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Alshabeeb MA, Alwadaani D, Al Qahtani FH, Abohelaika S, Alzahrani M, Al Zayed A, Al Saeed HH, Al Ajmi H, Alsomaie B, Rashid M, Daly AK. Impact of Genetic Variations on Thromboembolic Risk in Saudis with Sickle Cell Disease. Genes (Basel) 2023; 14:1919. [PMID: 37895268 PMCID: PMC10606407 DOI: 10.3390/genes14101919] [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: 07/16/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is a Mendelian disease characterized by multigenic phenotypes. Previous reports indicated a higher rate of thromboembolic events (TEEs) in SCD patients. A number of candidate polymorphisms in certain genes (e.g., FVL, PRT, and MTHFR) were previously reported as risk factors for TEEs in different clinical conditions. This study aimed to genotype these genes and other loci predicted to underlie TEEs in SCD patients. METHODOLOGY A multi-center genome-wide association study (GWAS) involving Saudi SCD adult patients with a history of TEEs (n = 65) and control patients without TEE history (n = 285) was performed. Genotyping used the 10× Affymetrix Axiom array, which includes 683,030 markers. Fisher's exact test was used to generate p-values of TEE associations with each single-nucleotide polymorphism (SNP). The haplotype analysis software tool version 1.05, designed by the University of Göttingen, Germany, was used to identify the common inherited haplotypes. RESULTS No association was identified between the targeted single-nucleotide polymorphism rs1801133 in MTHFR and TEEs in SCD (p = 0.79). The allele frequency of rs6025 in FVL and rs1799963 in PRT in our cohort was extremely low (<0.01); thus, both variants were excluded from the analysis as no meaningful comparison was possible. In contrast, the GWAS analysis showed novel genome-wide associations (p < 5 × 10-8) with seven signals; five of them were located on Chr 11 (rs35390334, rs331532, rs317777, rs147062602, and rs372091), one SNP on Chr 20 (rs139341092), and another on Chr 9 (rs76076035). The other 34 SNPs located on known genes were also detected at a signal threshold of p < 5 × 10-6. Seven of the identified variants are located in olfactory receptor family 51 genes (OR51B5, OR51V1, OR51A1P, and OR51E2), and five variants were related to family 52 genes (OR52A5, OR52K1, OR52K2, and OR52T1P). The previously reported association between rs5006884-A in OR51B5 and fetal hemoglobin (HbF) levels was confirmed in our study, which showed significantly lower levels of HbF (p = 0.002) and less allele frequency (p = 0.003) in the TEE cases than in the controls. The assessment of the haplotype inheritance pattern involved the top ten significant markers with no LD (rs353988334, rs317777, rs14788626882, rs49188823, rs139349992, rs76076035, rs73395847, rs1368823, rs8888834548, and rs1455957). A haplotype analysis revealed significant associations between two haplotypes (a risk, TT-AA-del-AA-ins-CT-TT-CC-CC-AA, and a reverse protective, CC-GG-ins-GG-del-TT-CC-TT-GG-GG) and TEEs in SCD (p = 0.024, OR = 6.16, CI = 1.34-28.24, and p = 0.019, OR = 0.33, CI = 0.13-0.85, respectively). CONCLUSIONS Seven markers showed novel genome-wide associations; two of them were exonic variants (rs317777 in OLFM5P and rs147062602 in OR51B5), and less significant associations (p < 5 × 10-6) were identified for 34 other variants in known genes with TEEs in SCD. Moreover, two 10-SNP common haplotypes were determined with contradictory effects. Further replication of these findings is needed.
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Affiliation(s)
- Mohammad A. Alshabeeb
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 11426, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh 11426, Saudi Arabia (M.A.)
| | - Deemah Alwadaani
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh 11426, Saudi Arabia (M.A.)
- Medical Genomics Research Department, King Abdullah International Medical Research Center (KAIMRC), Riyadh 11481, Saudi Arabia
| | - Farjah H. Al Qahtani
- Hematology/Oncology Center, King Saud University Medical City (KSUMC), Riyadh 11411, Saudi Arabia;
| | - Salah Abohelaika
- Research Department, Qatif Central Hospital (QCH), Qatif 32654, Saudi Arabia;
- Pharmacy Department, Qatif Central Hospital (QCH), Qatif 32654, Saudi Arabia
| | - Mohsen Alzahrani
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh 11426, Saudi Arabia (M.A.)
