Diagnostic Technologies Flashcards

1
Q

FISH

A
  • fluorescence in situ hybridization
  • combines cytogenetics and molecular diagnostics
  • molecular probes are hybridized to chromosomes
  • used to be silver
  • now fluorescent dyes
  • used to determine if a gene, specific mutation, or chromosomal rearrangement is present or absent
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2
Q

creating a probe

A
  • target is chosen and a fragment of DNA is isolated
  • DNA that is unique to the region
  • one strand labeled with dye
  • probe is hybridized to a metaphase cell preparation and it should bind to same location it came from, then probe can be used
  • test wither on metaphase or interphase cells
  • slides prepared same as karyotype
  • DNA is denatures and the labeled probe is allowed to bind
  • the rest of the DNA is counter stained
  • make sure to have control
  • only one signal on chromosome with deletion
  • need to know prob- locus/ chromosome specific
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3
Q

3 basic types of FISH

A
  • repeat sequence
  • single copy DNA-subtelomere
  • chromosome painting- multi color
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4
Q

repeat sequence probes

A
  • probes usually isolated from telomere or centromere regions
  • centromere probes used in chromosome enumeration
  • true telomere probe recognizes the six base repeat present at the ends of all chromosomes and will confirm if the telomere is there
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5
Q

single copy probe

A
  • probe usually isolated from cloned DNA or a disease causing gene or a fragment of DNA of known location associated with a particular gene
  • used to id the presence or absence of gene, gene region, or chromosomal rearrangement of interest
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6
Q

subtelomere FISH

A
  • DNA sequences from the distal ends of chromosomes in regions proximal to actual telomere region
  • can’t use telomere itself- the same
  • DNA must be unique to the chromosome
  • short arm in green and long arm red
  • allows us to id small deletions and rearrangements that cannot be seen by standard karyotype
  • 3-5% of unexplained mental retardation is due to cryptic sub terminal deletions
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7
Q

chromosome painting

A
  • whole chromosome paints
  • cocktail of many unique DNA fragments from along the entire length of a chromosome
  • complex rearrangements or marker chromosomes
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8
Q

multicolor fish

A
  • type of chromosome painting that is used to detect multiple chromosomes with one hybridization
  • special probes using a fluorescence microscope and computer with specialized software
  • the maximal number of useable colors is three
  • need computer assistance to see more than 3 colors
  • need more filters
  • can detect chromosomes rearrangements if computer gives every chromosome a color, but not id inversions, small deletions or small duplications
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9
Q

case 1

A
  • 9 year old male with developmental delay and dysmorphic features
  • possible VCFS
  • subtelomere FISH showed no signal on the distal long arm of 18
  • deletion resulting in partial monosomy for 18q
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10
Q

FISH caviats

A
  • doesn’t cover entire deletion, just critical region
  • in a 3 MB deletion, probe may only be 10 KB
  • deletion may be present tht can’t be detected by the FISH probe designated for that disease
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11
Q

what FISH when?

A
  • can’t screen all chromosomes or loci
  • maximize results
  • if you think you know disease, start there
  • if karyotype has given you chromosomes- use that info
  • does clinical information help?
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12
Q

contiguous gene syndromes

A
  • regions in the genome with clusters of closely associated genes whose normal functions are generally unrelated
  • deletion of that region results in multiple phenotypic anomalies that can be described as a particular syndrome
  • WAGR- 11p
  • Miller-Dieker- 17p
  • Williams- 7q
  • VCFS- 22q
  • 1p syndrome
  • prader-willi/angelman
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13
Q

WAGR

A
  • 11p
  • deletions can affect multiple genes
  • phenotype depends on which ones
  • about 1/3 children diagnosed with aniridia will also develop wilms tumor
  • only 1 in 50 wilms patients have aniridia
  • mental retrdation and GU defects seen with larger deletions
  • wilms tumor, aniridia, GU retardation
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14
Q

williams syndrome

A
  • deletion on 7q11.23
  • elastin gene
  • originally thought to be microdeletion, but is a deletion involving several adjacent genes
  • coarse skin and hair, lack of flexibility in aorta, supravalvular aortic stenosis
  • developmental problems and can’t live on their own
  • thickening of skin
  • skeletal and joint limitations
  • renal anomalies
  • low IQ
  • excellent musical skills, terrible with math
  • outgoing and friendly
  • blue sclera
  • stellate iris
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15
Q

