1
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von der Lippe C, Tveten K, Prescott TE, Holla ØL, Busk ØL, Burke KB, Sansbury FH, Baptista J, Fry AE, Lim D, Jolles S, Evans J, Osio D, Macmillan C, Bruno I, Faltera F, Climent S, Urreitzi R, Hoenicka J, Palau F, Cohen ASA, Engleman K, Zhou D, Amudhavalli SM, Jeanne M, Bonnet-Brilhault F, Lévy J, Drunat S, Derive N, Haug MG, Thorstensen WM. Heterozygous variants in ZBTB7A cause a neurodevelopmental disorder associated with symptomatic overgrowth of pharyngeal lymphoid tissue, macrocephaly, and elevated fetal hemoglobin. Am J Med Genet A 2021; 188:272-282. [PMID: 34515416 DOI: 10.1002/ajmg.a.62492] [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: 06/19/2021] [Revised: 08/14/2021] [Accepted: 08/21/2021] [Indexed: 11/11/2022]
Abstract
By clinical whole exome sequencing, we identified 12 individuals with ages 3 to 37 years, including three individuals from the same family, with a consistent phenotype of intellectual disability (ID), macrocephaly, and overgrowth of adenoid tissue. All 12 individuals harbored a rare heterozygous variant in ZBTB7A which encodes the transcription factor Zinc finger and BTB-domain containing protein 7A, known to play a role in lympho- and hematopoiesis. ID was generally mild. Fetal hemoglobin (HbF) fraction was elevated 2.2%-11.2% (reference value <2% in individuals > 6 months) in four of the five individuals for whom results were available. Ten of twelve individuals had undergone surgery at least once for lymphoid hypertrophy limited to the pharynx. In the most severely affected individual (individual 1), airway obstruction resulted in 17 surgical procedures before the age of 13 years. Sleep apnea was present in 8 of 10 individuals. In the nine unrelated individuals, ZBTB7A variants were novel and de novo. The six frameshift/nonsense and four missense variants were spread throughout the gene. This is the first report of a cohort of individuals with this novel syndromic neurodevelopmental disorder.
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Affiliation(s)
| | - Kristian Tveten
- Department of Medical Genetics, Telemark Hospital Trust, Skien, Norway
| | - Trine E Prescott
- Department of Medical Genetics, Telemark Hospital Trust, Skien, Norway
| | - Øystein L Holla
- Department of Medical Genetics, Telemark Hospital Trust, Skien, Norway
| | - Øyvind L Busk
- Department of Medical Genetics, Telemark Hospital Trust, Skien, Norway
| | - Katherine B Burke
- All Wales Medical Genomics Service, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Francis H Sansbury
- All Wales Medical Genomics Service, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Júlia Baptista
- Exeter Genomics Laboratory, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.,Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Andrew E Fry
- All Wales Medical Genomics Service, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK.,Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - Derek Lim
- Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Jennifer Evans
- Department of Paediatrics, University Hospital of Wales, Cardiff, UK
| | - Deborah Osio
- Clinical Genetics, West Midlands Regional Genetics Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Carol Macmillan
- Department of Pediatrics, University of Chicago, Chicago, Illinois, USA
| | - Irene Bruno
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Flavio Faltera
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Salvador Climent
- Pediatrics Service, Hospital General d'Ontinyent, Ontinyent, Spain
| | - Roser Urreitzi
- Department of Clinical Biochemistry and CIBERER, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Janet Hoenicka
- Laboratory of Neurogenetics and Molecular Medicine - IPER and CIBERER, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Francesc Palau
- Laboratory of Neurogenetics and Molecular Medicine - IPER and CIBERER, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Department of Genetic Medicine - IPER, Hospital Sant Joan de Déu, Barcelona, Spain.,Hospital Clínic and Division of Pediatrics, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ana S A Cohen
