Monogenic diabetes is a heterogeneous disorder characterized by hyperglycemia arising from defects in a single gene.Maturity-onset diabetes of the young(MODY)is the most common type with 14 subtypes,each linked to spe...Monogenic diabetes is a heterogeneous disorder characterized by hyperglycemia arising from defects in a single gene.Maturity-onset diabetes of the young(MODY)is the most common type with 14 subtypes,each linked to specific mutations affecting insulin synthesis,secretion and glucose regulation.Common traits across MODY subtypes include early-onset diabetes,a family history of autosomal dominant diabetes,lack of features of insulin resistance,and absent islet cell autoimmunity.Many cases are misdiagnosed as type 1 and type 2 diabetes mellitus.Biomarkers and scoring systems can help identify candidates for genetic testing.GCK-MODY,a common subtype,manifests as mild hyperglycemia and doesn’t require treatment except during pregnancy.In contrast,mutations in HNF4A,HNF1A,and HNF1B genes lead to progressive beta-cell failure and similar risks of complications as type 2 diabetes mellitus.Neonatal diabetes mellitus(NDM)is a rare form of monogenic diabetes that usually presents within the first six months.Half of the cases are lifelong,while others experience transient remission.Permanent NDM is most commonly due to activating mutations in genes encoding the adenosine triphosphate-sensitive potassium channel(KCNJ11 or ABCC8)and can be transitioned to sulfonylurea after confirmation of diagnosis.Thus,in many cases,monogenic diabetes offers an opportunity to provide precision treatment.The scope has broadened with next-generation sequencing(NGS)technologies,replacing older methods like Sanger sequencing.NGS can be for targeted gene panels,whole-exome sequencing(WES),or whole-genome sequencing.Targeted gene panels offer specific information efficiently,while WES provides comprehensive data but comes with bioinformatic challenges.The surge in testing has also led to an increase in variants of unknown significance(VUS).Deciding whether VUS is disease-causing or benign can be challenging.Computational models,functional studies,and clinical knowledge help to determine pathogenicity.Advances in genetic testing technologies offer hope for improved diagnosis and personalized treatment but also raise concerns about interpretation and ethics.展开更多
With diabetes currently affecting 537 million people globally,innovative research approaches are urgently required.Zebrafish(Danio rerio)has emerged as a pivotal model organism in diabetes research,particularly valuab...With diabetes currently affecting 537 million people globally,innovative research approaches are urgently required.Zebrafish(Danio rerio)has emerged as a pivotal model organism in diabetes research,particularly valuable for developmental biology studies and preclinical therapeutic validation.Its rapid life cycle,optical transparency,and genetic tractability collectively enable efficient longitudinal observation of pathological progression and pharmacological responses.Utilizing zebrafish models,researchers have elucidated fundamental mechanisms governing islet development,β-cell dysfunction,and metabolic dysregulation.These experimental systems have significantly advanced our understanding of various diabetes subtypes,including type 1,type 2,gestational,and monogenic forms,while also facilitating mechanistic studies of diabetic complications such as retinopathy and nephropathy.Recent model refinements,particularly in simulating monogenic disorders and pregnancy-associated metabolic changes,promise to deepen our comprehension of disease pathophysiology and therapeutic interventions.Nevertheless,a persistent limitation lies in their incomplete recapitulation of human-specific physiological complexity and multi-organ metabolic interactions,factors that may influence translational applicability.Despite these constraints,zebrafish-based research continues to provide an indispensable platform for diabetes investigation,holding significant promise for alleviating the escalating global burden of this metabolic disorder.展开更多
Inflammatory bowel disease(IBD)is a group of chronic disorders that cause relapsing inflammation in the gastrointestinal tract(GIT).It results either from gene-environment interactions or as a monogenic disease result...Inflammatory bowel disease(IBD)is a group of chronic disorders that cause relapsing inflammation in the gastrointestinal tract(GIT).It results either from gene-environment interactions or as a monogenic disease resulting from pa-thogenic mutations causing impairment in the protective mechanism of the GIT.Around 10%-15%of patients with very early onset IBDs may have an underlying monogenic condition.Monogenic IBD is very different from complex forms of polygenic IBD in the underlying molecular basis of uncontrolled intestinal inflam-mation,age of onset,extraintestinal comorbidities as well as treatment modality.An in-depth understanding of this distinct form of IBD is essential for deciding an appropriate therapeutic approach as well as prognostication.In this review,we aim to discuss about the epidemiology,clinical presentation,diagnostic approach,therapeutic challenges and latest advances in patients with monogenic IBD.展开更多
Monogenic disorders refer to a group of human diseases caused by mutations in single genes. While disease-modifying therapies have offered some relief from symptoms and delayed progression for some monogenic diseases,...Monogenic disorders refer to a group of human diseases caused by mutations in single genes. While disease-modifying therapies have offered some relief from symptoms and delayed progression for some monogenic diseases, most of these diseases still lack effective treatments. In recent decades, gene therapy has emerged as a promising therapeutic strategy for genetic disorders. Researchers have developed various gene manipulation tools and gene delivery systems to treat monogenic diseases. Despite this progress, concerns about inefficient delivery, persistent expression, immunogenicity, toxicity, capacity limitation, genomic integration, and limited tissue specificity still need to be addressed. This review gives an overview of commonly used gene therapy and delivery tools, along with the challenges they face and potential strategies to counter them.展开更多
