• Childhood Kidney Diseases
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• 제25권1호
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• pp.14-21
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• 2021

Chronic kidney disease, the presence of structural and functional abnormalities in the kidneys, is associated with a lower quality of life and increased morbidity and mortality in children. Genetic etiologies account for a substantial proportion of pediatric chronic kidney disease. With recent advances in genetic testing techniques, an increasing number of genetic causes of kidney disease continue to be found. Genetic testing is recommended in children with steroid-resistant nephrotic syndrome, congenital malformations of the kidney and urinary tract, cystic disease, or kidney disease with extrarenal manifestations. Diagnostic yields differ according to the category of clinical diagnosis and the choice of test. Here, we review the characteristics of genetic testing modalities and the implications of genetic testing in clinical genetic diagnostics.

• Asian-Australasian Journal of Animal Sciences
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• 제16권9호
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• pp.1247-1253
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• 2003

Selection for increased milk production in dairy cows has often resulted in a higher incidence of disease and thus incurred a greater health costs. Considerable interests have been shown in breeding dairy cattle for disease resistance in recent years. This paper discusses the limitations of breeding dairy cattle for genetic resistance in six parts: 1) complexity of disease resistance, 2) difficulty in estimating genetic parameters for planning breeding programs against disease, 3) undesirable relationship between production traits and disease, 4) disease as affected by recessive genes, 5) new mutation of the pathogens, and 6) variable environmental factors. The hidden problems of estimating genetic and phenotypic parameters involving disease incidence were examined in terms of categorical nature, non-independence, heterogeneity of error variance, non-randomness, and automatic relationship between disease and production traits. In light of these limitations, the prospect for increasing genetic resistance by conventional breeding methods would not be so bright as we like. Since the phenomenon of disease is the result of a joint interaction among host genotype, pathogen genotype and environment, it becomes essential to adopt an integrated approach of increasing genetic resistance of the host animals, manipulating the pathogen genotypes, developing effective vaccines and drugs, and improving the environmental conditions. The advances in DNA-based technology show considerable promise in directly manipulating host and pathogen genomes for genetic resistance and producing vaccines and drugs for prevention and medication to promote the wellbeing of the animals.

• Journal of Korean Neurosurgical Society
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• 제57권6호
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• pp.422-427
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• 2015

Moyamoya disease (MMD) is a chronic, progressive, cerebrovascular occlusive disorder that displays various clinical features and results in cerebral infarct or hemorrhagic stroke. Specific genes associated with the disease have not yet been identified, making identification of at-risk patients difficult before clinical manifestation. Familial MMD is not uncommon, with as many as 15% of MMD patients having a family history of the disease, suggesting a genetic etiology. Studies of single nucleotide polymorphisms (SNPs) in MMD have mostly focused on mechanical stress on vessels, endothelium, and the relationship to atherosclerosis. In this review, we discuss SNPs studies targeting the genetic etiology of MMD. Genetic analyses in familial MMD and genome-wide association studies represent promising strategies for elucidating the pathophysiology of this condition. This review also discusses future research directions, not only to offer new insights into the origin of MMD, but also to enhance our understanding of the genetic aspects of MMD. There have been several SNP studies of MMD. Current SNP studies suggest a genetic contribution to MMD, but further reliable and replicable data are needed. A large cohort or family-based design would be important. Modern SNP studies of MMD depend on novel genetic, experimental, and database methods that will hopefully hasten the arrival of a consensus conclusion.

• Journal of Genetic Medicine
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• 제20권2호
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• pp.31-38
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• 2023

Rare diseases, even though defined as fewer than 20,000 in South Korea, with over 8,000 rare Mendelian disorders having been identified, they collectively impact 6-8% of the global population. Many of the rare diseases pose significant challenges to patients, patients' families, and the healthcare system. The diagnostic journey for rare disease patients is often lengthy and arduous, hampered by the genetic diversity and phenotypic complexity of these conditions. With the advent of next-generation sequencing technology and clinical implementation of exome sequencing (ES) and genome sequencing (GS), the diagnostic rate for rare diseases is 25-50% depending on the disease category. It is also allowing more rapid new gene-disease association discovery and equipping us to practice precision medicine by offering tailored medical management plans, early intervention, family planning options. However, a substantial number of patients remain undiagnosed, and it could be due to several factors. Some may not have genetic disorders. Some may have disease-causing variants that are not detectable or interpretable by ES and GS. It's also possible that some patient might have a disease-causing variant in a gene that hasn't yet been linked to a disease. For patients who remain undiagnosed, reanalysis of existing data has shown promises in providing new molecular diagnoses achieved by new gene-disease associations, new variant discovery, and variant reclassification, leading to a 5-10% increase in the diagnostic rate. More advanced approach such as long-read sequencing, transcriptome sequencing and integration of multi-omics data may provide potential values in uncovering elusive genetic causes.

