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Soler AM, Pedroso GA, Geraldo APM, Albuquerque DM, Costa FF, Santos MNN, Knijnenburg J, Harteveld CL, Sonati MF, da Luz JA. A novel α 0-thalassemia deletion in a Brazilian child with Hb H disease: -- Mococa. Int J Lab Hematol 2024; 46:747-750. [PMID: 38566588 DOI: 10.1111/ijlh.14277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Affiliation(s)
- A M Soler
- Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Centro Universitario Regional (CENUR) Litoral Norte. Universidad de la República (UdelaR), Salto, Uruguay
| | - G A Pedroso
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - A P M Geraldo
- Integrated Center for Oncohematological Research in Childhood (CIPOI), UNICAMP, Campinas, SP, Brazil
| | - D M Albuquerque
- Center for Hematology and Hemotherapy, UNICAMP, Campinas, SP, Brazil
| | - F F Costa
- Center for Hematology and Hemotherapy, UNICAMP, Campinas, SP, Brazil
| | - M N N Santos
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - J Knijnenburg
- Department of Human and Clinical Genetics, Hemoglobinopathy Expert Center, Leiden University Medical Center-LUMC, Leiden, The Netherlands
| | - C L Harteveld
- Department of Human and Clinical Genetics, Hemoglobinopathy Expert Center, Leiden University Medical Center-LUMC, Leiden, The Netherlands
| | - M F Sonati
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - J A da Luz
- Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Centro Universitario Regional (CENUR) Litoral Norte. Universidad de la República (UdelaR), Salto, Uruguay
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2
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Lachover-Roth I, Peretz S, Zoabi H, Harel E, Livshits L, Filon D, Levin C, Koren A. Support Vector Machine-Based Formula for Detecting Suspected α Thalassemia Carriers: A Path toward Universal Screening. Int J Mol Sci 2024; 25:6446. [PMID: 38928152 PMCID: PMC11203927 DOI: 10.3390/ijms25126446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
The blood counts of α thalassemia carriers (α-thal) are similar to those of β thalassemia carriers, except for Hemoglobin A2 (Hb A2), which is not elevated. The objective of this study was to determine whether mathematical formulas are effective for detecting suspected α-thal. The data were obtained from the database of the prevention program for detecting couples at risk for having a child with hemoglobinopathy. Red Blood Cells (RBC) indices were analyzed using mathematical formulas, and the sensitivity and negative predictive value (NPV) were calculated. Among 1334 blood counts suspected of α-thal analyzed, only the Shine and Lal and the Support Vector Machine formulas revealed high sensitivity and NPV. Sensitivity was 85.54 and 99.33%, and NPV was 98.93 and 99.93%, respectively. Molecular defects were found in 291, and 81 had normal α genes. Molecular analysis was not performed in 962 of the samples. Based on these results, mathematical formulas incorporating one of these reliable formulas for detecting suspected α or β thalassemia carriers in the program of the automatic analyzers can flag these results, increase the awareness of the primary physicians about the carrier risk, and send an alert with a recommendation for further testing.
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Affiliation(s)
- Idit Lachover-Roth
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba 4428163, Israel;
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Sari Peretz
- Hematology Laboratory, Emek Medical Center, Afula 1834111, Israel; (S.P.); (H.Z.); (E.H.)
| | - Hiba Zoabi
- Hematology Laboratory, Emek Medical Center, Afula 1834111, Israel; (S.P.); (H.Z.); (E.H.)
| | - Eitam Harel
- Hematology Laboratory, Emek Medical Center, Afula 1834111, Israel; (S.P.); (H.Z.); (E.H.)
| | - Leonid Livshits
- Red Blood Cell Research Group, Vetsuisse Faculty, Institute of Veterinary Physiology, University of Zurich, 8057 Zürich, Switzerland;
- The Zurich Center for Integrative Human Physiology (ZIHP), 8057 Zürich, Switzerland
| | - Dvora Filon
- Hematology Division, Hadassah Medical Center, Jerusalem 9112001, Israel;
| | - Carina Levin
- Pediatric Hematology Unit, Research Laboratory, Emek Medical Center, Afula 1834111, Israel;
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa 3525422, Israel
| | - Ariel Koren
- Pediatric Hematology Unit, Research Laboratory, Emek Medical Center, Afula 1834111, Israel;
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3
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Alimohammadi-Bidhendi S, Azadmehr S, Razipour M, Zeinali S, Eslami M, Davoudi-Dehaghani E. Regulatory Mutation Study in Cases with Unsolved Hypochromic Microcytic Anemia and α-Major Regulatory Element Haplotype Analysis in Iran. Hemoglobin 2021; 45:37-40. [PMID: 33775199 DOI: 10.1080/03630269.2021.1882482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
α-Thalassemia (α-thal) is an inherited blood disorder with different clinical manifestations. Although genetic causes of anemia are identified routinely in the majority of α-thal cases, a pathogenic variant in a few cases remains undiagnosed. In this study, some reported regulatory mutations have been investigated in five unsolved α-thal carriers. α-Major regulatory element (α-MRE) haplotype analysis has also been performed in Iran for the first time. Four regions, including the HBA2 core promoter, the highly conserved sequence of hypersensitive-40 (HS-40), a region containing regulatory single nucleotide polymorphism (SNP) CR062116, and a region containing rs7203560, were screened for changes by Sanger sequencing in a total of five unsolved suspected α-thal carriers. The frequencies of α-MRE haplotypes B and C were also determined in control samples with normal hematological indices. No pathogenic variant was found in the investigated regions. Haplotype frequencies observed for B and C haplotypes fell into the range of frequencies observed in previous studies. The investigated genotypes in the control group were in the Hardy-Weinberg equilibrium. This study can provide evidence that there is no association between the B haplotype and microcytic hypochromic anemia. The cause of anemia remains a mystery in our unsolved cases, which demonstrates the need for further studies on the causes of hypochromic microcytic anemia in individuals with intact α- and β-globin genes without iron deficiency.
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Affiliation(s)
- Sara Alimohammadi-Bidhendi
- Department of Genetics, Faculty of Advanced Technologies in Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.,Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Sarah Azadmehr
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.,Department of Genetics, Faculty of Basic Sciences, Shahr-e Rey, Payame Noor University, Tehran, Iran
| | - Masoumeh Razipour
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.,Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sirous Zeinali
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.,Medical Genetics Laboratory of Dr. Zeinali, Kawsar Human Genetics Research Center, Tehran, Iran
| | - Maryam Eslami
- Departments of Genetics, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.,Applied Biotechnology Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Elham Davoudi-Dehaghani
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
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4
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Soler AM, Piellusch BF, da Silveira L, Pedroso GA, López P, Savio E, Sonati MDF, da Luz J. Alpha thalassemia and alpha-MRE haplotypes in Uruguayan patients with microcytosis and hypochromia without anemia. Genet Mol Biol 2021; 44:e20200399. [PMID: 33769430 PMCID: PMC7995682 DOI: 10.1590/1678-4685-gmb-2020-0399] [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: 10/30/2020] [Accepted: 02/10/2021] [Indexed: 11/21/2022] Open
Abstract
Alpha thalassemia is the most common genetic disorder across the world, being the α-3.7 deletion the most frequent mutation. In order to analyze the spectrum and origin of alpha thalassemia mutations in Uruguay, we obtained a sample of 168 unrelated outpatients with normal hemoglobin levels with microcytosis and hypochromia from two cities: Montevideo and Salto. The presence of α-thalassemia mutations was investigated by gap-PCR, restriction endonucleases analysis and HBA2 and HBA1 genes sequencing, whereas the alpha-MRE haplotypes were investigated by sequencing. We found 55 individuals (32.7%) with α-thalassemia mutations, 51(30.4%) carrying the -α3.7 deletion, one with the -α4.2 deletion and three having the rare punctual mutation HBA2:c.-59C>T. Regarding alpha-MRE analysis, we observed a significant higher frequency of haplotype D, characteristic of African populations, in the sample with the -α3.7 deletion. These results show that α-thalassemia mutations are an important determinant of microcytosis and hypochromia in Uruguayan patients with microcytosis and hypochromia without anemia, mainly due to the -α3.7 deletion. The alpha-MRE haplotypes and the α-thalassemia mutations spectrum suggest a predominant, but not exclusive, African origin of these mutations in Uruguay.