Monogenic diabetes is caused by one or even more genetic variations,which may be uncommon yet have a significant influence and cause diabetes at an early age.Monogenic diabetes affects 1%to 5%of children,and early det...Monogenic diabetes is caused by one or even more genetic variations,which may be uncommon yet have a significant influence and cause diabetes at an early age.Monogenic diabetes affects 1%to 5%of children,and early detection and genetically focused treatment of neonatal diabetes and maturity-onset diabetes of the young can significantly improve long-term health and well-being.The etiology of monogenic diabetes in childhood is primarily attributed to genetic variations affecting the regulatory genes responsible for beta-cell activity.In rare instances,mutations leading to severe insulin resistance can also result in the development of diabetes.Individuals diagnosed with specific types of monogenic diabetes,which are commonly found,can transition from insulin therapy to sulfonylureas,provided they maintain consistent regulation of their blood glucose levels.Scientists have successfully devised materials and methodologies to distinguish individuals with type 1 or 2 diabetes from those more prone to monogenic diabetes.Genetic screening with appropriate findings and interpretations is essential to establish a prognosis and to guide the choice of therapies and management of these interrelated ailments.This review aims to design a comprehensive literature summarizing genetic insights into monogenetic diabetes in children and adolescents as well as summarizing their diagnosis and management.展开更多
Monogenic diabetes,constituting 1%-2%of global diabetes cases,arises from single gene defects with distinctive inheritance patterns.Despite over 50 associated genetic disorders,accurate diagnoses and management of mon...Monogenic diabetes,constituting 1%-2%of global diabetes cases,arises from single gene defects with distinctive inheritance patterns.Despite over 50 associated genetic disorders,accurate diagnoses and management of monogenic diabetes remain inadequate,underscoring insufficient clinician awareness.The disease spectrum encompasses maturity-onset diabetes of the young(MODY),characterized by distinct genetic mutations affecting insulin secretion,and neonatal diabetes mellitus(NDM)-a heterogeneous group of severe hyperglycemic disorders in infants.Mitochondrial diabetes,autoimmune monogenic diabetes,genetic insulin resistance and lipodystrophy syndromes further diversify the monogenic diabetes landscape.A tailored approach based on phenotypic and biochemical factors to identify candidates for genetic screening is recommended for suspected cases of MODY.NDM diagnosis warrants immediate molecular genetic testing for infants under six months.Identifying these genetic defects presents a unique opportunity for precision medicine.Ongoing research aimed to develop cost-effective genetic testing methods and gene-based therapy can facilitate appropriate identification and optimize clinical outcomes.Identification and study of new genes offer a valuable opportunity to gain deeper insights into pancreatic cell biology and the pathogenic mechanisms underlying common forms of diabetes.The clinical review published in the recent issue of World Journal of Diabetes is such an attempt to fill-in our knowledge gap about this enigmatic disease.展开更多
BACKGROUND Monogenic forms of diabetes(MFD)are single gene disorders.Their diagnosis is challenging,and symptoms overlap with type 1 and type 2 diabetes.AIM To identify the genetic variants responsible for MFD in the ...BACKGROUND Monogenic forms of diabetes(MFD)are single gene disorders.Their diagnosis is challenging,and symptoms overlap with type 1 and type 2 diabetes.AIM To identify the genetic variants responsible for MFD in the Pakistani population and their frequencies.METHODS A total of 184 patients suspected of having MFD were enrolled.The inclusion criterion was diabetes with onset below 25 years of age.Brief demographic and clinical information were taken from the participants.The maturity-onset diabetes of the young(MODY)probability score was calculated,and glutamate decarboxylase ELISA was performed.Antibody negative patients and features resembling MODY were selected(n=28)for exome sequencing to identify the pathogenic variants.RESULTS A total of eight missense novel or very low-frequency variants were identified in 7 patients.Three variants were found in genes for MODY,i.e.HNF1A(c.169C>A,p.Leu57Met),KLF11(c.401G>C,p.Gly134Ala),and HNF1B(c.1058C>T,p.Ser353Leu).Five variants were found in genes other than the 14 known MODY genes,i.e.RFX6(c.919G>A,p.Glu307Lys),WFS1(c.478G>A,p.Glu160Lys)and WFS1(c.517G>A,p.Glu173Lys),RFX6(c.1212T>A,p.His404Gln)and ZBTB20(c.1049G>A,p.Arg350His).CONCLUSION The study showed wide spectrum of genetic variants potentially causing MFD in the Pakistani population.The MODY genes prevalent in European population(GCK,HNF1A,and HNF4a)were not found to be common in our population.Identification of novel variants will further help to understand the role of different genes causing the pathogenicity in MODY patient and their proper management and diagnosis.展开更多
Monogenic diabetes is caused by one or even more genetic variations, which maybe uncommon yet have a significant influence and cause diabetes at an early age.Monogenic diabetes affects 1 to 5% of children, and early d...Monogenic diabetes is caused by one or even more genetic variations, which maybe uncommon yet have a significant influence and cause diabetes at an early age.Monogenic diabetes affects 1 to 5% of children, and early detection and geneticallyfocused treatment of neonatal diabetes and maturity-onset diabetes of theyoung can significantly improve long-term health and well-being. The etiology ofmonogenic diabetes in childhood is primarily attributed to genetic variationsaffecting the regulatory genes responsible for beta-cell activity. In rare instances,mutations leading to severe insulin resistance can also result in the developmentof diabetes. Individuals diagnosed with specific types of monogenic diabetes,which are commonly found, can transition from insulin therapy to sulfonylureas,provided they maintain consistent regulation of their blood glucose levels.Scientists have successfully devised materials and methodologies to distinguishindividuals with type 1 or 2 diabetes from those more prone to monogenicdiabetes. Genetic screening with appropriate findings and interpretations isessential to establish a prognosis and to guide the choice of therapies andmanagement of these interrelated ailments. This review aims to design a comprehensiveliterature summarizing genetic insights into monogenetic diabetes inchildren and adolescents as well as summarizing their diagnosis and management.展开更多
