Genomic newborn screening as a paradigm shift in rare disease management, with emphasis on endocrine conditions.

IF 2.9
Laurence Faivre, Camille Level, Régis Coutant, Patrice Rodien, Anne Barlier, Alexandru Saveanu, Claire Bouvattier, Patricia Bretones, Laetitia Martinerie, Sylvie Rossignol, Camille Lenelle, Florence Roucher, Christine Binquet, Laurent Pasquier, Emeline Davoine, Coline Cormier, Marie Bournez, Raphaelle Maudinas, Maxime Gonnot, Augustin Lefevre, Julien Maraval, Hana Safraou, Yannis Duffourd, Christine Bellanné-Chantelot, Cécile Saint-Martin, Anne Bergougnoux, Delphine Mallet, Jérôme Bouligand, Nicolas de Roux, Lucie Coppin, Gwenaelle Diene, Christine Poitoux, Delphine Prunier, Xavier Dieu, Nelly Burnichon, Sophie Christin-Maitre, Sylvie Jaillard, Erika Launay, Jean-Pierre Rabès, Pascale Benlian, Mathilde Di Filippo, Oriane Marmontel, Christine Poitou Bernert, Corinne Vigouroux, Elise Bismuth, Jacques Beltrand, Michel Polak, Sophie Giraud, Pascal Pigny, Frédérique Savagner, Isabelle Olivier Petit, Jean-Baptiste Arnoux, Sophie Beliard, Marie-Françoise Odou, Pauline Romanet, Arnaud Molin, Andreea Apetrei, Nicolas Richard, Laurence Pacot, Eric Pasmant, Marguerite Hureaux, Rosa Vargas, Mathilde Gay-Bellile, Karine Aouchiche, Alain Carrié, Margaux Chauvet, Antonio Gallo, Julie Lemale, Philippe Moulin, Noël Peretti, Christel Thauvin-Robinet, Frédéric Huet, Véronique Tardy-Guidolet
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引用次数: 0

Abstract

Introduction: Genome sequencing (GS) is reshaping newborn screening (NBS) by enabling the early detection of a broader range of rare, treatable and/or actionable disorders. In the context of rapid therapeutic advances, international pilot programs - many coordinated within the International Consortium on Newborn Sequencing (ICoNS) - are evaluating genome-based NBS (gNBS) as a preventive public health strategy.

Materials and methods: We reviewed published international gNBS pilot studies, with particular attention to discussions related to endocrine disorders. We integrated insights from the French PERIGENOMED-CLINICS 1 (PGC1) project, including its curated gene list and collaboration mainly with the FIRENDO French network dedicated to rare endocrine diseases.

Results: No publications were identified specifically addressing gNBS in rare pediatric endocrine diseases as a unified domain. In comparative analyses of gNBS pilot programs, endocrine disorders represented approximately 10% of included conditions, with marked heterogeneity across initiatives and no primary endocrine disorder uniformly retained. Analysis of the PGC1 dataset identified 125 endocrine and endocrine-adjacent gene-disease dyads (14% of all project dyads), divided into list 1 ("treatable", n=62) and list 2 ("actionable", n=63). List 1 predominantly included early-onset, hormonally driven disorders, whereas list 2 extended toward obesity-related and multisystem syndromic conditions. Stratification by clinical actionability revealed four categories ranging from time-critical neonatal conditions to surveillance-driven and long-term risk phenotypes, underscoring substantial variability in timing of intervention, penetrance, and level of evidence supporting early benefit.

Conclusion: Genomic NBS is transforming rare disease management, including endocrine diseases, by enabling earlier diagnosis, precision care, and coordinated professional and family-based interventions, marking a paradigm shift in population health.

基因组新生儿筛查作为罕见病管理的范式转变,重点是内分泌条件。
基因组测序(GS)通过早期发现更广泛的罕见、可治疗和/或可采取行动的疾病,正在重塑新生儿筛查(NBS)。在治疗快速进步的背景下,国际试点项目——许多是在国际新生儿测序联盟(ICoNS)内协调的——正在评估基于基因组的新生儿测序(gNBS)作为一种预防性公共卫生战略。材料和方法:我们回顾了已发表的国际gNBS试点研究,特别关注与内分泌疾病相关的讨论。我们整合了来自法国perigenome - clinics 1 (PGC1)项目的见解,包括其策划的基因列表以及主要与致力于罕见内分泌疾病的法国FIRENDO网络的合作。结果:没有出版物被确定专门解决gNBS在罕见的儿科内分泌疾病作为一个统一的领域。在gNBS试点项目的比较分析中,内分泌疾病约占纳入条件的10%,各项目之间存在明显的异质性,没有原发性内分泌疾病统一保留。对PGC1数据集的分析确定了125个内分泌和内分泌邻近基因疾病双体(占所有项目双体的14%),分为列表1(“可治疗”,n=62)和列表2(“可操作”,n=63)。表1主要包括早发性、激素驱动的疾病,而表2扩展到肥胖相关和多系统综合征。临床可操作性分层揭示了四种类别,从时间关键型新生儿疾病到监测驱动型和长期风险表型,强调了干预时间、外显率和支持早期获益的证据水平的实质性变化。结论:基因组NBS通过实现早期诊断、精确护理以及协调的专业和家庭干预,正在改变包括内分泌疾病在内的罕见病管理,标志着人口健康的范式转变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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