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Sani A, Idrees Khan M, Shah S, Tian Y, Zha G, Fan L, Zhang Q, Cao C. Diagnosis and screening of abnormal hemoglobins. Clin Chim Acta 2024; 552:117685. [PMID: 38030031 DOI: 10.1016/j.cca.2023.117685] [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: 10/26/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023]
Abstract
Hemoglobin (Hb) abnormalities, such as thalassemia and structural Hb variants, are among the most prevalent inherited diseases and are associated with significant mortality and morbidity worldwide. However, there were not comprehensive reviews focusing on different clinical analytical techniques, research methods and artificial intelligence (AI) used in clinical screening and research on hemoglobinopathies. Hence the review offers a comprehensive summary of recent advancements and breakthroughs in the detection of aberrant Hbs, research methods and AI uses as well as the present restrictions anddifficulties in hemoglobinopathies. Recent advances in cation exchange high performance liquid chromatography (HPLC), capillary zone electrophoresis (CZE), isoelectric focusing (IEF), flow cytometry, mass spectrometry (MS) and polymerase chain reaction (PCR) etc have allowed for the definitive detection by using advanced AIand portable point of care tests (POCT) integrating with smartphone microscopic classification, machine learning (ML) model, complete blood counts (CBC), imaging-based method, speedy immunoassay, and electrochemical-, microfluidic- and sensing-related platforms. In addition, to confirm and validate unidentified and novel Hbs, highly specialized genetic based techniques like PCR, reverse transcribed (RT)-PCR, DNA microarray, sequencing of genomic DNA, and sequencing of RT-PCR amplified globin cDNA of the gene of interest have been used. Hence, adequate utilization and improvement of available diagnostic and screening technologies are important for the control and management of hemoglobinopathies.
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Affiliation(s)
- Ali Sani
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Muhammad Idrees Khan
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Saud Shah
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Youli Tian
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China; School of Life Science and Biotechnology, State Key Laboratory of Microbial Metabolism, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Genhan Zha
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Liuyin Fan
- Student Innovation Center, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Qiang Zhang
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Chengxi Cao
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China; School of Life Science and Biotechnology, State Key Laboratory of Microbial Metabolism, Shanghai Jiao Tong University, Shanghai, 200240, China.
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Sabath DE. The role of molecular diagnostic testing for hemoglobinopathies and thalassemias. Int J Lab Hematol 2023. [PMID: 37211360 DOI: 10.1111/ijlh.14089] [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: 03/01/2023] [Accepted: 04/27/2023] [Indexed: 05/23/2023]
Abstract
Hemoglobin disorders are among the most common genetic diseases worldwide. Molecular diagnosis is helpful in cases where the diagnosis is uncertain and for genetic counseling. Protein-based diagnostic techniques are frequently adequate for initial diagnosis. Molecular genetic testing is pursued in some cases, particularly when a definitive diagnosis is not possible and especially for the purpose of assessing genetic risk for couples wanting to have children. The expertise available in the clinical hematology laboratory is essential for the diagnosis of patients with hemoglobin abnormalities. Initial diagnoses are made using protein-based techniques such as electrophoresis and chromatography. Based on these findings, genetic risk to an individual's offspring can be assessed. In the setting of β-thalassemia and other β-globin disorders, coincident α-thalassemia may be difficult to diagnose, which can have potentially serious consequences. In addition, unusual forms of β-thalassemia caused by deletions in the β-globin locus cannot be definitively characterized using standard techniques. Molecular diagnostic testing has an important role in the diagnosis of hemoglobin disorders and is important in the setting of genetic counseling. Molecular testing also has a role in prenatal diagnosis to identify fetuses affected by severe hemoglobinopathies and thalassemias.
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Affiliation(s)
- Daniel E Sabath
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
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Studying the some biochemical parameters for thalassemia patients in AL-Najaf province. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns4.6313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The current study aims to study some biochemical indicators for thalassemia patients in the Najaf governorate, and the study included 25 patients with major beta thalassemia during the period from November 2019 to February 2020 and their ages ranged between (2 - 65) years and 15 healthy people who arenot He had genetic blood diseases and their ages ranged between (2-65) years. The results of the study showed that there are in some biochemical indicators, as there was a significant increase in the level of the enzyme of liver function ALT that was the focus in patients 23.74 ± 29.53 U\L and in healthy people it was 4.61 ± 11.67U\L Also, the creatinine concentration patients 9.92 ± 26.08 mmol\L and in healthy was, 68.06 ± 51.54 mmol\L, Except for urea, we notice that there was a decrease in its concentration in patients 0.89 ± 3.96 mmol\L and in healthy was 1.03 ± 2.36 mmol\L, There was an increase in the concentration of iron in the blood in patients 382.05 ±64.37 Umol\L And in healthy was 9.48 ± 61.36 Umol\L, as well as a decrease in the concentration of glucose in patients and an increase in healthy people
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Xinh PT, Chuong HQ, Ha NTT, Tram HDB, Van Dong C, Thanh LVH, Hoa NTH, Nghia H, Binh NT, Dung PC, Vu HA. Spectrum of HBB gene mutations among 696 β-thalassemia patients and carriers in Southern Vietnam. Mol Biol Rep 2022; 49:2601-2606. [PMID: 35023007 DOI: 10.1007/s11033-021-07062-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Thalassemias are common inherited blood disorders that have been extensively studied in Asia. Thus far, data on mutations of the HBB gene in Vietnamese patients with β-thalassemia are limited to small studies. METHODS We recruited 696 β-thalassemia patients and carriers in southern Vietnam and analyzed for the HBB gene mutations using Sanger sequencing technology. RESULTS We documented 27 types of known mutations and 10 types of novel variants on 737 alleles out of 1392 surveyed alleles. The three most common mutations, which account for more than ¾ of all mutant alleles, were c.79G > A (HbE), c.124_127delTTCT, and c.52A > T. The novel variants were mainly located in 5' untranslated region (c.-92delC and c.-67A > G) and 3' untranslated region (c.*4C > T, c.*116_*117insA, c.*142 T > C, c.*156G > C, c.*176_*177insA, and c.*247 T > C), except for one in intron 2 (c.316-99 T > G) and one in exon 3 (c.385delG). CONCLUSION We provide here a comprehensive mutation spectrum of the HBB gene in Southern Vietnam, which is crucial for carrier screening and prenatal diagnosis in the future.