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, Missouri, USA.,Genomic Medicine Center, Children's Mercy Hospital, Kansas City, Missouri, USA.,Kansas City School of Medicine, University of Missouri, Kansas City, Missouri, USA
| | - Kendra Engleman
- Kansas City School of Medicine, University of Missouri, Kansas City, Missouri, USA.,Division of Clinical Genetics, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Dihong Zhou
- Kansas City School of Medicine, University of Missouri, Kansas City, Missouri, USA.,Division of Clinical Genetics, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Shivarajan M Amudhavalli
- Kansas City School of Medicine, University of Missouri, Kansas City, Missouri, USA.,Division of Clinical Genetics, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Médéric Jeanne
- Service de Génétique, Centre Hospitalier Régional Universitaire, Tours, France.,UMR1253, iBrain, University of Tours, INSERM, Tours, France.,Excellence Center in Autism and Neurodevelopmental Disorders, Centre Hospitalier Régional Universitaire, Tours, France
| | - Frédérique Bonnet-Brilhault
- UMR1253, iBrain, University of Tours, INSERM, Tours, France.,Excellence Center in Autism and Neurodevelopmental Disorders, Centre Hospitalier Régional Universitaire, Tours, France
| | - Jonathan Lévy
- Department of Genetics, APHP-Robert Debré University Hospital, Paris, France.,Laboratoire de Biologie Médicale Multisites SeqOIA, Paris, France
| | - Séverine Drunat
- Department of Genetics, APHP-Robert Debré University Hospital, Paris, France.,Laboratoire de Biologie Médicale Multisites SeqOIA, Paris, France
| | - Nicolas Derive
- Laboratoire de Biologie Médicale Multisites SeqOIA, Paris, France
| | - Marte G Haug
- Department of Medical Genetics, St. Olavs University Hospital, Trondheim, Norway
| | - Wenche M Thorstensen
- Department of Otolaryngology, Head and Neck Surgery, St. Olavs University Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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2
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Altinoz MA, Ince B. Hemoglobins emerging roles in mental disorders. Metabolical, genetical and immunological aspects. Int J Dev Neurosci 2017; 61:73-85. [PMID: 28694195 DOI: 10.1016/j.ijdevneu.2017.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 12/13/2022] Open
Abstract
Hemoglobin (Hb) expression in the central nervous system is recently shown. Cooccurences of mental disorders (mainly bipolar disorder (BD) and tic disorders) with β- or α-thalassemia trait or erythrocytosis were witnessed, which may be due to peripheral or central hypoxia/hyperoxia or haplotypal gene interactions. β-Globin genes reside at 11p15.5 close to tyrosine hydroxylase, dopamine receptor DRD4 and Brain Derived Neurotrophic Factor, which involve in psychiatric diseases. α-Globin genes reside at 16p13.3 which associates with BD, tic disorders, ATR-16 Syndrome and Rubinstein Taybi Syndrome (RTS). CREB-Binding Protein (CEBBP)-gene is mutated in RTS, which commonly associates with mood disorders. 16p13.3 region also contains GRIN2A gene encoding N-methyl-d-aspartate receptor-2A and SSTR5 (Somatostatin Receptor-5), again involving in mental disorders. We demonstrated a protective role of minor HbA2 against post-partum episodes in BD and association of higher minor HbF (fetal hemoglobin) levels with family history of psychosis in a BD-patient cohort. HbA2 increases in cardiac ischemia and in mountain dwellers indicating its likely protection against ischemia/hypoxia. HMGIY, a repressive transcription factor of δ-globin chain of HbA2 is increased in lymphocytes of schizophrenics. In autism, deletional mutations were found in BCL11A gene, which cause persistence of HbF at high levels in adulthood. Also, certain polymorphisms in BCL11A strongly associate with schizophrenia. Further, many drugs from anabolic steroids to antimalarial agents elevate HbF and may cause mania. We ascribe a protective role to HbA2 and a maladaptive detrimental role to HbF in psychopathology. We believe that future studies on hemoglobins may pave to discover novel pathogenesis mechanisms in mental disorders.
