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Shegekar T, Pajai S. A Comprehensive Review of Pregnancy in Sickle Cell Disease. Cureus 2023; 15:e41165. [PMID: 37525766 PMCID: PMC10387184 DOI: 10.7759/cureus.41165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/29/2023] [Indexed: 08/02/2023] Open
Abstract
Sickle cell hemoglobinopathies encompass a range of qualitative and quantitative hemoglobin disorders that are inherited genetically. This group of disorders includes sickle cell beta thalassemia, sickle cell trait, and sickle cell disease (SCD). Globally, SCD is the most common disorder. Even epidemiological data suggests the majority of diseases, as well as traits, are concentrated in Sub-Saharan Africa, North-East Africa, the Middle East, and India. The physiological changes in pregnancy predispose to an increased risk of catastrophic events like a vaso-occlusive crisis, thromboembolic events, and their related sequelae, leading eventually to villous infarction, necrosis, and fibrosis leading to compromising uteroplacental circulation. Conversely, the mother may exhibit exacerbated symptoms of gestational hypertension, placental abruption, preterm labor, and venous thromboembolism. Although this disease is manageable, it has the potential to adversely impact maternal and child health on a national level. The chances of severe complications in the pregnant state affecting both mother and fetus attract due attention of health services towards redefining and researching this disease and its management frequently. The literature review on the following situation advocates the general treatment to be observed under the headings of preconceptual care, strengthened antenatal care, strict intranatal care, and compliant post-natal care. Preconceptually, genetic screening of couples, with education on the adverse effects of the disease, comes as the first line of management. Newer facilities like preimplantation genetic diagnosis and celocentesis may even allow for early diagnosis as well as help patients who do not wish to terminate the pregnancy by selective transfer of unaffected embryos. This may be combined with an extensive evaluation of the psychosocial aspect and socioeconomic status of couples who administer vaccines as prophylaxis for preventable diseases. Strengthening antenatal care is associated with routine blood investigations for every registered antenatal patient with adequate awareness about the conditions that precipitate the crisis. All patients should be prophylactically treated with appropriate doses of aspirin, iron, folic acid, and multivitamins. Radiological examinations by ultrasonography may be used to monitor placenta previa, abruption, or preterm labor. Later in pregnancy, it should be recommended to perform biophysical profiling and assessment of umbilical artery flow. Intranatal care deals with strict-term institutional delivery of all sickle cell-diseased mothers with a preference for vaginal delivery. Post-natal care requires a precise assessment of blood loss during labor to initiate transfusion therapy as soon as needed. Exclusive breastfeeding, with the importance of early initiation of it, must be emphasized. Screening of neonates as quickly as possible must be done for hemoglobinopathies. Through this review, authors are trying to make aware of the complications that can be faced during pregnancy in SCD patients, its prevention, and its treatment according to various new guidelines and research available.
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Affiliation(s)
- Tejas Shegekar
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Sandhya Pajai
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Adekile A, Akbulut-Jeradi N, Al Khaldi R, Fernandez MJ, Sukumaran J. Diagnosis of Sickle Cell Disease and HBB Haplotyping in the Era of Personalized Medicine: Role of Next Generation Sequencing. J Pers Med 2021; 11:jpm11060454. [PMID: 34071035 PMCID: PMC8224627 DOI: 10.3390/jpm11060454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 12/23/2022] Open
Abstract
Hemoglobin genotype and HBB haplotype are established genetic factors that modify the clinical phenotype in sickle cell disease (SCD). Current methods of establishing these two factors are cumbersome and/or prone to errors. The throughput capability of next generation sequencing (NGS) makes it ideal for simultaneous interrogation of the many genes of interest in SCD. This study was designed to confirm the diagnosis in patients with HbSS and Sβ-thalassemia, identify any ß-thal mutations and simultaneously determine the ßS HBB haplotype. Illumina Ampliseq custom DNA panel was used to genotype the DNA samples. Haplotyping was based on the alleles on five haplotype-specific SNPs. The patients studied included 159 HbSS patients and 68 Sβ-thal patients, previously diagnosed using high performance liquid chromatography (HPLC). There was considerable discordance between HPLC and NGS results, giving a false +ve rate of 20.5% with a sensitivity of 79% for the identification of Sβthal. Arab/India haplotype was found in 81.5% of βS chromosomes, while the two most common, of the 13 β-thal mutations detected, were IVS-1 del25 and IVS-II-1 (G>A). NGS is very versatile and can be deployed to simultaneously screen multiple gene loci for modifying polymorphisms, to afford personalized, evidence-based counselling and early intervention.
