Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
Department of Gynecology and Obstetrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
Chin Med J (Engl). 2018 Apr 5;131(7):770-775. doi: 10.4103/0366-6999.228237.
Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are common X-linked recessive neuromuscular disorders caused by mutations in dystrophin gene. Multiplex polymerase chain reaction (multiplex PCR) and multiplex ligation-dependent probe amplification (MLPA) are the most common methods for detecting dystrophin gene mutations. This study aimed to contrast the two methods and discern the genetic characterization of patients with DMD/BMD in Eastern China.
We collected 121 probands, 64 mothers of probands, and 15 fetuses in our study. The dystrophin gene was detected by multiplex PCR primarily in 28 probands, and MLPA was used in multiplex PCR-negative cases subsequently. The dystrophin gene of the remaining 93 probands and 62 female potential carriers was tested by MLPA directly. In fetuses, multiplex PCR and MLPA were performed on 4 fetuses and 10 fetuses, respectively. In addition, sequencing was also performed in 4 probands with negative MLPA.
We found that 61.98% of the subjects had genetic mutations including deletions (50.41%) and duplications (11.57%). There were 43.75% of mothers as carriers of the mutation. In 15 fetuses, 2 out of 7 male fetuses were found to be unhealthy and 2 out of 8 female fetuses were found to be carriers. Exons 3-26 and 45-52 have the maximum frequency in mutation regions. In the frequency of exons individually, exon 47 and exon 50 were the most common in deleted regions and exons 5, 6, and 7 were found most frequently in duplicated regions.
MLPA has better productivity and sensitivity than multiplex PCR. Prenatal diagnosis should be applied in DMD high-risk fetuses to reduce the disease incidence. Furthermore, it is the responsibility of physicians to inform female carriers the importance of prenatal diagnosis.
杜氏肌营养不良症(DMD)和贝克肌营养不良症(BMD)是常见的 X 连锁隐性神经肌肉疾病,由肌营养不良蛋白基因突变引起。多重聚合酶链反应(多重 PCR)和多重连接依赖性探针扩增(MLPA)是检测肌营养不良基因突变最常用的方法。本研究旨在对比两种方法,并探讨华东地区 DMD/BMD 患者的遗传特征。
我们收集了 121 名先证者、64 名先证者的母亲和 15 名胎儿。在 28 名先证者中,我们主要通过多重 PCR 检测肌营养不良蛋白基因,随后在多重 PCR 阴性病例中使用 MLPA。其余 93 名先证者和 62 名女性潜在携带者的肌营养不良蛋白基因直接通过 MLPA 进行检测。在胎儿中,分别对 4 名胎儿和 10 名胎儿进行多重 PCR 和 MLPA。此外,我们还对 4 名 MLPA 阴性的先证者进行了测序。
我们发现,61.98%的受试者存在基因突变,包括缺失(50.41%)和重复(11.57%)。有 43.75%的母亲是突变携带者。在 15 名胎儿中,7 名男性胎儿中有 2 名不健康,8 名女性胎儿中有 2 名是携带者。突变区域中重复频率最高的外显子为 3-26 和 45-52。在单个外显子的重复频率中,缺失区域最常见的外显子为 47 和 50,重复区域最常见的外显子为 5、6 和 7。
MLPA 比多重 PCR 具有更好的生产力和灵敏度。应在 DMD 高危胎儿中应用产前诊断,以降低疾病发生率。此外,告知女性携带者产前诊断的重要性是医生的责任。