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Grønbæk-Thygesen M, Hartmann-Petersen R. Cellular and molecular mechanisms of aspartoacylase and its role in Canavan disease. Cell Biosci 2024; 14:45. [PMID: 38582917 PMCID: PMC10998430 DOI: 10.1186/s13578-024-01224-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/24/2024] [Indexed: 04/08/2024] Open
Abstract
Canavan disease is an autosomal recessive and lethal neurological disorder, characterized by the spongy degeneration of the white matter in the brain. The disease is caused by a deficiency of the cytosolic aspartoacylase (ASPA) enzyme, which catalyzes the hydrolysis of N-acetyl-aspartate (NAA), an abundant brain metabolite, into aspartate and acetate. On the physiological level, the mechanism of pathogenicity remains somewhat obscure, with multiple, not mutually exclusive, suggested hypotheses. At the molecular level, recent studies have shown that most disease linked ASPA gene variants lead to a structural destabilization and subsequent proteasomal degradation of the ASPA protein variants, and accordingly Canavan disease should in general be considered a protein misfolding disorder. Here, we comprehensively summarize the molecular and cell biology of ASPA, with a particular focus on disease-linked gene variants and the pathophysiology of Canavan disease. We highlight the importance of high-throughput technologies and computational prediction tools for making genotype-phenotype predictions as we await the results of ongoing trials with gene therapy for Canavan disease.
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Affiliation(s)
- Martin Grønbæk-Thygesen
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200N, Copenhagen, Denmark.
| | - Rasmus Hartmann-Petersen
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200N, Copenhagen, Denmark.
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2
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Brace S, Diekmann Y, Booth T, Macleod R, Timpson A, Stephen W, Emery G, Cabot S, Thomas MG, Barnes I. Genomes from a medieval mass burial show Ashkenazi-associated hereditary diseases pre-date the 12th century. Curr Biol 2022; 32:4350-4359.e6. [PMID: 36044903 PMCID: PMC10499757 DOI: 10.1016/j.cub.2022.08.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022]
Abstract
We report genome sequence data from six individuals excavated from the base of a medieval well at a site in Norwich, UK. A revised radiocarbon analysis of the assemblage is consistent with these individuals being part of a historically attested episode of antisemitic violence on 6 February 1190 CE. We find that four of these individuals were closely related and all six have strong genetic affinities with modern Ashkenazi Jews. We identify four alleles associated with genetic disease in Ashkenazi Jewish populations and infer variation in pigmentation traits, including the presence of red hair. Simulations indicate that Ashkenazi-associated genetic disease alleles were already at appreciable frequencies, centuries earlier than previously hypothesized. These findings provide new insights into a significant historical crime, into Ashkenazi population history, and into the origins of genetic diseases associated with modern Jewish populations.
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Affiliation(s)
- Selina Brace
- Department of Earth Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD, UK
| | - Yoan Diekmann
- Research Department of Genetics, Evolution and Environment, University College London, Gower Street, London WC1E 6BT, UK; Palaeogenetics Group, Institute of Organismic and Molecular Evolution (iomE), Johannes Gutenberg-University Mainz, 55099 Mainz, Germany
| | - Thomas Booth
- Department of Earth Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD, UK; Francis Crick Institute, London NW1 1AT, UK; UCL Genetics Institute, University College London, London, UK
| | - Ruairidh Macleod
- Department of Earth Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD, UK; Research Department of Genetics, Evolution and Environment, University College London, Gower Street, London WC1E 6BT, UK; Department of Archaeology, University of Cambridge, Downing Street, Cambridge CB2 3DZ, UK
| | - Adrian Timpson
- Research Department of Genetics, Evolution and Environment, University College London, Gower Street, London WC1E 6BT, UK
| | - Will Stephen
- Department of Earth Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD, UK
| | - Giles Emery
- Norvic Archaeology, 7 Foxburrow Road, Norwich NR7 8QU, UK
| | - Sophie Cabot
- Norfolk Record Office, The Archive Centre, Martineau Lane, Norwich, Norfolk NR1 2DQ, UK
| | - Mark G Thomas
- Research Department of Genetics, Evolution and Environment, University College London, Gower Street, London WC1E 6BT, UK.
| | - Ian Barnes
- Department of Earth Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD, UK.
