Early detection of fragile X syndrome: Applications of a novel approach for improved quantitative methylation analysis in venous blood and newborn blood spots

Yoshimi Inaba, Charles E. Schwartz, Quang M. Bui, Xin Li, Cindy Skinner, Michael Field, Tiffany Wotton, Randi J Hagerman, David Francis, David J. Amor, John L. Hopper, Danuta Z. Loesch, Lesley Bretherton, Howard R. Slater, David E. Godler

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35 Scopus citations

Abstract

BACKGROUND: Standard fragile X syndrome (FXS) diagnostic tests that target methylation of the fragile X mental retardation 1 (FMR1)CpGisland 5' of the CGG expansion can be used to predict severity of the disease in males from birth, but not in females. METHODS: Wedescribe methylation specific-quantitative melt analysis (MS-QMA) that targets 10 CpG sites, with 9 within FMR1 intron 1, to screen for FXS from birth in both sexes. The novel method combines the qualitative strengths of high-resolution melt and the high-throughput, quantitative real-time PCR standard curve to provide accurate quantification of DNA methylation in a single assay. Its performance was assessed in 312 control (CGG<40), 143 premutation (PM) (CGG 56-170), 197 full mutation (FM) (CGG 200-2000), and 33 CGG size and methylation mosaic samples. RESULTS: In male and female newborn blood spots, MSQMA differentiated FM from control alleles, with sensitivity, specificity, and positive and negative predictive values between 92% and 100%. In venous blood of FM females between 6 and 35 years of age, MS-QMA correlated most strongly with verbal IQ impairment (P = 0.002). In the larger cohort of males and females, MSQMAcorrelated with reference methods Southern blot and MALDI-TOF mass spectrometry (P < 0.05), but was not significantly correlated with age. Unmethylated alleles in high-functioning FM and PM males determined by both reference methods were also unmethylated by MS-QMA. CONCLUSIONS: MS-QMA has an immediate application in FXS diagnostics, with a potential use of its quantitative methylation output for prognosis in both sexes.

Original languageEnglish (US)
Pages (from-to)963-973
Number of pages11
JournalClinical Chemistry
Volume60
Issue number7
DOIs
StatePublished - 2014

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ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Inaba, Y., Schwartz, C. E., Bui, Q. M., Li, X., Skinner, C., Field, M., Wotton, T., Hagerman, R. J., Francis, D., Amor, D. J., Hopper, J. L., Loesch, D. Z., Bretherton, L., Slater, H. R., & Godler, D. E. (2014). Early detection of fragile X syndrome: Applications of a novel approach for improved quantitative methylation analysis in venous blood and newborn blood spots. Clinical Chemistry, 60(7), 963-973. https://doi.org/10.1373/clinchem.2013.217331