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Mutation Screening Dr. Derakhshandeh, PhD Quantitative PCR and Dosage 2 Quantitative PCR and Dosage used in a number of diagnostic applications eg. SMA trisomy 21 X-linked Agammaglobulinemia 3 SMA 4 CLASSIFICATION SMA TYPE I (WerdnigHoffmann) SMA TYPE II (Classic) SMA TYPE III (Kugelberg-Welander) 5 SMA TYPE I Severe form of SMA Onset : first 6 months Death : < 2 year Never raising the head or sitting 6 SMA TYPE I 7 SMA TYPE II Less severe Clinical appearing : < 18 months Able to sit un aid Death : about 9 years 8 SMA TYPE III Mildest form of SMA Onset : > 18 months Walking without aid 9 GENETIC MAP Three candidate genes named SMN (Survival Motor Neuron), NAIP (Neuronal Apoptosis Inhibitory Protein) and P44 were identified in this locus Up to 95% of SMA patients (SMNI-III) are homozygously deleted for two exons (7&8) of both telomeric copy of SMN gene (SMNt) 10 Deletions Up to 5% of SMA patients have frameshift mutations, gene conversions and point mutation Exons 5 and 6 of NAIPt gene are deleted in approximately 50% of type I SMA and 18% of types II and III SMA P44t is lacked or intrrupted in 73% of SMA type I patients and 7% in types II and III 11 The summery of normal alleles (N) , mutant alleles (M) and deletion types (D) of SMN 12 MOLECULAR DIAGNOSIS & PND PCR-SSCP or PCR-RFLP of SMN gene enables confirmation of a suspected clinical diagnosis of SMA or prenatal diagnosis These two techniques based on nucleotide differences of both exon 7 and exon 8 of telomeric and centromeric copy of SMN 13 14 15 16 17 18 Deletion Analysis of SMN gene • Exones 7 and 8 of SMN gene were amplified and cut by Dra I and Dde I , respectively. (only centromeric copy is cutted) • Absence of SMNt exone(s) 7 (and 8) confirm diagnosis of SMA 19 20 Exon 7, DraI 188 bp 164 bp Exon 8, DdeI 188 bp 123 bp 65 bp 21 SMN Deletion Analysis Derakhshande et al. (Farhud Genetic Lab/ NRCGEB) • SMNt Exon 7 is deleted in affected child 22 NAIP Gene Deletion Analysis • Exones 5 & 6 of NAIP gene were amplified with exon 13 which was the internal control • Absence of exon 5 and exon 6 ( which only exist within the telomeric functional copy of NAIP) was detected in ~50% of type I SMA and 18% of types II and III SMA 23 NAIP Deletion analysis Derakhshande et al. (Farhud Genetic Lab/ NRCGEB) 24 25 • The objective of this study was to genetically characterize the childhood onset spinal muscular atrophy in Iran. SMN NAIP Deletion of exon 7 & 8 Deletion of exon 5 & 6 SMA type I (n=70) 70(100%) 61(87%) SMA type II (n=3) 2(66%) 1(33%) SMA type III (n=2) 1(50%) 0(0%) 26 • Various deletion haplotypes were constructed by using genotypes of SMN and NAIP genes. • Haplotype A, which has the deletions of all two involved genes, were deleted in approximately 83% of type I and II SMA but not in type III and was found predominantly in the severe group with an early onset at less than 6 month of age. • we report Thirty four our experiences for prenatal diagnosis Haplotypes (%) A B C SMA type I (n=70) 87 100 0 SMA type II (n=3) 33 66 33 SMA type III (n=2) 0 50 50 27 • These studies suggested that the frequency of gene deletions of SMN1 and NAIP gene is a few higher than previous reports. It is may be due to high rate of consanguine marriage by Iranian Muslims (96 % in this families). Thus, the conformation of SMA related gene deletion will also be a useful tool for the pre and postnatal diagnostic. In addition to common PCR methods for SMN exon 7 and 8 and NAIP exons 4 and 5, we also conducted multiplex PCR of exon 5, 6 and 13 of the NAIP telomere in one reaction. 28 Quantitative PCR and Dosage • Products can be measured by image scanning of agarose gels or Polaroid pictures • Method is not sensitive to template concentration (1.3g to 2.7pg DNA used) but can be affected by template quality so preparation is important. 29 More complex method SMA This method allows quantitation of the copy number of SMNT and SMNC genes on chromosome 5q12 30 The homologous gene quantitative polymerase chain reaction(HGQPCR) 31 Detection of trisomy 21 by HGQ-PCR Lanes 1–16 Serial dilutions for a normal individual and aDown’s syndrome patient used to evaluate the optimal HGQPCR 32 Sequencing 33 Top and bottom strand differences for a point mutation 34 Top and bottom strand differences for a heterozygous base (Click for full size image) Figure 2. Top and bottom strand differences for a heterozygous base 35 Sequencing 36 Forensics 37 Forensics PCR analysis PCR (polymerase chain reaction) RFLP analysis STR analysis Short tandem repeat (STR) technology is a forensic analysis For example, the likelihood that any two individuals (except identical twins) will have the same 13-loci DNA profile can be as high as 1 in 1 billion or greater. 