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3
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Barlow-Stewart K, Bardsley K, Elan E, Fleming J, Berman Y, Fleischer R, Recsei K, Goldberg D, Tucker J, Burnett L. Evaluating the model of offering expanded genetic carrier screening to high school students within the Sydney Jewish community. J Community Genet 2021; 13:121-131. [PMID: 34846685 PMCID: PMC8799788 DOI: 10.1007/s12687-021-00567-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/15/2021] [Indexed: 10/31/2022] Open
Abstract
Programs offering reproductive genetic carrier screening (RGCS) to high school students within the Ashkenazi Jewish community in several countries including Canada and Australia have demonstrated high uptake and retention of educational messages over time. This study was undertaken to evaluate whether testing for an expanded number of conditions in a high school setting would impact the effectiveness of education. In this questionnaire-based study, genetic carrier testing for nine conditions was offered to 322 year 11 students from five high schools, with students attending a compulsory 1-h education session prior to voluntary testing. Comparison of pre- and post-education measures demonstrated a significant increase in knowledge, positive attitudes, and reduced concern immediately after the education session. Retention of knowledge, measures of positive attitude, and low concern over a 12-month period were significantly higher than baseline, although there was some reduction over time. In total, 77% of students exhibited informed choice regarding their intention to test. A significant increase in baseline knowledge scores and positive attitude was also demonstrated between our original 1995 evaluation (with testing for only one condition) and 2014 (testing for nine conditions) suggesting community awareness and attitudes to RGCS have increased. These findings validate the implementation of effective education programs as a key component of RGCS and are relevant as gene panels expand with the introduction of genomic technologies.
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Affiliation(s)
- Kristine Barlow-Stewart
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia
| | - Kayley Bardsley
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Genetic Medicine, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Elle Elan
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Jane Fleming
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia
| | - Yemima Berman
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia.,Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Ron Fleischer
- Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia.,Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown, NSW, 2010, Australia
| | - Krista Recsei
- Pangolin Consulting, The Entrance, NSW, 2261, Australia
| | - Daniel Goldberg
- Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia
| | - John Tucker
- Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia
| | - Leslie Burnett
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW, 2065, Australia. .,Community Genetics Program (NSW), Wolper Jewish Hospital, Woollahra, NSW, 2025, Australia. .,Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia. .,St Vincent's Clinical School, UNSW Sydney, Darlinghurst, NSW, 2010, Australia.
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4
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Ziff M, Harris J. A collaborative genetic carrier screening model for the British Ashkenazi Jewish community. J Community Genet 2021; 13:133-135. [PMID: 34841494 PMCID: PMC8627906 DOI: 10.1007/s12687-021-00568-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
We present a unique model of a British genetic carrier screening programme for individuals with Ashkenazi Jewish ancestry that exemplifies a partnership between a publicly funded healthcare service (the NHS) and a charity, Jnetics. This model provides affordable access to carrier screening for severe autosomal recessive diseases increased in this community. Prior to the development of this programme, the British healthcare system only provided Tay Sachs’ screening for this community, leaving them at higher risk of having a child with a serious autosomal recessive disease. The Jnetics screening programme is promoted through community and social media campaigns, involves educational outreach, a pre-test genetic counselling service by a dedicated NHS-based genetic counsellor, saliva-based DNA testing, comprehensive reporting and, where required, post-test genetic counselling. The charity raises funds to subsidise the screening. In 6 years, the model has been successfully implemented in hospital and community settings and in schools and universities, aiming to reach those pre-conception. In response to the COVID-19 pandemic, the programme adapted by offering genetic screening virtually and has subsequently expanded in its outreach. Furthermore, the screening panel is currently being expanded to include other conditions increased in the Ashkenazi and also the Sephardi and Mizrahi Jewish communities. An example of innovation and accessibility, providing free screening to all students and disadvantaged individuals, the programme aims to provide a model that can potentially be adopted by other genetically at-risk communities.
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Affiliation(s)
- Monica Ziff
- University College London Hospital, London, UK.
| | - Juliette Harris
- Northwick Park Hospital, North West Thames Regional Genetics Service, London, UK
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5
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Morgenstern-Kaplan D, Raijman-Policar J, Majzner-Aronovich S, Aradhya S, Pineda-Alvarez DE, Aguinaga M, García-Vences EE. Carrier screening in the Mexican Jewish community using a pan-ethnic expanded carrier screening NGS panel. Genet Med 2021; 24:821-830. [PMID: 34961661 DOI: 10.1016/j.gim.2021.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022] Open
Abstract
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.
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Affiliation(s)
- Dan Morgenstern-Kaplan
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico.
