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Shlomovitz O, Atias-Varon D, Yagel D, Barel O, Shasha-Lavsky H, Skorecki K, Eliyahu A, Bathish Y, Frajewicki V, Kushnir D, Zaid R, Paperna T, Ofir A, Tchirkov M, Hassan K, Kruzel E, Khazim K, Geron R, Weisman I, Hanut A, Nakhoul F, Kenig-Kozlovsky Y, Refael G, Antebi A, Storch S, Leiba M, Kagan M, Shukrun R, Rechavi G, Dekel B, Ben Moshe Y, Weiss K, Assady S, Vivante A. Genetic Markers Among the Israeli Druze Minority Population With End-Stage Kidney Disease. Am J Kidney Dis 2024; 83:183-195. [PMID: 37717846 DOI: 10.1053/j.ajkd.2023.06.006] [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: 12/31/2022] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 09/19/2023]
Abstract
RATIONALE & OBJECTIVE Genetic etiologies have been identified among approximately 10% of adults with chronic kidney disease (CKD). However, data are lacking regarding the prevalence of monogenic etiologies especially among members of minority groups. This study characterized the genetic markers among members of an Israeli minority group with end-stage kidney disease (ESKD). STUDY DESIGN A national-multicenter cross-sectional study of Israeli Druze patients (an Arabic-speaking Near-Eastern transnational population isolate) who are receiving maintenance dialysis for ESKD. All study participants underwent exome sequencing. SETTING & PARTICIPANTS We recruited 94 adults with ESKD, comprising 97% of the total 97 Druze individuals throughout Israel being treated with dialysis during the study period. PREDICTORS Demographics and clinical characteristics of kidney disease. OUTCOME Genetic markers. ANALYTICAL APPROACH Whole-exome sequencing and the relationship of markers to clinical phenotypes. RESULTS We identified genetic etiologies in 17 of 94 participants (18%). None had a previous molecular diagnosis. A novel, population-specific, WDR19 homozygous pathogenic variant (p.Cys293Tyr) was the most common genetic finding. Other monogenic etiologies included PKD1, PKD2, type IV collagen mutations, and monogenic forms of noncommunicable diseases. The pre-exome clinical diagnosis corresponded to the final molecular diagnosis in fewer than half of the participants. LIMITATIONS This study was limited to Druze individuals, so its generalizability may be limited. CONCLUSIONS Exome sequencing identified a genetic diagnosis in approximately 18% of Druze individuals with ESKD. These results support conducting genetic analyses in minority populations with high rates of CKD and for whom phenotypic disease specificity may be low. PLAIN-LANGUAGE SUMMARY Chronic kidney disease (CKD) affects many people worldwide and has multiple genetic causes. However, there is limited information on the prevalence of genetic etiologies, especially among minority populations. Our national-multicenter study focused on Israeli Druze patients. Using exome-sequencing, we identified previously undetected genetic causes in nearly 20% of patients, including a new and population-specific WDR19 homozygous pathogenic variant. This mutation has not been previously described; it is extremely rare globally but is common among the Druze, which highlights the importance of studying minority populations with high rates of CKD. Our findings provide insights into the genetic basis of end-stage kidney disease in the Israeli Druze, expand the WDR19 phenotypic spectrum, and emphasize the potential value of genetic testing in such populations.
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Affiliation(s)
- Omer Shlomovitz
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Danit Atias-Varon
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Dina Yagel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ortal Barel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel
| | - Hadas Shasha-Lavsky
- Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel; Department of Pediatric Nephrology, Galilee Medical Center, Nahariya, Israel
| | - Karl Skorecki
- Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel
| | - Aviva Eliyahu
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Victor Frajewicki
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Daniel Kushnir
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Rinat Zaid
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Tamar Paperna
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Ayala Ofir
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Marina Tchirkov
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Kamal Hassan
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Etty Kruzel
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Khaled Khazim
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Ronit Geron
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Irit Weisman
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Anaam Hanut
- Division of Nephrology and Hypertension Baruch Padeh Medical Center Poriya, Tiberias, Israel
| | - Farid Nakhoul
- Division of Nephrology and Hypertension Baruch Padeh Medical Center Poriya, Tiberias, Israel
| | - Yael Kenig-Kozlovsky
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Gery Refael
- Nephrology Unit, Mayanei HaYeshua Medical Center, Bnei Brak, Israel
| | - Alon Antebi
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Shimon Storch
- Nephrology and Hypertension Unit, Bnai-Zion Medical Center, Haifa, Israel
| | | | - Maayan Kagan
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Rachel Shukrun
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Gidi Rechavi
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel; Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel
| | - Benjamin Dekel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; Pediatric Stem Cell Research Institute, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Division of Pediatric Nephrology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yishay Ben Moshe
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Karin Weiss
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Suheir Assady
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Asaf Vivante
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; Division of Pediatric Nephrology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
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Atia O, Benchimol EI, Ledderman N, Greenfeld S, Kariv R, Weisband YL, Matz E, Ollech J, Dotan I, Assa A, Shouval DS, Uhlig HH, Muise AM, Olén O, Kuenzig ME, Kaplan GG, Turner D. Incidence, Management, and Outcomes of Very Early Onset Inflammatory Bowel Diseases and Infantile-Onset Disease: An Epi-IIRN Study. Clin Gastroenterol Hepatol 2023; 21:2639-2648.e6. [PMID: 36336312 DOI: 10.1016/j.cgh.2022.10.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND & AIMS In this nationwide study from the Israeli Inflammatory Bowel Disease Research Nucleus, we aimed to describe the incidence of very early onset inflammatory bowel diseases (VEOIBDs) with a focus on infantile-onset disease and to compare management and disease course with older children. METHODS Data were retrieved from the 4 Israeli Health Maintenance Organizations covering 98% of the population. Pediatric-onset IBD was categorized as follows: adolescent onset (10 to <18 y), early onset (6 to <10 y), VEOIBD (0 to <6 y), toddler onset (2 to <6 y), and infantile onset (<2 y). RESULTS A total of 5243 children with 35,469 person-years of follow-up evaluation, were diagnosed with IBD during 2005 to 2020: 4444 (85%) with adolescent onset, 548 (10%) with early onset, and 251 (4.8%) with VEOIBD, of whom 81 (1.5%) had infantile onset. The incidence of pediatric-onset IBD increased from 10.8 per 100,000 in 2005 to 15.3 per 100,000 in 2019 (average annual percentage change, 2.8%; 95% CI, 2.2%-3.4%), but that of VEOIBD remained stable (average annual percentage change, 0%; 95% CI, -2.5% to 2.6%). The infantile-onset and toddler-onset groups were treated less often with biologics (36% and 35%, respectively) vs the early onset (57%) and adolescent-onset groups (53%; P < .001). The time to steroid dependency was shorter in infantile-onset (hazard ratio [HR], 2.1; 95% CI, 1.5-2.9) and toddler-onset disease (HR, 1.6; 95% CI, 1.2-2.0) vs early onset and adolescent-onset disease, but time to hospitalizations, time to surgery, and growth delay were worse only in infantile-onset disease. In a multivariable model, infantile-onset patients had a higher risk for surgery (HR, 1.4; 95% CI, 1.1-1.9) and hospitalization (HR, 1.7; 95% CI, 1.2-2.4) than the toddler-onset group. CONCLUSIONS The incidence of VEOIBD remained stable. Infantile-onset IBD had worse outcomes than older children, while toddler onset had mostly similar outcomes, despite less frequent use of biologics.
