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发育医学电子杂志  2025, Vol. 13 Issue (3): 225-233    DOI: 10.3969/j.issn.2095-5340.2025.03.011
  结构畸形   综述 |
细胞外胎儿DNA 检测诊断21- 羟化酶缺陷致女胎男性化畸形的研究现状
肖兆铭 岑金朋 王涛 甄楚倩 李清 赵善超
(1. 南方医科大学第三附属医院 泌尿外科,广东 广州 510000 ;2. 南方医科大学南方医院 泌尿外科,广东 广州 510000 ;3. 南方医科大学第五附属医院 泌尿外科,广东 广州 510000)
Research status of extracellular fetal DNA testing for diagnosing virilization malformations in female fetus caused by 21-hydroxylase deficiency
Xiao Zhaoming, Cen Jinpeng, Wang Tao, et al
(1. Department ofUrology, the Third Affiliated Hospital of Southern Medical University, Guangdong, Guangzhou 510000,China; 2. Department of Urology, Nanfang Hospital of Southern Medical University, Guangdong, Guangzhou510000, China; 3. Department of Urology, the Fifth Affiliated Hospital of Southern Medical University,Guangdong, Guangzhou 510000, China)
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摘要 【摘要】 妊娠早期地塞米松补充是逆转21- 羟化酶缺陷致女性胎儿外生殖器男性化畸形的重要临床策
略。但现有产前诊断措施不能及时检出致病基因,导致过量地塞米松治疗而损害母婴健康。胎儿绒毛
细胞凋亡可释放胎儿基因组DNA 进入母体循环,形成细胞外胎儿DNA 组分,可被二代靶向测序技术
检出,推断胎儿致病基因型。目前,临床诊疗方案可在妊娠第7 周检出致病基因并实现合理的地塞米松
干预治疗,同时避免以往方案中羊膜穿刺所带来的流产风险。
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关键词:  21- 羟化酶  先天性肾上腺增生症  细胞外胎儿DNA  外生殖器男性化畸形  无创筛查    
Abstract: 【Abstract】Supplement of dexamethasone before 9th week of pregnancy is a critical strategy in preventingthe virilization malformations in female due to 21-hydroxylase deficiency. However, current prenataldiagnostic methods are not competent in recognizing fetus possessing risky genotypes of 21-hydroxylasedeficiency at first trimister of pregnancy, resulting in dexamethasone over-treatments as a potential threatento the health in both maternal and infant. The fetus genomic DNA would be released into maternal plasmaduring the apoptosis of fetal chorionic villi cells, as a component named extracellular fetal DNA in maternalplasma which can be detected by targeted next generation sequencing to deduce the genotypes inherited by fetus.Currently, diagnostic strategy, based on the targeted sequencing of extracellular DNA from maternal plasma,can establish the timely diagnosis of risky genotypes of 21-hydroxylase deficiency at 7th pregnancy week, thusachieving the proper supplement of dexamethasone with reduced risk of miscarriage raised by amniocentesis
Key words:  21-hydroxylase    Congenital adrenal hyperplasia    Extracellular fetal DNA    Virilizationmalformations in female fetus    Non-invasive screen
收稿日期:  2023-11-22                     发布日期:  2025-05-31     
通讯作者:  赵善超    E-mail:  zhaoshanchao@263.net
引用本文:    
肖兆铭 岑金朋 王涛 甄楚倩 李清 赵善超. 细胞外胎儿DNA 检测诊断21- 羟化酶缺陷致女胎男性化畸形的研究现状[J]. 发育医学电子杂志, 2025, 13(3): 225-233.
Xiao Zhaoming, Cen Jinpeng, Wang Tao, et al. Research status of extracellular fetal DNA testing for diagnosing virilization malformations in female fetus caused by 21-hydroxylase deficiency. Journal of Developmental Medicine(Electronic Version), 2025, 13(3): 225-233.
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