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Affiliation(s)
- Adekunle Adekile
- Department of Pediatrics, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; jalajasukumaran@hotmail
- Correspondence: ; Tel.: +965-253-194-86
| | | | - Rasha Al Khaldi
- Advanced Technology Company, Hawali 32060, Kuwait; (N.A.-J.); (R.A.); (M.J.F.)
| | | | - Jalaja Sukumaran
- Department of Pediatrics, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; jalajasukumaran@hotmail
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Sickle Cell Disease and Pregnancy. Mediterr J Hematol Infect Dis 2019; 11:e2019040. [PMID: 31308916 PMCID: PMC6613624 DOI: 10.4084/mjhid.2019.040] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 05/30/2019] [Indexed: 01/19/2023] Open
Abstract
Sickle cell disease (SCD) is the most common inherited hemoglobinopathy and is associated with increased risk of complications and early mortality. Nowadays, with improved health care facilities, antibiotic prophylaxis, vaccination, and availability of drugs like hydroxyurea, the life expectancy of SCD patients has improved. More women are reaching reproductive age group and are expressing their desire to reproduce. Though SCD adversely affects pregnancy, leading to increased incidence of maternal and perinatal complications like pre-eclampsia, preterm labor, IUGR, abortions etc., adequate care throughout pregnancy ensures a better outcome. Also, recent advancements in the fields of prenatal diagnosis and preimplantation genetic diagnosis, help couples suffering from SCD to have a healthy baby. This paper focuses on the effects of SCD on pregnancy outcomes and effective management of complications during pregnancy, also comparing maternal and perinatal outcomes in studies conducted in different countries. The second part of the paper summarizes pregnancy management in SCD for better maternal and fetal outcomes.
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Abstract
The field of prenatal screening and diagnosis has undergone enormous progress over the past four decades. Most of this period has been characterized by gradual improvements in the technical and public health aspects of prenatal screening for Down syndrome. Compared to the direct analysis of fetal cells from amniocentesis or chorionic villus sampling, noninvasive approaches using maternal blood or ultrasound have the great advantage of posing no risk of miscarriage to the pregnancy. Recent advances in molecular genetics and DNA sequencing have revolutionized both the accuracy and the range of noninvasive testing for genetic abnormalities using cell-free DNA in maternal plasma. Many of these advances have already been incorporated into clinical care, including diagnosis of fetal blood group and aneuploidy screening. The accelerated pace of these recent developments is creating not just technical and logistical challenges, but is also magnifying the ethical and public policy issues traditionally associated with this field.
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Affiliation(s)
- Lisa Hui
- Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, VIC, Australia.
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia.
- Reproductive Epidemiology, Murdoch Children's Research Institute, Parkville, VIC, Australia.
