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Sorrentino U, Menegazzo M, Gabbiato I, Calosci D, Zambon CF, Zuccarello D. Challenges of Preimplantation Genetic Counselling in the Context of Cystic Fibrosis and Other CFTR-Related Disorders: A Monocentric Experience in a Cohort of 92 Couples. Genes (Basel) 2024; 15:937. [PMID: 39062716 PMCID: PMC11275312 DOI: 10.3390/genes15070937] [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: 06/20/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Cystic fibrosis is a highly prevalent genetic disorder caused by biallelic pathogenic variants in the CFTR gene, causing an altered function of the exocrine glands and a subsequent spectrum of hypofunctional and degenerative manifestations. The increasing availability of carrier screening programmes, the enhanced life expectancy of patients due to improved treatment and care strategies and the development of more precise and affordable molecular diagnostic tools have prompted a rise in demand of prenatal diagnosis procedures for at-risk couples, including Preimplantation Genetic Testing (PGT). However, challenges remain: heterogeneity among screening programmes, nuances of variant interpretation and availability of novel treatments demand a considerate and knowledgeable approach to genetic counselling. In this work, we retrospectively evaluated the molecular data of 92 unselected couples who received a diagnosis of CFTR-related status and were referred to the genetics clinic at the University Hospital of Padua for genetic counselling on eligibility for PGT. A total of 50 couples were considered eligible for the procedure based on risk of transmitting biallelic pathogenic variants. We report and discuss our experience with this case series in the context of the Italian medical care system and present an overview of the most relevant issues regarding genetic counselling for PGT in CFTR-related disorders.
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Affiliation(s)
- Ugo Sorrentino
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
| | - Massimo Menegazzo
- Kidney and Pancreas Transplant Surgery Unit, Regional Center for Diabetes Therapy, University of Padova, 35128 Padova, Italy
| | - Ilaria Gabbiato
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
| | - Davide Calosci
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
| | | | - Daniela Zuccarello
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
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Wang M, Zhou J, Long R, Mao R, Gao L, Wang X, Chen Y, Jin L, Zhu L. An overview of CFTR mutation profiles and assisted reproductive technology outcomes in Chinese patients with congenital obstructive azoospermia. J Assist Reprod Genet 2024; 41:505-513. [PMID: 38114870 PMCID: PMC10894795 DOI: 10.1007/s10815-023-03004-6] [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: 10/31/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
PURPOSE The cystic fibrosis transmembrane conductance regulator (CFTR) is the most common causative gene attributed to congenital obstructive azoospermia (OA). The aim of this study was to conduct an epidemiological survey of congenital OA patients, to screen for CFTR mutations, and to follow their pregnancy outcomes in assisted reproductive technology (ART). METHODS This cohort study enrolled congenital OA patients undergoing ART and whole-exome sequencing from January 2018 to September 2023. Semen parameters, sex hormones, and seminal plasma biochemistry were evaluated. CFTR mutations identified in OA patients were analyzed. In addition, the laboratory outcomes, clinical outcomes, and neonatal outcomes were compared between OA patients carrying two CFTR mutations and the others after surgical sperm extraction-intracytoplasmic sperm injection (ICSI) treatment. RESULTS A total of 76 patients with congenital OA were enrolled. CFTR mutations were identified in 35 (46.1%) congenital OA patients. A total of 60 CFTR mutation sites of 27 types were identified, and 10 of them were novel. The average frequency was 1.71 (60/35) per person. The most common mutation was c.1210-11T > G (25%, 15/60). After ICSI treatment, there were no statistically significant differences in laboratory outcomes, clinical outcomes, and neonatal outcomes between OA patients carrying two CFTR mutations (n = 25) and other OA patients (n = 51). CONCLUSION Apart from the IVS9-5T mutation, the genetic mutation pattern of CFTR in Chinese OA patients is heterogeneous, which is significantly different from that of Caucasians. Although carrying two CFTR mutations or not had no effect on the pregnancy outcomes in OA patients after ICSI, genetic counseling is still recommended for such patients.
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Affiliation(s)
- Meng Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Juepu Zhou
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Rui Long
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ruolin Mao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Limin Gao
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiangfei Wang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yinwei Chen
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Lixia Zhu
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Feng J, Zhang Y, Yang X, Zhang Y. Heterogeneous spectrum of CFTR gene mutations in Chinese patients with CAVD and the dilemma of genetic blocking strategy. Reproduction 2022; 164:R47-R56. [PMID: 35913788 DOI: 10.1530/rep-21-0315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 06/17/2022] [Indexed: 01/18/2023]
Abstract
In brief The genetic heterogeneity of CFTR gene mutations in Chinese patients with congenital absence of the vas deferens (CAVD) differs from the hotspot mutation pattern in Caucasians. This paper reviews and suggests a more suitable screening strategy for the Chinese considering the dilemma of CFTR genetic blocking. Abstract Congenital absence of the vas deferens (CAVD) is a major cause of obstructive azoospermia and male infertility, with CFTR gene mutation as the main pathogenesis. Other genes such as ADGRG2, SLC9A3, and PANK2 have been discovered and proven to be associated with CAVD in recent studies. Multiple CFTR hotspot mutations have been found in Caucasians in several foreign countries, and relevant genetic counseling and preimplantation genetic diagnosis (PGD) have been conducted for decades. However, when we examined research on Chinese CAVD, we discovered that CFTR mutations show heterogeneity in the Chinese Han population, and there is currently no well-established screening strategy. Therefore, we have reviewed the literature, combining domestic and international research as well as our own, aiming to review research progress on the CFTR gene in China and discuss the appropriate scope for CFTR gene detection, the detection efficiency of other CAVD-related genes, and the screening strategy applicable to the Chinese Han population. This study provides more valuable information for genetic counseling and a theoretical basis for PGD and treatment for couples with CAVD when seeking reproductive assistance.
