Brock D J
Human Genetics Unit, Western General Hospital, Edinburgh.
J Med Genet. 1990 Jan;27(1):8-13. doi: 10.1136/jmg.27.1.8.
The four Scottish university medical genetics centres formed a consortium in 1985 to provide a DNA based service in prenatal diagnosis, carrier detection, and predictive testing for a range of Mendelian disorders. Each centre took sole responsibility for laboratory analyses of an assigned set of disorders, while families continued to be investigated and patients counselled within their own areas. DNA was extracted from relevant tissues in the centre most convenient to the family member and then dispatched to the appropriate laboratory for analysis. Results were interpreted and risks assessed by discussion between laboratory staff and the clinical geneticist in charge of the case. In the first three years of the consortium 92 prenatal diagnoses or exclusion tests were carried out, the majority being for cystic fibrosis (35), Duchenne muscular dystrophy (21), and Huntington's disease (11). Carrier testing was carried out in 271 X linked recessive disorders, the most common indications being Duchenne and Becker muscular dystrophies (198) and haemophilias A and B (48). Predictive testing was attempted in 41 consultants at risk for Huntington's disease, 37 at risk for myotonic dystrophy, and 32 at risk for developing adult polycystic kidney disease. The total of all carrier tests, including those for autosomal recessives, was 543. A consortium or supraregional approach to molecular genetics services has a number of advantages. Constituent laboratories need hold only those probes and enzymes relevant to their assigned disorders and can gain maximum experience with these systems. Scattered families may often be linked into single kinships, thus allowing rapid confirmation of diagnosis when an urgent request is made for a prenatal diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
1985年,苏格兰的四个大学医学遗传学中心组成了一个联盟,为一系列孟德尔疾病提供基于DNA的产前诊断、携带者检测和预测性检测服务。每个中心对指定的一组疾病进行独立的实验室分析,而家庭则继续在其所在地区接受调查,患者也在当地接受咨询。DNA从对家庭成员最方便的中心的相关组织中提取,然后送往适当的实验室进行分析。实验室工作人员与负责该病例的临床遗传学家通过讨论来解释结果并评估风险。在联盟成立的头三年里,进行了92次产前诊断或排除测试,其中大多数是针对囊性纤维化(35例)、杜氏肌营养不良症(21例)和亨廷顿舞蹈症(11例)。对271例X连锁隐性疾病进行了携带者检测,最常见的指征是杜氏和贝克肌营养不良症(198例)以及甲型和乙型血友病(48例)。对41名有亨廷顿舞蹈症风险的顾问、37名有强直性肌营养不良症风险的顾问和32名有成年多囊肾病发病风险的顾问进行了预测性检测。包括常染色体隐性疾病检测在内的所有携带者检测总数为543次。采用联盟或超区域方法提供分子遗传学服务有许多优点。组成实验室只需持有与指定疾病相关的探针和酶,并能在这些系统上积累最多的经验。分散的家庭往往可以被联系成单一的亲属关系,这样在紧急要求进行产前诊断时就能迅速确诊。(摘要截选至250字)