38 Forensics Mitochondrial DNA Analysis Mitochondrial DNA analysis (mtDNA) can be used to examine the DNA from samples that cannot be analyzed by RFLP or STR Nuclear DNA must be extracted from samples for use in RFLP, PCR, and STR mtDNA analysis uses DNA extracted from another cellular organelle called a mitochondrion 39 Forensics While older biological samples that lack nucleated cellular material, such as hair, bones, and teeth, cannot be analyzed with STR and RFLP they can be analyzed with mtDNA In the investigation of cases that have gone unsolved for many years, mtDNA is extremely valuable. 40 Forensics Y-Chromosome Analysis The Y chromosome is passed directly from father to son so the analysis of genetic markers on the Y chromosome is especially useful for tracing relationships among males this technique can be very valuable if the laboratory detects complex mixtures (multiple male contributors) 41 Reverse Dot Blot for Human Mutation Detection Introduction • Reverse dot blot (RDB) • or reverse allele specific oligonucleotide (Reverse ASO) • hybridization • important method for genotyping common human mutations 43 Commonly used in: • a high mutation spectrum • high frequency disorders such as: – – – – – cystic fibrosis hemoglobin C (HbC) hemoglobin E (HbE) hemoglobin S (HbS) ß-thalassemias 44 Location of mutations in the b-globin gene 45 RDB procedure • exons (or other regions of interest) • amplified by the polymerase chain reaction (PCR) • using labeled oligonucleotide primers • 5' biotin label on PCR primers 46 Amplicons • Amplification products • denatured • hybridized – with mutation specific DNA probes • covalently bound to solid membran 47 Incubation • nucleic acids: incubated with an enzyme conjugated to streptavidin. • enzyme-conjugated, streptavidin-biotin-nucleic acid complex is then washed • incubated with – a chromogenic – or luminogenic substrate, which allows visualization of hybridized spots 48 Materials and Methods • Total genomic DNA • extracted from peripheral blood leukocytes • Amniotic fluid cells (AF) • chorionic villi (CVS) 49 A woman having amniocentesis 50 Oligonucleotide probes • A C6-amino-link phosphoramidite • amino moiety on the 5' end of the product 51 Oligonucleotides used for reverse dot blot (RDB) 52 RDB 53 Reverse dot (RDB) blot hybridization for detection of 10 common β-thalassaemia mutations 54 b-thalassemia Patients 55 Screening for causal mutations • genomic DNA from patient blood samples • reverse dot blot (RDB) • amplification refractory mutation systempolymerase chain reaction (ARMSPCR) • DNA sequencing 56 PCR from genomic DNA 720 bp 57 58 59 Strips 1 2 NM 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 60 The Blots 61 Comparison of different factors determining the efficiency of ARMS and reverse hybridization in beta thalassemia diagnosis ARMS Reverse hybridization Turnover time several days 6-8 hours Equipment Expensive (large PCR machine, gel electrophoresis, photodocumentationsyst em Less expensive (small PCR machine, agarose gel, small shaking water bath) Number of PCR reactions per sample 8-88 1 Documentation Requires documentation process after experiment Self-documented Technician time (number of patients: time in days) 1:1 10:1 Starting material Depending on the number of PCR reactions 0.5 μg genomic DNA for just one PCR reaction Toxic materials Ethidium bromide (carcinogen) None 62 In the late stages of muscular dystrophy, fat and connective tissue often replace muscle fibers. 63 64 DMD 65 Orthopaedic management of patients with Duchenne's muscular dystrophy 66 L A B C D E F G H L ~95% of deletions can be detected in males using multiplex PCR 67 MAPH • Detection of deletions/duplication mutations in Duchenne Muscular Dystrophy using: Multiplex Amplifiable Probe Hybridisation (MAPH) 68 MAPH • Although ~95% of deletions can be detected in males using multiplex PCR • other methods must be used to determine duplications, as well as the carrier status of females • The most commonly applied methods are quantitative multiplex PCR and quantitative Southern blotting • The drawback of quantitative multiplex PCR is that often not all mutations are examined • meaning that small and rare mutations are missed 69 MAPH • Using high-quality Southern blots it is possible to perform a quantitative analysis and detect duplications • this technique is time consuming • it is difficult to exactly determine the duplication • it can be difficult to detect duplications in females and triplications will be missed Armour et al (Nucl.Acids Res. 2000) 70 • system for analysing all 79 exons of the DMD gene for deletions and duplications • MAPH is based on a quantitative PCR of short DNA probes recovered after hybridisation to immobilized genomic DNA 71 • 1 ug of denatured genomic DNA is spotted on a small nylon filter • hybridized overnight in a solution containing one of the probe mixes • Following stringent washing the next day the filter is placed in a PCR tube • and a short PCR reaction is performed • This releases the specifically-bound probes into the solution • An aliquot of this is transferred to a second, quantitative PCR reaction 72