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胚胎植入前遗传学检测用于单基因疾病(PGT-M)为预防儿童患有遗传性神经系统疾病或代谢疾病(以神经系统表型为主)提供了一种替代策略:一项回顾性研究。

Preimplantation genetic testing for monogenic disorders (PGT-M) offers an alternative strategy to prevent children from being born with hereditary neurological diseases or metabolic diseases dominated by nervous system phenotypes: a retrospective study.

机构信息

Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China.

NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China.

出版信息

J Assist Reprod Genet. 2024 May;41(5):1245-1259. doi: 10.1007/s10815-024-03057-1. Epub 2024 Mar 12.

Abstract

BACKGROUND

Preimplantation genetic testing for monogenic disorders (PGT-M) is now widely used as an effective strategy to prevent various monogenic or chromosomal diseases.

MATERIAL AND METHODS

In this retrospective study, couples with a family history of hereditary neurological diseases or metabolic diseases dominated by nervous system phenotypes and/or carrying the pathogenic genes underwent PGT-M to prevent children from inheriting disease-causing gene mutations from their parents and developing known genetic diseases. After PGT-M, unaffected (i.e., normal) embryos after genetic detection were transferred into the uterus of their corresponding mothers.

RESULTS

A total of 43 carrier couples with the following hereditary neurological diseases or metabolic diseases dominated by nervous system phenotypes underwent PGT-M: Duchenne muscular dystrophy (13 families); methylmalonic acidemia (7 families); spinal muscular atrophy (5 families); infantile neuroaxonal dystrophy and intellectual developmental disorder (3 families each); Cockayne syndrome (2 families); Menkes disease, spinocerebellar ataxia, glycine encephalopathy with epilepsy, Charcot-Marie-Tooth disease, mucopolysaccharidosis, Aicardi-Goutieres syndrome, adrenoleukodystrophy, phenylketonuria, amyotrophic lateral sclerosis, and Dravet syndrome (1 family each). After 53 PGT-M cycles, the final transferable embryo rate was 12.45%, the clinical pregnancy rate was 74.19%, and the live birth rate was 89.47%; a total of 18 unaffected (i.e., healthy) children were born to these families.

CONCLUSIONS

This study highlights the importance of PGT-M in preventing children born with hereditary neurological diseases or metabolic diseases dominated by nervous system phenotypes.

摘要

背景

单基因疾病的胚胎植入前遗传学检测(PGT-M)现已广泛用作预防各种单基因或染色体疾病的有效策略。

材料和方法

在这项回顾性研究中,有遗传性神经疾病或代谢疾病家族史且以神经系统表型为主、或携带致病性基因的夫妇接受 PGT-M,以防止子女从父母那里继承致病基因突变并患上已知的遗传疾病。在 PGT-M 后,经过基因检测无异常(即正常)的胚胎被移植到相应母亲的子宫中。

结果

共有 43 对携带以下遗传性神经疾病或代谢疾病且以神经系统表型为主的夫妇接受了 PGT-M:杜氏肌营养不良症(13 个家庭);甲基丙二酸血症(7 个家庭);脊髓性肌萎缩症(5 个家庭);婴儿型神经元蜡样脂褐质沉积症和智力发育障碍(各 3 个家庭);科凯恩综合征(2 个家庭);Menkes 病、脊髓小脑共济失调、甘氨酸脑病伴癫痫、Charcot-Marie-Tooth 病、黏多糖贮积症、Aicardi-Goutières 综合征、肾上腺脑白质营养不良、苯丙酮尿症、肌萎缩侧索硬化症和 Dravet 综合征(各 1 个家庭)。在 53 个 PGT-M 周期后,最终可移植胚胎率为 12.45%,临床妊娠率为 74.19%,活产率为 89.47%;这些家庭共生育了 18 名无异常(即健康)的儿童。

结论

本研究强调了 PGT-M 在预防以神经系统表型为主的遗传性神经疾病或代谢疾病患儿出生方面的重要性。

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