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  • July 2024

Expert Q&A: Dr. Sajel Lala Kana on advancements in genetic testing

By
  • Dr. Daniel D. Zimmerman
  • Dr. Sajel L. Kana
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An image of Dr. Sajel Kana at 69色情片
In Brief

During a recent conversation with Dr. Dan Zimmerman from 69色情片鈥檚 , 69色情片 Genetics Consultant Dr. Sajel Lala Kana offers detailed insights into genetic testing issues impacting clinical and insurance medicine.

Key takeaways

  • Preimplantation genetic testing during IVF can be a valuable tool for couples who know they carry specific pathogenic genetic variants.
  • Noninvasive prenatal genetic testing (NIPT), now used routinely during pregnancy, is fundamentally a screening tool; its results are not a definitive diagnosis.
  • Whole genome sequencing (WGS) can improve diagnostic accuracy for newborns presenting with complex medical issues.

During a recent conversation with Dr. Daniel D. Zimmerman, Senior Vice President and Chief Science Advisor at 69色情片 and co-editor of ReFlections, 69色情片 Genetics Consultant Dr. Sajel Lala Kana offered detailed insights into some of the current issues in genetics that are most impacting clinical and insurance medicine.

Q. As in vitro fertilization technology continues to advance, what might be the ramifications for couples who carry certain adverse genetic variants, and how can preimplantation genetic testing (PGT) enhance family planning strategies? 

Dr. Kana: In vitro fertilization (IVF) offers a valuable and powerful tool to couples who know they carry specific pathogenic genetic variants. Preimplantation genetic testing (PGT), which tests embryos intended for implantation, can increase the likelihood of healthy pregnancies by mitigating the risk of transmitting known pathogenic variants. This makes PGT a powerful strategy for improving the chances of having healthy, viable, and variant-free offspring. A study in the Journal of Medical Genetics confirmed that PGT can significantly improve pregnancy outcomes for couples at increased risk of transmitting one or more genetic disorders to offspring.1

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Explore ReFlections, the industry's premier medical underwriting publication, to learn more about key medical issues impacting the insurance industry.

Q. Noninvasive prenatal genetic testing (NIPT) has ramped up in the last several years. Can you define it for us, and talk about its science, advantages, and disadvantages? Can you also tell us if it is commonly used in routine prenatal care, or whether it is more often reserved for certain cases depending on medical indications?

Dr. Kana: NIPT has emerged as a truly transformative technology in prenatal care. A simple maternal blood draw will contain circulating cell-free fetal DNA fragments (cffDNA), which can offer a valuable window into a fetus鈥檚 genetic makeup.2 Currently, NIPT is used primarily to screen for common chromosomal abnormalities such as Trisomy 21 (Down syndrome), Trisomy 18, Trisomy 13, and extra or missing copies of the X or Y chromosome. 

NIPT鈥檚 use in routine prenatal care is steadily increasing but may vary depending on individual circumstances such as maternal age and family history.

While noninvasive prenatal genetic testing (NIPT) may boast high detection rates for these conditions and poses minimal risk to mother and fetus, it is crucial to acknowledge that this is fundamentally a screening tool, and its results are not a definitive diagnosis.

The American College of Obstetricians and Gynecologists (ACOG), in fact, emphasizes that NIPT carries a small chance of false positives or negatives, and says further diagnostic procedures may be necessary, depending on the results.3 

The field of neonatal care is experiencing a sizable paradigm shift due to the application of novel genetic-related technologies.

Q. One of medicine鈥檚 most difficult diagnostic dilemmas is how best to assess newborns with complex medical disorders. Is genetic technology being applied to these situations, whether via whole genome sequencing or other types of genetic testing, and to what extent? Can application of these technologies make significant differences in care and outcomes for these newborns?  And how does the genetic information about their child鈥檚 condition help parents understand and make informed decisions regarding their newborn鈥檚 health issues?

Dr. Kana: The field of neonatal care is experiencing a sizable paradigm shift due to the application of novel genetic-related technologies. For example, for newborns presenting with complex medical issues, whole genome sequencing (WGS), which can produce results for a clinical team in as little as 48 hours, offers a potentially powerful clinical tool, especially as results might reveal an underlying genetic cause of a child鈥檚 condition. 

An article in a recent issue of Nature Medicine highlighted how WGS might expedite and improve diagnostic accuracy for a wide range of genetic disorders in neonates.4 This could lead to a more precise understanding of a child鈥檚 condition, which could significantly impact case management, especially for a critically ill patient in an intensive care setting. Furthermore, by pinpointing a possible genetic cause, WGS can empower parents with valuable information regarding the condition, its prognosis, and its potential management options. This knowledge can equip them to make informed decisions about their child's care and connect with relevant support groups.


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Meet the Authors & Experts

Dan Zimmerman
Author
Dr. Daniel D. Zimmerman
Senior Vice President, Chief Science Advisor & Managing Director, Longer Life Foundation
Dr. Sajel Kana
Author
Dr. Sajel L. Kana
Genetics Consultant

References

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