Aneuploidy

非整倍体
  • 文章类型: Journal Article
    在这项横断面前瞻性研究中,先进的下一代测序技术用于比较患有严重寡精子症的不育夫妇中单个人类精子细胞的分子核型分析(即,精子数量和运动性低)与精液正常的不育夫妇。曼谷Ramathibodi医院的14对不育夫妇,泰国,他们于2023年1月至11月招募,根据精液分析结果分为两组.该研究组包括患有严重的寡精子症的夫妇,对照组精液正常。通过显微操作技术从精液样品中分离出单个精子细胞,用于随后的全基因组扩增和下一代测序,其中主要结果是非整倍体率。分离出70个单独的精子细胞,扩增成功率为90%。下一代测序结果显示,非整倍体率为25%-75%,研究组的平均值为48.28%。相比之下,对照组表现出0-75%的非整倍体率,均值为15.15%。两组间差异有统计学意义(比值比:5.8,95%置信区间:1.30-26.03)。研究组精子细胞的非整倍体率比对照组高三倍,即使通过显微操作选择了正常形态的精子细胞。建议进行全面的咨询,以解决可能超过一般不育人群的非整倍体率升高的问题。还建议对植入前基因检测进行指导,以确保具有正常染色体的胚胎转移。
    In this cross-sectional prospective study, advanced next-generation sequencing technology was used to compare the molecular karyotyping of individual human sperm cells in infertile couples with severe oligoteratozoospermia (i.e., low sperm count and motility) to those of infertile couples with normal semen. Fourteen infertile couples who were patients at Ramathibodi Hospital in Bangkok, Thailand, were recruited from January to November 2023, and they were categorized into two groups based on semen analysis results. The study group comprised couples with severe oligoteratozoospermia, whereas the control group exhibited normal semen. Individual sperm cells from the semen samples were isolated by the micromanipulation technique for subsequent whole-genome amplification and next-generation sequencing, where the primary outcome was the aneuploidy rate. Seventy individual sperm cells were isolated with a 90% success rate for amplification. The next-generation sequencing results showed that the aneuploidy rate was 25%-75%, with a mean of 48.28% in the study group. In contrast, the control group exhibited aneuploidy rates of 0-75%, with a mean of 15.15%. The difference between the two groups was statistically significant (odds ratio: 5.8, 95% confidence interval: 1.30-26.03). Sperm cells of the study group showed a threefold higher aneuploidy rate than those in the control group, even though the sperm cells were selected by micromanipulation for their normal morphology. Comprehensive counseling is recommended to address elevated aneuploidy rates that potentially surpass those of the general infertile population. Guidance on preimplantation genetic testing is also recommended to ensure the transfer of embryos with normal chromosomes.
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  • 文章类型: Journal Article
    染色体不稳定(CIN),由细胞间染色体数量或结构的变化定义,被认为是与肿瘤适应挑战性环境的能力相关的癌症的独特特征。CIN已被认为是导致克隆异质性(CH)的遗传变异的来源。最近的研究结果表明,CIN和CH与BC患者的预后之间存在潜在的关联。特别是在表达表皮生长因子受体2(HER2)的肿瘤中。事实上,有关CIN在其他BC亚型中的作用的信息,包括管腔BC,是有限的。此外,尚不清楚CIN是否在腔BBC肿瘤中,高于特定阈值,可能对人类肿瘤的生长产生不利影响,或者与升高的水平相比,低或中等的CIN水平是否与更有利的BC患者预后有关。澄清这些关系可能会对风险分层和未来针对BC中CIN的治疗策略的发展产生重大影响。这项研究旨在评估来自10例腔BBC患者的肿瘤组织样本中的CIN和CH,并将其与已建立的临床病理参数进行比较。这项研究的结果表明,管腔BBC患者表现出中间CIN和稳定的非整倍体,两者都与淋巴管浸润有关。我们的结果还提供了有价值的初步数据,这些数据可能有助于理解CIN和CH在BC风险分层和未来治疗策略发展中的意义。
