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Brousse V, El Hoss S, Bouazza N, Arnaud C, Bernaudin F, Pellegrino B, Guitton C, Odièvre-Montanié MH, Mames D, Brouzes C, Picard V, Nguyen-Khoa T, Pereira C, Lapouméroulie C, Pissard S, Gardner K, Menzel S, Le Van Kim C, Colin-Aronovicz Y, Buffet P, Mohandas N, Elie C, Maier-Redelsperger M, El Nemer W, de Montalembert M. Prognostic factors of disease severity in infants with sickle cell anemia: A comprehensive longitudinal cohort study. Am J Hematol 2018; 93:1411-1419. [PMID: 30132969 DOI: 10.1002/ajh.25260] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 08/15/2018] [Indexed: 12/31/2022]
Abstract
In order to identify very early prognostic factors that can provide insights into subsequent clinical complications, we performed a comprehensive longitudinal multi-center cohort study on 57 infants with sickle cell anemia (55 SS; 2 Sβ°) during the first 2 years of life (ClinicalTrials.gov: NCT01207037). Time to first occurrence of a severe clinical event-acute splenic sequestration (ASS), vaso-occlusive (VOC) event requiring hospitalization, transfusion requirement, conditional/ abnormal cerebral velocities, or death-was used as a composite endpoint. Infants were recruited at a mean age of 4.4 ±1 months. Median follow-up was 19.4 months. During the study period, 38.6% of infants experienced ≥1 severe event: 14% ASS, 22.8% ≥ 1 VOC (median age: 13.4 and 12.8 months, respectively) and 33.3% required transfusion. Of note, 77% of the cohort was hospitalized, with febrile illness being the leading cause for admission. Univariate analysis of various biomarkers measured at enrollment showed that fetal hemoglobin (HbF) was the strongest prognostic factor of subsequent severe outcome. Other biomarkers measured at enrolment including absolute neutrophil or reticulocyte counts, expression of erythroid adhesion markers, % of dense red cells, cellular deformability or ϒ-globin genetic variants, failed to be associated with severe clinical outcome. Multivariate analysis demonstrated that higher Hb concentration and HbF level are two independent protective factors (adjusted HRs (95% CI) 0.27 (0.11-0.73) and 0.16 (0.06-0.43), respectively). These findings imply that early measurement of HbF and Hb levels can identify infants at high risk for subsequent severe complications, who might maximally benefit from early disease modifying treatments.
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Affiliation(s)
- Valentine Brousse
- Service de Pédiatrie et Maladies Infectieuses; Hôpital Universitaire Necker-Enfants Malades; Paris France
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Sara El Hoss
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Naïm Bouazza
- Unité de Recherche Clinique/Centre d'investigation clinique Paris Descartes Necker-Cochin; Assistance Publique-Hôpitaux de Paris; Paris France
- Université Paris Descartes; EA7323, Sorbonne Paris Cité; Paris France
| | - Cécile Arnaud
- Service de Pédiatrie; Centre Hospitalier Intercommunal de Créteil; Créteil France
| | - Francoise Bernaudin
- Service de Pédiatrie; Centre Hospitalier Intercommunal de Créteil; Créteil France
| | - Béatrice Pellegrino
- Service de Pediatrie; Centre Hospitalier Poissy-Saint Germain; Poissy France
| | - Corinne Guitton
- Service de Pédiatrie, Hôpital Universitaire Kremlin-Bicêtre; Le Kremlin Bicêtre France
| | | | - David Mames
- Laboratoire d'Hématologie; Hôpital Universitaire Tenon; Paris France
| | - Chantal Brouzes
- Laboratoires d'Hématologie et de Biochimie; Hôpital Universitaire Necker-Enfants Malades; Paris France
| | - Véronique Picard
- Laboratoire d'Hématologie; Hôpital Universitaire Kremlin Bicêtre; Le Kremlin Bicêtre France
| | - Thao Nguyen-Khoa
- Laboratoires d'Hématologie et de Biochimie; Hôpital Universitaire Necker-Enfants Malades; Paris France
| | - Catia Pereira
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Claudine Lapouméroulie
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Serge Pissard
- Laboratoire de Biochimie Génétique; Hôpital Universitaire Henri Mondor; Créteil France
| | - Kate Gardner
- King's College London; Division of Cancer Studies; London UK
- King's College Hospital NHS Foundation Trust; London UK
| | - Stephan Menzel
- King's College London; Division of Cancer Studies; London UK
| | - Caroline Le Van Kim
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Yves Colin-Aronovicz
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Pierre Buffet
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Narla Mohandas
- Red Cell Physiology Laboratory; New York Blood Center; New York New York
| | - Caroline Elie
- Unité de Recherche Clinique/Centre d'investigation clinique Paris Descartes Necker-Cochin; Assistance Publique-Hôpitaux de Paris; Paris France
| | | | - Wassim El Nemer
- UMR_S 1134 Biologie Intégrée du Globule Rouge; Université Sorbonne Paris Cité/Université Paris Diderot/INSERM/INTS/Laboratoire d'Excellence GR-Ex; Paris France
| | - Mariane de Montalembert
- Service de Pédiatrie et Maladies Infectieuses; Hôpital Universitaire Necker-Enfants Malades; Paris France
