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Abstract
This article focuses on essential components related to prenatal screening for cystic fibrosis, including the clinical disease, inheritance, prognosis and treatment, birth prevalence, and ethnic variability. The molecular basis of this disease is presented, including a discussion of the gene, mutations, and genotype/phenotype correlations. The models that have been used for delivering prenatal screening services in pilot trials are described, along with lessons learned, expected screening performance, and relevant ELSI considerations. A realistic view of laboratory issues is considered, including current standards of performance, guidelines and oversight, and quality assurance. Examples of current laboratory technologies for cystic fibrosis testing are displayed.
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Affiliation(s)
- Carolyn S Richards
- Diagnostic Sequencing Laboratory, Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030-6182, USA.
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Richards CS, Bradley LA, Amos J, Allitto B, Grody WW, Maddalena A, McGinnis MJ, Prior TW, Popovich BW, Watson MS, Palomaki GE. Standards and guidelines for CFTR mutation testing. Genet Med 2002; 4:379-91. [PMID: 12394352 DOI: 10.1097/00125817-200209000-00010] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
One mission of the ACMG Laboratory Quality Assurance (QA) Committee is to develop standards and guidelines for clinical genetics laboratories, including cytogenetics, biochemical, and molecular genetics specialties. This document was developed under the auspices of the Molecular Subcommittee of the Laboratory QA Committee by the Cystic Fibrosis (CF) Working Group. It was placed on the "fast track" to address the preanalytical, analytical, and postanalytical quality assurance practices of laboratories currently providing testing for CF. Due to the anticipated impact of the ACMG recommendation statement endorsing carrier testing of reproductive couples, it was viewed that CF testing would increase in volume and that the number of laboratories offering CF testing would also likely increase. Therefore, this document was drafted with the premise of providing useful information gained by experienced laboratory directors who have provided such testing for many years. In many instances, "tips" are given. However, these guidelines are not to be interpreted as restrictive or the only approach but to provide a helpful guide. Certainly, appropriately trained and credentialed laboratory directors have flexibility to utilize various testing platforms and design testing strategies with considerable latitude. We felt that it was essential to include technique-specific guidelines of several current technologies commonly used in laboratories providing CF testing, since three of the four technologies discussed are available commercially and are widely utilized. We take the view that these technologies will change, and thus this document will change with future review.
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Affiliation(s)
- Carolyn Sue Richards
- Molecular Subcommittee of the Laboratory Quality Assurance Committee, American College of Medical Genetics, 9650 Rockville Pike, Bethesda, MD 20914-3998, USA
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Houdayer C, Cazeneuve C, Cougoureux E, Magnier C, Tredano M, Aymard P, Goossens M, Feldmann D. Clinical Evaluation of the CF(12)m Cystic Fibrosis DNA Diagnostic Kit. Clin Chem 1998. [DOI: 10.1093/clinchem/44.6.1346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Claude Houdayer
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
| | - Cecile Cazeneuve
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
| | - Emmanuel Cougoureux
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
| | - Catherine Magnier
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
| | - Mohammed Tredano
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
| | - Pierre Aymard
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
| | - Michel Goossens
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
| | - Delphine Feldmann
- Department of Clinical Biochemistry, Hôpital Armand Trousseau, 75012 Paris, France, and Department of Biochemistry and Molecular Genetics, Hôpital Henri Mondor, 94010 Creteil, France
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Irish MS, Ragi JM, Karamanoukian H, Borowitz DS, Schmidt D, Glick PL. Prenatal diagnosis of the fetus with cystic fibrosis and meconium ileus. Pediatr Surg Int 1997; 12:434-6. [PMID: 9244121 DOI: 10.1007/bf01076961] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The sonographic finding of hyperechoic or dilated fetal bowel raises suspicion of a number of prenatal disorders including meconium ileus (MI), meconium peritonitis, congenital infection, neoplasm, or chromosomal trisomy. These findings may also represent transient normal variants. The following case report details the evaluation of one pregnancy with abnormal intestinal echogenic findings on serial sonograms (US), to demonstrate inherent diagnostic difficulties in such a case. A diagnostic algorithm is presented to aid in the proper use of US and DNA mutation analysis for cystic fibrosis (CF), so that the cause of an abnormal abdominal US can be established earlier and more accurately than suggested by previous management schemes. Earlier fetal diagnosis may help to anticipate postnatal problems associated with CF/MI, and therefore provide more optimal clinical management of the affected fetus.
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Affiliation(s)
- M S Irish
- The Buffalo Institute of Fetal Therapy (BIFT), The Children's Hospital of Buffalo, Department of Surgery, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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Sorenson JR, Cheuvront B, DeVellis B, Callanan N, Silverman L, Koch G, Sharp T, Fernald G. Acceptance of home and clinic-based cystic fibrosis carrier education and testing by first, second, and third degree relatives of cystic fibrosis patients. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/(sici)1096-8628(19970516)70:2<121::aid-ajmg4>3.0.co;2-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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de Vries HG, Collèe JM, van Veldhuizen MH, Achterhof L, Smit Sibinga CT, Scheffer H, Buys CH, ten Kate LP. Validation of the determination of deltaF508 mutations of the cystic fibrosis gene in over 11 000 mouthwashes. Hum Genet 1996; 97:334-6. [PMID: 8786076 DOI: 10.1007/bf02185766] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Mouthwashes can be used as a DNA resource for mutation detection and, because collection and DNA isolation is simple and cheap, they could in particular, be used for large numbers of samples. To determine the failure rate (the proportion of mouth samples in which no PCR product was obtained) and the specificity of buccal epithelial cell mutation detection in large numbers of samples, we collected mouthwashes and blood samples from 11 413 blood donors and tested the mouthwashes for the deltaF508 mutation, which has an estimated frequency Of 75% among cystic fibrosis chromosomes in The Netherlands. Blood samples were tested for the deltaF508 mutations only if the mutation was identified in the mouthwash or in the case of a failure to obtain PCR products. The sensitivity of the test was determined in mouthwashes of 75 deltaF508 carriers known from earlier family studies. These samples were offered blindly between the mouthwashes of the blood donors. Both specificity and sensitivity of the mouthwash procedure were 100%. The overall failure rate was 5.6%. This large figure was caused mainly by insufficient rinsing of the mouth in one particular blood bank. Exclusion of the results of this blood bank reduced the failure rate to 1.8%. Our results also confirmed that for a large number of samples the mouthwash procedure is suitable for mutation detection and, with proper instructions, can be used in community screening.
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Affiliation(s)
- H G de Vries
- Department of Medical Genetics, University of Groningen, The Netherlands
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