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Affiliation(s)
- Ana María Soler
- Universidad de la República (UdelaR), Centro Universitario Regional (CENUR) Litoral Norte, Departamento de Ciencias Biológicas, Laboratorio de Genética Molecular Humana, Salto, Uruguay
| | - Bruna Facanali Piellusch
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Patología Clínica, Campinas, SP, Brazil
| | - Lorena da Silveira
- Universidad de la República (UdelaR), Centro Universitario Regional (CENUR) Litoral Norte, Departamento de Ciencias Biológicas, Laboratorio de Genética Molecular Humana, Salto, Uruguay
| | - Gisele Audrei Pedroso
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Patología Clínica, Campinas, SP, Brazil
| | - Pablo López
- Universidad de la República (UdelaR), Facultad de Medicina, Hospital de Clínicas Manuel Quintela, Departamento de Laboratorio de Patología Clínica, Montevideo, Uruguay
| | - Enrique Savio
- Administración de los Servicios de Salud del Estado (ASSE), Hospital Departamental de Salto, Servicio de Laboratorio Clínico, Salto, Uruguay
| | - María de Fatima Sonati
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Patología Clínica, Campinas, SP, Brazil
| | - Julio da Luz
- Universidad de la República (UdelaR), Centro Universitario Regional (CENUR) Litoral Norte, Departamento de Ciencias Biológicas, Laboratorio de Genética Molecular Humana, Salto, Uruguay
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Yingjun X, Yuhuan X, Yuchang C, Dongzhi L, Ding W, Bing S, Yi Y, Dian L, Yanting X, Zeyu X, Nengqing L, Diyu C, Xiaofang S. CRISPR/Cas9 gene correction of HbH-CS thalassemia-induced pluripotent stem cells. Ann Hematol 2019; 98:2661-2671. [PMID: 31495903 PMCID: PMC6900276 DOI: 10.1007/s00277-019-03763-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 07/20/2019] [Indexed: 11/25/2022]
Abstract
Haemoglobin (Hb) H-constant spring (CS) alpha thalassaemia (- -/-αCS) is the most common type of nondeletional Hb H disease in southern China. The CRISPR/Cas9-based gene correction of patient-specific induced pluripotent stem cells (iPSCs) and cell transplantation now represent a therapeutic solution for this genetic disease. We designed primers for the target sites using CRISPR/Cas9 to specifically edit the HBA2 gene with an Hb-CS mutation. After applying a correction-specific PCR assay to purify the corrected clones followed by sequencing to confirm the mutation correction, we verified that the purified clones retained full pluripotency and exhibited a normal karyotype. This strategy may be promising in the future, although it is far from representing a solution for the treatment of HbH-CS thalassemia now.
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Affiliation(s)
- Xie Yingjun
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Xie Yuhuan
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Chen Yuchang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Li Dongzhi
- Prenatal Diagnostic Centre, Guangzhou Women and Children Medical Centre affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wang Ding
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Song Bing
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Yang Yi
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Lu Dian
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Xue Yanting
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Xiong Zeyu
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Liu Nengqing
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Chen Diyu
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Sun Xiaofang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China.
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6
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Hemoglobin Kirklareli [Α 2 59(E7) His>Leu; HBA2:c.176A>T] in a Brazilian child with severe dyspnea and low O 2 saturation. Ann Hematol 2019; 98:2853-2855. [PMID: 31712880 DOI: 10.1007/s00277-019-03839-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
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7
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Pedroso GA, Kimura EM, Santos MNN, Albuquerque DM, Malimpensa D, Jorge SE, Verissimo MPA, Costa FF, Sonati MF. Thalassemia major phenotype caused by HB Zürich-Albisrieden [α2 59(E8) Gly > Arg (HBA2:C.178G > C)] in a Brazilian child. Pediatr Blood Cancer 2018; 65:e27413. [PMID: 30151892 DOI: 10.1002/pbc.27413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 11/10/2022]
Abstract
Hemoglobin (Hb) Zürich-Albisrieden (ZA) [α2 59(E8) Gly > Arg; HBA2:c.178G > C] is a rare and highly unstable α-chain variant. A few simple and compound heterozygotes (αZA α/αα and -/αZA α, respectively) have been described so far in Switzerland and China. We describe here a case of homozygosity for the Hb ZA mutation (αZA α/αZA α) in a Brazilian child with severe congenital hemolytic anemia and ineffective erythropoiesis.
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Affiliation(s)
- Gisele A Pedroso
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Elza M Kimura
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Magnun N N Santos
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Dulcinéia M Albuquerque
- Hematology and Hemotherapy Center, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Danaê Malimpensa
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Susan E Jorge
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | | | - Fernando F Costa
- Hematology and Hemotherapy Center, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Maria F Sonati
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
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8
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Mota NO, Kimura EM, Ferreira RD, Pedroso GA, Albuquerque DM, Ribeiro DM, Santos MNN, Bittar CM, Costa FF, Sonati MDF. Rare α0-thalassemia deletions detected by MLPA in five unrelated Brazilian patients. Genet Mol Biol 2017; 40:768-773. [PMID: 28981562 PMCID: PMC5738609 DOI: 10.1590/1678-4685-gmb-2016-0330] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 07/23/2017] [Indexed: 11/21/2022] Open
Abstract
Alpha-thalassemias are among the most common genetic diseases in the world. They are characterized by hypochromic and microcytic anemia and great clinical variability, ranging from a practically asymptomatic phenotype to severe anemia, which can lead to intrauterine or early neonatal death. Deletions affecting the α-globin genes, located on chromosome 16p13.3, are the main causes of α-thalassemia. Multiplex ligation-dependent probe amplification (MLPA) can be used to detect rearrangements that cause α-thalassemia, particularly large deletions involving the whole α cluster and/or deletions in the HS-40 region. Here, MLPA was used to investigate the molecular basis of α-thalassemia in five unrelated patients, three of whom had Hb H disease. In addition to the -α3.7 deletion identified in the patients with Hb H disease, four different α0 deletions removing 15 to 225 kb DNA segments were found: two of them remove both the α genes, one affects only the regulatory element (HS-40) region, and another one extends over the entire α cluster and the HS-40 region. These results illustrate the diversity of α-thalassemia deletions in the Brazilian population and highlight the importance of molecular investigation in cases that present with microcytosis and hypochromia without iron deficiency and normal or reduced Hb A2 levels..
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Affiliation(s)
- Natália O Mota
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Elza M Kimura
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Roberta D Ferreira
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Gisele A Pedroso
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Daniela M Ribeiro
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Magnun N N Santos
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Fernando F Costa
- Hemocentro, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Maria de Fatima Sonati
- Laboratório de Hemoglobinopatias, Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
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Pedroso GA, Kimura EM, Santos MNN, Albuquerque DM, Ferruzzi JLH, Jorge SE, Costa FF, Saad STO, Sonati MF. Coinheritance of Hb Bristol-Alesha [β67(E11)Val→Met; HBB: c.202G>A] and the α212 Patchwork Allele in a Brazilian Child with Severe Congenital Hemolytic Anemia. Hemoglobin 2017; 41:203-208. [PMID: 28670945 DOI: 10.1080/03630269.2017.1340305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hb Bristol-Alesha [HBB: c.202G>A; β 67 Val>Met] is a rare structural variant of hemoglobin (Hb) resulting from a GTG>ATG substitution at codon 67 of the β-globin gene that leads to the replacement of valine by methionine in the corresponding position of the β-globin chain. The methionine residue is subsequently modified to aspartic acid [β67(E11)Val-Met→Asp], possibly by autoxidation mechanisms. This substitution prevents normal non-polar binding of Val67 to the heme group, resulting in molecular instability and severe hemolysis. We identified Hb Bristol-Alesha (in the heterozygous state), as the cause of severe congenital hemolytic anemia in an 11-month-old girl of mixed (native Indian and European) ethnic origin from the Midwestern region of Brazil, whose parents were clinically and hematologically normal. The mutation on the β-globin gene was found to have been coinherited with the α212 patchwork allele.