- King Fahad Hospital, Ministry of National Guard Health Affairs (MNGHA), Riyadh 11426, Saudi Arabia
| | - Abdullah Al Zayed
- Hematology Department, Qatif Central Hospital (QCH), Qatif 32654, Saudi Arabia; (A.A.Z.); (H.H.A.S.)
| | - Hussain H. Al Saeed
- Hematology Department, Qatif Central Hospital (QCH), Qatif 32654, Saudi Arabia; (A.A.Z.); (H.H.A.S.)
| | - Hala Al Ajmi
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 11426, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh 11426, Saudi Arabia (M.A.)
| | - Barrak Alsomaie
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 11426, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh 11426, Saudi Arabia (M.A.)
| | - Mamoon Rashid
- King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh 11426, Saudi Arabia (M.A.)
- Department of AI and Bioinformatics, King Abdullah International Medical Research Center (KAIMRC), Riyadh 11481, Saudi Arabia
| | - Ann K. Daly
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK
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Relevance of Plasma Homocysteine and Methylenetetrahydrofolate Reductase 677TT Genotype in Sickle Cell Disease: A Systematic Review and Meta-Analysis. Int J Mol Sci 2022; 23:ijms232314641. [PMID: 36498990 PMCID: PMC9736045 DOI: 10.3390/ijms232314641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/05/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2022] Open
Abstract
We evaluated the relevance of plasma homocysteine (HC) and the TT genotype of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism (rs1801133) in sickle cell disease (SCD) and associated vaso-occlusive crisis (VOC) and ischemic stroke (IS). We identified in Embase and Medline 22 studies on plasma HC and 22 on MTHFR genotypes. Due to age-related HC differences, adult and paediatric SCD were separated: 879 adult SCD and 834 controls (CTR) yielded a neutral effect size; 427 paediatric SCD and 625 CTR favoured SCD (p = 0.001) with wide heterogeneity (I2 = 95.5%) and were sub-grouped by country: six studies (Dutch Antilles n = 1, USA n = 5) yielded a neutral effect size, four (India n = 1, Arab countries n = 3) favoured SCD (p < 0.0001). Moreover, 249 SCD in VOC and 419 out of VOC yielded a neutral effect size. The pooled prevalence of the MTHFR TT genotype in 267 SCD equalled that of 1199 CTR (4.26% vs. 2.86%, p = 0.45), and in 84 SCD with IS equalled that of 86 without IS (5.9% vs. 3.7%, p = 0.47); removal of one paediatric study yielded a significant effect size (p = 0.006). Plasma HC in paediatric SCD from Middle East and India was higher, possibly due to vitamin deficiencies. Despite its low prevalence in SCD, the MTHFR TT genotype relates to adult IS.
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Sokkar MF, Kamal L, Salama N, Hamdy M. Thrombophilic mutations and risk of vascular complications in sickle cell disease. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bagher AM, Young AP, Neamatallah T, Al-Amoudi RM, Bagher SM, Denovan-Wright EM. Prevalence of methylenetetrahydrofolate reductase gene polymorphisms (C677T, and A1298C) among Saudi children receiving dental treatment. Ann Saudi Med 2021; 41:1-7. [PMID: 33550905 PMCID: PMC7868620 DOI: 10.5144/0256-4947.2021.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Methylenetetrahydrofolate reductase, the encoded by the MTHFR gene, plays a crucial role in converting the amino acid homocysteine to methionine. Two polymorphisms of the MTHFR gene, C677T and A1298C, reportedly reduce enzyme activity, resulting in hyperhomocysteinemia. Patients with C677T and A1298C polymorphisms may be at higher risk for developing abnormal hyperhomocysteinemia, which has been linked to catastrophic neurological including fatal outcomes. OBJECTIVE Determine the prevalence of the MTHFR gene variants C677T and A1298C among pediatric dental patients treated at King Abdulaziz University Hospital. DESIGN Cross-sectional. SETTING Clinics of pediatric dentistry department. SUBJECTS AND METHODS Healthy Saudi children 6-12 years old with no known allergies were screened for eligibility between May and December 2019. A single investigator collected saliva samples. The MTHFR C677T and A1298C polymorphisms were analyzed using polymerase chain reaction and restriction fragment length polymorphism. MAIN OUTCOME MEASURE The prevalence of MTHFR gene variants (C677T and A1298C) among the subjects. SAMPLE SIZE 138. RESULTS MTHFR C677T polymorphism was present in 36.2% of the sample and 90.0% of children carrying this allele were heterozygotes. MTHFR A1298C polymorphism was present in 91.3% of the sample and 77.0% of the children carrying this allele were heterozygotes. No linkage disequilibrium between MTHFR C677T and MTHFR A1298C was observed within this sample. CONCLUSIONS Our study found a high frequency of the MTHFR A1298C genotype, which was substantially more abundant than expected based on a Hardy-Weinberg distribution. Therefore, caution is advised in using N2O in Saudi children as the increased prevalence of this MTHFR allele may increase the incidence of serious adverse effects among these children. LIMITATIONS Further studies are recommended with a larger sample size from randomly selected hospitals from different regions of Saudi Arabia. CONFLICT OF INTEREST None.