    Chromosomal instability (CIN), defined by variations in the number or structure of chromosomes from cell to cell, is recognized as a distinctive characteristic of cancer associated with the ability of tumors to adapt to challenging environments. CIN has been recognized as a source of genetic variation that leads to clonal heterogeneity (CH). Recent findings suggest a potential association between CIN and CH with the prognosis of BC patients, particularly in tumors expressing the epidermal growth factor receptor 2 (HER2+). In fact, information on the role of CIN in other BC subtypes, including luminal B BC, is limited. Additionally, it remains unknown whether CIN in luminal B BC tumors, above a specific threshold, could have a detrimental effect on the growth of human tumors or whether low or intermediate CIN levels could be linked to a more favorable BC patient prognosis when contrasted with elevated levels. Clarifying these relationships could have a substantial impact on risk stratification and the development of future therapeutic strategies aimed at targeting CIN in BC. This study aimed to assess CIN and CH in tumor tissue samples from ten patients with luminal B BC and compare them with established clinicopathological parameters. The results of this study reveal that luminal B BC patients exhibit intermediate CIN and stable aneuploidy, both of which correlate with lymphovascular invasion. Our results also provide valuable preliminary data that could contribute to the understanding of the implications of CIN and CH in risk stratification and the development of future therapeutic strategies in BC.
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  • 文章类型: Journal Article
    目的:胚泡发育前,胚胎经历形态和代谢变化对其随后的生长至关重要。本研究的目的是探讨桑态度紧实和胚泡形成与随后的胚胎染色体状态之间的关系。
    方法:这项回顾性队列研究使用延时成像评估了胚胎发育(n=371);94个胚泡接受了非整倍性植入前遗传学测试(PGT-A)。
    结果:胚胎被分类为完全(组1,n=194)或部分(组2,n=177)压缩。第1组的良好和平均质量胚泡比例明显高于第2组(21.6%vs.3.4%,p=0.001;47.9%vs.26.6%,分别为p=0.001)。第1组从桑态度期到开始和完成紧实和胚泡形成的时间明显短于第2组(78.6vs.82.4h,p=0.001;87.0vs.92.2h,p=0.001;100.2vs.103.7h,分别为p=0.017)。在胚泡形成后的不同时间点,组1胚胎具有比组2胚胎更大的表面积。第1组囊胚的平均扩增率明显高于第2组囊胚(653.6vs.499.2μm2/h,p=0.001)。PGT-A显示第1组的整倍体胚胎比例高于第2组(47.2%vs.36.6%,p=0.303)。
    结论:延时显微镜揭示了紧实与胚泡质量之间的正相关关系及其与胚胎倍性的关联。因此,在选择移植或冷冻保存的胚泡之前,应优先进行压实评估。
    OBJECTIVE: Before blastocyst development, embryos undergo morphological and metabolic changes crucial for their subsequent growth. This study aimed to investigate the relationship between morula compaction and blastocyst formation and the subsequent chromosomal status of the embryos.
    METHODS: This retrospective cohort study evaluated embryo development (n = 371) using time-lapse imaging; 94 blastocysts underwent preimplantation genetic testing for aneuploidy (PGT-A).
    RESULTS: The embryos were classified as fully (Group 1, n = 194) or partially (Group 2, n = 177) compacted. Group 1 had significantly higher proportions of good- and average-quality blastocysts than Group 2 (21.6% vs. 3.4%, p = 0.001; 47.9% vs. 26.6%, p = 0.001, respectively). The time from the morula stage to the beginning and completion of compaction and blastocyst formation was significantly shorter in Group 1 than in Group 2 (78.6 vs. 82.4 h, p = 0.001; 87.0 vs. 92.2 h, p = 0.001; 100.2 vs. 103.7 h, p = 0.017, respectively). Group 1 embryos had larger surface areas than Group 2 embryos at various time points following blastocyst formation. Group 1 blastocysts had significantly higher average expansion rates than Group 2 blastocysts (653.6 vs. 499.2 μm2/h, p = 0.001). PGT-A revealed a higher proportion of euploid embryos in Group 1 than in Group 2 (47.2% vs. 36.6%, p = 0.303).
