Zhejiang University School of Medicine, Hangzhou 310058, China.
Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023 Nov 20;53(3):280-287. doi: 10.3724/zdxbyxb-2023-0440.
Preimplantation genetic testing is an important part in assisted reproductive technology, which can block the intergenerational inheritance of a single gene or chromosomal diseases. Preimplantation genetic testing for polygenic disease risk (PGT-P) is one of the latest developments in the field. With the development of artificial intelligence and genetic detection technology, PGT-P can be used to analyze genetic material, calculate polygenic risk scores and convert these into incidence probability. Embryos with relatively low incidence probability can be screened for transfer, in order to reduce the possibility that the offspring suffers from the disease in the future. This has significant clinical and social significance. At present, PGT-P has been applied clinically and made phased progress at home and abroad. But as a developing technology, PGT-P still has some technical limitations as unstable results, environmental influences and racial differences cannot be ruled out. From the ethical perspective, if the screening indications are not strictly regulated, it is likely to cause new social problems. In this paper, we review the technical details and recent progress in PGT-P, and discuss the prospects of its future development, especially how to establish a complete and suitable screening model for Chinese population.
胚胎植入前遗传学检测是辅助生殖技术的重要组成部分,可以阻断单基因或染色体疾病的代际遗传。多基因疾病风险的胚胎植入前遗传学检测(PGT-P)是该领域的最新进展之一。随着人工智能和基因检测技术的发展,PGT-P 可用于分析遗传物质、计算多基因风险评分,并将其转化为发病概率。可以筛选出具有相对较低发病概率的胚胎进行转移,以降低后代未来患病的可能性。这具有重要的临床和社会意义。目前,PGT-P 已在临床上得到应用,并在国内外取得了阶段性进展。但作为一项发展中的技术,PGT-P 仍存在一些技术局限性,如结果不稳定、环境影响和种族差异无法排除等。从伦理角度来看,如果筛查指征不严格规范,可能会引发新的社会问题。本文综述了 PGT-P 的技术细节和最新进展,并讨论了其未来发展前景,特别是如何为中国人群建立一个完整且适宜的筛查模型。