Abstract
A method based on quantitative fluorescent multiplex PCR has been developed to detect major rearrangements of the low density lipoprotein receptor gene (LDLR) which account for ~5% of mutations. The method involves two PCR reactions; the first (P1) amplifies the selected exons using unique primer sequences tagged with newly designed universal primers, while the second (P2) amplifies the P1 amplicons using the universal primers. One of the P2 universal primers is labelled with a fluorescent dye which is incorporated into the PCR products which are then electrophoresed on an ABI DNA sequencer. The relative amounts of the amplified peak areas are determined and compared to ratios obtained for DNA from four normal controls and known major rearrangements. The multiplex set developed is based on LDLR exons 3, 5, 8, 14, and 17 and 86% of reported major rearrangements would be detectable by this assay as well as any deletions and insertions of greater than 1 bp. The method was evaluated using DNA from 15 reported deletions and duplications which were all correctly identified. Two groups of UK patients with a clinical diagnosis of familial hypercholesterolaemia (FH) and where no mutation had been identified in LDLR or APOB (14 children and 42 adults) were screened for the presence of major LDLR rearrangements by this assay. Three major rearrangements were detected and a 4 bp duplication was identified in a fourth patient. Since it avoids the problems associated with Southern blotting, this method will be useful for detecting gene rearrangements. Keywords: familial hypercholesterolaemia; LDLR; major rearrangements; universal primer quantitative fluorescent multiplex PCR (UPQFM-PCR)
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- Beggs A. H., Koenig M., Boyce F. M., Kunkel L. M. Detection of 98% of DMD/BMD gene deletions by polymerase chain reaction. Hum Genet. 1990 Nov;86(1):45–48. doi: 10.1007/BF00205170. [DOI] [PubMed] [Google Scholar]
- Bertolini S., Garuti R., Lelli W., Rolleri M., Tiozzo R. M., Ghisellini M., Simone M. L., Masturzo P., Elicio N. C., Stefanutti C. Four novel partial deletions of LDL-receptor gene in Italian patients with familial hypercholesterolemia. Arterioscler Thromb Vasc Biol. 1995 Jan;15(1):81–88. doi: 10.1161/01.atv.15.1.81. [DOI] [PubMed] [Google Scholar]
- Bertolini S., Lelli N., Coviello D. A., Ghisellini M., Masturzo P., Tiozzo R., Elicio N., Gaddi A., Calandra S. A large deletion in the LDL receptor gene--the cause of familial hypercholesterolemia in three Italian families: a study that dates back to the 17th century (FH-Pavia). Am J Hum Genet. 1992 Jul;51(1):123–134. [PMC free article] [PubMed] [Google Scholar]
- Bertolini S., Patel D. D., Coviello D. A., Lelli N., Ghisellini M., Tiozzo R., Masturzo P., Elicio N., Knight B. L., Calandra S. Partial duplication of the EGF precursor homology domain of the LDL-receptor protein causing familial hypercholesterolemia (FH-Salerno). J Lipid Res. 1994 Aug;35(8):1422–1430. [PubMed] [Google Scholar]
- Chae J. J., Park Y. B., Kim S. H., Hong S. S., Song G. J., Han K. H., Namkoong Y., Kim H. S., Lee C. C. Two partial deletion mutations involving the same Alu sequence within intron 8 of the LDL receptor gene in Korean patients with familial hypercholesterolemia. Hum Genet. 1997 Feb;99(2):155–163. doi: 10.1007/s004390050331. [DOI] [PubMed] [Google Scholar]