| | - Jaime Raijman-Policar
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico
| | - Sore Majzner-Aronovich
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico
| | | | | | - Mónica Aguinaga
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico; Sexual and Reproductive Health Department, National Institute of Perinatology, Mexico City, Mexico
| | - Edna Elisa García-Vences
- Centro de Investigación en Ciencias de la Salud (CICSA), Health Sciences Faculty, Anahuac University, Mexico City, Mexico
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6
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Nijmeijer SCM, Conijn T, Lakeman P, Henneman L, Wijburg FA, Haverman L. Attitudes of relatives of mucopolysaccharidosis type III patients toward preconception expanded carrier screening. Eur J Hum Genet 2020; 28:1331-1340. [PMID: 32483342 PMCID: PMC7609293 DOI: 10.1038/s41431-020-0648-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/28/2020] [Indexed: 11/25/2022] Open
Abstract
Preconception expanded carrier screening (ECS) aims to detect carrier couples of autosomal recessive (AR) disorders before pregnancy in order to increase reproductive autonomy of prospective parents. Genetic knowledge and knowledge gained from experience influence decision making on participation in genetic testing and understanding carrier test results. In this study we assessed whether parents and relatives of patients with the severe AR condition mucopolysaccharidosis type III (MPS III), who are expected to have genetic and experiential knowledge, have more positive attitudes toward ECS than the Dutch reference group. Parents of all MPS III patients known to the Dutch expert center were invited to participate and asked to invite first and second degree relatives. The online questionnaire started with an educational text, and assessed attitudes toward ECS, genetic knowledge and perceived MPS III severity. Results were compared with the Dutch population. Parents and relatives of MPS III patients (n = 159) scored higher on the genetic knowledge test and perceived MPS III as more severe compared with the general Dutch population (n = 781). Parents and relatives reported to be more likely to participate in ECS (84.3% and 62.5%, respectively) compared with the public (31%) (p < 0.001). Being a relative of a MPS III patient was the strongest variable in the regression analyses for intended ECS participation. Our results show that genetic knowledge influences ECS decision making. Therefore, appropriate information on ECS and genetic counseling is needed to enable prospective parents from the general population, including relatives of patients with severe hereditary disorders, to make informed decisions.
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Affiliation(s)
- Stephanie C M Nijmeijer
- Amsterdam UMC, Pediatric Metabolic Diseases, Emma Children's Hospital and Amsterdam Lysosome Center "Sphinx", University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Thirsa Conijn
- Amsterdam UMC, Pediatric Metabolic Diseases, Emma Children's Hospital and Amsterdam Lysosome Center "Sphinx", University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam UMC, Psychosocial Department, Emma Children's Hospital, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Phillis Lakeman
- Amsterdam UMC, Department of Clinical Genetics, Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Lidewij Henneman
- Amsterdam UMC, Department of Clinical Genetics, Amsterdam Reproduction and Development Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Frits A Wijburg
- Amsterdam UMC, Pediatric Metabolic Diseases, Emma Children's Hospital and Amsterdam Lysosome Center "Sphinx", University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Lotte Haverman
- Amsterdam UMC, Psychosocial Department, Emma Children's Hospital, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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7
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Rabin R, Hirsch Y, Johansson MM, Ekstein J, Zeevi DA, Keena B, Zackai EH, Pappas J. Study of carrier frequency of Warsaw breakage syndrome in the Ashkenazi Jewish population and presentation of two cases. Am J Med Genet A 2019; 179:2144-2151. [DOI: 10.1002/ajmg.a.61284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/18/2019] [Accepted: 06/23/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Rachel Rabin
- Clinical Genetic Services, Department of PediatricsNYU School of Medicine New York New York
| | - Yoel Hirsch
- Dor Yeshorim, Committee for Prevention Jewish Genetic Diseases Brooklyn New York
| | - Martin M. Johansson
- Dor Yeshorim, Committee for Prevention Jewish Genetic Diseases Brooklyn New York
| | - Joseph Ekstein
- Dor Yeshorim, Committee for Prevention Jewish Genetic Diseases Brooklyn New York
| | - David A. Zeevi
- Dor Yeshorim, Committee for Prevention Jewish Genetic Diseases Jerusalem Israel
| | - Beth Keena
- Division of Human GeneticsChildren's Hospital of Philadelphia Philadelphia Pennsylvania
| | - Elaine H. Zackai
- Division of Human GeneticsChildren's Hospital of Philadelphia Philadelphia Pennsylvania
| | - John Pappas
- Clinical Genetic Services, Department of PediatricsNYU School of Medicine New York New York
- Clinical GeneticsNYU Orthopedic Hospital New York New York
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8
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Beyond the Brochure: Innovations in Clinical Counseling Practices for Prenatal Genetic Testing Options. J Perinat Neonatal Nurs 2019; 33:12-25. [PMID: 30676459 DOI: 10.1097/jpn.0000000000000374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Remarkable advancements related to preconception and prenatal genetic screening have emerged in recent years. While technology and testing options are more numerous and complex; fundamental genetic counseling issues remain the same. It is essential that with any prenatal genetic testing, women have an opportunity to make informed and autonomous decisions that are consistent with their personal needs and values. Opportunities to discuss testing options, including potential benefits and limitations, are often limited in obstetric visits due to time constraints or lack of sufficient provider education. As genetic testing is not considered a routine component of antepartum care, review of information regarding testing options is imperative so women can decide which, if any, testing to pursue. Developing new strategies to address the growing complexity of prenatal testing while ensuring provider education is accurate is crucial in imparting evidence-based care. This article will arm providers with the knowledge needed to educate women about currently available prenatal genetic screening and diagnostic tests along with guidance on the essential elements and importance of genetic counseling.
