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Biology and Diagnostic Applications of Cell-Free Fetal Nucleic Acids in Maternal Plasma

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Part of the book series: Nucleic Acids and Molecular Biology ((NUCLEIC,volume 25))

Abstract

The discovery of cell-free fetal nucleic acids in maternal plasma in 1997 has opened up new possibilities for noninvasive prenatal diagnosis. Since then, many of the fundamental biological parameters of this phenomenon have been elucidated, including the effects of gestational age, the size of the circulating nucleic acid molecules, and their rapid clearance following delivery. A variety of circulating fetal nucleic acid markers have also been developed, including fetal genetic, epigenetic, mRNA, and miRNA markers. A number of exciting new technologies have been developed for their analysis, including single molecule counting technologies, such as digital PCR and massively parallel sequencing. Together, these developments have culminated in a number of prenatal diagnostic applications, including fetal sexing, RhD blood group genotyping, monogenic disease analysis, and the detection of fetal chromosomal aneuploidies. It is hoped that such advances will ultimately make prenatal testing safer for pregnant women and their fetuses.

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References

  • Amicucci P, Gennarelli M, Novelli G, Dallapiccola B (2000) Prenatal diagnosis of myotonic dystrophy using fetal DNA obtained from maternal plasma. Clin Chem 46:301–302

    PubMed  CAS  Google Scholar 

  • Benachi A, Steffann J, Gautier E, Ernault P, Olivi M, Dumez Y, Costa JM (2003) Fetal DNA in maternal serum: does it persist after pregnancy? Hum Genet 113:76–79

    PubMed  CAS  Google Scholar 

  • Bianchi DW, Lo YM (2001) Fetomaternal cellular and plasma DNA trafficking: the Yin and the Yang. Ann NY Acad Sci 945:119–131

    Article  PubMed  CAS  Google Scholar 

  • Bianchi DW, Zickwolf GK, Weil GJ, Sylvester S, DeMaria MA (1996) Male fetal progenitor cells persist in maternal blood for as long as 27 years postpartum. Proc Natl Acad Sci USA 93:705–708

    Article  PubMed  CAS  Google Scholar 

  • Bianchi DW, Williams JM, Sullivan LM, Hanson FW, Klinger KW, Shuber AP (1997) PCR quantitation of fetal cells in maternal blood in normal and aneuploid pregnancies. Am J Hum Genet 61:822–829

    Article  PubMed  CAS  Google Scholar 

  • Bianchi DW, LeShane ES, Cowan JM (2001) Large amounts of cell-free fetal DNA are present in amniotic fluid. Clin Chem 47:1867–1869

    PubMed  CAS  Google Scholar 

  • Botezatu I, Serdyuk O, Potapova G, Shelepov V, Alechina R, Molyaka Y, Ananev V, Bazin I, Garin A, Narimanov M, Knysh V, Melkonyan H, Umansky S, Lichtenstein A (2000) Genetic analysis of DNA excreted in urine: a new approach for detecting specific genomic DNA sequences from cells dying in an organism. Clin Chem 46:1078–1084

    PubMed  CAS  Google Scholar 

  • Bustamante-Aragones A, Gallego-Merlo J, Trujillo-Tiebas MJ, de Alba MR, Gonzalez-Gonzalez C, Glover G, Diego-Alvarez D, Ayuso C, Ramos C (2008) New strategy for the prenatal detection/exclusion of paternal cystic fibrosis mutations in maternal plasma. J Cyst Fibros 7:505–510

    Article  PubMed  CAS  Google Scholar 

  • Chan KC, Zhang J, Hui AB, Wong N, Lau TK, Leung TN, Lo KW, Huang DW, Lo YM (2004) Size distributions of maternal and fetal DNA in maternal plasma. Clin Chem 50:88–92

    Article  PubMed  CAS  Google Scholar 

  • Chan KC, Ding C, Gerovassili A, Yeung SW, Chiu RW, Leung TN, Lau TK, Chim SS, Chung GT, Nicolaides KH, Lo YM (2006) Hypermethylated RASSF1A in maternal plasma: A universal fetal DNA marker that improves the reliability of noninvasive prenatal diagnosis. Clin Chem 52:2211–2218

