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2017 ; 9
(ä): 146-152
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Accurate clinical genetic testing for autoinflammatory diseases using the
next-generation sequencing platform MiSeq
#MMPMID28956000
Nakayama M
; Oda H
; Nakagawa K
; Yasumi T
; Kawai T
; Izawa K
; Nishikomori R
; Heike T
; Ohara O
Biochem Biophys Rep
2017[Mar]; 9
(ä): 146-152
PMID28956000
show ga
Autoinflammatory diseases occupy one of a group of primary immunodeficiency
diseases that are generally thought to be caused by mutation of genes responsible
for innate immunity, rather than by acquired immunity. Mutations related
to autoinflammatory diseases occur in 12 genes. For example, low-level somatic
mosaic NLRP3 mutations underlie chronic infantile neurologic, cutaneous,
articular syndrome (CINCA), also known as neonatal-onset multisystem inflammatory
disease (NOMID). In current clinical practice, clinical genetic testing plays an
important role in providing patients with quick, definite diagnoses. To increase
the availability of such testing, low-cost high-throughput gene-analysis systems
are required, ones that not only have the sensitivity to detect even low-level
somatic mosaic mutations, but also can operate simply in a clinical setting. To
this end, we developed a simple method that employs two-step tailed PCR and an
NGS system, MiSeq platform, to detect mutations in all coding exons of the 12
genes responsible for autoinflammatory diseases. Using this amplicon sequencing
system, we amplified a total of 234 amplicons derived from the 12 genes with
multiplex PCR. This was done simultaneously and in one test tube. Each sample was
distinguished by an index sequence of second PCR primers following PCR
amplification. With our procedure and tips for reducing PCR amplification bias,
we were able to analyze 12 genes from 25 clinical samples in one MiSeq run.
Moreover, with the certified primers designed by our short program-which detects
and avoids common SNPs in gene-specific PCR primers-we used this system for
routine genetic testing. Our optimized procedure uses a simple protocol, which
can easily be followed by virtually any office medical staff. Because of the
small PCR amplification bias, we can analyze simultaneously several clinical DNA
samples with low cost and can obtain sufficient read numbers to detect a low
level of somatic mosaic mutations.