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Affiliation(s)
- Phan Thị Xinh
- Department of Hematology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Ho Quoc Chuong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Thanh Ha
- Department of Molecular Biology, Dai Phuoc Clinic, Ho Chi Minh City, Vietnam
| | | | - Cao Van Dong
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Le Vu Ha Thanh
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Hong Hoa
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Huynh Nghia
- Department of Hematology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen Tan Binh
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam.,Department of Hematology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Phu Chi Dung
- Ho Chi Minh City Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam
| | - Hoang Anh Vu
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam.
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Sen A, Seenappa V, Chakrabarti P, Dolai TK. First Report of the 3'-Untranslated Region +1506 (A>C) [NM_000518.5: c.*32A>C] mutation on the β-Globin Gene in the Indian Population. Hemoglobin 2021; 45:325-328. [PMID: 34886762 DOI: 10.1080/03630269.2021.2011314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The 3'-untranslated region (3'-UTR) is well known to be associated with the post-transcriptional regulation, because of the presence of important sequences that influence the fate of mRNA, and thus, in protein synthesis. The present study describes a point mutation on the β-globin 3'-UTR, +1506 (A>C) (HBB: c.*32A>C) in an Indian family during prenatal diagnosis (PND) screening of an at-risk couple. The members of the family heterozygous for this mutation presented with a typical β-thalassemia (β-thal) phenotype. The haplotype analysis of the β-globin gene cluster was determined for this mutation and observed to be linked with haplotype [- + - + + + +]. Common α-globin gene deletions, triplication, and the Xmnl polymorphism, were also looked for and found to be absent in the family. The identified HBB: c.*32A>C mutation is located in the first adenylate uridylate (AU) motif of the four AU motifs situated in the 3'-UTR region of the β-globin gene. Bioinformatics analysis revealed binding of two miRNAs, hsa-miR-451a and hsa-miR-3914, at the mutation position, possibly influencing the mRNA stability by recruiting RNA binding proteins. This is the third publication reporting the 3'-UTR +1506 (A>C) mutation worldwide and the first report of the existence of this mutation in the Indian population, emphasizing the high heterogeneity of this population.
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Affiliation(s)
- Aditi Sen
- Department of Haematology, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Venu Seenappa
- Department of Molecular Genetics, Lifecell International Pvt. Ltd, Chennai, Tamil Nadu, India
| | - Prantar Chakrabarti
- Department of Haematology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Tuphan Kanti Dolai
- Department of Haematology, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
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Perera S, Allen A, Rees DC, Premawardhena A. Pitfalls in the Diagnosis of β-Thalassemia Intermedia. Hemoglobin 2021; 45:265-268. [PMID: 34612117 DOI: 10.1080/03630269.2021.1981370] [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: 10/20/2022]
Abstract
We present case histories of three patients who had β-thalassemia (β-thal) trait with 'unusual severity' managed as β-thal intermedia (β-TI) where the basis of disease severity could not be explained with routine hematological and genetic investigations. The clinical diagnosis of 'thalassemia intermedia' was justifiable as they had a β-thal mutation and disease severity that did not fit in with either β-thal trait or with β-thal major (β-TM). As mutations of α, β, and γ genes could not explain the unusual severity of the disease, further analysis with next-generation sequencing (NGS) for red cell diseases was carried out, which led to the diagnosis of coexisting membranopathies. This case series highlights the inherent difficulty in the diagnosis of β-TI with certainty in some patients where the genetic basis is not clear-cut.
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Affiliation(s)
- Shiromi Perera
- Department of Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Angela Allen
- Department of Molecular Haematology, Medical Research Council (MRC) Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.,Department of Clinical Sciences, Centre for Tropical and Infectious Disease, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David C Rees
- Department of Paediatric Haematology, King's College Hospital, London, UK
| | - Anuja Premawardhena
- Department of Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.,Hemal's Thalassaemia Care Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka
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Isley LJ, Chamberlain AK, Callum P, Shamonki J. Comparison of methodologies to detect hemoglobinopathy carriers in a multi-ethnic sperm donor population. J Genet Couns 2021; 30:1399-1406. [PMID: 33788337 DOI: 10.1002/jgc4.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 01/22/2021] [Accepted: 02/11/2021] [Indexed: 11/10/2022]
Abstract
An estimated 7% of the world's population are carriers for a hemoglobin disorder. Current guidelines recommend carrier screening by complete blood count, with follow-up hemoglobin electrophoresis or fractionation based on abnormal result or ethnicity. Advances in molecular genetic testing are thought to increase carrier detection. This study compares carrier screening methodologies in a multi-ethnic sperm donor population. A retrospective analysis was conducted using data from a US sperm bank. All men underwent carrier screening for hemoglobin disorders via complete blood count, hemoglobin fractionation, and molecular testing. Results were compared using counts and percentages. McNemar's exact test was used to examine differences in the marginal probabilities of screening methodologies. Of the 438 tested, 25 (5.7%) were identified as carriers of at least one hemoglobin disorder by molecular testing. Seventeen (68%) of those carriers were missed by recommended methods. No identified carriers were detected by recommended methods but missed by molecular testing. The difference between these discordant pairs was significant (p-value < 0.001). The majority (44%) of carriers were mixed ethnicity, followed by 36% White. Results indicate that molecular screening methodologies have a greater ability to detect carriers of hemoglobin disorders compared to currently recommended methods in a multi-ethnic population.
