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对病人进行全基因组测序已经用于临床诊断

随着测序技术的不断进步和费用的不断降低,全基因组测序用于临床诊断已经变成现实。这篇文章描述了一个全基因组测序在临床诊断和治疗的案例。

病人患有腓骨肌萎缩症(别名:遗传性运动感觉神经病,Charcot-Marie-Tooth综合征),对家族的成员进行全基因组测序后,发现了一个已知的能导致Charcot-Marie-Tooth综合征的基因突变,更重要的是,通过全基因组测序,还发现了另外一个错意突变,而这个突变在普通的临床诊断过程中是不可能被发现的。

目前,对人类的个人进行全基因组测序只需要5万美元,而这个费用还会不断降低。相信全基因组测序的临床应用会越来越普及。

这篇报道发表于3月份出版的新英格兰医学杂志 (N Engl J Med.)

参考文献:N Engl J Med. 2010 Mar 10. [Epub ahead of print]

Whole-Genome Sequencing in a Patient with Charcot-Marie-Tooth Neuropathy.
Lupski JR, Reid JG, Gonzaga-Jauregui C, Rio Deiros D, Chen DC, Nazareth L, Bainbridge M, Dinh H, Jing C, Wheeler DA, McGuire AL, Zhang F, Stankiewicz P, Halperin JJ, Yang C, Gehman C, Guo D, Irikat RK, Tom W, Fantin NJ, Muzny DM, Gibbs RA.

From the Department of Molecular and Human Genetics (J.R.L., J.G.R., C.G.-J., M.B., F.Z., P.S., D.M.M., R.A.G.), the Human Genome Sequencing Center (J.G.R., D.R.D., D.C.Y.C., L.N., M.B., H.D., C.J., D.A.W., D.M.M., R.A.G.), the Center for Medical Ethics and Health Policy (A.L.M.), the Department of Pediatrics (J.R.L.), and Texas Children's Hospital (J.R.L.) - all at Baylor College of Medicine, Houston; Atlantic Neuroscience Institute, Summit, NJ, and Mount Sinai School of Medicine, New York (J.J.H.); and Life Technologies, Carlsbad, CA (C.Y., C.G., D.G., R.K.I., W.T., N.J.F.). This article (10.1056/NEJMoa0908094) was published on March 10, 2010, at NEJM.org.

BACKGROUND: Whole-genome sequencing may revolutionize medical diagnostics through rapid identification of alleles that cause disease. However, even in cases with simple patterns of inheritance and unambiguous diagnoses, the relationship between disease phenotypes and their corresponding genetic changes can be complicated. Comprehensive diagnostic assays must therefore identify all possible DNA changes in each haplotype and determine which are responsible for the underlying disorder. The high number of rare, heterogeneous mutations present in all humans and the paucity of known functional variants in more than 90% of annotated genes make this challenge particularly difficult. Thus, the identification of the molecular basis of a genetic disease by means of whole-genome sequencing has remained elusive. We therefore aimed to assess the usefulness of human whole-genome sequencing for genetic diagnosis in a patient with Charcot-Marie-Tooth disease. METHODS: We identified a family with a recessive form of Charcot-Marie-Tooth disease for which the genetic basis had not been identified. We sequenced the whole genome of the proband, identified all potential functional variants in genes likely to be related to the disease, and genotyped these variants in the affected family members. RESULTS: We identified and validated compound, heterozygous, causative alleles in SH3TC2 (the SH3 domain and tetratricopeptide repeats 2 gene), involving two mutations, in the proband and in family members affected by Charcot-Marie-Tooth disease. Separate subclinical phenotypes segregated independently with each of the two mutations; heterozygous mutations confer susceptibility to neuropathy, including the carpal tunnel syndrome. CONCLUSIONS: As shown in this study of a family with Charcot-Marie-Tooth disease, whole-genome sequencing can identify clinically relevant variants and provide diagnostic information to inform the care of patients. Copyright 2010 Massachusetts Medical Society.

PMID: 20220177 [PubMed - as supplied by publisher]

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    这篇文章描述了一个全基因组测序在临床诊断和治疗的案例。
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    全基因组测序,临床
     
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