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Li H, Ch'ih Y, Li M, Luo Y, Liu H, Xu J, Song W, Ma Q, Shao Z. Newborn screening for G6PD deficiency in HeFei, FuYang and AnQing, China: Prevalence, cut-off value, variant spectrum. J Med Biochem 2024; 43:86-96. [PMID: 38496015 PMCID: PMC10943458 DOI: 10.5937/jomb0-43078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/14/2023] [Indexed: 03/19/2024] Open
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive Mendelian genetic disorder characterized by neonatal jaundice and hemolytic anemia, affecting more than 400 million people worldwide. The purpose of this research was to investigate prevalence rates of G6PD deficiency and to evaluate and establish specific cut-off values in early prediction of G6PD deficiency by regions (HeFei, FuYang, AnQing) on different seasons, as well as to investigate the frequencies of G6PD gene mutations among three regions mentioned above. Methods A total of 31,482 neonates (21,402, 7680, and 2340 for HeFei, FuYang, and AnQing cities, respectively) were recruited. Positive subjects were recalled to attend genetic tests for diagnosis. G6PD activity on the Genetic screening processor (GSP analyzer, 2021-0010) was measured following the manufactureržs protocol. The cut-off value was first set to 35 U/dL. The receiver operating characteristics (ROC) curve was employed to assess and compare the efficiency in predicting G6PD deficiency among HeFei, FuYang, and AnQing cities in different seasons.
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Affiliation(s)
- Hui Li
- HeFei Women and Children Medical Care Center, HeFei City, Anhui Province, China
| | - Yah Ch'ih
- Zhejiang Biosan Biochemical Technologies Co., Ltd, Hangzhou City, Zhejiang Province, China
| | - Meiling Li
- HeFei Women and Children Medical Care Center, HeFei City, Anhui Province, China
| | - Yulei Luo
- FuYang Maternal and Child Health Family Planning Service Center, FuYang City, Anhui Province, China
| | - Hao Liu
- AnQing Maternal and Child Health Family Planning Service Center, AnQing City, Anhui Province, China
| | - Junyang Xu
- HeFei Women and Children Medical Care Center, HeFei City, Anhui Province, China
| | - Wangsheng Song
- HeFei Women and Children Medical Care Center, HeFei City, Anhui Province, China
| | - Qingqing Ma
- HeFei Women and Children Medical Care Center, HeFei City, Anhui Province, China
| | - Ziyu Shao
- HeFei Women and Children Medical Care Center, HeFei City, Anhui Province, China
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Liang HF, Cao YB, Lin F, Yang YK, Liao YW, Ou WH, Chen JL, Zeng YQ, Huang YC, Zeng GK, Chen ZX, Situ JW, Yao JX, Yang LY. Molecular epidemiological investigation of G6PD deficiency in Yangjiang region, western Guangdong province. Front Genet 2024; 14:1345537. [PMID: 38264207 PMCID: PMC10803456 DOI: 10.3389/fgene.2023.1345537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024] Open
Abstract
Objectives: The prevalence of G6PD deficiency has not been reported in Yangjiang, a western city in Guangdong province. This study aims to investigate the molecular characteristics of G6PD deficiency in this region. Methods: Blood samples were collected from adults at a local hospital to screen for G6PD deficiency. The deficient samples were subjected to further analysis using PCR and reverse dot blot to determine the specific G6PD variants. Results: Among the 3314 male subjects, 250 cases of G6PD deficiency were found using the G6PD enzyme quantitative assay, resulting in a prevalence of 7.54% (250/3314) in the Yangjiang region. The prevalence of G6PD deficiency in females was 3.42% (176/5145). Out of the 268 cases of G6PD deficiency tested for G6PD mutations, reverse dot blot identified 20 different G6PD variants. The most common G6PD variant was c.1388G>A (81/268), followed by c.1376G>T (48/268), c.95A>G (32/268), c.1024C>T (9/268), c.392G>T (7/268), and c.871G>A/c.1311C>T (6/268). It was observed that c.871G>A was always linked to the polymorphism of c.1311C>T in this population. Conclusion: This investigation into G6PD deficiency in this area is expected to significantly improve our understanding of the prevalence and molecular characterization of this condition.
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Affiliation(s)
- Hong-Feng Liang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Yan-Bin Cao
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Fen Lin
- Precision Medical Lab Center, Chaozhou Central Hospital, Chaozhou, Guangdong, China
| | - Yi-Kang Yang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
- Institute of Medicine and Nursing, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yu-Wei Liao
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Wei-Hao Ou
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Jin-Ling Chen
- Department of Laboratory Medicine, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Yan-Qing Zeng
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Yu-Chan Huang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Guang-Kuan Zeng
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Zhi-Xiao Chen
- Department of Transfusion, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Jing-Wei Situ
- Department of Laboratory Medicine, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Jin-Xiu Yao
- Department of Laboratory Medicine, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Li-Ye Yang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
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Zhang Z, Wang X, Jiang J. Screening results and mutation frequency analysis of G6PD deficiency in 1,291,274 newborns in Huizhou, China: a twenty-year experience. Ann Hematol 2024; 103:29-36. [PMID: 37971548 DOI: 10.1007/s00277-023-05533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES This study aimed to investigate the incidence rate and spectrum of gene mutations of Glucose-6-phosphate dehydrogenase (G6PD) deficiency in the Huizhou city of southern China to provide a scientific basis for disease prevention and control in the area. METHODS From March 2003 to December 2022, newborn screening for G6PD enzyme activity was carried out in Huizhou city using the fluorescence quantitative method. Infants who tested positive during the initial screening were diagnosed using the nitroblue tetrazolium ratio method, while a subset of infants received further gene mutation analysis using the multicolor probe melting curve analysis method. RESULTS A total of 1,291,274 newborns were screened and the screening rate has increased from 20.39% to almost 100%. In the 20-year period, 57,217 (4.43%) infants testing positive during the initial screening. Out of these infants, 49,779 (87%) were recalled for confirmatory testing. G6PD deficiency was confirmed in 39,261 of the recalled infants, indicating a positive predictive value of 78.87%. The estimated incidence rate of G6PD deficiency in the region was 3.49%, which was significantly higher than the average incidence rate of 2.1% in southern China. On the other hand, seven pathogenic G6PD variants were identified in the analysis of the 99 diagnosed infants with the most common being c.1388 G > A (48.5%), followed by c.95 A > G (19.2%), c.1376 G > T (15.2%), c.871 G > A (9.1%), c.1360 C > T (3.0%), c.392 G > T (3.0%), and c.487 G > A (1.0%). CONCLUSION The incidence of G6PD deficiency in newborns in the Huizhou city was higher than the southern China average level, while the types and frequencies of gene mutations were found to vary slightly from other regions. Our findings suggested that free government screening and nearby diagnosis strategies could reduce the incidence of G6PD deficiency in the area.