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Affiliation(s)
- Ohad Atia
- Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eric I Benchimol
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Natan Ledderman
- Meuhedet Health Services, Meuhedet Research Institue, Tel-Aviv, Israel
| | - Shira Greenfeld
- Maccabi Health Services, Maccabi Research Institue, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Revital Kariv
- Maccabi Health Services, Maccabi Research Institue, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | | | - Eran Matz
- Leumit Health Services, Leumit Research Institue, Tel-Aviv, Israel
| | - Jacob Ollech
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel
| | - Iris Dotan
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel
| | - Amit Assa
- Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dror S Shouval
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Schneider Children's Hospital, Petah Tikva, Israel
| | - Holm H Uhlig
- Translational Gastroenterology Unit, Biomedical Research Center, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Aleixo M Muise
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Ola Olén
- Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - M Ellen Kuenzig
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Gilaad G Kaplan
- Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Dan Turner
- Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.
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Finkelstein A, Bachner YG, Stein E, Benisti L, Tenenbaum A. Challenging and Facilitating Factors When Coping with the News of a Newborn's Down Syndrome Diagnosis: Perceptions of Activist Israeli Mothers. HEALTH COMMUNICATION 2023; 38:1349-1358. [PMID: 34894913 DOI: 10.1080/10410236.2021.2010326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Studies have shown that healthcare professionals (HP) play a significant role in parents' experience when informed of the birth of a child with Down Syndrome (DS). Past studies have focused on faith dilemmas of religious mothers that were informed that their child was born with DS and on understanding how faith was a source of emotional support for them. Studies that focus on religious activist mothers are scarce. We utilized a qualitative methodology to explore the experiences of Jewish mothers who are religious and activists. Semistructured interviews and focus groups were conducted with 17 religious Jewish mothers of children with DS, who participated in an activist, self-support group. The data were analyzed using interpretative phenomenological analysis (IPA). Most mothers felt unsupported by the HP although a few mentioned being congratulated on the birth and empowered by a physician who focused on their child's potential to develop. The mothers appreciated when HPs considered their opinions and values. They shared the common goal of changing the existing pathological, statistics-based discourse concerning children with DS. The study reinforces the important role of HP and policymakers' in collaborating with parents and their support groups early in the diagnostic stage.
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Affiliation(s)
- Adi Finkelstein
- Department of Nursing, Faculty of Life and Health Sciences, Jerusalem College of Technology
| | | | - Elkie Stein
- Department of Pediatrics, Hadassah Medical Center and the Faculty of Medicine, Hebrew University of Jerusalem
| | | | - Ariel Tenenbaum
- Department of Pediatrics, Hadassah Medical Center and the Faculty of Medicine, Hebrew University of Jerusalem
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Mahtani R, Niyazov A, Lewis K, Rider A, Massey L, Arondekar B, Lux MP. Real-World Study of Regional Differences in Patient Demographics, Clinical Characteristics, and BRCA1/2 Mutation Testing in Patients with Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer in the United States, Europe, and Israel. Adv Ther 2023; 40:331-348. [PMID: 36333567 PMCID: PMC9859923 DOI: 10.1007/s12325-022-02302-2] [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: 07/13/2022] [Accepted: 08/10/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Genetic mutations in breast cancer susceptibility gene 1 or 2 (BRCA1/2) confer a high risk for developing breast cancer; however, at least 50% of women with BRCA1/2 mutations go undiagnosed. This study evaluated differences in patient demographics, clinical characteristics, and BRCA1/2 mutation testing in the USA, European Union (EU4), and Israel in a real-world population of patients with human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC). METHODS This study was a retrospective analysis of data from the Adelphi Real World ABC Disease Specific Programme in the USA, EU4, and Israel. Medical oncologists completed a patient record form, which included detailed questions on demographics, clinical assessments and outcomes, and treatment history. Eligible patients were at least 18 years of age and receiving therapy for stage IIIb-IV ABC. RESULTS Among the 2527 study patients, 407 were from the USA, 1926 were from the EU4, and 194 were from Israel; 86% had hormone receptor-positive (HR+)/HER2- ABC and 14% had triple-negative breast cancer (TNBC). Israeli patients had a higher rate of family history of BRCA-related cancer (69%) compared with patients in the EU4 (18%; p < 0.0001) and USA (18%; p < 0.0001). Among patients with HR+/HER2- ABC, the BRCA1/2 testing rate was 99% in Israel, 37% in the EU4, and 68% in the USA (p < 0.0001 vs Israel and the EU4). The age of tested patients was significantly younger in Israel (56 years) compared with the EU4 (59 years; p = 0.016 vs Israel) and USA (64 years; p < 0.0001 vs Israel and the EU4). Among patients with TNBC, the BRCA1/2 testing rate was 100% in Israel, 78% in the EU4 (p < 0.0001 vs Israel), and 93% in the USA (p < 0.002 vs the EU4). Among tested patients, genetic counseling rates were also higher in Israel (98%) compared with the EU4 (40%; p < 0.0001) and USA (38%; p < 0.0001). CONCLUSIONS Testing and genetic counseling rates for BRCA1/2 mutations were very high in Israel, potentially due to the high rate of family history of BRCA-related cancer in this population and higher general awareness of genetic testing. In the EU4 and USA, overall rates of testing for BRCA1/2 mutations and genetic counseling were significantly lower compared with Israel. Given the high risk of breast cancer in BRCA1/2 mutation carriers and the efficacy of new therapies in treating ABC with a BRCA1/2 mutation, efforts should be made to improve BRCA1/2 testing rates in Europe and the USA.
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Affiliation(s)
| | | | - Katie Lewis
- Oncology Franchise, Adelphi Real World, Adelphi Mill, Bollington, SK10 5JB UK
| | - Alex Rider
- Oncology Franchise, Adelphi Real World, Adelphi Mill, Bollington, SK10 5JB UK
| | - Lucy Massey
- Department of Statistics and Data Analytics, Adelphi Real World, Bollington, UK
| | | | - Michael P. Lux
- Klinik für Gynäkologie und Geburtshilfe Frauenklinik St. Louise, Paderborn, Frauenklinik St. Josefs-Krankenhaus, Salzkotten, St. Vincenz Kliniken, Paderborn, Germany
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Analysis of the genetic basis of height in large Jewish nuclear families. PLoS Genet 2019; 15:e1008082. [PMID: 31283753 PMCID: PMC6638967 DOI: 10.1371/journal.pgen.1008082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 07/18/2019] [Accepted: 03/11/2019] [Indexed: 12/26/2022] Open
Abstract
Despite intensive study, most of the specific genetic factors that contribute to variation in human height remain undiscovered. We conducted a family-based linkage study of height in a unique cohort of very large nuclear families from a founder (Jewish) population. This design allowed for increased power to detect linkage, compared to previous family-based studies. Loci we identified in discovery families could explain an estimated lower bound of 6% of the variance in height in validation families. We showed that these loci are not tagging known common variants associated with height. Rather, we suggest that the observed signals arise from variants with large effects that are rare globally but elevated in frequency in the Jewish population. Rare variants with large effects have been suggested to account for some of the missing heritability of height, but detection of such variants in genome-wide association studies (GWAS) requires very large sample sizes due to their low frequencies. Here, we designed a unique study of height, in which we sought to increase the effective frequency of rare variants in our sample. This was done by assembling a cohort of very large nuclear families, with an average of 12 and a maximum of 20 siblings per nuclear family. In this design, any variant segregating in our cohort has a minimum expected frequency of ~1%, regardless of its frequency in the general population. In addition, we recruited all participants from a founder (Jewish) population, in which some variants that are rare in a cosmopolitan population can rise to high frequencies. To further increase power, we developed methods to obtain highly accurate height measurements, genotype calls, and inheritance pattern reconstructions. These factors allowed us to detect many more QTLs than previous family-based studies of height, despite a modest sample size of only 397 participants. The approach described in this paper provides insights into the genetic basis of height and the roles of population-specific vs. cosmopolitan variants, and may serve as a complement to GWAS for genetic investigations of other complex traits.
