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Li Y, Ye J, Liang L, Tan X, Zheng L, Qin T, Yu L. Detection of α-thalassemia South-East Asian deletion based on a fully integrated digital polymerase chain reaction system DropXpert S6. Hematology 2024; 29:2365596. [PMID: 38864494 DOI: 10.1080/16078454.2024.2365596] [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: 01/10/2024] [Accepted: 06/04/2024] [Indexed: 06/13/2024] Open
Abstract
OBJECTIVES This study aimed to establish a droplet digital polymerase chain reaction (ddPCR) assay for South-East Asian (SEA) deletion based on a fully integrated digital PCR system DropXpert S6. METHODS A total of 151 whole blood samples, 10 chorionic villus samples, and 17 amniotic fluid samples were collected, including 106 SEA heterozygotes, 43 normal individuals, 10 Hb Bart's hydrops details, and 19 SEA deletions combined with other genotypes.Genotypes of these samples were determined by the Gap-PCR method. We perform a series of optimizations of the ddPCR system to ensure the performance of the entire ddPCR reaction, such as droplet stability, fluorescence clustering, sensitivity, and accuracy. RESULTS Our assay exhibited 99.4% (177/178) accuracy compared with the Gap-PCR method, and the minimum detection limit of DNA was 0.1 ng/μL.Both targets have reliable linearity, R2 = 0.9999 for the α-thalassemia SEA deletion allele and R2 = 1 for the wild-type allele. The coefficient of variation for α-thalassemia SEA deletion allele detection at 2 and 10 ng/μL concentrations was 5.42% and 1.91%, respectively. In contrast, the coefficient of variation for wild-type allele detection was 4.06% and 1.83%, demonstrating its high quantitative accuracy. In addition, the DropXpert S6 PCR system showed some advantages over other ddPCR instruments, such as reducing testing costs, simplifying and automating the workflow. CONCLUSIONS The DropXpert S6 PCR system provided a highly accurate diagnosis for α-thalassemia SEA deletion and can be used to detect α-thalassemia as an alternative method.
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Affiliation(s)
- Youqiong Li
- Center for Medical Genetics and Prenatal Diagnosis, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Junwei Ye
- Research and Development Department, Shenzhen Biorain Technology Co., Ltd, Shenzhen, People's Republic of China
| | - Liang Liang
- Center for Medical Genetics and Prenatal Diagnosis, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Xiao Tan
- Research and Development Department, Shenzhen Biorain Technology Co., Ltd, Shenzhen, People's Republic of China
| | - Lihong Zheng
- Center for Medical Genetics and Prenatal Diagnosis, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Ting Qin
- Center for Medical Genetics and Prenatal Diagnosis, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, People's Republic of China
| | - Linfen Yu
- Research and Development Department, Shenzhen Biorain Technology Co., Ltd, Shenzhen, People's Republic of China
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Huang Z, Li Z, Li Y, Cao Y, Zhong S, Liu J, Lin Z, Lin L, Fang Y, Zeng J, Su Z, Li H, Liang J, Zhu B, Lin Z, Huang Y, Yang X, Jiang L. Exploring Appropriate Reference Intervals and Clinical Decision Limits for Glucose-6-Phosphate Dehydrogenase Activity in Individuals From Guangzhou, China. Ann Lab Med 2024; 44:487-496. [PMID: 38699793 PMCID: PMC11375190 DOI: 10.3343/alm.2023.0477] [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: 12/09/2023] [Revised: 02/25/2024] [Accepted: 04/15/2024] [Indexed: 05/05/2024] Open
Abstract
Background Quantitative detection of glucose-6-phosphate dehydrogenase (G6PD) is commonly done to screen for G6PD deficiency. However, current reference intervals (RIs) of G6PD are unsuitable for evaluating G6PD-activity levels with local populations or associating G6PD variants with hemolysis risk to aid clinical decision-making. We explored appropriate RIs and clinical decision limits (CDLs) for G6PD activity in individuals from Guangzhou, China. Methods We enrolled 5,852 unrelated individuals between 2020 and 2022 and screened their samples in quantitative assays for G6PD activity. We conducted further investigations, including G6PD genotyping, thalassemia genotyping, follow-up analysis, and statistical analysis, for different groups. Results In Guangzhou, the RIs for the G6PD activities were 11.20-20.04 U/g Hb in male and 12.29-23.16 U/g Hb in female. The adjusted male median and normal male median (NMM) values were 15.47 U/g Hb and 15.51 U/g Hb, respectively. A threshold of 45% of the NMM could be used as a CDL to estimate the probability of G6PD variants. Our results revealed high hemolysis-risk CDLs (male: <10% of the NMM, female: <30% of the NMM), medium hemolysis-risk CDLs (male: 10%-45% of the NMM, female: 30%-79% of the NMM), and low hemolysis-risk CDLs (male: ≥ 45% of the NMM, female: ≥ 79% of the NMM). Conclusions Collectively, our findings contribute to a more accurate evaluation of G6PD-activity levels within the local population and provide valuable insights for clinical decision-making. Specifically, identifying threshold values for G6PD variants and hemolysis risk enables improved prediction and management of G6PD deficiency, ultimately enhancing patient care and treatment outcomes.
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Affiliation(s)
- Zhenyi Huang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ziyan Li
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yating Li
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yunshan Cao
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Suping Zhong
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jinlu Liu
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiqian Lin
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Lijuan Lin
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yanping Fang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jing Zeng
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhaoying Su
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Huibin Li
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jianfen Liang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Biqing Zhu
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zipei Lin
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yongxin Huang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xuexi Yang
- Institute of Antibody Engineering, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Lingxiao Jiang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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Chen S, Liu Y, Yin X, Lu Q, Du X, Huang R, Jia Y, Wang X, Xi X. Transfusion burden and willingness to pay for temporary alleviation of anemia status in transfusion-dependent beta-thalassemia patients in China. BMC Health Serv Res 2024; 24:1215. [PMID: 39390469 PMCID: PMC11468025 DOI: 10.1186/s12913-024-11547-2] [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: 06/18/2024] [Accepted: 09/05/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND Transfusion-dependent β-thalassemia (TDT) is one of the global public health concerns highlighted by the World Health Organization. Patients with TDT require regular blood transfusion to survive. However, the availability of blood resources is extremely limited. The purpose of this study was to investigate transfusion burden and willingness to pay (WTP) for temporary remission of anemia status among patients with TDT and to explore the associated factors. METHODS Adult patients with TDT were recruited through cluster sampling across several high-incidence provinces in China. Consenting patients completed online questionnaires on demographic information, transfusion burden and WTP with real-time WeChat communication assistance from researchers. The guiding techniques of double-bounded dichotomous choices and open-ended questions in the contingent valuation method (CVM) were used to obtain participants' WTP for 1 unit of leukocyte-depleted red blood cells. WTP calculations were performed using maximum likelihood estimation, with further insights gained through subgroup analysis based on gender, family monthly income level and convenience of blood transfusion. RESULTS The analysis included 149 TDT patients from five high-incidence provinces, with an average monthly income of $198.5. Patients received an average of 3.7 units per transfusion, 15.4 times annually, with an average WTP of $70.4 per unit (95% CI [62.0, 78.9]). Estimated WTP for temporary anemia alleviation per transfusion totaled $260.6, exceeding monthly income by 1.32 times. Higher WTP was observed among males, higher-income households, and those with at least junior education. Lower WTP was noted among patients with lower transfusion volumes and those needing to travel for transfusion or during hospitalization for blood transfusion. CONCLUSION High WTP indicated a strong desire for temporary anemia relief. Most TDT patients faced significant economic and transfusion burden. The evident gap in meeting clinical needed underscores the urgent demand for innovative treatments to reduce transfusion dependency, potentially transforming TDT care and improving socioeconomic well-being and clinical outcomes. These findings supported evidence-based decision-making for TDT pharmacoeconomics and efficient healthcare resource allocation in China.
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Affiliation(s)
- Shirui Chen
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yueyue Liu
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, China
| | - Xiaolin Yin
- The 923rd Hospital of the Joint Logistics Support Force of the People's Liberation Army, Nanning, China
| | - Quanyi Lu
- Zhongshan Hospital Xiamen University, Xiamen, China
| | | | - Rong Huang
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, China
| | - Yu Jia
- Bristol-Myers Squibb (China)Investment Co., Ltd, Shanghai, China
| | - Xin Wang
- School of Pharmacy, Hangzhou Medical College, Hangzhou, China
| | - Xiaoyu Xi
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, China.
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Wan Y, Zhang Y, Li T, Chen S, Niu C. Prediction the Occurrence of Thalassemia With Hematological Phenotype by Diagnosis of Abnormal HbA1c. J Clin Lab Anal 2024:e25104. [PMID: 39317177 DOI: 10.1002/jcla.25104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 08/26/2024] [Accepted: 09/04/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND The current investigation aims to analyze the occurrence of thalassemia in patients who participated in hemoglobin A1c (HbA1c) testing in clinical laboratory showing high hemoglobin F (HbF) level (≥ 1.5%) or abnormal Hb peak and predict the main influence factors by using different statistical models. METHODS The current investigation is a single-center retrospective cohort study. HbA1c concentration was detected by using TOSOH HLC-723G8 glycated hemoglobin analyzer. SNaPshot SNP (Single Nucleotide Polymorphism) typing and AccuCopy technology were employed to detect mutations in thalassemia-related pathogenic genes. RESULTS A total of 126 patients endured high HbF levels or abnormal Hb peak during HbA1c detection, and 66.7% of subjects (n = 84) showed thalassemia mutations. Three heterozygosity mutations, including c.52A>T (p.K18*), c.-78A>G, and c.126_129delCTTT(p.F42Lfs*19) present in HBB gene, were also identified. --SEA/αα mutation demonstrated the youngest ages (p < 0.001). 17 M (p < 0.001) and 41/42 M (p < 0.01) mutations with β-thalassemia showed higher HbF levels compared with patients without thalassemia mutations. Except for -α3.7, mutations in thalassemia showed lower levels of mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) compared with patients without thalassemia mutations. Patients with thalassemia mutations showed younger age (p < 0.001), lower Hb (p < 0.001), MCV and MCH levels (p < 0.001), higher red blood cell (RBC) count (p < 0.001), and platelet distribution width (PDW) level (p = 0.007) than patients without thalassemia mutations. Three statistical models indicate MCV is the most valuable independent factor for predicting thalassemia and ROC (receiver operating characteristic) curves analysis of AUC (Area Under the Curve) of 0.855 (95% CI [0.787-0.923], p < 0.001) with MCV. CONCLUSION High HbF level (≥ 1.5%) or abnormal Hb peak present in HbA1c testing indicated high incident rate of thalassemia. MCV is the most valuable independent predicting factor for subjects having thalassemia.
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Affiliation(s)
- Yafang Wan
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing, P.R. China
| | - Yu Zhang
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing, P.R. China
| | - Tian Li
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing, P.R. China
| | - Shuyue Chen
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing, P.R. China
| | - Changchun Niu
- Department of Clinical Laboratory, Chongqing General Hospital, Chongqing, P.R. China
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Ren Z, Huang P, Wang Y, Yao Y, Ren J, Xu L, Shu J, Zhou L, Zhao D, Li X, Zhang Z, Zhang C, Sun B, Lu S, Qian W, Zhou H, Fang C. Technically feasible solutions to challenges in preimplantation genetic testing for thalassemia: experiences of multiple centers between 2019 and 2022. J Assist Reprod Genet 2024:10.1007/s10815-024-03240-4. [PMID: 39256293 DOI: 10.1007/s10815-024-03240-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 08/22/2024] [Indexed: 09/12/2024] Open
Abstract
PURPOSE In clinical practice, the success of preimplantation genetic testing for monogenic diseases (PGT-M) for thalassemia was hindered by the absence of probands, incomplete family members, or failure in detecting embryonic gene mutation sites. This study aimed to address these issues. METHODS This retrospective study included 342 couples undergoing PGT-M for α- or β-thalassemia at three reproductive medicine centers from 2019 to 2022. Various methods were used to construct parental haplotypes. A total of 1778 embryos were analyzed and selected for transfer based on chromosomal ploidy and PGT-M results. Follow-up involved amniocentesis results and clinical outcomes. RESULTS Haplotypes were established using DNA samples from probands or parents, as well as sibling blood samples, single sperm, and affected embryos, achieving an overall success rate was 99.4% (340/342). For α-thalassemia and β-thalassemia, the concordance between embryo single nucleotide polymorphism (SNP) haplotype analysis results and mutation loci detection results was 93.8% (1011/1078) and 98.2% (538/548), respectively. Multiple annealing and looping-based amplification cycles (MALBAC) showed a higher whole genome amplification success rate than multiple displacement amplification (MDA) (98.8% (1031/1044) vs. 96.2% (703/731), p < 0.001). Amniocentesis confirmed PGT-M outcomes in 100% of cases followed up (99/99). CONCLUSION This study summarizes feasible solutions to various challenging scenarios encountered in PGT-M for thalassemia, providing valuable insights to enhance success rate of PGT-M in clinical practice.
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Affiliation(s)
- Zi Ren
- Reproductive Medicine Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
- Guangdong Engineering Technology Research Center of Fertility Preservation, Guangzhou, 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China
| | - Peng Huang
- Genetic Metabolism Center Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530000, China
| | - Yong Wang
- Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, 518000, China
| | - Yaxin Yao
- Yikon Genomics Co., Ltd, Suzhou, 215000, China
| | - Jun Ren
- Yikon Genomics Co., Ltd, Suzhou, 215000, China
| | - Linan Xu
- Reproductive Medicine Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
- Guangdong Engineering Technology Research Center of Fertility Preservation, Guangzhou, 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China
| | - Jinhui Shu
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530000, China
| | - Liang Zhou
- Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, 518000, China
| | - Dunmei Zhao
- Yikon Genomics Co., Ltd, Suzhou, 215000, China
| | - Xiaolan Li
- Reproductive Medicine Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
- Guangdong Engineering Technology Research Center of Fertility Preservation, Guangzhou, 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China
| | - Zhiqiang Zhang
- Reproductive Medicine Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
- Guangdong Engineering Technology Research Center of Fertility Preservation, Guangzhou, 510655, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China
| | - Chunhui Zhang
- Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, 518000, China
| | - Bolan Sun
- Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, 518000, China
| | - Sijia Lu
- Yikon Genomics Co., Ltd, Suzhou, 215000, China.
| | - Weiping Qian
- Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, 518000, China.
| | - Hong Zhou
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530000, China.
| | - Cong Fang
- Reproductive Medicine Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China.
- Guangdong Engineering Technology Research Center of Fertility Preservation, Guangzhou, 510655, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, China.
