RESUMO
OBJECTIVE: Genetic counseling and carrier screening are part of the gamete donation process by healthy individuals. We aim to review the findings of genetic counseling and carrier screening of a cohort of candidates at our public gametes bank. METHODS: Thirty-four male and 64 female candidates had genetic counseling with a medical geneticist before donation. Of these, one female candidate voluntarily dropped-out. Thirty-four males and 63 females performed karyotype and screening for the more common pathogenic variants for CFTR-related cystic fibrosis and spinal muscular atrophy (SMN1) in the Portuguese population. In addition, all females also performed Fragile X expansion screening (FMR1). Thirty candidates with known or assumed African ancestry performed hemoglobinopathies screening. RESULTS: Six candidates were definitely or temporarily withheld from the donation process given their family or personal history that required further investigation. Of 97 candidates tested, 16.5% presented anomalous laboratory results (16/97): ten candidates were carriers for an autosomal recessive disorder - cystic fibrosis (5/97), sickle cell anemia (3/30), and spinal muscular atrophy (2/97). One female was an FMR1 pre-mutation carrier (1/63). One female candidate presented with triple X mosaicism: 47,XXX[2]/46,XX[50]. Two candidates presented with chromosomal instability of unknown origin. In one candidate, a mosaic for the Philadelphia chromosome was detected, revealing the diagnosis of chronic myeloid leukemia. CONCLUSIONS: From a cohort of 97 candidates, 21.7% had a family/personal history or an anomalous laboratory result that required additional genetic counseling, stressing the importance of performing pre-donation genetic counseling in this population.
Assuntos
Fibrose Cística , Atrofia Muscular Espinal , Humanos , Masculino , Feminino , Aconselhamento Genético , Triagem de Portadores Genéticos/métodos , Fibrose Cística/diagnóstico , Fibrose Cística/genética , Portugal , Atrofia Muscular Espinal/diagnóstico , Atrofia Muscular Espinal/genética , Células Germinativas , Proteína do X Frágil da Deficiência Intelectual/genéticaRESUMO
PURPOSE: The Mexican Jewish community (MJC) is a previously uncharacterized, genetically isolated group composed of Ashkenazi and Sephardi-Mizrahi Jews who migrated in the early 1900s. We aimed to determine the heterozygote frequency of disease-causing variants in 302 genes in this population. METHODS: We conducted a cross-sectional study of the MJC involving individuals representing Ashkenazi Jews, Sephardi-Mizrahi Jews, or mixed-ancestry Jews. We offered saliva-based preconception pan-ethnic expanded carrier screening, which examined 302 genes. We analyzed heterozygote frequencies of pathogenic/likely pathogenic variants and compared them with those in the Genome Aggregation Database (gnomAD). RESULTS: We recruited 208 participants. The carrier screening results showed that 72.1% were heterozygous for at least 1 severe disease-causing variant in 1 of the genes analyzed. The most common genes with severe disease-causing variants were CFTR (16.8% of participants), MEFV (11.5%), WNT10A (6.7%), and GBA (6.7%). The allele frequencies were compared with those in the gnomAD; 85% of variant frequencies were statistically different from those found in gnomAD (P <.05). Finally, 6% of couples were at risk of having a child with a severe disorder. CONCLUSION: The heterozygote frequency of at least 1 severe disease-causing variant in the MJC was 72.1%. The use of carrier screening in the MJC and other understudied populations could help parents make more informed decisions.
Assuntos
Etnicidade , Judeus , Criança , Estudos Transversais , Frequência do Gene/genética , Triagem de Portadores Genéticos/métodos , Testes Genéticos , Heterozigoto , Humanos , Judeus/genética , Pirina/genéticaRESUMO
A doença de Chagas, enfermidade causada pelo protozoário Trypanosoma cruzi, tem sido relacionada com frequência à transmissão oral pelo consumo de açaí. Métodos moleculares que fornecem uma identificação rápida e precisa do patógeno para a detecção da presença do parasita são de extrema importância para a detecção da presença do parasita neste alimento. Este estudo teve como objetivo otimizar a detecção de DNA de T. cruzi em polpa de açaí por meio da reação em cadeia da polimerase (PCR). Foram preparadas várias diluições das formas tripomastigotas de T. cruzi DTU TcI cultivadas em meio de cultivo Liver Infusion Tryptose. O DNA de T. cruzi foi extraído das células e submetido à PCR. Posteriormente, as diluições da cultura foram adicionadas às polpas de açaí para avaliar o limite de detecção do novo ensaio de PCR otimizado. Mostramos que nosso ensaio pode detectar DNA de T. cruzi em polpas de açaí na concentração de 1.08 × 10-10 ng µL-1. Concluímos que a metodologia desenvolvida se mostra eficaz e pode ser uma ferramenta importante para a detecção de contaminação por T. cruzi em açaí.(AU)
Assuntos
Doença de Chagas , Doenças Transmitidas por Alimentos , Triagem de Portadores Genéticos , NoxasRESUMO
BACKGROUND: Procambarus clarkii produces high-quality, delicious meat that is high in protein, low in fat, and rich in calcium and phosphorus. It has become an important aquatic resource in China. Our objectives are (i) to analyze the level of genetic diversity of P. clarkii populations; (ii) to explore the genetic differentiation (Gst); and (iii) to propose appropriate strategies for the conservation. RESULTS: In this study, Shannon's index (I) and Nei's gene diversity index (H) for P. clarkii were high (I = 0.3462 and H = 0.2325 on average and I = 0.6264, H = 0.4377 at the species level) based on the SSR markers. The expected heterozygosity value of 17 microsatellite loci in 25 crayfish populations was 0.9317, the observed heterozygosity value was 0.9121, and the observed number of alleles per locus was 2.000; and the effective number of alleles per locus was 1.8075. Among the P. clarkii populations, the inbreeding coefficient within populations (Fis) was 0.2315, overall inbreeding coefficient (Fit) was 0.4438, genetic differentiation coefficient among populations (Fst) was 0.3145 and gene differentiation (Gst) was 0.4785 based on SSR analyses. The cluster analysis results obtained by unweighted pair-group method with arithmetic mean (UPGMA) analysis, principal coordinate analysis (PCoA) and STRUCTURE analysis were similar. A mantel test showed that the isolation-by-distance pattern was not significant. CONCLUSIONS: The high Gst among P. clarkii populations is attributed to genetic drift and geographic isolation. The results indicated that more P. clarkii populations should be collected when formulating conservation and aquaculture strategies.
