title: New multiplex PCR-based protocol allowing indirect diagnosis of FSHD on single cells: can PGD be offered despite high risk of recombination?
abstract: Molecular pathophysiology of facioscapulohumeral muscular dystrophy (FSHD) involves the heterozygous contraction of the number of tandemly repeated D4Z4 units at chromosome 4q35.2. FSHD is associated with a range of 1-10 D4Z4 units instead of 11-150 in normal controls. Several factors complicate FSHD molecular diagnosis, especially the cis-segregation of D4Z4 contraction with a 4qA allele, whereas D4Z4 shortening is silent both on alleles 4qB and 10q. Discrimination of pathogenic 4q-D4Z4 alleles from highly homologous 10q-D4Z4 arrays requires the use of the conventional Southern blot, which is not suitable at the single-cell level. Preimplantation genetic diagnosis (PGD) is a frequent request from FSHD families with several affected relatives. We aimed to develop a rapid and sensitive PCR-based multiplex approach on single cells to perform an indirect familial segregation study of pathogenic alleles. Among several available polymorphic markers at 4q35.2, the four most proximal (D4S2390, D4S1652, D4S2930 and D4S1523, <1.23 Mb) showing the highest heterozygote frequencies (67-91%) were selected. Five recombination events in the D4S2390-D4S1523 interval were observed among 144 meioses. In the D4S2390-D4Z4 interval, no recombination event occurred among 28 FSHD meioses. Instead, a particular haplotype segregated with both clinical and molecular status, allowing the characterization of an at-risk allele in each tested FSHD family (maximal LOD score 2.98 for theta=0.0). This indirect protocol can easily complement conventional techniques in prenatal diagnosis. Although our multiplex PCR-based approach technically fulfils guidelines for single-cell analysis, the relatively high recombination risk hampers its application to PGD.
authors: CHU de Montpellier, Laboratoire de Génétique Moléculaire, Montpellier, France. mouna.barat@inserm.fr
authors: Mouna
authors: M
authors: Barat-Houari
authors: Karine
authors: K
authors: Nguyen
authors: Rafaëlle
authors: R
authors: Bernard
authors: Céline
authors: C
authors: Fernandez
authors: Catherine
authors: C
authors: Vovan
authors: Corinne
authors: C
authors: Bareil
authors: Philippe
authors: P
authors: Khau Van Kien
authors: Delphine
authors: D
authors: Thorel
authors: Sylvie
authors: S
authors: Tuffery-Giraud
authors: Francis
authors: F
authors: Vasseur
authors: Shahram
authors: S
authors: Attarian
authors: Jean
authors: J
authors: Pouget
authors: Anne
authors: A
authors: Girardet
authors: Nicolas
authors: N
authors: Lévy
authors: Mireille
authors: M
authors: Claustres
mesh_terms: D000483:Alleles; D020090:Chromosome Segregation / Q000235:genetics; D004247:DNA / Q000235:genetics; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008540:Meiosis / Q000235:genetics; D018895:Microsatellite Repeats / Q000235:genetics; D020391:Muscular Dystrophy, Facioscapulohumeral / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology*; D010375:Pedigree; D016133:Polymerase Chain Reaction / Q000379:methods*; D019836:Preimplantation Diagnosis / Q000379:methods*; D011995:Recombination, Genetic / Q000235:genetics*; D015203:Reproducibility of Results; D012307:Risk Factors
chemical_list: D004247:DNA