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Affiliation(s)
- Zhiqiang Zhang
- Huizhou Second Maternal and Child Health Hospital, Huizhou, 516001, People's Republic of China
| | - Xiaoting Wang
- Huizhou Second Maternal and Child Health Hospital, Huizhou, 516001, People's Republic of China
| | - Jianhui Jiang
- Guangdong Maternal and Child Health Hospital, Guangzhou, 510000, People's Republic of China.
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Chamchoy K, Sudsumrit S, Wongwigkan J, Petmitr S, Songdej D, Adams ER, Edwards T, Leartsakulpanich U, Boonyuen U. Molecular characterization of G6PD mutations identifies new mutations and a high frequency of intronic variants in Thai females. PLoS One 2023; 18:e0294200. [PMID: 37967096 PMCID: PMC10651042 DOI: 10.1371/journal.pone.0294200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/26/2023] [Indexed: 11/17/2023] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked enzymopathy caused by mutations in the G6PD gene. A medical concern associated with G6PD deficiency is acute hemolytic anemia induced by certain foods, drugs, and infections. Although phenotypic tests can correctly identify hemizygous males, as well as homozygous and compound heterozygous females, heterozygous females with a wide range of G6PD activity may be misclassified as normal. This study aimed to develop multiplex high-resolution melting (HRM) analyses to enable the accurate detection of G6PD mutations, especially among females with heterozygous deficiency. Multiplex HRM assays were developed to detect six G6PD variants, i.e., G6PD Gaohe (c.95A>G), G6PD Chinese-4 (c.392G>T), G6PD Mahidol (c.487G>A), G6PD Viangchan (c.871G>A), G6PD Chinese-5 (c.1024C>T), and G6PD Union (c.1360C>T) in two reactions. The assays were validated and then applied to genotype G6PD mutations in 248 Thai females. The sensitivity of the HRM assays developed was 100% [95% confidence interval (CI): 94.40%-100%] with a specificity of 100% (95% CI: 88.78%-100%) for detecting these six mutations. The prevalence of G6PD deficiency was estimated as 3.63% (9/248) for G6PD deficiency and 31.05% (77/248) for intermediate deficiency by phenotypic assay. The developed HRM assays identified three participants with normal enzyme activity as heterozygous for G6PD Viangchan. Interestingly, a deletion in intron 5 nucleotide position 637/638 (c.486-34delT) was also detected by the developed HRM assays. G6PD genotyping revealed a total of 12 G6PD genotypes, with a high prevalence of intronic variants. Our results suggested that HRM analysis-based genotyping is a simple and reliable approach for detecting G6PD mutations, and could be used to prevent the misdiagnosis of heterozygous females by phenotypic assay. This study also sheds light on the possibility of overlooking intronic variants, which could affect G6PD expression and contribute to enzyme deficiency.
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Affiliation(s)
- Kamonwan Chamchoy
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Sirapapha Sudsumrit
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jutamas Wongwigkan
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Songsak Petmitr
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Duantida Songdej
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Emily R. Adams
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Thomas Edwards
- Centre for Drugs and Diagnostics Research, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ubolsree Leartsakulpanich
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Usa Boonyuen
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Liu Y, Huang H, Zheng Y, Wang C, Chen W, Huang W, Lin L, Wei H, Wang J, Lin M. Development of a POCT detection platform based on a locked nucleic acid-enhanced ARMS-RPA-GoldMag lateral flow assay. J Pharm Biomed Anal 2023; 235:115632. [PMID: 37573622 DOI: 10.1016/j.jpba.2023.115632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/16/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
In this study, a novel genotyping point-of-care testing (POCT) rapid detection device, the locked nucleic acid (LNA)-amplification refractory mutation system (ARMS)-recombinase polymerase amplification (RPA)-GoldMag lateral flow assay (LFA) platform, was provided by mining and synthesis based on prior technology. Research methods based on system-integrated innovation and knowledge-integrated generation have become a new trend in technology development. Here, we exploit the combination of LNA-coupled ARMS-RPA and gold nanoparticle probe technology for detection signal amplification, thus pioneering a new tool for accurate, rapid, and cost-effective genotyping. We also performed SNP typing detection and clinical validation of this new assay platform using common glucose-6-phosphate dehydrogenase (G6PD) gene single nucleotide polymorphism (SNP) loci, and the results demonstrated the high sensitivity, specificity, stability, accuracy and feasibility of the LNA-ARMS-RPA-GoldMag lateral flow assay platform. It is hoped that this new technology will make a significant contribution to the field of POCT rapid diagnosis and aim to expand the application space, reflecting its clinical application value and development prospects.