Assuntos
Animais , Variação Genética , Repetições de Microssatélites , Astacoidea/genética , Filogenia , China , Reação em Cadeia da Polimerase , Aquicultura , Ambiente Aquático , Áreas Alagadas , Triagem de Portadores GenéticosRESUMO
Introduction: Cystic fibrosis is an autosomal recessive genetic disease classified as a highcost orphan disease. Objective: To determine the cost-effectiveness ratio of the diagnostic test for the CFTR gene-sequencing in asymptomatic family carriers in the first, second, and third degree of consanguinity. Materials and methods: We conducted a systematic search evaluating operative characteristics of the diagnostic test and decision-tree models in cost-effectiveness studies. A decision-tree model was elaborated taking prevention of future conceptions as a unit of analysis. We obtained the costs of the disease from the high-cost report of the Ministerio de Salud y Protección Social. The costs of the test were referenced by national laboratories. We carried out a deterministic and probabilistic sensitivity analysis with a third-payer perspective and a one-year horizon. Results: An ICER of USD$ 5051.10 was obtained as the incremental cost for obtaining 10.89% more probability of avoiding the birth of a child with cystic fibrosis per screened couple. For family members in second and third degrees, the ICER was USD$ 19,380.94 and USD$ 55,913.53, respectively, evidenced when applying the GDP per capita. This technology was cost-effective in 39%, 61.18%, and 74.36% for 1, 2, and 3 GDP per capita in first degree of consanguinity relatives. Conclusions: The genetic test for the detection of CFTR gene carriers was cost-effective depending on the threshold of availability to pay and the assumptions and limitations established in the model.
Introducción. La fibrosis quística es una enfermedad genética de carácter autosómico recesivo clasificada como enfermedad huérfana de alto costo. Objetivo. Determinar la razón de costo-efectividad de la prueba diagnóstica de secuenciación del gen CFTR para los portadores asintomáticos familiares en primer, segundo y tercer grados de consanguinidad. Materiales y métodos. Se hizo una búsqueda sistemática sobre la evaluación de las características operativas de la prueba diagnóstica y los modelos de árbol de decisiones en estudios de costo-efectividad. Se elaboró un modelo de árbol de decisiones tomando como unidad de análisis la prevención de futuras concepciones. Los costos de la enfermedad se obtuvieron del reporte de alto costo del Ministerio de Salud de Colombia. Los costos de la prueba se obtuvieron de laboratorios nacionales. Se hizo un análisis de sensibilidad, determinístico y probabilístico, con la perspectiva del tercer pagador y horizonte a un año. Resultados. Se obtuvo una razón incremental de costo-efectividad (RICE) de USD$5.051,10 por obtener 10,89 % más de probabilidades de evitar el nacimiento de un niño enfermo con fibrosis quística por pareja. Para los familiares de segundo y tercer grados, se encontró una RICE de USD$ 19.380,94 y USD$ 55.913,53, respectivamente, al aplicar el PIB per cápita. Esta tecnología fue costo-efectiva en 39 %, 61,18 % y 74,36 % para 1, 2 y 3 PIB per cápita en familiares de primer grado de consanguinidad. Conclusiones. La prueba genética de detección de portadores del gen CFTR resultó costo-efectiva dependiendo del umbral de la disponibilidad de pagar, y de los supuestos y limitaciones establecidas en el modelo.
