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Guo Q, Chang YY, Huang CH, Hsiao YS, Hsiao YC, Chiu IF, Zhou Y, Zhang H, Ko TM. Population-based carrier screening and prenatal diagnosis of fragile X syndrome in East Asian populations. J Genet Genomics 2021; 48:1104-1110. [PMID: 34412977 DOI: 10.1016/j.jgg.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/13/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
Identification of carriers of fragile X syndrome (FXS) with the subsequent prenatal diagnosis and knowledge of FXS-associated genetic profiles are essential for intervention in specific populations. We report the results of carrier screening of 39,458 East Asian adult women and prenatal diagnosis from 87 FXS carriers. The prevalence of FXS carriers and full mutation fetuses was estimated to be 1/581 and 1/3124 in East Asian populations, respectively. We confirmed the validity of the current threshold of CGG trinucleotide repeats for FMR1 categorization; the integral risks of full mutation expansion were approximately 6.0%, 43.8%, and 100% for premutation alleles with 55-74, 75-89, and ≥90 CGG repeats, respectively. The protective effect of AGG (adenine-guanine-guanine nucleotides) interruption in East Asian populations was validated, which is important in protecting premutation alleles with 75-89 CGG repeats from full mutation expansion. Finally, family history was shown not an effective indicator for FXS carrier screening in East Asian populations, and population-based screening was more cost-effective. This study provides an insight into the largest carrier screening and prenatal diagnosis for FXS in East Asian populations to date. The FXS-associated genetic profiles of East Asian populations are delineated, and population-based carrier screening is shown to be promising for FXS intervention.
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Affiliation(s)
- Qiwei Guo
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine & School of Public Health, Xiamen University, Xiamen, Fujian 361102, China.
| | - Yih-Yuan Chang
- Genephile Bioscience Laboratory, Ko's Obstetrics and Gynecology, Taipei 100, Taiwan, China
| | - Chien-Hao Huang
- Genephile Bioscience Laboratory, Ko's Obstetrics and Gynecology, Taipei 100, Taiwan, China
| | - Yu-Shan Hsiao
- Genephile Bioscience Laboratory, Ko's Obstetrics and Gynecology, Taipei 100, Taiwan, China
| | - Yu-Chiao Hsiao
- Biofast Biotechnology Co., Ltd., Xiamen, Fujian 361102, China
| | - I-Fan Chiu
- Biofast Biotechnology Co., Ltd., Xiamen, Fujian 361102, China
| | - Yulin Zhou
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine & School of Public Health, Xiamen University, Xiamen, Fujian 361102, China
| | - Haixia Zhang
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine & School of Public Health, Xiamen University, Xiamen, Fujian 361102, China
| | - Tsang-Ming Ko
- Genephile Bioscience Laboratory, Ko's Obstetrics and Gynecology, Taipei 100, Taiwan, China.
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Gabis LV, Shefer S, Raas-Rothschild A. Ethical Dilemmas Linked to Fragile X Testing of Minors—a Preliminary Survey Among Professionals. J Mol Neurosci 2020; 70:254-259. [DOI: 10.1007/s12031-019-01445-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 11/13/2019] [Indexed: 11/29/2022]
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Johansen Taber K, Lim-Harashima J, Naemi H, Goldberg J. Fragile X syndrome carrier screening accompanied by genetic consultation has clinical utility in populations beyond those recommended by guidelines. Mol Genet Genomic Med 2019; 7:e1024. [PMID: 31694075 PMCID: PMC6900367 DOI: 10.1002/mgg3.1024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/30/2019] [Accepted: 10/01/2019] [Indexed: 01/12/2023] Open
Abstract
Background Fragile X syndrome (FXS) is the most common inherited form of intellectual disability. Many providers offer preconception or prenatal FXS carrier screening. However, guidelines recommend screening only for those with a family history or undergoing fertility evaluation. Wider screening has been resisted because of concerns about patient understanding of FXS‐associated inheritance patterns and phenotypes. Additionally, the clinical utility has been questioned. Methods We addressed these concerns by analyzing reproductive decision‐making and pregnancy management informed by post‐test genetic consultation among 122 FMR1 premutation carriers identified by expanded carrier screening. Results Sixty‐three percent of those screened met guidelines screening criteria; the remaining 37% did not. Ninety‐eight percent had undergone post‐test genetic consultation. Of respondents screened preconceptionally, 74% reported planning or pursuing actions to reduce the risk of an affected pregnancy; the extent to which couples planned/pursued these actions was not significantly different between those meeting either screening criterion (76%) versus those meeting neither criterion (55%). Of respondents screened prenatally, 41% pursued prenatal diagnostic testing; the extent to which couples pursued prenatal diagnosis was not significantly different between those who met either screening criterion (37%) versus those who met neither criterion (31%). Conclusion These results support the expansion of FXS screening criteria in guidelines.
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Affiliation(s)
| | | | | | - Jim Goldberg
- Myriad Women's Health, South San Francisco, CA, USA
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