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Volume 17
Issue 6
10.3390/genes17060656
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Establishment of a New-Generation National Reference Material System for Fragile X Syndrome Using Targeted Long-Read Sequencing

by
Mi Zhang
1,2,†,
Wenxin Zhang
1,2,†,
Fei Gao
1,2,
Huiying Fang
3,
Li Zhang
3,
Yaning Qi
1,
Wei Zhang
1,
Peiwen Xu
4,5,
Jie Li
4,5 and
Shoufang Qu
1,2,*
1
National Institutes for Food and Drug Control, Beijing 100050, China
2
State Key Laboratory of Drug Regulatory Science, Beijing 100050, China
3
Berry Genomics Corporation, Beijing 102200, China
4
State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Shandong University, Jinan 250000, China
5
National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan 250000, China
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Genes 2026, 17(6), 656; https://doi.org/10.3390/genes17060656
Submission received: 12 May 2026 / Revised: 28 May 2026 / Accepted: 29 May 2026 / Published: 2 June 2026
(This article belongs to the Special Issue Genetic Diagnosis and Genomics of Neurological Diseases)
Versions Notes

Abstract

Background: Fragile X syndrome (FXS) is the most common monogenic cause of inherited intellectual disability and is primarily caused by CGG repeat expansion in the FMR1 gene. Conventional diagnostic methods have limited precision for sizing long repeat sequences and cannot resolve AGG interruptions, which are critical for comprehensive risk assessment. Existing national FXS reference materials are based on conventional methods and provide limited molecular information. Methods: We developed a targeted long-read sequencing assay for comprehensive FMR1 characterization, termed tLRS-FMR1, and applied it to a panel of 22 national FXS reference materials. Results: The tLRS-FMR1 assay demonstrated 100% concordance with standard methods while overcoming key limitations of conventional approaches. It enabled precise quantification of CGG repeat numbers, including full mutations (>200 repeats) that were only qualitatively reported by traditional techniques and provided comprehensive mapping of AGG interruption patterns. The assay showed high reproducibility, with 100% genotyping concordance across intra- and inter-assay replicates and achieved a detection limit of 3 ng/μL. Conclusions: This study successfully developed tLRS-FMR1 and established a new-generation national FXS reference material system with expanded molecular information and improved precision, providing a foundation for advancing the standardization and accuracy of FXS molecular diagnosis.
Keywords: fragile X syndrome; targeted long-read sequencing; reference materials; CGG repeats; AGG interruptions fragile X syndrome; targeted long-read sequencing; reference materials; CGG repeats; AGG interruptions

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MDPI and ACS Style

Zhang, M.; Zhang, W.; Gao, F.; Fang, H.; Zhang, L.; Qi, Y.; Zhang, W.; Xu, P.; Li, J.; Qu, S. Establishment of a New-Generation National Reference Material System for Fragile X Syndrome Using Targeted Long-Read Sequencing. Genes 2026, 17, 656. https://doi.org/10.3390/genes17060656

AMA Style

Zhang M, Zhang W, Gao F, Fang H, Zhang L, Qi Y, Zhang W, Xu P, Li J, Qu S. Establishment of a New-Generation National Reference Material System for Fragile X Syndrome Using Targeted Long-Read Sequencing. Genes. 2026; 17(6):656. https://doi.org/10.3390/genes17060656

Chicago/Turabian Style

Zhang, Mi, Wenxin Zhang, Fei Gao, Huiying Fang, Li Zhang, Yaning Qi, Wei Zhang, Peiwen Xu, Jie Li, and Shoufang Qu. 2026. "Establishment of a New-Generation National Reference Material System for Fragile X Syndrome Using Targeted Long-Read Sequencing" Genes 17, no. 6: 656. https://doi.org/10.3390/genes17060656

APA Style

Zhang, M., Zhang, W., Gao, F., Fang, H., Zhang, L., Qi, Y., Zhang, W., Xu, P., Li, J., & Qu, S. (2026). Establishment of a New-Generation National Reference Material System for Fragile X Syndrome Using Targeted Long-Read Sequencing. Genes, 17(6), 656. https://doi.org/10.3390/genes17060656

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