Assuntos
Regulador de Condutância Transmembrana em Fibrose Cística/genética , Análise Mutacional de DNA/economia , Triagem de Portadores Genéticos/economia , Doenças Assintomáticas , Viés , Colômbia/epidemiologia , Análise Custo-Benefício , Fibrose Cística/economia , Fibrose Cística/epidemiologia , Fibrose Cística/genética , Fibrose Cística/prevenção & controle , Árvores de Decisões , Triagem de Portadores Genéticos/métodos , Aconselhamento Genético , Humanos , Reembolso de Seguro de Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Probabilidade , Sensibilidade e Especificidade , Análise de Sequência de DNA/economiaRESUMO
Introducción. La fibrosis quística es una enfermedad genética de carácter autosómico recesivo clasificada como enfermedad huérfana de alto costo. Objetivo. Determinar la razón de costo-efectividad de la prueba diagnóstica de secuenciación del gen CFTR para los portadores asintomáticos familiares en primer, segundo y tercer grados de consanguinidad. Materiales y métodos. Se hizo una búsqueda sistemática sobre la evaluación de las características operativas de la prueba diagnóstica y los modelos de árbol de decisiones en estudios de costo-efectividad. Se elaboró un modelo de árbol de decisiones tomando como unidad de análisis la prevención de futuras concepciones. Los costos de la enfermedad se obtuvieron del reporte de alto costo del Ministerio de Salud de Colombia. Los costos de la prueba se obtuvieron de laboratorios nacionales. Se hizo un análisis de sensibilidad, determinístico y probabilístico, con la perspectiva del tercer pagador y horizonte a un año. Resultados. Se obtuvo una razón incremental de costo-efectividad (RICE) de USD$ 5.051,10 por obtener 10,89 % más de probabilidades de evitar el nacimiento de un niño enfermo con fibrosis quística por pareja. Para los familiares de segundo y tercer grados, se encontró una RICE de USD$ 19.380,94 y USD$ 55.913,53, respectivamente, al aplicar el PIB per cápita. Esta tecnología fue costo-efectiva en 39 %, 61,18 % y 74,36 % para 1, 2 y 3 PIB per cápita en familiares de primer grado de consanguinidad. Conclusiones. La prueba genética de detección de portadores del gen CFTR resultó costo-efectiva dependiendo del umbral de la disponibilidad de pagar, y de los supuestos y limitaciones establecidas en el modelo.
Introduction: Cystic fibrosis is an autosomal recessive genetic disease classified as a high- cost orphan disease. Objective: To determine the cost-effectiveness ratio of the diagnostic test for the CFTR gene-sequencing in asymptomatic family carriers in the first, second, and third degree of consanguinity. Materials and methods: We conducted a systematic search evaluating operative characteristics of the diagnostic test and decision-tree models in cost-effectiveness studies. A decision-tree model was elaborated taking prevention of future conceptions as a unit of analysis. We obtained the costs of the disease from the high-cost report of the Ministerio de Salud y Protección Social. The costs of the test were referenced by national laboratories. We carried out a deterministic and probabilistic sensitivity analysis with a third-payer perspective and a one-year horizon. Results: An ICER of USD$ 5051.10 was obtained as the incremental cost for obtaining 10.89% more probability of avoiding the birth of a child with cystic fibrosis per screened couple. For family members in second and third degrees, the ICER was USD$ 19,380.94 and USD$ 55,913.53, respectively, evidenced when applying the GDP per capita. This technology was cost-effective in 39%, 61.18%, and 74.36% for 1, 2, and 3 GDP per capita in first degree of consanguinity relatives. Conclusions: The genetic test for the detection of CFTR gene carriers was cost-effective depending on the threshold of availability to pay and the assumptions and limitations established in the model.
Assuntos
Testes Genéticos , Fibrose Cística/genética , Análise de Custo-Efetividade , Aconselhamento Genético , Triagem de Portadores GenéticosRESUMO
Introducción: La enfermedad granulomatosa crónica es una inmunodeficiencia primaria causada por mutaciones en la enzima NADPH oxidasa. Esta compromete la producción de especies reactivas del oxígeno, que son importantes contra patógenos. La prueba de la oxidación de la dihidrorodamina es un método eficaz para diagnosticar la enfermedad. Objetivo: Demostrar la utilidad de la prueba de la oxidación de la dihidrorodamina y del patrón de herencia en la confirmación del diagnóstico de la enfermedad granulomatosa crónica de un paciente. Métodos: Estudio de caso de una familia con diagnóstico de enfermedad granulomatosa crónica. Se tomó muestra de sangre periférica para citometría de flujo a tres individuos. Se realizó la prueba de la oxidación de la dihidrorodamina bajo estímulo con acetato de forbolmiristato y se evaluaron las subpoblaciones linfocitarias. Las muestras se leyeron en un citómetro GALLIOS, Beckman Coulter. Los datos obtenidos se analizaron en el programa informático Kaluza. Resultados: El paciente masculino tuvo un valor de oxidación de la dihidrorodamina positiva de 0,87 por ciento, que confirmó un patrón de herencia ligado al cromosoma X; mientras que la madre y hermana gemela portadoras tuvieron valores de 46,76 por ciento y 37,32 por ciento, respectivamente. Se encontraron alteraciones en las subpoblaciones linfocitarias. Conclusiones: La prueba de la oxidación de la dihidrorodamina es un método muy efectivo, rápido y sencillo que confirma el diagnóstico de la enfermedad granulomatosa crónica y determina el patrón de herencia y fenotipo de la enfermedad. Además, permite identificar a las mujeres portadoras según la distribución de los neutrófilos normales y los que tienen el gen CYBB mutado(AU)