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9
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Fan CW, Castonguay L, Rummell S, Lévesque S, Mitchell JJ, Sillon G. Online Module for Carrier Screening in Ashkenazi Jewish Individuals Compared with In-Person Genetics Education: A Randomized Controlled Trial. J Genet Couns 2017; 27:426-438. [PMID: 28791521 DOI: 10.1007/s10897-017-0133-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 07/18/2017] [Indexed: 11/29/2022]
Abstract
To increase accessibility to genetics services for low-urgency patients seeking Ashkenazi Jewish (AJ) carrier screening, we designed an interactive computer (IC) module that provides pre-test genetics education and allows genetics professionals to order the test without meeting the patients beforehand. We compared this module with in-person genetic counseling (GC) using a randomized trial. AJ individuals were randomized to undergo genetics education via the IC module (n = 26) or GC (n = 28). We compared post-interventional genetics knowledge, perceived genetic risk, and anxiety between the two groups, after accounting for pre-interventional scores, using ANCOVA. Wilcoxon Rank-Sum test was used to compare post-interventional satisfaction. Post-interventional genetics knowledge, risk perception, or anxiety were not significantly different between the two groups after accounting for baseline scores (p = 0.50-0.54), although the data are inconclusive regarding the module's non-inferiority at a 5% margin. Post-intervention satisfaction scores were generally higher in the GC group than the IC module group. Our IC module has the potential to improve access to clinical genetics services for patients and staff, but it is not suitable for all AJ patients and cannot completely replace the benefits of in-person consultations.
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Affiliation(s)
- Chia Wei Fan
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lysanne Castonguay
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sonja Rummell
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sébastien Lévesque
- Department of Pediatrics, Division of Medical Genetics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - John J Mitchell
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Department of Medical Genetics, McGill University Health Center, 1001 boul. Décarie, Room A04.3140, Montreal, Quebec, H4A 3J1, Canada.,Department of Endocrinology and Metabolism, McGill University Health Center, Montreal, Quebec, Canada
| | - Guillaume Sillon
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. .,Department of Medical Genetics, McGill University Health Center, 1001 boul. Décarie, Room A04.3140, Montreal, Quebec, H4A 3J1, Canada.
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10
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Korngiebel DM, McMullen CK, Amendola LM, Berg JS, Davis JV, Gilmore MJ, Harding CO, Himes P, Jarvik GP, Kauffman TL, Kennedy KA, Simpson DK, Leo MC, Lynch FL, Quigley DI, Reiss JA, Richards CS, Rope AF, Schneider JL, Goddard KAB, Wilfond BS. Generating a taxonomy for genetic conditions relevant to reproductive planning. Am J Med Genet A 2016; 170:565-73. [PMID: 26889673 DOI: 10.1002/ajmg.a.37513] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 10/22/2015] [Indexed: 01/20/2023]
Abstract
As genome or exome sequencing (hereafter genome-scale sequencing) becomes more integrated into standard care, carrier testing is an important possible application. Carrier testing using genome-scale sequencing can identify a large number of conditions, but choosing which conditions/genes to evaluate as well as which results to disclose can be complicated. Carrier testing generally occurs in the context of reproductive decision-making and involves patient values in a way that other types of genetic testing may not. The Kaiser Permanente Clinical Sequencing Exploratory Research program is conducting a randomized clinical trial of preconception carrier testing that allows participants to select their preferences for results from among broad descriptive categories rather than selecting individual conditions. This paper describes (1) the criteria developed by the research team, the return of results committee (RORC), and stakeholders for defining the categories; (2) the process of refining the categories based on input from patient focus groups and validation through a patient survey; and (3) how the RORC then assigned specific gene-condition pairs to taxonomy categories being piloted in the trial. The development of four categories (serious, moderate/mild, unpredictable, late onset) for sharing results allows patients to select results based on their values without separately deciding their interest in knowing their carrier status for hundreds of conditions. A fifth category, lifespan limiting, was always shared. The lessons learned may be applicable in other results disclosure situations, such as incidental findings.
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Affiliation(s)
- Diane M Korngiebel
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington
| | - Carmit K McMullen
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Laura M Amendola
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington
| | - Jonathan S Berg
- Department of Genetics, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - James V Davis
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Marian J Gilmore
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | - Cary O Harding
- Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon
| | - Patricia Himes
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | - Gail P Jarvik
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington
| | - Tia L Kauffman
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Kathleen A Kennedy
- Department of Perinatal Services, Kaiser Permanente Northwest, Portland, Oregon
| | | | - Michael C Leo
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Frances L Lynch
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Denise I Quigley
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - Jacob A Reiss
- Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
| | - C Sue Richards
- Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon
| | - Alan F Rope
- Department of Medical Genetics, Kaiser Permanente Northwest, Portland, Oregon
| | | | | | - Benjamin S Wilfond
- Treuman Katz Center for Pediatrics Bioethics, Seattle Children's Research Institute, Seattle, Washington.,Division of Bioethics, Department of Pediatrics, University of Washington, Seattle, Washington
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11
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Ramos E, Callier SL, Swann PB, Harvey HH. Genomic Test Results and the Courtroom: The Roles of Experts and Expert Testimony. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2016; 44:205-215. [PMID: 27256136 DOI: 10.1177/1073110516644211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The rapid advancement from single-gene testing to whole genome sequencing has significantly broadened the type and amount of information available to researchers, physicians, patients, and the public in general. Much debate has ensued about whether genomic test results should be reported to research participants, patients and consumers, and at what stage we can be sure that existing evidence justifies their use in clinical settings. Courts and judges evaluating the utility of these results will not be immune to this uncertainty. As scholars increasingly explore the duty of care standards related to reporting genomic test results, it is timely to provide a framework for understanding how uncertainty about genetic and genomic tests influences evidentiary considerations in the court room. Here, we explore the subtleties and nuances of interpreting genetic data in an environment of substantial discord related to the value that individuals should place on genetic and genomic tests. In conjunction, we discuss the roles courts should play in qualifying experts, expert testimony, and genetic and genomic tests given the intricate and complex nature of genetic and genomic information.