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Frequencies of Beta Thalassemia Mutations Show Different Pattern in Bannu Region than Other Parts of Pashtun Population in Khyber Pakhtunkhwa Province Pakistan. Indian J Hematol Blood Transfus 2021; 37:479-483. [PMID: 34267470 DOI: 10.1007/s12288-020-01361-1] [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: 05/22/2020] [Accepted: 09/24/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE β-Thalassemia arises as result of mutations in HBB gene, influencing the globin production which results in hypochromic and microcytic anaemia. The present study was aimed to investigate the occurrence of six common β-thal mutations, its inheritance pattern, frequency, and consanguinity in parents of Bannu region Khyber Pakhtunkhwa (KP) province, Pakistan. Conducting such studies may impart important information about thalassemia prevention like prenatal diagnosis (PND), carrier screening and genetic counselling which may be helpful in controlling the suspected births. METHODS During the study, 250 blood samples were retrieved from different families comprising of one transfusion dependent child and sporadic patients from different areas of Bannu region. The collected blood samples were investigated to see if there is any common mutations which may trigger β-Thalassemia employing amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) approach. RESULTS Amongst the studied mutation in District Bannu, frame shift codons (FSC) 8/9 (+ G) (HBB: c.27_28insG) was observed to be the most common mutation followed by Codons 41/42 (- TTCT), IVS-I-5(G > C) and FSC 5 (- CT) having frequencies of 42, 26, 19 and 13 respectively. The results obtained by the present study were found different from previous studies demonstrated from other Pashtun regions of KP, showing heterogeneity in frequencies of known mutations. CONCLUSION These observations may help in implementing parental meetings about disease recurrence in future, large scale mutation screening, and prenatal diagnosis in the whole Pashtun ethnicity including District Bannu.
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Soremekun OS, Ezenwa C, Isewon I, Soliman M, Idowu O, Nashiru O, Fatumo S. Computational and drug target analysis of functional single nucleotide polymorphisms associated with Haemoglobin Subunit Beta (HBB) gene. Comput Biol Med 2020; 125:104018. [PMID: 33022520 DOI: 10.1016/j.compbiomed.2020.104018] [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: 08/12/2020] [Revised: 09/13/2020] [Accepted: 09/20/2020] [Indexed: 10/23/2022]
Abstract
There is overwhelming evidence implicating Haemoglobin Subunit Beta (HBB) protein in the onset of beta thalassaemia. In this study for the first time, we used a combined SNP informatics and computer algorithms such as Neural network, Bayesian network, and Support Vector Machine to identify deleterious non-synonymous Single Nucleotide Polymorphisms (nsSNPs) present in the HBB gene. Our findings highlight three major mutation points (R31G, W38S, and Q128P) within the HBB gene sequence that have significant statistical and computational associations with the onset of beta thalassaemia. The dynamic simulation study revealed that R31G, W38S, and Q128P elicited high structural perturbation and instability, however, the wild type protein was considerably stable. Ten compounds with therapeutic potential against HBB were also predicted by structure-based virtual screening. Interestingly, the instability caused by the mutations was reversed upon binding to a ligand. This study has been able to predict potential deleterious mutants that can be further explored in the understanding of the pathological basis of beta thalassaemia and the design of tailored inhibitors.
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Affiliation(s)
- Opeyemi S Soremekun
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
| | - Chisom Ezenwa
- Centre for Genomics Research and Innovation, National Biotechnology Agency, Nigeria
| | - Itunuoluwa Isewon
- Department of Computer and Information Sciences, Covenant University, Ota, Nigeria
| | - Mahmoud Soliman
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
| | - Omotuyi Idowu
- Centre for Genomics Research and Innovation, National Biotechnology Agency, Nigeria; Chemo-genomics Research Unit, Department of Biochemistry, Adekunle Ajasin University, Akungba-Akoko, Ondo State, Nigeria
| | - Oyekanmi Nashiru
- Centre for Genomics Research and Innovation, National Biotechnology Agency, Nigeria.
| | - Segun Fatumo
- Centre for Genomics Research and Innovation, National Biotechnology Agency, Nigeria; Uganda Medical Informatics Centre and MRC/UVRI LSHTM, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Kelkar K, Ramanan V, Anand S, Majethia P, Ranade S, Patil K, Gangodkar P, Bapat A, Pilankar A, Sengaokar V, Khatod K, Agarwal M, Phadke N. HBB gene mutation spectrum in an Indian cohort of 1530 cases using an in-house targeted next-generation sequencing assay. J Hematop 2020. [DOI: 10.1007/s12308-020-00414-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Many studies determined the demographic and ethnic border of patients with beta (β)-thalassemia mutations and their migration. The effective way to health care policy of β-thalassemia is to prevent homozygote births and reduce the severity of the disease. The objectives of this study contributed to investigating the molecular and serologic characteristics of β-thalassemia patients in Iraq. Peripheral blood samples were collected from 97 β-thalassemia patients and 32 healthy control subjects. Quantitative sandwich enzyme-linked immunosorbent assay was performed to measure serum ferritin, 25-hydroxy vitamin D, and 8-hydroxydeoxyguanosine (8-OHdG) levels. Further, the β-globin mutation detection assay involving an extensive screening of β-globin mutations by direct Sanger DNA sequencing and gap-PCR was performed to detect the Δ619 deletion mutation. The results revealed that compared with the control subjects, the β-thalassemia patients showed significantly decreased vitamin D levels and significantly increased serum ferritin and 8-OHdG levels (all, P<0.001). Molecular analysis detected 9 types of mutations in the β-thalassemia patients, only 2 of which, namely IVS II-1 G>A and IVS 1-5 G>C, have been previously reported in Iraqi studies, whereas the remaining 7, namely IVS-II-666 C>T, CD2 CAT>CAC, IVS-II-850 G>A, IVS-II-16 G<C, Hb King's Mill, Hb Saveh, and IVS-II-81 C>T, have never been reported in the Iraqi population. This study showed that the serum ferritin and 8-OHdG levels were significantly higher, and the serum 25-hydroxy vitamin D levels were significantly lower in the β-thalassemia patients than in the control subjects. Moreover, the results revealed seven newly identified mutations among Iraqi β-thalassemia patients and 2 previously reported mutations.
