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Jamwal M, Mallik N, Aravindan AV, Jain A, Sharma P, Malhotra P, Das R. Hemolytic erythrocytosis: an amalgamated phenotype from coinherited Chuvash polycythemia and G6PD Kerala-Kalyan with acquired transient stomatocytosis. Ann Hematol 2020; 100:2107-2109. [PMID: 33033909 DOI: 10.1007/s00277-020-04295-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Manu Jamwal
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Nabhajit Mallik
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Arun Vijayalakshmi Aravindan
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Arihant Jain
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Prashant Sharma
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Reena Das
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
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Mattè A, Lupo F, Tibaldi E, Di Paolo ML, Federti E, Carpentieri A, Pucci P, Brunati AM, Cesaro L, Turrini F, Gomez Manzo S, Choi SY, Marcial Quino J, Kim DW, Pantaleo A, Xiuli A, Iatcenko I, Cappellini MD, Forni GL, De Franceschi L. Fyn specifically Regulates the activity of red cell glucose-6-phosphate-dehydrogenase. Redox Biol 2020; 36:101639. [PMID: 32863204 PMCID: PMC7387845 DOI: 10.1016/j.redox.2020.101639] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 06/05/2020] [Accepted: 07/05/2020] [Indexed: 01/22/2023] Open
Abstract
Fyn is a tyrosine kinase belonging to the Src family (Src-Family-Kinase, SFK), ubiquitously expressed. Previously, we report that Fyn is important in stress erythropoiesis. Here, we show that in red cells Fyn specifically stimulates G6PD activity, resulting in a 3-fold increase enzyme catalytic activity (kcat) by phosphorylating tyrosine (Tyr)-401. We found Tyr-401 on G6PD as functional target of Fyn in normal human red blood cells (RBC), being undetectable in G6PD deficient RBCs (G6PD-Mediterranean and G6PD-Genova). Indeed, Tyr-401 is located to a region of the G6PD molecule critical for the formation of the enzymatically active dimer. Amino acid replacements in this region are mostly associated with a chronic hemolysis phenotype. Using mutagenesis approach, we demonstrated that the phosphorylation status of Tyr401 modulates the interaction of G6PD with G6P and stabilizes G6PD in a catalytically more efficient conformation. RBCs from Fyn-/-mice are defective in G6PD activity, resulting in increased susceptibility to primaquine-induced intravascular hemolysis. This negatively affected the recycling of reduced Prx2 in response to oxidative stress, indicating that defective G6PD phosphorylation impairs defense against oxidation. In human RBCs, we confirm the involvement of the thioredoxin/Prx2 system in the increase vulnerability of G6PD deficient RBCs to oxidation. In conclusion, our data suggest that Fyn is an oxidative radical sensor, and that Fyn-mediated Tyr-401 phosphorylation, by increasing G6PD activity, plays an important role in the physiology of RBCs. Failure of G6PD activation by this mechanism may be a major limiting factor in the ability of G6PD deficient RBCs to withstand oxidative stress.
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Affiliation(s)
- Alessandro Mattè
- Dept of Medicine University of Verona and AOUI Verona, Verona, Italy
| | - Francesca Lupo
- Dept of Medicine University of Verona and AOUI Verona, Verona, Italy
| | - Elena Tibaldi
- Dept of Molecular Medicine, University of Padua, Padua, Italy
| | | | - Enrica Federti
- Dept of Medicine University of Verona and AOUI Verona, Verona, Italy
| | | | - Piero Pucci
- Dept of Chemical Sciences, University Federico II, Naples, Italy
| | | | - Luca Cesaro
- Dept of Molecular Medicine, University of Padua, Padua, Italy
| | | | - Saul Gomez Manzo
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Soo Young Choi
- Institute of Bioscience and Biotechnology, Hallym University, Gangowo-do, South Korea
| | - Jaime Marcial Quino
- Consejo Nacional de Ciencia y Tecnology, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Dae Won Kim
- Institute of Bioscience and Biotechnology, Hallym University, Gangowo-do, South Korea
| | | | - An Xiuli
- School of Life Sciences, Zhengzhou University, Zhengzhou, China; Laboratory of Membrane Biology, New York Blood Center, New York, NY, USA
| | - Iana Iatcenko
- Dept of Medicine University of Verona and AOUI Verona, Verona, Italy
| | | | - Gian Luca Forni
- Centro Della Microcitemia e Delle Anemie Congenite, Ospedale Galliera, Genova, Italy
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Haiyambo DH, Ilunga A, Nangombe R, Ababio G, Hatuikulipi T, Aleksenko L, Misihairabgwi J, Uusiku P, Pernica JM, Greco B, Quaye IK. Glucose-6-phosphate dehydrogenase deficiency genotypes and allele frequencies in the Kavango and Zambezi regions of northern Namibia. Trans R Soc Trop Med Hyg 2020; 113:483-488. [PMID: 31086985 DOI: 10.1093/trstmh/trz035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/26/2019] [Accepted: 04/09/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Namibia has made significant gains in the fight against malaria, with a target of elimination by 2023. We examined the genotype and allele frequencies of glucose-6-phosphate dehydrogenase (G6PD) deficiency to inform decisions on primaquine use, as we recently detected clusters of Plasmodium ovale curtisi in Kavango. METHODS A multistaged cross-sectional sampling method was used to enrol 212 children 2-9 y of age from schools and clinics in the Okavango and Zambezi regions of northern Namibia. Genotypes for the 202 G→A and 376 A→G mutations were assigned by polymerase chain reaction restriction fragment length polymorphism. RESULTS Of the 212 subjects enrolled, genotypes were available for 210, made up of 61 males and 149 females. G6PD-deficient males (hemizygotes) and females (homozygotes) constituted 3.27% (2/61) and 0.0% (0/149), respectively. Female heterozygotes (AA- and BA-) constituted 10.07% (15/149), while G6PD wild-type males (with A or B haplotype) and females (with AA, BB or AB haplotypes) consisted of 96.72% (59/61) and 89.93% (134/149), respectively. The A-, A and B allele frequencies were 0.0474, 0.3036 and 0.6490, respectively. Hardy-Weinberg equilibrium tests for female genotype frequencies did not show deviation (p=0.29). CONCLUSIONS The frequency of G6PD deficiency alleles in males in the Kavango and Zambezi regions of northern Namibia constitute 3.27%, a first report to inform policy on primaquine role out.
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Affiliation(s)
- Daniel H Haiyambo
- Department of Biochemistry and Microbiology, University of Namibia School of Medicine, Windhoek, Namibia
| | - Alex Ilunga
- Department of Biochemistry and Microbiology, University of Namibia School of Medicine, Windhoek, Namibia
| | - Ruth Nangombe
- School of Nursing, Welwitchia University, Nkurenkuru, Namibia
| | - Grace Ababio
- Department of Medical Biochemistry, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Toini Hatuikulipi
- Department of Biochemistry and Microbiology, University of Namibia School of Medicine, Windhoek, Namibia
| | - Larysa Aleksenko
- Department of Obstetrics and Gynecology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jane Misihairabgwi
- Department of Biochemistry and Microbiology, University of Namibia School of Medicine, Windhoek, Namibia
| | - Petrina Uusiku
- National Malaria Control Program, Ministry of Health and Social Services, Windhoek, Namibia
| | - Jeffrey M Pernica
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Beatrice Greco
- Research and Development, Global Health Institute, Merck KGA, Germany
| | - Isaac K Quaye
- Department of Biochemistry and Microbiology, University of Namibia School of Medicine, Windhoek, Namibia
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Ang YS, Lai PS, Yung LYL. Design of Split Proximity Circuit as a Plug-and-Play Translator for Point Mutation Discrimination. Anal Chem 2020; 92:11164-11170. [PMID: 32605366 DOI: 10.1021/acs.analchem.0c01379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Point mutations are a common form of genetic variation and have been identified as important disease biomarkers. Conventional methods for analyzing point mutations, e.g., polymerase chain reaction (PCR), are based on differences in thermal stability of the DNA duplex, which require extensive optimization of the reaction condition and nontrivial design of sequence-selective primers. This motivated the design of molecular translators to convert molecular inputs into generic output sequences, which allows for the target recognition and signal generation regions to be designed independently. In this work, we propose a translator design based on the concept of split proximity circuit (SPC) to achieve both high sequence selectivity and assay robustness using a universal reaction condition, i.e., room temperature and constant ionic concentration. We discussed the design aspects of the SPC recognition regions and demonstrated its plug-and-play capability to discriminate different point mutations for both DNA (seven G6PD mutations) and RNA (let-7 microRNA family members) targets while retaining the same signal generation region. Despite its simple design and nonstringent assay condition requirements, the SPC retained good analytical performance to detect subnanomolar target concentration within a reasonable time of an hour.
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Affiliation(s)
- Yan Shan Ang
- Department of Chemical & Biomolecular Engineering, National University of Singapore, Singapore 117585, Singapore
| | - Poh San Lai
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Lin-Yue Lanry Yung
- Department of Chemical & Biomolecular Engineering, National University of Singapore, Singapore 117585, Singapore
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55
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Danquah KO, Mensah K, Nkansah C, Appiah SK, Noagbe M, Hardy Y, Ntiamoah DO, Boateng LA, Annani-Akollor ME, Owiredu EW, Debrah AY, Addai-Mensah O. Molecular Characterization of Glucose-6-Phosphate Dehydrogenase: Do Single Nucleotide Polymorphisms Affect Hematological Parameters in HIV-Positive Patients? J Trop Med 2020; 2020:5194287. [PMID: 32802082 PMCID: PMC7416277 DOI: 10.1155/2020/5194287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/19/2020] [Indexed: 11/17/2022] Open
Abstract
This descriptive, cross-sectional study aimed at evaluating the prevalence of G6PD deficiency and the 376A ⟶ G, 202G ⟶ A single nucleotide polymorphisms (SNPs) among HIV patients attending care at a teaching hospital in Ghana and determine how the SNPs affect haematological profile in HIV. A total of 200 HIV-positive Ghanaians were recruited. Venous blood samples were obtained and complete blood count, and G6PD screening and genotyping for the 376A ⟶ G, 202G ⟶ A SNPs were performed. Out of the 200 participants, 13.0% (26/200) were G6PD-deficient based on the methemoglobin reductase technique, with 1.5% (3/200) and 11.5% (23/200) presenting with partial and full enzyme defect, respectively. Among the 13.0% participants with G6PD deficiency, 19.2% (5/26), 30.8% (8/26), and 19.2% (5/26) presented with 376A ⟶ G only (enzyme activity (EA): 1.19 U/g Hb), 202G ⟶A only (EA: 1.41 U/g Hb), and G202/A376 SNPs (EA: 1.14 U/g Hb), respectively. Having the 376A ⟶ G mutation was associated not only with lower red blood cell (RBC) count (3.38 × 106/µL (3.16-3.46) vs 3.95 × 106/µL (3.53-4.41), p = 0.010) but also with higher mean cell volume (MCV) (102.90 (99.40-113.0) vs 91.10 fL (84.65-98.98), p = 0.041) and mean cell haemoglobin (MCH) (33.70 pg (32.70-38.50) vs 30.75 pg (28.50-33.35), p = 0.038), whereas possessing the 202G ⟶ A mutation was associated with higher MCV only (98.90 fL (90.95-102.35) vs 91.10 fL (84.65-98.98), p = 0.041) compared to G6PD nondeficient participants. The prevalence of G6PD deficiency among HIV patients in Kumasi, Ghana, is 13.0% prevalence, comprising 1.5% and 11.5% partial and full enzyme defect, respectively, based on the methemoglobin reductase technique among HIV patients in Ghana. Among G6PD-deficient HIV patients, the prevalence of G202/A376 SNPs is 19.2%. The 376A ⟶ G mutation is associated not only with lower RBC count but also with higher MCV and MCH, whereas the 202G ⟶ A mutation is associated with higher MCV compared to the normal G6PD population.
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Affiliation(s)
- Kwabena Owusu Danquah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kofi Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Haematology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Charles Nkansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Kwasi Appiah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mark Noagbe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yasmine Hardy
- HIV Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - David O. Ntiamoah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Basic and Applied Biology, University of Energy and Natural Resource, Sunyani, Ghana
| | - Lillian Antwi Boateng
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Yaw Debrah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Otchere Addai-Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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56
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Lu YW, Chen TC. Use of trimethoprim-sulfamethoxazole in a patient with G6PD deficiency for treating Pneumocystis jirovecii pneumonia without haemolysis: Case report and literature review. J Clin Pharm Ther 2020; 45:1483-1485. [PMID: 32648956 DOI: 10.1111/jcpt.13220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 05/27/2020] [Accepted: 06/12/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE A fixed dose of trimethoprim-sulphamethoxazole (TMP/SMZ) is the first-line therapy for Pneumocystis jirovecii pneumonia (PJP). Other alternative regiments have shown a suboptimal cure rate. However, TMP/SMZ has been reported to cause haemolyses when administered to patients with G6DP deficiency. PJP might be fatal without treatment. To date, there is still insufficient evidence to manage PJP with TMP/SMZ in G6DP deficiency population. CASE DESCRIPTION We report a G6PD-deficient patient with human immunodeficiency virus (HIV) and PJP infection treated successfully with 21 days of high dose TMP/SMZ without any signs and symptoms of haemolysis. WHAT IS NEW AND CONCLUSION Based on our experience, it is worth to note that despite TMP/SMZ is consider unsafe in patient with pre-existing G6PD-deficiency, it could still be suggested as the initial drug of choice in Taiwanese or southeast Asian population for treating PJP infected HIV patient.
