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'Ulya NM, Indrawati VN, Wulansari WT, Lesmana I, Handayani NSN. Mutation Spectrum of β-Globin Gene in Patients with β-Thalassemia at Tidar Hospital, Magelang, Central Java, Indonesia. Hemoglobin 2023; 47:152-156. [PMID: 37605561 DOI: 10.1080/03630269.2023.2244429] [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: 05/04/2023] [Accepted: 07/25/2023] [Indexed: 08/23/2023]
Abstract
β-Thalassemia is genetic disorder characterized by β-globin chain deficiency resulting from mutations in the β-globin coding gene. Both the quantity and quality of blood produced will be impacted by this condition. The distribution of mutation causing thalassemia is vary across ethnic and different regions in Indonesia. This study aims to identify the variant mutation in patients with β-thalassemia at Tidar Hospital as representative samples of Javanese population, the largest ethnicity in Indonesia. Sixty-one blood samples were obtained from blood transfusion-dependent patients with β-thalassemia. Mutation was identified using ARMS and RFLP PCR-based methods, and inconclusive samples were subjected to DNA sequencing. Results showed that the mutation variants were Cd 26/IVSI-5 (G > C) 47.54%, Cd 26/Cd 35 16.30%, Cd 26/IVSI-1 (G > T) 11.47%, Cd 26/IVSI-2 4.91%, IVSI-5 (G > C)/Cd 40 3.27%; 1.63%; IVSI-5 (G > C)/IVSI-1 (G > A) 1.63%; IVSI-5 (G > C)/Cap + 1 1.63%; Cd 26/Cd 15 1.63%; Cd 26/Cd 30 1.63%. We also found three homozygous of IVSI-1 (G > T), IVSI-5 (G > C) 6.55%, and Cd 35 1.63%. The most prevalent alleles would be recommended to be used as part of screening for β-thalassemia in the Javanese ethnicity in Central Java, especially for families affected by thalassemia.
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Affiliation(s)
- Nafis Muhimmatul 'Ulya
- Undergraduate Program, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | | | - Indra Lesmana
- Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Thalassemia Research Group Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Niken Satuti Nur Handayani
- Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Thalassemia Research Group Universitas Gadjah Mada, Yogyakarta, Indonesia
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Ejaz S, Abdullah I, Usman M, Iqbal MA, Munawar S, Khan MI, Imtiaz N, Tahir H, Bari MI, Rasool T, Fatima A, Anwar R, Durrani A, Hameed Y. Mutational analysis of hemoglobin genes and functional characterization of detected variants, through in-silico analysis, in Pakistani beta-thalassemia major patients. Sci Rep 2023; 13:13236. [PMID: 37580329 PMCID: PMC10425424 DOI: 10.1038/s41598-023-35481-1] [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: 04/12/2023] [Accepted: 05/18/2023] [Indexed: 08/16/2023] Open
Abstract
Thalassemia is one of the most prevalent genetic disorders worldwide. The present study aimed to explore the mutational spectrum of all hemoglobin (HB) encoding genes and to identify the potentially damaging and pathogenic variants in the beta (β)-thalassemia major patients and thalassemia minor carriers of Southern Punjab, Pakistan. A total of 49 β-thalassemia major patients and 49 carrier samples were screened for the identification of HBA1, HBA2, HBB, HBD, HBE1, HBG1 and HBG2 variants by NGS. PCR was performed for the amplification of HB encoding genes and the amplified product of 13 patients and 7 carrier samples were processed for the Sanger sequencing. Various bioinformatics tools and databases were employed to reveal the functional impact and pathogenicity potential of the observed variants. Results depicted a total of 20 variants of HB-related genes by NGS and 5 by Sanger sequencing in thalassemia patients. While 20 variants by NGS and 3 by Sanger were detected in carriers. Few known genetic variants of HB-encoding genes are being reported for the first time in Pakistani thalassemia patients and carriers. However, two novel HBB variants c.375A>C (p.P125P) and c.*61T>G and a novel variant of HBE1 (c.37A>T (p.T13S)) were also documented. Pathogenicity analysis predicted the pathogenic potential of HBB variants (c.47G>A (p.W16*), c.27-28insG (p. S10fs), and c.92+5G>C) for β thalassemia. The study of functional impact indicated that these HBB variants result in the premature termination of translation leading to the loss of functional β-globin protein. It is therefore suggested that the pathogenic HBB variants, identified during present study, can be employed for the diagnosis, carrier screening, and planning therapy of thalassemia.
