Prenatal diagnosis of ornithine transcarbamylase deficiency by using a single nucleated erythrocyte from maternal blood |
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Authors: | A Watanabe Akihiko Sekizawa Atsushi Taguchi Hiroshi Saito Takumi Yanaihara Mitsunobu Shimazu Ichiro Matsuda |
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Institution: | (1) Department of Obstetrics and Gynecology, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan Tel.: +81 3 3784 8551, Fax: +81 3 3784 8355, JP;(2) Mitsubishi Yuka Bio-Clinical Laboratories, INC., 3-30-1 Shimura, Itabashi-ku, Tokyo, 174 Japan, JP;(3) Department of Pediatrics, Kumamoto University, School of Medicine, 111 Honjo, Kumamoto, 860 Japan, JP |
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Abstract: | We have developed a method that allows the prenatal DNA diagnosis of ornithine transcarbamylase (OTC) deficiency by using
a single fetal nucleated erythrocyte (NRBC) isolated from maternal blood. OTC gene analysis of a male patient (TF) with early
onset OTC deficiency was performed by single-strand conformation polymorphism (PCR-SSCP) and DNA sequencing. To investigate
the possible prenatal diagnosis of OTC deficiency, maternal blood was obtained at 13 weeks of gestation of a subsequent pregnancy,
from the mother of patient TF. NRBCs in the maternal blood were separated by using the density gradient method and then collected
with a micromanipulator. The entire genome of a single NRBC was amplified by primer extension preamplification (PEP). The
human leukocyte antigen (HLA)-DQ alpha genotype and sex were determined from small aliquots of the PEP product. The HLA-DQ
alpha genotype of each of the parents of the male patient was also determined. Once a single NRBC had been identified as being
of fetal origin, the OTC gene was analyzed by using the restriction fragment length polymorphism (RFLP) method. DNA analysis
revealed a point mutation in exon 9 of the OTC gene in the OTC-deficient patient (TF). All NRBCs retrieved from maternal blood
were successfully identified as being of fetal origin by HLA-DQ alpha genotyping and sex determination. RFLP analysis demonstrated
that the fetal OTC gene was normal. This is the first study to successfully diagnose OTC deficiency prenatally, by using a
single fetal NRBC from the maternal circulation. Such prenatal DNA diagnosis is non-invasive and can be applied to other genetic
diseases, including autosomal and X-linked diseases.
Received: 19 December 1997 / Accepted: 14 February 1998 |
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