Recent developments have yielded new technologies that have greatly simplified the detection of deletions and duplications, i.e., copy number variants (CNVs). These technologies can be used to screen for CNVs in and around specific genomic regions, as well as genome-wide. Several genome-wide studies have demonstrated that CNV in the human genome is widespread and may include millions of nucleotides. One of the questions that emerge is which sequences, structures and/or processes are involved in their generation. Using as an example the human DMD gene, mutations in which cause Duchenne and Becker muscular dystrophy, we review the current data, determine the deletion and duplication profile across the gene and summarize the information that has been collected regarding their origin. In addition we discuss the methods most frequently used for their detection, in particular MAPH and MLPA.

1.
Abbs SJ, Bobrow M: Analysis of quantitative PCR for the diagnosis of deletion and duplication carriers in the dystrophin gene. J Med Genet 29:191–196 (1992).
2.
Aldred PM, Hollox EJ, Armour JA: Copy number polymorphism and expression level variation of the human alpha-defensin genes DEFA1 and DEFA3. Hum Mol Genet 14:2045–2052 (2005).
3.
Armour JA, Sismani C, Patsalis PC, Cross G: Measurement of locus copy number by hybridisation with amplifiable probes. Nucleic Acids Res 28:605–609 (2000).
4.
Beggs AH, Koenig M, Boyce FM, Kunkel LM: Detection of 98 percent DMD/BMD gene deletions by polymerase chain reaction. Hum Genet 86:45–48 (1990).
5.
Bierne H, Ehrlich SD, Michel B: The replication termination signal terB of the Escherichia coli chromosome is a deletion hot spot. EMBO J 10:2699–2705 (1991).
6.
Bignell GR, Huang J, Greshock J, Watt S, Butler A, et al: High-resolution analysis of DNA copy number using oligonucleotide microarrays. Genome Res 14:287–295 (2004).
7.
Blonden LAJ, Grootscholten PM, Den Dunnen JT, Bakker E, Abbs SJ, et al: 242 breakpoints in the 200-kb deletion-prone P20 region of the DMD-gene are widely spread. Genomics 10:631–639 (1991).
8.
Boulikas T: Chromatin domains and prediction of MAR sequences. Int Rev Cytol 162A:279–388 (1995).
9.
Chamberlain JS, Gibbs RA, Ranier JE, Nga Nguyen PN, Caskey CT: Deletion screening of the Duchenne muscular dystrophy locus via multiplex DNA amplification. Nucleic Acids Res 23:11141–11156 (1988).
10.
Conrad DF, Andrews TD, Carter NP, Hurles ME, Pritchard JK: A high-resolution survey of deletion polymorphism in the human genome. Nat Genet 38:75–81 (2006).
11.
Darras BT, Blattner P, Harper JF, Spiro AJ, Alter S, Francke U: Intragenic deletions in 21 Duchenne muscular dystrophy (DMD)/Becker muscular dystrophy families studied with the dystrophin cDNA: location of breakpoints on Hin dIII and Bgl II exon-containing fragment maps, meiotic and mitotic origin of the mutations. Am J Hum Genet 43:620–629 (1988).
12.
Dauwerse JG, Hansson KB, Brouwers AA, Peters DJ, Breuning MH: An XX male with the sex-determining region Y gene inserted in the long arm of chromosome 16. Fertil Steril 86:463.e1–e5 (2006).
13.
Den Dunnen JT, Bakker E, Klein-Breteler EG, Pearson PL, Van Ommen GJB: Direct detection of more than 50% Duchenne muscular dystrophy mutations by field-inversion gels. Nature 329:640–642 (1987).
14.
Den Dunnen JT, Grootscholten PM, Bakker E, Blonden LAJ, Ginjaar HB, et al: Topography of the DMD gene: FIGE and cDNA analysis of 194 cases reveals 115 deletions and 13 duplications. Am J Hum Genet 45:835–847 (1989).
15.
Den Dunnen JT, Grootscholten PM, Dauwerse JD, Monaco AP, Walker AP, et al: Reconstruction of the 2.4 Mb human DMD-gene by homologous YAC recombination. Hum Mol Genet 1:19–28 (1992).
16.
Dent KM, Dunn DM, von Niederhausern AC, Aoyagi AT, Kerr L, et al: Improved molecular diagnosis of dystrophinopathies in an unselected clinical cohort. Am J Med Genet A 134:295–298 (2005).
17.
Feuk L, MacDonald JR, Tang T, Carson AR, Li M, et al: Discovery of human inversion polymorphisms by comparative analysis of human and chimpanzee DNA sequence assemblies. PLoS Genet 1:e56 (2005).
18.
Florijn RJ, Blonden LAJ, Vrolijk H, Wiegant J, Vaandrager JW, et al: High-resolution FISH for genomic DNA mapping and colour bar-coding of large genes. Hum Mol Genet 4:831–836 (1995).