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Noninvasive paternal exclusion testing for cystic fibrosis in the first five to eight weeks of gestation. Sci Rep 2018; 8:15941. [PMID: 30374031 PMCID: PMC6205998 DOI: 10.1038/s41598-018-34396-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/16/2018] [Indexed: 12/23/2022] Open
Abstract
Prenatal genetic testing is not generally applicable to the very early stages of pregnancy (prior to week 8 gestation), a time period that is crucial to pregnant couples with high risk for transmission of genetic disease to their fetus. Therefore, we developed a new ultra-sensitive targeted next generation sequencing method for noninvasive haplotype-based paternal allele exclusion testing of the cystic fibrosis-associated gene, CFTR. This new method was compared to a conventional library prep and sequencing analysis method and all test results were validated by amniotic fluid testing at later stages of pregnancy. Out of 7 enrolled couples, who provided at least two blood samples (at least one week apart) for noninvasive CFTR testing, a result was obtained for 6 fetuses. Using the new hypersensitive method, all six couples (100%) received a correct diagnosis for the paternal allele as opposed to 3/6 (50%) when tested with the conventional strategy. Among 4 couples who provided just one early pregnancy blood draw for analysis, diagnosis was possible in one fetus, but only using the ultra-sensitive method. Thus, we describe a novel noninvasive CFTR screening method which demonstrates unprecedented fetal allele typing accuracy in the earliest stages of pregnancy.
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Aboukaoud M, Israel S, Brautbar C, Eyal S. Genetic Basis of Delayed Hypersensitivity Reactions to Drugs in Jewish and Arab Populations. Pharm Res 2018; 35:211. [PMID: 30225831 DOI: 10.1007/s11095-018-2472-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/01/2018] [Indexed: 12/15/2022]
Abstract
Genetic variation can affect drug pharmacokinetics and pharmacodynamics and contribute to variability between individuals in response to medications. Specifically, differences in allele frequencies among individuals and ethnic groups have been associated with variation in their propensity to develop drug hypersensitivity reactions (HSRs). This article reviews the current knowledge on the genetic background of HSRs and its relevance to Jewish and Arab populations. The focus is on human leukocyte antigen (HLA) alleles and haplotypes as predictive markers of HSRs ("immunopharmacogenetics"), but other genes and alleles are described as well. Also discussed is the translation of the pharmacogenetic information to practice recommendations.
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Affiliation(s)
- Mohammed Aboukaoud
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Room 613, Ein Kerem, 91120, Jerusalem, Israel
| | - Shoshana Israel
- Tissue Typing Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Chaim Brautbar
- Tissue Typing Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Sara Eyal
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Room 613, Ein Kerem, 91120, Jerusalem, Israel.
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Salen G, Steiner RD. Epidemiology, diagnosis, and treatment of cerebrotendinous xanthomatosis (CTX). J Inherit Metab Dis 2017; 40:771-781. [PMID: 28980151 DOI: 10.1007/s10545-017-0093-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/08/2017] [Accepted: 09/14/2017] [Indexed: 01/05/2023]
Abstract
Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disorder of bile acid synthesis caused by mutations in the cytochrome P450 CYP27A1 gene that result in production of a defective sterol 27-hydroxylase enzyme. CTX is associated with abnormally high levels of cholestanol in the blood and accumulation of cholestanol and cholesterol in the brain, tendon xanthomas, and bile. Hallmark clinical manifestations of CTX include chronic diarrhea, bilateral cataracts, tendon xanthomas, and neurologic dysfunction. Although CTX is a rare disorder, it is thought to be underdiagnosed, as presenting signs and symptoms may be nonspecific with significant overlap with other more common conditions. There is marked variability in signs and symptoms, severity, and age of onset between patients. The disease course is progressive and potentially debilitating or fatal, particularly with respect to neurologic presentations that can include intellectual disability, autism, behavioral and psychiatric problems, and dementia, among others. Treatment with chenodeoxycholic acid (CDCA; chenodiol) is the current standard of care. CDCA can help restore normal sterol, bile acid, bile alcohol, and cholestanol levels. CDCA also appears to be generally effective in preventing adverse clinical manifestations of the disease from occurring or progressing if administered early enough. Improved screening and awareness of the condition may help facilitate early diagnosis and treatment.
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Affiliation(s)
- Gerald Salen
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Robert D Steiner
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Genetics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Abstract
Sequencing large cohorts of ethnically homogeneous individuals yields genetic insights with implications for the entire population rather than a single individual. In order to evaluate the genetic basis of certain diseases encountered at high frequency in the Ashkenazi Jewish population (AJP), as well as to improve variant annotation among the AJP, we examined the entire exome, focusing on specific genes with known clinical implications in 128 Ashkenazi Jews and compared these data to other non-Jewish populations (European, African, South Asian and East Asian). We targeted American College of Medical Genetics incidental finding recommended genes and the Catalogue of Somatic Mutations in Cancer (COSMIC) germline cancer-related genes. We identified previously known disease-causing variants and discovered potentially deleterious variants in known disease-causing genes that are population specific or substantially more prevalent in the AJP, such as in the ATP and HGFAC genes associated with colorectal cancer and pancreatic cancer, respectively. Additionally, we tested the advantage of utilizing the database of the AJP when assigning pathogenicity to rare variants of independent whole-exome sequencing data of 49 Ashkenazi Jew early-onset breast cancer (BC) patients. Importantly, population-based filtering using our AJP database enabled a reduction in the number of potential causal variants in the BC cohort by 36%. Taken together, population-specific sequencing of the AJP offers valuable, clinically applicable information and improves AJP filter annotation.
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Molster CM, Lister K, Metternick-Jones S, Baynam G, Clarke AJ, Straub V, Dawkins HJS, Laing N. Outcomes of an International Workshop on Preconception Expanded Carrier Screening: Some Considerations for Governments. Front Public Health 2017; 5:25. [PMID: 28286745 PMCID: PMC5323409 DOI: 10.3389/fpubh.2017.00025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 02/09/2017] [Indexed: 01/08/2023] Open
Abstract
Background Consideration of expanded carrier screening has become an emerging issue for governments. However, traditional criteria for decision-making regarding screening programs do not incorporate all the issues relevant to expanded carrier screening. Further, there is a lack of consistent guidance in the literature regarding the development of appropriate criteria for government assessment of expanded carrier screening. Given this, a workshop was held to identify key public policy issues related to preconception expanded carrier screening, which governments should consider when deciding whether to publicly fund such programs. Methods In June 2015, a satellite workshop was held at the European Society of Human Genetics Conference. It was structured around two design features: (1) the provision of information from a range of perspectives and (2) small group deliberations on the key issues that governments need to consider and the benefits, risks, and challenges of implementing publicly funded whole-population preconception carrier screening. Results Forty-one international experts attended the workshop. The deliberations centered primarily on the conditions to be tested and the elements of the screening program itself. Participants expected only severe conditions to be screened but were concerned about the lack of a consensus definition of “severe.” Issues raised regarding the screening program included the purpose, benefits, harms, target population, program acceptability, components of a program, and economic evaluation. Participants also made arguments for consideration of the accuracy of screening tests. Conclusion A wide range of issues require careful consideration by governments that want to assess expanded carrier screening. Traditional criteria for government decision-making regarding screening programs are not a “best fit” for expanded carrier screening and new models of decision-making with appropriate criteria are required. There is a need to define what a “severe” condition is, to build evidence regarding the reliability and accuracy of screening tests, to consider the equitable availability and downstream effects on and costs of follow-up interventions for those identified as carriers, and to explore the ways in which the components of a screening program would be impacted by unique features of expanded carrier screening.
