1
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Sun M, Lou J, Xinghe W, Zhao Y, Dai Y, Liu S, Yan T. Hb H disease associated with compound heterozygosity for -- SEA deletion and a novel alpha globin chain variant ( HBA2:c.175C>A) on the distal histidine in a Chinese family. Hematology 2024; 29:2339559. [PMID: 38626234 DOI: 10.1080/16078454.2024.2339559] [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: 09/27/2023] [Accepted: 04/01/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVES In clinical practice, the majority of α-thalassaemia cases arise from deletions of the α-globin genes. However, a subset of cases is attributed to rare haemoglobin variants, which can manifest with borderline or normal screening results, potentially leading to missed diagnoses in clinical practice. METHODS Blood samples were collected from family members and underwent haematological, DNA and RNA analysis. RESULTS The five-month-old proband presented a haematological phenotype consistent with Hb H disease. The mother's haematology profile was consistent with an α-thalassaemia carrier, while the father exhibited a borderline reduction in MCV and MCH. MALDI-TOF identified an abnormal α-chain in the proband. DNA analysis revealed a novel α-globin variant (HBA2:c.175C>A, α58His>Asn, Hb DG-Nancheng) affecting the distal histidine in the family. The father and the mother had α-genotype of --SEA/αα and αDG-Nanchengα/αα, respectively; while the proband inherited both mutant alleles (--SEA/αDG-Nanchengα). Sequencing of cDNA from HBA2 gene identified an equal ratio of normal and mutant alleles. CONCLUSION This rare case highlighted the importance of identifying rare haemoglobin variant during prenatal screening. The clinical and genetic data provides useful information on the pathogenicity of this variant and further insight into the role of distal histidine residue of α-globin.
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Affiliation(s)
- Manna Sun
- Department of Obstetrics & Gynecolog, Dongguan Maternal and Children Hospital, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Maternal and Fetal Medicine, Dongguan, People's Republic of China
| | - Jiwu Lou
- Prenatal Diagnostic Center, Dongguan Maternal and Children Health Hospital, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Reproduction and Birth Defects Prevention and Control, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Genetic Disorder Prenatal Testing Precision medicine, Dongguan, People's Republic of China
| | - Wang Xinghe
- Department of Obstetrics & Gynecolog, Dongguan Maternal and Children Hospital, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Maternal and Fetal Medicine, Dongguan, People's Republic of China
| | - Ying Zhao
- Prenatal Diagnostic Center, Dongguan Maternal and Children Health Hospital, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Reproduction and Birth Defects Prevention and Control, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Genetic Disorder Prenatal Testing Precision medicine, Dongguan, People's Republic of China
| | - Yunshi Dai
- Prenatal Diagnostic Center, Dongguan Maternal and Children Health Hospital, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Reproduction and Birth Defects Prevention and Control, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Genetic Disorder Prenatal Testing Precision medicine, Dongguan, People's Republic of China
| | - Shuangai Liu
- Prenatal Diagnostic Center, Dongguan Maternal and Children Health Hospital, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Reproduction and Birth Defects Prevention and Control, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Genetic Disorder Prenatal Testing Precision medicine, Dongguan, People's Republic of China
| | - Tizhen Yan
- Prenatal Diagnostic Center, Dongguan Maternal and Children Health Hospital, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Reproduction and Birth Defects Prevention and Control, Dongguan, People's Republic of China
- Dongguan Key Laboratory of Genetic Disorder Prenatal Testing Precision medicine, Dongguan, People's Republic of China
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2
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Faheem Y, Baroudi MM, Emad Al Saddik S, John S, Hafez W. A rare hemoglobinopathy duo: Hb Adana×Hb SEA in a 1-year-old patient - a case report and a brief literature review. Ann Med Surg (Lond) 2024; 86:3730-3735. [PMID: 38846854 PMCID: PMC11152822 DOI: 10.1097/ms9.0000000000002101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/13/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction and importance Alpha thalassemia, resulting from nondeletional mutations, typically presents a more severe clinical manifestation compared to deletional mutations. Severe outcomes, such as hydrops fetalis, are associated with two specific nondeletional mutations. Therefore, DNA-based investigation is crucial for suspected carriers exhibiting subtle hematological abnormalities to facilitate proper diagnosis and effective family counseling. Case presentation In this report, the authors describe a phenotypically normal 1-year-old girl with a rare and unique alpha-thalassemia genotype due to the presence of Hb Adana, a nondeletional alpha-chain mutation compounded with Hb SEA, an alpha-globin gene deletion. Clinical discussion Mutations determine the clinical manifestations of alpha-thalassemia. DNA testing is recommended for suspected carriers with relatively small hematological abnormalities, for precise diagnosis and family counseling. To provide clinicians with a reference for diagnostic assessment, the authors established a genotype-phenotype correlations based on reported cases of Hb Adana following an exhaustive literature review. Being interested in determining which ethnicities and genotypes are associated with a higher risk of complications, including hydrops fetalis and transfusion dependence, the authors formalized a diagnostic evaluation guide and a guide for early screening to improve outcomes. Conclusion Precise genetic evaluation is important for the diagnosis of alpha thalassemia. Hematologists play a critical role in managing these disorders, understanding genotype-phenotype correlations, and highlighting the significance of genetic counseling for high-risk patients. Extensive studies on these various genophenotypes are required to improve the diagnosis and prognosis of such medical conditions and advocate preventative strategies.
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Affiliation(s)
| | | | | | - Steffi John
- NMC Royal Hospital, Khalifa City, Abu Dhabi, UAE
| | - Wael Hafez
- NMC Royal Hospital, Khalifa City, Abu Dhabi, UAE
- The Medical Research Division, Department of Internal Medicine, The National Research Center, Cairo, Egypt
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3
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Vadolas J, Nualkaew T, Voon HPJ, Vilcassim S, Grigoriadis G. Interplay between α-thalassemia and β-hemoglobinopathies: Translating genotype-phenotype relationships into therapies. Hemasphere 2024; 8:e78. [PMID: 38752170 PMCID: PMC11094674 DOI: 10.1002/hem3.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/22/2024] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
α-Thalassemia represents one of the most important genetic modulators of β-hemoglobinopathies. During this last decade, the ongoing interest in characterizing genotype-phenotype relationships has yielded incredible insights into α-globin gene regulation and its impact on β-hemoglobinopathies. In this review, we provide a holistic update on α-globin gene expression stemming from DNA to RNA to protein, as well as epigenetic mechanisms that can impact gene expression and potentially influence phenotypic outcomes. Here, we highlight defined α-globin targeted strategies and rationalize the use of distinct molecular targets based on the restoration of balanced α/β-like globin chain synthesis. Considering the therapies that either increase β-globin synthesis or reactivate γ-globin gene expression, the modulation of α-globin chains as a disease modifier for β-hemoglobinopathies still remains largely uncharted in clinical studies.
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Affiliation(s)
- Jim Vadolas
- Centre for Cancer ResearchHudson Institute of Medical ResearchClaytonVictoriaAustralia
- Department of Molecular and Translational SciencesMonash UniversityClaytonVictoriaAustralia
| | - Tiwaporn Nualkaew
- Centre for Cancer ResearchHudson Institute of Medical ResearchClaytonVictoriaAustralia
- Present address:
Department of Medical Technology, School of Allied Health SciencesWalailak UniversityNakhon Si ThammaratThailand
| | - Hsiao P. J. Voon
- Department of Biochemistry and Molecular Biology, Cancer Program, Biomedicine Discovery InstituteMonash UniversityClaytonVictoriaAustralia
| | - Shahla Vilcassim
- Centre for Cancer ResearchHudson Institute of Medical ResearchClaytonVictoriaAustralia
- School of Clinical Sciences at Monash HealthMonash UniversityClaytonAustralia
| | - George Grigoriadis
- Centre for Cancer ResearchHudson Institute of Medical ResearchClaytonVictoriaAustralia
- School of Clinical Sciences at Monash HealthMonash UniversityClaytonAustralia
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4
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Pan L, Wang Y, Lin H, Zhang X, Zhang R. A Novel Frameshift Mutation( HBA2:C.337delC) Associated With α-Thalassemia Trait Detected by Next-Generation Sequencing in Southern China. Hemoglobin 2024:1-3. [PMID: 38653553 DOI: 10.1080/03630269.2024.2344786] [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: 11/26/2023] [Accepted: 04/14/2024] [Indexed: 04/25/2024]
Abstract
Here, we report a novel frameshift mutation caused by a single base deletion in exon 3 of the HBA2 gene (HBA2:c.337delC) detected by next-generation sequencing. The proband was a 26-year-old Chinese pregnant woman who originates from Hunan Province. Her mean corpuscular volume(MCV) and mean corpuscular hemoglobin (MCH) had a mild decrease. Capillary electrophoresis (CE) showed that both Hb A (97.8%) and Hb F (0.0%) values were within normal range, while the Hb A2 (2.2%) value was below normal. Sequence analysis of the α and β-globin genes revealed a novel single base deletion at codon 112 (HBA2:c.337delC) in the heterozygous state, which resulted in a mild phenotype of α-thalassemia.
