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Albujja MH, Al-Ghedan M, Dakshnamoorthy L, Pla Victori J. Preimplantation genetic testing for embryos predisposed to hereditary cancer: Possibilities and challenges. CANCER PATHOGENESIS AND THERAPY 2024; 2:1-14. [PMID: 38328708 PMCID: PMC10846329 DOI: 10.1016/j.cpt.2023.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 05/03/2023] [Accepted: 05/14/2023] [Indexed: 02/09/2024]
Abstract
Preimplantation genetic testing (PGT), which was developed as an alternative to prenatal genetic testing, allows couples to avoid pregnancies with abnormal chromosomes and the subsequent termination of the affected fetus. Originally used for early onset monogenic conditions, PGT is now used to prevent various types of inherited cancer conditions based on the development of PGT technology, assisted reproductive techniques (ARTs), and in vitro fertilization (IVF). This review provides insights into the potential benefits and challenges associated with the application of PGT for hereditary cancer and provides an overview of the existing literature on this test, with a particular focus on the current challenges related to laws, ethics, counseling, and technology. Additionally, this review predicts the future potential applications of this method. Although PGT may be utilized to predict and prevent hereditary cancer, each case should be comprehensively evaluated. The motives of couples must be assessed to prevent the misuse of this technique for eugenic purposes, and non-pathogenic phenotypes must be carefully evaluated. Pathological cases that require this technology should also be carefully considered based on legal and ethical reasoning. PGT may be the preferred treatment for hereditary cancer cases; however, such cases require careful case-by-case evaluations. Therefore, this study concludes that multidisciplinary counseling and support for patients and their families are essential to ensure that PGT is a viable option that meets all legal and ethical concerns.
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Affiliation(s)
- Mohammed H. Albujja
- Department of Forensic Sciences, Naif Arab University for Security Sciences, Riyadh 11452, Saudi Arabia
| | - Maher Al-Ghedan
- Genetics Laboratory, Thuriah Medical Center, Riyadh 11523, Saudi Arabia
| | | | - Josep Pla Victori
- Department of Genetic Counselling, VI-RMA Global, Valencia 46004, Spain
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Huang P, Lan Y, Zhou H, Lin L, Shu J, Wang C, Zhao X, Liang L, He S, Mou J, Zhang X, Qiu Q, Wei H. Comprehensive application of multiple molecular diagnostic techniques in pre-implantation genetic testing for monogenic. Mol Genet Genomic Med 2024; 12:e2293. [PMID: 37828787 PMCID: PMC10767435 DOI: 10.1002/mgg3.2293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Pre-implantation genetic testing for monogenic disorders (PGT-M) is an effective approach to reducing the incidence of birth defects by preventing the transmission of inherited diseases to offspring. However, there are still controversies regarding the detection methods and transplantation of embryos. This paper aims to evaluate the effectiveness of different detection technologies applied to PGT-M through a retrospective analysis of clinical detection data. METHODS The carrier status of pathogenic mutations and chromosomal copy number variants (CNVs) in 892 embryos was characterized using next-generation sequencing (NGS), single-nucleotide polymorphism (SNP) array, and PCR-based detection technologies. Clinical data from PGT-M cases were retrospectively analyzed to assess the effectiveness of these detection methods in identifying genetic abnormalities in embryos. RESULTS A total of 829 embryos were analyzed, with 63 being unsuccessful. Our study revealed that the success rate of detecting deletional mutations using Gap-PCR 84.9%, which is lower than that of SNP array (98.7%) and NGS (92.5%). However, no significant difference was observed when detecting point mutations using any of the methods. These findings suggest that, when detecting deletional mutations, SNP array and NGS are more suitable choices compared to Gap-PCR. While SNP array may have a lower resolution and success rate (80.5%) in analyzing CNVs compared to NGS (95.5%), it may still be useful for revealing certain abnormal types. CONCLUSION In conclusion, this study found that SNP analysis is advantageous for identifying polygenic and deletional mutations, whereas NGS is more cost-efficient for detecting common monogenic diseases. Additionally, SNP-based haplotyping and PCR-based direct detection of mutations can be used together to enhance the accuracy and success rates of PGT-M. Our findings offer valuable insights for PGT technicians in choosing suitable detection methods for patients.