• Clinical and Experimental Pediatrics
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• 제58권3호
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• pp.84-88
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• 2015

Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects children, and can result in coronary artery lesions (CAL). A patient with KD who is resistant to treatment with intravenous immunoglobulin (IVIG) has a higher risk of developing CAL. Incomplete KD has increased in prevalence in recent years, and is another risk factor for the development of CAL. Although the pathogenesis of KD remains unclear, there has been increasing evidence for the role of genetic susceptibility to the disease since it was discovered in 1967. We retrospectively reviewed previous genetic research for known susceptibility genes in the pathogenesis of KD, IVIG resistance, and the development of CAL. This review revealed numerous potential susceptibility genes including genetic polymorphisms of ITPKC, CASP3, the transforming growth factor-${\beta}$ signaling pathway, B lymphoid tyrosine kinase, FCGR2A, KCNN2, and other genes, an imbalance of Th17/Treg, and a range of suggested future treatment options. The results of genetic research may improve our understanding of the pathogenesis of KD, and aid in the discovery of new treatment modalities for high-risk patients with KD.

• BMB Reports
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• 제50권11호
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• pp.535-536
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• 2017

A novel approach has been used to identify functional interactions relevant to human disease. Using high-throughput human-yeast genetic interaction screens, a first draft of disease interactome was obtained. This was achieved by first searching for candidate human disease genes that confer toxicity in yeast, and second, identifying modulators of toxicity. This study found potentially disease-relevant interactions by analyzing the network of functional interactions and focusing on genes implicated in amyotrophic lateral sclerosis (ALS), for example. In the subsequent proof-of-concept study focused on ALS, similar functional relationships between a specific kinase and ALS-associated genes were observed in mammalian cells and zebrafish, supporting findings in human-yeast genetic interaction screens. Results of combined analyses highlighted MAP2K5 kinase as a potential therapeutic target in ALS.

• Journal of Genetic Medicine
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• 제8권2호
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• pp.100-104
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• 2011

유전자 검사는 생명과학의 발달과 더불어 질병 진단 및 연구의 중요한 수단으로 일반화되고있으나, 태아에 대한 유전자 검사는 자기결정권이 없는 태아를 대상으로 하기 때문에 또 다른 윤리적, 사회적 문제가 있을 수 있으므로 특별한 주의를 기울여야 한다. 따라서 태아 유전자 검사를 시행하기 전에 유전 상담이 충분히 이루어져서 부모에게 병의 진단, 자연경과, 가능한 치료를 이해시키며, 질환의 유전방식과 가족의 재발 위험도를 평가하고 그에 따른 가능한 선택을 제시하여 가족들이 질환에 대해 최선의 결정을 할 수 있게 도움을 주어야 한다. 뿐만 아니라 태아 유전자 검사에 대한 현행법의 합리적인 법률 개정도 뒷받침되어야 한다.

• Genomics & Informatics
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• 제5권4호
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• pp.152-160
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• 2007

Most common diseases are caused by multiple genetic and environmental factors. Among the genetic factors, single nucleotide polymorphisms (SNPs) are common DNA sequence variations in individuals and can serve as important genetic markers. Recently, investigations of gene-based and whole genome-based SNPs have been applied to association studies for marker discovery. However, SNPs are so population-specific that the association needs to be verified. Fifty-five genes and 384 SNPs were selected based on association with disease. Genotypes of 337 SNPs in candidate genes were determined using Illumina Sentrix Array Matrix (SAM) chips by an allele-specific extension method in 364 unrelated Korean individuals. Allelic frequencies of SNPs were compared with those of other populations obtained from the International HapMap database. Minor allele frequencies, linkage disequilibrium blocks, tagSNPs, and haplotypes of functional candidate SNPs in 55 genetic disease-associated genes were provided. Our data may provide useful information for the selection of genetic markers for gene-based genetic disease-association studies of the Korean population.

