1.Genetic counseling for hearing loss today.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):1-7
		                        		
		                        			
		                        			Genetic counseling for hearing loss today originated from decoding the genetic code of hereditary hearing loss, which serves as an effective strategy for preventing hearing loss and constitutes a crucial component of the diagnostic and therapeutic framework. This paper described the main principles and contents of genetic counseling for hearing loss, the key points of counseling across various genetic models and its application in tertiary prevention strategies targeting hearing impairment. The prospects of an AI-assisted genetic counseling decision system and the envisions of genetic counseling in preventing hereditary hearing loss were introduced. Genetic counseling for hearing loss today embodies the hallmark of a new era, which is inseparable from the advancements in science and technology, and will undoubtedly contribute to precise gene intervention!
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Genetic Counseling
		                        			;
		                        		
		                        			Deafness/genetics*
		                        			;
		                        		
		                        			Hearing Loss/diagnosis*
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural/genetics*
		                        			
		                        		
		                        	
3.Genetic characteristic analysis of slight-to-moderate sensorineural hearing loss in children.
Rui ZHOU ; Jing GUAN ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):18-22
		                        		
		                        			
		                        			Objective:To analyze genetic factors and phenotype characteristics in pediatric population with slight-to-moderate sensorineural hearing loss. Methods:Children with slight-to-moderate sensorineural hearing loss of and their parents, enrolled from the Chinese Deafness Genome Project, were studied. Hearing levels were assessed using pure tone audiometry, behavioral audiometry, auditory steady state response(ASSR), auditory brainstem response(ABR) thresholds, and deformed partial otoacoustic emission(DPOAE). Classification of hearing loss is according to the 2022 American College of Medical Genetics and Genomics(ACMG) Clinical Practice Guidelines for Hearing Loss. Whole exome sequencing(WES) and deafness gene Panel testing were performed on peripheral venous blood from probands and validations were performed on their parents by Sanger sequencing. Results:All 134 patients had childhood onset, exhibiting bilateral symmetrical slight-to-moderate sensorineural hearing loss, as indicated by audiological examinations. Of the 134 patients, 29(21.6%) had a family history of hearing loss, and the rest were sporadic patients. Genetic causative genes were identified in 66(49.3%) patients. A total of 11 causative genes were detected, of which GJB2 was causative in 34 cases(51.5%), STRC in 10 cases(15.1%), MPZL2 gene in six cases(9.1%), and USH2A in five cases(7.6%).The most common gene detected in slight-to-moderate hearing loss was GJB2, with c. 109G>A homozygous mutation found in 16 cases(47.1%) and c. 109G>A compound heterozygous mutation in 9 cases(26.5%). Conclusion:This study provides a crucial genetic theory reference for early screening and detection of mild to moderate hearing loss in children, highlighting the predominance of recessive inheritance and the significance of gene like GJB2, STRC, MPZL2, USH2A.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Connexins/genetics*
		                        			;
		                        		
		                        			Connexin 26/genetics*
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural/diagnosis*
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			Usher Syndromes
		                        			;
		                        		
		                        			Hearing Loss, Bilateral
		                        			;
		                        		
		                        			Audiometry, Pure-Tone
		                        			;
		                        		
		                        			Intercellular Signaling Peptides and Proteins
		                        			
		                        		
		                        	
4.Splicing mutations of GSDME cause late-onset non-syndromic hearing loss.
Danyang LI ; Hongyang WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):30-37
		                        		
