Name: genetic analysis of hereditary transthyretin ala97ser related amyloidosis
Uploaded: 2018-06-09T15:00:00
Description: Watch this Scientific Journal Video about Genetic Analysis of Hereditary Transthyretin Ala97Ser Related Amyloidosis at JoVE.com

Wir wollen Miss Shin-Fun Wu für ihre Hilfe in den Experimenten zu danken. Diese Studie wurde unterstützt durch einen Zuschuss aus dem Chang Gung Medical Research Program (CMRPG3C0371, CMRPG3C0372, CMRPG3C0373) und IRB 100-4470A3, 104-2462A3, Taiwan.

Die Tests im Labor wurde gemäß den Anforderungen von den klinischen Labor Verbesserung Änderungen (CLIA) von 1988, die Vorschriften genehmigt durch die institutionelle Review Board der Chang Gung Memorial Hospital durchgeführt und Universität (Lizenz Nr. 100 - 4470A3 und 104-2462A3). Die Einwilligung wurde von allen Patienten.
1. Probe Blutentnahme
<ol><li>Sammeln Sie Vollblut in handelsübliche EDTA behandelt Röhren. Vorsichtig mischen und Blutprobe bei 4 ° C bis zur Verarbeitung lag...

<ol>
	<li>Plant&#233;-Bordeneuve, V., Said, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Familial+amyloid+polyneuropathy.">Familial amyloid polyneuropathy.</a> The Lancet Neurology. 10 (12), 1086-1097 (2011).</li><li>Plant&#233;-Bordeneuve, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+treatment+of+transthyretin+familial+amyloid+polyneuropathy+with+tafamidis:+a+clinical+and+neurophysiological+study.">Long-term treatment of transthyretin familial amyloid polyneuropathy with tafamidis: a clinical and neurophysiological study.</a> Journal of Neurology. 264 (2), 268-276 (2017).</li><li>Nichols, W. C., Benson, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hereditary+amyloidosis:+detection+of+variant+prealbumin+genes+by+restriction+enzyme+analysis+of+amplified+genomic+DNA+sequences.">Hereditary amyloidosis: detection of variant prealbumin genes by restriction enzyme analysis of amplified genomic DNA sequences.</a> Clinical Genetics. 37 (1), 44-53 (1990).</li><li>Lorenz, T. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Polymerase+Chain+Reaction:+Basic+Protocol+Plus+Troubleshooting+and+Optimization+Strategies.">Polymerase Chain Reaction: Basic Protocol Plus Troubleshooting and Optimization Strategies.</a> Journal of Visualized Experiments. (63), e3998 (2012).</li><li>Hsu, H. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Phenotypic+expressions+of+hereditary+Transthyretin+Ala97Ser+related+Amyloidosis+(ATTR)+in+Taiwanese.">Phenotypic expressions of hereditary Transthyretin Ala97Ser related Amyloidosis (ATTR) in Taiwanese.</a> BMC Neurology. 17 (1), 178 (2017).</li><li>Barroso, F. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+safety+and+efficacy+of+tafamidis+for+the+treatment+of+hereditary+transthyretin+amyloid+polyneuropathy:+results+up+to+6+years.">Long-term safety and efficacy of tafamidis for the treatment of hereditary transthyretin amyloid polyneuropathy: results up to 6 years.</a> Amyloid. 24 (3), 194-204 (2017).</li><li>Rapezzi, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Disease+profile+and+differential+diagnosis+of+hereditary+transthyretin-related+amyloidosis+with+exclusively+cardiac+phenotype:+an+Italian+perspective.">Disease profile and differential diagnosis of hereditary transthyretin-related amyloidosis with exclusively cardiac phenotype: an Italian perspective.</a> European Heart Journal. 34 (7), 520-528 (2013).</li><li>Mariani, L. