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Russo R, Iolascon A, Andolfo I, Marra R, Rosato BE. Updates on clinical and laboratory aspects of hereditary dyserythropoietic anemias. Int J Lab Hematol 2024; 46:595-605. [PMID: 38747503 DOI: 10.1111/ijlh.14307] [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: 02/15/2024] [Accepted: 04/26/2024] [Indexed: 07/04/2024]
Abstract
Hereditary dyserythropoietic anemias, or congenital dyserythropoietic anemias (CDAs), are rare disorders disrupting normal erythroid lineage development, resulting in ineffective erythropoiesis and monolinear cytopenia. CDAs include three main types (I, II, III), transcription-factor-related forms, and syndromic forms. The widespread use of next-generation sequencing in the last decade has unveiled novel causative genes and unexpected genotype-phenotype correlations. The discovery of the genetic defects underlying the CDAs not only facilitates accurate diagnosis but also enhances understanding of CDA pathophysiology. Notable advancements include identifying a hepatic-specific role of the SEC23B loss-of-function in iron metabolism dysregulation in CDA II, deepening CDIN1 dysfunction during erythroid differentiation, and uncovering a recessive CDA III form associated with RACGAP1 variants. Current treatments primarily rely on supportive measures tailored to disease severity and clinical features. Comparative studies with pyruvate kinase deficiency have illuminated new therapeutic avenues by elucidating iron dyshomeostasis and dyserythropoiesis mechanisms. We herein discuss recent progress in diagnostic methodologies, novel gene discoveries, and enhanced comprehension of CDA pathogenesis and molecular genetics.
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Affiliation(s)
- Roberta Russo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli 'Federico II', Naples, Italy
- CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Achille Iolascon
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli 'Federico II', Naples, Italy
- CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Immacolata Andolfo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli 'Federico II', Naples, Italy
- CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Roberta Marra
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli 'Federico II', Naples, Italy
- CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Barbara Eleni Rosato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli 'Federico II', Naples, Italy
- CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
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Saptarshi AN, Dongerdiye RK, More TA, Kedar PS. Development of High-Resolution Melting Curve Analysis for rapid detection of SEC23B gene mutation causing Congenital Dyserythropoietic Anemia type II in Indian population. Ital J Pediatr 2023; 49:84. [PMID: 37455305 DOI: 10.1186/s13052-023-01493-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/09/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Congenital dyserythropoietic anemias (CDAs) are a very rare and heterogeneous group of disorders characterized by ineffective erythropoiesis. CDA II is caused by mutations in the SEC23B gene. The most common mutation reported in India is c.1385 A > G, p.Y462C. There is no simple and cost-effective confirmatory diagnostic test available for CDA, and therefore, many patients remain undiagnosed. High-resolution melting curve (HRM) analysis is a polymerase chain reaction (PCR) based technique applied to identify genetic differences and scan nucleic acid sequences. HRM can be used to rapidly screen the common mutation causing CDA II in the Indian population. Thus, we studied the use of High-Resolution Melting Curve Analysis to detect common mutation causing CDA II in the Indian population. METHOD 11 patients having SEC23B (Y462C) mutation causing CDA II are considered for this study. HRM was used to check the presence of Y462C mutation. To verify the accuracy of the HRM analysis, we compared HRM results with the results of Sanger sequencing. This helped us to confirm the diagnosis. RESULTS We have described the clinical, hematological, and genetic data of eleven patients suffering from CDAII. According to HRM and Sanger sequencing, a homozygous SEC23B (Y462C) mutation was present in all patients, whereas a heterozygous Y462C mutation was present in their parents. CONCLUSION Our data showed that High-Resolution Melting (HRM) analysis could be used to rapidly screen common SEC23B mutation that causes CDA II in the Indian population.
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Affiliation(s)
- Arati Nandan Saptarshi
- Department of Haematogenetics, ICMR- National Institute of Immunohaematology, 13th Floor, New Multi Storeyed Building, KEM Hospital Campus, Parel, Mumbai, 400012, India
| | - Rashmi K Dongerdiye
- Department of Haematogenetics, ICMR- National Institute of Immunohaematology, 13th Floor, New Multi Storeyed Building, KEM Hospital Campus, Parel, Mumbai, 400012, India
| | - Tejashree Anil More
- Department of Haematogenetics, ICMR- National Institute of Immunohaematology, 13th Floor, New Multi Storeyed Building, KEM Hospital Campus, Parel, Mumbai, 400012, India
| | - Prabhakar S Kedar
- Department of Haematogenetics, ICMR- National Institute of Immunohaematology, 13th Floor, New Multi Storeyed Building, KEM Hospital Campus, Parel, Mumbai, 400012, India.