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Affiliation(s)
- Samina Ejaz
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan.
| | - Iqra Abdullah
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Muhammad Usman
- Department of Biotechnology, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | | | - Sidra Munawar
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Muhammad Irfan Khan
- Department of Hematological Diseases, Thalassemia and Bone Marrow Transplantation, Bahawal Victoria Hospital, Bahawalpur, 63100, Pakistan
| | - Nagina Imtiaz
- Department of Biotechnology, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Hanniah Tahir
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Muhammad Ihsan Bari
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Tayyaba Rasool
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Aneeza Fatima
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Ramsha Anwar
- Department of Biochemistry, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Ayman Durrani
- Department of Biotechnology, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Yasir Hameed
- Department of Biotechnology, Institute of Biochemistry, Biotechnology and Bioinformatics (IBBB), The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
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Abbasali F, Mahmoud K, Hengameh N, Mina D, Setare D, Hale D, Sima D. Rare and New Mutations of B-Globin in Azari Population of Iran, a Considerable Diversity. Balkan J Med Genet 2023; 25:51-62. [PMID: 37265972 PMCID: PMC10230832 DOI: 10.2478/bjmg-2022-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Background Thalassemia, as the most common single-gene genetic disorder, is related to a defect in the synthesis of one or more hemoglobin chains. More than 200 mutations have been identified in the β-globin gene. Globally, every susceptible racial group has its own specific spectrum of the common mutations that are well-known to a particular geographic region. On the other hand, varying numbers of diverse rare mutations may occur. Materials and Methods The subjects of the study included 2113 heterozygote or homozygote β-thalassemia cases selected among couples who participated in the Iranian national thalassemia screening program from January 2011 to November 2019. Molecular characterization of the β-thalassemia mutation was initially carried out by the amplification-refractory mutation system-polymerase chain reaction (ARMS-PCR) technique for common mutations, followed by sequencing, Gap PCR, and Multiple ligation-dependent probe amplification (MLPA) methods - in cases not detected by the ARMS-PCR. Results The existence of 39 rare and new point mutations and 4 large deletions were described in our cohort. Sicilian (-13,337bp) deletion, CD36/37 (-T), and CD15 TGG>TGA were encountered more often than the others in a decreasing order, in terms of frequency. The least frequent mutations/deletions were deletion from HBD exon 1 to HBB promoter, 619 bp deletion, Deletion from up HBBP1-Exon3 HBBP1 and up HBB-0.5Kb down HBB, CAP+8 C>A, CD37 (G>A), CD6 (-A), IVSI-2 (T>C), IVSII-705 T>G, and IVSII-772 (G>A). Each occurred once. Five mutations/variants were also determined which have not been reported previously in Iran. Conclusion According to the findings of the study, the Northwestern Iranian population displayed a wide variety of thalassemia allelic distributions. Identification of rare and new mutations in the β-thalassemia in the national population is beneficial for screening programs, genetic counseling, and prenatal diagnosis.
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Affiliation(s)
- F.H. Abbasali
- Hematology & Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - K.Sh. Mahmoud
- Medical Genetic Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Ebne Sina Medical Genetics Laboratory, Specialized and Sub-specialized Outpatient Clinics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - N. Hengameh
- Ebne Sina Medical Genetics Laboratory, Specialized and Sub-specialized Outpatient Clinics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - D.H. Mina
- Ebne Sina Medical Genetics Laboratory, Specialized and Sub-specialized Outpatient Clinics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - D. Setare
- Ebne Sina Medical Genetics Laboratory, Specialized and Sub-specialized Outpatient Clinics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - D.M Hale
- Ebne Sina Medical Genetics Laboratory, Specialized and Sub-specialized Outpatient Clinics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - D.M. Sima
- Medical Genetic Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Ebne Sina Medical Genetics Laboratory, Specialized and Sub-specialized Outpatient Clinics, Tabriz University of Medical Sciences, Tabriz, Iran
