Medical Genetics Institute and the Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Genet Med. 2010 Oct;12(10):628-33. doi: 10.1097/GIM.0b013e3181edef5b.
Israeli investigators have identified several relatively frequent disorders due to founder point mutations in Persian (Iranian) Jews, who, for nearly three centuries up to the Islamic Revolution of 1979, were completely isolated reproductively.
Using a community-based model previously employed with Tay-Sachs disease prevention, we developed a pilot program for the Persian Jewish community of greater Los Angeles. We screened for mutations responsible for four relatively frequent autosomal recessive conditions in Persian Jews in which effective interventions are available for each: Pseudocholinesterase deficiency (butyryl cholinesterase deficiency); Congenital hypoaldosteronism (corticosterone methyl oxidase II); Autoimmune polyendocrinopathy (autoimmune regulatory element); and Hereditary Inclusion Body myopathy.
One thousand individuals volunteered. Mutations were assessed in saliva-derived DNA and were positive for 121/1000 butyryl cholinesterase deficiency; 92/1000 Hereditary Inclusion Body myopathy; 38/1000 corticosterone methyl oxidase II; and 37/1000 autoimmune regulatory element. Ten homozygous individuals (9 butyryl cholinesterase deficiency and 1 Hereditary Inclusion Body myopathy) and 10 "at-risk" couples (seven for butyryl cholinesterase deficiency and one each for the other three disorders) were identified. These frequencies are comparable with those in Israel and indicate an extraordinary level of inbreeding, as anticipated.
A carefully planned effort can be delivered to an "increased risk" community if detailed attention is given to planning and organization. However, availability of an effective intervention for those found to be "at-risk" or possibly affected, is essential before embarking.
以色列研究人员已经发现了一些由于波斯(伊朗)犹太人的创始人点突变而导致的相对常见的疾病,这些犹太人在 1979 年伊斯兰革命之前的近三个世纪里完全被隔离生育。
我们使用以前在泰萨奇氏病预防中使用的基于社区的模型,为洛杉矶大都市区的波斯犹太社区制定了一个试点计划。我们针对在波斯犹太人中存在的四种相对常见的常染色体隐性疾病进行了筛查,这些疾病都有有效的干预措施:假性胆碱酯酶缺乏症(丁酰胆碱酯酶缺乏症);先天性低醛固酮血症(皮质酮甲基氧化酶 II);自身免疫性多内分泌腺病(自身免疫调节元件);和遗传性包涵体肌病。
有 1000 人自愿参加。在唾液衍生的 DNA 中评估了突变,丁酸酯酶缺乏症的阳性率为 121/1000;遗传性包涵体肌病为 92/1000;皮质酮甲基氧化酶 II 为 38/1000;自身免疫调节元件为 37/1000。确定了 10 名纯合子个体(9 名丁酸酯酶缺乏症和 1 名遗传性包涵体肌病)和 10 对“高危”夫妇(7 对丁酸酯酶缺乏症,1 对其他三种疾病)。这些频率与以色列的频率相当,表明存在极高的近亲繁殖水平,这是可以预期的。
如果对规划和组织给予详细关注,就可以将精心计划的努力提供给“高风险”社区。但是,在开始之前,对于发现处于“高危”或可能受影响的人,必须提供有效的干预措施。