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Sessa F, Chisari M, Salerno M, Esposito M, Zuccarello P, Capasso E, Scoto E, Cocimano G. Congenital heart diseases (CHDs) and forensic investigations: Searching for the cause of death. Exp Mol Pathol 2024; 137:104907. [PMID: 38820762 DOI: 10.1016/j.yexmp.2024.104907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/17/2024] [Accepted: 05/22/2024] [Indexed: 06/02/2024]
Abstract
Congenital Heart Diseases (CHDs) are a group of structural abnormalities or defects of the heart that are present at birth. CHDs could be connected to sudden death (SD), defined by the WHO (World Health Organization) as "death occurring within 24 h after the onset of the symptoms" in an apparently "healthy" subject. These conditions can range from relatively mild defects to severe, life-threatening anomalies. The prevalence of CHDs varies across populations, but they affect millions of individuals worldwide. This article aims to discuss the post-mortem investigation of death related to CHDs, exploring the forensic approach, current methodologies, challenges, and potential advancements in this challenging field. A further goal of this article is to provide a guide for understanding these complex diseases, highlighting the pivotal role of autopsy, histopathology, and genetic investigations in defining the cause of death, and providing evidence about the translational use of autopsy reports. Forensic investigations play a crucial role in understanding the complexities of CHDs and determining the cause of death accurately. Through collaboration between medical professionals and forensic experts, meticulous examinations, and analysis of evidence, valuable insights can be gained. These insights not only provide closure to the families affected but also contribute to the prevention of future tragedies.
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Affiliation(s)
- Francesco Sessa
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy.
| | - Mario Chisari
- "Rodolico-San Marco" Hospital, Santa Sofia Street, 87, Catania 95121, Italy.
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy.
| | | | - Pietro Zuccarello
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy.
| | - Emanuele Capasso
- Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", 80131 Naples, Italy.
| | - Edmondo Scoto
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy
| | - Giuseppe Cocimano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Vanvitelli", 80121 Napoli, Italy.
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Buckley L, Hopkins M, Kuller JA, Dugoff L. Prenatal Genetic Screening in Twin Pregnancy. Clin Obstet Gynecol 2023; 66:624-628. [PMID: 37436940 DOI: 10.1097/grf.0000000000000805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Twin pregnancy presents unique considerations for aneuploidy screening. Pre-test counseling regarding benefits, alternatives, and options for aneuploidy screening should be provided to all patients carrying twin pregnancy. This article aims to review the options for aneuploidy screening in twin pregnancy including the potential benefits and limitations.
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Affiliation(s)
- Lauren Buckley
- Obstetrics & Gynecology Institute, Cleveland Clinic, Cleveland, Ohio
| | - Maeve Hopkins
- Obstetrics & Gynecology Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jeffrey A Kuller
- Division of Maternal and Fetal Medicine, Duke University Hospital, Durham, North Carolina
| | - Lorraine Dugoff
- Division of Maternal and Fetal Medicine and Reproductive Genetics, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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3
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Xie X, Zhao Q, Fu Y, Zhang W, Meng Y, Lu Y. [Genetic testing and analysis of 2 cases of trisomy 11 mosaicism]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2022; 42:1057-1061. [PMID: 35869770 DOI: 10.12122/j.issn.1673-4254.2022.07.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Trisomy 11 mosaicism is clinically rare, for which making diagnostic and treatment decisions can be challenging. In this study, we used noninvasive prenatal testing, chromosome karyotype analysis, chromosome microarray analysis, copy number variation sequencing and fluorescence in situ hybridization for detecting trisomy 11 mosaicism in two cases and provided them with genetic counseling. In one of the cases, the fetus with confined placental mosaicism trisomy 11 presented with severe growth restriction and a placental mosaic level of 44%, and pregnancy was terminated at 25+3 weeks of gestation. In the other case with true low-level fetal mosaicism of trisomy 11, the pregnancy continued after exclusion of the possibility of uniparental disomy and structural abnormalities and careful prenatal counseling. The newborn was followed up for more than one year, and no abnormality was found. Noninvasive prenatal testing is capable of detecting chromosomal mosaicism but may cause missed diagnosis of true fetal mosaicism. For cases with positive noninvasive prenatal testing but a normal karyotype of the fetus, care should be taken in prenatal counseling and pregnancy management.
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Affiliation(s)
- X Xie
- Seventh Medical Center of Chinese PLA General Hospital, Department of Obstetrics and Gynecology, Beijing 100007, China
| | - Q Zhao
- Seventh Medical Center of Chinese PLA General Hospital, Department of Obstetrics and Gynecology, Beijing 100007, China
| | - Y Fu
- First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - W Zhang
- First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Y Meng
- Seventh Medical Center of Chinese PLA General Hospital, Department of Obstetrics and Gynecology, Beijing 100007, China
| | - Y Lu
- Seventh Medical Center of Chinese PLA General Hospital, Department of Obstetrics and Gynecology, Beijing 100007, China
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Zhou Y, Wang Y, Addai FP, Li X, Zhang X, Liu H, Yang G, Zeng F, Jiang T, Liu J. Analysis of cell-free fetal DNA in 16,843 pregnant women from a single center in China using targeted sequencing approach. Placenta 2022; 122:18-22. [DOI: 10.1016/j.placenta.2022.03.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 11/28/2022]
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Noninvasive prenatal diagnosis of congenital factor XIII deficiency in Iran. Blood Coagul Fibrinolysis 2022; 33:167-170. [PMID: 34980832 DOI: 10.1097/mbc.0000000000001121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Congenital factor (F) XIII deficiency is a rare coagulation factor deficiency that is inherited in an autosomal recessive manner. FXIII deficiency presents various clinical manifestations, such as intracranial hemorrhage (ICH), which is the most common cause of morbidity and mortality. As ICH can occur in the neonatal period, prenatal diagnosis (PND) is an effective way to reduce neonatal ICH and its associated fatal consequences. In this study, we investigated a noninvasive prenatal diagnosis (NIPD) method, cell-free fetal DNA (cffDNA), for PND in FXIII deficiency. This study was conducted on seven pregnant women in the first trimester. After extraction of cffDNA from maternal plasma, PCR-restriction fragment length polymorphism (PCR-RFLP) was performed to find the underlying F13A gene mutations previously identified in the family members. PCR-RFLP was also performed on postnatal DNA samples. Sanger sequencing was performed to confirm the results. Four cases were heterozygous for F13A gene mutations, whereas three were unaffected. PCR-RFLP results for cffDNA and postnatal DNA samples were identical, and Sanger sequencing confirmed the results. cffDNA is a noninvasive and effective method for PND in congenital FXIII deficiency.