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Affiliation(s)
- Caron M Molster
- Office of Population Health Genomics, Public Health Division, Department of Health Western Australia , Perth, WA , Australia
| | - Karla Lister
- Office of Population Health Genomics, Public Health Division, Department of Health Western Australia , Perth, WA , Australia
| | | | - Gareth Baynam
- Office of Population Health Genomics, Public Health Division, Department of Health Western Australia, Perth, WA, Australia; Genetic Services WA, Perth, WA, Australia; School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia; Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia; Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; Western Australian Register of Developmental Anomalies, Perth, WA, Australia; Spatial Sciences, Department of Science and Engineering, Curtin University, Perth, WA, Australia
| | - Angus John Clarke
- Division of Cancer and Genetics, School of Medicine, Cardiff University , Cardiff , UK
| | - Volker Straub
- Institute of Human Genetics, University of Newcastle upon Tyne , Newcastle upon Tyne , UK
| | - Hugh J S Dawkins
- Office of Population Health Genomics, Public Health Division, Department of Health Western Australia, Perth, WA, Australia; Centre for Comparative Genomics, Murdoch University, Perth, WA, Australia; Centre for Population Health Research, Curtin University, Perth, WA, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - Nigel Laing
- Centre for Medical Research, Harry Perkins Institute of Medical Research, University of Western Australia, Perth, WA, Australia; Neurogenetics Unit, Department of Diagnostic Genomics, PathWest Laboratory Medicine, Department of Health Western Australia, Perth, WA, Australia
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Aharoni S, Sadeh M, Shapira Y, Edvardson S, Daana M, Dor-Wollman T, Mimouni-Bloch A, Halevy A, Cohen R, Sagie L, Argov Z, Rabie M, Spiegel R, Chervinsky I, Orenstein N, Engel AG, Nevo Y. Congenital myasthenic syndrome in Israel: Genetic and clinical characterization. Neuromuscul Disord 2016; 27:136-140. [PMID: 28024842 DOI: 10.1016/j.nmd.2016.11.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
The objective of the study was to evaluate the epidemiology of patients with congenital myasthenic syndrome (CMS) in Israel. Targeted mutation analysis was performed based on the clinical symptoms and electrophysiological findings for known CMS. Additional specific tests were performed in patients of Iranian and/or Iraqi Jewish origin. All medical records were reviewed and clinical data, genetic mutations and outcomes were recorded. Forty-five patients with genetic mutations in known CMS genes from 35 families were identified. Mutations in RAPSN were identified in 13 kinships in Israel. The most common mutation was c.-38A>G detected in 8 patients of Iranian and/or Iraqi Jewish origin. Four different recessive mutations in COLQ were identified in 11 kinships, 10 of which were of Muslim-Arab descent. Mutations in CHRNE were identified in 7 kinships. Less commonly detected mutations were in CHRND, CHAT, GFPT1 and DOK7. In conclusion, mutations in RAPSN and COLQ are the most common causes of CMS in our cohort. Specific mutations in COLQ, RAPSN, and CHRNE occur in specific ethnic populations and should be taken into account when the diagnosis of a CMS is suspected.
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Affiliation(s)
- Sharon Aharoni
- Institute of Child Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Menachem Sadeh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Wolfson Medical Center, Holon, Israel
| | - Yehuda Shapira
- Neuropediatric Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Simon Edvardson
- Neuropediatric Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Muhannad Daana
- Neuropediatric Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Talia Dor-Wollman
- Neuropediatric Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Aviva Mimouni-Bloch
- Pediatric Neurology and Developmental Unit, Loewenstein Rehabilitation Hospital, Raanana, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ayelet Halevy
- Institute of Child Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rony Cohen
- Institute of Child Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liora Sagie
- Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Zohar Argov
- Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Malcolm Rabie
- Institute of Child Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Spiegel
- Genetic Institute, Emek Medical Center, Afula, Israel
| | | | - Naama Orenstein
- Genetics Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrew G Engel
- Department of Neurology and Neuromuscular Research Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Yoram Nevo
- Institute of Child Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Gal M, Khermesh K, Barak M, Lin M, Lahat H, Reznik Wolf H, Lin M, Pras E, Levanon EY. Expanding preconception carrier screening for the Jewish population using high throughput microfluidics technology and next generation sequencing. BMC Med Genomics 2016; 9:24. [PMID: 27175728 PMCID: PMC4865987 DOI: 10.1186/s12920-016-0184-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 05/02/2016] [Indexed: 11/15/2022] Open
Abstract
Background Genetic screening to identify carriers of autosomal recessive diseases has become an integral part of routine prenatal care. In spite of the rapid growth of known mutations, most current screening programs include only a small subset of these mutations, and are performed using diverse molecular techniques, which are generally labor-intensive and time consuming. We examine the implementation of the combined high-throughput technologies of specific target amplification and next generation sequencing (NGS), for expanding the carrier screening program in the Israeli Jewish population as a test case. Methods We compiled a panel of 370 germline mutations, causing 120 disorders, previously identified in affected Jewish individuals from different ethnicities. This mutation panel was simultaneously captured in 48 samples using a multiplex PCR-based microfluidics approach followed by NGS, thereby performing 17,760 individual assays in a single experiment. Results The sensitivity (measured with depth of at least 50×) and specificity of the target capture was 98 and 95 % respectively, leaving minimal rate of inconclusive tests per sample tested. 97 % of the targeted mutations present in the samples were correctly identified and validated. Conclusion Our methodology was shown to successfully combine multiplexing of target specific primers, samples indexing and NGS technology for population genetic screens. Moreover, it’s relatively ease of use and flexibility of updating the targets screened, makes it highly suitable for clinical implementation. This protocol was demonstrated in pre-conceptional screening for pan-Jewish individuals, but can be applied to any other population or different sets of mutations. Electronic supplementary material The online version of this article (doi:10.1186/s12920-016-0184-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Moran Gal
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, 52900, Israel
| | - Khen Khermesh
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, 52900, Israel
| | - Michal Barak
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, 52900, Israel
| | - Min Lin
- Fluidigm corporation, South San Francisco, California
| | - Hadas Lahat
- The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Haike Reznik Wolf
- The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Michael Lin
- Fluidigm corporation, South San Francisco, California
| | - Elon Pras
- The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Erez Y Levanon
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, 52900, Israel.
