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单基因肾病的植入前单基因疾病遗传学检测(PGT-M):一项单中心回顾性队列分析。

Preimplantation genetic testing for monogenic disorders (PGT-M) for monogenic nephropathy: a single-center retrospective cohort analysis.

作者信息

Liu Xinyu, Zhang Qian, Cao Kexin, Li Jie, Gao Yuan, Xu Peiwen, Niu Yuping, Zhou Wei, Ni Tianxiang, Sun Shuzhen, Yan Junhao

机构信息

State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, China.

National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China.

出版信息

Clin Kidney J. 2024 Nov 18;18(1):sfae356. doi: 10.1093/ckj/sfae356. eCollection 2025 Jan.

Abstract

BACKGROUND

Hereditary nephropathy is an important cause of renal insufficiency and end-stage renal disease. Therefore, for couples with monogenic nephropathy, preventing transmission of the disease to offspring is urgent. Preimplantation genetic testing for monogenic disorders (PGT-M) is a means to prevent intergenerational inheritance by screening and transplanting normal embryos. We provide a clinical overview of patients with monogenic nephropathy who underwent PGT-M.

METHODS

The single-center retrospective cohort study was conducted at the Center for Reproductive Medicine, Shandong University from January 2014 to December 2022. A total of 352 couples with nephropathy-related disease were included in the cohort totally.

RESULTS

Of the 352 couples with nephropathy-related disease, 180 accepted genetic screening. A total of 104 couples with monogenic nephropathy indications underwent PGT-M, including 90 of autosomal dominant inheritance, 10 of autosomal recessive inheritance, 4 of X-linked inheritance. 498 blastocysts were biopsied prior to testing, and 394 embryos underwent genetic testing, of which 76 were transferable, 247 were non-transferable and 71 were recommended for genetic counseling. Finally, 80 vitrified-thawed single blastocyst transfer cycles were performed in the cohort. Live births occurred in 38 women, of which 37 transferred embryos with non-pathogenic genotypes. The invasive prenatal diagnosis results of 18 women with live birth were obtained through follow-up, consistent with the PGT-M results of transferred embryos.

CONCLUSIONS

PGT-M is an effective means of preventing intergenerational inheritance of monogenic nephropathy. The absence of genetic abnormalities detected by prenatal diagnosis in healthy newborns without monogenic nephropathy also underscore its validity.

摘要

背景

遗传性肾病是肾功能不全和终末期肾病的重要病因。因此,对于患有单基因肾病的夫妇来说,防止疾病遗传给后代迫在眉睫。单基因疾病植入前基因检测(PGT-M)是一种通过筛选和移植正常胚胎来防止代际遗传的方法。我们提供了接受PGT-M的单基因肾病患者的临床概况。

方法

2014年1月至2022年12月在山东大学生殖医学中心进行了单中心回顾性队列研究。该队列共纳入352对患有肾病相关疾病的夫妇。

结果

在352对患有肾病相关疾病的夫妇中,180对接受了基因筛查。共有104对有单基因肾病指征的夫妇接受了PGT-M,其中常染色体显性遗传90对,常染色体隐性遗传10对,X连锁遗传4对。498个囊胚在检测前进行了活检,394个胚胎接受了基因检测,其中76个可移植,247个不可移植,71个建议进行遗传咨询。最后,该队列共进行了80个玻璃化冷冻单囊胚移植周期。38名女性成功分娩,其中37名移植了无致病基因型的胚胎。通过随访获得了18名分娩女性的侵入性产前诊断结果,与移植胚胎的PGT-M结果一致。

结论

PGT-M是防止单基因肾病代际遗传的有效手段。在无单基因肾病的健康新生儿中,产前诊断未检测到基因异常也强调了其有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3da6/11719030/6fa75515a319/sfae356fig1.jpg

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