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Affiliation(s)
- Amina M. Bagher
- From the Department of Pharmacology and Toxicology, Faculty of Pharmacy, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Alexander P. Young
- From the Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia
| | - Thikryat Neamatallah
- From the Department of Pharmacology and Toxicology, Faculty of Pharmacy, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Reham M. Al-Amoudi
- From the Department of Pediatric Dentistry, Faculty of Dentistry, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Sara M. Bagher
- From the Department of Pediatric Dentistry, Faculty of Dentistry, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Eileen M. Denovan-Wright
- From the Department of Pharmacology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia
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Habib E, Elshaer A, Shafquat A, Al-Ghamdi B. Pulmonary and Paradoxical Embolism after Slow Pathway Ablation: A Thrombotic Disorder Unmasked by a Rare Complication. J Atr Fibrillation 2019; 11:2142. [PMID: 31384363 DOI: 10.4022/jafib.2142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/14/2018] [Accepted: 12/26/2018] [Indexed: 11/10/2022]
Abstract
Cardiac electrophysiology study (EPS) and catheter ablation procedure are established diagnostic and therapeutic procedures for cardiac arrhythmias. Pulmonary embolism (PE) is a relatively rare but potentially fatal complication of Cardiac electrophysiology study (EPS). The paradoxical embolism (PDE) occurs due to an intracardiac defect with a right to left shunt with patent foramen ovale (PFO) being the most common cause. The simultaneous occurrence of PE and PDE is rare. Here we present a case of PE and PDE after EPS and radiofrequency catheter ablation (RFCA) of the slow pathway in a patient with recurrent supraventricular tachycardia (SVT) due to atrioventricular nodal reentry tachycardia (AVNRT). To our knowledge, such a case of PE and PDE has not been reported after SVT ablation.
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Affiliation(s)
- Eiad Habib
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC)
| | - Amani Elshaer
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC)
| | - Azam Shafquat
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC).,Alfaisal University, Riyadh, Saudi Arabia
| | - Bandar Al-Ghamdi
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC).,Alfaisal University, Riyadh, Saudi Arabia
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Association between MTHFR 677C>T polymorphism and vascular complications in sickle cell disease: A meta-analysis. Transfus Clin Biol 2019; 26:284-288. [PMID: 30686687 DOI: 10.1016/j.tracli.2019.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 01/04/2019] [Indexed: 01/26/2023]
Abstract
Sickle cell disease (SCD) is considered as a vascular disease due to its chronic vascular manifestations such as leg ulcers, priapism, acute chest syndrome (ACS), stroke, retinopathy, renal insufficiency, pulmonary hypertension, avascular necrosis of the femoral head (AVNF) and splenic infarction. Emerging evidence has shown that the MTHFR 677C>T variant allele is associated with vascular complications (VC) in patients with SCD; however, results from individual studies are inconclusive. The aim of this meta-analysis is to evaluate the association between the MTHFR 677C>T polymorphism and the susceptibility for VC in SCD patients. Articles published in English were collected from Medline, PubMed, Embase, and Web of Science databases. As a result, 11 studies in different populations including 614 SCD patients with VC, and 559 patients without VC were selected. Meta-analysis in fixed effect model showed that mutant genotypes (CT+TT vs. CC) of the MTHFR 677C>T polymorphism is associated with increased risk of vascular complication (OR=1.81, 95% CI=1.37-2.40, P<0.001). This study did not demonstrate publication bias or between-study heterogeneity. Our meta-analysis establishes that the MTHFR 677C>T polymorphism as a high-penetrant risk factor for VC in SCD patients. Further research is needed to support the clinical utility of MTHFR genetic testing for predicting VC in patients with sickle cell disease.