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Affiliation(s)
- Peng Huang
- PGD LaboratoryMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Yueyun Lan
- PGD LaboratoryMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Hong Zhou
- Reproductive CenterMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
| | - Luye Lin
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Jinhui Shu
- Reproductive CenterMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
| | - Caizhu Wang
- Reproductive CenterMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
| | - Xin Zhao
- Reproductive CenterMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
| | - Lifang Liang
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Sheng He
- PGD LaboratoryMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Jingfei Mou
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Xiaofei Zhang
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Qingming Qiu
- PGD LaboratoryMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
| | - Hongwei Wei
- PGD LaboratoryMaternal and Child Health Hospital of Guangxi Zhuang Autonomous RegionNanningChina
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous RegionNanningChina
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Potapov AA, Abdilatipov AA, Okhlopkov VA, Gavrilov AG, Zakharova NE, Goryaynov SA, Kobyakov GL, Absalyamova OV, Kravchuk AD, Kulikov AS, Shugay SV, Nikitin PV, Batalov AI, Shelygin YA, Lyubchenko LN, Aliev MD, Spallone A. [Li-Fraumeni syndrome in a patient with multiple anaplastic oligodendrogliomas of the brain (a case report and literature review)]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2018; 82:87-96. [PMID: 30137042 DOI: 10.17116/neiro201882487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Li-Fraumeni syndrome (LFS) is a clinically and genetically heterogeneous hereditary syndrome with predominantly oncological manifestations, which is associated with mutations in the TP53, MDM2, and CHEK2 genes. The most common variant is a TP53 mutation. OBJECTIVE To analyze the literature and present a clinical case of a patient with Li-Fraumeni syndrome and multiple anaplastic oligodendrogliomas of the brain. CLINICAL CASE A 42-year-old male patient presented with complaints of headaches, word finding difficulty, memory loss, right hemianopsia, and generalized convulsive attacks. For 10 years, he underwent multiple interventions and chemotherapy courses for colon adenocarcinoma and recurrent B-cell lymphoma. MRI revealed multiple space-occupying lesions of the cerebraln hemispheres, which were located in the left temporo-occipital and right frontal regions. RESULTS The patient underwent resection of multiple space-occupying lesions of the left temporo-occipital and right frontal regions. The postoperative period proceeded without complications. The histological diagnosis was WHO grade III anaplastic oligodendroglioma. The patient and one of his sons were detected with a R248W missense mutation in the TP53 gene. The patient underwent six courses of temozolomide chemotherapy. At a follow-up examination 20 months after surgery and chemotherapy, the patient's condition was satisfactory; he returned to work. Control MRI of the brain revealed no signs of continued tumor growth. CONCLUSION An analysis of the literature and the clinical case indicate the success of multiple surgical interventions and chemotherapy courses performed for a long time in the patient with Li-Fraumeni syndrome manifested by colon adenocarcinoma, recurrent B-cell lymphoma, and multiple anaplastic oligodendroglioma of the brain. The patient had a good quality of life and returned to professional activity.