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genotype-phenotype+correlation+and+course+of+transthyretin+familial+amyloid+polyneuropathies+in+France.">Genotype-phenotype correlation and course of transthyretin familial amyloid polyneuropathies in France.</a> Annals of Neurology. 78 (6), 901-916 (2015).</li><li>Hammarstr&#246;m, P., Jiang, X., Hurshman, A. R., Powers, E. T., Kelly, J. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sequence-dependent+denaturation+energetics:+A+major+determinant+in+amyloid+disease+diversity.">Sequence-dependent denaturation energetics: A major determinant in amyloid disease diversity.</a> Proceedings of the National Academy of Sciences of the United States of America. 99, 16427-16432 (2002).</li><li>Johnson, M., Zaretskaya, I., Raytselis, Y., Merezhuk, Y., McGinnis, S., Madden, T. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=NCBI+BLAST:+a+better+web+interface.">NCBI BLAST: a better web interface.</a> Nucleic Acids Research. 36, 5-9 (2008).</li><li>Fox, A. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Next+generation+sequencing+for+the+detection+of+actionable+mutations+in+solid+and+liquid+tumors.">Next generation sequencing for the detection of actionable mutations in solid and liquid tumors.</a> Journal of Visualized Experiments. (115), (2016).</li><li>Date, Y., Nakazato, M., Kangawa, K., Shirieda, K., Fujimoto, T., Matsukura, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+of+three+transthyretin+gene+mutations+in+familial+amyloidotic+polyneuropathy+by+analysis+of+DNA+extracted+from+formalin-fixed+and+paraffin-embedded+tissues.">Detection of three transthyretin gene mutations in familial amyloidotic polyneuropathy by analysis of DNA extracted from formalin-fixed and paraffin-embedded tissues.</a> Journal of the Neurological Sciences. 150 (2), 143-148 (1997).</li><li>Ye, J., Coulouris, G., Zaretskaya, I., Cutcutache, I., Rozen, S., Madden, T. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Primer-BLAST:+a+tool+to+design+target-specific+primers+for+polymerase+chain+reaction.">Primer-BLAST: a tool to design target-specific primers for polymerase chain reaction.</a> BMC Bioinformatics. 13, 134 (2012).</li><li>Green, M. R., Sambrook, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Molecular cloning: A laboratory manual. , (2012).</li><li>Buckingham, L., Flaws, M. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Molecular diagnostics: Fundamentals, methods, and clinical applications. , (2012).</li><li>Tan, S. C., Yiap, B. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=DNA,+RNA,+and+Protein+Extraction:+The+Past+and+The+Present.">DNA, RNA, and Protein Extraction: The Past and The Present.</a> Journal of Biomedicine and Biotechnology. 2009, (2009).</li><li>Rapezzi, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systemic+cardiac+amyloidoses:+disease+profiles+and+clinical+courses+of+the+3+main+types.">Systemic cardiac amyloidoses: disease profiles and clinical courses of the 3 main types.</a> Circulation. 120 (13), 1203-1212 (2009).</li><li>Gertz, M. A., Dispenzieri, A., Sher, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pathophysiology+and+treatment+of+cardiac+amyloidosis.">Pathophysiology and treatment of cardiac amyloidosis.</a> Nature Reviews Cardiology. 12 (2), 91-102 (2015).</li><li>Vrana, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+diagnosis+and+typing+of+systemic+amyloidosis+in+subcutaneous+fat+aspirates+by+mass+spectrometry-based+proteomics.">Clinical diagnosis and typing of systemic amyloidosis in subcutaneous fat aspirates by mass spectrometry-based proteomics.