Abstract
Background
Tandem mass spectrometry (MS/MS) has been used for newborn screening (NBS) of inherited metabolic diseases (IMDs) for decades. However, the traditional approach can yield false-positive or false-negative results and is affected by biochemical substrate-level fluctuations. To overcome the current limitations, we explored the possibility of using next-generation sequencing (NGS) as a second-tier diagnostic test to detect gene mutations in samples with abnormal MS/MS results.
Methods
Genomic DNA was extracted from dried blood spots and we designed a multigene panel, comprising 77 genes related to over 40 IMDs, for NBS. The prepared libraries were sequenced on the Ion Personal Genome Machine (PGM) platform. Thirty-eight samples identified as abnormal by MS/MS were tested for the diagnostic accuracy of NGS compared with Sanger sequencing.
Results
The concentration of DNA extracted from the 38 dried blood spots was sufficient for library preparation. The coverage and depth of the sequencing data were sufficient for the analysis. For all samples, the NGS results were consistent with the Sanger sequencing results.
Conclusions
The genomic DNA extracted from dried blood spots could be used for NGS, generating reliable sequencing results, and NGS may function as a second-tier diagnostic test for NBS. Ion PGM could facilitate the molecular diagnosis of IMDs with appropriate primers designed for candidate genes.
Acknowledgments
We are grateful to the patients and their parents for their participation; we also express our deep gratitude to all the pediatricians involved in the study.
Author contributions: All the authors have accepted responsibility for the entire content of the submitted manuscript and approved submission.
Research funding: This study was funded by the “National Natural Science Foundation of China” Funder ID: 10.13039/501100001809 (No. 81670812, to YYG); the “Innovation Fund for Translational Medicine Plan” from the Shanghai Jiao Tong University School of Medicine (No. 15ZH3003, to YYG); the “Jiaotong University Cross Biomedical Engineering” (No. YG2017MS72, to YGY); the “Shanghai Municipal Commission of Health and Family Planning” (No. 201740192, to YGY); the “Shanghai Shen Kang Hospital Development Center new frontier technology joint project” (No. SHDC12017109, to YGY).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2018-0088).
©2018 Walter de Gruyter GmbH, Berlin/Boston
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