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Affiliation(s)
| | - Yan Wang
- Department of Medical Genetics and Prenatal Diagnosis, Baoan Women's and Children's Hospital, Shenzhen, China
| | - Haiying Lin
- Department of Medical Genetics and Prenatal Diagnosis, Baoan Women's and Children's Hospital, Shenzhen, China
| | - Xiufa Zhang
- Department of Medical Genetics and Prenatal Diagnosis, Baoan Women's and Children's Hospital, Shenzhen, China
| | - Rui Zhang
- Department of Medical Genetics and Prenatal Diagnosis, Baoan Women's and Children's Hospital, Shenzhen, China
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5
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Tang B, Wang J, Qin D, Yao C, Chen K, Liang L, Chai H, Guo H, Du L. Hb Chapel Hill or Alpha2 74(EF3) Asp>Gly, a mildly unstable variant found in a Chinese family. Hematology 2023; 28:2187154. [PMID: 36939273 DOI: 10.1080/16078454.2023.2187154] [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: 10/29/2022] [Accepted: 02/28/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Hb Chapel Hill [Alpha2 74(EF3) Asp > Gly] results from an GAC > GGC substitution at codon 74 of the HBA1 or HBA2 genes. Hb Chapel Hill has not been reported since 1986. METHODS A heterozygous mutation, HBA2: c.224A > G, was identified in the proband, her father and sister. We compared the haematological and clinical data of this family with the data reported in the limited number of individuals. RESULTS Having excluded iron deficiency, the Hb Chapel Hill was asymptomatic in heterozygous state. The cases presented here characterize cases in new techniques including capillary electrophoresis (CE). Two aberrant peaks were identified by CE, a major peak migrating in the zone 7 that correspond to Hb Chapel Hill (αChapel Hill 2β2) and a minor peak migrating in the zone 1 that correspond to Hb Chapel Hill2 (αChapel Hill 2δ2). Focusing on the variant expression, the Hb Chapel Hill plus Hb A2 variant were around 18.9-20.6% of total Hb in three members. CONCLUSION This data will be useful for providing up-to-date and high quality information on the Hb Chapel Hill.
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Affiliation(s)
- Bin Tang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Jicheng Wang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Danqinq Qin
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Cuize Yao
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Keyi Chen
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Lihua Liang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Huiying Chai
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Hao Guo
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Li Du
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
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6
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Diamantidis MD, Pitsava S, Zayed O, Argyrakouli I, Karapiperis K, Chatzoulis C, Alexiou E, Manafas A, Tsangalas E, Karakoussis K. Concomitant Presence of Hb Agrinio and - -Med Deletion in a Greek Male Patient with Hemoglobinopathy H: More Severe Phenotype and Literature Review. Hematol Rep 2023; 15:483-490. [PMID: 37606495 PMCID: PMC10443284 DOI: 10.3390/hematolrep15030050] [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: 04/11/2023] [Revised: 05/17/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
Hemoglobin (Hb) Agrinio is a rare non-deletional a-globin mutation observed almost exclusively in Greek, Spanish or other Mediterranean families. The clinical manifestations of a carrier of a single Hb Agrinio mutation (single heterozygosity) depend on the concomitant presence or absence of other mutations or variants in the beta, alpha or other modifying genes. We present a Greek patient harboring a Hb Agrinio variant plus the - -Med alpha deletional allele, having an infrequent severe form of alpha thalassemia, in contrast to the typical alpha thalassemic patient and requiring regular red blood cell (RBC) transfusions and chelation treatment. We also provide a concise literature review regarding alpha thalassemic hemoglobin variants and their molecular and clinical combinations. A phase 2, double-blind, randomized, placebo-controlled, multicenter clinical trial to determine the efficacy and safety of luspatercept (BMS-986346/ACE-536) for the treatment of anemia in adults with alpha thalassemia with the participation of our center is currently recruiting patients (NCT05664737).
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Affiliation(s)
- Michael D. Diamantidis
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
| | - Stefania Pitsava
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
| | - Omar Zayed
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
| | - Ioanna Argyrakouli
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
| | - Konstantinos Karapiperis
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
| | - Christos Chatzoulis
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
| | - Evangelos Alexiou
- Radiology Department, General Hospital of Larissa, 41221 Larissa, Greece;
| | - Achilles Manafas
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
| | - Evangelos Tsangalas
- Thalassemia and Sickle Cell Disease Unit, Department of Hematology, General Hospital of Larissa, 41221 Larissa, Greece; (S.P.); (O.Z.); (I.A.); (K.K.); (C.C.); (A.M.); (E.T.)
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7
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Abstract
Clinical manifestations of α-thalassemia range from no symptoms to severe transfusion-dependent anemia. Alpha thalassemia trait is deletion of 1 to 2 α-globin genes, whereas α-thalassemia major (ATM; Barts hydrops fetalis) is the deletion all 4 α genes. All other genotypes of intermediate severity are categorized as HbH disease, a vastly heterogenous group. Clinical spectrum is classified as mild, moderate, and severe by symptoms and need for intervention. Anemia in prenatal period may be fatal without intrauterine transfusions. New therapies to modify HbH disease or provide cure for ATM are under development.
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Affiliation(s)
- Ashutosh Lal
- UCSF School of Medicine, UCSF Benioff Children's Hospital, 747 52nd Street, Oakland, CA 94609, USA.
| | - Elliott Vichinsky
- UCSF School of Medicine, UCSF Benioff Children's Hospital, 747 52nd Street, Oakland, CA 94609, USA
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8
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Abstract
Thalassemia syndromes are common monogenic disorders and represent a significant health issue worldwide. In this review, the authors elaborate on fundamental genetic knowledge about thalassemias, including the structure and location of globin genes, the production of hemoglobin during development, the molecular lesions causing α-, β-, and other thalassemia syndromes, the genotype-phenotype correlation, and the genetic modifiers of these conditions. In addition, they briefly discuss the molecular techniques applied for diagnosis and innovative cell and gene therapy strategies to cure these conditions.
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Affiliation(s)
- Nicolò Tesio
- Department of Clinical and Biological Sciences, San Luigi Gonzaga University Hospital, University of Torino, Regione Gonzole, 10, 10043 Orbassano, Turin, Italy. https://twitter.com/nicolotesio
| | - Daniel E Bauer
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, USA; Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Pediatrics, Harvard Stem Cell Institute, Broad Institute, Harvard Medical School, Boston, MA, USA.
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9
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Yao C, Qin D, Wang J, Bao X, Liang J, Du L. First study to describe a novel HbA2: c.400A > C mutation and Hb Dongguan heterozygote in two unrelated Chinese families. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2022; 27:867-873. [PMID: 35938954 DOI: 10.1080/16078454.2022.2109324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Here we report two rare α-globin chain variants in two unrelated families: Hb Val de Marne [α133(H16) Ser > Arg (AGC > CGC); HBA2: c.400A > C] and Hb Dongguan [α52(E6) Ser > Cys (TCT > TGT); HBA1: c.158C > G]. Notably, HBA2: c.400A > C is an unreported new variant in the third exon of the α2 gene, and simple heterozygous unstable Hb Dongguan haematological characteristics are proposed for the first time. METHODS Hb analysis was performed by using capillary electrophoresis (CE). Twenty-three common mutations were detected using a suspension array system. Mutations were identified by DNA sequencing. RESULTS The CE results showed an abnormal peak with incomplete separation from Hb A at zone 8 in two members of Family 1. DNA sequencing confirmed the presence of Hb Val de Marne [α133(H16) Ser > Arg (AGC > CGC); HBA2: c.400A > C]. Five members of Family 2 exhibited an abnormal peak at zone 11, and DNA sequencing confirmed the presence of Hb Dongguan [α52(E6) Ser > Cys (TCT > TGT); HBA1: c.158C > G]. CONCLUSIONS The discovery of HBA2: C.400A > C expands the existing spectrum of α-globin variants. The carriers of simple heterozygous Hb Dongguan generally do not have obvious clinical symptoms. The information in this study will help clinicians understand the screening, molecular diagnosis and clinical significance of Hb variants.
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Affiliation(s)
- Cuize Yao
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Danqing Qin
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Jicheng Wang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Xiuqin Bao
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Jie Liang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Li Du
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China.,Thalassemia Diagnosis Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong, People's Republic of China
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10
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Molecular Heterogeneity of Hb H Disease in India. THALASSEMIA REPORTS 2022. [DOI: 10.3390/thalassrep12030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Alpha thalassemia is an autosomal recessive disorder caused by large deletions and/or point mutations in the α- globin genes. Hemoglobin H (Hb H) disease is most frequently due to deletion of three of the four α globin genes associated with variable clinical severity depending on the genotype. There are few reports on Hb H disease in Indians where genotyping has been done and we have reviewed the molecular and clinical heterogeneity of these cases. An electronic search for relevant articles was conducted using two journal databases, i.e., PubMed and Science Direct using the key words “Hb H Disease”, “Hemoglobin H”, “α-thalassemia”, “mutations”, “molecular heterogeneity”, “case reports” and “India”. This review was performed based on preferred reporting items for the systematic review and meta-analysis protocols (PRISMA-P) guidelines. The molecular spectrum of Hb H disease in Indians includes the most common [-α3.7, -α4.2, --SA, Poly A (AATAAA→AATA--), Hb Sallanches], rare [--SEA, --MED, IVS 1nt 1 (G→A), Hb Koya Dora, Hb Sun Prairie], very rare [Hb Iberia, Hb Seal Rock, Hb Zürich-Albisrieden] and novel [Codon 76 (+T) and --Kol] α-globin gene mutations inherited largely as compound heterozygotes with considerable clinical variability. The molecular diagnosis of Hb H disease is important for genetic counseling and management.