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Belhaj Nefissi R, Doggui R, Ouali F, Messaoud T, Gritli N. Factor V Leiden G1691A, Prothrombin G20210A, and MTHFR C677T and A1298C Mutations in Patients With Sickle Cell Disease in Tunisia. Hemoglobin 2018; 42:96-102. [PMID: 30200836 DOI: 10.1080/03630269.2018.1451340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Sickle cell disease is a genetic disorder characterized by a hypercoagulable state. Several complications in this hemoglobinopathy are increased by thrombosis. Factor V Leiden (FVL), prothrombin (PRT) G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C mutations are major inherited risk factors of thrombotic complications. In this study, our aim was to compare the frequencies of these mutations in sickle cell patients with healthy controls. The study population comprised 35 homozygous Hb S (HBB: c.20A>T) patients, 29 compound heterozygous patients [16 Hb S/β0-thalassemia (β0-thal), four Hb S/β+-thal, seven Hb S/Hb C (HBB: c.19G>A) and two Hb S/Hb O-Arab (HBB: c.364G>A)] and 100 healthy subjects. All patients and controls were subjected to laboratory investigations as well as mutation genotyping. Our findings showed a severe anemia with the lowest values of protein S (PS), protein C (PC) and antithrombin (AT) in the homozygous Hb S group compared to Hb S/Hb C and Hb S/β-thal subjects. No significant difference in FVL genotype between patients and controls was observed, whereas high frequencies of PRT G20210A, MTHFR C677T and MTHFR A1298C mutations in the Hb S patients and a significant association between the MTHFR C677T mutation and Hb S/β0-thal were found.
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Affiliation(s)
- Rim Belhaj Nefissi
- a Laboratory of Molecular Biology, Department of Hematology , Military Hospital of Tunis , Tunisia
| | - Radhouene Doggui
- b Laboratory of Biochemistry and Molecular Biology , Children's Hospital of Tunis , Tunisia
| | - Faida Ouali
- c National Institute of Nutrition and Food Technology (INNTA) Tunis , Tunisia
| | - Taieb Messaoud
- c National Institute of Nutrition and Food Technology (INNTA) Tunis , Tunisia
| | - Nasreddine Gritli
- a Laboratory of Molecular Biology, Department of Hematology , Military Hospital of Tunis , Tunisia
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Samarah F, Srour MA. Factor V Leiden G1691A and prothrombin G20210A mutations among Palestinian patients with sickle cell disease. BMC HEMATOLOGY 2018; 18:1. [PMID: 29372059 PMCID: PMC5771009 DOI: 10.1186/s12878-018-0097-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 01/04/2018] [Indexed: 11/11/2022]
Abstract
Background Vascular thrombosis is an important pathophysiological aspect of sickle cell disease (SCD). This study aimed to investigate the prevalence and clinical impact of factor V Leiden G1691A (FVL) and prothrombin G20210A mutations among Palestinian sickle cell disease (SCD) patients. Methods A total of 117 SCD patients, including 59 patients with sickle cell anemia (SS), 33 patients with sickle β-thalassemia and 25 individuals with sickle cell trait (AS) were studied. The control group consisted of 118 healthy individuals. FVL and prothrombin G20210A mutations were determined by RFLP PCR. Results Analysis of the clinical history of SCD patients revealed that seven patients have had vascular complications such as ischemic stroke or deep vein thrombosis. In SCD patients, the inheritance of the FVL mutation showed a significantly higher incidence of pain in joints, chest and abdomen as well as regular dependence on blood transfusion compared to SCD with the wild type. Age- and sex-adjusted logistic regression analysis revealed a significant association between FVL and sickle cell anemia with an odds ratio (OR) of 5.6 (95% confidence intervals [CI] of 1.91–39.4, P = 0.039) in SS patients. However, increased prevalence of the FVL in AS subjects and sickle β-thalassemia patients was not statistically significant compared to controls (OR 3.97, 95% CI 0.51–28.6, P = 0.17 and OR 3.59, 95% CI 0.35–41.6, P = 0.26, respectively). The distribution of prothrombin G20210A mutation among SCD patients compared to controls was not significantly different, thus our findings do not support an association of this mutation with SCD. Conclusions FVL was more prevalent among SS patients compared to controls and it was associated with higher incidence of disease complications among SCD patients.