Introduction: Chronic granulomatous disease is a primary immunodeficiency caused by mutations in the NADPH oxidase enzymes. This compromises the production of oxygen reactive species, which are important against pathogens. The dihydrorhodamine oxidation test is an effective method for diagnosing the disease. Objective: To demonstrate the usefulness of the dihydrorhodamine oxidation test and the inheritance pattern in confirming the diagnosis of chronic granulomatous disease in a patient. Methods: A case study of a family with a diagnosis of chronic granulomatous disease. A peripheral blood sample was taken from three individuals and by flow cytometry. The dihydrorhodamine oxidation test was performed under stimulation with phorbolmyristate acetate, and lymphocyte subpopulations were evaluated. The samples were read on a GALLIOS, Beckman Coulter cytometer. The data obtained were analyzed using the computer program Kaluza. Results: The male patient had a positive dihydrorhodamine oxidation value of 0.87 percent, which confirmed an inheritance pattern linked to the X chromosome; while the carrier mother and twin sister had values 8203;8203;of 46.76 percent and 37.32 percent, respectively. Alterations were found in the lymphocyte subpopulations. Conclusions: The dihydrorhodamine oxidation test is a very effective, fast and simple method that confirms the diagnosis of chronic granulomatous disease and determines the inheritance pattern and phenotype of the disease. In addition, it allows the identification of female carriers according to the distribution of normal neutrophils and those with the CYBB mutation(AU)
Assuntos
Humanos , Masculino , Feminino , Portador Sadio/congênito , NADPH Oxidases/análise , Padrões de Herança/genética , Doença Granulomatosa Crônica/diagnóstico , Relatos de Casos , Cuba , Triagem de Portadores Genéticos/métodos , Anamnese/métodosRESUMO
OBJECTIVE: To conduct interviews with a multiyear sample of parents of infants found to have heterozygous status for sickle cell hemoglobinopathy or cystic fibrosis during newborn blood screening (NBS). STUDY DESIGN: Interviewers with clinical backgrounds telephoned parents, and followed a structured script that blended follow-up and research purposes. Recruiting followed several steps to minimize recruiting bias as much as possible for a NBS study. RESULTS: Follow-up calls were conducted with parents of 426 infant carriers of sickle cell hemoglobinopathy, and 288 parents of cystic fibrosis carriers (34.8% and 49.6% of those eligible). Among these, 27.5% and 7.8% had no recollection of being informed of NBS results. Of those who recalled a provider explanation, 8.6% and 13.0% appraised the explanation negatively. Overall, 7.4% and 13.2% were dissatisfied with the experience of learning about the NSB result. Mean anxiety levels were low but higher in the sickle cell hemoglobinopathy group (P < .001). Misconceptions that the infant might get the disease were present in 27.5% and 7.8% of parents (despite zero actual risk for disease). Several of these data were significantly predicted by NBS result, health literacy, parental age, and race/ethnicity factors. CONCLUSIONS: Patient-centered public health follow-up can be effective after NBS identifies carrier status. Psychosocial complications were uncommon, but harms were substantial enough to justify mitigation.
Assuntos
Anemia Falciforme/genética , Portador Sadio/psicologia , Fibrose Cística/genética , Triagem de Portadores Genéticos/normas , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Ansiedade/diagnóstico , Portador Sadio/diagnóstico , Estudos de Coortes , Feminino , Triagem de Portadores Genéticos/ética , Humanos , Lactente , Recém-Nascido , Consentimento Livre e Esclarecido , Masculino , Triagem Neonatal , Satisfação do Paciente , Relações Médico-Paciente , Pesquisa Qualitativa , Inquéritos e QuestionáriosRESUMO
Resumen La enfermedad por hemoglobina H es un cuadro clínico que se presenta en las alfa talasemias, las cuales son enfermedades que cursan con anemia microcítica hipocrómica, debidas principalmente a deleciones en el gen de alfaglobina, lo que disminuye la producción de la cadena de alfa globina y promueve la formación de variantes de hemoglobina. Cuando se detectan variantes de hemoglobina en las alfa talasemias, por lo general, se debe a genotipos homocigotas o dobles heterocigotas para mutaciones y deleciones del gen de alfa globina coheredadas. En este artículo se describe el primer caso en Costa Rica, de dos hermanos con enfermedad por hemoglobina H, que fenotípicamente presentaron las variantes de hemoglobina H y hemoglobina Constant Spring en el análisis electroforético de la hemoglobina, y cuyo análisis molecular del gen de alfa globina detectó tanto la deleción sudeste asiático como la mutación para hemoglobina Constant Spring, siendo diagnosticados como dobles heterocigotos por alfa talasemia (genotipo --SEA/ααCS).
Abstract Hemoglobin H disease occurs in patients with alpha thalassemia, diseases associated with hypochromic microcytic anemia, mainly due to deletions in the alpha globin gene, which decreases the production of the alpha globin chain and promotes the formation of hemoglobin variants. When hemoglobin variants are detected in alpha thalassemias it is usually due to homozygoys or doublé heterozygous genotypes, for mutations and deletions of the alpha globin gene. This article describes the first case in Costa Rica of two siblings with hemoglobin H disease, who phenotypically presented the hemoglobin H and Constant Spring hemoglobin variants in the electrophoretic analysis of the hemoglobin, and whose molecular DNA analysis of the alpha globin gene detected both, the Southeast Asian deletion and the mutation for Constant Spring Hemoglobin, being diagnosed as compound heterozygous for alpha thalassemia (genotipe --SEA/ααCS).
