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Sousos N, Adamidou D, Klonizakis P, Agapidou A, Theodoridou S, Spanos G, Psarras K, Vetsiou E, Vyzantiadis TA, Vlachaki E. Presence of the IVS-I-6-Mutated Allele in Beta-Thalassemia Major Patients Correlates with Extramedullary Hematopoiesis Incidence. Acta Haematol 2017; 137:175-182. [PMID: 28399542 DOI: 10.1159/000463919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/14/2016] [Indexed: 01/03/2023]
Abstract
Extramedullary hematopoiesis (EMH) results from the extension of hematopoietic tissue beyond the confines of the bones. Since the initiation of regular transfusion programs from an early age for all thalassemia major (ΤΜ) patients, EMH has not been considered a clinical issue anymore. The present study aims to record the prevalence of EMH in chronically transfused ΤΜ patients followed at our institution and to investigate possible risk factors associated with its occurrence. The project was designed as a retrospective, nonexperimental, descriptive, exploratory study. In total, the study enrolled 104 patients. EMH was revealed in 15/104 (14%) patients. The presence of intravening sequence (IVS)-I-6 was significantly related with the development of EMH (p < 0.05). No other demographic or biological factor studied was found to be related with the presence of EMH. The study stresses a profound incidence of asymptomatic EMH in a solid group of well-transfused ΤΜ patients. Given the high incidence of the IVS-I-6 allele in the Mediterranean and Middle Eastern region, high-quality, prospective, multicenter studies could confirm the association of EMH occurrence with the presence of the IVS-I-6 mutation and further evaluate the exact role of this mutation in the EMH process.
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Affiliation(s)
- Nikolaos Sousos
- Adult Thalassemia Unit, Second Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
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Gravia A, Chondrou V, Sgourou A, Papantoni I, Borg J, Katsila T, Papachatzopoulou A, Patrinos GP. Individualizing fetal hemoglobin augmenting therapy for β-type hemoglobinopathies patients. Pharmacogenomics 2015; 15:1355-64. [PMID: 25155936 DOI: 10.2217/pgs.14.101] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Individual genetic composition is an important cause of variations in the response and tolerance to drug treatment. Pharmacogenomics is a modern discipline aiming to delineate individual genomic profiles and drug response. To date, there are several medical disciplines where pharmacogenomics is readily applicable, while in others its usefulness is yet to be demonstrated. Recent experimental evidence suggest that besides genomic variation within the human β-globin gene cluster, other variants in modifier genes residing outside the human β-globin gene cluster are significantly associated with response to hydroxyurea treatment in β-type hemoglobinopathies patients, deducted from the increase in fetal hemoglobin levels. This article aims to provide an update and to discuss future challenges on the application of pharmacogenomics for β-type hemoglobinopathies therapeutics in relation to the current pharmacological treatment modalities for those disorders.
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Affiliation(s)
- Aikaterini Gravia
- University of Patras, School of Health Sciences, Department of Pharmacy, University Campus, Rion, GR-265 04, Patras, Greece
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Jouini L, Sahli CA, Laaouini N, Ouali F, Youssef IB, Dakhlaoui B, Othmeni R, Ouennich F, Fredj SH, Siala H, Becher M, Toumi NE, Fattoum S, Hafsia R, Bibi A, Messaoud T. Association between clinical expression and molecular heterogeneity in β-thalassemia Tunisian patients. Mol Biol Rep 2013; 40:6205-12. [DOI: 10.1007/s11033-013-2732-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 09/14/2013] [Indexed: 10/26/2022]
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Dabke P, Colah R, Ghosh K, Nadkarni A. Effect of Cis Acting Potential Regulators in the β Globin Gene Cluster on the Production of HbF in Thalassemia Patients. Mediterr J Hematol Infect Dis 2013; 5:e2013012. [PMID: 23505600 PMCID: PMC3591280 DOI: 10.4084/mjhid.2013.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 01/10/2013] [Indexed: 11/08/2022] Open
Abstract
The clinical presentation of β-thalassemia intermedia phenotypes are influenced by many factors. The persistence of fetal hemoglobin and several polymorphisms located in the promoters of γ- and β-globin genes are some of them. The aim of this study was to evaluate the combined effect of the -158 Gγ (C→T) polymorphism and of the (AT)x(T)y configuration, as well as their eventual association with elevated levels of HbF in β-thalassemia carriers, β-thalassemia intermedia, β-thalassemia major and normal controls of Indian origin. The -158 Gγ T allele was found to be associated with increased levels of HbF in β thalassemia carriers, and not in wild-type subjects. In the homozygous group, the -158 Gγ T allele was significantly higher in the thalassemia intermedia group (66%) as against the thalassemia major group (21%). The (AT)9(T)5 allele did not show any association with raised HbF levels. However 24% of milder cases showed presence of this allele. This study suggests that two regions of the β globin cluster, whether in cis or in trans to each other, can interact to enhance HbF expression when a β thalassemic determinant is present in heterozygosity and help in amelioration of the severity of the disease in homozygotes.