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Affiliation(s)
- Edward Ramos
- Edward Ramos, Ph.D., is a Program Director at the National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health. Shawneequa L. Callier, J.D., M.A., is an Assistant Professor in the Department of Clinical Research and Leadership at the George Washington University School of Medicine and Health Sciences. Peter B. Swann, J.D., is Judge, Division One, Arizona Court of Appeals. Hosea H. Harvey, J.D., Ph.D., is Associate Professor of Law and Temple University Beasley School of Law
| | - Shawneequa L Callier
- Edward Ramos, Ph.D., is a Program Director at the National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health. Shawneequa L. Callier, J.D., M.A., is an Assistant Professor in the Department of Clinical Research and Leadership at the George Washington University School of Medicine and Health Sciences. Peter B. Swann, J.D., is Judge, Division One, Arizona Court of Appeals. Hosea H. Harvey, J.D., Ph.D., is Associate Professor of Law and Temple University Beasley School of Law
| | - Peter B Swann
- Edward Ramos, Ph.D., is a Program Director at the National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health. Shawneequa L. Callier, J.D., M.A., is an Assistant Professor in the Department of Clinical Research and Leadership at the George Washington University School of Medicine and Health Sciences. Peter B. Swann, J.D., is Judge, Division One, Arizona Court of Appeals. Hosea H. Harvey, J.D., Ph.D., is Associate Professor of Law and Temple University Beasley School of Law
| | - Hosea H Harvey
- Edward Ramos, Ph.D., is a Program Director at the National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health. Shawneequa L. Callier, J.D., M.A., is an Assistant Professor in the Department of Clinical Research and Leadership at the George Washington University School of Medicine and Health Sciences. Peter B. Swann, J.D., is Judge, Division One, Arizona Court of Appeals. Hosea H. Harvey, J.D., Ph.D., is Associate Professor of Law and Temple University Beasley School of Law
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Kamal AM, Ahmed AK, Abdellatif MZM, Tawfik M, Hassan EE. Seropositivity of Toxoplasmosis in Pregnant Women by ELISA at Minia University Hospital, Egypt. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:605-10. [PMID: 26537040 PMCID: PMC4635823 DOI: 10.3347/kjp.2015.53.5.605] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 09/01/2015] [Accepted: 09/03/2015] [Indexed: 11/23/2022]
Abstract
Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women.
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Affiliation(s)
- Amany M Kamal
- Department of Parasitology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Azza K Ahmed
- Department of Parasitology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Manal Z M Abdellatif
- Department of Parasitology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Mohamed Tawfik
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Ebtesam E Hassan
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Minia 61519, Egypt
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13
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Reeves A, Trepanier A. Comparison of Informed Consent Preferences for Multiplex Genetic Carrier Screening among a Diverse Population. J Genet Couns 2015; 25:166-78. [PMID: 26174936 DOI: 10.1007/s10897-015-9854-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 06/22/2015] [Indexed: 11/29/2022]
Abstract
Multiplex genetic carrier screening is increasingly being integrated into reproductive care. Obtaining informed consent becomes more challenging as the number of screened conditions increases. Implementing a model of generic informed consent may facilitate informed decision-making. Current Wayne State University students and staff were invited to complete a web-based survey by blast email solicitation. Participants were asked to determine which of two generic informed consent scenarios they preferred: a brief versus a detailed consent. They were asked to rank the importance of different informational components in making an informed decision and to provide demographic information. Comparisons between informational preferences, demographic variables and scenario preferences were made. Six hundred ninety three participants completed the survey. When evaluating these generic consents, the majority preferred the more detailed consent (74.5%), and agreed that it provided enough information to make an informed decision (89.5%). Those who thought it would be more important to know the severity of the conditions being screened (p = .002) and range of symptoms (p = .000) were more likely to prefer the more detailed consent. There were no significant associations between scenario preferences and demographic variables. A generic consent was perceived to provide sufficient information for informed decision making regarding multiplex carrier screening with most preferring a more detailed version of the consent. Individual attitudes rather than demographic variables influenced preferences regarding the amount of information that should be included in the generic consent. The findings have implications for how clinicians approach providing tailored informed consent.