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Munjal T, Vukkadala N, Hazard FK, Meister KD. Next-Generation Sequencing as an Auxiliary Tool in Pediatric Laryngeal Lymphoma Diagnosis. Pediatrics 2021; 148:peds.2020-047662. [PMID: 34716219 DOI: 10.1542/peds.2020-047662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
Lymphomatous involvement of the larynx is a rare entity. We present a case of atypical laryngotracheitis as the initial manifestation of non-Hodgkin's lymphoma in a pediatric patient. The diagnosis was aided through the use of microbial cell-free DNA (mcfDNA) testing, which detected the presence of Epstein-Barr virus in the patient's plasma. This enabled the consideration of an Epstein-Barr virus-related lymphoproliferative process, leading to additional workup and the final diagnosis of lymphoma. To our knowledge, this is the first case of mcfDNA testing leading not simply to an infectious organism, but further to a new oncologic diagnosis. Plasma mcfDNA testing has the potential to inform clinical practice beyond classic infectious disease manifestations. In this article, we review both the possible future applications and the areas of further investigation that remain.
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Affiliation(s)
- Tina Munjal
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Stanford University, Palo Alto, California
| | - Neelaysh Vukkadala
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Stanford University, Palo Alto, California
| | - Florette K Hazard
- Division of Hematology, Department of Pathology, Lucile Packard Children's Hospital and Stanford University, Palo Alto, California
| | - Kara D Meister
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Stanford University, Palo Alto, California
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Libotte F, Carpineto SL, Dello Russo C, Viola A, Margiotti K, Restaldi F, Novelli A, Mesoraca A, Giorlandino C. Cytogenetics and Molecular Investigations detect a Mosaic Variant of Turner Syndrome only Suspected by Non-Invasive Prenatal Testing: Two Case Reports with Negative Ultrasound Examinations. J Med Life 2021; 13:624-628. [PMID: 33456614 PMCID: PMC7803325 DOI: 10.25122/jml-2020-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Prenatal testing has been moving towards non-invasive methods to determine fetal risk for genetic disorders. Numerous studies have focused the attention on common trisomies; although the detection rate (DR) for trisomy 21 is high (over 95%), the accuracy regarding the DR for trisomies 13 and 18 has come under scrutiny. The testing has been applied to sex chromosome aneuploidies, but many studies have shown that it is not as effective as it is for common trisomies. Although non-invasive prenatal test (NIPT) has become a standard screening procedure for all pregnant women, invasive sampling procedures remain important in confirming NIPT-positive findings. In the present study, we report discordant results of Turner syndrome (TS) mosaicism between NIPT and karyotyping. A 35-year-old pregnant woman underwent NIPT, and a probable risk for Xp deletion was indicated. Subsequently, amniocentesis was performed. The karyotype was identified as mos 45,X [28]/46,X,i(X)(q1.0)[5]. In the second case, a 33-year-old woman underwent amniocentesis after a positive NIPT that indicated a probable risk for monosomy X. The result was mos 45,X [8]/46,XY[8]. Since NIPT is a screening test, the possibility of false-positive or false-negative results should always be considered. We underline the importance of pre/post detailed counseling. Furthermore, women with abnormal NIPT results should undergo immediate amniocentesis that remains the only tool for a correct diagnosis of sex chromosome aneuploidies.
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Affiliation(s)
- Francesco Libotte
- Department of Genetics, Altamedica Fetal Medical Centre, Rome, Italy
| | | | | | - Antonella Viola
- Department of Genetics, Altamedica Fetal Medical Centre, Rome, Italy
| | - Katia Margiotti
- Department of Genetics, Altamedica Fetal Medical Centre, Rome, Italy
| | - Fabrizia Restaldi
- Department of Genetics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Antonio Novelli
- Department of Genetics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Alvaro Mesoraca
- Department of Genetics, Altamedica Fetal Medical Centre, Rome, Italy
| | - Claudio Giorlandino
- Department of Prenatal Diagnosis, Altamedica Fetal Medical Centre, Rome, Italy
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Abstract
The introduction of noninvasive prenatal screening (NIPS) using cell-free DNA (cfDNA) is the newest option for aneuploidy screening during pregnancy. Compared with other aneuploidy screening options, NIPS offers a higher detection rate for trisomy 21 with a low false-positive rate. However, pretest and post-test patient counseling is essential and should include a discussion of the benefits and limitations, the screening rather than diagnostic nature of the test, and the association of a test failure with an increased risk of aneuploidy. Refer patients for genetic counseling when appropriate, particularly if test failure occurs due to a low fetal fraction or if maternal mosaicism or malignancy is suspected.
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Lu W, Huang T, Wang XR, Zhou JH, Yuan HZ, Yang Y, Huang TT, Liu DP, Liu YQ. Next-generation sequencing: a follow-up of 36,913 singleton pregnancies with noninvasive prenatal testing in central China. J Assist Reprod Genet 2020; 37:3143-3150. [PMID: 33094428 PMCID: PMC7714822 DOI: 10.1007/s10815-020-01977-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/12/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To evaluate the noninvasive prenatal testing (NIPT) results of 36,913 cases in Jiangxi province of central China and explore its application value in prenatal screening and diagnosis. METHODS This retrospective analysis included 36,913 singleton pregnant women who underwent NIPT because of moderate-/high-risk pregnancy or voluntary requirements between January 2017 and December 2019 in our hospital. Chromosomal abnormalities such as trisomies 21, 18, and 13 (T21, T18, T13) and sex chromosome aneuploidies (SCAs) were judged by standard Z-score analysis. Positive NIPT results were confirmed by amniocentesis and karyotyping. Pregnancy outcomes were followed up via telephone interview. RESULTS A total of 1.01% (371/36,913) positive cases were detected by NIPT, comprising 137, 46, 31, and 157 cases of T21, T18, T13, and SCAs, respectively. A total of 116 of T21, 27 of T18, 13 of T13, and 51 of SCAs were confirmed to be true positive; all normal cases that had been followed up were verified to be true negative. The NIPT sensitivity in T21, T18, T13, and SCAs was 100.00% individually, whereas the specificity was 99.94% (36,488/36,509), 99.95% (36,579/36,598), 99.95% (36,594/36,612), and 99.72% (36,472/36,574), respectively. Furthermore, the negative predictive values of T21, T18, T13, and SCAs were all 100%, while the positive predictive values were 84.67%, 58.70%, 41.94%, and 33.33%, respectively. CONCLUSION NIPT is highly sensitive and has a low false positive rate in testing clinically significant fetal aneuploidies of general reproductive women. However, this technique cannot substitute for amniocentesis and karyotyping, and detailed genetic counseling is also essential for the high-risk group of NIPT.
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Affiliation(s)
- Wan Lu
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Ting Huang
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Xin-Rong Wang
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Ji-Hui Zhou
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Hui-Zhen Yuan
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Yan Yang
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Ting-Ting Huang
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Dan-Ping Liu
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China
| | - Yan-Qiu Liu
- Prenatal Diagnosis Center, Jiangxi Maternal and Child Health Hospital, Nanchang, 330006, Jiangxi, China.
