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科学家完成临床多基因风险评分检测和报告工作流程的开发
作者:小柯机器人 发布时间:2022/4/21 16:38:17

近日,美国哈佛医学院Jason L. Vassy团队完成临床多基因风险评分检测和报告工作流程的开发。相关论文于2022年4月18日在线发表在《自然—医学》杂志上。

对于正在进行的退伍军人事务基因组医学(GenoVA)研究,研究人员为六种已公布的多基因风险评分(PRS)开发了一种基于临床基因型阵列的检测方法。研究人员使用了来自36,423名麻省总医院布里格姆生物库参与者的数据,并对人口结构进行了调整,从而复制已知的PRS-疾病关联和已公布的PRS阈值,即疾病概率(OR)为2(范围从2型糖尿病的1.75(95%CI:1.57-1.95)到乳腺癌的2.38(95%CI:2.07-2.73))。在确认该管线作为个体患者的临床检测的高性能和稳健性后,研究人员分析了GenoVA研究的首批227个前瞻性样本,发现对应于公布的OR>2的PRS频率从结直肠癌的13/227(5.7%)到前列腺癌的23/150(15.3%)。
 
除了PRS实验室报告外,研究人员还开发了面向医生和病人的信息材料,以支持对PRS结果的决策。这项工作说明了针对多种情况的临床PRS检测的可推广性发展,以及在临床上实施PRS信息的技术、报告和临床工作流程的挑战。
 
据介绍,实施PRS可以改善疾病预防和管理,但也带来了一些挑战:构建临床上有效的检测方法,对个别病人进行解释,以及开发临床工作流程和资源以支持其在病人护理中的使用。
 
附:英文原文
 
Title: Development of a clinical polygenic risk score assay and reporting workflow

Author: Hao, Limin, Kraft, Peter, Berriz, Gabriel F., Hynes, Elizabeth D., Koch, Christopher, Korategere V Kumar, Prathik, Parpattedar, Shruti S., Steeves, Marcie, Yu, Wanfeng, Antwi, Ashley A., Brunette, Charles A., Danowski, Morgan, Gala, Manish K., Green, Robert C., Jones, Natalie E., Lewis, Anna C. F., Lubitz, Steven A., Natarajan, Pradeep, Vassy, Jason L., Lebo, Matthew S.

Issue&Volume: 2022-04-18

Abstract: Implementation of polygenic risk scores (PRS) may improve disease prevention and management but poses several challenges: the construction of clinically valid assays, interpretation for individual patients, and the development of clinical workflows and resources to support their use in patient care. For the ongoing Veterans Affairs Genomic Medicine at Veterans Affairs (GenoVA) Study we developed a clinical genotype array-based assay for six published PRS. We used data from 36,423 Mass General Brigham Biobank participants and adjustment for population structure to replicate known PRS–disease associations and published PRS thresholds for a disease odds ratio (OR) of 2 (ranging from 1.75 (95% CI: 1.57–1.95) for type 2 diabetes to 2.38 (95% CI: 2.07–2.73) for breast cancer). After confirming the high performance and robustness of the pipeline for use as a clinical assay for individual patients, we analyzed the first 227 prospective samples from the GenoVA Study and found that the frequency of PRS corresponding to published OR>2 ranged from 13/227 (5.7%) for colorectal cancer to 23/150 (15.3%) for prostate cancer. In addition to the PRS laboratory report, we developed physician- and patient-oriented informational materials to support decision-making about PRS results. Our work illustrates the generalizable development of a clinical PRS assay for multiple conditions and the technical, reporting and clinical workflow challenges for implementing PRS information in the clinic.

DOI: 10.1038/s41591-022-01767-6

Source: https://www.nature.com/articles/s41591-022-01767-6

期刊信息

Nature Medicine:《自然—医学》,创刊于1995年。隶属于施普林格·自然出版集团,最新IF:30.641
官方网址:https://www.nature.com/nm/
投稿链接:https://mts-nmed.nature.com/cgi-bin/main.plex