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Affiliation(s)
- Jiarong Feng
- 1Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yanan Zhang
- 1Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiaojian Yang
- 1Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yan Zhang
- 1Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Fisher JS, Kim ED. Azoospermia: vasal agenesis. Asian J Androl 2022; 24:1-4. [PMID: 31621656 PMCID: PMC8788597 DOI: 10.4103/aja.aja_113_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- J Sam Fisher
- Department of Urology, University of Tennessee, Knoxville, TN 37920, USA
| | - Edward D Kim
- Department of Urology, University of Tennessee, Knoxville, TN 37920, USA
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McBride JA, Kohn TP, Mazur DJ, Lipshultz LI, Coward RM. Sperm retrieval and intracytoplasmic sperm injection outcomes in men with cystic fibrosis disease versus congenital bilateral absence of the vas deferens. Asian J Androl 2021; 23:140-145. [PMID: 32930103 PMCID: PMC7991824 DOI: 10.4103/aja.aja_48_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Recent data suggest that cystic fibrosis transmembrane conductance regulator (CFTR) gene alterations negatively impact male fertility beyond obstruction. We sought to compare gene alterations, sperm retrieval rates, and intracytoplasmic sperm injection (ICSI) outcomes among men with cystic fibrosis (CF) disease and congenital bilateral absence of the vas deferens (CBAVD) only. We retrospectively evaluated all men who underwent surgical sperm retrieval at two academic, high-volume andrology centers from 2010 to 2018. Only men with documented CFTR alterations and obstructive azoospermia from either CBAVD or CF were included. Differences between groups for CFTR abnormality, sperm retrieval, and ICSI outcomes were statistically analyzed. Overall,39 patients were included with 10 in the CF and 29 in the CBAVD groups. Surgical sperm retrieval rates were significantly lower in the CF group for sperm concentration (14.8 × 106 ml-1vs 61.4 × 106 m-1, P = 0.02) and total motile sperm count (2.9 million vs 11.4 million, P = 0.01). This difference was only predicted by homozygous delta F508 CFTR mutations (P < 0.05). The CF group also demonstrated a significantly higher rate of rescue testicular sperm extraction (70.0% vs 27.6%, P < 0.03) and lower fertilization rate with ICSI (32.5% vs 68.9%, P < 0.01). In conclusion, those with CF demonstrated lower sperm quality, greater difficulty with sperm retrieval, and worse ICSI outcomes compared with CBAVD-only patients. Homozygous delta F508 CFTR mutations appear to significantly impair spermatogenesis and sperm function.
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Affiliation(s)
- J Abram McBride
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Taylor P Kohn
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Daniel J Mazur
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Larry I Lipshultz
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA
| | - R Matthew Coward
- Department of Urology, UNC School of Medicine, Chapel Hill, NC 27599, USA.,UNC Fertility, Raleigh, NC 27617, USA
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Cui X, Wu X, Li Q, Jing X. Mutations of the cystic fibrosis transmembrane conductance regulator gene in males with congenital bilateral absence of the vas deferens: Reproductive implications and genetic counseling (Review). Mol Med Rep 2020; 22:3587-3596. [PMID: 33000223 PMCID: PMC7533508 DOI: 10.3892/mmr.2020.11456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/21/2020] [Indexed: 11/05/2022] Open
Abstract
Congenital bilateral absence of the vas deferens (CBAVD) is predominantly caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. CBAVD accounts for 2–6% of male infertility cases and up to 25% of cases of obstructive azoospermia. With the use of pre-implantation genetic diagnosis, testicular or epididymal sperm aspiration, intracytoplasmic sperm injection and in vitro fertilization, patients affected by CBAVD are able to have children who do not carry CFTR gene mutations, thereby preventing disease. Therefore, genetic counseling should be provided to couples receiving assisted reproductive techniques to discuss the impact of CFTR gene mutations on reproductive health. In the present article, the current literature concerning the CFTR gene and its association with CBAVD is reviewed.
