Maria Erali1, David C. Pattison1, Nancy H. Augustine2, Harry R. Hill1,2, Carl T. Wittwer1,2 1 ARUP Institute for Clinical & Experimental Pathology, United States of America; 2 Department of Pathology, University of Utah, United States of America |
Abstract
Chronic Granulomatous Disease (CGD) is an inherited disorder affecting immune system cells. The most common defects in CGD are mutations in CYBB that encodes the gp91-phox protein component of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system in phagocytes. The syndrome associated with these mutations is called X-linked CGD and accounts for ~65% of CGD cases. The next most common mutation is a GT deletion in NCF1 that encodes the p47-phox protein of the NADPH oxidase system. This autosomal recessive defect is found in ~25% of CGD cases. High resolution melting analysis (HRMA) of amplicons was used to develop a mutation scanning assay for 13 CYBB exons and a control exon. HRMA of an unlabeled probe was used for a SNP detection assay for the GT deletion in NCF1. Specimen DNA was extracted on a MagNA Pure Compact and quantified on the NanoDrop 8000 spectrophotometer. For the mutation scanning assay, pre-coated 96-well PCR plates were prepared with M13 tailed CYBB exon specific primers using a Nanodrop Express.PCR was performed on a C1000 thermal cycler followed by HRMA on the LightScanner. Cycle sequencing was done only on those rare exons that contained variations. Sequence analysis was accomplished on a 16-capillary 3130xl Genetic Analyzer. For the autosomal recessive CGD assay, primers were designed to amplify an 80 base pair region covering the end of intron 1 and the start of exon 2 of NCF1 where the GT deletion is located. An unlabeled probe was designed to match the wild-type sequence. Asymmetric PCR and melting analysis were performed on the LightScanner 32 with appropriate controls. The mutation scanning assay allowed negative patient results to be reported in ~3 hours. Specimens identified with variations could then be cycle sequenced, purified, and sequenced by capillary electrophoreses. Following data analysis, the specific variations could be reported within 6 hours. If no variations were identified in the CYBB mutation scanning assay, the unlabeled probe assay could be run to determine the NCF1 GT deletion genotype and results were known within 2 hours. These assays have provided methods for the reliable and timely analysis of patient specimens without the need for extensive sequencing or the use of labeled oligos. Data from a number of clinical specimens are provided as examples.
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