• Journal of Genetic Medicine
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• 제4권2호
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• pp.186-189
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• 2007

현재까지 보고 된 유전질환을 포함한 희귀질환은 6000종이 넘으며, 이 중 2007년 12월 현재, 1,500종(임상검사 목적 1,211종과 연구 목적 289)의 유전자 검사가 가능하다. 외국의 경우, 원인 유전자가 밝혀지고 진단이 가능한 모든 유전질환에 대해 착상 전 및 산전 유전자검사가 가능한데 반해, 국내에서는 2005년 제정된 생명윤리 및 안전에 관한 법률 제25조 2항에 의해 착상전 및 산전 유전자검사가 가능한 유전 질환은 63종으로 제한되어 있다. 이 보고에서는, 63종으로 제한된 검사항목에 포함되어 있지 않아 산전 진단을 할 수 없게 된 최근의 증례를 검토하고 문제점과 대안에 대해 논의하였다. X-성염색체 연관 열성질환인 MNK의 보인자로 확진된 L씨(여 38세)는 2명의 자녀를 출산하였는데, 그중 1명은 MNK에 이환된 남아로 출생 후 사망하였다. L씨는 2003년에 산전 유전자검사를 실시하여 정상의 남아를 출산하였다. 현재 임신 중인 L씨는 MNK에 이환된 남아를 또다시 출산할 가능성이 50%로 산전 유전자 검사가 필요하지만, 2005년에 제정된 생명윤리 및 안전에 관한 법률에 의해 산전 유전자검사가 법적으로 불가능하였다. 이 증례는 유전질환 검사항목을 63종으로 제한한 현행법의 문제점과 질환 형평성의 문제점을 실질적으로 보여주고 있다. 질환 명에 상관없이 유전질환의 가족력이 있는 가족에게는 산전 유전자검사에 대한 자기결정의 기회가 제공되어야 할 것이며, 만일, 현행법의 개정이 현실적으로 불가능하다면, MNK처럼 3년 내에 사망에 이르는 등 질병의 정도가 심하며, 효과적인 치료 방법이 없는 질환에 대해서는 산모나 가족이 원하는 경우 전문의의 전문적인 판단에 근거하여 예외가 인정되어야 한다고 사료된다.

• Journal of Genetic Medicine
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• 제4권1호
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• pp.1-5
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• 2007

Unprecedented amount of genetic information being generated from the result of Human Genome Project (HGP) and advances in genetic research is already forcing changes in the paradigm of health and disease. The ultimate goal of genetic medicine is to use genetic information and technology to develop new ways of treatment or even prevention of the disease on an individual level for 'personalized medicine'. Genetics is play ing an increasingly important role in the diagnosis, monitoring and management of common multifactorial diseases in addition to rare single-gene disorders. While wide range of genetic testing have provided benefits to patients and family, uncertainties surrounding test interpretation, the current lack of available medical options for the diseases, and risks for discrimination and social stigmatization may remain to be resolved. However an increasing number of genetic tests are becoming commercially available, including direct to consumer genetic testing, yet public is often unaw are of their clinical and social implications. The personal nature of information generated by a genetic test, its power to affect major life decisions and family members, and its potential misuse raise important ethical considerations. Therefore appropriate genetic counseling is needed for patient to be informed with the benefits, limitations and risks of genetic tests, prior to informed consent for the tests. Physician also should be familiar with the legal and ethical issues involved in genetic testing to tell patients how w ell a particular genetic risk factor relates with likelihood of disease, and be able to provide appropriate genetic counseling. Genetic counseling become a mandatory requirement as global standard for many genetic testing such as prenatal diagnosis, presymtomatic DNA diagnostic tests and cancer susceptibility gene test for familial cancer syndrome. In oder to meet the challenge of genetic medicine of 21 century in korean health care system, professional education program and certification board for medical genetics specialist including non-MD genetic counselors should be addressed by medical society and regulatory policy of national health insurance reimbursement for genetic counseling to be in place to promote the implementation of clinical genetic service including genetic counseling for proper genetic testing.