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Amid A, Liu S, Babbs C, Higgs DR. Hemoglobin Bart's hydrops fetalis: charting the past and envisioning the future. Blood 2024; 144:822-833. [PMID: 38457773 DOI: 10.1182/blood.2023023692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/14/2024] [Accepted: 02/29/2024] [Indexed: 03/10/2024] Open
Abstract
ABSTRACT Hemoglobin Bart's hydrops fetalis syndrome (BHFS) represents the most severe form of α-thalassemia, arising from deletion of the duplicated α-globin genes from both alleles. The absence of α-globin leads to the formation of nonfunctional hemoglobin (Hb) Bart's (γ4) or HbH (β4) resulting in severe anemia, tissue hypoxia, and, in some cases, variable congenital or neurocognitive abnormalities. BHFS is the most common cause of hydrops fetalis in Southeast Asia; however, owing to global migration, the burden of this condition is increasing worldwide. With the availability of intensive perinatal care and intrauterine transfusions, an increasing number of patients survive with this condition. The current approach to long-term management of survivors involves regular blood transfusions and iron chelation, a task made challenging by the need for intensified transfusions to suppress the production of nonfunctional HbH-containing erythrocytes. Although our knowledge of outcomes of this condition is evolving, it seems, in comparison to individuals with transfusion-dependent β-thalassemia, those with BHFS may face an elevated risk of complications arising from chronic anemia and hypoxia, ongoing hemolysis, iron overload, and from their respective treatments. Although stem cell transplantation remains a viable option for a select few, it is not without potential side effects. Looking ahead, potential advancements in the form of genetic engineering and innovative therapeutic approaches, such as the reactivation of embryonic α-like globin gene expression, hold promise for furthering the treatment of this condition. Prevention remains a crucial aspect of care, particularly in areas with high prevalence or limited resources.
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Affiliation(s)
- Ali Amid
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Siyu Liu
- Laboratory of Gene Regulation, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
- Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford, United Kingdom
| | - Christian Babbs
- Laboratory of Gene Regulation, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Douglas R Higgs
- Laboratory of Gene Regulation, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
- Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford, United Kingdom
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Sani A, Tian Y, Zha G, Xiao X, Shah S, Idrees Khan M, Fan L, Zhang Q, Liu W, Wang Y, Chen P, Cao C. A high stable sample loading for analysis of adult alpha-thalassemia via the improved microarray isoelectric focusing of Hb species. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1244:124238. [PMID: 39018990 DOI: 10.1016/j.jchromb.2024.124238] [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: 03/24/2024] [Revised: 06/27/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024]
Abstract
The isoelectric focusing has realized various improvements, including the protocols and creation of mIEF (microcolumn isoelectric focusing) instruments with excellent sensitivity for screening of diabetes and beta thalassemia. However, the problem of manual sample loading and hydration for the mIEF limits the operational capacity for stably detecting and quantitating most abnormal hemoglobin (Hb). Herein, we provided a high stable sample loading protocol for analysis of alpha thalassemia and Hb variants. In contrast to the previous volume of 20 μl, a 100 µl blood sample solution in this protocol was optimized with mixture of 6.4-7.5 and 3-10 pH carrier ampholytes, pI markers and loaded for 30 mins IPG microcolumn hydration. The hydrated microcolumn was then automatically loaded onto the mIEF chip array to which CH3COOH and NH4OH act as anodic and cathodic solutions. Lastly, the IEF was run for 9 mins. Hb H, Barts, A1c, F, A2 and CS were simultaneously separated and focused with higher resolution and sensitivity in quantifying H and Barts as low as 0.6 and 0.5 % respectively. Accordingly, there was an enhanced stability and linearity with a rapid assay time of 45 secs per sample. Moreover, analysis showed a fitting linear relationship with conventional technology at R2 = 0.9803 for H and R2 = 0.9728 for Barts thereby indicating greater accuracy confirmed by the AUC. Hence, the developed protocol could simply be employed for high stable and throughput batch sample loading of hydration, and accurate separation and quantitation of Hb variants for alpha and beta thalassemia.
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Affiliation(s)
- Ali Sani
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Youli Tian
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Genhan Zha
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xuan Xiao
- NHC Key Laboratory of Thalassemia Medicine, Key Laboratory of Thalassemia Medicine, Chinese Academy of Medical Sciences, Guangxi Key Laboratory of Thalassemia Research, Guangxi Medical University, Nanning 530021, PR China
| | - Saud Shah
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Muhammad Idrees Khan
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Liuyin Fan
- Student Innovation Center, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Qiang Zhang
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Weiwen Liu
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yuxin Wang
- School of Physics and Astronomy, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Ping Chen
- NHC Key Laboratory of Thalassemia Medicine, Key Laboratory of Thalassemia Medicine, Chinese Academy of Medical Sciences, Guangxi Key Laboratory of Thalassemia Research, Guangxi Medical University, Nanning 530021, PR China.
| | - Chengxi Cao
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China.
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Yuan F, Huang Z, Yao D, Sun J. A Case of Pernicious Anemia with Concurrent Beta-Thalassemia Minor. J Blood Med 2024; 15:351-357. [PMID: 39132285 PMCID: PMC11317050 DOI: 10.2147/jbm.s473075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/23/2024] [Indexed: 08/13/2024] Open
Abstract
Vitamin B12 is essential for various bodily functions, and its deficiency may cause hematological manifestations. We report a case of a previously healthy 65-year-old female who was admitted to our hospital with reduced sense of taste and painful tongue. The serum level of vitamin B12 was decreased. However, her complete blood count did not show any evidence of macrocytosis, instead, her mean corpuscular volume was low. Gene sequencing indicated an β-thalassemia minor and that probably masked the megaloblastic features of vitamin B12 deficiency.
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Affiliation(s)
- Fuzhen Yuan
- Department of General Practice, Longgang District Central Hospital of Shenzhen, Shenzhen, 5181116, People’s Republic of China
| | - Zhenhua Huang
- Department of General Practice, Longgang District Central Hospital of Shenzhen, Shenzhen, 5181116, People’s Republic of China
- Shenzhen Clinical College of Medicine, Guangzhou University of Chinese Medicine, Shenzhen, 5181116, People’s Republic of China
| | - Dingye Yao
- Department of General Practice, Longgang District Central Hospital of Shenzhen, Shenzhen, 5181116, People’s Republic of China
- Shenzhen Clinical College of Medicine, Guangzhou University of Chinese Medicine, Shenzhen, 5181116, People’s Republic of China
| | - Junsheng Sun
- Department of General Practice, Longgang District Central Hospital of Shenzhen, Shenzhen, 5181116, People’s Republic of China
- Shenzhen Clinical College of Medicine, Guangzhou University of Chinese Medicine, Shenzhen, 5181116, People’s Republic of China
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9
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Zhang L, Fan E, Chen X, Zhuo Y, Lee Y, Yan R. Effects of thalassemia minor on umbilical artery blood flow and perinatal outcomes in pregnancy: A retrospective cohort study. Int J Gynaecol Obstet 2024. [PMID: 39073156 DOI: 10.1002/ijgo.15822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 07/05/2024] [Accepted: 07/13/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE The aim of the present study was to compare the fetal umbilical artery blood flow parameters in the third trimester and perinatal outcomes between pregnant women with and without thalassemia minor in South China. METHODS This was a retrospective cohort study. Doppler ultrasound was used to detect fetal umbilical artery hemodynamics in pregnant women with or without thalassemia minor during the third trimester. The main parameters assessed were umbilical artery peak systolic flow velocity/end-diastolic flow velocity (S/D), resistance index (RI), pulsation index (PI), and relevant perinatal outcomes. RESULTS This study included 540 pregnant women, 180 with thalassemia minor and 360 being healthy controls. In the third trimester, the thalassemia minor group had higher umbilical artery S/D (P = 0.002), RI (P = 0.002), and PI (P = 0.012) than healthy pregnant women, as well as lower levels of hemoglobin (Hb) (P < 0.001) and higher ferritin levels (P < 0.001). Compared to the non-thalassemia group, neonatal body weight in the thalassemia minor group was significantly lower (P = 0.001). Additionally, the incidence of maternal anemia (odds ratio [OR] 3.92; 95% confidence interval [CI]: 2.57-5.99, P < 0.001), low birth weight (OR 15.35; 95% CI: 1.71-137.93, P = 0.015), fetal distress (OR 2.18; 95% CI: 1.12-4.26, P = 0.023), neonatal asphyxia (OR 12.81; 95% CI: 1.40-117.33, P = 0.024), oligohydramnios (OR 18.25; 95% CI: 2.21-150.36, P = 0.007) and Apgar score <7 at 1 min after birth (OR 7.97; 95% CI: 1.53-41.54, P = 0.014) was significantly higher in the thalassemia minor group. CONCLUSION Pregnant women with thalassemia minor have higher umbilical artery S/D, RI and PI during the third trimester and a higher risk of adverse perinatal outcomes.
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Affiliation(s)
- Li Zhang
- International School, Jinan University, Guangzhou, China
| | - Erwen Fan
- International School, Jinan University, Guangzhou, China
| | - Xin Chen
- International School, Jinan University, Guangzhou, China
| | - Yeqi Zhuo
- International School, Jinan University, Guangzhou, China
| | - Yan Lee
- International School, Jinan University, Guangzhou, China
| | - Ruiling Yan
- Department of Fetal Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
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10
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Li D, Liang L, Meng D, He S. Routine antenatal molecular testing for α-thalassemia at a tertiary referral hospital in China: ten years of experience. Front Genet 2024; 15:1416047. [PMID: 38894721 PMCID: PMC11183328 DOI: 10.3389/fgene.2024.1416047] [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: 04/11/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Objective This study aimed to evaluate the efficacy of α-thalassemia gene testing as a part of an antenatal intervention program over a 10-year period. Methods All patients underwent α-thalassemia gene testing, which included the analysis of three types of deletions and mutations. Rare α-thalassemia gene testing was performed using Sanger sequencing, multiplex ligation-dependent probe amplification, and sequencing techniques. Prenatal diagnosis was performed in high-risk couples using chorionic villus sampling or amniocentesis. Results From 2010 to 2019, among the 91,852 patients examined, α-thalassemia mutations were identified in 41.78% of patients. The most frequent α0 gene mutation was--SEA, followed by--THAI. Two rare α0-thalassemia gene mutations at --32.8 and --230, were also observed. A total of 2,235 high-risk couples were identified, of which 562 were affected, including three with the--SEA/--THAI genotype and one with the--SEA/--230 genotype. Additionally, prenatal diagnosis revealed four cases of fetal anemia and/or mild edema, along with two cases of severe fetal edema. Chromosome and gene chip results were normal. Thalassemia gene testing showed an αCSα/αCSα genotype in four patients with anemia and/or mild edema, while two patients with severe fetal edema had one--SEA/αCSα genotype and one--SEA/--GX genotype. Using the cut-off points of 74.6 fL and 24.4 pg as criteria for identifying α0-thalassemia carriers and HbH disease, the detection rate of missed diagnoses in high-risk couples is consistent with national guidelines for standards, potentially saving 10,217,700 ¥. Conclusion Routine molecular testing for α-thalassemia in high-risk prenatal populations effectively prevented severe α-thalassemia births. Despite the high cost, the cutoff points proposed by this study suggest that implementing screening using a new parameter has the potential to reduce current expenses.
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Affiliation(s)
- Dongming Li
- Department of Laboratory Medicine, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lifang Liang
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Dahua Meng
- Department of Clinical Genetics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Sheng He
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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11
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Hu J, Song Z, Zhao L, Gonzalez SC, Wang E, Hou X. The temporal trends of prevalence and years lived with disability of anaemia in China, Japan, and South Korea, from 1990 to 2021: Results from the Global Burden of Disease Study 2021. J Glob Health 2024; 14:04073. [PMID: 38779874 PMCID: PMC11112532 DOI: 10.7189/jogh.14.04073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Studies have shown that the disease burden of anaemia varies globally, yet they have not yet determined its exact extent in East Asian countries specifically. We thus aimed to investigate the prevalence and years lived with disability (YLDs) due to anaemia from 1990 to 2021 in China, Japan, and South Korea. Methods We extracted the prevalence and YLDs with their age-standardised rates (ASRs) in China, Japan, and South Korea from the Global Burden of Disease Study 2021, stratified by sex, age, and causes. We then examined the temporal trend of anaemia burden from 1990 to 2021 using joinpoint analysis and the association of anaemia burden with the Human Development Index and Universal Health Index through Spearman's correlation analysis. Results In 2021, anaemia affected 136 million people in China (95% uncertainty interval (UI) = 131, 141), with ASRs of prevalence of 8.9% (95% UI = 8.6, 9.3), and accounted for 3.0 million YLDs (95% UI = 2.0, 4.4). It affected 13.6 million people in Japan (95% UI = 11.8, 16.0), with ASRs of prevalence of 7.4% (95% UI = 6.1, 9.0), and caused 181 thousand YLDs (95% UI = 108, 282). It also affected 2.7 million individuals in South Korea (95% UI = 2.4, 3.0), with ASRs of prevalence of 5.2% (95% UI = 4.6, 5.7), and led to 34 thousand YLDs (95% UI = 22, 55). We observed a significant gender discrepancy in the anaemia burden in these three countries, with the prevalence and YLD rates in women being almost twice as high as those in men. Moreover, the peak age of the anaemia burden shifted toward higher age groups in all three countries, particularly in Japan. Chronic kidney disease was responsible for a growing share of anaemia cases and YLDs, especially in adults aged more than 60 years in Japan and South Korea. Haemoglobinopathies were another noticeable cause of anaemia in China, though dietary iron deficiency remained the leading cause. Both socioeconomic development and essential health service coverage showed negative associations with the anaemia burden in the three countries in the past three decades, though with differential patterns. Conclusions Anaemia remains a major public health issue in China, Japan, and South Korea; targeted surveillance and interventions are recommended for high-risk populations and cause-specific anaemia.
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Affiliation(s)
- Jie Hu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zongbin Song
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Liang Zhao
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sarel Chavarria Gonzalez
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - E Wang
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinran Hou
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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12
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Pan L, Li L, Qiu Y, Ling X, Wang C, Wu Z, Li X, Lin F, Huang Y. A novel discriminant algorithm for differential diagnosis of mild to moderate thalassemia and iron deficiency anemia. Medicine (Baltimore) 2024; 103:e38205. [PMID: 38758841 PMCID: PMC11098195 DOI: 10.1097/md.0000000000038205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/19/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Mild to moderate thalassemia trait (TT) and iron deficiency anemia (IDA) are the most common conditions of microcytic hypochromic anemia (MHA) and they exhibit highly similar clinical and laboratory features. It is sometimes difficult to make a differential diagnosis between TT and IDA in clinical practice. Therefore, a simple, effective, and reliable index is needed to discriminate between TT and IDA. METHODS Data of 598 patients (320 for TT and 278 for IDA) were enrolled and randomly assigned to training set (278 of 598, 70%) and validation set (320 of 598, 30%). Stepwise discriminant analysis was used to define the best diagnostic formula for the discrimination between TT and IDA in training set. The accuracy and diagnostic performance of formula was tested and verified by receiver operating characteristic (ROC) analysis in validation set and its diagnostic performance was compared with other published indices. RESULTS A novel formula, Thalassemia and IDA Discrimination Index (TIDI) = -13.932 + 0.434 × RBC + 0.033 × Hb + 0.025 ×MCHC + 53.593 × RET%, was developed to discriminate TT from IDA. TIDI showed a high discrimination performance in ROC analysis, with the Area Under the Curve (AUC) = 0.936, Youden' s index = 78.7%, sensitivity = 89.5%, specificity = 89.2%, respectively. Furthermore, the formula index also obtained a good classification performance in distinguishing 5 common genotypes of TT from IDA (AUC from 0.854-0.987). CONCLUSION The new, simple algorithm can be used as an effective and robust tool for the differential diagnosis of mild to moderate TT and IDA in Guangxi region, China.