    Article  PubMed  CAS  Google Scholar 

  • Chim SS, Tong YK, Chiu RW, Lau TK, Leung TN, Chan LY, Oudejans CB, Ding C, Lo YM (2005) Detection of the placental epigenetic signature of the maspin gene in maternal plasma. Proc Natl Acad Sci USA 102:14753–14758

    Article  PubMed  CAS  Google Scholar 

  • Chim SS, Jin S, Lee TY, Lun FM, Lee WS, Chan LY, Jin Y, Yang N, Tong YK, Leung TY, Lau TK, Ding C, Chiu RW, Lo YM (2008a) Systematic search for placental DNA-methylation markers on chromosome 21: toward a maternal plasma-based epigenetic test for fetal trisomy 21. Clin Chem 54:500–511

    Article  PubMed  CAS  Google Scholar 

  • Chim SS, Shing TK, Hung EC, Leung TY, Lau TK, Chiu RW, Lo YM (2008b) Detection and characterization of placental microRNAs in maternal plasma. Clin Chem 54:482–490

    Article  PubMed  CAS  Google Scholar 

  • Chinnapapagari SK, Holzgreve W, Lapaire O, Zimmermann B, Hahn S (2005) Treatment of maternal blood samples with formaldehyde does not alter the proportion of circulatory fetal nucleic acids (DNA and mRNA) in maternal plasma. Clin Chem 51:652–655

    Article  PubMed  CAS  Google Scholar 

  • Chiu RW, Poon LL, Lau TK, Leung TN, Wong EM, Lo YM (2001) Effects of blood-processing protocols on fetal and total DNA quantification in maternal plasma. Clin Chem 47:1607–1613

    PubMed  CAS  Google Scholar 

  • Chiu RW, Lau TK, Cheung PT, Gong ZQ, Leung TN, Lo YM (2002a) Noninvasive prenatal exclusion of congenital adrenal hyperplasia by maternal plasma analysis: a feasibility study. Clin Chem 48:778–780

    PubMed  CAS  Google Scholar 

  • Chiu RW, Lau TK, Leung TN, Chow KC, Chui DH, Lo YM (2002b) Prenatal exclusion of beta thalassaemia major by examination of maternal plasma. Lancet 360:998–1000

    Article  PubMed  Google Scholar 

  • Chiu RW, Lui WB, Cheung MC, Kumta N, Farina A, Banzola I, Grotti S, Rizzo N, Haines CJ, Lo YM (2006) Time profile of appearance and disappearance of circulating placenta-derived mRNA in maternal plasma. Clin Chem 52:313–316

    Article  PubMed  CAS  Google Scholar 

  • Chiu RW, Chan KC, Gao Y, Lau VY, Zheng W, Leung TY, Foo CH, Xie B, Tsui NB, Lun FM, Zee BC, Lau TK, Cantor CR, Lo YM (2008) Noninvasive prenatal diagnosis of fetal chromosomal aneuploidy by massively parallel genomic sequencing of DNA in maternal plasma. Proc Natl Acad Sci USA 105:20458–20463

    Article  PubMed  CAS  Google Scholar 

  • Chiu RW, Cantor CR, Lo YM (2009) Non-invasive prenatal diagnosis by single molecule counting technologies. Trends Genet 25:324–331

    Article  PubMed  CAS  Google Scholar 

  • Chow KC, Chiu RW, Tsui NB, Ding C, Lau TK, Leung TN, Lo YM (2007) Mass spectrometric detection of an SNP panel as an internal positive control for fetal DNA analysis in maternal plasma. Clin Chem 53:141–142

    Article  PubMed  CAS  Google Scholar 

  • Chung GT, Chiu RW, Chan KC, Lau TK, Leung TN, Chan LW, Lo YM (2005a) Detrimental effect of formaldehyde on plasma RNA detection. Clin Chem 51:1074–1076

    Article  PubMed  CAS  Google Scholar 

  • Chung GT, Chiu RW, Chan KC, Lau TK, Leung TN, Lo YM (2005b) Lack of dramatic enrichment of fetal DNA in maternal plasma by formaldehyde treatment. Clin Chem 51:655–658

    Article  PubMed  CAS  Google Scholar 

  • Costa JM, Benachi A, Gautier E (2002) New strategy for prenatal diagnosis of X-linked disorders. N Engl J Med 346:1502

