Clinical Genetic Testing in Endocrinology: Current Concepts and Contemporary Challenges

Paul J. Newey (Lead / Corresponding author)

    Research output: Contribution to journalReview articlepeer-review

    12 Citations (Scopus)
    143 Downloads (Pure)

    Abstract

    Recent advances in DNA sequencing technology have led to an unprecedented period of disease‐gene discovery offering many new opportunities for genetic testing in the clinical setting. Endocrinology has seen a rapid expansion in the taxonomy of monogenic disorders, which can be detected by an expanding portfolio of genetic tests in both diagnostic and predictive settings. Successful testing relies on many factors including the ability to identify those at increased risk of genetic disease in the busy clinic as well as a working knowledge of the various testing platforms and their limitations. The clinical utility of a given test is dependent upon many factors, which include the reliability of the genetic testing platform, the accuracy of the test result interpretation and knowledge of disease penetrance and expression. The increasing adoption of ‘high‐content' genetic testing based on next‐generation sequencing (NGS) to diagnose hereditary endocrine disorders brings a number of challenges including the potential for uncertain test results and/or genetic findings unrelated to the indication for testing. Therefore, it is increasingly important that the clinician is aware of the current evolution in genetic testing, and understands the different settings in which it may be employed. This review provides an overview of the genetic testing workflow, focusing on each of the major components required for successful testing in adult and paediatric endocrine settings. In addition, the challenges of variant interpretation are highlighted, as are issues related to informed consent, prenatal diagnosis and predictive testing. Finally, the future directions of genetic testing relevant to endocrinology are discussed.

    Original languageEnglish
    Pages (from-to)587-607
    Number of pages21
    JournalClinical Endocrinology
    Volume91
    Issue number5
    Early online date29 Jun 2019
    DOIs
    Publication statusPublished - Nov 2019

    Keywords

    • endocrine neoplasia
    • gene panel
    • next-generation sequencing
    • penetrance
    • variant interpretation

    ASJC Scopus subject areas

    • Endocrinology, Diabetes and Metabolism
    • Endocrinology

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