    CONCLUSIONS: Time-lapse microscopy uncovered a positive relationship between compaction and blastocyst quality and its association with embryo ploidy. Hence, compaction evaluation should be prioritized before blastocyst selection for transfer or cryopreservation.
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  • 文章类型: Randomized Controlled Trial
    外源性促性腺激素治疗的安全性,基于它对胚胎和妊娠结局的影响,仍然没有定论。
    评估不同剂量和持续时间的促性腺激素与不育症夫妇整倍体胚胎移植后胚胎遗传状态和妊娠结局的关系。
    这项研究是对2017年7月至2018年6月在中国14个生殖中心进行的多中心随机临床试验(RCT)的事后分析,该试验评估了患有不育症和预后良好的夫妇中有无非整倍体植入前遗传检测(PGT-A)的累积活产率。从原始RCT中选择PGT-A组进行二次分析。根据外源性促性腺激素的总剂量和治疗时间将患者分为4组:第1组(≤1500IU和<10天),第2组(≤1500IU,≥10天),第3组(>1500IU和<10天),和第4组(>1500IU和≥10天)。第1组作为对照组。数据从2023年6月到8月进行了分析。
    囊胚活检和PGT-A。
    主要结果是胚胎非整倍体,胚胎镶嵌,整倍体胚胎移植后的累积活产率。
    共有603对夫妇(准母亲的平均年龄[SD],29.13[3.61]年)接受PGT-A的人被包括在内,和1809个胚胎使用下一代测序进行筛选。第2组的胚胎镶嵌率显着较高(339个胚胎中有44个[13.0%];调整后的比值比[aOR],1.69[95%CI,1.09-2.64]),3(186个胚胎中的27个[14.5%];aOR,1.98[95%CI,1.15-3.40]),和4(651个胚胎中的82个[12.6%];aOR,1.60[95%CI,1.07-2.38])比第1组(633个胚胎中的56个[8.8%])。促性腺激素剂量或持续时间与胚胎非整倍体率之间没有关联。第2组的累积活产率显着降低(113对夫妇中的83对[73.5%];aOR,0.49[95%CI,0.27-0.88]),3(62对夫妇中的42对[67.7%];或,0.41[95%CI,0.21-0.82]),和4(217对夫妇中的161对[74.2%];或,0.53[95%CI,0.31-0.89])高于第1组(211对夫妇中的180对[85.3%])。
    在这项研究中,在预后良好的夫妇中,过度施用外源性促性腺激素与整倍体胚胎移植后胚胎镶嵌性增加和累积活产率降低相关.这些结果表明,应考虑尽量减少外源性促性腺激素剂量和限制治疗持续时间,以改善胚胎结局并提高活产率。
    ClinicalTrials.gov标识符:NCT03118141。
    UNASSIGNED: The safety of exogenous gonadotropin treatment, based on its effect on embryos and pregnancy outcomes, remains inconclusive.
    UNASSIGNED: To evaluate the associations of different doses and durations of gonadotropins with embryonic genetic status and pregnancy outcomes after euploid embryo transfer in couples with infertility.
    UNASSIGNED: This study was a post hoc analysis of a multicenter randomized clinical trial (RCT) conducted at 14 reproductive centers throughout China from July 2017 to June 2018 that evaluated the cumulative live birth rate with or without preimplantation genetic testing for aneuploidy (PGT-A) among couples with infertility and good prognosis. The PGT-A group from the original RCT was selected for secondary analysis. Patients were divided into 4 groups according to the total dosage of exogenous gonadotropins and treatment duration: group 1 (≤1500 IU and <10 days), group 2 (≤1500 IU and ≥10 days), group 3 (>1500 IU and <10 days), and group 4 (>1 500 IU and ≥10 days). Group 1 served as the control group. Data were analyzed from June through August 2023.