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11
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Grimholt RM, Fjeld B, Klingenberg O. Hemoglobinopathy gone astray-three novel forms of α-thalassemia in Norwegian patients characterized by quantitative real-time PCR and DNA sequencing. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:670-678. [PMID: 34791962 DOI: 10.1080/00365513.2021.2004218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
α-thalassemia is one of the most common monogenic diseases worldwide and is caused by reduced or absent synthesis of α-globin chains, most commonly due to deletions of one or more of the α-globin genes. α-thalassemia occurs with high frequency in tropical and subtropical regions of the world and are very rarely found in the indigenous Scandinavian population. Here, we describe four rare forms of α-thalassemia out of which three are novel, found in together 20 patients of Norwegian origin. The study patients were diagnosed during routine hemoglobinopathy evaluation carried out at the Department of Medical Biochemistry, Oslo University Hospital, Norway. The patients were selected for their thalassemic phenotype, despite Norway as country of origin. All samples went through standard hemoglobinopathy evaluation. DNA sequencing and copy number variation (CNV) analysis using quantitative real-time polymerase chain reaction (qPCR) was applied to detect sequence variants and uncommon deletions in the α-globin gene cluster, respectively. Deletion breakpoints were characterized using gap-PCR and DNA sequencing. DNA sequencing revealed a single nucleotide deletion in exon 3 of the HBA2 gene (NM_000517.4(HBA2):c.345del) and a novel deletion of 20 nucleotides in exon 2 of the HBA2 gene (NM_000517.4(HBA2):c.142_161del). qPCR CNV analysis detected two novel large deletions in the α-globin gene cluster, -(NOR) deletion covering both α-globin genes and (αα)Aurora Borealis affecting the regulatory region, leaving the downstream α-globin genes intact. Even though inherited globin gene disorders are extremely rare in indigenous Scandinavians, the possibility of a carrier state should not be ignored.
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Affiliation(s)
- Runa M Grimholt
- Department of Medical Biochemistry, Oslo University Hospital, Ullevaal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Life Sciences and Health, Oslo Metropolitan University, Oslo, Norway
| | - Bente Fjeld
- Department of Medical Biochemistry, Oslo University Hospital, Ullevaal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Olav Klingenberg
- Department of Medical Biochemistry, Oslo University Hospital, Ullevaal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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12
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mRNA Analysis of Frameshift Mutations with Stop Codon in the Last Exon: The Case of Hemoglobins Campania [α1 cod95 (-C)] and Sciacca [α1 cod109 (-C)]. Biomedicines 2021; 9:biomedicines9101390. [PMID: 34680508 PMCID: PMC8533187 DOI: 10.3390/biomedicines9101390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/05/2022] Open
Abstract
An insertion or deletion of a nucleotide (nt) in the penultimate or the last exon can result in a frameshift and premature termination codon (PTC), giving rise to an unstable protein variant, showing a dominant phenotype. We described two α-globin mutants created by the deletion of a nucleotide in the penultimate or the last exon of the α1-globin gene: the Hb Campania or α1 cod95 (−C), causing a frameshift resulting in a PTC at codon 102, and the Hb Sciacca or α1 cod109 (−C), causing a frameshift and formation of a PTC at codon 133. The carriers showed α-thalassemia alterations (mild microcytosis with normal Hb A2) and lacked hemoglobin variants. The 3D model indicated the α-chain variants’ instability, due to the severe structural alterations with impairment of the chaperone alpha-hemoglobin stabilizing protein (AHSP) interaction. The qualitative and semiquantitative analyses of the α1mRNA from the reticulocytes of carriers highlighted a reduction in the variant cDNAs that constituted 34% (Hb Campania) and 15% (Hb Sciacca) of the total α1-globin cDNA, respectively. We developed a workflow for the in silico analysis of mechanisms triggering no-go decay, and its results suggested that the reduction in the variant mRNA was likely due to no-go decay caused by the presence of a rare triplet, and, in the case of Hb Sciacca, also by the mRNA’s secondary structure variation. It would be interesting to correlate the phenotype with the quantity of other frameshift mRNA variants, but very few data concerning α- and β-globin variants are available.
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Saensuwanna A, Penglong T, Srinoun K. Upregulation of miR-214 Mediates Oxidative Stress in Hb H Disease via Targeting of ATF4. Hemoglobin 2021; 45:197-202. [PMID: 34156885 DOI: 10.1080/03630269.2021.1941081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Thalassemia is a genetic disorder, occurring because of an imbalance in the globin chain production. Oxidative stress in erythroid cells of thalassemia is mainly generated from excess globin chains, by Fenton reaction, leading to hemolysis and ineffective erythropoiesis. Previously, data has shown that microRNAs (miRNAs) are involved in oxidative stress regulation in red blood cells (RBCs). microR-214 has been reported to respond with an external oxidative stress in erythroid cells by modulating activating transcription factor 4 (ATF4). In this study, we illustrated the expressions of miR-214 and ATF4 in Hb H (β4) disease, and Hb E (HBB: c.79G>A)/β-thalassemia (β-thal) reticulocyte samples. Our results showed miR-214 expression was increased in Hb H disease, but not significantly different in Hb E/β-thal reticulocytes. The ATF4 target was decreased in both thalassemic groups. Moreover, miR-214 expression level positively correlated with the reactive oxygen species (ROS) level, while it was negatively correlated with mean corpuscular volume (MCV), mean corpuscular hemoglobin (Hb) (MCH) and mean corpuscular Hb concentration (MCHC). We suggested that the upregulation of miR-214 correlated with the oxidative stress as well as anemia severity of Hb H disease patients, by suppression of ATF4. Understanding the oxidative pathways in erythrocyte could be useful to manage and relieve the clinical manifestation, such as anemia, in thalassemic patients.
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Affiliation(s)
- Apisara Saensuwanna
- Faculty of Medicine, Department of Biomedical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Tipparat Penglong
- Faculty of Medicine, Department of Pathology, Prince of Songkla University, Songkhla, Thailand
| | - Kanitta Srinoun
- Faculty of Medical Technology, Prince of Songkla University, Songkhla, Thailand
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14
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Ropero P, M Nieto J, González Fernández FA, Villegas A, Benavente C. Hb Maruchi [α165 (E14) Ala>Pro; HBA1: c.196G>C]: A new thalassemia hemoglobinopathy related to the alpha1 globin gene. Clin Biochem 2021; 92:77-81. [PMID: 33675809 DOI: 10.1016/j.clinbiochem.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe a new mutation causing alpha thalassemia and its mechanism of action. DESIGN AND METHODS The propositus was a 37-year-old man who presented maintained microcytosis without iron deficiency. Molecular characterization was undertaken using automatic sequencing after testing negative for the most frequent α-globin mutations by multiplex PCR followed by reverse-hybridization. RESULTS The mutation is a single base substitution at codon 65 of the α1 globin gene [α65(E14) Ala>Pro; HBA1: c.196G>C] and leads to the substitution of a proline residue in the E helix. The resulting hemoglobin variant has been named Hb Maruchi. This new variant cannot be separated from Hb A by electrophoretic and chromatographic techniques. CONCLUSIONS The substitution α65(E14) Ala>Pro; HBA1: c.196G>C causes a α-thalassemia silent associated with a very mild phenotype. The diagnosis of this type of mutation is important because it may cause alpha thalassemia if inherited with other clinically relevant HBA1/HBA2 variants.
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Affiliation(s)
- Paloma Ropero
- Servicio de Hematología, Hospital Clínico San Carlos Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos Madrid, Spain.
| | - Jorge M Nieto
- Servicio de Hematología, Hospital Clínico San Carlos Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos Madrid, Spain
| | | | - Ana Villegas
- Servicio de Hematología, Hospital Clínico San Carlos Madrid, Spain
| | - Celina Benavente
- Servicio de Hematología, Hospital Clínico San Carlos Madrid, Spain
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15
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Forouzesh Pour F, Karimi K, Ghaderi Z, Tavakoli Koudehi A, Najmabadi H. Heterozygosity for the Novel HBA2: c.*91_*92delTA Polyadenylation Site Variant on the α2-Globin Gene Expanding the Genetic Spectrum of α-Thalassemia in Iran. Hemoglobin 2020; 44:423-426. [PMID: 33054440 DOI: 10.1080/03630269.2020.1831529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There are four copy numbers of α-globin genes (16p13.3) in the human genome and the number of defective α-globin genes dictates the severity of α-thalassemia (α-thal). Mutations that occur in the 3' untranslated region (3'UTR), and especially at the polyadenylation (polyA) sites, affect the translation, stability and export of mRNA. A patient with hypochromic microcytic anemia was referred to the Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran by the health network. Molecular analysis of genomic DNA for the evaluation of mutations on the α- and β-globin genes was performed. Direct sequencing of the hemoglobin (Hb) subunit α2 (HBA2) gene revealed a two nucleotide deletion between +816 and +817 in the 3'UTR, located at the polyA site, which seems to be a novel pathogenic variant. This novel variant expands the genetic spectrum of α-thal in the 3'UTR of the HBA2 gene.
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Affiliation(s)
| | - Keyvan Karimi
- Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran
| | - Zhila Ghaderi
- Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran
| | | | - Hossein Najmabadi
- Kariminejad-Najmabadi Pathology & Genetics Center, Tehran, Iran.,Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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16
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Cardiero G, Musollino G, Friscia MG, Testa R, Virruso L, Di Girgenti C, Caldora M, Colella Bisogno R, Gaudiano C, Manco G, Lacerra G. Effect of Mutations on mRNA and Globin Stability: The Cases of Hb Bernalda/Groene Hart and Hb Southern Italy. Genes (Basel) 2020; 11:genes11080870. [PMID: 32751969 PMCID: PMC7466077 DOI: 10.3390/genes11080870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
We identified two unstable variants in the third exon of α-globin genes: Hb Bernalda/Groene Hart (HBA1:c.358C>T), and Hb Caserta (HBA2:c.79G>A) in cis to Hb Sun Prairie (HBA2:c.391G>C), also named Hb Southern Italy. These mutations occurred in the H helix of the α-globin that is involved in heme contacting, specific recognition of α-hemoglobin-stabilizing protein (AHSP), and α1β1 interactions. The carriers showed α-thalassemia phenotype, but one also jaundice and cholelithiasis. Molecular identification of clusters of families in Southern Italy encouraged molecular characterization of mRNA, globin chain analyses, molecular modeling studies, and comparison with globin variants to understand the mechanisms causing the α-thalassemia phenotype. A normal amount of Hb Bernalda/Groene Hart mRNA were found, and molecular modeling highlighted additional H bonds with AHSP. For Hb Southern Italy, showing an unexpected α/β biosynthetic ratio typical of the β-thalassemia type, two different molecular mechanisms were shown: Reduction of the variant mRNA, likely due to the No-Go Decay for the presence of unused triplet ACG at cod 26, and protein instability due to the impairment of AHSP interaction. The UDP glucuronosyltransferase 1A (UGT1A1) genotyping was conclusive in the case of jaundice and cholelithiasis. Multiple approaches are needed to properly identify the mechanisms leading to unstable variants and the effect of a mutation.