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Affiliation(s)
- Yaqun Liu
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, People's Republic of China
| | - Huiying Huang
- Shool of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, People's Republic of China
| | - Yuzhong Zheng
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, People's Republic of China
| | - Chunfang Wang
- Shool of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, People's Republic of China
| | - Wencheng Chen
- Shool of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, People's Republic of China
| | - Weiyi Huang
- Shool of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, People's Republic of China
| | - Liyun Lin
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, People's Republic of China
| | - Huagui Wei
- Shool of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, People's Republic of China
| | - Junli Wang
- Shool of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, People's Republic of China.
| | - Min Lin
- School of Food Engineering and Biotechnology, Hanshan Normal University, Chaozhou, Guangdong, People's Republic of China; Shool of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, Guangxi, People's Republic of China.
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Molecular Characterization and Genotype-Phenotype Correlation of G6PD Mutations in Five Ethnicities of Northern Vietnam. Anemia 2022; 2022:2653089. [PMID: 35845714 PMCID: PMC9277213 DOI: 10.1155/2022/2653089] [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: 04/21/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder and is caused by G6PD gene mutations. To date, more than 400 variants in the G6PD gene have been discovered, and about 160 identified variants are associated with a significant decrease in the G6PD enzyme activity. However, the molecular characterization and epidemiological study of G6PD deficiency are still limited in Vietnam. Therefore, we conducted this study to determine the G6PD variants among the Vietnamese populations and evaluate their correlation to G6PD enzyme activity. A total of 339 patients (302 males and 37 females) were enrolled in this study. The G6PD variants were identified by Sanger sequencing. Our results indicate that males are more severely deficient in G6PD than females. This enzyme activity in males (1.27 ± 1.06 IU/g·Hb) is significantly lower than in females (2.98 ± 1.57 IU/g·Hb) (p < 0.0001). The enzyme activity of the heterozygous-homozygous females and heterozygous females-hemizygous males was found to be significantly different (p < 0.05), which is interpreted due to random X-inactivation. For G6PD molecular characteristics, Viangchan (c.871G>A), Canton (c.1376G>T) and Kaiping (c.1388G>A) variants were the most dominant, accounting for 24.48%, 17.70%, and 22.42%, respectively, whereas the highest frequency of complex variants was observed in Viangchan/Silent with 20.35%. In terms of G6PD activity, the Union variant presented the lowest mean value (1.03 IU/g·Hb) compared to the other variants (p < 0.05). Computational analysis using Polyphen-2 tool investigated that all variants were relative to G6PD deficiency and separated the levels as benign and damaged. The result will establish effective methods to screen G6PD variants in Vietnam.
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Liang HF, Lin F, Lu J, Chen ZX, Yang LY. Glucose-6-phosphate dehydrogenase deficiency screening and gene analysis in blood donors of Guangdong province. Hematology 2022; 27:494-498. [PMID: 35465846 DOI: 10.1080/16078454.2022.2065094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hong-Feng Liang
- Precision Medical Lab Center, People’s Hospital of Yangjiang Affiliated to Guangdong Medical University, Yangjiang, People’s Republic of China
| | - Fen Lin
- Precision Medical Center, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, People’s Republic of China
| | - Jin Lu
- Foshan Central Blood Bank, Foshan, People’s Republic of China
| | - Zhi-Xiao Chen
- Department of Transfusion, People’s Hospital of Yangjiang Affiliated to Guangdong Medical University, Yangjiang, People’s Republic of China
| | - Li-Ye Yang
- Precision Medical Lab Center, People’s Hospital of Yangjiang Affiliated to Guangdong Medical University, Yangjiang, People’s Republic of China
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Xu A, Jiang M, Zhang W, Lin Y, Shao Y, Mei H, Cheng J, Liang C, Li C, Li X, Liu L. Glucose-6-Phosphate dehydrogenase deficiency associated hemolysis in a cohort of new onset type 1 diabetes children in Guangdong province, China. Diabetol Metab Syndr 2022; 14:43. [PMID: 35313968 PMCID: PMC8935706 DOI: 10.1186/s13098-022-00812-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human genetic abnormalities, with a high prevalence in Guangdong, China. The purpose of this study was to explore the characteristics of newly diagnosed type 1 diabetes (T1D) patients with G6PD deficiency in a cohort of Chinese children and to investigate the relationship between the diabetic ketoacidosis (DKA) and hemolysis due to G6PD deficiency in these patients. METHODS A total of 503 newly diagnosed T1D children aged 6 months-18 years were collected and their G6PD enzyme activity were measured. Fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and G6PD gene were analysed. The pH, HCO3, and plasma osmotic pressure between DKA patients with and without hemolysis at the presentation were compared. RESULTS In the present study, G6PD deficiency accounted for 5.3% of newly diagnosed T1D children. There were no significant differences in FPG/HbA1c and HbA1c levels between T1D children alone and T1D children with G6PD deficiency. Hemolysis appeared in five of the twenty-two DKA patients with G6PD deficiency. Two patients had fever at onset and were given ibuprofen and cefazolin. The other three patients did not have infection or ingestion of hemolytic drugs. There were no significant difference in pH, HCO3, and osmotic pressure between the children with DKA with and without hemolysis at the presentation. The hemolysis occurred between 2 and 7 days after admission and the hyperglycaemia had been corrected by the time hemolysis occurs. Four G6PD gene mutations were found in the diabetes with G6PD deficiency patients: c.1376G > T, c.1388G > A, c.95A > G, and c.871G > A, all of which were genes with high frequency of G6PD deficiency in Guangdong Province. No correlation between genotype and hemolysis was found. CONCLUSION In the present study, we found the frequency of G6PD deficiency among newly diagnosed T1D children was similar to that of the general population. However, DKA children with G6PD deficiency are prone to occur hemolytic anemia, and these hemolysis usually occurs when DKA is corrected and blood glucose is in homeostatic state, which is easy to be ignored. To reduce the risk of this complication, especially in areas with high incidence of G6PD deficiency, screening for G6PD activity in people with newly diagnosed diabetes should be considered.
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Affiliation(s)
- Aijing Xu
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Minyan Jiang
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Wen Zhang
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Yunting Lin
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Yongxian Shao
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Huifen Mei
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Jing Cheng
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Cuili Liang
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Cuiling Li
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China
| | - Xiuzhen Li
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China.
| | - Li Liu
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China.