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Affiliation(s)
- Ya-Wen Lu
- Department of Pharmacy, Taichung Hospital, Ministry of Health Welfare, Taichung, Taiwan
| | - Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
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57
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Capoluongo ED, Amato F, Castaldo G. The friendly use of chloroquine in the COVID-19 disease: a warning for the G6PD-deficient males and for the unaware carriers of pathogenic alterations of the G6PD gene. Clin Chem Lab Med 2020; 58:1162-1164. [PMID: 32333649 DOI: 10.1515/cclm-2020-0442] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Ettore D Capoluongo
- CEINGE, Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, and Department of Laboratory and Transfusion Medicine - Federico II University Hospital, Naples, Italy
| | - Felice Amato
- CEINGE, Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Giuseppe Castaldo
- CEINGE, Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
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58
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Shen S, Xiong Q, Cai W, Xiong H, Hu X. A novel G6PD gene variant in a Chinese girl with favism. J Clin Lab Anal 2020; 34:e23402. [PMID: 32557798 PMCID: PMC7521235 DOI: 10.1002/jcla.23402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022] Open
Abstract
Background Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency is the most common human enzymopathy. The human G6PD gene is highly polymorphic, and over 200 mutations have been identified, many of which are associated with hemolytic anemia. Here, we analyzed the clinical genetics data of a Chinese girl with favism who developed acute hemolytic anemia after fava bean ingestion. Methods The clinical genetics data of the proband who developed acute hemolytic anemia were collected and analyzed, and G6PD gene exons were sequenced in the proband and her family. Results We reported for the first time a novel G6PD gene variant in a Chinese girl, which we named “G6PD Wuhan.” This variant is localized exon 3 of the G6PD gene at genomic position 141G > C, that is a change from p.Lys47 to Asn. The bioinformatics analysis and protein modeling study indicated this variant may have negative effects on the enzyme activity of G6PD. Conclusions Our results indicated that favism in the proband was caused by this novel heterozygous variant (c.141G > C) in G6PD. The variant in G6PD has implications for genetic counseling and could provide insights into the functional roles of G6PD mutations.
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Affiliation(s)
- Shanshan Shen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan City, China
| | - Qian Xiong
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan City, China
| | - Wenqian Cai
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan City, China
| | - Hao Xiong
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan City, China
| | - Xijiang Hu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan City, China
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59
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Praoparotai A, Junkree T, Imwong M, Boonyuen U. Functional and structural analysis of double and triple mutants reveals the contribution of protein instability to clinical manifestations of G6PD variants. Int J Biol Macromol 2020; 158:884-893. [PMID: 32387609 DOI: 10.1016/j.ijbiomac.2020.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/11/2020] [Accepted: 05/04/2020] [Indexed: 11/18/2022]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common polymorphism and enzymopathy in humans, affecting approximately 400 million people worldwide. Over 200 point mutations have been identified in g6pd and the molecular mechanisms underlying the severity of G6PD variants differ. We report the detailed functional and structural characterization of 11 recombinant human G6PD variants: G6PD Asahi, G6PD A, G6PD Guadalajara, G6PD Acrokorinthos, G6PD Ananindeua, G6PD A-(202), G6PD Sierra Leone, G6PD A-(680), G6PD A-(968), G6PD Mount Sinai and G6PD No name. G6PD Guadalajara, G6PD Mount Sinai and G6PD No name are inactive variants and, correlating with the observed clinical manifestations, exhibit complete loss of enzyme activity. Protein structural instability, causing a reduction in catalytic efficiency, contributes to the clinical phenotypes of all variants. In double and triple mutants sharing the G6PD A mutation, we observed cooperative interaction between two and three mutations to cause protein dysfunction. The G6PD A (Asn126Asp) mutation exhibits no effect on protein activity and stability, indicating that the additional mutations in these G6PD variants significantly contribute to enzyme deficiency. We provide insight into the molecular basis of G6PD deficiency, which can explain the severity of clinical manifestations observed in individuals with G6PD deficiency.
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Affiliation(s)
- Aun Praoparotai
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Thanyaphorn Junkree
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Mallika Imwong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Usa Boonyuen
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
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60
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Pfeffer DA, Ley B, Howes RE, Adu P, Alam MS, Bansil P, Boum Y, Brito M, Charoenkwan P, Clements A, Cui L, Deng Z, Egesie OJ, Espino FE, von Fricken ME, Hamid MMA, He Y, Henriques G, Khan WA, Khim N, Kim S, Lacerda M, Lon C, Mekuria AH, Menard D, Monteiro W, Nosten F, Oo NN, Pal S, Palasuwan D, Parikh S, Pitaloka Pasaribu A, Poespoprodjo JR, Price DJ, Roca-Feltrer A, Roh ME, Saunders DL, Spring MD, Sutanto I, Ley-Thriemer K, Weppelmann TA, von Seidlein L, Satyagraha AW, Bancone G, Domingo GJ, Price RN. Quantification of glucose-6-phosphate dehydrogenase activity by spectrophotometry: A systematic review and meta-analysis. PLoS Med 2020; 17:e1003084. [PMID: 32407380 PMCID: PMC7224463 DOI: 10.1371/journal.pmed.1003084] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 04/13/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The radical cure of Plasmodium vivax and P. ovale requires treatment with primaquine or tafenoquine to clear dormant liver stages. Either drug can induce haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, necessitating screening. The reference diagnostic method for G6PD activity is ultraviolet (UV) spectrophotometry; however, a universal G6PD activity threshold above which these drugs can be safely administered is not yet defined. Our study aimed to quantify assay-based variation in G6PD spectrophotometry and to explore the diagnostic implications of applying a universal threshold. METHODS AND FINDINGS Individual-level data were pooled from studies that used G6PD spectrophotometry. Studies were identified via PubMed search (25 April 2018) and unpublished contributions from contacted authors (PROSPERO: CRD42019121414). Studies were excluded if they assessed only individuals with known haematological conditions, were family studies, or had insufficient details. Studies of malaria patients were included but analysed separately. Included studies were assessed for risk of bias using an adapted form of the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Repeatability and intra- and interlaboratory variability in G6PD activity measurements were compared between studies and pooled across the dataset. A universal threshold for G6PD deficiency was derived, and its diagnostic performance was compared to site-specific thresholds. Study participants (n = 15,811) were aged between 0 and 86 years, and 44.4% (7,083) were women. Median (range) activity of G6PD normal (G6PDn) control samples was 10.0 U/g Hb (6.3-14.0) for the Trinity assay and 8.3 U/g Hb (6.8-15.6) for the Randox assay. G6PD activity distributions varied significantly between studies. For the 13 studies that used the Trinity assay, the adjusted male median (AMM; a standardised metric of 100% G6PD activity) varied from 5.7 to 12.6 U/g Hb (p < 0.001). Assay precision varied between laboratories, as assessed by variance in control measurements (from 0.1 to 1.5 U/g Hb; p < 0.001) and study-wise mean coefficient of variation (CV) of replicate measures (from 1.6% to 14.9%; p < 0.001). A universal threshold of 100% G6PD activity was defined as 9.4 U/g Hb, yielding diagnostic thresholds of 6.6 U/g Hb (70% activity) and 2.8 U/g Hb (30% activity). These thresholds diagnosed individuals with less than 30% G6PD activity with study-wise sensitivity from 89% (95% CI: 81%-94%) to 100% (95% CI: 96%-100%) and specificity from 96% (95% CI: 89%-99%) to 100% (100%-100%). However, when considering intermediate deficiency (<70% G6PD activity), sensitivity fell to a minimum of 64% (95% CI: 52%-75%) and specificity to 35% (95% CI: 24%-46%). Our ability to identify underlying factors associated with study-level heterogeneity was limited by the lack of availability of covariate data and diverse study contexts and methodologies. CONCLUSIONS Our findings indicate that there is substantial variation in G6PD measurements by spectrophotometry between sites. This is likely due to variability in laboratory methods, with possible contribution of unmeasured population factors. While an assay-specific, universal quantitative threshold offers robust diagnosis at the 30% level, inter-study variability impedes performance of universal thresholds at the 70% level. Caution is advised in comparing findings based on absolute G6PD activity measurements across studies. Novel handheld quantitative G6PD diagnostics may allow greater standardisation in the future.
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Affiliation(s)
- Daniel A. Pfeffer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- * E-mail:
| | - Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Rosalind E. Howes
- Malaria Atlas Project, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Patrick Adu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - Pooja Bansil
- Diagnostics Program, PATH, Seattle, Washington, United States of America
| | - Yap Boum
- Médecins sans Frontières Epicentre, Mbarara Research Centre, Mbarara, Uganda
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Marcelo Brito
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brasil
| | - Pimlak Charoenkwan
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Archie Clements
- Faculty of Health Sciences, Curtin University, Bentley, Australia
- Telethon Kids Institute, Nedlands, Australia
| | - Liwang Cui
- Department of Entomology, Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Zeshuai Deng
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - Ochaka Julie Egesie
- Department of Hematology and Blood Transfusion, Faculty of Medical Sciences, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Fe Esperanza Espino
- Department of Parasitology, Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa City, Philippines
| | - Michael E. von Fricken
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, United States of America
| | - Muzamil Mahdi Abdel Hamid
- Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Republic of the Sudan
| | - Yongshu He
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - Gisela Henriques
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wasif Ali Khan
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - Nimol Khim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Saorin Kim
- Malaria Molecular Epidemiology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Marcus Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brasil
| | - Chanthap Lon
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Didier Menard
- Malaria Genetics and Resistance Group, Institut Pasteur, Paris, France
| | - Wuelton Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brasil
| | - François Nosten
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nwe Nwe Oo
- Department of Medical Research, Lower Myanmar, Yangon, Myanmar
| | - Sampa Pal
- Diagnostics Program, PATH, Seattle, Washington, United States of America
| | - Duangdao Palasuwan
- Oxidation in Red Cell Disorders and Health Research Unit, Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Sunil Parikh
- Yale School of Public Health, New Haven, Connecticut, United States of America
| | | | | | - David J. Price
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- The Peter Doherty Institute for Infection and Immunity, The University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | | | - Michelle E. Roh
- Global Health Group, Malaria Elimination Initiative, University of California, San Francisco, San Francisco, United States of America
| | - David L. Saunders
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
- F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
- US Army Medical Materiel Development Activity, Fort Detrick, Maryland, United States of America
| | - Michele D. Spring
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Kamala Ley-Thriemer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Thomas A. Weppelmann
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Lorenz von Seidlein
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Germana Bancone
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Gonzalo J. Domingo
- Diagnostics Program, PATH, Seattle, Washington, United States of America
| | - Ric N. Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Effects of Single and Double Mutants in Human Glucose-6-Phosphate Dehydrogenase Variants Present in the Mexican Population: Biochemical and Structural Analysis. Int J Mol Sci 2020; 21:ijms21082732. [PMID: 32326520 PMCID: PMC7215812 DOI: 10.3390/ijms21082732] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 11/16/2022] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most frequent human enzymopathy, affecting over 400 million people globally. Worldwide, 217 mutations have been reported at the genetic level, and only 19 have been found in Mexico. The objective of this work was to contribute to the knowledge of the function and structure of three single natural variants (G6PD A+, G6PD San Luis Potosi, and G6PD Guadalajara) and a double mutant (G6PD Mount Sinai), each localized in a different region of the three-dimensional (3D) structure. In the functional characterization of the mutants, we observed a decrease in specific activity, protein expression and purification, catalytic efficiency, and substrate affinity in comparison with wild-type (WT) G6PD. Moreover, the analysis of the effect of all mutations on the structural stability showed that its presence increases denaturation and lability with temperature and it is more sensible to trypsin digestion protease and guanidine hydrochloride compared with WT G6PD. This could be explained by accelerated degradation of the variant enzymes due to reduced stability of the protein, as is shown in patients with G6PD deficiency.
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Fine Mapping of Glucose 6 Phosphate Dehydrogenase (G6PD) Deficiency in a Rural Malaria Area of South West Odisha Using the Clinical, Hematological and Molecular Approach. Mediterr J Hematol Infect Dis 2020; 12:e2020015. [PMID: 32180910 PMCID: PMC7059741 DOI: 10.4084/mjhid.2020.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/10/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction The aim of the study was to enumerate the clinical, hematological, and molecular spectrum of G6PD deficiency in malaria endemic regions of south west Odisha. Methods Diagnosis of G6PD deficiency was made by using the Di-chloroindophenol Dye test in two south west districts (Kalahandi and Rayagada) of Odisha State. Demographic and clinical history was taken from each individual using a pre-structured questionnaire. Molecular characterization of G6PD deficiency was done using PCR-RFLP and Sanger sequencing. Results A total of 1981 individuals were screened; among them, 59 (2.97%) individuals were G6PD deficient. The analysis revealed that G6PD deficiency was more among males (4.0%) as compared to females (2.3%). Prevalence of G6PD deficiency was significantly higher among tribal populations (4.8%) as compared to non-tribal populations (2.4%) (p=0.012, OR=2.014, 95%CI=1.206–3.365). Twenty four individuals with G6PD deficiency had mild to moderate anemia, whereas 26 G6PD deficient individuals had a history of malaria infection. Among them, 3 (11.5%) required blood transfusion during treatment. Molecular analysis revealed G6PD Orissa as the most common (88%) mutation in the studied cohort. G6PD Kaiping (n=3), G6PD Coimbra (n=2) and G6PD Union (n=1) were also noted in this cohort. Conclusion The cumulative prevalence of G6PD deficiency in the present study is below the estimated national prevalence. G6PD deficiency was higher among tribes as compared to non-tribes. Clinical significance for G6PD deficiency was noted only in malaria infected individuals. Rare G6PD Kaiping and G6PD Union variants were also present.
