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

Desideriamo ringraziare Miss Shin-Fun Wu per il suo aiuto negli esperimenti. Questo studio è stato sostenuto da una sovvenzione dal programma di ricerca medica di Chang Gung (CMRPG3C0371, CMRPG3C0372, CMRPG3C0373) e IRB 100-4470A3, 104-2462A3, Taiwan.

I test eseguiti in laboratorio è stato effettuato in conformità con i requisiti della clinica laboratorio miglioramento emendamenti (CLIA) del 1988, il regolamento, approvato dal Consiglio di revisione istituzionale di Chang Gung Memorial Hospital e Università (licenza n. 100 - 4470A3 e 104-2462A3). Consenso informato è stato ottenuto da tutti i pazienti.
1. raccolta di campioni di sangue
<ol><li>Prelevare il sangue intero in provette EDTA-trattati commercialmente disponibili. Mescolare ...

<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. 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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. 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Ci sono due passaggi critici all'interno del protocollo. In primo luogo, al fine di avere un numero sufficiente di cellule bianche del sangue, un esemplare di hemodiluted dovrebbe essere evitato11. In secondo luogo, l'uso appropriati degli iniettori di PCR è fondamentale per ottenere risultati affidabili12. Abbiamo utilizzato lo strumento web di Primer-BLAST per progettare il primer4,13; un minimo di 40 paia di bas...

Amiloidosi da transtiretina (TTR) (ATTR) sono la forma più comune di amiloidosi sistemica1e possono essere causato da una mutazione dominante ereditata autosomal in gene transtiretina (TTR)2. Mutazioni di TTR destabilizzano la struttura della proteina tetramerica e portano alla sua dissociazione nei monomeri che ricompone in fibrille amiloidi2. Più di 100 mutazioni di TTR amiloidogeniche sono stati segnalati in tutto il mondo1. Analisi genetiche con metodi di reazione a catena (PCR) polimerasi confermano la presenza di mutazione di punto TTR e presentano vantaggi tra cui evitare la manipolazione della sonda marcata radioattivamente a rispetto del sud della macchia3. PCR è una tecnica veloce, facile, economico e affidabile che è stata applicata in numerosi campi in scienze moderne4.
La diagnosi precoce di questa malattia progressiva e fatale è impegnativa, data la sua eterogeneità fenotipica. Con l'aumento dell'attenzione e riconoscimento più ampio su manifestazioni iniziali di ATTR, nonché i trattamenti emergenti5, studi diagnostici adatti tra cui test genetico TTR sono quindi criticamente fondamentali per migliorare la prognosi. Inoltre, mutazioni differenti sono associate con diversa penetranza del tratto, l'età di esordio, i modelli di progressione, sopravvivenza mediana, la gravità della malattia e l'efficacia di trapianto del fegato, o TTR stabilizzatori2,6, e gradi variabili di coinvolgimento neurologico e cardiologico, che hanno grandi implicazioni per la consulenza genetica7,8,9. Inoltre, un accurato test genetico è l'unico strumento che differenzia i due tipi distinti di ATTR: ereditaria (mutante) e wild type (forma non mutante, amiloidosi sistemica senile, SSA)7. È indispensabile per confermare i tipi di ATTR, perché le terapie variano ampiamente2. Di conseguenza, c'è una crescente necessità di descrivere il protocollo graduale del test genetico TTR.
L'approccio molecolare per rilevare la mutazione sarà illustrato utilizzando Ala97Ser, la mutazione più comune endemica in Taiwan, come esempio. Modifiche in fase di estrazione di DNA ridurre la quantità delle tre soluzioni utilizzate e produce una quantità sufficiente di DNA. In questo protocollo, tutti e quattro gli essoni TTR sono stati analizzati, mentre le regioni tra cui 5' a Monte, 3' a valle, promotori, introni, e regioni non tradotte (UTR) non sono state sequenziate.

<table border="0" cellpadding="0" cellspacing="0" style="width:951px;" width="951">
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	</colgroup>
	<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

Test genetici è la prova più affidabile per transthyretin ereditario legate amiloidosi e deve essere eseguita nella maggior parte dei casi di amiloidosi da transtiretina (ATTR). ATTR è una malattia rara ma fatale con fenotipi eterogenei; di conseguenza, la diagnosi a volte è in ritardo. Con l'aumento dell'attenzione e riconoscimento più ampio su manifestazioni iniziali di ATTR, nonché trattamenti emergenti, studi diagnostici appropriati, tra cui la transtiretina (TTR) genetica test, per confermare i tipi e varianti di ATTR sono pertanto fondamentale per migliorare la prognosi. Analisi genetiche con metodi di reazione a catena (PCR) polimerasi confermano la presenza di mutazioni puntiformi TTR molto più rapidamente e più sicuro rispetto ai metodi tradizionali come la macchia del sud. Qui, dimostriamo la conferma genetica della mutazione ATTR Ala97Ser, la mutazione più comune endemica in Taiwan. Il protocollo comprende quattro fasi principali: raccolta dei campioni di sangue intero, estrazione del DNA, l'analisi genetica di tutti e quattro gli essoni TTR con PCR e sequenziamento del DNA.

Elettroforesi del gel dell'agarosi di due pazienti e un sano singole bande ha rivelato delle dimensioni previste, tra cui un prodotto PCR di bp 454 per esone 4 del gene TTR (Figura 1).
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/57743/57743fig1.jpg"> Figura 1 . Elettroforesi del gel raffigurante PCR amplificato gene TTR. Normale: un in...

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

Qui, presentiamo un protocollo per confermare la presenza di mutazione di punto per la diagnosi di amiloidosi ereditaria da transtiretina, utilizzando Ala97Ser, la mutazione più comune endemica in Taiwan, come esempio.

L'analisi genetica di ereditario Transthyretin Ala97Ser relative amiloidosi

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

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