    Article  PubMed  Google Scholar 

  • Dhallan R, Au WC, Mattagajasingh S, Emche S, Bayliss P, Damewood M, Cronin M, Chou V, Mohr M (2004) Methods to increase the percentage of free fetal DNA recovered from the maternal circulation. JAMA 291:1114–1119

    Article  PubMed  CAS  Google Scholar 

  • Ding C, Chiu RW, Lau TK, Leung TN, Chan LC, Chan AY, Charoenkwan P, Ng IS, Law HY, Ma ES, Xu X, Wanapirak C, Sanguansermsri T, Liao C, Ai MA, Chui DH, Cantor CR, Lo YM (2004) MS analysis of single-nucleotide differences in circulating nucleic acids: application to noninvasive prenatal diagnosis. Proc Natl Acad Sci USA 101:10762–10767

    Article  PubMed  CAS  Google Scholar 

  • Fan HC, Quake SR (2007) Detection of aneuploidy with digital polymerase chain reaction. Anal Chem 79:7576–7579

    Article  PubMed  CAS  Google Scholar 

  • Fan HC, Blumenfeld YJ, Chitkara U, Hudgins L, Quake SR (2008) Noninvasive diagnosis of fetal aneuploidy by shotgun sequencing DNA from maternal blood. Proc Natl Acad Sci USA 105:16266–16271

    Article  PubMed  CAS  Google Scholar 

  • Farina A, Chan CW, Chiu RW, Tsui NB, Carinci P, Concu M, Banzola I, Rizzo N, Lo YM (2004) Circulating corticotropin-releasing hormone mRNA in maternal plasma: relationship with gestational age and severity of preeclampsia. Clin Chem 50:1851–1854

    Article  PubMed  CAS  Google Scholar 

  • Geifman-Holtzman O, Grotegut CA, Gaughan JP, Holtzman EJ, Floro C, Hernandez E (2009) Noninvasive fetal RhCE genotyping from maternal blood. BJOG 116:144–151

    Article  PubMed  CAS  Google Scholar 

  • Gupta AK, Holzgreve W, Huppertz B, Malek A, Schneider H, Hahn S (2004) Detection of fetal DNA and RNA in placenta-derived syncytiotrophoblast microparticles generated in vitro. Clin Chem 50:2187–2190

    Article  PubMed  CAS  Google Scholar 

  • Hahn S, Huppertz B, Holzgreve W (2005) Fetal cells and cell free fetal nucleic acids in maternal blood: new tools to study abnormal placentation? Placenta 26:515–526

    Article  PubMed  CAS  Google Scholar 

  • Hung EC, Shing TK, Chim SS, Yeung PC, Chan RW, Chik KW, Lee V, Tsui NB, Li CK, Wong CS, Chiu RW, Lo YM (2009) Presence of donor-derived DNA and cells in the urine of sex-mismatched hematopoietic stem cell transplant recipients: implication for the transrenal hypothesis. Clin Chem 55:715–722

    Article  PubMed  CAS  Google Scholar 

  • Hyodo M, Samura O, Fujito N, Tanigawa M, Miyoshi H, Fujiwra H, Miharu N, Kudo Y (2007) No correlation between the number of fetal nucleated cells and the amount of cell-free fetal DNA in maternal circulation either before or after delivery. Prenat Diagn 27:717–721

    Article  PubMed  CAS  Google Scholar 

  • Invernizzi P, Biondi ML, Battezzati PM, Perego F, Selmi C, Cecchini F, Podda M, Simoni G (2002) Presence of fetal DNA in maternal plasma decades after pregnancy. Hum Genet 110:587–591

    Article  PubMed  CAS  Google Scholar 

  • Jacobs PA, Browne C, Gregson N, Joyce C, White H (1992) Estimates of the frequency of chromosome abnormalities detectable in unselected newborns using moderate levels of banding. J Med Genet 29:103–108

    Article  PubMed  CAS  Google Scholar 

  • Koide K, Sekizawa A, Iwasaki M, Matsuoka R, Honma S, Farina A, Saito H, Okai T (2005) Fragmentation of cell-free fetal DNA in plasma and urine of pregnant women. Prenat Diagn 25:604–607