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Commons RJ, McCarthy JS, Price RN. Tafenoquine for the radical cure and prevention of malaria: the importance of testing for G6PD deficiency. Med J Aust 2020; 212:152-153.e1. [PMID: 32036613 PMCID: PMC7064913 DOI: 10.5694/mja2.50474] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Robert J Commons
- Menzies School of Health ResearchDarwinNT
- WorldWide Antimalarial Resistance NetworkDarwinNT
- Ballarat Health ServicesBallaratVIC
| | - James S McCarthy
- QIMR Berghofer Medical Research InstituteBrisbaneQLD
- University of QueenslandBrisbaneQLD
| | - Ric N Price
- Menzies School of Health ResearchDarwinNT
- Centre for Tropical Medicine and Global HealthNuffield Department of Clinical MedicineUniversity of OxfordOxfordUK
- Mahidol UniversityBangkokThailand
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Impact of G6PD status on red cell storage and transfusion outcomes. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 17:289-295. [PMID: 31385801 DOI: 10.2450/2019.0092-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/18/2019] [Indexed: 12/17/2022]
Abstract
There are inter-individual differences in the quality of refrigerator-stored red blood cells (RBCs). Possible sources of these variations include nutritional and genetic factors. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common enzyme deficiency worldwide that affects the ability of RBCs to respond to oxidative stress, has been implicated as a genetic factor that affects the quality of stored RBCs. This review considers the literature concerning G6PD-deficient RBCs. It discusses RBC unit variables such as in vitro storage, 24-hour post-transfusion recovery (PTR), post-transfusion survival, and post-transfusion clinical outcomes.There are several differences in the in vitro storage characteristics between G6PD-deficient and G6PD-normal RBCs. Recent studies identified differences in the pathways related to glycolysis, purine metabolism, glutathione homeostasis, and fatty acid metabolism. In vitro experiments modelling the transfusion of G6PD-deficient RBCs, as well as autologous PTR studies in vivo, demonstrate increased haemolysis and decreased PTR, respectively, both indicators of a decrease in quality as compared to G6PD-normal RBCs. Finally, studies transfusing G6PD-deficient and G6PD-normal RBCs show that, in certain clinical settings, G6PD-deficient RBCs are associated with increased haemolysis.In summary, G6PD deficiency is associated with a decrease in the quality of RBCs after storage and its impact is often under-estimated. Understanding the underlying mechanisms by which G6PD deficiency affects RBC storage and transfusion outcomes may provide important clues to help optimise the future efficacy and safety of transfusions.
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Roper D, Layton M, Rees D, Lambert C, Vulliamy T, De la Salle B, D’Souza C. Laboratory diagnosis of G6PD deficiency. A British Society for Haematology Guideline. Br J Haematol 2020; 189:24-38. [DOI: 10.1111/bjh.16366] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- David Roper
- Department of Haematology Imperial College Healthcare NHS Trust London UK
| | - Mark Layton
- Department of Haematology Imperial College Healthcare NHS Trust London UK
| | - David Rees
- Department of Haematology King's College Hospital NHS Foundation Trust London UK
| | - Chris Lambert
- Department of Haematology and Blood Transfusion King's College Hospital NHS Foundation Trust London UK
| | - Tom Vulliamy
- Queen Mary University of London Blizard Institute London UK
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Reference levels for glucose-6-phosphate dehydrogenase enzyme activity in infants 7–90 days old in Taiwan. J Formos Med Assoc 2020; 119:69-74. [DOI: 10.1016/j.jfma.2019.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/25/2019] [Accepted: 03/11/2019] [Indexed: 11/27/2022] Open
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Alina MF, Azma RZ, Norunaluwar J, Azlin I, Darnina AJ, Cheah FC, Noor-Farisah AR, Siti-Hawa AA, Danny XRK, Zulkifli NF, Ainoon O. Genotyping of Malaysian G6PD-deficient neonates by reverse dot blot flow-through hybridisation. J Hum Genet 2019; 65:263-270. [PMID: 31863082 DOI: 10.1038/s10038-019-0700-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 10/13/2019] [Accepted: 11/23/2019] [Indexed: 11/09/2022]
Abstract
G6PD deficiency is the commonest enzyme deficiency found in humans. Current diagnostic methods lack sensitivity to detect all cases of G6PD deficiency. We evaluated the reverse dot blot flow-through hybridisation assay designed to detect simultaneously multiple known G6PD mutations in a group of Malaysian neonates. Archival DNA samples from 141 G6PD-deficient neonates were subjected to reverse dot blot flow-through hybridisation assay using the GenoArray Diagnostic Kit (Hybribio Limited, Hong Kong) and DNA sequencing. The method involved PCR amplification of 5 G6PD exons using biotinylated primers, hybridisation of amplicons to a membrane containing oligoprobes designed for G6PD mutations known to occur in the Malaysian population and colour detection by enzyme immunoassay. The assay detected 13 of the 14 G6PD mutations and genotyped 133 (94.3%) out of 141 (102 males, 39 females) cases. Among the 39 female G6PD-deficient neonates, there were 7 homozygous and 6 compound heterozygous cases. The commonest alleles were G6PD Viangchan 871G > A (21%) and G6PD Mahidol 487G > A(20%) followed by G6PD Mediterranean 563C > T, (14%), G6PD Vanua Lava 383T > C (12%), G6PD Canton 1376G > T (10%), G6PD Orissa 131C > G (6.3%) G6PD Coimbra 592C > T (5.6%) plus 6 other mutations. DNA sequencing of remaining cases revealed 6 cases of intron 11 nt 93C > T not previously reported in Malaysia and two novel mutations, one case each of nt 1361G > T and nt 1030G > A. We found the reverse dot blot assay easy to perform, rapid, accurate and reproducible, potentially becoming an improved diagnostic test for G6PD deficiency.
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Affiliation(s)
- M F Alina
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.,Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - R Z Azma
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia.
| | - J Norunaluwar
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia.,Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - I Azlin
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - A J Darnina
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - F C Cheah
- Department of Paediatrics, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - A R Noor-Farisah
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - A A Siti-Hawa
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - X R K Danny
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Noor-Fadzilah Zulkifli
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - O Ainoon
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.
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Pengboon P, Thamwarokun A, Changsri K, Kaset C, Chomean S. Evaluation of quantitative biosensor for glucose-6-phosphate dehydrogenase activity detection. PLoS One 2019; 14:e0226927. [PMID: 31860695 PMCID: PMC6924682 DOI: 10.1371/journal.pone.0226927] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/06/2019] [Indexed: 11/19/2022] Open
Abstract
Neonatal jaundice is a common and severe disease in premature infants with Glucose-6-Phosphate Dehydrogenase (G-6-PD) deficiency. The World Health Organization (WHO) has recommended screening for G-6-PD deficiency in newborns for early recognition as well as to prevent unwanted outcomes in a timely manner. The present study aimed to assess a point-of-care, careSTARTTM G6PD biosensor as a quantitative method for the diagnosis of G-6-PD deficiency. Factors influencing the evaluation of G-6-PD enzyme activity were examined in 40 adults, including ethylenediaminetetraacetic acid (EDTA) anticoagulant, hematocrit concentration, storage temperature and time. Analytic performance of the careSTARTTM G6PD biosensor was evaluated in 216 newborns and compared with fluorescent spot test (FST) and standard quantitative G-6-PD enzyme activity (SGT) assay. The results of factors affecting the G-6-PD enzyme activity showed that the activity determined from finger-prick was not statistically different from venous blood (p = 0.152). The G-6-PD value was highly dependent on the hematocrit and rose with increasing hematocrit concentration. Its activity was stable at 4°C for 3 days. Reliability analysis between the careSTARTTM G6PD biosensor and SGT assay showed a strong correlation with a Pearson's correlation coefficient of 0.82 and perfect agreement by intraclass correlation coefficient (ICC) of 0.90. Analysis of the area under the Receiver Operating Curve (AUC) illustrated that the careSTARTTM G6PD biosensor had 100% sensitivity, 96% specificity, 73% positive predictive value (PPV), 100% negative predictive value (NPV) and 97% accuracy at 30% of residual activity. While the diagnostic ability for identifying G-6-PD deficiency had 78% sensitivity, 89% specificity, 56% positive predictive value (PPV), 96% negative predictive value (NPV) and 88% accuracy when stratified by gender. The careSTARTTM G6PD biosensor is an attractive option as a point-of-care quantitative method for G-6-PD activity detection. Quantification of G-6-PD enzyme activity in newborns is the most effective approach for the management of G-6-PD deficiency to prevent severe jaundice and acute hemolysis.
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Affiliation(s)
- Pairat Pengboon
- Graduate Program in Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
| | - Areenuch Thamwarokun
- Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
| | - Khaimuk Changsri
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
| | - Chollanot Kaset
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
| | - Sirinart Chomean
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumtani, Thailand
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Ley B, Winasti Satyagraha A, Rahmat H, von Fricken ME, Douglas NM, Pfeffer DA, Espino F, von Seidlein L, Henriques G, Oo NN, Menard D, Parikh S, Bancone G, Karahalios A, Price RN. Performance of the Access Bio/CareStart rapid diagnostic test for the detection of glucose-6-phosphate dehydrogenase deficiency: A systematic review and meta-analysis. PLoS Med 2019; 16:e1002992. [PMID: 31834890 PMCID: PMC6910667 DOI: 10.1371/journal.pmed.1002992] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/08/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND To reduce the risk of drug-induced haemolysis, all patients should be tested for glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) prior to prescribing primaquine (PQ)-based radical cure for the treatment of vivax malaria. This systematic review and individual patient meta-analysis assessed the utility of a qualitative lateral flow assay from Access Bio/CareStart (Somerset, NJ) (CareStart Screening test for G6PD deficiency) for the diagnosis of G6PDd compared to the gold standard spectrophotometry (International Prospective Register of Systematic Reviews [PROSPERO]: CRD42019110994). METHODS AND FINDINGS Articles published on PubMed between 1 January 2011 and 27 September 2019 were screened. Articles reporting performance of the standard CSG from venous or capillary blood samples collected prospectively and considering spectrophotometry as gold standard (using kits from Trinity Biotech PLC, Wicklow, Ireland) were included. Authors of articles fulfilling the inclusion criteria were contacted to contribute anonymized individual data. Minimal data requested were sex of the participant, CSG result, spectrophotometry result in U/gHb, and haemoglobin (Hb) reading. The adjusted male median (AMM) was calculated per site and defined as 100% G6PD activity. G6PDd was defined as an enzyme activity of less than 30%. Pooled estimates for sensitivity and specificity, unconditional negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated comparing CSG results to spectrophotometry using a random-effects bivariate model. Of 11 eligible published articles, individual data were available from 8 studies, 6 from Southeast Asia, 1 from Africa, and 1 from the Americas. A total of 5,815 individual participant data (IPD) were available, of which 5,777 results (99.3%) were considered for analysis, including data from 3,095 (53.6%) females. Overall, the CSG had a pooled sensitivity of 0.96 (95% CI 0.90-0.99) and a specificity of 0.95 (95% CI 0.92-0.96). When the prevalence of G6PDd was varied from 5% to 30%, the unconditional NPV was 0.99 (95% CI 0.94-1.00), with an LR+ and an LR- of 18.23 (95% CI 13.04-25.48) and 0.05 (95% CI 0.02-0.12), respectively. Performance was significantly better in males compared to females (p = 0.027) but did not differ significantly between samples collected from capillary or venous blood (p = 0.547). Limitations of the study include the lack of wide geographical representation of the included data and that the CSG results were generated under research conditions, and therefore may not reflect performance in routine settings. CONCLUSIONS The CSG performed well at the 30% threshold. Its high NPV suggests that the test is suitable to guide PQ treatment, and the high LR+ and low LR- render the test suitable to confirm and exclude G6PDd. Further operational studies are needed to confirm the utility of the test in remote endemic settings.
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Affiliation(s)
- Benedikt Ley
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- * E-mail:
| | | | - Hisni Rahmat
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Michael E. von Fricken
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, United States of America
| | - Nicholas M. Douglas
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Daniel A. Pfeffer
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Fe Espino
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Philippines
| | - Lorenz von Seidlein
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Gisela Henriques
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nwe Nwe Oo
- Department of Medical Research (Lower Myanmar), Yangon, Republic of the Union of Myanmar
| | - Didier Menard
- Malaria Genetics and Resistance Unit, Institut Pasteur, Paris, France
| | - Sunil Parikh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Germana Bancone
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Ric N. Price
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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Arun G, Rajaram R, Kaleshkumar K, Gayathri N, Sivasudha T, Kandasamy S. Synergistic effect of novel chitosan combined metformin drug on streptozotocin-induced diabetes mellitus rat. Int J Biol Macromol 2019; 153:1335-1349. [PMID: 31730994 DOI: 10.1016/j.ijbiomac.2019.10.270] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 02/08/2023]
Abstract
Metformin is widely used as a frontline medicine of type-II diabetes. Frequent overdose side-effects and their consequent adversative need to be reduced. The novel source of marine hydrozoa, Thyroscyphus ramosus derived chitosan combined metformin drug was administrated to evaluate the antidiabetic potential on a high-fat diet (HFD) with streptozotocin (STZ) induced diabetic rats. The primary analysis of In vitro antioxidant activity was tested for various solvent dissolved chitosan. Based on their IC50 dose values, CsnAA was chosen for further experiments. The chitosan was combined with metformin by sonication and confirmed through XRD, FTIR and SEM analysis. The enhanced activity was observed in 100 mg/kg metformin combined with CSN500mg/kg. The level of serum bilirubin, total protein, SGH, liver glycogen, Glucose-6-phosphatase and fructose-1,6- phosphatase values were significantly similar to metformin 300 mg/kg treated group. With this beneficiary, the novel chitosan was recommended to administrate with metformin to improve the drug efficacy and reduction of overdose lethal effects.
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Affiliation(s)
- Ganesan Arun
- DNA Barcoding and Marine Genomics Laboratory, Department of Marine Science, School of Marine Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620 024, India
| | - Rajendran Rajaram
- DNA Barcoding and Marine Genomics Laboratory, Department of Marine Science, School of Marine Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620 024, India.
| | - Karunanidhi Kaleshkumar
- DNA Barcoding and Marine Genomics Laboratory, Department of Marine Science, School of Marine Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620 024, India
| | - Nambirajan Gayathri
- Department of Environmental Biotechnology, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620 024, India
| | - Thilagar Sivasudha
- Department of Environmental Biotechnology, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620 024, India
| | - Singaram Kandasamy
- Clinical Biochemistry Division, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Danvantrinagar, Puducherry 605006, India
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Arunachalam AK, Sumithra S, Maddali M, Fouzia NA, Abraham A, George B, Edison ES. Molecular Characterization of G6PD Deficiency: Report of Three Novel G6PD Variants. Indian J Hematol Blood Transfus 2019; 36:349-355. [PMID: 32425388 DOI: 10.1007/s12288-019-01205-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022] Open
Abstract
G6PD deficiency is a monogenic, X-linked genetic defect with a worldwide prevalence of around 400 million people and an overall prevalence of 8.5% in India. Hemolytic anemia is encountered in only a small proportion of patients with G6PD variants and is usually triggered by some exogenous agent. Although G6PD deficiency was reported in India more than 50 years ago, there are very few studies on molecular characterization and phenotypic correlation in G6PD deficient patients. We aimed to study the epidemiology and correlate the phenotypic expression with molecular genotypes in symptomatic G6PD deficient patients. All symptomatic hemolytic anaemia patients with a possible etiology of G6PD deficiency based on the clinical, hematological and biochemical parameters and reduced G6PD enzyme levels were included in this study. Molecular analysis of the G6PD gene was done by direct Sanger sequencing. From a total of 38 patients with hemolytic anemia suspected for G6PD deficiency, 24 patients had reduced G6PD enzyme levels and were included for the molecular analysis and mutations in the G6PD gene were identified in 21 of them (83.3%). The different mutations identified in our study include 6 patients with c.131C > G (G6PD Orissa), 3 patients with c.563C > T (G6PD Mediterranean), two patients with c.825G > T (G6PD Bangkok), one patient each with c.208T > C (G6PD Namouru), c.487G > A (G6PD Mahidol), c.949G > A (G6PD Kerala-Kalyan), c.100 G > A (G6PD Chatham), c.1178C > G (G6PD Nashville), c.1361 G > A (G6PD Andalus) and 4 patients with novel mutations (2 patients with c.1186C > T and 1 patient each with c.1288-2A > T and c.1372C > T. No disease causing genetic variants were identified in the other three cases. Co-inheritance of other red cell and hemoglobin disorders can modify the clinical phenotype of G6PD patients and the diagnostic accuracy can be improved by molecular characterization of the variant.
