Gene hunting in the genomic era: approaches to diagnostic dilemmas in patients with primary immunodeficiencies.

Gene hunting in the genomic era: approaches to diagnostic dilemmas in patients with primary immunodeficiencies.
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DOI:
10.1016/j.jaci.2013.08.021
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发表时间:
2014-08
影响因子:
14.2
通讯作者:
Chou, Janet
Chou, Janet
中科院分区:
医学1区
文献类型:
--
作者:
Platt, Craig;Geha, Raif S.;Chou, Janet

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迄今为止,已发现 180 多种原发性免疫缺陷的不同遗传原因。识别致病突变的方法可大致分为 3 种策略:(1) 基于对免疫细胞发育和功能至关重要的已知信号通路的有根据的猜测,(2) 临床表型与小鼠模型的相似性,以及 (3) 无偏见的遗传方法。下一代 DNA 测序可以对整个基因组或外显子组进行高效测序,但也需要过滤大量数据的策略。最近的研究已经确定了解决疑难病例的方法,例如常染色体显性遗传、不完全外显或非编码区突变的疾病。本综述重点关注最近发现的原发性免疫缺陷,以说明寻找这些疾病新病因的策略、技术和潜在陷阱。
There are more than 180 different genetic causes of primary immunodeficiencies identified to date. Approaches for identifying causative mutations can be broadly classified into 3 strategies: (1) educated guesses based on known signaling pathways essential for immune cell development and function, (2) similarity of clinical phenotypes to mouse models, and (3) unbiased genetic approaches. Next-generation DNA sequencing permits efficient sequencing of whole genomes or exomes but also requires strategies for filtering vast amounts of data. Recent studies have identified ways to solve difficult cases, such as diseases with autosomal dominant inheritance, incomplete penetrance, or mutations in noncoding regions. This review focuses on recently identified primary immunodeficiencies to illustrate the strategies, technologies, and potential pitfalls in finding novel causes of these diseases.
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