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Affiliation(s)
| | - Bahri Ince
- Department of Psychiatry, Bakirkoy Education and Research Hospital for Psychiatry, Turkey
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3
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Mejri A, Mansri M, Hadj Fredj S, Ouali F, Bibi A, Hafsia R, Messaoud T, Siala H. First description of the rs45496295 polymorphism of the C/EBPE gene in β-thalassemia intermedia patients. Hemoglobin 2016; 40:411-416. [PMID: 27829304 DOI: 10.1080/03630269.2016.1252386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The C/EBPE gene, located in 14q11.2, encodes for a B/zip-type transcription factor. The C/EBPɛ is involved in terminal differentiation and functional maturity of granulocyte progenitor cells and in cell apoptosis during myeloid differentiation. A C/EBPE gene has recently been described as a candidate gene involved in clinical variability of β-thalassemia (β-thal). In this study, the C/EBPE gene was sequenced in 146 subjects divided into the severe type of β-thal major (β-TM) and moderate type of β-thal intermedia (β-TI), and a control group. The analysis identified the rs45496295 (C > T) polymorphism in the heterozygous state in 73.9% β-TI patients, which was not the case in the β-TM patients or in the control group. Thus, the T allele is consequently associated with the β-TI group (p = 10-3). According to the Human Splicing Finder (version 3.0, Marseille, France), the presence of the rs45496295 polymorphism leads the creation of a new intronic exotic splicing enhancer (ESE) site. Moreover, the T allele of rs45496295 is associated with a lower transfusion regimen (p = 10-3) and a higher pretransfusion hemoglobin (Hb) rate (p = .006). The comparison of several factors concerning T allele carriers and non-carriers showed that the T allele does not act on the Hb F rate. The T allele of rs45496295, associated with moderate type of β-thal, seems to modify the C/EBPɛ action, thereby preventing the hemolysis.
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Affiliation(s)
- Awatef Mejri
- a Biochemistry and Molecular Biology Laboratory , Children's Hospital Bechir Hamza, Research Laboratory LR00SP03 , Tunis , Tunisia
| | - Marwa Mansri
- a Biochemistry and Molecular Biology Laboratory , Children's Hospital Bechir Hamza, Research Laboratory LR00SP03 , Tunis , Tunisia
| | - Sondess Hadj Fredj
- a Biochemistry and Molecular Biology Laboratory , Children's Hospital Bechir Hamza, Research Laboratory LR00SP03 , Tunis , Tunisia
| | - Faida Ouali
- a Biochemistry and Molecular Biology Laboratory , Children's Hospital Bechir Hamza, Research Laboratory LR00SP03 , Tunis , Tunisia
| | - Amina Bibi
- b Biochemistry Laboratory , National Institute of Nutrition and Food Technology , Tunis , Tunisia
| | - Raouf Hafsia
- c Hematology Department , Hospital Aziza Othmana , Tunis , Tunisia
| | - Taieb Messaoud
- a Biochemistry and Molecular Biology Laboratory , Children's Hospital Bechir Hamza, Research Laboratory LR00SP03 , Tunis , Tunisia
| | - Hajer Siala
- a Biochemistry and Molecular Biology Laboratory , Children's Hospital Bechir Hamza, Research Laboratory LR00SP03 , Tunis , Tunisia
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4
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Trova S, Mereu P, Cocco E, Masala B, Manca L, Pirastru M. The New -474(C→T) Substitution Discovered in the HBG2 Promoter of a Sardinian δβ-Thalassemia Carrier. Acta Haematol 2016; 136:178-85. [PMID: 27561840 DOI: 10.1159/000447942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/22/2016] [Indexed: 11/19/2022]
Abstract
During a screening for hemoglobinopathies, we found a carrier of the Sardinian δβ-thalassemia condition. The proband's hematology and hemoglobin (Hb) profile agreed with those of the other carriers previously identified during our diagnostic program except for the fetal Hb (HbF) composition, which consisted of both α2Aγ2 and α2Gγ2 instead of nearly 100% α2Aγ2. In order to explain the unusual γ-chain ratio, sequencing of the Gγ promoter was carried out and revealed two nucleotide substitutions in cis: C→T at position -474 and A→G at position -309 from the Cap site. The latter had previously been observed in subjects with raised HbF levels, although it has not yet been evaluated at functional level. We used the luciferase assay to determine whether the two mutations modify the transcriptional activity of the Gγ promoter. Results indicated that the observed in vivo Gγ-globin production cannot be translated into increased in vitro promoter function, suggesting that the assessed mutations cannot be considered as functional single nucleotide polymorphisms per se; instead, a more complex regulatory mechanism might be involved.