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Affiliation(s)
- Arun Kumar Arunachalam
- 1Department of Haematology, Christian Medical College, OT Building, 4th Floor, Vellore, Tamil Nadu 632004 India
| | - S Sumithra
- 1Department of Haematology, Christian Medical College, OT Building, 4th Floor, Vellore, Tamil Nadu 632004 India
| | - Madhavi Maddali
- 1Department of Haematology, Christian Medical College, OT Building, 4th Floor, Vellore, Tamil Nadu 632004 India
| | - N A Fouzia
- 2Department of Hematology, Christian Medical College, OT Building, 1st Floor, Vellore, Tamil Nadu 632004 India
| | - Aby Abraham
- 2Department of Hematology, Christian Medical College, OT Building, 1st Floor, Vellore, Tamil Nadu 632004 India
| | - Biju George
- 2Department of Hematology, Christian Medical College, OT Building, 1st Floor, Vellore, Tamil Nadu 632004 India
| | - Eunice S Edison
- 1Department of Haematology, Christian Medical College, OT Building, 4th Floor, Vellore, Tamil Nadu 632004 India
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72
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Pal S, Bansil P, Bancone G, Hrutkay S, Kahn M, Gornsawun G, Penpitchaporn P, Chu CS, Nosten F, Domingo GJ. Evaluation of a Novel Quantitative Test for Glucose-6-Phosphate Dehydrogenase Deficiency: Bringing Quantitative Testing for Glucose-6-Phosphate Dehydrogenase Deficiency Closer to the Patient. Am J Trop Med Hyg 2019; 100:213-221. [PMID: 30350771 PMCID: PMC6335905 DOI: 10.4269/ajtmh.18-0612] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a common genetic blood condition, can result in kernicterus at birth, and later in life as severe hemolysis on exposure to certain infections, foods, and drugs. The unavailability of point-of-care tests for G6PD deficiency is a barrier to routine curative treatment of Plasmodium vivax malaria with 8-aminoquinolines, such as primaquine. Two quantitative reference tests (Trinity Biotech, Bray, Ireland and Pointe Scientific, Canton, MI; Cat No. G7583) and the point-of-care STANDARD™ G6PD test (SD Biosensor, Suwon, South Korea) were evaluated. The STANDARD G6PD test was evaluated at multiple temperatures, in anticoagulated venous and capillary samples, including 79 G6PD-deficient and 66 intermediate samples and across two laboratories, one in the United States and one in Thailand. The STANDARD test performed equivalently to a reference assay for its ability to diagnose G6PD deficiency (< 30% normal) with a sensitivity of 100% (0.95 confidence interval [CI]: 95.7–100) and specificity of 97% (0.95 CI: 94.5–98.5), and could reliably identify females with less than 70% normal G6PD activity with a sensitivity of 95.5% (0.95 CI: 89.7–98.5) and specificity of 97% (0.95 CI: 94.5–98.6). The STANDARD G6PD product represents an opportunity to diagnose G6PD deficiency equally for males and females in basic clinical laboratories in high- and low-resource settings. This quantitative point-of-care diagnostic test for G6PD deficiency can provide equal access to safe radical cure of P. vivax cases in high- and low-resource settings, for males and females and may support malaria elimination, in countries where P. vivax is endemic.
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Affiliation(s)
- Sampa Pal
- Diagnostics Program, PATH, Seattle, Washington
| | | | - Germana Bancone
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | - Maria Kahn
- Diagnostics Program, PATH, Seattle, Washington
| | - Gornpan Gornsawun
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Pimsupah Penpitchaporn
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Cindy S Chu
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - François Nosten
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
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73
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Tantular I. MTT FORMAZAN REPLACED WST-8 AS A BETTER SIMPLE SCREENING METHOD FOR DETECTION OF GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY. INDONESIAN JOURNAL OF TROPICAL AND INFECTIOUS DISEASE 2019. [DOI: 10.20473/ijtid.v7i6.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We have previously developed the WST-8 method as a simple and rapid screening test for detection of glucose-6-phosphate dehydrogenase (G6PD) deficiency accomplished by the naked eye. However, it was little difficult to distinguish between faint orange colors developed by heterozygous females and pink colors of normal hemolyzed blood, since both have similar tones. To solve this problem, we established a new and simple screening method that utilizes another formazan substrate, MTT (3-(4,5-dimethyl-2- thiazolyl)-2,5-diphenyl-2H tetrazolium bromide) in combination with a hydrogen carrier, 1-methoxy phenazine methosulfate. MTT formazan exhibits a purple color, thus allowing for the ability to easily distinguish the pink colors of hemolyzed blood. However, MTT has been reported to react with hemoglobin non-specifically and to interfere with the interpretation of the color reaction. In our examinations by mixing MTT with hemolyzed blood, we found that the non-specific reaction was very slow, and that the addition of a small amount of blood (5~10 μl) into a reaction mixture (800 μl) did not interfere with the reaction of G6PD activity. In this new MTT method, a strong purple color was generated in normal blood samples at 20~30 min after incubation, which could be distinguished by the naked eye from G6PD-deficient blood samples with less than 50% residual activity. In addition, quantitative measurement using a spectrophotometer was also possible despite the fact that MTT formazan is water-insoluble.
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74
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Rudilla F, Franco-Jarava C, Martínez-Gallo M, Garcia-Prat M, Martín-Nalda A, Rivière J, Aguiló-Cucurull A, Mongay L, Vidal F, Solanich X, Irastorza I, Santos-Pérez JL, Tercedor Sánchez J, Cuscó I, Serra C, Baz-Redón N, Fernández-Cancio M, Carreras C, Vagace JM, Garcia-Patos V, Pujol-Borrell R, Soler-Palacín P, Colobran R. Expanding the Clinical and Genetic Spectra of Primary Immunodeficiency-Related Disorders With Clinical Exome Sequencing: Expected and Unexpected Findings. Front Immunol 2019; 10:2325. [PMID: 31681265 PMCID: PMC6797824 DOI: 10.3389/fimmu.2019.02325] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 09/16/2019] [Indexed: 01/18/2023] Open
Abstract
Primary immunodeficiencies (PIDs) refer to a clinically, immunologically, and genetically heterogeneous group of over 350 disorders affecting development or function of the immune system. The increasing use of next-generation sequencing (NGS) technology has greatly facilitated identification of genetic defects in PID patients in daily clinical practice. Several NGS approaches are available, from the unbiased whole exome sequencing (WES) to specific gene panels. Here, we report on a 3-year experience with clinical exome sequencing (CES) for genetic diagnosis of PIDs. We used the TruSight One sequencing panel, which includes 4,813 disease-associated genes, in 61 unrelated patients (pediatric and adults). The analysis was done in 2 steps: first, we focused on a virtual PID panel and then, we expanded the analysis to the remaining genes. A molecular diagnosis was achieved in 19 (31%) patients: 12 (20%) with mutations in genes included in the virtual PID panel and 7 (11%) with mutations in other genes. These latter cases provided interesting and somewhat unexpected findings that expand the clinical and genetic spectra of PID-related disorders, and are useful to consider in the differential diagnosis. We also discuss 5 patients (8%) with incomplete genotypes or variants of uncertain significance. Finally, we address the limitations of CES exemplified by 7 patients (11%) with negative results on CES who were later diagnosed by other approaches (more specific PID panels, WES, and comparative genomic hybridization array). In summary, the genetic diagnosis rate using CES was 31% (including a description of 12 novel mutations), which rose to 42% after including diagnoses achieved by later use of other techniques. The description of patients with mutations in genes not included in the PID classification illustrates the heterogeneity and complexity of PID-related disorders.
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Affiliation(s)
- Francesc Rudilla
- Immunogenetics and Histocompatibility Laboratory, Banc de Sang i Teixits, Barcelona, Spain.,Transfusional Medicine Group, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Clara Franco-Jarava
- Immunology Division, Department of Cell Biology, Physiology and Immunology, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.,Jeffrey Model Foundation Excellence Center, Barcelona, Spain
| | - Mónica Martínez-Gallo
- Immunology Division, Department of Cell Biology, Physiology and Immunology, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.,Jeffrey Model Foundation Excellence Center, Barcelona, Spain
| | - Marina Garcia-Prat
- Jeffrey Model Foundation Excellence Center, Barcelona, Spain.,Pediatric Infectious Diseases and Immunodeficiencies Unit (UPIIP), Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Andrea Martín-Nalda
- Jeffrey Model Foundation Excellence Center, Barcelona, Spain.,Pediatric Infectious Diseases and Immunodeficiencies Unit (UPIIP), Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Jacques Rivière
- Jeffrey Model Foundation Excellence Center, Barcelona, Spain.,Pediatric Infectious Diseases and Immunodeficiencies Unit (UPIIP), Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Aina Aguiló-Cucurull
- Immunology Division, Department of Cell Biology, Physiology and Immunology, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.,Jeffrey Model Foundation Excellence Center, Barcelona, Spain
| | - Laura Mongay
- Immunogenetics and Histocompatibility Laboratory, Banc de Sang i Teixits, Barcelona, Spain
| | - Francisco Vidal
- Immunogenetics and Histocompatibility Laboratory, Banc de Sang i Teixits, Barcelona, Spain.,Transfusional Medicine Group, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain.,CIBER on Cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III (ISCIII), Valencia, Spain
| | - Xavier Solanich
- Adult Immunodeficiencies Unit (UFIPA), Internal Medicine Department, Institut d'Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Iñaki Irastorza
- Pediatric Gastroenterology, Cruces University Hospital, Basque Country University, Bilbao, Spain
| | - Juan Luis Santos-Pérez
- Immunodeficiencies and Infectious Disease Unit, Universitary Hospital Virgen de las Nieves, Granada, Spain
| | - Jesús Tercedor Sánchez
- Unidad de Dermatología Pediátrica y Anomalías Vasculares, Servicio de Dermatología, Instituto de Investigación Biosanitaria IBS, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Ivon Cuscó
- Genetics Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Clara Serra
- Genetics Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Noelia Baz-Redón
- Growth and Development Group, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain
| | - Mónica Fernández-Cancio
- Growth and Development Group, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.,CIBER Rare Diseases (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Carmen Carreras
- Pediatric Hematology and Immunodeficiencies Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - José Manuel Vagace
- Hematology Department, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - Vicenç Garcia-Patos
- Dermatology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ricardo Pujol-Borrell
- Immunology Division, Department of Cell Biology, Physiology and Immunology, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.,Jeffrey Model Foundation Excellence Center, Barcelona, Spain
| | - Pere Soler-Palacín
- Jeffrey Model Foundation Excellence Center, Barcelona, Spain.,Pediatric Infectious Diseases and Immunodeficiencies Unit (UPIIP), Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Roger Colobran
- Immunology Division, Department of Cell Biology, Physiology and Immunology, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.,Jeffrey Model Foundation Excellence Center, Barcelona, Spain.,Genetics Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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75
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Liu Z, Yu C, Li Q, Cai R, Qu Y, Wang W, Wang J, Feng J, Zhu W, Ou M, Huang W, Tang D, Guo W, Liu F, Chen Y, Fu L, Zhou Y, Lv W, Zhang H, Zhang J, Wang M, Yang J, Wan K, Miao J, Yuan Z, Liu H, He X, Li W, Chen W, Ye L, Chen Y, Huang S, Liu H, Ding H, Gan X, Wang S, Qiang R, Gong M, Teng P, Wang H, Zhou M, Wei H, Liu X, Tang K, Ma Y, Wu H, Shu X, Chen Y, Zhuang D, Li H, Liu Z, Liu X, Chen Y, Zhu L, Zhu X, Mo C, Tang H, Yin F, Shao Z, Zhang P, Peng B, Lu Q, Wang Z, Zou L. Chinese newborn screening for the incidence of G6PD deficiency and variant of G6PD gene from 2013 to 2017. Hum Mutat 2019; 41:212-221. [PMID: 31489982 DOI: 10.1002/humu.23911] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 08/28/2019] [Accepted: 09/02/2019] [Indexed: 11/10/2022]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common X-linked enzymopathies caused by G6PD gene variant. We aimed to provide the characteristics of G6PD deficiency and G6PD gene variant distribution in a large Chinese newborn screening population. We investigated the prevalence of G6PD in China from 2013 to 2017. Then, we examined G6PD activity and G6PD gene in representative Chinese birth cohort to explore the distribution of G6PD gene variant in 2016. We then performed multicolor melting curve analysis to classify G6PD gene variants in 10,357 neonates with activity-confirmed G6PD deficiency, and DNA Sanger sequencing for G6PD coding exons if hot site variants were not found. The screened population, organizations, and provinces of G6PD deficiency were increased from 2013 to 2017 in China. The top five frequency of G6PD gene variants were c.1376G>T, c.1388G>A, c.95A>G, c.1024C>T, and c.871G>A and varied in different provinces, with regional and ethnic features, and four pathogenic variant sites (c.152C>T, c.290A>T, c.697G>C, and c.1285A>G) were first reported. G6PD deficiency mainly occurs in South China, and the frequency of G6PD gene variant varies in different regions and ethnicities.
