6 - Molecular Diagnostics Flashcards

1
Q

How was DNA sequenced in the 1970’s and 1980’s?

A

You had to clone the DNA, prep the plasmid from a culture, isolate the fragment from the vector, fun the sequencing reactions, and then fun the products on a gel.

Then transfer the gel from glass plates to filter paper without ripping. Dry them, radiograph and read by hand. Error prone reading.

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2
Q

How did DNA sequencing change in the 1980’s and 1990’s?

A

PCR and fluorescent labeling rather than radioactive.

Could read 4x as much per gel and didn’t need to clone segments because PCR could amplify target.

Optical detection allowed longer electrophoresis, which 4x the read lengths.

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3
Q

What was a benefit of capillary electrophoresis?

A

Faster separation and greater parallel processing capacity.

Overcame trouble of high GC content.

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4
Q

What the characteristics of next-generation sequencing?

A

Adaptor ligation step allowed multiple samples to be analyzed together.

Eliminated physical separation of molecules by electrophoresis.

Reactions performed in situ on solid substrate.

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5
Q

What are some limitations to next-generation sequencing?

A

Read lengths are much shorter, but the number of parallel reactions is much greater.

Net effect: increase capacity ~10^6

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6
Q

What is single nucleotide polymorphism? What makes something polymorphic by definition?

A

Genetic variation when a different base is present than most commonly found.

A site is polymorphic if a minor allele is present at a population freq of >1%.

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7
Q

What is a variant called when it is found at a frequency of < 1% in a population?

A

A SNP, and the locus is not considered polymorphic.

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8
Q

What are two ways that SNPs can be assayed?

A

using RT-PCR or genome-wide genotyping arrays.

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9
Q

How is an RT-PCR done?

A

Allele specific probes with fluorescent dye and a quencher bind to target sequence during annealing phase.

During elongation, quencher and dye are separated yielding a signal.

If the reactions contains both alleles, and each probe has a different colored signal, 2 colors will be generated in equal amts.

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10
Q

How does a SNP genotyping array work?

A

Still uses allele specific hybridization, but on a solid substrate with coordinates of each SNP pre-selected.

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11
Q

What are some limitations to the SNP assays?

A

Limited to specific, previously identified base; incapable of finding variation at other locations (even within same gene).

Unable to detect deletions, as a null allele will appear to be homozygous for the remaining allele.

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12
Q

How does melting-based genotyping work?

A

Mismatched heteroduplexes will melt at lower temps than AT bonds.

Partly denatured DNA migrates differently than single or dsDNA. By separating molecules near melting point, species can be distinguished.

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13
Q

What are the advantages and disadvantages of melting-based genotyping?

A

It can find SNPS and indels in a small region of DNA, but not at a specific position. It’s rapid and relatively inexpensive.

Can’t specify exact variant and can’t distinguish functionally important variants from silent ones. Also insensitive to deletions.

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14
Q

What are indels? How can they be found?

A

Insertion or deletion variants.

Found by comparative genomic hybridization.

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15
Q

What are micro-satellites?

A

Small indel that consists of a tandemly repeated array of a very short repeated sequence.

For most microsatelite loci, the copy number of the repeated sequence turns out to be polymorphic within a pop, but stable from generation to generation to be usable as a mendelian trait.

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16
Q

How is each locus of a microsatellite defined? What happens after PCR products are separated?

A

By a unique sequence flanking the repeat unit.

Alleles are distinguished by size. Each person will have either 1 (homozygous) or 2 (heterozygous) bands.

17
Q

What is the relationship between how common a variant is and its functional impact?

A

There is typically an inverse relationship: the most rare are usually the most functionally lethal.

This makes sense because natural selection would select for less lethal diseases.

18
Q

What is linkage disequilibrium?

A

It’s present when alleles at neighboring loci are associated more frequently than expected by chance alone.

19
Q

What is an example of a clinically relevant polymorphism?

A

Cyt p450 polymorphisms that impact how a drug is metabolized.

20
Q

What is pharmogenomics?

A

A field that seeks to use genetic information to predict response to medication in the hopes of reducing adverse drug responses.

21
Q

What is the function of the cyt p450 family?

A

Major phase 1 enzymes involved in metabolism and bioactivation, accounting for ~75% of total metabolism of drugs and xenobiotics.

22
Q

What two things contribute to cyt p450 related variation in drug metabolism?

A

SNPs and copy number differences.

23
Q

What is the pharmogenomic nomenclature of CYP450 variations?

A

*1 is an extensive, normal metabolism.

For each *n there is a corresponding variant.

24
Q

Why may some patients fail to metabolize Clopidogrel, a platelet inhibitor?

A

It’s a prodrug that needs to be activated by CYP2C19.

People with decreased CYP2C19 (2* or 3) may fail to benefit from the drug, while others with increased CYP2C19 (such as 17) may need reduced doses.

25
Q

What is a SNP microarray?

A

A panel that tests for 1,936 SNPs in 231 genes that affect how we respond to drugs

26
Q

What are some limitations of SNP microarrays?

A

Other factors such as age, ethnicity, and health status may effect metabolism.

Not all potential functional variants will be tested.

Treatments such as transfusions may alter results.

27
Q

What is Multiple Endocrine Neoplasia Type 1 (MEN1)?

A

Tumor syndrome caused by loss of function of MEN1 gene. Autosomal dominant.

28
Q

How can MEN1 be tested for?

A

Capillary sequencing coupled with copy number variation (CNV) analysis.

Sequencing detects SNPs, while CNV detects deletions that would be missed with sequencing alone.

29
Q

How does a copy number variation assays differ from comparative genomic hybridization assays?

A

They are the same type of assays, but CNV assays are confined to the region surrounding the MEN1 gene.

30
Q

What is trinucleotide repeat expansion disease?

A

Class of diseases caused by expansion of trinucleotide tracts within genes.

For each, a number of copy number range remains stable.

31
Q

What is it called in trinucleotide repeat expansion disease when there’s a high number of copies? What can this cause?

A

Premutation, which is the possibility of either replication slipage or unequalcrossing increases.

When the # of repeats exceeds threshold, a person suffers the disease. Excess copy numbers are pathogenic.

32
Q

what is done when there is a novel clinical syndrome?

A

Situation in which next generation sequencing coupled with genomic CGD is the best option.

In this scenario, there’s no prior knowledge that might limit the scope of the search for pathogenic DNA variant.

33
Q

What is difficult about novel clinical syndrome?

A

Sequencing is easy, teh post-sequencing analysis is hard. Many steps of bioinformatic filtering needs to be done to bring down the number of variants detected to a small number of candidates.