19.
Fredman D, White SJ, Potter S, Eichler EE, Den Dunnen JT, Brookes AJ: Complex SNP-related sequence variation in segmental genome duplications. Nat Genet 36:861–866 (2004).
20.
Gajecka M, Yu W, Ballif BC, Glotzbach CD, Bailey KA, et al: Delineation of mechanisms and regions of dosage imbalance in complex rearrangements of 1p36 leads to a putative gene for regulation of cranial suture closure. Eur J Hum Genet 13:139–149 (2005).
21.
Gale KC, Osheroff N: Intrinsic intermolecular DNA ligation activity of eukaryotic topoisomerase II. Potential roles in recombination. J Biol Chem 267:12090–12097 (1992).
22.
Gonzalez E, Kulkarni H, Bolivar H, Mangano A, Sanchez R, et al: The influence of CCL3L1 gene-containing segmental duplications on HIV-1/AIDS susceptibility. Science 307:1434–1440 (2005).
23.
Hinds DA, Kloek AP, Jen M, Chen X, Frazer KA: Common deletions and SNPs are in linkage disequilibrium in the human genome. Nat Genet 38:82–85 (2006).
24.
Hollox EJ, Armour JA, Barber JC: Extensive normal copy number variation of a beta-defensin antimicrobial-gene cluster. Am J Hum Genet 73:591–600 (2003).
25.
Hu X, Ray PN, Murphy E, Thompson MW, Worton RG: Duplicational mutation at the Duchenne muscular dystrophy locus: its frequency, distribution, origin and phenotype/genotype correlation. Am J Hum Genet 46:682–695 (1990).
26.
Hu X, Ray PN, Worton RG: Mechanisms of tandem duplication in the Duchenne muscular dystrophy gene include both homologous and nonhomologous intrachromosomal recombination. EMBO J 10:2471–2477 (1991).
27.
Iafrate AJ, Feuk L, Rivera MN, Listewnik ML, Donahoe PK, et al: Detection of large-scale variation in the human genome. Nat Genet 36:949–951 (2004).
28.
Iarovaia OV, Bystritskiy A, Ravcheev D, Hancock R, Razin SV: Visualization of individual DNA loops and a map of loop domains in the human dystrophin gene. Nucleic Acids Res 32:2079–2086 (2004).
29.
Inoue K, Lupski JR: Molecular mechanisms for genomic disorders. Annu Rev Genomics Hum Genet 3:199–242 (2002).
30.
Ioannou P, Christopoulos G, Panayides K, Kleanthous M, Middleton L: Detection of Duchenne and Becker muscular dystrophy carriers by quantitative multiplex polymerase chain reaction analysis. Neurol 42:1783–1790 (1992).
31.
Janssen B, Hartmann C, Scholz V, Jauch A, Zschocke J: MLPA analysis for the detection of deletions, duplications and complex rearrangements in the dystrophin gene: potential and pitfalls. Neurogenetics 6:29–35 (2005).
32.
Kehrer-Sawatzki H, Kluwe L, Sandig C, Kohn M, Wimmer K, et al: High frequency of mosaicism among patients with neurofibromatosis type 1 (NF1) with microdeletions caused by somatic recombination of the JJAZ1 gene. Am J Hum Genet 75:410–423 (2004).
33.
Koenig M, Hoffman EP, Bertelson CJ, Monaco AP, Feener CA, Kunkel LM: Complete cloning of the Duchenne muscular dystrophy (DMD) cDNA and preliminary genomic organization of the DMD gene in normal and affected individuals. Cell 50:509–517 (1987).
34.
Kunkel LM, Monaco AP, Middlesworth W, Ochs HD, Latt SA: Specific cloning of DNA fragments absent from the DNA of a male patient with an X-chromosome deletion. Proc Natl Acad Sci USA 82:4778–4782 (1985).
35.
Lakich D, Kazazian HHJ, Antonarakis SE, Gitschier J: Inversions disrupting the factor VIII gene are a common cause of severe haemophilia A. Nat Genet 5:236–241 (1993).
36.
Lalic T, Vossen RH, Coffa J, Schouten JP, Guc-Scekic M, et al: Deletion and duplication screening in the DMD gene using MLPA. Eur J Hum Genet 13:1231–1234 (2005).
37.
Lemmers RJL, de Kievit P, van Geel M, van der Wielen MJ, Bakker E, et al: Complete allele information in the diagnosis of facioscapulohumeral muscular dystrophy by triple DNA analysis. Ann Neurol 50:816–819 (2001).
38.
Lucito R, Healy J, Alexander J, Reiner A, Esposito D, et al: Representational oligonucleotide microarray analysis: a high-resolution method to detect genome copy number variation. Genome Res 13:2291–2305 (2003).
39.
