RESUMEN
Cascade screening is the process of contacting relatives of people who have been diagnosed with certain hereditary conditions. Its purpose is to identify, inform, and manage those who are also at risk. We conducted a scoping review to obtain a broad overview of cascade screening interventions, facilitators and barriers to their use, relevant policy considerations, and future research needs. We searched for relevant peer-reviewed literature in the period 1990-2017 and reviewed 122 studies. Finally, we described 45 statutes and regulations related to the use and release of genetic information across the fifty states. We sought standardized best practices for optimizing cascade screening across various geographic and policy contexts, but we found none. Studies in which trained providers contacted relatives directly, rather than through probands (index patients), showed greater cascade screening uptake; however, policies in some states might limit this approach. Major barriers to cascade screening delivery include suboptimal communication between the proband and family and geographic barriers to obtaining genetic services. Few US studies examined interventions for cascade screening or used rigorous study designs such as randomized controlled trials. Moving forward, there remains an urgent need to conduct rigorous intervention studies on cascade screening in diverse US populations, while accounting for state policy considerations.
Asunto(s)
Enfermedades Genéticas Congénitas/diagnóstico , Predisposición Genética a la Enfermedad/epidemiología , Pruebas Genéticas/métodos , Tamizaje Masivo/métodos , Femenino , Enfermedades Genéticas Congénitas/epidemiología , Enfermedades Genéticas Congénitas/genética , Humanos , Masculino , Linaje , Estados UnidosRESUMEN
Bardet-Biedl syndrome (BBS) is an autosomal recessive disease characterized by retinal dystrophy, polydactyly, obesity, learning disabilities, renal involvement, and male hypogenitalism. BBS is genetically heterogeneous with mutations of 14 genes, accounting for approximately 70% of cases. Triallelic inheritance has been suggested in about 5% of cases. Forty-nine unrelated BBS patients were screened for mutations by DHPLC analysis in BBS1, BBS2, BBS4, BBS6/MKKS, BBS10, and BBS12. The selected genes either account for more than 5% of the mutational load or are commonly reported in triallelic inheritance. Eight patients with only one or no BBS mutation were further investigated by single nucleotide polymorphism (SNP) analysis. In total, mutations were detected in 44 patients. Twenty percent had two mutations in BBS1, 18% in BBS2, 4% in BBS9, 43% in BBS10, and 2% in BBS12. Five patients were heterozygous for a sequence variation in BBS6/MKKS. We found eight patients with three sequence variations in two genes, which could be explained by triallelic inheritance, by the prevalence of heterozygous carriers or the third sequence variations representing rare polymorphisms. All changes found in a second BBS gene were amino acid substitutions. Genotype-phenotype correlations suggest a milder phenotype for BBS1 compared to BBS2 and BBS10, which we ascribe to the hypomorphic p.Met390Arg-mutation.
Asunto(s)
Síndrome de Bardet-Biedl/genética , Mutación/genética , Alelos , Secuencia de Aminoácidos , Secuencia de Bases , Secuencia Conservada , Análisis Mutacional de ADN , Dinamarca , Evolución Molecular , Femenino , Estudios de Asociación Genética , Genotipo , Chaperoninas del Grupo II/química , Chaperoninas del Grupo II/genética , Humanos , Patrón de Herencia/genética , Masculino , Datos de Secuencia Molecular , Polimorfismo de Nucleótido Simple/genéticaRESUMEN
Ocular involvement in muscular dystrophy ranges from structural defects to abnormal electroretinograms. While the mechanisms underlying the abnormal retinal physiology in patients are not understood, it is thought that alpha-dystroglycan extracellular interactions are critical for normal visual function. Here we show that beta-dystroglycan anchors dystrophin and the inward rectifying K(+) channel Kir4.1 at glial endfeet and that disruption of dystrophin and potassium channel clustering in dystroglycan mutant mice is associated with an attenuation of the electroretinogram b-wave. Glial-specific inactivation of dystroglycan or deletion of the cytoplasmic domain of beta-dystroglycan was sufficient to attenuate the electroretinogram b-wave. Unexpectedly, deletion of the beta-dystroglycan cytoplasmic domain did not disrupt the laminar structure of the retina. In contrast to the role of alpha-dystroglycan extracellular interactions during early development of the CNS, beta-dystroglycan intracellular interactions are important for visual function but not the laminar development of the retina.
