Salehi Rasoul, Khosravi Sharifeh, Salehi Mansour, Kheirollahi Majid, Khanahmad Hossein
Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2017 Mar 7;6:23. doi: 10.4103/2277-9175.201682. eCollection 2017.
Thalassemias are the most common monogenic disorders in many countries throughout the world. The best practice to control the prevalence of the disease is prenatal diagnosis (PND) services. Extensive practicing of PND proved effective in reducing new cases but on the other side of this success high abortion rate is hided, which ethically unfair and for many couples, especially with a previous experience of a therapeutic abortion, or moral concerns, is not a suitable choice. Preimplantation genetic diagnosis (PGD) is a strong alternative to conventional PND. At present PGD is the only abortion free fetal diagnostic process. Considering the fact that there are more than 6000 single gene disorders affecting approximately 1 in 300 live-births, the medical need for PGD services is significant.
In the present study development of a PGD protocol for a thalassemia trait couple using nested multiplex fluorescent polymerase chain reaction (PCR) for the combination of polymorphic linked short tandem repeat (STR) markers and thalassemia mutations is described. Restriction fragment length polymorphism used to discriminate between wild and mutated alleles.
In PGD clinical cycle, paternal and maternal alleles for D11S988 and D11S1338 STR markers were segregated as it was expected. PCR product for IVSII-1 mutation was subsequently digested with BtscI restriction enzyme to differentiate normal allele from the mutant allele. The mother's mutation, being a comparatively large deletion, was detectable through size differences on agarose gel.
The optimized single cell protocol developed and evaluated in this study is a feasible approach for preimplantation diagnosis of β-thalassemia in our patients.
地中海贫血是世界上许多国家最常见的单基因疾病。控制该疾病流行率的最佳做法是开展产前诊断(PND)服务。广泛开展PND已证明在减少新发病例方面有效,但在这一成功的背后隐藏着高流产率,这在伦理上是不公平的,而且对于许多夫妇,尤其是有过治疗性流产经历或有道德顾虑的夫妇来说,这不是一个合适的选择。植入前基因诊断(PGD)是传统PND的有力替代方法。目前,PGD是唯一无流产的胎儿诊断程序。鉴于有超过6000种单基因疾病影响约每300例活产中的1例,对PGD服务的医疗需求很大。
在本研究中,描述了一种针对一对地中海贫血特征夫妇的PGD方案的开发,该方案使用巢式多重荧光聚合酶链反应(PCR)来联合多态性连锁短串联重复序列(STR)标记和地中海贫血突变。采用限制性片段长度多态性来区分野生型和突变型等位基因。
在PGD临床周期中,D11S988和D11S1338 STR标记的父本和母本等位基因如预期那样分离。随后,用BtscI限制性内切酶消化IVSII-1突变的PCR产物,以区分正常等位基因和突变等位基因。母亲的突变是一个相对较大的缺失,可以通过琼脂糖凝胶上的大小差异检测到。
本研究中开发并评估的优化单细胞方案是对我们的患者进行β地中海贫血植入前诊断的可行方法。