Cystic Fibrosis: The role of genetic testing in the early detection and treatment of symptoms

Cystic Fibrosis (CF) is a life-threatening, progressive, inherited condition that causes severe damage mainly to organs of the respiratory and digestive system. It is estimated that more than 70,000 people worldwide have CF, with the average life expectancy being 47 years.

CF is caused by mutations on the cystic fibrosis transmembrane conductance regulator gene (CFTR). Although more than 1700 different mutations can cause CF, approximately 120 of them are responsible for most CF cases. These mutations affect the movement of salt and water in and out of cells responsible for producing sweat, mucus, and digestive fluids. Normally, these fluids are thin and slippery, whereas in people with CF, these fluids are thick and sticky — clogging ducts, tubes, and passageways in the body, and affecting the lungs, pancreas, liver, intestines, and digestive system. People with CF experience multiple symptoms that vary depending on the severity of the disease. Some people experience mild to no symptoms until adolescence or adulthood. Symptoms might include salty sweat, frequent chest infections, cough, shortness of breath, malnutrition, and exercise intolerance among others. CF can cause continuous chest and respiratory infections which can lead to respiratory failure. Other CF-related diseases include male infertility, diabetes, liver, and bone disease.

CF is an autosomal recessive disease, so two copies of the genetic mutation are needed ­– one from each parent – to inherit the disease. In Cyprus, the prevalence of inheriting CF is 1 in 8,000 [1]. Even if the parents do not have CF themselves, they could be carriers of the disease. Being a carrier means that someone has one copy of the genetic mutation. In Caucasians, the prevalence of being a CF carrier is around 1 in 25. When both parents are carriers, there is a 25% chance of the child being born with CF, a 25% chance of the child being unaffected and a 50% chance of the child being a carrier himself. Carrier screening, a genetic test that informs individuals whether they carry a gene for a certain genetic condition, such as CF, can be a key step towards informed family planning. Because of its prevalence, carrier screening is recommended for every couple considering pregnancy by international organizations such as the American College of Obstetricians and Gynecologists and the American College of Medical Genetics.

Most countries with high prevalence of CF include the most common mutations of the CFTR gene in their newborn screening test. Newborn screening tests are part of each country’s public health programs that screen infants shortly after birth for genetic conditions. These programs provide early diagnosis of critical or life-threatening, yet manageable conditions which allows for early treatment and improved prognosis. Alternatively, CF can be diagnosed at any age with a sweat chloride test or a genetic test.

Unfortunately, there is no cure for CF, but there are some treatment options that can ease the symptoms and limit complications. Different types of medications are used as a primary treatment option. Amongst the most used CF treatments are antibiotics to prevent infections, anti-inflammatory medications to lessen swelling in the airways, mucus-thinning drugs, medication to reduce the mucus in the body and oral pancreatic enzymes. Men with CF can use assisted reproductive techniques such as in vitro fertilization, to overcome infertility and have children. There are also techniques that assist in keeping the airways and lungs clean such as, deep breathing exercises or autogenic drainage via airway cleaning devices. A person with CF must also consider their nutrition and seek dietary advice, as it is hard to digest food and absorb necessary nutrients. In some severe cases of malnutrition, a feeding tube may be placed to increase calorie intake. For people experiencing more intense symptoms, treatment options include several surgical interventions such as bowel surgery to treat bowel blockages. Liver, pancreas, and lung transplants can be considered when severe CF-related diseases affect these organs.

Gene therapy, a technique that aims for the repair or reconstruction of the genes with mutations, has been the most promising research for finding a cure for CF [2]. Gene therapy for CF will not be able to fix any organ damage that has already happened, but it could reduce the symptoms, prevent any further damage, and improve the quality of life of an individual with CF. The earlier CF is diagnosed, and gene therapy is implemented, the better the prognosis will be for the affected individual.

The path to treat CF is an evolving map with many challenges. A few decades ago, most children with CF did not survive into adulthood. Advancements in medicine has enabled people with CF to now live into their 40s and beyond. Many institutions and research centers around the world work hard to bring new perspectives to the study of this disease and find a cure. New and ambitious perspectives aim for innovative drug development and treatment options and finally find a cure.

Oreana neonatal screening and Adventia carrier screening, offered by NIPD Genetics, can detect mutations that cause the classic Cystic Fibrosis phenotype along with many other conditions. To learn more, please visit nipd.com. Possible next steps and clinical management should always be discussed with your doctor.

The content is intended only for educational purposes and should not be perceived as medical advice.

