非免疫性胎儿水肿的单基因病因学系统评价。
A systematic review of monogenic etiologies of nonimmune hydrops fetalis.
机构信息
Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
出版信息
Genet Med. 2021 Jan;23(1):3-12. doi: 10.1038/s41436-020-00967-0. Epub 2020 Oct 21.
Hydrops fetalis (HF), accumulation of fluid in two or more fetal compartments, is life-threatening to the fetus. Genetic etiologies include many chromosomal and monogenic disorders. Despite this, the clinical workup typically evaluates limited genetic targets. To support broader molecular testing of pregnancies with HF, we cataloged the spectrum of monogenic disorders associated with nonimmune hydrops fetalis (NIHF). We performed a systematic literature review under PROSPERO tag CRD42018099495 of cases reporting NIHF meeting strict phenotypic criteria and well-defined genetic diagnosis. We ranked the evidence per gene based on number of reported cases, phenotype, and molecular/biochemical diagnosis. We identified 131 genes with strong evidence for an association with NIHF and 46 genes with emerging evidence spanning the spectrum of multisystem syndromes, cardiac disorders, hematologic disorders, and metabolic disorders. Several genes previously implicated with NIHF did not have any reported cases in the literature with both fetal hydrops and molecular diagnosis. Many genes with strong evidence for association with NIHF would not be detected using current sequencing panels. Nonimmune HF has many possible monogenic etiologies, several with treatment implications, but current diagnostic approaches are not exhaustive. Studies are needed to assess if broad sequencing approaches like exome sequencing are useful in clinical management of HF.
胎儿水肿(HF)是指两个或多个胎儿腔室中液体的积聚,对胎儿有生命威胁。遗传病因包括许多染色体和单基因疾病。尽管如此,临床检查通常只评估有限的遗传靶标。为了支持对 HF 妊娠进行更广泛的分子检测,我们对与非免疫性胎儿水肿(NIHF)相关的单基因疾病谱进行了编目。我们在 PROSPERO 标签 CRD42018099495 下进行了系统的文献综述,报告了符合严格表型标准和明确遗传诊断的 NIHF 病例。我们根据报告病例的数量、表型和分子/生化诊断对每个基因的证据进行了排名。我们确定了 131 个与 NIHF 强烈相关的基因和 46 个具有新兴证据的基因,涵盖了多系统综合征、心脏疾病、血液疾病和代谢疾病。以前与 NIHF 相关的几个基因在文献中没有任何既有胎儿水肿又有分子诊断的病例。许多与 NIHF 强烈相关的基因如果使用当前的测序面板则无法检测到。非免疫性 HF 有许多可能的单基因病因,其中一些有治疗意义,但目前的诊断方法并不详尽。需要研究评估外显子组测序等广泛的测序方法是否对 HF 的临床管理有用。