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Wang X, Xia Z, He Y, Zhou X, Zhang H, Gao C, Ge Y, Cai X, Zhou Y, Guo Q. Newborn Screening for G6PD Deficiency in Xiamen, China: Prevalence, Variant Spectrum, and Genotype-Phenotype Correlations. Front Genet 2021; 12:718503. [PMID: 34659341 PMCID: PMC8517332 DOI: 10.3389/fgene.2021.718503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/20/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common inherited enzymatic defect. The purpose of this study was to evaluate the profile of G6PD deficiency and investigate the factors associated with the accuracy of newborn screening (NBS) in Xiamen, China. Methods: A total of 99,546 newborns were screened by modified fluorescent spot test at the Women and Children’s Hospital, Xiamen University. High-risk neonates were recalled for diagnosis by either a measurement of G6PD activity or genetic testing for the presence of pathogenic G6PD variants using a quantitative G6PD enzymatic assay or the MeltPro® G6PD assay, respectively. Results: In the first-tier screening, 1,256 newborns were categorized as high risk. Of these, 1,051 were diagnosed with G6PD deficiency, indicating a prevalence of 1.39% in Xiamen, China. Among the 1,013 neonates who underwent genotyping, 851 carried hemizygous, heterozygous, homozygous, or compound heterozygous variants, for a positive predictive value (PPV) of 84.01%. In total, 12 variants and 32 genotypes were identified, and the six most common variants were c.1376G>T, c.1388G>A, c.95A>G, c.1024C>T, c.871G>A, and c.392G>T, which accounted for approximately 94% of the identified alleles. Different variants showed characteristic enzymatic activities, although high phenotypic heterogeneity was observed for each variant. The use of cold-chain transportation significantly improved the PPV of NBS. Conclusions: We determined the profile of G6PD deficiency in Xiamen, including the prevalence, variant spectrum, and genotype-phenotype correlations and confirmed that maintaining a low temperature during sample transport is essential to ensure the high screening accuracy of NBS. Our data provides epidemiological, genotypic, phenotypic, and clinical practice references to standardize future interventions for G6PD deficiency.
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Affiliation(s)
- Xudong Wang
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, China.,Xiamen Newborn Screening Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Zhongmin Xia
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, China
| | - Ying He
- Xiamen Newborn Screening Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Xiaoman Zhou
- School of Medicine, Xiamen University, Xiamen, China
| | - Haixia Zhang
- School of Public Health, Xiamen University, Xiamen, China
| | - Chunliu Gao
- School of Public Health, Xiamen University, Xiamen, China
| | - Yunsheng Ge
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, China
| | - Xiaofang Cai
- Xiamen Newborn Screening Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Yulin Zhou
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, China.,Xiamen Newborn Screening Center, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Qiwei Guo
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, China
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Gao J, Lin S, Chen S, Wu Q, Zheng K, Su J, Guo Z, Duan S. Molecular Characterization of Glucose-6-Phosphate Dehydrogenase Deficiency in the Shenzhen Population. Hum Hered 2021; 85:110-116. [PMID: 34134107 DOI: 10.1159/000516808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is caused by one or more mutations in the G6PD gene on chromosome X. This study aimed to characterize the G6PD gene variant distribution in Shenzhen of Guangdong province. METHODS A total of 33,562 individuals were selected at the hospital for retrospective analysis, of which 1,213 cases with enzymatic activity-confirmed G6PD deficiency were screened for G6PD gene variants. Amplification refractory mutation system PCR was first used to screen the 6 dominant mutants in the Chinese population (c.1376G>T, c.1388G>A, c.95A>G, c.1024C>T, c.392G>T, and c.871G>A). If the 6 hotspot variants were not found, next-generation sequencing was then performed. Finally, Sanger sequencing was used to verify all the mutations. RESULTS The incidence of G6PD deficiency in this study was 3.54%. A total of 26 kinds of mutants were found in the coding region, except for c.-8-624T>C, which was in the noncoding region. c.1376G>T and c.1388G>A, both located in exon 12, were the top 2 mutants, accounting for 68.43% of all individuals. The 6 hotspot mutations had a cumulative proportion of 94.02%. CONCLUSIONS This study provided detailed characteristics of G6PD gene variants in Shenzhen, and the results would be valuable to enrich the knowledge of G6PD deficiency.
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Affiliation(s)
- Jian Gao
- Laboratory of Molecular Medicine, Shenzhen Health Development Research Center, Shenzhen, China,
| | - Sheng Lin
- Laboratory of Molecular Medicine, Shenzhen Health Development Research Center, Shenzhen, China
| | - Shiguo Chen
- Laboratory of Molecular Medicine, Shenzhen Health Development Research Center, Shenzhen, China
| | - Qunyan Wu
- Laboratory of Molecular Medicine, Shenzhen Health Development Research Center, Shenzhen, China
| | - Kaifeng Zheng
- Laboratory of Molecular Medicine, Shenzhen Health Development Research Center, Shenzhen, China
| | - Jindi Su
- Laboratory of Molecular Medicine, Shenzhen Health Development Research Center, Shenzhen, China
| | - Zhaopeng Guo
- Shenzhen Luohu Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Shan Duan
- Laboratory of Molecular Medicine, Shenzhen Health Development Research Center, Shenzhen, China
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11
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Dai W, Yang T, Wang Y, Zhao Q, Zhan Y, Ye J, Han L, Qiu W, Zhang H, Liang L, Gu X, Yu Y. Rapid detection of twenty-nine common Chinese glucose-6-phosphate dehydrogenase variants using a matrix-assisted laser desorption/ionization-time of flight mass spectrometry assay on dried blood spots. Clin Biochem 2021; 94:27-34. [PMID: 33882285 DOI: 10.1016/j.clinbiochem.2021.04.012] [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] [Received: 01/12/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited disease. Current neonatal screening methods for G6PD deficiency primarily rely on the use of biochemical tests. However, only 15%-20% of female carriers were estimated to have been detected using these tests. As a better alternative, DNA-based tests could be used for G6PD deficiency screening. We aimed to develop a matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) assay for G6PD variant detection. METHODS A MALDI-TOF MS assay with multiprimer extension (multi-PEX) was developed to rapidly and accurately detect the 29 common G6PD variants in the Chinese population using a dried blood spot as a template. A parallel study screening 571 unrelated neonatal samples using the MALDI-TOF MS and fluorescence quantitative enzymatic assays was performed. All results were confirmed by Sanger sequencing in a blind study. RESULTS In 571 unrelated neonatal samples, 34 positive samples, including 26 samples from hemizygous males and eight samples from heterozygous females, were correctly identified, yielding a clinical sensitivity of 100%. The results were validated using Sanger sequencing with 100% concordance. In contrast, the fluorescence quantitative enzymatic assay had a 75% false negative and 88.8% false positive rate for the detection of heterozygous G6PD deficient females. CONCLUSIONS We established a reliable MALDI-TOF MS assay for G6PD deficiency screening in the Chinese population maximizing the chance of detection of heterozygous G6PD deficient females and reducing the false negative and false positive rates associated with routinely used newborn screening procedures.