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Li X, Yang T, Li CS, Jin L, Lou H, Song Y. Prenatal detection of thalassemia by cell-free fetal DNA (cffDNA) in maternal plasma using surface enhanced Raman spectroscopy combined with PCR. BIOMEDICAL OPTICS EXPRESS 2018; 9:3167-3176. [PMID: 29984090 PMCID: PMC6033558 DOI: 10.1364/boe.9.003167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/04/2018] [Accepted: 02/09/2018] [Indexed: 05/30/2023]
Abstract
Thalassemias are widely occurring genetic hemoglobin disorders; patients with severe thalassemia often require regular blood transfusions for survival. Prenatal detection of thalassemia is currently invasive and carries the risk of miscarriage and infection. A polymerase chain reaction (PCR)-based surface enhanced Raman spectroscopy (SERS) technique was investigated in this paper for the purpose of detecting prenatal α-thalassemia Southeast Asian (SEA) type deletion using maternal plasma. Couples with the same SEA thalassemia (-SEA/αα) were selected, and the quantification of SEA and wild type (WT) alleles in the maternal plasma sample predicted the fetal genotype. PCR was performed using two pairs of fluorescence tag-labeled primers to produce tag-labeled PCR products for both the SEA (labeled with R6G) and WT (labeled with Cy3) alleles. Then, the labeled PCR products containing the two fluorescence tags were measured by SERS. The ratios between the R6G and Cy3 tags were obtained using multiple linear regressions (MLR), and these ratios corresponded with the physical ratio of WT and SEA concentrations in maternal plasma. After verifying this technique on DNA mixtures with known SEA and WT ratios, the plasma from 24 pregnant women was screened. An accuracy of 91.7% was achieved for detecting the fetal genotypes of Hb Bart's, alpha-trait, and normal trait. The results indicated that the simple PCR-SERS method may be sensitive enough for use on cell free fetal DNA (cffDNA) in maternal plasma for non-invasive prenatal detection (NIPD).
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Affiliation(s)
- Xiaozhou Li
- School of Science, Shenyang Ligong University, Shenyang 110159, China
- College of Environmental Sciences, Liaoning University, Shenyang 110036, China
| | - Tianyue Yang
- School of Science, Shenyang Ligong University, Shenyang 110159, China
| | - Caesar Siqi Li
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Lili Jin
- School of Life Science, Liaoning University, Shenyang 110036, China
| | - Hong Lou
- School of Life Science, Liaoning University, Shenyang 110036, China
| | - Youtao Song
- College of Environmental Sciences, Liaoning University, Shenyang 110036, China
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Vrettou C, Kakourou G, Mamas T, Traeger-Synodinos J. Prenatal and preimplantation diagnosis of hemoglobinopathies. Int J Lab Hematol 2018; 40 Suppl 1:74-82. [DOI: 10.1111/ijlh.12823] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/01/2018] [Indexed: 12/19/2022]
Affiliation(s)
- C. Vrettou
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
| | - G. Kakourou
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
| | - T. Mamas
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
| | - J. Traeger-Synodinos
- Department of Medical Genetics; National and Kapodistrian University of Athens; Athens Greece
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Traeger-Synodinos J, Harteveld CL. Preconception carrier screening and prenatal diagnosis in thalassemia and hemoglobinopathies: challenges and future perspectives. Expert Rev Mol Diagn 2017; 17:281-291. [DOI: 10.1080/14737159.2017.1285701] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Joanne Traeger-Synodinos
- Department of Medical Genetics, National and Kapodistrian University of Athens, St. Sophia’s Children’s Hospital, Athens, Greece
| | - Cornelis L. Harteveld
- Department of Clinical Genetics, Laboratory for Diagnostic Genome Analysis (LDGA), Leiden, The Netherlands
