
CLINICAL AND MOLECULAR DATA ON
MENTAL RETARDATION IN BULGARIA Todorov T1#, Todorova A1#, Avdjieva D2, Dimova P3,
Angelova L4, Tincheva R2 and Mitev V1 *Corresponding Author: Tihomir Todorov, Department of Medical Chemistry and Biochemistry,
Sofia Medical University, 2 “Zdrave” str., Sofia 1431, Bulgaria; Tel./Fax: +359 29530715;
tisho.todorov@abv.bg page: 11
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PROTOCOLS FOR MECP2, CDKL5 and ARX GENE ANALYSIS
Sequencing. These X-chromosome genes were
directly sequenced, as all the exons (including the
first non coding one for the MECP2 gene) and
intron/exon splice site borders were included/
covered. The sequence of primers used for PCR
amplification was taken from the literature [6,12,13]
or designed in our laboratory (the primer sequence
is available upon request). Standard PCR conditions
were applied: primer concentration 0.4 μM, 0.2
mM dNTPs, 0.4 M Betaine (Sigma, St. Louis, MO,
USA), 4% DMSO; 1× supplied PCR reaction buffer
(Genet Bio, Chungnam, Korea) and 0.5U Prime
Taq (Genet Bio). The annealing temperature varied
between 55°C and 68°C.
The PCR products were purified by PCR
Product Pre-Sequencing Kit (USB, Affymetrix, Inc.,
Santa Clara, CA, USA) containing 4 U exonuclease
I (10 U/μL) and 0.8 U shrimp alkaline phosphatase
(2 U/μL). The sequencing reaction was performed by ABI PRISM™ BigDye Terminator v.3.1 Cycle
Sequencing Kit (Applied Biosystems) and analyzed
on an ABI PRISM™ 310 Genetic Analyzer (Applied
Biosystems).
MLPA analysis. The SALSA MLPA P015-D1
MECP2 probemix was used to screen for large
deletions/ duplications along the genes MECP2,
CDKL5 and ARX. The analysis was performed
following the manufacturer’s instructions [14]. Fifty
to 200 ng of DNA was diluted in TE buffer to a total
volume of 5 μL. The diluted samples were subjected
to hybridization with the probes specific for the
MECP2, CDKL5 and ARX genes, and 17 control
probes. Hybridization was performed overnight at
60°C. Hybridized probes were ligated by a specific
ligase mix, provided by the manufacturer. The final
step represents PCR amplification of the obtained
ligated fragments. The PCR buffer, PCR primers (6-
FAM labeled), the enzyme dilution buffer and the
polymerase were provided in the kit.
The obtained PCR products were analyzed on
an ABI PRISM™ 310 Genetic Analyzer (Applied
Biosystems) in the presence of ROX500 size
standard (Applied Biosystems). Each patient sample
was analyzed simultaneously with at least two
normal controls. The relative peak ratios in order to
assess deletions were calculated using the formula:
r = (peak areapatient/mean peak area both neighbouring
control peakspatient)/(peak areacontrol/mean peak area
both neighbouring control peakscontrol). Relative
ratio of <0.6 corresponded to a deletion.
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