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Affiliation(s)
- Fekri Samarah
- 1Department of Medical Technology, Faculty of Allied Health Sciences, Arab American University in Jenin, Jenin, Palestine
| | - Mahmoud A Srour
- 2Department of Medical Laboratory Sciences, Faculty of Health professions, Al-Quds University, Jerusalem, Palestine.,3Present address: Department of Biology & Biochemistry, Faculty of Science, Birzeit University, Birzeit, Palestine
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Global prevalence of prothrombin gene mutation G20210A and implications in women's health. Blood Coagul Fibrinolysis 2016; 27:481-9. [DOI: 10.1097/mbc.0000000000000562] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pakbaz Z, Wun T. Role of the hemostatic system on sickle cell disease pathophysiology and potential therapeutics. Hematol Oncol Clin North Am 2014; 28:355-74. [PMID: 24589271 DOI: 10.1016/j.hoc.2013.11.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Recent studies suggest that sickle cell disease (SCD) is a hypercoagulable state contributing to vaso-occlusive events in the microcirculation, resulting in acute and chronic sickle cell-related organ damage. In this article, we review the existing evidence for contribution of hemostatic system perturbation to SCD pathophysiology. We also review the data showing increased risk of thromboembolic events, particularly newer information on the incidence of venous thromboembolism. Finally, the potential role of platelet inhibitors and anticoagulants in SCD is briefly reviewed.
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Affiliation(s)
- Zahra Pakbaz
- Division of Hematology Oncology, Davis School of Medicine, 4501 X Street, Suite 3016, Sacramento, CA 95817, USA
| | - Ted Wun
- Division of Hematology Oncology, Davis School of Medicine, 4501 X Street, Suite 3016, Sacramento, CA 95817, USA; UC Davis Clinical and Translational Sciences Center, VA Northern California Health Care System, Sacramento, CA, USA.
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Nishank SS, Singh MPSS, Yadav R. Clinical impact of factor V Leiden, prothrombin G20210A, and MTHFR C677T mutations among sickle cell disease patients of Central India. Eur J Haematol 2013; 91:462-6. [DOI: 10.1111/ejh.12190] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Rajiv Yadav
- Regional Medical Research Centre for Tribals (ICMR); Jabalpur Madhya Pradesh India
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12
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Kangne HK, Jijina FF, Italia YM, Jain DL, Nadkarni AH, Ghosh KK, Colah RB. The Prevalence of Factor V Leiden (G1691A) and Methylenetetrahydrofolate Reductase C677T Mutations in Sickle Cell Disease in Western India. Clin Appl Thromb Hemost 2013; 21:186-9. [DOI: 10.1177/1076029613495308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The prevalence of the Factor V Leiden (FVL; G1691A) mutation and the methylenetetrahydrofolate reductase (MTHFR; C677T) mutation was determined in 180 patients with sickle cell (SS) disease (126 sickle homozygous and 54 sickle β-thalassaemia—age 1-47 years) and in 130 healthy controls. The FVL mutation in the heterozygous state was present in only 3 patients with SS disease and was absent in the controls. Genotyping of MTHFR 677C > T revealed increased frequency of the C allele than the T allele in patients as well as in controls. This suggests that these genetic markers may not be major risk factors for a hypercoagulable state in Indian patients with SS disease.
