B1 allele in two enzyme-negative obligate carriers. Our data indicate that NGS can be used as a TSD clinical carrier screening tool. We demonstrate that NGS can be superior in detecting TSD carriers compared to traditional enzyme and genotyping methodologies, which are limited by false-positive and false-negative results and ethnically focused, limited mutation panels, respectively, but is not ready for sole use due to lack of information regarding some VUS.
Collapse
Affiliation(s)
- Jodi D Hoffman
- Division of Genetics, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center Boston, Massachusetts
| | | | - Erin T Strovel
- Division of Genetics, Department of Pediatrics, University of MD School of Medicine Baltimore, Maryland
| | - Miriam G Blitzer
- Division of Genetics, Department of Pediatrics, University of MD School of Medicine Baltimore, Maryland
| | | | | | - Brian Bishop
- Good Start Genetics Inc. Cambridge, Massachusetts
| | | | | | | | | | | | | |
Collapse
|
23
|
Fedick A, Jalas C, Abeliovich D, Krakinovsky Y, Ekstein J, Ekstein A, Treff N. Carrier frequency of twoBBS2mutations in the Ashkenazi population. Clin Genet 2013; 85:578-82. [DOI: 10.1111/cge.12231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/03/2013] [Accepted: 07/03/2013] [Indexed: 01/17/2023]
Affiliation(s)
- A. Fedick
- Department of Microbiology and Molecular Genetics; UMDNJ-Robert Wood Johnson Medical School; Piscataway NJ USA
- Reproductive Medicine Associates of New Jersey; Basking Ridge NJ USA
| | - C. Jalas
- Center for Rare Jewish Genetic Disorders; Brooklyn NY USA
| | - D. Abeliovich
- Committee for Prevention of Jewish Genetic Diseases; Jerusalem Israel
- Mogen Body Laboratory LTD; Jerusalem Israel
| | | | - J. Ekstein
- Committee for Prevention of Jewish Genetic Diseases; Jerusalem Israel
- Committee for Prevention of Jewish Genetic Diseases; Brooklyn NY USA
| | - A. Ekstein
- Committee for Prevention of Jewish Genetic Diseases; Jerusalem Israel
| | - N.R. Treff
- Department of Microbiology and Molecular Genetics; UMDNJ-Robert Wood Johnson Medical School; Piscataway NJ USA
- Reproductive Medicine Associates of New Jersey; Basking Ridge NJ USA
| |
Collapse
|
24
|
Fedick A, Jalas C, Treff NR. A deleterious mutation in the PEX2 gene causes Zellweger syndrome in individuals of Ashkenazi Jewish descent. Clin Genet 2013; 85:343-6. [PMID: 23590336 DOI: 10.1111/cge.12170] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 04/12/2013] [Accepted: 04/12/2013] [Indexed: 11/29/2022]
Abstract
Zellweger syndrome is known to be caused by numerous mutations that occur in at least 12 of the PEX genes. While phenotypes vary, many are severely debilitating, and death can result in affected newborns. Since the disease follows an autosomal recessive pattern of inheritance, carrier screening can be done for at-risk couples, but the number of potential mutations sites to screen can be daunting. Ethnicity-specific studies can help narrow this range by highlighting mutations that are present at higher percentages in certain populations. In this article, the carrier frequencies for two mutations causative of the severe Zellweger syndrome spectrum phenotype that occur in the PEX2 gene, c.355C>T and c.550del, were studied in individuals of Ashkenazi Jewish descent in order to advise on inclusion in existing carrier screening mutation panels for this population. The screening was performed for 2093 individuals through the use of TaqMan genotyping assays, real-time PCR, and allelic discrimination. Results indicated a carrier frequency of 0.813% (±0.385%) for the c.355C>T mutation and a carrier frequency of 0.00% (±0.00%) for the c.550del mutation. On the basis of these frequencies, we believe that the c.355C>T mutation should be considered for inclusion in carrier screening panels for the Ashkenazi population.