</a> Haematologica. 99 (7), 1239-1247 (2014).</li><li>Nakamura, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Identification+of+a+new+transthyretin+variant+(Ile49)+in+familial+amyloidotic+polyneuropathy+using+electrospray+ionization+mass+spectrometry+and+nonisotopic+RNase+cleavage+assay.">Identification of a new transthyretin variant (Ile49) in familial amyloidotic polyneuropathy using electrospray ionization mass spectrometry and nonisotopic RNase cleavage assay.</a> Human Heredity. 49 (4), 186-189 (1999).</li><li>Ueda, M., Ando, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recent+advances+in+transthyretin+amyloidosis+therapy.">Recent advances in transthyretin amyloidosis therapy.</a> Translational Neurodegeneration. 3, 19 (2014).</li><li>Brown, E. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+testing+improves+identification+of+transthyretin+amyloid+(ATTR)+subtype+in+cardiac+amyloidosis.">Genetic testing improves identification of transthyretin amyloid (ATTR) subtype in cardiac amyloidosis.</a> Amyloid. 24 (2), 92-95 (2017).</li><li>Tasaki, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rapid+detection+of+wild-type+and+mutated+transthyretins.">Rapid detection of wild-type and mutated transthyretins.</a> Annals of Clinical Biochemistry. 53 (4), 508-510 (2015).</li><li>Plante-Bordeneuve, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diagnostic+pitfalls+in+sporadic+transthyretin+familial+amyloid+polyneuropathy+(TTR-FAP).">Diagnostic pitfalls in sporadic transthyretin familial amyloid polyneuropathy (TTR-FAP).</a> Neurology. 69 (7), 693-698 (2007).</li><li>Hsu, J. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+prospective,+observational+study+of+patients+with+uncommon+distal+symmetric+painful+small-fiber+neuropathy.">A prospective, observational study of patients with uncommon distal symmetric painful small-fiber neuropathy.</a> PLoS ONE. 12 (9), 0183948 (2017).</li><li>Salvi, F., Pastorelli, F., Plasmati, R., Bartolomei, I., Dall'Osso, D., Rapezzi, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genotypic+and+phenotypic+correlation+in+an+Italian+population+of+hereditary+amyloidosis+TTR-related+(HA-TTR):+Clinical+and+neurophysiological+aids+to+diagnosis+and+some+reflections+on+misdiagnosis.">Genotypic and phenotypic correlation in an Italian population of hereditary amyloidosis TTR-related (HA-TTR): Clinical and neurophysiological aids to diagnosis and some reflections on misdiagnosis.</a> Amyloid. 19, 58-60 (2012).</li><li>Suhr, O. B., Lundgren, E., Westermark, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=One+mutation,+two+distinct+disease+variants:+Unravelling+the+impact+of+transthyretin+amyloid+fibril+composition.">One mutation, two distinct disease variants: Unravelling the impact of transthyretin amyloid fibril composition.</a> Journal of Internal Medicine. 281 (4), 337-347 (2017).</li><li>Vil&#224;-Rico, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+analysis+of+post-translational+modifications+in+human+serum+transthyretin+associated+with+familial+amyloidotic+polyneuropathy+by+targeted+LC-MS+and+intact+protein+MS.">Quantitative analysis of post-translational modifications in human serum transthyretin associated with familial amyloidotic polyneuropathy by targeted LC-MS and intact protein MS.</a> Journal of Proteomics. 127, 234-246 (2015).</li></ol>

