The metabolic newborn screening as a healthcare model of the precision medicine. Perspective from the Spanish Association for the Study of Congenital Errors of Metabolism (AECOM)

e202101021

Authors

  • Domingo González-Lamuño Leguina Pediatría. Unidad de Nefrología-Metabolismo Infantil. Universidad de Cantabria-Hospital Universitario Marqués de Valdecilla. Santander. España. / Asociación Española para el Estudio de los Errores Congénitos del Metabolismo (AECOM). España.
  • Mª Dolores Bóveda Fontán Bioquímica Clínica. Laboratorio de Metabolopatías. Unidad de Diagnóstico y Tratamiento de Enfermedades Metabólicas Congénitas. Hospital Clínico Universitario. Santiago de Compostela (CSUR, MetabERN). España. / Asociación Española para el Estudio de los Errores Congénitos del Metabolismo (AECOM). España.
  • María Bueno Delgado Pediatría. Unidad de Metabolopatías. Hospital Universitario Virgen del Rocío, Sevilla (CSUR). España. / Asociación Española para el Estudio de los Errores Congénitos del Metabolismo (AECOM). España.
  • Laura Gort Mas Biología, Genética. Consultor Sección de Errores Congénitos del Metabolismo – IBC. Servicio de Bioquímica y Genética Molecular, CDB. CIBERER e IDIBAPS. Hospital Clínic de Barcelona. España. / Asociación Española para el Estudio de los Errores Congénitos del Metabolismo (AECOM). España.
  • María Unceta Suárez Análisis Clínicos. Servicio de Bioquímica. Unidad de Enfermedades Metabólicas. Hospital Universitario de Cruces. Barakaldo, Bizkaia (CSUR-MetabERN). España. / Asociación Española para el Estudio de los Errores Congénitos del Metabolismo (AECOM). España.
  • Montserrat Morales Conejo Medicina Interna. Consulta de Enfermedades minoritarias y Enfermedades Metabólicas Congénitas del Adulto. Hospital Universitario 12 de Octubre (CSUR-MetabERN). Instituto de Investigación Hospital 12 de Octubre (i+12), CIBERER. Universidad Complutense de Madrid. España. / Asociación Española para el Estudio de los Errores Congénitos del Metabolismo (AECOM). España.

Keywords:

Newborn screening, Inborn errors of metabolism, Public Health, Prevention

Abstract

Newborn screening programs for congenital diseases aim to achieve a presymptomatic and early diagnosis of treatable disorders, in order to prevent or significantly reduce morbidity and/or mortality. Many of the conditions included in these programs are inborn errors of metabolism (IEM); however, the detection of endocrine, hematological, immunological, cardiovascular diseases, and congenital hearing loss are also included in many of them. Newborn screening tests are not diagnostic and therefore additional tests are needed to confirm or exclude the suspected diagnosis. The social and professional demand of the hand of the technological advances and new therapeutic options, allow the continuous expansion of neonatal screening; This progress has a clear benefit for patients, since thanks to the early diagnosis and treatment of their disease they can have a better prognosis and a better quality of life. The inclusion criteria of the different diseases should not be evaluated exclusively in function of the moment in which the evaluation is carried out, it is necessary to apply a long-term vision of opportunity based on the strengths of the health system. Today, after 50 years of experience, we can assure that neonatal screening programs constitute one of the most significant advances that have occurred in public health, their widespread practice has been one of the great achievements in pediatric healthcare and are marking the healthcare organization of many adult units. Hand in hand with advances in genetics and genomics, newborn screening programs will continue to expand for those disorders in which early intervention can significantly modify the course of the disease.

Downloads

Download data is not yet available.

References

Grupo de trabajo de la Comisión de Salud Pública para el desarrollo del Sistema de Información sobre Cribado Neonatal. Objetivos y requisitos de calidad del Programa de Cribado Neonatal de enfermedades endocrino-metabólicas del Sistema Nacional de Salud. 22-11-2013 (www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/docs/ObjetivosCribadoNeonatal.pdf, con acceso 20 abril de 2020).

