Nerakh Gayatri, Ranganath Prajnya, Murugan Sakthivel
Department of Medical Genetics, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
MedGenome Labs Ltd., Bengaluru, India.
J Pediatr Genet. 2021 Mar;10(1):23-28. doi: 10.1055/s-0040-1713850. Epub 2020 Jul 8.
Multiplex ligation-dependent probe amplification (MLPA) detects exonic deletions and duplications in the gene in around 65 to 70% of patients with the Duchenne muscular dystrophy (DMD) phenotype. This study looks at the diagnostic yield of next-generation sequencing (NGS) and the mutation spectrum in an Asian Indian cohort of MLPA-negative cases with the DMD phenotype. NGS-based sequencing of gene was done in 28 MLPA-negative cases (25 male probands with the DMD phenotype and 3 obligate carrier mothers of deceased affected male patients) and disease-causing variants were identified in 19 (67.9%) of these cases. Further molecular testing in four of the remaining nine cases revealed gene variants associated with limb girdle muscular dystrophies. Thus, NGS-based multigene panel testing for muscular dystrophy-associated genes or clinical exome sequencing rather than targeted gene sequencing appears to be a more cost-effective testing modality with better diagnostic yield, for MLPA-negative patients with the DMD phenotype.
多重连接依赖探针扩增(MLPA)可在约65%至70%的杜氏肌营养不良(DMD)表型患者中检测到该基因的外显子缺失和重复。本研究观察了下一代测序(NGS)在一组具有DMD表型的MLPA阴性的亚洲印度人群中的诊断效率及突变谱。对28例MLPA阴性病例(25例具有DMD表型的男性先证者和3例已故受影响男性患者的 obligate 携带者母亲)进行了基于NGS的该基因测序,其中19例(67.9%)鉴定出致病变异。对其余9例中的4例进行的进一步分子检测发现了与肢带型肌营养不良相关的基因变异。因此,对于具有DMD表型的MLPA阴性患者,基于NGS的肌营养不良相关基因多基因panel检测或临床外显子组测序而非靶向该基因测序似乎是一种更具成本效益且诊断效率更高的检测方式。