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Affiliation(s)
- Liqiu Pan
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Linlin Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yuling Qiu
- NHC Key Laboratory of Thalassemia Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Xiaoting Ling
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Chenghan Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Zuhao Wu
- School of Basic Medicine, Guangxi Medical University, Nanning, Guangxi, P. R. China
| | - Xiaoman Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Faquan Lin
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- NHC Key Laboratory of Thalassemia Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
| | - Yifang Huang
- Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
- NHC Key Laboratory of Thalassemia Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, P. R. China
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Wu LS, Luo X, Tan M, Zhang LJ, Luo HF, Huang G, Huang P, Chen J, Chen Y. Prevalence of thalassemia-carrier couples and fertility risk assessment. Int J Hematol 2024; 119:374-382. [PMID: 38411864 DOI: 10.1007/s12185-024-03722-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/28/2024]
Abstract
Thalassemia is a highly prevalent hematologic disease in Guizhou, China. This study aimed to determine the epidemiological characteristics of thalassemia in couples at childbearing age and assess the neonatal risk of thalassemia in this subpopulation. A cohort of 4481 couples at childbearing age were recruited for thalassemia carrier screening by both traditional hematological tests and next-generation sequencing. Of them, 1314 (14.66%) thalassemia carriers were identified, including 857 (9.76%) α-thalassemia, 391 (4.36%) β-thalassemia, and 48 (0.54%) composite α and β-thalassemia. A total of 12 α-globin gene alterations and 16 β-globin mutations were detected, including four novel thalassemia mutations. SEA was the most common α-thalassemia genotype (26.86%), CD41-42 the most common β-thalassemia genotype (36.57%), and αα/- α3.7 + CD41-42 the most common composite α- and β-thalassemia genotype (18.75%). Ethnically, the Zhuang had the highest rate of thalassemia gene carriers among the ethnic groups. Geographically, Qiannan had the highest rate of thalassemia gene carriers. In addition, 38 of the 48 couples with composite α- and β-thalassemia were high-risk thalassemia carriers, and 4 carrying the -SEA/αα gene needed fertility guidance.
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Affiliation(s)
- Liu-Song Wu
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Rd., Zunyi, 56300, Guizhou, China
- Department of Pediatrics, Guizhou Children's Hospital, Zunyi, Guizhou, China
- Collaborative Innovation Center for Tissue Injury Repair and Regenerative Medicine of Zunyi Medical University, Zunyi, Guizhou, China
| | - Xi Luo
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Rd., Zunyi, 56300, Guizhou, China
- Department of Pediatrics, Guizhou Children's Hospital, Zunyi, Guizhou, China
- Collaborative Innovation Center for Tissue Injury Repair and Regenerative Medicine of Zunyi Medical University, Zunyi, Guizhou, China
| | - Mei Tan
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Rd., Zunyi, 56300, Guizhou, China
- Department of Pediatrics, Guizhou Children's Hospital, Zunyi, Guizhou, China
- Collaborative Innovation Center for Tissue Injury Repair and Regenerative Medicine of Zunyi Medical University, Zunyi, Guizhou, China
| | - Li-Jun Zhang
- Department of Pediatrics, The Qian-Nan-Zhou People's Hospital of Guizhou, Guizhou, China
| | - Hong-Fang Luo
- Department of Pediatrics, The 2nd Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Ge Huang
- Clinical Laboratory, The Qian-Dong-Nan People's Hospital of Guizhou, Guizhou, China
| | - Pei Huang
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Rd., Zunyi, 56300, Guizhou, China
- Department of Pediatrics, Guizhou Children's Hospital, Zunyi, Guizhou, China
- Collaborative Innovation Center for Tissue Injury Repair and Regenerative Medicine of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jindong Chen
- Exploring Health, LLC., 3 Lanyue Rd., Huangpu District, Guangzhou, 510663, China.
- Department of Urology, University of Rochester Medical Center, Rochester, NY, 14642, USA.
| | - Yan Chen
- Department of Pediatrics, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Rd., Zunyi, 56300, Guizhou, China.
- Department of Pediatrics, Guizhou Children's Hospital, Zunyi, Guizhou, China.
- Collaborative Innovation Center for Tissue Injury Repair and Regenerative Medicine of Zunyi Medical University, Zunyi, Guizhou, China.
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Huang X, Lu J, Huang R, Lu Q, Luo Y, Huang X, An L, Chen Y. Effects of multidisciplinary team continuous care model on psychological behavior and quality of life in children with β-thalassemia major. Am J Transl Res 2024; 16:905-915. [PMID: 38586087 PMCID: PMC10994799 DOI: 10.62347/obwd7382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To explore the effects of a multidisciplinary team (MDT) continuous care model on psychological behavior and quality of life in children with β-thalassemia major (β-TM). METHODS A retrospective study was conducted on 90 children with β-TM who were hospitalized in the Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for Nationalities from October 2021 to May 2022. According to nursing methods, the children were divided into a routine group and an experimental group, with 45 cases in each group. The routine group was intervened with routine nursing approaches, and the experimental group was intervened with the MDT continuous nursing mode on the basis of the control group. The psychological behavior [Positive and Negative Affect Scale for Children (PANAS-C)], quality of life (QoL) [Pediatric Quality of Life Inventory TM (PedsQLTM)] and satisfaction were compared between the two groups before and 6 months after intervention. The hemoglobin level and ferritin level of children after 3 months and 6 months of intervention were measured. The occurrence of complications and nursing satisfaction were recorded. The prognostic factors were further analyzed. RESULTS After the intervention, the positive emotion score, QoL score, hemoglobin level, satisfaction score in the experimental group were all higher than those in the conventional group, and the negative emotion score and ferritin level in the experimental group were all lower than those in the conventional group (all P < 0.05). The results of Cox analysis showed that the use of iron-removing drugs and arrhythmia/heart rate failure were risk factors affecting the prognosis of children with β-TM, while the MDT continuous nursing mode was a protective factor (all P < 0.05). CONCLUSION The MDT continuous care model can effectively promote mental health in children with β-TM, improve their quality of life, medical satisfaction, ameliorate the degree of anemia in children, reduce the incidence of complications and improve the prognosis; thus, it is worthy of wide clinical application.
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Affiliation(s)
- Xiuping Huang
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Jian Lu
- Center for Reproductive Medicine, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Rongxian Huang
- Department of Pediatrics, Baise People’s HospitalBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Qingmei Lu
- School of Nursing, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yanni Luo
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xiaoxiao Huang
- Pediatric Intensive Care Unit, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Liqiao An
- Pediatric Intensive Care Unit, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yuke Chen
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
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Lan Y, Zhou H, He S, Shu J, Liang L, Wei H, Luo J, Wang C, Zhao X, Qiu Q, Huang P. Appropriate whole genome amplification and pathogenic loci detection can improve the accuracy of preimplantation genetic diagnosis for deletional α-thalassemia. Front Endocrinol (Lausanne) 2024; 14:1176063. [PMID: 38523870 PMCID: PMC10957767 DOI: 10.3389/fendo.2023.1176063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 11/13/2023] [Indexed: 03/26/2024] Open
Abstract
Objective To improve the accuracy of preimplantation genetic testing (PGT) in deletional α-thalassemia patients. Design Article. Patients fifty-two deletional α-thalassemia couples. Interventions Whole genome amplification (WGA), Next-generation sequencing (NGS) and PCR mutation loci detection. Main outcome measures WGA, Single nucleotide polymorphism (SNP) and PCR mutation loci detection results; Analysis of embryo chromosome copy number variation (CNV). Results Multiple Displacement Amplification (MDA) and Multiple Annealing and Looping-Based Amplification Cycles (MALBAC) methods for PGT for deletional α-thalassemia. Blastocyst biopsy samples (n = 253) were obtained from 52 deletional α-thalassemia couples. The results of the comparison of experimental data between groups MALBAC and MDA are as follows: (i) The average allele drop-out (ADO) rate, MALBAC vs. MDA = 2.27% ± 3.57% vs. 0.97% ± 1.4%, P=0.451); (ii) WGA success rate, MALBAC vs. MDA = 98.61% vs. 98.89%, P=0.851; (iii) SNP haplotype success rate, MALBAC vs. MDA = 94.44% vs. 96.68%, P=0.409; (iv) The result of SNP haplotype analysis is consistent with that of Gap-PCR/Sanger sequencing results, MALBAC vs. MDA = 36(36/72, 50%) vs. 151(151/181, 83.43%), P=0; (v) Valid SNP loci, MALBAC vs. MDA = 30 ± 9 vs. 34 ± 10, P=0.02; (vi) The mean CV values, MALBAC vs. MDA = 0.12 ± 0.263 vs. 0.09 ± 0.40, P=0.916; (vii) The average number of raw reads, MALBAC vs. MDA =3244259 ± 999124 vs. 3713146 ± 1028721, P=0; (viii) The coverage of genome (%), MALBAC vs. MDA = 5.02 ± 1.09 vs. 5.55 ± 1.49, P=0.008. Conclusions Our findings indicate that MDA is superior to MALBAC for PGT of deletional α-thalassemia. Furthermore, SNP haplotype analysis combined with PCR loci detection can improve the accuracy and detection rate of deletional α-thalassemia.
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Affiliation(s)
- Yueyun Lan
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Genetic and Metabolic Central Laboratory of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Hong Zhou
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
| | - Sheng He
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Genetic and Metabolic Central Laboratory of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Nanning, China
- Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Jinhui Shu
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
| | - Lifang Liang
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Nanning, China
- Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Hongwei Wei
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Genetic and Metabolic Central Laboratory of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Nanning, China
- Guangxi Key Laboratory of Birth Defects Research and Prevention, Nanning, China
| | - Jingsi Luo
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Genetic and Metabolic Central Laboratory of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Caizhu Wang
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
| | - Xin Zhao
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
| | - Qingming Qiu
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Genetic and Metabolic Central Laboratory of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Nanning, China
| | - Peng Huang
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Birth Defects Prevention and Control Institute of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Reproductive Health and Birth Defect Prevention, Nanning, China
- Genetic and Metabolic Central Laboratory of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Guangxi Key Laboratory of Precision Medicine for Genetic Diseases, Nanning, China
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Zhang R, Zhang S, Ming J, Xie J, Liu B, Jiang W, Fu Y, Zhen X, Sun X. A cross-sectional study: caregiver burden and related determinants of adult patients with β-thalassemia major in mainland China. BMC Nurs 2024; 23:151. [PMID: 38439062 PMCID: PMC10910837 DOI: 10.1186/s12912-024-01826-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/25/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The informal caregivers of adult patients with β-thalassemia major (β-TM) bear not only physical but also emotional and economic pressures of providing care. This study is the first to evaluate the caregiver burden by Zarit Burden Interview (ZBI) of adult patients with β-TM in mainland China and to identify predictors of caregiver burden. METHODS In this cross-sectional study, we conducted an online survey with snowball sampling covering seven provinces between September 1, 2021, and January 31, 2022, of patients aged ≥ 18 years with β-TM and their informal caregivers. Caregiver burden was assessed using the ZBI. Data on patient demographics, disease and therapy characteristics, and informal caregivers' demographic characteristics were collected and analysed using independent t-tests, analysis of variance, Spearman's correlation and multiple linear regression. RESULTS Of 75 included patients, more than half (50.7%) were male. The mean patient age was 24.69 ± 5.59 years. The mean age of the informal caregivers was 50.60 ± 9.16 years, with women (74.7%) being predominant. The ZBI score was 38.00 ± 17.02. Multiple linear regression analysis showed that patients with interrupted blood transfusion therapy and informal caregivers required to care of others were positively associated with caregiver burden (p < 0.05). Age of informal caregivers were borderline significant positively associated with caregiver burden (p < 0.1). Married informal caregivers were negatively associated with caregiver burden (p < 0.05). CONCLUSIONS The informal caregivers of adult patients with β-TM in mainland China experienced a moderate-to-severe level of caregiving burden. The caregiver burden was higher in patients with a history of interrupted blood transfusion therapy or in informal caregivers who were older or needed to care for others. Additionally, married informal caregivers experienced lower burdens compared to non-married informal caregivers. These findings provide a reference to identify informal caregivers with higher burdens among patients with β-TM.
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Affiliation(s)
- Runqi Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China
| | - Shuo Zhang
- Shandong Public Health Clinical Center, Jinan, 250100, China
| | - Jing Ming
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China
| | - Jing Xie
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China
| | - Baoguo Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China
| | - Weihang Jiang
- New Sunshine Charity Foundation, Beijing, 100097, China
| | - Yingjie Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China
| | - Xuemei Zhen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China.
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China.
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Chen Y, Zhong R, Guo X, Chen S, Wang Y, Li J, Huang L, Li Y, Wang X, Wu L, Huang M, Huang X, Fang J, Chu Z, Sun J, Peng Z, Sun Y. Carrier rate of thalassemia among 25,910 high school students in Shaoguan area, China. J Med Screen 2024; 31:53-57. [PMID: 37439030 DOI: 10.1177/09691413231188069] [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] [Indexed: 07/14/2023]
Abstract
OBJECTIVES As one of the most common hereditary diseases, thalassemia affects a large number of people in China. The aim of this study was to investigate the feasibility of a method based on next-generation sequencing (NGS) for screening of thalassemia carriers among high school students in the Shaoguan area. MATERIALS AND METHODS The NGS-based method was performed using 25,910 high school students recruited from 38 schools. The screening yield was systematically analyzed. Before screening, a lecture on how the disease is inherited, the symptoms of thalassemia, and how to prevent it was given to 28,780 students. RESULTS Implying successful delivery of information on the disease, 90.03% (25,910 of 28,780) of the students agreed to join this program for thalassemia screening. A thalassemia carrier rate of 15.99% (4144 of 25,910) was found. Also, 69 rare genotypes (28 of α-thalassemia and 41 of β-thalassemia) and 9 novel variants were identified. CONCLUSIONS This NGS-based method provided a feasible platform for high school population thalassemia screening. Combined with a clinical follow-up strategy, it could help eventually to prevent the births of affected children.
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Affiliation(s)
- Yajun Chen
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Rui Zhong
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Xueqin Guo
- BGI-Wuhan Clinical Laboratories, BGI-Shenzhen, Wuhan, China
| | - Shiping Chen
- Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Yan Wang
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Jiufeng Li
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Lichan Huang
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Yi Li
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Xiaoling Wang
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Liting Wu
- Shaoguan Maternal and Child Health Hospital, Shaoguan, China
| | - Mubao Huang
- Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Xiaoyan Huang
- Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Junbin Fang
- Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Zhongjie Chu
- Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Jun Sun
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
- BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Zhiyu Peng
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Yan Sun
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
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Li Y, Jin J, Tuo Y, Huang P, Huang J, Yang H, He Z. Molecular Characterization of α- and β-Thalassemia Among Children Less Than 18 Years Old in Guizhou, China. J Clin Lab Anal 2024; 38:e25022. [PMID: 38506255 PMCID: PMC10997815 DOI: 10.1002/jcla.25022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 02/05/2024] [Accepted: 02/15/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Thalassemia is an inherited hemolytic disease, the complications and sequelae of which have posed a huge impact on both patients and society. But limited studies have investigated the molecular characterization of α- and β-thalassemia in children from Guizhou, China. METHODS Between January 2019 and December 2022, a total of 3301 children, aged 6 months to 18 years, suspected of having thalassemia underwent molecular analysis. RESULTS Out of the total sample, 824 (25%) children were found to carry thalassemia mutations. The carrier rates of α-thalassemia, β-thalassemia, and α + β-thalassemia were determined as 8.1%, 15.6%, and 1.3%, respectively. Approximately 96.5% of the α-thalassemia gene mutations were --SEA (51%), ααCS (20.9%), -α3.7 (19.6%), and -α4.2 (5.0%). The most prevalent mutations of β-thalassemia were βCD17(A>T) (41.5%), βCD41-42(-TTCT) (37.7%), and βIVS-II-654(C>T) (11.3%). Additionally, we identified rare cases, including one case with ααHb Nunobiki/αα, two cases with triplicated α-thalassemia (one case with ααα/ααα and βCD41-42/βN and the other with ααα-3.7/αα and βE CD26/βN), and also one case with α Q-Thailandα/-α4.2 and βCD41-42/βN. CONCLUSIONS Our study findings provide important insights into the heterogeneity of thalassemia carrier rates and molecular profiles among children in the Guizhou region. The findings support the development of prevention strategies to reduce the incidence of severe thalassemia in the future.