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Affiliation(s)
- Giovanna Cardiero
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, (IGB-ABT, CNR), National Research Council, 80131 Naples, Italy; (G.C.); (G.M.)
| | - Gennaro Musollino
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, (IGB-ABT, CNR), National Research Council, 80131 Naples, Italy; (G.C.); (G.M.)
| | - Maria Grazia Friscia
- Azienda Ospedaliera Ospedali Civili Riuniti, Centro Trasfusionale e di Microcitemia, 92019 Sciacca, Italy;
| | - Rosario Testa
- Azienda Ospedaliero-Universitaria “Policlinico-Vittorio Emanuele”, Servizio di Talassemia ed Emoglobinopatie, 95123 Catania, Italy;
| | - Lucrezia Virruso
- ARNAS P.O. Civico e Di Cristina Benfratelli, U.O.s.d. Lab. Spec. Genetica Molecolare, 90127 Palermo, Italy; (L.V.); (C.D.G.)
| | - Caterina Di Girgenti
- ARNAS P.O. Civico e Di Cristina Benfratelli, U.O.s.d. Lab. Spec. Genetica Molecolare, 90127 Palermo, Italy; (L.V.); (C.D.G.)
| | | | - Rosario Colella Bisogno
- Azienda Ospedaliera Universitaria OO. RR. San Giovanni di Dio e Ruggi D’Aragona, Medicina Trasfusionale, 84131 Salerno, Italy;
| | - Carlo Gaudiano
- P.O. Madonna delle Grazie, Centro per la Lotta Contro le Microcitemie, ASL 4, 75100 Matera, Italy;
| | - Giuseppe Manco
- Institute of Biochemistry and Cell Biology (IBBC, CNR), National Research Council, 80131 Naples, Italy;
| | - Giuseppina Lacerra
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, (IGB-ABT, CNR), National Research Council, 80131 Naples, Italy; (G.C.); (G.M.)
- Correspondence:
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17
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Panyasai S, Phasit A. α-Thalassemia Intermedia Results from Interactions of Unstable Hb Prato [α31(B12)Arg→Ser ( HBA1 or HBA2 c.96G>T or C)] with the α-Thalassemia-1 [- - SEA (Southeast Asian)] Deletion in Thailand. Hemoglobin 2020; 44:264-271. [PMID: 32727229 DOI: 10.1080/03630269.2020.1797773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The clinical consequences of many abnormal hemoglobins (Hbs) interacting with α- or β-thalassemia (α- or β-thal) or other hemoglobinopathies have not been described. We evaluated a 75-year-old Thai woman and her 45-year-old daughter. Hematological data was obtained on an automated cell counter. Hemoglobin (Hb) analysis was carried out using high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) assays. Mutations and globin haplotypes were identified by appropriated DNA techniques. The proband presented with moderate anemia and inclusion bodies in most of the red blood cells (RBCs), while altered RBC parameters were absent in her daughter. Hemoglobin analysis showed an abnormal Hb peak only in the proband. DNA analysis identified a G>T substitution at codon 31 of the α1-globin gene, corresponding to Hb Prato [α31(B12)Arg→Ser (HBA1 or HBA2 c.96G>T or C)] in both subjects. The α-thal-1 [- -SEA (Southeast Asian)] deletion was also identified in the proband, but not in her daughter. These mutations could be identified using newly developed allele-specific polymerase chain reaction (ASPCR) assays. The α haplotypic analysis demonstrated the Thai Hb Prato allele was associated with haplotype [+ - S + - + -] [the S represents the inter ζ hypervariable region (HVR)]. The combination of the unstable Hb Prato with α-thal-1 result in α-thal intermedia (α-TI) phenotypes. A simple DNA method is essential for detection, and a haplotypic α-globin gene cluster are presented.
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Affiliation(s)
- Sitthichai Panyasai
- Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Amphai Phasit
- Department of Medical Technology, Lampang Hospital, Lampang, Thailand
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18
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Kalle Kwaifa I, Lai MI, Md Noor S. Non-deletional alpha thalassaemia: a review. Orphanet J Rare Dis 2020; 15:166. [PMID: 32600445 PMCID: PMC7322920 DOI: 10.1186/s13023-020-01429-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Defective synthesis of the α-globin chain due to mutations in the alpha-globin genes and/or its regulatory elements leads to alpha thalassaemia syndrome. Complete deletion of the 4 alpha-globin genes results in the most severe phenotype known as haemoglobin Bart's, which leads to intrauterine death. The presence of one functional alpha gene is associated with haemoglobin H disease, characterised by non-transfusion-dependent thalassaemia phenotype, while silent and carrier traits are mostly asymptomatic. MAIN BODY Clinical manifestations of non-deletional in alpha thalassaemia are varied and have more severe phenotype compared to deletional forms of alpha thalassaemia. Literature for the molecular mechanisms of common non-deletional alpha thalassaemia including therapeutic measures that are necessarily needed for the understanding of these disorders is still in demand. This manuscript would contribute to the better knowledge of how defective production of the α-globin chains due to mutations on the alpha-globin genes and/or the regulatory elements leads to alpha thalassaemia syndrome. CONCLUSION Since many molecular markers are associated with the globin gene expression and switching over during the developmental stages, there is a need for increased awareness, new-born and prenatal screening program, especially for countries with high migration impact, and for improving the monitoring of patients with α-thalassaemia.
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Affiliation(s)
- Ibrahim Kalle Kwaifa
- Haematology Unit, Department of Pathology, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Selangor, Malaysia
- Department of Haematology, School of Medical Laboratory Sciences, College of Health Sciences, Usmanu Danfodiyo University (UDU), Sokoto, North-Western, Nigeria
| | - Mei I Lai
- Haematology Unit, Department of Pathology, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Selangor, Malaysia
- Genetics and Regenerative Medicine Research Centre, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia(UPM), Serdang, Selangor, Malaysia
| | - Sabariah Md Noor
- Haematology Unit, Department of Pathology, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Selangor, Malaysia.
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19
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Mehta N, Johnston JM, Hein M, Kipp BR, Coon L, Savedra ME, Hoyer JD, He R, Rangan A, Shi M, Oliveira JL. Further Characterization of Hb Bronovo [α103(G10)His→Leu; HBA2: c.311A>T] and First Report of the Homozygous State. Hemoglobin 2020; 44:174-178. [PMID: 32552204 DOI: 10.1080/03630269.2020.1776322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Hb Bronovo [α103(G10)His→Leu, HBA2: c.311A>T] is an α-globin variant that interferes with and decreases binding efficiency to α hemoglobin (Hb) stabilizing protein (AHSP), a chaperone molecule. The histidine residue at position 103 is integral to the AHSP hydrogen bond formation where disruption results in an increased quantity of cytotoxic free α-globin chains, thereby creating a similar pathophysiology as β-thalassemia (β-thal). We report a family with Hb Bronovo, including a homozygous proband, which resulted from maternal uniparental disomy (UPD). Although not detected by routine studies in previous reports, the variant protein is visible by intact mass spectrometry (MS).
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Affiliation(s)
- Nikita Mehta
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA.,Department of Pathology, Diagnostic Molecular Genetics Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Martin Johnston
- Division of Pediatric Hematology/Oncology, Renown Children's Hospital, Reno, NV, USA
| | - Molly Hein
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Benjamin R Kipp
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Lea Coon
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Michelle E Savedra
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - James D Hoyer
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Rong He
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Aruna Rangan
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Min Shi
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Jennifer L Oliveira
- Department of Laboratory Medicine and Pathology, Metabolic Hematology Laboratory, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
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20
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Curcio C, Giannone V, Benzoni E, Cesaretti C, Ivaldi G. Hb Milano [α109(G16)Leu→Pro (C TG>C CG); HBA1: c.329T>C]: A Novel Variant on the α1-Globin Gene in an Italian Family. Hemoglobin 2019; 43:4-6. [DOI: 10.1080/03630269.2019.1566138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Cristina Curcio
- Laboratorio Genetica, Fondazione (Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italia
| | - Valentina Giannone
- Laboratorio Genetica, Fondazione (Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italia
| | - Elena Benzoni
- Laboratorio Genetica, Fondazione (Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italia
| | - Claudia Cesaretti
- Genetica Medica, Departimento Donna-Bambino-Neonato, IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italia
| | - Giovanni Ivaldi
- Laboratorio di Genetica Umana e Microcitemia, Ospedale Galliera, Genova, Italia
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21
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Pedroso GA, Kimura EM, Santos MNN, Albuquerque DM, Malimpensa D, Jorge SE, Verissimo MPA, Costa FF, Sonati MF. Thalassemia major phenotype caused by HB Zürich-Albisrieden [α2 59(E8) Gly > Arg (HBA2:C.178G > C)] in a Brazilian child. Pediatr Blood Cancer 2018; 65:e27413. [PMID: 30151892 DOI: 10.1002/pbc.27413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 11/10/2022]
Abstract
Hemoglobin (Hb) Zürich-Albisrieden (ZA) [α2 59(E8) Gly > Arg; HBA2:c.178G > C] is a rare and highly unstable α-chain variant. A few simple and compound heterozygotes (αZA α/αα and -/αZA α, respectively) have been described so far in Switzerland and China. We describe here a case of homozygosity for the Hb ZA mutation (αZA α/αZA α) in a Brazilian child with severe congenital hemolytic anemia and ineffective erythropoiesis.
