Chromosomal mosaicism in amniotic fluid cell cultures.

Over the past 6 years, using in situ processing methods, we have identified 32 cases of mosaicism in amniotic fluid cell cultures prepared from 1,100 samples. Two of these (45,X/46,XX and 46,XX/47,XX, + 21) were called true mosaics because multiple colonies demonstrated the same abnormal chromosome complement, and on subsequent evaluation of the newborn blood or fetal tissues, mosaicism was confirmed. Of the remaining cases, 29 were designated as pseudomosaics because only single or partial colonies exhibited an aberrant chromosome complement, 12 having a trisomy 2 line. In the final case, a double trisomy was demonstrated in only one of eight colonies in the first culture, but in the culture from a repeat sample an additional two colonies showed the same double trisomy. Since no abnormal cells were observed in infant blood, it was postulated that the mosaicism may only have been present in the extraembryonic tissues. It is our conviction that the use of these cloning methods should diminish the danger of misdiagnosis in genetic amniocentesis.     

Chromosome lesions in amniotic fluid cell cultures

Summary The frequencies of chromosome lesions were determined on 3537 mitoses in samples of varying sizes from cultures of 25 amniotic fluid specimens taken from patients at cytogenetic risk. The average percentage values of aberrant cells, including and excluding gaps, were 12.5 and 4.9, respectively. The corresponding values for fibroblasts and peripheral blood lymphocytes from normal adult donors, calculated under the same laboratory conditions, were 5.0 (including gaps) and 2.4 (excluding gaps) and 2.4 (including gaps) and 1.0 (excluding gaps), respectively. The hypothesis of a correlation between the increased incidence of chromosome lesions and the occurrence of abnormal karyotypes in amniotic fluid cell cultures is discussed.     

Prenatal diagnosis of cystic fibrosis by assay of amniotic fluid microvillar enzymes

Summary Activities of the microvillar enzymes -glutamyl-transpeptidase (GGTP), aminopeptidase M (APM), phosphodiesterase and maltase have been examined in second-trimester amniotic fluid as possible aids to the early prenatal diagnosis of cystic fibrosis (CF). The two peptidases, GGTP and APM, gave best results. If the fifth percentile of the normal range is used as an action line, the sensitivity of a positive test (low GGTP value) is 78% and the predictability 84%. At the tenth percentile the sensitivity is 100% and the predictability 77%. These approximate figures apply only to pregnancies where there has been a previous affected child. Until the primary protein defect in CF is discovered, this may prove an acceptable form of prenatal diagnosis to the high-risk mother.     

Differentiation in human amniotic fluid cell cultures: Chorionic gonadotropin production

Summary Two of the distinguishable cell classes subcultured from human amniotic fluid were examined for their capability to produce human chorionic gonadotropin (hCG) as determined by radioimmunoassay. The class that predominates in most cultures used for prenatal genetic diagnosis, previously termed AF (for amniotic fluid), secretes hCG into the culture medium. Dermal fibroblasts do not, nor does another type of cultured cell from amniotic fluid, previously termed F because of a resemblance to fibroblasts. Primary AF cultures produce more hCG than do subcultures. Evidence that this hormone is intact hCG is provided by its immunoreactivity with antisera raised against the β-subunit and against the intact molecule of hCG. Furthermore, a dose-response curve for hormone in culture medium is parallel to that of highly purified intact hCG. It is postulated that AF cultures are derived from fetal membranes and retain properties of trophoblast. Research supported by Grand HD 11379 from the National Institutes of Health.     

The significance of accessory bisatellited marker chromosomes in amniotic fluid cell cultures

Thirteen new cases of accessory bisatellited marker chromosomes were found among 20,370 amniocentesis. Six of these were familial, six originated de novo and in one case the origin of marker chromosome remained unknown. Eleven cases were carried to term and follow up studies revealed no abnormality. In two cases the pregnancies were terminated and the pathological examination revealed apparently normal fetuses. A cytogenetic categorization of bisatellited marker chromosomes is described. The available data show clearly that there is no increased risk for offspring with abnormal phenotype born to a healthy carrier of an accessory bisatellited marker chromosome with either a single or two closely adjacent C-bands (category AI or AII). The unbiased sample of cases with de novo accessory bisatellited marker chromosomes of category AI or AII is still too small to allow a satisfactory estimation. However, the actual risk for a fetus to be affected may be low too.     

