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Biomedical subjects

J A Phillips

Publications and source records attributed to J A Phillips.

240 records · Page 14Linked to original sources

An improved polymerase chain reaction (PCR) protocol for unambigous detection of growth hormone gene deletions.

hGH-1 gene deletions are detected by simultaneous PCR amplification along the two homologous DNA sequences flanking the hGH-1 gene on both sides and are differentiated by SmaI restriction enzyme digestion. We have observed that among the SmaI digested PCR products from normal homozygous subjects, from those heterozygous for the 7.6 kb deletion and from those heterozygous for a 6.7 kb deletion, along with the expected fragments there is an unexpected 1470 bp fragment. This fragment arises from the co-amplification of a third homologous sequence located downstream from the hGH-1 gene and it confuses differentiation between normal homozygous and heterozygous for 7.6 kb subjects from the 6.7 kb heterozygous subjects. To overcome this problem we have improved PCR conditions using a different reverse primer. These changes avoid the interaction of the primers with the third homologous sequence located downstream from the hGH-1 gene and prevent the appearance of this additional band that complicates the interpretation of the results. We conclude that the new reverse primer sequence avoids the amplification of the downstream hGH-1 gene sequence and the production of the 1474 bp band after SmaI endonuclease enzyme digestion and makes it possible to differentiate homozygous normal subjects and those who are heterozygous for a 7.6 kb deletion from those who are heterozygous for a 6.7 kb deletion.

Ethidium↗

Recombinant human acid alpha-glucosidase enzyme therapy for infantile glycogen storage disease type II: results of a phase I/II clinical trial.

PURPOSE: Infantile glycogen storage disease type II (GSD-II) is a fatal genetic muscle disorder caused by deficiency of acid alpha-glucosidase (GAA). The purpose of this study was to investigate the safety and efficacy of recombinant human GAA (rhGAA) enzyme therapy for this fatal disorder. METHODS: The study was designed as a phase I/II, open-label, single-dose study of rhGAA infused intravenously twice weekly in three infants with infantile GSD-II. rhGAA used in this study was purified from genetically engineered Chinese hamster ovary (CHO) cells overproducing GAA. Adverse effects and efficacy of rhGAA upon cardiac, pulmonary, neurologic, and motor functions were evaluated during 1 year of the trial period. The primary end point assessed was heart failure-free survival at 1 year of age. This was based on historical control data that virtually all patients died of cardiac failure by 1 year of age. RESULTS: The results of more than 250 infusions showed that rhGAA was generally well tolerated. Steady decreases in heart size and maintenance of normal cardiac function for more than 1 year were observed in all three infants. These infants have well passed the critical age of 1 year (currently 16, 18, and 22 months old) and continue to have normal cardiac function. Improvements of skeletal muscle functions were also noted; one patient showed marked improvement and currently has normal muscle tone and strength as well as normal neurologic and Denver developmental evaluations. Muscle biopsies confirmed that dramatic reductions in glycogen accumulation had occurred after rhGAA treatment in this patient. CONCLUSIONS: This phase I/II first study of recombinant human GAA derived from CHO cells showed that rhGAA is capable of improving cardiac and skeletal muscle functions in infantile GSD-II patients. Further study will be needed to assess the overall potential of this therapy.

Age Factors↗

Prenatal diagnosis of sickle cell anemia and beta-thalassemia by amniocentesis.

Prenatal diagnosis by amniocentesis alone is possible for about 90% of pregnancies at risk for sickle cell anemia and about 70-75% of pregnancies at risk for beta-thalassemia. It should be stressed that to obtain these percentages, a previous homozygous normal or affected child or, alternatively, the couple's parents are needed to confirm the linkage of variant genes to respective DNA markers (polymorphic restriction sites). Families at risk should be studied prior to or early in pregnancy to determine whether these methods will be applicable to their specific case. If appropriate markers are identified and their linkage to the genes being studied is verified, then prenatal diagnosis by amniocentesis can be done at 16-18 weeks; and for these couples, fetoscopy, with its increased risk of fetal loss, can be avoided. The change of errors in diagnosis due to crossing-over between the mutant gene and the linked marker is small. The probability of such a recombination between the beta-globin gene and the polymorphic G gamma Hind III or the 3' Hpa I site is 1/3,000 and 1/14,000 per generation, respectively (13). A more serious problem is non-paternity because of the errors caused in linkage analysis. Improved methods to enable direct detection of the beta S and/or beta thal mutations would remove both of these potential sources of error.

Amniocentesis↗