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Abstract
Haemophilia A and B are rare congenital, recessive X-linked disorders caused by lack or deficiency of clotting factor VIII (FVIII) or IX (FIX), respectively. The severity of the disease depends on the reduction of levels of FVIII or FIX, which are determined by the type of the causative mutation in the genes encoding the factors (F8 and F9, respectively). The hallmark clinical characteristic, especially in untreated severe forms, is bleeding (spontaneous or after trauma) into major joints such as ankles, knees and elbows, which can result in the development of arthropathy. Intracranial bleeds and bleeds into internal organs may be life-threatening. The median life expectancy was ~30 years until the 1960s, but improved understanding of the disorder and development of efficacious therapy based on prophylactic replacement of the missing factor has caused a paradigm shift, and today individuals with haemophilia can look forward to a virtually normal life expectancy and quality of life. Nevertheless, the potential development of inhibitory antibodies to infused factor is still a major hurdle to overcome in a substantial proportion of patients. Finally, gene therapy for both types of haemophilia has progressed remarkably and could soon become a reality.
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Ahmadi MH, Amirizadeh N, Rabiee M, Rahimi-Sharbaf F, Pourfathollah AA. Noninvasive Fetal Sex Determination by Real-Time PCR and TaqMan Probes. Rep Biochem Mol Biol 2020; 9:315-323. [PMID: 33649725 DOI: 10.29252/rbmb.9.3.315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background Noninvasive fetal sex determination by analyzing Y chromosome-specific sequences is very useful in the management of cases related to sex-linked genetic diseases. The aim of this study was to establish a non-invasive fetal sex determination test using Real-Time PCR and specific probes. Methods The study was a prospective observational cohort study conducted from August 2018 to September 2019. Venous blood samples were collected from 25 Iranian pregnant women at weeks 7 to 25 of gestation. Cell-free DNA (cfDNA) was isolated from the plasma of samples and fetal sex was determined by SRY gene analysis using the Real-Time PCR technique. In the absence of SRY detection, the presence of fetal DNA was investigated using cfDNA treated with BstUI enzyme and PCR for the epigenetic marker RASSF1A. Results Of the total samples analyzed, 48% were male and 52% female. The RASSF1A assay performed on SRY negative cases also confirmed the presence of cell-free fetal DNA. Genotype results were in full agreement with neonate gender, and the accuracy of noninvasive fetal sex determination was 100%. Conclusion Fetal sex determination using the strategy applied in this study is noninvasive and highly accurate and can be exploited in the management of sex-linked genetic diseases.
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Affiliation(s)
- Mohammad Hossein Ahmadi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Naser Amirizadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Maryam Rabiee
- Department of Obstetrics and Gynecology, Shahed University, Tehran, Iran
| | - Fatemeh Rahimi-Sharbaf
- Department of Perinatology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Pourfathollah
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Chen M, Chen C, Huang X, Sun J, Jiang L, Li Y, Zhu Y, Tian C, Li Y, Lu Z, Wang Y, Zeng F, Yang Y, Song X, Peng Z, Yin C, Chen D. Noninvasive prenatal diagnosis for Duchenne muscular dystrophy based on the direct haplotype phasing. Prenat Diagn 2020; 40:918-924. [PMID: 31916613 DOI: 10.1002/pd.5641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/12/2019] [Accepted: 12/20/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE We aimed to investigate the validity of noninvasive prenatal diagnosis (NIPD) based on direct haplotype phasing without the proband or other family members and its feasibility for clinical application in the case of Duchenne muscular dystrophy (DMD). METHODS Thirteen singleton-pregnancy families affected by DMD were recruited. The pathogenic variants in the pregnant females have been identified by multiplex ligation-dependent probe amplification (MLPA). We resolved maternal haplotypes for each family by performing targeted linked-read sequencing of their high molecular weight DNA, respectively. Then, we integrated the maternal haplotypes and the targeted sequencing results of maternal plasma DNA to infer the fetal haplotype and the DMD gene variant status. The fetal genotypes were further validated by using chorionic villus sampling. RESULTS The method of directly resolving maternal haplotype through targeted linked-read sequencing was smoothly performed in 12 participated families, but one failed (F11). The predicted variant status of 12 fetuses was correct, which had been confirmed by invasive prenatal diagnosis. CONCLUSION Direct haplotyping of NIPD based on linked-read sequencing for DMD is accurate.
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Affiliation(s)
- Min Chen
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics and Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China
| | - Chao Chen
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | | | - Jun Sun
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Lu Jiang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Yingting Li
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yaping Zhu
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | | | - Yufan Li
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics and Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China
| | - Zhe Lu
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Yaoshen Wang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | | | - Yun Yang
- Wuhan BGI Clinical Laboratory Co., Ltd, BGI-Wuhan, BGI-Shenzhen, Wuhan, China
| | - Xiwei Song
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Zhiyu Peng
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Chenghong Yin
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Dunjin Chen
- Department of Fetal Medicine and Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Obstetrics and Gynecology Institute of Guangzhou, Guangzhou, China.,The Medical Centre for Critical Pregnant Women in Guangzhou, Guangzhou, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.,Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Guangzhou, China
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Lannoy N, Hermans C. Genetic mosaicism in haemophilia: A practical review to help evaluate the risk of transmitting the disease. Haemophilia 2020; 26:375-383. [PMID: 32267612 DOI: 10.1111/hae.13975] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 02/24/2020] [Accepted: 03/04/2020] [Indexed: 12/29/2022]
Abstract
Approximately 70% of patients with haemophilia exhibit a clear inheritance pattern, while for the remaining 30%, patients are the first to be diagnosed in their family and are considered sporadic cases. In such a setting, the determination of carrier status and the risk estimation of disease transmission to another child are major challenges for genetic counselling. Large studies have suggested that genetic testing reveals 70% of sporadic patients' mothers are carriers. In the remaining 30%, in some apparently non-carrier mothers, the pathogenic variant can be detected as low somatic and gonosomal mosaicism. The significance of mosaic pathogenic variants has thus far been underestimated, since conventional Sanger sequencing and other technology are not sufficiently sensitive. The study of various tissue samples and recent extra-sensitive molecular methods have now made it easier to detect both single-nucleotide variants (SNVs) and copy-number variants (CNVs), at a mosaic level in parents, and to predict the probability of disease recurrence. This review seeks to examine various kinds of mosaicism in haemophilia, including the mechanisms by which they arise and the risk of passing these variants on to the next generation. In addition, we focus on the selection of cell tissues and methods to detect these mosaic variants in the haemophilia setting. Taking into account the high rate of mosaicism in mothers of sporadic cases, we propose a diagnostic flow chart that could facilitate better evaluation of the risk of transmitting haemophilia in genetic and prenatal counselling.