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Kabir T, Anwar S, Mourosi JT, Akter S, Hosen MJ. α- and β-Globin Gene Mutations in Individuals with Hemoglobinopathies in the Chattogram and Sylhet Regions of Bangladesh. Hemoglobin 2023; 47:3-10. [PMID: 36890736 DOI: 10.1080/03630269.2023.2166526] [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: 03/10/2023]
Abstract
Hemoglobinopathies, including α- and β-thalassemias and sickle cell disease, are among the most widely disseminated hereditary blood disorders worldwide. Bangladesh is considered a hotspot for hemoglobinopathies, and these diseases cause a significant health concern in the country. However, the country has a dearth of knowledge on the molecular etiology and carrier frequency of thalassemias, primarily due to a lack of diagnostic facilities, limited access to information, and the absence of efficient screening programs. This study sought to investigate the spectrum of mutations underlying hemoglobinopathies in Bangladesh. We developed a set of polymerase chain reaction (PCR)-based techniques to detect mutations in α- and β-globin genes. We recruited 63 index subjects with previously diagnosed thalassemia. Along with age- and sex-matched control subjects, we assessed several hematological and serum indices and genotyped them using our PCR-based methods. We identified that parental consanguinity was associated with the occurrence of these hemoglobinopathies. Our PCR-based genotyping assays identified 23 HBB genotypes, with the codons 41/42 (-TTCT) (HBB: c.126_129delCTTT) mutation leading the spectrum. We also observed the presence of cooccurring HBA conditions, of which the participants were not aware. All index participants in this study were on iron chelation therapies, yet we found they had very high serum ferritin (SF) levels, indicating inefficient management of the individuals undergoing such treatments. Overall, this study provides essential information on the hemoglobinopathy mutation spectrum in Bangladesh and highlights the need for nationwide screening programs and an integrated policy for diagnosing and managing individuals with hemoglobinopathies.
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Affiliation(s)
- Tamanna Kabir
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Saeed Anwar
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Jarin Taslem Mourosi
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Shanjida Akter
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mohammad Jakir Hosen
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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Xinh PT, Chuong HQ, Ha NTT, Tram HDB, Van Dong C, Thanh LVH, Hoa NTH, Nghia H, Binh NT, Dung PC, Vu HA. Spectrum of HBB gene mutations among 696 β-thalassemia patients and carriers in Southern Vietnam. Mol Biol Rep 2022; 49:2601-2606. [PMID: 35023007 DOI: 10.1007/s11033-021-07062-w] [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: 10/04/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Thalassemias are common inherited blood disorders that have been extensively studied in Asia. Thus far, data on mutations of the HBB gene in Vietnamese patients with β-thalassemia are limited to small studies. METHODS We recruited 696 β-thalassemia patients and carriers in southern Vietnam and analyzed for the HBB gene mutations using Sanger sequencing technology. RESULTS We documented 27 types of known mutations and 10 types of novel variants on 737 alleles out of 1392 surveyed alleles. The three most common mutations, which account for more than ¾ of all mutant alleles, were c.79G > A (HbE), c.124_127delTTCT, and c.52A > T. The novel variants were mainly located in 5' untranslated region (c.-92delC and c.-67A > G) and 3' untranslated region (c.*4C > T, c.*116_*117insA, c.*142 T > C, c.*156G > C, c.*176_*177insA, and c.*247 T > C), except for one in intron 2 (c.316-99 T > G) and one in exon 3 (c.385delG). CONCLUSION We provide here a comprehensive mutation spectrum of the HBB gene in Southern Vietnam, which is crucial for carrier screening and prenatal diagnosis in the future.
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Affiliation(s)
- Phan Thị Xinh
- Department of Hematology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Ho Quoc Chuong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Thanh Ha
- Department of Molecular Biology, Dai Phuoc Clinic, Ho Chi Minh City, Vietnam
| | | | - Cao Van Dong
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Le Vu Ha Thanh
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Hong Hoa
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Huynh Nghia
- Department of Hematology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Tan Binh
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam.,Department of Hematology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Phu Chi Dung
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Hoang Anh Vu
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam.