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Affiliation(s)
- Gisele A Pedroso
- a Hemoglobinopathies Laboratory, Department of Clinical Pathology , School of Medical Sciences, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
| | - Elza M Kimura
- a Hemoglobinopathies Laboratory, Department of Clinical Pathology , School of Medical Sciences, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
| | - Magnun N N Santos
- a Hemoglobinopathies Laboratory, Department of Clinical Pathology , School of Medical Sciences, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
| | - Dulcinéia M Albuquerque
- b Hematology and Hemotherapy Center, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
| | - Jucilane L H Ferruzzi
- c University Hospital, Federal University of Grande Dourados (UFGD), Dourados , Mato Grosso do Sul , Brazil
| | - Susan E Jorge
- a Hemoglobinopathies Laboratory, Department of Clinical Pathology , School of Medical Sciences, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
| | - Fernando F Costa
- b Hematology and Hemotherapy Center, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
| | - Sara T O Saad
- b Hematology and Hemotherapy Center, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
| | - Maria F Sonati
- a Hemoglobinopathies Laboratory, Department of Clinical Pathology , School of Medical Sciences, State University of Campinas (UNICAMP), Campinas , São Paulo , Brazil
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10
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Mota NO, Kimura EM, Ferreira RD, Albuquerque DM, Ribeiro DM, Santos MNN, Costa FF, Sonati MF. A novel α0-thalassemia deletion in a Brazilian child with Hb H disease [--(Braz)]. Int J Lab Hematol 2017; 39:e106-e109. [DOI: 10.1111/ijlh.12646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- N. O. Mota
- Department of Clinical Pathology; School of Medical Sciences; State University of Campinas - UNICAMP; Campinas SP Brazil
| | - E. M. Kimura
- Department of Clinical Pathology; School of Medical Sciences; State University of Campinas - UNICAMP; Campinas SP Brazil
| | - R. D. Ferreira
- Department of Clinical Pathology; School of Medical Sciences; State University of Campinas - UNICAMP; Campinas SP Brazil
| | | | - D. M. Ribeiro
- Department of Clinical Pathology; School of Medical Sciences; State University of Campinas - UNICAMP; Campinas SP Brazil
| | - M. N. N. Santos
- Department of Clinical Pathology; School of Medical Sciences; State University of Campinas - UNICAMP; Campinas SP Brazil
| | - F. F. Costa
- Hematology and Hemotherapy Center; UNICAMP; Campinas SP Brazil
| | - M. F. Sonati
- Department of Clinical Pathology; School of Medical Sciences; State University of Campinas - UNICAMP; Campinas SP Brazil
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11
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Kimura EM, Oliveira DM, Jorge SE, Ribeiro DM, Zaccariotto TR, Santos MNN, Almeida V, Albuquerque DM, Costa FF, Sonati MDF. Investigating alpha-globin structural variants: a retrospective review of 135,000 Brazilian individuals. Rev Bras Hematol Hemoter 2015; 37:103-8. [PMID: 25818820 PMCID: PMC4382568 DOI: 10.1016/j.bjhh.2015.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/30/2014] [Indexed: 12/04/2022] Open
Abstract
Background Brazil has a multiethnic population with a high diversity of hemoglobinopathies. While screenings for beta-globin mutations are far more common, alterations affecting alpha-globin genes are usually more silent and less well known. The aim of this study was to describe the results of a screening program for alpha-globin gene mutations in a representative sample of the Southeastern Brazilian population. Methods A total of 135,000 individuals, including patients with clinical suspicion of hemoglobinopathies and their family members, randomly chosen individuals submitted to blood tests and blood donors who were abnormal hemoglobin carriers were analyzed. The variants were screened by alkaline and acid electrophoreses, isoelectric focusing and cation-exchange high performance liquid chromatography (HPLC) and the abnormal chains were investigated by reverse-phase high performance liquid chromatography (RP-HPLC). Mutations were identified by molecular analyses, and the oxygen affinity, heme–heme cooperativity and Bohr effect of the variants were evaluated by functional tests. Results Four new and 22 rare variants were detected in 98 families. Some of these variants were found in co-inheritance with other hemoglobinopathies. Of the rare hemoglobins, Hasharon, Stanleyville II and J-Rovigo were the most common, the first two being S-like and associated with alpha-thalassemia. Conclusion The variability of alpha-globin alterations reflects the high degree of racial miscegenation and an intense internal migratory flow between different Brazilian regions. This diversity highlights the importance of programs for diagnosing hemoglobinopathies and preventing combinations that may lead to important clinical manifestations in multiethnic populations.
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Affiliation(s)
- Elza Miyuki Kimura
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil
| | - Denise Madureira Oliveira
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil
| | - Susan Elisabeth Jorge
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil
| | - Daniela Maria Ribeiro
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil
| | - Tânia Regina Zaccariotto
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil
| | - Magnun Nueldo Nunes Santos
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil
| | - Vanessa Almeida
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil
| | - Dulcinéia Martins Albuquerque
- National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil; Hematology and Hemotherapy Center, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fernando Ferreira Costa
- National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil; Hematology and Hemotherapy Center, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Maria de Fátima Sonati
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil; National Institute of Blood Science and Technology, National Council for Scientific and Technological Development (CNPq), Ministry of Science and Technology (MCT), Brazil.
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Luz JD, Ávila A, Icasuriaga S, Gongóra M, Castillo L, Serrón A, Kimura EM, Costa FF, Sans M, Sonati MDF. Frequency and spectrum of hemoglobinopathy mutations in a Uruguayan pediatric population. Genet Mol Biol 2013; 36:316-22. [PMID: 24130436 PMCID: PMC3795163 DOI: 10.1590/s1415-47572013005000027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 04/12/2013] [Indexed: 11/22/2022] Open
Abstract
Hemoglobinopathies are the most common recessive diseases worldwide but their prevalence in Uruguay has not been investigated. In this study, 397 unrelated outpatient children from the Pereira Rosell Hospital Center (CHPR), as well as 31 selected patients with microcytic anemia and 28 β-thalassemia carriers were analyzed for hemoglobinopathies by using biochemical and molecular biology methods. Parametric and non-parametric methods were used to compare the hematological indices between groups of genotypes. Of the 397 patients in the first group, approximately 1% (0.76% HbS and 0.25% β-thalassemia) had a mutation in the HBB gene and 3.3% had β-thalassemia. These mutations had a heterogeneous distribution that varied according to individual ancestry. HbS was found exclusively in individuals with declared African ancestry and had a carrier frequency of 2.2%. The frequency of α-thalassemia carriers in outpatients of European and African ancestry was 1.2% and 6.5%, respectively. In contrast, the frequency of α-thalassemia carriers in patients with microcytic anemia was 25.8%, significantly higher (p < 0.01) than that observed in the sample as a whole and in Afro-descendants and Euro-descendants. Significant differences were observed in the hematological parameters between individuals with thalassemia genotypes and those with a normal genotype. These results indicate that hemoglobinopathies are a relevant health problem in Uruguay.
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Affiliation(s)
- Julio Da Luz
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo,
Uruguay
| | - Amalia Ávila
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo,
Uruguay
| | - Sandra Icasuriaga
- Departamento de Laboratorio Clínico, Centro Hospitalario Pereira Rosell, Montevideo,
Uruguay
| | - María Gongóra
- Servicio de Hemato-Oncología Pediátrica, Centro Hospitalario Pereira Rosell, Montevideo,
Uruguay
| | - Luis Castillo
- Servicio de Hemato-Oncología Pediátrica, Centro Hospitalario Pereira Rosell, Montevideo,
Uruguay
| | - Alejandra Serrón
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo,
Uruguay
| | - Elza Miyuki Kimura
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP,
Brazil
| | - Fernando Ferreira Costa
- Hemocentro, Faculdade de Ciências Médicas, Universidad Estadual de Campinas, Campinas, SP,
Brazil
| | - Mónica Sans
- Departmento de Antropología Biológica, Facultad de Humanidades y Ciencias de la Educación, Universidad de la República, Montevideo,
Uruguay
| | - Maria de Fátima Sonati
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP,
Brazil
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Opoku-Okrah C, Gordge M, Kweku Nakua E, Abgenyega T, Parry M, Robertson C, Smith CL. An investigation of the protective effect of alpha+-thalassaemia against severe Plasmodium falciparum amongst children in Kumasi, Ghana. Int J Lab Hematol 2013; 36:62-70. [PMID: 23837700 DOI: 10.1111/ijlh.12122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 05/30/2013] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Several factors influence the severity of Plasmodium falciparum; here, we investigate the impact of alpha+-thalassaemia genotype on P. falciparum parasitemia and prevalence of severe anaemia amongst microcytic children from Kumasi, Ghana. METHODS Seven hundred and thirty-two children (≤10 years) with P. falciparum were categorised into normocytic and microcytic (mean cell volume ≤76 fL). Microcytic individuals were genotyped for the -α(3.7) deletional thalassaemia mutation and parasite densities determined. RESULTS Amongst microcytic patients both parasite densities and prevalence of severe malaria parasitemia (≥100 000/μL) were significantly lower (P < 0.001) in the presence of an alpha+-thalassaemia genotype compared with non-alpha+-thalassaemia genotype. There was no evidence that alpha+-thalassaemia protected against severe anaemia. The protection conferred by alpha-thalassaemia genotype against severe P. falciparum parasitemia did not change with increasing age. CONCLUSION The severity of P. falciparum parasitemia was significantly lower in both the homozygous and heterozygous alpha+-thalassaemia groups compared with microcytic individuals with non-alpha+-thalassaemia genotype. The protective effect, from severe malaria, of the alpha+-thalassaemia allele does not alter with age.
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Affiliation(s)
- C Opoku-Okrah
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,University of Westminster, School of Life Sciences, London, UK
| | - M Gordge
- University of Westminster, School of Life Sciences, London, UK
| | - E Kweku Nakua
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - T Abgenyega
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - M Parry
- University of Westminster, School of Life Sciences, London, UK
| | - C Robertson
- University of Westminster, School of Life Sciences, London, UK
| | - C L Smith
- University of Westminster, School of Life Sciences, London, UK
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14
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Grosso M, Puzone S, Storino MR, Sessa R, Izzo P. Prenatal diagnosis of haemoglobinopathies: our experience of 523 cases. Clin Chem Lab Med 2013; 51:2219-25. [PMID: 23612661 DOI: 10.1515/cclm-2013-0195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/08/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND We performed counselling for prenatal diagnosis (PD) of haemoglobinopathies in 372 couples. Thirty-four out of 372 (9.1%) did not undergo PD: six due to spontaneous abortion; nine because it was too difficult to make a decision if PD was positive; 18 because counselling excluded the carrier status of one or both parents; and one because parental mutations were mild. METHODS Eleven out of 338 (3.3%) couples underwent PD because they had a thalassaemic child; 106 (31.4%) were found to be at high risk during pre-conceptional screening; 221 (65.4%) because of familiarity. Of 523 PDs in 486 (92.9%), including six dichorionic twin pregnancies, PD was performed on DNA from chorionic villi (CV), and in 37 from amniocytes (7.1%). In 1/523 cases, PD was not completed because DNA from CV was not sufficient; in two cases single tandem repeat analysis revealed maternal contamination of foetal DNA; in 7/522 (1.3%) cases PD revealed non-paternity. In 435/522 (83.3%) cases, PD was performed using reverse dot-blot and ARMS; 34/522 (6.5%) required sequencing. In 53/522 (10.2%) cases it was necessary to test globin loci for large rearrangements. RESULTS One hundred and twenty out of 522 (23.0%) PDs revealed an affected foetus. In all but two cases the couple interrupted pregnancy. In the six twin pregnancies PD revealed a normal and a carrier foetus (two cases), carrier status in both foetuses (two cases) and a carrier and an affected foetus (two cases). In these latter cases the couple planned selective interruption. CONCLUSIONS Our PD procedure is successful and reliable, and is useful in high-risk areas characterised by molecular heterogeneity.
