title: Rapid screening for alpha1-antitrypsin deficiency in patients with chronic obstructive pulmonary disease using dried blood specimens.
abstract: We describe two reliable methods for high-throughput screening of proteinase inhibitor (PI) S and PI Z alpha(1)-antitrypsin (alpha(1)-AT) deficiency alleles from dried blood spot (DBS) specimens using the LightCycler fluorimetric analyzer. The method was used to study 72 patients with chronic obstructive pulmonary disease. Results were confirmed with DNA sequencing. The alpha(1)-AT concentration in DBS was determined with immune nephelometry. Sixteen patients (22%) showed no PI Z or PI S mutations. Five patients (7%) had a heterozygous genotype consisting of a PI S allele and a normal allele for the Z and S positions (non-S non-Z). Twenty-five patients (35%) had a heterozygous genotype consisting of a PI Z and a non-S non-Z allele. Two (3%) had the PI SS genotype, 2 (3%) the PI SZ, and 20 (28%) the PI ZZ. All patients with two normal alpha(1)-AT alleles and 10 heterozygous carriers of one normal and one deficient allele had alpha(1)-AT levels that fell within the alpha(1)-AT DBS normal range (1.8-3.1 mg/dl). Two patients with the rare PI MM(malton)- and PI MM(heerlen)-deficient variants showed deficient alpha(1)-AT levels; PI S and PI Z were not detected. Processing 32 samples requires only 40 minutes. This single-step, cost-effective technology is optimal for working with small amounts of DNA, as are present in DBS. The method is suitable for large-scale screening, in cases where PI type is important.
authors.affiliation: Department of Biochemistry, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodriguez
authors.forename: Rosendo
authors.initials: R
authors.lastname: Jardí
authors.forename: Xose
authors.initials: X
authors.lastname: Costa
authors.forename: Montserrat
authors.initials: M
authors.lastname: Cotrina
authors.forename: Roman
authors.initials: R
authors.lastname: Galimany
authors.forename: Rafael
authors.initials: R
authors.lastname: Vidal
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
mesh_terms: D000328:Adult; D000368:Aged; D000483:Alleles; D001483:Base Sequence; D001769:Blood; D004247:DNA; D005838:Genotype; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D009391:Nephelometry and Turbidimetry; D016133:Polymerase Chain Reaction / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000235:genetics / Q000503:physiopathology; D015842:Serine Proteinase Inhibitors / Q000235:genetics; D012907:Smoking / Q000009:adverse effects; D000515:alpha 1-Antitrypsin / Q000235:genetics; D019896:alpha 1-Antitrypsin Deficiency / Q000175:diagnosis* / Q000235:genetics*
chemical_list: D015842:Serine Proteinase Inhibitors; D000515:alpha 1-Antitrypsin; D004247:DNA