摘要
新生儿遗传病筛查目前以代谢物生化指标检测为主,检测结果假阳性率较高,且有一定的假阴性,筛查的病种较少。近几年逐步开展的新生儿遗传病筛查基因检测技术包括定量聚合酶链反应技术和高通量测序。高通量测序又分为基因包测序、全外显子组测序和全基因组测序。但目前用于新生儿遗传病筛查的基因技术主要为定量聚合酶链反应技术和基因包测序。新生儿基因筛查病种由单病种筛查如耳聋、脊髓性肌萎缩及重症联合免疫缺陷病等向多病种筛查发展。新生儿基因筛查结果解读除遵循美国医学遗传学与基因组学学会联合分子病理协会在2015年提出的“序列变异解读标准和指南”外,还需要结合生化指标检测及其他检测结果综合分析。新生儿遗传病基因筛查的开展需要遵循伦理原则,包括将新生儿基因筛查作为公共卫生项目的伦理、新生儿及其家庭成员知情选择权和隐私权伦理等。新生儿遗传病基因筛查的开展将使更多的遗传病患者能够早期诊断,改善其预后,在新生儿遗传病筛查领域具有里程碑意义。
Neonatal genetic disease is currently screened mainly based on metabolite biochemical technology.The false positive rate of biochemical screening technology is relatively high,and there are certain false negatives,and only few types of diseases can be screened.The genetic techniques have been gradually used for neonatal genetic disease screening in recent years.Gene detection technology includes quantitative PCR(qPCR)and high-throughput sequencing.High-throughput sequencing includes gene panel sequencing,whole-exome sequencing and whole-genome sequencing.At present,qPCR and gene panel sequencing are the main technologies to be used for newborn genetic disease screening.Genetic screening diseases range from single disease such as hearing loss,spinal muscular atrophy and severe combined immunodeficiency to multiple diseases.Besides standards and guidelines for the interpretation of sequence variants proposed by the American College of Medical Genetics and Genomics and the Association for Molecular Pathology in 2015,the interpretation of genetic screening results should also consider biochemical results and other results.The development of newborn genetic screening needs to follow ethical principles,including the ethics of newborn genetic screening as a public health project,the privacy ethics of newborns and their family members,and the ethics of bioinformatics.The development of newborn genetic screening will enable more patients with inherited diseases to receive early diagnosis and treatment and improve their prognosis,which is a milestone in the field of neonatal screening.
作者
韩连书
HAN Lianshu(Department of Pediatric Endocrinology and Genetic Metabolism,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai Institute for Pediatric Research,Shanghai 200092,China)
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2021年第4期429-435,共7页
Journal of Zhejiang University(Medical Sciences)
基金
国家重点研发计划(2016YFC0901505)。
关键词
新生儿筛查
遗传性疾病
先天性
基因
定量PCR
高通量测序
综述
Neonatal screening
Genetic disease,inborn
Gene
Quantitative PCR
High-throughput sequencing
Review
作者简介
通信作者:韩连书,主任医师,硕士生导师,主要从事儿童内分泌遗传代谢病研究,E-mail:hanlianshu@xinhuamed.com.cn,https://orcid.org/0000-0003-4209-5119。