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de Martino CC, Alencar CS, Loureiro P, Carneiro-Proietti ABDF, Máximo CDA, Mota RA, Rodrigues DOW, Gaburo Junior N, Kelly S, Sabino EC. Use of an automated pyrosequencing technique for confirmation of sickle cell disease. PLoS One 2019; 14:e0216020. [PMID: 31830127 PMCID: PMC6907837 DOI: 10.1371/journal.pone.0216020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/26/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The diagnosis of sickle cell disease (SCD) is made by hemoglobin assays such as high-performance liquid chromatography (HPLC), isoelectric focusing and cellulose acetate or citrate agar electrophoresis. These assays are easy to perform and used in large-scale newborn screening in many countries. These tests however may not easily differentiate Sβ0 thalassemia from SS or identify other hemoglobin variants, and in this case, hemoglobin (HBB) gene sequencing may be necessary. OBJECTIVES To develop a high throughput DNA based confirmatory assay for SCD and to detect mutations in the HBB gene. METHODS We developed an automated pyrosequencing technique (PyS) based on QIAGEN technology (Hilden, Germany) to detect homozygous or heterozygous hemoglobin S mutations as well as hemoglobin C mutations. The technique was tested on 2,748 samples from patients enrolled in a multi-center SCD cohort in Brazil. Patients were previously tested using HPLC to diagnose SCD as part of routine clinical care. Any subjects with discrepant results between HPLC and PyS or with heterozygous hemoglobin S detected had Sanger sequencing of the HBB gene. RESULTS We identified 168 samples with discrepant results between HPLC and PyS and 100 with concordant PyS = heterozygous S and HPLC, which would suggest SB-thalassemia or other heterozygous S variants. The PyS assay correctly identified 1906 (98.7%) of the 1930 HbSS and 628 (98.7%) of the 636 HbSC samples. Of the 179 remaining samples, PyS correctly indicated S heterozygosis in 165 (92.2%). Of the 165 heterozygous S samples confirmed by Sanger as consistent with Sβ thalassemia genotype, 84 samples were classified as Sβ0 thalassemia and 81 as Sβ+ thalassemia. The most frequent beta thalassemia mutations of Sβ0 and Sβ+ were HBB: c.118C>T (Gln40Stop) and HBB c.92 + 6T> C, respectively. DISCUSSION The PyS proved to be satisfactory for large-scale confirmatory testing of hemoglobin mutation. Moreover, with this study we were able to describe the most common β+ and β0 mutations in SCD patients with Sβ-thalassemia in a large multi-institutional SCD cohort in Brazil.
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Affiliation(s)
- Camila Cruz de Martino
- Instituto de Medicina Tropical de São Paulo, Laboratório de Parasitologia, LIM 46, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Cecilia Salete Alencar
- Laboratório de Investigacao Medica, LIM 03, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | | | | | | | | | | | - Nelson Gaburo Junior
- Instituto de Medicina Tropical de São Paulo, Laboratório de Parasitologia, LIM 46, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Shannon Kelly
- Vitalant Research Institute, San Francisco, California, United States of America
- UCSF Benioff Children’s Hospital Oakland, Oakland, California, United States of America
| | - Ester Cerdeira Sabino
- Instituto de Medicina Tropical de São Paulo, Laboratório de Parasitologia, LIM 46, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- * E-mail:
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Perera S, Allen A, Silva I, Hapugoda M, Wickramarathne MN, Wijesiriwardena I, Allen S, Rees D, Efremov DG, Fisher CA, Weatherall DJ, Premawardhena A. Genotype-phenotype association analysis identifies the role of α globin genes in modulating disease severity of β thalassaemia intermedia in Sri Lanka. Sci Rep 2019; 9:10116. [PMID: 31300739 PMCID: PMC6625979 DOI: 10.1038/s41598-019-46674-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 06/28/2019] [Indexed: 01/14/2023] Open
Abstract
β thalassaemia intermedia (βTI) are a heterogeneous group of disorders known to be extremely phenotypically diverse. This group is more complex to manage as no definitive treatment guidelines exist unlike for β thalassaemia major (βTM). There are only a few studies looking at genotype phenotype associations of βTI outside the Mediterranean region. The reasons for the diverse clinical phenotype in βTI are unknown. We categorized fifty Sri Lankan patients diagnosed with βTI as mild, moderate or severe according to published criteria. DNA samples were genotyped for β thalassaemia mutations, α globin genotype and copy number and known genetic modifiers of haemoglobin F production. There were 26/50 (52.0%) in mild group and 12/50 (24.0%) each in moderate and sever categories. 18/26 (69.2%) classified as mild were β heterozygotes and 17/18 (94.4%) had excess α globin genes. 11/12 (91.6%) classified as moderate were β heterozygotes and 8/11 (72.2%) had excess α globin genes. In contrast, 8/12 (66.7%) classified as severe were β homozygotes and 7/8(87.5%) had α globin gene deletions. In Sri Lanka, co-inheritance of either excess α globin genes in β thalassaemia heterozygotes or α globin gene deletions in β thalassaemia homozygotes is a significant factor in modulating disease severity.