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16
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Should I Perform Genetic Testing? A Qualitative Look into the Decision Making Considerations of Religious Israeli Undergraduate Students. J Genet Couns 2016; 25:1093-115. [DOI: 10.1007/s10897-016-9942-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 02/25/2016] [Indexed: 10/22/2022]
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17
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Reinstein E, Smirin-Yosef P, Lagovsky I, Davidov B, Peretz Amit G, Neumann D, Orr-Urtreger A, Ben-Shachar S, Basel-Vanagaite L. A founder mutation in ADAMTSL4 causes early-onset bilateral ectopia lentis among Jews of Bukharian origin. Mol Genet Metab 2016; 117:38-41. [PMID: 26653794 DOI: 10.1016/j.ymgme.2015.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 11/24/2015] [Accepted: 11/24/2015] [Indexed: 02/02/2023]
Abstract
The term isolated ectopia lentis (EL; subluxation or dislocation of the human crystalline lens) is applied to patients with EL, without skeletal features and in the absence of aortic root dilatation. To date, the only gene shown to cause autosomal-recessive isolated EL is ADAMTSL4. Here we report a novel founder mutation in ADAMTSL4 gene in children of Bukharian Jewish origin presenting with early-onset bilateral EL. A carrier frequency of 1:48 was determined among unrelated healthy Bukharian Jews. Given the complications associated with disease and the allele frequency, a population screening for individuals of this ancestry is warranted in order to allow prenatal, pre-implantation or early postnatal diagnosis.
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Affiliation(s)
- Eyal Reinstein
- Medical Genetics Institute, Meir Medical Center, Kfar-Saba, Israel; Sackler School of Medicine, Tel Aviv University, Israel.
| | - Pola Smirin-Yosef
- Genomic Bioinformatics Laboratory, Department of Molecular Biology, Ariel University, Ariel, Israel; Felsenstein Medical Research Center, Rabin Medical Center, Petach Tikva, Israel
| | - Irina Lagovsky
- Felsenstein Medical Research Center, Rabin Medical Center, Petach Tikva, Israel
| | - Bella Davidov
- The Raphael Recanati Genetic Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Gabriela Peretz Amit
- The Raphael Recanati Genetic Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Doron Neumann
- Unit of Pediatric Ophthalmology, Wolfson Medical Center, Holon, Israel
| | - Avi Orr-Urtreger
- Sackler School of Medicine, Tel Aviv University, Israel; The Genetic Institute & Prenatal Diagnosis Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shay Ben-Shachar
- Sackler School of Medicine, Tel Aviv University, Israel; The Genetic Institute & Prenatal Diagnosis Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Lina Basel-Vanagaite
- Sackler School of Medicine, Tel Aviv University, Israel; Felsenstein Medical Research Center, Rabin Medical Center, Petach Tikva, Israel; The Raphael Recanati Genetic Institute, Rabin Medical Center, Petach Tikva, Israel; Pediatric Genetics Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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18
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Siani M, Ben-Zvi Assaraf O. The Moral Reasoning of Genetic Dilemmas Amongst Jewish Israeli Undergraduate Students with Different Religious Affiliations and Scientific Backgrounds. J Genet Couns 2015; 25:596-609. [PMID: 26642964 DOI: 10.1007/s10897-015-9918-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 11/19/2015] [Indexed: 12/01/2022]
Abstract
The main objective of this study was to shed light on the moral reasoning of undergraduate Israeli students towards genetic dilemmas, and on how these are affected by their religious affiliation, by the field they study and by their gender. An open ended questionnaire was distributed among 449 undergraduate students in institutions of higher education in Israel, and their answers were analyzed according to the framework described by Sadler and Zeidler (Science Education, 88(1), 4-27, 2004). They were divided into two major categories: those whose reasoning was based on the consideration of moral consequences (MC), and those who supported their opinion by citing non-consequentialist moral principles (MP). Students' elaborations to questions dealing with values towards genetic testing showed a correlation between the students' religious affiliation and their reasoning, with religious students' elaborations tending to be more principle based than those of secular ones. Overall, the students' elaborations indicate that their main concern is the possibility that their personal genetic information will be exposed, and that their body's personal rights will be violated. We conclude the paper by offering several practical recommendations based on our findings for genetic counseling that is specifically tailored to fit different patients according to their background.
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Affiliation(s)
- Merav Siani
- Science and Technology Education Department, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - Orit Ben-Zvi Assaraf
- Science and Technology Education Department, Ben-Gurion University of the Negev, Beer Sheva, Israel
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19
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Abstract
Huntington's disease (HD) is an inherited neurodegenerative disorder. Involuntary choreaform movements are the main symptom. The prevalence of HD in Arab countries is not fully understood, as there are only a few reports indicating disease incidence. Therefore, there is an urgent need for an investigation to determine the frequency of HD in the Middle East, especially within Arab countries, and at the same time enhance people's awareness of the disease.
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20
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Patients’ Attitudes Towards Disclosure of Genetic Test Results to Family Members: The Impact of Patients’ Sociodemographic Background and Counseling Experience. J Genet Couns 2015; 25:314-24. [DOI: 10.1007/s10897-015-9873-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
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21
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Shloim N, Hugh-Jones S, Rudolf MCJ, Feltbower RG, Lans O, Hetherington MM. "It's like giving him a piece of me.": Exploring UK and Israeli women's accounts of motherhood and feeding. Appetite 2015; 95:58-66. [PMID: 26119810 DOI: 10.1016/j.appet.2015.06.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/21/2015] [Accepted: 06/06/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The present study explored how Israeli and UK mothers integrate feeding into their conceptualisations of mothering 2-6 months post-partum. BACKGROUND The nature and importance of motherhood is subject to differential contextual, cultural, political and historical influences. We set out to compare experiences of motherhood and feeding between these two countries using a qualitative approach. METHODS Forty one women (mean age 36.4 ± 2.7 years) from Israel and the UK, mostly married or in a committed relationship were interviewed about their experience of pregnancy, motherhood and feeding. Data were analysed thematically. RESULTS The experience of motherhood in the early postnatal period was dominated, for all mothers, by the experience of breastfeeding and clustered around three representations of mothering, namely; 1) a devoted mother who ignores her own needs; 2) a mother who is available for her infant but acknowledges her needs as well; and 3) a struggling mother for whom motherhood is a burden. Such representations existed within both cultural groups and sometimes coexisted within the same mothers. UK women described more struggles within motherhood whereas a tendency towards idealising motherhood was observed for Israeli women. CONCLUSION There are similarities in the ways that UK and Israeli women experienced motherhood and feeding. Where family life is strongly emphasized, mothers reported extremes of idealism and burden and associated an "ideal" mother with a breastfeeding mother. Where motherhood is represented as just one of many roles women take up, they are more likely to represent a "good enough" approach to mothering. Understanding the experience of motherhood and feeding in different cultural settings is important to provide the context for postnatal care specifically where mothers are reluctant to share problems or difficulties encountered.