    Article  PubMed  CAS  Google Scholar 

  • Lam NY, Rainer TH, Chiu RW, Joynt GM, Lo YM (2004a) Plasma mitochondrial DNA concentrations after trauma. Clin Chem 50:213–216

    Article  PubMed  CAS  Google Scholar 

  • Lam NY, Rainer TH, Chiu RW, Lo YM (2004b) EDTA is a better anticoagulant than heparin or citrate for delayed blood processing for plasma DNA analysis. Clin Chem 50:256–257

    Article  PubMed  CAS  Google Scholar 

  • Lapaire O, Holzgreve W, Oosterwijk JC, Brinkhaus R, Bianchi DW (2007) Georg Schmorl on trophoblasts in the maternal circulation. Placenta 28:1–5

    Article  PubMed  CAS  Google Scholar 

  • Lau TK, Lo KW, Chan LY, Leung TY, Lo YM (2000) Cell-free fetal deoxyribonucleic acid in maternal circulation as a marker of fetal-maternal hemorrhage in patients undergoing external cephalic version near term. Am J Obstet Gynecol 183:712–716

    Article  PubMed  CAS  Google Scholar 

  • Lau TW, Leung TN, Chan LY, Lau TK, Chan KC, Tam WH, Lo YM (2002) Fetal DNA clearance from maternal plasma is impaired in preeclampsia. Clin Chem 48:2141–2146

    PubMed  CAS  Google Scholar 

  • Lazar L, Nagy B, Ban Z, Nagy GR, Papp Z (2006) Presence of cell-free fetal DNA in plasma of women with ectopic pregnancies. Clin Chem 52:1599–1601

    Article  PubMed  CAS  Google Scholar 

  • Leung TN, Zhang J, Lau TK, Hjelm NM, Lo YM (1998) Maternal plasma fetal DNA as a marker for preterm labour. Lancet 352:1904–1905

    Article  PubMed  CAS  Google Scholar 

  • Leung TN, Zhang J, Lau TK, Chan LY, Lo YM (2001) Increased maternal plasma fetal DNA concentrations in women who eventually develop preeclampsia. Clin Chem 47:137–139

    PubMed  CAS  Google Scholar 

  • Leung TY, Chan LW, Law LW, Sahota DS, Fung TY, Leung TN, Lau TK (2009) First trimester combined screening for Trisomy 21 in Hong Kong: outcome of the first 10, 000 cases. J Matern Fetal Neonatal Med 22:300–304

    Article  PubMed  CAS  Google Scholar 

  • Levine RJ, Qian C, Leshane ES, Yu KF, England LJ, Schisterman EF, Wataganara T, Romero R, Bianchi DW (2004) Two-stage elevation of cell-free fetal DNA in maternal sera before onset of preeclampsia. Am J Obstet Gynecol 190:707–713

    Article  PubMed  CAS  Google Scholar 

  • Li Y, Holzgreve W, Page-Christiaens GC, Gille JJ, Hahn S (2004a) Improved prenatal detection of a fetal point mutation for achondroplasia by the use of size-fractionated circulatory DNA in maternal plasma–case report. Prenat Diagn 24:896–898

    Article  PubMed  CAS  Google Scholar 

  • Li Y, Zimmermann B, Rusterholz C, Kang A, Holzgreve W, Hahn S (2004b) Size separation of circulatory DNA in maternal plasma permits ready detection of fetal DNA polymorphisms. Clin Chem 50:1002–1011

    Article  PubMed  CAS  Google Scholar 

  • Li Y, Di Naro E, Vitucci A, Zimmermann B, Holzgreve W, Hahn S (2005) Detection of paternally inherited fetal point mutations for beta-thalassemia using size-fractionated cell-free DNA in maternal plasma. JAMA 293:843–849

    Article  PubMed  CAS  Google Scholar 

  • Li Y, Holzgreve W, Kiefer V, Hahn S (2006) MALDI-TOF mass spectrometry compared with real-time PCR for detection of fetal cell-free DNA in maternal plasma. Clin Chem 52:2311–2312

    Article  PubMed  CAS  Google Scholar 

  • Li Y, Page-Christiaens GC, Gille JJ, Holzgreve W, Hahn S (2007) Non-invasive prenatal detection of achondroplasia in size-fractionated cell-free DNA by MALDI-TOF MS assay. Prenat Diagn 27:11–17