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Al Moamen NJ, Mahdi F, Salman E, Ahmed T, Abbas R, Al Arrayed S, Sanad H, Ahmed AA. Silent β-Thalassemia Mutations at −101 (C>T) and −71 (C>T) and Their Coinheritance with the Sickle Cell Mutation in Bahrain. Hemoglobin 2013; 37:369-77. [DOI: 10.3109/03630269.2013.785434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Jorge SEDC, Petruk AA, Kimura EM, Oliveira DM, Caire L, Suemasu CN, Silveira PAA, Albuquerque DM, Costa FF, Skaf MS, Martínez L, Sonati MDF. Hb S-São Paulo: a new sickling hemoglobin with stable polymers and decreased oxygen affinity. Arch Biochem Biophys 2012; 519:23-31. [PMID: 22244832 DOI: 10.1016/j.abb.2012.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 12/22/2011] [Accepted: 01/01/2012] [Indexed: 01/19/2023]
Abstract
Hb S-São Paulo (SP) [HBB:c.20A>T p.Glu6Val; c.196A>G p.Lys65Glu] is a new double-mutant hemoglobin that was found in heterozygosis in an 18-month-old Brazilian male with moderate anemia. It behaves like Hb S in acid electrophoresis, isoelectric focusing and solubility testing but shows different behavior in alkaline electrophoresis, cation-exchange HPLC and RP-HPLC. The variant is slightly unstable, showed reduced oxygen affinity and also appeared to form polymers more stable than the Hb S. Molecular dynamics simulation suggests that the polymerization is favored by interfacial electrostatic interactions. This provides a plausible explanation for some of the reported experimental observations.
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Affiliation(s)
- Susan E D C Jorge
- Department of Clinical Pathology, School of Medical Sciences, State University of Campinas, Campinas, State of São Paulo, Brazil
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Villegas A, Ropero P, Anguita E, Hernández A, Polo M, González FA. Caracterización molecular de dos nuevas mutaciones de α° talasemia en 2 familias españolas (mutación --ED y --GP). Med Clin (Barc) 2011; 136:674-7. [DOI: 10.1016/j.medcli.2011.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 01/27/2011] [Accepted: 01/27/2011] [Indexed: 10/18/2022]
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18
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Suemasu C, Kimura E, Oliveira D, Bezerra M, Araújo A, Costa F, Sonati M. Characterization of alpha thalassemic genotypes by multiplex ligation-dependent probe amplification in the Brazilian population. Braz J Med Biol Res 2011; 44:16-22. [DOI: 10.1590/s0100-879x2010007500144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 12/03/2010] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | - A.S. Araújo
- Fundação de Hematologia e Hemoterapia de Pernambuco, Brasil
| | - F.F. Costa
- Universidade Estadual de Campinas, Brasil
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19
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Wagner SC, de Castro SM, Gonzalez TP, Santin AP, Filippon L, Zaleski CF, Azevedo LA, Amorin B, Callegari-Jacques SM, Hutz MH. Prevalence of common α-thalassemia determinants in south Brazil: Importance for the diagnosis of microcytic anemia. Genet Mol Biol 2010; 33:641-5. [PMID: 21637571 PMCID: PMC3036136 DOI: 10.1590/s1415-47572010005000086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 06/21/2010] [Indexed: 11/21/2022] Open
Abstract
Alpha thalassemia has not been systematically investigated in Brazil. In this study, 493 unrelated individuals from the southernmost Brazilian state of Rio Grande do Sul were screened for deletional forms of α-thalassemia. One hundred and one individuals had microcytic anemia (MCV < 80 fL) and a normal hemoglobin pattern (Hb A 2 < 3.5% and Hb F < 1%). The subjects were screened for - α3.7 , - α4.2 , - α20.5 , — SEA and — MED deletions but only the - α3.7 allele was detected. The - α3.7 allele frequency in Brazilians of European and African ancestry was 0.02 and 0.12, respectively, whereas in individuals with microcytosis the frequency was 0.20. The prevalence of α-thalassemia was significantly higher in individuals with microcytosis than in healthy individuals (p = 0.001), regardless of their ethnic origin. There were also significant differences in the hematological parameters of individuals with - α3.7 / αα, - α3.7 /- α3.7 and β-thalassemia trait compared to healthy subjects. These data suggest that α-thalassemia is an important cause of microcytosis and mild anemia in Brazilians.
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Affiliation(s)
- Sandrine C Wagner
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
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Abstract
Alpha-thalassaemia is inherited as an autosomal recessive disorder characterised by a microcytic hypochromic anaemia, and a clinical phenotype varying from almost asymptomatic to a lethal haemolytic anaemia. It is probably the most common monogenic gene disorder in the world and is especially frequent in Mediterranean countries, South-East Asia, Africa, the Middle East and in the Indian subcontinent. During the last few decades the incidence of alpha thalassaemia in North-European countries and Northern America has increased because of demographic changes. Compound heterozygotes and some homozygotes have a moderate to severe form of alpha thalassaemia called HbH disease. Hb Bart's hydrops foetalis is a lethal form in which no alpha-globin is synthesized. Alpha thalassaemia most frequently results from deletion of one or both alpha genes from the chromosome and can be classified according to its genotype/phenotype correlation. The normal complement of four functional alpha-globin genes may be decreased by 1, 2, 3 or all 4 copies of the genes, explaining the clinical variation and increasing severity of the disease. All affected individuals have a variable degree of anaemia (low Hb), reduced mean corpuscular haemoglobin (MCH/pg), reduced mean corpuscular volume (MCV/fl) and a normal/slightly reduced level of HbA2. Molecular analysis is usually required to confirm the haematological observations (especially in silent alpha-thalassaemia and alpha-thalassaemia trait). The predominant features in HbH disease are anaemia with variable amounts of HbH (0.8-40%). The type of mutation influences the clinical severity of HbH disease. The distinguishing features of the haemoglobin Bart's hydrops foetalis syndrome are the presence of Hb Bart's and the total absence of HbF. The mode of transmission of alpha thalassaemia is autosomal recessive. Genetic counselling is offered to couples at risk for HbH disease or haemoglobin Bart's Hydrops Foetalis Syndrome. Carriers of alpha+- or alpha0-thalassaemia alleles generally do not need treatment. HbH patients may require intermittent transfusion therapy especially during intercurrent illness. Most pregnancies in which the foetus is known to have the haemoglobin Bart's hydrops foetalis syndrome are terminated due to the increased risk of both maternal and foetal morbidity.
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Affiliation(s)
- Cornelis L Harteveld
- 1Department of Human and Clinical Genetics, Leiden University Medical Center, Einthovenweg 20, 2333ZC Leiden, The Netherlands
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Thalassemia in Western Australia: 11 novel deletions characterized by Multiplex Ligation-dependent Probe Amplification. Blood Cells Mol Dis 2010; 44:146-51. [DOI: 10.1016/j.bcmd.2009.12.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Revised: 12/16/2009] [Accepted: 12/17/2009] [Indexed: 11/17/2022]
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Sessa R, Puzone S, Ammirabile M, Piscopo C, Pagano L, Colucci S, Izzo P, Grosso M. Identification and molecular characterization of the --CAMPANIA deletion, a novel alpha (0) -thalassemic defect, in two unrelated Italian families [corrected]. Am J Hematol 2010; 85:143-4. [PMID: 20054848 DOI: 10.1002/ajh.21591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kimura EM, Oliveira DM, Fertrin K, Pinheiro VR, Jorge SEDC, Costa FF, de Fátima Sonati M. Hb H disease resulting from the association of an α-thalassemia allele [-(α)] with an unstable α-globin variant [Hb Icaria]: First report on the occurrence in Brazil. Genet Mol Biol 2009; 32:712-5. [PMID: 21637442 PMCID: PMC3036908 DOI: 10.1590/s1415-47572009005000071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Accepted: 05/21/2009] [Indexed: 11/23/2022] Open
Abstract
Hb H Disease is caused by the loss or inactivation of three of the four functional α-globin genes. Patients present chronic hemolytic anemia and splenomegaly. In some cases, occasional blood transfusions are required. Deletions are the main cause of this type of thalassemia ( α-thalassemia). We describe here an unusual case of Hb H disease caused by the combination of a common α0 deletion [-( α) 20.5 ] with a rare point mutation (c.427T > A), thus resulting in an elongated and unstable α-globin variant, Hb Icaria, (X142K), with 31 additional amino-acid residues. Very high levels of Hb H and Hb Bart's were detected in the patient's red blood cells (14.7 and 19.0%, respectively). This is the first description of this infrequent association in the Brazilian population.