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Affiliation(s)
- Pooja Dabke
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
| | - Roshan Colah
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
| | - Kanjaksha Ghosh
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
| | - Anita Nadkarni
- National Institute of Immunohaematology (ICMR), 13th Floor, New Multistoried Building, K.E.M. Hospital Campus, Parel, Mumbai –4000 12
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Arya V, Agarwal S, Pradhan M. Association of polymorphic pattern of the (AT) × (T)y motif of β-globin gene in North Indian thalassemia patients with variable clinical expression. Indian J Hematol Blood Transfus 2010; 26:21-3. [PMID: 23100997 DOI: 10.1007/s12288-010-0008-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Accepted: 01/24/2009] [Indexed: 10/19/2022] Open
Abstract
Among the polymorphic genetic markers of the β-globin gene cluster, the (AT) × (T)y motif and a common C→T variation at -158 of the Gγ globin gene were investigate din 20 β-thalassemia IVSI-5 (G→C) homozygous patients with variable clinical manifestation and 10 normal subjects from north India to deduce any association with the co-inherited genetic polymorphism. We found (AT)(7)(T)(7) repeat motif in all the 20 chromosomes of normal subjects and two different sequence configuration(AT)(8)(T)(5), (AT)(9)(T)(5) in the patient group whereas the presence of -158(C→T) Gγ was quite polymorphic. We conclude that polymorphism -158(C→T) Gγ and (AT) × (T)y sequence variation other than (AT)(7)(T)(7) could influence the phenotype by increasing Hb F expression.
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Affiliation(s)
- Vandana Arya
- Department of Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh India
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Amato A, Pia Cappabianca M, Ponzini D, Di Biagio P, Colosimo A, Guida V, Mastropietro F, Foglietta E, Grisanti P, Rinaldi S, Dallapiccola B, Bianco I. Detection of a Rare β-Globin Nonsense Mutation [Codon 59 (AAG→TAG)] in an Italian Family. Hemoglobin 2009; 30:405-7. [PMID: 16840234 DOI: 10.1080/03630260600755948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this study we report on the hematological and molecular findings of a family from Central Italy, whose 33-year-old male proband presented with a beta0-thalassemia (thal) trait associated to a relevant Hb F level. The proband and his family (parents and a sister) were investigated by hematological analysis. The two beta-thal carriers of the beta-globin nonsense mutation [codon 59 (AAG-->TAG)] (the proband and his father) showed the hematological picture of a beta0-thal trait: the only hematological difference between the two beta-thal carriers was in the Hb F level (3.3% in the proband and 1% in his father).
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Affiliation(s)
- Antonio Amato
- Associazione Nazionale Microcitemie Italia (ANMI ONLUS), Centro Studi Microcitemie di Roma, Roma, Italia.
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Perry RT, Gearhart DA, Wiener HW, Harrell LE, Barton JC, Kutlar A, Kutlar F, Ozcan O, Go RCP, Hill WD. Hemoglobin binding to A beta and HBG2 SNP association suggest a role in Alzheimer's disease. Neurobiol Aging 2006; 29:185-93. [PMID: 17157413 PMCID: PMC2266611 DOI: 10.1016/j.neurobiolaging.2006.10.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 08/04/2006] [Accepted: 10/11/2006] [Indexed: 10/23/2022]
Abstract
From a normal human brain phage display library screen we identified the gamma (A)-globin chain of fetal hemoglobin (Hb F) as a protein that bound strongly to A beta1-42. We showed the oxidized form of adult Hb (metHb A) binds with greater affinity to A beta1-42 than metHb F. MetHb is more toxic than oxyhemoglobin because it loses its heme group more readily. Free Hb and heme readily damage vascular endothelial cells similar to Alzheimer's disease (AD) vascular pathology. The XmnI polymorphism (C-->T) at -158 of the gamma (G)-globin promoter region can contribute to increased Hb F expression. Using family-based association testing, we found a significant protective association of this polymorphism in the NIMH sibling dataset (n=489) in families, with at least two affected and one unaffected sibling (p=0.006), with an age of onset >50 years (p=0.010) and >65 years (p=0.013), and families not homozygous for the APOE4 allele (p=0.041). We hypothesize that Hb F may be less toxic than adult Hb in its interaction with A beta and may protect against the development of AD.
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Affiliation(s)
- Rodney T. Perry
- Department. of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA; Birmingham, AL 35294-0022, ; ;
| | - Debra A. Gearhart
- Department of Pharmacology & Toxicology, Medical College of Georgia, Augusta , GA 30912-2300, USA;
| | - Howard W. Wiener
- Department. of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA; Birmingham, AL 35294-0022, ; ;
| | - Lindy E. Harrell
- Alzheimer' Disease Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294-0017;
| | | | - Abdullah Kutlar
- Department of Medicine, Medical College of Georgia, Augusta GA 30912-2000 (USA); ;
| | - Ferdane Kutlar
- Department of Medicine, Medical College of Georgia, Augusta GA 30912-2000 (USA); ;
| | - Ozan Ozcan
- Department of Cellular Biology & Anatomy, Medical College of Georgia ; Department of Biology, Paine College, Augusta, GA 30912-2000;
| | - Rodney C. P. Go
- Department. of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA; Birmingham, AL 35294-0022, ; ;
| | - William D. Hill
- Department of Cellular Biology and Anatomy, Department of Neurology, Institute of Molecular Medicine and Genetics, Medical College of Georgia; Augusta Veterans Administration Medical Center, Augusta, GA 30912-2000, USA;
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