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Affiliation(s)
- Gisele A Pedroso
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Elza M Kimura
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Magnun N N Santos
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Dulcinéia M Albuquerque
- Hematology and Hemotherapy Center, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Danaê Malimpensa
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Susan E Jorge
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | | | - Fernando F Costa
- Hematology and Hemotherapy Center, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Maria F Sonati
- Hemoglobinopathies Laboratory, Department of Clinical Pathology, School of Medical Sciences, State University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
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22
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Singh SA, Sarangi S, Appiah-Kubi A, Hsu P, Smith WB, Gallagher PG, Glader B, Chui DHK. Hb Adana (HBA2 or HBA1: c.179G > A) and alpha thalassemia: Genotype-phenotype correlation. Pediatr Blood Cancer 2018; 65:e27220. [PMID: 29749692 DOI: 10.1002/pbc.27220] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/17/2018] [Accepted: 03/29/2018] [Indexed: 11/11/2022]
Abstract
Alpha thalassemia due to nondeletional mutations usually leads to more severe disease than that caused by deletional mutations. Devastating outcomes such as hydrops fetalis can occur with two nondeletional mutations, therefore warranting DNA-based workup for suspected carriers with subtle hematological abnormalities for family counseling purposes. We describe three cases with hemoglobin (Hb) Adana, a nondeletional alpha chain mutation, compounded with an alpha globin gene deletion resulting in thalassemia intermedia. We review the literature, draw genotype-phenotype correlations from published cases of Hb Adana, and propose that this correlation can be used by clinicians to help direct diagnostic studies and urge hematologists to thoroughly workup high-risk patients.
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Affiliation(s)
- Sharon A Singh
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan
| | | | | | | | | | | | - Bertil Glader
- Stanford University Medical Center, Palo Alto, California
| | - David H K Chui
- Boston University School of Medicine, Boston, Massachusetts
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23
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Theodoridou S, Teli A, Yfanti E, Vyzantiadis TA, Theodoridis T, Economou M. Compound Heterozygosity for Hb Adana (HBA2: c.179G>A) and the -α 3.7/αα Thalassemia Deletion in Greece: Clinical Phenotype and Genetic Counseling. Hemoglobin 2018; 42:129-131. [PMID: 30025477 DOI: 10.1080/03630269.2018.1466711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Hb Adana (HBA2: c.179G>A) is found worldwide but is extremely rare and carriers are asymptomatic, with red cell indices similar to α+-thalassemia (α+-thal) carriers. First line screening tests are unable to detect the unstable hemoglobin (Hb). Coinheritance with the α-thal (-α3.7) deletion is herein presented and the challenges involving genetic counseling of couples carrying the mutations are discussed.
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Affiliation(s)
- Stamatia Theodoridou
- a Haemoglobinopathy Prevention Unit , Hippokration Hospital of Thessaloniki , Thessaloniki , Greece
| | - Aikaterini Teli
- b First Depatment of Paediatrics , Aristotelion University of Thessaloniki , Thessaloniki , Greece
| | - Eleni Yfanti
- c Thalassaemia National Centre of Greece , Laikon General Hospital of Athens , Athens , Greece
| | | | - Theodoros Theodoridis
- e First Department of Obstetrics and Gynaecology , Aristotelion University of Thessaloniki , Thessaloniki , Greece
| | - Marina Economou
- b First Depatment of Paediatrics , Aristotelion University of Thessaloniki , Thessaloniki , Greece
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24
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Coinheritance of Sicilian (δβ) 0-Thalassemia and Two Rare Hemoglobin Variants: A Complex Case of Hemoglobinopathy. Indian J Clin Biochem 2018; 33:231-234. [PMID: 29651217 DOI: 10.1007/s12291-017-0676-z] [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: 02/18/2017] [Accepted: 06/26/2017] [Indexed: 10/19/2022]
Abstract
α-Thalassemia (α-thal) is considered as the most common inherited hemoglobin disorder worldwide. The present study describes the first observation of a combination of rare α-chain variants, and β-globin gene cluster deletion. A 21-year-old woman with thalassemia trait, marked microcytosis, mild anemia, and normal range of Hb F was referred to Amirkola genetic center in the North of Iran for routine molecular test of thalassemia in the context of carrier detection and prevention of thalassemia major birth. Nucleotide sequencing revealed a novel compound heterozygosity status for two non-deletional mutations on HBA2, Hb O Indonesia (α116(GH4)Glu → Lys), and Hb Matsue-Oki (α75 (EF4) Asp → Asn), together with heterozygosity for the sicilian (δβ)0-thal mutation. This finding highlights the necessity of deep molecular investigation of thalassemia in regions where thalassemia is abundant, and present highly heterogeneous population.
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Farashi S, Harteveld CL. Molecular basis of α-thalassemia. Blood Cells Mol Dis 2017; 70:43-53. [PMID: 29032940 DOI: 10.1016/j.bcmd.2017.09.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 02/05/2023]
Abstract
α-Thalassemia is an inherited, autosomal recessive, disorder characterized by a microcytic hypochromic anemia. It is one of the most common monogenic gene disorders in the world population. The clinical severity varies from almost asymptomatic, to mild microcytic hypochromic, and to a lethal hemolytic condition, called Hb Bart's Hydrops Foetalis Syndrome. The molecular basis are usually deletions and less frequently, point mutations affecting the expression of one or more of the duplicated α-genes. The clinical variation and increase in disease severity is directly related to the decreased expression of one, two, three or four copies of the α-globin genes. Deletions and point mutations in the α-globin genes and their regulatory elements have been studied extensively in carriers and patients and these studies have given insight into the α-globin genes are regulated. By looking at naturally occurring deletions and point mutations, our knowledge of globin-gene regulation and expression will continue to increase and will lead to new targets of therapy.
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Affiliation(s)
- Samaneh Farashi
- Dept. of Clinical Genetics, Hemoglobinopathy Expert Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelis L Harteveld
- Dept. of Clinical Genetics, Hemoglobinopathy Expert Center, Leiden University Medical Center, Leiden, The Netherlands.
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Brennan SO, Wang D, Horridge M, Sheen CR. Hb Amsterdam-A1 [α32(B13)Met→Ile; HBA1: c.99G>A]: A Hyperunstable Variant Due to a New Mutation on the α1 Gene. Hemoglobin 2017; 41:140-143. [DOI: 10.1080/03630269.2017.1311911] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Stephen O. Brennan
- Molecular Pathology Laboratory, University of Otago, Christchurch, New Zealand
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Darrell Wang
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Mark Horridge
- Canterbury Health Laboratories, Christchurch, New Zealand
| | - Campbell R. Sheen
- Protein Science and Engineering, Callaghan Innovation, Christchurch, New Zealand
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27
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Brunner-Agten S, von Känel T, Röthlisberger B, Broquet C, Huber AR. Hb Bakersfield (HBA1: c.151_152insGGAGCC): The Insertion of Arg-His Between Codons 49 and 50 of the α1-Globin Chain Leads to Increased Oxygen Affinity. Hemoglobin 2017; 41:1-5. [PMID: 28532286 DOI: 10.1080/03630269.2017.1302467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We describe an insertion variant on the α1-globin gene (HBA1) identified in a 49-year-old woman of Jurassian ancestry presenting with macrocytosis and erythrocytosis. The variant resulted in a peak of 15.5% of the total hemoglobin (Hb) on high performance liquid chromatography (HPLC). Stability and oxygen affinity testing revealed that the variant was stable and had an increased oxygen affinity. Molecular genetic testing detected the heterozygous sequence variant Hb Bakersfield [α50(CE8)His→0; Arg-Ser-His- inserted between 49(CE7) and 51(CE9) of α1; HBA1: c.151_152insGGAGCC (p.Ser50_His51insArgSer)] in the index patient, one of her sons, as well as in two of her grandchildren, who showed a similar hematological pattern.
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Affiliation(s)
- Saskia Brunner-Agten
- a Institute of Laboratory Medicine , Canton Hospital Aarau , Aarau , Switzerland
| | - Thomas von Känel
- a Institute of Laboratory Medicine , Canton Hospital Aarau , Aarau , Switzerland.,b Central Hospital Institutes , State Hospital of Valais , Sion , Switzerland
| | - Benno Röthlisberger
- a Institute of Laboratory Medicine , Canton Hospital Aarau , Aarau , Switzerland
| | | | - Andreas R Huber
- a Institute of Laboratory Medicine , Canton Hospital Aarau , Aarau , Switzerland
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Makis A, Georgiou I, Traeger-Synodinos J, Chaliasos N, Grosso M, Gambale A, Iolascon A. Diagnosis and molecular characterization of a novel α 0 -thalassemia deletion (-Kozani) found in a Greek child with unexplained microcytic hypochromic anemia. Int J Lab Hematol 2017; 39:e124-e126. [PMID: 28603861 DOI: 10.1111/ijlh.12690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/24/2017] [Indexed: 11/27/2022]
Affiliation(s)
- A Makis
- Child Health Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - I Georgiou
- Genetics and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - J Traeger-Synodinos
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, Athens, Greece
| | - N Chaliasos
- Child Health Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - M Grosso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, CEINGE- Advanced Biotechnologies, Italy
| | - A Gambale
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, CEINGE- Advanced Biotechnologies, Italy
| | - A Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, CEINGE- Advanced Biotechnologies, Italy
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Lin L, Chen B, Yi S, Chen Q, Wei H, Li G, Zheng C, Qiu XX, He S. A Novel α2-Globin Gene Mutation: Hb Debao [α31(B12)Arg→Trp; HBA2: c.94A>T]. Hemoglobin 2017; 41:65-67. [PMID: 28367658 DOI: 10.1080/03630269.2017.1289102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report a novel mutation on the α2-globin gene, Hb Debao [α31(B12)Arg→Trp; HBA2: c.94A>T] detected in a Chinese family. This mutation gives rise to a previously undescribed hemoglobin (Hb) variant that was undetectable by electrophoretic or chromatographic methods. Hb Debao was associated with an α+-thalassemia (α+-thal) deletion [-α3.7 (rightward)] producing a mild phenotype with significant microcytosis and hypochromia, while the combination of this mutation with an α0-thal deletion (--SEA) resulting in a severe form of Hb H (β4) disease, which is consistent with a thalassemic phenotype associated with the novel mutation.