Assuntos
Humanos , Feminino , Lactente , Hemoglobina H , Talassemia alfa , Costa Rica , Hemoglobinopatias/genética , Triagem de Portadores Genéticos , Anemia HipocrômicaRESUMO
OBJECTIVE: Genetic carrier screening has the potential to identify couples at risk of having a child affected with an autosomal recessive or X-linked disorder. However, the current prevalence of carrier status for these conditions in developing countries is not well defined. This study assesses the prevalence of carrier status of selected genetic conditions utilizing an expanded, pan-ethnic genetic carrier screening panel (ECS) in a large population of Mexican patients. METHODS: Retrospective chart review of all patients tested with a single ECS panel at an international infertility center from 2012 to 2018 were included, and the prevalence of positive carrier status in a Mexican population was evaluated. RESULTS: Eight hundred five individuals were analyzed with ECS testing for 283 genetic conditions. Three hundred fifty-two carriers (43.7%) were identified with 503 pathogenic variants in 145 different genes. Seventeen of the 391 participating couples (4.34%) were identified as being at-risk couples. The most prevalent alleles found were associated with alpha thalassemia, cystic fibrosis, GJB2 nonsyndromic hearing loss, biotinidase deficiency, and familial Mediterranean fever. CONCLUSION: Based on the prevalence and severity of Mendelian disorders, we recommend that couples who wish to conceive regardless of their ethnicity background explore carrier screening and genetic counseling prior to reproductive medical treatment.
Assuntos
Triagem de Portadores Genéticos , Doenças Genéticas Inatas/epidemiologia , Cuidado Pré-Concepcional , Adulto , Biotinidase/genética , Deficiência de Biotinidase/epidemiologia , Deficiência de Biotinidase/genética , Conexina 26/genética , Fibrose Cística/epidemiologia , Fibrose Cística/genética , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Febre Familiar do Mediterrâneo/epidemiologia , Febre Familiar do Mediterrâneo/genética , Feminino , Aconselhamento Genético , Doenças Genéticas Inatas/genética , Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Neurossensorial/genética , Hemoglobina A/genética , Heterozigoto , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Pirina/genética , Estudos Retrospectivos , Medição de Risco , Talassemia alfa/epidemiologia , Talassemia alfa/genéticaRESUMO
Resumen En este reporte de caso se describe el primer paciente doble heterocigoto para alfa+-talasemia tipo -3,7 y rasgo heterocigoto por hemoglobina S en Costa Rica, diagnosticado desde su nacimiento por medio del tamizaje neonatal como heterocigoto para hemoglobina S. Luego de la detección de la hemoglobina S por tamizaje, el paciente fue referido al servicio de Hematología del Hospital Nacional de Niños para su seguimiento, en donde se observa hemograma con índices y morfología de glóbulos rojos sugestivos de alfa talasemia, con presentación de electroforesis de hemoglobina con patrón AS cuya expresión relativa de HbS era menor de lo esperado, lo que motivó a efectuar estudio molecular del gen de alfa globina, que confirmó el diagnóstico de alfa talasemia con deleción heterocigota de tipo -3,7 en herencia conjunta con la heterocigosis de hemoglobina S.
Abstract In this case report we describe the first patient compound heterozygous for type -3.7 alpha+ thalassemia and sickle cell trait in Costa Rica, who was diagnosed from birth by neonatal screening as heterozygous for hemoglobin S. After detection of hemoglobin S by screening, the patient was referred to the Hematology service of the National Children`s Hospital for follow-up, where hemogram with indexes and morphology of red blood cells suggestive of alpha thalassemia is observed, presenting hemoglobin electrophoresis with AS pattern whose relative expression of hemoglobin S was lower tan expected, which led to a molecular study of the alpha globin gene confirming the diagnosis of alpha thalassemia with heretozygous deletion of type -3.7, in co-inheritance with hemoglobin S heterozygosis.
Assuntos
Humanos , Masculino , Recém-Nascido , Hemoglobina A , Hemoglobina Falciforme , Triagem Neonatal , Talassemia alfa , Costa Rica , Hemoglobinopatias , Triagem de Portadores GenéticosRESUMO
OBJECTIVE: To conduct a systematic review of the evidence to determine the impact of cystic fibrosis (CF) on unaffected siblings. STUDY DESIGN: We searched MEDLINE (Ovid interface, from 1946); EMBASE (Ovid interface, from 1946); CINAHL (EBSCO interface); Academic Search Complete (EBSCO interface); Psych Info (EBSCO interface); ProQuest Theses' and Dissertation's (ProQuest); British Index of Nursing (ProQuest); Web of Science (ISI, Web of Knowledge portal); PubMed (PubMed NCBI); BASE (Bielefeld Academic Research Engine); Scopus; EThOS (e-theses online service); Open Grey; and Cochrane Library. Contents pages of the Journal of Cystic Fibrosis, June 2002-April 2017 were hand searched to identify further eligible studies. Reference lists of eligible articles and relevant review papers were screened. Inclusion criteria were full studies published after 1989 in English focusing on the impact of cystic fibrosis on unaffected siblings. RESULTS: In total, 13 papers, 4 PhD theses and 1 MSc thesis were included in the review. Four themes were identified; family functioning, psychosocial impact, knowledge of CF, and condition-specific differences. CONCLUSIONS: Most studies are old and may not accurately represent the impact of CF on unaffected siblings following changes to health care provision including newborn bloodspot screening and the advent of CF transmembrane regulator modulator therapies. Further work is needed directly with siblings rather than using mothers as proxies to determine effect of age, sex, and disease trajectory on unaffected siblings' experiences.
