title: The use of DHPLC (Denaturing High Performance Liquid Chromatography) in II level screening of the CFTR gene in Prenatal Diagnosis.
abstract: OBJECTIVE
  The aim of the study is to evaluate the role of Denaturing High Performance Liquid Chromatography (DHPLC) in the second level screening of the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene.
  
  
  METHODS
  A 9-month prospective study, between June 2008 and March 2009 at Artemisia Fetal Medical Centre, included 3829 samples of amniotic fluid collected from women undergoing mid-trimester amniocentesis.The genetic diagnosis of CF was based on research of the main mutations of the CFTR gene on fetal DNA extracted from the amniocytes, (first level screening) using different commercial diagnostic systems. A second level screening using DHPLC, on the amniotic fluid and on a blood sample from the couple, was offered in case of fetuses heterozygous at first level screening.
  
  
  RESULTS
  Of 3829 fetuses, 134 were found to be positive, 129 heterozygous and 5 affected. Of the 129 couples, following appropriate genetic counselling, 53 requested a second level screening. Through the use of DHPLC, 44 couples were found to be negative, and in nine couples, nine rare mutations were identified.
  
  
  CONCLUSIONS
  The first level screening can be useful to evidence up to 75% of the CF mutations. The second level screening can identify a further 10% of mutant alleles. DHPLC was found to be a reliable and specific method for the rapid identification of the rare CFTR mutations which were not revealed in initial first level screening.
authors.affiliation: Artemisia Medical Center, Department of Molecular Biology.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Mesoraca
authors.forename: Manuela
authors.initials: M
authors.lastname: Di Natale
authors.forename: Antonella
authors.initials: A
authors.lastname: Cima
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Giacomo
authors.forename: Monica
authors.initials: M
authors.lastname: Sarti
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Barone
authors.forename: Domenico
authors.initials: D
authors.lastname: Bizzoco
authors.forename: Pietro
authors.initials: P
authors.lastname: Cignini
authors.forename: Luisa
authors.initials: L
authors.lastname: Mobili
authors.forename: Laura
authors.initials: L
authors.lastname: Dʼemidio
authors.forename: Claudio
authors.initials: C
authors.lastname: Giorlandino