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10
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Wu M, Leung J, Liu L, Kam C, Chan KYK, Li RA, Feng S, Chen S. A Small-Molecule AIE Chromosome Periphery Probe for Cytogenetic Studies. Angew Chem Int Ed Engl 2020; 59:10327-10331. [PMID: 32163217 PMCID: PMC7318220 DOI: 10.1002/anie.201916718] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/04/2020] [Indexed: 01/12/2023]
Abstract
The chromosome periphery (CP) is a complex network that covers the outer surface of chromosomes. It acts as a carrier of nucleolar components, helps maintain chromosome structure, and plays an important role in mitosis. Current methods for fluorescence imaging of CP largely rely on immunostaining. We herein report a small-molecule fluorescent probe, ID-IQ, which possesses aggregation-induced emission (AIE) property, for CP imaging. By labelling the CP, ID-IQ sharply highlighted the chromosome boundaries, which enabled rapid segmentation of touching and overlapping chromosomes, direct identification of the centromere, and clear visualization of chromosome morphology. ID-IQ staining was also compatible with fluorescence in situ hybridization and could assist the precise location of the gene in designated chromosome. Altogether, this study provides a versatile cytogenetic tool for improved chromosome analysis, which greatly benefits the clinical diagnostic testing and genomic research.
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Affiliation(s)
- Ming‐Yu Wu
- Ming Wai Lau Centre for Reparative MedicineKarolinska InstitutetHong KongChina
- School of Life Science and EngineeringSouthwest Jiaotong UniversityChengduSichuan610031China
| | - Jong‐Kai Leung
- Ming Wai Lau Centre for Reparative MedicineKarolinska InstitutetHong KongChina
| | - Li Liu
- School of Life Science and EngineeringSouthwest Jiaotong UniversityChengduSichuan610031China
| | - Chuen Kam
- Ming Wai Lau Centre for Reparative MedicineKarolinska InstitutetHong KongChina
| | - Kelvin Yuen Kwong Chan
- Department of Obstetrics and GynaecologyQueen Mary HospitalHong KongChina
- Prenatal Diagnostic LaboratoryTsan Yuk HospitalHong KongChina
| | - Ronald A. Li
- Ming Wai Lau Centre for Reparative MedicineKarolinska InstitutetHong KongChina
- Dr. Li Dak-Sum Research CentreThe University of Hong KongHong KongChina
| | - Shun Feng
- School of Life Science and EngineeringSouthwest Jiaotong UniversityChengduSichuan610031China
| | - Sijie Chen
- Ming Wai Lau Centre for Reparative MedicineKarolinska InstitutetHong KongChina
- Dr. Li Dak-Sum Research CentreThe University of Hong KongHong KongChina
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11
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Pei Y, Hu L, Liu J, Wen L, Luo X, Lu J, Wei F. Efficiency of noninvasive prenatal testing for the detection of fetal microdeletions and microduplications in autosomal chromosomes. Mol Genet Genomic Med 2020; 8:e1339. [PMID: 32543126 PMCID: PMC7434727 DOI: 10.1002/mgg3.1339] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
Background Noninvasive prenatal testing (NIPT) is commonly used to screen for fetal genetic abnormalities. However, the ability of NIPT to detect copy number variations (CNVs) has not been reported. Accordingly, in this study, we analyzed the efficiency of NIPT for the detection of fetal autosomal CNVs. Methods Patients who were positive for autosomal CNVs by NIPT and underwent diagnostic studies by karyotype analysis and chromosomal microarray (CMA) were evaluated. Samples were divided into groups according to age, in vitro fertilization, fetal‐free DNA concentration, uniquely mapped reads number, CNV size, and CNV type. Results Chromosomal microarray showed that the positive predictive value (PPV) of autosomal CNVs detected by NIPT was 14.89%. Increasing fetal DNA concentrations and uniquely mapped read numbers did not affect the PPV of CNVs detected by NIPT. There were no differences between microduplication and microdeletion PPVs detected by NIPT. The PPV of CNVs less than 10 Mb was significantly higher than that of CNVs greater than 10 Mb detected by NIPT. Conclusion The accuracy of NIPT for autosomal CNVs needs to be improved.
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Affiliation(s)
- Yuanyuan Pei
- Genetic Laboratory of Shenzhen Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Liang Hu
- Genetic Laboratory of Shenzhen Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Jinxing Liu
- Genetic Laboratory of Shenzhen Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Lijuan Wen
- Genetic Laboratory of Shenzhen Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Xiaojin Luo
- Genetic Laboratory of Shenzhen Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China
| | - Jian Lu
- Medical Genetic Centre of Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Fengxiang Wei
- Genetic Laboratory of Shenzhen Longgang Maternal and Child Health Hospital, Shenzhen, Guangdong, China.,Department of Cell Biology, Jiamusi University, Jiamusi, Heilongjiang, China.,Department of Pathogenic Microorganisms, Zunyi Medical University, Zunyi, Guangdong, China.,School of Public Health, Anhui Medical University, Hefei, Anhui, China
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12
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Lopes JL, Lopes GS, Enninga EAL, Kearney HM, Hoppman NL, Rowsey RA. Most noninvasive prenatal screens failing due to inadequate fetal cell free DNA are negative for trisomy when repeated. Prenat Diagn 2020; 40:831-837. [PMID: 32274800 DOI: 10.1002/pd.5693] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/06/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We aimed to test for an association between the amount of circulating fetal cell-free DNA and trisomy, and whether NIPS failure due to low fetal fraction indicates trisomy risk. METHOD Maternal BMI, maternal age, fetal sex, gestational age, fetal cfDNA fraction, and NIPS results was collected on 2374 pregnancies. Additional clinical information was available for 1180 research consented patients. We investigated associations between fetal fraction and available variables and determined the success rate of repeat NIPS testing. RESULTS Fetal trisomy was marginally associated with decreased fetal fraction (P = .067). However, the proportions of trisomy events were not significantly increased in women who had failed NIPS due to low fetal fraction (<4%) (OR = 1.37 [0.3-7.4]; P = .714). 66% of repeated NIPS after a second blood draw were successful. CONCLUSION Failure to meet the clinical cutoff of 4% fetal fraction established for NIPS accuracy did not suggest increased risk for trisomy in our cohort. Because repeat testing was successful in the majority of cases and most failures were explained by high BMI and low gestational age, a redraw may be an appropriate next step before invasive screening due to concerns for trisomic pregnancies.