Es gibt zwei wichtige Schritte im Rahmen des Protokolls. Erstens sollte ein Hemodiluted Exemplar um ausreichende Anzahl von weißen Blutkörperchen, vermiedene11. Zweitens ist die Verwendung von entsprechenden PCR Primer grundlegend für zuverlässige Ergebnisse12zu erhalten. Wir verwendet die Primer-BLAST-Web-Tool, um Primer4,13zu entwerfen; ein Minimum von 40 Basenpaare auf jeder Seite vier TTR Exons sollten abged...

Transthyretin (TTR) Amyloidose (ATTR) ist die häufigste Form des erblichen systemische Amyloidose1und kann durch eine autosomal dominant vererbte Mutation im Transthyretin (TTR) gen2verursacht werden. TTR Mutationen destabilisieren die tetrameres Protein-Struktur und führen zu seiner Dissoziation in Monomere, die Amyloid-Fibrillen2setzt. Mehr als 100 Amyloidogenic TTR Mutationen wurden berichteten weltweit1. Genetische Analysen mit der Polymerase-Kettenreaktion (PCR) Methoden bestätigen das Vorhandensein von TTR Punktmutation und haben Vorteile, einschließlich den Umgang mit radioaktiv markierte Sonden im Vergleich zu Südlicher Fleck3zu vermeiden. PCR ist eine schnell, einfach, billig und zuverlässige Technik, die auf zahlreichen Feldern in modernen Wissenschaften4angewendet wurde.
Die Früherkennung dieser progressive und tödliche Krankheit ist schwierig, angesichts ihrer phänotypischen Heterogenität. Mit zunehmender Aufmerksamkeit und breitere Anerkennung auf den frühen Manifestationen der ATTR sowie die aufstrebenden Behandlungen5, sind entsprechende diagnostische Untersuchungen einschließlich TTR Gentest daher kritisch grundlegend für die Prognose zu verbessern. Darüber hinaus sind verschiedene Mutationen im Zusammenhang mit unterschiedlicher Penetranz des Merkmals, Erkrankungsalter, Muster der Progression, schwere der Erkrankung, mediane Überlebenszeit, Wirksamkeit der Lebertransplantation oder TTR Stabilisatoren2,6, und Variable Grad der neurologischen und kardiologischen Beteiligung, die große Auswirkungen auf die genetische Beratung7,8,9haben. Ein hochgenauer Gentest ist übrigens das einzige Werkzeug, das unterscheidet zwei verschiedenen Arten von ATTR: erbliche (mutierten) und Wildtyp (nicht mutierte Form, senile systemische Amyloidose, SSA)7. Es ist zwingend notwendig, um die Arten von ATTR, bestätigen, weil die Therapien2unterschiedlich. Daher ist eine zunehmende Notwendigkeit, das schrittweise Protokoll der TTR-Gentest zu beschreiben.
Die molekularen Ansatz zu erkennen, die Mutation wird mit Ala97Ser, die am häufigsten verwendeten endemische Mutation in Taiwan, als Beispiel veranschaulicht werden. Änderungen in der DNA-Extraktionsschritt reduzieren die Menge der drei Lösungen verwendet und liefert eine ausreichende Menge an DNA. In diesem Protokoll alle vier TTR Exons wurden analysiert, während Regionen einschließlich 5' stromaufwärts, 3' flussabwärts, Promotoren, Introns und unübersetzte Regionen (UTR) wurden nicht sequenziert.

<table border="0" cellpadding="0" cellspacing="0" style="width:951px;" width="951">
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		<col />
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	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">EDTA-treated tubes</td>
			<td style="width:199px;">BD</td>
			<td style="width:347px;"></td>
			<td style="width:192px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">DNA Extraction Kit</td>
			<td style="width:199px;">Stratagen</td>
			<td style="width:347px;">200600</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">NanoDrop ND2000 spectrophotometer&#160;</td>
			<td style="width:199px;">Thermo Fisher Scientific</td>
			<td style="width:347px;">NanoDrop 2000</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">Delicate Task Wipers</td>
			<td style="width:199px;">Kimberly-Clark</td>
			<td style="width:347px;">Kimtech Science Kimwipes</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">AmpliTaq Gold 360 DNA Polymerase kit</td>
			<td style="width:199px;">Applied Biosystems</td>
			<td style="width:347px;">4398823</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">TTR gene intronic primers&#160;</td>
			<td style="width:199px;">Exon1</td>
			<td style="width:347px;">F: 5&#8217;-TCAGATTGGCAGGGATAAGC-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;"></td>
			<td style="width:199px;">Exon1</td>
			<td style="width:347px;">R: 5&#8217;-GCAAAGCTGGAAGGAGTCAC-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;"></td>
			<td style="width:199px;">Exon2</td>
			<td style="width:347px;">F: 5&#8217;-TCTTGTTTCGCTCCAGATTTC-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;"></td>
			<td style="width:199px;">Exon2</td>
			<td style="width:347px;">R: 5&#8217;-TCTACCAAGTGAGGGGCAAA-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;"></td>
			<td style="width:199px;">Exon3</td>
			<td style="width:347px;">F: 5&#8217;-GTGTTAGTTGGTGGGGGTGT-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;"></td>
			<td style="width:199px;">Exon3</td>
			<td style="width:347px;">R: 5&#8217;-TGAGTAAAACTGTGCATTTCCTG-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;"></td>
			<td style="width:199px;">Exon4</td>
			<td style="width:347px;">F: 5&#8217;-GACTTCCGGTGGTCAGTCAT-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;"></td>
			<td style="width:199px;">Exon4</td>
			<td style="width:347px;">R: 5&#8217;-GCGTTCTGCCCAGATACTTT-3&#8217;</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">thermocycler</td>
			<td style="width:199px;">Applied Biosystems</td>
			<td style="width:347px;">GeneAmp PCR System 9700</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">electrophoresis cell&#160;</td>
			<td style="width:199px;">ADVANCE</td>
			<td style="width:347px;">Mupid-2plus</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">DNA ladder</td>
			<td style="width:199px;">Protech</td>
			<td style="width:347px;">PT-M1-100</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">dye</td>
			<td style="width:199px;">BioLabs</td>
			<td style="width:347px;">B7021</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">AlphaImager EC</td>
			<td style="width:199px;">Alpha Innotech</td>
			<td style="width:347px;">AlphaImager EC</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">automatic sequencer&#160;</td>
			<td style="width:199px;">Applied Biosystems</td>
			<td style="width:347px;">3730xl DNA Analyzer</td>
			<td></td>
		</tr>
	</tbody>
</table>

