1. High-throughput STELA provides a rapid test for the diagnosis of telomere biology disorders.
- Author
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Norris K, Walne AJ, Ponsford MJ, Cleal K, Grimstead JW, Ellison A, Alnajar J, Dokal I, Vulliamy T, and Baird DM
- Subjects
- Adolescent, Adult, Age Factors, Aged, Asymptomatic Diseases, Bone Marrow Failure Disorders genetics, Bone Marrow Failure Disorders pathology, Case-Control Studies, Child, Child, Preschool, Dyskeratosis Congenita genetics, Dyskeratosis Congenita pathology, Female, Fetal Growth Retardation genetics, Fetal Growth Retardation pathology, Heterozygote, Humans, Infant, Intellectual Disability genetics, Intellectual Disability pathology, Male, Microcephaly genetics, Microcephaly pathology, Middle Aged, Severity of Illness Index, Survival Analysis, Telomere metabolism, Telomere Homeostasis, Bone Marrow Failure Disorders diagnosis, Dyskeratosis Congenita diagnosis, Fetal Growth Retardation diagnosis, Genetic Carrier Screening methods, Intellectual Disability diagnosis, Microcephaly diagnosis, Telomere pathology
- Abstract
Telomere biology disorders are complex clinical conditions that arise due to mutations in genes required for telomere maintenance. Telomere length has been utilised as part of the diagnostic work-up of patients with these diseases; here, we have tested the utility of high-throughput STELA (HT-STELA) for this purpose. HT-STELA was applied to a cohort of unaffected individuals (n = 171) and a retrospective cohort of mutation carriers (n = 172). HT-STELA displayed a low measurement error with inter- and intra-assay coefficient of variance of 2.3% and 1.8%, respectively. Whilst telomere length in unaffected individuals declined as a function of age, telomere length in mutation carriers appeared to increase due to a preponderance of shorter telomeres detected in younger individuals (< 20 years of age). These individuals were more severely affected, and age-adjusted telomere length differentials could be used to stratify the cohort for overall survival (Hazard Ratio = 5.6 (1.5-20.5); p < 0.0001). Telomere lengths of asymptomatic mutation carriers were shorter than controls (p < 0.0001), but longer than symptomatic mutation carriers (p < 0.0001) and telomere length heterogeneity was dependent on the diagnosis and mutational status. Our data show that the ability of HT-STELA to detect short telomere lengths, that are not readily detected with other methods, means it can provide powerful diagnostic discrimination and prognostic information. The rapid format, with a low measurement error, demonstrates that HT-STELA is a new high-quality laboratory test for the clinical diagnosis of an underlying telomeropathy.
- Published
- 2021
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