Zhu Li, Cheng Jingliang, Zhou Boxu, Wei Chunli, Yang Weichan, Jiang Dong, Ijaz Iqra, Tan Xiaojun, Chen Rui, Fu Junjiang
The Research Center for Precision Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China.
The Central Hospital of Loudi, Loudi, Hunan 417000, P.R. China.
Mol Med Rep. 2017 Mar;15(3):1157-1164. doi: 10.3892/mmr.2017.6119. Epub 2017 Jan 13.
To develop an effective strategy to isolate and use cell‑free fetal DNA (cffDNA) for the combined use of next‑generation sequencing (NGS) for diagnosing choroideremia and non‑invasive prenatal testing (NIPT) for Y chromosome determination, a large Chinese family with an X‑linked recessive disease, choroideremia, was recruited. Cell‑free DNA was extracted from maternal plasma, and SRY polymerase chain reaction amplification was performed using NIPT. Sanger sequencing was subsequently used for fetal amniotic fluid DNA verification. A nonsense mutation (c.C799T:p.R267X) of the CHM gene on the X chromosome of the proband (IV:7) and another 5 males with choroideremia were detected, while 3 female carriers with no symptoms were also identified. The fetus (VI:7) was identified as female from the cffDNA, and the same heterozygous nonsense mutation present in her mother was also confirmed. At one and a half years of age, the female baby did not present with any associated symptoms of choroideremia. Therefore, cffDNA was successfully used for the combined use of NGS for diagnosing choroideremia in a large Chinese pedigree, and NIPT for Y chromosome determination. This approach should result in a markedly increased use of prenatal diagnosis and improvement, and more sophisticated clinical management of diseases in China and other developing countries. The establishment of a highly accurate method for prenatal gene diagnosis will allow for more reliable gene diagnosis, improved genetic counseling, and personalized clinical management of our patients.
为制定一种有效的策略,用于分离和利用游离胎儿DNA(cffDNA),将下一代测序(NGS)联合用于诊断无脉络膜症以及进行Y染色体测定的无创产前检测(NIPT),我们招募了一个患有X连锁隐性疾病——无脉络膜症的大型中国家系。从孕妇血浆中提取游离DNA,并使用NIPT进行SRY聚合酶链反应扩增。随后采用桑格测序法对胎儿羊水DNA进行验证。在先证者(IV:7)以及另外5名患有无脉络膜症的男性的X染色体上检测到了CHM基因的无义突变(c.C799T:p.R267X),同时还鉴定出3名无症状的女性携带者。通过cffDNA确定胎儿(VI:7)为女性,并且证实其母亲存在相同的杂合无义突变。在一岁半时,该女婴未出现任何无脉络膜症的相关症状。因此,cffDNA成功用于在一个大型中国家系中联合使用NGS诊断无脉络膜症以及进行Y染色体测定的NIPT。这种方法应会显著增加中国和其他发展中国家产前诊断的应用并改善疾病的临床管理,使其更加精细。建立一种高度准确的产前基因诊断方法将使我们能够进行更可靠的基因诊断、改善遗传咨询并为患者提供个性化的临床管理。