Department of Dermatology, Kanazawa Medical University, Uchinada 920-0293, Japan.
Center for Clinical Genomics, Kanazawa Medical University Hospital, Uchinada 920-0293, Japan.
Genes (Basel). 2023 Nov 15;14(11):2079. doi: 10.3390/genes14112079.
Advances in genetic technologies have made genetic testing more accessible than ever before. However, depending on national, regional, legal, and health insurance circumstances, testing procedures may still need to be streamlined in real-world clinical practice. In cases of autosomal recessive disease with consanguinity, the mutation locus is necessarily isodisomy because both alleles originate from a common ancestral chromosome. Based on this premise, we implemented integrated genetic diagnostic methods using SNP array screening and long range PCR-based targeted NGS in a Japanese patient with xeroderma pigmentosum (XP) under the limitation of the national health insurance system. SNP array results showed isodisomy only in and loci. NGS, with a minimal set of long-range PCR primers, detected a homozygous frameshift mutation in ; NM_004628.5:c.218_219insT p.(Lys73AsnfsTer9), confirmed by Sanger sequencing, leading to a rapid diagnosis of XP group C. This shortcut strategy is applicable to all autosomal recessive diseases caused by consanguineous marriages, especially in scenarios with a moderate number of genes to test, a common occurrence in clinical genetic practice.
遗传技术的进步使得基因检测比以往任何时候都更加容易。然而,根据国家、地区、法律和健康保险的情况,测试程序在实际临床实践中仍可能需要简化。在常染色体隐性遗传病伴亲缘关系的情况下,突变位点必然是同系二倍体,因为两个等位基因都来自共同的祖先染色体。基于这一前提,我们在国家健康保险制度的限制下,对一名日本 XP 患者实施了 SNP 阵列筛选和基于长距离 PCR 的靶向 NGS 综合遗传诊断方法。SNP 阵列结果仅显示 和 基因座的同系二倍体。使用最小一组长距离 PCR 引物的 NGS 检测到 中的纯合移码突变;NM_004628.5:c.218_219insT p.(Lys73AsnfsTer9),通过 Sanger 测序证实,导致 XP 组 C 的快速诊断。这种快捷策略适用于所有由近亲结婚引起的常染色体隐性遗传病,特别是在基因数量适中的情况下,这种情况在临床遗传实践中很常见。