Recent and advanced protocols are now available to derive human induced pluripotent stem cells (hiPSCs) from patients affected by genetic diseases. No curative treatments are available for many of these diseases; thus...Recent and advanced protocols are now available to derive human induced pluripotent stem cells (hiPSCs) from patients affected by genetic diseases. No curative treatments are available for many of these diseases; thus, hiPSCs represent a major impact on patient’ health. hiPSCs represent a valid model for the in vitro study of monogenic diseases, together with a better comprehension of the pathogenic mechanisms of the pathology, for both cell and gene therapy protocol applications. Moreover, these pluripotent cells represent a good opportunity to test innovative pharmacological treatments focused on evaluating the efficacy and toxicity of novel drugs. Today, innovative gene therapy protocols, especially gene editing-based, are being developed, allowing the use of these cells not only as in vitro disease models but also as an unlimited source of cells useful for tissue regeneration and regenerative medicine, eluding ethical and immune rejection problems. In this review, we will provide an up-to-date of modelling monogenic disease by using hiPSCs and the ultimate applications of these in vitro models for cell therapy. We consider and summarize some peculiar aspects such as the type of parental cells used for reprogramming, the methods currently used to induce the transcription of the reprogramming factors, and the type of iPSC-derived differentiated cells, relating them to the genetic basis of diseases and to their inheritance model.展开更多
We offer a new approach to deal with the pointwise convergence of FourierLaplace series on the unit sphere of even-dimensional Euclidean spaces. By using spherical monogenics defined through the generalized Cauchy-Rie...We offer a new approach to deal with the pointwise convergence of FourierLaplace series on the unit sphere of even-dimensional Euclidean spaces. By using spherical monogenics defined through the generalized Cauchy-Riemann operator, we obtain the spherical monogenic expansions of square integrable functions on the unit sphere. Based on the generalization of Fueter＇s theorem inducing monogenic functions from holomorphic functions in the complex plane and the classical Carleson＇s theorem, a pointwise convergence theorem on the new expansion is proved. The result is a generalization of Carleson＇s theorem to the higher dimensional Euclidean spaces. The approach is simpler than those by using special functions, which may have the advantage to induce the singular integral approach for pointwise convergence problems on the spheres.展开更多
During the past few decades, the investigative technologies of molecular biology- especially sequencing-underwent huge advances, leading to the sequencing of the entire human genome, as well as the identification of s...During the past few decades, the investigative technologies of molecular biology- especially sequencing-underwent huge advances, leading to the sequencing of the entire human genome, as well as the identification of several candidate genes and the causative geneticvariations that are responsible for monogenic skin diseases. These advances provided a solid basis for subsequent studies elucidating mechanisms of monogenic skin diseases and improving our understanding of common skin diseases. Furthermore, these discoveries also contributed to the development of novel therapeutic modalities for monogenic skin diseases. In this review, we have used the disease spectrum caused by mutations in the CYLD gene- Brooke-Spiegler syndrome, familial cylindromatosis and multiple familial trichoepithelioma type 1- as a model for demonstrating the knowledge explosion for this group of diseases.展开更多
Monogenic binary coding （MBC） have been known to be effective for local feature extraction, while sparse or collaborative representation based classification （CRC） has shown interesting results in robust face reco...Monogenic binary coding （MBC） have been known to be effective for local feature extraction, while sparse or collaborative representation based classification （CRC） has shown interesting results in robust face recognition. In this paper, a novel face recognition algorithm of fusing MBC and CRC named M-CRC is proposed; in which the dimensionality problem is resolved by projection matrix. The proposed algorithm is evaluated on benchmark face databases, including AR, PolyU-NIR and CAS-PEAL. The results indicate a significant increase in the performance when compared with state-of-the-art face recognition methods.展开更多
Background Monogenic lupus is defined as systemic lupus erythematosus(SLE)/SLE-like patients with either dominantly or recessively inherited pathogenic variants in a single gene with high penetrance.However,because th...Background Monogenic lupus is defined as systemic lupus erythematosus(SLE)/SLE-like patients with either dominantly or recessively inherited pathogenic variants in a single gene with high penetrance.However,because the clinical phenotype of monogenic SLE is extensive and overlaps with that of classical SLE,it causes a delay in diagnosis and treatment.Currently,there is a lack of early identification models for clinical practitioners to provide early clues for recognition.Our goal was to create a clinical model for the early identification of pediatric monogenic lupus,thereby facilitating early and precise diagnosis and treatment for patients.Methods This retrospective cohort study consisted of 41 cases of monogenic lupus treated at the Department of Pediatrics at Peking Union Medical College Hospital from June 2012 to December 2022.The control group consisted of classical SLE patients recruited at a 1:2 ratio.Patients were randomly divided into a training group and a validation group at a 7:3 ratio.A logistic regression model was established based on the least absolute shrinkage and selection operator to generate the coefficient plot.The predictive ability of the model was evaluated using receiver operator characteristic curves and the area under the curve(AUC)index.Results A total of 41 cases of monogenic lupus patients and 82 cases of classical SLE patients were included.Among the monogenic lupus cases(with a male-to-female ratio of 1:1.05 and ages of onset ranging from birth to 15 years),a total of 18 gene mutations were identified.The variables included in the coefficient plot were age of onset,recurrent infections,intracranial calcifications,growth and developmental delay,abnormal muscle tone,lymphadenopathy/hepatosplenomegaly,and chilblain-like skin rash.Our model demonstrated satisfactory diagnostic performance through internal validation,with an AUC value of 0.97(95% confidence interval=0.92–0.97).Conclusions We summarized and analyzed the clinical characteristics of pediatric monogenic lupus and developed a predictive model for early identification by clinicians.Clinicians should exercise high vigilance for monogenic lupus when the score exceeds -9.032299.展开更多
