Telomeropathies: Etiology, diagnosis, treatment and follow-up. Ethical and legal considerations

Clin Genet. 2019 Jul;96(1):3-16. doi: 10.1111/cge.13526. Epub 2019 Mar 25.

Abstract

Telomeropathies involve a wide variety of infrequent genetic diseases caused by mutations in the telomerase maintenance mechanism or the DNA damage response (DDR) system. They are considered a family of rare diseases that often share causes, molecular mechanisms and symptoms. Generally, these diseases are not diagnosed until the symptoms are advanced, diminishing the survival time of patients. Although several related syndromes may still be unrecognized this work describes those that are known, highlighting that because they are rare diseases, physicians should be trained in their early diagnosis. The etiology and diagnosis are discussed for each telomeropathy and the treatments when available, along with a new classification of this group of diseases. Ethical and legal issues related to this group of diseases are also considered.

Keywords: DNA damage response system; laminopathies; legal issues; rare diseases; telomere; telomere biology disorders; telomere maintenance; telomeropathies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticipation, Genetic
  • DNA Damage*
  • Ethics, Medical
  • Genetic Association Studies
  • Genetic Diseases, Inborn / diagnosis*
  • Genetic Diseases, Inborn / therapy*
  • Genetic Markers
  • Genetic Testing
  • Genetic Variation
  • Humans
  • Mutation
  • Phenotype
  • Rare Diseases
  • Telomerase / genetics*
  • Telomerase / metabolism
  • Telomere / genetics
  • Telomere / metabolism
  • Telomere Homeostasis* / genetics

Substances

  • Genetic Markers
  • Telomerase