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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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Manoli I, Fryssira H. Medical genetics and genomic medicine in Greece: achievements and challenges. Mol Genet Genomic Med 2015; 3:383-90. [PMID: 26436103 PMCID: PMC4585445 DOI: 10.1002/mgg3.179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Irini Manoli
- Genetics and Molecular Biology Branch, National Human Genome Research Institute, National Institutes of Health Bethesda, Maryland
| | - Helen Fryssira
- Medical Genetics, Choremio Research Laboratory, "Aghia Sophia" Children's Hospital, University of Athens - School of Medicine Athens, Greece
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Chen M, Tan ASC, Cheah FSH, Saw EEL, Chong SS. Identification of novel microsatellite markers <1 Mb from theHBBgene and development of a single-tube pentadecaplex PCR panel of highly polymorphic markers for preimplantation genetic diagnosis of beta-thalassemia. Electrophoresis 2015; 36:2914-24. [DOI: 10.1002/elps.201500146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 07/20/2015] [Accepted: 08/17/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Min Chen
- Department of Pediatrics, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Arnold S. C. Tan
- Department of Pediatrics, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
- Preimplantation Genetic Diagnosis Center, Khoo Teck Puat - National University Children's Medical Institute; National University Health System; Singapore
| | - Felicia S. H. Cheah
- Preimplantation Genetic Diagnosis Center, Khoo Teck Puat - National University Children's Medical Institute; National University Health System; Singapore
| | - Eugene E. L. Saw
- Preimplantation Genetic Diagnosis Center, Khoo Teck Puat - National University Children's Medical Institute; National University Health System; Singapore
| | - Samuel S. Chong
- Department of Pediatrics, Yong Loo Lin School of Medicine; National University of Singapore; Singapore
- Department of Laboratory Medicine; National University Hospital; Singapore
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Carlos AM, Souza RAV, Souza BMBD, Pereira GDA, Tostes Júnior S, Martins PRJ, Moraes-Souza H. Hemoglobinopathies in newborns in the southern region of the Triângulo Mineiro, Brazil. Cross-sectional study. SAO PAULO MED J 2015; 133:439-44. [PMID: 26648434 PMCID: PMC10871810 DOI: 10.1590/1516-3180.2015.00042302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 02/23/2015] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Hemoglobinopathies are among the commonest and most widespread genetic disorders worldwide. Their prevalence varies according to ethnic composition and/or geographical region. The aim of this study was to investigate the presence of hemoglobinopathies and their association with ethnicity among 1,004 newborns, to confirm the guideline of the Brazilian National Neonatal Screening Program. DESIGN AND SETTING Cross-sectional study conducted in a public referral hospital in the Triângulo Mineiro region, Minas Gerais, Brazil. METHODS Qualitative assessment of hemoglobin was performed through electrophoresis on cellulose acetate: at alkaline pH to identify the hemoglobin (Hb) profile and at acid pH to differentiate Hb S from Hb D and Hb C from Hb E and others that migrate to similar positions at alkaline pH. Neutral pH was used to detect Hb Bart's identified in alpha thalassemia (α-thal). The elution method after electrophoresis was used to quantitatively assess hemoglobins. RESULTS There was predominance of α-thal, with 105 cases (10.46%), followed by Hb S with 61 cases (6.08%, comprising 46 Hb AS, 2 Hb SS and 13 Hb S/α-thal), 9 cases (0.9%) of Hb AC and 6 cases (0.6%) suggestive of beta thalassemia (β-thal). The frequency of hemoglobinopathies was significantly higher among Afro-descendants. CONCLUSIONS These findings corroborated of the National Neonatal Screening Program for diagnosing sickle cell disease and Hb C, Hb D, Hb E and β-thal hemoglobinopathies.