Assuntos
Fibrose Cística , Irmãos , Triagem de Portadores Genéticos , Culpa , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Satisfação Pessoal , Autoimagem , Relações entre IrmãosRESUMO
INTRODUCTION AND OBJECTIVES: Niemann-Pick disease type A (NPD-A) and B (NPD-B) are lysosomal storage diseases with a birth prevalence of 0.4-0.6/100,000. They are caused by a deficiency in acid sphingomyelinase, an enzyme encoded by SMPD1. We analyzed the phenotype and genotype of four unrelated Mexican patients, one with NPD-A and three with NPD-B. PATIENTS AND METHODS: Four female patients between 1 and 7 years of age were diagnosed with NPD-A or NPD-B by hepatosplenomegaly, among other clinical characteristics, and by determining the level of acid sphingomyelinase enzymatic activity and sequencing of the SMPD1 gene. Additionally, a 775bp amplicon of SMPD1 (from 11:6393835_6394609, including exons 5 and 6) was analyzed by capillary sequencing in a control group of 50 unrelated healthy Mexican Mestizos. RESULTS: An infrequent variant (c.1343A>G p.Tyr448Cys) was observed in two patients. One is the first NPD-A homozygous patient reported with this variant and the other a compound heterozygous NPD-B patient with the c.1829_1831delGCC p.Arg610del variant. Another compound heterozygous patient had the c.1547A>G p.His516Arg variant (not previously described in affected individuals) along with the c.1805G>A p.Arg602His variant. A new c.1263+8C>T pathogenic variant was encountered in a homozygous state in a NPD-B patient. Among the healthy control individuals there was a heterozygous carrier for the c.1550A>T (rs142787001) pathogenic variant, but none with the known pathogenic variants in the 11:6393835_6394609 region of SMPD1. CONCLUSIONS: The present study provides further NPD-A or B phenotype-genotype correlations. We detected a heterozygous carrier with a pathogenic variant in 1/50 healthy Mexican mestizos.
Assuntos
Doença de Niemann-Pick Tipo A/genética , Doença de Niemann-Pick Tipo B/genética , Esfingomielina Fosfodiesterase/genética , Adolescente , Adulto , Criança , Pré-Escolar , Epistaxe/fisiopatologia , Feminino , Triagem de Portadores Genéticos , Genótipo , Transtornos do Crescimento/fisiopatologia , Voluntários Saudáveis , Hepatomegalia/fisiopatologia , Heterozigoto , Humanos , Lactente , Fígado/patologia , Fígado/ultraestrutura , México , Doença de Niemann-Pick Tipo A/metabolismo , Doença de Niemann-Pick Tipo A/patologia , Doença de Niemann-Pick Tipo A/fisiopatologia , Doença de Niemann-Pick Tipo B/metabolismo , Doença de Niemann-Pick Tipo B/patologia , Doença de Niemann-Pick Tipo B/fisiopatologia , Fenótipo , Esfingomielina Fosfodiesterase/metabolismo , Esplenomegalia/fisiopatologia , Adulto JovemRESUMO
In recent years, anthropogenic factors such as pollution, overfishing, and construction of hydroelectric plants have significantly impacted natural fish populations. Research focusing on genetically evaluation of these impacts is necessary to objectively target conservation programs. The aim of this study was to evaluate the genetic diversity of Curimba (Prochilodus lineatus), Pacu (Piaractus mesopotamicus), and Piracanjuba (Brycon orbignyanus) populations from the Água Vermelha Reservoir, Rio Grande-SP. Microsatellite loci were amplified, producing 56, 24, and 26 alleles for the populations of the three species, respectively. The number of alleles per locus ranged from three to ten for P. lineatus, two to five for P. mesopotamicus, and two to four for B. orbignyanus. The observed heterozygosity (Ho) was higher in the P. lineatus population (0.547), relative to the P. mesopotamicus and B. orbignyanus populations (0.473 and 0.527, respectively). The mean values of Ho were lower than the average expected heterozygosity (He) in the three species, being corroborated by the positive inbreeding coefficient (Fis). Deviations from the Hardy-Weinberg equilibrium (HWE) were found in five, three, and two loci for P. lineatus, P. mesopotamicus, and B. orbignyanus, respectively. Wilcoxon tests revealed recent bottlenecks in the three species, evidenced by a significant excess of heterozygotes (p < 0.05) detected only in the Infinite Allele Model (IAM). In conclusion, adequate genetic variability was observed in the three populations with the presence of heterozygous deficits.(AU)