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Affiliation(s)
- Xiangrong Cui
- Reproductive Medicine Center, Children's Hospital of Shanxi and Women's Health Center of Shanxi, Taiyuan, Shanxi 030001, P.R. China
| | - Xueqing Wu
- Reproductive Medicine Center, Children's Hospital of Shanxi and Women's Health Center of Shanxi, Taiyuan, Shanxi 030001, P.R. China
| | - Qiang Li
- Reproductive Medicine Center, Children's Hospital of Shanxi and Women's Health Center of Shanxi, Taiyuan, Shanxi 030001, P.R. China
| | - Xuan Jing
- Clinical Laboratory, Shanxi Province People's Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
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Are ovarian response and pregnancy rates similar in selected FMR1 premutated and mutated patients undergoing preimplantation genetic testing? J Assist Reprod Genet 2020; 37:1675-1683. [PMID: 32483686 DOI: 10.1007/s10815-020-01809-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To assess if the ovarian response of FMR1 premutated women undergoing preimplantation genetic testing (PGT) for Fragile X syndrome is lower compared with fully mutated patients, due to their frequent premature ovarian failure. METHODS In a retrospective cohort study from January 2009 to March 2019, we compared PGT outcomes in 18 FMR1 premutated women and 12 fully mutated women and aimed to identify predictive factors of stimulation outcomes. RESULTS Eighty-six IVF/PGT-M cycles for FMR1 PGT were analyzed. Premutation and full mutation patients were comparable in terms of age, body mass index (BMI), basal FSH, antral follicular count, and cycle length. However, premutation carriers had significantly lower AMH (1.9 versus 4.0 ng/mL, p = 0.0167). Premutated patients required higher doses of FSH (2740 versus 1944 IU, p = 0.0069) but had similar numbers of metaphase II oocytes (7.1 versus 6.6, p = 0.871) and embryos (5.6 versus 4.9, p = 0. 554). Pregnancy rates (37.1% versus 13.3%, p = 0.1076) were not statistically different in both groups. CONCLUSION In spite of lower ovarian reserve and thanks to an increased total dose of FSH, FMR1 premutated selected patients seem to have similar ovarian response as fully mutated patients. Neither the number of CGG repeats in FMR1 gene nor FMR1 mutation status was good predictors of the number of retrieved oocytes.
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Chamayou S, Sicali M, Lombardo D, Maglia E, Liprino A, Cardea C, Fichera M, Venti E, Guglielmino A. The true panel of cystic fibrosis mutations in the Sicilian population. BMC MEDICAL GENETICS 2020; 21:89. [PMID: 32357917 PMCID: PMC7195759 DOI: 10.1186/s12881-020-0958-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/21/2020] [Indexed: 11/24/2022]
Abstract
Background The aim was to establish the true risk of having an affected child with Cystic Fibrosis (CF) in the Sicilian infertile population. Methods A longitudinal CFTR screening of 1279 Sicilian infertile patients for all CFTR mutations sequencing the entire gene by Next Generation Sequencing (NGS) was performed from patient’s blood. Results One patient out of 16 was a carrier of a CFTR mutation. Twenty-four mutations were found. Theoretically one couple out of 256 was at risk of CF transmission. Conclusions The risk of CF transmission is unexpectedly high in Sicily and with a high heterogeneity. Sequencing an entire and long gene such as CFTR makes accessible the true panel of mutations in a specific population and helps better to understand the true risk of having an affected child.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Michele Fichera
- Unit of Gynecology and Obstetric - Department of general surgery and medical surgical specialties, University of Catania, Catania, Italy
| | - Ermanno Venti
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, 95030, Catania, Sant'Agata Li Battiati, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Ragolia C, Maglia E, Liprino A, Cardea C, Storaci G, Romano S, Guglielmino A. Universal strategy for preimplantation genetic testing for cystic fibrosis based on next-generation sequencing. J Assist Reprod Genet 2019:10.1007/s10815-019-01636-1. [PMID: 31848897 DOI: 10.1007/s10815-019-01636-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE We developed and applied a universal strategy for preimplantation genetic testing for all cystic fibrosis gene mutations (PGT-CF) based on next-generation sequencing (NGS). METHODS A molecular protocol was designed to diagnose all CF mutations at preimplantation stage. The detection of CF mutations was performed by direct gene sequencing and linkage strategy testing 38 specific SNPs located upstream and inside the gene for PGT-CF. Seventeen couples at risk of CF transmission decided to undergo PGT-CF. Trophectoderm cell biopsies were performed on days 5-6 blastocysts. PGT for aneuploidy (PGT-A) was performed from the same samples. Tested embryos were transferred on further natural cycles. RESULTS PGT was performed on 109 embryos. Fifteen CF mutations were tested. PGT-CF and PGT-A were conclusive for, respectively, 92.7% and 95.3% of the samples. A mean of 24.1 SNPs was informative per couple. After single embryo transfer on natural cycle, 81.3% of the transferred tested embryos implanted. CONCLUSIONS The present protocol based on the entire CFTR gene sequencing together with informative SNPs outside and inside the gene can be applied to diagnose all CF mutations at preimplantation stage.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione, Centro HERA, via Barriera del Bosco n. 51/53, 95030, Sant'Agata Li Battiati, Catania, Italy
