Liu Chang, Deng Huiting, Yang Cheng, Li Xixi, Zhu Yanrong, Chen Xiangfa, Li Hui, Li Shuo, Cui Hao, Zhang Xiaoyan, Tan Xiaoyue, Li Dong, Zhang Zhujun
Department of Pathology, School of Medicine, Nankai University, Tianjin, China.
Department of Neurology, Tianjin Children's Hospital, Tianjin, China.
J Clin Lab Anal. 2018 Oct;32(8):e22575. doi: 10.1002/jcla.22575. Epub 2018 May 25.
The genetic diagnosis of Duchenne muscular dystrophy (DMD) has been complicated by the large size of the gene and its heterogeneous mutational spectrum. Multiplex PCR and multiplex ligation-dependent probe amplification (MLPA) are two well-established mutation screening methods. Here, we applied targeted next-generation sequencing (NGS) to clarify discrepant results between multiplex PCR and MLPA in a Chinese patient with DMD.
MLPA was performed to confirm multiplex PCR results obtained previously. Targeted NGS was then used to analyze the full-length DMD gene including introns.
Multiplex PCR had previously identified an apparent deletion of exon 43 in the patient with DMD, but current MLPA indicated that exon 43 was present. Targeted NGS to clarify the genetic diagnosis identified a novel mutation, c.6241_c.6290 + 1109del1159insAC, which caused partial deletion of exon 43. This mutation removed the annealing sequence of the exon 43 reverse primer in multiplex PCR but had no influence on the hybridization site of the MLPA probe. Therefore, the discrepancy between the two methods was caused by partial exonic deletion that escaped MLPA detection.
Targeted NGS disclosed a novel partial exonic deletion in the DMD gene as the cause of discrepancy between multiplex PCR and MLPA. Targeted NGS could be used to provide a more accurate genetic diagnosis of DMD, particularly in cases of partial exonic deletions, which will be of benefit in patient management and the identification of disease carriers.
杜氏肌营养不良症(DMD)的基因诊断因该基因的巨大规模及其异质性突变谱而变得复杂。多重PCR和多重连接依赖探针扩增(MLPA)是两种成熟的突变筛查方法。在此,我们应用靶向新一代测序(NGS)来阐明一名中国DMD患者多重PCR和MLPA结果之间的差异。
进行MLPA以确认先前获得的多重PCR结果。然后使用靶向NGS分析包括内含子在内的全长DMD基因。
多重PCR先前在该DMD患者中鉴定出第43外显子明显缺失,但当前MLPA表明第43外显子存在。用于阐明基因诊断的靶向NGS鉴定出一种新突变,c.6241_c.6290 + 1109del1159insAC,该突变导致第43外显子部分缺失。此突变消除了多重PCR中第43外显子反向引物的退火序列,但对MLPA探针的杂交位点没有影响。因此,两种方法之间的差异是由逃避MLPA检测的外显子部分缺失引起的。
靶向NGS揭示了DMD基因中一种新的外显子部分缺失,这是多重PCR和MLPA之间差异的原因。靶向NGS可用于提供更准确的DMD基因诊断,特别是在外显子部分缺失的情况下,这将有助于患者管理和疾病携带者的识别。