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Affiliation(s)
- Yan Li
- Department of Pediatrics, School of Clinical MedicineGuizhou Medical UniversityGuiyangChina
- Department of Pediatric HematologyAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Jiao Jin
- Department of Pediatric HematologyAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Yuanyuan Tuo
- Department of Pediatric HematologyAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Pei Huang
- Department of PediatricAffiliated Hospital of Zunyi Medical UniversityZunyiChina
| | - Jing Huang
- Department of Pediatric HematologyAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Honglan Yang
- Department of Pediatric HematologyAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Zhixu He
- Department of Pediatrics, School of Clinical MedicineGuizhou Medical UniversityGuiyangChina
- Department of PediatricAffiliated Hospital of Zunyi Medical UniversityZunyiChina
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Zeng D, Chen Z, Yang Y, Li J, Tian B, Mo L. Genotype analysis of 55,281 cases of thalassemia in northern Guangxi. Am J Transl Res 2024; 16:51-62. [PMID: 38322564 PMCID: PMC10839378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To understand the genotype and distribution of thalassemia in northern Guangxi. METHODS The study subjects were 55,281 individuals who came to the Affiliated Hospital of Guilin Medical University for genetic diagnosis of thalassemia from January 2012 to August 2023. All of their household registration was in the precincts of Guibei District and its affiliated counties. Red blood cell parameters and hemoglobin analysis were used for thalassemia screening. Gap-PCR, PCR-reverse dot blot hybridization (PCR-RDB), and multicolor melting curve analysis (MMCA) were used to identify common thalassemia genes. Multiplex ligation-dependent probe amplification (MLPA), Sanger sequencing, and third-generation single-molecule real-time (SMRT) sequencing were employed to identify rare thalassemia genes. RESULTS Among the 55,281 samples, 16,442 (29.74%) were diagnosed with thalassemia. The detection rates of α, β, and α combined β-thalassemia were 18.57%, 9.99% and 1.18%, respectively. Among ethnical groups, allele mutation frequency of thalassemia was the highest in Zhuang (44.97%), followed by Yao (40.11%), Dong (31.33%), Han (29.85%), Miao (24.31%), and Hui (20.6%). A total of 11,659 alleles (21.09%) of 8 types of α-thalassemia were identified in 55,281 samples, primarily --SEA (53.9%), followed by -α3.7 (21.3%), including rare alleles: --THAI (0.45%) and HKαα (0.38%). A total of 6367 (11.52%) and 14 types of β-thalassemia alleles were identified, mainly CD41-42 (50.12%), followed by CD17 (22.22%), including rare alleles: βCD37 (0.16%) and Gγ+ (Aγδβ)0/βN (0.05%). A total of 31 genotypes were detected in 10,264 cases of α-thalassemia, and the main types were --SEA/αα (53.23%), -α3.7/αα (19.15%), and -α4.2/αα (7.21%). A total of 34 genotypes were detected in 5525 cases of β-thalassemia, and the main types were βCD41-42/βN (50.53%), βCD17/βN (21.77%), and βIVS-II-654/βN (12.16%). A total of 78 gene types were detected in 653 cases of α- and β-thalassemia, and the main types were --SEA/αα, βCD41-42/βN (18.68%) and -α3.7/αα, βCD41-42/βN (13.02%). There were 580 cases (5.65%) of HbH disease (α0/α+), and 4 cases of Hemoglobin Bart's Hydrops Foetus syndrome (--SEA/--SEA). In addition, there were 92 cases (1.67%) of intermedia or severe types of β-thalassemia (β0/β0, β0/β+, β+/β+), including 23 cases of combined α-thalassemia. Among the samples screened negative for thalassemia, 3.7% of them were found to carry thalassemia genes, and 91.35% of the genotypes were αWSα/αα, -α3.7/αα, and -α4.2/αα. In addition, 40.26% of αWSα/αα, 22.89% of -α3.7/αα, and 18.51% of -α4.2/αα had no hematological phenotype. CONCLUSION The population in northern Guangxi exhibited rich ethnic diversity, with high allelic carrying rates among the Zhuang, Yao and Dong ethnic groups. Thalassemia gene mutations are diverse, encompassing a variety of gene types, with α thalassemia predominating, notably the --SEA/αα gene type. The prevalence of intermedia or severe types of thalassemia is not low, but there are still some carriers of thalassemia in people who are initially tested negative.
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Affiliation(s)
- Dan Zeng
- Ruikang Clinical Medical College of Guangxi University of Traditional Chinese MedicineNanning 530011, Guangxi, PR China
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
- Precision Joint Testing Center, Guangxi Zhuang Autonomous Region People’s HospitalNanning 530021, Guangxi, PR China
| | - Zhizhong Chen
- Ruikang Clinical Medical College of Guangxi University of Traditional Chinese MedicineNanning 530011, Guangxi, PR China
- Precision Joint Testing Center, Guangxi Zhuang Autonomous Region People’s HospitalNanning 530021, Guangxi, PR China
| | - Yifeng Yang
- Department of Laboratory, Guilin People’s HospitalGuilin 541002, Guangxi, PR China
| | - Jun Li
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
| | - Baodong Tian
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
| | - Limin Mo
- Laboratory of Genetics and Precision Medicine, Affiliated Hospital of Guilin Medical UniversityGuilin 541000, Guangxi, PR China
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20
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Chetruengchai W, Phowthongkum P, Shotelersuk V. Carrier frequency estimation of pathogenic variants of autosomal recessive and X-linked recessive mendelian disorders using exome sequencing data in 1,642 Thais. BMC Med Genomics 2024; 17:9. [PMID: 38167091 PMCID: PMC10762924 DOI: 10.1186/s12920-023-01771-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND People with autosomal recessive disorders often were born without awareness of the carrier status of their parents. The American College of Medical Genetics and Genomics (ACMG) recommends screening 113 genes known to cause autosomal recessive and X-linked conditions in couples seeking to learn about their risk of having children with these disorders to have an appropriate reproductive plan. METHODS We analyzed the exome sequencing data of 1,642 unrelated Thai individuals to identify the pathogenic variant (PV) frequencies in genes recommended by ACMG. RESULTS In the 113 ACMG-recommended genes, 165 PV and likely PVs in 60 genes of 559 exomes (34%, 559/1642) were identified. The carrier rate was increased to 39% when glucose-6-phosphate dehydrogenase (G6PD) was added. The carrier rate was still as high as 14.7% when thalassemia and hemoglobinopathies were excluded. In addition to thalassemia, hemoglobinopathies, and G6PD deficiency, carrier frequencies of > 1% were found for Gaucher disease, primary hyperoxaluria, Pendred syndrome, and Wilson disease. Nearly 2% of the couples were at risk of having offsprings with the tested autosomal recessive conditions. CONCLUSIONS Based on the study samples, the expanded carrier screening, which specifically targeted common autosomal recessive conditions in Thai individuals, will benefit clinical outcomes, regarding preconception/prenatal genetic carrier screening.
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Affiliation(s)
- Wanna Chetruengchai
- Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
- Center of Excellence for Medical Genomics, Medical Genomics Cluster, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Prasit Phowthongkum
- Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand.
- Division of Medical Genetics and Genomics, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Vorasuk Shotelersuk
- Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
- Center of Excellence for Medical Genomics, Medical Genomics Cluster, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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Shao B, Wang Y, Zhang J, Wang Y, Tan J, Wang L, Hu P, Tan J, Xu Z. Mutation spectrum of thalassemia among pre-pregnant adults in the Jiangsu Province by capillary electrophoresis-based multiplex PCR assay. Mol Genet Genomic Med 2024; 12:e2344. [PMID: 38112059 PMCID: PMC10767610 DOI: 10.1002/mgg3.2344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 11/02/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Thalassemia is a common genetic disorder in southwestern China, and an increasing number of cases from eastern China have been recently reported. Here, we developed a rapid, convenient, and accurate assay to evaluate the mutation spectrum of thalassemia in eastern China. METHODS A carrier screening assay for 61 hotspot variants among HBA1/HBA2 and HBB (OMIM: 141800, 141850, and 141900) genes was developed by SNaPshot/high-throughput ligation-dependent probe amplification (HLPA) technology. We used this assay to detect the mutation spectrum of thalassemia in individuals from eastern China and compared with the data collected from literatures focused on southern and northern China for variant distribution. RESULTS Among 4276 tested individuals, 2.62% (112/4276) were α-thalassemia carriers, with 90 carrying one deletion or mutation and 22 carrying two deletions. 0.40% (17/4276) were β-thalassemia carriers, and the most common variant of β-thalassemia was c.126_129delCTTT (29.41%) followed by c.316-197C>T (23.53%). The genotype distribution in our study was similar to those from southern China populations. CONCLUSION The Chinese population from different regions presented comparable mutation spectrum of thalassemia, and the SNaPshot/HLPA technique may serve as a capable assay for a routine genetic test in clinical practice with its accurate, rapid, and inexpensive advantage.
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Affiliation(s)
- Binbin Shao
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Yuguo Wang
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Jingjing Zhang
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Yan Wang
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Juan Tan
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Lulu Wang
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Ping Hu
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Jianxin Tan
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
| | - Zhengfeng Xu
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalNanjingPeople's Republic of China
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Chen M, Lv A, Zhang S, Zheng J, Zhang M, Chen L, He Q, Zhuang J, Lin N, Xu L, Huang H. First Report of Filipino β 0-Thalassemia/β-Thalassemia in a Chinese Family. Hemoglobin 2024; 48:34-38. [PMID: 38192212 DOI: 10.1080/03630269.2023.2301487] [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: 09/28/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024]
Abstract
A pregnant woman living in Fujian Province, southeastern China, presented due to a risk of having a baby with β-thalassemia major, during her second pregnancy, since she and her husband were suspected as β-thalassemia carriers and their affected daughter was a transfusion-dependent patient. Using the common α-thalassemia and β-thalassemia genotypes test, the pregnant woman was diagnosed as a β-thalassemia carrier with βIVS-2 - 654 (C→T)/βN genotype and her daughter had a homozygosity for IVS - 2 - 654 (C→T) mutation, however, no abnormalities were detected in her husband. SMRT identified a Filipino β0-deletion in her husband, and MLPA also revealed an unknown deletion in the HBB gene. Electrophoresis showed approximately 350 bp of the PCR product, and the β-Filipino genotype presented novel fracture fragments ranging from 5,112,884 to 5,231,358 bp, and lacked a 118,475 bp fragment relative to the wild-type sequence. The daughter was therefore diagnosed with the βIVS-2 - 654 (C→T)/βFilipino genotype. Prenatal diagnosis with umbilical cord blood at 27th week of gestation showed heteroztgosity for IVS - 2 - 654 (C→T) mutation in the fetus and continued pregnancy was recommended. In conclusion, we identified the Filipino β0-deletion in a Chinese family, from Fujian area, for the first time, during prenatal screening.
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Affiliation(s)
- Meihuan Chen
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Aixiang Lv
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Siwen Zhang
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
- The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China
| | - Junhao Zheng
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
- The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China
| | - Min Zhang
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Lingji Chen
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Qianqian He
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Jianlong Zhuang
- Prenatal Diagnosis Center, Quanzhou Women's and Children's Hospital, Quanzhou, China
| | - Na Lin
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Liangpu Xu
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Hailong Huang
- Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
- The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China
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23
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Xu L, Chen M, Zheng J, Zhang S, Zhang M, Chen L, He Q, Guo D, Lin N, Huang H. Identification of a novel 91.5 kb-deletion (αα) FJ in the α-globin gene cluster using single-molecule real-time (SMRT) sequencing. J Matern Fetal Neonatal Med 2023; 36:2254890. [PMID: 37673790 DOI: 10.1080/14767058.2023.2254890] [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: 04/18/2023] [Revised: 08/01/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES To present a novel 91.5-kb deletion of the α-globin gene cluster (αα)FJ identified by genetic assay and prenatal diagnosis in a Chinese family. SUBJECTS AND METHODS The proband was a 34-year-old G3P1 (Gravida 3, Para 1) female at the gestational age of 21+ weeks with a history of an edematous fetus. A routine genetic assay (reverse dot blot hybridization, RDB) was performed to detect common thalassemia mutations. Multiplex ligation-dependent probe amplification (MLPA) and single-molecule real-time technology (SMRT) were used to detect rare thalassemia mutations. RESULTS The hematological phenotypes of the proband, her mother, elder sister, husband, daughter, and nephew were consistent with the phenotype of α-thalassemia trait. No mutations were found in these family members by RDB, except for the proband's husband who carried an α-globin gene deletion --SEA/αα. MLPA results showed that the proband and other α-thalassemia-suspected relatives had heterozygous deletions around the POLR3K-3-463nt, HS40-178nt, and HBA-HS40-382nt probes. The 5'-breakpoint was out of probe scope and could not be determined. SMRT was performed and a 91.5-kb deletion (NC_000016.10: g.39268_130758del) in the α-globin gene cluster (αα)FJ was identified in the proband and other suspected relatives, which could explain their phenotypes. At the proband's gestational age of 22+ weeks, an amniotic fluid sample was collected and analyzed. As only the 91.5-kb deletion (αα)FJ was identified in the fetus with RDB, MLPA, and SMRT. The proband was suggested to continue the pregnancy. CONCLUSION We first reported a 91.5-kb deletion (NC_000016.10: g.hg38-chr16:39268-_130758del) of the HS-40 region in the α-globin gene cluster (αα)FJ identified in a Chinese family. Since the HS-40 loss of heterozygosity in combination with the heterozygous deletion --SEA might result in Hb Bart's hydrops fetalis, routine genetic assay, and SMRT were recommended to individuals at risk for prenatal diagnosis.
