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对发育迟缓及/或智力残疾儿童进行的下一代测序基因检测。

Genetic tests by next-generation sequencing in children with developmental delay and/or intellectual disability.

作者信息

Han Ji Yoon, Lee In Goo

机构信息

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Clin Exp Pediatr. 2020 Jun;63(6):195-202. doi: 10.3345/kjp.2019.00808. Epub 2019 Nov 4.

Abstract

Developments in next-generation sequencing (NGS) techogies have assisted in clarifying the diagnosis and treatment of developmental delay/intellectual disability (DD/ID) via molecular genetic testing. Advances in DNA sequencing technology have not only allowed the evolution of targeted panels but also, and more currently enabled genome-wide analyses to progress from research era to clinical practice. Broad acceptance of accuracy- guided targeted gene panel, whole-exome sequencing (WES), and whole-genome sequencing (WGS) for DD/ID need prospective analyses of the increasing cost-effectiveness versus conventional genetic testing. Choosing the appropriate sequencing method requires individual planning. Data are required to guide best-practice recommendations for genomic testing, regarding various clinical phenotypes in an etiologic approach. Targeted panel testing may be recommended as a first-tier testing approach for children with DD/ID. Family-based trio testing by WES/WGS can be used as a second test for DD/ ID in undiagnosed children who previously tested negative on a targeted panel. The role of NGS in molecular diagnostics, treatment, prediction of prognosis will continue to increase further in the coming years. Given the rapid pace of changes in the past 10 years, all medical providers should be aware of the changes in the transformative genetics field.

摘要

下一代测序(NGS)技术的发展通过分子基因检测,有助于明确发育迟缓/智力残疾(DD/ID)的诊断和治疗。DNA测序技术的进步不仅推动了靶向基因panel的发展,而且更重要的是,目前已使全基因组分析从研究阶段发展到临床实践。对于DD/ID,准确性导向的靶向基因panel、全外显子组测序(WES)和全基因组测序(WGS)的广泛接受需要对其相对于传统基因检测不断增加的成本效益进行前瞻性分析。选择合适的测序方法需要个性化规划。需要数据以病因学方法指导针对各种临床表型的基因组检测的最佳实践建议。对于患有DD/ID的儿童,靶向panel检测可作为一线检测方法。对于先前靶向panel检测呈阴性的未确诊儿童,基于家系的三联体WES/WGS检测可作为DD/ID的二次检测。未来几年,NGS在分子诊断、治疗、预后预测中的作用将继续进一步增强。鉴于过去10年变化的快速步伐,所有医疗服务提供者都应了解变革性遗传学领域的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a306/7303420/d2afcaec4cfd/kjp-2019-00808f1.jpg

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