    UNASSIGNED: Blastocyst biopsy and PGT-A.
    UNASSIGNED: The primary outcomes were embryonic aneuploidy, embryonic mosaicism, and cumulative live birth rates after euploid embryo transfer.
    UNASSIGNED: A total of 603 couples (mean [SD] age of prospective mothers, 29.13 [3.61] years) who underwent PGT-A were included, and 1809 embryos were screened using next-generation sequencing. The embryo mosaicism rate was significantly higher in groups 2 (44 of 339 embryos [13.0%]; adjusted odds ratio [aOR], 1.69 [95% CI, 1.09-2.64]), 3 (27 of 186 embryos [14.5%]; aOR, 1.98 [95% CI, 1.15-3.40]), and 4 (82 of 651 embryos [12.6%]; aOR, 1.60 [95% CI, 1.07-2.38]) than in group 1 (56 of 633 embryos [8.8%]). There were no associations between gonadotropin dosage or duration and the embryo aneuploidy rate. The cumulative live birth rate was significantly lower in groups 2 (83 of 113 couples [73.5%]; aOR, 0.49 [95% CI, 0.27-0.88]), 3 (42 of 62 couples [67.7%]; aOR, 0.41 [95% CI, 0.21-0.82]), and 4 (161 of 217 couples [74.2%]; aOR, 0.53 [95% CI, 0.31-0.89]) than in group 1 (180 of 211 couples [85.3%]).
    UNASSIGNED: In this study, excessive exogenous gonadotropin administration was associated with increased embryonic mosaicism and decreased cumulative live birth rate after euploid embryo transfer in couples with a good prognosis. These findings suggest that consideration should be given to minimizing exogenous gonadotropin dosage and limiting treatment duration to improve embryo outcomes and increase the live birth rate.
    UNASSIGNED: ClinicalTrials.gov Identifier: NCT03118141.
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  • 文章类型: Clinical Trial Protocol
    背景:孕激素可以抑制体外受精(IVF)卵巢刺激过程中垂体黄体生成素(LH)的激增,研究表明孕激素引发的卵巢刺激(PPOS)可有效阻断IVF中LH的激增。越来越多的中心正在使用PPOS,因为这种方案看起来更简单,更便宜。这项研究旨在比较PPOS方案和促性腺激素释放激素拮抗剂方案在接受非整倍性植入前遗传测试(PGT-A)的女性中胚泡的整倍体率。
    方法:这是一项随机试验。根据计算机生成的随机化列表,将总共招募400名接受PGT-A的妇女,并将其随机分配到(1)拮抗剂组:从卵巢刺激第6天到排卵触发日每天给予一次的拮抗剂;或(2)PPOS组:从卵巢刺激的第一天到排卵触发的那天,多屈孕酮。主要结果是胚泡的整倍体率。
    获得了上海嘉爱遗传与试管婴儿研究所辅助生殖医学伦理委员会的伦理批准(JIAIE2020-03)。在进行任何研究程序之前,将获得每位女性的书面知情同意书。根据良好的临床实践。这项随机试验的结果将在同行评审的期刊上发布。
    背景:NCT04414748。
    BACKGROUND: Progestin can inhibit the pituitary luteinising hormone (LH) surge during ovarian stimulation for in vitro fertilisation (IVF) and studies show progestin-primed ovarian stimulation (PPOS) is effective in blocking the LH surge in IVF. More and more centres are using PPOS because this regimen appears simpler and cheaper. This study aims to compare the euploidy rate of blastocysts following the PPOS protocol and the gonadotropin-releasing hormone antagonist protocol in women undergoing preimplantation genetic testing for aneuploidy (PGT-A).