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Tossea SK, Adji EG, Coulibaly B, Ako BA, Coulibaly DN, Joly P, Assi SB, Toure A, Jambou R. Cross sectional study on prevalence of sickle cell alleles S and C among patients with mild malaria in Ivory Coast. BMC Res Notes 2018; 11:215. [PMID: 29609623 PMCID: PMC5880027 DOI: 10.1186/s13104-018-3296-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/20/2018] [Indexed: 01/13/2023] Open
Abstract
Objectives Sickle cell anemia is due to a mutations on the betaglobin gene, inducing abnormal hemoglobin. In West Africa the main mutations lead to S or C types of hemoglobin. Patients with homozygote mutations seem protected against severe malaria, but not against mild disease. The prevalence of abnormal hemoglobin among patients attending dispensaries for mild malaria is thus unknown. A retrospective study was conducted to update data on the prevalence of S and C hemoglobin among patients attending dispensaries with mild malaria. Enrolment of patients was conducted during in vivo malaria treatment efficacy survey following the 42 days WHO protocol. A group of non-infected pregnant women and a group of patients with fever different from malaria, were also recruited in the same dispensaries. Results 794 blood samples were included. S and C genotypes were found in all the regions of Ivory Coast with the highest prevalence in the Northern region (S and C genotypes, 27%). In non-infected patients, prevalence of mutations was higher than in malaria patients. Conclusion A high proportion of patients with mild malaria carried genetic hemoglobin disorder. This population of high risk must be better investigated to control treatment efficacy and to manage complications. Electronic supplementary material The online version of this article (10.1186/s13104-018-3296-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephane Koui Tossea
- Departement de Parasitologie Mycologie, Institut Pasteur de Côte d'Ivoire, BP 490, Abidjan 01, Côte d'Ivoire
| | - Eric Gbessi Adji
- Departement de Parasitologie Mycologie, Institut Pasteur de Côte d'Ivoire, BP 490, Abidjan 01, Côte d'Ivoire
| | - Baba Coulibaly
- Departement de Parasitologie Mycologie, Institut Pasteur de Côte d'Ivoire, BP 490, Abidjan 01, Côte d'Ivoire
| | - Berenger Ako Ako
- Departement de Parasitologie Mycologie, Institut Pasteur de Côte d'Ivoire, BP 490, Abidjan 01, Côte d'Ivoire
| | - David Ngolo Coulibaly
- Departement de Parasitologie Mycologie, Institut Pasteur de Côte d'Ivoire, BP 490, Abidjan 01, Côte d'Ivoire
| | - Philippe Joly
- Univ Lyon, University Claude Bernard Lyon 1, EA 7424, Lyon, France.,Unité de Pathologie Moléculaire du Globule Rouge, Laboratoire de Biochimie et Biologie Moléculaire Grand Est, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Serge-Brice Assi
- Programme National de Lutte Contre le Paludisme, Ministère de la Santé, Abidjan, Côte d'Ivoire
| | - Andre Toure
- Departement de Parasitologie Mycologie, Institut Pasteur de Côte d'Ivoire, BP 490, Abidjan 01, Côte d'Ivoire
| | - Ronan Jambou
- Departement de Parasitologie Mycologie, Institut Pasteur de Côte d'Ivoire, BP 490, Abidjan 01, Côte d'Ivoire. .,Departement Parasites et Insectes Vecteurs, Institut Pasteur Paris, Paris, France.
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Breveglieri G, Finotti A, Borgatti M, Gambari R. Recent patents and technology transfer for molecular diagnosis of β-thalassemia and other hemoglobinopathies. Expert Opin Ther Pat 2015; 25:1453-76. [PMID: 26413795 DOI: 10.1517/13543776.2015.1090427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Biological tests and genetic analyses for diagnosis and characterization of hematological diseases in health laboratories are designed with the aim of meeting the major medical needs of hospitals and pharmaceutical companies involved in this field of applied biomedicine. Genetic testing approaches to perform diagnosis consist of molecular techniques, which should be absolutely reproducible, fast, sensitive, cheap, and portable. AREAS COVERED Biological tests analyzed involve adult/newborn subjects, whereas genetic analyses involve adult thalassemia patients, newborns, embryos/fetuses (including non-invasive prenatal diagnosis), pre-implantation embryos, and pre-fertilization oocytes. EXPERT OPINION The most recent findings in the diagnostic approach for β-thalassemias are related to three major fields of investigation: moving towards ultrasensitive methodologies for effective detection of the primary causative mutation of β-thalassemia, including the development of polymerase chain reaction-free approaches and non-invasive prenatal diagnosis; comparing analyses of the genotype of β-thalassemia patients to high-HbF-associated polymorphisms; introducing whole genome association assays and next-generation sequencing. All these issues should be considered and discussed in the context of several aspects, including regulatory, ethical and social issues. DNA sequence data aligned with the identification of genes central to the induction, development, progression, and outcome of β-thalassemia will be a key point for directing personalized therapy.
