在大规模测序或NGS(下一代测序)的概念下,多种高度复杂的诊断技术显着增加了儿科神经病学的诊断可能性。我们可以根据几个标准对它们进行分类。

历史标准(一代)。
19955111 {19955111:I5ZMYFCS} 1 温哥华 50 默认 2240 https://neuropediatoolkit.org/wp-content/plugins/zotpress/
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1.
Gupta N, Verma VK. Next-Generation Sequencing and Its Application: Empowering in Public Health Beyond Reality. In: Arora PK, editor. Microbial Technology for the Welfare of Society [Internet]. Singapore: Springer; 2019 [cited 2021 May 2]. p. 313–41. (Microorganisms for Sustainability). Available from: https://doi.org/10.1007/978-981-13-8844-6_15
  • Los métodos de secuenciación de segunda generación se basan en el principio del «鸟枪法测序«, y requieren la fragmentación del DNA en estudio, pero lamentablemente la longitud de las lecturas es corta (short-read sequencing), por lo que determinados tipos de mutaciones no son identificables (STR, delecciones o duplicaciones, etc.).
  • 第三代和第四代方法的开发就是为了克服这个限制,这就是为什么它们也被称为 长读长测序.
捕获类型。

所使用的捕获类型具有根本的临床重要性,因为它几乎比所使用的技术类型更能决定我们在未获得明确的诊断结果时必须做出的临床决策。

基因面板。
  • 它涉及最多大约 200 个基因的分析。
  • 它允许研究具有基因型变异的疾病,但需要生成先前的假设(表型优先方法)。
  • 它极大地限制了与所研究问题无关的发现数量以及不确定含义的变体。
临床/靶向/脑髓瘤外显子组测序研究
  • 它包括对先前已描述的疾病相关基因的所有编码区(编码区占基因组的1%,并积累了80%的已知致病变异)的分析(那些功能未知的基因即使发现致病变异也不能提供临床相关信息)。
  • 它允许在不提出先验假设(基因型优先方法)的情况下进行研究,并涉及超过 4000 个基因的分析(取决于科学知识的演变,目前在 奥米米 已经超过 6000),相当于大约 10 Mb 的大小。
  • 它允许检测侧翼非编码变体(3' 或 5' UTR 中的变体)。
  • 它不允许将功能未知的基因用于研究目的,因为它们不包括在内,因此也不允许对所述基因进行重新分析,因为尚未获得它们的序列。
  • 几年后对数据进行重新分析可能会很有趣,因为研究的基因数量意味着未来将发现的致病变异可能尚未被描述。
  • 它在不确定意义的变异风险和诊断盈利能力之间提供了良好的平衡,而不会增加分析整个外显子组或基因组的经济和劳动力成本。
外显子组测序研究。
  • 它可以检测蛋白质编码区的变异,无论是在已经与病理学相关的基因中还是在那些尚未描述的基因中,这就是为什么它涉及超过 20,000 个基因的分析,这相当于大约 100 Mb 的大小。
  • 它允许检测侧翼非编码变体(3' 或 5' UTR 中的变体)。
  • 它允许制定研究假设,并发现新的疾病和目前尚未得到很好描述的基因的未知功能。
  • 它允许在研究进行几年后重新分析数据以寻找新知识,而无需获取新样本。
  • 它显着增加了经济和工作成本。
  • 它显着增加了发现不确定意义和意外发现的可能性,这就是为什么建议以自动方式交叉引用家庭信息的三人组进行研究。
基因组测序研究。
  • 它可以检测蛋白质编码区的所有变异。
  • 它可以检测所有非编码变异(深内含子、3' 或 5' UTR 中的变异)。
  • 它允许检测调节区域(增强子、消音器、绝缘子)中的变异。
  • 它可以检测小缺失或重复(单个外显子)。
  • 它可以检测结构变异(易位、插入、缺失及其断点)。
  • 从经济和劳动力角度来看,这是最昂贵的过程。
  • 它显着增加了发现不确定意义和意外发现的可能性,这就是为什么建议以自动方式交叉引用家庭信息的三人组进行研究。
  • 它大约相当于 3 GB 的大小。

Puedes consultar los distintos tipos de captura comercializados para conocer su extensión.

测序技术类型
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1.
Gupta N, Verma VK. Next-Generation Sequencing and Its Application: Empowering in Public Health Beyond Reality. In: Arora PK, editor. Microbial Technology for the Welfare of Society [Internet]. Singapore: Springer; 2019 [cited 2021 May 2]. p. 313–41. (Microorganisms for Sustainability). Available from: https://doi.org/10.1007/978-981-13-8844-6_15
  • 有趣的是,由于 PCR 在这些区域遇到困难,使用扩增的方法可能会在分析富含 GC 的序列时产生偏差。

https://link.springer.com/chapter/10.1007/978-981-13-8844-6_15

https://info.abmgood.com/next-generation-sequencing-ngs