Grupo de trabajo de la Comisión de Salud Pública para el desarrollo del Sistema de Información sobre Cribado Neonatal. Sistema de Información del Programa Poblacional de Cribado Neonatal del Sistema Nacional de Salud. 20-03-2014. (www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/docs/SistemaInformacionCribadoNeonatal.pdf, con acceso 20 abril de 2020).

González-Lamuño D, Couce Pico ML. Cribado neonatal. Pediatr Integral 2019; XXIII (3): 169.e1 – 169.e10.

Castiñeras DE, Couce ML, Marin JL, González-Lamuño D, Rocha H. [Newborn screening for metabolic disorders in Spain and worldwide]. An Pediatr (Barc). 2019 Aug; 91(2): 128.e1-128.e14.

Loeber JG, Burgard P, Cornel MC, Rigter T, Weinreich SS, Rupp K, Hoffmann GF, Vittozzi L. Newborn screening programmes in Europe; arguments and efforts regarding harmonization. Part 1. From blood spot to screening result. J Inherit Metab Dis. 2012 Jul; 35(4):603-11.

Burgard P, Rupp K, Lindner M, Haege G, Rigter T, Weinreich SS, Loeber JG, Taruscio D, Vittozzi L, Cornel MC, Hoffmann GF. Newborn screening programmes in Europe; arguments and efforts regarding harmonization. Part 2. From screening laboratory results to treatment, follow-up and quality assurance. J Inherit Metab Dis. 2012 Jul; 35(4):613-25.

Guthrie R, Susi A. A Simple Phenylalanine Method for Detecting Phenylketonuria in Large Populations of Newborn Infants. Pediatrics, 1963. 32: p. 338-43.

Millington DS, Kodo N, Norwood DL, Roe CR. Tandem mass spectrometry: A new method for acylcarnitine profiling with potential for neonatal screening for inborn errors of metabolism. J Inherit Metab Dis. 1990; 13:321-4.

Cerdá Mota T. Programas de cribado: Características y condiciones para su puesta en marcha. Medicine. 2003;8(118): 6312-17.

Wilson JMG, Junger G. Principles and Practice of Screening for Disease. Geneva: World Helth Organization; 1968.

Vanderhilst C, Derk T, Reijngoud D et al. Cost-Effectiveness of Neonatal Screening for Medium Chain acyl-CoA Dehydrogenase Deficiency: The Homogeneous Population of the Netherlands. The Journal of Pediatrics, 2007. 151(2): p. 115-120.e3.

Pandor A, Eastham J, Beverly C et al. Clinical effectiveness and cost-effectiveness of neonatal screening for inborn errors of metabolism using tandem mass spectrometry: a systematic review. Health Technology Assessment. 2004; 8: 1-121.

American College of Medical Genetics Newborn Screening Expert Group. Newborn screening: toward a uniform screening panel and system: executive summary. Pediatrics. 2006; 117(5).

Cornel M, Rigter T, Weinreich S et al. Newborn screening in Europe Expert Opinion document - Evaluation of population newborn screening practices for rare disorders in Member States of the European Union, E. Comission, Editor. 2012.

Almannai M, Marom R, Sutton VR. Newborn screening: A review of history, recent advancements, and future perspectives in the era of next generation sequencing. Curr Opin Pediatr. 2016; 2 8: 694-9.

Lewys MH. Newborn screening controversy: Past, present, and future. JAMA Pediatr. 2014; 168: 199-200.

Marín J, Aldamiz L, Castiñeiras D, Dalmau Serra J, Fernández Sánchez A, González-Lamuño D et al. Programas de cribado neonatal en España: actualización y propuestas de futuro. Documento de consenso.Real Patronato sobre discapacidad, Ministerio de Sanidad y Política Social. Gobierno de España. Madrid: Editorial Polibea, (2010).

Matesanz R, Domínguez-Gil B, Coll E, de la Rosa G, Marazuela R. Spanish experience as a leading country: what kind of measures were taken? Transpl Int. 2011 Apr; 24(4): 333-43.

Couce ML, Castiñeiras DE, Moure JD, Cocho JA, Sánchez-Pintos P, García-Villoria J, Quelhas D, Gregersen N, Andresen BS, Ribes A, Fraga JM. Relevance of expanded neonatal screening of medium-chain acyl co-a dehydrogenase deficiency: outcome of a decade in galicia (Spain). JIMD Rep. 2011; 1: 131-6).