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Rangarajan HG, Stanek JR, Abdel-Azim H, Modi A, Haight A, McKinney CM, McKeone DJ, Buchbinder DK, Katsanis E, Abusin GA, Ahmed I, Law J, Silva JG, Mallhi KK, Burroughs LM, Shah N, Shaw PJ, Greiner R, Shenoy S, Pulsipher MA, Abu-Arja R. Hematopoietic Cell Transplantation for Congenital Dyserythropoietic Anemia. A Report from the Pediatric Transplant and Cellular Therapy Consortium (PTCTC). Transplant Cell Ther 2022; 28:329.e1-329.e9. [DOI: 10.1016/j.jtct.2022.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
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Abstract
Congenital dyserythropoietic anemias (CDAs) are a heterogeneous group of inherited anemias that affect the normal differentiation-proliferation pathways of the erythroid lineage. They belong to the wide group of ineffective erythropoiesis conditions that mainly result in monolinear cytopenia. CDAs are classified into the 3 major types (I, II, III), plus the transcription factor-related CDAs, and the CDA variants, on the basis of the distinctive morphological, clinical, and genetic features. Next-generation sequencing has revolutionized the field of diagnosis of and research into CDAs, with reduced time to diagnosis, and ameliorated differential diagnosis in terms of identification of new causative/modifier genes and polygenic conditions. The main improvements regarding CDAs have been in the study of iron metabolism in CDAII. The erythroblast-derived hormone erythroferrone specifically inhibits hepcidin production, and its role in the mediation of hepatic iron overload has been dissected out. We discuss here the most recent advances in this field regarding the molecular genetics and pathogenic mechanisms of CDAs, through an analysis of the clinical and molecular classifications, and the complications and clinical management of patients. We summarize also the main cellular and animal models developed to date and the possible future therapies.
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Thornton N, Karamatic Crew V, Tilley L, Green CA, Tay CL, Griffiths RE, Singleton BK, Spring F, Walser P, Alattar AG, Jones B, Laundy R, Storry JR, Möller M, Wall L, Charlewood R, Westhoff CM, Lomas-Francis C, Yahalom V, Feick U, Seltsam A, Mayer B, Olsson ML, Anstee DJ. Disruption of the tumour-associated EMP3 enhances erythroid proliferation and causes the MAM-negative phenotype. Nat Commun 2020; 11:3569. [PMID: 32678083 PMCID: PMC7366909 DOI: 10.1038/s41467-020-17060-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/29/2020] [Indexed: 12/14/2022] Open
Abstract
The clinically important MAM blood group antigen is present on haematopoietic cells of all humans except rare MAM-negative individuals. Its molecular basis is unknown. By whole-exome sequencing we identify EMP3, encoding epithelial membrane protein 3 (EMP3), as a candidate gene, then demonstrate inactivating mutations in ten known MAM-negative individuals. We show that EMP3, a purported tumour suppressor in various solid tumours, is expressed in erythroid cells. Disruption of EMP3 by CRISPR/Cas9 gene editing in an immortalised human erythroid cell line (BEL-A2) abolishes MAM expression. We find EMP3 to associate with, and stabilise, CD44 in the plasma membrane. Furthermore, cultured erythroid progenitor cells from MAM-negative individuals show markedly increased proliferation and higher reticulocyte yields, suggesting an important regulatory role for EMP3 in erythropoiesis and control of cell production. Our data establish MAM as a new blood group system and demonstrate an interaction of EMP3 with the cell surface signalling molecule CD44.
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Affiliation(s)
- Nicole Thornton
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK.
| | - Vanja Karamatic Crew
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - Louise Tilley
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - Carole A Green
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant and NIHR Blood and Transplant Unit in Red Cell Products, University of Bristol, Bristol, UK
| | - Chwen Ling Tay
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - Rebecca E Griffiths
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant and NIHR Blood and Transplant Unit in Red Cell Products, University of Bristol, Bristol, UK
| | - Belinda K Singleton
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant and NIHR Blood and Transplant Unit in Red Cell Products, University of Bristol, Bristol, UK
| | - Frances Spring
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant and NIHR Blood and Transplant Unit in Red Cell Products, University of Bristol, Bristol, UK
| | - Piers Walser
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - Abdul Ghani Alattar
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Benjamin Jones
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - Rosalind Laundy
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - Jill R Storry
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Office of Medical Services, Lund, Sweden
| | - Mattias Möller
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Lorna Wall
- Reference Laboratory, New Zealand Blood Service, Auckland, New Zealand
| | | | | | | | - Vered Yahalom
- Magen David Adom, National Blood Services, Ramat Gan, Israel
| | - Ute Feick
- Deutsches Rotes Kreuz, Blood Donor Service, Institute Bad Kreuznach, Bad Kreuznach, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Institute Springe, Springe, Germany
| | - Beate Mayer
- Institute of Transfusion Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martin L Olsson
- Division of Hematology and Transfusion Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Office of Medical Services, Lund, Sweden
| | - David J Anstee