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Affiliation(s)
- Weiqian Dai
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Tingting Yang
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Yu Wang
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Qianfeng Zhao
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Yongkun Zhan
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Jun Ye
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Lianshu Han
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Wenjuan Qiu
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Huiwen Zhang
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Lili Liang
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China
| | - Xuefan Gu
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China.
| | - Yongguo Yu
- Department of Pediatric Endocrinology and Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, Shanghai 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.
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12
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He Y, Zhang Y, Chen X, Wang Q, Ling L, Xu Y. Glucose-6-phosphate dehydrogenase deficiency in the Han Chinese population: molecular characterization and genotype-phenotype association throughout an activity distribution. Sci Rep 2020; 10:17106. [PMID: 33051526 PMCID: PMC7555859 DOI: 10.1038/s41598-020-74200-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/28/2020] [Indexed: 11/09/2022] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common hereditary disorder in China. The existing prevalence and molecular epidemiology of G6PD deficiency in China were geographically limited. In this study, the spectrum of G6PD gene mutations was well characterized in a large and diverse population all over the country; and the correlation of genotype and enzyme activity phenotype was explored for the first time. The results showed that the overall prevalence of G6PD deficiency in China was 2.10% at the national level. The top six common mutations were c.1388 G>A, c.1376 G>T, c.95 A>G, c.392 G>T, c.871 G>A and c.1024 C>T, accounting for more than 90% of G6PD deficient alleles. Compound mutation patterns were frequently observed in females with severe deficiency. The distribution of G6PD activities depended on the type of mutation patterns and genders. Hemizygote, homozygote, and compound heterozygote were predominantly associated with severe G6PD deficiency, whereas heterozygotes with single mutation mainly presented moderate enzyme deficiency. A significant gap between G6PD activities in hemizygous and normal males was observed, and yet, the overall distribution of that in females carrying missense mutations was a continuum from G6PD severely deficient to normal. This is the first report of discussing the association between G6PD genetic variants in the Chinese and enzyme activity phenotypes.
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Affiliation(s)
- Ying He
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong Province, China
| | - Yinhui Zhang
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong Province, China
| | - Xionghao Chen
- Maternity and Children, Healthcare Hospital of Futian, Shenzhen, Guangdong Province, China
| | - Qiong Wang
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong Province, China
| | - Lifen Ling
- Department of Laboratory Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong Province, China
| | - Yuhong Xu
- Department of Clinical Pharmacy, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong Province, China.
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13
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A novel G6PD deleterious variant identified in three families with severe glucose-6-phosphate dehydrogenase deficiency. BMC MEDICAL GENETICS 2020; 21:150. [PMID: 32680472 PMCID: PMC7367331 DOI: 10.1186/s12881-020-01090-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 07/08/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase deficiency (D-G6PD) is an X-linked recessive disorder resulted from deleterious variants in the housekeeping gene Glucose-6-phosphate 1-dehydrogenase (G6PD), causing impaired response to oxidizing agents. Screening for new variations of the gene helps with early diagnosis of D-G6PD resulting in a reduction of disease related complications and ultimately increased life expectancy of the patients. METHODS One thousand five hundred sixty-five infants with pathological jaundice were screened for G6PD variants by Sanger sequencing all of the 13 exons, and the junctions of exons and introns of the G6PD gene. RESULTS We detected G6PD variants in 439 (28.1%) of the 1565 infants with pathological jaundice. In total, 9 types of G6PD variants were identified in our cohort; and a novel G6PD missense variant c.1118 T > C, p.Phe373Ser in exon 9 of the G6PD gene was detected in three families. Infants with this novel variant showed decreased activity of G6PD, severe anemia, and pathological jaundice, consistent with Class I G6PD deleterious variants. Analysis of the resulting protein's structure revealed this novel variant affects G6PD protein stability, which could be responsible for the pathogenesis of D-G6PD in these patients. CONCLUSIONS High rates of G6PD variants were detected in infants with pathological jaundice, and a novel Class I G6PD deleterious variants was identified in our cohort. Our data reveal that variant analysis is helpful for the diagnosis of D-G6PD in patients, and also for the expansion of the spectrum of known G6PD variants used for carrier detection and prenatal diagnosis.