    METHODS: This is a randomised trial. A total of 400 women undergoing PGT-A will be enrolled and randomised according to a computer-generated randomisation list to either (1) the antagonist group: an antagonist given once daily from day 6 of ovarian stimulation till the day of the ovulation trigger; or (2) the PPOS group: dydrogesterone from the first day of ovarian stimulation till the day of ovulation trigger. The primary outcome is the euploidy rate of blastocysts.
    UNASSIGNED: An ethical approval was granted from the ethics committee of assisted reproductive medicine in Shanghai JiAi Genetics and IVF institute (JIAIE2020-03). A written informed consent will be obtained from each woman before any study procedure is performed, according to good clinical practice. The results of this randomised trial will be disseminated in a peer-reviewed journal.
    BACKGROUND: NCT04414748.
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  • 文章类型: Journal Article
    背景:非侵入性产前检测(NIPT),它可以筛选非整倍体,如21三体,正在欧洲的几个公共医疗保健系统中实施。文献中强调了全面的沟通和信息是支持妇女生殖决策和解决相关道德问题(如程序化)的重要因素。英国和法国等国家正在采用大致相似的实施模式,为具有高非整倍体概率的妊娠提供NIPT。然而,我们没有更深入地了解专业人员的咨询价值观和实践在这些背景下可能有什么不同。
    方法:在本文中,我们探讨了英国和法国的专业人员如何在提供NIPT时支持患者决策,并批判性地比较专业实践和价值观.我们利用半结构化的医疗保健专业人员访谈数据。
    结果:英国和法国专业人士都强调与患者选择和同意有关的价值观。然而,这些价值观在NIPT规定实践中的理解和应用是不同的。英语受访者更加强调通过“原则”镜头解释和描述咨询患者和临床护理的过程。他们专注于非指向性,标准化,以及医疗保健专业人员作为患者的“决策促进者”。法国受访者通过“程序”镜头描述了他们的方法。他们的重点是正式同意,信息,和医疗保健专业人员作为“信息提供者”。英语和法语专业人员都表示,资源不足是有效将其价值观转化为实践的关键障碍。
    结论:我们的研究结果表明,在提供NIPT时支持患者选择可能在表面水平上被认为是一个重要的共同价值,但可以以不同的方式理解并转化为实践。我们的发现可以指导进一步的研究,并为NIPT规定的实践和政策提供有益的信息。
    BACKGROUND: Non-invasive prenatal testing (NIPT), which can screen for aneuploidies such as trisomy 21, is being implemented in several public healthcare systems across Europe. Comprehensive communication and information have been highlighted in the literature as important elements in supporting women\'s reproductive decision-making and addressing relevant ethical concerns such as routinisation. Countries such as England and France are adopting broadly similar implementation models, offering NIPT for pregnancies with high aneuploidy probability. However, we do not have a deeper understanding of how professionals\' counselling values and practices may differ between these contexts.
    METHODS: In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals.
    RESULTS: Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a \"principle\" lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as \"decision-facilitator\" for patients. French interviewees described their approach through a \"procedural\" lens. Their focus was on formal consent, information, and the healthcare professional as \"information-giver\". Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice.
    CONCLUSIONS: Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision.
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  • 文章类型: Journal Article
    对患有两个子宫(子宫双子宫)的女性所生的不寻常的双胞胎类型的双胞胎进行了回顾。这篇综述是关于双胎妊娠产前非整倍体筛查的最新研究和观点的总结。同性男性夫妇的双胞胎概念,连体双胞胎的法律人格,和对大麻使用的双胞胎研究。还提供了有关媒体上出现的双胞胎的有趣信息,即双胞胎如何拯救了一对姐妹;诺贝尔奖获得者的双胞胎孩子,英国“混血儿”双胞胎,三胞胎出生在俄罗斯对乌克兰的攻击开始,和出生在不同年份的双胞胎。
    A review of an unusual twin type-twins born to women with two uteri (uterus didelphys)-is presented. This review is followed by summaries of recent research and perspectives concerning prenatal aneuploidy screening for twin pregnancies, twin conceptions by same-sex male couples, legal personality of conjoined twins, and a twin study of cannabis use. Interesting information about twins that has appeared in the media is also presented, namely how being taken for twins saved a pair of sisters; twin children of a jailed Nobel Prize winner, British \'biracial\' twins, triplets born at the start of Russia\'s attack on Ukraine, and twins born in different years.