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Affiliation(s)
- Elza M Kimura
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP Brazil
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Kidd JL, Azimi M, Lubin B, Vichinsky E, Hoppe C. Application of an expanded multiplex genotyping assay for the simultaneous detection of Hemoglobin Constant Spring and common deletional alpha-thalassemia mutations. Int J Lab Hematol 2009; 32:373-80. [PMID: 19919622 DOI: 10.1111/j.1751-553x.2009.01197.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hemoglobin Constant Spring (HbCS) is the most common nondeletional alpha-thalassemia variant causing HbH disease, making its detection crucial in populations at risk. Universal newborn screening for HbH is carried out in California. Identification of alpha-thalassemia genotypes responsible for HbH and HbH-CS requires rapid, accurate and cost-effective genotyping methods suitable for population screening. We incorporated the HbCS mutation into our existing seven-plex genotyping assay for common alpha-thalassemia deletions. To assess the feasibility and diagnostic utility of this expanded multiplex gap-PCR assay, we determined genotypic frequencies of HbCS in samples referred for alpha-thalassemia testing between 1 January 2006 and 31 December 2008. During the 3-year study period, 1436 samples were genotyped for alpha-thalassemia. HbH-CS accounted for 23 (13%) of the 176 cases of HbH disease identified. In a subset of 145 newborns referred by the California NBS program with an elevated Hb Bart's level at birth, HbH disease was confirmed in 134 (93%) and HbH-CS identified in 13 (10%) of these. This expanded genotyping assay has proven to be a rapid, reliable and clinically useful diagnostic tool for the detection of HbH-CS disease.
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Affiliation(s)
- J L Kidd
- Hemoglobinopathy Reference Laboratory, Children's Hospital & Research Center Oakland, 747 52nd Street, Oakland, CA 94609, USA
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Harteveld CL, Wijermans PW, van Delft P, Rasp E, Haak HL, Giordano PC. An α‐Thalassemia Phenotype in a Dutch Hindustani, Caused by a New Point Mutation that Creates an Alternative Splice Donor Site in the First Exon of the α2‐Globin Gene. Hemoglobin 2009; 28:255-9. [PMID: 15481895 DOI: 10.1081/hem-120040257] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The proband is an elderly woman (79 years of age) of Surinamese-Hindustani origin, suspected of being a carrier of a nondeletional alpha-thalassemia (thal) because of a moderate microcytic hypochromic anemia at normal ferritin levels and in the absence of any other alpha-thal deletions. Sequence analysis revealed a silent mutation (GGC-->GGT) at codon 22 of the alpha2-globin gene. This mutation generates a splice donor site consensus sequence (GGTGAG) between codons 22 and 23. The abnormally spliced mRNA leads to a premature termination between codons 48 and 49. The presence of a downstream intron may induce the intracellular degradation of the affected mRNA, a pathway known as nonsense mediated decay (NMD), and this explains the alpha(+)-thal phenotype observed in the patient. The codon 22 (GGC-->GGT) transition described in this report is the first mutation creating a splice donor site in one of the alpha-globin genes.
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Affiliation(s)
- Cornelis L Harteveld
- Hemoglobinopathies Laboratory, Department of Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
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Mesbah-Amroun H, Rouabhi F, Ducrocq R, Elion J. Molecular Basis of α-Thalassemia in Algeria. Hemoglobin 2009; 32:273-8. [DOI: 10.1080/03630260802004301] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bezerra MAC, Albuquerque DM, Santos MNN, Kimura EM, Jorge SEDC, Oliveira DM, Domingues BLTB, Peres JC, Araújo AS, Costa FF, Sonati MF. Two new unstable haemoglobins leading to chronic haemolytic anaemia: Hb Caruaru [beta122 (GH5) Phe-->Ser], a probable case of germ line mutation, and Hb Olinda [beta22 (B4) - 25 (B7)], a deletion of a 12 base-pair sequence. Eur J Haematol 2009; 83:378-82. [PMID: 19527272 DOI: 10.1111/j.1600-0609.2009.01296.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We describe here two new unstable beta-globin variants, Hb Caruaru and Hb Olinda, found in northeastern Brazil, both associated with chronic haemolytic anaemia. Haemoglobin Caruaru is caused by a single base substitution at codon 122 (TTC-->TCC), possibly originating from the germ line cells of the patient's grandmother. Haemoglobin Olinda is also a de novo mutation, caused by a 12 bp deletion leading to the removal of the 22nd to the 25th residues of the normal beta-globin chain.
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Affiliation(s)
- Marcos A C Bezerra
- Haematology and Haemotherapy Centre of Pernambuco-HEMOPE, Recife, Pernambuco, Brazil
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Rahimi Z, Akramipour R, Vaisi-Raygani A, Nagel RL, Muniz A. An Iranian child with HbQ-Iran [alpha75 (EF4) Asp-->His]/-alpha3.7 kb/IVSII.1 G-->A: first report. J Pediatr Hematol Oncol 2007; 29:649-51. [PMID: 17805044 DOI: 10.1097/mph.0b013e318142b572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hemoglobin Q (HbQ)-Iran [alpha75 (EF4) Asp-->His] is an alpha-chain variant that in the heterozygous state has normal hematology and has not been reported in association with a thalassemic phenotype. Here, for the first time, we described the hematologic characteristics of a 5-year-old boy with HbQ-Iran/-alpha3.7 kb trans to HbQ-Iran mutation/beta0-thalassemia (IVSII.1.G-->A) living in the Kermanshah province of Iran. OBSERVATIONS The level of HbQ-Iran was found to be 22.4%. However, a significant reduction in mean corpuscular volume (59.3 fL) and mean corpuscular hemoglobin (19.6 pg) and an elevation of hemoglobin F (6.3%) was observed. CONCLUSIONS This report indicates that HbQ-Iran to be a benign structural variant of Hb, that in combination with -alpha3.7 kb gene and beta0-thalassemia, presents a minor beta-thalassemia picture with moderate anemia.
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Affiliation(s)
- Zohreh Rahimi
- Medical Biology Research Center, Department of Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Di Bella C, Salpietro C, La Rosa M, Cuppari C, Piraino B, Cutri MR, Rigoli L. Identification of α-thalassemia mutations in subjects from Eastern Sicily (Italy) with abnormal hematological indices and normal Hb A2. Ann Hematol 2006; 85:829-31. [PMID: 16951927 DOI: 10.1007/s00277-006-0165-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Accepted: 06/23/2006] [Indexed: 12/01/2022]
Abstract
We analyzed the prevalence of alpha-thalassemia mutations in 298 subjects from Eastern Sicily (Italy) with reduced mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), normal HbA2 and HbF, and normal serum iron. In 131 subjects (43.9%) we found six different genotypes of alpha-thalassemia: -alpha3.7/alphaalpha (36.6%), -alpha3.7/-alpha3.7 (27.5%), -(MED)/alphaalpha (10.0%), -alpha20.5/alphaalpha (9.1%), alphaHphIalpha/alphaalpha (8.4%), alphaHphIalpha/alphaHphIalpha (6.1%), and -alpha3.7/alphaHphIalpha (2.3%). Our data underline that in Eastern Sicily populations, the molecular screening of alpha-thalassemia mutations and/or deletions may be useful to better characterize the clinically asymptomatic subjects with a slightly reduced MCV and MCH and normal iron status.
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Affiliation(s)
- Chiara Di Bella
- Unità Operativa di Genetica, Dipartimento di Scienze Pediatriche Mediche e Chirurgiche, pad NI, Policlinico Universitario, Messina, Italy
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31
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Zesong L, Ruijun G, Wen Z. Rapid detection of deletional alpha-thalassemia by an oligonucleotide microarray. Am J Hematol 2005; 80:306-8. [PMID: 16315259 DOI: 10.1002/ajh.20369] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A simple, fast, and highly reproducible protocol for detection of the three most common deletional alpha-thalassemias (- -SEA, - alpha3.7, -alpha4.2) using an oligonucleotide microarray was developed. PCR products were directly hybridized to the microarrays with different deletion-specific probes. Genotypes were determined by quantitative analysis of the fluorescent signals detected by fluorescence scanning. Blind assays on 400 samples validated the efficiency and specificity of the protocol. This method may be suitable for routine clinical use and population screening for deletional alpha-thalassemia.
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Affiliation(s)
- Li Zesong
- Shenzhen Yishengtang Biological Products Co. Ltd., Shenzhen, China.