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Affiliation(s)
- Shiromi Perera
- Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
| | - Angela Allen
- MRC Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.,Centre for Tropical and Infectious Disease, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Ishari Silva
- Hemal's Thalassemia Care Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka
| | - Menaka Hapugoda
- Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | | | | | - Stephen Allen
- Centre for Tropical and Infectious Disease, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David Rees
- Department of Paediatric Haematology, King's College Hospital, London, UK
| | - Dimitar G Efremov
- Molecular Hematology Unit, International Centre for Genetic Engineering and Biotechnology, Rome, Italy
| | - Christopher A Fisher
- MRC Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - David J Weatherall
- MRC Molecular Hematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Anuja Premawardhena
- Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.,Hemal's Thalassemia Care Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka
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Zhang H, Li C, Li J, Hou S, Chen D, Yan H, Chen S, Liu S, Yin Z, Yang X, Tan J, Huang X, Zhang L, Fang J, Zhang C, Li W, Guo J, Lei D. Next-generation sequencing improves molecular epidemiological characterization of thalassemia in Chenzhou Region, P.R. China. J Clin Lab Anal 2019; 33:e22845. [PMID: 30809867 PMCID: PMC6528559 DOI: 10.1002/jcla.22845] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/19/2018] [Accepted: 01/03/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives Thalassemia is a highly prevalent monogenic inherited disease in southern China. It is important to collect epidemiological data comprehensively for proper prevention and treatment. Methods In this study, blood samples collected from 15 807 residents of Chenzhou were primarily screened by hematological tests. A total of 3973 samples of suspected thalassemia carriers were further characterized by combined next‐generation sequencing (NGS) and Gap‐PCR. Results In total, 1704 subjects were diagnosed as thalassemia carriers with a total prevalence rate of 10.78%, including 943 α‐thalassemia carriers, 708 β‐thalassemia carriers, and 53 composite α and β‐thalassemia carriers. The prevalence rates of α‐thalassemia, β‐thalassemia, and composite α and β‐thalassemia were 5.97%, 4.48%, and 0.34%, respectively. Meanwhile, we characterized 19 α‐thalassemia variations and 21 β‐thalassemia variations in thalassemia carriers. Approximately 2.88% of thalassemia carriers would be missed by traditional genetic analysis. In addition, four novel thalassemia mutations and one novel abnormal hemoglobin mutation were identified. Conclusions Our data suggest a high prevalence of thalassemia and a diverse spectrum of thalassemia‐associated variations in Chenzhou. Also, combined NGS and Gap‐PCR is an effective thalassemia screening method. Our findings might be helpful for prevention and treatment of thalassemia in this region.
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Affiliation(s)
- Haoqing Zhang
- Center of Prenatal Diagnosis, Chenzhou No. 1 People's Hospital, Chenzhou, China
| | - Caiyun Li
- Center of Prenatal Diagnosis, Chenzhou No. 1 People's Hospital, Chenzhou, China
| | - Jianbiao Li
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Shuai Hou
- Center of Prenatal Diagnosis, Chenzhou No. 1 People's Hospital, Chenzhou, China
| | - Danjing Chen
- Center of Prenatal Diagnosis, Chenzhou No. 1 People's Hospital, Chenzhou, China
| | - Haiying Yan
- Center of Prenatal Diagnosis, Chenzhou No. 1 People's Hospital, Chenzhou, China
| | - Shiping Chen
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.,Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Saijun Liu
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Zhenzhen Yin
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Xiaoqin Yang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.,Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Jufang Tan
- Center of Prenatal Diagnosis, Chenzhou No. 1 People's Hospital, Chenzhou, China
| | - Xiaoyan Huang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.,Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Liming Zhang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.,Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Junbin Fang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.,Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Caifen Zhang
- BGI Genomics, BGI-Shenzhen, Shenzhen, China.,Clinical Laboratory of BGI Health, BGI-Shenzhen, Shenzhen, China
| | - Wei Li
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Jian Guo
- BGI-Shenzhen, Shenzhen, China.,China National GeneBank, BGI-Shenzhen, Shenzhen, China
| | - Dongzhu Lei
- Center of Prenatal Diagnosis, Chenzhou No. 1 People's Hospital, Chenzhou, China
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15
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Sabath DE. Molecular Diagnosis of Thalassemias and Hemoglobinopathies: An ACLPS Critical Review. Am J Clin Pathol 2017; 148:6-15. [PMID: 28605432 DOI: 10.1093/ajcp/aqx047] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe the use of molecular diagnostic techniques for patients with hemoglobin disorders. METHODS A clinical scenario is presented in which molecular diagnosis is important for genetic counseling. Globin disorders, techniques for their diagnosis, and the role of molecular genetic testing in managing patients with these disorders are described in detail. RESULTS Hemoglobin disorders, including thalassemias and hemoglobinopathies, are among the commonest genetic diseases, and the clinical laboratory is essential for the diagnosis of patients with these abnormalities. Most disorders can be diagnosed with protein-based techniques such as electrophoresis and chromatography. Since severe syndromes can result due to inheritance of combinations of globin genetic disorders, genetic counseling is important to prevent adverse outcomes. Protein-based methods cannot always detect potentially serious thalassemia disorders; in particular, α-thalassemia may be masked in the presence of β-thalassemia. Deletional forms of β-thalassemia are also sometimes difficult to diagnose definitively with standard methods. CONCLUSIONS Molecular genetic testing serves an important role in identifying individuals carrying thalassemia traits that can cause adverse outcomes in offspring. Furthermore, prenatal genetic testing can identify fetuses with severe globin phenotypes.