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Sánchez-Martínez LJ, Hernández CL, Rodríguez JN, Dugoujon JM, Novelletto A, Ropero P, Pereira L, Calderón R. Genetic variation patterns of β-thalassemia in Western Andalusia (Spain) reveal a structure of specific mutations within the Iberian Peninsula. Ann Hum Biol 2021; 48:406-417. [PMID: 34727790 DOI: 10.1080/03014460.2021.2000641] [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: 10/19/2022]
Abstract
BACKGROUND Analyses of the genomic variation in the western Mediterranean population are being used to reveal its evolutionary history and to understand the molecular basis of particular diseases. AIM To observe the β-thalassemia mutational spectrum in western Andalusia, Spain, in the context of the Mediterranean. In addition, associations between disease and neutral gene variants within the β-globin gene (HBB) were also evaluated. SUBJECTS AND METHODS This study included 63 unrelated individuals diagnosed with β-thalassemia. In addition, 97 unrelated, healthy subjects of the same territory were also analysed as proxies of the normal genetic background. Allele associations and population genetic structure analyses were performed using different methodologies. RESULTS Data have revealed a rather restricted spectrum of β-thalassemia mutations in the analysed sample. Although the detected variants fit well with the Mediterranean pattern, certain singularities support a structure of some specific β-thalassemia alleles. The IVSI-1 (G > A) shows a strong regionalisation. The spatial correlogram revealed a typically narrow wave structure, presumably linked to genetic isolation and genetic drift. CONCLUSIONS The long history of endemic malaria in the study territory, the rather high consanguinity rates among its autochthonous population, and other demographic features have been used here to understand the western Andalusian β-thalassemia molecular portrait.
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Affiliation(s)
- Luis J Sánchez-Martínez
- Departamento de Biodiversidad, Ecología y Evolución, Facultad de Biología, Universidad Complutense, Madrid, Spain
| | - Candela L Hernández
- Departamento de Biodiversidad, Ecología y Evolución, Facultad de Biología, Universidad Complutense, Madrid, Spain
| | - Juan N Rodríguez
- Servicio de Hematología y Hemoterapia, Hospital Juan Ramón Jiménez, Huelva, Spain
| | - Jean M Dugoujon
- CNRS UMR 5288 Laboratoire d'Anthropologie Moléculaire et d'Imagerie de Synthèse (AMIS), Université Paul Sabatier Toulouse III, Toulouse, France
| | | | - Paloma Ropero
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
| | - Luisa Pereira
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Rosario Calderón
- Departamento de Biodiversidad, Ecología y Evolución, Facultad de Biología, Universidad Complutense, Madrid, Spain
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Peng WK, Ng TT, Loh TP. Machine learning assistive rapid, label-free molecular phenotyping of blood with two-dimensional NMR correlational spectroscopy. Commun Biol 2020; 3:535. [PMID: 32985608 PMCID: PMC7522972 DOI: 10.1038/s42003-020-01262-z] [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: 07/15/2020] [Accepted: 08/28/2020] [Indexed: 01/02/2023] Open
Abstract
Translation of the findings in basic science and clinical research into routine practice is hampered by large variations in human phenotype. Developments in genotyping and phenotyping, such as proteomics and lipidomics, are beginning to address these limitations. In this work, we developed a new methodology for rapid, label-free molecular phenotyping of biological fluids (e.g., blood) by exploiting the recent advances in fast and highly efficient multidimensional inverse Laplace decomposition technique. We demonstrated that using two-dimensional T1-T2 correlational spectroscopy on a single drop of blood (<5 μL), a highly time- and patient-specific 'molecular fingerprint' can be obtained in minutes. Machine learning techniques were introduced to transform the NMR correlational map into user-friendly information for point-of-care disease diagnostic and monitoring. The clinical utilities of this technique were demonstrated through the direct analysis of human whole blood in various physiological (e.g., oxygenated/deoxygenated states) and pathological (e.g., blood oxidation, hemoglobinopathies) conditions.
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Affiliation(s)
- Weng Kung Peng
- Precision Medicine - Engineering Group, International Iberian Nanotechnology Laboratory, 4715 330, Braga, Portugal.
| | - Tian-Tsong Ng
- Institute for Infocomm Research, Fusionopolis Way, Singapore, Singapore
| | - Tze Ping Loh
- Department of Laboratory Medicine, National University Hospital, Singapore, Singapore.