Recommended Uniform Screening Panel. Available at: https://www.hrsa.gov/advisory-committees/heritable-disorders/rusp/index.html. Con acceso el 20 abril de 2020.

Screening Programs/National Newborn Screening and Global Resource Center. Available at: https://genes-r-us.uthscsa.edu/screening. Con acceso el 20 abril de 2020).

Ministerio Della Salute. Italia 19-08-2016. (www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=55762. Con acceso el 20 abril de 2020).

Ministerio Della Salute. Italia 13-10-2016. www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=56764. Con acceso el 20 abril de 2020).

Psychogios N, Hau DD, Peng J, Guo AC, Mandal R, Bouatra S, Sinelnikov I, Krishnamurthy R, Eisner R, Gautam B, Young N, Xia J, Knox C, Dong E, Huang P, Hollander Z, Pedersen TL, Smith SR, Bamforth F, Greiner R, McManus B, Newman JW, Goodfriend T, Wishart DS. The human serum metabolome. PLoS One. 2011 Feb 16; 6(2): e16957.

Nanjappa V, Thomas JK, Marimuthu A, Muthusamy B, Radhakrishnan A, Sharma R, Ahmad Khan A, Balakrishnan L, Sahasrabuddhe NA, Kumar S, Jhaveri BN, Sheth KV, Kumar Khatana R, Shaw PG, Srikanth SM, Mathur PP, Shankar S, Nagaraja D, Christopher R, Mathivanan S, Raju R, Sirdeshmukh R, Chatterjee A, Simpson RJ, Harsha HC, Pandey A, Prasad TS. Plasma Proteome Database as a resource for proteomics research: 2014 update. Nucleic Acids Res. 2014 Jan; 42(Database issue): D959-65.

Kuhara T. Noninvasive human metabolome analysis for differential diagnosis of inborn errors of metabolism. J Chromatogr B Analyt Technol Biomed Life Sci. 2007 Aug;855(1): 42-50.

Gelb MH, Lukacs Z, Ranieri E, Schielen PCJI. Newborn Screening for Lysosomal Storage Disorders: Methodologies for Measurement of Enzymatic Activities in Dried Blood Spots. Int J Neonatal Screen. 2019; 5(1):1.

Wasserstein MP, Andriola M, Arnold G et al. Clinical outcomes of children with abnormal newborn screening results for Krabbe disease in New York State. Genet Med 2016;18(12): 1235–43.

Kemper AR, Brosco J, Comeau AM et al. Newborn screening for X-linked adrenoleukodystrophy: evidence summary and advisory committee recommendation. Genet Med 2017;19(1): 121–6).

Wang KS. Section on surgery, committee on fetus and newborn, childhood liver disease research network. Newborn screening for biliary atresia. Pediatrics 2015; 136(6): e1663–9.

Bleyle L, Huidekoper HH, Vaz FM et al. Update on newborn dried bloodspot testing for cerebrotendinous xanthomatosis: an available high-throughput liquid-chromatography tandem mass spectrometry method. Mol Genet Metab Rep 2016;7:11–5.

Gatheridge MA, Kwon JM, Mendell JM et al. Identifying non-Duchenne muscular dystrophy-positive and false negative results in prior Duchenne muscular dystrophy newborn screening programs: a review. JAMA Neurol 2016; 73(1):111–6.

Pasquali M, Schwarz E, Jensen M et al. Feasibility of newborn screening for guanidinoacetate methyltransferase (GAMT) deficiency. J Inherit Metab Dis 2014; 37(2): 231–6).

Filges I, Friedman JM. Exome sequencing for gene discovery in lethal fetal disorders--harnessing the value of extreme phenotypes. Prenat Diagn. 2015 Oct;35(10):1005-9.

Ormond KE, Wheeler MT, Hudgins L, Klein TE, Butte AJ, Altman RB, Ashley EA, Greely HT. Challenges in the clinical application of whole-genome sequencing. Lancet. 2010 May 15; 375(9727): 1749-51.

