Division of Genetics and Molecular Medicine, King's College London (Guy's Campus), St John's Institute of Dermatology Research Laboratories, Guy's Hospital, London, UK.
Dermatol Clin. 2010 Apr;28(2):231-7, viii. doi: 10.1016/j.det.2010.02.001.
One of the most significant benefits of translational research in dermatology has been the development of prenatal diagnosis for couples at risk of recurrence of severe inherited skin diseases. Indeed, over the last 30 years a greater understanding of the molecular basis of epidermolysis bullosa (EB), as well as technical refinements in laboratory procedures, has facilitated the development of several different approaches for prenatal diagnosis. Initial tests were based on fetal skin biopsy sampling, but these have largely been superseded by DNA based analyses, mostly using fetal DNA derived from chorionic villus sampling taken at around 10--12 weeks' gestation. Further advances, however, have led to the introduction of licensed preimplantation genetic screening for some forms of EB, an approach that defines a disease-associated genotype before implantation into the uterus. Pioneering research also continues to try to develop less invasive approaches with the prospects of maternal blood sampling early during the first trimester as a feasible objective. The availability of several different options for prenatal diagnostic testing therefore has led to an increased choice for families at risk of recurrence of EB.
皮肤科转化研究的最重要的益处之一是为有严重遗传性皮肤疾病复发风险的夫妇开发了产前诊断。事实上,在过去的 30 年中,对大疱性表皮松解症 (EB) 的分子基础的更深入了解,以及实验室程序的技术改进,促进了几种不同的产前诊断方法的发展。最初的测试基于胎儿皮肤活检取样,但这些方法在很大程度上已被基于 DNA 的分析所取代,这些分析主要使用来自绒毛膜绒毛取样的胎儿 DNA,该取样在大约 10-12 周妊娠时进行。然而,进一步的进展导致了一些形式的 EB 的植入前遗传筛选的引入,该方法在植入子宫之前定义了与疾病相关的基因型。开创性的研究也在继续尝试开发侵入性较小的方法,希望在孕早期通过母亲血液取样作为可行的目标。因此,有几种不同的产前诊断测试选择方案可供选择,这为有 EB 复发风险的家庭提供了更多的选择。