- Chamberlain J. S., Gibbs R. A., Ranier J. E., Nguyen P. N., Caskey C. T. Deletion screening of the Duchenne muscular dystrophy locus via multiplex DNA amplification. Nucleic Acids Res. 1988 Dec 9;16(23):11141–11156. doi: 10.1093/nar/16.23.11141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gudnason V., King-Underwood L., Seed M., Sun X. M., Soutar A. K., Humphries S. E. Identification of recurrent and novel mutations in exon 4 of the LDL receptor gene in patients with familial hypercholesterolemia in the United Kingdom. Arterioscler Thromb. 1993 Jan;13(1):56–63. doi: 10.1161/01.atv.13.1.56. [DOI] [PubMed] [Google Scholar]
- Heath K. E., Gudnason V., Humphries S. E., Seed M. The type of mutation in the low density lipoprotein receptor gene influences the cholesterol-lowering response of the HMG-CoA reductase inhibitor simvastatin in patients with heterozygous familial hypercholesterolaemia. Atherosclerosis. 1999 Mar;143(1):41–54. doi: 10.1016/s0021-9150(98)00274-3. [DOI] [PubMed] [Google Scholar]
- Hobbs H. H., Brown M. S., Goldstein J. L., Russell D. W. Deletion of exon encoding cysteine-rich repeat of low density lipoprotein receptor alters its binding specificity in a subject with familial hypercholesterolemia. J Biol Chem. 1986 Oct 5;261(28):13114–13120. [PubMed] [Google Scholar]
- Hobbs H. H., Brown M. S., Russell D. W., Davignon J., Goldstein J. L. Deletion in the gene for the low-density-lipoprotein receptor in a majority of French Canadians with familial hypercholesterolemia. N Engl J Med. 1987 Sep 17;317(12):734–737. doi: 10.1056/NEJM198709173171204. [DOI] [PubMed] [Google Scholar]
- Hobbs H. H., Russell D. W., Brown M. S., Goldstein J. L. The LDL receptor locus in familial hypercholesterolemia: mutational analysis of a membrane protein. Annu Rev Genet. 1990;24:133–170. doi: 10.1146/annurev.ge.24.120190.001025. [DOI] [PubMed] [Google Scholar]
- Horsthemke B., Dunning A., Humphries S. Identification of deletions in the human low density lipoprotein receptor gene. J Med Genet. 1987 Mar;24(3):144–147. doi: 10.1136/jmg.24.3.144. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ji W., Zhang X. Y., Warshamana G. S., Qu G. Z., Ehrlich M. Effect of internal direct and inverted Alu repeat sequences on PCR. PCR Methods Appl. 1994 Oct;4(2):109–116. doi: 10.1101/gr.4.2.109. [DOI] [PubMed] [Google Scholar]
- Kajinami K., Mabuchi H., Itoh H., Michishita I., Takeda M., Wakasugi T., Koizumi J., Takeda R. New variant of low density lipoprotein receptor gene. FH-Tonami. Arteriosclerosis. 1988 Mar-Apr;8(2):187–192. doi: 10.1161/01.atv.8.2.187. [DOI] [PubMed] [Google Scholar]
- Koivisto P. V., Koivisto U. M., Kovanen P. T., Gylling H., Miettinen T. A., Kontula K. Deletion of exon 15 of the LDL receptor gene is associated with a mild form of familial hypercholesterolemia. FH-Espoo. Arterioscler Thromb. 1993 Nov;13(11):1680–1688. doi: 10.1161/01.atv.13.11.1680. [DOI] [PubMed] [Google Scholar]
- Langlois S., Kastelein J. J., Hayden M. R. Characterization of six partial deletions in the low-density-lipoprotein (LDL) receptor gene causing familial hypercholesterolemia (FH). Am J Hum Genet. 1988 Jul;43(1):60–68. [PMC free article] [PubMed] [Google Scholar]
- Lehrman M. A., Goldstein J. L., Russell D. W., Brown M. S. Duplication of seven exons in LDL receptor gene caused by Alu-Alu recombination in a subject with familial hypercholesterolemia. Cell. 1987 Mar 13;48(5):827–835. doi: 10.1016/0092-8674(87)90079-1. [DOI] [PubMed] [Google Scholar]
