The SALSA MLPA probemix P248 MLH1-MSH2 Confirmation is an in vitro diagnostic (IVD)1
or research use only (RUO) semi-quantitative assay2
for the detection of deletions or duplications in the MLH1
genes in genomic DNA isolated from human peripheral whole blood specimens. P248 MLH1-MSH2 Confirmation is intended to confirm a potential cause for and clinical diagnosis of Lynch syndrome, as initially determined using the SALSA MLPA probemix P003 MLH1/MSH2. P248 MLH1-MSH2 Confirmation cannot be used to verify deletions or duplications in EPCAM
detected by P003 MLH1/MSH2.
Discordant results between the P248 MLH1-MSH2 Confirmation probemix and the P003 MLH1/MSH2 probemix should be confirmed with a different technique. Most defects in the MLH1
genes are point mutations, none of which will be detected by MLPA.
Assay results are intended to be used in conjunction with other clinical and diagnostic findings, consistent with professional standards of practice, including confirmation by alternative methods, clinical genetic evaluation, and counselling, as appropriate. The results of this test should be interpreted by a clinical molecular geneticist or equivalent.
This device is not intended to be used for standalone diagnostic purposes, pre-implantation or prenatal testing, population screening, or for the detection of, or screening for, acquired or somatic genetic aberrations, e.g. from DNA extracted from formalin-fixed paraffin embedded (FFPE) or fresh tumour materials.
Please note that this probemix is for in vitro diagnostic (IVD) use in the countries specified at the end of this product description. In all other countries, the product is for research use only (RUO).
To be used in combination with a SALSA MLPA Reagent Kit and Coffalyser.Net analysis software.
Lynch syndrome (formerly known as hereditary non-polyposis colorectal cancer; HNPCC) is a hereditary cancer susceptibility syndrome, predisposing to cancer of the digestive tract, particularly the colon and rectum, as well as numerous other cancers. It is an autosomal dominantly inherited syndrome with gene-dependent, age-related cancer penetrance. Germline defects in the DNA mismatch repair genes MLH1
are the most frequent cause of Lynch syndrome. More information is available on http://www.ncbi.nlm.nih.gov/books/NBK1211/
Approximately 50% of Lynch syndrome cases are attributed to mutations in MLH1
and 40% are attributed to mutations in MSH2
. In addition, 10-20% of the cases can be explained by mutations in the MSH6
genes and 1-3% are due to EPCAM
deletions. Among the various defects in the MLH1
genes that have been found in patients are deletions and duplications of complete exons, which are usually missed by standard sequence analysis. The MLPA technique can detect most of these deletions and duplications and therefore complements sequence analysis of the MLH1
The SALSA MLPA Probemix P248-B2 MLH1-MSH2 Confirmation contains 49 MLPA probes with amplification products between 130 and 493 nucleotides (nt). This includes 21 probes for the MLH1
gene, 17 probes for the MSH2
gene and one probe located downstream of the MSH2
gene. In addition, 10 reference probes are included that detect autosomal chromosomal locations. Almost all MLH1 and MSH2 probes included in probemix P003 MLH1/MSH2 have different ligation sites from those in P248, except for the 355 nt MSH2 exon 1 probe (02735-L20467). Complete probe sequences and the identity of the genes detected by the reference probes are available online (www.mrcholland.com
This probemix contains nine quality control fragments generating amplification products between 64 and 105 nt: four DNA Quantity fragments (Q-fragments), two DNA Denaturation fragments (D-fragments), one Benchmark fragment, and one chromosome X and one chromosome Y-specific fragment. More information on how to interpret observations on these control fragments can be found in the MLPA General Protocol and online at www.mrcholland.com