Shah Nidhi, Brlek Petar, Bulić Luka, Brenner Eva, Škaro Vedrana, Skelin Andrea, Projić Petar, Shah Parth, Primorac Dragan
Petar Brlek, St. Catherine Specialty Hospital, Ul. kneza Branimira 71E, 10000, Zagreb, Croatia,
Croat Med J. 2024 Jun 13;65(3):261-267. doi: 10.3325/cmj.2024.65.261.
Traditional newborn screening (NBS) serves as a critical tool in identifying conditions that may impact a child's health from an early stage. Newborn sequencing (NBSeq), the comprehensive analysis of an infant's genome, holds immense promise for revolutionizing health care throughout the lifespan. NBSeq allows for early detection of genetic disease risk and precision personalized medicine. The rapid evolution of DNA sequencing technologies and increasing affordability have spurred numerous endeavors to explore the potential of whole-genome sequencing in newborn screening. However, this transformative potential cannot be realized without challenges. Ethical aspects must be carefully navigated to safeguard individual rights and maintain public trust. Moreover, genomic data interpretation poses complex challenges due to its amount, the presence of variants of uncertain significance, and the dynamic nature of our understanding of genetics. Implementation hurdles, including cost, infrastructure, and specialized expertise, also present barriers to the widespread adoption of NBSeq. Addressing these challenges requires collaboration among clinicians, researchers, policymakers, ethicists, and stakeholders across various sectors. Robust frameworks for informed consent, data protection, and governance are essential. Advances in bioinformatics, machine learning, and genomic interpretation are crucial for translation into actionable clinical insights. Scalability and improving downstream health care access are vital for equitability, particularly in underserved communities. By fostering interdisciplinary collaboration, advancing technology and infrastructure, and upholding ethical principles, we can unlock the full potential of NBSeq as a tool for precision medicine and pave the way toward a future where every child has the opportunity for a healthier, genomics-informed start to life.
传统的新生儿筛查(NBS)是识别可能在早期影响儿童健康的疾病的关键工具。新生儿测序(NBSeq),即对婴儿基因组进行全面分析,有望彻底改变整个生命周期的医疗保健。NBSeq能够早期检测遗传疾病风险并实现精准个性化医疗。DNA测序技术的迅速发展和成本的不断降低,促使人们开展了众多探索全基因组测序在新生儿筛查中潜力的努力。然而,要实现这种变革潜力并非没有挑战。必须谨慎应对伦理问题,以保障个人权利并维持公众信任。此外,由于基因组数据量庞大、存在意义不确定的变异以及我们对遗传学理解的动态性,基因组数据解读带来了复杂的挑战。实施障碍,包括成本、基础设施和专业知识,也阻碍了NBSeq的广泛应用。应对这些挑战需要临床医生、研究人员、政策制定者、伦理学家和各部门利益相关者之间的合作。健全的知情同意、数据保护和治理框架至关重要。生物信息学、机器学习和基因组解读方面的进展对于转化为可操作的临床见解至关重要。可扩展性和改善下游医疗保健服务对于公平性至关重要,特别是在服务不足的社区。通过促进跨学科合作、推进技术和基础设施建设以及坚持伦理原则,我们可以释放NBSeq作为精准医疗工具的全部潜力,为每个儿童都有机会在基因组学指导下开启更健康生活的未来铺平道路。