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Affiliation(s)
- Li Lin
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
| | - Biyan Chen
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
| | - Shang Yi
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
| | - Qiuli Chen
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
| | - Hongwei Wei
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
| | - Guojian Li
- b Research Department , Guangxi Zhuang Autonomous Region Health and Family Planning Commission , Nanning , PR China
| | - Chenguang Zheng
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
| | - Xiao-Xia Qiu
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
| | - Sheng He
- a Prenatal Diagnosis Center , Guangxi Zhuang Autonomous Region Women and Children Care Hospital , Nanning , PR China
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Chiasakul T, Uaprasert N. Iron deficiency anemia interfering the diagnosis of compound heterozygosity for Hb constant spring and Hb Paksé: The first case report. J Clin Lab Anal 2017; 32. [PMID: 28244614 DOI: 10.1002/jcla.22187] [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] [Received: 11/21/2016] [Accepted: 01/29/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diagnosis of thalassemia or hemoglobinopathy concomitant with iron deficiency anemia (IDA) is challenging. METHOD We report a case of 43-year-old female whose diagnosis of compound heterozygosity for hemoglobin Constant Spring (HbCS) and Hb Paksé became apparent after the treatment of IDA. RESULTS Prior to treatment, Hb analysis using isoelectric focusing (IEF) showed HbA 95.6%, HbA2 2.7%, and HbCS 1.7% compatible with heterozygous HbCS. After 4 months of oral iron therapy resulting in an improved Hb level, her HbCS level was substantially increased to 8.7% on IEF suggesting homozygous HbCS. Subsequent DNA analysis using multiplex amplification refractory mutation system analysis revealed compound heterozygosity for HbCS and Hb Paksé. CONCLUSION This case demonstrated that IDA can significantly reduce HbCS/Hb Paksé levels and probably mask the diagnosis of homozygous HbCS, homozygous Hb Paksé or the compound heterozygosity for both hemoglobinopathies by hemoblogin analysis. The test should be repeated after resolution of IDA, or molecular testing should be performed to confirm the diagnosis.
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Affiliation(s)
- Thita Chiasakul
- Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Noppacharn Uaprasert
- Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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de la Fuente-Gonzalo F, Nieto JM, Velasco D, Cela E, Pérez G, Fernández-Teijeiro A, Escudero A, Villegas A, González-Fernández FA, Ropero P. HB Puerta del Sol [HBA1:c.148A>C], HB Valdecilla [HBA2:c.3G>T], HB Gran Vía [HBA2:c.98T>G], HB Macarena [HBA2:c.358C>T] and HB El Retiro [HBA2:c.364_366dupGTG]: description of five new hemoglobinopathies. Clin Chem Lab Med 2016; 54:553-60. [PMID: 26485748 DOI: 10.1515/cclm-2015-0649] [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: 07/08/2015] [Accepted: 09/02/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Structural hemoglobinopathies do not usually have a clinical impact, but they can interfere with the analytical determination of some parameters, such as the glycated hemoglobin in diabetic patients. Thalassemias represent a serious health problem in areas where their incidence is high. The defects in the post-translational modifications produce hyper-unstable hemoglobin that is not detected by most of electrophoretic or chromatographic methods that are available so far. METHODS We studied seven patients who belong to six unrelated families. The first two families were studied because they had peak abnormal hemoglobin (Hb) during routine analytical assays. The other four families were studied because they had microcytosis and hypochromia with normal HbA2 and HbF without iron deficiency. HbA2 and F quantification and abnormal Hb separation were performed by chromatographic and electrophoretic methods. The molecular characterization was performed using specific sequencing. RESULTS The Hb Puerta del Sol presents electrophoretic mobility and elution in HPLC that is different from HbA and similar to HbS. The electrophoretic and chromatographic profiles of the four other variants are normal and do not show any anomalies, and their identification was only possible with sequencing. CONCLUSIONS Some variants, such as Hb Valdecilla, Hb Gran Vía, Hb Macarena and Hb El Retiro, have significant clinical impact when they are associated with other forms of α-thalassemia, which could lead to more serious forms of this group of pathologies as for HbH disease. Therefore, it is important to maintain an adequate program for screening these diseases in countries where the prevalence is high to prevent the occurrence of severe forms.
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Chu G, Cai W, Shao X. Determination of Bovine Hemoglobin by Near-Infrared Diffuse Reflectance Spectroscopy with Novel Adsorption Preconcentration. ANAL LETT 2016. [DOI: 10.1080/00032719.2016.1216124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ganghui Chu
- Xinjiang Laboratory of Native Medicinal and Edible Plant Resources Chemistry, College of Chemistry and Environmental Science, Kashgar University, Kashgar, China
- Research Center for Analytical Sciences, College of Chemistry, Tianjin Key Laboratory of Biosensing and Molecular Recognition, State Key Laboratory of Medicinal Chemical Biology, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Nankai University, Tianjin, China
| | - Wensheng Cai
- Research Center for Analytical Sciences, College of Chemistry, Tianjin Key Laboratory of Biosensing and Molecular Recognition, State Key Laboratory of Medicinal Chemical Biology, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Nankai University, Tianjin, China
| | - Xueguang Shao
- Xinjiang Laboratory of Native Medicinal and Edible Plant Resources Chemistry, College of Chemistry and Environmental Science, Kashgar University, Kashgar, China
- Research Center for Analytical Sciences, College of Chemistry, Tianjin Key Laboratory of Biosensing and Molecular Recognition, State Key Laboratory of Medicinal Chemical Biology, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Nankai University, Tianjin, China
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33
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Farashi S, Najmabadi H. Diagnostic pitfalls of less well recognized HbH disease. Blood Cells Mol Dis 2015; 55:387-95. [DOI: 10.1016/j.bcmd.2015.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
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34
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Farashi S, Garous NF, Vakili S, Ashki M, Imanian H, Azarkeivan A, Najmabadi H. Characterization of Homozygous Hb Setif (HBA2: c.283G>T) in the Iranian Population. Hemoglobin 2015; 40:53-5. [PMID: 26574177 DOI: 10.3109/03630269.2015.1091357] [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: 11/13/2022]
Abstract
Hemoglobin (Hb) variants are abnormalities resulting from point mutations in either of the two α-globin genes (HBA2 or HBA1) or the β-globin gene (HBB). Various reports of Hb variants have been described in Iran and other countries around the world. Hb Setif (or HBA2: c.283G>T) is one of these variants with a mutation at codon 94 of of the α2-globin gene that is characterized in clinically normal heterozygous individuals. We here report clinical and hematological findings in two homozygous cases of Iranian origin for this unstable Hb variant.
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Affiliation(s)
- Samaneh Farashi
- a Genetics Research Centre, University of Social Welfare & Rehabilitation Sciences , Tehran , Iran.,b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Negin F Garous
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Shadi Vakili
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Mehri Ashki
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Hashem Imanian
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
| | - Azita Azarkeivan
- b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran.,c Iranian Blood Transfusion Organization, High Institute for Transfusion Research Centre , Tehran , Iran
| | - Hossein Najmabadi
- a Genetics Research Centre, University of Social Welfare & Rehabilitation Sciences , Tehran , Iran.,b Kariminejad-Najmabadi Pathology & Genetics Centre , Tehran , Iran
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35
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Farashi S, Vakili S, Garous NF, Ashki M, Forouzesh Pour F, Zeinali F, Rad F, Imanian H, Azarkeivan A, Najmabadi H. Identification of Mutations Causing Aberrant Termination and Deficient Splice Donor Site on theHBA1Gene. Hemoglobin 2015; 40:38-43. [DOI: 10.3109/03630269.2015.1088456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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36
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Farashi S, Bayat N, Vakili S, Faramarzi Garous N, Ashki M, Imanian H, Najmabadi H, Azarkeivan A. Point mutations which should not be overlooked in Hb H disease. Expert Rev Hematol 2015; 9:107-13. [DOI: 10.1586/17474086.2016.1107470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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37
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Farashi S, Vakili S, Garous NF, Ashki M, Imanian H, Azarkeivan A, Najmabadi H. Mutations on theα2-Globin Gene That May Triggerα+-Thalassemia. Hemoglobin 2015; 39:398-402. [DOI: 10.3109/03630269.2015.1075890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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38
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de la Fuente-Gonzalo F, Nieto JM, Ricard P, Anguita J, Martínez R, Cervera A, Villegas A, González FA, Ropero P. Hb Cervantes, Hb Marañón, Hb La Mancha and Hb Goya: Description of 4 new haemoglobinopathies. Clin Biochem 2015; 48:662-7. [DOI: 10.1016/j.clinbiochem.2015.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/23/2015] [Accepted: 04/24/2015] [Indexed: 11/29/2022]
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39
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Farashi S, Faramarzi Garous N, Ashki M, Vakili S, Zeinali F, Imanian H, Azarkeivan A, Najmabadi H. Hb Dartmouth (HBA2: c.200T>C): An α2-Globin Gene Associated with Hb H Disease in One Homozygous Patient. Hemoglobin 2015; 39:152-5. [DOI: 10.3109/03630269.2015.1027915] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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40
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Pornprasert S, Saoboontan S, Punyamung M. Detection of Hb Constant Spring (HBA2: c.427T>C) Heterozygotes in Combination with β-Thalassemia or Hb E Trait by Capillary Electrophoresis. Hemoglobin 2015; 39:211-5. [PMID: 25884994 DOI: 10.3109/03630269.2015.1027827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hb Constant Spring (Hb CS; HBA2: c.427T>C) is often missed by routine laboratory testing as its mRNA as well as gene product are unstable and presented at a low level in peripheral blood. This study aimed to analyze the efficacy of capillary electrophoresis (CE) for detecting and quantifying of Hb CS in β-thalassemia (β-thal) trait or Hb E (HBB: c.79G>A) trait samples with reduced β-globin chain expression. Thalassemia diagnostic data were reviewed in 2524 blood samples that were submitted to the laboratory of the Associated Medical Sciences Clinical Service Center, Chiang Mai, Thailand for hemoglobinopathy and thalassemia diagnosis. DNA analysis for Hb CS was performed in 322 β-thal trait and 397 Hb E trait samples using the amplification refractory mutation system (ARMS). The CE electropherogram of Hb CS at zone 2 was observed in all five samples with β-thal trait and nine samples with Hb E trait with levels varying from 0.1-2.8 and 0.1-2.3%, respectively. Thus, the CE method proved useful for screening of Hb CS in samples with β-thal trait or Hb E trait, which is essential for providing accurate diagnosis, genetic counseling, prevention and control programs of Hb H-CS disease.