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Affiliation(s)
- A A Potapov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | | | - A G Gavrilov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | | | - G L Kobyakov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - A D Kravchuk
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A S Kulikov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - S V Shugay
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - P V Nikitin
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A I Batalov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - Yu A Shelygin
- Ryzhikh State Research Center of Coloproctology, Moscow, Russia
| | | | - M D Aliev
- Blokhin Russian Cancer Research Center, Moscow, Russia
| | - A Spallone
- Neurological Center of Latium, Rome, Italy; Department of Biomedicine, University of Rome Tor Vergata and NCL-Institute of Neurological Sciences, Rome, Italy
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Jiang Z, Wang Y, Lin J, Xu J, Ding G, Huang H. Genetic and epigenetic risks of assisted reproduction. Best Pract Res Clin Obstet Gynaecol 2017; 44:90-104. [PMID: 28844405 DOI: 10.1016/j.bpobgyn.2017.07.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 07/22/2017] [Accepted: 07/26/2017] [Indexed: 12/30/2022]
Abstract
Assisted reproductive technology (ART) is used primarily for infertility treatments to achieve pregnancy and involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and cryopreservation. Moreover, preimplantation genetic diagnosis (PGD) of ART is used in couples for genetic reasons. In ART treatments, gametes and zygotes are exposed to a series of non-physiological processes and culture media. Although the majority of children born with this treatment are healthy, some concerns remain regarding the safety of this technology. Animal studies and follow-up studies of ART-borne children suggested that ART was associated with an increased incidence of genetic, physical, or developmental abnormalities, although there are also observations that contradict these findings. As IVF, ICSI, frozen-thawed embryo transfer, and PGD manipulate gametes and embryo at a time that is important for reprogramming, they may affect epigenetic stability, leading to gamete/embryo origins of adult diseases. In fact, ART offspring have been reported to have an increased risk of gamete/embryo origins of adult diseases, such as early-onset diabetes, cardiovascular disease, and so on. In this review, we will discuss evidence related to genetic, especially epigenetic, risks of assisted reproduction.
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Affiliation(s)
- Ziru Jiang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yinyu Wang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Lin
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingjing Xu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guolian Ding
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Embryo-Fetal Original Adult Disease, Shanghai Key Laboratory for Reproductive Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hefeng Huang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Institute of Embryo-Fetal Original Adult Disease, Shanghai Key Laboratory for Reproductive Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Salehi R, Khosravi S, Salehi M, Kheirollahi M, Khanahmad H. Simple and Easy to Perform Preimplantation Genetic Diagnosis for β-thalassemia Major Using Combination of Conventional and Fluorescent Polymerase Chain Reaction. Adv Biomed Res 2017; 6:23. [PMID: 28401070 PMCID: PMC5360017 DOI: 10.4103/2277-9175.201682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Thalassemias are the most common monogenic disorders in many countries throughout the world. The best practice to control the prevalence of the disease is prenatal diagnosis (PND) services. Extensive practicing of PND proved effective in reducing new cases but on the other side of this success high abortion rate is hided, which ethically unfair and for many couples, especially with a previous experience of a therapeutic abortion, or moral concerns, is not a suitable choice. Preimplantation genetic diagnosis (PGD) is a strong alternative to conventional PND. At present PGD is the only abortion free fetal diagnostic process. Considering the fact that there are more than 6000 single gene disorders affecting approximately 1 in 300 live-births, the medical need for PGD services is significant. MATERIALS AND METHODS In the present study development of a PGD protocol for a thalassemia trait couple using nested multiplex fluorescent polymerase chain reaction (PCR) for the combination of polymorphic linked short tandem repeat (STR) markers and thalassemia mutations is described. Restriction fragment length polymorphism used to discriminate between wild and mutated alleles. RESULTS In PGD clinical cycle, paternal and maternal alleles for D11S988 and D11S1338 STR markers were segregated as it was expected. PCR product for IVSII-1 mutation was subsequently digested with BtscI restriction enzyme to differentiate normal allele from the mutant allele. The mother's mutation, being a comparatively large deletion, was detectable through size differences on agarose gel. CONCLUSION The optimized single cell protocol developed and evaluated in this study is a feasible approach for preimplantation diagnosis of β-thalassemia in our patients.