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Affiliation(s)
- Jaime L Lopes
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Guilherme S Lopes
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Hutton M Kearney
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicole L Hoppman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ross A Rowsey
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
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13
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Wu M, Leung J, Liu L, Kam C, Chan KYK, Li RA, Feng S, Chen S. A Small‐Molecule AIE Chromosome Periphery Probe for Cytogenetic Studies. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.201916718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Ming‐Yu Wu
- Ming Wai Lau Centre for Reparative Medicine Karolinska Institutet Hong Kong China
- School of Life Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Jong‐Kai Leung
- Ming Wai Lau Centre for Reparative Medicine Karolinska Institutet Hong Kong China
| | - Li Liu
- School of Life Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Chuen Kam
- Ming Wai Lau Centre for Reparative Medicine Karolinska Institutet Hong Kong China
| | - Kelvin Yuen Kwong Chan
- Department of Obstetrics and Gynaecology Queen Mary Hospital Hong Kong China
- Prenatal Diagnostic Laboratory Tsan Yuk Hospital Hong Kong China
| | - Ronald A. Li
- Ming Wai Lau Centre for Reparative Medicine Karolinska Institutet Hong Kong China
- Dr. Li Dak-Sum Research Centre The University of Hong Kong Hong Kong China
| | - Shun Feng
- School of Life Science and Engineering Southwest Jiaotong University Chengdu Sichuan 610031 China
| | - Sijie Chen
- Ming Wai Lau Centre for Reparative Medicine Karolinska Institutet Hong Kong China
- Dr. Li Dak-Sum Research Centre The University of Hong Kong Hong Kong China
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14
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Farrell RM, Mercer M, Agatisa PK, Coleridge MB. Balancing Needs and Autonomy: The Involvement of Pregnant Women's Partners in Decisions About cfDNA. QUALITATIVE HEALTH RESEARCH 2019; 29:211-221. [PMID: 30182811 DOI: 10.1177/1049732318796833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cell-free fetal DNA (cfDNA) screening is used to identify the presence of fetal genetic variants early in pregnancy. Patients' informed decision-making is central to the success of this new screen in clinical practice. Although research has focused on pregnant women's decision-making, little is known about partners' role and preferences as a member of the decision-making dyad. Using a grounded theory approach, this study analyzed 23 in-depth interviews to examine partners' perspectives about cfDNA screening and preferences with respect to their role in the decision-making process. Participants wished to be actively involved in testing decisions. They articulated a distinct set of needs and preferences in the decision-making process. Such involvement was hindered by several biological and logistical barriers. This study demonstrates the need to develop mechanisms that foster informed decision-making for cfDNA screening and related new reproductive genetic technologies that focus on not just the pregnant woman but also the decision-making dyad that includes her partner as well.
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15
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Li H, Lei Y, Zhu H, Luo Y, Qian Y, Chen M, Sun Y, Yan K, Yang Y, Liu B, Wang L, Huang Y, Hu J, Xu J, Dong M. The application of NIPT using combinatorial probe-anchor synthesis to identify sex chromosomal aneuploidies (SCAs) in a cohort of 570 pregnancies. Mol Cytogenet 2018; 11:59. [PMID: 30524505 PMCID: PMC6278040 DOI: 10.1186/s13039-018-0407-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/19/2018] [Indexed: 01/03/2023] Open
Abstract
Background Non-invasive prenatal testing (NIPT) as alternative screening method had been proven to have very high sensitivity and specificity for detecting common aneuploidies such as T21, T18, and T13, with low false positive and false negative rates. Unfortunately, recent studies suggested that the NIPT achieved lower accuracy in sex chromosomal aneuploidies (SCAs) detection than autosomal aneuploidies detection. BGISEQ-500 powered by Combinatorial Probe-Anchor Synthesis (CPAS) and DNA Nanoballs (DNBs) technology that combined linear amplification and rolling circle replication to reduce the error rate while enhancing the signal. Therefore, NIPT based on CPAS might be a good method for SCAs screening in routine clinical practice. In the study, we intended to evaluate the clinical utility of NIPT based on CPAS on screening for fetal SCAs. Results A total of 570 pregnant women were included in the retrospective study. Maternal blood samples were collected for NIPT; amniocentesis was performed on all pregnant women. NIPT was carried out by BGISEQ-500 sequencing platform based on CPAS. Karyotype analysis of amniotic cells was performed by standard G-banding techniques. 43 out of the total 570 pregnant women tested by NIPT showed fetal SCAs (19 of 45,X, 12 of 47,XXY, 10 of 47,XXX, and 2 of 47,XYY). The following amniocentesis confirmed that 26 cases were true positive (7 of true positive 45,X, 9 of true positive 47,XXY, 9 of true positive 47,XXX as well as 1 of 47,XYY) and the positive predictive value (PPV) for fetal SCAs was 60.47%. In addition, the PPV of advanced maternal age group (67.74%) was higher than the other indications group (45.45%) or serological screening high-risk /critical-risk group (0%). Conclusions NIPT based on CPAS could be a potential method for SCAs screening. However, it still had high false positive rates, especially for 45,X. The pregnant women with fetal SCAs detected by NIPT, especially those with non-age-related prenatal diagnostic indications, should be advised to accept invasive prenatal karyotype analysis.
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Affiliation(s)
- Hongge Li
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Yu Lei
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Hui Zhu
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Yuqin Luo
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Yeqing Qian
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Min Chen
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Yixi Sun
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Kai Yan
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Yanmei Yang
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Bei Liu
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Liya Wang
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Yingzhi Huang
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Junjie Hu
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Jianyun Xu
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
| | - Minyue Dong
- 1Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China.,2Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China.,Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou Zhejiang, 310006 People's Republic of China
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Khanna S, Padhan P, Das S, Jaiswal KS, Tripathy A, Smita S, Tripathy SK, Raghav SK, Gupta B. A Simple Colorimetric Method for Naked-Eye Detection of Circulating Cell-Free DNA Using Unlabelled Gold Nanoparticles. ChemistrySelect 2018. [DOI: 10.1002/slct.201802671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Shweta Khanna
- Disease Biology Laboratory; School of Biotechnology; Kalinga Institute of Industrial Technology (KIIT); Deemed to be University, Bhubaneswar, Odisha; 751024 India
| | - Prasanta Padhan
- Department of Rheumatology; Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha; India
| | - Sourav Das
- Chemical and Bioprocess Engineering Lab; School of Chemical Technology; Kalinga Institute of Industrial Technology (KIIT); Deemed to be University, Bhubaneswar, Odisha; 751024 India
| | - Kumar Sagar Jaiswal
- Disease Biology Laboratory; School of Biotechnology; Kalinga Institute of Industrial Technology (KIIT); Deemed to be University, Bhubaneswar, Odisha; 751024 India
| | - Archana Tripathy
- Disease Biology Laboratory; School of Biotechnology; Kalinga Institute of Industrial Technology (KIIT); Deemed to be University, Bhubaneswar, Odisha; 751024 India
| | - Shuchi Smita
- Laboratory of Immuno-Genomics and Systems Biology; Institute of Life Sciences, Bhubaneswar, Odisha; India
| | - Suraj K. Tripathy
- Chemical and Bioprocess Engineering Lab; School of Chemical Technology; Kalinga Institute of Industrial Technology (KIIT); Deemed to be University, Bhubaneswar, Odisha; 751024 India
| | - Sunil Kumar Raghav
- Laboratory of Immuno-Genomics and Systems Biology; Institute of Life Sciences, Bhubaneswar, Odisha; India
| | - Bhawna Gupta
- Disease Biology Laboratory; School of Biotechnology; Kalinga Institute of Industrial Technology (KIIT); Deemed to be University, Bhubaneswar, Odisha; 751024 India
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D'ambrosio V, Squarcella A, Vena F, Di Mascio D, Corno S, Pajno C, Piccioni MG, Brunelli R, Pizzuti A, Benedetti Panici P, Giancotti A. Update in non-invasive prenatal testing. ACTA ACUST UNITED AC 2018; 71:44-53. [PMID: 30318870 DOI: 10.23736/s0026-4784.18.04306-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Non-invasive prenatal testing (NIPT) has revolutionized the approach to prenatal diagnosis and, to date, it is the most superior screening method for the common autosomal aneuploidies, mostly trisomy 21. This screening is having a significant population-wide impact on the uptake of conventional screening and diagnostic testing. In recent years, emerging genomic technologies, largely based around next generation sequencing, have expanded the analyses to the sub-chromosomal aneuploidies. However, further clinical validation studies are needed to better characterize this technology. These tests bring advantage through providing a higher diagnostic yield, without risks of miscarriage than previously available diagnostic test, but also raise the question of harms related to an increase in uncertain and unknown results. In view of the revolution brought about by the NIPT, numerous scientific societies have published recommendations regarding the appropriate application of cell-free DNA screening in pregnancy. In this review, we discuss the progress that has been made to date in NIPT.