Nos últimos anos, fatores antrópicos como poluição, sobrepesca e construção de hidrelétricas têm impactado significativamente as populações naturais de peixes. Pesquisas que permitam avaliar geneticamente esse impacto são necessárias para orientar objetivamente programas de conservação. O objetivo do presente estudo foi avaliar a diversidade genética de populações de Curimba (Prochilodus lineatus), Pacu (Piaractus mesopotamicus) e Piracanjuba (Brycon orbignyanus) provenientes do reservatório de Água Vermelha, Rio Grande-SP. Foram amplificados loci microssatélites que produziram 56, 24 e 26 alelos para as populações das três espécies, respectivamente. O número de alelos por locus variou de três a dez para P. lineatus, dois a cinco para P. mesopotamicus e dois a quatro para B. orbignianus. A heterozigosidade observada (Ho) foi mais elevada na população de P. lineatus (0,547) em relação às populações de P. mesopotamicus e B. orbignyanus (0,473 e 0,527, respectivamente). A média dos valores de Ho foram inferiores à média de He nas três espécies sendo corroborado pelo Fis positivo observado. Foi encontrado desvio do equilíbrio de Hardy-Weinberg (HWE) em cinco loci para P. lineatus, três loci para P. mesopotamicus e dois em B. orbignyanus. A análise de bottleneck revelou excesso de heterozigotos (p<0,05) pelo teste de Wilcoxon nas três espécies apenas no modelo Infinite Allele Model (IAM). Foi observada adequada variabilidade genética nas três populações com a presença de déficit de heterozigotos.(AU)
Assuntos
Animais , Caraciformes/genética , Variação Genética , Frequência do Gene , Alelos , Triagem de Portadores Genéticos , Migração Animal , Reação em Cadeia da Polimerase/veterinária , Repetições de MicrossatélitesRESUMO
In recent years, anthropogenic factors such as pollution, overfishing, and construction of hydroelectric plants have significantly impacted natural fish populations. Research focusing on genetically evaluation of these impacts is necessary to objectively target conservation programs. The aim of this study was to evaluate the genetic diversity of Curimba (Prochilodus lineatus), Pacu (Piaractus mesopotamicus), and Piracanjuba (Brycon orbignyanus) populations from the Água Vermelha Reservoir, Rio Grande-SP. Microsatellite loci were amplified, producing 56, 24, and 26 alleles for the populations of the three species, respectively. The number of alleles per locus ranged from three to ten for P. lineatus, two to five for P. mesopotamicus, and two to four for B. orbignyanus. The observed heterozygosity (Ho) was higher in the P. lineatus population (0.547), relative to the P. mesopotamicus and B. orbignyanus populations (0.473 and 0.527, respectively). The mean values of Ho were lower than the average expected heterozygosity (He) in the three species, being corroborated by the positive inbreeding coefficient (Fis). Deviations from the Hardy-Weinberg equilibrium (HWE) were found in five, three, and two loci for P. lineatus, P. mesopotamicus, and B. orbignyanus, respectively. Wilcoxon tests revealed recent bottlenecks in the three species, evidenced by a significant excess of heterozygotes (p < 0.05) detected only in the Infinite Allele Model (IAM). In conclusion, adequate genetic variability was observed in the three populations with the presence of heterozygous deficits.
Nos últimos anos, fatores antrópicos como poluição, sobrepesca e construção de hidrelétricas têm impactado significativamente as populações naturais de peixes. Pesquisas que permitam avaliar geneticamente esse impacto são necessárias para orientar objetivamente programas de conservação. O objetivo do presente estudo foi avaliar a diversidade genética de populações de Curimba (Prochilodus lineatus), Pacu (Piaractus mesopotamicus) e Piracanjuba (Brycon orbignyanus) provenientes do reservatório de Água Vermelha, Rio Grande-SP. Foram amplificados loci microssatélites que produziram 56, 24 e 26 alelos para as populações das três espécies, respectivamente. O número de alelos por locus variou de três a dez para P. lineatus, dois a cinco para P. mesopotamicus e dois a quatro para B. orbignianus. A heterozigosidade observada (Ho) foi mais elevada na população de P. lineatus (0,547) em relação às populações de P. mesopotamicus e B. orbignyanus (0,473 e 0,527, respectivamente). A média dos valores de Ho foram inferiores à média de He nas três espécies sendo corroborado pelo Fis positivo observado. Foi encontrado desvio do equilíbrio de Hardy-Weinberg (HWE) em cinco loci para P. lineatus, três loci para P. mesopotamicus e dois em B. orbignyanus. A análise de bottleneck revelou excesso de heterozigotos (p<0,05) pelo teste de Wilcoxon nas três espécies apenas no modelo Infinite Allele Model (IAM). Foi observada adequada variabilidade genética nas três populações com a presença de déficit de heterozigotos.