		                        			
		                        			Objective:To dentify the genetic and audiological characteristics of families affected by late-onset hearing loss due to GSDMEgene mutations, aiming to explore clinical characteristics and pathogenic mechanisms for providing genetic counseling and intervention guidance. Methods:Six families with late-onset hearing loss from the Chinese Deafness Genome Project were included. Audiological tests, including pure-tone audiometry, acoustic immittance, speech recognition scores, auditory brainstem response, and distortion product otoacoustic emission, were applied to evaluate the hearing levels of patients. Combining with medical history and physical examination to analyze the phenotypic differences between the probands and their family members. Next-generation sequencing was used to identify pathogenic genes in probands, and validations were performed on their relatives by Sanger sequencing. Pathogenicity analysis was performed according to the American College of Medical Genetics and Genomics Guidelines. Meanwhile, the pathogenic mechanisms of GSDME-related hearing loss were explored combining with domestic and international research progress. Results:Among the six families with late-onset hearing loss, a total of 30 individuals performed hearing loss. The onset of hearing loss in these families ranged from 10 to 50 years(mean age: 27.88±9.74 years). In the study, four splicing mutations of the GSDME were identified, including two novel variants: c. 991-7C>G and c. 1183+1G>T. Significantly, the c. 991-7C>G was a de novo variant. The others were previously reported variants: c. 991-1G>C and c. 991-15_991-13del, the latter was identified in three families. Genotype-phenotype correlation analysis revealed that probands with the c. 991-7C>G and c. 1183+1G>T performed a predominantly high-frequency hearing loss. The three families carrying the same mutation exhibited varying degrees of hearing loss, with an annual rate of hearing deterioration exceeding 0.94 dB HL/year. Furthermore, follow-up of interventions showed that four of six probands received intervention(66.67%), but the results of intervention varied. Conclusion:The study analyzed six families with late-onset non-syndromic hearing loss linked to GSDME mutations, identifying four splicing variants. Notably, c. 991-7C>G is the first reported de novo variant of GSDME globally. Audiological analysis revealed that the age of onset generally exceeded 10 years,with variable effectiveness of interventions.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Young Adult
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural/diagnosis*
		                        			;
		                        		
		                        			Deafness/genetics*
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			Hearing Loss/genetics*
		                        			;
		                        		
		                        			Pedigree
		                        			
		                        		
		                        	
5.Genetic and phenotypic analysis of MYO15A rare variants associated with autosomal recessive hearing loss.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):38-43
		                        		
		                        			
		                        			Objective:To analyze the phenotype and genotype characteristics of autosomal recessive hearing loss caused by MYO15A gene variants, and to provide genetic diagnosis and genetic counseling for patients and their families. Methods:Identification of MYO15A gene variants by next generation sequencing in two sporadic cases of hearing loss at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The sequence variants were verified by Sanger sequencing.The pathogenicity of these variants was determined according to the American College of Medical Genetics and Genomics(ACMG) variant classification guidelines, in conjuction with clinical data. Results:The probands of the two families have bilateral,severe or complete hearing loss.Four variants of MYO15A were identified, including one pathogenic variant that has been reported, two likely pathogenic variants,and one splicing variant of uncertain significance. Patient I carries c. 3524dupA(p. Ser1176Valfs*14), a reported pathogenic variant, and a splicing variant c. 10082+3G>A of uncertain significance according to the ACMG guidelines. Patient I was treated with bilateral hearing aids with satisfactory effect, demonstrated average hearing thresholds of 37.5 dB in the right ear and 33.75 dB in the left ear. Patient Ⅱ carries c. 7441_7442del(p. Leu2481Glufs*86) and c. 10250_10252del(p. Ser3417del),a pair of as likely pathogenic variants according to the ACMG guidelines. Patient Ⅱ, who underwent right cochlear implantation eight years ago, achieved scores of 9 on the Categorical Auditory Performance-Ⅱ(CAP-Ⅱ) and 5 on the Speech Intelligibility Rating(SIR). Conclusion:This study's discovery of the rare c. 7441_7442del variant and the splicing variant c. 10082+3G>A in the MYO15A gene is closely associated with autosomal recessive hearing loss, expanding the MYO15A variant spectrum. Additionally, the pathogenicity assessment of the splicing variant facilitates classification of splicing variations.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Pedigree
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Deafness/genetics*
		                        			;
		                        		
		                        			Hearing Loss/genetics*
		                        			;
		                        		
		                        			Phenotype
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural/genetics*
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			Myosins/genetics*
		                        			
		                        		
		                        	
6.Research progress on hereditary endocrine and metabolic diseases associated with sensorineural hearing loss.
Fang CHEN ; Qinying ZHANG ; Qiujing ZHANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):63-69
		                        		
		                        			
		                        			Hereditary endocrine and metabolic diseases , caused by genetic factors, exhibit complex and diverse symptoms, including the possibility of concurrent sensorineural deafness. Currently, there is a limited clinical understanding of hereditary endocrine and metabolic diseases that manifest with deafness, the pathogenesis remains unclear,and there is a lack of effective diagnostic and treatment methods. This article summarizes the research progress of hereditary endocrine and metabolic diseases complicated with deafness from the pathogenesis, clinical phenotype, diagnosis and treatment. Understanding the current research progress and integrating genetic analysis into clinical practice are crucial for accurate diagnosis and treatment, evaluating clinical efficacy, and providing effective genetic counseling for these diseases.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Deafness/genetics*
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural/diagnosis*
		                        			;
		                        		