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Affiliation(s)
- Nathalie Lannoy
- Division of Adult Haematology, Haemophilia Center, Saint-Luc University Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Cedric Hermans
- Division of Adult Haematology, Haemophilia Center, Saint-Luc University Hospital, Université catholique de Louvain, Brussels, Belgium
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Mahdavi S, Karami F, Sabbaghi S. Non-invasive prenatal diagnosis of foetal gender through maternal circulation in first trimester of pregnancy. J OBSTET GYNAECOL 2019; 39:1071-1074. [PMID: 31177896 DOI: 10.1080/01443615.2019.1586851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Owing to the lack of perfect accuracy and sufficient sample size in previously performed studies on cell-free foetal DNA (cffDNA) for detection of foetal gender through maternal plasma, this study aimed to investigate the efficiency of using two Y-chromosome specific probes in foetal sex determination during first trimester of pregnancy. Five millilitres of whole blood was drawn from 192 pregnant women (10-12 weeks) and was subjected to isolate cffDNA following separation of plasma. TaqMan Real-time PCR was performed on isolated cffDNA using primer pairs and probes specific for SRY, ZFY and β-globin genes. Co-amplification of ZFY and SRY genes was detected in 103 samples confirmed after the birth. Sensitivity and specificity of the test were calculated to be 100%. Further study on larger sample size is required to confirm the reproducibility of the present test in early and non-invasive determination of foetal sex. IMPACT STATEMENT What is already known on this subject? Foetal gender analysis through maternal plasma has been investigated in some cell-free foetal DNA (cffDNA) analysis. However, the detection rate and method of cffDNA analysis were different among various studies. What do the results of this study add? This study introduced a modified simple probe based real time analysis with perfect detection rate. What are the implications of these findings for clinical practice and/or further research? The proposed method can be used as diagnostic test in all laboratories around the world using real-time PCR to non-invasively determine the foetal gender in the initial weeks of pregnancy following confirmation in larger sample size.
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Affiliation(s)
- Saeed Mahdavi
- Department of Research and Development, Saeed Pathobiology Laboratory , Tehran , Iran
| | - Fatemeh Karami
- Department of Research and Development, Saeed Pathobiology Laboratory , Tehran , Iran.,Department of Medical Genetic, Applied Biophotonics Research Center, Science and Research Branch, Islamic Azad University , Tehran , Iran
| | - Saeed Sabbaghi
- Department of Research and Development, Saeed Pathobiology Laboratory , Tehran , Iran
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Prenatal non-invasive foetal RHD genotyping: diagnostic accuracy of a test as a guide for appropriate administration of antenatal anti-D immunoprophylaxis. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2018; 16:514-524. [PMID: 29757138 DOI: 10.2450/2018.0270-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/13/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Foetal RHD genotyping can be predicted by real-time polymerase chain reaction (qPCR) using cell-free foetal DNA extracted from maternal plasma. The object of this study was to determine the diagnostic accuracy and feasibility of non-invasive RHD foetal genotyping, using a commercial multiple-exon assay, as a guide to appropriate administration of targeted antenatal immunoprophylaxis. MATERIAL AND METHODS Cell-free foetal DNA was extracted from plasma of RhD-negative women between 11-30 weeks of pregnancy. The foetal RHD genotype was determined non-invasively by qPCR amplification of exons 5, 7 and 10 of the RHD gene using the Free DNA Fetal Kit® RhD. Results were compared with serological RhD cord blood typing at birth. The analysis of diagnostic accuracy was restricted to the period (24-28+6 weeks) during which foetal genotyping is usually performed for targeted antenatal immunoprophylaxis. RESULTS RHD foetal genotyping was performed on 367 plasma samples (24-28+6 weeks). Neonatal RhD phenotype results were available for 284 pregnancies. Foetal RHD status was inconclusive in 9/284 (3.2%) samples, including four cases with RhD maternal variants. Two false-positive results were registered. The sensitivity was 100% and the specificity was 97.5% (95% CI: 94.0-100). The diagnostic accuracy was 99.3% (95% CI: 98.3-100), decreasing to 96.1% (95% CI: 93.9-98.4) when the inconclusive results were included. The negative and positive predictive values were 100% (95% CI: 100-100) and 99.0% (95% CI: 97.6-100), respectively. There was one false-negative result in a sample collected at 18 weeks. After inclusion of samples at early gestational age (<23+6 week), sensitivity and accuracy were 99.6% (95% CI: 98.7-100) and 95.5% (95% CI: 93.3-97.8), respectively. DISCUSSION This study demonstrates that foetal RHD detection on maternal plasma using a commercial multiple-exon assay is a reliable and accurate tool to predict foetal RhD phenotype. It can be a safe guide for the appropriate administration of targeted prenatal immunoprophylaxis.
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Li K, Duan Y, Ting MYL, Ou Z, Liu L, Zhang K, Fu X. Future Science Prize goes to non-invasive prenatal testing. SCIENCE CHINA-LIFE SCIENCES 2017; 60:429-431. [PMID: 28299578 DOI: 10.1007/s11427-016-0411-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 12/19/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Kang Li
- Molecular Medicine Research Center, Department of Ophthalmology, West China Hospital, Sichuan University, Sichuan, 610041, China.,Guangzhou Elite Health Biological Pharmaceutical Technology Company Ltd., Guangzhou, 510005, China
| | - Yaou Duan
- Institute for Genomic Medicine and Shiley Eye Institute, University of California San Diego, La Jolla, CA, 92328, USA
| | - Magdalene Yin Lin Ting
- Institute for Genomic Medicine and Shiley Eye Institute, University of California San Diego, La Jolla, CA, 92328, USA
| | - Zhiying Ou
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Li Liu
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Kang Zhang
- Institute for Genomic Medicine and Shiley Eye Institute, University of California San Diego, La Jolla, CA, 92328, USA.,Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Xin Fu
- Institute for Genomic Medicine and Shiley Eye Institute, University of California San Diego, La Jolla, CA, 92328, USA. .,Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
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8
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Neofytou MC, Tsangaras K, Kypri E, Loizides C, Ioannides M, Achilleos A, Mina P, Keravnou A, Sismani C, Koumbaris G, Patsalis PC. Targeted capture enrichment assay for non-invasive prenatal testing of large and small size sub-chromosomal deletions and duplications. PLoS One 2017; 12:e0171319. [PMID: 28158220 PMCID: PMC5291539 DOI: 10.1371/journal.pone.0171319] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
Noninvasive prenatal testing (NIPT) using whole genome and targeted sequencing has become increasingly accepted for clinical detection of Trisomy 21 and sex chromosome aneuploidies. Few studies have shown that sub-chromosomal deletions or duplications associated with genetic syndromes can also be detected in the fetus noninvasively. There are still limitations on these methodologies such as the detection of variants of unknown clinical significance, high number of false positives, and difficulties to detect small aberrations. We utilized a recently developed targeted sequencing approach for the development of a NIPT assay, for large and small size deletions/duplications, which overcomes these existing limitations. Artificial pregnancies with microdeletion/microduplication syndromes were created by spiking DNA from affected samples into cell free DNA (cfDNA) from non-pregnant samples. Unaffected spiked samples and normal pregnancies were used as controls. Target Capture Sequences (TACS) for seven syndromes were designed and utilized for targeted capture enrichment followed by sequencing. Data was analyzed using a statistical pipeline to identify deletions or duplications on targeted regions. Following the assay development a proof of concept study using 33 normal pregnancies, 21 artificial affected and 17 artificial unaffected pregnancies was carried out to test the sensitivity and specificity of the assay. All 21 abnormal spiked-in samples were correctly classified as subchromosomal aneuploidies while the 33 normal pregnancies or 17 normal spiked-in samples resulted in a false positive result. We have developed an NIPT assay for the detection of sub-chromosomal deletions and duplications using the targeted capture enrichment technology. This assay demonstrates high accuracy, high read depth of the genomic region of interest, and can identify deletions/duplications as small as 0.5 Mb. NIPT of fetal microdeletion/microduplication syndromes can be of enormous benefit in the management of pregnancies at risk both for prospective parents and health care providers.
