
MOLECULAR DIAGNOSTICS OF
BULGARIAN PATIENTS WITH CMT1
USING POLYMORPHIC DNA MARKERS
Ivanova N1, Jordanova A1, Kantardjieva A1, Tournev I2,
Ishpekova B2, Gergelcheva V2, Daskalov M2, Litvinenko I3,
Veleva S2, Mitev V4, Kremensky I1
*Corresponding Author: Dr. Albena Jordanova, Laboratory of Molecular Pathology, Sofia Medical Univer¬sity, 1431 Sofia, Bulgaria; Tel: +359 2 9520124; Fax: +359 2 9520490; E-mail: ajordanova@excite.com page: 41
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INTRODUCTION
Charcot-Marie-Tooth (CMT) disease, a hereditary motor and sensory neuropathy, is the most common inherited disorder of the peripheral nervous system with a prevalence of 1/2500 [1]. It is a genetically and clinically heterogeneous group of disorders with the most common type designated as CMT1 [2]. The majority of CMT1 cases are due to reciprocal 1.5 Mb duplication/deletion in chromosome 17p11.2, that results in two clinically different neuropathies named CMT1A and HNPP, respectively [3]. CMT1A is demonstrated by progressive symmetrical weakness and atrophy of the distal limb muscles, reduced or absent deep-tendon reflexes, decreased nerve conduction velocities and characteristic segmental de- and remyelination named “onion bulb formation” [4]. HNPP is characterized by recurrent nerve palsies resulting from minor trauma. Histopathological findings from nerve biopsies of HNPP patients show typical sausage-like thickening called “tomacula” [4]. Both CMT1A and HNPP are responsible for about 80% of autosomal-dominant CMT1 cases. The duplicated/deleted region encompasses the genes responsible for expression of peripheral myelin protein 22 (PMP22) and a gene dosage
effect has been hypothesized as underlying the pathological mechanism for development of the following neuro-degenerative processes [5].
Southern blotting, pulsed field gel electrophoresis, and fluorescent in situ hybridization have recently been used for molecular genetic diagnostic purposes [6]. Polymerase chain reaction (PCR)-based strategy for the determination of the PMP22 gene copies, based on comparison between co-amplified fragments containing PMP22 and the reporter gene [7], have also been reported. Although new and attractive detection methods have been developed, the method of choice for many laboratories still remains segregation analysis with polymorphic markers closely linked to the CMT1 region. By quantification of the PCR amplification, we developed a quick and reliable combined PCR-fluorescent detection strategy to find the 1.5 Mb duplication. Using this approach, we studied 57 Bulgarian families for two highly polymorphic markers D17S122 and D17S921, and found statistically significant differences between patients and healthy individuals with common electrophoretic patterns.
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