- Lehrman M. A., Russell D. W., Goldstein J. L., Brown M. S. Exon-Alu recombination deletes 5 kilobases from the low density lipoprotein receptor gene, producing a null phenotype in familial hypercholesterolemia. Proc Natl Acad Sci U S A. 1986 Jun;83(11):3679–3683. doi: 10.1073/pnas.83.11.3679. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Leitersdorf E., Tobin E. J., Davignon J., Hobbs H. H. Common low-density lipoprotein receptor mutations in the French Canadian population. J Clin Invest. 1990 Apr;85(4):1014–1023. doi: 10.1172/JCI114531. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lelli N., Garuti R., Zambelli F., Cassanelli S., Tiozzo R., Corsini A., Bertolini S., Riva E., Ortisi M. T., Bellù R. Alternative splicing of mutant LDL-receptor mRNA in an Italian patient with familial hypercholesterolemia due to a partial deletion of LDL-receptor gene (FHPotenza). J Lipid Res. 1993 Aug;34(8):1347–1354. [PubMed] [Google Scholar]
- Lelli N., Ghisellini M., Calandra S., Gaddi A., Ciarrocchi A., Coviello D. A., Bertolini S. Duplication of exons 13, 14 and 15 of the LDL-receptor gene in a patient with heterozygous familial hypercholesterolemia. Hum Genet. 1991 Feb;86(4):359–362. doi: 10.1007/BF00201833. [DOI] [PubMed] [Google Scholar]
- Lelli N., Ghisellini M., Gualdi R., Tiozzo R., Calandra S., Gaddi A., Ciarrocchi A., Arca M., Fazio S., Coviello D. A. Characterization of three mutations of the low density lipoprotein receptor gene in Italian patients with familial hypercholesterolemia. Arterioscler Thromb. 1991 Mar-Apr;11(2):234–243. doi: 10.1161/01.atv.11.2.234. [DOI] [PubMed] [Google Scholar]
- Nicolaides N. C., Stoeckert C. J., Jr A simple, efficient method for the separate isolation of RNA and DNA from the same cells. Biotechniques. 1990 Feb;8(2):154–156. [PubMed] [Google Scholar]
- Peeters A. V., Van Gaal L. F., du Plessis L., Lombardi M. P., Havekes L. M., Kotze M. J. Mutational and genetic origin of LDL receptor gene mutations detected in both Belgian and Dutch familial hypercholesterolemics. Hum Genet. 1997 Aug;100(2):266–270. doi: 10.1007/s004390050503. [DOI] [PubMed] [Google Scholar]
- Ried T., Mahler V., Vogt P., Blonden L., van Ommen G. J., Cremer T., Cremer M. Direct carrier detection by in situ suppression hybridization with cosmid clones of the Duchenne/Becker muscular dystrophy locus. Hum Genet. 1990 Oct;85(6):581–586. doi: 10.1007/BF00193578. [DOI] [PubMed] [Google Scholar]
- Roberts R. G., Barby T. F., Manners E., Bobrow M., Bentley D. R. Direct detection of dystrophin gene rearrangements by analysis of dystrophin mRNA in peripheral blood lymphocytes. Am J Hum Genet. 1991 Aug;49(2):298–310. [PMC free article] [PubMed] [Google Scholar]
- Russell D. W., Lehrman M. A., Südhof T. C., Yamamoto T., Davis C. G., Hobbs H. H., Brown M. S., Goldstein J. L. The LDL receptor in familial hypercholesterolemia: use of human mutations to dissect a membrane protein. Cold Spring Harb Symp Quant Biol. 1986;51(Pt 2):811–819. doi: 10.1101/sqb.1986.051.01.094. [DOI] [PubMed] [Google Scholar]
- Rødningen O. K., Leren T. P. Application of long polymerase chain reaction in the study of the LDL receptor gene. Scand J Clin Lab Invest. 1996 Feb;56(1):93–96. doi: 10.1080/00365519609088593. [DOI] [PubMed] [Google Scholar]