Asunto(s)
Distroglicanos/deficiencia , Trastornos de la Visión/genética , Trastornos de la Visión/fisiopatología , Animales , Distrofina/metabolismo , Electrorretinografía/métodos , Regulación de la Expresión Génica/genética , Proteína Ácida Fibrilar de la Glía/genética , Proteína Ácida Fibrilar de la Glía/metabolismo , Proteínas de Filamentos Intermediarios/genética , Proteínas de Filamentos Intermediarios/metabolismo , Laminina/genética , Laminina/metabolismo , Aprendizaje por Laberinto/fisiología , Ratones , Ratones Transgénicos , Mutación/genética , Proteínas del Tejido Nervioso/genética , Proteínas del Tejido Nervioso/metabolismo , Nestina , Estimulación Luminosa/métodos , Canales de Potasio de Rectificación Interna/metabolismo , Retina/metabolismo , Retina/patología , Campos Visuales/genéticaRESUMEN
PURPOSE: Tests of vision for mice remain limited and the visual phenotype of some retinal disorders in mice remain poorly understood. A novel assay of vision was used to determine how the form and extent of retinal disease affects visual phenotype in mice. METHODS: Retinal histology, the suppression of locomotion by light and visual guidance of locomotion, were assessed in mice with progressive photoreceptor degeneration (rd/rd) or visual cycle dysfunction (Rpe65 rd12). RESULTS: In wild-type mice, there was visual guidance of locomotor activity in dim light and suppression of activity (negative masking) in bright light. In rd/rd mice, vision was sufficient to guide locomotion at postnatal day (P)34 but was lost from P46 onward. In bright light rd/rd mice had enhanced negative masking. Although Rpe65 rd12 mice had no dim light response, with high illumination, vision was sufficient to guide locomotion at all ages tested. CONCLUSIONS: A major concern for gene and cell replacement therapies is the development of visual pathways through which restored retinal function can connect to visual centers of the brain. The residual retinal response to high illumination in Rpe65 rd12 mice translates into useful vision, and visual pathways remain functional--a prerequisite for restoring vision in disorders of the retina. Similarly, useful vision in young rd/rd mice shows that there is visual pathway function before photoreceptor degeneration and suggests the potential for early therapy. Together, these findings recommend observation of masking responses in the assessment of gene and cell replacement therapies.
Asunto(s)
Proteínas Portadoras/genética , Proteínas del Ojo/genética , Células Fotorreceptoras de Vertebrados/fisiología , Degeneración Retiniana/fisiopatología , Trastornos de la Visión/fisiopatología , Visión Ocular/fisiología , Percepción Visual/fisiología , Envejecimiento/fisiología , Animales , Conducta Animal/fisiología , Genotipo , Luz , Ratones , Ratones Endogámicos C57BL , Actividad Motora/fisiología , Fenotipo , Degeneración Retiniana/genética , Trastornos de la Visión/genética , cis-trans-IsomerasasAsunto(s)
Síndrome de Bardet-Biedl/etnología , Síndrome de Bardet-Biedl/genética , Mutación , Proteínas/genética , Proteínas/fisiología , Secuencia de Aminoácidos , Secuencia Conservada , Proteínas del Citoesqueleto , Análisis Mutacional de ADN , Bases de Datos Genéticas , Familia , Pruebas Genéticas , Humanos , Datos de Secuencia Molecular , Proteínas de Unión a Fosfato , Grupos Raciales/genéticaRESUMEN
A measure of improved vision remains the most meaningful way to demonstrate the efficacy of a therapy. Animal models allow us to describe the pathology of inherited retinal degenerations and to evaluate emerging therapies in specific disorders in ways not possible in human subjects. The potential use of mice in this role has been limited by the lack of a simple, unambiguous and practical test of an innate visually guided behavior. To begin to address this need, we have developed equipment and protocols to measure a performance enhancing effect of vision on use of a running wheel; a scotopic visually guided behavior termed positive masking. This assay is objective, quantitative, automated and can be adapted for in-depth studies of visual thresholds, longitudinal studies of visual pathology or treatment efficacy, and large scale screening programs. Proof-of-principle experiments show that our equipment and protocols are able to characterize the full range of masking responses in normal mice in an informative and efficient manner. A sustained activity increase across a range of dim light irradiances was consistent with scotopic visual guidance of behavior, while at higher irradiances a dose dependent suppression of activity was apparent. This study also describes for the first time the interaction of experience and vision in performing a task. Specifically, we identified an experience dependent acclimatization to wheel use in scotopic conditions; a performance reduction in complete darkness; and a partial but not complete recovery of performance levels with experience in complete darkness. This suggests that where visual guidance is performance enhancing but not essential, loss of the contribution of visual guidance to the tasks might be compensated for by experience or training.
