人工智能快速全基因组自动分析系统在新生儿/儿童重症监护室的应用

罗芳, 李昊旻

中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (5) : 433-437.

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中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (5) : 433-437. DOI: 10.7499/j.issn.1008-8830.2012143
国外儿科研究动态

人工智能快速全基因组自动分析系统在新生儿/儿童重症监护室的应用

  • 罗芳1, 李昊旻2
作者信息 +

Application of the artificial intelligence-rapid whole-genome sequencing diagnostic system in the neonatal/pediatric intensive care unit

  • LUO Fang1, LI Hao-Min2
Author information +
文章历史 +

摘要

新生儿重症监护室及儿童重症监护室患儿是遗传性疾病的高发人群,对遗传性疾病早期快速的病因诊断并针对性给予干预措施可以降低患儿病死率或不同程度改善预后。全基因组测序(whole exome sequencing,WGS)因涵盖点突变、拷贝数、内含子区域的各种结构及重组变异等更为全面的信息,已成为遗传性疾病有力的诊断工具之一。但测序数据获取后需要极高专业性的判读和解释,数周才能返回为临床所用,无法满足病情快速进展的儿童遗传性疾病的诊治需求。该文拟针对快速WGS在新生儿/儿童重症监护室的临床应用进行介绍,并对1个快速、高吞吐量、自动提供遗传疾病诊断的平台,即人工智能快速全基因组自动分析诊断系统的相关技术进行简述。该诊断系统将人工智能引入WGS后数据的处理,从时间上和功能上解决了常规基因组测序解读周期长及解读专业性依赖的现状,可在24 h内为疑似遗传病重症患儿提供快速的诊断方案,值得临床应用推广。

Abstract

Pediatric patients in the neonatal intensive care unit (NICU) and the pediatric intensive care unit (PICU) have a high incidence rate of genetic diseases, and early rapid etiological diagnosis and targeted interventions can help to reduce mortality or improve prognosis. Whole-genome sequencing covers more comprehensive information including point mutation, copy number, and structural and rearrangement variations in the intron region and has become one of the powerful diagnostic tools for genetic diseases. Sequencing data require highly professional judgment and interpretation and are returned for clinical application after several weeks, which cannot meet the need for the diagnosis and treatment of genetic diseases in children. This article introduces the clinical application of rapid whole-genome sequencing in the NICU/PICU and briefly describes related techniques of artificial intelligence-rapid whole-genome sequencing diagnostic system, a rapid high-throughput automated platform for the diagnosis of genetic diseases. The diagnostic system introduces artificial intelligence into the processing of data after whole-genome sequencing and can solve the problems of long time and professional interpretation required for routine genome sequencing and provide a rapid diagnostic regimen for critically ill children suspected of genetic diseases within 24 hours, and therefore, it holds promise for clinical application.

关键词

遗传性疾病 / 人工智能 / 全基因组测序 / 重症监护 / 新生儿

Key words

Genetic disease / Artificial intelligence / Whole-genome sequencing / Intensive care / Neonate

引用本文

导出引用
罗芳, 李昊旻. 人工智能快速全基因组自动分析系统在新生儿/儿童重症监护室的应用[J]. 中国当代儿科杂志. 2021, 23(5): 433-437 https://doi.org/10.7499/j.issn.1008-8830.2012143
LUO Fang, LI Hao-Min. Application of the artificial intelligence-rapid whole-genome sequencing diagnostic system in the neonatal/pediatric intensive care unit[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(5): 433-437 https://doi.org/10.7499/j.issn.1008-8830.2012143