McCarroll SA, Hadnott TN, Perry GH, Sabeti PC, Zody MC, et al: Common deletion polymorphisms in the human genome. Nat Genet 38:86–92 (2006).
40.
McNaughton JC, Cockburn DJ, Hughes G, Jones WA, Laing NG, et al: Is gene deletion in eukaryotes sequence-dependent? A study of nine deletion junctions and nineteen other deletion breakpoints in intron 7 of the human dystrophin gene. Gene 222:41–51 (1998).
41.
Monaco AP, Bertelson CJ, Liechti-Gallati S, Moser H, Kunkel LM: An explanation for the phenotypic differences between patients bearing partial deletions of the DMD locus. Genomics 2:90–95 (1988).
42.
Osborne LR, Li M, Pober B, Chitayat D, Bodurtha J, et al: A 1.5 million-base pair inversion polymorphism in families with Williams-Beuren syndrome. Nat Genet 29:321–325 (2001).
43.
Oudet C, Hanauer A, Clemens P, Caskey CT, Mandel JL: Two hot spots of recombination in the DMD-gene correlate with the deletion prone regions. Hum Mol Genet 1:599–603 (1992).
44.
Passos-Bueno MR, Bakker E, Kneppers ALJ, Takata RI, Rapaport D, et al: Different mosaicism frequencies for proximal and distal Duchenne muscular dystrophy (DMD) mutations indicate difference in etiology and recurrence risk. Am J Hum Genet 51:1150–1155 (1992).
45.
Ray PN, Belfall B, Duff C, Logan C, Kean V, et al: Cloning of the breakpoint of an X:21 translocation associated with Duchenne muscular dystrophy. Nature 318:672–675 (1985).
46.
Rooms L, Reyniers E, van Luijk R, Scheers S, Wauters J, et al: Subtelomeric deletions detected in patients with idiopathic mental retardation using multiplex ligation-dependent probe amplification (MLPA). Hum Mutat 23:17–21 (2004).
47.
Schouten JP, McElgunn CJ, Waaijer R, Zwijnenburg D, Diepvens F, Pals G: Relative quantification of 40 nucleic acid sequences by multiplex ligation-dependent probe amplification. Nucleic Acids Res 30:e57 (2002).
48.
Schwartz M, Duno M: Improved molecular diagnosis of dystrophin gene mutations using the multiplex ligation-dependent probe amplification method. Genet Test 8:361–367 (2004).
49.
Sebat J, Lakshmi B, Troge J, Alexander J, Young J, et al: Large-scale copy number polymorphism in the human genome. Science 305:525–528 (2004).
50.
Sharp AJ, Locke DP, McGrath SD, Cheng Z, Bailey JA, et al: Segmental duplications and copy-number variation in the human genome. Am J Hum Genet 77:78–88 (2005).
51.
Sironi M, Pozzoli U, Cagliani R, Giorda R, Comi GP, et al: Relevance of sequence and structure elements for deletion events in the dystrophin gene major hot-spot. Hum Genet 112:272–288 (2003).
52.
Stefansson H, Helgason A, Thorleifsson G, Steinthorsdottir V, Masson G, et al: A common inversion under selection in Europeans. Nat Genet 37:129–137 (2005).
53.
Svetlova EY, Razin SV, Debatisse M: Mammalian recombination hot spot in a DNA loop anchorage region: A model for the study of common fragile sites. J Cell Biochem 81:170–178 (2001).
54.
Toledo F, Coquelle A, Svetlova E, Debatisse M: Enhanced flexibility and aphidicolin-induced DNA breaks near mammalian replication origins: implications for replicon mapping and chromosome fragility. Nucleic Acids Res 28:4805–4813 (2000).
55.
van Ommen GJ: Frequency of new copy number variation in humans. Nat Genet 37:333–334 (2005).
56.
Verbovaia LV, Razin SV: Mapping of replication origins and termination sites in the Duchenne muscular dystrophy gene. Genomics 45:24–30 (1997).
57.
Wang JC, Caron PR, Kim RA: The role of DNA topoisomerases in recombination and genome stability: a double-edged sword? Cell 62:403–406 (1990).
58.
White S, Kalf M, Liu Q, Villerius M, Engelsma D, et al: Comprehensive detection of genomic duplications and deletions in the DMD gene, by use of multiplex amplifiable probe hybridization. Am J Hum Genet 71:365–374 (2002).
59.
White SJ, Aartsma-Rus A, Flanigan KM, Weiss RB, Kneppers ALJ, et al: Duplications in the DMD gene. Hum Mut 27:938–945 (2006).
60.
Woodward KJ, Cundall M, Sperle K, Sistermans EA, Ross M, et al: Heterogeneous duplications in patients with Pelizaeus-Merzbacher disease suggest a mechanism of coupled homologous and nonhomologous recombination. Am J Hum Genet 77:966–987 (2005).
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.