genetic analysis of hereditary transthyretin ala97ser related amyloidosis

Gentests ist der zuverlässigste Test für erbliche Transthyretin Amyloidose und sollte in den meisten Fällen der Transthyretin-Amyloidose (ATTR) durchgeführt werden. ATTR ist eine seltene, aber tödlichen Krankheit mit heterogenen Phänotypen; Daher wird die Diagnose manchmal verzögert. Mit zunehmender Aufmerksamkeit und breitere Anerkennung auf frühen Äusserungen der ATTR sowie aufstrebenden Behandlungen, geeignete diagnostische Studien, einschließlich der genetischen Transthyretin (TTR) zu testen, um die Typen zu bestätigen und Varianten der ATTR sind daher grundlegender Bedeutung für die Prognose zu verbessern. Genetische Analysen mit der Polymerase-Kettenreaktion (PCR) Methoden bestätigen das Vorhandensein von TTR Punktmutationen sehr viel schneller und sicherer als herkömmliche Methoden wie Südlicher Fleck. Hier zeigen wir genetische Bestätigung der ATTR Ala97Ser Mutation, die am häufigsten verwendeten endemische Mutation in Taiwan. Das Protokoll umfasst vier Hauptschritte: Sammeln von Vollblut-Probe, DNA-Extraktion, genetische Analyse der alle vier TTR Exons mit PCR und DNA-Sequenzierung.

Agarose-Gelelektrophorese von zwei Patienten und eine gesunde individuelle offenbarten Bands der erwarteten Größen, einschließlich ein 454 bp-PCR-Produkt für Exon 4 des TTR-Gens (Abbildung 1).
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/57743/57743fig1.jpg"> Abbildung 1 . Gelelektrophorese Darstellung PCR verstärkt TTR gen. Normal...

Watch this Scientific Journal Video about Genetic Analysis of Hereditary Transthyretin Ala97Ser Related Amyloidosis at JoVE.com

Genetic Analysis of Hereditary Transthyretin Ala97Ser Related Amyloidosis

Hier präsentieren wir ein Protokoll bestätigen das Vorhandensein von Punktmutation für die Diagnose einer erblichen Transthyretin-Amyloidose, mit Ala97Ser, die am häufigsten verwendeten endemische Mutation in Taiwan, als Beispiel.

Genetische Analyse der erblichen Transthyretin-Ala97Ser im Zusammenhang mit Amyloidose

Genetic testing is the most reliable test for hereditary transthyretin related amyloidosis and should be performed in most cases of transthyretin ...