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Affiliation(s)
- Valentina D'ambrosio
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - Antonia Squarcella
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy - .,Department of Experimental Medicine, Sapienza University, Umberto I Polyclinic Hospital, Rome, Italy
| | - Flaminia Vena
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - Daniele Di Mascio
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - Sara Corno
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - Cristina Pajno
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - Maria G Piccioni
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - Roberto Brunelli
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Sapienza University, Umberto I Polyclinic Hospital, Rome, Italy
| | | | - Antonella Giancotti
- Department of Gynecological, Obstetrical, and Urological Sciences, Sapienza University, Rome, Italy
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18
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Scott F, Bonifacio M, Sandow R, Ellis K, Smet ME, McLennan A. Rare autosomal trisomies: Important and not so rare. Prenat Diagn 2018; 38:765-771. [PMID: 29956348 DOI: 10.1002/pd.5325] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/09/2018] [Accepted: 06/23/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Noninvasive prenatal testing (NIPT) can assess chromosomes other than 13, 18, 21, X and Y. These rare autosomal trisomies (RATs) can adversely affect pregnancy outcome. METHODS A prospective study of NIPT using the Illumina sequencing platform assessing all chromosomes were reported for further management. RESULTS There were 28 RATs identified in 23 388 samples (one in 835), the most common being trisomy 7 (n = 6), followed by trisomy 16 (n = 4) and trisomy 22 (n = 3). Abnormal outcomes occurred in 16 cases: miscarriage (n = 6), true fetal mosaicism (n = 5), and fetal structural anomaly on ultrasound (n = 5). Growth restriction was seen in eight cases and correlated with very low-pregnancy-associated plasma protein-A levels. Two of the 17 live born babies had a structural anomaly, and one had a phenotype similar to mosaic trisomy 16 despite a normal microarray result. CONCLUSION Rare autosomal trisomies are not rare and often associated with poor obstetric outcomes. They should be discussed with the clinician to guide management. Pregnancy outcomes varied by chromosome being generally favourable for some (eg, trisomy 7) and poor for others (eg, trisomy 22). In the presence of a RAT, pregnancy-associated plasma protein-A is predictive of placental dysfunction and fetal growth restriction.
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Affiliation(s)
- Fergus Scott
- Sydney Ultrasound for Women, Bondi Junction, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia
| | | | - Rhiannon Sandow
- Sydney Ultrasound for Women, Bondi Junction, New South Wales, Australia
| | | | | | - Andrew McLennan
- Sydney Ultrasound for Women, Bondi Junction, New South Wales, Australia.,Discipline of Obstetrics, Gynaecology and Neonatology, University of Sydney, Camperdown, New South Wales, Australia
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19
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Qian YQ, Wang XQ, Chen M, Luo YQ, Yan K, Yang YM, Liu B, Wang LY, Huang YZ, Li HG, Pan HY, Jin F, Dong MY. Detection of fetal subchromosomal aberration with cell-free DNA screening led to diagnosis of parental translocation: Review of 11344 consecutive cases in a university hospital. Eur J Med Genet 2018; 62:115-123. [PMID: 29929010 DOI: 10.1016/j.ejmg.2018.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 01/03/2018] [Accepted: 06/17/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Fetal chromosome aberrations and sub-chromosomal copy number variations (CNVs) are not rare. There are several ways to detect duplications and deletions; cell-free DNA screening (cfDNA screening) is nowadays an accurate and safe detection method. The objective of this study is to report the feasibility of cfDNA screening as an indicator of parental balanced chromosome translocation. RESULTS From February 2015 to March 2016, cfDNA screening was offered to 11344 pregnant women. 137 out of 11344 individuals tested positive for aneuploidies using cfDNA screening were confirmed by karyotyping. 6 additional cases also tested positive for other deletion/duplication were confirmed by chromosomal microarray analysis (CMA). 11201 patients tested negative and 10342 of them were confirmed through interviews after delivery. Among the 137 cases that were screened positive in cfDNA screening, 91 were common trisomies (63 cases of trisomy 21, 25 cases of trisomy 18 and 3 cases of trisomy 13) and 46 cases were positive for sex-chromosomal abnormalities. In addition, 6 cases were positive for other deletion/duplication in which 2 were identified as terminal duplication and deletion on different chromosomes. The cfDNA screening findings were confirmed by CMA or karyotyping, and the origins of CNVs were validated afterward by karyotyping or fluorescence in situ hybridization (FISH) using parental blood samples. CONCLUSION CfDNA screening may help identify deletions and duplications in fetus, which in some cases may indicate risk of a parent being a balanced rearrangement carrier, and that the diagnostic follow-up testing is necessary.
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Affiliation(s)
- Ye-Qing Qian
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Xiao-Qing Wang
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Min Chen
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Yu-Qin Luo
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Kai Yan
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Yan-Mei Yang
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Bei Liu
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Li-Ya Wang
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Ying-Zhi Huang
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Hong-Ge Li
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Hang-Yi Pan
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Fan Jin
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China
| | - Min-Yue Dong
- Women's Hospital, School of Medicine Zhejiang University, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, 1 Xueshi Road, Hangzhou, Zhejiang, 310006, PR China; Key Laboratory of Women's Reproductive Health of Zhejiang Province, 1, Xueshi Road, Hangzhou, Zhejiang, 310006, PR China.
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20
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Zhang S, Han S, Zhang M, Wang Y. Non-invasive prenatal paternity testing using cell-free fetal DNA from maternal plasma: DNA isolation and genetic marker studies. Leg Med (Tokyo) 2018; 32:98-103. [PMID: 29626747 DOI: 10.1016/j.legalmed.2018.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 03/01/2018] [Accepted: 03/31/2018] [Indexed: 12/13/2022]
Abstract
Invasive prenatal paternity tests can result in miscarriage and congenital malformations; therefore, a non-invasive method of testing is preferable. However, little progress could be made in this field until the introduction of cell-free fetal DNA (cffDNA) in 2009. In this review, two aspects regarding the history and development of non-invasive prenatal paternity testing (NIPAT) are summarized: (1) extraction and enrichment of cffDNA and (2) genetic marker-based studies. Although column-based kits are used widely for NIPAT, some researchers have suggested that an automated method, such as magnetic extraction, generally has a higher cffDNA yield than that of manual column-based extraction; therefore, its popularity might increase in the near future. In addition, size- and methylation-based enrichment methods are expected to perform better than formaldehyde-based methods. On the other hand, single nucleotide polymorphism-based techniques have contributed to NIPAT, whereas the application of short tandem repeat testing has so far been restricted to pregnant women bearing male fetuses only. Additional methods and techniques are expected to be innovated to facilitate the forensic practice of NIPAT.