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Hashmi G, Qidwai A, Fernandez K, Seul M. Enabling routine β-thalassemia Prevention and Patient Management by scalable, combined Thalassemia and Hemochromatosis Mutation Analysis. BMC MEDICAL GENETICS 2020; 21:108. [PMID: 32414341 PMCID: PMC7229588 DOI: 10.1186/s12881-020-01017-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 03/31/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Beta (β)-thalassemia is one of the most common inherited disorders worldwide, with high prevalence in the Mediterranean, the Middle East and South Asia. Over the past 40 years, awareness and prevention campaigns in many countries have greatly reduced the incidence of affected child births. In contrast, much remains to be done in South-Asia. Thus, for Pakistan, an estimated ~ 7000 children annually are born with thalassemia, with no sign of improvement. Although there is good agreement that intermarriage of carriers significantly contributes to the high prevalence of the disorder, effective tools for molecular screening and diagnosis on which to base prevention programs are not readily available. METHODS Here, we present results for a novel LeanSequencing™ process to identify a combination of 18 β-thalassemia mutations (including the sickle cell anemia mutation, HbS, and structural variants HbC and HbE) and 2 hemochromatosis mutations in a multi-ethnic population of 274 pediatric and adolescent patients treated at Afzaal Memorial Thalassemia Foundation in Karachi, Pakistan. RESULTS We found substantial differences in the predominance of disease-causing mutations among the principal ethnic groups in our cohort. We also found the hemochromatosis mutation H63D C > G in 61 (or 22.1%) of our patients including 6 (or 2.2%) homozygotes. CONCLUSIONS To our knowledge, this is the first screen combining a large set of β-thalassemia and hemochromatosis mutations, so as to facilitate the early identification of patients who may be at increased potential risk for complications from iron overload and thereby to improve the prospective management of thalassemia patients.
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Affiliation(s)
- Ghazala Hashmi
- BioMolecular Analytics, 10 Independence Blvd, Suite 140, Warren, NJ, 07059, USA.,Sanya K Hashmi Foundation, 56 Telegraph Hill Road, Holmdel, NJ, 07733, USA
| | - Asim Qidwai
- Afzaal Memorial Thalassemia Foundation, Karachi, Pakistan
| | | | - Michael Seul
- BioMolecular Analytics, 10 Independence Blvd, Suite 140, Warren, NJ, 07059, USA.
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Yasmeen H, Hasnain S. Epidemiology and risk factors of transfusion transmitted infections in thalassemia major: a multicenter study in Pakistan. Hematol Transfus Cell Ther 2019; 41:316-323. [PMID: 31399357 PMCID: PMC6978535 DOI: 10.1016/j.htct.2019.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/19/2019] [Accepted: 03/22/2019] [Indexed: 01/17/2023] Open
Abstract
Background Blood transfusion-transmitted infections in individuals suffering from beta-thalassemia have been reported in Pakistan, but the information on their sociodemographic and clinical determinants is lacking. This study aims to describe the prevalence, as well as the factors, contributing in blood transfusion-transmitted infections. Method Between December 2011 and December 2013, in a non-probable sampling, 350 thalassemia patients were recruited in Lahore, Multan, Karachi and Peshawar, Pakistan. Subjects were screened for transfusion-transmitted infections. Results A seropositive rate of 36.5% was observed; males (94, 73.4%) and females (34, 26.6%). Among several risk factors associated with transfusion-transmitted infections, province (p = 0.001), gender (p = 0.003), age (p < 0.03), education (p < 0.00), degree of consanguinity (p = 0.05), age at fetal blood test (p = 0.005), fetal hemoglobin levels (p = 0.005), death due to thalassemia (p = 0.001) and iron-related complications (p = 0.04) showed significant correlation. Participants with an age >10 years were significantly more prone to seropositivity than those aged ≤10 years. Moreover, the ferritin level was also significantly higher in those aged >10 years than in those ≤10 years. It was observed that males had a higher seroprevalence rate (94, 73.4%) than females (34, 26.6%). The most prevalent transfusion-transmitted infections was the hepatitis C virus, with 115 cases (89.8%). Conclusion A high prevalence rate of HCV in subjects with transfusion-dependent thalassemia is linked with insufficient facilities, poor management and compromised socioeconomic status. Therefore, more multicenter studies covering cities from different regions of the country are needed in order to develop preventive measurements at the regional and national level.
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Affiliation(s)
- Humaira Yasmeen
- Department of Microbiology and Molecular Genetics, University of the Punjab, Quaid-e-Azam Campus, Lahore, Punjab, Pakistan; Department of Microbiology and Molecular Genetics, The Women University Multan, Punjab, Pakistan.