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  • 文章类型: Journal Article
    肥胖与生殖失败的风险增加有关,尤其是早产。随着非整倍体的植入前基因检测(PGT-A)在全球范围内越来越多地使用,然而,目前尚不清楚体重指数(BMI)对接受PGT-A体外受精(IVF)的患者移植单个整倍体囊胚时的早产率是否有影响.
    这次回顾展,单中心队列研究包括851名女性,她们在2015年至2020年间接受了PGT-A冻融单整倍体囊胚移植的第一个周期.主要结果是早产率。次要结果是临床妊娠,流产,异位妊娠,妊娠并发症,和活产。
    患者按世界卫生组织(WHO)BMI等级分组:体重不足(<18.5,n=81),正常体重(18.5-24.9,n=637),超重(25-30,n=108),肥胖(≥30,n=25)。临床妊娠没有差异,流产,异位妊娠,妊娠并发症,和按BMI类别划分的活产。在多变量逻辑回归分析中,超重女性的早产率明显更高(调整后比值比[aOR]3.18;95%置信区间[CI],1.29-7.80,p=.012)和肥胖(aOR1.49;95%CI,1.03-12.78,p=.027)与正常体重参考组相比。
    肥胖女性在整倍体胚胎移植后比体重正常的女性早产率更高,这表明肥胖对IVF和临床结局的负面影响可能与非整倍体以外的其他机制有关.
    UNASSIGNED: Obesity has been associated with an increased risk of reproductive failure, especially preterm birth. As preimplantation genetic testing for aneuploidies (PGT-A) is increasingly used worldwide, however, it is still unclear whether body mass index (BMI) has an effect on the preterm birth rate in patients undergoing in vitro fertilization (IVF) with PGT-A when transferring a single euploid blastocyst.
    UNASSIGNED: This retrospective, single-center cohort study included 851 women who underwent the first cycle of frozen-thawed single euploid blastocyst transfer with PGT-A between 2015 and 2020. The primary outcome was the preterm birth rate. Secondary outcomes were clinical pregnancy, miscarriage, ectopic pregnancy, pregnancy complications, and live birth.
    UNASSIGNED: Patients were grouped by World Health Organization (WHO) BMI class: underweight (<18.5, n = 81), normal weight (18.5-24.9, n = 637), overweight (25-30, n = 108), and obese (≥30, n = 25). There was no difference in the clinical pregnancy, miscarriage, ectopic pregnancy, pregnancy complication, and live birth by BMI category. In multivariate logistic regression analysis, preterm birth rates were significantly higher in women with overweight (adjusted odds ratio [aOR] 3.18; 95% confidence interval [CI], 1.29-7.80, p = .012) and obese (aOR 1.49; 95% CI, 1.03-12.78, p = .027) compared with the normal weight reference group.
    UNASSIGNED: Women with obesity experience a higher rate of preterm birth after euploid embryo transfer than women with a normal weight, suggesting that the negative impact of obesity on IVF and clinical outcomes may be related to other mechanisms than aneuploidy.
