Landegren U
Rudbeck Laboratory, Department of Genetics and Pathology, Uppsala, Sweden.
J Intern Med. 2000 Oct;248(4):271-6. doi: 10.1046/j.1365-2796.2000.00753.x.
Gene-based diagnostics has been slow to enter medical routine practice in a grand way, but it is now spurred on by three important developments: the total genetic informational content of humans and most of our pathogens is rapidly becoming available; a very large number of genetic factors of diagnostic value in disease are being identified; and such factors include the identity of genes frequently targeted by mutations in specific diseases, common DNA sequence variants associated with disease or responses to therapy, and copy number alterations at the level of DNA or RNA that are characteristic of specific diseases. Finally, improved methodology for genetic analysis now brings all of these genetic factors within reach in clinical practice. The increasing opportunities for genetic diagnostics may gradually influence views on health and normality, and on the genetic plasticity of human beings, provoking discussions about some of the central attributes of genetics.
基于基因的诊断方法大规模进入医学常规实践的进程一直较为缓慢,但目前有三个重要进展推动着这一进程:人类以及我们大多数病原体的完整基因信息内容正迅速可得;大量在疾病诊断中具有价值的遗传因素正在被识别出来;这些因素包括特定疾病中经常发生突变的基因的身份、与疾病或治疗反应相关的常见DNA序列变异,以及特定疾病所特有的DNA或RNA水平的拷贝数改变。最后,遗传分析方法的改进使得所有这些遗传因素在临床实践中都触手可及。基因诊断机会的不断增加可能会逐渐影响人们对健康与正常状态以及人类基因可塑性的看法,引发关于遗传学一些核心属性的讨论。