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Chamayou S, Sicali M, Lombardo D, Alecci C, Ragolia C, Maglia E, Liprino A, Cardea C, Storaci G, Romano S, Guglielmino A. Universal strategy for preimplantation genetic testing for cystic fibrosis based on next generation sequencing. J Assist Reprod Genet 2019; 37:213-222. [PMID: 31828483 PMCID: PMC7000499 DOI: 10.1007/s10815-019-01635-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose We developed and applied a universal strategy for preimplantation genetic testing for all cystic fibrosis gene mutations (PGT-CF) based on next-generation sequencing (NGS). Methods A molecular protocol was designed to diagnose all CF mutations at preimplantation stage. The detection of CF mutations was performed by direct gene sequencing and linkage strategy testing 38 specific SNPs located upstream and inside the gene for PGT-CF. Seventeen couples at risk of CF transmission decided to undergo PGT-CF. Trophectoderm cell biopsies were performed on day 5–6 blastocysts. PGT for aneuploidy (PGT-A) was performed from the same samples. Tested embryos were transferred on further natural cycles. Results PGT was performed on 109 embryos. Fifteen CF mutations were tested. PGT-CF and PGT-A were conclusive for respectively 92.7% and 95.3% of the samples. A mean of 24.1 SNPs was informative per couple. After a single embryo transfer on natural cycle, 81.3% of the transferred tested embryos were implanted. Conclusions The present protocol based on the entire CFTR gene together with informative SNPs outside and inside the gene can be applied to diagnose all CF mutations at preimplantation stage. Electronic supplementary material The online version of this article (10.1007/s10815-019-01635-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sandrine Chamayou
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy.
| | - Maria Sicali
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Debora Lombardo
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Carmelita Alecci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Carmen Ragolia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Elena Maglia
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Annalisa Liprino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Clementina Cardea
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Giorgia Storaci
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Simona Romano
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
| | - Antonino Guglielmino
- Unità di Medicina della Riproduzione - Centro HERA, via Barriera del Bosco n. 51/53, Sant'Agata Li Battiati, 95030, Catania, Italy
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Feng J, Wu X, Zhang Y, Yang X, Ma G, Chen S, Luo S, Zhang Y. A novel mutation (-195C>A) in the promoter region of CFTR gene is associated with Chinese Congenital Bilateral Absence of Vas Deferens (CBAVD). Gene 2019; 719:144007. [PMID: 31357024 DOI: 10.1016/j.gene.2019.144007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 10/26/2022]
Abstract
Congenital bilateral absence of vas deferens (CBAVD), a frequent cause of obstructive azoospermia and male infertility in Chinese, is mainly due to mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This study aim to explore the promoter region of CFTR gene in CBAVD patients and study the mutations by functional analysis, and to discuss the significance of mutation testing in this area. We performed screening analysis on 65 CBAVD patients and 50 controls to detect mutations in the CFTR gene, and studied the functions of promoter mutations using reporter gene constructs, transient transfection techniques and subsequent assessment of transcriptional activity and expression levels. Mutations c.-195C>A and c.-34C>T in the promoter region of the CFTR gene were detected in 4 of our Chinese CBAVD patients, one of which was novel (c.-195C>A) and located in the conservative area, as well as the binding site of SP1 transcription factor through the prediction of bioinformatics analysis. By reverse transcription qPCR assay and luciferase assay, we validated it as a functional disease-causing variant that down-regulates the CFTR gene expression, and this effect was related to the amount of transcription factors. This study was the first to explore the promoter region of the CFTR gene in Chinese, and we believe that mutations in this region are associated with Chinese CBAVD patients. We also suggest a systematic strategy for genotyping Chinese CBAVD couples, which should help in developing reproductive counseling.
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Affiliation(s)
- Jiarong Feng
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiao Wu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yanan Zhang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaojian Yang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Gongchao Ma
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Shitao Chen
- International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shaoge Luo
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
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12
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Bergougnoux A, Taulan-Cadars M, Claustres M, Raynal C. Current and future molecular approaches in the diagnosis of cystic fibrosis. Expert Rev Respir Med 2018; 12:415-426. [PMID: 29580110 DOI: 10.1080/17476348.2018.1457438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Cystic Fibrosis is among the first diseases to have general population genetic screening tests and one of the most common indications of prenatal and preimplantation genetic diagnosis for single gene disorders. During the past twenty years, thanks to the evolution of diagnostic techniques, our knowledge of CFTR genetics and pathophysiological mechanisms involved in cystic fibrosis has significantly improved. Areas covered: Sanger sequencing and quantitative methods greatly contributed to the identification of more than 2,000 sequence variations reported worldwide in the CFTR gene. We are now entering a new technological age with the generalization of high throughput approaches such as Next Generation Sequencing and Droplet Digital PCR technologies in diagnostics laboratories. These powerful technologies open up new perspectives for scanning the entire CFTR locus, exploring modifier factors that possibly influence the clinical evolution of patients, and for preimplantation and prenatal diagnosis. Expert commentary: Such breakthroughs would, however, require powerful bioinformatics tools and relevant functional tests of variants for analysis and interpretation of the resulting data. Ultimately, an optimal use of all those resources may improve patient care and therapeutic decision-making.