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Affiliation(s)
| | | | | | - Gilberto de Araujo Pereira
- Biostatistics Section, Department of Nursing, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Sebastião Tostes Júnior
- Forensic Medicine Section, Department of Social Medicine, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Paulo Roberto Juliano Martins
- Hematology and Hemotherapy Section, Department of Medicine, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Helio Moraes-Souza
- Hematology and Hemotherapy Section, Department of Medicine, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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Traeger-Synodinos J, Harteveld CL, Old JM, Petrou M, Galanello R, Giordano P, Angastioniotis M, De la Salle B, Henderson S, May A. EMQN Best Practice Guidelines for molecular and haematology methods for carrier identification and prenatal diagnosis of the haemoglobinopathies. Eur J Hum Genet 2014; 23:426-37. [PMID: 25052315 PMCID: PMC4666573 DOI: 10.1038/ejhg.2014.131] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 04/30/2014] [Accepted: 05/08/2014] [Indexed: 12/21/2022] Open
Abstract
Haemoglobinopathies constitute the commonest recessive monogenic disorders worldwide, and the treatment of affected individuals presents a substantial global disease burden. Carrier identification and prenatal diagnosis represent valuable procedures that identify couples at risk for having affected children, so that they can be offered options to have healthy offspring. Molecular diagnosis facilitates prenatal diagnosis and definitive diagnosis of carriers and patients (especially ‘atypical' cases who often have complex genotype interactions). However, the haemoglobin disorders are unique among all genetic diseases in that identification of carriers is preferable by haematological (biochemical) tests rather than DNA analysis. These Best Practice guidelines offer an overview of recommended strategies and methods for carrier identification and prenatal diagnosis of haemoglobinopathies, and emphasize the importance of appropriately applying and interpreting haematological tests in supporting the optimum application and evaluation of globin gene DNA analysis.
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Affiliation(s)
- Joanne Traeger-Synodinos
- Department of Medical Genetics, Choremeio Research Laboratory, University of Athens, St Sophia's Children's Hospital, Athens, Greece
| | - Cornelis L Harteveld
- Department of Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - John M Old
- National Haemoglobinopathy Reference Laboratory, Molecular Haematology, John Radcliffe Hospital, Oxford, UK
| | - Mary Petrou
- Haemoglobinopathy Genetics Centre, University College London Hospitals NHS Foundation Trust and Institute of Women's Health, University College London, London, UK
| | - Renzo Galanello
- Ospedale Regionale Microitemie, Via Jenner (sn), Cagliari, Italy
| | - Piero Giordano
- Department of Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Shirley Henderson
- National Haemoglobinopathy Reference Laboratory, Molecular Haematology, John Radcliffe Hospital, Oxford, UK
| | - Alison May
- Department of Haematology, Cardiff University Medical School, University Hospital of Wales, Cardiff, UK
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Traeger-Synodinos J, Harteveld CL. Advances in technologies for screening and diagnosis of hemoglobinopathies. Biomark Med 2014; 8:119-31. [PMID: 24325233 DOI: 10.2217/bmm.13.103] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Hemoglobinopathies constitute the most common monogenic disorders worldwide, caused by mutations in the globin genes that synthesize the globin chains of hemoglobin. Synthesis may be reduced (thalassemia) or underlie abnormal hemoglobins. Mutation interactions produce a wide range of disorders. For neonatal and antenatal screening, identification of affected newborns or carriers is achieved by hematological tests. DNA analysis supports definitive diagnosis, and additionally facilitates prenatal diagnosis procedures. Most methods used today have been developed over several decades, with few recent advances in hematology methods. However, DNA methods evolve continuously. With global migration and multiethnic societies the trend is from targeted, population-specific methods towards generic methods, such as Sanger sequencing (point mutations) and multiplex ligation probe amplification (deletions). DNA microarrays constitute an advanced DNA method for some mutation categories. The newest DNA technology is next-generation sequencing. Although not completely ready for routine use currently, next-generation sequencing may soon become a reality for some hemoglobin diagnostic laboratories.
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Affiliation(s)
- Jan Traeger-Synodinos
- Medical Genetics, University of Athens, St Sophia's Children's Hospital, Athens 11527, Greece.
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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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Hui L, Bianchi DW. Recent advances in the prenatal interrogation of the human fetal genome. Trends Genet 2012; 29:84-91. [PMID: 23158400 DOI: 10.1016/j.tig.2012.10.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 10/10/2012] [Accepted: 10/15/2012] [Indexed: 02/07/2023]
Abstract
The amount of genetic and genomic information obtainable from the human fetus during pregnancy is accelerating at an unprecedented rate. Two themes have dominated recent technological advances in prenatal diagnosis: interrogation of the fetal genome in increasingly high resolution and the development of non-invasive methods of fetal testing using cell-free DNA in maternal plasma. These two areas of advancement have now converged with several recent reports of non-invasive assessment of the entire fetal genome from maternal blood. However, technological progress is outpacing the ability of the healthcare providers and patients to incorporate these new tests into existing clinical care, and further complicates many of the economic and ethical dilemmas in prenatal diagnosis. This review summarizes recent work in this field and discusses the integration of these new technologies into the clinic and society.