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Affiliation(s)
- Rasoul Salehi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sharifeh Khosravi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansour Salehi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Kheirollahi
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Khanahmad
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Pre-implantation genetic diagnosis. Best Pract Res Clin Obstet Gynaecol 2017; 39:74-88. [DOI: 10.1016/j.bpobgyn.2016.10.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/06/2016] [Accepted: 10/14/2016] [Indexed: 12/11/2022]
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Guimarães F, Roque M, Valle M, Kostolias A, Azevedo RAD, Martinhago CD, Sampaio M, Geber S. Live births after polar body biopsy and frozen-thawed cleavage stage embryo transfer: case report. JBRA Assist Reprod 2016; 20:253-256. [PMID: 28050963 PMCID: PMC5265627 DOI: 10.5935/1518-0557.20160049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pre-implantation genetic diagnosis (PGD) or screening (PGS) technology, has
emerged and developed in the past few years, benefiting couples as it allows the
selection and transfer of healthy embryos during IVF treatments. These
techniques can be performed in oocytes (polar-body biopsy) or embryos
(blastomere or trophectoderm biopsy). In this case report, we describe the first
two live births to be published in Brazil after a polar-body (PB) biopsy. In
case 1, a 42-year-old was submitted to PB biopsy with PGS due to advanced
maternal age and poor ovarian reserve. Five MII oocytes underwent first and
second polar body biopsy and four cleavage embryos were cryopreserved. The PGS
analysis resulted in two euploid embryos (next generation sequence). A
frozen-thawed embryo transfer (FET) was performed after endometrial priming and
a healthy baby was delivered after a cesarean section (37 weeks, female, 3390g,
47.5 cm). In case 2, a 40-year old patient with balanced translocation and poor
ovarian response was submitted to PB biopsy. Two MII oocytes underwent first and
second polar body biopsy and two embryos were cryopreserved in cleavage stage.
The analysis resulted in one euploid embryo that was transferred after
endometrial priming. A preterm healthy baby (34 weeks, female, 2100g, 40 cm) was
delivered via cesarean section. In conclusion, although the blastocyst biopsy is
the norm when performing PGS/PGD during IVF treatments, other alternatives (as
PB biopsy) should be considered in some specific situations.
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Affiliation(s)
| | - Matheus Roque
- ORIGEN - Center for Reproductive Medicine, Rio de Janeiro/RJ - Brazil.,UFMG - Universidade Federal de Minas Gerais, Belo Horizonte/MG - Brazil
| | - Marcello Valle
- ORIGEN - Center for Reproductive Medicine, Rio de Janeiro/RJ - Brazil
| | | | | | | | - Marcos Sampaio
- ORIGEN - Center for Reproductive Medicine, Belo Horizonte/MG - Brazil
| | - Selmo Geber
- UFMG - Universidade Federal de Minas Gerais, Belo Horizonte/MG - Brazil.,ORIGEN - Center for Reproductive Medicine, Belo Horizonte/MG - Brazil
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Traeger-Synodinos J. Preimplantation genetic diagnosis, an alternative to conventional prenatal diagnosis of the hemoglobinopathies. Int J Lab Hematol 2013; 35:571-9. [DOI: 10.1111/ijlh.12086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 01/28/2013] [Indexed: 12/01/2022]
Affiliation(s)
- J. Traeger-Synodinos
- Department of Medical Genetics; National and Kapodistrian University of Athens; St. Sophia's Children's Hospital; Athens Greece
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Thomaidis L, Kitsiou-Tzeli S, Critselis E, Drandakis H, Touliatou V, Mantoudis S, Leze E, Destouni A, Traeger-Synodinos J, Kafetzis D, Kanavakis E. Psychomotor development of children born after preimplantation genetic diagnosis and parental stress evaluation. World J Pediatr 2012; 8:309-16. [PMID: 23151857 DOI: 10.1007/s12519-012-0374-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 08/08/2011] [Indexed: 12/19/2022]
Abstract
BACKGROUND The increasing number of children conceived following preimplantation genetic diagnosis (PGD) necessitates the evaluation of their motor and cognitive development. The primary study objective was to evaluate the physical, developmental, and neurological outcome of children born after PGD in Greece. In addition, the secondary study objective was to compare the stress levels regarding parental roles between parents of PGD children and those of naturally conceived children. METHODS A cross-sectional study design was applied. The study population consisted of 31 children (aged 2 months to 7.5 years) born after PGD analysis and their parents. The developmental evaluation of children included a detailed physical evaluation and cognitive assessment with the Bayley Scales of Infant Development. The parent stress index was applied to evaluate comparative parental stress levels between those parents of PGD children and those of naturally conceived healthy children. RESULTS High rates of caesarean deliveries, increased incidence of prematurity, multiples and low-birth weight were observed among the 31 PGD children. Overall, 24 of the 31 PGD children had cognitive skills within normal range [general developmental quotient (GDQ): 86-115], while 6 children had lower levels of cognitive skills (GDQ<85). With regard to parental stress, PGD parents reported lower levels of parenting stress as compared to parents of naturally conceived children (P<0.01). CONCLUSIONS The enhanced frequency of poor cognitive and motor skills as well as low parental stress necessitates early detection and intervention for developmental delays among PGD children.