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Affiliation(s)
- Sakorn Pornprasert
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University , Chiang Mai , Thailand
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41
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Petropoulou M, Poula A, Traeger-Synodinos J, Kanavakis E, Christopoulos TK, Ioannou PC. Multi-allele DNA biosensor for the rapid genotyping of 'nondeletion' alpha thalassaemia mutations in HBA1 and HBA2 genes by means of multiplex primer extension reaction. Clin Chim Acta 2015; 446:241-7. [PMID: 25892676 DOI: 10.1016/j.cca.2015.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/10/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alpha-thalassaemia is an autosomal recessive disorder characterized by defective production of the alpha chain of haemoglobin. It is caused mainly by deletions of one or both of the duplicated alpha-globin genes on chromosome 16, and/or by nucleotide variations, known as "nondeletion" mutations. Definition of the alpha globin genotype in carriers supports genetic counselling, and in patients with Hb H disease is useful to predict prognosis and management options. Here, we report a method that facilitates direct detection by naked eye of the 13 most common "nondeletion" alpha-globin gene mutations in populations around the Mediterranean and Middle East. METHODS AND RESULTS The method comprises (i) PCR amplification of a single 1087 bp fragment for each HBA1 and HBA2 gene (separately); (ii) multiplex primer extension reaction of just 10 cycles, using unpurified amplification product as a template, to incorporate biotin into those allele-specific primers that extend and, finally, (iii) visual detection of the reaction products within minutes by the dipstick biosensor. The method was evaluated by analysing 105 samples of known genotypes and the results were found fully concordant with those obtained by the reference methods. CONCLUSIONS The proposed assay is particularly suited for small molecular-diagnostic laboratories with a limited budget and a low-to-medium sample volume. In addition this platform represents a very simple and useful genotyping tool to support gene scanning methods whenever nucleotide variations have to be specified.
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Affiliation(s)
- Margarita Petropoulou
- Laboratory of Analytical Chemistry, Department of Chemistry, Athens University, Athens 15771, Greece
| | - Amalia Poula
- Laboratory of Analytical Chemistry, Department of Chemistry, Athens University, Athens 15771, Greece
| | | | | | - Theodore K Christopoulos
- Department of Chemistry, University of Patras, Patras 26500, Greece; Foundation for Research and Technology Hellas, Institute of Chemical Engineering and High Temperature Chemical Processes (FORTH/ICE-HT), Patras 26504, Greece
| | - Penelope C Ioannou
- Laboratory of Analytical Chemistry, Department of Chemistry, Athens University, Athens 15771, Greece.
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Hassan SM, Harteveld CL, Bakker E, Giordano PC. Hb Lansing (HBA2: c.264C > G) and a new β promoter transversion [-52 (G > T)]: an attempt to define the phenotype of two mutations found in the Omani population. Hemoglobin 2015; 39:111-4. [PMID: 25826385 DOI: 10.3109/03630269.2015.1016615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report two examples showing how problematic it can be to define the phenotype of new or rare globin genes mutations. We describe two mutations observed for the first time in the Omani population: the first was found in the consanguineous parents of a deceased newborn with hepatomegaly, cardiomegaly and severe hemolytic anemia, putatively homozygous for the rare Hb Lansing (HBA2: c.264C > G) variant. The second is a novel β-globin gene promoter mutation [-52 (G > T)] observed in four independent patients. Two with borderline/elevated Hb A2, α-thalassemia (α-thal) and hypochromic red cell indices, and two heterozygotes for Hb S (HBB: c.20A > T), α-thal and with Hb A/Hb S ratios possibly indicating a very mild β(+)-thalassemia (β(+)-thal) mutation.
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Affiliation(s)
- Suha M Hassan
- Molecular Genetic Laboratory, National Genetic Centre , Muscat , Sultanate of Oman and
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de la Fuente-Gonzalo F, Ropero P, Martínez-Nieto J, Villegas A, González FA, Díaz-Mediavilla J. [Association between hemoglobin Groene Hart and hemoglobin J-Paris-I: first case in Spain]. Med Clin (Barc) 2015; 144:212-5. [PMID: 24530052 DOI: 10.1016/j.medcli.2013.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 10/14/2013] [Accepted: 10/17/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Thalassemias are the most frequent monogenic disorder around the world. α-thalassemias are due to a deficiency of synthesis in the alpha-globin chain of the hemoglobin (Hb). Hb Groene Hart is a hyperunstable variant. In this work, we have studied 24 cases affected by Hb Groene Hart, one of them associated with Hb J-Paris-I. PATIENTS AND METHODS Twenty-four patients from 17 unrelated families were included in this study. The characterization was done by sequencing. RESULTS α1 gene sequencing showed the mutation CCT→TCT (Pro→Ser) at codon 119 (Hb Groene Hart) in all patients. In one case, there was an association with Hb J-Paris-I. CONCLUSIONS In the Hb Groene Hart, the residue 119 of alpha-globin chain is affected. This amino acid has a key role in preserving the stability of alpha-globin chain. It is also remarkable the presence of this variant in both the immigrant and native population. Thus, the identification of Hb Groene Hart carriers should be considered in the screening of α-thalassemia in Spain, as it is done in Northern Africa.
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Affiliation(s)
| | - Paloma Ropero
- Servicio de Hematología, Hospital Clínico San Carlos, Madrid, España
| | | | - Ana Villegas
- Servicio de Hematología, Hospital Clínico San Carlos, Madrid, España
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Bisconte MG, Caldora M, Musollino G, Cardiero G, Flagiello A, La Porta G, Lagona L, Prezioso R, Qualtieri G, Gaudiano C, Medulla E, Merlino A, Pucci P, Lacerra G. α-Thalassemia associated with hb instability: a tale of two features. the case of Hb Rogliano or α1 Cod 108(G15)Thr→Asn and Hb Policoro or α2 Cod 124(H7)Ser→Pro. PLoS One 2015; 10:e0115738. [PMID: 25730315 PMCID: PMC4346585 DOI: 10.1371/journal.pone.0115738] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 12/01/2014] [Indexed: 11/28/2022] Open
Abstract
We identified two new variants in the third exon of the α-globin gene in families from southern Italy: the Hb Rogliano, α1 cod108 ACC>AAC or α1[α108(G15)Thr→Asn] and the Hb Policoro, α2 cod124 TCC>CCC or α2[α124(H7)Ser→Pro]. The carriers showed mild α-thalassemia phenotype and abnormal hemoglobin stability features. These mutations occurred in the G and H helices of the α-globin both involved in the specific recognition of AHSP and β1 chain. Molecular characterization of mRNA, globin chain analyses and molecular modelling studies were carried out to highlight the mechanisms causing the α-thalassemia phenotype. The results demonstrated that the α-thalassemia defect associated with the two Hb variants originated by different defects. Hb Rogliano showed an intrinsic instability of the tetramer due to anomalous intra- and inter-chain interactions suggesting that the variant chain is normally synthesized and complexed with AHSP but rapidly degraded because it is unable to form the α1β1 dimers. On the contrary in the case of Hb Policoro two different molecular mechanisms were shown: the reduction of the variant mRNA level by an unclear mechanism and the protein instability due to impairment of AHSP interaction. These data highlighted that multiple approaches, including mRNA quantification, are needed to properly identify the mechanisms leading to the α-thalassemia defect. Elucidation of the specific mechanism leads to the definition of a given phenotype providing important guidance for the diagnosis of unstable variants.