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32
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Ozgönenel B, Savaşan S. Leftward -alpha4.2 deletion alpha-thalassemia in a patient of northern European extraction. J Pediatr Hematol Oncol 2004; 26:29-30. [PMID: 14707709 DOI: 10.1097/00043426-200401000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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33
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Foglietta E, Bianco I, Maggio A, Giambona A. Rapid detection of six common Mediterranean and three non-Mediterranean alpha-thalassemia point mutations by reverse dot blot analysis. Am J Hematol 2003; 74:191-5. [PMID: 14587048 DOI: 10.1002/ajh.10414] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We describe the implementation of reverse dot blot (RDB) hybridization as a rapid nonradioactive method for the identification of six frequent globin gene point mutations in the Mediterranean population: alpha(Hph)alpha: alpha2 IVS I donor site GGTGAGG --> GG-----; alpha(NcoI)alpha: alpha2 initiation codon ATG --> ACG; alpha(TSaudi)alpha: alpha2Poly A signal AATAA --> AATAAG; alpha(Icaria)alpha: alpha2 termination codon TAA --> AAA (Ter --> LYS); alpha(CS)alpha: alpha2 termination codon TAA --> CAA (Ter --> gly); alphaalpha(NcoI): alpha1 initiation codon ATG --> GTG; and three alpha2 globin gene point mutations found in immigrants in Italy: alpha(T-Quongsze)alpha: alpha2 codon 12 CTG --> CCG (Leu --> Pro); alpha(Seal Rock)alpha: alpha2 termination codon TAA --> GAA (TER --> GLU); and alpha(Koyadora)alpha: alpha2 termination codon TAA --> TCA (TER --> SER). The method uses the principle of allele-specific oligonucleotide (ASO) hybridization, but it is a nonradioactive method and permits rapid and simultaneous typing of point mutations and small deletions.
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Affiliation(s)
- Enrica Foglietta
- Associazione Nazionale per la Lotta contro le Microcitemie in Italia, Rome, Italy
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34
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Khan SN, Hasan F, Sollaino C, Perseu L, Riazuddin S. Molecular characterization of alpha-thalassemia in Pakistan. Hemoglobin 2003; 27:161-6. [PMID: 12908800 DOI: 10.1081/hem-120023379] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Common alpha-thalassemia (thal) rearrangements were studied in a normal random population and in six ethnic groups of Pakistan. Analyses of 204 individuals from the normal population revealed the presence of only the -alpha(3.7) allele with an overall frequency of 8.3%. Ethnic differences were statistically significant for Pashtoon vs. Balochi (p < 0.0005) and Pashtoon vs. Sindhi (p < 0.002). Two hundred and eighty-five thalassemia patients were also studied to identify rare alpha-thal alleles. In this group, 24.6% of the patients had one or two alpha genes deleted. Two rare alleles in the Pakistani population, -alpha(4.2) (0.2%) and alphaalphaalpha(anti3.7) (0.9%), were identified in these patients. The -alpha(4.2) allele was found only in Sindhis, while alphaalphaalpha(anti3.7) was present in Punjabis, Sindhis and Balochis. Five patients with triplicated alpha genes were homozygous for either the beta+ or the beta(0) genotype.
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Affiliation(s)
- Shaheen N Khan
- Centre for Applied Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore, Pakistan.
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35
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Fucharoen S, Changtrakun Y, Ratanasiri T, Fucharoen G, Sanchaisuriya K. Complex interaction of Hb Hekinan [alpha27(B8) Glu-Asp] and Hb E [beta26(B8) Glu-Lys] with a deletional alpha-thalassemia 1 in a Thai family. Eur J Haematol 2003; 70:304-9. [PMID: 12694166 DOI: 10.1034/j.1600-0609.2003.00049.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Hemoglobin (Hb) Hekinan (alpha27; Glu-Asp) is a rare alpha-chain variant found mainly in Japanese and Chinese whereas Hb E (beta26; Glu-Lys) is common among Southeast Asians. We report a hitherto undescribed condition in which these two variants co-segregate. The proband was a 25-yr-old Thai woman who was encountered with the presence of mild hypochromic microcytosis with Hb 8.2 g/dL, hematocrit (Hct) 26.0%, Mean Corpuscular Value (MCV) 68.6 fL, Mean Corpuscular Hemoglobin (MCH) 21.6 pg and Mean Corpuscular Hemoglobin Concentration (MCHC) 31.5 g/dL. Although Hb electrophoresis at alkaline pH did not show any abnormal band except Hb E in addition to Hb A, high performance liquid chromatography analysis revealed abnormal peaks at the Hb A and Hb E positions. DNA analysis of the proband revealed a GAG-GAT mutation at codon 27 of the minor alpha1-globin gene for Hb Hekinan in trans to the South-east Asian (SEA) deletional alpha-thalassemia 1 determinant and a GAG-AAG mutation at codon 26 of the beta-globin gene for Hb E. She was therefore a triple heterozygote for these three anomalies. Family study identified that her mother was a double heterozygote for Hb Hekinan and Hb E without alpha-thalassemia whereas her father was a classical Hb H disease patient. The genotype-phenotype relationship observed in this Thai family with complex hemoglobinopathies is presented and a simple DNA assay based on the polymerase chain reaction methodology for rapid diagnosis of Hb Hekinan is described.
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Affiliation(s)
- Supan Fucharoen
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
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36
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Harteveld CL, van Delft P, Wijermans PW, Kappers-Klunne MC, Weegenaar J, Losekoot M, Giordano PC. A novel 7.9 kb deletion causing alpha+-thalassaemia in two independent families of Indian origin. Br J Haematol 2003; 120:364-6. [PMID: 12542500 DOI: 10.1046/j.1365-2141.2003.04060.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe the characterization of a novel 7.9 kb deletion that eliminated one of the duplicated alpha-globin genes, causing an alpha+-thalassaemia phenotype in two independent carriers of Suriname-Indian origin. The molecular characterization of the deletion breakpoint fragment revealed neither involvement of Alu repeat sequences nor the presence of homologous regions prone to recombination, suggesting a non-homologous recombination event. This alpha+-thalassaemia deletion was found to give rise to an atypical haemoglobin H (HbH) disease characterized by a non-transfusion-dependent moderate microcytic hypochromic anaemia in combination with a poly adenylation signal mutation of the alpha-globin gene (alpha2 AATAAA --> AATA-- --).
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Affiliation(s)
- Cornelis L Harteveld
- Department of Human and Clinical Genetics, Leiden University Medical Centre, The Netherlands.
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37
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Fucharoen S, Fucharoen G, Sanchaisuriya K, Surapot S. Molecular characterization of thalassemia intermedia associated with HPFH-6/beta-thalassemia and HPFH-6/Hb E in Thai patients. Acta Haematol 2002; 108:157-61. [PMID: 12373089 DOI: 10.1159/000064707] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We report the molecular and hematological characterizations of thalassemia caused by interactions of the hereditary persistence of fetal hemoglobin (HPFH)-6 with beta-thalassemia in 2 Thai patients and the HPFH-6 with Hb E in another Thai patient. Marked hypochromic microcytosis, characteristics of thalassemia intermedia, were obvious in the former 2 cases but the latter had much milder clinical phenotype with normal Hb and a slightly reduced mean corpuscular volume (MCV) value. Hb analysis revealed no Hb A but Hb A(2)F patterns in the compound HPFH-6/beta-thalassemia patients and the EF pattern in the HPFH-6/Hb E patient. The (G)gamma-globin chain predominated in all cases. Globin gene analyses demonstrated that all patients carried the 101-kb HPFH-6 deletion in trans to the beta-thalassemia genes with the IVS1#5 G-C mutation and the G insertion between codons 8/9 and the beta(E)-gene, respectively. Hematologic data of the patients were compared to those of the HPFH-6 heterozygotes found in their family members and different genotype-phenotype interactions of this HPFH determinant in these Thai patients are illustrated.
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Affiliation(s)
- Supan Fucharoen
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.
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38
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Panyasai S, Sringam P, Fucharoen G, Sanchaisuriya K, Fucharoen S. A simplified screening for alpha-thalassemia 1 (SEA type) using a combination of a modified osmotic fragility test and a direct PCR on whole blood cell lysates. Acta Haematol 2002; 108:74-8. [PMID: 12187024 DOI: 10.1159/000064746] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In order to provide a rapid method for identifying alpha-thalassemia 1 in a region with massive population and limited resources, we have tested a rapid screening strategy. Preliminary screening was done using a modified one tube osmotic fragility test (OF test) followed by RBC indices; Hb analysis and detection of alpha-thalassemia 1 with the Southeast Asian deletion (SEA type) were performed by PCR. One hundred and seventy-five adult Thai subjects were studied. Fifty-one of the 175 subjects (29.1%) were positive for a modified OF test. They all had significantly lower MCV and MCH but higher RDW-CV values as compared to the OF negative group. A successful identification of alpha-thalassemia 1 deletion using a direct PCR on cell lysates was demonstrated. Among the 51 OF-test-positive subjects, 7 were found to be alpha-thalassemia 1 carriers, 3 of whom were also carriers of Hb E. No alpha-thalassemia 1 was detected in the OF-test-negative group. A combination of a modified OF test and a direct PCR analysis on whole blood cell lysates would therefore provide an effective screening for alpha-thalassemia 1 in the regions where a program of prevention and control of the disease remains underserved.