| | - Shahida Hasnain
- Department of Microbiology and Molecular Genetics, University of the Punjab, Quaid-e-Azam Campus, Lahore, Punjab, Pakistan; Department of Microbiology and Molecular Genetics, The Women University Multan, Punjab, Pakistan
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Jia W, Wang W, Zhu H, Chen P. A Novel Mutation at HBB: c.91delA (Codon 30, -A) Causing β-Thalassemia in a Chinese Family. Acta Haematol 2019; 142:249-252. [PMID: 31108495 DOI: 10.1159/000499860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/22/2019] [Indexed: 12/28/2022]
Abstract
β-Thalassemia is a genetic disease characterized by the defective synthesis of the hemoglobin tetramer β-globin chains. So far, a number of mutations have been identified and associated with this genetic disease. A high incidence of thalassemia has been found in Guangxi (China). Herein, we report a case of a patient with slightly increased HbA2 levels (4.6%). Based on the clinical data and laboratory findings, the patient was diagnosed with β-thalassemia. Routine genetic screening tests were negative. Sequencing revealed an A deletion at codon 30 (HBB: c.91delA) and the genotype of this patient was βCD30M/β. This mutation changes the splice receptor site of intron 1 from AG to GG, which likely abolishes splicing at the normal 5' splicing site and may cause β0-thalassemia. Based on hematological and clinical evaluations, this novel mutation was regarded as a β0-thalassemia allele. A homozygosity or compound heterozygosity of this mutation and other β0-thalassemia alleles can lead to severe thalassemia disease.
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Affiliation(s)
- Wenguang Jia
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Thalassemia Research, Nanning, China
| | | | - Hengying Zhu
- The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Thalassemia Research, Nanning, China
| | - Ping Chen
- The First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Thalassemia Research, Nanning, China,
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Reflection of treatment proficiency of hydroxyurea treated β-thalassemia serum samples through nuclear magnetic resonance based metabonomics. Sci Rep 2019; 9:2041. [PMID: 30765825 PMCID: PMC6376050 DOI: 10.1038/s41598-019-38823-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 12/27/2018] [Indexed: 12/13/2022] Open
Abstract
β-Thalassemia is a widespread autosomal recessive blood disorder found in most parts of the world. Fetal hemoglobin (HbF), a form of hemoglobin is found in infants, replaced by adult hemoglobin (HbA) after birth. Hydroxyurea (HU) is one of the most effective HbF inducer used for the treatment of anemic diseases. We aimed to improve the understanding of HU therapy in β-thalassemia by metabonomics approach using 1H NMR spectroscopy. This study includes 40 cases of β-thalassemia before and after HU therapy along with 40 healthy as controls. Carr-Purcell-Meiboom-Gill (CPMG) sequence was used to identify forty-one putative metabolites. Generation of models like partial least square discriminant analysis (PLS-DA) and orthogonal projections to latent structures discriminant analysis (OPLS-DA) based on different metabolites including lipids, amino acids, glucose, fucose, isobutyrate, and glycerol revealed satisfactory outcomes with 85.2% and 91.1% classification rates, respectively. The concentration of these metabolites was altered in β-thalassemia samples. However, after HU treatment metabolic profile of same patients showed closeness towards healthy. Deviant metabolic pathways counting lipoprotein changes, glycolysis, TCA cycle, fatty acid and choline metabolisms were identified as having significant differences among study groups. Findings of this study may open a better way to monitor HU treatment effectiveness in β-thalassemia patients, as the results suggested that metabolic profile of β-thalassemia patients shows similarity towards normal profile after this therapy.
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Iqbal A, Ansari SH, Parveen S, Khan IA, Siddiqui AJ, Musharraf SG. Hydroxyurea Treated β-Thalassemia Children Demonstrate a Shift in Metabolism Towards Healthy Pattern. Sci Rep 2018; 8:15152. [PMID: 30310134 PMCID: PMC6182004 DOI: 10.1038/s41598-018-33540-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/24/2018] [Indexed: 12/02/2022] Open
Abstract
Augmentation of fetal hemoglobin (HbF) production has been an enduring therapeutic objective in β-thalassemia patients for which hydroxyurea (HU) has largely been the drug of choice and the most cost-effective approach. A serum metabolomics study on 40 patients with β-thalassemia prior to and after administration of HU was done along with healthy controls. Treated patients were divided further into non-responders (NR), partial (PR) and good (GR) per their response. 25 metabolites that were altered before HU therapy at p ≤ 0.05 and fold change >2.0 in β-thalassemia patients; started reverting towards healthy group after HU treatment. A prediction model based on another set of 70 HU treated patients showed a good separation of GR from untreated β-thalassemia patients with an overall accuracy of 76.37%. Metabolic pathway analysis revealed that various important pathways that were disturbed in β-thalassemia were reverted after treatment with HU and among them linoleic acid pathway was most impactfully improved in HU treated patients which is a precursor of important signaling molecules. In conclusion, this study indicates that HU is a good treatment option for β-thalassemia patients because in addition to reducing blood transfusion burden it also ameliorates disease complications by shifting body metabolism towards normal.