    Article  PubMed  Google Scholar 

  • Li Y, Holzgreve W, Hahn S (2008) Size fractionation of cell-free DNA in maternal plasma and its application in noninvasive detection of fetal single gene point mutations. Methods Mol Biol 444:239–251

    Article  PubMed  CAS  Google Scholar 

  • Lo YM, Corbetta N, Chamberlain PF, Rai V, Sargent IL, Redman CW, Wainscoat JS (1997) Presence of fetal DNA in maternal plasma and serum. Lancet 350:485–487

    Article  PubMed  CAS  Google Scholar 

  • Lo YM, Hjelm NM, Fidler C, Sargent IL, Murphy MF, Chamberlain PF, Poon PM, Redman CW, Wainscoat JS (1998a) Prenatal diagnosis of fetal RhD status by molecular analysis of maternal plasma. N Engl J Med 339:1734–1738

    Article  PubMed  CAS  Google Scholar 

  • Lo YM, Tein MS, Lau TK, Haines CJ, Leung TN, Poon PM, Wainscoat JS, Johnson PJ, Chang AM, Hjelm NM (1998b) Quantitative analysis of fetal DNA in maternal plasma and serum: implications for noninvasive prenatal diagnosis. Am J Hum Genet 62:768–775

    Article  PubMed  CAS  Google Scholar 

  • Lo YM, Lau TK, Zhang J, Leung TN, Chang AM, Hjelm NM, Elmes RS, Bianchi DW (1999a) Increased fetal DNA concentrations in the plasma of pregnant women carrying fetuses with trisomy 21. Clin Chem 45:1747–1751

    PubMed  CAS  Google Scholar 

  • Lo YM, Leung TN, Tein MS, Sargent IL, Zhang J, Lau TK, Haines CJ, Redman CW (1999b) Quantitative abnormalities of fetal DNA in maternal serum in preeclampsia. Clin Chem 45:184–188

    PubMed  CAS  Google Scholar 

  • Lo YM, Zhang J, Leung TN, Lau TK, Chang AM, Hjelm NM (1999c) Rapid clearance of fetal DNA from maternal plasma. Am J Hum Genet 64:218–224

    Article  PubMed  CAS  Google Scholar 

  • Lo YM, Chiu RW, Chan KC, Chung GT (2004) Free fetal DNA in maternal circulation. JAMA 292:2835

    Article  PubMed  Google Scholar 

  • Lo YM, Lun FM, Chan KC, Tsui NB, Chong KC, Lau TK, Leung TY, Zee BC, Cantor CR, Chiu RW (2007a) Digital PCR for the molecular detection of fetal chromosomal aneuploidy. Proc Natl Acad Sci USA 104:13116–13121

    Article  PubMed  CAS  Google Scholar 

  • Lo YM, Tsui NB, Chiu RW, Lau TK, Leung TN, Heung MM, Gerovassili A, Jin Y, Nicolaides KH, Cantor CR, Ding C (2007b) Plasma placental RNA allelic ratio permits noninvasive prenatal chromosomal aneuploidy detection. Nat Med 13:218–223

    Article  PubMed  CAS  Google Scholar 

  • Lui YY, Chik KW, Chiu RW, Ho CY, Lam CW, Lo YM (2002a) Predominant hematopoietic origin of cell-free DNA in plasma and serum after sex-mismatched bone marrow transplantation. Clin Chem 48:421–427

    PubMed  CAS  Google Scholar 

  • Lui YY, Chik KW, Lo YM (2002b) Does centrifugation cause the ex vivo release of DNA from blood cells? Clin Chem 48:2074–2076

    PubMed  CAS  Google Scholar 

  • Lui YY, Woo KS, Wang AY, Yeung CK, Li PK, Chau E, Ruygrok P, Lo YM (2003) Origin of plasma cell-free DNA after solid organ transplantation. Clin Chem 49:495–496

    Article  PubMed  CAS  Google Scholar 

  • Lun FM, Chiu RW, Allen Chan KC, Yeung Leung T, Kin Lau T, Lo YM (2008a) Microfluidics digital PCR reveals a higher than expected fraction of fetal DNA in maternal plasma. Clin Chem 54:1664–1672

