Francescatto Ludmila, Katsanis Nicholas
Center for Human Disease Modeling, Duke University School of Medicine, 300 N Duke St, Durham, NC 27701.
Center for Human Disease Modeling, Duke University School of Medicine, 300 N Duke St, Durham, NC 27701.
Semin Perinatol. 2015 Dec;39(8):617-22. doi: 10.1053/j.semperi.2015.09.010. Epub 2015 Oct 21.
Across the span of the last 75+ years, technological and conceptual advances in genetics have found rapid implementation at the beginning of human life. From karyotype testing, to molecular cytogenetics, to gene panel testing, and now to whole exome and whole genome sequencing, each iterative expansion of our capability to acquire genetic data on the next generation has been implemented quickly in the clinical setting. In tandem, our continuously expanding ability to acquire large volumes of genetic data has generated its own challenges in terms of interpretation, clinical utility of the information, and concerns over privacy and discrimination; for the first time, we are faced with the possibility of having complete access to our genetic data from birth, if not shortly after conception. Here, we discuss the evolution of the field toward this new reality and we consider the potentially far-reaching consequences and, at present, an unclear path toward developing best practices for implementation.
在过去75多年的时间里,遗传学领域的技术和概念进步在人类生命伊始便迅速得到应用。从核型检测到分子细胞遗传学,再到基因panel检测,如今又发展到全外显子组和全基因组测序,我们获取下一代遗传数据能力的每一次迭代扩展都在临床环境中迅速得以实施。与此同时,我们获取大量遗传数据的能力不断增强,这在解读、信息的临床实用性以及隐私和歧视等方面也带来了自身的挑战;我们首次面临从出生起(甚至在受孕后不久)就有可能完全获取自身遗传数据的情况。在此,我们探讨该领域朝着这一新现实的发展历程,并思考其可能产生的深远影响,以及目前在制定最佳实施实践方面尚不明确的路径。