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14
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Lu YW, Chen TC. Use of trimethoprim-sulfamethoxazole in a patient with G6PD deficiency for treating Pneumocystis jirovecii pneumonia without haemolysis: Case report and literature review. J Clin Pharm Ther 2020; 45:1483-1485. [PMID: 32648956 DOI: 10.1111/jcpt.13220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 05/27/2020] [Accepted: 06/12/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE A fixed dose of trimethoprim-sulphamethoxazole (TMP/SMZ) is the first-line therapy for Pneumocystis jirovecii pneumonia (PJP). Other alternative regiments have shown a suboptimal cure rate. However, TMP/SMZ has been reported to cause haemolyses when administered to patients with G6DP deficiency. PJP might be fatal without treatment. To date, there is still insufficient evidence to manage PJP with TMP/SMZ in G6DP deficiency population. CASE DESCRIPTION We report a G6PD-deficient patient with human immunodeficiency virus (HIV) and PJP infection treated successfully with 21 days of high dose TMP/SMZ without any signs and symptoms of haemolysis. WHAT IS NEW AND CONCLUSION Based on our experience, it is worth to note that despite TMP/SMZ is consider unsafe in patient with pre-existing G6PD-deficiency, it could still be suggested as the initial drug of choice in Taiwanese or southeast Asian population for treating PJP infected HIV patient.
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Affiliation(s)
- Ya-Wen Lu
- Department of Pharmacy, Taichung Hospital, Ministry of Health Welfare, Taichung, Taiwan
| | - Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
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15
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Fasting glucose-to-HbA1c ratio is a good indicator of G6PD deficiency, but not thalassemia, in patients with type 2 diabetes mellitus. Clin Chim Acta 2020; 506:9-15. [PMID: 32156605 DOI: 10.1016/j.cca.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/22/2020] [Accepted: 03/06/2020] [Indexed: 12/23/2022]
Abstract
AIMS Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency or thalassemia have a shorter red blood cell lifespan; therefore, HbA1c is underestimated in these patients. To address these issues, we sought an early indicator for G6PD deficiency or thalassemia in DM patients. METHODS A total of 4908 patients with DM and 1848 subjects without DM were included in this study. Fasting glucose (FG) levels, HbA1c levels, hemogram profiles and G6PD activities were measured. Genotypic analyses of G6PD deficiency and thalassemia were performed. RESULTS DM patients with G6PD deficiency had significantly higher FG/HbA1c ratios than did those without G6PD deficiency (26.54 vs. 18.36; p < 0.0001). We divided the FG level into four categories: ≤150, 151-250, 251-350, and ≥351 mg/dL. Among all groups, only patients with DM and G6PD deficiency had higher FG/HbA1c ratios than those of patients with DM alone or DM with thalassemia. To evaluate the reliability of the FG/HbA1c ratio, receiver operating characteristic analyses were performed. The areas under the curve for detecting FG ≤ 150, 151-250, 251-350, and ≥351 mg/dL with G6PD deficiency based on the FG/HbA1c ratio were 0.839 (p < 0.001), 0.888 (p < 0.001), 0.891 (p < 0.001), and 0.640 (p = 0.3954), respectively. G6PD deficiency was confirmed by genetic analysis. We found common mutations that influenced G6PD activity and HbA1c levels. CONCLUSIONS The FG/HbA1c ratio is a good indicator of DM with G6PD deficiency. If this ratio is determined to be high in a clinical setting, then the clinician must consider whether the patient has a G6PD deficiency, and HbA1c reference values must be adjusted to avoid misdiagnosis and incorrect treatment decisions.
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16
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Lin F, Lou ZY, Xing SY, Zhang L, Yang LY. The gene spectrum of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Guangdong province, China. Gene 2018; 678:312-317. [PMID: 30077011 DOI: 10.1016/j.gene.2018.07.068] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/07/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND G6PD deficiency presents a higher incidence rate in southern China. Many variants of G6PD resulted from point mutations in the G6PD gene, which lead to decrease of enzyme activity. The objective of this study was to analyze the genotype of G6PD deficiency in four regions of Guangdong province. METHODS Genotype of 1756 cases with G6PD deficiency was identified by reverse dot blotting (RDB). Unidentified Genotype of the samples was further ascertained by direct DNA sequencing. RESULTS 34 genotype were found in 1756 cases of G6PD deficiency, Canton (c.1376 G>T) and Kaiping (c.1388 G>A) were the most common variants, accounting for more than 63% of G6PD deficiency individuals, and the following mutations were Gaohe (c.95 A>G), Chinese-5 (c.1024 C>T) and Chinese-4 (c.392 G>T). Two rare mutations Orisa (c.131 C>G) and IVS-5 637/638 T del have been discovered in this study. In addition, c.1311 C>T/IVS-1193 T>C polymorphism had a relatively high frequency in the normal G6PD individuals. CONCLUSIONS This study provided detailed genotypes of G6PD deficiency in Guangdong, and would be valuable for diagnosis and research of G6PD deficiency in this area.
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Affiliation(s)
- Fen Lin
- Central Laboratory, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, China
| | - Zhao-Yun Lou
- Central Laboratory, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, China
| | - Shao-Yi Xing
- Central Laboratory, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, China
| | - Lin Zhang
- Central Laboratory, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, China
| | - Li-Ye Yang
- Central Laboratory, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, China.
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17
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Lee J, Kim TI, Kang JM, Jun H, Lê HG, Thái TL, Sohn WM, Myint MK, Lin K, Kim TS, Na BK. Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among malaria patients in Upper Myanmar. BMC Infect Dis 2018; 18:131. [PMID: 29548282 PMCID: PMC5857094 DOI: 10.1186/s12879-018-3031-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 03/01/2018] [Indexed: 11/13/2022] Open
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD; EC 1.1.1.49) deficiency is one of the most common X-linked recessive hereditary disorders in the world. Primaquine (PQ) has been used for radical cure of P. vivax to prevent relapse. Recently, it is also used to reduce P. falciparum gametocyte carriage to block transmission. However, PQ metabolites oxidize hemoglobin and generate excessive reactive oxygen species which can trigger acute hemolytic anemia in malaria patients with inherited G6PD deficiency. Methods A total of 252 blood samples collected from malaria patients in Myanmar were used in this study. G6PD variant was analysed by a multiplex allele specific PCR kit, DiaPlexC™ G6PD Genotyping Kit [Asian type]. The accuracy of the multiplex allele specific PCR was confirmed by sequencing analysis. Results Prevalence and distribution of G6PD variants in 252 malaria patients in Myanmar were analysed. Six different types of G6PD allelic variants were identified in 50 (7 females and 43 males) malaria patients. The predominant variant was Mahidol (68%, 34/50), of which 91.2% (31/34) and 8.8% (3/34) were males and females, respectively. Other G6PD variants including Kaiping (18%, 9/50), Viangchan (6%, 3/50), Mediterranean (4%, 2/50), Union (2%, 1/50) and Canton (2%, 1/50) were also observed. Conclusions Results of this study suggest that more concern for proper and safe use of PQ as a radical cure of malaria in Myanmar is needed by combining G6PD deficiency test before PQ prescription. Establishment of a follow-up system to monitor potential PQ toxicity in malaria patients who are given PQ is also required.