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Affiliation(s)
- Maria C. Neofytou
- Translational Genetics Team, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | | | - Elena Kypri
- Translational Genetics Team, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- NIPD Genetics Ltd, Nicosia, Cyprus
| | | | | | | | | | - Anna Keravnou
- Translational Genetics Team, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Carolina Sismani
- Department of Cytogenetics and Genomics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - George Koumbaris
- Translational Genetics Team, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- NIPD Genetics Ltd, Nicosia, Cyprus
| | - Philippos C. Patsalis
- Translational Genetics Team, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- NIPD Genetics Ltd, Nicosia, Cyprus
- * E-mail:
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Hui WWI, Jiang P, Tong YK, Lee WS, Cheng YKY, New MI, Kadir RA, Chan KCA, Leung TY, Lo YMD, Chiu RWK. Universal Haplotype-Based Noninvasive Prenatal Testing for Single Gene Diseases. Clin Chem 2017; 63:513-524. [DOI: 10.1373/clinchem.2016.268375] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 11/17/2016] [Indexed: 01/02/2023]
Abstract
Abstract
BACKGROUND
Researchers have developed approaches for the noninvasive prenatal testing of single gene diseases. One approach that allows for the noninvasive assessment of both maternally and paternally inherited mutations involves the analysis of single nucleotide polymorphisms (SNPs) in maternal plasma DNA with reference to parental haplotype information. In the past, parental haplotypes were resolved by complex experimental methods or inferential approaches, such as through the analysis of DNA from other affected family members. Recently, microfluidics-based linked-read sequencing technology has become available and allows the direct haplotype phasing of the whole genome rapidly. We explored the feasibility of applying this direct haplotyping technology in noninvasive prenatal testing.
METHODS
We first resolved the haplotypes of parental genomes with the use of linked-read sequencing technology. Then, we identified SNPs within and flanking the genes of interest in maternal plasma DNA by targeted sequencing. Finally, we applied relative haplotype dosage analysis to deduce the mutation inheritance status of the fetus.
RESULTS
Haplotype phasing and relative haplotype dosage analysis of 12 out of 13 families were successfully achieved. The mutational status of these 12 fetuses was correctly classified.
CONCLUSIONS
High-throughput linked-read sequencing followed by maternal plasma-based relative haplotype dosage analysis represents a streamlined approach for noninvasive prenatal testing of inherited single gene diseases. The approach bypasses the need for mutation-specific assays and is not dependent on the availability of DNA from other affected family members. Thus, the approach is universally applicable to pregnancies at risk for the inheritance of a single gene disease.
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Affiliation(s)
- Winnie W I Hui
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Peiyong Jiang
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Yu K Tong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing-Shan Lee
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yvonne K Y Cheng
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Maria I New
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, NY
| | - Rezan A Kadir
- Department of Obstetrics and Gynaecology, Royal Free London NHS Foundation Trust, London, UK
- Katharine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, UK
| | - K C Allen Chan
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Tak Y Leung
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Y M Dennis Lo
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Rossa W K Chiu
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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Liu L, Li K, Fu X, Chung C, Zhang K. A Forward Look At Noninvasive Prenatal Testing. Trends Mol Med 2016; 22:958-968. [PMID: 27726956 DOI: 10.1016/j.molmed.2016.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/15/2016] [Indexed: 02/05/2023]
Abstract
Genomic abnormalities are a leading cause of birth defects and pregnancy complications, including in utero growth retardation and risk of miscarriage. Traditional invasive methods detecting such genomic abnormalities pose a relative risk to mother and unborn fetus. Non-invasive prenatal testing (NIPT) is a method that determines the genomic status of a fetus in utero by analyzing circulating fetal DNA in maternal plasma or serum. This review comes at a time when more and more physicians and hospitals might be using NIPT; there is great potential in extending this technology to other diagnostic applications. We discuss here the most current advances in diagnostic NIPT, its applications and limitations, as well as the development of future technology and possible clinical applications.
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Affiliation(s)
- Li Liu
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China.
| | - Kang Li
- Molecular Medicine Research Center, West China Hospital, Sichuan University, Sichuan 610041, China; Guangzhou Elite Health Biological Pharmaceutical Technology Company Ltd., Guangzhou 510005, China
| | - Xin Fu
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China; Institute for Genomic Medicine and Shiley Eye Institute, University of California San Diego, La Jolla, CA 92328, USA
| | - Christopher Chung
- Institute for Genomic Medicine and Shiley Eye Institute, University of California San Diego, La Jolla, CA 92328, USA
| | - Kang Zhang
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China; Institute for Genomic Medicine and Shiley Eye Institute, University of California San Diego, La Jolla, CA 92328, USA.
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11
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Mackie FL, Hemming K, Allen S, Morris RK, Kilby MD. The accuracy of cell-free fetal DNA-based non-invasive prenatal testing in singleton pregnancies: a systematic review and bivariate meta-analysis. BJOG 2016; 124:32-46. [DOI: 10.1111/1471-0528.14050] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 12/18/2022]
Affiliation(s)
- FL Mackie
- Centre for Women's & Newborn Health and the Institute of Metabolism and Systems Research; University of Birmingham; Birmingham UK
| | - K Hemming
- Public Health, Epidemiology and Biostatistics; Institute of Applied Health Sciences; University of Birmingham; Birmingham UK
| | - S Allen
- West Midlands Regional Genetics Laboratory; Birmingham Women's Hospital NHS Foundation Trust; Birmingham UK
| | - RK Morris
- Centre for Women's & Newborn Health and the Institute of Metabolism and Systems Research; University of Birmingham; Birmingham UK
- Fetal Medicine Centre; Birmingham Women's Hospital NHS Foundation Trust; Birmingham UK
| | - MD Kilby
- Centre for Women's & Newborn Health and the Institute of Metabolism and Systems Research; University of Birmingham; Birmingham UK
- Fetal Medicine Centre; Birmingham Women's Hospital NHS Foundation Trust; Birmingham UK
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12
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Perlado S, Bustamante-Aragonés A, Donas M, Lorda-Sánchez I, Plaza J, Rodríguez de Alba M. Fetal Genotyping in Maternal Blood by Digital PCR: Towards NIPD of Monogenic Disorders Independently of Parental Origin. PLoS One 2016; 11:e0153258. [PMID: 27078875 PMCID: PMC4831728 DOI: 10.1371/journal.pone.0153258] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/26/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To date, non-invasive prenatal diagnosis (NIPD) of monogenic disorders has been limited to cases with a paternal origin. This work shows a validation study of the Droplet Digital PCR (ddPCR) technology for analysis of both paternally and maternally inherited fetal alleles. For the purpose, single nucleotide polymorphisms (SNPs) were studied with the only intention to mimic monogenic disorders. METHODS NIPD SNP genotyping was performed by ddPCR in 55 maternal plasma samples. In 19 out of 55 cases, inheritance of the paternal allele was determined by presence/absence criteria. In the remaining 36, determination of the maternally inherited fetal allele was performed by relative mutation dosage (RMD) analysis. RESULTS ddPCR exhibited 100% accuracy for detection of paternal alleles. For diagnosis of fetal alleles with maternal origin by RMD analysis, the technology showed an accuracy of 96%. Twenty-nine out of 36 were correctly diagnosed. There was one FP and six maternal plasma samples that could not be diagnosed. DISCUSSION In this study, ddPCR has shown to be capable to detect both paternal and maternal fetal alleles in maternal plasma. This represents a step forward towards the introduction of NIPD for all pregnancies independently of the parental origin of the disease.