With increasing attention on early manifestations of transthyretin amyloidosis as well as emerging treatments appropriate studies to confirm the types and variants of transthyretin amyloidosis are fundamental to improve prognosis. The main advantage of this protocol is that this test is feasible and easy to preform in the clinical laboratory. To begin the protocol obtain a DNA extraction kit, add 10 milliliters of solution one to the previous obtained 4.0 milliliter blood sample and incubate the sample on ice for 10 minutes.After incubation centrifuge the sample at 2000 G for five minutes at four degrees Celsius. Carefully remove and discard the supernatant. Re suspend the pellet in three milliliters of solution one.Centrifuge the sample at 2000 G for five minutes at four degrees Celsius again. Discard the supernatant. Re suspend the pellet in three milliliters of solution two.Next, add 10 microliters of Pronase stock solution to get a final concentration of 100 micrograms per milliliter and mix the contents well. Incubate the DNA at 37 degrees Celsius overnight. The next day, chill the tube on ice for 10 minutes.Add 0.8 milliliters of solution three to the sample and invert it three to five times. Then, place the sample on ice for five minutes. Centrifuge the sample at 3000 G for 15 minutes at four degrees Celsius.Carefully transfer the supernatant to a 15 milliliter sterile conical centrifuge tube and add six microliters of RNase stock solution to obtain a final concentration of 20 micrograms per milliliter. Incubate the sample, add 2.5 milliliters of isopropyl alcohol to the tube and gently invert the tube several times to precipitate the DNA which appears as strands of white flocculant material. With a large bore pipette transfer the precipitate to a new 1.5 milliliter centrifuge tube.Centrifuge the precipitate at 12, 000 G for three minutes at four degrees Celsius. Discard the supernatant carefully. Then wash the DNA pellet by adding 500 microliters of 70%ethanol.Centrifuge the DNA at 12, 000 G for one minute and discard the supernatant. Air dry the DNA pellet at room temperature. Add 100 microliters of DDH2O and incubate the sample at 65 degrees Celsius for 15 minutes to re suspend the DNA.Perform PCR in a 25 microliter reaction mixture using a DNA polymerase kit. Add the reagents to a 0.2 milliliter PCR tube. Mix the contents gently and briefly centrifuge them in a bench top centrifuge.Place the tube in a thermal cycler. Perform the PCR for 30 cycles with a denaturation step for 30 seconds at 94 degrees Celsius, primer enabling for 30 seconds at 58 degrees Celsius and polymerase extension for 45 seconds at 72 degrees Celsius. Prepare a 1.2%agarose gel by mixing 1.2 grams of agarose powder with 100 milliliters of 0.5 XTBE in a microwaveable flask.Microwave the solution for two minutes until the agarose is completely dissolved. Cool down the agarose mixture to 55 degrees Celsius. Add two microliters of ethidium bromide solution to the agarose mixture and mix gently.Pour the mixture into a gel tray to about five to seven millimeters. Then, insert the comb. Allow the gel to solidify for at least 30 minutes.After the gel has solidified carefully remove the comb. Place the gel and tray into the electrophoresis cell. Fill the electrophoresis cell with 0.5 XTBE until the gel is covered.Carefully load two microliters of a 100 base pair DNA ladder into the one lane of the gel as a molecular size marker. Load the dye and sample mixture into the additional lanes. Turn on the power supply and run the gel for 25 minutes at 100 volts.Remove the gel from the electrophoresis cell. Finally, visualize the DNA fragments under UV light in an imaging system. Agarose gel electrophoresis of two patients and one healthy individual reveal bands of the expected sizes including a 454 base pair PCR product for exon four of the TTR gene.Sequence chromatograms disclosed a nucleotide T substitution for G in exon four of the TTR gene resulting in a missense mutation and an alanine to serine substitution at amino acid position 97 in two patients. After watching this video you should have a good understanding of how to confirm the presence of point mutations for the diagnosis of hereditary transthyretin amyloidosis.

Research

JoVE Journal

Medicine

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Forschung

Medizin

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