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Affiliation(s)
- Anne Bergougnoux
- a Laboratoire de Génétique Moléculaire , Centre Hospitalier Universitaire de Montpellier , Montpellier , France.,b EA 7402 , Université de Montpellier , Montpellier , France
| | | | | | - Caroline Raynal
- a Laboratoire de Génétique Moléculaire , Centre Hospitalier Universitaire de Montpellier , Montpellier , France
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13
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Furgeri DT, Marson FAL, Correia CAA, Ribeiro JD, Bertuzzo CS. Cystic fibrosis transmembrane regulator haplotypes in households of patients with cystic fibrosis. Gene 2018; 641:137-143. [PMID: 29054758 DOI: 10.1016/j.gene.2017.10.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/06/2017] [Accepted: 10/16/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Nearly 2000 mutations in the cystic fibrosis transmembrane regulator (CFTR) gene have been reported. The F508del mutation occurs in approximately 50-65% of patients with cystic fibrosis (CF). However, molecular diagnosis is not always possible. Therefore, silent polymorphisms can be used to label the mutant allele in households of patients with CF. OBJECTIVE To verify the haplotypes of four polymorphisms at the CFTR locus in households of patients with CF for pre-fertilization, pre-implantation, and prenatal indirect mutation diagnosis to provide better genetic counseling for families and patients with CF and to associate the genotypes/haplotypes with the F508del mutation screening. METHODS GATT polymorphism analysis was performed using direct polymerase chain reaction amplification, and the MP6-D9, TUB09 and TUB18 polymorphism analyses were performed using restriction fragment length polymorphism. RESULTS Nine haplotypes were found in 37 CFTR alleles, and of those, 24 were linked with the F508del mutation and 13 with other CFTR mutations. The 6 (GATT), C (MP6-D9), G (TUB09), and C (TUB18) haplotypes showed the highest prevalence (48%) of the mutant CFTR allele and were linked to the F508del mutation (64%). In 43% of households analyzed, at least one informative polymorphism can be used for the indirect diagnostic test. CONCLUSION CFTR polymorphisms are genetic markers that are useful for identifying the mutant CFTR alleles in households of patients with CF when it is not possible to establish the complete CFTR genotype. Moreover, the polymorphisms can be used for indirect CFTR mutation identification in cases of pre-fertilization, pre-implantation and prenatal analysis.
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Affiliation(s)
- Daniela Tenório Furgeri
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, 13081-970, 6111, Campinas, São Paulo, Brazil
| | - Fernando Augusto Lima Marson
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, 13081-970, 6111, Campinas, São Paulo, Brazil; Department of Pediatrics, School of Medical Sciences, University of Campinas, 13081-970, 6111, Campinas, São Paulo, Brazil.
| | - Cyntia Arivabeni Araújo Correia
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, 13081-970, 6111, Campinas, São Paulo, Brazil
| | - José Dirceu Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas, 13081-970, 6111, Campinas, São Paulo, Brazil
| | - Carmen Sílvia Bertuzzo
- Department of Medical Genetics, School of Medical Sciences, University of Campinas, 13081-970, 6111, Campinas, São Paulo, Brazil.
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14
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Girardet A, Ishmukhametova A, Viart V, Plaza S, Saguet F, Verriere G, Hamamah S, Coupier I, Haquet E, Anahory T, Willems M, Claustres M. Thirteen years' experience of 893 PGD cycles for monogenic disorders in a publicly funded, nationally regulated regional hospital service. Reprod Biomed Online 2017; 36:154-163. [PMID: 29203382 DOI: 10.1016/j.rbmo.2017.10.113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/20/2017] [Accepted: 10/27/2017] [Indexed: 11/24/2022]
Abstract
This study provides an overview of preimplantation genetic diagnosis (PGD) for single gene diseases and the management of expanding indications in the context of a fully financially covered service at Montpellier's regional hospital centre. Within the framework of a restrictive law ruling PGD in France, only the parental genetic risk can be studied in embryos (concurrent aneuploidy screening is not allowed). PCR-based techniques were developed combining mutation detection and closely linked short tandem repeat markers within or flanking the affected genes, and set up more than 100 different robust fluorescent multiplex assays for 61 monogenic disorders. This strategy was used to analyse blastomeres from cleavage-stage embryos. Overall, 893 cycles were initiated in 384 couples; 727 cycles proceeded to oocyte retrieval and 608 cycles to embryo transfer, resulting in 184 deliveries. Clinical pregnancy rate per transfer, implantation and miscarriage rates were 33.6%, 25.1% and 8.8%, respectively. Our PGD programme resulted in the birth of 214 healthy babies for 162 out of 358 couples (45.3%), constituting a relevant achievement within an organizational framework that does not allow aneuploidy screening but provides equal access to PGD, both geographically and socioeconomically. This is a rare example of a fully free-of-charge PGD service.