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Affiliation(s)
- Jinyoung Lee
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,Present address: Department of Tropical Medicine, and Inha Research Institute for Medical Sciences, Inha University College of Medicine, Incheon, 22212, Republic of Korea
| | - Tae Im Kim
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,Present address: Planning and Management Division, Nakdonggang National Institute of Biological Resources, Sangju, 37242, Republic of Korea
| | - Jung-Mi Kang
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Hojong Jun
- Department of Tropical Medicine, and Inha Research Institute for Medical Sciences, Inha University College of Medicine, Incheon, 22212, Republic of Korea
| | - Hương Giang Lê
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Thị Lam Thái
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea.,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Woon-Mok Sohn
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea
| | - Moe Kyaw Myint
- Department of Medical Research Pyin Oo Lwin Branch, Pyin Oo Lwin, Myanmar
| | - Khin Lin
- Department of Medical Research Pyin Oo Lwin Branch, Pyin Oo Lwin, Myanmar
| | - Tong-Soo Kim
- Department of Tropical Medicine, and Inha Research Institute for Medical Sciences, Inha University College of Medicine, Incheon, 22212, Republic of Korea.
| | - Byoung-Kuk Na
- Department of Parasitology and Tropical Medicine, and Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, 52727, Republic of Korea. .,BK21Plus Team for Anti-aging Biotechnology and Industry, Department of Convergence Medical Science, Gyeongsang National University, Jinju, 52727, Republic of Korea.
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18
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Fu C, Luo S, Li Q, Xie B, Yang Q, Geng G, Lin C, Su J, Zhang Y, Wang J, Qin Z, Luo J, Chen S, Fan X. Newborn screening of glucose-6-phosphate dehydrogenase deficiency in Guangxi, China: determination of optimal cutoff value to identify heterozygous female neonates. Sci Rep 2018; 8:833. [PMID: 29339739 PMCID: PMC5770456 DOI: 10.1038/s41598-017-17667-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/29/2017] [Indexed: 12/24/2022] Open
Abstract
The aim of this study is to assess the disease incidence and mutation spectrum of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Guangxi, China, and to determine an optimal cutoff value to identify heterozygous female neonates. A total of 130, 635 neonates were screened from the year of 2013 to 2017. Neonates suspected for G6PD deficiency were further analyzed by quantitatively enzymatic assay and G6PD mutation analysis. The overall incidence of G6PD deficiency was 7.28%. A total of 14 G6PD mutations were identified, and different mutations lead to varying levels of G6PD enzymatic activities. The best cut-off value of G6PD activity in male subjects is 2.2 U/g Hb, same as conventional setting. In female population, however, the cut-off value is found to be 2.8 U/g Hb (sensitivity: 97.5%, specificity: 87.7%, AUC: 0.964) to best discriminate between normal and heterozygotes, and 1.6 U/g Hb (sensitivity: 82.2%, specificity: 85.9%, AUC: 0.871) between heterozygotes and deficient subjects. In conclusion, we have conducted a comprehensive newborn screening of G6PD deficiency in a large cohort of population from Guangxi, China, and first established a reliable cut-off value of G6PD activity to distinguish heterozygous females from either normal or deficient subjects.
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Affiliation(s)
- Chunyun Fu
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Shiyu Luo
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Qifei Li
- Guangxi Huayin Medical Laboratory Center, Nanning, 530012, China
| | - Bobo Xie
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Qi Yang
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Guoxing Geng
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Caijuan Lin
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Jiasun Su
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Yue Zhang
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Jin Wang
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Zailong Qin
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Jingsi Luo
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China
| | - Shaoke Chen
- Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China. .,Department of Pediatrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.
| | - Xin Fan
- Department of Genetic Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China. .,Research Center for Guangxi Birth Defects Control and Prevention, Nanning, 530003, China.
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19
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Sun P, Song Y, Ruan G, Mao X, Kang Y, Dong B, Lin F. Clinical validation of the PCR-reverse dot blot human papillomavirus genotyping test in cervical lesions from Chinese women in the Fujian province: a hospital-based population study. J Gynecol Oncol 2017; 28:e50. [PMID: 28657218 PMCID: PMC5540716 DOI: 10.3802/jgo.2017.28.e50] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/11/2017] [Accepted: 04/09/2017] [Indexed: 11/30/2022] Open
Abstract
Objective To determine the clinical significance of the polymerase chain reaction (PCR)-reverse dot blot (RDB) human papillomavirus (HPV) genotyping assay in cervical cancer screening. Methods A total of 10,442 women attending the Fujian Provincial Maternity and Children's Health Hospital were evaluated using the liquid-based cytology (thinprep cytologic test [TCT]) and the PCR-RDB HPV test. Women with HPV infection and/or abnormal cytology were referred for colposcopy and biopsy. For HPV DNA sequencing, 120 specimens were randomly selected. Pathological diagnosis was used as the gold standard. Results Using the PCR-RDB HPV test, overall HPV prevalence was 20.57% (2,148/10,442) and that of high-risk (HR)-HPV infection was 18.68% (1,951/10,442). There was 99.2% concordance between HPV PCR-RDB testing and sequencing. In this studied population, the most common HR-HPV types were HPV-16, -52, -58, -18, -53, -33, and -51, rank from high to low. HPV-16, -18, -58, -59, and -33 were the top 5 prevalent genotypes in cervical cancer but HPV-16, -18, -59, -45, and -33 were the top 5 highest risk factors for cancer (odds ratio [OR]=34.964, 7.278, 6.728, 6.101, and 3.658; all p<0.05, respectively). Among 10,442 cases, 1,278 had abnormal cytology results, of which, the HR-HPV positivity rate was 83.02% (1,061/1,278). To screen for cervical cancer by PCR-RDB HPV testing, when using CIN2+, CIN3+, and cancer as observed endpoints, the sensitivity was 90.43%, 92.61%, and 94.78% and the negative predictive value (NPV) was 99.06%, 99.42%, and 99.78%, respectively. PCR-RDB HPV and TCT co-testing achieved the highest sensitivity and NPV. Conclusion For cervical cancer screening, the PCR-RDB HPV test can provide a reliable and sensitive clinical reference.