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Affiliation(s)
- Zhidai Liu
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Chaowen Yu
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Qingge Li
- School of Life Science, Xiamen University, Xiamen, Fujian, China
| | - Ren Cai
- Department of Medical Genetics, Liuzhou Maternal and Child Health Hospital, Liuzhou, Guangxi, China
| | - Yiping Qu
- Newborn Screening Center of Zhejiang, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Weipeng Wang
- Center of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, China
| | - Jie Wang
- Center of Clinical Laboratory, Maternal and Child Health Care Hospital of Hainan Province, Haikou, Hainan, China
| | - Jinwen Feng
- Key Laboratory of Newborn Screening Center of Yunfu, Yunfu, Guangdong, China
| | - Wenbin Zhu
- Fujian Neonatal Screening Center, Fujian Maternal and Children Health Hospital, Fuzhou, Fujian, China
| | - Mingcai Ou
- Newborn Screening Center of Sichuan, Maternal and Child Health Hospital of Sichuan Province, Chengdu, Sichuan, China
| | - Weitong Huang
- Newborn Screening Center of Nanning, Maternal and Child Health Hospital of Nanning, Nanning, Guangxi, China
| | - Deguo Tang
- Maternal and Child Health Hospital of Yongzhou, Yongzhou, Hunan, China
| | - Wei Guo
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Fangjie Liu
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Yanhua Chen
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Lifang Fu
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Yanxia Zhou
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Wenqiong Lv
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Hang Zhang
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Juan Zhang
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Ming Wang
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Jing Yang
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Kexing Wan
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Jingkun Miao
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Zhaojian Yuan
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Hao Liu
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Xiaoyan He
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Wenjie Li
- Qingdao Women & Children Hospital Neonatal Screening Lab, Qingdao, Shandong, China
| | - Wengao Chen
- Bijie Municipal Medical Technology Section of Healthcare and Family Planning Service Center, Bijie, Guizhou, China
| | - Lixin Ye
- Dongguan Newborn Screening Center, Dongguan Maternal & Infant Health Hospital, Dongguan, Guangdong, China
| | - Yajun Chen
- Medical Genetic Center of Maternal and Child Health Hospital of Shaoguan City, Shaoguan, Guangdong, China
| | - Shuodan Huang
- Newborn Screening Center of Meizhou, Meizhou, Guangdong, China
| | - Haiping Liu
- Newborn Screening Center of Foshan, Foshan, Guangdong, China
| | - Hongxiang Ding
- Department of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinhui Gan
- Neo-Screening Section, Zaozhuang Maternal and Child Health Hospital, Zaozhuang, Shandong, China
| | - Shuyuan Wang
- Department of Eugenics and Genetic, Maternal and Child Health Hospital of Xiangtan City, Xiangtan, Hunan, China
| | - Rong Qiang
- Neonatal Screening Department, Prenatal Diagnosis Department, Genetic Medical Center, Northwest Women and Children's Hospital, Xi'an, Shanxi, China
| | - Minhong Gong
- Clinical Laboratory, Maternal and Child Health Hospital of Shangluo, Shangluo, Shanxi, China
| | - Ping Teng
- Newborn Screening Center of Changde, Changde, Hunan, China
| | - Hua Wang
- Maternal and Child Health Hospital of Hunan Province, Changsha, Hunan, China
| | - Muping Zhou
- Maternal and Child Health Hospital of Shaoyang, Shaoyang, Hunan, China
| | - Hongwei Wei
- Maternal and Child Health Hospital of Linyi, Linyi, Shandong, China
| | - Xiangju Liu
- Maternal and Child Health Hospital of Tai'an, Tai'an, Shandong, China
| | - Kai Tang
- Newborn Screening Center of Baoji, Baoji, Shanxi, China
| | - Yahong Ma
- Maternal and Child Health Hospital of Yan'an, Yan'an, Shanxi, China
| | - Hongliang Wu
- Newborn Screening Center of Yueyang, Yueyang, Hunan, China
| | - Xiaoli Shu
- Gastrointestinal Laboratory, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yizhen Chen
- Clinical Laboratory, Maternal and Child Health Hospital of Ningbo, Ningbo, Zhejiang, China
| | - Danyan Zhuang
- Department of Medical Statistical, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Hui Li
- Center of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, China
| | - Zhi Liu
- Center of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, China
| | - Xiulian Liu
- Center of Clinical Laboratory, Maternal and Child Health Care Hospital of Hainan Province, Haikou, Hainan, China
| | - Yao Chen
- Fujian Neonatal Screening Center, Fujian Maternal and Children Health Hospital, Fuzhou, Fujian, China
| | - Lidan Zhu
- Department of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoyan Zhu
- Department of Eugenics and Genetic, Maternal and Child Health Hospital of Xiangtan City, Xiangtan, Hunan, China
| | - Caihong Mo
- Key Laboratory of Newborn Screening Center of Yunfu, Yunfu, Guangdong, China
| | - Hua Tang
- Maternal and Child Health Hospital of Hunan Province, Changsha, Hunan, China
| | - Feng Yin
- Maternal and Child Health Hospital of Tai'an, Tai'an, Shandong, China
| | - Zhibing Shao
- Newborn Screening Center of Yueyang, Yueyang, Hunan, China
| | - Penghui Zhang
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Bin Peng
- Department of Medical Statistical, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qing Lu
- Division of Translational and Regenerative Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Zhiguo Wang
- National Center for Clinical Laboratories, Beijing, China
| | - Lin Zou
- Department of Clinical Molecular Medicine & Newborn Screening Center, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
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CYP2D6 Polymorphisms and the Safety and Gametocytocidal Activity of Single-Dose Primaquine for Plasmodium falciparum. Antimicrob Agents Chemother 2019; 63:AAC.00538-19. [PMID: 31383656 PMCID: PMC6761544 DOI: 10.1128/aac.00538-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/08/2019] [Indexed: 12/18/2022] Open
Abstract
Single-dose primaquine (PQ) clears mature gametocytes and reduces the transmission of Plasmodium falciparum after artemisinin combination therapy. Genetic variation in CYP2D6, the gene producing the drug-metabolizing enzyme cytochrome P450 2D6 (CYP2D6), influences plasma concentrations of PQ and its metabolites and is associated with PQ treatment failure in Plasmodium vivax malaria. Single-dose primaquine (PQ) clears mature gametocytes and reduces the transmission of Plasmodium falciparum after artemisinin combination therapy. Genetic variation in CYP2D6, the gene producing the drug-metabolizing enzyme cytochrome P450 2D6 (CYP2D6), influences plasma concentrations of PQ and its metabolites and is associated with PQ treatment failure in Plasmodium vivax malaria. Using blood and saliva samples of varying quantity and quality from 8 clinical trials across Africa (n = 1,076), we were able to genotype CYP2D6 for 774 samples (72%). We determined whether genetic variation in CYP2D6 has implications for PQ efficacy in individuals with gametocytes at the time of PQ administration (n = 554) and for safety in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals treated with PQ (n = 110). Individuals with a genetically inferred CYP2D6 poor/intermediate metabolizer status had a higher gametocyte prevalence on day 7 or 10 after PQ than those with an extensive/ultrarapid CYP2D6 metabolizer status (odds ratio [OR] = 1.79 [95% confidence interval {CI}, 1.10, 2.90]; P = 0.018). The mean minimum hemoglobin concentrations during follow-up for G6PD-deficient individuals were 11.8 g/dl for CYP2D6 extensive/ultrarapid metabolizers and 12.1 g/dl for CYP2D6 poor/intermediate metabolizers (P = 0. 803). CYP2D6 genetically inferred metabolizer status was also not associated with anemia following PQ treatment (P = 0.331). We conclude that CYP2D6 poor/intermediate metabolizer status may be associated with prolonged gametocyte carriage after treatment with single-low-dose PQ but not with treatment safety.
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Djigo OKM, Bollahi MA, Hasni Ebou M, Ould Ahmedou Salem MS, Tahar R, Bogreau H, Basco L, Ould Mohamed Salem Boukhary A. Assessment of glucose-6-phosphate dehydrogenase activity using CareStart G6PD rapid diagnostic test and associated genetic variants in Plasmodium vivax malaria endemic setting in Mauritania. PLoS One 2019; 14:e0220977. [PMID: 31525211 PMCID: PMC6746352 DOI: 10.1371/journal.pone.0220977] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/26/2019] [Indexed: 02/06/2023] Open
Abstract
Background Primaquine is recommended by the World Health Organization (WHO) for radical treatment of Plasmodium vivax malaria. This drug is known to provoke acute hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Due to lack of data on G6PD deficiency, the use of primaquine has been limited in Africa. In the present study, G6PD deficiency was investigated in blood donors of various ethnic groups living in Nouakchott, a P. vivax endemic area in Mauritania. Methodology/Principal findings Venous blood samples from 443 healthy blood donors recruited at the National Transfusion Center in Nouakchott were screened for G6PD activity using the CareStart G6PD deficiency rapid diagnostic test. G6PD allelic variants were investigated using DiaPlexC G6PD genotyping kit that detects African (A-) and Mediterranean (B-) variants. Overall, 50 of 443 (11.3%) individuals (49 [11.8%] men and 1 [3.7%] woman) were phenotypically deficient. Amongst men, Black Africans had the highest prevalence of G6PD deficiency (15 of 100 [15%]) and White Moors the lowest (10 of 168, [5.9%]). The most commonly observed G6PD allelic variants among 44 tested G6PD-deficient men were the African variant A- (202A/376G) in 14 (31.8%), the Mediterranean variant B- (563T) in 13 (29.5%), and the Betica-Selma A- (376G/968C) allelic variant in 6 (13.6%). The Santamaria A- variant (376G/542T) and A variant (376G) were observed in only one and two individuals, respectively. None of the expected variants was observed in 8 (18.2%) of the tested phenotypically G6PD-deficient men. Conclusion This is the first published data on G6PD deficiency in Mauritanians. The prevalence of phenotypic G6PD deficiency was relatively high (11.3%). It was mostly associated with either African or Mediterranean variants, in agreement with diverse Arab and Black African origins of the Mauritanian population.
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Affiliation(s)
- Oum kelthoum Mamadou Djigo
- Unité de recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouveau Campus Universitaire, Nouakchott, Mauritania
| | | | - Moina Hasni Ebou
- Unité de recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouveau Campus Universitaire, Nouakchott, Mauritania
| | - Mohamed Salem Ould Ahmedou Salem
- Unité de recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouveau Campus Universitaire, Nouakchott, Mauritania
| | - Rachida Tahar
- UMR 216 MERIT, IRD, Faculté de Pharmacie, Univ. Paris Descartes, Paris, France
| | - Hervé Bogreau
- Unité de Parasitologie et d’Entomologie, Institut de Recherche Biomédicale des Armées, IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
- Centre National de Référence du Paludisme, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Marseille, France
| | - Leonardo Basco
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Ali Ould Mohamed Salem Boukhary
- Unité de recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouveau Campus Universitaire, Nouakchott, Mauritania
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- * E-mail:
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78
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Tee WV, Guarnera E, Berezovsky IN. On the Allosteric Effect of nsSNPs and the Emerging Importance of Allosteric Polymorphism. J Mol Biol 2019; 431:3933-3942. [PMID: 31306666 DOI: 10.1016/j.jmb.2019.07.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/11/2019] [Accepted: 07/04/2019] [Indexed: 12/19/2022]
Abstract
The molecular mechanisms of pathological non-synonymous single-nucleotide polymorphisms are still the object of intensive research. To this end, we explore here whether non-synonymous single-nucleotide polymorphisms can work via allosteric mechanisms. Using structure-based statistical mechanical model of allostery and analyzing energetics of the effects of mutations in a set of 27 proteins with at least 50 pathological SNPs in each molecule, we found that, indeed, some SNPs can work allosterically. We illustrate the molecular basis of disease phenotypes caused by allosteric SNPs with the case studies of human galactose 1-phosphate uridyltransferase (GALT) and glucose-6-phosphate dehydrogenase (G6PD). We also found that mutations of a number of other residues in the protein may cause modulation comparable to those observed for known pathological SNPs. In order to explain this, we propose a notion of allosteric polymorphism, which implies the presence of a number of critical positions in the protein sequence, whose mutations can allosterically disrupt the protein function and result in a disease phenotype. We conclude that the emerging importance of allosteric polymorphism calls for the development of computational framework for analyzing the allosteric effects of mutations and their role in the modulation of protein activity.
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Affiliation(s)
- Wei-Ven Tee
- Bioinformatics Institute (BII), Agency for Science, Technology and Research (A*STAR), 30 Biopolis Street, #07-01, Matrix, Singapore 138671; Department of Biological Sciences (DBS), National University of Singapore (NUS), 8 Medical Drive, Singapore 117597
| | - Enrico Guarnera
- Bioinformatics Institute (BII), Agency for Science, Technology and Research (A*STAR), 30 Biopolis Street, #07-01, Matrix, Singapore 138671
| | - Igor N Berezovsky
- Bioinformatics Institute (BII), Agency for Science, Technology and Research (A*STAR), 30 Biopolis Street, #07-01, Matrix, Singapore 138671; Department of Biological Sciences (DBS), National University of Singapore (NUS), 8 Medical Drive, Singapore 117597.
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79
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Ben Fredj D, Barro C, Joly P, Thomassin N, Collardeau-Frachon S, Plantaz D, Adjaoud D. Transient liver injury and severe neonatal cholestasis in infant with glucose-6-phosphate dehydrogenase deficiency due to a new mutation. Arch Pediatr 2019; 26:370-373. [PMID: 31278024 DOI: 10.1016/j.arcped.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/03/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
We report the case of a neonate with a new, previously undescribed, glucose-6-phosphate dehydrogenase (G6PD) gene mutation, which was revealed by severe cholestasis, hyperbilirubinemia, and transient liver dysfunction. The severity of the clinical phenotype with ongoing chronic hemolytic anemia suggests that this mutation belongs to class 1 G6PD deficiency. The hemizygous mutation «c.675G>c; p.Trp225Cys» was detected by genomic sequencing. Since severe G6PD deficiency can be revealed by cholestasis, it is important to check G6PD enzyme activity when faced with a case of liver dysfunction in the neonatal period.