Collapse
Affiliation(s)
- A Fedick
- Department of Microbiology and Molecular Genetics, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, 08854-5635, USA; Reproductive Medicine Associates of New Jersey, Basking Ridge, NJ, 07920, USA
| | | | | |
Collapse
|
25
|
Fedick A, Su J, Jalas C, Northrop L, Devkota B, Ekstein J, Treff NR. High-throughput carrier screening using TaqMan allelic discrimination. PLoS One 2013; 8:e59722. [PMID: 23555759 PMCID: PMC3608587 DOI: 10.1371/journal.pone.0059722] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 02/17/2013] [Indexed: 12/29/2022] Open
Abstract
Members of the Ashkenazi Jewish community are at an increased risk for inheritance of numerous genetic diseases such that carrier screening is medically recommended. This paper describes the development and evaluation of 30 TaqMan allelic discrimination qPCR assays for 29 mutations on 2 different high-throughput platforms. Four of these mutations are in the GBA gene and are successfully examined using short amplicons due to the qualitative nature of TaqMan allelic discrimination. Two systems were tested for their reliability (call rate) and consistency with previous diagnoses (diagnostic accuracy) indicating a call rate of 99.04% and a diagnostic accuracy of 100% (+/−0.00%) from one platform, and a call rate of 94.66% and a diagnostic accuracy of 93.35% (+/−0.29%) from a second for 9,216 genotypes. Results for mutations tested at the expected carrier frequency indicated a call rate of 97.87% and a diagnostic accuracy of 99.96% (+/−0.05%). This study demonstrated the ability of a high throughput qPCR methodology to accurately and reliably genotype 29 mutations in parallel. The universally applicable nature of this technology provides an opportunity to increase the number of mutations that can be screened simultaneously, and reduce the cost and turnaround time for accommodating newly identified and clinically relevant mutations.
Collapse
Affiliation(s)
- Anastasia Fedick
- Department of Microbiology and Molecular Genetics, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey, United States of America.
| | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
Biochemical testing of hexosaminidase A (HexA) enzyme activity has been available for decades and has the ability to detect almost all Tay-Sachs disease (TSD) carriers, irrespective of ethnic background. This is increasingly important, as the gene pool of those who identify as Ashkenazi Jewish is diversifying. Here we describe the analysis of a cohort of 4,325 individuals arising from large carrier screening programs and tested by the serum and/or platelet HexA enzyme assays and by targeted DNA mutation analysis. Our results continue to support the platelet assay as a highly effective method for TSD carrier screening, with a low inconclusive rate and the ability to detect possible disease-causing mutation carriers that would have been missed by targeted DNA mutation analysis. Sequence analysis performed on one such platelet assay carrier, who had one non-Ashkenazi Jewish parent, identified the amino acid change Thr259Ala (A775G). Based on crystallographic modeling, this change is predicted to be deleterious, as threonine 259 is positioned proximal to the HexA alpha subunit active site and helps to stabilize key residues therein. Accordingly, if individuals are screened for TSD in broad-based programs by targeted molecular testing alone, they must be made aware that there is a more sensitive and inexpensive test available that can identify additional carriers. Alternatively, the enzyme assays can be offered as a first tier test, especially when screening individuals of mixed or non-Jewish ancestry.
