Haemoglobin synthesis in thalassaemia

Globin biosynthesis in sickle cell, Hb SC, and Hb C diseases

The wide range of globin synthesis ratios reported in patients with sickle cell disease casts doubt on whether the presence of genes for alpha- or beta-thalassemia in combination with Hb S can be detected by globin synthesis studies. We have studied globin synthesis in 20 patients with Hb SS who had a mean betaA/alpha ratio of 1.05+/-0.04, similar to that of 28 control children. In nine of these patients the percentage of newly synthesized radioactive alpha-chains in dimer or monomer forms was 16.3%+/-1.3, also similar to the control subjects. The remainder of alpha-chain was in hemoglobin tetramer. In nine patients with Hb SC, the (non-alpha)/alpha ratio was 0.97+/-0.04, and the free alpha-chain pool radioactivity in four patients was 14.1%+/-4.2. In three patients with Hb CC, betac/alpha ratios were 0.99, 1.07, and 1.10. These results indicate that globin synthesis ratios and alpha-chain radioactivity in the free alpha-chain pool of peripheral blood of patients with Hb SS, Hb SC, and Hb CC have narrow ranges, close to those of nonthalassemic controls. The data provide a basis for detecting syndromes with Hb S or Hb C associated with alpha- or beta-thalassemia. This precise differentiation is important for clinical studies of severity in sickle cell disease and for genetic counseling.

Free alpha-globin pool in human bone marrow

A pool of free alpha-globin chains was found in the bone marrow samples from three controls, two patients with beta-thalassemia trait, three with sickle beta-thalassemia, three with hemoglobin (Hb) Lepore trait, one with alphabeta-thalassemia, four with homozygous beta-thalassemia, and one doubly heterozygous for Hb Lepore and beta-thalassemia. The average percentage of newly synthesized alpha-chains found in the free alpha-globin pool was 6.2% in the controls and 33.0% in the patients heterozygous for thalassemia or Hb Lepore. These controls and patients had balanced beta- and alpha-globin synthesis in the bone marrow. In the homozygous patients and in the one patient doubly heterozygous for thalassemia and Hb Lepore, there was a marked deficit of beta-chain synthesis in the bone marrow and also a large pool of newly synthesized free alpha-chains. The function of this pool of free alpha-chains is not known, but it may be involved in the regulation of globin chain synthesis in normal patients and in the compensatory synthesis of beta-chains that occurs in the bone marrow of patients heterozygous for thalassemia or for Hb Lepore.

Hemoglobin synthesis in beta-thalassemia: the properties of the free alpha-chains

The decrease in hemoglobin A (HbA, alpha(2)beta(2)) synthesis in the erythroid cells of patients with beta-thalassemia is due to a selective defect in beta-chain synthesis. Since alpha-chains continue to be formed at a normal rate in these cells, this results in a marked relative excess of alpha-chain synthesis over beta- and gamma-chain synthesis. The alpha-chains uncombined with beta- or beta-like-chains (delta, gamma) will be referred to as free alpha-chains. The experiments presented in this paper show that these free alpha-chains are capable of combining with beta-chains to form HbA and are, therefore, structurally normal. Alternatively, in the absence of added beta-chains, alpha-chains aggregates of various sizes are formed. Peripheral blood from patients with beta-thalassemia was incubated with radioactive amino acids and hemolysates were prepared. Column chromatography demonstrates that a majority of the free alpha-chains are not present in HbA. They are strongly bound to carboxymethylcellulose resin at pHs from 7.0 to 10.0, and do not elute with HbA. However, when chemically prepared hemoglobin H (Hbbeta(4)) is added to the fresh hemolysates, the free alpha-chains are readily recovered in the HbA peak. This indicates that the free alpha-chains are able to combine normally with beta-chains to form HbA. Freshly labeled hemolysates were also subjected to Sephadex G-100 chromatography. The free alpha-chains eluted as a broad peak migrating between myoglobin and hemoglobin, consistent with their forming alpha-chain aggregates of various mol wt between 16,000 and 64,000. It is suggested that the chromatographic behavior of the free alpha-chains reported herein simply reflects the chemical properties of normal alpha-chains in the absence of adequate numbers of beta- or gamma-chains. The tendency of these free alpha-chains to aggregate may lead to their intracellular precipitation and the subsequent destruction of the cells containing them.