Tan Hu, Xie Yinong, Chen Fei, Chen Min, Yu Li, Chen Dunjin, Chen Jingsi
Key Laboratory for Major Obstetric Diseases of Guangdong Province, Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong, China; The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou 510150, China; Obstetrics & Gynecology Institute of Guangzhou, Guangzhou 510150, China.
Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China.
Clin Chim Acta. 2020 Nov;510:599-604. doi: 10.1016/j.cca.2020.08.018. Epub 2020 Aug 14.
Fetal central nervous system abnormalities often associated with infant death or severe disability. The etiology in fetuses with CNS abnormalities who have normal karyotypes and copy number variants (CNVs) remains unclear, which increases the difficulty in following management and the assessment of prognosis.
11 unrelated fetuses with CNS abnormalities and their parents were enrolled. Genomic DNA was obtained and then trios-medical exome sequencing (trios-MES) including 4000 genes (fetuses and their parents) was performed after both karyotyping and chromosome microarray showed negative results.
Pathogenic and likely pathogenic variants were identified in five of 11 cases (5/11, 45.5%), including five novel mutations and two recurrent mutations in ISPD, L1CAM, and GRIN2B genes. Most cases (4/5, 80%) carried one or two recessive mutations, indicating a high recurrent risk.
Exome sequencing should be considered for fetuses with CNS abnormalities following negative results of karyotyping and chromosome array. Trios-MES as one of exome sequencing is a potential method for the diagnosis of these fetuses.
胎儿中枢神经系统异常常与婴儿死亡或严重残疾相关。染色体核型和拷贝数变异(CNV)均正常的中枢神经系统异常胎儿的病因仍不清楚,这增加了后续管理的难度和预后评估的难度。
纳入11例无亲缘关系的中枢神经系统异常胎儿及其父母。获取基因组DNA,在染色体核型分析和染色体微阵列检测结果均为阴性后,对包括4000个基因(胎儿及其父母)进行三联体医学外显子组测序(trios-MES)。
11例中有5例(5/11,45.5%)鉴定出致病和可能致病的变异,包括ISPD、L1CAM和GRIN2B基因中的5个新突变和2个复发性突变。大多数病例(4/5,80%)携带一个或两个隐性突变,表明复发风险较高。
染色体核型分析和染色体阵列检测结果为阴性的中枢神经系统异常胎儿应考虑进行外显子组测序。三联体医学外显子组测序作为外显子组测序方法之一,是诊断这些胎儿的一种潜在方法。