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Affiliation(s)
- Sittichai Panyasai
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
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39
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Fucharoen S, Pengjam Y, Surapot S, Fucharoen G, Sanchaisuriya K. Molecular and hematological characterization of HPFH-6/Indian deletion-inversion Ggamma(Agammadeltabeta)0-thalassemia and Ggamma(Agammadeltabeta)0-thalassemia/HbE in Thai patients. Am J Hematol 2002; 71:109-13. [PMID: 12353310 DOI: 10.1002/ajh.10202] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The hereditary persistence of fetal hemoglobin (HPFH)-6 is sporadically found in Thailand whereas the deletion-inversion type (G)gamma((A)gamma delta beta)(0)-thalassemia is described among Indians. We report a hitherto un-described case in which these two defects co-segregate. He was a 3-year-old Thai boy who had a feature of thalassemia intermedia phenotype with the following hematologic data; Hb 8.8 g/dL, Hct 29.2%, MCV 66.9 fL, MCH 20 pg, and MCHC 30.1 g/dL. Hemoglobin analysis revealed 100% Hb F with only (G)gamma-globin chain. Globin gene analyses demonstrated that he carried the HPFH-6 deletion in trans to the Indian deletion-inversion (G)gamma((A)gamma delta beta)(0)-thalassemia. Hematologic data of the patient was compared to those of the HPFH-6 heterozygote found in his father, to (G)gamma((A)gamma delta beta)(0)-thalassemia heterozygotes detected in his mother and sister, and to that of an unrelated Thai patient who was a compound heterozygote for the deletion-inversion (G)gamma((A)gamma delta beta)(0)-thalassemia and HbE.
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Affiliation(s)
- Supan Fucharoen
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
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40
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Fucharoen S, Changtrakun Y, Surapot S, Fucharoen G, Sanchaisuriya K. Molecular characterization of Hb D-Punjab [beta121(GH4)Glu-->Gln] in Thailand. Hemoglobin 2002; 26:261-9. [PMID: 12403491 DOI: 10.1081/hem-120015030] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We describe the hematological and DNA characterization of Hb D-Punjab [beta121(GH4)Glu-->Gln] in Thailand. Nine patients from five unrelated families were studied; four patients were simple carriers of Hb D-Punjab, two were compound heterozygotes for Hb D-Punjab/beta+-thalassemia; another two patients were double heterozygotes for Hb D-Punjab and alpha-thalassemia-2, and one patient was a compound heterozygote for Hb D-Punjab and Hb E [beta26(B8)Glu-->Lys]. Typical thalassemic indices with hypochromic microcytosis were observed in compound Hb D-Punjab/ beta+-thalassemia and Hb D-Punjab/Hb E but normal hematological profiles were observed in the remaining cases. DNA sequencing of the beta-globin gene identified the GAA-->CAA substitution at codon 121 causing Hb D-Punjab in all cases, and the -28 (A-->G) mutation for the beta+-thalassemia alleles. beta-Globin gene haplotype analysis demonstrated, for the first time, that all these Asian beta(D-Punjab) globin genes were associated with haplotype [-++-+++], previously undescribed in other populations. The finding of Hb D-Punjab in Thailand is compatible either with an independent origin of this abnormal hemoglobin or a spread of the Hb D-Punjab gene with a single origin among Asians.
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Affiliation(s)
- Supan Fucharoen
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.
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41
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Abstract
This paper review the most important aspects of carrier detection procedures, genetic counselling, population screening and prenatal diagnosis of beta-thalassemias. Carrier detection can be made retrospectively, following the birth of an affected child or prospectively. Several programmes, with the aim of preventing homozygous beta-thalassemia, based on carrier screening and counselling of couples at marriage; preconception or early pregnancy, are operating in several Mediterranean at-risk populations. These programmes have been very effective, as indicated by increasing knowledge on thalassemia and its prevention by the target population and by the marked decline of the incidence of thalassemia major. Carrier detection is carried out by haematological methods followed by mutation detection by DNA analysis. Prenatal diagnosis is accomplished by mutation analysis on PCR-amplified DNA from chorionic villi. Future prospects include automation of the process of mutation-detection, simplification of preconception and preimplantation diagnosis and fetal diagnosis by analysis of fetal cells in maternal circulation.
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Affiliation(s)
- Antonio Cao
- Dipartimento di Scienze Biomediche e Biotecnologie, Università Studi Cagliari, Italy
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42
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Sanchaisuriya K, Fucharoen G, Fucharoen S. Hb Paksé [(alpha2) codon 142 (TAA-->TAT or Term-->Tyr)J in Thai patients with EAbart's disease and Hb H Disease. Hemoglobin 2002; 26:227-35. [PMID: 12403487 DOI: 10.1081/hem-120015026] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hb Paksé is caused by an alpha2-globin gene termination codon mutation, TAA-->TAT or Term-->Tyr, initially described in a Laotian family. We now report for the first time that the same mutation has been found in 14 Thai patients, seven with EABart's disease, four with Hb H disease, and three with alpha-thalassemia trait who were initially diagnosed as having Hb Constant Spring (Hb CS; alpha2-globin gene termination codon mutation TAA-->CAA or Term-->Gln). Co-inheritance of this mutation with alpha-thalassemia-1 (SEA type) leads to Hb H disease (hereafter designated as Hb H-Paksé disease) and to a complex thalassemia syndrome, namely EABart's-Paksé disease. Hematological data of these patients were compared with those of classical Hb H-CS and the EABart's patients. To facilitate epidemiological and diagnostic screening of Hb Paksé, a simple assay procedure based on allele specific polymerase chain reaction (PCR) amplifications was developed and validated. Using this allele specific PCR as a screening method, five additional individuals with Hb Paksé were found among 71 Thai subjects previously thought to have Hb CS.
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Affiliation(s)
- Kanokwan Sanchaisuriya
- Department of Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
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43
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Harteveld CL, van Delft P, Plug R, Versteegh FGA, Hagen B, van Rooijen I, Kok PJMJ, Wajcman H, Kister J, Giordano PC. Hb Groene Hart: a new Pro-->Ser amino acid substitution at position 119 of the alpha1-globin chain is associated with a mild alpha-thalassemia phenotype. Hemoglobin 2002; 26:255-60. [PMID: 12403490 DOI: 10.1081/hem-120015029] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Alpha-Thalassemia (thal) is generally considered to be an expression defect caused mostly by deletions silencing one or more alpha-globin genes. Although nondeletional alpha-thalassemia is considered rare, in our laboratory we frequently observe alpha-thal phenotypes induced by point mutations. We report a new point mutation generating an abnormal hemoglobin (Hb) associated with a mild alpha-thal phenotype in two members of a Moroccan family, who presented with mild but persistent microcytic hypochromic parameters and a balanced beta/alpha synthetic ratio. All attempts to separate an abnormal native or denatured fraction were unsuccessful using electrophoresis, isoelectrofocusing (IEE), ion exchange and reversed phase high performance liquid chromatography (HPLC), denaturing polyacrylamide gel electrophoresis (PAGE), and electrospray mass spectrometry (ES/MS). The anomalous protein was only predictable by DNA analysis. The mutated gene product, not separable with any of the techniques used, could be a monomer unsuitable for tetramer formation, which is proteolyzed at an early stage. Alternatively, this mutation could perhaps lead to an abnormal splicing. The CCTCT sequence generated by the mutant, not found in the translated region of the gene, but normally present at the end of the IVS-II, could induce a possible exon skipping. This mutant could generate a mild or a critical Hb H disease in combination with one of the common alpha0-thal deletion defects.
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Affiliation(s)
- Cornelis L Harteveld
- Department of Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
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44
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Cao A, Rosatelli MC, Monni G, Galanello R. Screening for thalassemia: a model of success. Obstet Gynecol Clin North Am 2002; 29:305-28, vi-vii. [PMID: 12108831 DOI: 10.1016/s0889-8545(01)00006-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Programs of prospective carrier screening and genetic counseling for beta-thalassemia among couples planning marriage, preconception, or during early pregnancy are ongoing in several at-risk populations in the Mediterranean area, including Greeks, Greek Cypriots and Continental Italians. Carrier detection is carried out by haematological analysis followed by mutation detection by DNA analysis. Once carrier couples are identified, prenatal diagnosis is accomplished by mutation analysis on PCR amplified DNA from chorionic villi. These programs have been very effective, due to education programs and subsequent acceptance of screening. Future prospects include automation of the process of mutation detection by microchips analysis, introduction of preconception and preimplantation diagnosis and hopefully fetal diagnosis by analysis of fetal cells in maternal circulation.
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Affiliation(s)
- Antonio Cao
- Department of Pediatrics, Università degli Studi di Cagliari, Sardinia, Italy.