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Affiliation(s)
- Liangpu Xu
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Meihuan Chen
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Junhao Zheng
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
- Medical Technology and Engineering College, Fujian Medical University, Fuzhou, China
| | - Siwen Zhang
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
- Medical Technology and Engineering College, Fujian Medical University, Fuzhou, China
| | - Min Zhang
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Lingji Chen
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Qianqian He
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Danhua Guo
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Na Lin
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
| | - Hailong Huang
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China
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Xie X, Gan J, Liu Z, Zhou Y, Yuan K, Chen Z, Chen S, Zhou R, Liu L, Huang X, Zhang Y, Liu Q, Zhang W, Huang J, Chen J. Prevalence and genetic analysis of triplicated α-globin gene in Ganzhou region using high-throughput sequencing. Front Genet 2023; 14:1267892. [PMID: 37928241 PMCID: PMC10620506 DOI: 10.3389/fgene.2023.1267892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023] Open
Abstract
α-globin gene triplication carriers were not anemic in general, while some studies found that α-globin gene triplication coinherited with heterozygous β-thalassemia may cause adverse clinical symptoms, which yet lacks sufficient evidence in large populations. In this study, we investigated the prevalence and distribution of α-globin gene triplication as well as the phenotypic characteristics of α-globin gene triplication coinherited with heterozygous β-thalassemia in Ganzhou city, southern China. During 2021-2022, a total of 73,967 random individuals who received routine health examinations before marriage were genotyped for globin gene mutations by high-throughput sequencing. Among them, 1,443 were α-globin gene triplication carriers, with a carrier rate of 1.95%. The most prevalent mutation was αααanti3.7/αα (43.10%), followed by αααanti4.2/αα (38.12%). 42 individuals had coinherited α-globin gene triplication and heterozygous β-thalassemia. However, they did not differ from the individuals with heterozygous β-thalassemia and normal α-globin (αα/αα) in terms of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) levels. In addition, heterogenous clinical phenotypes were found in two individuals with the same genotype. Our study established a database of Ganzhou α-globin gene triplication and provided practical advice for the clinical diagnosis of α-globin gene triplication.
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Affiliation(s)
- Xinxing Xie
- Ganzhou Maternal and Child Health Hospital, Ganzhou, Jiangxi, China
| | - Jinhui Gan
- Ganzhou Maternal and Child Health Hospital, Ganzhou, Jiangxi, China
| | - Zezhang Liu
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Wuhan, China
| | - Yulian Zhou
- Dayu Maternal and Child Health Hospital, Ganzhou, Jiangxi, China
| | - Kun Yuan
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Wuhan, China
| | - Zhigang Chen
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Wuhan, China
| | | | - Rui Zhou
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Wuhan, China
| | - Lipei Liu
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Tianjin, China
| | | | - Yan Zhang
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Wuhan, China
| | - Qian Liu
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Wuhan, China
| | - Wenqian Zhang
- BGI Genomics, Shenzhen, China
- Clin Lab, BGI Genomics, Wuhan, China
| | - Jungao Huang
- Ganzhou Maternal and Child Health Hospital, Ganzhou, Jiangxi, China
| | - Junkun Chen
- Ganzhou Maternal and Child Health Hospital, Ganzhou, Jiangxi, China
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Chen M, Wang X, Wang H, Zhang M, Chen L, Chen H, Pan Y, Zhang Y, Xu L, Huang H. The clinical value of hsa-miR-190b-5p in peripheral blood of pediatric β-thalassemia and its regulation on BCL11A expression. PLoS One 2023; 18:e0292031. [PMID: 37796993 PMCID: PMC10553837 DOI: 10.1371/journal.pone.0292031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The B cell CLL/lymphoma 11A (BCL11A) is a key regulator of hemoglobin switching in β-thalassemia (β-thal). Previous study has suggested that dysregulated microRNAs are involved in the regulation of BCL11A expression. The aim of this study was to investigate the clinical value of hsa-miR-190b-5p in β-thal, and to confirm the regulatory effect of hsa-miR-190b-5p on BCL11A expression. METHODS The peripheral blood of 25 pediatric β-thal patients and 25 healthy controls were selected, and qRT-PCR was used to analyze the levels of hsa-miR-190b-5p and BCL11A mRNA. The relationship between hsa-miR-190b-5p expression and hematological parameters was assessed by Pearson's correlation test. The diagnostic power of hsa-miR-190b-5p was evaluated by ROC curves analysis. The direct integration between hsa-miR-190b-5p and BCL11A 3'-UTR was confirmed by luciferase reporter assay. RESULTS Hsa-miR-190b-5p expression in pediatric β-thal was upregulated, and negatively correlated with the MCH and HbA levels, but positively correlated with the HbF level. Hsa-miR-190b-5p showed a good diagnostic capability for pediatric β-thal equivalent to that of HbA2 (AUC: 0.760 vs. 0.758). Moreover, the levels of BCL11A mRNA in pediatric β-thal were decreased, and hsa-miR-190b-5p had a negative correlation with BCL11A mRNA expression (r = -0.403). BCL11A was a target gene of hsa-miR-190b-5p. The mRNA and protein levels of BCL11A were diminished by introduction of hsa-miR-190b-5p, whereas its expression was upregulated by knockdown of hsa-miR-190b-5p. CONCLUSIONS Hsa-miR-190b-5p expression was upregulated in pediatric β-thal and might be an effective diagnostic biomarker. BCL11A was negatively regulated by hsa-miR-190b-5p, which might provide new target for the treatment of pediatric β-thal.
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Affiliation(s)
- Meihuan Chen
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Xinrui Wang
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
- Medical Research Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Haiwei Wang
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Min Zhang
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Lingji Chen
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Hong Chen
- School of Pharmacy, Fujian Medical University, Fuzhou, Fujian, China
| | - Yali Pan
- Medical Technology and Engineering College of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Yanhong Zhang
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Liangpu Xu
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
| | - Hailong Huang
- Medical Genetic Diagnosis and Therapy Center of Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Provincial Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, Fujian Province, China
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Chen SC, Zhou XY, Li SY, Zhao MM, Huang HF, Jia J, Xu CM. Carrier burden of over 300 diseases in Han Chinese identified by expanded carrier testing of 300 couples using assisted reproductive technology. J Assist Reprod Genet 2023; 40:2157-2173. [PMID: 37450097 PMCID: PMC10440320 DOI: 10.1007/s10815-023-02876-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Expanded carrier screening (ECS) has become a common practice for identifying carriers of monogenic diseases. However, existing large gene panels are not well-tailored to Chinese populations. In this study, ECS testing for pathogenic variants of both single-nucleotide variants (SNVs) and copy number variants (CNVs) in 330 genes implicated in 342 autosomal recessive (AR) or X-linked diseases was carried out. We assessed the differences in allele frequencies specific to the Chinese population who have used assisted reproductive technology (ART) and the important genes to screen for in this population. METHODOLOGY A total of 300 heterosexual couples were screened by our ECS panel using next-generation sequencing. A customed bioinformatic algorithm was used to analyze SNVs and CNVs. Guidelines from the American College of Medical Genetics and Genomics and the Association for Molecular Pathology were adapted for variant interpretation. Pathogenic or likely pathogenic (P/LP) SNVs located in high homology regions/deletions and duplications of one or more exons in length were independently verified with other methods. RESULTS 64.83% of the patients were identified to be carriers of at least one of 342 hereditary conditions. We identified 622 P/LP variants, 4.18% of which were flagged as CNVs. The rate of at-risk couples was 3%. A total of 149 AR diseases accounted for 64.05% of the cumulative carrier rate, and 48 diseases had a carrier rate above 1/200 in the test. CONCLUSION An expanded screening of inherited diseases by incorporating different variant types, especially CNVs, has the potential to reduce the occurrence of severe monogenic diseases in the offspring of patients using ART in China.
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Affiliation(s)
- Song-Chang Chen
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, 566 Fangxie Road, Huangpu District, Shanghai, 200001, China
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Xuan-You Zhou
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, 566 Fangxie Road, Huangpu District, Shanghai, 200001, China
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Shu-Yuan Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Ming-Min Zhao
- Fujungenetics Biotechnology Co., Ltd., No. 70 of Tongchuan Road, Putuo District, Shanghai, 200333, China
| | - He-Feng Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, 566 Fangxie Road, Huangpu District, Shanghai, 200001, China
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
| | - Jia Jia
- Fujungenetics Biotechnology Co., Ltd., No. 70 of Tongchuan Road, Putuo District, Shanghai, 200333, China.
| | - Chen-Ming Xu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, 566 Fangxie Road, Huangpu District, Shanghai, 200001, China.
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China.
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Zhen X, Ming J, Zhang R, Zhang S, Xie J, Liu B, Wang Z, Sun X, Shi L. Economic burden of adult patients with β-thalassaemia major in mainland China. Orphanet J Rare Dis 2023; 18:252. [PMID: 37644448 PMCID: PMC10466866 DOI: 10.1186/s13023-023-02858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 08/20/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND β-thalassaemia major poses a substantial economic burden, especially in adults. We aimed to estimate the economic burden of adult patients with β-thalassaemia major from a societal perspective using the real-world data. According to the clinical guideline, we also estimated the annual medical costs for patients with the same body weight and calculated the lifetime medical costs over 50 years in mainland China. METHODS This was a retrospective cross-sectional study. An online survey with snowball sampling covering seven provinces was conducted. We extracted patient demographics, caregiver demographics, disease and therapy information, caring burden, and costs for adult patients diagnosed with β-thalassaemia major and their primary caregivers. In the real world, we estimated the annual direct medical cost, direct nonmedical cost, and indirect cost. In addition, we calculated the annual direct medical cost and lifetime direct medical cost by weight with discounted and undiscounted rates according to the clinical guideline. RESULTS Direct medical costs was the main driver of total cost, with blood transfusion and iron chelation therapy as the most expensive components of direct medical cost. In addition, adult patients with β-thalassaemia major weighing 56 kg were associated with an increase of $2,764 in the annual direct medical cost using the real-world data. The undiscounted and discounted (5% discount rate) total lifetime treatment costs were $518,871 and $163,441, respectively. CONCLUSIONS Patients with β-thalassaemia major often encounter a substantial economic burden in mainland China. Efforts must be made to help policymakers develop effective strategies to reduce the burden and pevalence of thalassaemia.
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Affiliation(s)
- Xuemei Zhen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University), No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Jing Ming
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University), No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Runqi Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University), No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Shuo Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University), No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Jing Xie
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University), No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Baoguo Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University), No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China
| | - Zijing Wang
- Beijing New Sunshine Charity Foundation, No.25 Landianchangnan Road, Beijing, 100097, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University), No.44 Wenhuaxi Road, Jinan, 250012, Shandong, China.
| | - Lizheng Shi
- Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
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Yang T, Luo X, Liu Y, Lin M, Zhao Q, Zhang W, Chen Z, Dong M, Wang J, Wang Q, Zhang X, Zhong T. Next-generation sequencing analysis of the molecular spectrum of thalassemia in Southern Jiangxi, China. Hum Genomics 2023; 17:77. [PMID: 37592328 PMCID: PMC10436446 DOI: 10.1186/s40246-023-00520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/26/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Thalassemia is an extremely prevalent monogenic inherited blood disorder in southern China. It is important to comprehensively understand the molecular spectrum of thalassemia in an area with such a high prevalence of thalassemia before taking appropriate actions for the prevention and treatment of this disorder. Herein, we explored the clinical feasibility of using next-generation sequencing (NGS) for large-scale population screening to illustrate the prevalence and spectrum of thalassemia in Southern Jiangxi. METHODS Blood samples collected from 136,312 residents of reproductive age in Southern Jiangxi were characterized for thalassemia by NGS. A retrospective analysis was then conducted on blood samples determined to be positive for thalassemia. RESULTS In total, 19,827 (14.545%) subjects were diagnosed as thalassemia carriers, and the thalassemia prevalence rate significantly varied by geographical region (p < 0.001). A total of 40 α-thalassemia genotypes including 21 rare genotypes were identified, with -@-SEA/αα being the most prevalent genotype. 42 β-thalassemia genotypes including 27 rare genotypes were identified, with the most common mutation IVS II-654 C > T accounting for 35.257% of these β-thalassemia genotypes. Furthermore, 74 genotypes were identified among 608 individuals with combined α- and β-thalassemia. Notably, most individuals with rare thalassemia mutations had mildly abnormal hematologic parameters including microcytic hypochromia. CONCLUSIONS Our findings demonstrate the great heterogeneity and diverse spectrum of thalassemia in Southern Jiangxi, emphasizing the importance and necessity of persistent prevention and control of thalassemia in this region. Additionally, our findings further suggest that NGS can effectively identify rare mutations and reduce the misdiagnosis rate of thalassemia.
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Affiliation(s)
- Tong Yang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Xuemei Luo
- Ganzhou Municipal Health Commission, Ganzhou, China
| | - Yanqiu Liu
- Department of Medical Genetics, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Min Lin
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, China
| | - Qinfei Zhao
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Wenqian Zhang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
- BGI-Wuhan Clinical Laboratories, BGI-Shenzhen, Wuhan, China
| | - Zhigang Chen
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
- BGI-Wuhan Clinical Laboratories, BGI-Shenzhen, Wuhan, China
| | - Minghua Dong
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Junli Wang
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Qi Wang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China
| | - Xiaokang Zhang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China.
| | - Tianyu Zhong
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, China.
- Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, Jiangxi, China.
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Jiang F, Zhou J, Zuo L, Tang X, Li J, Li F, Yang T, Qu Y, Wan J, Liao C, Li D. Utilization of multiple genetic methods for prenatal diagnosis of rare thalassemia variants. Front Genet 2023; 14:1208102. [PMID: 37529778 PMCID: PMC10387553 DOI: 10.3389/fgene.2023.1208102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Background: Thalassemia is the most prevalent monogenic disorder caused by an imbalance between the α- and β-globin chains as a result of pathogenic variants in the α- or β-globin genes. Novel or complex structural changes in globin genes are major hurdles for genetic consulting and prenatal diagnosis. Methods: From 2020 to 2022, genetic analysis was performed on 1,316 families suspected of having children with thalassemia major, including 42 pregnant couples suspected of being thalassemia carriers with rare variants. Multiple techniques including multiplex ligation-dependent probe amplification (MLPA), Sanger sequencing, targeted next-generation sequencing, and single-molecule real-time (SMRT) sequencing were used to diagnose rare thalassemia. Results: The rate of prenatal diagnosis for rare thalassemia variants was 3.19% (42/1,316). The most prevalent alleles of α- and β-thalassemia are Chinese Gγ(Aγδβ)0and -- THAI deletion. In addition, ten rare complex genotypes include one Chinese Gγ(Aγδβ)0 deletion combined with HBG1-HBG2 fusion, two rare deletions at HBB gene (hg38, Chr11: 5224211-5232470, hg38, Chr11: 5224303-5227790), one complete 7,412 bp fusion gene for anti-Lepore Hong Kong, two complex rearrangements of the α-globin gene cluster, two novel duplications, and two rare large deletions in the α-globin gene cluster. Conclusion: Accurate gene diagnosis for probands with combined molecular biology techniques is the key to prenatal diagnosis of rare thalassemia.
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Affiliation(s)
- Fan Jiang
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jianying Zhou
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Liandong Zuo
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xuewei Tang
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jian Li
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Fatao Li
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Tianhe Yang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yanxia Qu
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Junhui Wan
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Can Liao
- *Correspondence: Can Liao, ; Dongzhi Li,
| | - Dongzhi Li
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center Affiliated with Guangzhou Medical University, Guangzhou, Guangdong, China
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Wang WD, Hu F, Zhou DH, Gale RP, Lai YR, Yao HX, Li C, Wu BY, Chen Z, Fang JP, Chen SJ, Liang Y. Thalassaemia in China. Blood Rev 2023; 60:101074. [PMID: 36963988 DOI: 10.1016/j.blre.2023.101074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/15/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023]
Abstract
Because of successful thalassaemia prevention programmes in resource-rich countries and it's huge population China now has the greatest number of new cases of thalassaemia globally as well as more people with thalassaemia than any other country. 30 million Chinese have thalassaemia-associated mutations and about 300,000 have thalassaemia major or intermedia requiring medical intervention. Over the past 2 decades there has been tremendous economic growth in China including per capita spending on health care. There is now nation-wide availability and partial or full insurance for prenatal genetic testing, RBC-transfusions, iron-chelating drugs and haematopoietic cell transplants. Prenatal screening and educational programmes have reduced the incidence of new cases. However, substantial challenges remain. For example, regional differences in access to medical care and unequal economic development require innovations to reduce the medical, financial and psychological burdens of Chinese with thalassaemia and their families. In this review we discuss success in preventing and treating thalassaemia in China highlighting remaining challenges. Our discussion has important implications for resource-poor geospaces challenged with preventing and treating thalassaemia.