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Affiliation(s)
- D Ben Fredj
- CS 10217, department of Pediatrics, Grenoble Alpes University Hospital, 38043 Grenoble cedex 09, France.
| | - C Barro
- CS 10217, department of Biological Hematology, institut de biologie et pathologie, Grenoble Alpes University Hospital, 38043 Grenoble cedex 09, France
| | - P Joly
- Biochemistry-Molecular Biology, Haemoglobinopathies Lab, hospices Civils de Lyon, centre biologie pathologie Est, groupement hospitalier Est, 59, boulevard Pinel, 69677 Bron cedex, France
| | - N Thomassin
- CS 10217, Department of Pediatric Gastro-Enterology, Grenoble Alpes University Hospital, 38043 Grenoble cedex 09, France
| | - S Collardeau-Frachon
- Anatomical pathologist, Hospices Civils de Lyon, centre biologie pathologie est, groupement hospitalier Est, 59, boulevard Pinel, 69677 Bron cedex, France
| | - D Plantaz
- CS 10217, Department of Pediatric Onco-Immuno-Hematology, Grenoble Alpes University Hospital, 38043 Grenoble, France
| | - D Adjaoud
- CS 10217, Department of Pediatric Onco-Immuno-Hematology, Grenoble Alpes University Hospital, 38043 Grenoble, France
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Chu CS, Freedman DO. Tafenoquine and G6PD: a primer for clinicians. J Travel Med 2019; 26:taz023. [PMID: 30941413 PMCID: PMC6542331 DOI: 10.1093/jtm/taz023] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/19/2019] [Accepted: 03/21/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Tafenoquine, an 8-aminoquinoline, is now indicated for causal prophylaxis against all human malarias and as radical curative (anti-relapse) treatment against Plasmodium vivax and Plasmodium ovale. As with other 8-aminoquinolines, tafenoquine causes hemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (hemizygous males and homozygous females) and is contraindicated in this population. Those with intermediate G6PD activity (heterozygous females) are also at risk for hemolysis. Awareness of how to prescribe tafenoquine in relation to G6PD status is needed so it can be used safely. METHODS A standard literature search was performed on varying combinations of the terms tafenoquine, Arakoda, Kodatef, Krintafel, Kozenis, primaquine, G6PD deficiency, malaria prophylaxis and radical cure. The data were gathered and interpreted to review how tafenoquine should be prescribed in consideration of the G6PD status of an individual and traveller. RESULTS Tafenoquine should only be given to those with G6PD activity >70% of the local population median. Qualitative G6PD tests are sufficient for diagnosing G6PD deficiency in males. However, in females quantitative G6PD testing is necessary to differentiate deficient, intermediate and normal G6PD statuses. Testing for G6PD deficiency is mandatory before tafenoquine prescription. Measures can be taken to avoid tafenoquine administration to ineligible individuals (i.e. due to G6PD status, age, pregnancy and lactation). Primaquine is still necessary for some of these cases. This review provides actions that can be taken to diagnose and manage hemolysis when tafenoquine is given inadvertently to ineligible individuals. CONCLUSION Attention to G6PD status is required for safe prescription of tafenoquine. A high index of suspicion is needed if hemolysis occurs. Clinicians should seek evidence-based information for the management and treatment of iatrogenicy hemolysis caused by 8-aminoquinolines.
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Affiliation(s)
- Cindy S Chu
- Shoklo Malaria Research Unit, Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David O Freedman
- William C. Gorgas Center for Geographic Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
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Minucci A, Onori ME, Mazzuccato G, Urbani A, Capoluongo E. Molecular basis of favism triggered by ingestion of frozen pumpkin cross-contaminated with fava beans. Clin Biochem 2019; 69:45-47. [PMID: 31152693 DOI: 10.1016/j.clinbiochem.2019.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/20/2019] [Accepted: 05/25/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Angelo Minucci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | | | | | - Andrea Urbani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
| | - Ettore Capoluongo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy
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82
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Rets A, Clayton AL, Christensen RD, Agarwal AM. Molecular diagnostic update in hereditary hemolytic anemia and neonatal hyperbilirubinemia. Int J Lab Hematol 2019; 41 Suppl 1:95-101. [DOI: 10.1111/ijlh.13014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Anton Rets
- Department of Pathology University of Utah Health Salt Lake City Utah
- ARUP Laboratories Salt Lake City Utah
| | | | - Robert D. Christensen
- Division of Neonatology and Hematology/Oncology University of Utah Health Salt Lake City Utah
| | - Archana M. Agarwal
- Department of Pathology University of Utah Health Salt Lake City Utah
- ARUP Laboratories Salt Lake City Utah
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83
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Ong KIC, Iwagami M, Araki H, Khattignavong P, Soundala P, Keomalaphet S, Prasayasith P, Lorpachan L, Xangsayalath P, Pongvongsa T, Hongvanthong B, Brey PT, Kano S, Jimba M. Prevalence of G6PD Viangchan variant in malaria endemic areas in Lao PDR: an implication for malaria elimination by 2030. Malar J 2019; 18:75. [PMID: 30866940 PMCID: PMC6416863 DOI: 10.1186/s12936-019-2715-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/08/2019] [Indexed: 11/16/2022] Open
Abstract
Background Primaquine is effective against the latent liver stage of Plasmodium vivax. Eliminating the latent liver stage of P. vivax is one of the necessary conditions to achieve the goal of malaria elimination in Lao People’s Democratic Republic (PDR) by 2030. However, people with glucose-6-phosphate dehydrogenase (G6PD) deficiency are at risk of haemolysis when ingesting primaquine. The aim of this study was to detect the prevalence of the G6PD Viangchan variant, which is said to be common in Lao PDR and which can result in severe haemolysis in patients exposed to primaquine. Methods Blood samples were collected from villagers in three malaria endemic provinces: Champasak and Savannakhet in the south, and Phongsaly in the north. Each blood sample was semi-quantitatively assayed for G6PD enzyme activity using the G6PD Assay Kit-WST Lyophilized (DOJINDO Laboratories, Japan). Blood samples that were found to be G6PD deficient were sequenced to detect G6PD Viangchan mutation. Results In total, 2043 blood samples were collected from Phongsaly (n = 426, 20.9%), Savannakhet (n = 924, 45.2%), and Champasak (n = 693, 33.9%) provinces in Lao PDR from 2016 to 2017. Of these, 964 (47.2%) were taken from male villagers and 1079 (52.8%) were taken from female villagers. G6PD Viangchan mutation was not detected in Phongsaly province in this study. In Savannakhet province, 48 of the 924 samples (45 males, 3 females) had the G6PD Viangchan mutation (n = 48, 5.2%). In Champasak province, 42 of the 693 samples (18 males, 24 females) had the G6PD Viangchan mutation (n = 42, 6.1%). Conclusions G6PD Viangchan variant, which can cause severe haemolysis in the carrier when exposed to primaquine, was detected among 6.1% of the villagers in Champasak and 5.2% in Savannakhet but not in Phongsaly in this study. G6PD Viangchan variant might be common in the south of Laos but not so in the north. In the north, other G6PD deficiency variants might be more prevalent. However, in order not to overlook anyone and ensure a safe primaquine therapy for people living in malaria endemic areas in Lao PDR, G6PD testing is necessary. Electronic supplementary material The online version of this article (10.1186/s12936-019-2715-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic
| | - Moritoshi Iwagami
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Department of Tropical Medicine and Malaria, Research Institute, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Hitomi Araki
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic
| | - Phonepadith Khattignavong
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Pheovaly Soundala
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Sengdeuane Keomalaphet
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Phoyphaylinh Prasayasith
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Lavy Lorpachan
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Phonepadith Xangsayalath
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic.,National Institute of Public Health, Ministry of Health, Vientiane, Lao People's Democratic Republic.,National Center for Laboratory and Epidemiology, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Tiengkham Pongvongsa
- Savannakhet Provincial Health Department, Kaysone-Phomvihan District, Savannakhet, Lao People's Democratic Republic
| | - Bouasy Hongvanthong
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Center of Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Paul T Brey
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Shigeyuki Kano
- SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.,Department of Tropical Medicine and Malaria, Research Institute, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.,Institut Pasteur du Laos, Ministry of Health, Samsenthai Road, Ban Kao-Gnot, Sisattanak District, P.O. Box 3560, Vientiane, Lao People's Democratic Republic
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. .,SATREPS Project (JICA/AMED) for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.
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Pereira LLMD, Bravin CA, Cintra TS, Cassa WSP, Santos TA, Fonseca A, Pratte-Santos R. Prevalence of G6PD deficiency and molecular characterization of G202A, A376G and C563T polymorphisms in newborns in Southeastern Brazil. EINSTEIN-SAO PAULO 2019; 17:eAO4436. [PMID: 30673054 PMCID: PMC6438675 DOI: 10.31744/einstein_journal/2019ao4436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/24/2018] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the prevalence of G6PD deficiency and characterize G202A, A376G and C563T polymorphisms in neonates using molecular assays. Methods A total of one thousand samples were tested through quantitative analysis of enzyme activity, detecting 25 G6PD-deficient individuals. Patients identified as deficient were submitted to molecular analysis quantitative real-time polymerase chain reaction – (qPCR) to investigate the presence of variants associated with the deficiency. Results The total prevalence of G6PD deficient was 2.5%. Of the 25 samples identified as deficient, 21 were submitted to qPCR assay to analyze the presence of G202A, A376G and C563T variants. All samples showed the G202A/A376G genotype, characterizing G6PD A- phenotype. Conclusion The prevalence of G6PD deficiency in the present study was similar to that observed in other study populations in Brazil. Molecular analysis identified in all patients the presence of the genetic polymorphism G202A/A376G, more common in the Brazilian population with G6PD deficiency, which is directly estimated by enzyme activity level.
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Affiliation(s)
| | | | | | | | | | - Armando Fonseca
- Diagnósticos Laboratoriais Especializados Ltda , São Paulo , SP , Brazil
| | - Rodrigo Pratte-Santos
- Faculdade PIO XII , Cariacica , ES , Brazil .,Universidade Federal do Espírito Santo , Vitória , ES , Brazil
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Grignard L, Mair C, Curry J, Mahey L, Bastiaens GJH, Tiono AB, Okebe J, Coulibaly SA, Gonçalves BP, Affara M, Ouédraogo A, Bougouma EC, Sanou GS, Nébié I, Lanke KHW, Sirima SB, d'Alessandro U, Clark TG, Campino S, Bousema T, Drakeley C. Bead-based assays to simultaneously detect multiple human inherited blood disorders associated with malaria. Malar J 2019; 18:14. [PMID: 30665411 PMCID: PMC6341711 DOI: 10.1186/s12936-019-2648-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/12/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase deficiency (G6PDd), haemoglobin C (HbC) and S (HbS) are inherited blood disorders (IBD) common in populations in malaria endemic areas. All are associated to some degree with protection against clinical malaria whilst additionally G6PDd is associated with haemolysis following treatment with 8-aminoquinolines. Measuring the prevalence of these inherited blood disorders in affected populations can improve understanding of disease epidemiology. Current methodologies in epidemiological studies commonly rely on individual target amplification and visualization; here a method is presented to simultaneously detect the polymorphisms and that can be expanded to include other single nucleotide polymorphisms (SNPs) of interest. METHODS Human DNA from whole blood samples was amplified in a novel, multiplex PCR reaction and extended with SNP-specific probes in an allele specific primer extension (ASPE) to simultaneously detect four epidemiologically important human markers including G6PD SNPs (G202A and A376G) and common haemoglobin mutations (HbS and HbC). The products were hybridized to magnetic beads and the median fluorescence intensity (MFI) was read on MAGPIX® (Luminex corp.). Genotyping data was compared to phenotypical data generated by flow cytometry and to established genotyping methods. RESULTS Seventy-five samples from Burkina Faso (n = 75/78, 96.2%) and 58 samples from The Gambia (n = 58/61, 95.1%) had a G6PD and a HBB genotype successfully assigned by the bead-based assay. Flow cytometry data available for n = 61 samples further supported the concordance between % G6PD normal/deficient cells and genotype. CONCLUSIONS The bead based assay compares well to alternative measures of genotyping and phenotyping for G6PD. The screening is high throughput, adaptable to inclusion of multiple targets of interest and easily standardized.
