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欧洲土耳其和北非囊性纤维化患者中的CFTR突变:对筛查的影响。

CFTR mutations in Turkish and North African cystic fibrosis patients in Europe: implications for screening.

作者信息

Lakeman Phillis, Gille Johan J P, Dankert-Roelse Jeannette E, Heijerman Harry G M, Munck Anne, Iron Albert, Grasemann Hartmut, Schuster Antje, Cornel Martina C, Ten Kate Leo P

机构信息

Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

Genet Test. 2008 Mar;12(1):25-35. doi: 10.1089/gte.2007.0046.

Abstract

AIMS

To obtain more insight into the variability of the CFTR mutations found in immigrant cystic fibrosis (CF) patients who are living in Europe now, and to estimate the test sensitivity of different frequently used methods of DNA analysis to detect CF carriers or patients among these Turkish or North African immigrants.

METHODS

A survey among 373 European CF centers asking which CFTR mutations had been found in Turkish and North African CF patients.

RESULTS

31 and 26 different mutations were reported in Turkish and North African patients, identifying 64.2% (113/176) and 87.4% (118/135) alleles, respectively (p < 0.001). The mean sensitivity (detection rate) of three most common CFTR mutation panels to detect these mutations differed between Turkish and North African people, 44.9% (79/176) versus 69.6% (94/135) (p < 0.001), and can be increased to 57.4% (101/176) and 79.3% (107/135) (p < 0.001), respectively, by expanding these panels with 13 mutations which have been found on two or more alleles.

CONCLUSION

35.8% and 12.6%, respectively, of CF alleles in Turkish and North African patients living in Europe now had not been identified. Among these populations, the test sensitivity of common CFTR mutation panels is insufficient for use in screening programs in Europe, even after expansion with frequent Turkish and North African mutations. This raises questions about whether and how to implement CF carrier and neonatal screening in a multiethnic society.

摘要

目的

更深入了解目前居住在欧洲的移民囊性纤维化(CF)患者中发现的CFTR突变的变异性,并评估不同常用DNA分析方法在这些土耳其或北非移民中检测CF携带者或患者的检测敏感性。

方法

对373个欧洲CF中心进行调查,询问在土耳其和北非CF患者中发现了哪些CFTR突变。

结果

在土耳其和北非患者中分别报告了31种和26种不同的突变,分别鉴定出64.2%(113/176)和87.4%(118/135)的等位基因(p<0.001)。三种最常见的CFTR突变检测板检测这些突变的平均敏感性(检出率)在土耳其人和北非人之间存在差异,分别为44.9%(79/176)和69.6%(94/135)(p<0.001),通过在这些检测板中增加在两个或更多等位基因上发现的13种突变,平均敏感性可分别提高到57.4%(101/176)和79.3%(107/135)(p<0.001)。

结论

目前居住在欧洲的土耳其和北非患者中,分别有35.8%和12.6%的CF等位基因尚未被鉴定。在这些人群中,即使在增加了常见的土耳其和北非突变后,常用CFTR突变检测板的检测敏感性仍不足以用于欧洲的筛查项目。这引发了关于在多民族社会中是否以及如何实施CF携带者和新生儿筛查的问题。

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