Material Type  

 학위논문

 

0017164938

Date and Time of Latest Transaction  

20250211153105

ISBN  

9798384092193

DDC  

610

Author  

Diabate, Mariame Diabate.

Title/Author  

Bridging Racial Health Disparities: Advancing Health Equity Through the Incorporation of Functional Assay Insights.

Publish Info  

[S.l.] : The Ohio State University., 2024

Publish Info  

Ann Arbor : ProQuest Dissertations & Theses, 2024

Material Info  

177 p.

General Note  

Source: Dissertations Abstracts International, Volume: 86-04, Section: B.

General Note  

Includes supplementary digital materials.

General Note  

Advisor: Parvin, Jeffrey.

학위논문주기  

Thesis (Ph.D.)--The Ohio State University, 2024.

Abstracts/Etc  

요약BRCA1 pathogenic variants are well-established risk factors for hereditary breast and ovarian cancer (HBOC). The increasing accessibility and affordability of genetic testing have led to the identification of individuals with BRCA1 variants of uncertain significance (VUS), creating a clinical challenge due to the rarity of these variants. This issue disproportionately affects women from minority backgrounds, who often face a high prevalence of VUS in their genetic screening results. The American College of Medical Geneticists (ACMG) guidelines stipulate that clinical recommendations cannot be made until these VUS are reclassified, leaving many individuals stranded in the healthcare system without access to advancements in preventive medicine.To address this gap, ACMG has permitted the use of functional assays to experimentally assess the effects of BRCA1 variants. This dissertation aims to identify the genetic and environmental factors contributing to the gaps in care for minority women dealing with HBOC, redesign the analysis pipeline for multiplexed DNA repair assays, introduce a novel multiplexed repair assay based on cisplatin resistance (CR), and adapt this pipeline to functional limited datasets.Our research successfully functionally characterized 2271 variants from the carboxy terminus for homology-directed repair function (HDR) and 1427 variants for CR. Notably, we observed consistent results between the two multiplexed functional assays, especially for non-functional variants located within critical regions of the BRCA1 protein essential for tumor suppression. Variants classified in the multiplex HDR assay exhibited 81% specificity and 93% sensitivity, while those in the multiplex CR assay demonstrated 100% specificity and 86% sensitivity. Furthermore, the functional categorizations of the variants correlated with known clinical significance and other BRCA1 functional assays.Utilizing the redesigned analysis pipeline, we reanalyzed previously published multiplexed HDR results for amino-terminus variants, providing functional insights for 2172 variants. We also compared our functional classifications to clinical interpretations, enabling variants classified as functionally normal to be applied as BS3 strong and those classified as LOF as PS3 moderate.Applying our analysis pipeline to functionally classify the limited datapoints in the coiled-coil domain of BRCA1, we provided 330 functional classifications for variants in this region. Notably, when compared to ClinVar's designated benign or likely benign and pathogenic or likely pathogenic variants, our multiplexed assay demonstrated 100% specificity and 100% sensitivity.The functional classification of 4773 BRCA1 variants presented in this dissertation offers a valuable solution to bridge the diagnostic gap in the care cascade for the treatment of breast and ovarian cancer. It is our hope that clinicians can utilize this information to better inform all patients about the risks associated with HBOC variants, ultimately leading to an improved quality of life for those affected by these genetic variants.

Subject Added Entry-Topical Term  

Medicine.

Subject Added Entry-Topical Term  

Public health.

Subject Added Entry-Topical Term  

Cellular biology.

Subject Added Entry-Topical Term  

Biomedical engineering.

Subject Added Entry-Topical Term  

Health sciences.

Subject Added Entry-Topical Term  

Information science.

Index Term-Uncontrolled  

Breast and ovarian cancer

Index Term-Uncontrolled  

RING domain

Index Term-Uncontrolled  

Functional classifications

Index Term-Uncontrolled  

Homology directed repair

Index Term-Uncontrolled  

Health disparities

Index Term-Uncontrolled  

Care cascade

Added Entry-Corporate Name  

The Ohio State University Biomedical Sciences

Host Item Entry  

Dissertations Abstracts International. 86-04B.

Electronic Location and Access  

로그인을 한후 보실 수 있는 자료입니다.

Control Number  

joongbu:655932