Collapse
|
27
|
|
28
|
Scott SA, Edelmann L, Liu L, Luo M, Desnick RJ, Kornreich R. Experience with carrier screening and prenatal diagnosis for 16 Ashkenazi Jewish genetic diseases. Hum Mutat 2010; 31:1240-50. [PMID: 20672374 DOI: 10.1002/humu.21327] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The success of prenatal carrier screening as a disease prevention strategy in the Ashkenazi Jewish (AJ) population has driven the expansion of screening panels as disease-causing founder mutations have been identified. However, the carrier frequencies of many of these mutations have not been reported in large AJ cohorts. We determined the carrier frequencies of over 100 mutations for 16 recessive disorders in the New York metropolitan area AJ population. Among the 100% AJ-descended individuals, screening for 16 disorders resulted in ∼1 in 3.3 being a carrier for one disease and ∼1 in 24 for two diseases. The carrier frequencies ranged from 0.066 (1 in 15.2; Gaucher disease) to 0.006 (1 in 168; nemaline myopathy), which averaged ∼15% higher than those for all screenees. Importantly, over 95% of screenees chose to be screened for all possible AJ diseases, including disorders with lower carrier frequencies and/or detectability. Carrier screening also identified rare individuals homozygous for disease-causing mutations who had previously unrecognized clinical manifestations. Additionally, prenatal testing results and experience for all 16 disorders (n = 574) are reported. Together, these data indicate the general acceptance, carrier frequencies, and prenatal testing results for an expanded panel of 16 diseases in the AJ population.
Collapse
Affiliation(s)
- Stuart A Scott
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine of New York University, New York, NY 10029, USA
| | | | | | | | | | | |
Collapse
|
29
|
Colaianni A, Chandrasekharan S, Cook-Deegan R. Impact of gene patents and licensing practices on access to genetic testing and carrier screening for Tay-Sachs and Canavan disease. Genet Med 2010; 12:S5-S14. [PMID: 20393311 PMCID: PMC3042321 DOI: 10.1097/gim.0b013e3181d5a669] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Genetic testing for Tay-Sachs and Canavan disease is particularly important for Ashkenazi Jews, because both conditions are more frequent in that population. This comparative case study was possible because of different patenting and licensing practices. The role of DNA testing differs between Tay-Sachs and Canavan diseases. The first-line screening test for Tay-Sachs remains an enzyme activity test rather than genotyping. Genotyping is used for preimplantation diagnosis and confirmatory testing. In contrast, DNA-based testing is the basis for Canavan screening and diagnosis. The HEXA gene for Tay-Sachs was cloned at the National Institutes of Health, and the gene was patented but has not been licensed. The ASPA gene for Canavan disease was cloned and patented by Miami Children's Hospital. Miami Children's Hospital did not inform family members and patient groups that had contributed to the gene discovery that it was applying for a patent, and pursued restrictive licensing practices when a patent issued in 1997. This led to intense controversy, litigation, and a sealed, nonpublic 2003 settlement that apparently allowed for nonexclusive licensing. A survey of laboratories revealed a possible price premium for ASPA testing, with per-unit costs higher than for other genetic tests in the Secretary's Advisory Committee on Genetics, Health, and Society case studies. The main conclusion from comparing genetic testing for Tay-Sachs and Canavan diseases, however, is that patenting and licensing conducted without communication with patients and advocates cause mistrust and can lead to controversy and litigation, a negative model to contrast with the positive model of patenting and licensing for genetic testing of cystic fibrosis.
