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曼哈顿一所大学医学中心患者的遗传背景:对个性化医学的启示。

Genetic background of patients from a university medical center in Manhattan: implications for personalized medicine.

机构信息

Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States of America.

出版信息

PLoS One. 2011 May 4;6(5):e19166. doi: 10.1371/journal.pone.0019166.

Abstract

BACKGROUND

The rapid progress currently being made in genomic science has created interest in potential clinical applications; however, formal translational research has been limited thus far. Studies of population genetics have demonstrated substantial variation in allele frequencies and haplotype structure at loci of medical relevance and the genetic background of patient cohorts may often be complex.

METHODS AND FINDINGS

To describe the heterogeneity in an unselected clinical sample we used the Affymetrix 6.0 gene array chip to genotype self-identified European Americans (N = 326), African Americans (N = 324) and Hispanics (N = 327) from the medical practice of Mount Sinai Medical Center in Manhattan, NY. Additional data from US minority groups and Brazil were used for external comparison. Substantial variation in ancestral origin was observed for both African Americans and Hispanics; data from the latter group overlapped with both Mexican Americans and Brazilians in the external data sets. A pooled analysis of the African Americans and Hispanics from NY demonstrated a broad continuum of ancestral origin making classification by race/ethnicity uninformative. Selected loci harboring variants associated with medical traits and drug response confirmed substantial within- and between-group heterogeneity.

CONCLUSION

As a consequence of these complementary levels of heterogeneity group labels offered no guidance at the individual level. These findings demonstrate the complexity involved in clinical translation of the results from genome-wide association studies and suggest that in the genomic era conventional racial/ethnic labels are of little value.

摘要

背景

基因组科学的快速发展引发了人们对其潜在临床应用的兴趣;然而,目前正式的转化研究还很有限。群体遗传学研究表明,在与医学相关的基因座上,等位基因频率和单倍型结构存在显著差异,且患者群体的遗传背景通常较为复杂。

方法和发现

为了描述未经选择的临床样本中的异质性,我们使用 Affymetrix 6.0 基因芯片对来自纽约市西奈山医疗中心的自我认定的欧洲裔美国人(N=326)、非裔美国人(N=324)和西班牙裔(N=327)进行基因分型。还使用了来自美国少数民族和巴西的额外数据进行外部比较。非裔美国人和西班牙裔的祖先起源存在很大差异;后者的数据与外部数据集的墨西哥裔美国人和巴西人重叠。来自纽约的非裔美国人和西班牙裔的 pooled 分析显示,祖先起源广泛连续,使得按种族/族裔分类变得没有意义。携带与医学特征和药物反应相关的变异的选定基因座证实了存在大量的组内和组间异质性。

结论

由于这些互补层次的异质性,群体标签在个体水平上没有提供指导。这些发现表明,从全基因组关联研究结果进行临床转化涉及到复杂性,并表明在基因组时代,传统的种族/族裔标签几乎没有价值。

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