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Affiliation(s)
- Sandro Trova
- Dipartimento di Scienze Biomediche, Università di Sassari, Sassari, Italia
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5
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Gielezynska A, Stachurska A, Fabijanska-Mitek J, Debska M, Muzyka K, Kraszewska E. Quantitative fetomaternal hemorrhage assessment with the use of five laboratory tests. Int J Lab Hematol 2016; 38:419-25. [DOI: 10.1111/ijlh.12518] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 04/06/2016] [Indexed: 12/01/2022]
Affiliation(s)
- A. Gielezynska
- Department of Immunohaematology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - A. Stachurska
- Department of Immunohaematology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - J. Fabijanska-Mitek
- Department of Immunohaematology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - M. Debska
- Department of Obstetrics and Gynaecology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - K. Muzyka
- Department of Obstetrics and Gynaecology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - E. Kraszewska
- Department of Gastroenterology and Hepatology; Centre of Postgraduate Medical Education; Warsaw Poland
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6
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Pereira C, Relvas L, Bento C, Abade A, Ribeiro ML, Manco L. Polymorphic variations influencing fetal hemoglobin levels: association study in beta-thalassemia carriers and in normal individuals of Portuguese origin. Blood Cells Mol Dis 2015; 54:315-20. [PMID: 25842369 DOI: 10.1016/j.bcmd.2015.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 02/13/2015] [Accepted: 02/14/2015] [Indexed: 01/03/2023]
Abstract
Three major loci have been associated with HbF levels, including -158C/T (XmnI) at HBG2 promoter region, and several polymorphisms at BCL11A intron-2 and HBS1L-MYB (HMIP) intergenic region. Mutations in the KLF1 gene were recently associated with increased HbF levels. This study aims to evaluate whether genetic variability at these loci influences HbF levels in β-thalassemia carriers and in normal individuals of Portuguese origin. Sixty five β-thalassemia carriers, HbF levels ranging from 0.2% to 9.5%, and 60 individuals with normal hematological parameters, HbF levels ranging from 0.2% to 7.4%, were selected for this study. In β-thal carriers linear regression models revealed a strong statistical significant association for HBG2 (XmnI) rs7482144 (β=0.455; P=5.858×10(-7)), and nominal significance for BCL11A rs766432 (β=0.215; P=0.029) and HMIP rs9399137 (β=0.209; P=0.011). In normal individuals, a case (HbF>2%; n=15) vs. control (HbF<1.7%; n=45) model, showed nominal significant associations for BCL11A SNPs rs11886868 (OR=4; P=0.001), rs766432 (OR=3.7; P=0.002) and rs7606173 (OR=0.36; P=0.032). KLF1 rs3817621 was not found associated with HbF levels. Our results suggest that in Portuguese β-thal carriers the HBG2 XmnI polymorphism is strongly associated with HbF levels. In normal individuals, BCL11A polymorphisms, but not HMIP or HBG2 (XmnI) loci, are nominally associated with HbF expression.
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Affiliation(s)
- Clara Pereira
- Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Luís Relvas
- Department of Hematology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Celeste Bento
- Department of Hematology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Augusto Abade
- Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - M Letícia Ribeiro
- Department of Hematology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Licínio Manco
- Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, University of Coimbra, Coimbra, Portugal; Department of Hematology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.
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7
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Dabke P, Colah R, Ghosh K, Nadkarni A. Effect of Cis Acting Potential Regulators in the β Globin Gene Cluster on the Production of HbF in Thalassemia Patients. Mediterr J Hematol Infect Dis 2013; 5:e2013012. [PMID: 23505600 PMCID: PMC3591280 DOI: 10.4084/mjhid.2013.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 01/10/2013] [Indexed: 11/08/2022] Open
Abstract
The clinical presentation of β-thalassemia intermedia phenotypes are influenced by many factors. The persistence of fetal hemoglobin and several polymorphisms located in the promoters of γ- and β-globin genes are some of them. The aim of this study was to evaluate the combined effect of the -158 Gγ (C→T) polymorphism and of the (AT)x(T)y configuration, as well as their eventual association with elevated levels of HbF in β-thalassemia carriers, β-thalassemia intermedia, β-thalassemia major and normal controls of Indian origin. The -158 Gγ T allele was found to be associated with increased levels of HbF in β thalassemia carriers, and not in wild-type subjects. In the homozygous group, the -158 Gγ T allele was significantly higher in the thalassemia intermedia group (66%) as against the thalassemia major group (21%). The (AT)9(T)5 allele did not show any association with raised HbF levels. However 24% of milder cases showed presence of this allele. This study suggests that two regions of the β globin cluster, whether in cis or in trans to each other, can interact to enhance HbF expression when a β thalassemic determinant is present in heterozygosity and help in amelioration of the severity of the disease in homozygotes.