- Rüdiger N. S., Heinsvig E. M., Hansen F. A., Faergeman O., Bolund L., Gregersen N. DNA deletions in the low density lipoprotein (LDL) receptor gene in Danish families with familial hypercholesterolemia. Clin Genet. 1991 Jun;39(6):451–462. doi: 10.1111/j.1399-0004.1991.tb03057.x. [DOI] [PubMed] [Google Scholar]
- Segues B., Rozet J. M., Gilbert B., Saugier-Veber P., Rabier D., Saudubray J. M., Carré M., Rouleau F. P., Menget A., Bonardi J. M. Apparent segregation of null alleles ascribed to deletions of the ornithine transcarbamylase gene in congenital hyperammonaemia. Prenat Diagn. 1995 Aug;15(8):757–761. doi: 10.1002/pd.1970150812. [DOI] [PubMed] [Google Scholar]
- Shapiro L. J., Yen P., Pomerantz D., Martin E., Rolewic L., Mohandas T. Molecular studies of deletions at the human steroid sulfatase locus. Proc Natl Acad Sci U S A. 1989 Nov;86(21):8477–8481. doi: 10.1073/pnas.86.21.8477. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shuber A. P., Grondin V. J., Klinger K. W. A simplified procedure for developing multiplex PCRs. Genome Res. 1995 Dec;5(5):488–493. doi: 10.1101/gr.5.5.488. [DOI] [PubMed] [Google Scholar]
- Southern E. M. Detection of specific sequences among DNA fragments separated by gel electrophoresis. J Mol Biol. 1975 Nov 5;98(3):503–517. doi: 10.1016/s0022-2836(75)80083-0. [DOI] [PubMed] [Google Scholar]
- Sun X. M., Webb J. C., Gudnason V., Humphries S., Seed M., Thompson G. R., Knight B. L., Soutar A. K. Characterization of deletions in the LDL receptor gene in patients with familial hypercholesterolemia in the United Kingdom. Arterioscler Thromb. 1992 Jul;12(7):762–770. doi: 10.1161/01.atv.12.7.762. [DOI] [PubMed] [Google Scholar]
- Vnencak-Jones C. L., Phillips J. A., 3rd Hot spots for growth hormone gene deletions in homologous regions outside of Alu repeats. Science. 1990 Dec 21;250(4988):1745–1748. doi: 10.1126/science.1980158. [DOI] [PubMed] [Google Scholar]
- Wilson D. J., Gahan M., Haddad L., Heath K., Whittall R. A., Williams R. R., Humphries S. E., Day I. N. A World Wide Web site for low-density lipoprotein receptor gene mutations in familial hypercholesterolemia: sequence-based, tabular, and direct submission data handling. Am J Cardiol. 1998 Jun 15;81(12):1509–1511. doi: 10.1016/s0002-9149(98)00215-x. [DOI] [PubMed] [Google Scholar]
- Woodward K., Kendall E., Vetrie D., Malcolm S. Pelizaeus-Merzbacher disease: identification of Xq22 proteolipid-protein duplications and characterization of breakpoints by interphase FISH. Am J Hum Genet. 1998 Jul;63(1):207–217. doi: 10.1086/301933. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yamamoto T., Davis C. G., Brown M. S., Schneider W. J., Casey M. L., Goldstein J. L., Russell D. W. The human LDL receptor: a cysteine-rich protein with multiple Alu sequences in its mRNA. Cell. 1984 Nov;39(1):27–38. doi: 10.1016/0092-8674(84)90188-0. [DOI] [PubMed] [Google Scholar]
- Yau S. C., Bobrow M., Mathew C. G., Abbs S. J. Accurate diagnosis of carriers of deletions and duplications in Duchenne/Becker muscular dystrophy by fluorescent dosage analysis. J Med Genet. 1996 Jul;33(7):550–558. doi: 10.1136/jmg.33.7.550. [DOI] [PMC free article] [PubMed] [Google Scholar]
- den Dunnen J. T., Bakker E., Breteler E. G., Pearson P. L., van Ommen G. J. Direct detection of more than 50% of the Duchenne muscular dystrophy mutations by field inversion gels. Nature. 1987 Oct 15;329(6140):640–642. doi: 10.1038/329640a0. [DOI] [PubMed] [Google Scholar]