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Affiliation(s)
- Shanshan Zhang
- Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong University, No. 105 Jiefang Road, Jinan, Shandong 250013, PR China
| | - Shuyi Han
- Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong University, No. 105 Jiefang Road, Jinan, Shandong 250013, PR China.
| | - Maoxiu Zhang
- Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong University, No. 105 Jiefang Road, Jinan, Shandong 250013, PR China
| | - Yunshan Wang
- Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong University, No. 105 Jiefang Road, Jinan, Shandong 250013, PR China.
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Schwartz S, Kohan M, Pasion R, Papenhausen PR, Platt LD. Clinical experience of laboratory follow-up with noninvasive prenatal testing using cell-free DNA and positive microdeletion results in 349 cases. Prenat Diagn 2018; 38:210-218. [DOI: 10.1002/pd.5217] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 12/14/2022]
Affiliation(s)
- S. Schwartz
- Cytogenetics Laboratory, Laboratory Corporation of America® Holdings; Research Triangle Park NC 27709 USA
| | - M. Kohan
- Integrated Genetics, LabCorp Specialty Testing Group; 655 Huntington Drive Monrovia CA 91016 USA
| | - R. Pasion
- Cytogenetics Laboratory, Laboratory Corporation of America® Holdings; Research Triangle Park NC 27709 USA
| | - P. R. Papenhausen
- Cytogenetics Laboratory, Laboratory Corporation of America® Holdings; Research Triangle Park NC 27709 USA
| | - L. D. Platt
- David Geffen School of Medicine; UCLA; Los Angeles CA USA
- Center for Fetal Medicine and Women's Ultrasound; Los Angeles CA USA
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22
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Lee SY, Kim SJ, Han SH, Park JS, Choi HJ, Ahn JJ, Oh MJ, Shim SH, Cha DH, Hwang SY. A new approach of digital PCR system for non-invasive prenatal screening of trisomy 21. Clin Chim Acta 2018; 476:75-80. [DOI: 10.1016/j.cca.2017.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
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Azoury SC, Reddy S, Shukla V, Deng CX. Fibroblast Growth Factor Receptor 2 ( FGFR2) Mutation Related Syndromic Craniosynostosis. Int J Biol Sci 2017; 13:1479-1488. [PMID: 29230096 PMCID: PMC5723914 DOI: 10.7150/ijbs.22373] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/01/2017] [Indexed: 12/30/2022] Open
Abstract
Craniosynostosis results from the premature fusion of cranial sutures, with an incidence of 1 in 2,100-2,500 live births. The majority of cases are non-syndromic and involve single suture fusion, whereas syndromic cases often involve complex multiple suture fusion. The fibroblast growth factor receptor 2 (FGFR2) gene is perhaps the most extensively studied gene that is mutated in various craniosynostotic syndromes including Crouzon, Apert, Pfeiffer, Antley-Bixler, Beare-Stevenson cutis gyrata, Jackson-Weiss, Bent Bone Dysplasia, and Seathre-Chotzen-like syndromes. The majority of these mutations are missense mutations that result in constitutive activation of the receptor and downstream molecular pathways. Treatment involves a multidisciplinary approach with ultimate surgical fixation of the cranial deformity to prevent further sequelae. Understanding the molecular mechanisms has allowed for the investigation of different therapeutic agents that can potentially be used to prevent the disorders. Further research efforts are need to better understand screening and effective methods of early intervention and prevention. Herein, the authors provide a comprehensive update on FGFR2-related syndromic craniosynostosis.
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Affiliation(s)
- Saïd C. Azoury
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Sashank Reddy
- Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Vivek Shukla
- TGIB, NCI, National Institutes of Health, Bethesda, MD, USA
| | - Chu-Xia Deng
- Faculty of Health Sciences, University of Macau, Macau SAR, China
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Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Understand the role of prenatal screening and counseling of parents of unborn children with syndromic craniosynostosis. 2. Recognize the genetic abnormalities, craniofacial phenotype, associated anomalies, and challenges associated with each of the five major forms of syndromic craniosynostosis. 3. Identify the pros and cons associated with timing and types of cranial vault remodeling techniques in this patient population. 4. Understand the risks and benefits associated with midface advancement with Le Fort III, Le Fort II plus zygomatic repositioning, monobloc, and facial bipartition. 5. Understand the important role of psychological counseling throughout childhood in this at-risk group. SUMMARY Crouzon, Apert, Pfeiffer, Muenke, and Saethre-Chotzen syndromes are the five most common forms of syndromic craniosynostosis. Although each has different genetic underpinnings and associated anomalies, their hallmark finding is turribrachycephaly most often associated with bicoronal craniosynostosis. The role of prenatal screening and counseling is growing, with caregivers becoming involved before birth. Multidisciplinary care from birth onward involves craniofacial plastic surgeons, neurosurgeons, otolaryngologists, ophthalmologists, orthodontists, anesthesiologists, psychologists, speech therapists, and geneticists. Early partial, or regional, craniectomy may be urgently indicated in multisuture cases with signs of increased intracranial pressure. Others may be managed successfully with posterior cranial vault distraction, middle vault expansion, or fronto-orbital advancement. Some authors have advocated early monobloc advancement for those patients who require acute airway intervention and globe protection, although the risks of these procedures are high. Many patients will require midfacial advancement with a Le Fort III, Le Fort II plus zygomatic repositioning, monobloc, or facial bipartition. The indications, risks, and benefits for each midfacial procedure must be considered, as this step in the treatment algorithm may carry the greatest functional and aesthetic benefits but also the potential for the greatest morbidity. At the culmination of facial growth, it is not uncommon for patients to require conventional orthognathic surgery and other bony contouring and soft-tissue procedures. Finally, an understanding of the psychological aspects of craniofacial difference, both in affected individuals and in their families, is essential to a successful, holistic approach.
