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Anderson JA, Meyn MS, Shuman C, Zlotnik Shaul R, Mantella LE, Szego MJ, Bowdin S, Monfared N, Hayeems RZ. Parents perspectives on whole genome sequencing for their children: qualified enthusiasm? J Med Ethics 2017; 43:535-539. [PMID: 27888232 DOI: 10.1136/medethics-2016-103564] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/17/2016] [Accepted: 10/14/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To better understand the consequences of returning whole genome sequencing (WGS) results in paediatrics and facilitate its evidence-based clinical implementation, we studied parents' experiences with WGS and their preferences for the return of adult-onset secondary variants (SVs)-medically actionable genomic variants unrelated to their child's current medical condition that predict adult-onset disease. METHODS We conducted qualitative interviews with parents whose children were undergoing WGS as part of the SickKids Genome Clinic, a research project that studies the impact of clinical WGS on patients, families, and the healthcare system. Interviews probed parents' experience with and motivation for WGS as well as their preferences related to SVs. Interviews were analysed thematically. RESULTS Of 83 invited, 23 parents from 18 families participated. These parents supported WGS as a diagnostic test, perceiving clear intrinsic and instrumental value. However, many parents were ambivalent about receiving SVs, conveying a sense of self-imposed obligation to take on the 'weight' of knowing their child's SVs, however unpleasant. Some parents chose to learn about adult-onset SVs for their child but not for themselves. CONCLUSIONS Despite general enthusiasm for WGS as a diagnostic test, many parents felt a duty to learn adult-onset SVs. Analogous to 'inflicted insight', we call this phenomenon 'inflicted ought'. Importantly, not all parents of children undergoing WGS view the best interests of their child in relational terms, thereby challenging an underlying justification for current ACMG guidelines for reporting incidental secondary findings from whole exome and WGS.
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Affiliation(s)
- J A Anderson
- Department of Bioethics, The Hospital for Sick Children, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada
- Joint Centre for Bioethics, University of Toronto, Toronto, Canada
| | - M S Meyn
- The Centre for Genetic Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
- Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, Canada
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - C Shuman
- The Centre for Genetic Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
- Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, Canada
- Genetic Counselling, The Hospital for Sick Children, Toronto, Canada
| | - R Zlotnik Shaul
- Department of Bioethics, The Hospital for Sick Children, Toronto, Canada
- Joint Centre for Bioethics, University of Toronto, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - L E Mantella
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada
| | - M J Szego
- Joint Centre for Bioethics, University of Toronto, Toronto, Canada
- St. Joseph's Health Centre, Toronto, Canada
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - S Bowdin
- The Centre for Genetic Medicine, The Hospital for Sick Children, Toronto, Canada
- Program in Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - N Monfared
- The Centre for Genetic Medicine, The Hospital for Sick Children, Toronto, Canada
| | - R Z Hayeems
- The Centre for Genetic Medicine, The Hospital for Sick Children, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Mantella LE, Singh KK, Sandhu P, Kantores C, Ramadan A, Khyzha N, Quan A, Al-Omran M, Fish JE, Jankov RP, Verma S. Fingerprint of long non-coding RNA regulated by cyclic mechanical stretch in human aortic smooth muscle cells: implications for hypertension. Mol Cell Biochem 2017; 435:163-173. [PMID: 28526936 DOI: 10.1007/s11010-017-3065-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 05/05/2017] [Indexed: 11/26/2022]
Abstract
Emerging evidence suggests that long non-coding RNAs (lncRNAs) represent a cellular hub coordinating various cellular processes that are critical in health and disease. Mechanical stress triggers changes in vascular smooth muscle cells (VSMCs) that in turn contribute to pathophysiological changes within the vasculature. We sought to evaluate the role that lncRNAs play in mechanical stretch-induced alterations of human aortic smooth muscle cells (HASMCs). RNA (lncRNA and mRNA) samples isolated from HASMCs that had been subjected to 10 or 20% elongation (1 Hz) for 24 h were profiled with the Arraystar Human LncRNA Microarray V3.0. LncRNA expression was quantified in parallel via qRT-PCR. Of the 30,586 human lncRNAs screened, 580 were differentially expressed (DE, P < 0.05) in stretched HASMCs. Amongst the 26,109 protein-coding transcripts evaluated, 25 of those DE were associated with 25 of the aforementioned DE lncRNAs (P < 0.05). Subsequent Kyoto Encyclopedia of Genes and Genomes analysis revealed that the DE mRNAs were largely associated with the tumor necrosis factor signaling pathway and inflammation. Gene Ontology analysis indicated that the DE mRNAs were associated with cell differentiation, stress response, and response to external stimuli. We describe the first transcriptome profile of stretch-induced changes in HASMCs and provide novel insights into the regulatory switches that may be fundamental in governing aberrant VSMC remodeling.