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Affiliation(s)
- Anne Girardet
- Laboratory of Molecular Genetics, CHU and University of Montpellier, 34095 Montpellier, France.
| | - Aliya Ishmukhametova
- Laboratory of Molecular Genetics, CHU and University of Montpellier, 34095 Montpellier, France
| | - Victoria Viart
- Laboratory of Molecular Genetics, CHU and University of Montpellier, 34095 Montpellier, France
| | - Stéphanie Plaza
- Laboratory of Molecular Genetics, CHU and University of Montpellier, 34095 Montpellier, France
| | - Florielle Saguet
- Laboratory of Molecular Genetics, CHU and University of Montpellier, 34095 Montpellier, France
| | - Garance Verriere
- Laboratory of Molecular Genetics, CHU and University of Montpellier, 34095 Montpellier, France
| | - Samir Hamamah
- Department of Reproductive Medicine, CHU and University of Montpellier, 34095 Montpellier, France
| | - Isabelle Coupier
- Departement of Medical Genetics, CHU of Montpellier, 34095 Montpellier, France
| | - Emmanuelle Haquet
- Departement of Medical Genetics, CHU of Montpellier, 34095 Montpellier, France
| | - Tal Anahory
- Departement of Gynecology, CHU of Montpellier, 34095 Montpellier, France
| | - Marjolaine Willems
- Departement of Medical Genetics, CHU of Montpellier, 34095 Montpellier, France
| | - Mireille Claustres
- Laboratory of Molecular Genetics, CHU and University of Montpellier, 34095 Montpellier, France
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15
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Malcov M, Gold V, Peleg S, Frumkin T, Azem F, Amit A, Ben-Yosef D, Yaron Y, Reches A, Barda S, Kleiman SE, Yogev L, Hauser R. Improving preimplantation genetic diagnosis (PGD) reliability by selection of sperm donor with the most informative haplotype. Reprod Biol Endocrinol 2017; 15:31. [PMID: 28446182 PMCID: PMC5405512 DOI: 10.1186/s12958-017-0247-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study is aimed to describe a novel strategy that increases the accuracy and reliability of PGD in patients using sperm donation by pre-selecting the donor whose haplotype does not overlap the carrier's one. METHODS A panel of 4-9 informative polymorphic markers, flanking the mutation in carriers of autosomal dominant/X-linked disorders, was tested in DNA of sperm donors before PGD. Whenever the lengths of donors' repeats overlapped those of the women, additional donors' DNA samples were analyzed. The donor that demonstrated the minimal overlapping with the patient was selected for IVF. RESULTS In 8 out of 17 carriers the markers of the initially chosen donors overlapped the patients' alleles and 2-8 additional sperm donors for each patient were haplotyped. The selection of additional sperm donors increased the number of informative markers and reduced misdiagnosis risk from 6.00% ± 7.48 to 0.48% ±0.68. The PGD results were confirmed and no misdiagnosis was detected. CONCLUSIONS Our study demonstrates that pre-selecting a sperm donor whose haplotype has minimal overlapping with the female's haplotype, is critical for reducing the misdiagnosis risk and ensuring a reliable PGD. This strategy may contribute to prevent the transmission of affected IVF-PGD embryos using a simple and economical procedure. TRIAL REGISTRATION All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. DNA testing of donors was approved by the institutional Helsinki committee (registration number 319-08TLV, 2008). The present study was approved by the institutional Helsinki committee (registration number 0385-13TLV, 2013).