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Chen M, Fu XY, Luo YQ, Qian YQ, Pan L, Wang LY, Dong MY. Detection of fetal duplication 16p11.2q12.1 by next-generation sequencing of maternal plasma and invasive diagnosis. J Matern Fetal Neonatal Med 2017; 32:38-45. [PMID: 28882078 DOI: 10.1080/14767058.2017.1369947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of study is to report the feasibility of non-invasive prenatal screening (NIPS) combined with invasive detection by chromosomal analysis in identifying fetal duplication, providing clinical performance of NIPS on copy number variations (CNVs) detection. MATERIAL AND METHODS NIPS was offered to a 35-year-old pregnant woman. Amniocentesis was performed to confirm the positive screening result. Fetal sample was detected by karyotyping, fluorescence in situ hybridization (FISH), and chromosomal microarray (CMA). Parental karyotyping was also conducted. RESULTS NIPS result was positive for chromosome 16, indicating an extra copy of chromosome 16. FISH and chromosomal karyotyping revealed that the fetus had a marker chromosome derived from chromosome 16. CMA further demonstrated an approximately 19-Mb duplication in chromosome 16. The final fetal karyotype was 47,XY,+mar. ish der (16)(D16Z3+).arr 16p11.2q12.1 (30 624 186-49 696 337 × 3). Ultrasound scan and MRI showed some structure malformations. CONCLUSIONS A protocol for CNVs detection by combining a series of genetic methods was presented in this study and a novel marker duplication 16p11.2q12.1 was reported. With the ability to identify subchromosomal deletions and duplications in fetus, NIPS could reduce the possibility of invasive diagnosis. The followed confirmation test for positive sample is necessary and ensures the accuracy of the diagnosis.
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Affiliation(s)
- Min Chen
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Xiao-Ying Fu
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Yu-Qin Luo
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Ye-Qing Qian
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Ling Pan
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Li-Ya Wang
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
| | - Min-Yue Dong
- a Women's Hospital, School of Medicine, Zhejiang University , Hangzhou , China.,b Key Laboratory of Reproductive Genetics , Zhejiang University, Ministry of Education , Hangzhou , China.,c Key Laboratory of Women's Reproductive Health of Zhejiang Province , Hangzhou , China
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Comparative evaluation of the Minimally-Invasive Karyotyping (MINK) algorithm for non-invasive prenatal testing. PLoS One 2017; 12:e0171882. [PMID: 28306738 PMCID: PMC5356998 DOI: 10.1371/journal.pone.0171882] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 01/29/2017] [Indexed: 01/18/2023] Open
Abstract
Minimally Invasive Karyotyping (MINK) was communicated in 2009 as a novel method for the non-invasive detection of fetal copy number anomalies in maternal plasma DNA. The original manuscript illustrated the potential of MINK using a model system in which fragmented genomic DNA obtained from a trisomy 21 male individual was mixed with that of his karyotypically normal mother at dilutions representing fetal fractions found in maternal plasma. Although it has been previously shown that MINK is able to non-invasively detect fetal microdeletions, its utility for aneuploidy detection in maternal plasma has not previously been demonstrated. The current study illustrates the ability of MINK to detect common aneuploidy in early gestation, compares its performance to other published third party methods (and related software packages) for prenatal aneuploidy detection and evaluates the performance of these methods across a range of sequencing read inputs. Plasma samples were obtained from 416 pregnant women between gestational weeks 8.1 and 34.4. Shotgun DNA sequencing was performed and data analyzed using MINK RAPIDR and WISECONDOR. MINK performed with greater accuracy than RAPIDR and WISECONDOR, correctly identifying 60 out of 61 true trisomy cases, and reporting only one false positive in 355 normal pregnancies. Significantly, MINK achieved accurate detection of trisomy 21 using just 2 million aligned input reads, whereas WISECONDOR required 6 million reads and RAPIDR did not achieve complete accuracy at any read input tested. In conclusion, we demonstrate that MINK provides an analysis pipeline for the detection of fetal aneuploidy in samples of maternal plasma DNA.
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Ethical and practical challenges in providing noninvasive prenatal testing for chromosome abnormalities: an update. Curr Opin Obstet Gynecol 2016; 28:119-24. [PMID: 26938150 DOI: 10.1097/gco.0000000000000254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Noninvasive prenatal testing (NIPT) through the analysis of cell-free DNA in maternal plasma has rapidly changed screening for fetal chromosome abnormalities. We review practical and ethical challenges associated with the transition, progress in their resolution, and identify new emerging difficulties. RECENT FINDINGS NIPT is an advanced screening test for trisomies 21, 18, and 13 that was initially limited to women at high risk for an affected pregnancy. It is now recognized as suitable for all women. The testing has been expanded to include sex chromosome abnormalities and some microdeletion syndromes. Some ethicists are concerned about inclusion of disorders that have less severe phenotypes. SUMMARY Clinical providers have experienced difficulty in maintaining an up-to-date knowledge about the scope of NIPT, differences between tests, who should be offered the testing, performance of tests, reasons for false-positive results, and optimal patient management following positive results. Some of the practical difficulties associated with the introduction can be attributed to this knowledge gap. There remain some important ethical issues associated with NIPT. We believe that the same ethical and legal principles that were considered in the justification of conventional prenatal screening can be used to assess the appropriateness of additional NIPT applications.
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McNamara ER, Swartz JM, Diamond DA. Initial Management of Disorders of Sex Development in Newborns. Urology 2016; 101:1-8. [PMID: 27538800 DOI: 10.1016/j.urology.2016.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/08/2016] [Accepted: 08/09/2016] [Indexed: 12/25/2022]
Abstract
Disorders of sex development are challenging to evaluate and diagnose in the newborn. As pediatric urologists, our goals are to (1) identify patients who should be evaluated; (2) rule out life-threatening syndromes; and (3) involve a multidisciplinary team for evaluation, diagnosis, and gender assignment. This review briefly goes over the newborn differential diagnosis in disorders of sex development, highlights the important laboratory and imaging data needed, and discusses the multidisciplinary approach to gender assignment and care of these patients. Early involvement of the family in decision-making with the multidisciplinary team is paramount to a timely evaluation and diagnosis in these patients.
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Affiliation(s)
- Erin R McNamara
- Department of Urology, Boston Children's Hospital, Boston, MA.