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Affiliation(s)
- Loretta Thomaidis
- Developmental Assessment Unit, Second Department of Pediatrics, P. & A. Kyriakou Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
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Constructing embryos, constructing politics: Connecting politics and technology in the Netherlands and Germany. BIOSOCIETIES 2011. [DOI: 10.1057/biosoc.2011.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Traeger-Synodinos J, Vrettou C, Kanavakis E. Prenatal, noninvasive and preimplantation genetic diagnosis of inherited disorders: hemoglobinopathies. Expert Rev Mol Diagn 2011; 11:299-312. [PMID: 21463239 DOI: 10.1586/erm.11.7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Disorders of hemoglobin synthesis have been used as a prototype for the development of most approaches for prenatal diagnosis (PND). PND for hemoglobinopathies based on molecular analysis of trophoblast or amniocyte DNA has accumulated approximately 30 years of experience. Disadvantages with conventional PND include 'invasive' fetal sampling and the need to terminate affected ongoing pregnancies. New developments are directed towards improving both the timing and/or safety of procedures. Preimplantation genetic diagnosis, an established procedure with 20 years of clinical application, avoids the need to terminate affected pregnancies through the identification and selective transfer of unaffected in vitro fertilization embryos. Approaches towards 'noninvasive' PND, through analyzing fetal cells or free fetal DNA present in the circulation of pregnant women, are a focus of ongoing research. Overall, PND, preimplantation genetic diagnosis (and potentially 'noninvasive' PND) represent valuable reproductive options for couples at risk of having a child affected with a severe inherited disease.
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Affiliation(s)
- Joanne Traeger-Synodinos
- Department of Medical Genetics, National and Kapodistrian University of Athens, St Sophia's Children's Hospital, Athens 11527, Greece.
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PGD for X-linked and gender-dependent disorders using a robust, flexible single-tube PCR protocol. Reprod Biomed Online 2010; 19:418-25. [PMID: 19778490 DOI: 10.1016/s1472-6483(10)60178-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
X-linked genetic diseases include a wide range of disorders such as the dystrophinopathies. Additionally in some rare genetic diseases, severity of expression is gender dependent. Prevention of such disorders usually involves prenatal diagnosis and termination of affected pregnancies, while preimplantation genetic diagnosis (PGD) represents a specialized alternative that avoids pregnancy termination. To preclude the rejection of unaffected male embryos that cannot be differentiated from those affected when using fluorescence in-situ hybridization, a flexible protocol based on multiplex fluorescence polymerase chain reaction (PCR) was standardized and validated for gender determination in single cells, which can potentially incorporate any disease-specific locus. The final panel of nine loci included four loci on the Y chromosome, two on the X chromosome plus up to three microsatellite markers to either support the gender diagnosis or to further monitor extraneous contamination. The protocol, standardized on single lymphocytes, established a PCR efficiency of >93% for all loci with maximum allele dropout rates of 4%. Microsatellite analysis excluded external contamination and confirmed biallelic inheritance. Proof of principle for the simplicity and flexibility of the assay was demonstrated through its application to clinical PGD cycles for lipoid congenital adrenal hyperplasia, which presents a more severe clinical course in males, and Duchenne muscular dystrophy.