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Affiliation(s)
- Mira Malcov
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Veronica Gold
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sagit Peleg
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tsvia Frumkin
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Foad Azem
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ami Amit
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dalit Ben-Yosef
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Yaron
- 0000 0004 1937 0546grid.12136.37Prenatal Diagnosis Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Reches
- 0000 0004 1937 0546grid.12136.37Wolfe PGD-Stem Cell Lab, Racine IVF Unit Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- 0000 0004 1937 0546grid.12136.37Prenatal Diagnosis Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shimi Barda
- 0000 0004 1937 0546grid.12136.37The Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906 Israel
| | - Sandra E. Kleiman
- 0000 0004 1937 0546grid.12136.37The Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906 Israel
| | - Leah Yogev
- 0000 0004 1937 0546grid.12136.37The Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906 Israel
| | - Ron Hauser
- 0000 0004 1937 0546grid.12136.37The Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, Tel Aviv, 6423906 Israel
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16
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Viart V, Willems M, Ishmukhametova A, Dufernez F, Anahory T, Hamamah S, Schmitt S, Claustres M, Girardet A. Germline mosaicism is a pitfall in PGD for X-linked disorders. Single sperm typing detects very low frequency paternal gonadal mosaicism in a case of recurrent chondrodysplasia punctata misattributed to a maternal origin. Prenat Diagn 2017; 37:201-205. [PMID: 27943351 DOI: 10.1002/pd.4982] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/20/2016] [Accepted: 11/29/2016] [Indexed: 11/10/2022]
Abstract
This manuscript presents a molecularly demonstrated gonadal mosaicism from paternal origin for X-linked dominant chondrodysplasia punctata by single sperm typing. A couple who had experienced two medical terminations of pregnancy of female fetuses was referred to our pre-implantation genetic diagnosis (PGD) centre with the diagnosis of maternally derived gonadal mosaicism. Indeed, genetic analyses of different DNA samples - including semen - from the healthy parents failed to detect the variant found in the fetuses. Six embryos, all male, were obtained during the PGD cycle. The causative variant was not detected in any embryo, whereas five embryos had inherited the 'at-risk' maternal haplotype. The assumption of a maternal gonadal mosaicism was still possible, but this finding allowed us to consider the possibility of a paternal rather than maternal gonadal mosaicism. It prompted us to perform extensive single sperm analyses, demonstrating a low-frequency paternal germline mosaicism, which led to completely different haplotype phasing and PGD counselling. In conclusion, this case further exemplifies that germline mosaicism is a pitfall in PGD where diagnosis largely relies on linkage analysis and suggests that tracing the parental inheritance through polar body analysis and/or single sperm typing experiments is of major importance for adequate genetic counselling and accurate PGD. © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Victoria Viart
- Laboratoire de Génétique Moléculaire, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France.,Université de Montpellier, Montpellier, France
| | - Marjolaine Willems
- Département de Génétique Clinique, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Aliya Ishmukhametova
- Laboratoire de Génétique Moléculaire, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France.,Université de Montpellier, Montpellier, France
| | - Fabienne Dufernez
- Laboratoire de Génétique (LCBGM), Hôpital St Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tal Anahory
- Département de Gynécologie Obstétrique, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Samir Hamamah
- Université de Montpellier, Montpellier, France.,Département de Biologie de la Reproduction et du Développement, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Sébastien Schmitt
- Laboratoire de Génétique Moléculaire, Service de Génétique Médicale, CHRU de Nantes, Nantes, France
| | - Mireille Claustres
- Laboratoire de Génétique Moléculaire, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France.,Université de Montpellier, Montpellier, France
| | - Anne Girardet
- Laboratoire de Génétique Moléculaire, CHRU de Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, France.,Université de Montpellier, Montpellier, France
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17
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Non-invasive prenatal diagnosis (NIPD) of cystic fibrosis: an optimized protocol using MEMO fluorescent PCR to detect the p.Phe508del mutation. J Cyst Fibros 2016; 16:198-206. [PMID: 28040480 DOI: 10.1016/j.jcf.2016.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/24/2016] [Accepted: 12/11/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND Analysis of cell-free foetal DNA (cff-DNA) in maternal plasma is very promising for early diagnosis of monogenic diseases; in particular, cystic fibrosis (CF). However, NIPD of single-gene disorders has been limited by the availability of suitable technical platforms and the need to set up patient or disease-specific custom-made approaches. METHODS To make research applications more readily accessible to the clinic, we offer a simple assay combining two independent methods to determine the presence or absence of paternally inherited foetal allele p.Phe508del (the most frequent mutation in CF patients worldwide). The first method detects the presence or absence of a p.Phe508del allele by Mutant Enrichment with 3'-Modified Oligonucleotide PCR coupled to Fragment Length Analysis (MEMO-PCR-FLA). The second method detects the p.Phe508del allele with classical Multiplex Fluorescent PCR including five intragenic and extragenic STR markers of the CFTR locus and a specific SRY sequence. RESULTS We collected 24 plasma samples from 23 women carrying foetuses at risk for CF and tested each sample using both methods. Our new procedures were successfully applied to 10 couples where fathers carried the p.Phe508del mutation and mothers were carrying a different mutation in the CFTR gene. These simple tests provided clear positive or negative results from the maternal plasma of the pregnant women. We confirmed the presence of cff-DNA in the studied samples by the identification of a tri-allelic DNA profile using a miniSTR kit. All results were correlated with chorionic villus sampling or amniocentesis analyses. CONCLUSIONS This NIPD approach, easily set up in any clinical laboratory where prenatal diagnosis is routinely performed, offers many advantages over current methods: it is simple, rapid, and cost-effective. It opens up the possibility for testing a large number of couples with offspring at risk for CF.