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Affiliation(s)
- Ayesha Iqbal
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Saqib Hussain Ansari
- Department of Pediatric Hematology & Molecular Medicine, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, 75300, Pakistan
| | - Sadia Parveen
- Department of Pediatric Hematology & Molecular Medicine, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, 75300, Pakistan
| | - Ishtiaq Ahmad Khan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Amna Jabbar Siddiqui
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Syed Ghulam Musharraf
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
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Hafeez Kandhro A, Shoombuatong W, Prachayasittikul V, Nuchnoi P. New Bioinformatics-Based Discrimination Formulas for Differentiation of Thalassemia Traits From Iron Deficiency Anemia. Lab Med 2018; 48:230-237. [PMID: 28934514 DOI: 10.1093/labmed/lmx029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Thalassemia traits (TTs) and iron deficiency anemia (IDA) are the most common disorders of hypochromic microcytic anemia (HMA). The present study aimed to differentiate TTs from IDA by analyzing discrimination formulas and provides comprehensive data of hemoglobin disorders prevalent in Pakistan. Among 12 published discrimination formulas, 6 formulas-MI, EF, G&K, RDWI, R, and HHI-were the most reliable to discriminate TTs from IDA. The failure cutoff values were improved by the random forest (RF) decision-tree approach. Moreover, the Shine and Lal (S&L) formula, which completely failed to discriminate IDA from TTs with original cutoff value (<1530), improved with the use of new proposed cutoff value (<1016) and was found to successfully discriminate all cases of TTs from those with IDA. In addition, 2 newly proposed formulas discriminated TTs from IDA more reliably than the original 12 formulas assessed. The proposed formulas could play a crucial role for clinicians to discriminate between TTs and IDA.
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Affiliation(s)
- Abdul Hafeez Kandhro
- Center of Data Mining & Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
- Center for Research & Innovation Faculty of Medical Technology, Mahidol University, Bangkok
| | - Watshara Shoombuatong
- Center of Data Mining & Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Virapong Prachayasittikul
- Department of Clinical Microbiology & Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok
| | - Pornlada Nuchnoi
- Center for Research & Innovation Faculty of Medical Technology, Mahidol University, Bangkok
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok
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Huang G, Zheng YW, Wang JJ, Wu J, Liu SN. [Identification of a new 3.8kb deletional α thalassemia and detection of the deletion fragment]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:997-1000. [PMID: 28736383 PMCID: PMC6765508 DOI: 10.3969/j.issn.1673-4254.2017.07.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To report the identification of a novel 3.8-kb deletion that caused α thalassemia and establish the method for detecting the deletion fragment. METHODS Peripheral blood samples were collected from the proband and his mother for analysis of the hematological parameters and routine test for thalassemia genes. For the sample with an inconsistency between the genotyping results and phenotypic analysis results, a specific gap-PCR was employed to identify the rare or novel mutations. RESULTS A novel 3814-bp deletion causing α thalassemia was found in the proband and his mother, who had genotypes of -α4.2/-α3.8 and αα/-α3.8, respectively. CONCLUSION We identified a 3.8-kb deletion in the α-globin gene cluster that caused α thalassemia, and this finding enriches the α thalassemia gene mutation spectrum. Specific gap-PCR offers a convenient and efficient means for for detecting this deletion fragment.
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Affiliation(s)
- Ge Huang
- Department of Clinical Laboratory, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, China.E-mail:
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Hussain A, Ahmed S, Ali N, S. Mailk H, Anees M, Chuahdry AH, Ahmed P. Rare β-Globin Gene Mutations in Pakistan. Hemoglobin 2017; 41:100-103. [DOI: 10.1080/03630269.2017.1339612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ahsan Hussain
- Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - Suhaib Ahmed
- Department of Pathology, Riphah International University, Islamabad, Pakistan
| | - Nadir Ali
- Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - Hamid S. Mailk
- Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - Mariam Anees
- Department of Biochemistry, Quaid-i-Azam University Islamabad, Pakistan
| | - Altaf H. Chuahdry
- Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - Parvez Ahmed
- Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan
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