		                        			Phenotype
		                        			;
		                        		
		                        			Metabolic Diseases/genetics*
		                        			;
		                        		
		                        			Genetic Counseling
		                        			
		                        		
		                        	
7.A case of sudden hearing loss combined with familial hyperlipidemia.
Hui ZHONG ; Xiaonan WU ; Jing GUAN ; Dayong WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):70-72
		                        		
		                        			
		                        			Hyperlipidemia is characterized by elevated levels of blood lipids. The clinical manifestations are mainly atherosclerosis caused by the deposition of lipids in the vascular endothelium. The link between abnormal lipid metabolism and sudden hearing loss remains unclear. This article presents a case study of sudden hearing loss accompanied by familial hyperlipidemia. Pure tone audiometry indicated intermediate frequency hearing loss in one ear. Laboratory tests showed abnormal lipid metabolism, and genetic examination identified a heterozygous mutation in theAPOA5 gene. Diagnosis: Sudden hearing loss; hypercholesterolemia. The patient responded well to pharmacological treatment. This paper aims to analyze and discuss thepotential connection between abnormal lipid metabolism and sudden hearing loss.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Audiometry, Pure-Tone
		                        			;
		                        		
		                        			Deafness/complications*
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural/diagnosis*
		                        			;
		                        		
		                        			Hearing Loss, Sudden/diagnosis*
		                        			;
		                        		
		                        			Hyperlipidemias/complications*
		                        			;
		                        		
		                        			Lipids
		                        			
		                        		
		                        	
8.Clinical features of CAPOS syndrome caused by maternal ATP1A3 gene variation: a case report.
Yun GAO ; Fengjiao LI ; Rong LUO ; Guohui CHEN ; Danyang LI ; Dayong WANG ; Qiuju WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):73-76
		                        		
		                        			
		                        			CAPOS syndrome is an autosomal dominant neurological disorder caused by mutations in the ATP1A3 gene. Initial symptoms, often fever-induced, include recurrent acute ataxic encephalopathy in childhood, featuring cerebellar ataxia, optic atrophy, areflflexia, sensorineural hearing loss, and in some cases, pes cavus. This report details a case of CAPOS syndrome resulting from a maternal ATP1A3 gene mutation. Both the child and her mother exhibited symptoms post-febrile induction,including severe sensorineural hearing loss in both ears, ataxia, areflexia, and decreased vision. Additionally, the patient's mother presented with pes cavus. Genetic testing revealed a c. 2452G>A(Glu818Lys) heterozygous mutation in theATP1A3 gene in the patient . This article aims to enhance clinicians' understanding of CAPOS syndrome, emphasizing the case's clinical characteristics, diagnostic process, treatment, and its correlation with genotypeic findings.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Cerebellar Ataxia/diagnosis*
		                        			;
		                        		
		                        			Talipes Cavus
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural/diagnosis*
		                        			;
		                        		
		                        			Optic Atrophy/diagnosis*
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			Phenotype
		                        			;
		                        		
		                        			Sodium-Potassium-Exchanging ATPase/genetics*
		                        			;
		                        		
		                        			Foot Deformities, Congenital
		                        			;
		                        		
		                        			Reflex, Abnormal
		                        			
		                        		
		                        	