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Affiliation(s)
- N Shloim
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK.
| | - S Hugh-Jones
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK
| | - M C J Rudolf
- Bar Ilan Faculty of Medicine in the Galilee, Safed, Israel
| | - R G Feltbower
- School of Medicine, Centre for Epidemiology and Biostatistics, Leeds Institute for Genetics Health and Therapeutics, University of Leeds, Leeds LS2 9JT, UK
| | - O Lans
- Social Work Department, Tel Hai Academic College, Upper Galilee, 12110, Israel
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22
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Nogueiro I, Teixeira JC, Amorim A, Gusmão L, Alvarez L. Portuguese crypto-Jews: the genetic heritage of a complex history. Front Genet 2015; 6:12. [PMID: 25699075 PMCID: PMC4313780 DOI: 10.3389/fgene.2015.00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 01/11/2015] [Indexed: 11/22/2022] Open
Abstract
The first documents mentioning Jewish people in Iberia are from the Visigothic period. It was also in this period that the first documented anti-Judaic persecution took place. Other episodes of persecution would happen again and again during the long troubled history of the Jewish people in Iberia and culminated with the Decrees of Expulsion and the establishment of the Inquisition: some Jews converted to Catholicism while others resisted and were forcedly baptized, becoming the first Iberian Crypto-Jews. In the 18th century the official discrimination and persecution carried out by the Inquisition ended and several Jewish communities emerged in Portugal. From a populational genetics point of view, the worldwide Diaspora of contemporary Jewish communities has been intensely studied. Nevertheless, very little information is available concerning Sephardic and Iberian Crypto-Jewish descendants. Data from the Iberian Peninsula, the original geographic source of Sephardic Jews, is limited to two populations in Portugal, Belmonte, and Bragança district, and the Chueta community from Mallorca. Belmonte was the first Jewish community studied for uniparental markers. The construction of a reference model for the history of the Portuguese Jewish communities, in which the genetic and classical historical data interplay dynamically, is still ongoing. Recently an enlarged sample covering a wide region in the Northeast Portugal was undertaken, allowing the genetic profiling of male and female lineages. A Jewish specific shared female lineage (HV0b) was detected between the community of Belmonte and Bragança. In contrast to what was previously described as a hallmark of the Portuguese Jews, an unexpectedly high polymorphism of lineages was found in Bragança, showing a surprising resistance to the erosion of genetic diversity typical of small-sized isolate populations, as well as signs of admixture with the Portuguese host population.
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Affiliation(s)
- Inês Nogueiro
- Institute of Molecular Pathology and Immunology of the University of Porto Porto, Portugal ; Faculty of Sciences, University of Porto Porto, Portugal ; Instituto de Investigaç ao e Inovaç ao em Saúde, Universidade do Porto Porto, Portugal
| | - João C Teixeira
- Department of Evolutionary Genetics, Max Planck Institute for Evolutionary Anthropology Leipzig, Germany
| | - António Amorim
- Institute of Molecular Pathology and Immunology of the University of Porto Porto, Portugal ; Faculty of Sciences, University of Porto Porto, Portugal ; Instituto de Investigaç ao e Inovaç ao em Saúde, Universidade do Porto Porto, Portugal
| | - Leonor Gusmão
- Institute of Molecular Pathology and Immunology of the University of Porto Porto, Portugal ; Instituto de Investigaç ao e Inovaç ao em Saúde, Universidade do Porto Porto, Portugal ; DNA Diagnostic Laboratory, State University of Rio de Janeiro Rio de Janeiro, Brazil
| | - Luis Alvarez
- Institute of Molecular Pathology and Immunology of the University of Porto Porto, Portugal ; Faculty of Sciences, University of Porto Porto, Portugal ; Instituto de Investigaç ao e Inovaç ao em Saúde, Universidade do Porto Porto, Portugal
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Shao Y, Liu S, Grinzaid K. Evaluation of two-year Jewish genetic disease screening program in Atlanta: insight into community genetic screening approaches. J Community Genet 2015; 6:137-45. [PMID: 25564014 DOI: 10.1007/s12687-014-0208-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/08/2014] [Indexed: 11/24/2022] Open
Abstract
Improvements in genetic testing technologies have led to the development of expanded carrier screening panels for the Ashkenazi Jewish population; however, there are major inconsistencies in current screening practices. A 2-year pilot program was launched in Atlanta in 2010 to promote and facilitate screening for 19 Jewish genetic diseases. We analyzed data from this program, including participant demographics and outreach efforts. This retrospective analysis is based on a de-identified dataset of 724 screenees. Data were obtained through medical chart review and questionnaires and included demographic information, screening results, response to outreach efforts, and follow-up behavior and preferences. We applied descriptive analysis, chi-square tests, and logistic regression to analyze the data and compare findings with published literature. The majority of participants indicated that they were not pregnant or did not have a partner who was pregnant were affiliated with Jewish organizations and reported 100 % AJ ancestry. Overall, carrier frequency was 1 in 3.9. Friends, rabbis, and family members were the most common influencers of the decision to receive screening. People who were older, had a history of pregnancy, and had been previously screened were more likely to educate others (all p < 0.05). Analysis of this 2-year program indicated that people who are ready to have children or expand their families are more likely to get screened and encourage others to be screened. The most effective outreach efforts targeted influencers who then encouraged screening in the target population. Educating influencers and increasing overall awareness were the most effective outreach strategies.
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Affiliation(s)
- Yunru Shao
- Department of Human Genetics, Emory University, 615 Michael Street, Suite 301, Whitehead Bldg., Atlanta, GA, 30322, USA
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24
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Mezei G, Sudan M, Izraeli S, Kheifets L. Epidemiology of childhood leukemia in the presence and absence of Down syndrome. Cancer Epidemiol 2014; 38:479-89. [DOI: 10.1016/j.canep.2014.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/10/2014] [Accepted: 07/11/2014] [Indexed: 02/05/2023]
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25
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Weiss K, Orr-Urtreger A, Kaplan Ber I, Naiman T, Shomrat R, Bardugu E, Yaron Y, Ben-Shachar S. Ethnic effect on FMR1 carrier rate and AGG repeat interruptions among Ashkenazi women. Genet Med 2014; 16:940-4. [PMID: 24875300 DOI: 10.1038/gim.2014.64] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 05/02/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Fragile X syndrome, a common cause of intellectual disability, is usually caused by CGG trinucleotide expansion in the FMR1 gene. CGG repeat size correlates with expansion risk. Premutation alleles (55-200 repeats) may expand to full mutations in female meiosis. Interspersed AGG repeats decrease allele instability and expansion risk. The carrier rate and stability of FMR1 alleles were evaluated in large cohorts of Ashkenazi and non-Ashkenazi women. METHODS A total of 4,344 Ashkenazi and 4,985 non-Ashkenazi cases were analyzed using Southern blotting and polymerase chain reaction between 2004 and 2011. In addition, AGG interruptions were evaluated in 326 Ashkenazi and 298 non-Ashkenazi women who were recruited during 2011. RESULTS Both groups had major peaks of 30 and 29 repeats. Ashkenazi women had a higher frequency of 30 repeats and a lower frequency of other peaks (P < 0.0001). A higher rate of premutations in the 55-59 repeats range (1:114 vs. 1:277) was detected among the Ashkenazi women. Loss of AGG interruptions (<2) was significantly less common among Ashkenazi women (9 vs. 19.5% for non-Ashkenazi women, P = 0.0002). CONCLUSION Ashkenazi women have a high fragile X syndrome carrier rate and mostly lower-range premutations, and carry a low risk for expansion to a full mutation. Normal-sized alleles in Ashkenazi women have higher average number of AGG interruptions that may increase stability. These factors may decrease the risk for fragile X syndrome offspring among Ashkenazi women.
