S/MS is a powerful tool to potentially diagnose all these
defects. However, according to the current protocols, only classic
homocystinuria due to CBS deficiency can be considered a candidate for
such screening program, since early detection of the disease can lead to
more efficacious treatment. For the other disorders of homocysteine/
folate cycle we do not have any evidence of proven efficacy for current
therapeutic approaches.
Introduction of microarray, gene-scanning technology and NGS to
newborn screening virtually allow analysis and diagnosis of an unlimit-
ed number of inherited disorders. In particular, the availability of
31 V. Iacobazzi et al. / Molecular Genetics and Metabolism 113 (2014) 27–33NGS creates high expectations regarding the potential of this technolo-
gy in the context of Newborn screening. However, the application of
NGS technologies to the diagnosis of genetic disorders, including
hyperhomocysteinemias, can be presently considered premature. It is
likely that its implementation in newborns will become routine in the
(near) future. This possibility will change the landscape of newborn
screening, although it will raise new medical, ethical and social prob-
lems concerning the consequences of a positive screen test. For exam-
ple, interpretation of DNA data in a population of healthy newborns is
a challenge. In fact, the genotype-phenotype correlation in metabolic
conditions often is not straightforward. Storage of genetic information
raises other questions, ranging from governance and privacy to
handling and accessibility of the data.
In conclusion,NBS programs are aimed to establish a comprehensive
systemto identify, save, and improve the lives of infants affected by dif-
ferent genetically based conditions. The advent of multitask analytical
technology (MS/MS) and, more recently, of sequence testing (WES
andWGS) is leading NBS to incorporate new ideas, technologies, ongo-
ing program of evaluation and processes into their systems. Improve-
ments of sensitivity and specificity of screening technologies as well as
screening of multiple disorders at the same time, will make future pro-
gram expansions more practical and help keep cost more manageable.
S/MS is a powerful tool to potentially diagnose all thesedefects. However, according to the current protocols, only classichomocystinuria due to CBS deficiency can be considered a candidate forsuch screening program, since early detection of the disease can lead tomore efficacious treatment. For the other disorders of homocysteine/folate cycle we do not have any evidence of proven efficacy for currenttherapeutic approaches.Introduction of microarray, gene-scanning technology and NGS tonewborn screening virtually allow analysis and diagnosis of an unlimit-ed number of inherited disorders. In particular, the availability of31 V. Iacobazzi et al. / Molecular Genetics and Metabolism 113 (2014) 27–33NGS creates high expectations regarding the potential of this technolo-gy in the context of Newborn screening. However, the application ofNGS technologies to the diagnosis of genetic disorders, includinghyperhomocysteinemias, can be presently considered premature. It islikely that its implementation in newborns will become routine in the(near) future. This possibility will change the landscape of newbornscreening, although it will raise new medical, ethical and social prob-lems concerning the consequences of a positive screen test. For exam-ple, interpretation of DNA data in a population of healthy newborns isa challenge. In fact, the genotype-phenotype correlation in metabolicconditions often is not straightforward. Storage of genetic informationคำถามอื่น ๆ กำกับดูแลกิจการและเป็นส่วนตัวการจัดการและการเข้าถึงข้อมูลเบียดเบียน ไซด์โปรแกรมมุ่งเน้นการสร้างครอบคลุมsystemto ระบุ บันทึก และปรับปรุงชีวิตของทารกที่ได้รับผลกระทบ โดย dif-ferent แปลงพันธุกรรมตามเงื่อนไข การมาถึงของ multitask วิเคราะห์เทคโนโลยี (MS/MS) และ เมื่อเร็ว ๆ นี้ ลำดับที่ทดสอบ (เวสandWGS) เป็นผู้นำไซด์เพื่อรวบรวมแนวความคิดใหม่ เทคโนโลยี ongo-โปรแกรมกำลังประเมินและกระบวนการของระบบ ปรับปรุง-ments ไวและ specificity คัดกรองเทคโนโลยีตลอดจนการคัดกรองของหลายโรคพร้อมกัน จะทำในอนาคต pro-กรัมขยายปฏิบัติมากขึ้นและช่วยให้ต้นทุนได้ง่ายขึ้น
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