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Affiliation(s)
| | - Angela Trepanier
- Wayne State University Genetic Counseling Graduate Program, 540 E. Canfield Street, Detroit, MI, 48201, USA.
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Holtkamp KCA, van Maarle MC, Schouten MJE, Dondorp WJ, Lakeman P, Henneman L. Do people from the Jewish community prefer ancestry-based or pan-ethnic expanded carrier screening? Eur J Hum Genet 2015; 24:171-7. [PMID: 25966636 PMCID: PMC4717216 DOI: 10.1038/ejhg.2015.97] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/02/2015] [Accepted: 04/14/2015] [Indexed: 01/08/2023] Open
Abstract
Ancestry-based carrier screening in the Ashkenazi Jewish population entails screening for specific autosomal recessive founder mutations, which are rarer among the general population. As it is now technically feasible to screen for many more diseases, the question arises whether this population prefers a limited ancestry-based offer or a pan-ethnic expanded carrier screening panel that goes beyond the diseases that are frequent in their own population, and is offered regardless of ancestry. An online questionnaire was completed by 145 individuals from the Dutch Jewish community (≥18 years) between April and July 2014. In total, 64.8% were aware of the existence of ancestry-based carrier screening, and respondents were generally positive about screening. About half (53.8%) preferred pan-ethnic expanded carrier screening, whereas 42.8% preferred ancestry-based screening. Reasons for preferring pan-ethnic screening included ‘everyone has a right to be tested', ‘fear of stigmatization when offering ancestry-based panels', and ‘difficulties with identifying risk owing to mixed backgrounds'. ‘Preventing high healthcare costs' was the most important reason against pan-ethnic carrier screening among those in favor of an ancestry-based panel. In conclusion, these findings show that people from the Dutch Jewish community have a positive attitude regarding carrier screening in their community for a wide range of diseases. As costs of expanded carrier screening panels are most likely to drop in the near future, it is expected that these panels will receive more support in the future.
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Affiliation(s)
- Kim C A Holtkamp
- Department of Clinical Genetics, Section of Community Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Merel C van Maarle
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria J E Schouten
- Department of Clinical Genetics, Section of Community Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Wybo J Dondorp
- Department of Health, Ethics and Society, Research Institutes CAPHRI and GROW, Maastricht University, Maastricht, The Netherlands
| | - Phillis Lakeman
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Lidewij Henneman
- Department of Clinical Genetics, Section of Community Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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15
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Grinzaid KA, Page PZ, Denton JJ, Ginsberg J. Creation of a National, At-home Model for Ashkenazi Jewish Carrier Screening. J Genet Couns 2014; 24:381-7. [DOI: 10.1007/s10897-014-9800-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
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16
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Population-based screening for breast and ovarian cancer risk due to BRCA1 and BRCA2. Proc Natl Acad Sci U S A 2014; 111:14205-10. [PMID: 25192939 DOI: 10.1073/pnas.1415979111] [Citation(s) in RCA: 234] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In the Ashkenazi Jewish (AJ) population of Israel, 11% of breast cancer and 40% of ovarian cancer are due to three inherited founder mutations in the cancer predisposition genes BRCA1 and BRCA2. For carriers of these mutations, risk-reducing salpingo-oophorectomy significantly reduces morbidity and mortality. Population screening for these mutations among AJ women may be justifiable if accurate estimates of cancer risk for mutation carriers can be obtained. We therefore undertook to determine risks of breast and ovarian cancer for BRCA1 and BRCA2 mutation carriers ascertained irrespective of personal or family history of cancer. Families harboring mutations in BRCA1 or BRCA2 were ascertained by identifying mutation carriers among healthy AJ males recruited from health screening centers and outpatient clinics. Female relatives of the carriers were then enrolled and genotyped. Among the female relatives with BRCA1 or BRCA2 mutations, cumulative risk of developing either breast or ovarian cancer by age 60 and 80, respectively, were 0.60 (± 0.07) and 0.83 (± 0.07) for BRCA1 carriers and 0.33 (± 0.09) and 0.76 (± 0.13) for BRCA2 carriers. Risks were higher in recent vs. earlier birth cohorts (P = 0.006). High cancer risks in BRCA1 or BRCA2 mutation carriers identified through healthy males provide an evidence base for initiating a general screening program in the AJ population. General screening would identify many carriers who are not evaluated by genetic testing based on family history criteria. Such a program could serve as a model to investigate implementation and outcomes of population screening for genetic predisposition to cancer in other populations.