Differentiation in human amniotic fluid cell cultures: chorionic gonadotropin production.

Two of the distinguishable cell classes subcultured from human amniotic fluid were examined for their capability to produce human chorionic gonadotropin (hCG) as determined by radioimmunoassay. The class that predominates in most cultures used for prenatal genetic diagnosis, previously termed AF (for amniotic fluid), secretes hCG into the culture medium. Dermal fibroblasts do not, nor does another type of cultured cell from amniotic fluid, previously termed F because of a resemblance to fibroblasts. Primary AF cultures produce more hCG than do subcultures. Evidence that this hormone is intact hCG is provided by its immunoreactivity with antisera raised against the beta-subunit and against the intact molecule of hCG. Furthermore, a dose-response curve for hormone in culture medium is parallel to that of highly purified intact hCG. It is postulated that AF cultures are derived from fetal membranes and retain properties of trophoblast.     

Prenatal diagnosis of cystic fibrosis. Analytical evaluation of microvillar enzyme determinations in amniotic fluid

The activity of gamma-glutamyltranspeptidase and total alkaline phosphatase and its isoenzymes has been determined in 261 amniotic fluid samples taken from pregnant women with known normal outcome and in 30 amniotic fluid samples from pregnant women with a 1:4 risk for cystic fibrosis (CF). Preliminarily, 114 amniotic fluid samples were assayed in parallel in three different laboratories, and a good correlation was found even though different assays were used. From the results obtained in control amniotic fluids, normal range and CF-predictive cutoff values were established. No false-negative results were found in this study. Among the predicted affected pregnancies 7 were terminated, and 3 went to term: 1 resulting in a CF-affected child and the other 2 in healthy children. CF was confirmed in all the aborted fetuses. In 1 case the results were inconclusive. In this study numerical results obtained for samples with a 1:4 risk of CF analyzed in the three laboratories were always virtually identical.     

A technique for in situ karyotyping of primary amniotic fluid cell cultures.

A time proven technique is described for growing amniotic fluid cell cultures on cover glasses in Leighton tubes and for processing the mitotic cells in situ. Karyotyping the clones in situ eliminates most of the problems caused by somatic chromosome mutations in vitro and by maternal cell growth.     

Slide Flask direct amniotic fluid cultures.

Slide Flask direct amniotic fluid culture enabling: to decrease the risk of abnormalities caused by the technique itself, to facilitate laboratory work, to shorten culture time (8 to 13 days).     

On the significance of true trisomy 20 mosaicism in amniotic fluid culture

Summary Nine new cases of prenatally detected true mosaic trisomy 20 (T20) are reported. In three instances the fetuses were aborted. One fetus showed multiple malformations associated with a high percentage of T20 cells among amniotic fluid (AF) cells and fibroblasts of different fetal tissues. In two other fetuses only a slight facial dysmorphy was seen which was accompanied by a low percentage of T20 cells among AF cells. In five instances the pregnancies were carried to term, and normal somatic and psychomotor development of the children has been observed, in one case up to the age of 24 months. In one case the pregnancy is continuing. The T20 cells were not detected among cultured lymphocytes of these children.A review of the hitherto known cases of prenatally detected mosaic T20 indicates a relationship between the prenatal findings and the fetal development. This may serve as a provisory basis for genetic counselling: in the case of a percentage above 50% of T20 cells among AF cells there seems to be a risk of about 50% for the fetus to be affected by severe anomalies. However, in cases of a prenatally detected mosaic T20 with a percentage equal to or less than 50, fetal or congenital malformations have not been observed among 23 individuals so far examined.     

Prenatal diagnosis of homozygous alpha thalassaemia by direct DNA analysis of uncultured amniotic fluid cells.

Prenatal diagnosis of homozygous alpha thalassaemia was performed in eight successive patients at risk using DNA from uncultured amniotic fluid cells. The presence of alpha gene was determined by restriction endonuclease mapping and hybridisation with cloned alpha and beta globin probes. This method is reliable and may be performed at 16 weeks of gestation.     