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Affiliation(s)
- Sara Perlado
- Department of Genetics, IIS-Fundación Jiménez Díaz UAM, CIBERER, Madrid, Spain
| | | | - Marta Donas
- Department of Genetics, IIS-Fundación Jiménez Díaz UAM, CIBERER, Madrid, Spain
| | | | - Javier Plaza
- Department of Obstetrics & Gynecology, Fundación Jiménez Díaz-IIS, Madrid, Spain
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13
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Mokari-Zadeh N, Mesbah-Namin SA. Evaluation of an Improved Non-invasive Fetal Sex Determination in Haemophilia A Patients. J Clin Diagn Res 2015; 9:GC01-4. [PMID: 26393142 DOI: 10.7860/jcdr/2015/12556.6175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/29/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Haemophilia A (HA) is the most severe sex-linked bleeding disorder that is characterized with non-controlled and often threatening Haemorrhage. Routine fetal sex determination in early pregnancy with Haemophilia is based on invasive procedures that can be dangerous to the mother and fetus. AIM The goal of this study is to present an improved assay for the non-invasive fetal sex determination using a Real-Time duplex PCR on the free fetal DNA (ffDNA) obtained from the maternal serum of the HA carriers. MATERIALS AND METHODS Blood samples were eventually collected from 23 pregnant HA carriers between the 8(th) and 12(th) weeks of gestation, and after amplification by duplex-PCR of the single copy of Y chromosome-specific sequence (SRY), the product was then subjected to Real-Time PCR analysis. RESULTS Data were compared with the outcome of chorionic villus sampling (CVS) and indicated that the SRY sequence was detected in 6 of 6 serum samples from male pregnancies and that sequence was absent in 9 samples where the fetus was female. The remaining samples determined without having the CVS positive samples. CONCLUSION We tried to develop a Real-Time duplex PCR for accurate diagnosis of fetal gender early in the pregnancy of HA carriers. This study has brought up two remarkable points, the first is the method's improvement with high specificity in sex determination, especially in screening of prenatal sex-linked disorders in male gender and the second is that fresh serum samples would be a good source for this purpose, advocated by similar studies carried out in this regard.
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Affiliation(s)
- Narmin Mokari-Zadeh
- Faculty, Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University , Tehran, Iran
| | - Seyed Alireza Mesbah-Namin
- Faculty, Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University , Tehran, Iran
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14
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Khalil A, Mahmoodian N, Kulkarni A, Homfray T, Papageorghiou A, Bhide A, Thilaganathan B. Estimation of Detection Rates of Aneuploidy in High-Risk Pregnancy Using an Approach Based on Nuchal Translucency and Non-Invasive Prenatal Testing: A Cohort Study. Fetal Diagn Ther 2015; 38:254-61. [PMID: 25925597 DOI: 10.1159/000381182] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 02/19/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim was to investigate aneuploidy detection using an approach based on nuchal translucency (NT) and non-invasive prenatal testing (NIPT). METHODS This was a cohort study including 5,306 high-risk pregnancies with NT measurements and chorionic villus samples (CVS) tested for full karyotype. RESULTS The fetal karyotype was normal in 4,172 (78.6%) cases and abnormal in 1,134 (21.4%), including 1,009 with a likely clinically significant adverse outcome. Universal CVS with full karyotyping would lead to the diagnosis of all clinically significant abnormalities. A policy of relying solely on NIPT would have led to the diagnosis of 88.9% of clinically significant abnormalities. A strategy whereby NIPT is the main method, with CVS reserved for cases with NT ≥3.0 mm, would require CVS in 21.7% of cases, identify 94.8% of significant abnormalities and avoid miscarriage in 41 pregnancies compared to CVS for all. CONCLUSIONS A policy of NIPT for increased-risk cases and CVS with full karyotype if the NT was ≥3.0 mm reduced the risk of miscarriage yet still identified 95% of clinically significant aneuploidy.
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Affiliation(s)
- Asma Khalil
- Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's University of London, London, UK
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15
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Economou M, Banov L, Ljung R. Perinatal aspects of haemophilia. Eur J Haematol 2015; 76:21-5. [PMID: 24957104 DOI: 10.1111/ejh.12371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 11/29/2022]
Abstract
Haemophilia is an X-linked recessive genetic disease of haemostasis. Women carriers may present with a bleeding tendency similar to milder forms of the disease. Haemophilic newborns present risk factors and patterns of bleeding that are challenging. Identification of carriers and genetic counselling before conception is considered optimal to help decide on available conception options and during pregnancy to help minimise bleeding risks for both carrier mother and affected baby. Preimplantation genetic diagnosis is attractive to many couples at risk of having a child with haemophilia and relevant technology is becoming more available although it has both practical and ethical limitations. Pregnancy in carriers should be managed by a multidisciplinary team in a comprehensive treatment centre. The optimal mode of delivery for carriers expecting a baby known to have or being at risk of haemophilia is an issue of great debate. The general consensus among authors is avoidance of instrumental delivery, foetal scalp electrodes and blood sampling in pregnancies at risk of carrying an affected foetus, as well as early recourse to Caesarean section as guided by obstetric indications. Intracranial haemorrhage, although infrequent, is one the most devastating types of bleeding in haemophilic newborns and can occur regardless of the mode of delivery or the severity of haemophilia. Early screening is proposed for all infants with severe or moderate haemophilia who have had traumatic delivery and/or have evidence of extracranial haemorrhage. Women with postpartum haemorrhage should have a bleeding work-up.
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Affiliation(s)
- Marina Economou
- 1st Pediatric Department, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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16
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Xu Y, Li X, Ge HJ, Xiao B, Zhang YY, Ying XM, Pan XY, Wang L, Xie WW, Ni L, Chen SP, Jiang WT, Liu P, Ye H, Cao Y, Zhang JM, Liu Y, Yang ZJ, Chen YW, Chen F, Jiang H, Ji X. Haplotype-based approach for noninvasive prenatal tests of Duchenne muscular dystrophy using cell-free fetal DNA in maternal plasma. Genet Med 2015; 17:889-96. [PMID: 25654318 DOI: 10.1038/gim.2014.207] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 12/22/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study demonstrates noninvasive prenatal testing (NIPT) for Duchenne muscular dystrophy (DMD) using a newly developed haplotype-based approach. METHODS Eight families at risk for DMD were recruited for this study. Parental haplotypes were constructed using target-region sequencing data from the parents and the probands. Fetal haplotypes were constructed using a hidden Markov model through maternal plasma DNA sequencing. The presence of haplotypes linked to the maternal mutant alleles in males indicated affected fetuses. This method was further validated by comparing the inferred single-nucleotide polymorphism (SNP) genotypes to the direct sequencing results of fetal genomic DNA. Prenatal diagnosis was confirmed with amniocentesis, and those results were interpreted in a blinded fashion. RESULTS The results showed an average accuracy of 99.98% for the total inferred maternal SNPs. With a mean depth of 30× achieved in the 10-Mb target region of each sample, the noninvasive results were consistent with those of the invasive procedure. CONCLUSION This is the first report of NIPT for DMD and the first application of a haplotype-based approach in NIPT for X-linked diseases. With further improvements in accuracy, this haplotype-based strategy could be feasible for NIPT for DMD and even other X-linked single-gene disorders.