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Warsch JRL, Warsch S, Herman E, Zakarin L, Schneider A, Hoffman J, Wasserman D, Barbouth D. Knowledge, attitudes, and barriers to carrier screening for the Ashkenazi Jewish panel: a Florida experience : Education and Barriers assessment for Jewish Genetic Diseases. J Community Genet 2014; 5:223-31. [PMID: 24415495 DOI: 10.1007/s12687-013-0179-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 12/11/2013] [Indexed: 11/25/2022] Open
Abstract
The knowledge, attitudes, and barriers to Jewish genetic diseases (JGDs) and screening and their relative importance in reproductive decision-making were assessed in a population-based sample of Ashkenazi Jewish young adults in Florida. These adults attended educational screening fairs hosted by The Victor Center for the Prevention of Jewish Genetic Diseases at the University of Miami. Parametric and nonparametric tests were used as appropriate to analyze data from a single group pretest/posttest design. Four hundred twelve individuals (mean age = 24.9; 54.7 % female, 45.3 % male) completed the questionnaires. Participants' level of knowledge increased from pre- to post-intervention (81.4 vs. 91.0 %; p < 0.0001). Concern about the possibility of being a carrier of a JGD was significantly higher after an educational session (5-point Likert scale mean difference = 0.45; p < 0.0001), as was their level of concern regarding having an affected child (mean difference = 0.20; p < 0.0001). The number of participants who agreed or strongly agreed that the test results would not have any influence on their reproductive behavior was lower after the session (17.2 vs. 20.8 %; p < 0.0001). This study demonstrates that an educational carrier screening program increased knowledge and elucidated awareness of the attitudes and barriers toward JGDs and carrier screening.
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Affiliation(s)
- Jessica R L Warsch
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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Klugman S, Schreiber-Agus N, Nazareth S, Evans EA. Detection of Carriers in the Ashkenazi Jewish Population: An Objective Comparison of High-Throughput Genotyping Versus Gene-by-Gene Testing. Genet Test Mol Biomarkers 2013; 17:763-7. [DOI: 10.1089/gtmb.2013.0105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Susan Klugman
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine of Yeshiva University, Program for Jewish Genetic Health, Montefiore Medical Center, Bronx, New York
| | - Nicole Schreiber-Agus
- Human Genetics Lab, Jacobi Medical Center, Bronx, New York
- Department of Genetics, Albert Einstein College of Medicine; Program for Jewish Genetic Health, Bronx, New York
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Yonath H, Reznik-Wolf H, Berkenstadt M, Eisenberg-Barzilai S, Lehtokari VL, Wallgren-Pettersson C, Mehta L, Achiron R, Gilboa Y, Polak-Charcon S, Winder T, Frydman M, Pras E. Carrier state for the nebulin exon 55 deletion and abnormal prenatal ultrasound findings as potential signs of nemaline myopathy. Prenat Diagn 2012; 32:70-4. [DOI: 10.1002/pd.2905] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Hagith Yonath
- Danek Gertner Institute of Human Genetics; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Haike Reznik-Wolf
- Danek Gertner Institute of Human Genetics; Sheba Medical Center; Ramat Gan Israel
| | - Michal Berkenstadt
- Danek Gertner Institute of Human Genetics; Sheba Medical Center; Ramat Gan Israel
| | | | - Vilma-Lotta Lehtokari
- Folkhälsan Insitute of Genetics and Department of Medical Genetics, Haartman Institute; University of Helsinki; Helsinki Finland
| | - Carina Wallgren-Pettersson
- Folkhälsan Insitute of Genetics and Department of Medical Genetics, Haartman Institute; University of Helsinki; Helsinki Finland
| | - Lakshmi Mehta
- Department of Genetics & Genomic Sciences; Mount Sinai School of Medicine; New York NY USA
| | - Reuven Achiron
- Department of Obstetrics and Gynecology; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Yinon Gilboa
- Department of Obstetrics and Gynecology; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Sylvie Polak-Charcon
- Department of Pathology; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | | | - Moshe Frydman
- Danek Gertner Institute of Human Genetics; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Elon Pras
- Danek Gertner Institute of Human Genetics; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
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Guha S, Rosenfeld JA, Malhotra AK, Lee AT, Gregersen PK, Kane JM, Pe'er I, Darvasi A, Lencz T. Implications for health and disease in the genetic signature of the Ashkenazi Jewish population. Genome Biol 2012; 13:R2. [PMID: 22277159 PMCID: PMC3334583 DOI: 10.1186/gb-2012-13-1-r2] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 01/13/2012] [Accepted: 01/25/2012] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Relatively small, reproductively isolated populations with reduced genetic diversity may have advantages for genomewide association mapping in disease genetics. The Ashkenazi Jewish population represents a unique population for study based on its recent (< 1,000 year) history of a limited number of founders, population bottlenecks and tradition of marriage within the community. We genotyped more than 1,300 Ashkenazi Jewish healthy volunteers from the Hebrew University Genetic Resource with the Illumina HumanOmni1-Quad platform. Comparison of the genotyping data with that of neighboring European and Asian populations enabled the Ashkenazi Jewish-specific component of the variance to be characterized with respect to disease-relevant alleles and pathways. RESULTS Using clustering, principal components, and pairwise genetic distance as converging approaches, we identified an Ashkenazi Jewish-specific genetic signature that differentiated these subjects from both European and Middle Eastern samples. Most notably, gene ontology analysis of the Ashkenazi Jewish genetic signature revealed an enrichment of genes functioning in transepithelial chloride transport, such as CFTR, and in equilibrioception, potentially shedding light on cystic fibrosis, Usher syndrome and other diseases over-represented in the Ashkenazi Jewish population. Results also impact risk profiles for autoimmune and metabolic disorders in this population. Finally, residual intra-Ashkenazi population structure was minimal, primarily determined by class 1 MHC alleles, and not related to host country of origin. CONCLUSIONS The Ashkenazi Jewish population is of potential utility in disease-mapping studies due to its relative homogeneity and distinct genomic signature. Results suggest that Ashkenazi-associated disease genes may be components of population-specific genomic differences in key functional pathways.