9.Skin prick tests and enzyme-linked immunosorbent assays among allergic patients using allergenic local pollen extracts.
Maria Katrina Diana M. Cruz ; Mary Anne R. Castor ; Krystal M. Hate ; Gregg Austine M. Balanag ; Roche Dana C. Reyes ; Maria Socorro Agcaoili-De Jesus ; Cherie C. Ocampo-Cervantes ; Leslie Michelle M. Dalmacio
Acta Medica Philippina 2024;58(16):23-29
BACKGROUND
Allergic respiratory diseases are prevalent in the Philippines, with allergic rhinitis and asthma occurring at 20% and 8.7% of the population, respectively. The diagnosis of respiratory allergies is achieved by a combination of patient history and different screening tools, especially for the identificati on of the allergic triggers such as allergy skin prick test (SPT) and serum-specific IgE enzyme-linked immunosorbent assays (sIgE ELISA). The Philippines, being a tropical country, have a wide variety of plant species with potential to produce allergenic pollen grains. Knowledge of the sensitization profiles of Filipino allergic patients to our local pollen allergens is currently limited.
OBJECTIVESThe aim of this study is to determine the sensitization profile of patients with respiratory allergies (allergic rhinitis and/or asthma) through the allergy skin prick test (SPT) using allergenic local pollen extracts. It also aimed to determine if there is a positive agreement between the SPT and sIgE ELISA positivity rate and whether the results have relationship with the pollen purity and the protein content of the extracts.
METHODSPollen allergens were extracted from Amaranthus spinosus (pigweed), Mimosa pudica (makahiya), Tridax procumbens (wild daisy), Imperata cylindrica (cogon), Oryza sativa (rice), Pennisetum polystachion (foxtail grass), Sorghum halepense (Johnson grass), Albizia saman (acacia), Cocos nucifera (coconut), Leucaena leucocephala (ipil-ipil), and Mangifera indica (mango). SPT was performed at the Allergy Clinic of the University of the Philippines-Philippine General Hospital on patients with allergic rhinitis and/or bronchial asthma. Blood samples were collected from patients who developed wheal diameters of 3 mm or more than the negative control. Sera were tested against the same pollen extracts using ELISA.
RESULTSOf the one hundred sixty-five (165) patients who submitted for skin prick test, 129 showed positive SPT results to the pollen extracts. Weeds were the most sensitizing (51.9%-58.1%). Blood samples were collected from these patients and tested for sIgE ELISA and among them, 71 were positive in the sIgE ELISA. Highest sensitization rates in sIgE ELISA were found in coconut, pigweed, Johnson grass, and rice. The highest positive agreements or the proportion of patients with positive sIgE ELISA among those with positive SPT were in coconut, followed by Johnson grass, pigweed, and rice. Most of the pollen sensitized patients on SPT are polysensitized.
CONCLUSIONSPT is a safe, simple, and rapid method for the diagnosis of IgE-mediated allergy. The lower number of positive patients in sIgE ELISA may be attributed to the low serum IgE levels and low quantities of effectual allergen components in extracts. Results of both SPT and ELISA must be correlated with a patient's clinical history, particularly the patient’s exposures, and physical examination.
Pollen ; Rhinitis ; Asthma
10.Research status and prospect of tissue engineering technology in treatment of atrophic rhinitis.
Shuting LEI ; Juanjuan HU ; Yingqi TANG ; Weigang GAN ; Yuting SONG ; Yanlin JIANG ; Honghui ZHANG ; Yaya GAO ; Hui YANG ; Huiqi XIE
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(6):727-731
		                        		
		                        			OBJECTIVE:
		                        			To review the research progress of the feasibility of a new treatment method for atrophic rhinitis (ATR) based on tissue engineering technology (seed cells, scaffold materials, and growth factors), and provide new ideas for the treatment of ATR.
		                        		
		                        			METHODS:
		                        			The literature related to ATR was extensively reviewed. Focusing on the three aspects of seed cells, scaffold materials, and growth factors, the recent research progress of ATR treatment was reviewed, and the future directions of tissue engineering technology to treat ATR were proposed.
		                        		
		                        			RESULTS:
		                        			The pathogenesis and etiology of ATR are still unclear, and the effectiveness of the current treatments are still unsatisfactory. The construction of a cell-scaffold complex with sustained and controlled release of exogenous cytokines is expected to reverse the pathological changes of ATR, promoting the regeneration of normal nasal mucosa and reconstructing the atrophic turbinate. In recent years, the research progress of exosomes, three-dimensional printing, and organoids will promote the development of tissue engineering technology for ATR.
		                        		
		                        			CONCLUSION
		                        			Tissue engineering technology can provide a new treatment method for ATR.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Tissue Engineering/methods*
		                        			;
		                        		
		                        			Tissue Scaffolds
		                        			;
		                        		
		                        			Rhinitis, Atrophic
		                        			;
		                        		
		                        			Printing, Three-Dimensional
		                        			;
		                        		
		                        			Cytokines
		                        			
		                        		
		                        	
            

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