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14
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Prenatal diagnosis of hemoglobin disorders: Present and future strategies. Clin Biochem 2009; 42:1767-79. [DOI: 10.1016/j.clinbiochem.2009.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 06/24/2009] [Accepted: 07/02/2009] [Indexed: 12/14/2022]
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Upton B, Chu Q, Li BDL. Li-Fraumeni syndrome: the genetics and treatment considerations for the sarcoma and associated neoplasms. Surg Oncol Clin N Am 2009; 18:145-56, ix. [PMID: 19056046 DOI: 10.1016/j.soc.2008.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Li-Fraumeni syndrome is an autosomal dominant disorder first reported by Drs Li and Fraumeni in 1969. Malkin was the first to describe a germline mutation as an underlying defect of Li-Fraumeni syndrome. Cancer risk in mutation carriers has been estimated to be 50% by age 40 and 90% by age 60. Children of affected parents have an approximate 50% risk of inheriting the familial mutation. Functional assays have been established that allow for easy genetic testing for TP53 mutation. Treatment goals center on early detection and surgical resection of affected organ. Targeted therapy for the TP53 gene may hold promise for the future.
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Affiliation(s)
- Brandi Upton
- Department of Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
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Krahn T, Wong SI. Preimplantation genetic diagnosis and reproductive autonomy. Reprod Biomed Online 2009; 19 Suppl 2:34-42. [DOI: 10.1016/s1472-6483(10)60275-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Noble R, Bahadur G, Iqbal M, Sanyal A. Pandora's box: ethics of PGD for inherited risk of late-onset disorders. Reprod Biomed Online 2008; 17 Suppl 3:55-60. [DOI: 10.1016/s1472-6483(10)60332-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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18
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Kokkali G, Traeger-Synodinos J, Vrettou C, Stavrou D, Jones GM, Cram DS, Makrakis E, Trounson AO, Kanavakis E, Pantos K. Blastocyst biopsy versus cleavage stage biopsy and blastocyst transfer for preimplantation genetic diagnosis of β-thalassaemia: a pilot study. Hum Reprod 2007; 22:1443-9. [PMID: 17261575 DOI: 10.1093/humrep/del506] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Trophectoderm biopsy at the blastocyst stage is an emerging approach in preimplantation genetic diagnosis (PGD). This study aimed to compare genotyping success and implantation rates in PGD cycles for beta-thalassaemia following biopsy at the cleavage versus the blastocyst stage, with transfer of blastocysts. METHODS This pilot study included 20 cycles: Group A: 10 cycles, day 3 blastomere biopsy, day 5 transfer; Group B: 10 cycles, day 5 trophectoderm biopsy, day 6 transfer. Standard-assisted reproduction and laser biopsy procedures were used. Biopsied cells were genotyped using real-time PCR multiplexed with fluorescent microsatellite analysis. RESULTS In Group A, 131 fertilized eggs developed to 101 embryos suitable for single blastomere biopsy; 76/101 blastomeres were diagnosed (75.2%), 30 unaffected blastocysts were transferred resulting in six pregnancies (eight fetal hearts, 26.7% implantation rate). In Group B, 128 fertilized eggs developed to 53 blastocysts for trophectoderm biopsy (four to five cells), with 50/53 blastocysts diagnosed (94.3%), 21 unaffected blastocysts transferred and 6 pregnancies initiated (10 fetal hearts, 47.6% implantation rate). Overall, nine pregnancies reached >10 weeks gestation and were confirmed unaffected by prenatal diagnosis, with 12 healthy babies born. CONCLUSIONS This pilot study suggests that trophectoderm biopsy and blastocyst transfer may be more advantageous than cleavage stage biopsy with respect to outcome of PGD for monogenic diseases.
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Affiliation(s)
- G Kokkali
- Centre for Human Reproduction, Genesis Hospital, Athens, Greece.