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Affiliation(s)
- Pooja Dabke
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
| | - Roshan Colah
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
| | - Kanjaksha Ghosh
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
| | - Anita Nadkarni
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
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8
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Mejri A, Siala H, Ouali F, Bibi A, Messaoud T. Identification of candidate genes involved in clinical variability among Tunisian patients with β-thalassemia. Gene 2012; 506:166-72. [PMID: 22771911 DOI: 10.1016/j.gene.2012.06.078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 06/25/2012] [Indexed: 10/28/2022]
Abstract
The short tandem repeats (STR) are undoubtedly the most used molecular markers in genetic diversity studies. β-thalassemia is a hereditary hemolytic anemia which is a common health problem all over the world. The disease has two main clinical forms: the severe form or β-thalassemia major (TM) and the moderate form or β-thalassemia intermedia (TI). To help understand this inconsistency, five STR have been studied in a group of 27 β-thalassemic patients divided into 15 (TM) and 12 (TI). For each STR, the distribution of alleles, has been compared among patients with β-thalassemia major (TM) and those with β-thalassemia intermedia (TI).The comparison has shown, for the STR D14S72, one specific allele to (TM) and for the STR D14S990 and D14S68, two specific alleles to TI patients. The combination of these alleles with severe beta-thalassemia genotypes leads to the phenotype of beta-thalassemia intermedia even though there are no any attenuating factors such as XmnI Gg polymorphism at position -158 of the HBG2 promotor or the alpha-globin defects. This suggests that these alleles are associated with factors reducing β-thalassemia clinical effects. One of this STR is located in the 5'UTR of the CEBPε gene which incodes a transcription factor expressed in the myeloid lineage. Thus, the involvement of the transcription factor CEBPε in the myeloid cells suggests that CEBPε is a candidate gene involved in the modulation of the β-thalassemia expression through immune system reactions.
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Affiliation(s)
- Awatef Mejri
- Laboratory of Biochemistry, Hospital for Children of Tunis, Tunisia.
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9
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Jouini L, Bibi A, Ouali F, Hadj Fredj S, Ouennich F, Siala H, Messaoud T, Fattoum S. Contribution of β-globin cluster polymorphisms to raise fetal hemoglobin levels in normal adults. Mol Biol Rep 2011; 39:4619-25. [DOI: 10.1007/s11033-011-1253-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 09/14/2011] [Indexed: 11/30/2022]
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10
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SHANG X, RAO Z, LOU J, LI W, XIONG F, ZHOU HP, XU X. Compound heterozygosity for a rare small deletion and a common point mutation in the beta-globin gene: report of two Chinese families. Int J Lab Hematol 2010; 33:79-84. [DOI: 10.1111/j.1751-553x.2010.01253.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Olaniyi JA, Arinola OG, Odetunde AB. FOETAL HAEMOGLOBIN (HbF) STATUS IN ADULT SICKLE CELL ANAEMIA PATIENTS IN IBADAN, NIGERIA. Ann Ib Postgrad Med 2010; 8:30-3. [PMID: 25161472 PMCID: PMC4138770 DOI: 10.4314/aipm.v8i1.63955] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
AIM Elevated HbF, among other biological and environmental factors, is responsible for decrease in mortality in sickle cell anaemia (SCA). This study determined the levels of HbF in adult SCA patients in steady state compared with HbAA controls. HbF was discussed in line with the clinical course of the disease so as to emphasize the relevance of hydroxyurea in the management of adult SCA patients. MATERIALS AND METHODS The HbF levels of 66 confirmed SCA patients and 31 HbAA controls were estimated using Betke method and HbF percentage was calculated using formula: %HbF percentage = A413 filtrate x 100A413 standard x 20. RESULT A statistical significant difference in the mean of the levels of HbF in patients (5.16±4.04) compared to controls (1.04±0.44) (p = 0.000) was observed. The mean levels of HbF for males (4.71±3.49) compared to that of females (4.99) were statistically similar (p =0.773). It was also observed that the mean HbF level appears to be declining as age advances. SCA patients were classified to three categories viz: HbF <2% (21.2% SCA patients); HbF of 2.1% -10%, (68.2% SCA patients); and HbF of 10.1% -16%, (10.6% SCA patients). CONCLUSION Substantial proportion of our patients actually will require treatment with hydroxylurea to stimulate HbF production especially those with HbF percentage of <2 and some with HbF percentage of 2.1 - 10%. HPFH may be considered rare since only 10. 6% had HbF at the range of 10.1-16%. This study showed that in treating our SCA patients in Nigeria we need to adopt and encourage the use of HbF activating agents like hydroxyurea or any other safe agent that will be found to stimulate HbF production in SCD patients.