References:

[1] https://assets.researchsquare.com/files/rs-413045/v1/a1f57b6e-70f0-4355-aa68-6600743b9517.pdf

[2] https://www.cff.org/Research/Research-Into-the-Disease/Restore-CFTR-Function/Gene-Therapy-for-Cystic-Fibrosis/


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NIPD Genetics - Privacy Policy

General Statement

NIPD Genetics is a leading, innovative biotechnology company that designs, develops, and provides a broad spectrum of healthcare services to its customers through its expansive portfolio of molecular and clinical laboratory tests in all disciplines.

At NIPD Genetics we are committed to protecting and respecting our customer’s privacy and personal information. Personal information or personal data means any information that identifies, relates to, describes, is capable of being associated with, or could be reasonably linked, directly or indirectly, with a particular individual, such as name, identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that individual.

NIPD Genetics collects and processes your personal information according to the General Data Protection Regulation (EU) 2016/679 and the Cypriot law providing for the protection of natural persons with regards to the processing of personal data and for the free movement of such data (L. 125(I)/2018). The following principles lie at the heart of our approach to handling personal data:

NIPD Genetics has appointed a Data Protection Officer (DPO) who is responsible for overseeing and ensuring that personal information is collected and processed in line with these principles. The contact details of the Data Protection Officer (DPO) can be found below:

Email address: dpo@nipd.com

Postal address: 31 Neas Engomis street, 2409 Engomi, Nicosia, Cyprus

Telephone number: + 357 22266888

By accessing or using our products or services, or by transmitting information to us by email or other electronic means, you accept our policies, procedures and practices described in this Privacy Policy. If you do not agree with our policies, procedures and practices as described, you can choose not to access or use our products or services or not to transmit personal information to us.

This Privacy Policy applies to NIPD Genetics facilities, its websites www.nipd.com, www.nipdlabs.com, www.nipdlabs.com.cy and their subdomains, that link to this privacy pol icy.

PERSONAL INFORMATION COLLECTION AND PROCESSING

We collect and process several types of personal information from and about users of our websites and of our products and services, including:

Information about children

If you are under 18 years of age, do not register on our website or provide any information about yourself to us. We do not provide our products or services directly to children or proactively collect their personal information. Despite this prohibition, it is possible that we may sometimes be given information about children while handling samples from our customers in our clinical labs, or through use of our products and services by our customers and partners. If we become aware that we have inadvertently collected personal information from children under the age of 18, without parental consent, we will take the necessary steps to delete it as soon as possible in compliance with applicable laws.

LEGAL BASIS FOR PROCESSING OF YOUR PERSONAL INFORMATION

Your personal information is collected by NIPD Genetics for the following purposes:

  1. To provide you with our products and services, respond to your inquiries or fulfill your requests and otherwise manage your relationship with us. The legal basis for processing is to meet the requirements of a contract, to comply with our legal obligations and/or because we have a legitimate interest in responding to requests for information about our products and services.
  2. To communicate with you about content and product offerings, newsletters and event invitations which are relevant to your interests and in line with your preferences. The legal basis for processing is the individual’s explicit consent prior to sending the information and managing individuals preferences.
  3. To process and respond to complaints. The legal basis for processing is to meet a legal obligation.
  4. To monitor and record information relating to the use of our products and services, including our website. The legal basis for processing is our legitimate interest in order to improve our products and services and our website for individuals.

To provide our products and services, NIPD Genetics may collect, receive and process biological samples to isolate and sequence DNA. NIPD Genetics may then store resulting genetic information and use genetic information to provide our products and services. In some cases, NIPD Genetics may provide interpretations of genetic information on behalf of its customers, including healthcare providers. This is only done pursuant to a written contract or a Sample Information Form with a patient’s informed consent and is subject to applicable legal and ethical safeguards.

This sensitive information described above is collected by NIPD Genetics for the following purposes:

  1. To provide support and maintenance services to customers who use our products and services – The legal basis for processing is to meet the requirements of a contract.
  2. To provide genotyping and sequencing services and analysis for our customers, including healthcare providers. The legal basis of this processing is to meet the requirements of a contract or as allowed in the Sample Information Form with a patient’s informed consent.
  3. To conduct genotyping and sequencing services and analysis for quality control, process and product development and improvements, and optimization in our labs to reflect quality improvements and advances in our technology. The legal basis for processing is the patient’s informed consent given through the Sample Information Form.

Transfer of Data

Your information, including personal data, may be transferred to - and maintained on - computers located outside your province, country or other governmental jurisdiction where the data protection laws may differ than those from your jurisdiction.

If you are located outside Cyprus and choose to provide information to us, please note that we transfer the data, including personal data, to Cyprus and process it there.