Background Newborn screening(NBS)is an important and successful public health program that helps improve the long-term clinical outcomes of newborns by providing early diagnosis and treatment of certain inborn disease...Background Newborn screening(NBS)is an important and successful public health program that helps improve the long-term clinical outcomes of newborns by providing early diagnosis and treatment of certain inborn diseases.The develop-ment of next-generation sequencing(NGS)technology provides new opportunities to expand current newborn screening methodologies.Methods We designed a a newborn genetic screening(NBGS)panel targeting 135 genes associated with 75 inborn disorders by multiplex PCR combined with NGS.With this panel,a large-scale,multicenter,prospective multidisease analysis was conducted on dried blood spot(DBS)profiles from 21,442 neonates nationwide.Results We presented the positive detection rate and carrier frequency of diseases and related variants in different regions;and 168(0.78%)positive cases were detected.Glucose-6-Phosphate Dehydrogenase deficiency(G6PDD)and phenylketonuria(PKU)had higher prevalence rates,which were significantly different in different regions.The positive detection of G6PD variants was quite common in south China,whereas PAH variants were most commonly identified in north China.In addi-tion,NBGS identified 3 cases with DUOX2 variants and one with SLC25A13 variants,which were normal in conventional NBS,but were confirmed later as abnormal in repeated biochemical testing after recall.Eighty percent of high-frequency gene carriers and 60%of high-frequency variant carriers had obvious regional differences.On the premise that there was no significant difference in birth weight and gestational age,the biochemical indicators of SLC22A5 c.1400C>G and ACADSB c.1165A>G carriers were significantly different from those of non-carriers.Conclusions We demonstrated that NBGS is an effective strategy to identify neonates affected with treatable diseases as a supplement to current NBS methods.Our data also showed that the prevalence of diseases has significant regional charac-teristics,which provides a theoretical basis for screening diseases in different regions.展开更多
BACKGROUND Dyschromatosis universalis hereditaria(DUH)is a rare type of autosomal dominant inheritance disease.It has varying gene mutation sites among different ethnicities.SASH1 and ABCB6 have been identified as the...BACKGROUND Dyschromatosis universalis hereditaria(DUH)is a rare type of autosomal dominant inheritance disease.It has varying gene mutation sites among different ethnicities.SASH1 and ABCB6 have been identified as the causative genes of this disorder.CASE SUMMARY A 30-year-old woman presented with irregular black pigmentation spots to our department.Upon examination,the pigmentations were found to be especially dense on the extremities and the face.She had no family history of inbreeding,nor any previous chemical exposure.Genetic testing confirmed that the disease occu-rred because the patient has a SASH1 gene mutation.Following the use of assisted reproductive technology and preimplantation genetic testing for monogenic disorders,the patient give birth to a health baby.CONCLUSION Using assisted reproductive technology/preimplantation genetic testing for monogenic disorders is an option for DUH patients to reduce the risk of trans-mitting the pathogenic variant to their offspring.展开更多
BACKGROUND Wolfram syndrome is a rare autosomal recessive genetic disorder characterized by early-onset diabetes and progressive neurodegeneration,most notably sensorineural hearing loss and optic atrophy.Because its ...BACKGROUND Wolfram syndrome is a rare autosomal recessive genetic disorder characterized by early-onset diabetes and progressive neurodegeneration,most notably sensorineural hearing loss and optic atrophy.Because its initial manifestations are usually similar to those of type 1 diabetes,the diagnosis may be delayed until other manifestations appear.Pathogenic variations of the WFS1 gene can disrupt endoplasmic reticulum function and cellular homeostasis,but the complete mutation spectrum of WFS1 has not been fully determined.Early identification of monogenic diabetes caused by Wolfram syndrome is of vital importance,as it enables the provision of targeted multidisciplinary care and genetic counseling for affected families.CASE SUMMARY A 2-year-old Han Chinese girl was admitted with a 1-month history of polydipsia,polyuria,and polyphagia,and was diagnosed with diabetic ketoacidosis and impaired insulin secretion.Sensorineural hearing loss was also detected.Wholeexome sequencing identified a previously unreported heterozygous mutation,WFS1 c.986T>C(p.Phe329Ser),in the patient and her father,confirming the diagnosis of Wolfram syndrome.Bioinformatic analysis supported the likely pathogenicity of this mutation.In silico pathogenicity predictors(REVEL,SIFT,Poly-Phen-2,MutationTaster,and GERP+)supported a deleterious effect on wolframin structure and function.The patient was initially treated with intravenous insulin and fluid resuscitation,then transitioned to a basal–bolus insulin regimen.Glycemic control was subsequently maintained with continuous subcutaneous insulin infusion and intermittent subcutaneous injections.At the 1-and 6-month follow-ups,blood glucose remained well controlled(hemoglobin A1c:5.89%and 6.58%,respectively),with no evidence of organ dysfunction or further complications.CONCLUSION This case identifies WFS1 c.986T>C(p.Phe329Ser)as a novel pathogenic variant causing Wolfram syndrome.It highlights the importance of early genetic testing in pediatric patients with atypical diabetes presentations to enable timely diagnosis,individualized therapy,and comprehensive family support.展开更多
We study the adaptive decomposition of functions in the monogenic Hardy spaces H2by higher order Szeg kernels under the framework of Clifford algebra and Clifford analysis,in the context of unit ball and half space.Th...We study the adaptive decomposition of functions in the monogenic Hardy spaces H2by higher order Szeg kernels under the framework of Clifford algebra and Clifford analysis,in the context of unit ball and half space.This is a sequel and a higher-dimensional generalization of our recent study on the complex Hardy spaces.展开更多
New higher-dimensional distributions have been introduced in the framework of Clifford analysis in previous papers by Brackx, Delanghe and Sommen. Those distributions were defined using spherical co-ordinates, the ＂f...New higher-dimensional distributions have been introduced in the framework of Clifford analysis in previous papers by Brackx, Delanghe and Sommen. Those distributions were defined using spherical co-ordinates, the ＂finite part＂ distribution Fp x＋^μ on the real line and the generalized spherical means involving vector-valued spherical monogenics. In this paper, we make a second generalization, leading to new families of distributions, based on the generalized spherical means involving a multivector-valued spherical monogenic. At the same time, as a result of our attempt at keeping the paper self-contained, it offers an overview of the results found so far.展开更多