Hodgson JM, Metcalfe SA, Aitken M, Donath SM, Gaff CL, Winship IM, Delatycki MB, Skene LL, McClaren BJ, Paul JL, Halliday JL. Improving family Communications after a new genetic diagnosis: a randomised controlled trial of a genetic counselling intervention. BMC Med Genet. 2014 Mar 14; 15:33.

Morrison, Alan S. Screening in chronic disease. 2nd ed. New York: Oxford University Press, 1992.

Coulter A, Ellins J, Swain D, Clarke A, Heron R, Rasul F et al. Assessing the quality of information to support people in making decisions about their health and healthcare. Oxford: Picker Institute Europe; 2006. p. 70.

Ley 41/2002, de 14 de noviembre, básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica. Ley 41/2002 de 14 de noviembre. Boletín Oficial del Estado, nº 274, (15 de noviembre de 2002).

O’Connor AM, Legare F, Stacey D. Risk communication in practice: the contribution of decision aids. BMJ. 2003; 327(7417): 736-40.

Jepson RG, Hewison J, Thompson A, Weller D. Patient perspectives on information and choice in cancer screening: A qualitative study in the UK. Soc Sci Med. 2007; 65(5): 890-9.

Grimes DA, Schulz KF. Uses and abuses of screening tests. Lancet. 2002; 359: 881-4.

De La Fuente J, Hernandez Aguado JJ, San Martín M, Ramirez Boix P, Cedillo Gómez S, López N. Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain. Hum Vaccin Immunother. 2019; 15(7-8): 1949-1961.

El-Hattab AW, Almannai M, Sutton VR. Newborn Screening: History, Current Status, and Future Directions. Pediatr Clin North Am. 2018 Apr; 65(2): 389-405.

Schielen PCJI, Kemper EA, Gelb MH. Newborn Screening for Lysosomal Storage Diseases: A Concise Review of the Literature on Screening Methods, Therapeutic Possibilities and Regional Programs. Int J Neonatal Screen. 2017; 3(2):6.

Ombrone D, Giocaliere E, Forni G et al. Expanded newborn screening by mass spectrometry: new tests, future perspectives. Mass Spectrom Rev 2016;35(1): 71–84.

Bhattacharjee A, Sokolsky T, Wyman SK et al. Development of DNA confirmatory and high-risk diagnostic testing for newborns using targeted next-generation DNA sequencing. Genet Med 2015; 17(5): 337–47.

Poulsen JB, Lescai F, Grove J et al. High-quality exome sequencing of whole genome amplified neonatal dried blood spot DNA. PLoS One 2016; 11(4): e0153253.

Botkin JR, Rothwell E. Whole genome sequencing and newborn screening. Curr Genet Med Rep 2016;4(1):1–6; (48) Wu C-C, Tsai C-H, Hung C-C, et al. Newborn genetic screening for hearing impairment: a population-based longitudinal study. Genet Med 2017; 19(1): 6–12.

Wu CC, Tsai CH, Hung CC et al. Newborn genetic screening for hearing impairment: a population-based longitudinal study. Genet Med 2017; 19(1): 6–12.

Narravula A, Garber KB, Askree SH et al. Variants of uncertain significance in newborn screening disorders: implications for large-scale genomic sequencing. Genet Med 2017; 19(1): 77–82.

Kølvraa S, Singh R, Normand EA et al. Genome-wide copy number analysis on DNA from fetal cells isolated from the blood of pregnant women. Prenat Diagn 2016; 36(12): 1127–34.

Goodacre R, Vaidyanathan S, Dunn WB et al. Metabolomics by numbers: acquiring and understanding global metabolite data. Trends Biotechnol 2004; 22(5): 245–52.

Miller MJ, Kennedy AD, Eckhart AD et al. Untargeted metabolomic analysis for the clinical screening of inborn errors of metabolism. J Inherit Metab Dis 2015; 38(6):1029–39.

Dénes J, Szaboó E, Robinette SL et al. Metabonomics of newborn screening dried blood spot samples: a novel approach in the screening and diagnostics of inborn errors of metabolism. Anal Chem 2012; 84(22): 10113–20.

Guo L, Milburn MV, Ryals JA et al. Plasma metabolomic profiles enhance precision medicine for volunteers of normal health. Proc Natl Acad Sci U S A 2015; 112(35): E4901–10.