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Affiliation(s)
- Harshada K. Kangne
- Department of Haematogenetics, National Institute of Immunohaematology (ICMR), KEM Hospital Campus, Parel, Mumbai, India
| | | | | | - Dipti L. Jain
- Department of Pediatrics, Government Medical College, Nagpur, India
| | - Anita H. Nadkarni
- Department of Haematogenetics, National Institute of Immunohaematology (ICMR), KEM Hospital Campus, Parel, Mumbai, India
| | - Kanjaksha K. Ghosh
- Department of Haematogenetics, National Institute of Immunohaematology (ICMR), KEM Hospital Campus, Parel, Mumbai, India
| | - Roshan B. Colah
- Department of Haematogenetics, National Institute of Immunohaematology (ICMR), KEM Hospital Campus, Parel, Mumbai, India
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D. Hatzlhofer BL, Bezerra MAC, Santos MN, Albuquerque DM, Freitas EM, Costa FF, Araújo AS, Muniz MTC. MTHFRPolymorphic Variant C677T Is Associated to Vascular Complications in Sickle-Cell Disease. Genet Test Mol Biomarkers 2012; 16:1038-43. [DOI: 10.1089/gtmb.2011.0361] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Betânia L. D. Hatzlhofer
- Centro de Hematologia e Hemoterapia de Pernambuco—HEMOPE, Recife, Pernambuco, Brasil
- Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Pernambuco, Brasil
| | - Marcos André C. Bezerra
- Centro de Ciências Biológicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil
| | - Magnun N.N. Santos
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas-UNICAMP, Campinas, São Paulo, Brasil
| | - Dulcinéia M. Albuquerque
- Hospital de Hematologia e Hemoterapia, Universidade Estadual de Campinas-UNICAMP, Campinas, São Paulo, Brasil
| | - Elizabete M. Freitas
- Instituto de Ciências Biológicas-ICB, Universidade de Pernambuco-UPE, Recife, Pernambuco, Brasil
| | - Fernando F. Costa
- Hospital de Hematologia e Hemoterapia, Universidade Estadual de Campinas-UNICAMP, Campinas, São Paulo, Brasil
| | - Aderson S. Araújo
- Centro de Hematologia e Hemoterapia de Pernambuco—HEMOPE, Recife, Pernambuco, Brasil
| | - Maria Tereza C. Muniz
- Instituto de Ciências Biológicas-ICB, Universidade de Pernambuco-UPE, Recife, Pernambuco, Brasil
- Centro de Oncohematologia Pediátrica-CEONHPE/UPE, Hospital Universitário Oswaldo Cruz, Recife, Pernambuco, Brasil
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Prevalence of factor V Leiden (G1619A) and prothrombin gene (G20210A) mutation in Egyptian children with sickle cell disease. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s00580-012-1469-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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15
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Pandey SK, Meena A, Kishor K, Mishra RM, Pandey S, Saxena R. Prevalence of Factor V Leiden G1691A, MTHFR C677T, and Prothrombin G20210A Among Asian Indian Sickle Cell Patients. Clin Appl Thromb Hemost 2011; 18:320-3. [DOI: 10.1177/1076029611425830] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The prevalence of factor V (FV) Leiden G1691A, prothrombin G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T mutations were investigated among 90 sickle trait, 61 sickle homozygous, 75 sickle beta thalassemia, and 15 HbSD Asian Indian sickle cell patients. In all, 297 healthy controls were evaluated to compare the polymorphism frequency. The prevalence of FV Leiden heterozygous G>A were significant in the group ( P = .02), while PRT G20210A polymorphism was not seen among patients as well as controls. However, an increased frequency of the MTHFR 677 C>T genotype was seen among patients as well as controls, but this was not statistically significant ( P = .13). This suggested a low impact of inherited hypercoagulability risk factors in the pathogenesis of sickle cell disease and/or its complications.
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Affiliation(s)
- Sanjay Kumar Pandey
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Meena
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Kamal Kishor
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - R. M. Mishra
- Department of Environmental Biology, Awadhesh Pratap Singh University Rewa, India
| | - Sweta Pandey
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Saxena
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Sickle cell disease and venous thromboembolism. Mediterr J Hematol Infect Dis 2011; 3:e2011024. [PMID: 21713075 PMCID: PMC3113276 DOI: 10.4084/mjhid.2011.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 05/14/2011] [Indexed: 01/21/2023] Open
Abstract
Hemoglobin S in homozygous state or in combination with one of the structural variants of Hb D-Punjab, Hb O-Arab, Hb C or β-thalassemia mutation results in sickle cell disease (SCD) that is characterized by chronic hemolytic anemia and tissue injury secondary to vasooclusion. A chronic hypercoagulable state in SCD has been established with the increased risk of thromboembolic complications in these patients. The goal of present review is to survey of the literature related to thromboembolic events and genetic risk factors involved in the manifestation of these events in SCD patients with focus on studies from Mediterranean countries. Also, this review covers the pathogenesis of hypercoagulability and alteration in the components of hemostasis system.