| | - Jonathan M Swartz
- Department of Medicine, Division of Endocrinology, Boston Children's Hospital, Boston, MA
| | - David A Diamond
- Department of Urology, Boston Children's Hospital, Boston, MA
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Dietrich D. Current status and future perspectives of circulating cell-free DNA methylation in clinical diagnostics. ACTA ACUST UNITED AC 2016. [DOI: 10.1515/labmed-2016-0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract:Aberrant DNA methylation is a hallmark of malignancies and can be detected in circulating cell-free DNA (ccfDNA) in bodily fluids, i.e. blood plasma, serum and urine. The availability of technologies that allow for an accurate and sensitive quantification of ccfDNA DNA methylation enables the precise monitoring of dynamic pathologic processes and pharmacodynamics. Recently, the first ccfDNA methylation biomarker
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Non-invasive Prenatal Screening for Fetal Aneuploidy: Comparison with Cytogenetic Results. CURRENT GENETIC MEDICINE REPORTS 2015. [DOI: 10.1007/s40142-015-0072-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Benn P, Curnow KJ, Chapman S, Michalopoulos SN, Hornberger J, Rabinowitz M. An Economic Analysis of Cell-Free DNA Non-Invasive Prenatal Testing in the US General Pregnancy Population. PLoS One 2015; 10:e0132313. [PMID: 26158465 PMCID: PMC4497716 DOI: 10.1371/journal.pone.0132313] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 06/11/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Analyze the economic value of replacing conventional fetal aneuploidy screening approaches with non-invasive prenatal testing (NIPT) in the general pregnancy population. METHODS Using decision-analysis modeling, we compared conventional screening to NIPT with cell-free DNA (cfDNA) analysis in the annual US pregnancy population. Sensitivity and specificity for fetal aneuploidies, trisomy 21, trisomy 18, trisomy 13, and monosomy X, were estimated using published data and modeling of both first- and second trimester screening. Costs were assigned for each prenatal test component and for an affected birth. The overall cost to the healthcare system considered screening costs, the number of aneuploid cases detected, invasive procedures performed, procedure-related euploid losses, and affected pregnancies averted. Sensitivity analyses evaluated the effect of variation in parameters. Costs were reported in 2014 US Dollars. RESULTS Replacing conventional screening with NIPT would reduce healthcare costs if it can be provided for $744 or less in the general pregnancy population. The most influential variables were timing of screening entry, screening costs, and pregnancy termination rates. Of the 13,176 affected pregnancies undergoing screening, NIPT detected 96.5% (12,717/13,176) of cases, compared with 85.9% (11,314/13,176) by conventional approaches. NIPT reduced invasive procedures by 60.0%, with NIPT and conventional methods resulting in 24,596 and 61,430 invasive procedures, respectively. The number of procedure-related euploid fetal losses was reduced by 73.5% (194/264) in the general screening population. CONCLUSION Based on our analysis, universal application of NIPT would increase fetal aneuploidy detection rates and can be economically justified. Offering this testing to all pregnant women is associated with substantial prenatal healthcare benefits.
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Affiliation(s)
- Peter Benn
- Division of Human Genetics, Department of Genetics and Genome Sciences, University of Connecticut Health Center, Farmington, CT, United States of America
| | | | | | | | - John Hornberger
- Cedar Associates, Menlo Park, CA, United States of America
- Stanford University, Stanford, CA, United States of America
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Agatisa PK, Mercer MB, Leek AC, Smith MB, Philipson E, Farrell RM. A first look at women's perspectives on noninvasive prenatal testing to detect sex chromosome aneuploidies and microdeletion syndromes. Prenat Diagn 2015; 35:692-8. [DOI: 10.1002/pd.4594] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/20/2015] [Accepted: 03/13/2015] [Indexed: 12/26/2022]
Affiliation(s)
| | | | - Angela C. Leek
- Department of Bioethics; Cleveland Clinic; Cleveland OH USA
| | | | - Elliot Philipson
- Department of Obstetrics & Gynecology; Cleveland Clinic Women's Health Institute; Cleveland OH USA
| | - Ruth M. Farrell
- Department of Bioethics; Cleveland Clinic; Cleveland OH USA
- Genomic Medicine Institute; Cleveland Clinic; Cleveland OH USA
- Department of Obstetrics & Gynecology; Cleveland Clinic Women's Health Institute; Cleveland OH USA
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Cuckle H, Benn P, Pergament E. Cell-free DNA screening for fetal aneuploidy as a clinical service. Clin Biochem 2015; 48:932-41. [PMID: 25732593 DOI: 10.1016/j.clinbiochem.2015.02.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 01/19/2015] [Accepted: 02/12/2015] [Indexed: 12/25/2022]
Abstract
Non-invasive prenatal testing (NIPT) through the analysis of cell free (cf)DNA is revolutionizing prenatal screening for fetal aneuploidy. Current methods used in clinical practice include shotgun massively parallel sequencing (s-MPS); targeted (t-MPS); and an approach that takes advantage of single nucleotide polymorphism (SNP) differences between mother and fetus. Efficacy of cfDNA testing for the common autosomal trisomies far exceeds that of conventional screening. Depending on the methodology used, reasons for discordancy between cfDNA results and fetal karyotype can include true fetal mosaicism, confined placental mosaicism, presence of a maternal karyotype abnormality, insufficient counting due to low fetal fraction, and a vanishing twin. Among the possible cfDNA strategies a Primary test has the highest performance but is expensive, while a Contingent cfDNA test can achieve high performance at a relatively low cost. Practicalities to be considered in the provision of testing include pretest counseling about the scope and accuracy of the testing, the interpretation of results when there is a low fetal fraction and follow-up studies for positive test results. The role of first trimester nuchal translucency measurement and conventional biochemical testing needs to be reassessed in the context of the use of cfDNA.
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Affiliation(s)
- Howard Cuckle
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY 10032, USA.
| | - Peter Benn
- Department of Genetics and Developmental Biology, University of Connecticut Health Center, Farmington, CT 06030, USA
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Benn P. Noninvasive Prenatal Testing Using Cell-free DNA in Maternal Circulation. JOURNAL OF FETAL MEDICINE 2014. [DOI: 10.1007/s40556-014-0021-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Araki M, Ishii T. International regulatory landscape and integration of corrective genome editing into in vitro fertilization. Reprod Biol Endocrinol 2014; 12:108. [PMID: 25420886 PMCID: PMC4251934 DOI: 10.1186/1477-7827-12-108] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/24/2014] [Indexed: 12/20/2022] Open
Abstract
Genome editing technology, including zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeat (CRISPR)/Cas, has enabled far more efficient genetic engineering even in non-human primates. This biotechnology is more likely to develop into medicine for preventing a genetic disease if corrective genome editing is integrated into assisted reproductive technology, represented by in vitro fertilization. Although rapid advances in genome editing are expected to make germline gene correction feasible in a clinical setting, there are many issues that still need to be addressed before this could occur. We herein examine current status of genome editing in mammalian embryonic stem cells and zygotes and discuss potential issues in the international regulatory landscape regarding human germline gene modification. Moreover, we address some ethical and social issues that would be raised when each country considers whether genome editing-mediated germline gene correction for preventive medicine should be permitted.
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Affiliation(s)
- Motoko Araki
- Office of Health and Safety, Hokkaido University, Sapporo, 060-0808 Japan
| | - Tetsuya Ishii
- Office of Health and Safety, Hokkaido University, Sapporo, 060-0808 Japan
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Prenatal Screening Using Maternal Markers. J Clin Med 2014; 3:504-20. [PMID: 26237388 PMCID: PMC4449694 DOI: 10.3390/jcm3020504] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 03/28/2014] [Accepted: 03/28/2014] [Indexed: 11/17/2022] Open
Abstract
Maternal markers are widely used to screen for fetal neural tube defects (NTDs), chromosomal abnormalities and cardiac defects. Some are beginning to broaden prenatal screening to include pregnancy complications such as pre-eclampsia. The methods initially developed for NTDs using a single marker have since been built upon to develop high performance multi-maker tests for chromosomal abnormalities. Although cell-free DNA testing is still too expensive to be considered for routine application in public health settings, it can be cost-effective when used in combination with existing multi-maker marker tests. The established screening methods can be readily applied in the first trimester to identify pregnancies at high risk of pre-eclampsia and offer prevention though aspirin treatment. Prenatal screening for fragile X syndrome might be adopted more widely if the test was to be framed as a form of maternal marker screening.
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