Asunto(s)
Conducta Animal , Degeneración Retiniana/diagnóstico , Pruebas de Visión/métodos , Animales , Modelos Animales de Enfermedad , Ratones , Ratones Endogámicos C57BL , Actividad Motora , Enmascaramiento Perceptual , Estimulación Luminosa/métodos , Desempeño PsicomotorRESUMEN
Bardet-Biedl syndrome (BBS) is a genetically heterogeneous disorder that results in retinal degeneration, obesity, cognitive impairment, polydactyly, renal abnormalities, and hypogenitalism. Of the 12 known BBS genes, BBS1 is the most commonly mutated, and a single missense mutation (M390R) accounts for approximately 80% of BBS1 cases. To gain insight into the function of BBS1, we generated a Bbs1(M390R/M390R) knockin mouse model. Mice homozygous for the M390R mutation recapitulated aspects of the human phenotype, including retinal degeneration, male infertility, and obesity. The obese mutant mice were hyperphagic and hyperleptinemic and exhibited reduced locomotor activity but no elevation in mean arterial blood pressure. Morphological evaluation of Bbs1 mutant brain neuroanatomy revealed ventriculomegaly of the lateral and third ventricles, thinning of the cerebral cortex, and reduced volume of the corpus striatum and hippocampus. Similar abnormalities were also observed in the brains of Bbs2(-/-), Bbs4(-/-), and Bbs6(-/-) mice, establishing these neuroanatomical defects as a previously undescribed BBS mouse model phenotype. Ultrastructural examination of the ependymal cell cilia that line the enlarged third ventricle of the Bbs1 mutant brains showed that, whereas the 9 + 2 arrangement of axonemal microtubules was intact, elongated cilia and cilia with abnormally swollen distal ends were present. Together with data from transmission electron microscopy analysis of photoreceptor cell connecting cilia, the Bbs1 M390R mutation does not affect axonemal structure, but it may play a role in the regulation of cilia assembly and/or function.
Asunto(s)
Síndrome de Bardet-Biedl/genética , Síndrome de Bardet-Biedl/patología , Modelos Animales de Enfermedad , Ratones/genética , Proteínas Asociadas a Microtúbulos/genética , Animales , Ventrículos Cerebrales/patología , Cilios/ultraestructura , Masculino , Mutación , Obesidad/genética , Enfermedades de la Retina/genética , Cola del Espermatozoide/patologíaRESUMEN
We used expression quantitative trait locus mapping in the laboratory rat (Rattus norvegicus) to gain a broad perspective of gene regulation in the mammalian eye and to identify genetic variation relevant to human eye disease. Of >31,000 gene probes represented on an Affymetrix expression microarray, 18,976 exhibited sufficient signal for reliable analysis and at least 2-fold variation in expression among 120 F(2) rats generated from an SR/JrHsd x SHRSP intercross. Genome-wide linkage analysis with 399 genetic markers revealed significant linkage with at least one marker for 1,300 probes (alpha = 0.001; estimated empirical false discovery rate = 2%). Both contiguous and noncontiguous loci were found to be important in regulating mammalian eye gene expression. We investigated one locus of each type in greater detail and identified putative transcription-altering variations in both cases. We found an inserted cREL binding sequence in the 5' flanking sequence of the Abca4 gene associated with an increased expression level of that gene, and we found a mutation of the gene encoding thyroid hormone receptor beta2 associated with a decreased expression level of the gene encoding short-wavelength sensitive opsin (Opn1sw). In addition to these positional studies, we performed a pairwise analysis of gene expression to identify genes that are regulated in a coordinated manner and used this approach to validate two previously undescribed genes involved in the human disease Bardet-Biedl syndrome. These data and analytical approaches can be used to facilitate the discovery of additional genes and regulatory elements involved in human eye disease.