Prenatal diagnosis of GM1 gangliosidosis by detection of galactosyl-oligosaccharides in amniotic fluid with high-performance liquid chromatography.

Prenatal diagnosis of infantile GM1 gangliosidosis was accomplished by analyzing the galactosyl-oligosaccharides accumulating in amniotic fluid with high-performance liquid chromatography (HPLC) at 14 weeks gestation. The pattern of amniotic oligosaccharides was nearly identical with that in neonatal urine in GM1 gangliosidosis but the concentrations were about one-fiftieth of that in urine, necessitating a highly sensitive assay.     

Prenatal diagnosis of propionic acidemia by measuring methylcitric acid in dried amniotic fluid on filter paper using GC/MS

Propionic acidemia is a frequent inborn error of metabolism. Methylcitric acid, a key indicator of propionic acidemia, increases in the amniotic fluid of affected fetuses. For prenatal diagnosis, the methylcitric acid in amniotic fluid can be measured by stable-isotope dilution GC/MS. Here, we quantified this indicator in samples of amniotic fluid that had been dried on filter paper and transported at ambient temperatures, and compared the results with data obtained from the original amniotic fluid. We then used the filter-paper method to screen at-risk fetuses and obtained a clear-cut diagnosis in each case.     

A rapid culture-harvest protocol for amniotic cell cultures

Summary A rapid culture-harvest technique for amniotic fluid is presented using the poly-L-lysine technique (Rajendra et al. 1980). The procedure is simple, reproducible, and involves harvesting primary cultures five to eight days after culture. This technique is particularly useful as an adjunct to routine procedures, in advanced gestational age where preliminary chromosome counts are re1uired to relieve anxiety, sex determination when sex linked traits are involved, and in situations where the cultures produce very small colonies that do not proliferate or respond to sub-cultures and thus are difficult to harvest.     

Activity of enzymes in amniotic fluid in prenatal diagnosis of cystic fibrosis

The activity of microvillar enzymes--gamma-glutamyltranspeptidase, aminopeptidase, general and intestinal forms of alkalyne phosphotases was studied in amniotic fluid (AF) of 33 women with 25% risk of cystic fibrosis (CF) (mucoviscidoses) in their progeny. The figures obtained in this group were compared with corresponding values of the same enzymes in 100 AF samples from normal pregnancies (negative control) and with 9 AF samples from women which were known to give birth to the children with CF (positive control). CF has been predicted in 5 cases, pregnancies were artificially terminated in 4 women. Biochemical CF prediction was proved by immunochemical assay of albumin contents in meconium of fetal ileum. One woman from the high risk group refused abortion and gave birth to a CF child. Among 26 cases of low CF prediction, 13 resulted in birth of a child without a sign of CF, one - in a child with clear-cut diagnosis of CF and 12 other pregnancies still proceed. The efficiency of complex biochemical, pathomorphological and molecular approaches for verification of intrauterine CF diagnosis in aborted fetuses as well as for detection of heterozygous carriers of CF gene and prenatal diagnosis of CF is discussed.     

Glycoproteins that distinguish different cell types found in amniotic fluid

Summary Two concanavalin A-binding glycoproteins of approximate Mw 150 K and 140 K are described, which enable two of the main cell types found in amniotic fluid samples obtained by amniocentesis, AF and F cells, to be reliably distinguished. Further, the Mw 150 K glycoprotein has been used to trace the developmental origin of the AF cell type. AF cells, which generally form the majority of amniotic fluid cells found in culture, appear to arise in the extra-embryonic membranes, specifically the amnion.     

Proteomic analysis of amniotic fluid for the diagnosis of fetal aneuploidies

Advances in technologies associated with mass spectrometry-based proteomic techniques have added a new dimension to the field of biomedical research. Most of the existing research on human gestation has focused on the application of these high-throughput methodologies in the study of amniotic fluid. In cases of fetal aneuploidies, the use of proteomic platforms has contributed to the identification of relevant protein biomarkers that could potentially change early diagnosis and treatment. The current article focuses on studies of normal amniotic fluid using proteomic technologies and describes alterations noted in the amniotic fluid proteome in the presence of fetal aneuploidies.