参考文献

[1] OMIM. OMIM entry statistics:number of entries in OMIM[EB/OL].[2021-03-03]. https://www.omim.org/statistics/entry.
[2] Chong JX, Buckingham KJ, Jhangiani SN, et al. The genetic basis of mendelian phenotypes:discoveries, challenges, and opportunities[J]. Am J Hum Genet, 2015, 97(2):199-215.
[3] Khokha MK, Mitchell LE, Wallingford JB. White paper on the study of birth defects[J]. Birth Defects Res, 2017, 109(2):180-185.
[4] Murphy SL, Xu JQ, Kochanek KD, et al. Mortality in the United States, 2017[J]. NCHS Data Brief, 2018(328):1-8.
[5] Savage L, Adams SD, James K, et al. Rapid whole-genome sequencing identifies a homozygous novel variant, His540Arg, in HSD17B4 resulting in D-bifunctional protein deficiency disorder diagnosis[J]. Cold Spring Harb Mol Case Stud, 2020, 6(6):a005496.
[6] Hildreth A, Wigby K, Chowdhury S, et al. Rapid whole-genome sequencing identifies a novel homozygous NPC1 variant associated with Niemann-Pick type C1 disease in a 7-week-old male with cholestasis[J]. Cold Spring Harb Mol Case Stud, 2017, 3(5):a001966.
[7] Saunders CJ, Miller NA, Soden SE, et al. Rapid whole-genome sequencing for genetic disease diagnosis in neonatal intensive care units[J]. Sci Transl Med, 2012, 4(154):154ra135.
[8] Miller NA, Farrow EG, Gibson M, et al. A 26-hour system of highly sensitive whole genome sequencing for emergency management of genetic diseases[J]. Genome Med, 2015, 7:100.
[9] Clark MM, Hildreth A, Batalov S, et al. Diagnosis of genetic diseases in seriously ill children by rapid whole-genome sequencing and automated phenotyping and interpretation[J]. Sci Transl Med, 2019, 11(489):eaat6177.
[10] Willig LK, Petrikin JE, Smith LD, et al. Whole-genome sequencing for identification of Mendelian disorders in critically ill infants:a retrospective analysis of diagnostic and clinical findings[J]. Lancet Respir Med, 2015, 3(5):377-387.
[11] Petrikin JE, Cakici JA, Clark MM, et al. The NSIGHT1-randomized controlled trial:rapid whole-genome sequencing for accelerated etiologic diagnosis in critically ill infants[J]. NPJ Genom Med, 2018, 3:6.
[12] Sanford EF, Clark MM, Farnaes L, et al. Rapid whole genome sequencing has clinical utility in children in the PICU[J]. Pediatr Crit Care Med, 2019, 20(11):1007-1020.
[13] Mestek-Boukhibar L, Clement E, Jones WD, et al. Rapid Paediatric Sequencing (RaPS):comprehensive real-life workflow for rapid diagnosis of critically ill children[J]. J Med Genet, 2018, 55(11):721-728.
[14] Kernan KF, Ghaloul-Gonzalez L, Vockley J, et al. Rapid whole genome sequencing and fulfilling the promise of precision pediatric critical care[J]. Pediatr Crit Care Med, 2019, 20(11):1085-1086.
[15] Farnaes L, Hildreth A, Sweeney NM, et al. Rapid whole-genome sequencing decreases infant morbidity and cost of hospitalization[J]. NPJ Genom Med, 2018, 3:10.
[16] Petrikin JE, Willig LK, Smith LD, et al. Rapid whole genome sequencing and precision neonatology[J]. Semin Perinatol, 2015, 39(8):623-631.
[17] Son JH, Xie GC, Yuan C, et al. Deep phenotyping on electronic health records facilitates genetic diagnosis by clinical exomes[J]. Am J Hum Genet, 2018, 103(1):58-73.
[18] Wei WQ, Denny JC. Extracting research-quality phenotypes from electronic health records to support precision medicine[J]. Genome Med, 2015, 7(1):41.
[19] Dhombres F, Bodenreider O. Interoperability between phenotypes in research and healthcare terminologies-Investigating partial mappings between HPO and SNOMED CT[J]. J Biomed Semantics, 2016, 7:3.
[20] Kingsmore SF, Cakici JA, Clark MM, et al. A randomized, controlled trial of the analytic and diagnostic performance of singleton and trio, rapid genome and exome sequencing in ill infants[J]. Am J Hum Genet, 2019, 105(4):719-733.
[21] Bell SG. Ethical implications of rapid whole-genome sequencing in neonates[J]. Neonatal Netw, 2018, 37(1):42-44.
[22] Cakici JA, Dimmock DP, Caylor SA, et al. A prospective study of parental perceptions of rapid whole-genome and -exome sequencing among seriously ill infants[J]. Am J Hum Genet, 2020, 107(5):953-962.
[23] Dimmock DP, Clark MM, Gaughran M, et al. An RCT of rapid genomic sequencing among seriously ill infants results in high clinical utility, changes in management, and low perceived harm[J]. Am J Hum Genet, 2020, 107(5):942-952.


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