Villoria Judit Garcia, Pajares Sonia, López Rosa María, Marin José Luis, Ribes Antonia
From the Seccción de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital ClinicHospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain.
From the Seccción de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital ClinicHospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain.
Semin Pediatr Neurol. 2016 Nov;23(4):257-272. doi: 10.1016/j.spen.2016.11.001. Epub 2016 Nov 16.
The scope of newborn screening (NBS) programs is continuously expanding. NBS programs are secondary prevention interventions widely recognized internationally in the "field of Public Health." These interventions are aimed at early detection of asymptomatic children affected by certain diseases, with the objective to establish a definitive diagnosis and apply the proper treatment to prevent further complications and sequelae and ensure a better quality of life. The most significant event in the history of neonatal screening was the discovery of phenylketonuria in 1934. This disease has been the paradigm of inherited metabolic diseases. The next paradigm was the introduction of tandem mass spectrometry in the NBS programs that make possible the simultaneous measurement of several metabolites and consequently, the detection of several diseases in one blood spot and in an unique analysis. We aim to review the current situation of neonatal screening in 2016 worldwide and show scientific evidence of the benefits for some diseases. We will also discuss future challenges. It should be taken into account that any consideration to expand an NBS panel should involve a rigorous process of decision-making that balances benefits against the risks of harm.
新生儿筛查(NBS)项目的范围正在不断扩大。NBS项目是在“公共卫生领域”获得国际广泛认可的二级预防干预措施。这些干预措施旨在早期发现受某些疾病影响的无症状儿童,目的是做出明确诊断并实施适当治疗,以预防进一步的并发症和后遗症,确保更好的生活质量。新生儿筛查历史上最重要的事件是1934年苯丙酮尿症的发现。这种疾病一直是遗传性代谢疾病的范例。下一个范例是在NBS项目中引入串联质谱技术,这使得同时测量多种代谢物成为可能,从而能够在一个血斑中通过一次独特分析检测出多种疾病。我们旨在回顾2016年全球新生儿筛查的现状,并展示一些疾病获益的科学证据。我们还将讨论未来的挑战。应该考虑到,任何扩大NBS筛查项目的考量都应涉及一个严格的决策过程,权衡益处与潜在危害风险。