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墨西哥患者队列中六种溶酶体贮积症的新生儿筛查:墨西哥封闭卫生系统筛查项目的三年结果

Newborn screening for six lysosomal storage disorders in a cohort of Mexican patients: Three-year findings from a screening program in a closed Mexican health system.

作者信息

Navarrete-Martínez Juana Inés, Limón-Rojas Ana Elena, Gaytán-García Maria de Jesús, Reyna-Figueroa Jesús, Wakida-Kusunoki Guillermo, Delgado-Calvillo Ma Del Rocío, Cantú-Reyna Consuelo, Cruz-Camino Héctor, Cervantes-Barragán David Eduardo

机构信息

Department of Genetics, Hospital Central Sur de Alta Especialidad, PEMEX, Mexico City, Mexico.

General Dictatorate, Hospital Central Sur de Alta Especialidad, PEMEX, Mexico City, Mexico.

出版信息

Mol Genet Metab. 2017 May;121(1):16-21. doi: 10.1016/j.ymgme.2017.03.001. Epub 2017 Mar 9.

Abstract

OBJECTIVE

To evaluate the results of a lysosomal newborn screening (NBS) program in a cohort of 20,018 Mexican patients over the course of 3years in a closed Mexican Health System (Petróleos Mexicanos [PEMEX] Health Services).

STUDY DESIGN

Using dried blood spots (DBS), we performed a multiplex tandem mass spectrometry enzymatic assay for six lysosomal storage disorders (LSDs) including Pompe disease, Fabry disease, Gaucher disease, mucopolysaccharidosis type I (MPS-I), Niemann-Pick type A/B, and Krabbe disease. Screen-positive cases were confirmed using leukocyte enzymatic activity and DNA molecular analysis.

RESULTS

From July 2012 to April 2016, 20,018 patients were screened; 20 patients were confirmed to have an LSD phenotype (99.9 in 100,000 newborns). Final distributions include 11 Pompe disease, five Fabry disease, two MPS-I, and two Niemann-Pick type A/B patients. We did not find any Gaucher or Krabbe patients. A final frequency of 1 in 1001 LSD newborn phenotypes was established.

DISCUSSION

NBS is a major public health achievement that has decreased the morbidity and mortality of inborn errors of metabolism. The introduction of NBS for LSD presents new challenges. This is the first multiplex Latin-American study of six LSDs detected through NBS.

摘要

目的

在墨西哥一个封闭的卫生系统(墨西哥国家石油公司[PEMEX]卫生服务机构)中,对20018名墨西哥患者进行为期3年的队列研究,以评估溶酶体新生儿筛查(NBS)项目的结果。

研究设计

我们使用干血斑(DBS),对包括庞贝病、法布里病、戈谢病、I型黏多糖贮积症(MPS-I)、A/B型尼曼-匹克病和克拉伯病在内的六种溶酶体贮积病(LSD)进行多重串联质谱酶分析。筛查呈阳性的病例通过白细胞酶活性和DNA分子分析进行确诊。

结果

2012年7月至2016年4月,共筛查了20018名患者;20名患者被确诊患有LSD表型(每10万名新生儿中有99.9例)。最终分布包括11例庞贝病、5例法布里病、2例MPS-I和2例A/B型尼曼-匹克病患者。未发现戈谢病或克拉伯病患者。确定LSD新生儿表型的最终发病率为1/1001。

讨论

新生儿筛查是一项重大的公共卫生成就,降低了先天性代谢缺陷的发病率和死亡率。引入溶酶体贮积病的新生儿筛查带来了新的挑战。这是拉丁美洲首次通过新生儿筛查对六种溶酶体贮积病进行的多重研究。

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