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Affiliation(s)
- Yan Xu
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | | | | | - Bing Xiao
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | | | - Xiao-Min Ying
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | | | - Lei Wang
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | | | - Lin Ni
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | | | - Wen-Ting Jiang
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | | | - Hui Ye
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Ying Cao
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Jing-Min Zhang
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Yu Liu
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Zu-Jing Yang
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Ying-Wei Chen
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Fang Chen
- BGI-Shenzhen, Shenzhen, China.,Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences of Copenhagen, Section of Molecular Disease Biology, Copenhagen, Denmark
| | - Hui Jiang
- BGI-Shenzhen, Shenzhen, China.,Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Xing Ji
- Department of Prenatal Diagnosis Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute of Pediatric Research, Shanghai, China
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17
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Non-Invasive Prenatal Diagnosis in the Management of Preimplantation Genetic Diagnosis Pregnancies. J Clin Med 2014; 3:913-22. [PMID: 26237485 PMCID: PMC4449636 DOI: 10.3390/jcm3030913] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/27/2014] [Accepted: 06/25/2014] [Indexed: 11/17/2022] Open
Abstract
Prenatal diagnosis (PD) is recommended in pregnancies after a Preimplantation Genetic Diagnosis (PGD). However, conventional PD entails a risk of fetal loss which makes PGD patients reluctant to undergo obstetric invasive procedures. The presence of circulating fetal DNA in maternal blood allows performing a non-invasive prenatal diagnosis (NIPD) without risk for the pregnancy outcome. This work shows the introduction of NIPD for confirmation of PGD results in eight pregnancies. In those pregnancies referred to PGD for an X-linked disorder (six out of eight), fetal sex determination in maternal blood was performed to confirm fetal sex. One pregnancy referred to PGD for Marfan syndrome and one referred for Huntington disease (HD) were also analyzed. In seven out of eight cases, PGD results were confirmed by NIPD in maternal blood. No results were obtained in the HD pregnancy. NIPD in PGD pregnancies can be a reliable alternative for couples that after a long process feel reluctant to undergo PD due to the risk of pregnancy loss.
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18
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Bustamante-Aragones A, Gonzalez-Gonzalez C, de Alba MR, Ainse E, Ramos C. Noninvasive prenatal diagnosis using ccffDNA in maternal blood: state of the art. Expert Rev Mol Diagn 2014; 10:197-205. [DOI: 10.1586/erm.09.86] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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19
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Non-invasive prenatal testing for fetal sex determination: is ultrasound still relevant? Eur J Obstet Gynecol Reprod Biol 2013; 171:197-204. [DOI: 10.1016/j.ejogrb.2013.09.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/12/2013] [Accepted: 09/03/2013] [Indexed: 11/19/2022]
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20
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Yenilmez ED, Tuli A, Evrüke İC. Noninvasive prenatal diagnosis experience in the Çukurova Region of Southern Turkey: detecting paternal mutations of sickle cell anemia and β-thalassemia in cell-free fetal DNA using high-resolution melting analysis. Prenat Diagn 2013; 33:1054-62. [DOI: 10.1002/pd.4196] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 07/01/2013] [Accepted: 07/02/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Ebru Dündar Yenilmez
- Çukurova University, Faculty of Medicine; Department of Medical Biochemistry; Adana Turkey
| | - Abdullah Tuli
- Çukurova University, Faculty of Medicine; Department of Medical Biochemistry; Adana Turkey
| | - İ. Cüneyt Evrüke
- Çukurova University, Faculty of Medicine; Department of Gynecology Obstetrics; Adana Turkey
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21
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Cutler J, Chappell LC, Kyle P, Madan B. Third trimester amniocentesis for diagnosis of inherited bleeding disorders prior to delivery. Haemophilia 2013; 19:904-7. [DOI: 10.1111/hae.12247] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
- J. Cutler
- Molecular Haemostasis and Thrombosis Laboratory; GSTS Pathology; London UK
| | - L. C. Chappell
- Women's Health Academic Centre; King's College London and King's Health Partners; London UK
| | - P. Kyle
- Fetal Medicine Unit; Guy's and St Thomas' NHS Foundation Trust; London UK
| | - B. Madan
- The Centre for Haemostasis and Thrombosis; Guy's and St Thomas' NHS Foundation Trust; London UK
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22
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Ma Y, Gong H, Wen Y. Nucleic acid-based non-invasive prenatal diagnosis of genetic skin diseases: are we ready? Exp Dermatol 2013; 22:392-5. [PMID: 23711062 DOI: 10.1111/exd.12156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2013] [Indexed: 01/02/2023]
Abstract
The discovery of circulating fetal nucleic acids is a great step on the way of developing non-invasive prenatal diagnosis (NIPD) for genetic disorders. Here, we briefly discuss the current applications of circulating fetal nucleic acids in genetic testing for different kinds of hereditary diseases with an emphasis on using circulating cell-free fetal DNA in diagnosis of monogenic disorders. As the genetic skin disorders impair the quality of life at different levels, we next discuss some ethical issues in NIPD for genetic skin diseases of various severities and in particular, the responsibility of doctors and parents, respectively, in the prenatal genetic testing.
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Affiliation(s)
- Yonghui Ma
- Institute for Science, Ethics and Innovation, University of Manchester, Manchester, UK
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23
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Perlado-Marina S, Bustamante-Aragones A, Horcajada L, Trujillo-Tiebas MJ, Lorda-Sanchez I, Ruiz Ramos M, Plaza J, Rodriguez de Alba M. Overview of Five-Years of Experience Performing Non-Invasive Fetal Sex Assessment in Maternal Blood. Diagnostics (Basel) 2013; 3:283-90. [PMID: 26835681 PMCID: PMC4665538 DOI: 10.3390/diagnostics3020283] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 04/26/2013] [Accepted: 05/06/2013] [Indexed: 11/16/2022] Open
Abstract
Since the discovery of the presence of fetal DNA in maternal blood, non-invasive fetal sex determination has been the test most widely translated into clinical practice. To date there is no agreement between the different laboratories performing such tests in relation to which is the best protocol. As a consequence there are almost as many protocols as laboratories offering the service, using different methodologies and thus obtaining different diagnostic accuracies. By the end of 2007, after a validation study performed in 316 maternal samples collected between the 5th and 12th week of gestation, the fetal sex determination was incorporated into clinical practice in our Service. The test is performed in the first trimester of pregnancy, and it is offered as part of the genetic counseling process for couples at risk of X-linked disorders. As a general rule and in order to avoid misdiagnosis, two samples at different gestational ages are tested per patient. The analysis is performed by the study of the SRY gene by RT-PCR. Two hundred and twenty six pregnancies have been tested so far in these 5 years. Neither false positives nor false negatives diagnoses have been registered, thus giving a diagnostic accuracy of 100%.
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Affiliation(s)
- Sara Perlado-Marina
- Genetics Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Valencia 46010, Spain.
| | - Ana Bustamante-Aragones
- Genetics Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Valencia 46010, Spain.
| | - Laura Horcajada
- Genetics Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Valencia 46010, Spain.
| | - Maria Jose Trujillo-Tiebas
- Genetics Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Valencia 46010, Spain.
| | - Isabel Lorda-Sanchez
- Genetics Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Valencia 46010, Spain.
| | - Marta Ruiz Ramos
- Genetics Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Valencia 46010, Spain.
| | - Javier Plaza
- Gynecology and Obstetric Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
| | - Marta Rodriguez de Alba
- Genetics Department, Fundacion Jimenez Diaz, Avda, Reyes Catolicos 2, Madrid 28040, Spain.
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Valencia 46010, Spain.