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Affiliation(s)
- Karin Weiss
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avi Orr-Urtreger
- 1] Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel [2] Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idit Kaplan Ber
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tova Naiman
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ruth Shomrat
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eyal Bardugu
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yuval Yaron
- 1] Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel [2] Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shay Ben-Shachar
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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26
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Wienke S, Brown K, Farmer M, Strange C. Expanded carrier screening panels-does bigger mean better? J Community Genet 2014; 5:191-8. [PMID: 24062228 PMCID: PMC3955460 DOI: 10.1007/s12687-013-0169-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 08/28/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Sara Wienke
- Division of Pulmonary & Critical Care, Medical University of South Carolina, Charleston, SC, USA,
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Gan-Or Z, Ozelius LJ, Bar-Shira A, Saunders-Pullman R, Mirelman A, Kornreich R, Gana-Weisz M, Raymond D, Rozenkrantz L, Deik A, Gurevich T, Gross SJ, Schreiber-Agus N, Giladi N, Bressman SB, Orr-Urtreger A. The p.L302P mutation in the lysosomal enzyme gene SMPD1 is a risk factor for Parkinson disease. Neurology 2013; 80:1606-10. [PMID: 23535491 DOI: 10.1212/wnl.0b013e31828f180e] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To study the possible association of founder mutations in the lysosomal storage disorder genes HEXA, SMPD1, and MCOLN1 (causing Tay-Sachs, Niemann-Pick A, and mucolipidosis type IV diseases, respectively) with Parkinson disease (PD). METHODS Two PD patient cohorts of Ashkenazi Jewish (AJ) ancestry, that included a total of 938 patients, were studied: a cohort of 654 patients from Tel Aviv, and a replication cohort of 284 patients from New York. Eight AJ founder mutations in the HEXA, SMPD1, and MCOLN1 genes were analyzed. The frequencies of these mutations were compared to AJ control groups that included large published groups undergoing prenatal screening and 282 individuals matched for age and sex. RESULTS Mutation frequencies were similar in the 2 groups of patients with PD. The SMPD1 p.L302P was strongly associated with a highly increased risk for PD (odds ratio 9.4, 95% confidence interval 3.9-22.8, p < 0.0001), as 9/938 patients with PD were carriers of this mutation compared to only 11/10,709 controls. CONCLUSIONS The SMPD1 p.L302P mutation is a novel risk factor for PD. Although it is rare on a population level, the identification of this mutation as a strong risk factor for PD may further elucidate PD pathogenesis and the role of lysosomal pathways in disease development.
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Affiliation(s)
- Ziv Gan-Or
- Genetic Institute and Movement Disorders Unit, Parkinson Center, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
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Sagi M, Uhlmann WR. Genetic counseling services and training of genetic counselors in Israel: an overview. J Genet Couns 2013; 22:890-6. [PMID: 23435755 DOI: 10.1007/s10897-013-9576-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 02/04/2013] [Indexed: 10/27/2022]
Abstract
Genetic counseling services have existed in Israel since 1964 and are available in almost all the major hospitals. Given the socialized healthcare system and small country size, genetic services are generally accessible and often free. The existence of founder mutations in various communities in Israel makes genetic testing easier to perform. Yet, the ethnic, cultural and religious diversity of the population has major implications on the design of the screening programs and the use of genetic services. The Israeli Association of Genetic Counselors (IAGC) was established in 2008 and had existed informally since 1989. There are two Master level genetic counseling training programs (6 students/class, 2 year program): Hebrew University-Hadassah Medical School (established in 1997) and the Technion (established in 2009). Genetic counselors' clinical training is largely observational and 2 years of supervised counseling sessions post degree are required for board exam eligibility. Genetic counselors are licensed and lead counseling sessions individually, but currently must work under medical geneticist supervision. This is the first article to summarize the history and training of Master level genetic counselors in Israel. Genetic services, coverage and regulations are also described.
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Affiliation(s)
- Michal Sagi
- Department of Human Genetics and Metabolic Diseases, Hadassah Hebrew University Medical Center, Jerusalem, 91120, Israel,
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BRCA genetic testing of individuals from families with low prevalence of cancer: experiences of carriers and implications for population screening. Genet Med 2013; 14:688-94. [PMID: 22481128 DOI: 10.1038/gim.2012.31] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE BRCA genes are associated with hereditary breast and ovarian cancers. Guidelines worldwide currently recommend BRCA genetic testing in asymptomatic individuals only if they belong to "high-risk" families. However, population screening for BRCA1/2 may be the logical next step in populations with a high prevalence of founder mutations, such as Ashkenazi Jews. This study aimed to explore (i) the impact of a positive BRCA genetic test result on individuals who have neither a personal history nor a familial history of cancer and (ii) their attitudes toward the concept of population screening. METHODS Semistructured in-depth interviews were carried out with 14 Ashkenazi Jewish women who were asymptomatic BRCA carriers and who belonged to families with low prevalence of cancer. RESULTS Three main findings emerged: (i) having no family history of cancer was a source of optimism but also confusion; (ii) engaging in intensified medical surveillance and undergoing preventive procedures was perceived as health-promoting but also tended to induce a sense of physical and psychological vulnerability; and (iii) there was overall support for BRCA population screening, with some reservations. CONCLUSION Women belonging to low-cancer-prevalence families within a "high-risk" ethnic community view BRCA genetic testing positively despite the difficulties entailed, because it allows prevention or early detection of cancer. However, implementing a BRCA population screening program should be carried out with proper pre- and post-testing preparation and support for the individuals undergoing testing.
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Ben-Shachar S, Zvi T, Rolfs A, Breda Klobus A, Yaron Y, Bar-Shira A, Orr-Urtreger A. A founder mutation causing a severe methylenetetrahydrofolate reductase (MTHFR) deficiency in Bukharian Jews. Mol Genet Metab 2012; 107:608-10. [PMID: 22947400 DOI: 10.1016/j.ymgme.2012.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 08/09/2012] [Accepted: 08/09/2012] [Indexed: 11/18/2022]
Abstract
Methylenetetrahydrofolate reductase (MTHFR) deficiency is a rare autosomal recessive disorder. A novel homozygous MTHFR c.474A>T (p.G158G) mutation was detected in two unrelated children of Jewish Bukharian origin. This mutation generates an abnormal splicing and early termination codon. A carrier frequency of 1:39 (5/196) was determined among unrelated healthy Bukharian Jews. Given the disease severity and allele frequency, a population screening for individuals of this ancestry is warranted in order to allow prenatal, or preimplantation diagnosis.
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Affiliation(s)
- Shay Ben-Shachar
- The Genetic Institute & Prenatal Diagnosis Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Hahn S, Hösli I, Lapaire O. Non-invasive prenatal diagnostics using next generation sequencing: technical, legal and social challenges. ACTA ACUST UNITED AC 2012; 6:517-28. [PMID: 23480834 DOI: 10.1517/17530059.2012.703650] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Newly developed non-invasive prenatal diagnostic techniques, using maternal blood samples, have the potential to reduce or obviate the need for invasive prenatal diagnostic practices such as amniocentesis or chorionic villous sampling. This will lead to a change in how obstetric care is extended by health care providers to pregnant women at-risk of bearing an aneuploid child. AREAS COVERED The process leading to the development of fetal aneuploidy detection via the analysis of cell-free DNA in maternal plasma by massive parallel sequencing. Optimization of these strategies and approaches used in the recent or up-coming commercial launches. In addition, this review provides insight into legal implications, potential patent disputes, ethical and societal concerns raised by this development, such as whole genome data storage, retrieval and access. EXPERT OPINION There is a need for engagement by professional societies, to ensure correct usage of these newly emerging technologies and their restriction to high-risk pregnancies. National agencies need to ensure the necessary degree of high quality required for prenatal diagnosis.