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Affiliation(s)
- Daniel E Sabath
- Department of Laboratory Medicine, University of Washington, Seattle
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16
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Muhammad R, Shakeel M, Rehman SU, Lodhi MA. Population-Based Genetic Study of β-Thalassemia Mutations in Mardan Division, Khyber Pakhtunkhwa Province, Pakistan. Hemoglobin 2017. [DOI: 10.1080/03630269.2017.1330210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Raj Muhammad
- Department of Biochemistry, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa Province, Pakistan
| | - Muhammad Shakeel
- Department of Biotechnology, Bacha Khan University, Charsadda, Khyber Pakhtunkhwa Province, Pakistan
| | - Shoaib U. Rehman
- Department of Biotechnology, University of Science and Technology, Bannu, Khyber Pakhtunkhwa Province, Pakistan
| | - Muhammad A. Lodhi
- Department of Biochemistry, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa Province, Pakistan
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17
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Orts JA, Zúñiga Á, Bello Y, Fabregat AB, Vicente AI. Hb A 1c Determination by Capillary Electrophoresis is an Efficient Method for Detecting β-Thalassemias and Hemoglobin Variants. Hemoglobin 2016; 40:335-340. [PMID: 27535164 DOI: 10.1080/03630269.2016.1224767] [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: 10/21/2022]
Abstract
Glycated hemoglobin (Hb A1c) determination by multicapillary zone electrophoresis (MZE) can additionally be used to detect Hb A2, Hb F and most common hemoglobin (Hb) variants. We assessed the effectiveness of this method for detecting β-thalassemia (β-thal), δβ-thalassemia (δβ-thal) and most common Hb variants. Moreover, Hb F/Hb A2 is evaluated as an index for discriminating between β- and δβ-thal traits. The theoretical β-thalassemia major (β-TM) birth rate in our healthcare area is calculated and contrasted with real data. A MZE technique was used for Hb A1c measurements in 27,724 patients. Previous criteria for carrier detection were established and subsequently confirmed by molecular biology techniques. Positive predictive value (PPV) was 100.0%. The prevalence of β-thal trait (including δβ-thal) was 0.34%. The most prevalent mutations (estimated per 100,000 population) were HBB: c.118C > T (57.7%), HBB: c.93-21G>A (50.5%), HBB: c.92 + 1G > A (43.3%), HBB: c.92 + 6T > C (32.5%) and HBB: c.20delA (18.0%) for β-thalassemias, and Hb S (HBB: c.20A > T) (32.5%) and Hb J-Baltimore (HBB:c.3880T>A) (28.9%) for Hb variants. We found a paradoxical result between the theoretical β-TM birth rate and real data. We calculated an optimal Hb F/Hb A2 index cutoff of 0.71 for discriminating between β- and δβ-thal traits. This method is highly cost-effective for detecting β-thalassemias and common Hb variants. Prevalence results match previous data for the Spanish population. Heterogeneity of mutations in Spain has markedly increased as a consequence of migration. The Hb F/Hb A2 index cutoff could be used to predict δβ-thal trait.
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Affiliation(s)
- Juan A Orts
- a Department of Biochemistry , Hospital Universitario de la Ribera , Alzira , Valencia , Spain
| | - Ángel Zúñiga
- b Department of Molecular Biology , Hospital Universitario de la Ribera , Alzira , Valencia , Spain
| | - Yanis Bello
- b Department of Molecular Biology , Hospital Universitario de la Ribera , Alzira , Valencia , Spain
| | - Aleix B Fabregat
- a Department of Biochemistry , Hospital Universitario de la Ribera , Alzira , Valencia , Spain
| | - Ana I Vicente
- c Department of Hematology , Hospital Universitario de la Ribera , Alzira , Valencia , Spain
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18
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Alwazani WA, Zahid R, Elaimi A, Bajouh O, Hindawi S, Arab B, Damanhouri G, Saka MY, Turki R, Khan JA, Dallol A, Abuzenadah AM. Detection of β-Thalassemia Mutations Using TaqMan Single Nucleotide Polymorphism Genotyping Assays. Genet Test Mol Biomarkers 2016; 20:154-7. [PMID: 26890443 DOI: 10.1089/gtmb.2015.0222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Sickle-cell anemia and β-thalassemia are two of the most common autosomal recessive disorders in the developing world. The severity of the problem and the pressure it exerts on the health services in the Kingdom of Saudi Arabia forced the introduction of a national premarital screening program to lessen its impact on the society. Furthermore, a significant effort has been exerted in the elucidation of the genetic causes of such diseases to facilitate diagnosis and detection of carriers. METHODS We have designed and validated the use of custom TaqMan(®) genotyping assays for the rapid detection of IVS-I-1 (G>A), IVS-I-5 (G>C), codon 39 (C>T), and IVS-I-110 (G>A) mutations in transfusion-dependent β-thalassemia patients' cohort. RESULTS We demonstrated that IVS-I-5 (rs33915217) is the most common single-nucleotide variant in our cohort, with the variant allele constituting 26% of the total alleles investigated. However, this variant was not found in 352 alleles screened from buccal swab DNA obtained from healthy volunteers. CONCLUSION The TaqMan single nucleotide polymorphism (SNP) genotyping assays are a rapid, accurate, and cost-effective method for the initial screening of β-thalassemia cases, which will minimize the need for direct sequencing of the HBB gene, thus reducing detection costs and increasing throughput.