    Article  PubMed  CAS  Google Scholar 

  • Lun FM, Tsui NB, Chan KC, Leung TY, Lau TK, Charoenkwan P, Chow KC, Lo WY, Wanapirak C, Sanguansermsri T, Cantor CR, Chiu RW, Lo YM (2008b) Noninvasive prenatal diagnosis of monogenic diseases by digital size selection and relative mutation dosage on DNA in maternal plasma. Proc Natl Acad Sci USA 105:19920–19925

    Article  PubMed  CAS  Google Scholar 

  • Majer S, Bauer M, Magnet E, Strele A, Giegerl E, Eder M, Lang U, Pertl B (2007) Maternal urine for prenatal diagnosis–an analysis of cell-free fetal DNA in maternal urine and plasma in the third trimester. Prenat Diagn 27:1219–1223

    Article  PubMed  CAS  Google Scholar 

  • Masuzaki H, Miura K, Yamasaki K, Miura S, Yoshiura K, Yoshimura S, Nakayama D, Mapendano CK, Niikawa N, Ishimaru T (2005) Clinical applications of plasma circulating mRNA analysis in cases of gestational trophoblastic disease. Clin Chem 51:1261–1263

    Article  PubMed  CAS  Google Scholar 

  • Ng EK, Leung TN, Tsui NB, Lau TK, Panesar NS, Chiu RW, Lo YM (2003a) The concentration of circulating corticotropin-releasing hormone mRNA in maternal plasma is increased in preeclampsia. Clin Chem 49:727–731

    Article  PubMed  CAS  Google Scholar 

  • Ng EK, Tsui NB, Lau TK, Leung TN, Chiu RW, Panesar NS, Lit LC, Chan KW, Lo YM (2003b) mRNA of placental origin is readily detectable in maternal plasma. Proc Natl Acad Sci USA 100:4748–4753

    Article  PubMed  CAS  Google Scholar 

  • Old RW, Crea F, Puszyk W, Hulten MA (2007) Candidate epigenetic biomarkers for non-invasive prenatal diagnosis of Down syndrome. Reprod Biomed Online 15:227–235

    Article  PubMed  CAS  Google Scholar 

  • Poon LL, Leung TN, Lau TK, Lo YM (2000) Presence of fetal RNA in maternal plasma. Clin Chem 46:1832–1834

    PubMed  CAS  Google Scholar 

  • Poon LL, Leung TN, Lau TK, Chow KC, Lo YM (2002) Differential DNA methylation between fetus and mother as a strategy for detecting fetal DNA in maternal plasma. Clin Chem 48:35–41

    PubMed  CAS  Google Scholar 

  • Rijnders RJ, Van der Schost CE, Bossers B, de Vroede MA, Christiaens GC (2001) Fetal sex determination form maternal plasma in pregnancies at risk for congenital adrenal hyperplasia. Obstet Tiynecol 98:374–378

    Google Scholar 

  • Saito H, Sekizawa A, Morimoto T, Suzuki M, Yanaihara T (2000) Prenatal DNA diagnosis of a single-gene disorder from maternal plasma. Lancet 356:1170

    Article  PubMed  CAS  Google Scholar 

  • Sekizawa A, Samura O, Zhen DK, Falco V, Farina A, Bianchi DW (2000) Apoptosis in fetal nucleated erythrocytes circulating in maternal blood. Prenat Diagn 20:886–889

    Article  PubMed  CAS  Google Scholar 

  • Sekizawa A, Sugito Y, Iwasaki M, Watanabe A, Jimbo M, Hoshi S, Saito H, Okai T (2001) Cell-free fetal DNA is increased in plasma of women with hyperemesis gravidarum. Clin Chem 47:2164–2165

    PubMed  CAS  Google Scholar 

  • Smid M, Galbiati S, Vassallo A, Gambini D, Ferrari A, Viora E, Pagliano M, Restagno G, Ferrari M, Cremonesi L (2003) No evidence of fetal DNA persistence in maternal plasma after pregnancy. Hum Genet 112:617–618