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Affiliation(s)
- Pengming Sun
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China.,Department of Gynecology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China.
| | - Yiyi Song
- Department of Gynecology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Guanyu Ruan
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Xiaodan Mao
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Yafang Kang
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Binhua Dong
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
| | - Fen Lin
- Laboratory of Gynecologic Oncology, Fujian Provincial Maternity & Children's Health Hospital of Fujian Medical University, Fuzhou, China
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Zhang L, Zhou Y, Li X, Cheng T. Hyperbilirubinemia Influences Sleep-Wake Cycles of Term Newborns in a Non-Linear Manner. PLoS One 2017; 12:e0169783. [PMID: 28072860 PMCID: PMC5224785 DOI: 10.1371/journal.pone.0169783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/21/2016] [Indexed: 12/04/2022] Open
Abstract
Hyperbilirubinemia is a common cause for irreversible neuronal influence in the brain of term newborns, while the feature of neurological symptoms associated with hyperbilirubinemia has not been well characterized yet. In the present study, we examined a total of 203 neonates suffering from hyperbilirubinemia with a bedside amplitude-integrated Electroencephalography (aEEG) device, in order to determine whether there is any special change in sleep-wake cycles (SWCs). Among these patients, 14 cases showed no recognizable SWCs with the total serum bilirubin (TSB) level at 483.9–996.2 μmol/L; 75 cases exhibited reduced SWCs with the TSB level at 311.2–688.5 μmol/L; and the rest cases had the normal SWCs. The number of the normal SWCs occurrence had a significant negative correlation with the increased TSB level in a non-linear manner (r = -0.689, p <0.001). In addition, the increased TSB reshaped the structure of SWC by narrowing down the broadband and broadening the narrowband. Spearman’s correlation analysis indicated a significant negative correlation between the TSB level and the ratio of broadband (r = -0.618, p < 0.001), a significant positive correlation between the TSB level and the narrowband ratio (r = 0.618, p < 0.001), respectively. Furthermore, the change of SWC seemed like a continuous phenomenon, and the hyperbilirubinemia caused SWC changes was fit into a loess model in this paper. In summary, the hyperbilirubinemia influenced SWC of term newborns significantly at a non-linear manner, and these results revealed the feature of the neurological sequela that is associated with TSB.
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Affiliation(s)
- Lian Zhang
- Department of Neonatology, Guangzhou Women and Children’s Medical Center, Guangzhou, P. R. China
- * E-mail:
| | - Yanxia Zhou
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou, P. R. China
| | - Xufang Li
- Department of Neonatology, Guangzhou Women and Children’s Medical Center, Guangzhou, P. R. China
| | - Tingting Cheng
- Department of Neonatology, Guangzhou Women and Children’s Medical Center, Guangzhou, P. R. China
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Huang S, Xu Y, Liu X, Zhou M, Wu X, Jia Y. Molecular newborn screening of four genetic diseases in Guizhou Province of South China. Gene 2016; 591:119-122. [DOI: 10.1016/j.gene.2016.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 12/29/2022]
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Zhang L, Yang Y, Liu R, Li Q, Yang F, Ma L, Liu H, Chen X, Yang Z, Cui L, He Y. A multiplex method for detection of glucose-6-phosphate dehydrogenase (G6PD) gene mutations. Int J Lab Hematol 2015; 37:739-45. [PMID: 26190099 DOI: 10.1111/ijlh.12405] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/05/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect caused by G6PD gene mutations. This study aimed to develop a cost-effective, multiplex, genotyping method for detecting common mutations in the G6PD gene. METHODS We used a SNaPshot approach to genotype multiple G6PD mutations that are common to human populations in South-East Asia. This assay is based on multiplex PCR coupled with primer extension reactions. Different G6PD gene mutations were determined by peak retention time and colors of the primer extension products. RESULTS We designed PCR primers for multiplex amplification of the G6PD gene fragments and for primer extension reactions to genotype 11 G6PD mutations. DNA samples from a total of 120 unrelated G6PD-deficient individuals from the China-Myanmar border area were used to establish and validate this method. Direct sequencing of the PCR products demonstrated 100% concordance between the SNaPshot and the sequencing results. CONCLUSION The SNaPshot method offers a specific and sensitive alternative for simultaneously interrogating multiple G6PD mutations.
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Affiliation(s)
- L Zhang
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - Y Yang
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - R Liu
- The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan Province, China
| | - Q Li
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - F Yang
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
| | - L Ma
- Department of Histology and Embryology, Kunming Medical University, Kunming, Yunnan Province, China
| | - H Liu
- The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan Province, China
| | - X Chen
- Kunming City Maternal and Child Health Hospital, Kunming, Yunnan Province, China
| | - Z Yang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, Yunnan Province, China
| | - L Cui
- Department of Entomology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Y He
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, Yunnan Province, China
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