A dyadic approach to the delineation of diagnostic entities in clinical genomics

Academic Journal

Biesecker, Leslie G. | Adam, Margaret P. | Alkuraya, Fowzan S. | Amemiya, Anne R. | Bamshad, Michael J. | Beck, Anita E. | Bennett, James T. | Bird, Lynne M. | Carey, John C. | Chung, Brian | Clark, Robin D. | Cox, Timothy C. | Curry, Cynthia | Dinulos, Mary Beth Palko | Dobyns, William B. | Giampietro, Philip F. | Girisha, Katta M. | Glass, Ian A. | Graham, Jr. John M. | Gripp, Karen W. | Haldeman-Englert, Chad R. | Hall, Bryan D. | Innes, A. Micheil | Kalish, Jennifer M. | Keppler-Noreuil, Kim M. | Kosaki, Kenjiro | Kozel, Beth A. | Mirzaa, Ghayda M. | Mulvihill, John J. | Nowaczyk, Malgorzata J.M. | Pagon, Roberta A. | Retterer, Kyle | Rope, Alan F. | Sanchez-Lara, Pedro A. | Seaver, Laurie H. | Shieh, Joseph T. | Slavotinek, Anne M. | Sobering, Andrew K. | Stevens, Cathy A. | Stevenson, David A. | Tan, Tiong Yang | Tan, Wen-Hann | Tsai, Anne C. | Weaver, David D. | Williams, Marc S. | Zackai, Elaine | Zarate, Yuri A.

Summary The delineation of disease entities is complex, yet recent advances in the molecular characterization of diseases provide opportunities to designate diseases in a biologically valid manner. Here, we have formalized an approach to the delineation of Mendelian genetic disorders that encompasses two distinct but inter-related concepts: (1) the gene that is mutated and (2) the phenotypic descriptor, preferably a recognizably distinct phenotype. We assert that only by a combinatorial or dyadic approach taking both of these attributes into account can a unitary, distinct genetic disorder be designated. We propose that all Mendelian disorders should be designated as “GENE-related phenotype descriptor” (e.g., “CFTR-related cystic fibrosis”). This approach to delineating and naming disorders reconciles the complexity of gene-to-phenotype relationships in a simple and clear manner yet communicates the complexity and nuance of these relationships.

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