Your consent to this Privacy Policy followed by your submission of such information represents your agreement to that transfer.

NIPD Genetics will take all reasonable steps necessary to ensure that your data is treated securely and in accordance with this Privacy Policy and no transfer of your personal information will take place to an organization or a country unless there are adequate controls in place including the security of your data and other personal information.

Disclosure of Data

NIPD Genetics complies with the General Data Protection Regulation and will not sell or trade your personal information.

NIPD Genetics may disclose your personal information in the good faith that such action is necessary:

COOKIES AND OTHER TRACKING TECHNOLOGIES

Cookies are files with small amount of data which may include an anonymous unique identifiers. Cookies are sent to your browser when you visit a website and stored on your device. Tracking technologies used on the website are beacons, tags and scripts, to collect and track information and to improve and analyze our websites.

We use cookies and similar tracking technologies to track the activity on our websites and collect certain information. This includes information about the computer or device you are using, such as Internet protocol (IP) address, information about the browser type or version, the pages of our website that you visit, the time and date of your visit, the time spent on those pages, unique device identifiers and other diagnostic data.

You can instruct your browser to refuse all cookies or to indicate when a cookie is being sent. However, if you do not accept cookies, you may not be able to use some portions of our websites.

Examples of Cookies we may use:

Session Cookies. We use Session Cookies to operate our websites.

Preference Cookies. We use Preference Cookies to remember your preferences and various settings.

Security Cookies. We use Security Cookies for security purposes.

Visitor behavior cookies. To understand how visitors use and navigate the websites

Keyword cookies. To understand how visitors discover the websites.

ANALYTICS

We may use third-party Service Providers to monitor and analyze the use of our websites.

Google Analytics

Google Analytics is a web analytics service offered by Google that tracks and reports website traffic. Google uses the data collected to track and monitor the use of our service. This data is shared with other Google services. Google may use the collected data to contextualize and personalize the ads of its own advertising network.

You can opt-out of having made your activity on the Service available to Google Analytics by installing the Google Analytics opt-out browser add-on. The add-on prevents the Google Analytics JavaScript (ga.js, analytics.js, and dc.js) from sharing information with Google Analytics about visits activity.

For more information on the privacy practices of Google, please visit the Google Privacy & Terms web page

SECURITY OF DATA

We are committed to protecting the security of the information we collect, and we take reasonable physical, technical, and administrative safeguards such as data anonymization and encryption to help protect personal information from unauthorized or inappropriate access or use. It is your responsibility to protect the confidentiality of your passwords, and any other access features associated with your access or use of the website or our products and services, as well as to adhere to any applicable Terms of Use or other contract between us and you or your organization.

PERSONAL DATA RETENTION

We may retain collected information even after you remove it from the website, our Services, or our Products, to comply with applicable law, to resolve disputes, to enforce any rights in connection with the website, our Services, or our Products, and to use as provided in this Privacy Policy, the Terms of Use, or an applicable contract between us and you or your organization. How long we retain specific personal information varies depending on the purpose for its use and we may delete or retain your personal information in accordance with applicable law.

SERVICE PROVIDERS

We may employ third party companies and individuals to facilitate, maintain or operate our websites (“Service Providers”), to provide the websites on our behalf, to perform service-related services or to assist us in analyzing how our websites are used.

These third parties have access to your Personal Data only to perform these tasks on our behalf and are obligated not to disclose or use it for any other purpose.

LINKS TO OTHER SITES

Our websites may contain links to other sites that are not operated by us. If you click on a third-party link, you will be directed to that third party's site. We strongly advise you to review the Privacy Policy of every site you visit.

We have no control over and assume no responsibility for the content, privacy policies or practices of any third-party sites or services.

CHANGES TO THIS PRIVACY POLICY

This Privacy Policy may be updated from time to time. We will notify you of any changes by posting the new Privacy Policy on this page.

We will let you know via email and/or a prominent notice on our website, prior to the change becoming effective and update the “effective date” at the bottom of this Privacy Policy.

You are advised to review this Privacy Policy periodically for any changes. Changes to this Privacy Policy are effective when they are posted on this page.

YOUR LEGAL RIGHTS

NIPD Genetics ensures that it can respond immediately to requests that you make for the exercise of your legal rights in accordance with data protection laws. These rights are as follows:

You also have the right to lodge a complaint at any time to the Office of the Commissioner for Personal Data Protection.

We encourage you to contact us, should you wish to practice any of your legal rights or you have any questions about this Privacy Policy, by sending an email to NIPD Genetics’ Data Protection Officer at dpo@nipd.com.

Effective date: 18/06/2021

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