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Affiliation(s)
- Laura-Eve Mantella
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Krishna K Singh
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
- Division of Vascular Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Paul Sandhu
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
| | - Crystal Kantores
- Lung Biology Programme, Physiology and Experimental Medicine, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Azza Ramadan
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Nadiya Khyzha
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Toronto General Research Institute, University Health Network, Toronto, ON, Canada
- Heart & Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada
| | - Adrian Quan
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
| | - Mohammed Al-Omran
- Division of Vascular Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Department of Surgery, King Saud University, Riyadh, Kingdom of Saudi Arabia
- The King Saud University-Li Ka Shing Collaborative Research Program, Riyadh, Kingdom of Saudi Arabia
| | - Jason E Fish
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Toronto General Research Institute, University Health Network, Toronto, ON, Canada
- Heart & Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada
| | - Robert P Jankov
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- Department of Physiology, University of Toronto, Toronto, ON, Canada
- Lung Biology Programme, Physiology and Experimental Medicine, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Heart & Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada
| | - Subodh Verma
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada.
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada.
- Department of Surgery, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Heart & Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada.
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Singh KK, Mantella LE, Pan Y, Quan A, Sabongui S, Sandhu P, Teoh H, Al-Omran M, Verma S. A global profile of glucose-sensitive endothelial-expressed long non-coding RNAs. Can J Physiol Pharmacol 2016; 94:1007-14. [DOI: 10.1139/cjpp-2015-0585] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Hyperglycemia-related endothelial dysfunction is believed to be the crux of diabetes-associated micro- and macro-vascular complications. We conducted a systematic transcriptional survey to screen for human endothelial long non-coding RNAs (lncRNAs) regulated by elevated glucose levels. lncRNAs and protein-coding transcripts from human umbilical vein endothelial cells (HUVECs) cultured under high (25 mmol/L) or normal (5 mmol/L) glucose conditions for 24 h were profiled with the Arraystar Human LncRNA Expression Microarray V3.0. Of the 30 586 lncRNAs screened, 100 were significantly upregulated and 186 appreciably downregulated (P < 0.05) in response to high-glucose exposure. In the same HUVEC samples, 133 of the 26 109 mRNAs screened were upregulated and 166 downregulated. Of these 299 differentially expressed mRNAs, 26 were significantly associated with 28 differentially expressed long intergenic non-coding RNAs (P < 0.05). Bioinformatics analyses indicated that the mRNAs most upregulated are primarily enriched in axon guidance signaling pathways; those most downregulated are notably involved in pathways targeting vascular smooth muscle cell contraction, dopaminergic signaling, ubiquitin-mediated proteolysis, and adrenergic signaling. This is the first lncRNA and mRNA transcriptome profile of high-glucose-mediated changes in human endothelial cells. These observations may prove novel insights into novel regulatory molecules and pathways of hyperglycemia-related endothelial dysfunction and, accordingly, diabetes-associated vascular disease.
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Affiliation(s)
- Krishna K. Singh
- Divisions of Cardiac Surgery and Vascular Surgery, Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Laura-Eve Mantella
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Yi Pan
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Adrian Quan
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Sandra Sabongui
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Paul Sandhu
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Hwee Teoh
- Divisions of Cardiac Surgery and Endocrinology & Metabolism, Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Mohammed Al-Omran
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
- Division of Vascular Surgery, Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Department of Surgery, King Saud University and the King Saud University – Li Ka Shing Collaborative Research Program, Riyadh, Kingdom of Saudi Arabia
| | - Subodh Verma
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
- Division of Cardiac Surgery, Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5S 1A8, Canada
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Ehsan M, Singh KK, Lovren F, Pan Y, Quan A, Mantella LE, Sandhu P, Teoh H, Al-Omran M, Verma S. Adiponectin limits monocytic microparticle-induced endothelial activation by modulation of the AMPK, Akt and NFκB signaling pathways. Atherosclerosis 2016; 245:1-11. [DOI: 10.1016/j.atherosclerosis.2015.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 11/20/2015] [Accepted: 11/20/2015] [Indexed: 12/25/2022]
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