Assuntos
Animais , Alelos , Caraciformes/genética , Frequência do Gene , Triagem de Portadores Genéticos , Variação Genética , Migração Animal , Reação em Cadeia da Polimerase/veterinária , Repetições de MicrossatélitesRESUMO
Portuguese immigration to Brazil occurred in several waves and greatly contributed to the genetic composition of current Brazilian population. In this study, we evaluated the frequency of a Portuguese founder Alu insertion in BRCA2 exon 3 (c.156_157insAlu) among individuals fulfilling Hereditary Breast and Ovarian Cancer (HBOC) syndrome criteria in 1,380 unrelated families originated from three distinct Brazilian States. We identified the c.156_157insAlu BRCA2 mutation in nine (9/1,380; 0.65%) probands analised. In carrier probands, European ancestry had the highest proportion (80%), followed by the African (10%) and Amerindian and in most families with the rearrangement, haplotype analyses were compatible with the Portuguese ancestral haplotype. In conclusion, the present study reports a low albeit relevant frequency of the Portuguese BRCA2 founder mutation c.156_157insAlu in Brazilian patients at-risk for HBOC Brazilian population.
Assuntos
Genes BRCA2 , Testes Genéticos , Síndrome Hereditária de Câncer de Mama e Ovário/genética , Povo Asiático/genética , Brasil , Estudos de Coortes , Feminino , Efeito Fundador , Triagem de Portadores Genéticos , Haplótipos , Humanos , Mutação INDEL , População Branca/genéticaRESUMO
ABSTRACT Objective: Initial diagnosis of medullary thyroid carcinoma (MTC) is frequently associated with advanced stages and a poor prognosis. Thus, the need for earlier diagnoses and detection in relatives at risk for the disease has led to increased use of RET genetic screening. Subjects and methods: We performed RET screening in 247 subjects who were referred to the Brazilian Research Consortium for Multiple Endocrine Neoplasia (BRASMEN) Center in the State of Ceará. Direct genetic sequencing was used to analyze exons 8, 10, 11, and 13-16 in MTC index cases and specific exons in at risk relatives. Afterward, clinical follow-up was offered to all the patients with MTC and their affected relatives. Results: RET screening was performed in 60 MTC index patients and 187 at-risk family members. At the initial clinical assessment of the index patients, 54 (90%) were diagnosed with apparently sporadic disease and 6 (10%) diagnosed with hereditary disease. After RET screening, we found that 31 (52%) index patients had sporadic disease, and 29 (48%) had hereditary disease. Regarding at-risk relatives, 73/187 were mutation carriers. Mutations in RET codon 804 and the rare p.M918V mutation were the most prevalent. Conclusions: Performing RET screening in Ceará allowed us to identify a different mutation profile in this region compared with other areas. RET screening also enabled the diagnosis of a significant number of hereditary MTC patients who were initially classified as sporadic disease patients and benefited their relatives, who were unaware of the risks and the consequences of bearing a RET mutation.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Mutação em Linhagem Germinativa/genética , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/genética , Proteínas Proto-Oncogênicas c-ret/genética , Triagem de Portadores Genéticos/métodos , Fatores de Tempo , Brasil , Neoplasias da Glândula Tireoide/patologia , Imuno-Histoquímica , Transfecção/métodos , Rearranjo Gênico/genética , Reprodutibilidade dos Testes , Fatores de Risco , Fatores Etários , Carcinoma Neuroendócrino/patologia , Medição de Risco , Detecção Precoce de Câncer , Estudos de Associação GenéticaRESUMO
Women carriers of mutations in the genes BRCA1 and BRCA2 coding for tumor suppressor proteins are at high risk of developing breast and ovarian cancers. Hereditary breast and ovarian cancers due to BRCA pathogenic mutations occur at earlier ages: mean age 43 years at diagnosis of breast cancer for BRCA1 mutations; onset of ovarian cancer up to 10-21% by age 50 years. Preventive strategies are then defined in the reproductive years. The National Comprehensive Cancer Network (NCCN) guidelines define that BRCA1/2 genetic testing should begin with the affected cancer individual (BRCA1/2 full sequencing); then, family members should be tested for the specific gene mutation found. A woman known to be a carrier needs a strict specific surveillance strategy to achieve early diagnosis. The NCCN proposes breast imageneological surveillance beginning at age 25 years; ovarian surveillance beginning at age 30-35 years. Concomitantly, risk-reducing strategies should be analyzed: surgical or pharmacological. When prophylactic bilateral salpingo-oophorectomy is performed before menopause, estrogen replacement therapy could be required. For BRCA, we review the risks of cancer in mutations carriers, criteria for genetic testing, surveillance and risk-reduction strategies, and the safety of prescribing hormone therapy when needed.
Assuntos
Neoplasias da Mama/prevenção & controle , Genes BRCA1 , Genes BRCA2 , Predisposição Genética para Doença , Neoplasias Ovarianas/prevenção & controle , Neoplasias da Mama/genética , Terapia de Reposição de Estrogênios , Feminino , Triagem de Portadores Genéticos , Aconselhamento Genético , Humanos , Mutação , Neoplasias Ovarianas/genética , Medição de Risco , Fatores de Risco , Salpingo-OoforectomiaRESUMO
The possibility of sequencing hundreds of genes simultaneously and performing molecular karyotyping thanks to the introduction of novel genetic tools has expanded the use of preconception screening for blastocyst recessive mutations and aneuploidies before embryo transfer, with the ultimate purpose of increasing the proportion of normal healthy newborns. Since medically-assisted reproduction procedures are increasingly required to be eugenic, and the aforementioned genetic tests cover only half of the potential genetic diseases occurring at birth, it seems reasonable to incorporate genetic counseling in the practice of assisted reproduction to avoid prosecution for malpractice.