Bodamer O A, Hoffmann G F, Lindner M
Division of Biochemical and Pediatric Genetics, University Children's Hospital Vienna, Vienna, Austria.
J Inherit Metab Dis. 2007 Aug;30(4):439-44. doi: 10.1007/s10545-007-0666-z. Epub 2007 Jul 23.
By January 2007 seven European countries had expanded, and more are considering the expansion of their newborn screening programmes by inclusion of ESI tandem mass spectrometry. We present an overview of the current status of expanded newborn screening programmes in Europe. While the first pilot programmes were initiated in 1998 in Germany, most countries started within the last 3 years. The number of disorders screened for by MS/MS ranges from two disorders (phenylketonuria and medium-chain acyl-CoA dehydrogenase deficiency) in some countries to 20 in others. The number of live births investigated per screening centre varies from 18,000 to 77,000. Few programmes have reported the number of positively identified cases and technical data, although many participate in quality assurance and proficiency test schemes. Given the relatively common genetic background of most European populations and similar health care systems, the reasons for the differences observed appear arbitrary and contrary to the optimal benefit of this important preventive health measure. Harmonization of disease screening panels, spectrum of metabolites analysed, sizes of screening laboratories, analytical procedures, follow-up management and proficiency and quality testing is urgently warranted on the European level. This will hopefully occur before screening by novel applications of tandem mass spectrometry for additional groups of disorders including lysosomal storage disorders and X-linked adrenoleukodystrophy are implemented.
到2007年1月,已有七个欧洲国家扩大了新生儿筛查项目,并且更多国家正在考虑通过纳入电喷雾串联质谱法来扩大其新生儿筛查项目。我们概述了欧洲扩大后的新生儿筛查项目的现状。虽然1998年德国启动了首个试点项目,但大多数国家是在过去三年中开始的。通过串联质谱法筛查的疾病数量在一些国家为两种(苯丙酮尿症和中链酰基辅酶A脱氢酶缺乏症),而在其他国家则多达20种。每个筛查中心检测的活产数从18,000例到77,000例不等。尽管许多项目参与了质量保证和能力验证计划,但很少有项目报告确诊病例数和技术数据。鉴于大多数欧洲人群相对常见的遗传背景以及相似的医疗保健系统,所观察到的差异原因似乎是任意的,并且与这项重要预防保健措施的最佳效益相悖。迫切需要在欧洲层面统一疾病筛查组合、分析的代谢物谱、筛查实验室规模、分析程序、后续管理以及能力和质量检测。希望在通过串联质谱法的新应用对包括溶酶体贮积症和X连锁肾上腺脑白质营养不良在内的其他疾病组进行筛查实施之前能够实现这一点。