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant and NIHR Blood and Transplant Unit in Red Cell Products, University of Bristol, Bristol, UK
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Flatt JF, Stevens-Hernandez CJ, Cogan NM, Eggleston DJ, Haines NM, Heesom KJ, Picard V, Thomas C, Bruce LJ. Expression of South East Asian Ovalocytic Band 3 Disrupts Erythroblast Cytokinesis and Reticulocyte Maturation. Front Physiol 2020; 11:357. [PMID: 32411010 PMCID: PMC7199003 DOI: 10.3389/fphys.2020.00357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/27/2020] [Indexed: 12/17/2022] Open
Abstract
Southeast Asian Ovalocytosis results from a heterozygous deletion of 9 amino acids in the erythrocyte anion exchange protein AE1 (band 3). The report of the first successful birth of an individual homozygous for this mutation showed an association with severe dyserythropoietic anemia. Imaging of the proband’s erythrocytes revealed the presence of band 3 at their surface, a reduction in Wr(b) antigen expression, and increases in glycophorin C, CD44, and CD147 immunoreactivity. Immunoblotting of membranes from heterozygous Southeast Asian Ovalocytosis red cells showed a quantitative increase in CD44, CD147, and calreticulin suggesting a defect in reticulocyte maturation, as well as an increase in phosphorylation at residue Tyr359 of band 3, and peroxiredoxin-2 at the membrane, suggesting altered band 3 trafficking and oxidative stress, respectively. In vitro culture of homozygous and heterozygous Southeast Asian Ovalocytosis erythroid progenitor cells produced bi- and multi-nucleated cells. Enucleation was severely impaired in the homozygous cells and reduced in the heterozygous cells. Large internal vesicular accumulations of band 3 formed, which co-localized with other plasma membrane proteins and with the autophagosome marker, LC3, but not with ER, Golgi or recycling endosome markers. Immunoprecipitation of band 3 from erythroblast cell lysates at the orthochromatic stage showed increased interaction of the mutant band 3 with heat shock proteins, ubiquitin and cytoskeleton proteins, ankyrin, spectrin and actin. We also found that the mutant band 3 forms a strong interaction with non-muscle myosins IIA and IIB, while this interaction could not be detected in wild type erythroblasts. Consistent with this, the localization of non-muscle myosin IIA and actin was perturbed in some Southeast Asian Ovalocytosis erythroblasts. These findings provide new insights toward understanding in vivo dyserythropoiesis caused by the expression of mutant membrane proteins.
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Affiliation(s)
- Joanna F Flatt
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Christian J Stevens-Hernandez
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom.,School of Biochemistry, University of Bristol, Bristol, United Kingdom
| | - Nicola M Cogan
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Daniel J Eggleston
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Nicole M Haines
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Kate J Heesom
- School of Biochemistry, University of Bristol, Bristol, United Kingdom
| | - Veronique Picard
- Assistance Publique-Hôpitaux de Paris, Service d'Hématologie Biologique, Hôpital Bicêtre, Paris, France.,Faculté de Pharmacie, Université Paris-Saclay, Chatenay Malabry, France
| | - Caroline Thomas
- Hématologie et Immunologie Pédiatrique, Hôpital Mère Enfants, Nantes, France
| | - Lesley J Bruce
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
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Kedar P, Parmar V, Devendra R, Gupta V, Warang P, Madkaikar M. Congenital dyserythropoietic anemia type II mimicking hereditary spherocytosis in Indian patient with SEC23B-Y462C mutations. Ann Hematol 2017; 96:2135-2139. [PMID: 28879554 DOI: 10.1007/s00277-017-3116-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/17/2017] [Indexed: 11/25/2022]
MESH Headings
- Adult
- Amino Acid Substitution
- Anemia, Dyserythropoietic, Congenital/blood
- Anemia, Dyserythropoietic, Congenital/diagnosis
- Anemia, Dyserythropoietic, Congenital/genetics
- Child
- Consanguinity
- Diagnostic Errors
- Female
- Genes, Recessive
- Genotype
- Humans
- Male
- Mutation, Missense
- Sequence Analysis, DNA/methods
- Spherocytosis, Hereditary/diagnosis
- Vesicular Transport Proteins/chemistry
- Vesicular Transport Proteins/genetics
- Young Adult
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Affiliation(s)
- Prabhakar Kedar
- Department of Haematogenetics, National Institute of Immunohaematology, Indian Council of Medical Research, 13th Floor, New Multistoried Building, K.E.M Hospital Campus, Parel, Mumbai, 400012, India.
| | - Vaishali Parmar
- Department of Haematogenetics, National Institute of Immunohaematology, Indian Council of Medical Research, 13th Floor, New Multistoried Building, K.E.M Hospital Campus, Parel, Mumbai, 400012, India
| | - Rati Devendra
- Department of Haematogenetics, National Institute of Immunohaematology, Indian Council of Medical Research, 13th Floor, New Multistoried Building, K.E.M Hospital Campus, Parel, Mumbai, 400012, India
| | - Vinod Gupta
- Department of Haematogenetics, National Institute of Immunohaematology, Indian Council of Medical Research, 13th Floor, New Multistoried Building, K.E.M Hospital Campus, Parel, Mumbai, 400012, India
| | - Prashant Warang
- Department of Haematogenetics, National Institute of Immunohaematology, Indian Council of Medical Research, 13th Floor, New Multistoried Building, K.E.M Hospital Campus, Parel, Mumbai, 400012, India
| | - Manisha Madkaikar
- Department of Haematogenetics, National Institute of Immunohaematology, Indian Council of Medical Research, 13th Floor, New Multistoried Building, K.E.M Hospital Campus, Parel, Mumbai, 400012, India
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