VCFS

A
  • 2nd most common syndrome known in humans
  • cleft palate and conotruncal heart defects
  • diagnosed when kids have trouble feeding, cardiac defects, and characteristic facial dysmorphologies
  • learning disabilities, short stature, and conductive hearing loss are noted as the individual ages
  • 3 MB- microdeletion
  • chromosome 22
  • 40 genes and 8 pseudo genes
  • there are repeated sequences that flank the gene, during meiosis, the homologous chromosomes should pair evenly
  • repeats are similar- wrong ones could pair and deletions and duplications occur when recombinations happen
  • most common is largest-3 MB at two most distal repeats
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16
Q

VCFS 2

A
  • same 3 mb deletion is seen in majority of cases
  • phenotype is variable
  • 15% of the time, a parent carries the same deletion but may not be clinically abnormal
  • combo of alleles is different than what the parent has
  • one parents alleles can’t compensate
17
Q

microarray

A
  • gene chip technology
  • gene arrays
  • expression arrays
  • a test DNA is compared to a reference DNA that has a known genetic complement
  • DNAs are hybridized and the resulting fluorescent signal is identified and recorded
  • data collection is done by specialized equipment
  • if DNAs are equivalent, signal should be a composite of red and green that equals yellow
  • green means excess of reference DNA, deletion in test
  • red means excess of test DNA, and duplication of test
18
Q

gene array

A
  • polymorphisms
  • mutations
  • copy number variation
  • won’t detect balanced rearrangements, because amt of DNA is same
19
Q

expression arrays

A
  • DNA fragments representative of the genome are placed on the slide
  • RNA is extracted from tissue of interest, cDNA is make and labeled with color, and added to slide
  • high level of expression is detected by red signal, green indicated decreased gene expression
  • can look at same gene in different tissues and see what genes are turned on
  • can put it all together as tumor fingerprinter, and clinical testing can be established
20
Q

copy number variants

A
  • DNA fragment is directly associated with its location on a chromosome
  • hybridization done, data plotted in order along the lengths of each chromosomes
  • peaks mean gain and valleys mean loss
21
Q

chromosome microarray

A
  • for deletion of 18, can see excess red- more control DNA annd low green
  • for duplication of 5, see excess green-more test DNA
22
Q

case 2

A
  • 14 year old
  • microcephaly
  • hemiparesis
  • menstrual disorder
  • X chromosome anomaly?
  • then at 16, some developmental delay noticed
  • tested for VCFS, subtelomeres
  • then at 24- found deletion of 12p
  • 8.8 mb
  • 8732 markers
  • 40 genes- including SOX5- development
  • can’t see just on karyotype
23
Q

microarray 2

A

-first tier study in cases of unexplained developmental delay, intellectual disability, autism spectrum disorder, and multiple congenital anomalies

24
Q

tech comparison

A
  • karyotype is large, numerical and structural abnormalities, genome wide
  • molecular diagnostics is well defined, specific, very small mutations, targeted
  • FISH is well defined, specific, medium mutations, targeted
  • microarray-generalized genome wide screen for small to large mutations, will not detect balanced rearrangements
25
Q

other options from microarray

A
  • prenatal diagnosis
  • pharmacogenetics
  • mitochondrial disease id
  • personalized medicine
26
Q

conclusions

A
  • FISH now an established tool in genetics and oncology
  • microarray adds a new dimension to testing
  • can generate clinically relevant data that can’t be obtained with other tests
  • some uncertainty because we don’t yet know what all of the results are telling us
  • new findings will be contributed to national databases to expand the general knowledge of the human genome
27
Q

next gen sequencing

A

-specific mutations, sequence variation
-gene/chromosome rearrangement
-expression profiles
VERY complex results