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Affiliation(s)
- J A Olaniyi
- Department of Haematology, University College Hospital, Ibadan, Nigeria
| | - O G Arinola
- Department of Chemical Pathology; University College Hospital, Ibadan, Nigeria
| | - A B Odetunde
- IMRAT, College of Medicine, University of Ibadan
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12
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Lee ST, Yoo EH, Kim JY, Kim JW, Ki CS. Multiplex ligation-dependent probe amplification screening of isolated increased HbF levels revealed three cases of novel rearrangements/deletions in the β-globin gene cluster. Br J Haematol 2010; 148:154-60. [DOI: 10.1111/j.1365-2141.2009.07927.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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ROTTGARDT INKEN, ROTHHAMMER FRANCISCO, DITTMAR MANUELA. Native highland and lowland populations differ in .GAMMA.-globin gene promoter polymorphisms related to altered fetal hemoglobin levels and delayed fetal to adult globin switch after birth. ANTHROPOL SCI 2010. [DOI: 10.1537/ase.090402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- INKEN ROTTGARDT
- Department of Human Biology, Zoological Institute, Christian Albrechts-University, Kiel
| | - FRANCISCO ROTHHAMMER
- Instituto de Alta Investigación, Universidad de Tarapacá, Arica
- Departamento de Biología Celular y Genética Molecular, Facultad de Medicina, Universidad de Chile, Santiago
| | - MANUELA DITTMAR
- Department of Human Biology, Zoological Institute, Christian Albrechts-University, Kiel
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14
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Liu L, Muralidhar S, Singh M, Sylvan C, Kalra IS, Quinn CT, Onyekwere OC, Pace BS. High-density SNP genotyping to define beta-globin locus haplotypes. Blood Cells Mol Dis 2008; 42:16-24. [PMID: 18829352 DOI: 10.1016/j.bcmd.2008.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 07/24/2008] [Indexed: 10/21/2022]
Abstract
Five major beta-globin locus haplotypes have been established in individuals with sickle cell disease (SCD) from the Benin, Bantu, Senegal, Cameroon, and Arab-Indian populations. Historically, beta-haplotypes were established using restriction fragment length polymorphism (RFLP) analysis across the beta-locus, which consists of five functional beta-like globin genes located on chromosome 11. Previous attempts to correlate these haplotypes as robust predictors of clinical phenotypes observed in SCD have not been successful. We speculate that the coverage and distribution of the RFLP sites located proximal to or within the globin genes are not sufficiently dense to accurately reflect the complexity of this region. To test our hypothesis, we performed RFLP analysis and high-density single nucleotide polymorphism (SNP) genotyping across the beta-locus using DNA samples from healthy African Americans with either normal hemoglobin A (HbAA) or individuals with homozygous SS (HbSS) disease. Using the genotyping data from 88 SNPs and Haploview analysis, we generated a greater number of haplotypes than that observed with RFLP analysis alone. Furthermore, a unique pattern of long-range linkage disequilibrium between the locus control region and the beta-like globin genes was observed in the HbSS group. Interestingly, we observed multiple SNPs within the HindIII restriction site located in the Ggamma-globin intervening sequence II which produced the same RFLP pattern. These findings illustrated the inability of RFLP analysis to decipher the complexity of sequence variations that impacts genomic structure in this region. Our data suggest that high-density SNP mapping may be required to accurately define beta-haplotypes that correlate with the different clinical phenotypes observed in SCD.