Published

2021-01-26

How to Cite

1.
González-Lamuño Leguina D, Bóveda Fontán MD, Bueno Delgado M, Gort Mas L, Unceta Suárez M, Morales Conejo M. The metabolic newborn screening as a healthcare model of the precision medicine. Perspective from the Spanish Association for the Study of Congenital Errors of Metabolism (AECOM): e202101021. Rev Esp Salud Pública [Internet]. 2021 Jan. 26 [cited 2024 Jul. 8];95:17 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/598

Most read articles by the same author(s)

  • José Luis Marín Soria, José Manuel González de Aledo Castillo, Ana Argudo Ramírez, Rosa Mª López Galera, Sonia Pajares García, Antonia Ribes Rubió, Judith García Villoria, Raquel Yahyaoui Macías, Ana Isabel Álvarez Ríos, Enrique Melguizo Madrid, Yolanda González Irazabal, Guillermo Hernández de Abajo, Belén Prieto García, Leire Cardo González, Eduardo Martínez Morillo, Juan Robles Bauza, Josep Miquel Bauçà Rosselló, Gerardo Pérez Esteban, Felícitas Díaz-Flores Estevez, Eva Pérez Mangas, Verónica Cañadas Garzó, Ana Cristina Muñoz Boyero, Pedro A. Redondo Cardeña, Mª Josefa Bueno Llarena, Javier Sánchez Alarcon, Daisy Castiñeiras Ramos, José Ángel Cocho de Juan, Cristóbal Colón Mejeras, Paula Blanco Soto, Ana Cambra Conejero, Miguel L. Fernández Ruano, Alicia Ortiz Temprado, José Mª Egea Mellado, Inmaculada González Gallego, Mª Jesús Juan Fita, Mercedes Espada Saenz-Torre, Dolores Rausell Felix, Jose Vicente Marcos Tomás, Sandra Ruiz Aja, Carmen Delgado Pecellín, Mª Dolores Bóveda Fontán, Beginnings, evolution and current situation of the Newborn Screening Programs in Spain , Revista Española de Salud Pública: Vol. 95 (2021)
  • Jose Luis Marín Soria, Rosa Mª López Galera, Ana Argudo Ramírez, Jose Manuel González de Aledo, Sonia Pajares García, Aleix Navarro Sastre, Jose Mª Hernandez Pérez, Antonia Ribes Rubio, Laura Gort Mas, Judit García Villoria, Silvia Gartner Tizano, Sandra Rovira Amigo, Óscar Asensio de la Cruz, Miguel García González, María Cols Roig, Jordi Costa Colomer, Celia Bádenas Orquin, Diego Yeste Fernández, Ariadna Campos Martorell, María Clemente León, Eduardo Mogas Viñals, Roser Ferrer Costa, Marina Giralt Arnaiz, Jaume Campistol Plana, Ángeles García Cazorla, David Beneitez Pastor, Ana Ortuño Cabrero, Adoración Blanco Álvarez, Barbara Tazón Vega, Gael Roué, Pablo Velasco Puyo, Thais Murciano Carrillo, Laura Murillo Sanjuan, Cristina Díaz de Heredia Rubio, Mª del Mar Mañú Pereira, Josep Lluis Vives Corrons, José Antonio Arranz Amo, Clara Carnicer Cáceres, Mireia del Toro Riera, Aida Ormazábal Herrero, Rafael Artuch Iriberri, Camila García-Volpe, Mariela Mercedes de los Santos, Cristina Sierra March, Carlos José Ruiz Hernández, Silvia Mª Meavilla Olivas, Andrea Martín Nalda, Jacques G. Rivière, Alba Parra Martínez, Pere Soler Palacín, Mónica Martínez Gallo, Roger Colobran, Teresa Casals Senent, Mercè Armelles Sebastia, Mª José Vidal Benede, Mireia Jané Checa, Rosa Mª Fernández Bordón, Laia Asso Ministral, Blanca Prats Viedma, Carmen Cabezas Peña, 50 years of the Neonatal Screening Program in Catalonia , Revista Española de Salud Pública: Vol. 94 (2020)