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Al-Saqladi AWM, Harper G, Delpisheh A, Fijnvandraat K, Bin-Gadeem HA, Brabin BJ. Frequency of the MTHFR C677T Polymorphism in Yemeni Children with Sickle Cell Disease. Hemoglobin 2010; 34:67-77. [DOI: 10.3109/09687630903554111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Al-Absi IK, Al-Subaie AM, Ameen G, Mahdi N, Mohammad AM, Fawaz NA, Almawi WY. Association of the Methylenetetrahydrofolate Reductase A1298C but not the C677T Single Nucleotide Polymorphism with Sickle Cell Disease in Bahrain. Hemoglobin 2009; 30:449-53. [PMID: 16987799 DOI: 10.1080/03630260600867958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The association of methylenetetrahydrofolate reductase (MTHFR) gene mutations, C677T and A1298C, together with changes in homocysteine (Hcy) levels was investigated in 106 sickle cell disease patients and 156 healthy controls from Bahrain. The mutation analysis was done by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). While the frequencies of the mutant alleles C677T and A1298C were comparable between patients and controls, the frequency of the A1298C (C/C) (p = 0.03) but not C677T (T/T) (p = 0.67) genotype, and of the 677T/1298C haplotype were significantly higher in the patients (p = 0.05). Homocysteine levels were normal in all subjects. This suggests that the A1298C, but not C677T, mutation is associated with the genotype of sickle cell disease.
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Affiliation(s)
- Iman K Al-Absi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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HLA class II haplotypes distinctly associated with vaso-occlusion in children with sickle cell disease. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2008; 15:729-31. [PMID: 18272668 DOI: 10.1128/cvi.00425-07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We investigated the association of HLA class II alleles and haplotypes with sickle cell anemia vaso-occlusive crisis (VOC). DRB1*100101 was positively associated, while DRB1*140101, DRB1*150101, and DQB1*060101 were negatively associated, with VOC. Both susceptible (DRB1*100101-DQB1*050101) and protective (DRB1*110101-DQB1*030101 and DRB1*150101-DQB1*060101) haplotypes were identified, indicating that HLA class II haplotypes influence VOC risk.
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Rahimi Z, Vaisi-Raygani A, Nagel RL, Muniz A. Thrombophilic mutations among Southern Iranian patients with sickle cell disease: high prevalence of factor V Leiden. J Thromb Thrombolysis 2007; 25:288-92. [PMID: 17619828 DOI: 10.1007/s11239-007-0069-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Accepted: 06/05/2007] [Indexed: 01/29/2023]
Abstract
BACKGROUND A hypercoagulable state in sickle cell disease (SCD) and beta thalassemia has been established and thrombosis is an important aspect of the clinical spectrum of sickle cell disease. In a case-control study, the prevalence of factor V Leiden and prothrombin G20210A mutations were investigated among SCD patients from Southern Iran. METHODS Patients comprised 60 individuals with SCD; of them 35 were with sickle cell anemia (SS) including 21 males and 14 females aged 17.2+/-8.3 years, 15 were sickle cell trait (AS) consisted of nine males and six females aged 30+/-15.4 years and 10 were sickle/beta thalassemia (S/Thal) (three males and seven females) aged 24.6+/-10.4 years. The control group were 126 apparently healthy individuals (50 males and 76 females) aged 20.1+/-9.8 years. Genotyping was done by polymerase chain reaction restriction fragment-length polymorphism (PCR-RFLP) using Mnl I and Hind III for factor V Leiden and prothrombin G20210A, respectively. RESULTS Heterozygous factor V Leiden mutation was found in five of 35 (14.3%) SS patients, two of 15 (13.3%) AS individuals, one (a sickle/beta-zero thalassemia patient with IVSII.1 G-->A mutation) of 10 S/Thal patients (10%), and two of 126 (1.6%) control subjects (P<0.05). However, only one AS individual (6.7%) was found to be a carrier for prothrombin G20210A compared to five of 126 (4%) healthy individuals. Adjusted logistic regression analysis for the effects of age and sex was performed and a significant association was found between factor V Leiden mutation and sickle cell anemia with odds ratios (OR) of 6.5 (95% confidence intervals [CI] 1.19-35.33, P=0.03) in SS patients. However, increased prevalence of the factor V Leiden in AS individuals and S/Thal patients was not statistically significant compared to controls (OR 3.84, 95% CI 0.49-29.9, P=0.19 and OR 3.77, 95% CI 0.31-45.9, P=0.29, respectively). CONCLUSIONS Our findings indicate a significant correlation between factor V Leiden and sickle cell anemia among Iranian patients. Association between venous thrombophilia and factor V Leiden mutation in Iranians with sickle cell anemia should be further studied.
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Affiliation(s)
- Zohreh Rahimi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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