Collapse
Affiliation(s)
- Alessandra Colaianni
- Center for Public Genomics, Center for Genome Ethics, Law & Policy, Institute for Genome Sciences & Policy, Duke University, Durham, NC 27708, USA
| | | | | |
Collapse
|
30
|
Best practices: antenatal screening for common genetic conditions other than aneuploidy. Curr Opin Obstet Gynecol 2010; 22:139-45. [DOI: 10.1097/gco.0b013e3283372379] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Current world literature. Curr Opin Obstet Gynecol 2010; 22:166-75. [PMID: 20216348 DOI: 10.1097/gco.0b013e328338c956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
32
|
Kalman L, Wilson JA, Buller A, Dixon J, Edelmann L, Geller L, Highsmith WE, Holtegaard L, Kornreich R, Rohlfs EM, Payeur TL, Sellers T, Toji L, Muralidharan K. Development of genomic DNA reference materials for genetic testing of disorders common in people of ashkenazi jewish descent. J Mol Diagn 2009; 11:530-6. [PMID: 19815695 DOI: 10.2353/jmoldx.2009.090050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Many recessive genetic disorders are found at a higher incidence in people of Ashkenazi Jewish (AJ) descent than in the general population. The American College of Medical Genetics and the American College of Obstetricians and Gynecologists have recommended that individuals of AJ descent undergo carrier screening for Tay Sachs disease, Canavan disease, familial dysautonomia, mucolipidosis IV, Niemann-Pick disease type A, Fanconi anemia type C, Bloom syndrome, and Gaucher disease. Although these recommendations have led to increased test volumes and number of laboratories offering AJ screening, well-characterized genomic reference materials are not publicly available. The Centers for Disease Control and Prevention-based Genetic Testing Reference Materials Coordination Program, in collaboration with members of the genetic testing community and Coriell Cell Repositories, have developed a panel of characterized genomic reference materials for AJ genetic testing. DNA from 31 cell lines, representing many of the common alleles for Tay Sachs disease, Canavan disease, familial dysautonomia, mucolipidosis IV, Niemann-Pick disease type A, Fanconi anemia type C, Bloom syndrome, Gaucher disease, and glycogen storage disease, was prepared by the Repository and tested in six clinical laboratories using three different PCR-based assay platforms. A total of 33 disease alleles was assayed and 25 different alleles were identified. These characterized materials are publicly available from Coriell and may be used for quality control, proficiency testing, test development, and research.
Collapse
Affiliation(s)
- Lisa Kalman
- Laboratory Practice Evaluation and Genomics Branch, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop G23, Atlanta, GA 30333, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Raz AE. Can population-based carrier screening be left to the community? J Genet Couns 2009; 18:114-8. [PMID: 19234774 DOI: 10.1007/s10897-008-9209-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Accepted: 12/04/2008] [Indexed: 10/21/2022]
Abstract
As more genes and mutations are identified in diseases for which particular populations are at increased risk, it is becoming more important to address the social interface between communities and carrier screening. While disproportionately targeted in genetic research, the Orthodox Jewish community often shies away, due to social and religious constraints, from genetic testing and counseling offered by the public health system. The solution is provided by Dor Yeshorim--a program which has become for many a prototype for the successful merging of modern reprogenetic screening and traditional communities. My commentary focuses on the gaps between the rationale and practice of Dor Yeshorim, and the implications of these gaps regarding the trade-off involved in leaving carrier screening to the community. I conclude with a set of questions raised by the implications of the unintended consequences of community genetics.
Collapse
Affiliation(s)
- Aviad E Raz
- Dept of Sociology and Anthropology, Ben-Gurion University, Beer-Sheva, Israel.
| |
Collapse
|
34
|
Solomon BD, Jack BW, Feero WG. The clinical content of preconception care: genetics and genomics. Am J Obstet Gynecol 2008; 199:S340-4. [PMID: 19081428 PMCID: PMC2636723 DOI: 10.1016/j.ajog.2008.09.870] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Revised: 09/22/2008] [Accepted: 09/25/2008] [Indexed: 11/17/2022]
Abstract
The prevalence of paternal and maternal genetic conditions that affect pregnancy varies according to many factors that include parental age, medical history, and family history. Although some genetic conditions that affect pregnancy are identified easily early in life, other conditions are not and may require additional diagnostic testing. A complete 3-generation family medical history that includes ethnicity information about both sides of the family is arguably the single best genetic "test" that is applicable to preconception care. Assessment of genetic risk by an experienced professional has been shown to improve the detection rate of identifiable risk factors. Learning about possible genetic issues in the preconception period is ideal, because knowledge permits patients to make informed reproductive decisions. Options that are available to couples before conception include adoption, surrogacy, use of donor sperm, in vitro fertilization after preimplantation genetic diagnosis, and avoidance of pregnancy. Future technologic advances will increase the choices that are available to couples.
Collapse
Affiliation(s)
- Benjamin D Solomon
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | | | | |
Collapse
|
35
|
|