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Georgiou I, Syrrou M, Pardalidis N, Karakitsios K, Mantzavinos T, Giotitsas N, Loutradis D, Dimitriadis F, Saito M, Miyagawa I, Tzoumis P, Sylakos A, Kanakas N, Moustakareas T, Baltogiannis D, Touloupides S, Giannakis D, Fatouros M, Sofikitis N. Genetic and epigenetic risks of intracytoplasmic sperm injection method. Asian J Androl 2007; 8:643-73. [PMID: 17111067 DOI: 10.1111/j.1745-7262.2006.00231.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Pregnancies achieved by assisted reproduction technologies, particularly by intracytoplasmic sperm injection (ICSI) procedures, are susceptible to genetic risks inherent to the male population treated with ICSI and additional risks inherent to this innovative procedure. The documented, as well as the theoretical, risks are discussed in the present review study. These risks mainly represent that consequences of the genetic abnormalities underlying male subfertility (or infertility) and might become stimulators for the development of novel approaches and applications in the treatment of infertility. In addition, risks with a polygenic background appearing at birth as congenital anomalies and other theoretical or stochastic risks are discussed. Recent data suggest that assisted reproductive technology might also affect epigenetic characteristics of the male gamete, the female gamete, or might have an impact on early embryogenesis. It might be also associated with an increased risk for genomic imprinting abnormalities.
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Affiliation(s)
- Ioannis Georgiou
- Laboratory of Molecular Urology and Genetics of Human Reproduction, Department of Urology, Ioannina University School of Medicine, Ioannina 45110, Greece
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20
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Soini S, Ibarreta D, Anastasiadou V, Aymé S, Braga S, Cornel M, Coviello DA, Evers-Kiebooms G, Geraedts J, Gianaroli L, Harper J, Kosztolanyi G, Lundin K, Rodrigues-Cerezo E, Sermon K, Sequeiros J, Tranebjaerg L, Kääriäinen H. The interface between assisted reproductive technologies and genetics: technical, social, ethical and legal issues. Eur J Hum Genet 2006; 14:588-645. [PMID: 16636693 DOI: 10.1038/sj.ejhg.5201598] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The interface between assisted reproductive technologies (ART) and genetics comprises several sensitive and important issues that affect infertile couples, families with severe genetic diseases, potential children, professionals in ART and genetics, health care, researchers and the society in general. Genetic causes have a considerable involvement in infertility. Genetic conditions may also be transmitted to the offspring and hence create transgenerational infertility or other serious health problems. Several studies also suggest a slightly elevated risk of birth defects in children born following ART. Preimplantation genetic diagnosis (PGD) has become widely practiced throughout the world for various medical indications, but its limits are being debated. The attitudes towards ART and PGD vary substantially within Europe. The purpose of the present paper was to outline a framework for development of guidelines to be issued jointly by European Society of Human Genetics and European Society of Human Reproduction and Embryology for the interface between genetics and ART. Technical, social, ethical and legal issues of ART and genetics will be reviewed.
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Affiliation(s)
- Sirpa Soini
- Department of Medical Genetics, University of Turku, Turku, Finland, and Archbishop Hospital and Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
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21
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Traeger-Synodinos J. Real-time PCR for prenatal and preimplantation genetic diagnosis of monogenic diseases. Mol Aspects Med 2006; 27:176-91. [PMID: 16430951 DOI: 10.1016/j.mam.2005.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The provision of prenatal diagnosis requires the highest standards in laboratory practice to ensure an accurate result. In preimplantation genetic diagnosis protocols additionally have to address the need to achieve an accurate result from 1 to 2 cells within a limited time. Emerging protocols of "non-invasive" prenatal diagnosis, which are based on analysis of free fetal DNA in the circulation of the pregnant mother, also have to achieve a result from a limited quantity of fetal DNA against a high background of maternal free DNA. Real-time PCR uses fluorescent probes or dyes and dedicated instruments to monitor the accumulation of amplicons produced throughout the progress of a PCR reaction. Real-time PCR can be used for quantitative or qualitative evaluation of PCR products and is ideally suited for analysis of nucleotide sequence variations (point mutations) and gene dosage changes (locus deletions or insertions/duplications) that cause human monogenic diseases. Real-time PCR offers a means for more rapid and potentially higher throughput assays, without compromising accuracy and has several advantages over end-point PCR analysis, including the elimination of post-PCR processing steps and a wide dynamic range of detection with a high degree of sensitivity. This review will focus on real-time PCR protocols that are suitable for genotyping monogenic diseases with particular emphasis on applications to prenatal diagnosis, non-invasive prenatal diagnosis and preimplantation genetic diagnosis.