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Advanced therapies for the treatment of hemophilia: future perspectives. Orphanet J Rare Dis 2012; 7:97. [PMID: 23237078 PMCID: PMC3551751 DOI: 10.1186/1750-1172-7-97] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/07/2012] [Indexed: 11/24/2022] Open
Abstract
Monogenic diseases are ideal candidates for treatment by the emerging advanced therapies, which are capable of correcting alterations in protein expression that result from genetic mutation. In hemophilia A and B such alterations affect the activity of coagulation factors VIII and IX, respectively, and are responsible for the development of the disease. Advanced therapies may involve the replacement of a deficient gene by a healthy gene so that it generates a certain functional, structural or transport protein (gene therapy); the incorporation of a full array of healthy genes and proteins through perfusion or transplantation of healthy cells (cell therapy); or tissue transplantation and formation of healthy organs (tissue engineering). For their part, induced pluripotent stem cells have recently been shown to also play a significant role in the fields of cell therapy and tissue engineering. Hemophilia is optimally suited for advanced therapies owing to the fact that, as a monogenic condition, it does not require very high expression levels of a coagulation factor to reach moderate disease status. As a result, significant progress has been possible with respect to these kinds of strategies, especially in the fields of gene therapy (by using viral and non-viral vectors) and cell therapy (by means of several types of target cells). Thus, although still considered a rare disorder, hemophilia is now recognized as a condition amenable to gene therapy, which can be administered in the form of lentiviral and adeno-associated vectors applied to adult stem cells, autologous fibroblasts, platelets and hematopoietic stem cells; by means of non-viral vectors; or through the repair of mutations by chimeric oligonucleotides. In hemophilia, cell therapy approaches have been based mainly on transplantation of healthy cells (adult stem cells or induced pluripotent cell-derived progenitor cells) in order to restore alterations in coagulation factor expression.
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25
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Hill M, Barrett AN, White H, Chitty LS. Uses of cell free fetal DNA in maternal circulation. Best Pract Res Clin Obstet Gynaecol 2012; 26:639-54. [DOI: 10.1016/j.bpobgyn.2012.03.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 03/28/2012] [Indexed: 12/21/2022]
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26
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Wright CF, Wei Y, Higgins JPT, Sagoo GS. Non-invasive prenatal diagnostic test accuracy for fetal sex using cell-free DNA a review and meta-analysis. BMC Res Notes 2012; 5:476. [PMID: 22937795 PMCID: PMC3444439 DOI: 10.1186/1756-0500-5-476] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 08/14/2012] [Indexed: 01/19/2023] Open
Abstract
Background Cell-free fetal DNA (cffDNA) can be detected in maternal blood during pregnancy, opening the possibility of early non-invasive prenatal diagnosis for a variety of genetic conditions. Since 1997, many studies have examined the accuracy of prenatal fetal sex determination using cffDNA, particularly for pregnancies at risk of an X-linked condition. Here we report a review and meta-analysis of the published literature to evaluate the use of cffDNA for prenatal determination (diagnosis) of fetal sex. We applied a sensitive search of multiple bibliographic databases including PubMed (MEDLINE), EMBASE, the Cochrane library and Web of Science. Results Ninety studies, incorporating 9,965 pregnancies and 10,587 fetal sex results met our inclusion criteria. Overall mean sensitivity was 96.6% (95% credible interval 95.2% to 97.7%) and mean specificity was 98.9% (95% CI = 98.1% to 99.4%). These results vary very little with trimester or week of testing, indicating that the performance of the test is reliably high. Conclusions Based on this review and meta-analysis we conclude that fetal sex can be determined with a high level of accuracy by analyzing cffDNA. Using cffDNA in prenatal diagnosis to replace or complement existing invasive methods can remove or reduce the risk of miscarriage. Future work should concentrate on the economic and ethical considerations of implementing an early non-invasive test for fetal sex.
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27
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Bustamante-Aragonés A, Rodríguez de Alba M, Perlado S, Trujillo-Tiebas MJ, Arranz JP, Díaz-Recasens J, Troyano-Luque J, Ramos C. Non-invasive prenatal diagnosis of single-gene disorders from maternal blood. Gene 2012; 504:144-9. [DOI: 10.1016/j.gene.2012.04.045] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 03/06/2012] [Accepted: 04/18/2012] [Indexed: 11/28/2022]
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28
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Stumm M, Entezami M, Trunk N, Beck M, Löcherbach J, Wegner RD, Hagen A, Becker R, Hofmann W. Noninvasive prenatal detection of chromosomal aneuploidies using different next generation sequencing strategies and algorithms. Prenat Diagn 2012; 32:569-77. [PMID: 22573401 DOI: 10.1002/pd.3862] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Markus Stumm
- Zentrum für Pränataldiagnostik und Humangenetik; Kurfürstendamm 199 10719 Berlin Germany
| | - Michael Entezami
- Zentrum für Pränataldiagnostik und Humangenetik; Kurfürstendamm 199 10719 Berlin Germany
| | - Nastasja Trunk
- GATC Biotech AG; Jakob-Stadler-Platz 7 78467 Konstanz Germany
| | - Martina Beck
- GATC Biotech AG; Jakob-Stadler-Platz 7 78467 Konstanz Germany
| | | | - Rolf-Dieter Wegner
- Zentrum für Pränataldiagnostik und Humangenetik; Kurfürstendamm 199 10719 Berlin Germany
| | - Andreas Hagen
- Zentrum für Pränataldiagnostik und Humangenetik; Kurfürstendamm 199 10719 Berlin Germany
| | - Rolf Becker
- Zentrum für Pränataldiagnostik und Humangenetik; Kurfürstendamm 199 10719 Berlin Germany
| | - Wera Hofmann
- LifeCodexx AG; Jakob-Stadler-Platz 7 78467 Konstanz Germany
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Rodríguez de Alba M, Bustamante-Aragonés A, Perlado S, Trujillo-Tiebas MJ, Díaz-Recasens J, Plaza-Arranz J, Ramos C. Noninvasive prenatal diagnosis of monogenic disorders. Expert Opin Biol Ther 2012; 12 Suppl 1:S171-9. [DOI: 10.1517/14712598.2012.674509] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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30
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Chitty LS, Hill M, White H, Wright D, Morris S. Noninvasive prenatal testing for aneuploidy-ready for prime time? Am J Obstet Gynecol 2012; 206:269-75. [PMID: 22464064 DOI: 10.1016/j.ajog.2012.02.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 02/21/2012] [Accepted: 02/21/2012] [Indexed: 10/28/2022]
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31
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Balak DMW, Gouw SC, Plug I, Mauser-Bunschoten EP, Vriends AHJT, Van Diemen-Homan JEM, Rosendaal FR, van der Bom JG. Prenatal diagnosis for haemophilia: a nationwide survey among female carriers in the Netherlands. Haemophilia 2012; 18:584-92. [PMID: 22250892 DOI: 10.1111/j.1365-2516.2011.02742.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Carriers of haemophilia face difficult choices regarding prenatal diagnosis, but little is known about the determinants that influence their decisions. The aim of this study was to assess the incidence of prenatal diagnosis and potential determinants affecting the choice for prenatal diagnosis. A nationwide survey was performed among all women who underwent carriership testing for haemophilia in the Netherlands between 1992 and 2004. Prenatal diagnosis was assessed in 207 carriers of haemophilia A or B who had been pregnant. Prenatal diagnosis was categorized into early first trimester (Y-PCR testing or chorionic villus sampling) often intended to prevent the birth of a child with haemophilia, and into late prenatal diagnosis (amniocentesis or ultrasound assessment) aimed at obstetrical management. Of 207 carriers 112 (54%) underwent prenatal diagnosis. Forty-eight women underwent early prenatal diagnosis and 64 women underwent late prenatal diagnosis. In 26 pregnancies early prenatal diagnosis was positive for haemophilia, and in 18 of these pregnancies termination was opted for. The choice for early prenatal diagnosis was associated with a liberal view towards termination of pregnancy (relative risk (RR) 12.5; 95% confidence interval (CI) 3.1-51.2), severe haemophilia in the family (RR 20.2; CI 2.7-153.6), absence of a religion (RR 1.9; CI 1.1-3.1) and older age (RR 2.0; CI 1.0-3.9). The choice for late prenatal diagnosis was associated with birth year after 1970 (RR 2.3; CI 1.5-3.5) and a previous child with haemophilia (RR 2.2; CI 1.4-3.4). More than half of all Dutch haemophilia carriers underwent prenatal diagnosis. Several determinants were strongly associated with prenatal diagnosis.