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Affiliation(s)
- Wissam A Alwazani
- 1 Center of Innovation in Personalized Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia .,2 King Fahad Medical Research Center, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Rawabi Zahid
- 1 Center of Innovation in Personalized Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Aisha Elaimi
- 1 Center of Innovation in Personalized Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia .,3 Faculty of Applied Medical Sciences, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Osamah Bajouh
- 1 Center of Innovation in Personalized Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia .,4 King Abdulaziz University Hospital, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Salwa Hindawi
- 4 King Abdulaziz University Hospital, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Badr Arab
- 4 King Abdulaziz University Hospital, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Ghazi Damanhouri
- 2 King Fahad Medical Research Center, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia .,4 King Abdulaziz University Hospital, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Mohamad Yassin Saka
- 2 King Fahad Medical Research Center, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Rola Turki
- 4 King Abdulaziz University Hospital, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Jalaluddin A Khan
- 5 Department of Biochemistry, Faculty of Science, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Ashraf Dallol
- 1 Center of Innovation in Personalized Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia .,6 Center of Excellence in Genomic Medicine Research, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Adel M Abuzenadah
- 1 Center of Innovation in Personalized Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia .,3 Faculty of Applied Medical Sciences, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia .,6 Center of Excellence in Genomic Medicine Research, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
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19
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Sabath DE, Bender MA, Sankaran VG, Vamos E, Kentsis A, Yi HS, Greisman HA. Characterization of Deletions of the HBA and HBB Loci by Array Comparative Genomic Hybridization. J Mol Diagn 2015; 18:92-9. [PMID: 26612711 DOI: 10.1016/j.jmoldx.2015.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 06/22/2015] [Accepted: 07/28/2015] [Indexed: 10/22/2022] Open
Abstract
Thalassemia is among the most common genetic diseases worldwide. α-Thalassemia is usually caused by deletion of one or more of the duplicated HBA genes on chromosome 16. In contrast, most β-thalassemia results from point mutations that decrease or eliminate expression of the HBB gene on chromosome 11. Deletions within the HBB locus result in thalassemia or hereditary persistence of fetal Hb. Although routine diagnostic testing cannot distinguish thalassemia deletions from point mutations, deletional hereditary persistence of fetal Hb is notable for having an elevated HbF level with a normal mean corpuscular volume. A small number of deletions accounts for most α-thalassemias; in contrast, there are no predominant HBB deletions causing β-thalassemia. To facilitate the identification and characterization of deletions of the HBA and HBB globin loci, we performed array-based comparative genomic hybridization using a custom oligonucleotide microarray. We accurately mapped the breakpoints of known and previously uncharacterized HBB deletions defining previously uncharacterized deletion breakpoints by PCR amplification and sequencing. The array also successfully identified the common HBA deletions --(SEA) and --(FIL). In summary, comparative genomic hybridization can be used to characterize deletions of the HBA and HBB loci, allowing high-resolution characterization of novel deletions that are not readily detected by PCR-based methods.
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Affiliation(s)
- Daniel E Sabath
- Department of Laboratory Medicine, University of Washington, Seattle, Washington.
| | - Michael A Bender
- Department of Pediatrics, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Vijay G Sankaran
- Division of Hematology/Oncology, Boston Children's Hospital and Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Esther Vamos
- Departments of Pediatrics and Genetics, Université Libre de Bruxelles, Brussels, Belgium
| | - Alex Kentsis
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hye-Son Yi
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Harvey A Greisman
- Department of Laboratory Medicine, University of Washington, Seattle, Washington.
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20
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Pisciotta L, Vitali C, Favari E, Fossa P, Adorni MP, Leone D, Artom N, Fresa R, Calabresi L, Calandra S, Bertolini S. A complex phenotype in a child with familial HDL deficiency due to a novel frameshift mutation in APOA1 gene (apoA-IGuastalla). J Clin Lipidol 2015; 9:837-846. [PMID: 26687706 DOI: 10.1016/j.jacl.2015.09.001] [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: 04/08/2015] [Revised: 08/07/2015] [Accepted: 09/09/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND We describe a kindred with high-density lipoprotein (HDL) deficiency due to APOA1 gene mutation in which comorbidities affected the phenotypic expression of the disorder. METHODS An overweight boy with hypertriglyceridemia (HTG) and HDL deficiency (HDL cholesterol 0.39 mmol/L, apoA-I 40 mg/dL) was investigated. We sequenced the candidate genes for HTG (LPL, APOC2, APOA5, GPIHBP1, LMF1) and HDL deficiency (LCAT, ABCA1 and APOA1), analyzed HDL subpopulations, measured cholesterol efflux capacity (CEC) of sera and constructed a model of the mutant apoA-I. RESULTS No mutations in HTG-related genes, ABCA1 and LCAT were found. APOA1 sequence showed that the proband, his mother and maternal grandfather were heterozygous of a novel frameshift mutation (c.546_547delGC), which generated a truncated protein (p.[L159Afs*20]) containing 177 amino acids with an abnormal C-terminal tail of 19 amino acids. Trace amounts of this protein were detectable in plasma. Mutation carriers had reduced levels of LpA-I, preβ-HDL and large HDL and no detectable HDL-2 in their plasma; their sera had a reduced CEC specifically the ABCA1-mediated CEC. Metabolic syndrome in the proband explains the extremely low HDL cholesterol level (0.31 mmol/L), which was half of that found in the other carriers. The proband's mother and grandfather, both presenting low plasma low-density lipoprotein cholesterol, were carriers of the β-thalassemic trait, a condition known to be associated with a reduced low-density lipoprotein cholesterol and a reduced prevalence of cardiovascular disease. This trait might have delayed the development of atherosclerosis related to HDL deficiency. CONCLUSIONS In these heterozygotes for apoA-I truncation, the metabolic syndrome has deleterious effect on HDL system, whereas β-thalassemia trait may delay the onset of cardiovascular disease.