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Affiliation(s)
- Giulia Breveglieri
- a 1 University of Ferrara, Section of Biochemistry and Molecular Biology, Department of Life Sciences and Biotechnology , Ferrara, Italy
| | - Alessia Finotti
- a 1 University of Ferrara, Section of Biochemistry and Molecular Biology, Department of Life Sciences and Biotechnology , Ferrara, Italy
| | - Monica Borgatti
- a 1 University of Ferrara, Section of Biochemistry and Molecular Biology, Department of Life Sciences and Biotechnology , Ferrara, Italy
| | - Roberto Gambari
- b 2 University of Ferrara, Section of Biochemistry and Molecular Biology, Department of Life Sciences and Biotechnology , Via Fossato di Mortara 74, 44121 Ferrara, Italy +39 05 32 97 44 43 ; +39 05 32 97 45 00 ;
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Joly P, Lacan P, Garcia C, Delasaux A, Francina A. Rapid and reliable β-globin gene cluster haplotyping of sickle cell disease patients by FRET Light Cycler and HRM assays. Clin Chim Acta 2011; 412:1257-61. [DOI: 10.1016/j.cca.2011.03.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 03/18/2011] [Indexed: 12/01/2022]
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Nimir AA, Khalil EAG, Musa AM, Yassin HM, El-Hassan AM. Evaluation of the particle gel diffusion technique for the detection of haemoglobin S in Sudanese patients. Ann Clin Biochem 2009; 46:114-6. [PMID: 19164340 DOI: 10.1258/acb.2008.008155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sickle cell disease is a heterogenous disorder characterized by an abnormal haemoglobin and sickling phenomena of red cells. It is prevalent among certain nomadic tribes in Sudan. Painful, aplastic and haemolytic crises mark sickle cell anaemia. Haemoglobin S (HbS) is detected using haemoglobin electrophoresis, iso-electric focusing and/or high-performance liquid chromatography techniques with high sensitivity, but entails cost and expertise. This study aimed to determine the sensitivity, specificity and positive predictive values (PPV) of the ID-particle gel diffusion technique for screening, diagnosis and phenotyping of HbS in patients with a provisional diagnosis of abnormal haemoglobin. METHODS Following informed consent, 100 sequential individuals who reported to a central referral haemoglobinopathy clinic were enrolled. ID-particle gel diffusion technique was compared with cellulose acetate electrophoresis to determine haemoglobin phenotypes. RESULTS The ID-particle gel test detected HbAA with 100% sensitivity and 100% specificity. Sensitivity for HbS was 100%, whether as HbSS or as a mixed pattern. HbSS was identified in all cases where this is the only haemoglobin present. Other patterns were detected with <100% specificity and these would require further testing by other means to definitively identify abnormal haemoglobins. CONCLUSIONS Although the ID-particle technique is a simple and cheap technique with high sensitivity, specificity and PPV compared with cellulose acetate electrophoresis in detecting HbSS, it could not differentiate HbAS from HbSS with high levels of HbF. High environmental temperatures could melt the test microtubes. Cellulose acetate electrophoresis remains the technique of choice for the screening of abnormal haemoglobins in the Sudan.
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Affiliation(s)
- Ahmed A Nimir
- Faculty of Laboratory Medicine, University of Khartoum, Khartoum, Sudan
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Costa C, Goossens M, Girodon E. Simultaneous molecular haplotyping of both IVS8 (TG)m and (T)n tracts in the CFTR gene: still a challenge. Clin Chem 2006; 52:1621-2; author reply 1622. [PMID: 16873311 DOI: 10.1373/clinchem.2005.065383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Arya M, Shergill IS, Williamson M, Gommersall L, Arya N, Patel HRH. Basic principles of real-time quantitative PCR. Expert Rev Mol Diagn 2005; 5:209-19. [PMID: 15833050 DOI: 10.1586/14737159.5.2.209] [Citation(s) in RCA: 308] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Real-time quantitative PCR allows the sensitive, specific and reproducible quantitation of nucleic acids. Since its introduction, real-time quantitative PCR has revolutionized the field of molecular diagnostics and the technique is being used in a rapidly expanding number of applications. This exciting technology has enabled the shift of molecular diagnostics toward a high-throughput, automated technology with lower turnaround times. This article reviews the basic principles of real-time PCR and describes the various chemistries available: the double-stranded DNA-intercalating agent SYBR Green 1, hydrolysis probes, dual hybridization probes, molecular beacons and scorpion probes. Quantitation methods are discussed in addition to the competing instruments available on the market. Examples of applications of this important and versatile technique are provided throughout the review.
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Affiliation(s)
- Manit Arya
- Institute of Urology, Prostate Cancer Research Centre, University College London, UK.
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