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Affiliation(s)
- Li Liu
- Department of Molecular and Cell Biology, Sickle Cell Disease Research Center, University of Texas at Dallas, Richardson, TX 75083, USA
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15
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de Vooght KMK, van Wijk R, Rijksen G, van Solinge WW. A family with multiple mutations and sequence variations in the alpha- and beta-globin gene clusters. Clin Chem Lab Med 2008; 46:165-8. [PMID: 18076350 DOI: 10.1515/cclm.2008.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Usually, laboratory diagnostics of hereditary hemoglobin disorders is fairly straightforward. Sometimes, however, correct diagnosis can be difficult. In this study, we describe a family with multiple mutations and sequence variations in the alpha- and beta-globin gene clusters. METHODS Hemocytometry results were obtained using an automated cell counter. Hemoglobin variant analysis was performed by cation-exchange HPLC. PCR and DNA sequence analyses were used to identify mutations in the globin genes. RESULTS The proposita was referred to our laboratory for hematological evaluation [hemoglobin 145 g/L (119-155 g/L) mean corpuscular volume 72 fl (80-97 fl), mean corpuscular hemoglobin 26 pg (28-36 pg), erythrocytes 5.6 x 10(12)/L (3.7-5.0 10(12)/L)]. Characterization and quantification of hemoglobin variants showed 11.3% HbA1, 4.4% HbA2, 58.9% HbC and 23.0% HbF. Subsequent analysis revealed, in addition to a heterozygous HbC mutation, the presence of a beta-thalassemia causing mutation (-90C>T), a heterozygous alpha-thalassemia (-alpha(-3.7)/alpha alpha) and three different gamma-globin sequence variations. Additional molecular analysis was performed in all family members. CONCLUSIONS In the family presented in this study, 10 different mutations were found in the globin genes. Molecular analysis was necessary to clarify hemoglobin variant analysis, in particular the low amount of HbA1 in the proposita. Knowledge of the molecular background facilitates in the understanding of the hematological parameters and proper counseling of the patient.
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Affiliation(s)
- Karen M K de Vooght
- Department of Clinical Chemistry and Haematology, Laboratory for Red Blood Cell Research, University Medical Center Utrecht, Utrecht, The Netherlands
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16
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Abstract
Fetal hemoglobin (HbF), the predominant hemoglobin in the fetus, is a mixture of two molecular species (alpha(2)(G)gamma(2) and alpha(2)(A)gamma(2)) that differ only at position 136 reflecting the products of two nonallelic gamma-globin genes. At the time of birth, HbF accounts for approximately 70% of the total Hb. The (G)gamma:(A)gamma globin ratio in the HbF of normal newborn is 70:30 whereas in the trace amounts of HbF that is found in the adult it reverses to 40:60 because of a gamma- to beta-globin gene switch. Alterations of these ratios are indicative of a molecular defect at the level of the HbF synthesis. Qualitative hemoglobinopathies due to (G)gamma and (A)gamma chain structural variants, and quantitative hemoglobinopathies affecting the synthesis of HbF such as gamma-thalassemias, duplications, triplications, and even sextuplications of the gamma-globin genes, which may be detected in newborn blood lysates, have been described. Moreover, several pathological and nonpathological conditions affecting the beta-globin gene cluster, such as beta-thalassemia, sickle cell disease, deltabeta-thalassemia, and hereditary persistence of HbF syndromes, are characterized by the continued synthesis of gamma-globin chains in the adult life. Studies of these natural mutants associated with increased synthesis of HbF in adult life have provided considerable insight into the understanding of the control of globin gene expression and Hb switching.
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Affiliation(s)
- Laura Manca
- Department of Physiological, Biochemical and Cell Sciences, University of Sassari, Sassari, Italy
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17
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Perry RT, Gearhart DA, Wiener HW, Harrell LE, Barton JC, Kutlar A, Kutlar F, Ozcan O, Go RCP, Hill WD. Hemoglobin binding to A beta and HBG2 SNP association suggest a role in Alzheimer's disease. Neurobiol Aging 2006; 29:185-93. [PMID: 17157413 PMCID: PMC2266611 DOI: 10.1016/j.neurobiolaging.2006.10.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 08/04/2006] [Accepted: 10/11/2006] [Indexed: 10/23/2022]
Abstract
From a normal human brain phage display library screen we identified the gamma (A)-globin chain of fetal hemoglobin (Hb F) as a protein that bound strongly to A beta1-42. We showed the oxidized form of adult Hb (metHb A) binds with greater affinity to A beta1-42 than metHb F. MetHb is more toxic than oxyhemoglobin because it loses its heme group more readily. Free Hb and heme readily damage vascular endothelial cells similar to Alzheimer's disease (AD) vascular pathology. The XmnI polymorphism (C-->T) at -158 of the gamma (G)-globin promoter region can contribute to increased Hb F expression. Using family-based association testing, we found a significant protective association of this polymorphism in the NIMH sibling dataset (n=489) in families, with at least two affected and one unaffected sibling (p=0.006), with an age of onset >50 years (p=0.010) and >65 years (p=0.013), and families not homozygous for the APOE4 allele (p=0.041). We hypothesize that Hb F may be less toxic than adult Hb in its interaction with A beta and may protect against the development of AD.