With the increasing awareness of genetics in respiratory medicine and improvements in molecular diagnostic techniques,many complicated and rare diseases in respiratory medicine can be diagnosed.Most respiratory diseas...With the increasing awareness of genetics in respiratory medicine and improvements in molecular diagnostic techniques,many complicated and rare diseases in respiratory medicine can be diagnosed.Most respiratory diseases have no specific phenotype.However,the clinical spectrum of monogenic diseases in respiratory medicine varies,from pulmonary disease to other inherited disorders that involve the lung.The genes that mediate some of these diseases have been identified.Certain monogenic diseases remain poorly characterized clinically.Because of the specificity of the phenotype of respiratory disease,a future challenge will be to correlate the phenotype and genotype and understand its phenotypic variability.With the development of precision medicine,research on monogenic disorders has been intensive and vigorous.In this article,we provide a brief clinical introduction to monogenic diseases in pediatrics.展开更多
文摘Monogenic diabetes is a heterogeneous disorder characterized by hyperglycemia arising from defects in a single gene.Maturity-onset diabetes of the young(MODY)is the most common type with 14 subtypes,each linked to specific mutations affecting insulin synthesis,secretion and glucose regulation.Common traits across MODY subtypes include early-onset diabetes,a family history of autosomal dominant diabetes,lack of features of insulin resistance,and absent islet cell autoimmunity.Many cases are misdiagnosed as type 1 and type 2 diabetes mellitus.Biomarkers and scoring systems can help identify candidates for genetic testing.GCK-MODY,a common subtype,manifests as mild hyperglycemia and doesn’t require treatment except during pregnancy.In contrast,mutations in HNF4A,HNF1A,and HNF1B genes lead to progressive beta-cell failure and similar risks of complications as type 2 diabetes mellitus.Neonatal diabetes mellitus(NDM)is a rare form of monogenic diabetes that usually presents within the first six months.Half of the cases are lifelong,while others experience transient remission.Permanent NDM is most commonly due to activating mutations in genes encoding the adenosine triphosphate-sensitive potassium channel(KCNJ11 or ABCC8)and can be transitioned to sulfonylurea after confirmation of diagnosis.Thus,in many cases,monogenic diabetes offers an opportunity to provide precision treatment.The scope has broadened with next-generation sequencing(NGS)technologies,replacing older methods like Sanger sequencing.NGS can be for targeted gene panels,whole-exome sequencing(WES),or whole-genome sequencing.Targeted gene panels offer specific information efficiently,while WES provides comprehensive data but comes with bioinformatic challenges.The surge in testing has also led to an increase in variants of unknown significance(VUS).Deciding whether VUS is disease-causing or benign can be challenging.Computational models,functional studies,and clinical knowledge help to determine pathogenicity.Advances in genetic testing technologies offer hope for improved diagnosis and personalized treatment but also raise concerns about interpretation and ethics.
基金Supported by Natural Science Foundation of Zhejiang Province,China,No.LQ24H070007。
文摘With diabetes currently affecting 537 million people globally,innovative research approaches are urgently required.Zebrafish(Danio rerio)has emerged as a pivotal model organism in diabetes research,particularly valuable for developmental biology studies and preclinical therapeutic validation.Its rapid life cycle,optical transparency,and genetic tractability collectively enable efficient longitudinal observation of pathological progression and pharmacological responses.Utilizing zebrafish models,researchers have elucidated fundamental mechanisms governing islet development,β-cell dysfunction,and metabolic dysregulation.These experimental systems have significantly advanced our understanding of various diabetes subtypes,including type 1,type 2,gestational,and monogenic forms,while also facilitating mechanistic studies of diabetic complications such as retinopathy and nephropathy.Recent model refinements,particularly in simulating monogenic disorders and pregnancy-associated metabolic changes,promise to deepen our comprehension of disease pathophysiology and therapeutic interventions.Nevertheless,a persistent limitation lies in their incomplete recapitulation of human-specific physiological complexity and multi-organ metabolic interactions,factors that may influence translational applicability.Despite these constraints,zebrafish-based research continues to provide an indispensable platform for diabetes investigation,holding significant promise for alleviating the escalating global burden of this metabolic disorder.
文摘Inflammatory bowel disease(IBD)is a group of chronic disorders that cause relapsing inflammation in the gastrointestinal tract(GIT).It results either from gene-environment interactions or as a monogenic disease resulting from pa-thogenic mutations causing impairment in the protective mechanism of the GIT.Around 10%-15%of patients with very early onset IBDs may have an underlying monogenic condition.Monogenic IBD is very different from complex forms of polygenic IBD in the underlying molecular basis of uncontrolled intestinal inflam-mation,age of onset,extraintestinal comorbidities as well as treatment modality.An in-depth understanding of this distinct form of IBD is essential for deciding an appropriate therapeutic approach as well as prognostication.In this review,we aim to discuss about the epidemiology,clinical presentation,diagnostic approach,therapeutic challenges and latest advances in patients with monogenic IBD.
文摘Monogenic disorders refer to a group of human diseases caused by mutations in single genes. While disease-modifying therapies have offered some relief from symptoms and delayed progression for some monogenic diseases, most of these diseases still lack effective treatments. In recent decades, gene therapy has emerged as a promising therapeutic strategy for genetic disorders. Researchers have developed various gene manipulation tools and gene delivery systems to treat monogenic diseases. Despite this progress, concerns about inefficient delivery, persistent expression, immunogenicity, toxicity, capacity limitation, genomic integration, and limited tissue specificity still need to be addressed. This review gives an overview of commonly used gene therapy and delivery tools, along with the challenges they face and potential strategies to counter them.