Asunto(s)
Oftalmopatías/genética , Ojo/metabolismo , Regulación de la Expresión Génica , Análisis de Varianza , Animales , Mapeo Cromosómico , Ligamiento Genético , Marcadores Genéticos , Humanos , Sitios de Carácter Cuantitativo/genética , Ratas , Ratas Endogámicas , Tamaño de la MuestraRESUMEN
Progressive rod-cone degeneration (prcd) is a late-onset, autosomal recessive photoreceptor degeneration of dogs and a homolog for some forms of human retinitis pigmentosa (RP). Previously, the disease-relevant interval was reduced to a 106-kb region on CFA9, and a common phenotype-specific haplotype was identified in all affected dogs from several different breeds and breed varieties. Screening of a canine retinal EST library identified partial cDNAs for novel candidate genes in the disease-relevant interval. The complete cDNA of one of these, PRCD, was cloned in dog, human, and mouse. The gene codes for a 54-amino-acid (aa) protein in dog and human and a 53-aa protein in the mouse; the first 24 aa, coded for by exon 1, are highly conserved in 14 vertebrate species. A homozygous mutation (TGC --> TAC) in the second codon shows complete concordance with the disorder in 18 different dog breeds/breed varieties tested. The same homozygous mutation was identified in a human patient from Bangladesh with autosomal recessive RP. Expression studies support the predominant expression of this gene in the retina, with equal expression in the retinal pigment epithelium, photoreceptor, and ganglion cell layers. This study provides strong evidence that a mutation in the novel gene PRCD is the cause of autosomal recessive retinal degeneration in both dogs and humans.
Asunto(s)
Enfermedades de los Perros/genética , Perros/genética , Mutación Puntual , Degeneración Retiniana/veterinaria , Retinitis Pigmentosa/genética , Secuencia de Aminoácidos , Animales , Cruzamiento , Clonación Molecular , Secuencia Conservada , Análisis Mutacional de ADN , ADN Complementario/genética , Etiquetas de Secuencia Expresada , Proteínas del Ojo/genética , Femenino , Biblioteca de Genes , Genes Recesivos , Genómica , Homocigoto , Humanos , Masculino , Ratones , Datos de Secuencia Molecular , Linaje , Degeneración Retiniana/genética , Homología de Secuencia de Aminoácido , Especificidad de la EspecieRESUMEN
PURPOSE: Oculocutaneous albinism type 1 (OCA1) patients demonstrate a partial or total lack of melanin in the skin, hair and eye. OCA1 is an autosomal recessive genetic disorder caused by mutations in the TYR gene located at chromosome band 11q14-q25. The purpose of this study was to carry out genetic analysis of OCA1 in Indian families. METHODS: Genomic DNA was isolated from blood leukocytes of all the individuals in this study. Haplotype analysis was performed at the TYR locus using informative microsatellite markers. Eight sets of primers were used to amplify the entire coding region of the TYR gene for bidirectional direct sequencing mutation analysis. RESULTS: Two novel deletions (c.937del8, c.1379del2) and a previously known nonsense mutation (R278X) in the TYR gene were identified from a total of 8 oculocutaneous albinism patients in India. CONCLUSIONS: Our study reports the distribution of two novel frameshift and a previously reported nonsense mutations in four OCA1 families from the Indian population. These findings will contribute to the development of a diagnostic method for OCA1 carrier status and genetic counseling for OCA1 affected families.
Asunto(s)
Albinismo Oculocutáneo/genética , Codón sin Sentido , Mutación del Sistema de Lectura , Monofenol Monooxigenasa/genética , Cromosomas Humanos Par 11/genética , Análisis Mutacional de ADN , Cartilla de ADN/química , Femenino , Haplotipos , Humanos , India , Masculino , Repeticiones de Microsatélite , Biología Molecular , Linaje , Reacción en Cadena de la PolimerasaRESUMEN
Photoreception is best understood in retinal rods and cones, but it is not confined to these cells. In non-mammals, intrinsically photosensitive cells have been identified within several structures including the pineal, hypothalamus and skin. More recently novel light sensitive cells have been identified in the inner/basal retina of both teleosts and rodents. Melanopsin has been proposed as the photopigment mediating many of these non-rod, non-cone responses to light. However, much about the melanopsin gene family remains to be clarified including their potential role as photopigments, and taxonomic distribution. We have isolated the first orthologue of melanopsin from a teleost fish and show expression of this gene in a sub-set of retinal horizontal cells (type B). Zebrafish melanopsin, and orthologues of this gene, differ markedly from the vertebrate photopigment opsins. The putative counterion is not a glutamate but a tyrosine, the putative G-protein binding domain in the third cytoplasmic loop is not conserved, and they show low levels of amino acid identity (approximately 27%) to both the known photopigment opsins and to other members of the melanopsin family. Mouse melanopsin is only 58% identical to Xenopus, and 68% identical to zebrafish. By contrast, the photosensory opsin families show approximately 75% conservation. On the basis of their structure, genomic organisation, discrete evolutionary lineage, and their co-expression with other opsins, the melanopins are not obvious photosensory opsins. They might represent a separate branch of photopigment evolution in the vertebrates or they may have a non-direct photosensory function, perhaps as a photoisomerase, in non-rod, non-cone light detection.