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Affiliation(s)
- Maria Grazia Bisconte
- U.O.S. Microcitemia e patologia del globulo rosso, O.O.C. Ematologia A.O. Cosenza, Italy
| | - Mercedes Caldora
- Laboratorio Specialistico di Ematologia, P.O. San Giovanni Bosco A.S.L. NA1, Napoli, Italy
| | - Gennaro Musollino
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
| | - Giovanna Cardiero
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
| | - Angela Flagiello
- Dipartimento di Scienze Chimiche and Ceinge Biotecnologie Avanzate, Università degli Studi “Federico II”, Napoli, Italy
| | - Gaetana La Porta
- U.O.S. Microcitemia e patologia del globulo rosso, O.O.C. Ematologia A.O. Cosenza, Italy
| | - Laura Lagona
- U.O.D. di Thalassemia, ARNAS “Garibaldi”, Catania, Italy
| | - Romeo Prezioso
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
| | - Gabriele Qualtieri
- U.O.S. Microcitemia e patologia del globulo rosso, O.O.C. Ematologia A.O. Cosenza, Italy
| | - Carlo Gaudiano
- Ospedale Civile, Centro per la lotta contro le Microcitemie, Matera, Italy
| | - Emilia Medulla
- U.O.D. di Thalassemia, ARNAS “Garibaldi”, Catania, Italy
| | - Antonello Merlino
- Dipartimento di Scienze Chimiche, Università degli Studi “Federico II” and Istituto di Biostrutture e Bioimmagini, CNR Napoli, Italy
| | - Piero Pucci
- Dipartimento di Scienze Chimiche and Ceinge Biotecnologie Avanzate, Università degli Studi “Federico II”, Napoli, Italy
| | - Giuseppina Lacerra
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
- * E-mail:
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Vasseur C, Baudin-Creuza V. [Role of alpha-hemoglobin molecular chaperone in the hemoglobin formation and clinical expression of some hemoglobinopathies]. Transfus Clin Biol 2015; 22:49-57. [PMID: 25724329 DOI: 10.1016/j.tracli.2015.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/21/2015] [Indexed: 10/24/2022]
Abstract
Alpha-hemoglobin stabilizing protein (AHSP), described as a chaperone of alpha-hemoglobin (α-Hb), is synthesized at a high concentration in the erythroid precursors. AHSP specifically recognizes the G and H helices of α-Hb and forms a stable complex with free α-Hb until its association with the partner β-subunits. Unlike the free β-Hb which are soluble and form homologous tetramers, freshly synthesized α-Hb chains are highly unstable molecular species which precipitate and generate reactive oxygen species within the erythrocyte precursors of the bone marrow leading to apoptosis and ineffective erythropoiesis. AHSP protects the free α-Hb chains in maintaining it in the soluble state. In this review, we report data from the literature and our laboratory concerning the key role of AHSP in the biosynthesis of Hb and its possible involvement in some disorders of the red blood cell as well as the hemoglobinopathies and we discuss its use as a prognostic tool in thalassemia syndromes.
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Affiliation(s)
- C Vasseur
- Institut national de la santé et de la recherche médicale (INSERM) U955, équipe 2, université Paris Est Créteil, 5, avenue Gustave-Eiffel, 94000 Créteil, France; Laboratoire d'excellence des globules rouges (GR-EX), 75015 Paris, France
| | - V Baudin-Creuza
- Institut national de la santé et de la recherche médicale (INSERM) U955, équipe 2, université Paris Est Créteil, 5, avenue Gustave-Eiffel, 94000 Créteil, France; Laboratoire d'excellence des globules rouges (GR-EX), 75015 Paris, France.
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Kattamis A, Delaporta P, Fylaktou I, Vrettou C, Kyriakopoulou D, Stamoulakatou A, Papassotiriou I, Kanavakis E, Traeger-Synodinos J. Hb Souli, a 6 bp in-frame deletion on the HBA2 gene (HBA2: c.[41-46delCCTGGG]) leads to α-thalassemia intermedia, when in trans to a single α-globin gene deletion. Hemoglobin 2014; 39:55-7. [PMID: 25476779 DOI: 10.3109/03630269.2014.981827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report the case of a 5-year-old child with clinical and hematological findings consistent with the diagnosis of α-thalassemia intermedia (α-TI). Molecular analysis disclosed the common 3.7 kb deletion in the α-globin gene cluster in trans to a novel in-frame 6 bp deletion in the HBA2 gene. It removes the sequence CCTGGG (or GCCTGG) that normally encodes for alanine (codon 13) and tryptophan (codon 14). Even though several hemoglobin (Hb) variants with mutations affecting codons 13 or 14 have been described, Hb Souli (HBA2: c.[41-46delCCTGGG]) is, to the best of our knowledge, the first variant to be reported where both amino acid residues, α13Ala and α14Trp, are deleted, leading to unstable and rapidly degraded α-globin chains.
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Affiliation(s)
- Antonis Kattamis
- First Department of Pediatrics, Athens University Medical School , Athens , Greece
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Role of α-globin H helix in the building of tetrameric human hemoglobin: interaction with α-hemoglobin stabilizing protein (AHSP) and heme molecule. PLoS One 2014; 9:e111395. [PMID: 25369055 PMCID: PMC4219717 DOI: 10.1371/journal.pone.0111395] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/23/2014] [Indexed: 11/25/2022] Open
Abstract
Alpha-Hemoglobin Stabilizing Protein (AHSP) binds to α-hemoglobin (α-Hb) or α-globin and maintains it in a soluble state until its association with the β-Hb chain partner to form Hb tetramers. AHSP specifically recognizes the G and H helices of α-Hb. To investigate the degree of interaction of the various regions of the α-globin H helix with AHSP, this interface was studied by stepwise elimination of regions of the α-globin H helix: five truncated α-Hbs α-Hb1-138, α-Hb1-134, α-Hb1-126, α-Hb1-123, α-Hb1-117 were co-expressed with AHSP as two glutathione-S-transferase (GST) fusion proteins. SDS-PAGE and Western Blot analysis revealed that the level of expression of each truncated α-Hb was similar to that of the wild type α-Hb except the shortest protein α-Hb1-117 which displayed a decreased expression. While truncated GST-α-Hb1-138 and GST-α-Hb1-134 were normally soluble; the shorter globins GST-α-Hb1-126 and GST-α-Hb1-117 were obtained in very low quantities, and the truncated GST-α-Hb1-123 provided the least material. Absorbance and fluorescence studies of complexes showed that the truncated α-Hb1-134 and shorter forms led to modified absorption spectra together with an increased fluorescence emission. This attests that shortening the H helix leads to a lower affinity of the α-globin for the heme. Upon addition of β-Hb, the increase in fluorescence indicates the replacement of AHSP by β-Hb. The CO binding kinetics of different truncated AHSPWT/α-Hb complexes showed that these Hbs were not functionally normal in terms of the allosteric transition. The N-terminal part of the H helix is primordial for interaction with AHSP and C-terminal part for interaction with heme, both features being required for stability of α-globin chain.
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Abstract
Thalassemia is the most common monogenic inherited disease worldwide and it affects most countries to various extents. This review summarizes the current approaches to phenotypic and genotypic diagnosis of thalassemia in clinical practice. Prevention strategies that encompass carrier screening, genetic counseling and prenatal diagnosis are discussed. The importance of public education and an awareness of a changing perception regarding this group of diseases are emphasized. It also addresses the impact of the rapidly increasing knowledge in disease severity modification by hemoglobin F (Hb F).
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Affiliation(s)
- Ho-Wan Ip
- Department of Pathology and Clinical Biochemistry, Queen Mary Hospital , Hong Kong SAR , China and
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Comparative plasma protein profiling of hemoglobin H disease. DISEASE MARKERS 2014; 2014:340214. [PMID: 25024506 PMCID: PMC4082903 DOI: 10.1155/2014/340214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 05/29/2014] [Indexed: 12/18/2022]
Abstract
HbH and HbH-constant spring (HbH-CS) are the most common forms of α-thalassemia detected in the Thai population. The accumulation of excess β globin chains in these diseases results in increased red cell hemolysis, and patients with HbH-CS normally have a more severe clinical presentation than patients with HbH disease. This study aimed to detect alterations in the expression of plasma proteins of HbH and HbH-CS patients as compared to normal plasma. Platelet poor plasma was separated from HbH and HbH-CS and normal subjects and differential plasma proteins were detected using two-dimensional gel electrophoresis and identified using LC/MS/MS. A total of 14 differentially expressed proteins were detected of which 5 proteins were upregulated and 9 were downregulated. Most of the differentially expressed proteins are liver secreted proteins involved in hemolysis, oxidative stress response, and hemoglobin degradation. Seven proteins were found to be differentially expressed between HbH and HbH-CS. Levels of haptoglobin, a hemoglobin scavenging protein, were significantly increased in HbH patients as compared to HbH-CS patients. The identification of differentially expressed proteins may lead to a better understanding of the biological events underlying the clinical presentation of HbH and HbH-CS patients and can have application as hemolytic markers or severity predictors.
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Joly P, Lacan P, Garcia C, Francina A. Description of the phenotypes of 63 heterozygous, homozygous and compound heterozygous patients carrying the Hb Groene Hart [α119(H2)Pro→Ser; HBA1: c.358C>T] variant. Hemoglobin 2013; 38:64-6. [PMID: 24111644 DOI: 10.3109/03630269.2013.834264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We here report the phenotypes and genotypes of 63 patients of North African origin, carriers of Hb Groene Hart [Hb GH, α119(H2)Pro → Ser; HBA1: c.358C>T], an α(+)-thalassemia (α(+)-thal) hemoglobin (Hb) variant. Fifty patients were heterozygous, five were homozygous and eight also carried the common -α(3.7) (rightward) deletion in compound heterozygosity. The expression of the α(GH)-globin chain is increased in the following order: heterozygous, compound heterozygous and homozygous. Parallel significant changes of mean corpuscular Hb (MCH) and mean corpuscular volume (MCV) were also observed. Our large cohort of Hb GH carriers could have been obtained by the systematic realization of globin chain separation by reversed phase liquid chromatography (RP-LC) in our routine Hb testing.
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Affiliation(s)
- Philippe Joly
- Unité de Pathologie Moléculaire du Globule Rouge, Laboratoire de Biochimie et Biologie Moléculaire, Hôpital Edouard Herriot, Hospices Civils & Université Claude Bernard-Lyon 1 , Lyon , France
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