National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
Lancet. 2019 Aug 10;394(10197):511-520. doi: 10.1016/S0140-6736(19)31140-7. Epub 2019 Aug 5.
Advances in technologies for assessing genomic variation and an increasing understanding of the effects of genomic variants on health and disease are driving the transition of genomics from the research laboratory into clinical care. Genomic medicine, or the use of an individual's genomic information as part of their clinical care, is increasingly gaining acceptance in routine practice, including in assessing disease risk in individuals and their families, diagnosing rare and undiagnosed diseases, and improving drug safety and efficacy. We describe the major types and measurement tools of genomic variation that are currently of clinical importance, review approaches to interpreting genomic sequence variants, identify publicly available tools and resources for genomic test interpretation, and discuss several key barriers in using genomic information in routine clinical practice.
技术的进步使得评估基因组变异变得更加容易,同时人们对基因组变异如何影响健康和疾病的认识也不断加深,这些都推动了基因组学从研究实验室向临床实践的转变。基因组医学,或者说将个体的基因组信息应用于临床护理的实践,在常规实践中越来越被接受,包括评估个体及其家庭成员的疾病风险、诊断罕见和未确诊的疾病,以及提高药物的安全性和疗效。我们描述了目前具有临床重要性的主要类型和测量工具的基因组变异,回顾了基因组序列变异解释的方法,确定了用于基因组测试解释的公共可用工具和资源,并讨论了在常规临床实践中使用基因组信息的几个关键障碍。