Elce Ausilia, Boccia Angelo, Cardillo Giuseppe, Giordano Sonia, Tomaiuolo Rossella, Paolella Giovanni, Castaldo Giuseppe
Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy.
Clin Chem. 2009 Jul;55(7):1372-9. doi: 10.1373/clinchem.2008.119545. Epub 2009 May 14.
Molecular diagnosis for cystic fibrosis (CF) is based on the direct identification of mutations in the CFTR gene [cystic fibrosis transmembrane conductance regulator (ATP-binding cassette sub-family C, member 7)] (detection rate about 90% with scanning procedures) and on segregation analysis of intragenic polymorphisms for carrier and prenatal diagnosis in about 20% of CF families in which 1 or both causal mutations are unknown.
We identified 3 novel intragenic polymorphic repeats (IVS3polyA, IVS4polyA, and IVS10CA repeats) in the CFTR gene and developed and validated a procedure based on the PCR followed by capillary electrophoresis for large-scale analysis of these polymorphisms and the 4 previously identified microsatellites (IVS1CA, IVS8CA, IVS17bTA, and IVS17bCA repeats) in a single run. We validated the procedure for both single- and 2-cell samples (for a possible use in preimplantation diagnosis), and on a large number of CF patients bearing different genotypes and non-CF controls.
The allelic distribution and heterozygosity results suggest that the 3 novel polymorphisms strongly contribute to carrier and prenatal diagnosis of CF in families in which 1 or both causal mutations have not been identified. At least 1 of the 4 previously identified microsatellites was informative in 78 of 100 unrelated CF families; at least 1 of all 7 polymorphisms was informative in 98 of the families. Finally, the analysis of haplotypes for the 7 polymorphisms revealed that most CF mutations are associated with different haplotypes, suggesting multiple slippage events but a single origin for most CFTR mutations.
The analysis of the 7 polymorphisms is a rapid and efficient tool for routine carrier, prenatal, and preimplantation diagnosis of CF.
囊性纤维化(CF)的分子诊断基于直接鉴定CFTR基因[囊性纤维化跨膜传导调节因子(ATP结合盒亚家族C,成员7)]中的突变(扫描程序的检测率约为90%),以及对约20%的CF家族进行基因内多态性的连锁分析,用于携带者和产前诊断,在这些家族中,一个或两个致病突变均未知。
我们在CFTR基因中鉴定出3个新的基因内多态性重复序列(IVS3polyA、IVS4polyA和IVS10CA重复序列),并开发并验证了一种基于聚合酶链反应(PCR)随后进行毛细管电泳的程序,用于在单次运行中大规模分析这些多态性以及4个先前鉴定的微卫星(IVS1CA、IVS8CA、IVS17bTA和IVS17bCA重复序列)。我们针对单细胞和双细胞样本(可能用于植入前诊断)以及大量携带不同基因型的CF患者和非CF对照验证了该程序。
等位基因分布和杂合性结果表明,这3个新的多态性对未鉴定出一个或两个致病突变的CF家族的携带者和产前诊断有很大贡献。在100个无关的CF家族中,78个家族中至少有1个先前鉴定的微卫星具有信息性;在所有98个家族中,7个多态性中至少有1个具有信息性。最后,对这7个多态性的单倍型分析表明,大多数CF突变与不同的单倍型相关,提示存在多个滑动事件,但大多数CFTR突变起源单一。
对这7个多态性的分析是CF常规携带者、产前和植入前诊断的快速有效工具。