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Affiliation(s)
- Livia Pisciotta
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Cecilia Vitali
- Center E. Grossi Paoletti, Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Elda Favari
- Department of Pharmacy, University of Parma, Parma, Italy
| | - Paola Fossa
- Department of Pharmacy, University of Genoa, Genoa, Italy
| | | | - Daniela Leone
- Laboratory of Human Genetics, Galliera Hospital, Genoa, Italy
| | - Nathan Artom
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Raffaele Fresa
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Laura Calabresi
- Center E. Grossi Paoletti, Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Sebastiano Calandra
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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21
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Ben Charfeddine I, Ben Lazreg T, M’sakni A, Amara A, Mlika A, Chaïeb A, Hlel K, Zouari N, Zbidi F, Bouguila J, Soyah N, Ayedi A, Ben Hamouda H, Abroug S, Boughamoura L, Saad A, Gribaa M. Multiplex Minisequencing of the HBBGene: A Rapid Strategy to Confirm the Most Frequent β-Thalassemia Mutations in the Tunisian Population. Hemoglobin 2015; 39:251-5. [DOI: 10.3109/03630269.2015.1041605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Vannocci T, Kurata H, Fuente J, Roberts IA, Porter ACG. Nuclease‐stimulated homologous recombination at the human β‐globin gene. J Gene Med 2014. [DOI: 10.1002/jgm.2751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Tommaso Vannocci
- Centre for Haematology, Imperial College Faculty of Medicine Hammersmith Hospital Campus London UK
| | - Hitoshi Kurata
- Centre for Haematology, Imperial College Faculty of Medicine Hammersmith Hospital Campus London UK
| | - Josu Fuente
- Paediatric Haematology, Imperial College Healthcare Trust St Mary's Hospital London UK
| | - Irene A. Roberts
- Centre for Haematology, Imperial College Faculty of Medicine Hammersmith Hospital Campus London UK
| | - Andrew C. G. Porter
- Centre for Haematology, Imperial College Faculty of Medicine Hammersmith Hospital Campus London UK
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23
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Efficient detection of Mediterranean β-thalassemia mutations by multiplex single-nucleotide primer extension. PLoS One 2012; 7:e48167. [PMID: 23110203 PMCID: PMC3482202 DOI: 10.1371/journal.pone.0048167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Accepted: 09/21/2012] [Indexed: 11/20/2022] Open
Abstract
β-Thalassemias and abnormal hemoglobin variants are among the most common hereditary abnormalities in humans. Molecular characterization of the causative genetic variants is an essential part of the diagnostic process. In geographic areas with high hemoglobinopathy prevalence, such as the Mediterranean region, a limited number of genetic variants are responsible for the majority of hemoglobinopathy cases. Developing reliable, rapid and cost-effective mutation-specific molecular diagnostic assays targeting particular populations greatly facilitates routine hemoglobinopathy investigations. We developed a one-tube single-nucleotide primer extension assay for the detection of eight common Mediterranean β-thalassemia mutations: Codon 5 (-CT); CCT(Pro)->C–, Codon 6 (-A); GAG(Glu)->G-G, Codon 8 (-AA); AAG(Lys)->–G, IVS-I-1 (G->A), IVS-I-6 (T->C), IVS-I-110 (G->A), Codon 39 (C->T), and IVS-II-745 (C->G), as well as the hemoglobin S variant beta 6(A3) Glu>Val. We validated the new assay using previously genotyped samples obtaining 100% agreement between independent genotyping methods. Our approach, applicable in a range of Mediterranean countries, offers a combination of high accuracy and rapidity exploiting standard techniques and widely available equipment. It can be further adapted to particular populations by including/excluding assayed mutations. We facilitate future modifications by providing detailed information on assay design.
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Traeger-Synodinos J, Vrettou C, Kanavakis E. Prenatal, noninvasive and preimplantation genetic diagnosis of inherited disorders: hemoglobinopathies. Expert Rev Mol Diagn 2011; 11:299-312. [PMID: 21463239 DOI: 10.1586/erm.11.7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Disorders of hemoglobin synthesis have been used as a prototype for the development of most approaches for prenatal diagnosis (PND). PND for hemoglobinopathies based on molecular analysis of trophoblast or amniocyte DNA has accumulated approximately 30 years of experience. Disadvantages with conventional PND include 'invasive' fetal sampling and the need to terminate affected ongoing pregnancies. New developments are directed towards improving both the timing and/or safety of procedures. Preimplantation genetic diagnosis, an established procedure with 20 years of clinical application, avoids the need to terminate affected pregnancies through the identification and selective transfer of unaffected in vitro fertilization embryos. Approaches towards 'noninvasive' PND, through analyzing fetal cells or free fetal DNA present in the circulation of pregnant women, are a focus of ongoing research. Overall, PND, preimplantation genetic diagnosis (and potentially 'noninvasive' PND) represent valuable reproductive options for couples at risk of having a child affected with a severe inherited disease.
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Affiliation(s)
- Joanne Traeger-Synodinos
- Department of Medical Genetics, National and Kapodistrian University of Athens, St Sophia's Children's Hospital, Athens 11527, Greece.
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25
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Sheng ZM, Chertow DS, Morens DM, Taubenberger JK. Fatal 1918 pneumonia case complicated by erythrocyte sickling. Emerg Infect Dis 2010; 16:2000-1. [PMID: 21122243 PMCID: PMC3294594 DOI: 10.3201/eid1612.101376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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