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Affiliation(s)
- Wei-da Wang
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Fang Hu
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Dun-Hua Zhou
- Children's Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Robert Peter Gale
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; Department of Immunology and Inflammation, Haematology Research Centre, Imperial College London, London, UK
| | - Yong-Rong Lai
- Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Hong-Xia Yao
- Department of Hematology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China
| | - Chunfu Li
- Nanfang-Chunfu Children's Institute of Hematology and Oncology, Taixin Hospital, Dongguan, China
| | - Bing-Yi Wu
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Zhu Chen
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jian-Pei Fang
- Children's Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
| | - Sai-Juan Chen
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Yang Liang
- Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
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Han Z, Nie H, Huang Z, Tuo Z, Chen S, Ma Y, Shi X. Differences in medical costs between TCM users and TCM nonusers in inpatients with thalassemia. BMC Health Serv Res 2023; 23:635. [PMID: 37316816 DOI: 10.1186/s12913-023-09651-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Thalassemia has brought serious health threats and economic burdens to patients worldwide. There is no sovereign remedy for thalassemia, both conventional and Traditional Medicine (TM) methods have certain effects on this disease. As typical of TM, Traditional Chinese Medicine (TCM) has been widely used in the treatment of thalassemia. Previous studies mainly focused on conventional treatments for thalassemia and patients' medical burden, but no research has examined the effects of TCM use on the economic burdens for thalassemia inpatients in mainland China. The main objective of this study is to compare the medical cost differences between TCM users and TCM nonusers, furtherly, we will discuss the role of TCM use in the treatment of thalassemia. METHODS We employed the 2010-2016 Medicare claims database provided by the China Health Insurance Research Association (CHIRA). Chi-square and Mann-Whitney tests were used to analyze the differences between TCM users and TCM nonusers. Multiple regression analysis was performed using the ordinary least squares method to compare the TCM users' inpatient medical cost with TCM nonusers', and to further examine the correlation between TCM cost, conventional medication cost and nonpharmacy cost for TCM users. RESULTS A total of 588 urban thalassemia inpatients were identified, including 222 TCM users and 366 TCM nonusers. The inpatient medical cost of TCM users was RMB10,048 (USD1,513), which was significantly higher than TCM nonusers (RMB1,816 (USD273)). Total inpatient cost for TCM users was 67.4% higher than those of TCM nonusers (P < 0.001). With confounding factors fixed, we found that the conventional medication cost and nonpharmacy cost were positively correlated with TCM cost. CONCLUSION Total hospitalization expenses for TCM users were higher than TCM nonusers. Both the conventional medication cost and nonpharmacy cost of TCM users were all higher than TCM nonusers. We infer TCM plays a complementary role, rather than an alternative, in the treatment of thalassemia due to the lack of cooperative treatment guidelines. It is recommended that a cooperative diagnosis and treatment guidelines should be generated to balance the use of TCM and conventional medicine for treating thalassemia, so as to reduce the economic burdens on patients.
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Affiliation(s)
- Zhaoran Han
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Hanlin Nie
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Zhengwei Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Zegui Tuo
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Sisi Chen
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Yong Ma
- China Health Insurance Research Association, Beijing, China
| | - Xuefeng Shi
- School of Management, Beijing University of Chinese Medicine, Beijing, China.
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Zhang F, Yang J, Wang Y, Cai M, Ouyang J, Li J. TT@MHA: A Machine Learning-based Webpage Tool for Discriminating Thalassemia Trait from Microcytic Hypochromic Anemia Patients. Clin Chim Acta 2023; 545:117368. [PMID: 37127232 DOI: 10.1016/j.cca.2023.117368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/27/2023] [Accepted: 04/23/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Iron deficiency anemia (IDA) and thalassemia trait (TT) are the most common causes of microcytic hypochromic anemia (MHA) and are endemic in lower resource settings and rural areas with poor medical infrastructure. Accurate discrimination between IDA and TT is an essential issue for MHA patients. Although various discriminant formulas have been reported, distinguishing between IDA and TT is still a challenging problem due to the diversity of anemic populations. METHODS We retrospectively collected laboratory data from 798 MHA patients. High proportions of α-TT (43.33%) and TT concomitant with IDA (TT&IDA) patients (14.04%) were found among TT patients. Five machine learning (ML) approaches, including Liner SVC (L-SVC), support vector machine learning (SVM), Extreme gradient boosting (XGB), Logistic Regression (LR), and Random Forest (RF), were applied to develop a discriminant model. Performance was assessed and compared with six existing discriminant formulas. RESULTS The RF model was chosen as the discriminant algorithm, namely TT@MHA. TT@MHA was tested in an interlaboratory cohort with a sensitivity, specificity, accuracy, and AUC of 91.91%, 91.00%, 91.53%, and 0.942, respectively. A webpage tool of TT@MHA (https://dxonline.deepwise.com/prediction/index.html?baseUrl=%2Fapi%2F&id=26408&topicName=undefined&from=share&platformType=wisdom) was developed to facilitate the healthcare providers in rural areas. CONCLUSION The ML-based TT@MHA algorithm, with high sensitivity and specificity, could help discriminate TT patients from MHA patients, especially in populations with high proportions of α-TT patients and TT&IDA patients. Moreover, a user-friendly webpage tool for TT@MHA could facilitate healthcare providers in rural areas where advanced technologies are not accessible.
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Affiliation(s)
- Fan Zhang
- Department of Medical Laboratory, First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Er Road, Guangzhou, Guangdong Province, 510080, China
| | - Jing Yang
- Department of Medical Laboratory, Second Affiliated Hospital of Guangzhou Medical University, 250 Changgang Zhong Road, 510260, China
| | - Yang Wang
- Department of Medical Laboratory, First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Er Road, Guangzhou, Guangdong Province, 510080, China
| | - Manyi Cai
- BGI Genomics Co.,Ltd, National Gene Bank of Guanyinshan Park, Jinsha Road, Dapeng Street, Dapeng New District, Shenzhen, Guangdong Province, 518120, China
| | - Juan Ouyang
- Department of Medical Laboratory, First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Er Road, Guangzhou, Guangdong Province, 510080, China.
| | - JunXun Li
- Department of Medical Laboratory, First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Er Road, Guangzhou, Guangdong Province, 510080, China.
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Bu M, Deng X, Zhang Y, Chen SW, Jiang M, Chen BT. Brain iron content and cognitive function in patients with β-thalassemia. Ther Adv Hematol 2023; 14:20406207231167050. [PMID: 37151807 PMCID: PMC10155013 DOI: 10.1177/20406207231167050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 03/15/2023] [Indexed: 05/09/2023] Open
Abstract
Patients with β-thalassemia (β-TM) may have brain iron overload from long-term blood transfusions, ineffective erythropoiesis, and increased intestinal iron absorption, leading to cognitive impairment. Brain magnetic resonance imaging (MRI) methods such as the transverse relaxation rate, susceptibility-weighted imaging, and quantitative susceptibility mapping can provide quantitative, in vivo measurements of brain iron. This review assessed these MRI methods for brain iron quantification and the measurements for cognitive function in patients with β-TM. We aimed to identify the neural correlates of cognitive impairment, which should help to evaluate therapies for improving cognition and quality of life in patients with β-TM.
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Affiliation(s)
- Meiru Bu
- Department of Radiology, First Affiliated
Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Xi Deng
- Department of Radiology, First Affiliated
Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Yu Zhang
- Department of Radiology, First Affiliated
Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Sean W. Chen
- Department of Medical Oncology &
Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte,
CA, USA
| | - Muliang Jiang
- Department of Radiology, First Affiliated
Hospital of Guangxi Medical University, Nanning 530021, P. R. China
| | - Bihong T. Chen
- Department of Diagnostic Radiology, City of
Hope National Medical Center, Duarte, CA, USA
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Mo D, Zheng Q, Xiao B, Li L. Predicting thalassemia using deep neural network based on red blood cell indices. Clin Chim Acta 2023; 543:117329. [PMID: 37019327 DOI: 10.1016/j.cca.2023.117329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/11/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND AND OBJECTIVE The traditional statistical screening method for thalassemia based on red blood cell (RBC) indices is being replaced by machine learning. Here, we developed deep neural networks (DNNs) that outperformed the traditional method for predicting thalassemia. METHOD Using a dataset of 8693 records comprising genetic tests and other 11 features we constructed 11 DNN models and 4 traditional statistical models and then compared their performances and analysed feature importance for interpreting DNN models. RESULTS The area under the receiver operating characteristic curve, accuracy, Youden's index, F1 score, sensitivity, specificity, positive predictive value and negative predictive value, were 0.960, 0.897, 0.794, 0.897, 0.883, 0.911, 0.914, and 0.882, respectively, for our best model, and compared with the traditional statistical model based on the mean corpuscular volume, these values were increased by 10.22%, 10.09%, 26.55%, 8.92%, 4.13%, 16.90%, 13.86% and 6.07%, respectively, and by 15.38%, 11.70%, 31.70%, 9.89%, 3.05%, 22.13%, 17.11% and 5.94%, respectively, for the mean cellular haemoglobin model. The DNN model performance will reduce without age, RBC distribution width (RDW), sex, or both WBC and PLT. CONCLUSIONS Our DNN model outperformed the current screening model. In 8 features, RDW and age were the most useful, followed by sex and the combination of WBC and PLT, the remaining nearly useless.
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Affiliation(s)
- Donghua Mo
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Clinical Laboratory Medicine Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qian Zheng
- Department of Cardiovascular, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bin Xiao
- Department of Laboratory Medicine, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, 511518 Qingyuan, China.
| | - Linhai Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Department of Laboratory Medicine, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, 511518 Qingyuan, China.
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Li Z, Huang Z, Liu Y, Cao Y, Li Y, Fang Y, Huang M, Liu Z, Lin L, Jiang L. Genotypic and phenotypic characterization of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Guangzhou, China. Hum Genomics 2023; 17:26. [PMID: 36949502 PMCID: PMC10035184 DOI: 10.1186/s40246-023-00473-9] [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: 11/23/2022] [Accepted: 03/15/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND G6PD deficiency is a common inherited disorder worldwide and has a higher incidence rate in southern China. Many variants of G6PD result from point mutations in the G6PD gene, leading to decreased enzyme activity. This study aimed to analyse the genotypic and phenotypic characteristics of G6PD deficiency in Guangzhou, China. METHODS In this study, a total of 20,208 unrelated participants were screened from 2020 to 2022. G6PD deficiency was further analysed by quantitative enzymatic assay and G6PD mutation analysis. The unidentified genotype of the participants was further ascertained by direct DNA sequencing. RESULTS A total of 12 G6PD mutations were identified. Canton (c.1376G>T) and Kaiping (c.1388G>A) were the most common variants, and different mutations led to varying levels of G6PD enzyme activity. Comparing the enzyme activities of the 6 missense mutations between the sexes, we found significant differences (P < 0.05) in the enzyme activities of both male hemizygotes and female heterozygotes. Two previously unreported mutations (c.1438A>T and c.946G>A) were identified. CONCLUSIONS This study provided detailed genotypes of G6PD deficiency in Guangzhou, which could be valuable for diagnosing and researching G6PD deficiency in this area.
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Affiliation(s)
- Ziyan Li
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhenyi Huang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanxia Liu
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yunshan Cao
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yating Li
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanping Fang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Meiying Huang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zixi Liu
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lijuan Lin
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Lingxiao Jiang
- Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Wang X, Huang H, Zhao Y, Zhou Y, Zhang Q, Wang G. Molecular spectrum of α- and β-thalassemia among individuals of reproductive age in the Zhuhai region of southern China. Int J Lab Hematol 2023. [PMID: 36918023 DOI: 10.1111/ijlh.14059] [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: 12/06/2022] [Accepted: 03/04/2023] [Indexed: 03/15/2023]
Abstract
INTRODUCTION Thalassemia is the most common monogenic disease in South and Southeast Asia. An accurate assessment of the relative frequency and composition of thalassemia mutations is important for the design of appropriate strategies to prevent the disease. In this study, we aimed to decode the molecular characterization of thalassemia mutations in Zhuhai region of southern China. METHODS A total of 8048 individuals who were potential thalassemia carriers were enrolled. Gap-polymerase chain reaction (Gap-PCR) and reverse dot-blot (RDB) hybridization methods were employed to detect common deletional and non-deletional thalassemia mutations. Multiplex ligation dependent probe amplification (MLPA) and Sanger sequencing were used to analyze and verify rare and complex mutations. RESULTS We diagnosed 3433 individuals as thalassemia carriers or patients. Of these, 2395 (69.76%) individuals with α-thalassemia harbored 13 α-globin gene mutations. The three most common α-thalassemia mutations were --SEA (60.08%), -α3.7 (20.62%) and -α4.2 (9.25%). We diagnosed 903 (26.30%) individuals with β-thalassemia and identified 20 β-globin gene mutations, of which the three most frequent were CD41/42 (-TCTT) (38.10%), IVS-II-654 (C>T) (23.69%) and TATAbox-28 (A>G) (15.18%). In addition, we identified 15 rare thalassemia variants. We also summarized the association between the thalassemia genotype and hematological parameters, which demonstrated the broad phenotypic heterogeneity caused by globin gene mutations. CONCLUSION This is the first survey of thalassemia molecular epidemiology and hematological phenotype in Zhuhai region. It uncovered a high prevalence and complex molecular spectrum of thalassemia. These findings can be used as a basis for thalassemia diagnosis, counseling and prevention management.