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Affiliation(s)
- D M W Balak
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Zhang M, Li T, Chen J, Li L, Zhou C, Wang Y, Liu W, Zhang Y. Non-invasive prenatal diagnosis of trisomy 21 by dosage ratio of fetal chromosome-specific epigenetic markers in maternal plasma. JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY. MEDICAL SCIENCES = HUA ZHONG KE JI DA XUE XUE BAO. YI XUE YING DE WEN BAN = HUAZHONG KEJI DAXUE XUEBAO. YIXUE YINGDEWEN BAN 2011; 31:687. [PMID: 22038362 DOI: 10.1007/s11596-011-0583-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Indexed: 01/15/2023]
Abstract
This study examined the methylation difference in AIRE and RASSF1A between maternal and placental DNA, and the implication of this difference in the identification of free fetal DNA in maternal plasma and in prenatal diagnosis of trisomy 21. Maternal plasma samples were collected from 388 singleton pregnancies, and placental or chorionic villus tissues from 112 of them. Methylation-specific PCR (MSP) and methylation-sensitive restriction enzyme digestion followed by fluorescent quantitative PCR (MSRE + PCR) were employed to detect the maternal-fetal methylation difference in AIRE and RASSF1A. Diagnosis of trisomy 21 was established according to the ratio of fetal-specific AIRE to RASSF1A in maternal plasma. Both methods confirmed that AIRE and RASSF1A were hypomethylated in maternal blood cells but hypermethylated in placental or chorionic villus tissues. Moreover, the differential methylation for each locus could be seen during the whole pregnant period. The positive rates of fetal AIRE and RASSF1A in maternal plasma were found to be 78.1% and 82.1% by MSP and 94.8% and 96.9% by MSRE + PCR. MSRE + PCR was superior to MSP in the identification of fetal-specific hypermethylated sequences (P<0.05). Based on the data from 266 euploidy pregnancies, the 95% reference interval of the fetal AIRE/RASSF1A ratio in maternal plasma was 0.33-1.77, which was taken as the reference value for determining the numbers of fetal chromosome 21 in 102 pregnancies. The accuracy rate in 98 euploidy pregnancies was 96.9% (95/98). Three of the four trisomy 21 pregnancies were confirmed with this method. It was concluded that hypermethylated AIRE and RASSF1A may serve as fetal-specific markers for the identification of fetal DNA in maternal plasma and may be used for noninvasive prenatal diagnosis of trisomy 21.
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Affiliation(s)
- Ming Zhang
- Reproductive Medicine Center, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Tao Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jingyi Chen
- Reproductive Medicine Center, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Li Li
- Reproductive Medicine Center, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Chun Zhou
- Reproductive Medicine Center, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Yan Wang
- Reproductive Medicine Center, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Wenhui Liu
- Reproductive Medicine Center, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Yuanzhen Zhang
- Reproductive Medicine Center, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China.
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Sedrak M, Hashad D, Adel H, Azzam A, Elbeltagy N. Use of Free Fetal DNA in Prenatal Noninvasive Detection of Fetal RhD Status and Fetal Gender by Molecular Analysis of Maternal Plasma. Genet Test Mol Biomarkers 2011; 15:627-31. [DOI: 10.1089/gtmb.2010.0263] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mona Sedrak
- Department of Clinical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa Hashad
- Department of Clinical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hesham Adel
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amal Azzam
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nermeen Elbeltagy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Devaney SA, Palomaki GE, Scott JA, Bianchi DW. Noninvasive fetal sex determination using cell-free fetal DNA: a systematic review and meta-analysis. JAMA 2011; 306:627-36. [PMID: 21828326 PMCID: PMC4526182 DOI: 10.1001/jama.2011.1114] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
CONTEXT Noninvasive prenatal determination of fetal sex using cell-free fetal DNA provides an alternative to invasive techniques for some heritable disorders. In some countries this testing has transitioned to clinical care, despite the absence of a formal assessment of performance. OBJECTIVE To document overall test performance of noninvasive fetal sex determination using cell-free fetal DNA and to identify variables that affect performance. DATA SOURCES Systematic review and meta-analysis with search of PubMed (January 1, 1997-April 17, 2011) to identify English-language human studies reporting primary data. References from review articles were also searched. STUDY SELECTION AND DATA EXTRACTION Abstracts were read independently to identify studies reporting primary data suitable for analysis. Covariates included publication year, sample type, DNA amplification methodology, Y chromosome sequence, and gestational age. Data were independently extracted by 2 reviewers. RESULTS From 57 selected studies, 80 data sets (representing 3524 male-bearing pregnancies and 3017 female-bearing pregnancies) were analyzed. Overall performance of the test to detect Y chromosome sequences had the following characteristics: sensitivity, 95.4% (95% confidence interval [CI], 94.7%-96.1%) and specificity, 98.6% (95% CI, 98.1%-99.0%); diagnostic odds ratio (OR), 885; positive predictive value, 98.8%; negative predictive value, 94.8%; area under curve (AUC), 0.993 (95% CI, 0.989-0.995), with significant interstudy heterogeneity. DNA methodology and gestational age had the largest effects on test performance. Methodology test characteristics were AUC, 0.988 (95% CI, 0.979-0.993) for polymerase chain reaction (PCR) and AUC, 0.996 (95% CI, 0.993-0.998) for real-time quantitative PCR (RTQ-PCR) (P = .02). Gestational age test characteristics were AUC, 0.989 (95% CI, 0.965-0.998) (<7 weeks); AUC, 0.994 (95% CI, 0.987-0.997) (7-12 weeks); AUC, 0.992 (95% CI, 0.983-0.996) (13-20 weeks); and AUC, 0.998 (95% CI, 0.990-0.999) (>20 weeks) (P = .02 for comparison of diagnostic ORs across age ranges). RTQ-PCR (sensitivity, 96.0%; specificity, 99.0%) outperformed conventional PCR (sensitivity, 94.0%; specificity, 97.3%). Testing after 20 weeks (sensitivity, 99.0%; specificity, 99.6%) outperformed testing prior to 7 weeks (sensitivity, 74.5%; specificity, 99.1%), testing at 7 through 12 weeks (sensitivity, 94.8%; specificity, 98.9%), and 13 through 20 weeks (sensitivity, 95.5%; specificity, 99.1%). CONCLUSIONS Despite interstudy variability, performance was high using maternal blood. Sensitivity and specificity for detection of Y chromosome sequences was greatest using RTQ-PCR after 20 weeks' gestation. Tests using urine and tests performed before 7 weeks' gestation were unreliable.
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Affiliation(s)
- Stephanie A Devaney
- Genetics and Public Policy Center, Johns Hopkins University, Washington, DC, USA.