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Affiliation(s)
- Joanne Traeger-Synodinos
- Department of Medical Genetics, National and Kapodistrian University of Athens, St. Sophia's Children's Hospital, Athens 11527, Greece.
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Vrettou C, Traeger-Synodinos J, Tzetis M, Palmer G, Sofocleous C, Kanavakis E. Real-time PCR for single-cell genotyping in sickle cell and thalassemia syndromes as a rapid, accurate, reliable, and widely applicable protocol for preimplantation genetic diagnosis. Hum Mutat 2004; 23:513-21. [PMID: 15108284 DOI: 10.1002/humu.20022] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Sickle-cell and beta-thalassemia syndromes are priority genetic diseases for prevention programs involving population screening with the option of prenatal diagnosis for carrier couples. Preimplantation genetic diagnosis (PGD) represents a specialized alternative to prenatal diagnosis and is most appropriately used for couples with an unsuccessful reproductive history and/or undergoing assisted reproduction. However, clinical application of PGD has been hindered by difficulties in reliably transferring molecular diagnostic protocols to the single-cell level. We standardized and validated a protocol involving first-round multiplex PCR, amplifying the region of the beta-globin gene containing most of the common disease mutations world-wide and two unlinked microsatellite markers (GABRB3 and D13S314), followed by: 1) analysis of beta-globin genotypes with real-time PCR and 2) microsatellite sizing to exclude chance contamination. The protocol was standardized on 100 single lymphocytes from a beta-thalassemia heterozygote, including 15 artificially contaminated samples, the latter demonstrated through microsatellite analysis. PCR failure and allele drop-out (ADO) were observed in one (uncontaminated) sample each (1.2%). A pilot study in six clinical PGD cycles with five different beta-globin genotype interactions achieved results (in 5-6 hr) in 46 out of 50 single blastomeres (92%), all concordant with results from an established PGD method applied simultaneously; microsatellite analysis detected only parental alleles, excluding contamination. Beta-globin genotypes were also confirmed in two blastomeres through prenatal diagnosis (twin pregnancy), and in 11 out of 12 spare embryos, revealing one incident of ADO. Overall, the protocol proved to be sensitive, accurate, reliable, rapid, and applicable for many genotype interactions, with internal monitoring of contamination, thus fulfilling all requirements for clinical PGD application.
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Affiliation(s)
- Christina Vrettou
- Medical Genetics, Athens University, St. Sophia's Children's Hospital, Athens, Greece
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23
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Current awareness in prenatal diagnosis. Prenat Diagn 2003; 23:1027-32. [PMID: 14703639 DOI: 10.1002/pd.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Using modern biotechnology, it is increasingly common that genes can be identified and characterized, their protein products can be understood and tests to identify changes in these genes that lead to disease can be developed. Genetic tests are rapidly being introduced into clinical practice. Although there are many clinical benefits of genetic testing for a variety of medical conditions, there are also important practical and ethical concerns about the applications of genetic testing. The recent introduction of genetic tests for common forms of hereditary deafness (see also Rehm, 2003, in this issue) also promises many clinical benefits. Many of the same ethical concerns for genetic testing in general, also apply to genetic testing for deafness, with the added concerns brought about by the existence of the linguistic and cultural differences of the Deaf community. Sensitive genetic counseling performed by skilled geneticists is an important part of the genetic testing process to ensure that families and individuals can make informed choices regarding the use of genetic testing.
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Affiliation(s)
- Kathleen S Arnos
- Genetics Program, Department of Biology, Gallaudet University, Washington, DC, USA.
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