CARRIER DETECTION FOR PRENATAL-DIAGNOSIS OF HEMOPHILIA-A IN ITALIAN FAMILIES

Background. The results obtained from a comparative analysis between phenotypic bioassays as the ratio of factor VIII: C clotting activity to factor VIII: C-related antigen, and DNA haplotypes from RFLP's TaqI/St14 and BclI/F8A in 12 hemophilia A (HeA) families are described. Methods. DNA from HeA patients and related at-risk women has been analyzed by Southern blotting with two probes: the intragenic F8A and the extragenic St14. Factor VIII: C coagulant activity was measured by a one-stage method, and the Factor VIII-related antigen (FVIII: RAg) was assayed with bidimensional electrophoresis. Linkage analysis was performed with the LINKAGE computer programs; in particular, the risks of carrying HeA were calculated using the MLINK program. Results. The observed heterozygosity for the flanking marker DXS 52 (TaqI/St14 RFLP) in combination with intragenic BclI/F8A polymorphism was 0.94. A statistically significant difference in frequency was detected at the DXS 52 locus (allele 4) in comparison with other Caucasian populations. Linkage analysis made it possible to combine the plasma bioassay values with the DNA marker haplotypes to determine the probability of carriership; 22 females at risk were investigated: 4 of them were identified as carriers and 18 were excluded. The risk of carrying hemophilia A for some women at risk in six families is reported. Conclusions. This study compares a classic method and DNA analysis in genetic counselling for hemophilia A. In some cases the two methods may give different results when identifying carriers in at-risk families. From these data it is possible to conclude that DNA analysis combined with the phenotypic bioassays for carrier detection gives more information that the two analyses taken separately.