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Affiliation(s)
- Lynn Grignard
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK.
| | - Catherine Mair
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Guide J H Bastiaens
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Alfred B Tiono
- Department of Biomedical Sciences, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Joseph Okebe
- Disease Control & Elimination Theme, Medical Research Council Unit at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Sam A Coulibaly
- Department of Biomedical Sciences, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Bronner P Gonçalves
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK
| | - Muna Affara
- Disease Control & Elimination Theme, Medical Research Council Unit at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Alphonse Ouédraogo
- Department of Biomedical Sciences, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Edith C Bougouma
- Department of Biomedical Sciences, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Guillaume S Sanou
- Department of Biomedical Sciences, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Issa Nébié
- Department of Biomedical Sciences, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Kjerstin H W Lanke
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Sodiomon B Sirima
- Department of Biomedical Sciences, Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Umberto d'Alessandro
- Disease Control & Elimination Theme, Medical Research Council Unit at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Taane G Clark
- Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Susana Campino
- Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Teun Bousema
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Chris Drakeley
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK
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86
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May WL, Kyaw MP, Blacksell SD, Pukrittayakamee S, Chotivanich K, Hanboonkunupakarn B, Thein KN, Lim CS, Thaipadungpanit J, Althaus T, Jittamala P. Impact of glucose-6-phosphate dehydrogenase deficiency on dengue infection in Myanmar children. PLoS One 2019; 14:e0209204. [PMID: 30601843 PMCID: PMC6314580 DOI: 10.1371/journal.pone.0209204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/01/2018] [Indexed: 01/15/2023] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency may affect the clinical presentation of dengue due to the altered redox state in immune cells. We aimed to determine the association between G6PD deficiency and severity of dengue infection in paediatric patients in Myanmar. A cross-sectional study was conducted among paediatric patients aged 2–13 years with dengue in Yankin Children Hospital, Myanmar. One hundred and ninety-six patients positive for dengue infection, as determined via PCR or ELISA, were enrolled. Dengue severity was determined according to the 2009 WHO classification guidelines. Spectrophotometric assays determined G6PD levels. The adjusted median G6PD value of males in the study population was used to define various cut-off points according to the WHO classification guidelines. G6PD genotyping for Mahidol, Kaiping and Mediterranean mutations was performed for 128 out of 196 samples by real-time multiplex PCR. 51 of 196 (26.0%) patients had severe dengue. The prevalence of G6PD phenotype deficiency (< 60% activity) in paediatric patients was 14.8% (29/196), specifically, 13.6% (14/103) in males and 16.2% (15/93) in females. Severe deficiency (< 10% activity) accounted for 7.1% (14/196) of our cohort, occurring 11.7% (12/103) in males and 2.2% (2/93) in females. Among 128 samples genotyped, the G6PD gene mutations were detected in 19.5% (25/128) of patients, with 20.3% (13/ 64) in males and 18.8% (12/64) in females. The G6PD Mahidol mutation was 96.0% (24/25) while the G6PD Kaiping mutation was 4.0% (1/25). Severe dengue was not associated with G6PD enzyme deficiency or presence of the G6PD gene mutation. Thus, no association between G6PD deficiency and dengue severity could be detected. Trial registration: The study was registered following the WHO International Clinical Trials Registry Platform (WHO-ICTRP) on Thai Clinical Trials Registry (TCTR) website, registration number # TCTR20180720001
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Affiliation(s)
- Win Lai May
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Medical Research, Yangon, Myanmar
| | | | - Stuart D. Blacksell
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sasithon Pukrittayakamee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kesinee Chotivanich
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Borimas Hanboonkunupakarn
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Khin Nyo Thein
- Department of Paediatrics, University of Medicine 2, Yangon, Myanmar
| | | | - Janjira Thaipadungpanit
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thomas Althaus
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Podjanee Jittamala
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- * E-mail:
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87
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Abstract
Carbohydrate kinases activate a wide variety of monosaccharides by adding a phosphate group, usually from ATP. This modification is fundamental to saccharide utilization, and it is likely a very ancient reaction. Modern organisms contain carbohydrate kinases from at least five main protein families. These range from the highly specialized inositol kinases, to the ribokinases and galactokinases, which belong to families that phosphorylate a wide range of substrates. The carbohydrate kinases utilize a common strategy to drive the reaction between the sugar hydroxyl and the donor phosphate. Each sugar is held in position by a network of hydrogen bonds to the non-reactive hydroxyls (and other functional groups). The reactive hydroxyl is deprotonated, usually by an aspartic acid side chain acting as a catalytic base. The deprotonated hydroxyl then attacks the donor phosphate. The resulting pentacoordinate transition state is stabilized by an adjacent divalent cation, and sometimes by a positively charged protein side chain or the presence of an anion hole. Many carbohydrate kinases are allosterically regulated using a wide variety of strategies, due to their roles at critical control points in carbohydrate metabolism. The evolution of a similar mechanism in several folds highlights the elegance and simplicity of the catalytic scheme.
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88
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Mohamed GS, Lemine SM, Cheibetta S, Mohamed A. [Neonatal screening for glucose-6-phosphate dehydrogenase (G6PD) deficiency in Mauritania]. Pan Afr Med J 2018; 30:224. [PMID: 30574242 PMCID: PMC6295302 DOI: 10.11604/pamj.2018.30.224.13947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/23/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction We conducted a cross-sectional descriptive study aiming to identify risk factors associated with G6PD deficiency, its frequency and geographic distribution in Nouakchott, in order to provide useful informations to monitor it. As this disease has never previously been studied in Mauritania, we tried to define the epidemiological profile and the burden of morbidity related to G6PD deficiency in a newborn population in two health structures in the city of Nouakchott. Methods This study was conducted in two hospitals in Nouakchott, at the Maternity and Infant Hospital and at the Health Center in Sebkha between August and October 2015. A sampling of 523 newborns having different sexes was enrolled in the study. Screening was based on BinaxNow G6PD test, followed by quantitative confirmation in positive patients. Statistical analysis was performed using SPSS20. Results G6PD deficiency was higher in male newborns (15% vs 7% p = 0.007) and, in particular, in black children (15% vs 8% p = 0.001). The prevalence of G6PD deficiency in the study population was 11.09% (58/523). Conclusion To our knowledge, this is the first study on G6PD deficiency in the Mauritanian population. It provides important informations on the epidemiological features of G6PD deficiency in the region of Nouakchott. A degree of variability exists in the occurrence of G6PD deficiency in the ethnic groups.
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Affiliation(s)
- Ghaber Sidi Mohamed
- Maurilab, Nouakchott, Mauritanie.,Hôpital National de Nouakchott, Mauritanie.,Université de Nouakchott, Mauritanie
| | | | | | - Aminetou Mohamed
- Hôpital National de Nouakchott, Mauritanie.,Université de Nouakchott, Mauritanie
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89
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Devendra R, Warang P, Gupta V, Chiddarwar A, Kedar P, Agarwal MB, Mukherjee MB. A Novel G6PD p. Gly 321 Val Mutation Causing Severe Hemolysis in an Indian Infant. Indian J Hematol Blood Transfus 2018; 35:399-401. [PMID: 30988594 DOI: 10.1007/s12288-018-1049-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
- R Devendra
- Department of Hematogenetics, National Institute of Immunohematology, 13th Floor, NMS Building, K.E.M Hospital Campus, Parel, Mumbai, India
| | - P Warang
- Department of Hematogenetics, National Institute of Immunohematology, 13th Floor, NMS Building, K.E.M Hospital Campus, Parel, Mumbai, India
| | - V Gupta
- Department of Hematogenetics, National Institute of Immunohematology, 13th Floor, NMS Building, K.E.M Hospital Campus, Parel, Mumbai, India
| | - A Chiddarwar
- Department of Hematogenetics, National Institute of Immunohematology, 13th Floor, NMS Building, K.E.M Hospital Campus, Parel, Mumbai, India
| | - P Kedar
- Department of Hematogenetics, National Institute of Immunohematology, 13th Floor, NMS Building, K.E.M Hospital Campus, Parel, Mumbai, India
| | - M B Agarwal
- 2Department of Hematology, Bombay Hospital, Mumbai, India
| | - M B Mukherjee
- Department of Hematogenetics, National Institute of Immunohematology, 13th Floor, NMS Building, K.E.M Hospital Campus, Parel, Mumbai, India
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90
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Anantasomboon P, Chanda M, Jugnam‐ang W, Witoonpanich P, Cheepsunthorn P, Nuchprayoon I, Fucharoen S, Cheepsunthorn CL. Evaluating the performance of automated UV enzymatic assay for screening of glucose 6‐phosphate dehydrogenase deficiency. Int J Lab Hematol 2018; 41:192-199. [DOI: 10.1111/ijlh.12943] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/04/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
Affiliation(s)
| | - Makamas Chanda
- Biomedical Sciences ProgramGraduate SchoolChulalongkorn University Bangkok Thailand
| | - Watcharapong Jugnam‐ang
- Medical Biochemistry ProgramDepartment of BiochemistryFaculty of MedicineChulalongkorn University Bangkok Thailand
| | - Pirada Witoonpanich
- Division of NeurologyDepartment of MedicineFaculty of Medicine Ramathibodi HospitalMahidol University Bangkok Thailand
| | | | - Issarang Nuchprayoon
- Department of PaediatricsFaculty of MedicineChulalongkorn University Bangkok Thailand
| | - Suthat Fucharoen
- Thalassemia Research CenterInstitute of Molecular BiosciencesMahidol University Nakornpathom Thailand
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91
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Cloning and biochemical characterization of three glucose‑6‑phosphate dehydrogenase mutants presents in the Mexican population. Int J Biol Macromol 2018; 119:926-936. [DOI: 10.1016/j.ijbiomac.2018.08.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/05/2018] [Accepted: 08/07/2018] [Indexed: 11/23/2022]
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92
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La Vieille S, Lefebvre DE, Khalid AF, Decan MR, Godefroy S. Dietary restrictions for people with glucose-6-phosphate dehydrogenase deficiency. Nutr Rev 2018; 77:96-106. [DOI: 10.1093/nutrit/nuy053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sébastien La Vieille
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
- Department of Food Sciences, Faculty of Agriculture and Food Sciences, Université Laval, Québec City, Québec, Canada
| | - David E Lefebvre
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Ahmad Firas Khalid
- Health Policy PhD Program, McMaster University, Hamilton, Ontario, Canada
| | - Matthew R Decan
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Samuel Godefroy
- Department of Food Sciences, Faculty of Agriculture and Food Sciences, Université Laval, Québec City, Québec, Canada
- Institute of Nutrition and Functional Foods, Université Laval, Québec City, Québec, Canada
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93
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Kießling N, Brintrup J, Zeynudin A, Abduselam N, Götz S, Mack M, Pritsch M, Wieser A, Kohne E, Berens-Riha N. Glucose-6-phosphate dehydrogenase activity measured by spectrophotometry and associated genetic variants from the Oromiya zone, Ethiopia. Malar J 2018; 17:358. [PMID: 30314477 PMCID: PMC6186078 DOI: 10.1186/s12936-018-2510-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/08/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The study aimed to gain first data on the prevalence of G6PD enzyme deficiency measured by spectrophotometry and associated genetic variants in Jimma and surroundings, Ethiopia. The area is a Plasmodium vivax endemic region, but 8-aminoquinolines such as primaquine are not recommended as G6PD testing is not available. METHODS Healthy volunteers were recruited at Jimma University, Ethiopia. Enzyme activity was tested by spectrophotometry at the University of Ulm, Germany. A G6PD RDT (Binax NOW® G6PD, Alere, USA) was additionally performed. The G6PD gene was analysed for polymorphisms in a sub-population. Tests for haemoglobinopathies and the presence of malaria parasites were conducted. RESULTS No severe or moderate (cut-off 60%) G6PD deficiency was found in 206 volunteers. Median male activity was 6.1 U/g Hb. Eleven participants (5.4%) showed activities between 70 and 80%. No haemoglobinopathy was detected. None of the subjects showed asymptomatic parasitaemia. One G6PD-A+ variant (A376G) and one new non-synonymous mutation (G445A) were found. CONCLUSIONS As the prevalence of G6PD deficiency seems low in this area, the use of 8-aminoquinolines should be encouraged. However, reliable G6PD testing methods have to be implemented and safe cut-off levels need to be defined.
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Affiliation(s)
- Nora Kießling
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstrasse 5, 80802, Munich, Germany
| | - Joaquin Brintrup
- Hemoglobin Laboratory, Department of Pediatrics, University Hospital Ulm, Eythstrasse 24, 89075, Ulm, Germany
| | - Ahmed Zeynudin
- Department of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Nuredin Abduselam
- Department of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Sylvia Götz
- Hemoglobin Laboratory, Department of Pediatrics, University Hospital Ulm, Eythstrasse 24, 89075, Ulm, Germany
| | - Margith Mack
- Hemoglobin Laboratory, Department of Pediatrics, University Hospital Ulm, Eythstrasse 24, 89075, Ulm, Germany
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstrasse 5, 80802, Munich, Germany.,German Centre for Infection Research (DZIF) at LMU, Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstrasse 5, 80802, Munich, Germany.,Department of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia.,German Centre for Infection Research (DZIF) at LMU, Munich, Germany
| | - Elisabeth Kohne
- Hemoglobin Laboratory, Department of Pediatrics, University Hospital Ulm, Eythstrasse 24, 89075, Ulm, Germany
| | - Nicole Berens-Riha
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstrasse 5, 80802, Munich, Germany. .,German Centre for Infection Research (DZIF) at LMU, Munich, Germany.
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94
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Hwang S, Mruk K, Rahighi S, Raub AG, Chen CH, Dorn LE, Horikoshi N, Wakatsuki S, Chen JK, Mochly-Rosen D. Correcting glucose-6-phosphate dehydrogenase deficiency with a small-molecule activator. Nat Commun 2018; 9:4045. [PMID: 30279493 PMCID: PMC6168459 DOI: 10.1038/s41467-018-06447-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 09/05/2018] [Indexed: 01/06/2023] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency, one of the most common human genetic enzymopathies, is caused by over 160 different point mutations and contributes to the severity of many acute and chronic diseases associated with oxidative stress, including hemolytic anemia and bilirubin-induced neurological damage particularly in newborns. As no medications are available to treat G6PD deficiency, here we seek to identify a small molecule that corrects it. Crystallographic study and mutagenesis analysis identify the structural and functional defect of one common mutant (Canton, R459L). Using high-throughput screening, we subsequently identify AG1, a small molecule that increases the activity of the wild-type, the Canton mutant and several other common G6PD mutants. AG1 reduces oxidative stress in cells and zebrafish. Furthermore, AG1 decreases chloroquine- or diamide-induced oxidative stress in human erythrocytes. Our study suggests that a pharmacological agent, of which AG1 may be a lead, will likely alleviate the challenges associated with G6PD deficiency. Glucose-6-phosphate dehydrogenase (G6PD) deficiency provides insufficient protection from oxidative stress, contributing to diverse human pathologies. Here, the authors identify a small molecule that increases the activity and/or stability of mutant G6PD and show that it reduces oxidative stress in zebrafish and hemolysis in isolated human erythrocytes.