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18
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Destouni A, Poulou M, Kakourou G, Vrettou C, Tzetis M, Traeger-Synodinos J, Kitsiou-Tzeli S. Single-cell high resolution melting analysis: A novel, generic, pre-implantation genetic diagnosis (PGD) method applied to cystic fibrosis (HRMA CF-PGD). J Cyst Fibros 2015; 15:163-70. [PMID: 26493493 DOI: 10.1016/j.jcf.2015.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/15/2015] [Accepted: 09/23/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Institutions offering CF-PGD face the challenge of developing and optimizing single cell genotyping protocols that should cover for the extremely heterogeneous CF mutation spectrum. Here we report the development and successful clinical application of a generic CF-PGD protocol to facilitate direct detection of any CFTR nucleotide variation(s) by HRMA and simultaneous confirmation of diagnosis through haplotype analysis. METHODS A multiplex PCR was optimized supporting co-amplification of any CFTR exon-region, along with 6 closely linked STRs. Single cell genotypes were established through HRM analysis following melting of the 2nd round PCR products and were confirmed by STR haplotype analysis of the 1st PCR products. The protocol was validated pre-clinically, by testing 208 single lymphocytes, isolated from whole blood samples from 4 validation family trios. Fifteen PGD cycles were performed and 103 embryos were biopsied. RESULTS In 15 clinical PGD cycles, genotypes were achieved in 88/93 (94.6%) embryo biopsy samples, of which 57/88 (64.8%) were deemed genetically suitable for embryo transfer. Amplification failed at all loci for 10/103 blastomeres biopsied from poor quality embryos. Six clinical pregnancies were achieved (2 twin, 4 singletons). PGD genotypes were confirmed following conventional amniocentesis or chorionic villus sampling in all achieved pregnancies. CONCLUSIONS The single cell HRMA CF-PGD protocol described herein is a flexible, generic, low cost and robust genotyping method, which facilitates the analysis of any CFTR genotype combination. Single-cell HRMA can be beneficial to other clinical settings, for example the detection of single nucleotide variants in single cells derived from clinical tumor samples.
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Affiliation(s)
- A Destouni
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - M Poulou
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece.
| | - G Kakourou
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - C Vrettou
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - M Tzetis
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - J Traeger-Synodinos
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - S Kitsiou-Tzeli
- Department of Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens, Greece
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19
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Girardet A, Viart V, Plaza S, Daina G, De Rycke M, Des Georges M, Fiorentino F, Harton G, Ishmukhametova A, Navarro J, Raynal C, Renwick P, Saguet F, Schwarz M, SenGupta S, Tzetis M, Roux AF, Claustres M. The improvement of the best practice guidelines for preimplantation genetic diagnosis of cystic fibrosis: toward an international consensus. Eur J Hum Genet 2015; 24:469-78. [PMID: 26014425 PMCID: PMC4929885 DOI: 10.1038/ejhg.2015.99] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/15/2015] [Accepted: 04/17/2015] [Indexed: 12/11/2022] Open
Abstract
Cystic fibrosis (CF) is one of the most common indications for preimplantation genetic diagnosis (PGD) for single gene disorders, giving couples the opportunity to conceive unaffected children without having to consider termination of pregnancy. However, there are no available standardized protocols, so that each center has to develop its own diagnostic strategies and procedures. Furthermore, reproductive decisions are complicated by the diversity of disease-causing variants in the CFTR (cystic fibrosis transmembrane conductance regulator) gene and the complexity of correlations between genotypes and associated phenotypes, so that attitudes and practices toward the risks for future offspring can vary greatly between countries. On behalf of the EuroGentest Network, eighteen experts in PGD and/or molecular diagnosis of CF from seven countries attended a workshop held in Montpellier, France, on 14 December 2011. Building on the best practice guidelines for amplification-based PGD established by ESHRE (European Society of Human Reproduction and Embryology), the goal of this meeting was to formulate specific guidelines for CF-PGD in order to contribute to a better harmonization of practices across Europe. Different topics were covered including variant nomenclature, inclusion criteria, genetic counseling, PGD strategy and reporting of results. The recommendations are summarized here, and updated information on the clinical significance of CFTR variants and associated phenotypes is presented.
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Affiliation(s)
- Anne Girardet
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Faculté de Médecine, Université Montpellier I, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | - Victoria Viart
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | - Stéphanie Plaza
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | - Gemma Daina
- Unitat de Biologia Cellular i Genetica Medica, Universitat Autonoma de Barcelona, Bellaterra, Spain
| | | | - Marie Des Georges
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | | | | | - Aliya Ishmukhametova
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | - Joaquima Navarro
- Unitat de Biologia Cellular i Genetica Medica, Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Caroline Raynal
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | - Pamela Renwick
- Center for Preimplantation Genetic Diagnosis, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK
| | - Florielle Saguet
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | | | - Sioban SenGupta
- UCL Center for PGD, Institute for Women's Health, University College London, London, UK
| | - Maria Tzetis
- Department of Medical Genetics, University of Athens, Greece
| | - Anne-Françoise Roux
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Unité INSERM U827, Montpellier, France
| | - Mireille Claustres
- Laboratoire de Génétique Moléculaire, CHU Arnaud de Villeneuve, Montpellier, France.,Faculté de Médecine, Université Montpellier I, Montpellier, France.,Unité INSERM U827, Montpellier, France
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