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  • 文章类型: Journal Article
    白色念珠菌中应激诱导的基因组变化有助于该物种适应各种环境条件。动物来源的白色念珠菌菌株的基因组组成的变化在很大程度上是未探索的,并且驱动这些酵母进化的药物抗性或其他选择压力仍然是一个有趣的问题。进行了比较基因组分析,以揭示染色体非整倍体和杂合性缺失(LOH)的区域,管理基因组可塑性的两种机制。我们仅在人类分离物中检测到非整倍性。鸟源分离株在通常与抗真菌药物抗性相关的基因中显示LOH,与人类分离株相似。我们的研究表明,环境杀菌剂的使用可能会对感染动物的白色念珠菌施加选择性压力,从而有助于潜在抗性菌株在不同宿主之间的传播。
    Stress-induced genomic changes in Candida albicans contribute to the adaptation of this species to various environmental conditions. Variations of the genome composition of animal-origin C. albicans strains are largely unexplored and drug resistance or other selective pressures driving the evolution of these yeasts remained an intriguing question. Comparative genome analysis was carried out to uncover chromosomal aneuploidies and regions with loss of heterozygosity (LOH), two mechanisms that manage genome plasticity. We detected aneuploidy only in human isolates. Bird-derived isolates showed LOH in genes commonly associated with antifungal drug resistance similar to human isolates. Our study suggests that environmental fungicide usage might exert selective pressure on C. albicans infecting animals, thus contributing to the spread of potentially resistant strains between different hosts.
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  • 文章类型: Journal Article
    目的:使用基于序列的单个滋养细胞拷贝数分析,对基于细胞的无创性产前基因检测进行临床评估。
    方法:从401(243+158)名个体(8-22周)获得血液并运送过夜。红细胞被裂解,和有核细胞对细胞角蛋白(CK)和CD45染色,并富集阳性CK染色。使用自动扫描来鉴定和挑选单个CK+/CD45-滋养层,其经受下一代测序。
    结果:从计划进行CVS或羊膜穿刺术的243例妊娠中获得血液。160例单例的Luna结果正常,而15例异常(14例非整倍性和1例单卵双生子伴威廉姆斯综合征缺失)。在两个胎儿中都证实了缺失。236例Luna病例中有7例(3.0%)发生胎盘镶嵌,188例CVS病例中有3例(1.6%)发生胎盘镶嵌(总计4.6%)。在236个可用样品中的32个中没有回收到可评价的滋养层。此外,158例未接受CVS/羊膜穿刺术的低危妊娠在133例中显示正常结果。七个有非整倍性结果,有三个可能的致病性缺失/重复,包括one15q11-q13删除。
    结论:尽管样本量适中,并且无法对测试性能进行统计准确的测量,根据与CVS/羊膜穿刺术的一致性,Luna试验检测到非整倍体和缺失/重复。
    OBJECTIVE: To clinically assess a cell-based noninvasive prenatal genetic test using sequence-based copy number analysis of single trophoblasts from maternal blood.
    METHODS: Blood was obtained from 401 (243 + 158) individuals (8-22 weeks) and shipped overnight. Red cells were lysed, and nucleated cells stained for cytokeratin (CK) and CD45 and enriched for positive CK staining. Automated scanning was used to identify and pick single CK+ /CD45- trophoblasts which were subjected to next-generation sequencing.
    RESULTS: Blood was obtained from 243 pregnancies scheduled for CVS or amniocentesis. Luna results were normal for 160 singletons while 15 cases were abnormal (14 aneuploidy and one monozygotic twin with Williams syndrome deletion). The deletion was confirmed in both fetuses. Placental mosaicism occurred in 7 of 236 (3.0%) Luna cases and in 3 of 188 (1.6%) CVS cases (total 4.6%). No scorable trophoblasts were recovered in 32 of 236 usable samples. Additionally, 158 low-risk pregnancies not undergoing CVS/amniocentesis showed normal results in 133 cases. Seven had aneuploidy results, and there were three likely pathogenic deletions/duplications, including one15q11-q13 deletion.
    CONCLUSIONS: Although the sample size is modest and statistically accurate measures of test performance are not possible, the Luna test detected aneuploidy and deletions/duplications based on concordance with CVS/amniocentesis.
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