Harahap Nur Imma Fatimah, Harahap Indra Sari Kusuma, Kaszynski Richard Hideki, Nurputra Dian Kesuma Pramudya, Hartomo Tri Budi, Pham Huyen Thi Van, Yamamoto Tomoto, Morikawa Satoru, Nishimura Noriyuki, Rusdi Imam, Widiastuti Retno, Nishio Hisahide
Division of Genetic Epidemiology, Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, Kobe, Japan.
Genet Test Mol Biomarkers. 2012 Feb;16(2):123-9. doi: 10.1089/gtmb.2011.0109. Epub 2011 Sep 23.
Spinal muscular atrophy (SMA) is a common autosomal recessive neuromuscular disorder. It is caused by mutations in the SMN1, and its clinical severity is modified by copy number variations of the SMN2. According to previous studies, deletion of SMN1 exon 7 is the most frequently observed in patients with SMA. Therefore, molecular analyses exploiting this genetic lesion could be beneficial in the diagnosis of SMA. Unfortunately, in many geographical regions, physicians do not have the latest molecular screening technologies at their immediate disposal. Thus, to overcome this issue, we developed an SMA-diagnosing system using dried blood spots (DBS) placed on filter paper to facilitate remote diagnosis.
In this study, we validate the applicability of DBS on Flinders Technology Associates (FTA) filter paper for detecting SMN1 exon 7 deletions and copy number variations of SMN1 and SMN2. To detect exon 7 deletions in SMN1, polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis was conducted by using DNA extracted from the DBS on FTA filter paper that had been stored at room temperature for a period of up to 4 years. To determine the copy numbers of SMN1 and SMN2, we carried out SYBR green-based real-time PCR by using the same blood specimens.
The results obtained from the DBS on FTA filter paper were in complete concordance with those analyses using fresh blood specimens. This indicates that DBS on filter papers is a reliable method for SMA patient detection and carrier screenings.
The SMA-diagnosing system, combined with the mailing of DBS on filter paper, will be beneficial for patients suffering from neuromuscular disorders in areas with limited or no access to diagnostic facilities with molecular capabilities.
脊髓性肌萎缩症(SMA)是一种常见的常染色体隐性神经肌肉疾病。它由SMN1基因突变引起,其临床严重程度受SMN2拷贝数变异的影响。根据以往研究,SMN1外显子7缺失在SMA患者中最为常见。因此,利用这种基因损伤进行分子分析可能有助于SMA的诊断。不幸的是,在许多地理区域,医生无法立即获得最新的分子筛查技术。因此,为克服这一问题,我们开发了一种使用置于滤纸上的干血斑(DBS)的SMA诊断系统,以方便远程诊断。
在本研究中,我们验证了置于弗林德斯技术协会(FTA)滤纸上的DBS用于检测SMN1外显子7缺失以及SMN1和SMN2拷贝数变异的适用性。为检测SMN1中的外显子7缺失,使用从在室温下保存长达4年的FTA滤纸上的DBS提取的DNA进行聚合酶链反应(PCR)-限制性片段长度多态性分析。为确定SMN1和SMN2的拷贝数,我们使用相同的血液标本进行基于SYBR Green的实时PCR。
从FTA滤纸上的DBS获得的结果与使用新鲜血液标本的分析结果完全一致。这表明滤纸上的DBS是一种用于SMA患者检测和携带者筛查的可靠方法。
SMA诊断系统与通过滤纸邮寄DBS相结合,将有利于在缺乏或没有分子诊断设施的地区患有神经肌肉疾病的患者。