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Eusebiu V. Gorduza, Roxana Popescu, Lavinia Caba, Iuliu Ivanov, Violeta Martiniuc, Florina Nedelea, Mariela Militaru and Demetra G. Socolov

Abstract

Background. The Down syndrome is a severe disease without pathogenic therapy. The only possibility to reduce the consequences of disease is prenatal screening and diagnosis. The gold standard in prenatal diagnosis is the conventional banding cytogenetic analysis of fetal cells obtained by invasive procedures. To reduce the complications, in the last years different methods to detect fetal cells or DNA in maternal blood were developed. Aim. The aim of study was to verify the reliability of quantification by immunoprecipitation of methylated fetal DNA in maternal blood in the prenatal diagnosis of 21 trisomy. Method. We analyzed probes from 12 pregnant women (7 with confirmed 21 trisomy pregnancy and 5 with normal pregnancy), with two being rejected for technical considerations. For each probe we carried out: extraction of total DNA (maternal and fetal), DNA fragmentation, immunoprecipitation of methylated DNA, washing, isolation of DNA and qPCR for immunoprecipitated DNA. To highlighting specific methylated regions on fetal 21 chromosome we used eight pairs of specific primers for chromosome 21. Finally we analysed the results of qPCR applying the formula D=- 6.331+0.959XEP4+1.188XEP5+0.424XEP6+0.621XEP7+0.028XEP8+0.387XEP10-0.683XEP11+ 0.897XEP12, where XEPi= fraction value for each marker. Results. In all normal pregnancies the value of D factor was negative concordant with absence of trisomy (100% specificity). In 5 from 6 pregnancies with 21 trisomy the value of D factor was positive, which indicated a high sensibility. However, to a precise estimation of this method is required a larger number of cases that allowing the obtaining of statistically validated results.

Open access

L. Caba, C. Rusu, V. Plăiaşu, G. Gug, M. Grămescu, C. Bujoran, D. Ochiană, M. Voloşciuc, R. Popescu, E. Braha, M. Pânzaru, L. Butnariu, A. Sireteanu, M. Covic and E.V. Gorduza

ABSTRACT

Ring chromosomes are rare entities, usually associated with phenotypic abnormalities in correlation with the loss of genetic material. There are various breakpoints and sometimes there is a dynamic mosaicism that is reflected in clinical features. Most of the ring chromosomes are de novo occurrences. Our study reflects the experience of three Romanian cytogenetic laboratories in the field of ring chromosomes. We present six cases with ring chromosomes involving chromosomes 5, 13, 18, and 21. All ring chromosomes were identified after birth in children with plurimalformative syndromes. The ring chromosome was present in mosaic form in three cases, and this feature reflects the ring’s instability. In case of ring chromosome 5, we report a possible association with oculo-auriculo-vertebral spectrum.

Open access

Adriana Sireteanu, Roxana Popescu, Elena Emanuela Braha, Cornel Bujoran, Lăcrămioara Butnariu, Lavinia Caba, Elena Graur, Eusebiu Vlad Gorduza, Mihaela Grămescu, Iuliu Cristian Ivanov, Monica Pânzaru and Cristina Rusu

Abstract

Intellectual disability (ID) is a common disorder, with major consequences for individual, family and society. Due to clinical and genetic heterogeneity of ID, in about 50% of cases an etiologic diagnosis cannot be established. The aim of this study was to evaluate the ability of a combination of MLPA kits to establish the diagnosis in 369 patients with syndromic ID and normal or uncertain routine karyotype results. All patients were assessed for chromosome imbalance using SALSA MLPA P064 or P096 kits, if the phenotype was suggestive of a microdeletion syndrome (subgroup A - 186 patients), or subtelomeric P036 and P070 kits, if the phenotype was not suggestive of a microdeletion syndrome or if the result of the standard karyotype was uncertain (subgroup B - 183 patients). Abnormal results detected by these kits were further characterized using appropriate follow-up MLPA kits (Telomere Follow-up set, P029-A1, P250-B2, ME028-B1). In subgroup A we identified 25 patients with microdeletions (13.4%). Using subtelomere screening and follow-up kits in subgroup B we detected cryptic rearrangements in 7.5% cases and identified the origin of the unknown material noticed in the standard karyotype in 10 out of 11 patients. Summarizing data from the two groups, the combined use of MLPA kits led to the diagnosis in 10.6% (38/358) patients with normal karyotype. Using follow-up MLPA kits allowed us both to confirm abnormalities and to determine their size, which facilitated the interpretation of the clinical significance of these rearrangements. For laboratories that do not have yet access to microarray technology, using several MLPA kits represents an effective strategy for establishing the diagnosis in ID patients.