文摘Monogenic diabetes is caused by one or even more genetic variations,which may be uncommon yet have a significant influence and cause diabetes at an early age.Monogenic diabetes affects 1%to 5%of children,and early detection and genetically focused treatment of neonatal diabetes and maturity-onset diabetes of the young can significantly improve long-term health and well-being.The etiology of monogenic diabetes in childhood is primarily attributed to genetic variations affecting the regulatory genes responsible for beta-cell activity.In rare instances,mutations leading to severe insulin resistance can also result in the development of diabetes.Individuals diagnosed with specific types of monogenic diabetes,which are commonly found,can transition from insulin therapy to sulfonylureas,provided they maintain consistent regulation of their blood glucose levels.Scientists have successfully devised materials and methodologies to distinguish individuals with type 1 or 2 diabetes from those more prone to monogenic diabetes.Genetic screening with appropriate findings and interpretations is essential to establish a prognosis and to guide the choice of therapies and management of these interrelated ailments.This review aims to design a comprehensive literature summarizing genetic insights into monogenetic diabetes in children and adolescents as well as summarizing their diagnosis and management.
文摘Monogenic diabetes,constituting 1%-2%of global diabetes cases,arises from single gene defects with distinctive inheritance patterns.Despite over 50 associated genetic disorders,accurate diagnoses and management of monogenic diabetes remain inadequate,underscoring insufficient clinician awareness.The disease spectrum encompasses maturity-onset diabetes of the young(MODY),characterized by distinct genetic mutations affecting insulin secretion,and neonatal diabetes mellitus(NDM)-a heterogeneous group of severe hyperglycemic disorders in infants.Mitochondrial diabetes,autoimmune monogenic diabetes,genetic insulin resistance and lipodystrophy syndromes further diversify the monogenic diabetes landscape.A tailored approach based on phenotypic and biochemical factors to identify candidates for genetic screening is recommended for suspected cases of MODY.NDM diagnosis warrants immediate molecular genetic testing for infants under six months.Identifying these genetic defects presents a unique opportunity for precision medicine.Ongoing research aimed to develop cost-effective genetic testing methods and gene-based therapy can facilitate appropriate identification and optimize clinical outcomes.Identification and study of new genes offer a valuable opportunity to gain deeper insights into pancreatic cell biology and the pathogenic mechanisms underlying common forms of diabetes.The clinical review published in the recent issue of World Journal of Diabetes is such an attempt to fill-in our knowledge gap about this enigmatic disease.
基金Canadian Institutes of Health Research,No.PJT-159715.
文摘BACKGROUND Monogenic forms of diabetes(MFD)are single gene disorders.Their diagnosis is challenging,and symptoms overlap with type 1 and type 2 diabetes.AIM To identify the genetic variants responsible for MFD in the Pakistani population and their frequencies.METHODS A total of 184 patients suspected of having MFD were enrolled.The inclusion criterion was diabetes with onset below 25 years of age.Brief demographic and clinical information were taken from the participants.The maturity-onset diabetes of the young(MODY)probability score was calculated,and glutamate decarboxylase ELISA was performed.Antibody negative patients and features resembling MODY were selected(n=28)for exome sequencing to identify the pathogenic variants.RESULTS A total of eight missense novel or very low-frequency variants were identified in 7 patients.Three variants were found in genes for MODY,i.e.HNF1A(c.169C>A,p.Leu57Met),KLF11(c.401G>C,p.Gly134Ala),and HNF1B(c.1058C>T,p.Ser353Leu).Five variants were found in genes other than the 14 known MODY genes,i.e.RFX6(c.919G>A,p.Glu307Lys),WFS1(c.478G>A,p.Glu160Lys)and WFS1(c.517G>A,p.Glu173Lys),RFX6(c.1212T>A,p.His404Gln)and ZBTB20(c.1049G>A,p.Arg350His).CONCLUSION The study showed wide spectrum of genetic variants potentially causing MFD in the Pakistani population.The MODY genes prevalent in European population(GCK,HNF1A,and HNF4a)were not found to be common in our population.Identification of novel variants will further help to understand the role of different genes causing the pathogenicity in MODY patient and their proper management and diagnosis.
文摘Monogenic diabetes is caused by one or even more genetic variations, which maybe uncommon yet have a significant influence and cause diabetes at an early age.Monogenic diabetes affects 1 to 5% of children, and early detection and geneticallyfocused treatment of neonatal diabetes and maturity-onset diabetes of theyoung can significantly improve long-term health and well-being. The etiology ofmonogenic diabetes in childhood is primarily attributed to genetic variationsaffecting the regulatory genes responsible for beta-cell activity. In rare instances,mutations leading to severe insulin resistance can also result in the developmentof diabetes. Individuals diagnosed with specific types of monogenic diabetes,which are commonly found, can transition from insulin therapy to sulfonylureas,provided they maintain consistent regulation of their blood glucose levels.Scientists have successfully devised materials and methodologies to distinguishindividuals with type 1 or 2 diabetes from those more prone to monogenicdiabetes. Genetic screening with appropriate findings and interpretations isessential to establish a prognosis and to guide the choice of therapies andmanagement of these interrelated ailments. This review aims to design a comprehensiveliterature summarizing genetic insights into monogenetic diabetes inchildren and adolescents as well as summarizing their diagnosis and management.
基金Supported by Agenzia Spaziale Italiana(ASI),CoReA,No2013-084-R.0
文摘Recent and advanced protocols are now available to derive human induced pluripotent stem cells (hiPSCs) from patients affected by genetic diseases. No curative treatments are available for many of these diseases; thus, hiPSCs represent a major impact on patient’ health. hiPSCs represent a valid model for the in vitro study of monogenic diseases, together with a better comprehension of the pathogenic mechanisms of the pathology, for both cell and gene therapy protocol applications. Moreover, these pluripotent cells represent a good opportunity to test innovative pharmacological treatments focused on evaluating the efficacy and toxicity of novel drugs. Today, innovative gene therapy protocols, especially gene editing-based, are being developed, allowing the use of these cells not only as in vitro disease models but also as an unlimited source of cells useful for tissue regeneration and regenerative medicine, eluding ethical and immune rejection problems. In this review, we will provide an up-to-date of modelling monogenic disease by using hiPSCs and the ultimate applications of these in vitro models for cell therapy. We consider and summarize some peculiar aspects such as the type of parental cells used for reprogramming, the methods currently used to induce the transcription of the reprogramming factors, and the type of iPSC-derived differentiated cells, relating them to the genetic basis of diseases and to their inheritance model.
