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使用单基因疾病植入前基因检测来预防1型瓜氨酸血症的传播。

Using preimplantation genetic testing for monogenic disease for preventing citrullinemia type 1 transmission.

作者信息

Wu Zubo, Liang Tao, Liu Yi, Ding Xiaofang, Shu Defeng

机构信息

Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Genet. 2024 Aug 8;15:1389461. doi: 10.3389/fgene.2024.1389461. eCollection 2024.

Abstract

AIM

The aim of this study is to investigate if Preimplantation Genetic Testing (PGT) can effectively identify unreported variants according to American College of Medical Genetics and Genomics (ACMG)to prevent citrullinemia type 1 affection.

DESIGN

This study involves a detailed case analysis of a family with history of citrullinemia type 1, focusing on the use of PGT for monogenic diseases (PGT-M). The genetic variants were identified using ACMG guidelines, and PGT was employed to prevent the inheritance of these variants. The study included haplotype analysis and Sanger sequencing to confirm the results.

RESULTS

The study identified previously unreported variations in the ASS1 gene causing citrullinemia type 1. PGT successfully prevented the transmission of these variants, resulting in the birth of a healthy fetus. However, challenges such as allele dropout (ADO) and gene recombination were encountered during haplotype analysis, which could potentially defeat the diagnosis. The study demonstrated that combining haplotype analysis with Sanger sequencing can enhance the accuracy of PGT.

CONCLUSION

Preimplantation Genetic Testing (PGT) targeting likely pathogenic and pathogenic variants in the ASS1 gene, as rated by ACMG, allows the birth of healthy infants free from citrullinemia type 1. Additionally, the establishment of single haplotypes and Sanger sequencing can reduce the misdiagnosis rate caused by allele dropout (ADO) and genetic recombination.

摘要

目的

本研究旨在调查植入前基因检测(PGT)是否能根据美国医学遗传学与基因组学学会(ACMG)有效地识别未报告的变异,以预防1型瓜氨酸血症。

设计

本研究对一个有1型瓜氨酸血症病史的家庭进行了详细的病例分析,重点是单基因疾病的植入前基因检测(PGT-M)。使用ACMG指南鉴定基因变异,并采用PGT预防这些变异的遗传。该研究包括单倍型分析和桑格测序以确认结果。

结果

该研究在导致1型瓜氨酸血症的ASS1基因中发现了以前未报告的变异。PGT成功地阻止了这些变异的传递,从而诞生了一个健康的胎儿。然而,在单倍型分析过程中遇到了诸如等位基因脱扣(ADO)和基因重组等挑战,这可能会影响诊断。该研究表明,将单倍型分析与桑格测序相结合可以提高PGT的准确性。

结论

针对ACMG评定的ASS1基因中可能致病和致病的变异进行植入前基因检测(PGT),可使无1型瓜氨酸血症的健康婴儿出生。此外,建立单倍型和桑格测序可以降低由等位基因脱扣(ADO)和基因重组引起的误诊率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f9/11338862/76437bc8e3fa/fgene-15-1389461-g001.jpg

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