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Tounta G, Kolialexi A, Papantoniou N, Tsangaris GT, Kanavakis E, Mavrou A. Non-invasive prenatal diagnosis using cell-free fetal nucleic acids in maternal plasma: Progress overview beyond predictive and personalized diagnosis. EPMA J 2011. [PMID: 23199146 PMCID: PMC3405386 DOI: 10.1007/s13167-011-0085-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The discovery of circulating cell-free fetal DNA (cffDNA) in maternal plasma allowed for the development of alternative methodologies that may facilitate safe non-invasive prenatal diagnosis (NIPD). The low concentration of cffDNA in maternal plasma, however, and the coexistence of maternal DNA limit its clinical application to the detection or exclusion of fetal targets that are not present in the mother, such as Y chromosome sequences, the RHD gene in a RhD-negative woman and genetic conditions inherited from the father. Strategies for NIPD of monogenic disorders and fetal chromosomal aneuploidies have also been achieved using next-generation sequencing and could be introduced to the clinics as soon as cost-effective and high throughput protocols are developed.
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Affiliation(s)
- Georgia Tounta
- Department of Medical Genetics, Athens University School of Medicine, Athens, Greece
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Chalmers E, Williams M, Brennand J, Liesner R, Collins P, Richards M. Guideline on the management of haemophilia in the fetus and neonate. Br J Haematol 2011; 154:208-15. [PMID: 21554256 DOI: 10.1111/j.1365-2141.2010.08545.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Evidence-based guidelines are presented for the management of haemophilia in the fetus and neonate. This includes information regarding the management of pregnancy and delivery as well as aspects of management during the early neonatal period. Specific issues regarding the mode of delivery and the risk of intra-cranial and extra-cranial haemorrhage are discussed.
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Mortarino M, Garagiola I, Lotta LA, Siboni SM, Semprini AE, Peyvandi F. Non-invasive tool for foetal sex determination in early gestational age. Haemophilia 2011; 17:952-6. [PMID: 21492325 DOI: 10.1111/j.1365-2516.2011.02537.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Free foetal DNA in maternal blood during early pregnancy is an ideal source of foetal genetic material for non-invasive prenatal diagnosis. The aim of this study was to evaluate the use of free foetal DNA analysis at early gestational age as pretest for the detection of specific Y-chromosome sequences in maternal plasma of women who are carriers of X-linked disorders, such as haemophilia. Real-time quantitative PCR analysis of maternal plasma was performed for the detection of the SRY or DYS14 sequence. A group of 208 pregnant women, at different gestational periods from 4 to 12 weeks, were tested to identify the optimal period to obtain an adequate amount of foetal DNA for prenatal diagnosis. Foetal gender was determined in 181 pregnant women sampled throughout pregnancy. Pregnancy outcome and foetal gender were confirmed using karyotyping, ultrasonography or after birth. The sensitivity, which was low between 4th and 7th week (mean 73%), increased significantly after 7+1th weeks of gestation (mean 94%). The latter sensitivity after 7+1th week of gestation is associated to a high specificity (100%), with an overall accuracy of 96% for foetal gender determination. This analysis demonstrates that foetal gender determination in maternal plasma is reliable after the 9th week of gestation and it can be used, in association with ultrasonography, for screening to determine the need for chorionic villus sampling for prenatal diagnosis of X-linked disorders, such as haemophilia.
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Affiliation(s)
- M Mortarino
- UOS Dipartimentale per la Diagnosi e la Terapia delle Coagulopatie, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan and Luigi Villa Foundation, Milan, Italy
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Noninvasive prenatal diagnosis of hemophilia by microfluidics digital PCR analysis of maternal plasma DNA. Blood 2011; 117:3684-91. [DOI: 10.1182/blood-2010-10-310789] [Citation(s) in RCA: 202] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Abstract
Hemophilia is a bleeding disorder with X-linked inheritance. Current prenatal diagnostic methods for hemophilia are invasive and pose a risk to the fetus. Cell-free fetal DNA analysis in maternal plasma provides a noninvasive mean of assessing fetal sex in such pregnancies. However, the disease status of male fetuses remains unknown if mutation-specific confirmatory analysis is not performed. Here we have developed a noninvasive test to diagnose whether the fetus has inherited a causative mutation for hemophilia from its mother. The strategy is based on a relative mutation dosage approach, which we have previously established for determining the mutational status of fetuses for autosomal disease mutations. In this study, the relative mutation dosage method is used to deduce whether a fetus has inherited a hemophilia mutation on chromosome X by detecting whether the concentration of the mutant or wild-type allele is overrepresented in the plasma of heterozygous women carrying male fetuses. We correctly detected fetal genotypes for hemophilia mutations in all of the 12 studied maternal plasma samples obtained from at-risk pregnancies from as early as the 11th week of gestation. This development would make the decision to undertake prenatal testing less traumatic and safer for at-risk families.
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Hill M, Taffinder S, Chitty LS, Morris S. Incremental cost of non-invasive prenatal diagnosis versus invasive prenatal diagnosis of fetal sex in England. Prenat Diagn 2011; 31:267-73. [DOI: 10.1002/pd.2680] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 11/16/2010] [Accepted: 11/25/2010] [Indexed: 11/10/2022]
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40
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Tantawy AA. Molecular genetics of hemophilia A: Clinical perspectives. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2010. [DOI: 10.1016/j.ejmhg.2010.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hill M, Finning K, Martin P, Hogg J, Meaney C, Norbury G, Daniels G, Chitty LS. Non-invasive prenatal determination of fetal sex: translating research into clinical practice. Clin Genet 2010; 80:68-75. [DOI: 10.1111/j.1399-0004.2010.01533.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bustamante-Aragones A, Trujillo-Tiebas MJ, Gallego-Merlo J, Rodriguez de Alba M, Gonzalez-Gonzalez C, Cantalapiedra D, Ayuso C, Ramos C. Prenatal diagnosis of Huntington disease in maternal plasma: direct and indirect study. Eur J Neurol 2008; 15:1338-44. [DOI: 10.1111/j.1468-1331.2008.02312.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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González-González MC, Garcia-Hoyos M, Trujillo-Tiebas MJ, Bustamante Aragonés A, Rodriguez de Alba M, Diego Alvarez D, Diaz-Recasens J, Ayuso C, Ramos C. Improvement in strategies for the non-invasive prenatal diagnosis of Huntington disease. J Assist Reprod Genet 2008; 25:477-81. [PMID: 18853247 DOI: 10.1007/s10815-008-9256-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Accepted: 09/24/2008] [Indexed: 12/01/2022] Open
Abstract
PURPOSE We focused on the improvements of prenatal diagnosis by the analysis of DNA from maternal plasma, using Huntington disease as a model of disease. METHODS We studied plasma from a pregnancy at risk of having a fetus affected with Huntington disease by the use of two direct analysis of the mutation and polymorphic STRs. RESULTS Direct methods were not informative. Analysis with STRs revealed the presence of the allele that does not co-segregate with the disease, thus the fetus was healthy. CONCLUSIONS This strategy is very useful to face complex cases when the direct study is not informative not only for Huntington disease but also for many other disorders.
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Bustamante-Aragones A, Pérez-Cerdá C, Pérez B, de Alba MR, Ugarte M, Ramos C. Prenatal diagnosis in maternal plasma of a fetal mutation causing propionic acidemia. Mol Genet Metab 2008; 95:101-3. [PMID: 18599334 DOI: 10.1016/j.ymgme.2008.05.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Revised: 05/21/2008] [Accepted: 05/21/2008] [Indexed: 11/26/2022]
Abstract
Prenatal diagnosis (PD) is available to families affected with propionic acidemia (PA), however, it entails a risk of miscarriage. Fetal DNA circulating in maternal blood could allow performing a safe prenatal diagnosis of fetal mutations. Exclusion of the paternal mutation in maternal plasma may avoid conventional PD in cases of recessive disorders such us PA. In this work, we have correctly diagnosed in maternal plasma the status of a fetus at risk of PA for the paternal mutation.
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