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Affiliation(s)
- Saurav Guha
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of the North Shore - Long Island Jewish Health System, 75-59, 263rd St Glen Oaks, NY 11004, USA
| | - Jeffrey A Rosenfeld
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of the North Shore - Long Island Jewish Health System, 75-59, 263rd St Glen Oaks, NY 11004, USA
| | - Anil K Malhotra
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of the North Shore - Long Island Jewish Health System, 75-59, 263rd St Glen Oaks, NY 11004, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
- Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Ave, Bronx, NY 10461, USA
- Department of Psychiatry, Hofstra University School of Medicine, Hempstead, NY 11549, USA
- Department of Molecular Medicine, Hofstra University School of Medicine, Hempstead, NY 11549, USA
| | - Annette T Lee
- Robert S Boas Center for Human Genetics and Genomics, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - Peter K Gregersen
- Department of Molecular Medicine, Hofstra University School of Medicine, Hempstead, NY 11549, USA
- Robert S Boas Center for Human Genetics and Genomics, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - John M Kane
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of the North Shore - Long Island Jewish Health System, 75-59, 263rd St Glen Oaks, NY 11004, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
- Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Ave, Bronx, NY 10461, USA
- Department of Psychiatry, Hofstra University School of Medicine, Hempstead, NY 11549, USA
- Department of Molecular Medicine, Hofstra University School of Medicine, Hempstead, NY 11549, USA
| | - Itsik Pe'er
- Department of Computer Science, Columbia University, 500 W 120th St New York, NY 10027, USA
| | - Ariel Darvasi
- Department of Genetics The Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem, 91904, Israel
| | - Todd Lencz
- Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of the North Shore - Long Island Jewish Health System, 75-59, 263rd St Glen Oaks, NY 11004, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
- Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine of Yeshiva University, 1300 Morris Park Ave, Bronx, NY 10461, USA
- Department of Psychiatry, Hofstra University School of Medicine, Hempstead, NY 11549, USA
- Department of Molecular Medicine, Hofstra University School of Medicine, Hempstead, NY 11549, USA
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Rosenberg PS, Tamary H, Alter BP. How high are carrier frequencies of rare recessive syndromes? Contemporary estimates for Fanconi Anemia in the United States and Israel. Am J Med Genet A 2011; 155A:1877-83. [PMID: 21739583 PMCID: PMC3140593 DOI: 10.1002/ajmg.a.34087] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 04/07/2011] [Indexed: 11/07/2022]
Abstract
For many recessive genetic syndromes, carrier frequencies have been assessed through screening studies in founder populations but remain unclear in heterogeneous populations. One such syndrome is Fanconi Anemia (FA). FA is a model disease in cancer research, yet there are no contemporary data on carrier frequency or prevalence in the general United States (US) population or elsewhere. We inferred carrier frequency from birth incidence using the Hardy-Weinberg law. We estimated prevalence using birth incidence and survival data. We defined "plausible ranges" to incorporate uncertainty about completeness of case ascertainment. We made estimates for the US and Israel using demographic data from the Fanconi Anemia Research Fund and Israeli Fanconi Anemia Registry. In the US, a plausible range for the carrier frequency is 1:156-1:209 [midpoint 1:181]; we estimate that 550-975 persons were living with FA in 2010. For Israel, a plausible range for the carrier frequency is 1:66-1:128 [midpoint 1:93] in line with founder screening studies; we estimate that 40-135 Israelis were living with FA in 2008. The estimated US FA carrier frequency of 1:181 is significantly higher than the historical estimate of 1:300; hence, the gap may be narrower than previously recognized between the US carrier frequency and higher carrier frequencies of around 1:100 in several founder groups including Ashkenazi Jews. Assessment of cancer risks in heterozygous carriers merits further study. Clinical trials in FA will require co-ordination and innovative design because the number of living US patients is probably less than 1,000.
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Affiliation(s)
- Philip S Rosenberg
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA.
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