Pornprasert Sakorn, Sukunthamala Kanyakan, Kunyanone Naowarat, Sittiprasert Sririchai, Thungkham Khanungnit, Junorse Sumeth, Pongsawatkul Khachonsilp, Pattanaporn Wisut, Jitwong Chantip, Sanguansermsri Torpong
Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
J Med Assoc Thai. 2010 Nov;93(11):1243-8.
Noninvasive prenatal diagnosis based on detection of fetal cell-free DNA is hampered when mother and father are both carriers for the same autosomal recessive mutation.
To compare the diagnosis of Bart's hydrops fetalis using conventional Gap-PCR analysis of fetal cells/tissues with the measurement of quantitative difference (deltaCp) between alpha-thalassemia-1 SEA type deletion gene (C(T-mutant)) and wild type alpha-globin gene (C(T-wild type)) in plasma of pregnancies by using the Taqman real-time quantitative PCR.
Plasma DNA samples were collected from three groups of pregnancies whose fetuses have known thalasemia status (7 normal, 11 heterozygote alpha-thalassemia-1 SEA type deletion, and 7 Bart's hydrops fetalis). The alpha-thalassemia-1 SEA type deletion gene and wild type alpha-globin gene were quantified by using Taqman real-time quantitative PCR and then the delta C(T) was analyzed by subtracting the C(T-mutant) from C(T-wild type).
Mean deltaC(T) values were not significantly different among the three groups. However, women whose fetuses were diagnosed as Bart's hydrops fetalis had a higher proportion (43%) of plasma DNA samples that had negative deltaC(T) value than women whose fetuses were diagnosed as normal or heterozygote alpha-thalassemia-1 SEA type deletion (0 and 27%, respectively).
Further investigations are needed to improve the diagnosis of Bart's hydrops fetalis using fetal cell-free DNA.
当父母双方均为同一常染色体隐性突变的携带者时,基于检测胎儿游离DNA的非侵入性产前诊断会受到阻碍。
比较使用胎儿细胞/组织的常规缺口PCR分析诊断巴氏水肿胎儿与通过Taqman实时定量PCR测量妊娠血浆中α-地中海贫血-1型SEA缺失基因(C(T-突变型))和野生型α-珠蛋白基因(C(T-野生型))之间的定量差异(ΔCp)来诊断巴氏水肿胎儿。
从三组胎儿已知地中海贫血状态的妊娠中采集血浆DNA样本(7例正常、11例α-地中海贫血-1型SEA缺失杂合子和7例巴氏水肿胎儿)。使用Taqman实时定量PCR对α-地中海贫血-1型SEA缺失基因和野生型α-珠蛋白基因进行定量,然后通过从C(T-野生型)中减去C(T-突变型)来分析ΔC(T)。
三组之间的平均ΔC(T)值无显著差异。然而,胎儿被诊断为巴氏水肿胎儿的女性血浆DNA样本中ΔC(T)值为阴性的比例(43%)高于胎儿被诊断为正常或α-地中海贫血-1型SEA缺失杂合子的女性(分别为0和27%)。
需要进一步研究以改善使用胎儿游离DNA诊断巴氏水肿胎儿的方法。