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Affiliation(s)
- Sinuhe Hahn
- University Hospital Basel, Department of Biomedicine/ Department of Obstetrics and Gynecology, Lab. Prenatal Medicine , Basel , Switzerland
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Large-scale population screening for spinal muscular atrophy: clinical implications. Genet Med 2011; 13:110-4. [PMID: 21233719 DOI: 10.1097/gim.0b013e3182017c05] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To determine the frequency of SMN1 deletion carriers in the Israeli population and to assess the feasibility of population screening for spinal muscular atrophy. METHODS A total of 6394 individuals without family history of spinal muscular atrophy underwent genetic screening by multiplex ligation-dependent probe amplification, designed to detect SMN1 exon 7 and exon 8 copy number. RESULTS One hundred fifty-nine individuals carried an SMN1 heterozygous exon 7 deletion, yielding a carrier frequency of 1:40. About 10.8% of individuals were found to carry two or more SMN1 exon 7 copies on the same chromosome (cis configuration). This implies that some deletion carriers may not be detected by multiplex ligation-dependent probe amplification or similar quantitative methods. The acceptance of spinal muscular atrophy screening among women undergoing testing for fragile X syndrome and cystic fibrosis reached 93%. CONCLUSIONS Currently used molecular techniques cannot detect about 5% of spinal muscular atrophy carriers with a cis configuration or individuals with SMN1 sequence mutations and de novo deletions. Thus, it is estimated that the spinal muscular atrophy carrier detection rate is about 90%. Given the severity of spinal muscular atrophy, the relatively high carrier frequency, and the estimated detection rate, we conclude that population-based screening for spinal muscular atrophy is feasible and acceptable.
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Banin E, Bandah-Rozenfeld D, Obolensky A, Cideciyan AV, Aleman TS, Marks-Ohana D, Sela M, Boye S, Sumaroka A, Roman AJ, Schwartz SB, Hauswirth WW, Jacobson SG, Hemo I, Sharon D. Molecular anthropology meets genetic medicine to treat blindness in the North African Jewish population: human gene therapy initiated in Israel. Hum Gene Ther 2010; 21:1749-57. [PMID: 20604683 DOI: 10.1089/hum.2010.047] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The history of the North African Jewish community is ancient and complicated with a number of immigration waves and persecutions dramatically affecting its population size. A decade-long process in Israel of clinical-molecular screening of North African Jews with incurable autosomal recessive blindness led to the identification of a homozygous splicing mutation (c.95-2A > T; IVS2-2A > T) in RPE65, the gene encoding the isomerase that catalyzes a key step in the retinoid-visual cycle, in patients from 10 unrelated families. A total of 33 patients (four now deceased) had the severe childhood blindness known as Leber congenital amaurosis (LCA), making it the most common cause of retinal degeneration in this population. Haplotype analysis in seven of the patients revealed a shared homozygous region, indicating a population-specific founder mutation. The age of the RPE65 founder mutation was estimated to have emerged 100-230 (mean, 153) generations ago, suggesting it originated before the establishment of the Jewish community in North Africa. Individuals with this RPE65 mutation were characterized with retinal studies to determine if they were candidates for gene replacement, the recent and only therapy to date for this otherwise incurable blindness. The step from molecular anthropological studies to application of genetic medicine was then taken, and a representative of this patient subgroup was treated with subretinal rAAV2-RPE65 gene therapy. An increase in vision was present in the treated area as early as 15 days after the intervention. This process of genetically analyzing affected isolated populations as a screen for gene-based therapy suggests a new paradigm for disease diagnosis and treatment.
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Affiliation(s)
- Eyal Banin
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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Grossman I, Lutz MW, Crenshaw DG, Saunders AM, Burns DK, Roses AD. Alzheimer's disease: diagnostics, prognostics and the road to prevention. EPMA J 2010; 1:293-303. [PMID: 21124753 PMCID: PMC2987528 DOI: 10.1007/s13167-010-0024-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 05/19/2010] [Indexed: 02/03/2023]
Abstract
Alzheimer's disease (AD) presents one of the leading healthcare challenges of the 21st century, with a projected worldwide prevalence of >107 million cases by 2025. While biomarkers have been identified, which may correlate with disease progression or subtype for the purpose of disease monitoring or differential diagnosis, a biomarker for reliable prediction of late onset disease risk has not been available until now. This deficiency in reliable predictive biomarkers, coupled with the devastating nature of the disease, places AD at a high priority for focus by predictive, preventive and personalized medicine. Recent data, discovered using phylogenetic analysis, suggest that a variable length poly-T sequence polymorphism in the TOMM40 gene, adjacent to the APOE gene, is predictive of risk of AD age-of-onset when coupled with a subject's current age. This finding offers hope for reliable assignment of disease risk within a 5-7 year window, and is expected to guide enrichment of clinical trials in order to speed development of preventative medicines.
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Affiliation(s)
| | - Michael W. Lutz
- Duke University, Box 90344, Durham, NC 27708-0120 USA
- Deane Drug Discovery Institute, Durham, NC USA
| | - Donna G. Crenshaw
- Duke University, Box 90344, Durham, NC 27708-0120 USA
- Deane Drug Discovery Institute, Durham, NC USA
| | - Ann M. Saunders
- Duke University, Box 90344, Durham, NC 27708-0120 USA
- Deane Drug Discovery Institute, Durham, NC USA
| | - Daniel K. Burns
- Cabernet Pharmaceuticals, Durham, NC USA
- Duke University, Box 90344, Durham, NC 27708-0120 USA
- Deane Drug Discovery Institute, Durham, NC USA
| | - Allen D. Roses
- Cabernet Pharmaceuticals, Durham, NC USA
- Duke University, Box 90344, Durham, NC 27708-0120 USA
- Deane Drug Discovery Institute, Durham, NC USA
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Erlich Y, Gordon A, Brand M, Hannon GJ, Mitra PP. Compressed Genotyping. IEEE TRANSACTIONS ON INFORMATION THEORY 2010; 56:706-723. [PMID: 21451737 PMCID: PMC3065185 DOI: 10.1109/tit.2009.2037043] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Over the past three decades we have steadily increased our knowledge on the genetic basis of many severe disorders. Nevertheless, there are still great challenges in applying this knowledge routinely in the clinic, mainly due to the relatively tedious and expensive process of genotyping. Since the genetic variations that underlie the disorders are relatively rare in the population, they can be thought of as a sparse signal. Using methods and ideas from compressed sensing and group testing, we have developed a cost-effective genotyping protocol to detect carriers for severe genetic disorders. In particular, we have adapted our scheme to a recently developed class of high throughput DNA sequencing technologies. The mathematical framework presented here has some important distinctions from the 'traditional' compressed sensing and group testing frameworks in order to address biological and technical constraints of our setting.
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Affiliation(s)
- Yaniv Erlich
- Watson School of Biological Science, Cold Spring Harbor Laboratory, NY, 11724 USA
| | - Assaf Gordon
- Watson School of Biological Science, Cold Spring Harbor Laboratory, NY, 11724 USA
| | | | - Gregory J. Hannon
- Watson School of Biological Science, Cold Spring Harbor Laboratory, NY, 11724 USA
| | - Partha P. Mitra
- Watson School of Biological Science, Cold Spring Harbor Laboratory, NY, 11724 USA
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