    PubMed  Google Scholar 

  • Tjoa ML, Cindrova-Davies T, Spasic-Boskovic O, Bianchi DW, Burton GJ (2006) Trophoblastic oxidative stress and the release of cell-free feto-placental DNA. Am J Pathol 169:400–404

    Article  PubMed  CAS  Google Scholar 

  • Tong YK, Ding C, Chiu RW, Gerovassili A, Chim SS, Leung TY, Leung TN, Lau TK, Nicolaides KH, Lo YM (2006) Noninvasive prenatal detection of fetal trisomy 18 by epigenetic allelic ratio analysis in maternal plasma: theoretical and empirical considerations. Clin Chem 52:2194–2202

    Article  PubMed  CAS  Google Scholar 

  • Tong YK, Chiu RW, Leung TY, Ding C, Lau TK, Leung TN, Lo YM (2007) Detection of restriction enzyme-digested target DNA by PCR amplification using a stem-loop primer: application to the detection of hypomethylated fetal DNA in maternal plasma. Clin Chem 53:1906–1914

    Article  PubMed  CAS  Google Scholar 

  • Tsang JC, Charoenkwan P, Chow KC, Jin Y, Wanapirak C, Sanguansermsri T, Lo YM, Chiu RW (2007) Mass spectrometry-based detection of hemoglobin E mutation by allele-specific base extension reaction. Clin Chem 53:2205–2209

    Article  PubMed  CAS  Google Scholar 

  • Tsui NB, Ng EK, Lo YM (2002) Stability of endogenous and added RNA in blood specimens, serum, and plasma. Clin Chem 48:1647–1653

    PubMed  CAS  Google Scholar 

  • Tsui DW, Chan KC, Chim SS, Chan LW, Leung TY, Lau TK, Lo YM, Chiu RW (2007) Quantitative aberrations of hypermethylated RASSF1A gene sequences in maternal plasma in pre-eclampsia. Prenat Diagn 27:1212–1218

    Article  PubMed  CAS  Google Scholar 

  • Walknowska J, Conte FA, Grumbach MM (1969) Practical and theoretical implications of fetal-maternal lymphocyte transfer. Lancet 1:1119–1122

    Article  PubMed  CAS  Google Scholar 

  • Wataganara T, Leshane ES, Chen AY, Sullivan LM, Peter I, Borgatta L, Johnson KL, Bianchi DW (2004) Circulating cell-free fetal nucleic acid analysis may be a novel marker of fetomaternal hemorrhage after elective first-trimester termination of pregnancy. Ann NY Acad Sci 1022:129–134

    Article  PubMed  CAS  Google Scholar 

  • Wong BC, Chiu RW, Tsui NB, Chan KC, Chan LW, Lau TK, Leung TN, Lo YM (2005) Circulating placental RNA in maternal plasma is associated with a preponderance of 5' mRNA fragments: implications for noninvasive prenatal diagnosis and monitoring. Clin Chem 51:1786–1795

    Article  PubMed  CAS  Google Scholar 

  • Zhong XY, Holzgreve W, Li JC, Aydinli K, Hahn S (2000) High levels of fetal erythroblasts and fetal extracellular DNA in the peripheral blood of a pregnant woman with idiopathic polyhydramnios: case report. Prenat Diagn 20:838–841

    Article  PubMed  CAS  Google Scholar 

  • Zhong XY, Holzgreve W, Hahn S (2001) Circulatory fetal and maternal DNA in pregnancies at risk and those affected by preeclampsia. Ann NY Acad Sci 945:138–140

    Article  PubMed  CAS  Google Scholar 

  • Zhong XY, Holzgreve W, Gebhardt S, Hillermann R, Tofa KC, Gupta AK, Huppertz B, Hahn S (2006) Minimal alteration in the ratio of circulatory fetal DNA to fetal corticotropin-releasing hormone mRNA level in preeclampsia. Fetal Diagn Ther 21:246–249

    Article  PubMed  Google Scholar 

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Correspondence to Y. M. Dennis Lo .

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Tsang, J.C.H., Lo, Y.M.D. (2010). Biology and Diagnostic Applications of Cell-Free Fetal Nucleic Acids in Maternal Plasma. In: Kikuchi, Y., Rykova, E. (eds) Extracellular Nucleic Acids. Nucleic Acids and Molecular Biology, vol 25. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-12617-8_9

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