Accuracy and Performance Evaluation of Triplet Repeat Primed PCR as an Alternative to Conventional Diagnostic Methods for Fragile X Syndrome.

Abstract:

Background:Conventional diagnosis of fragile X syndrome (FXS) is based on a combination of fragment analysis (FA) and Southern blotting (SB); however, this diagnostic approach is time- and labor-intensive and has pitfalls such as the possibility of missing large number alleles. Triplet repeat primed PCR (TP-PCR) is a current alternative used to overcome these limitations. We evaluated the diagnostic usefulness of TP-PCR compared with the conventional diagnostic protocol consisting of FA and/or SB in terms of allele categorization, repeat number correlation, and zygosity concordance in female genetic carriers. Methods:From November 2013 to March 2018, 458 patients (326 males, 132 females) were simultaneously examined using FA and/or SB and TP-PCR by detecting CGG repeat numbers in FMR1 gene and diagnosed as per American College of Medical Genetics guidelines. Results:The TP-PCR results showed high concordance with the FA and/or SB results for all three aspects (allele categorization, repeat number correlation, and zygosity concordance in female genetic carriers). TP-PCR detected CGG expansions ≥200 in all full mutation (FM) allele cases in male patients, as well as both the normal allele (NL) and FM allele in female carriers. In premutation (PM) allele carriers, the TP-PCR results were consistent with the FA and/or SB results. In terms of zygosity concordance in female genetic carriers, 12 NL cases detected by TP-PCR showed a merged peak consisting of two close heterozygous peaks; however, this issue was resolved using a 10-fold dilution. Conclusions:TP-PCR may serve as a reliable alternative method for FXS diagnosis.

journal_name

Ann Lab Med

authors

Gu H,Kim MJ,Yang D,Song JY,Cho SI,Park SS,Seong MW

doi

10.3343/alm.2021.41.4.394

keywords:

["Allele categorization","CGG expansion","Fragile X syndrome","Fragment analysis","Repeat number","Southern blotting","Triplet repeat primed PCR","Zygosity"]

subject

Has Abstract

pub_date

2021-07-01 00:00:00

pages

394-400

issue

4

eissn

2234-3806

issn

2234-3814

pii

alm.2021.41.4.394

journal_volume

41

pub_type

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