Giambona Antonino, Leto Filippo, Cassarà Filippo, Tartaglia Viviana, Campisi Rosario, Campisi Corrado, Cigna Valentina, Mugavero Elena, Cucinella Gaspare, Orlandi Emanuela, Picciotto Francesco, Maggio Aurelio, Vinciguerra Margherita
Unit of Molecular Diagnostics of Rare Hematological Diseases, A.O.O.R. "Villa Sofia Cervello", Palermo, Italy.
Campisi Laboratories, Avola, Siracusa, Italy.
Hemoglobin. 2022 Nov;46(6):297-302. doi: 10.1080/03630269.2023.2167659. Epub 2023 Feb 21.
The procedures commonly used for prenatal diagnosis (PND) of thalassemia are villocentesis or amniocentesis, respectively, at the 11th and 16th weeks of gestation. Their main limitation is essentially due to the late gestation week in which diagnosis is performed. The celomic cavity is accessible between the 7th and 9th weeks of gestation and it has been demonstrated that it contains embryonic erythroid precursor cells as a source of fetal DNA for earlier invasive PND of thalassemia and other monogenic diseases. In this study, we report the use of celomatic fluids obtained from nine women with high-risk pregnancies for Sicilian (δβ)-thalassemia [(δβ)-thal] deletion (NG_000007.3: g.64336_77738del13403) and β-thalassemia (β-thal). Fetal cells were isolated by a micromanipulator, and nested polymerase chain reaction (PCR) and short tandem repeats (STRs) analysis were performed. Prenatal diagnosis was successfully performed in all examined cases. One fetus was a compound heterozygote for (δβ)- and β-thal, three fetuses were found to be carriers of β-thal, four fetuses carriers of a Sicilian δβ deletion, and one fetus without parental mutations. Accidentally, a rare case of paternal triploidy was observed. The genotypic analysis, carried out both by amniocentesis and on abortive tissue or after birth, showed concordance with results obtained on fetal celomic DNA. Our results unequivocally show that fetal DNA can be obtained by nucleated fetal cells present in the celomatic fluid and demonstrate, for the first time, that PND of Sicilian (δβ)-thal and β-thal is feasible at an earlier time in pregnancy than other procedures.
地中海贫血产前诊断(PND)常用的方法分别是在妊娠第11周和第16周进行绒毛取样或羊膜穿刺术。其主要局限性本质上是由于诊断进行时孕周较晚。在妊娠第7至9周可进入体腔,并且已经证明体腔中含有胚胎红细胞前体细胞,可作为胎儿DNA的来源,用于更早地对地中海贫血和其他单基因疾病进行侵入性PND。在本研究中,我们报告了从9例西西里(δβ)-地中海贫血[(δβ)-thal]缺失(NG_000007.3:g.64336_77738del13403)和β-地中海贫血(β-thal)高危妊娠女性中获取体腔液的情况。通过显微操作器分离胎儿细胞,并进行巢式聚合酶链反应(PCR)和短串联重复序列(STRs)分析。在所有检查病例中均成功进行了产前诊断。1例胎儿为(δβ)-和β-地中海贫血的复合杂合子,3例胎儿被发现是β-地中海贫血携带者,4例胎儿是西西里δβ缺失携带者,1例胎儿无亲本突变。偶然观察到1例罕见的父源性三倍体病例。通过羊膜穿刺术以及对流产组织或出生后进行的基因分型分析,结果与从胎儿体腔DNA获得的结果一致。我们的结果明确表明,可以通过体腔液中存在的有核胎儿细胞获得胎儿DNA,并首次证明西西里(δβ)-地中海贫血和β-地中海贫血的PND在妊娠早期比其他方法更可行。