Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Describe what constitutes ‘non-coding’ DNA? 2. Discuss the role of non-coding DNA in disease and health
Estimated time to complete activity: 0.25 hours
Ashley Comfort, MD, FACOG is the Director of Medical Content, ObG Project.
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Ashley Comfort, MD, has a financial interest in Pfizer and has no other conflicts of interest to disclose.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from 3/31/2022 through 3/1/2023, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.25 contact hours.
DNA provides the necessary information to construct proteins, which control normal development and structural function
The complete sequence of DNA for a particular organism is called a ‘genome’ and is composed of 3 billion bases
Approximately 1% of DNA is considered ‘coding DNA’ | Remaining 98% to 99% of DNA is non-coding
Once labelled “junk DNA,” non-coding DNA is now known to influence gene activity
Much about non-coding DNA is still not understood and remains an active area of genetic research
What are the different types of non-coding DNA and what do they do?
One primary function of non-coding DNA is serving as a regulatory element for genes
For example, non-coding DNA can turn genes on or off, thereby regulating gene activity and protein production
Introns (regions of non-coding DNA found in protein-coding exons) are eventually spliced out along the path to making messenger RNA | Introns do not directly code for proteins but are necessary for normal gene expression and regulation
Some types of regulatory elements are embedded in these non-coding regions
They serve as important binding sites that help control how a gene is read
Non-coding DNA also serves to protect chromosomes
Telomeres are repeated segments of non-coding DNA found on the ends of chromosomes that protect these ends from being manipulated or degraded when the DNA replicates prior to cell division
Genes that code for RNA
Some non-coding DNA segments hold the instructions for making RNA molecules such as: transfer RNAs (tRNAs), ribosomal RNAs (rRNAs), long non-coding RNAs (lncRNAs) and microRNAs (miRNAs)
These RNA transcripts are involved with multiple vital cellular processes and play an important role in the regulation of gene expression
Non-Coding DNA and Disease
While most mutations in the non-coding regions will have no impact, some DNA alterations can play an imporant role in health and disease
Some genetic variants in these regions are associated with genetic syndromes, such as myotonic dystrophy type 1 that is caused by expansion of CTG trinucleotide repeats in the non-coding region of the DMPK gene
Variants in non-coding DNA may also be related to more common, complex disorders, including heart disease and cancer
Therapies are being developed as research provides more clues as to the relationship between non-coding DNA and disease
What Test Can Identify Changes in Non-Coding DNA?
Whole Genome Sequencing (WGS)
WGS is the genetic test that looks at the entire genome, and therefore covers non-coding regions as well
WGS is generally considered in individuals who are on a diagnostic journey
For example, people with rare diseases or syndromes for whom testing of specific potentially disease-causing genes have not identified any disease-causing gene mutations
WGS analysis usually requires a sample (blood or saliva) from the patient and possibly other family members
Results from WGS will not always yield a definitive diagnosis or provide actionable results
WGS testing is most informative when an individual’s family members are also tested to clarify result interpretation
For example, a child and both parents (trio)
Extremely important before WGS analysis
The potential exists for results that are unexpected or not definitive
Genetic counseling is recommended before and after WGS analysis
Note: Counseling before any genetic testing serves to explain the limitations and the possible test results that could be informative or noninformative | Posttest counseling focuses on the results and focuses on health information, health surveillance, and the occasional finding of nonpaternity
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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