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45
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Chen TP, Liu TC, Chang CS, Chang JG, Tsai HJ, Lin SF. PCR-based analysis of alpha-thalassemia in Southern Taiwan. Int J Hematol 2002; 75:277-80. [PMID: 11999355 DOI: 10.1007/bf02982041] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Southeast Asia type deletion of alpha-thalassemia-1 (--SEA) is the most common type of alpha-thalassemia-1 in Taiwan. There are 2 less common types, Filipino type (--FIL) and Thai type (--THAI). In the current study, we screened 754 cases of alpha-thalassemia-1 in Southern Taiwan using a polymerase chain reaction (PCR)-based method. Our results show that the prevalence of the (--SEA) type is 90.6%, followed by the (--FIL) type (8.6%), the (--THAI) type (0.5%), and the (-alpha(3.7/-alpha(3.7)) type (0.3%). We also analyzed the genotypes of 96 patients with hemoglobin (Hb) H disease and 48 cases of hydrops fetalis with Hb Bart's. The frequencies of the genotypes of the alpha-thalassemia-1 allele in Hb H disease are in accordance with the results of analyses of alpha-thalassemia-1 cases. The alpha-thalassemia-2 allele includes alpha(4.2), alpha(G), alpha(CS), and alpha(QS)alpha. Forty-one cases, 6 cases, and 1 case of hydrops fetalis with Hb Bart's were caused by --SEA/--SEA, --SEA/--FIL and --SEA/--THAI respectively. The genotypes and frequencies of alpha-thalassemia in this study are different from those in previous studies in Taiwan and Hong Kong. These differences may be attributed to the diverse genetic origin among different ethnic groups and the extensive inclusion of the (--FIL) and (--THAI) alpha-thalassemia-1 types.
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Affiliation(s)
- Tyen-Po Chen
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan
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46
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McBride KL, Snow K, Kubik KS, Fairbanks VF, Hoyer JD, Fairweather RB, Chaffee S, Edwards WH. Hb Dartmouth [alpha66(E15)Leu-->Pro (alpha2) (CTG-->CCG)]: a novel alpha2-globin gene mutation associated with severe neonatal anemia when inherited in trans with Southeast Asian alpha-thalassemia-1. Hemoglobin 2001; 25:375-82. [PMID: 11791870 DOI: 10.1081/hem-100107874] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We report a novel mutation at alpha66(E15)Leu-->Pro (alpha2) (CTG-->CCG), that we have named Hb Dartmouth for the medical center at which the patients were cared for, in monozygotic twins who also inherited the Southeast Asian alpha-thalassemia-1 deletion. The mother, of Khmer ancestry, is heterozygous for alpha-thalassemia-1. The father, who is of Scottish-Irish ancestry, is a silent carrier of the codon 66 mutation. The twins had severe neonatal anemia requiring transfusion.
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Affiliation(s)
- K L McBride
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA
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47
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Fucharoen S, Pengjam Y, Surapot S, Fucharoen G, Sanchaisuriya K. Molecular characterization of (deltabeta)(0)/beta(0)-thalassemia and (deltabeta)(0)-thalassemia/hemoglobin E in Thai patients. Eur J Haematol 2001; 67:258-62. [PMID: 11860449 DOI: 10.1034/j.1600-0609.2001.00524.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Two cases of the Thai thalassemia patients with compound heterozygosities for (deltabeta)(0)/beta(0)-thalassemia and (deltabeta)(0)-thalassemia/hemoglobin E have been reported. The first case was a 8-yr-old boy who had the following hematologic data: Hb 6.5 g/dL, Hct 20.5%, MCV 70.4 fL, MCH 22.3 pg and MCHC 31.7 g/dL. Hemoglobin analysis revealed 1.9% hemoglobin A2 and 91.7% hemoglobin F. The second case, with Hb 13.9 g/dL, Hct 41.5%, MCV 69.5 fL, MCH 22.5 pg and MCHC 32.2 g/dL, was a 16-yr-old male who had 46.1% hemoglobin E and 49.8% hemoglobin F. Globin gene analyses showed that both probands carried the same deletional type (deltabeta)(0)-thalassemia trans to the 4 bp deletions in codons 41/42 beta(0)-thalassemia and to the betaE-globin gene, respectively. Polymerase chain reaction and DNA sequence analyses demonstrated that the 5' breakpoint of the (deltabeta)(0)-thalassemia deletion was located in the second intron of the delta-globin gene and that the 3' breakpoint lay within a cluster of LI repetitive sequences at 4.7 kb 3' to the beta-globin gene.
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Affiliation(s)
- S Fucharoen
- Department of Clinical Chemistry, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
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Laosombat V, Wongchanchailert M, Sattayasevana B, Wiriyasateinkul A, Fucharoen S. Clinical and hematological features of beta(+)-thalassemia (IVS-1 nt 5, G-C mutation) in Thai patients. Eur J Haematol 2001; 67:100-4. [PMID: 11722597 DOI: 10.1034/j.1600-0609.2001.t01-1-00431.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Seventy-eight patients with IVS-1 nt 5, G-C, which is the common mutation of beta+-thalassemia found in the southern part of Thailand, were studied to determine whether it is possible to predict phenotypic severity from genetic factors. The clinical phenotype of homozygotes for IVS-1 nt 5, G-C and compound heterozygotes for IVS-1 nt 5, G-C and beta(0) - or beta(+)-thalassemia were variable and could not be accurately predicted. The associations between concomittant alpha-thalassemia or Hb CS or the presence of XmnI-Ggamma polymorphism and a mild clinical phenotype are not apparent, indicating the involvement of other ameliorating determinants or genetic modifications.
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Affiliation(s)
- V Laosombat
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand.
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Sanchaisuriya K, Fucharoen G, Sae-ung N, Siriratmanawong N, Surapot S, Fucharoen S. Molecular characterization of hemoglobin C in Thailand. Am J Hematol 2001; 67:189-93. [PMID: 11391717 DOI: 10.1002/ajh.1105] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We describe hematologic and DNA characterization of 12 hemoglobin C heterozygotes and three compound heterozygotes for hemoglobin C and hemoglobin E found in Thailand. Amplification and DNA analysis of genomic DNA by the polymerase chain reaction procedure permitted the identification of the beta(C) mutation at codon 6 of beta-globin gene (beta 6; GAG-AAG). beta-Globin gene haplotype analysis demonstrated that all beta(C) globin genes detected in these Thai individuals were associated with the haplotype (+ - - - - - +), indicating a non-African origin of this abnormal hemoglobin in Thailand. On routine hemoglobin typing, hemoglobin C is usually mistakenly identified as hemoglobin E because of theirs similar mobilities on cellulose acetate electrophoresis. The simple DNA assay for hemoglobin C based on an allele-specific polymerase chain reaction for accurate diagnosis of hemoglobin C was therefore developed.
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Affiliation(s)
- K Sanchaisuriya
- Department of Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
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50
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Borges E, Wenning MR, Kimura EM, Gervásio SA, Costa FF, Sonati MF. High prevalence of alpha-thalassemia among individuals with microcytosis and hypochromia without anemia. Braz J Med Biol Res 2001; 34:759-62. [PMID: 11378664 DOI: 10.1590/s0100-879x2001000600009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In order to determine the contribution of alpha-thalassemia to microcytosis and hypochromia, 339 adult outpatients seen at Unicamp University Hospital (with the exception of the Clinical Hematology outpatient clinics), who showed normal hemoglobin (Hb) levels and reduced mean corpuscular volume and mean corpuscular hemoglobin, were analyzed. Ninety-eight were Blacks (28.9%) and 241 were Caucasians (71.1%). In all cases, Hb A2 and F levels were either normal or low. The most common deletional and nondeletional forms of alpha-thalassemia [-alpha3.7, -alpha4.2, --MED, -(alpha)20.5, alphaHphIalpha, alphaNcoIalpha, alphaalphaNcoI and alphaTSAUDI] were investigated by PCR and restriction enzyme analyses. A total of 169 individuals (49.9%) presented alpha-thalassemia: 145 (42.8%) were heterozygous for the -alpha3.7 deletion (-alpha3.7/alphaalpha) and 18 (5.3%) homozygous (-alpha3.7/-alpha3.7), 5 (1.5%) were heterozygous for the nondeletional form alphaHphIalpha (alphaHphIalpha/alphaalpha), and 1 (0.3%) was a --MED carrier (--MED/alphaalpha). Among the Blacks, 56 (57.1%) showed the -alpha3.7/alphaalpha genotype, whereas 12 (12.2%) were -alpha3.7/-alpha3.7 and 1 (1.0%) was an alphaHphIalpha carrier; among the Caucasians, 89 (36.9%) were -alpha3.7/alphaalpha, 6 (2.5%) had the -alpha3.7/-alpha3.7 genotype, 4 (1.7%) presented the nondeletional form (alphaHphIalpha/alphaalpha), and 1 (0.4%) was a --MED carrier. These results demonstrate that alpha-thalassemia, mainly through the -alpha3.7 deletion, is an important cause of microcytosis and hypochromia in individuals without anemia. These data are of clinical relevance since these hematological alterations are often interpreted as indicators of iron deficiency.
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Affiliation(s)
- E Borges
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, 13083-970 Campinas, SP, Brazil
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