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Affiliation(s)
- Rodney T. Perry
- Department. of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA; Birmingham, AL 35294-0022, ; ;
| | - Debra A. Gearhart
- Department of Pharmacology & Toxicology, Medical College of Georgia, Augusta , GA 30912-2300, USA;
| | - Howard W. Wiener
- Department. of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA; Birmingham, AL 35294-0022, ; ;
| | - Lindy E. Harrell
- Alzheimer' Disease Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294-0017;
| | | | - Abdullah Kutlar
- Department of Medicine, Medical College of Georgia, Augusta GA 30912-2000 (USA); ;
| | - Ferdane Kutlar
- Department of Medicine, Medical College of Georgia, Augusta GA 30912-2000 (USA); ;
| | - Ozan Ozcan
- Department of Cellular Biology & Anatomy, Medical College of Georgia ; Department of Biology, Paine College, Augusta, GA 30912-2000;
| | - Rodney C. P. Go
- Department. of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA; Birmingham, AL 35294-0022, ; ;
| | - William D. Hill
- Department of Cellular Biology and Anatomy, Department of Neurology, Institute of Molecular Medicine and Genetics, Medical College of Georgia; Augusta Veterans Administration Medical Center, Augusta, GA 30912-2000, USA;
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18
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De Angioletti M, Lacerra G, Pagano L, Alessi M, D'Avino R, Manca L, Carestia C. β
-thalassaemia-87 C→G: relationship of the Hb F modulation and polymorphisms in compound heterozygous patients. Br J Haematol 2004; 126:743-9. [PMID: 15327529 DOI: 10.1111/j.1365-2141.2004.05089.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A clinical, haematological, biochemical and molecular study was carried out in 17 patients affected with thalassaemia intermedia, who were compound heterozygotes for the beta-thalassaemia mutation beta-87 C-->G to determine the genetic basis of their clinical heterogeneity. The beta-87 was found associated with haplotype VIII (beta-87/VIII) or V (beta-87/V). The 10 patients with the beta-87/VIII showed milder clinical conditions, with significantly higher levels of haemoglobin (Hb) (9.8 +/- 1.1 g/dl vs. 8.5 +/- 1.3 g/dl) and fetal haemoglobin (Hb F) (6.2 +/- 1.5 g/dl vs. 2.6 +/- 1.5 g/dl; P = 0.0034) and higher synthesis of (G)gamma ((G)gamma/(Total)gamma 69.4 +/- 2.6% vs. 42.8 +/- 16.2%; P = 0.0042) than the seven patients with the beta-87/V. The beta-87/VIII showed a configuration of rare polymorphisms in the 5' sub-haplotype, which have been reported to exert an increasing effect on Hb F. They were "T"-158 (G)gamma-globin gene, T-A-G in pre-(G)gamma framework, (TG)(11)(CG)(3) in the (G)gamma-IVS2, (AT)(9)N(12)(AT)(10) in LCR-HS2; in contrast, the haplotype V had, respectively, "C", T-G-A (TG)(19)(CG)(2)CACG in the (G)gamma-IVS2, and (AT)(10)N(12)(AT)(11). In all patients the beta-87 was associated with the (AT)(9)T(5) motif 5' beta-globin gene with increased affinity for the BP-1 protein, and with the (TG)(13) in the (A)gamma-IVS2. The high increase of the Hb F, mostly of the (G)gamma-type, strongly suggests the hypothesis that the 'T'-158 (G)gamma plays a principal role and that the other polymorphisms could exert a cooperative role in the modulation of Hb F in patients with erythropoietic stress.
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Affiliation(s)
- Maria De Angioletti
- Istituto di Genetica e Biofisica Adriano Buzzati Traverso, CNR, Via G. Marconi 10-12, 80125 Naples, Italy
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