Newborn Screening: Review of its Impact for Cystinosis
Katharina Hohenfellner1, Ewa Elenberg2, Gema Ariceta3
1Department of Pediatric Nephrology, RoMed Clinis, Pettenkoferstr. 10, 83022 Rosenheim, Germany.
Insights
Newborn screening (NBS) can prevent childhood disease and mortality. This review highlights the importance of NBS for infantile nephropathic cystinosis (INC) using molecular technologies for early diagnosis and treatment.
Area of Science:
- Medical Genetics
- Pediatric Nephrology
- Public Health
Background:
- Newborn screening (NBS) is a vital public health strategy for early detection and treatment of childhood diseases, reducing morbidity and mortality.
- Implementing new NBS targets requires rigorous evaluation of scientific, analytical, IT, and logistical aspects, alongside ethical and financial considerations.
- Infantile nephropathic cystinosis (INC) is a rare lysosomal disorder treatable with cysteamine, enabling patients to reach adulthood if diagnosed early.
Purpose of the Study:
- To review the principles and importance of newborn screening (NBS).
- To discuss the significance of applying molecular technologies to NBS for infantile nephropathic cystinosis (INC).
- To highlight the benefits of early INC diagnosis for initiating timely cysteamine therapy and improving patient outcomes.
Main Methods:
- Review of existing literature on newborn screening programs and infantile nephropathic cystinosis.
- Analysis of the feasibility of using molecular technologies for cystinosis detection in a pilot screening project.
- Discussion of the scientific, analytical, and logistical requirements for integrating INC into NBS.
Main Results:
- Newborn screening (NBS) demonstrates success in preventing or reducing childhood disease burden.
- Molecular technologies have proven feasible for detecting cystinosis in pilot newborn screening initiatives.
- Early diagnosis of INC through NBS allows for prompt initiation of cysteamine treatment, crucial for renal and overall patient survival.
Conclusions:
- Newborn screening (NBS) is a critical tool for secondary prevention in childhood.
- Integrating infantile nephropathic cystinosis (INC) into NBS using molecular technologies is feasible and highly beneficial.
- Early detection of INC via NBS significantly improves patient prognosis and long-term survival.
Abstract:
Newborn screening (NBS) programmes are considered to be one of the most successful secondary prevention measures in childhood to prevent or reduce morbidity and/or mortality via early disease identification and subsequent initiation of therapy. However, while many rare diseases can now be detected at an early stage using appropriate diagnostics, the introduction of a new target disease requires a detailed analysis of the entire screening process, including a robust scientific background, analytics, information technology, and logistics. In addition, ethics, financing, and the required medical measures need to be considered to allow the benefits of screening to be evaluated at a higher level than its potential harm. Infantile nephropathic cystinosis (INC) is a very rare lysosomal metabolic disorder. With the introduction of cysteamine therapy in the early 1980s and the possibility of renal replacement therapy in infancy, patients with cystinosis can now reach adulthood. Early diagnosis of cystinosis remains important as this enables initiation of cysteamine at the earliest opportunity to support renal and patient survival. Using molecular technologies, the feasibility of screening for cystinosis has been demonstrated in a pilot project. This review aims to provide insight into NBS and discuss its importance for nephropathic cystinosis using molecular technologies.
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