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Affiliation(s)
- Lisa Hui
- Mother Infant Research Institute at Tufts Medical Center, 800 Washington St, Box 394, Boston, MA 02111, USA.
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Papanikos F, Iliadi A, Petropoulou M, Ioannou PC, Christopoulos TK, Kanavakis E, Traeger-Synodinos J. Lateral flow dipstick test for genotyping of 15 beta-globin gene (HBB) mutations with naked-eye detection. Anal Chim Acta 2012; 727:61-6. [PMID: 22541824 DOI: 10.1016/j.aca.2012.03.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 02/29/2012] [Accepted: 03/26/2012] [Indexed: 01/16/2023]
Abstract
For definitive diagnosis of thalassemia carriers and patients, as well as for prenatal diagnosis, genotype analysis is of fundamental importance. We report a dry-reagent, lateral flow dipstick test that enables visual genotyping (detection by naked eye) of 15 mutations common in Mediterranean populations in the beta-globin gene (HBB). The method comprises 3 simple steps: (i) PCR amplification of a single 1896 bp segment of the beta globin gene flanking all 15 mutations; (ii) a multiplex (10-plex and/or 30-plex) primer extension reaction of the unpurified amplification product using allele-specific primers. Biotin is incorporated in the extended product; (iii) a dry-reagent multi-allele (10-plex) dipstick assay for visual detection of the primer extension reaction products within minutes. The total time required for PCR, primer extension reaction and the dipstick assay is ~2 h. The method was evaluated by genotyping 45 DNA samples of known genotypes and 54 blind samples. The results were fully concordant with reference methods. The method is simple, rapid, and cost-effective. Detection by the dipstick assay does not require specialized instrumentation or highly qualified personnel. The proposed method could be a particularly useful tool in laboratories with limited resources and a basis for point-of-care diagnostics especially in combination with PCR amplification from whole blood.
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Affiliation(s)
- Frantzeskos Papanikos
- Laboratory of Analytical Chemistry, Department of Chemistry, Athens University, Athens 15771, Greece
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D'Agata R, Breveglieri G, Zanoli LM, Borgatti M, Spoto G, Gambari R. Direct detection of point mutations in nonamplified human genomic DNA. Anal Chem 2011; 83:8711-7. [PMID: 21978174 DOI: 10.1021/ac2021932] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ultrasensitive detection protocols not requiring polymerase chain reaction (PCR)-mediated target DNA amplification are expected to significantly improve our possibilities in several research and diagnostic applications for which minute cell quantities are available. For this reason we have tested a nanoparticle-enhanced surface plasmon resonance imaging (SPRI) sensing strategy to detect point mutations in nonamplified genomic DNA. We have used genomic DNAs, not subject to costly, time-consuming, and prone to contamination PCR-based amplification procedures, obtained from both healthy individuals and homozygous or heterozygous patients affected by β-thalassemia, in order to demonstrate the specificity and the sensitivity of the described sensing strategy. The assay we describe is ultrasensitive and convenient. Attomolar concentrations of target genomic DNA are detected, DNAs from healthy individuals and homozygous or heterozygous patients affected by β-thalassemia are discriminated, and only simple manipulations of the genetic samples are required before the analysis. The proposed ultrasensitive detection of DNA point mutations involved in genomic disorders possibly represents an important advantage in several biomedical applications.
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Affiliation(s)
- Roberta D'Agata
- Dipartimento di Scienze Chimiche, Università di Catania, Catania, Italy
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