基金Sponsored by Research Grant of the University of Macao No. RG024/03-04S/QT/FST
文摘We offer a new approach to deal with the pointwise convergence of FourierLaplace series on the unit sphere of even-dimensional Euclidean spaces. By using spherical monogenics defined through the generalized Cauchy-Riemann operator, we obtain the spherical monogenic expansions of square integrable functions on the unit sphere. Based on the generalization of Fueter＇s theorem inducing monogenic functions from holomorphic functions in the complex plane and the classical Carleson＇s theorem, a pointwise convergence theorem on the new expansion is proved. The result is a generalization of Carleson＇s theorem to the higher dimensional Euclidean spaces. The approach is simpler than those by using special functions, which may have the advantage to induce the singular integral approach for pointwise convergence problems on the spheres.
基金Supported by The European Union and the State of Hungaryco-financed by the European Social Fund in the framework of TáMOP-4.2.4.A/ 2-11/1-2012-0001 "National Excellence Program"+1 种基金by the Hungarian Scientific Research Fund (OTKA) PD104782 grant (to Nikoletta Nagy)by the TáMOP-4.2.2.A-11-1-KONV-2012-0035 grant
文摘During the past few decades, the investigative technologies of molecular biology- especially sequencing-underwent huge advances, leading to the sequencing of the entire human genome, as well as the identification of several candidate genes and the causative geneticvariations that are responsible for monogenic skin diseases. These advances provided a solid basis for subsequent studies elucidating mechanisms of monogenic skin diseases and improving our understanding of common skin diseases. Furthermore, these discoveries also contributed to the development of novel therapeutic modalities for monogenic skin diseases. In this review, we have used the disease spectrum caused by mutations in the CYLD gene- Brooke-Spiegler syndrome, familial cylindromatosis and multiple familial trichoepithelioma type 1- as a model for demonstrating the knowledge explosion for this group of diseases.
文摘Monogenic binary coding （MBC） have been known to be effective for local feature extraction, while sparse or collaborative representation based classification （CRC） has shown interesting results in robust face recognition. In this paper, a novel face recognition algorithm of fusing MBC and CRC named M-CRC is proposed; in which the dimensionality problem is resolved by projection matrix. The proposed algorithm is evaluated on benchmark face databases, including AR, PolyU-NIR and CAS-PEAL. The results indicate a significant increase in the performance when compared with state-of-the-art face recognition methods.
基金supported by National Key R&D Program of China(2021YFC2702005)National High Level Hospital Clinical Research Funding(2022-PUMCH-B-079).
文摘Background Monogenic lupus is defined as systemic lupus erythematosus(SLE)/SLE-like patients with either dominantly or recessively inherited pathogenic variants in a single gene with high penetrance.However,because the clinical phenotype of monogenic SLE is extensive and overlaps with that of classical SLE,it causes a delay in diagnosis and treatment.Currently,there is a lack of early identification models for clinical practitioners to provide early clues for recognition.Our goal was to create a clinical model for the early identification of pediatric monogenic lupus,thereby facilitating early and precise diagnosis and treatment for patients.Methods This retrospective cohort study consisted of 41 cases of monogenic lupus treated at the Department of Pediatrics at Peking Union Medical College Hospital from June 2012 to December 2022.The control group consisted of classical SLE patients recruited at a 1:2 ratio.Patients were randomly divided into a training group and a validation group at a 7:3 ratio.A logistic regression model was established based on the least absolute shrinkage and selection operator to generate the coefficient plot.The predictive ability of the model was evaluated using receiver operator characteristic curves and the area under the curve(AUC)index.Results A total of 41 cases of monogenic lupus patients and 82 cases of classical SLE patients were included.Among the monogenic lupus cases(with a male-to-female ratio of 1:1.05 and ages of onset ranging from birth to 15 years),a total of 18 gene mutations were identified.The variables included in the coefficient plot were age of onset,recurrent infections,intracranial calcifications,growth and developmental delay,abnormal muscle tone,lymphadenopathy/hepatosplenomegaly,and chilblain-like skin rash.Our model demonstrated satisfactory diagnostic performance through internal validation,with an AUC value of 0.97(95% confidence interval=0.92–0.97).Conclusions We summarized and analyzed the clinical characteristics of pediatric monogenic lupus and developed a predictive model for early identification by clinicians.Clinicians should exercise high vigilance for monogenic lupus when the score exceeds -9.032299.
基金the Foundation of National Key R&D Program of China of Research on Application Demonstration and Evaluation of Comprehensive Prevention And Control Technology of Birth Defects(Grant No.2018YFC1002700)Zhejiang R&D Research Project Research on New Technologies for Birth Health,Birth Safety and Perinatal Disease Diagnosis and Treatment(Grant No.2021C03099).