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Affiliation(s)
- Xingmin Wang
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Haoyang Huang
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yanling Zhao
- Zhuhai Institute of Medical Genetics, Zhuhai Women and Children's Hospital, Zhuhai, China
| | - Yuqiu Zhou
- Zhuhai Institute of Medical Genetics, Zhuhai Women and Children's Hospital, Zhuhai, China
| | - Qianqian Zhang
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Dongguan Maternal and Child Health Care Hospital, Postdoctoral Innovation Practice Base of Southern Medical University, Dongguan, China
| | - Ge Wang
- Zhuhai Institute of Medical Genetics, Zhuhai Women and Children's Hospital, Zhuhai, China
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Liang HF, Liang WM, Xie WG, Lin F, Liu LL, Li LJ, Ge YY, Lu M, Liao YW, Zeng GK, Yao JX, Situ JW, Yang LY. The gene spectrum of thalassemia in Yangjiang of western Guangdong Province. Front Genet 2023; 14:1126099. [PMID: 36861132 PMCID: PMC9968962 DOI: 10.3389/fgene.2023.1126099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
Background: Thalassemia presents a higher incidence in southern China. The objective of this study is to analyze the genotype distribution of thalassemia in Yangjiang, a western city of Guangdong Province in China. Methods: The genotypes of suspected cases with thalassemia were tested by PCR and reverse dot blot (RDB). Unidentified rare thalassemia genotypes of the samples were further ascertained by PCR and direct DNA sequencing. Results: Among 22467 suspected cases with thalassemia, 7658 cases were found with thalassemia genotypes using our PCR-RDB kit. Among these 7658 cases, 5313 cases were found with α-thalassemia (α-thal) alone, --SEA/αα was the most common genotype, accounting for 61.75% of α-thal genotypes, and the following mutations were found: α3.7/αα, -α4.2/αα, αCSα/αα, αWSα/αα, and αQSα/αα. A total of 2032 cases were found with β-thalassemia (β-thal) alone. βCD41-42/βN, βIVS-II-654/βN, and β-28/βN accounted for 80.9% of all β-thal genotypes, and the following genotypes were found: βCD17/βN, βCD71-72/βN, and βE/βN. Compound heterozygotes of β-thal and β-thalassemia homozygotes were identified in 11 and five cases, respectively, in this study. α-thal combined with β-thal was identified in 313 cases, showing 57 genotype combinations of the coincidence of both Hb disorders; one extreme patient had a genotype of --SEA/αWSα and βCD41-42/β-28. In addition, four rare α-mutations (--THAI, HKαα, Hb Q-Thailand, and CD31 AGG>AAG) and six rare β-mutations (CD39 CAG>TAG, IVS-Ⅱ-2 (-T), -90(C>T), Chinese Gγ+(Aγδβ)0, CD104 (-G), and CD19 A>G) were also found in this study population. Conclusion: This study provided detailed genotypes of thalassemia in Yangjiang of western Guangdong Province in China and reflected the complexity of genotypes in this high-prevalence region, and this would be valuable for diagnosis and counseling for thalassemia in this area.
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Affiliation(s)
- Hong-Feng Liang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Wei-Min Liang
- Medical Laboratory, Women and Children Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Wen-Guang Xie
- Medical Laboratory, Women and Children Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Fen Lin
- Precision Medical Lab Center, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, Guangdong, China
| | - Li-Li Liu
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Lie-Jun Li
- Guangdong Hybribio Limited Corporation, Chaozhou, Guangdong, China
| | - Yi-Yuan Ge
- Guangdong Hybribio Limited Corporation, Chaozhou, Guangdong, China
| | - Min Lu
- Guangdong Hybribio Limited Corporation, Chaozhou, Guangdong, China
| | - Yu-Wei Liao
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Guang-Kuan Zeng
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Jin-Xiu Yao
- Laboratory Medical Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Jing-Wei Situ
- Laboratory Medical Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Li-Ye Yang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China,*Correspondence: Li-Ye Yang,
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Zhang R, Zhang S, Ming J, Xie J, Liu B, Chen C, Sun X, Zhen X. Predictors of health state utility values using SF-6D for Chinese adult patients with β-thalassemia major. Front Public Health 2023; 10:1072866. [PMID: 36743186 PMCID: PMC9892772 DOI: 10.3389/fpubh.2022.1072866] [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: 10/18/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
Background Patients with β-thalassemia major (β-TM), predominantly adult patients, are associated with physical, mental, and social problems, that result in decreased quality of life (QoL). However, there is a paucity of data on QoL and health status utility (HSU) among adult patients with β-TM in mainland China. Our study aimed to evaluate the QoL by short form 36 questionnaire (SF-36) of adult patients with β-TM in mainland China and to estimate their HSU by SF-6D. In addition, we aimed to identify predictors of HSU. Methods In this cross-sectional descriptive study, a total of 75 adult patients with β-TM were included by the snowball sampling method that applied involving seven provinces with a relatively high prevalence of thalassemia across mainland China between September 1, 2021 and January 31, 2022. The collected information included social-demographic characteristics, health conditions, treatment, social support (social support rating scale), caregiver burden (Zarit burden interview), and QoL (SF-36). HSU scores were calculated for each adult patient from their SF-36 responses using the SF-6D algorithm with Hong Kong's tariff. The frequency of participants' responses to the SF-6D for each item of the options was described. Mean HSU scores between different subgroups were calculated. Ordinary least squares (OLS) regression modeling was performed to identify factors associated with HSU. Results A total of 75 adult patients with β-TM were included in this study. The mean SF-36 score was 50.2 ± 10.70, of which physical and mental scores were 47.57 ± 11.28 and 52.85 ± 14.21, respectively. In addition, the mean SF-6D utility score was estimated to be 0.598 ± 0.112, ranging from 0.391 to 0.962. Univariate analyses showed that interruption of iron chelation treatment significantly affected HSU values (P = 0.038); diagnosis with comorbidity very slightly affected HSU values (P = 0.0996). In the multivariate analysis, diagnosis with comorbidity (P = 0.042) was significantly negatively associated with HSU values; the minimum pre-transfusion hemoglobin concentration (P = 0.047) and social support (P = 0.068) were positively associated with HSU values. Conclusion This study presents poor QoL and HSU outcomes in Chinese adult patients with β-TM. The study also highlights the importance of social support and treatment compliance, which can increase hemoglobin content and reduce comorbidities, further to ensure the QoL of patients. These findings can be used for future clinical and economic studies.
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Affiliation(s)
- Runqi Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Shuo Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Jing Ming
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Jing Xie
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Baoguo Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Cuiqian Chen
- Beijing New Sunshine Charity Foundation, Beijing, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China,*Correspondence: Xiaojie Sun ✉
| | - Xuemei Zhen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China,Xuemei Zhen ✉
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Zhuang J, Luo Q, Zeng S, Chen Y, Lin S, Wang Y, Jiang Y. A First Clinical and Molecular Study of Rare IVS-II-806 (G > C) (HBB:c.316-45G > C) Variant in the β-globin Gene: A Possibly Benign Variant. Indian J Hematol Blood Transfus 2023; 39:102-106. [PMID: 36699435 PMCID: PMC9868022 DOI: 10.1007/s12288-022-01555-9] [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: 12/11/2021] [Accepted: 07/04/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction β-thalassemia is a common genetic disease affecting a single gene, disease with a high incidence in South China. We hereby, aim to provide the clinical and hematological features of a rare β-globin gene variant in the Chinese population. Methods Ten subjects from three unrelated Chinese families were enrolled in this study. Hematological analysis and thalassemia gene testing were preformed to screen for common α and β-thalassemia variants. Gap-polymerase chain reaction (Gap-PCR) and DNA sequencing were utilized to examine the rare or novel thalassemia variants. Results Six cases were identified carrying the rare IVS-II-806 (G > C) (HBB:c.316-45G > C) variant in the β-globin gene. The proband in family 1 carry three rare β-globin gene mutations including CD39 (C > T), IVS-II-81 (C > T) and IVS-II-806 (G > C) combined with a --SEA/αα deletion, exhibiting the β-thalassemia trait. Further pedigree investigation indicated that the genotype of the proband in family 1 was --SEA/αα, βCD39 (C>T), IVS-II-81(C>T)/βIVS-II-806(G>C). Meanwhile, the twin girls in family 1 carrying the IVS-II-806 (G > C) mutation demonstrated a normal hematological phenotype. In family 2, the proband and his sister carry the IVS-II-806 (G > C) mutation, eliciting high levels of Hb A2 and slightly low levels of MCV and MCH. Moreover, the proband in family 3 carrying the same mutation exhibited a slightly low MCV level as well. Conclusions In this study, clinical and hematological analysis of the IVS-II-806 (G > C) mutation was first conducted within the Chinese population, with results indicating that it may be a benign variant.
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Affiliation(s)
- Jianlong Zhuang
- Prenatal Diagnosis Center, Quanzhou Women’s and Children’s Hospital, Quanzhou, 362000 Fujian Province China
| | - Qi Luo
- Department of public health for women and children, Quanzhou Women’s and Children’s Hospital, Quanzhou, 362000 Fujian Province China
| | - Shuhong Zeng
- Prenatal Diagnosis Center, Quanzhou Women’s and Children’s Hospital, Quanzhou, 362000 Fujian Province China
| | - Yu’e Chen
- Ultrasonography, Quanzhou Women’s and Children’s Hospital, Quanzhou, 362000 Fujian Province China
| | - Shuxia Lin
- Department of women healthcare, Huian Maternal and Child Health Hospital, Quanzhou, 362000 Fujian Province China
| | - Yuanbai Wang
- Prenatal Diagnosis Center, Quanzhou Women’s and Children’s Hospital, Quanzhou, 362000 Fujian Province China
| | - Yuying Jiang
- Prenatal Diagnosis Center, Quanzhou Women’s and Children’s Hospital, Quanzhou, 362000 Fujian Province China
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Lai Y, Tao F, Zou Y, Huang M, Lin K, Li Y, Huang W, Zhou W. Molecular spectrum of thalassemia in tropical Hainan Island of southern China: high allele frequency with low health burden. J Genet Genomics 2022; 49:1162-1164. [PMID: 35398270 DOI: 10.1016/j.jgg.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 01/14/2023]
Affiliation(s)
- Yanquan Lai
- Department of Eugenics, Hainan Provincial Public Service Center of Prenatal and Postnatal Care, Haikou, Hainan 570203, China
| | - Fangchao Tao
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Yu Zou
- Department of Clinical Laboratory, Hainan Provincial Public Service Center of Prenatal and Postnatal Care, Haikou, Hainan 570203, China
| | - Min Huang
- Department of Clinical Laboratory, Hainan Provincial Public Service Center of Prenatal and Postnatal Care, Haikou, Hainan 570203, China
| | - Kaiting Lin
- Danzhou Family Planning Service Center, Danzhou, Hainan 571799, China
| | - Yang Li
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Weilun Huang
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Wanjun Zhou
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China.
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Amarasinghe GS, Agampodi TC, Mendis V, Agampodi SB. The geo-spatial perspective of biological, social and environmental determinants of early pregnancy anaemia in rural Sri Lanka: Need for context-specific approaches on prevention. GEOSPATIAL HEALTH 2022; 17. [PMID: 36468596 DOI: 10.4081/gh.2022.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
We provide a novel approach to understanding the multiple causations of maternal anaemia in a geospatial context, highlighting how genetics, environment and socioeconomic disparities at the micro-geographical level lead to the inequitable distribution of anaemia. All first-trimester pregnant women registered for the antenatal care programme in Anuradhapura District, Sri Lanka from July to September 2019 were invited to the Rajarata Pregnancy Cohort (RaPCo), which assessed the prevalence of anaemia in early pregnancy. The combination of the prevalence of anaemia and minor haemoglobinopathy-related anaemia (MHA) with the poverty headcount index of the 22 health divisions in the district was investigated using GeoDa spatial K-means clustering. Sociodemographic and economic data at the divisional level were compared between identified clusters. Combining the analysis with the geographical and environmental characteristics of the region, further hypotheses regarding anaemia in this community were formulated. The study included data from 3,137 pregnant women in early pregnancy. The anaemia and MHA prevalence varied from 13.6 to 21.7% and from 2.6% to 5%, respectively. We identified four distinct spatial clusters. The cluster with the highest anaemia prevalence also included high poverty and the highest prevalence of MHA. The clusters had significant differences with regard to ethnic distribution, access to water, sanitation and dietary patterns. Areas supplied by major irrigation projects had significantly low levels of anaemia, probably attributable to internal migration and improved livelihood. It was evident that genetic, socioeconomic and environmental risk factors were grouped at the divisional level, and that their complex interactions make controlling anaemia with blanket interventions unsuccessful. Analysis of the distribution of heterogeneous risk factors at the micro-geospatial level helped identify context-specific approaches to tackle anaemia in pregnancy.
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Affiliation(s)
- Gayani Shashikala Amarasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura.
| | - Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura.
| | - Vasana Mendis
- Department of Pathology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura.
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura.
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Li J, Fang J, Luo J, Duan Y, Xiao X, Li Y, Luo M. The Association Between Severity of Anemia During Pregnancy and Severe Maternal Outcomes: A Retrospective Cohort Study. Clin Epidemiol 2022; 14:1427-1437. [DOI: 10.2147/clep.s383680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
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Ding J, Huang Z, Jiang X, Li Q, Cao Y, Guo Y. The prevalence and genetic disorders spectrum of thalassemia among breast cancer patients in Jiangxi province, China. Front Genet 2022; 13:1001369. [PMID: 36330446 PMCID: PMC9623098 DOI: 10.3389/fgene.2022.1001369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/04/2022] [Indexed: 09/09/2023] Open
Abstract
Background: Thalassemia is a common inherited hematological disease with genetic disorders characterized by imbalanced synthesis of the globin chains. Due to the improvement of treatment methods, patients with thalassemia can survive for a long time. Therefore, it is not uncommon for patients with thalassemia suffering from malignant tumors. However, there are quite few reports on thalassemia patients complicated with breast cancer. Herein, we try to investigate the prevalence and genetic disorders spectrum of thalassemia in patients with breast cancer. Methods: Blood routing tests and serum ferritin analysis were conducted in 1887 breast cancer patients treated in the department of radiation oncology during 1 April 2020 and 30 March 2022. The suspected thalassemia carriers with small mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MCH) or mean corpuscular hemoglobin concentration (MCHC) but the concentration of serum ferritin within normal limits were further investigated by polymerase chain reaction (PCR) and flow through hybridization gene chip to detect common mutations of α-globin and β-globin genes using Thalassemia Geno Array Diagnostic Kit. The prevalence and genetic mutation spectrum of thalassemia among breast cancer patients were analyzed. Results: Four hundred and eighty-nine suspected thalassemia carriers were detected by complete blood cell counts and serum ferritin analysis among 1887 breast cancer patients. One hundred and seven cases (5.7%) were identified as carriers of thalassemia, of which 55 cases (51.4%) were α-thalassemia, 50 cases (46.7%) were β-thalassemia, and 2 cases (1.9%) were co-inheritance of α-thalassemia and β-thalassemia simultaneously. In α-thalassemia, the most prevalent genotype is -SEA/αα; as for β-thalassemia, βIVS-II-654/β is the most common genotype. The degree of anemia is more severe in β-thalassemia than in α-thalassemia. Conclusion: This is the first comprehensive molecular epidemiological investigation on thalassemia among breast cancer patients. Our data indicated that thalassemia was not uncommon in breast cancer patients. The physicians should have the knowledge to avoid misdiagnosis as iron deficiency anemia.
