Validation of a Fast, Robust, Inexpensive, Two-Tiered Neonatal Screening Test algorithm on Dried Blood Spots for Spinal Muscular Atrophy.
Strunk. Annuska A; Abbes. Andre A; Stuitje. Antoine R AR; Hettinga. Chris C; Sepers. Eline M EM; Snetselaar. Reinier R; Schouten. Jan J; Asselman. Fay-Lynn FL; Cuppen. Inge I; Lemmink. Henny H; van der Pol. W Ludo WL; Engel. Henk H
Key Findings
- The new MC002 melting‑curve assay detects the absence of SMN1 exon 7 with 100% sensitivity and specificity.
- The test works on three common PCR platforms and does not mistakenly flag carriers.
- Using the P021‑B1 version, the assay can also accurately determine SMN2 copy number from dried blood spots.
Practical Outcomes
- The main takeaway is that a low‑cost, reliable SMA newborn screening method is now available, which could be adopted by public health labs worldwide. For individual health‑optimizers, the relevance is limited unless they are involved in neonatal testing or advocacy for early‑treatment programs.
Summary
Scientists created a cheap, fast test that can spot babies who lack the SMN1 gene, which causes spinal muscular atrophy (SMA). The test works on dried blood spots, is 100% accurate in the study, and can also tell how many copies of the related SMN2 gene a patient has. While this is great for newborn screening programs, it doesn't directly change how most biohackers or self‑experimenters manage their own health.
Abstract
Spinal muscular atrophy (SMA) is one of the leading genetic causes of infant mortality with an incidence of 1:10,000. The recently-introduced antisense oligonucleotide treatment improves the outcome of this disease, in particular when applied at an early stage of progression. The genetic cause of SMA is, in >95% of cases, a homozygous deletion of the survival motor neuron 1 (<i>SMN1</i>) gene, which makes the low-cost detection of SMA cases as part of newborn screening programs feasible. We developed and validated a new SALSA MC002 melting curve assay that detects the absence of the <i>SMN1</i> exon 7 DNA sequence without detecting asymptomatic carriers and reliably discriminates <i>SMN1</i> from its genetic homolog <i>SMN2</i> using crude extracts from newborn screening cards. Melting curve analysis shows peaks specific for both the <i>SMN1</i> gene and the disease modifying <i>SMN2</i> homolog. The detection of the <i>SMN2</i> homolog, of which the only clinically relevant difference from the <i>SMN1</i> gene is a single nucleotide in exon 7, was only used to confirm a correct reaction in samples that lacked the <i>SMN1</i> gene, and not for <i>SMN2</i> quantification. We retrieved 47 DBS samples from children with genetically-confirmed SMA, after informed consent from parents, and 375 controls from the national archive of the Dutch National Institute for Public Health and the Environment (RIVM). The assay correctly identified all anonymized and randomized SMA and control samples (i.e., sensitivity and specificity of 100%), without the detection of carriers, on the three most commonly-used PCR platforms with melting curve analysis. This test's concordance with the second-tier 'golden standard' P021 SMA MLPA test was 100%. Using the new P021-B1 version, crude extracts from DBS cards could also be used to determine the <i>SMN2</i> copy number of SMA patients with a high level of accuracy. The MC002 test showed the feasibility and accuracy of SMA screening in a neonatal screening program.
Study Information
pubmed
2019
2019-05-15T00:00:00.000Z
10.3390/ijns5020021
16
28