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Published on: August 12, 2020
Neonatal screening for severe combined immune deficiency
1Department of Pediatrics, Institute for Human Genetics, University of California San Francisco, San Francisco, California 94143-0519, USA. puckj@peds.ucsf.edu
Insights
Newborn screening for severe combined immunodeficiency (SCID) is crucial for early detection and treatment. Advances in screening methods, like T cell receptor excision circles, are paving the way for pilot trials.
Area of Science:
- Immunology
- Genetics
- Pediatrics
Background:
- Severe combined immunodeficiency (SCID) is a serious genetic disorder affecting the immune system.
- Early diagnosis and treatment are critical for improving outcomes in SCID patients.
Purpose of the Study:
- To review the rationale for including SCID in newborn screening programs.
- To outline current advancements and challenges in universal SCID screening.
Main Methods:
- Review of existing literature on SCID screening.
- Evaluation of T cell receptor excision circles (TRECs) as a screening biomarker.
- Discussion of proposed and emerging screening methodologies.
Main Results:
- SCID is treatable with hematopoietic stem cell transplantation, with outcomes improving significantly with early intervention.
- Universal newborn screening can facilitate prompt diagnosis and timely treatment.
- TREC quantitation on dried blood spots is a viable screening method, with other tests under evaluation.
Conclusions:
- Newborn screening for SCID is progressing towards implementation in pilot programs.
- Successful screening requires integrated systems for testing, diagnosis, treatment, and outcome tracking.
Purpose Of Review:
Severe combined immunodeficiency has been identified as a high-priority disease for inclusion in population-based newborn screening programs. In this review, the justification, advances to date and remaining challenges for universal severe combined immunodeficiency screening are outlined.
Recent Findings:
Severe combined immunodeficiency is treatable by hematopoietic stem cell transplantation, with best outcome if recognized and treated early in life. Universal screening of newborns could make possible prompt diagnosis and lifesaving treatment for all affected infants. One screening test using the dried blood spots already collected from all newborns involves quantitation of T cell receptor excision circles, and other test methods have been proposed and are being evaluated. Development of screening programs will require integration of screening, contacting infants with abnormal screen results for definitive testing, prompt treatment of affected infants, and outcome tracking.
Summary:
Newborn screening for severe combined immunodeficiency is advancing toward pilot trials.
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