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Yıl:2017; Cilt: 28; Sayı: 3>> Özet
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Türk Psikiyatri Dergisi; 2017;28(3):156-162
Otizmli Olgularda Moleküler Karyotipleme Yöntemi ile Genetik Etiyolojinin Aydınlatılması
B Özbaran, B Akgün, D Kaçamak, S Köse, A Kavasoğlu, H Onay
Ege Üniversitesi, İzmir
Amaç: Bu çalışmada, otizmli olgularda moleküler karyotipleme yöntemiyle genom genelinde delesyon ve duplikasyonların araştırılması ve otizm etiyolojisinin daha net olarak aydınlatılabilmesi amaçlanmaktadır. Yöntem: Ege Üniversitesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Polikliniğine başvuran otizm tanısı almış, kromozom analizi ve Frajil X çalışması normal bulunmuş, 4 ile 18 yaşları arasındaki 31 hasta (20 erkek, 11 kız) çalışmaya alınmıştır. DSM-IV-TR tanı kriterlerine göre otizm tanısı alan, belirti şiddet değerlendirmesi Çocukluk Otizmi Derecelendirme Ölçeği (Childhood Autism Rating Scale) ile yapılan olgularda moleküler karyotipleme çalışması yapılmıştır. Bu örneklerden elde edilen DNA’larda Illumina IScan sisteminde 330.000 tek nükleotid polimorfizm (TNP) tarayabilen orta çözünürlükte çipler yardımıyla tüm genom taraması yapılmış ve 10 kb çözünürlükte yapısal anomaliler saptanmaya çalışılmıştır. Bulgular: Çalışmaya alınan olguların tamamında 20 kb-3 mb büyüklüğünde çeşitli kopya sayısı değişiklikleri (KSD) saptanmıştır. KaryoStudio programında ve DGV veritabanı yapılan analizlerle tüm olgularda saptanan değişiklikler değerlendirilmiş ve hastalıkla ilişkili olabilecekler belirlenmiştir. Toplam 9 hastada (%29) klinikle ilişkili olduğu değerlendirilen kopya sayısı değişiklikleri saptanmıştır. Bunlardan 7 tanesi delesyon, 2 tanesi duplikasyondur. Sonuç: Bu çalışma ile ülkemizde ilk defa otizmli olgularda moleküler karyotipleme yöntemi başarıyla uygulanmıştır. Ayrıca orta çözünürlükteki 330.000 TNP içeren çipin, moleküler karyotipleme çalışması için uygun olduğu gösterilmiştir.
The Role of Molecular Karyotyping in the Genetic Etiology of Autism
Objective: The aim of this study was to investigate the deletions and duplications with a molecular karyotyping technique and to elucidate the etiology of autism. Method: A total of 31 patients (20 boys and 11 girls) between 4 to 18 years old with normal chromosomal analysis and no Fragile X mutation were diagnosed in the Ege University Child and Adolescent Psychiatry Clinic with autism (according to DSM-IV-TR criteria) and were enrolled in the study. Symptom severity of the patients was evaluated with a Childhood Autism Rating Scale. Blood samples (EDTA collected) were obtained in order to extract DNA. Whole genome molecular karyotyping analyses were performed with Illumina IScan system by chips, which can scan 330.000 Single Nucleotid Polymorphisms (SNPs) to detect structural anomalies with a 10-kb resolution. Results: All patients had copy number variations (CNV) that sized between 20-kb and 3-Mb. All detected CNVs were analyzed by the help of KaryoStudio software and DGV database. The ones which might be causal and pathogenic were selected. Pathogenic CNVs (7 deletions, 2 duplications) were detected in 9 patients (29%). Conclusion: As a result, this is the first study whereby a molecular karyotyping technique was successfully used in autism patients in Turkey. Moreover, an intermediate resolution of 330.000 SNP chips were proven to be efficient for molecular karyotyping analysis.

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