亨廷顿氏病的植入前遗传学诊断--病例报告和文献综述

Denise Maria Christofolini, José Ricardo Magliocco Ceroni, Bianca Alves Vieira Bianco, Caio Parente Barbosa
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摘要

背景:亨廷顿氏病是一种罕见的神经退行性常染色体显性遗传病,成年后发病,病因是 HTT 基因中 36 个或更多的 CAG 三核苷酸重复序列扩增。 在巴西和其他一些国家,接受体外受精程序的 HTT 扩增等位基因携带者可以对胚胎进行遗传学调查,以确定哪些胚胎遗传了扩增等位基因,哪些胚胎只遗传了正常大小的等位基因。在某些情况下,一个人有阳性的家族病史,不想知道自己的携带者身份,但愿意怀上没有这种疾病的孩子。目的:通过病例报告和文献综述,展示亨廷顿病患者生育的可能性。方法:在此,我们以一个未公开的植入前基因检测(PGT)病例为基础,讨论基因筛查技术的应用和可行性。结果:一对夫妇接受了亨廷顿病的非公开检测,由于有家族病史,他们接受了体外受精、胚胎活检和样本基因分析。进行了染色体和突变特异性检测,并选择了一个胚胎进行子宫移植。这对夫妇没有被告知其他胚胎被取出的原因。结论尽管这一决定涉及许多伦理和实际方面的问题,但除了精子、卵子或胚胎收养或儿童收养外,还可以为这些夫妇提供不公开的 PGT 作为一种选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PREIMPLANTATION GENETIC DIAGNOSIS FOR HUNTINGTON’S DISEASE - CASE REPORT AND LITERATURE REVIEW
Background: Huntington’s disease is a rare, neurodegenerative, autosomal dominant disorder with adult onset caused by an expansion of 36 or more CAG trinucleotide repeats in the HTT gene.  In Brazil and in some other countries, carriers of HTT’s expanded allele of submitted to in vitro fertilization procedure can investigate embryos genetically to identify the ones that have inherited the expanded allele and the ones that inherited only the normal size alleles. In some instances, an individual has a positive familial history for the disease and do not want to know his/her personal carrier status but is willing to conceive children without the disease. Objective: to demonstrate the reproductive possibilities available to patients with Huntington disease through a case report and literature review. Methods: Here, we discussed the application and viability of the genetic screening techniques, based on a non-disclosure case of Preimplantation Genetic Testing (PGT). Results: a couple submitted to a non-disclosure test for Huntington disease was submitted to IVF, embryo biopsy and genetic analysis of the samples due to a familial history of the condition. Chromosome and mutation specific tests were applied, and one embryo was selected for uterine transfer. The couple was not informed why the other embryos were discharged. Conclusion: Although many ethical and practical aspects are involved in this decision, a non-disclosure PGT can be offered as an option for these couples, besides sperm, egg or embryo adoption, or child adoption.
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