文摘Background Newborn screening(NBS)is an important and successful public health program that helps improve the long-term clinical outcomes of newborns by providing early diagnosis and treatment of certain inborn diseases.The develop-ment of next-generation sequencing(NGS)technology provides new opportunities to expand current newborn screening methodologies.Methods We designed a a newborn genetic screening(NBGS)panel targeting 135 genes associated with 75 inborn disorders by multiplex PCR combined with NGS.With this panel,a large-scale,multicenter,prospective multidisease analysis was conducted on dried blood spot(DBS)profiles from 21,442 neonates nationwide.Results We presented the positive detection rate and carrier frequency of diseases and related variants in different regions;and 168(0.78%)positive cases were detected.Glucose-6-Phosphate Dehydrogenase deficiency(G6PDD)and phenylketonuria(PKU)had higher prevalence rates,which were significantly different in different regions.The positive detection of G6PD variants was quite common in south China,whereas PAH variants were most commonly identified in north China.In addi-tion,NBGS identified 3 cases with DUOX2 variants and one with SLC25A13 variants,which were normal in conventional NBS,but were confirmed later as abnormal in repeated biochemical testing after recall.Eighty percent of high-frequency gene carriers and 60%of high-frequency variant carriers had obvious regional differences.On the premise that there was no significant difference in birth weight and gestational age,the biochemical indicators of SLC22A5 c.1400C>G and ACADSB c.1165A>G carriers were significantly different from those of non-carriers.Conclusions We demonstrated that NBGS is an effective strategy to identify neonates affected with treatable diseases as a supplement to current NBS methods.Our data also showed that the prevalence of diseases has significant regional charac-teristics,which provides a theoretical basis for screening diseases in different regions.
文摘BACKGROUND Dyschromatosis universalis hereditaria(DUH)is a rare type of autosomal dominant inheritance disease.It has varying gene mutation sites among different ethnicities.SASH1 and ABCB6 have been identified as the causative genes of this disorder.CASE SUMMARY A 30-year-old woman presented with irregular black pigmentation spots to our department.Upon examination,the pigmentations were found to be especially dense on the extremities and the face.She had no family history of inbreeding,nor any previous chemical exposure.Genetic testing confirmed that the disease occu-rred because the patient has a SASH1 gene mutation.Following the use of assisted reproductive technology and preimplantation genetic testing for monogenic disorders,the patient give birth to a health baby.CONCLUSION Using assisted reproductive technology/preimplantation genetic testing for monogenic disorders is an option for DUH patients to reduce the risk of trans-mitting the pathogenic variant to their offspring.
基金Supported by Beijing Holistic Integrative Medicine Association Clinical Research Funding Program,No.ZHKY-2024-2209.
文摘BACKGROUND Wolfram syndrome is a rare autosomal recessive genetic disorder characterized by early-onset diabetes and progressive neurodegeneration,most notably sensorineural hearing loss and optic atrophy.Because its initial manifestations are usually similar to those of type 1 diabetes,the diagnosis may be delayed until other manifestations appear.Pathogenic variations of the WFS1 gene can disrupt endoplasmic reticulum function and cellular homeostasis,but the complete mutation spectrum of WFS1 has not been fully determined.Early identification of monogenic diabetes caused by Wolfram syndrome is of vital importance,as it enables the provision of targeted multidisciplinary care and genetic counseling for affected families.CASE SUMMARY A 2-year-old Han Chinese girl was admitted with a 1-month history of polydipsia,polyuria,and polyphagia,and was diagnosed with diabetic ketoacidosis and impaired insulin secretion.Sensorineural hearing loss was also detected.Wholeexome sequencing identified a previously unreported heterozygous mutation,WFS1 c.986T>C(p.Phe329Ser),in the patient and her father,confirming the diagnosis of Wolfram syndrome.Bioinformatic analysis supported the likely pathogenicity of this mutation.In silico pathogenicity predictors(REVEL,SIFT,Poly-Phen-2,MutationTaster,and GERP+)supported a deleterious effect on wolframin structure and function.The patient was initially treated with intravenous insulin and fluid resuscitation,then transitioned to a basal–bolus insulin regimen.Glycemic control was subsequently maintained with continuous subcutaneous insulin infusion and intermittent subcutaneous injections.At the 1-and 6-month follow-ups,blood glucose remained well controlled(hemoglobin A1c:5.89%and 6.58%,respectively),with no evidence of organ dysfunction or further complications.CONCLUSION This case identifies WFS1 c.986T>C(p.Phe329Ser)as a novel pathogenic variant causing Wolfram syndrome.It highlights the importance of early genetic testing in pediatric patients with atypical diabetes presentations to enable timely diagnosis,individualized therapy,and comprehensive family support.
基金supported by Macao FDCT 056/2010/A3 and research grant of the University of Macao(Grant No.UL017/08-Y4/MAT/QT01/FST)
文摘We study the adaptive decomposition of functions in the monogenic Hardy spaces H2by higher order Szeg kernels under the framework of Clifford algebra and Clifford analysis,in the context of unit ball and half space.This is a sequel and a higher-dimensional generalization of our recent study on the complex Hardy spaces.
文摘New higher-dimensional distributions have been introduced in the framework of Clifford analysis in previous papers by Brackx, Delanghe and Sommen. Those distributions were defined using spherical co-ordinates, the ＂finite part＂ distribution Fp x＋^μ on the real line and the generalized spherical means involving vector-valued spherical monogenics. In this paper, we make a second generalization, leading to new families of distributions, based on the generalized spherical means involving a multivector-valued spherical monogenic. At the same time, as a result of our attempt at keeping the paper self-contained, it offers an overview of the results found so far.
文摘With the increasing awareness of genetics in respiratory medicine and improvements in molecular diagnostic techniques,many complicated and rare diseases in respiratory medicine can be diagnosed.Most respiratory diseases have no specific phenotype.However,the clinical spectrum of monogenic diseases in respiratory medicine varies,from pulmonary disease to other inherited disorders that involve the lung.The genes that mediate some of these diseases have been identified.Certain monogenic diseases remain poorly characterized clinically.Because of the specificity of the phenotype of respiratory disease,a future challenge will be to correlate the phenotype and genotype and understand its phenotypic variability.With the development of precision medicine,research on monogenic disorders has been intensive and vigorous.In this article,we provide a brief clinical introduction to monogenic diseases in pediatrics.