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Affiliation(s)
- Jingxian Ding
- Department of Radiation Oncology, The Breast Cancer Institute, The Third Hospital of Nanchang, Nanchang, China
| | - Zhaohui Huang
- Department of Radiation Oncology, The Breast Cancer Institute, The Third Hospital of Nanchang, Nanchang, China
| | - Xiaoliu Jiang
- Department of Radiation Oncology, The Breast Cancer Institute, The Third Hospital of Nanchang, Nanchang, China
| | - Qingge Li
- Department of Radiation Oncology, The Breast Cancer Institute, The Third Hospital of Nanchang, Nanchang, China
| | - Yali Cao
- Department of Breast Surgery, The Breast Cancer Institute, The Third Hospital of Nanchang, Nanchang, China
| | - Yonghong Guo
- Department of Radiation Oncology, The Fourth Affiliated Hospital of Nanchang University, Nanchang, China
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Huang C, Wu HL, Zhou WJ, Huang ZH, Luo XF, Tang YL, Liu Q, Fan LQ, Nie HC, Zhu WB. Genetic testing of sperm donors at a human sperm bank in China. Front Endocrinol (Lausanne) 2022; 13:942447. [PMID: 36204111 PMCID: PMC9530660 DOI: 10.3389/fendo.2022.942447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/06/2022] [Indexed: 12/05/2022] Open
Abstract
Background In China, numerous human sperm banks only perform three-generation family history evaluation to exclude genetic diseases with clinical symptoms; therefore, many inherited risks cannot be detected before donor qualification even when a thorough genetic family history evaluation has been performed. Hence, the risk of recessive disease inheritance persists with the current eligibility guidelines in China regarding the donor selection process. Methods Retrospective study that reviewed the genetic test analyses and clinical outcomes of young adult men who were qualified sperm donors at the Hunan Province Human Sperm Bank of China from January 1, 2018, to May 1, 2021. We included a total of 3231 qualified sperm donors: all donors underwent primary screening for thalassemia and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Whereafter, 278 of donors underwent genetic testing for specific genes, and 43 donors underwent whole exome sequencing. Results 2.4% of 3231 qualified sperm donors might have thalassemia and 1.4% might have G6PD deficiency. Sperm donors with thalassemia and G6PD deficiency would be eliminated. Specific gene testing identified 7 of the 278 donors (2.5%) as carriers of at least one pathogenic or likely pathogenic variant in a gene, including 1.9% of 154 donors (3/154) as carrier variants in α-Like or β-Like globin genes, 17.6% of 17 donors (3/17) as carrier variants in GJB2, 12.5% of 8 donors (1/8) as carrier variants in SMN1. In addition, among the 43 sperm donors carrying the 111 pathogenic/likely pathogenic variants, eight (18.6%) were carriers of pathogenic variants of the GJB2 gene. The frequency, therefore, was approximately 1 in 5. Conclusions The data suggest that used blood routine and RDT can make a preliminary screening of sperm donors, and special gene testing should be performed for sperm donors according to the regional incidence of specific genetic diseases. Meanwhile, whole exome sequencing can be used as a supplementary application in sperm donor genetic testing, and aid a successful and healthy pregnancy. However, industry guidelines must be modified to incorporate its use.
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Affiliation(s)
- Chuan Huang
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of China International Trust and Investment Corporation (CITIC)-Xiangya, Changsha, China
| | - Hui-Lan Wu
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of China International Trust and Investment Corporation (CITIC)-Xiangya, Changsha, China
| | - Wen-Jun Zhou
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Zeng-Hui Huang
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of China International Trust and Investment Corporation (CITIC)-Xiangya, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Xue-Feng Luo
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Yu-Ling Tang
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Qian Liu
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Li-Qing Fan
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of China International Trust and Investment Corporation (CITIC)-Xiangya, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Hong-Chuan Nie
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of China International Trust and Investment Corporation (CITIC)-Xiangya, Changsha, China
| | - Wen-Bing Zhu
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of China International Trust and Investment Corporation (CITIC)-Xiangya, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
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Wang K, Yi T, Wu WT, Lu J, He LN, Zhou HP, Ke JW, Liu FD. Investigation of the Distribution of Thalassemia in Children in Jiangxi Province, the People's Republic of China. Hemoglobin 2022; 46:272-276. [PMID: 36317662 DOI: 10.1080/03630269.2022.2138429] [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: 11/05/2022]
Abstract
Thalassemia is one of southern China's most common inherited disorders. Little is known about the genotypes of thalassemia in children in Jiangxi Province, the People's Republic of China (PRC). Two thousand, nine hundred and fifty-two children with suspected thalassemia were recruited from August 2016 to December 2020 at the Jiangxi Provincial Children's Hospital, Nanchang, PRC. Reverse dot-blot hybridization was used to detect α- and β-thalassemia (α- and β-thal) genotypes. A rare mutation was detected using gap-polymerase chain reaction (gap-PCR) and gene sequencing. The overall distribution of thalassemia (1534 cases) was 51.96%, and the detection rate of α-thal (616 cases), β-thal (888 cases) and concurrent α- and β-thalassemias (30 cases) was 20.86, 30.08, and 1.02%, respectively. A rare α-thal genotype, -α27.6/- -SEA (Southeast Asian), was identified. Seventy-eight cases of severe β-thal were detected, accounting for 8.78% of the cases, including 56 double heterozygous cases and 22 cases that were homozygous. Both α- and β-thalassemias are widely distributed in the children of Jiangxi Province. Thalassemia genetic testing is essential to establish a comprehensive thalassemia prevention program and improve public education.
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Affiliation(s)
- Ke Wang
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
| | - Ting Yi
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
| | - Wen-Tao Wu
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
| | - Juan Lu
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
| | - Li-Na He
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
| | - Hong-Ping Zhou
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
| | - Jiang-Wei Ke
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
| | - Fa-Di Liu
- Department of Clinical Laboratory, Jiangxi Provincial Children's Hospital, Nanchang, People's Republic of China
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Esmaeilzadeh F, Ahmadi B, Vahedi S, Barzegari S, Rajabi A. Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran. Int J Health Policy Manag 2022; 11:1112-1119. [PMID: 33619933 PMCID: PMC9808182 DOI: 10.34172/ijhpm.2021.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/12/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Beta-thalassemia minor and thalassemia major are an autosomal recessive disease with hypochromic, microcytic anemia, and morbidities, Today, therapeutic advances have significantly improved the life expectancy of thalassemia major patients, but at the cost of financial toxicity. The present study aimed to investigate the possibility of increasing the funding for thalassemia screening programs and comparing the cost-effectiveness of screening for thalassemia in the treatment of the patients. METHODS In this study, screening for thalassemia minor was compared with the treatment of thalassemia major patients. A decision tree model was used for analysis. A hospital database, supplemented with a review of published literature, was used to derive input parameters for the model. A lifetime study horizon was used and future costs and consequences were discounted at 3%. The approach of purchases of services was used to evaluate the screening test costs for patients with thalassemia major. Also, a bottom-up method was applied to estimate other screening and treatment costs. All the costs were calculated over one year. The number of gained quality-adjusted life years (QALYs) was calculated using the EQ-5D questionnaire in the evaluated patients. RESULTS In this study, 26.97 births of patients with thalassemia major were prevented by screening techniques. On the other hand, total screening costs for patients with thalassemia major were estimated equal to US$ 879879, while the costs of preventing the birth of each thalassaemia major patient was US$ 32 624 by screening techniques. In comparison, the cost of managing a patient with thalassemia major is about US$ 136 532 per year. The life time QALYs for this is 11.8 QALYs. Results are presented using a societal perspective. Incremental cost per QALY gained with screening as compared with managing thalassaemia major was US$ 11 571. CONCLUSION Screening is a long-term value for money intervention that is highly cost effective and its long-term clinical and economic benefits outweigh those of managing thalassaemia major patients.
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Affiliation(s)
- Firooz Esmaeilzadeh
- Department of Public Health, School of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Batoul Ahmadi
- Department of Health Management & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sajad Vahedi
- Department of Healthcare Administration, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Barzegari
- Department of Health Information Technology, Amol Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolhalim Rajabi
- Department of Health Management and Social Development Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
- Department of Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
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Wang M, Zhang X, Zhang Y, Xiao M. Prevalence and Genetic Analysis of Thalassemia and Hemoglobinopathy in Different Ethnic Groups and Regions in Hainan Island, Southeast China. Front Genet 2022; 13:874624. [PMID: 35783269 PMCID: PMC9245582 DOI: 10.3389/fgene.2022.874624] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background: There are limited studies on the molecular profile of thalassemia in Hainan, the free trade island in China. Our aim was to reveal the prevalence and molecular mutation spectrum of thalassemia in different ethnic groups and regions of Hainan through a large sample study for the first time.Methods: A total of 231,596 individuals from 19 cities and counties in Hainan were screened by hematological parameter analysis, and further genetic analysis was performed on individuals with MCV less than 82 fL.Results: Totally, 31,780 (13.72%) subjects were diagnosed as thalassemia carriers. The overall prevalence of α-thalassemia, β-thalassemia, and α+β-thalassemia were 11.04%, 1.48%, and 1.20%, respectively. We further analyzed the molecular profiles of thalassemia in various ethnic groups and mainly compared the difference between Han and Li. The results showed that the frequency of thalassemia in the Li population (47.03%) was much higher than that in Han (9.37%). Except for β-thalassemia (1.31% of Li vs. 1.47% of Han), the frequencies of α-thalassemia (39.59% of Li vs. 7.35% of Han) and α+β-thalassemia (6.13% of Li vs. 0.56% of Han) in the Li were obviously higher than those in Han. The high-frequent genotypes of α-thalassemia in Han were αα/--SEA (25.55%), -α3.7/αα (22.17%), -α4.2/αα (21.59%), αWSα/αα (8.93%), and -α3.7/-α4.2 (4.17%) and those of Li were -α4.2/αα (17.24%), -α3.7/αα (17.16%), -α3.7/-α4.2 (15.09%), αWSα/αα (9.69%), and αWSα/-α3.7 (8.06%), respectively. The αα/--SEA was the highest genotype of α-thalassemia in Han but only accounted for 1.87% in Li. For β-thalassemia, the top three high-frequent genotypes in both Han and Li were βCD41/42(-TTCT)/βN, β-28(A>G)/βN, and βIVS-Ⅱ-654(C>T)/βN, but the frequency of βCD41/42(-TTCT)/βN in Li (90.96%) was much higher than that in Han (56.32%) and the data reported in other provinces of China. Additionally, the prevalence of thalassemia ranged from 8.16% to 34.35% in Hainan, Wuzhishan, Baoting, Qiongzhong, and Baisha have a higher prevalence than other areas.Conclusion: Our study revealed the characteristics of ethnic and regional differences in the prevalence of thalassemia in the childbearing age population of Hainan for the first time, indicating that the prevalence of thalassemia among Li nationality is the highest in China. Those findings will be useful for genetic counseling and the prevention of thalassemia.
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Affiliation(s)
- Min Wang
- Hainan Women and Children’ Medical Center, Haikou, China
- NHC Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, China
- *Correspondence: Min Wang, ; Meifang Xiao,
| | - Xiaozhuang Zhang
- Hainan Women and Children’ Medical Center, Haikou, China
- NHC Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, China
| | - Yubin Zhang
- Hainan Women and Children’ Medical Center, Haikou, China
- NHC Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, China
| | - Meifang Xiao
- Hainan Women and Children’ Medical Center, Haikou, China
- NHC Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, China
- *Correspondence: Min Wang, ; Meifang Xiao,
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Huang LF, Yu LL, Nikuze L, Singh S, Jiang JX, Jiang JL, Li YP, Qin YH, Wei HY. Spectrum of β-Thalassemia Mutations in Some Areas of Guangxi Zhuang Autonomous Region of Southern China: A Study on a Pediatric Population Aged 0-15 Years. Hemoglobin 2022; 45:318-321. [PMID: 35514176 DOI: 10.1080/03630269.2022.2041435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
β-Thalassemia (β-thal), one of the most common form of single-gene inheritable blood diseases in the world, is highly prevalent in southern China, especially in the Guangxi Zhuang Autonomous Region. To update the β-thal mutation spectrum in this region, we performed hematological and genetic analyses on 888 β-thal major (β-TM), β-thal intermedia (β-TI) and β-thal carrier patients, aged 0-15 years old, from different parts of Guangxi Province. We identified 55 genotypes and 18 β-thal mutations. The codons 41/42 (-TTCT) (HBB: c.126_129delCTTT) (43.97%), codon 17 (A>T) (HBB: c.52A>T) (25.43%), -28(A>G) (HBB: c.-78A>G) (8.18%), IVS-II-654 (C>T) (HBB: c.316-197C>T) (7.85%) and codon 26 (G>A) (HBB: c.79G>A) (5.02%) were the five most common, accounting for more than 90.0%. The results of our study are providing an up-to-date β-thal mutation spectrum in the 0-15-year-old pediatric population, which will help genetic counseling and prevention of β-TM in mainland China's most endemic region, Guangxi Zhuang Autonomous Region.
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Affiliation(s)
- Li-Fang Huang
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
| | - Li-Li Yu
- Department of Pediatrics, Qinzhou Maternal and Child Health Care Hospital, Qinzhou, Guangxi Province, People's Republic of China
| | - Lauriane Nikuze
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
| | - Sanjeev Singh
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
| | - Jin-Xia Jiang
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
| | - Jia-Li Jiang
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
| | - Yu-Ping Li
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
| | - Yu-Hui Qin
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
| | - Hong-Ying Wei
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, People's Republic of China
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Kang L, Yi S, Tan S, Li Q, Li C. Establishment of pregnant-specific intervals for hemoglobin (Hb) A2, HbF and cut-off points for HbA2 for thalassemia in Chongqing, China. Saudi Med J 2022; 43:353-359. [PMID: 35414613 PMCID: PMC9998055 DOI: 10.15537/smj.2022.43.4.20210729] [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: 10/08/2021] [Accepted: 03/01/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To analyze pregnant-specific intervals for hemoglobin A2 (HbA2), hemoglobin fetal (HbF), and cut-off points of HbA2 for thalassemia in Chongqing, China. METHODS Between September 2015 and April 2019, the study recruited 10039 individuals of reproductive age. Of which, 4399 healthy normal individuals were selected to determine reference values for HbA2 and HbF. The remaining 5640 individuals suspected of thalassemia were included to explore the cut-off points of HbA2 for thalassemia. RESULTS The reference values of HbA2 in males was 2.3-3.2%, in females was 2.1-3.1%, and in pregnant women was 1.9-3.1%. While the reference values of HbF in males was 0.0-0.0%, in females was 0.0-0.9%, and in pregnant women was 0.0-4.3%. Approximately 2.3% cut-off points for pregnant women was determined to be optimal for α-thalassemia screening. In the entire group, 2.5% was best for all α-thalassemia screenings. The cut-off for β-thalassemia screening using HbA2 was 3.2% for the entire group. CONCLUSION The reference interval of HbA2 for pregnant females group was significantly lower than other groups. Therefore, we recommend cut-off points of HbA2 for α-thalassemia at 2.3% for pregnant women. While partitioning was not needed due to gender. Gender and pregnancy had little effect on the cut-off points of HbA2 for β-thalassemia carrier.
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Affiliation(s)
- Lihua Kang
- From the Department of Laboratory (Kang, Yi, Tan, Q. Li, C. Li), Chongqing Health Center for Women and Children, Chongqing, China.
| | - Siwei Yi
- From the Department of Laboratory (Kang, Yi, Tan, Q. Li, C. Li), Chongqing Health Center for Women and Children, Chongqing, China.
| | - Si Tan
- From the Department of Laboratory (Kang, Yi, Tan, Q. Li, C. Li), Chongqing Health Center for Women and Children, Chongqing, China.
| | - Qiuhong Li
- From the Department of Laboratory (Kang, Yi, Tan, Q. Li, C. Li), Chongqing Health Center for Women and Children, Chongqing, China.
| | - Chunli Li
- From the Department of Laboratory (Kang, Yi, Tan, Q. Li, C. Li), Chongqing Health Center for Women and Children, Chongqing, China.
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Jie Q, Lei S, Qu C, Wu H, Liu Y, Huang P, Teng S. 利用CRISPR/Cas9基因编辑技术治疗β-地中海贫血的最新进展. CHINESE SCIENCE BULLETIN-CHINESE 2022. [DOI: 10.1360/tb-2022-0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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