超音波検査 (PAGE) によって検出された胎児の構造的異常における産前エクソーム配列分析:コホート研究
Jenny Lord1, Dominic J McMullan2, Ruth Y Eberhardt1
1Wellcome Sanger Institute, Hinxton, UK.
Lancet (London, England)
|February 5, 2019
まとめ
全エクソームシーケンシング (WES) は,構造的異常を持つ胎児の8.5%で診断遺伝的変異を特定し,症候群と非症候群の区別を助けました. この遺伝子検査は 産前診断を改善しますが 臨床的有用性を最大化するために 慎重に症例を選択する必要があります
科学分野:
- 医学 遺伝学
- 産前診断
- 発達生物学
背景:
- 超音波で検出される胎児の構造的異常は,アヌプロイド性,複製数変異 (CNVs),および発達遺伝子の配列変異などの遺伝的原因から生じる可能性があります.
- 現在行われているアヌプロイドとCNVの検査は,産前における全ゲノム次世代配列決定の臨床的有用性について,限られた洞察を提供している.
- この研究では,構造的異常を示す胎児内の発達障害遺伝子の遺伝的変異を特定するための全エクソーム配列決定 (WES) の診断成果を調査しています.
研究 の 目的:
- 発達障害に関連する識別可能な遺伝子変異を有する構造異常を有する胎児の割合を全エクソーム配列化 (WES) を使用して評価する.
- 胎児の構造的異常の産前診断におけるWESの臨床的有用性を評価する.
- マルチシステム,心臓,骨格の異常,並びに孤立したの透明性の増加を含む様々な胎児のフェノタイプに対するWESの診断出力を決定する.
主な方法:
- イギリスとスコットランドの34の胎児医学部を対象とした前向きなコホート研究.
- 構造的異常を有する610人の胎児と親のサンプルで,全エクソームシーケンシング (WES) を実施した.
- 配列解析の結果は,発育障害の標的遺伝子パネルを用いて解釈され,遺伝的変異は産後検証された.
主要な成果:
- 診断可能な遺伝子変異は胎児の8. 5% (52/ 610) で特定され,さらに3. 9% (24/ 610) が臨床的有用性のある不確実な変異を示した.
- 診断変異の検出は,症候群と非症候群の胎児異常を区別するのに役立ちました.
- 最も高い検出率は,多システム (15. 4%),骨格 (15. 4%) および心臓 (11. 1%) の異常を有する胎児で観察され,最も低い割合は,孤立したの透明性の増加 (3. 2%) であった.
結論:
- 全エクソームシーケンシング (WES) は胎児の構造異常の遺伝子診断を容易にし,より正確な予後と再発リスクの予測を可能にします.
- WESは構造的異常を持つ胎児の遺伝的疾患の特定を改善しますが,この前向きなコホートにおける全体的な検出率は予想より低かった.
- WESの臨床的有用性を最大化するために,妊産婦の環境で広く実施する前に,慎重に症例を選択することが不可欠です.
関連する概念動画
Imaging Studies II: Ultrasonography
439
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
439
Ultrasonography
7.6K
Ultrasonography is an imaging technique that uses high-frequency sound waves to visualize the body's internal structures. It is a non-invasive and safe procedure that does not involve the use of ionizing radiation, making it widely used in various medical fields. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development.
During an ultrasonography procedure, a handheld device called...
During an ultrasonography procedure, a handheld device called...
7.6K
Ultrasound I: Abdominal Ultrasonography
1.5K
Introduction:
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
1.5K
Fetal Circulation
2.9K
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
2.9K
Cis-regulatory Sequences
11.8K
Cis-regulatory sequences are short fragments of non-coding DNA that are present on the same chromosomes as the genes that they regulate. These fragments serve as binding sites for transcriptional regulators, proteins that are responsible for controlling gene transcription and differential gene expression across cell types in eukaryotes. Cis-regulatory sequences can be close to the gene of interest or thousands of bases away in the DNA sequence; however, those sequences that are further away are...
11.8K
Protein and Protein Structure
87.4K
Proteins are one of the most abundant organic molecules in living systems and have the most diverse range of functions of all macromolecules. Proteins may be structural, regulatory, contractile, or protective. They may serve in transport, storage, or membranes; or they may be toxins or enzymes. Their structures, like their functions, vary greatly. They are all, however, amino acid polymers arranged in a linear sequence.
A protein's shape is critical to its function. For example, an enzyme...
A protein's shape is critical to its function. For example, an enzyme...
87.4K