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Affiliation(s)
- Sunhee Hwang
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Karen Mruk
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,University of Wyoming School of Pharmacy, 1000 E. University Ave., HS 596, Laramie, WY, 82071, USA
| | - Simin Rahighi
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,Chapman University School of Pharmacy (CUSP), Harry and Diane Rinker Health Science Campus, Chapman University, Irvine, CA, 92618, USA
| | - Andrew G Raub
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,Department of Chemistry, Stanford University, Stanford, CA, 94305-5080, USA
| | - Che-Hong Chen
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Lisa E Dorn
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,The Ohio State University College of Medicine, 473 W 12th Ave, Columbus, OH, 43210, USA
| | - Naoki Horikoshi
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Soichi Wakatsuki
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,Photon Science, SLAC National Accelerator Laboratory, Menlo Park, CA, 94025-7015, USA
| | - James K Chen
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.,Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Daria Mochly-Rosen
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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95
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Tseghereda YG, Nganga JK, Kimang'a AN, Mehari TH, Weldemichael YG. Glucose-6-phosphate dehydrogenase deficiency allelic variants and their prevalence in malaria patients in Eritrea. Pan Afr Med J 2018; 31:46. [PMID: 30918572 PMCID: PMC6430948 DOI: 10.11604/pamj.2018.31.46.16527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/31/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction Glucose 6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy with a relatively high frequency in malaria-endemic regions. In Eritrea, there is scanty knowledge of G6PD deficiency. The aim of the study was to characterize and determine the prevalence of four common G6PD allelic variants. Methods Three hundred and fourteen dried blood spot samples from unrelated microscopically diagnosed malaria patient Eritrean ethnic groups living in five zobas (regions) of Eritrea were analysed by PCR-RFLP method to identify the G6PD B, G6PD A (A376G), G6PD A-(G202A), and G6PD Mediterranean (C563T) variants. To confirm the RFLP results, samples positive for A376G but negative for G202A variants were subjected to Sanger sequencing and a subset of PCR products (exon 5) directly sequenced to identify A376G and other mutations. Results For G6PD genotyping, G6PD B was detected in 87.5% and A376G detected in 12.5% of malaria patients, whereas G202A and C563T were absent. Bivariate Statistical analysis showed a statistically significant association between G6PD genotypes and zoba (P < 0.004 < 0.05). Sequencing revealed the expected A376G variant. In exon 5, four common (A376G) mutations, three uncommon mutations rs782669677 (535G→A) and one potentially new mutation (451G→C), relative to the reference, mRNA NM_001042351 were detected. Bioinformatic analysis of these mutations' potential functional impact suggests minimal effect on protein function. Conclusion This is the first report indicating that G6PD B and G6PD A genotypes are prevalent in Eritrea. Similar findings were reported in neighboring countries. Further studies including phenotype analysis are needed to corroborate the observed results.
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96
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Henriques G, Phommasone K, Tripura R, Peto TJ, Raut S, Snethlage C, Sambo I, Sanann N, Nguon C, Adhikari B, Pongvongsa T, Imwong M, von Seidlein L, Day NP, White NJ, Dondorp AM, Newton P, Ley B, Mayxay M. Comparison of glucose-6 phosphate dehydrogenase status by fluorescent spot test and rapid diagnostic test in Lao PDR and Cambodia. Malar J 2018; 17:243. [PMID: 29929514 PMCID: PMC6013858 DOI: 10.1186/s12936-018-2390-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/13/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy worldwide. Primaquine is the only licensed drug that effectively removes Plasmodium vivax hypnozoites from the human host and prevents relapse. While well tolerated by most recipients, primaquine can cause haemolysis in G6PD deficient individuals and is, therefore, underused. Rapid diagnostic tests (RDTs) could permit ascertainment of G6PD status outside of laboratory settings and hence safe treatment in remote areas. The performance of the fluorescent spot test (Trinity, Ireland; FST) and a G6PD RDT (Carestart, USA) against spectrophotometry were assessed. METHODS Participants were enrolled during cross-sectional surveys in Laos and by purposive sampling in Cambodia. FST and RDT were performed during village surveys and 3 mL of venous blood was collected for subsequent G6PD measurement by spectrophotometry. RESULTS A total of 757 participants were enrolled in Laos and 505 in Cambodia. FST and RDT performed best at 30% cut-off activity and performed significantly better in Laos than in Cambodia. When defining intermediate results as G6PD deficient, the FST had a sensitivity of 100% (95%CI 90-100) and specificity of 90% (95%CI 87.7-92.2) in Laos and sensitivity of 98% (94.1-99.6) and specificity of 71% (95%CI 66-76) in Cambodia (p < 0.001). The RDT had sensitivity and specificity of 100% (95%CI 90-100) and 99% (95%CI 97-99) in Laos and sensitivity and specificity of 91% (86-96) and 93% (90-95) in Cambodia (p < 0.001). The RDT performed significantly better (all p < 0.05) than the FST when intermediate FST results were defined as G6PD deficient. CONCLUSION The interpretation of RDT results requires some training but is a good alternative to the FST. Trial registration clinicaltrials.gov; NCT01872702; 06/27/2013; https://clinicaltrials.gov/ct2/show/NCT01872702.
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Affiliation(s)
- Gisela Henriques
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Life Science, Imperial College London, London, UK
| | - Koukeo Phommasone
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao PDR
| | - Rupam Tripura
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Thomas J Peto
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Shristi Raut
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao PDR
| | - Coco Snethlage
- School of Medicine, Amsterdam University, Amsterdam, The Netherlands
| | - Im Sambo
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nou Sanann
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chea Nguon
- National Centre for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Tiengkham Pongvongsa
- Savannakhet Provincial Station of Malariology, Parasitology and Entomology, Savannakhet, Savannakhet Province, Lao PDR
| | - Mallika Imwong
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Lorenz von Seidlein
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
| | - Nicholas P Day
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Nicholas J White
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Paul Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Benedikt Ley
- Menzies School of Health Research, Darwin, Australia
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.,Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR
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97
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High-Throughput, Multiplex Genotyping Directly from Blood or Dried Blood Spot without DNA Extraction for the Screening of Multiple G6PD Gene Variants at Risk for Drug-Induced Hemolysis. J Mol Diagn 2018; 19:638-650. [PMID: 28826608 DOI: 10.1016/j.jmoldx.2017.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/13/2017] [Accepted: 05/31/2017] [Indexed: 11/23/2022] Open
Abstract
Clinical or epidemiologic screening of single-nucleotide polymorphism markers requires large-scale multiplexed genotyping. Available genotyping tools require DNA extraction and multiplex PCR, which may limit throughput and suffer amplification bias. Herein, a novel genotyping approach has been developed, multiplex extension and ligation-based probe amplification (MELPA), which eliminates DNA extraction and achieves uniform PCR amplification. MELPA lyses blood or dried blood spot and directly captures specific target DNA to 96-well plates using tailed probes. Subsequent enzymatic extension and ligation form target single-nucleotide polymorphism-spanning single-stranded templates, which are PCR-amplified using universal primers. Multiplexed genotyping by single-base primer extension is analyzed by mass spectrometry, with a call rate >97%. MELPA was compared with a commercial assay (iPLEX) for detecting 24 G6PD variants known to be at risk for primaquine-induced hemolysis. MELPA provided results that were more reliable than iPLEX, with higher throughput and lower cost. Genotyping archival blood from 106 malaria patients taking primaquine found 10 G6PD-deficient variants, including 1 patient with a hemizygous Mahidol mutation who had hemolysis. Preemptive G6PD genotyping of 438 dried blood spots from a malaria-endemic area identified three variants. MELPA also enabled pooled genotyping without diluting rare alleles, in which undesired common-allele background increased by sample pooling can be repressed by adding specific common allele blockers. Thus, MELPA represents a high-throughput, cost-effective approach to targeted genotyping at the population level.
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98
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Understanding human genetic factors influencing primaquine safety and efficacy to guide primaquine roll-out in a pre-elimination setting in southern Africa. Malar J 2018; 17:120. [PMID: 29558929 PMCID: PMC5859786 DOI: 10.1186/s12936-018-2271-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/13/2018] [Indexed: 12/27/2022] Open
Abstract
Background Primaquine (PQ) is recommended as an addition to standard malaria treatments in pre-elimination settings due to its pronounced activity against mature Plasmodium falciparum gametocytes, the parasite stage responsible for onward transmission to mosquitoes. However, PQ may trigger haemolysis in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals. Additional human genetic factors, including polymorphisms in the human cytochrome P450 2D6 (CYP2D6) complex, may negatively influence the efficacy of PQ. This study assessed the prevalence of G6PD deficiency and two important CYP2D6 variants in representative pre-elimination settings in South Africa, to inform malaria elimination strategies. Methods Volunteers (n = 248) attending six primary health care facilities in a malaria-endemic region of South Africa were enrolled between October and November 2015. G6PD status was determined phenotypically, using a CareStart™ G6PD rapid diagnostic test (RDT), and genotypically for two common African G6PD variants, namely A+ (A376G) and A− (G202A, A542T, G680T & T968C) by PCR, restriction fragment length polymorphisms (RFLP) and DNA sequencing. CYP2D6*4 and CYP2D6*17 variants were determined with PCR and RFLP. Results A prevalence of 13% (33/248) G6PD deficiency was observed in the cohort by G6PD RDT whilst by genotypic assessment, 32% (79/248) were A+ and 3.2% were A−, respectively. Among the male participants, 11% (6/55) were G6PD A− hemizygous; among females 1% (2/193) were G6PD A− homozygous and 16% (32/193) G6PD A− heterozygous. The strength of agreement between phenotyping and genotyping result was fair (Cohens Kappa κ = 0.310). The negative predictive value for the G6PD RDT for detecting hemizygous, homozygous and heterozygous individuals was 0.88 (95% CI 0.85–0.91), compared to the more sensitive genotyping. The CYP2D6*4 allele frequencies for CYP2D6*4 (inferred poor metabolizer phenotype) and CYP2D6*17 (inferred intermediate metabolizer phenotype) were 3.2 and 19.5%, respectively. Conclusions Phenotypic and genotypic analyses both detected low prevalence of G6PD deficiency and the CYP2D6*4 variants. These findings, combined with increasing data confirming safety of single low-dose PQ in individuals with African variants of G6PD deficiency, supports the deployment of single low-dose PQ as a gametocytocidal drug. PQ would pose minimal risks to the study populations and could be a useful elimination strategy in the study area.
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99
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Lee J, Kim TI, Kang JM, Jun H, Lê HG, Thái TL, Sohn WM, Myint MK, Lin K, Kim TS, Na BK. Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among malaria patients in Upper Myanmar. BMC Infect Dis 2018; 18:131. [PMID: 29548282 PMCID: PMC5857094 DOI: 10.1186/s12879-018-3031-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 03/01/2018] [Indexed: 11/13/2022] Open
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD; EC 1.1.1.49) deficiency is one of the most common X-linked recessive hereditary disorders in the world. Primaquine (PQ) has been used for radical cure of P. vivax to prevent relapse. Recently, it is also used to reduce P. falciparum gametocyte carriage to block transmission. However, PQ metabolites oxidize hemoglobin and generate excessive reactive oxygen species which can trigger acute hemolytic anemia in malaria patients with inherited G6PD deficiency. Methods A total of 252 blood samples collected from malaria patients in Myanmar were used in this study. G6PD variant was analysed by a multiplex allele specific PCR kit, DiaPlexC™ G6PD Genotyping Kit [Asian type]. The accuracy of the multiplex allele specific PCR was confirmed by sequencing analysis. Results Prevalence and distribution of G6PD variants in 252 malaria patients in Myanmar were analysed. Six different types of G6PD allelic variants were identified in 50 (7 females and 43 males) malaria patients. The predominant variant was Mahidol (68%, 34/50), of which 91.2% (31/34) and 8.8% (3/34) were males and females, respectively. Other G6PD variants including Kaiping (18%, 9/50), Viangchan (6%, 3/50), Mediterranean (4%, 2/50), Union (2%, 1/50) and Canton (2%, 1/50) were also observed. Conclusions Results of this study suggest that more concern for proper and safe use of PQ as a radical cure of malaria in Myanmar is needed by combining G6PD deficiency test before PQ prescription. Establishment of a follow-up system to monitor potential PQ toxicity in malaria patients who are given PQ is also required.
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Affiliation(s)
- Jinyoung Lee
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,Present address: Department of Tropical Medicine, and Inha Research Institute for Medical Sciences, Inha University College of Medicine, Incheon, 22212, Republic of Korea
| | - Tae Im Kim
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,Present address: Planning and Management Division, Nakdonggang National Institute of Biological Resources, Sangju, 37242, Republic of Korea
| | - Jung-Mi Kang
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Hojong Jun
- Department of Tropical Medicine, and Inha Research Institute for Medical Sciences, Inha University College of Medicine, Incheon, 22212, Republic of Korea
| | - Hương Giang Lê
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Thị Lam Thái
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Woon-Mok Sohn
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea
| | - Moe Kyaw Myint
- Department of Medical Research Pyin Oo Lwin Branch, Pyin Oo Lwin, Myanmar
| | - Khin Lin
- Department of Medical Research Pyin Oo Lwin Branch, Pyin Oo Lwin, Myanmar
| | - Tong-Soo Kim
- Department of Tropical Medicine, and Inha Research Institute for Medical Sciences, Inha University College of Medicine, Incheon, 22212, Republic of Korea.
| | - Byoung-Kuk Na
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea. .,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea.
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100
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Powers JL, Best DH, Grenache DG. Genotype-Phenotype Correlations of Glucose-6-Phosphate-Deficient Variants Throughout an Activity Distribution. J Appl Lab Med 2018; 2:841-850. [PMID: 33636823 DOI: 10.1373/jalm.2017.024935] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 11/08/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder that may manifest as neonatal jaundice or acute hemolytic anemia. Quantitative assessment of G6PD activity in erythrocytes is required to definitively diagnose a deficiency. Most males and homozygous females have low enzyme activities, whereas heterozygous females may have a range of activities. We sought to examine G6PD genotype-phenotype associations to identify an activity cutoff above which G6PD deficiency is unlikely. METHODS Ninety-five residual samples were randomly selected to represent the various regions of a G6PD activity distribution. DNA was isolated from the leukocyte fraction and sequenced using the Sanger method. ROC curves were used to establish cutoffs. RESULTS Thirteen variant alleles were identified, including 1 not previously reported. In the very deficient activity range, we found males and homozygous females of both class II and III variants. In the deficient category, we found predominantly class III males and heterozygous females. The presumed deficient category contained class III and IV variants and nonvariants. An activity cutoff of <7.85 U/g hemoglobin (Hb) was 100% sensitive and 94% specific for identifying a G6PD-deficient male, and a cutoff of <8.95 U/g Hb was 90% sensitive and 82% specific for a deficient female. CONCLUSIONS The observed activity groupings were not because of a particular variant class. Cutoffs to identify the presence of a deficiency variant for males and females may be useful when trying to decide whether to recommend genetic analysis.
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Affiliation(s)
- Jennifer L Powers
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| | - D Hunter Best
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| | - David G Grenache
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
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