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Chaouch L, Moumni I, Ben Abdallah J, Bouchahda R, Methlouthi J, Mahdhaoui N, Matamri W, Braham N, Bouguila F, Mejri L, Charefeddine B, Chaieb A, Khairi H, Menif S. New Born Screening of Hemoglobinopathies in a Center Tunisian Population. J Pediatr Hematol Oncol 2024; 46:e296-e299. [PMID: 38748601 DOI: 10.1097/mph.0000000000002864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/15/2024] [Indexed: 06/25/2024]
Abstract
Sickle cell diseases, β-thalassemia, and other hemoglobinopathies are common in Africa. Their distribution differs from one region to another. There are higher frequencies in Western and Northern Africa. Their clinical complications presented a real public health problem in each country. For this, early treatment can improve the severity of these diseases. Hemoglobinopathies targeted by screening are associated with SCD, β, and α thalassemia. Our study aim is to report our experience with newborn screening for hemoglobinopathy in Tunis. The 156 newborn's cord blood was collected at the time of childbirth in the center region (Farhat Hached Hôspital). We opted for hemoglobin exploration to achieve maximum efficiency and effectiveness in screening. After that, all patients suspected to have hemoglobinopathies are affected by molecular investigation. Our findings showed the presence of some hemoglobinopathies such as β-thalassemia and α-thalassemia with the following frequencies: 12% and 0.33%. The molecular results show the presence of HBB: c.93-21G>A, IVS-I-110G>A, HBBc. -106G>A -56G>C, HBBc.404T>C, Hb Yaounde described for the first time in Tunisia and α 3,7 . In conclusion, newborn screening diagnoses neonates with different examples of hemoglobinopathies, which will be beneficial not only for the care of the child but also for genetic counseling of the potential risk's parents.
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Affiliation(s)
- Leila Chaouch
- Laboratoire d'hématologie moléculaire et cellulaire, Université de Tunis El Manar, Institut Pasteur de Tunis
- Laboratoire de Biochimie, Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie
| | - Imen Moumni
- Laboratoire d'hématologie moléculaire et cellulaire, Université de Tunis El Manar, Institut Pasteur de Tunis
| | - Jihene Ben Abdallah
- Laboratoire de Biochimie, Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie
| | - Rim Bouchahda
- Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie, centre de maternité
| | - Jihene Methlouthi
- Neonatology Department, Farhat Hached Hospital, University of Sousse, Faculty of Medicine of Sousse, Tunisia
| | - Nabiha Mahdhaoui
- Neonatology Department, Farhat Hached Hospital, University of Sousse, Faculty of Medicine of Sousse, Tunisia
| | - Wided Matamri
- Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie, service d'hématologie, Tunisia
| | - Najia Braham
- Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie, service d'hématologie, Tunisia
| | - Fatma Bouguila
- Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie, centre de maternité
| | - Lina Mejri
- Laboratoire d'hématologie moléculaire et cellulaire, Université de Tunis El Manar, Institut Pasteur de Tunis
| | - Bassem Charefeddine
- Laboratoire de Biochimie, Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie
| | - Anouar Chaieb
- Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie, centre de maternité
| | - Hedi Khairi
- Hôpital Farhat Hached, Université de Sousse, Faculté de Médecine de Sousse, Tunisie, centre de maternité
| | - Samia Menif
- Laboratoire d'hématologie moléculaire et cellulaire, Université de Tunis El Manar, Institut Pasteur de Tunis
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Kabir T, Anwar S, Mourosi JT, Akter S, Hosen MJ. α- and β-Globin Gene Mutations in Individuals with Hemoglobinopathies in the Chattogram and Sylhet Regions of Bangladesh. Hemoglobin 2023; 47:3-10. [PMID: 36890736 DOI: 10.1080/03630269.2023.2166526] [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: 03/10/2023]
Abstract
Hemoglobinopathies, including α- and β-thalassemias and sickle cell disease, are among the most widely disseminated hereditary blood disorders worldwide. Bangladesh is considered a hotspot for hemoglobinopathies, and these diseases cause a significant health concern in the country. However, the country has a dearth of knowledge on the molecular etiology and carrier frequency of thalassemias, primarily due to a lack of diagnostic facilities, limited access to information, and the absence of efficient screening programs. This study sought to investigate the spectrum of mutations underlying hemoglobinopathies in Bangladesh. We developed a set of polymerase chain reaction (PCR)-based techniques to detect mutations in α- and β-globin genes. We recruited 63 index subjects with previously diagnosed thalassemia. Along with age- and sex-matched control subjects, we assessed several hematological and serum indices and genotyped them using our PCR-based methods. We identified that parental consanguinity was associated with the occurrence of these hemoglobinopathies. Our PCR-based genotyping assays identified 23 HBB genotypes, with the codons 41/42 (-TTCT) (HBB: c.126_129delCTTT) mutation leading the spectrum. We also observed the presence of cooccurring HBA conditions, of which the participants were not aware. All index participants in this study were on iron chelation therapies, yet we found they had very high serum ferritin (SF) levels, indicating inefficient management of the individuals undergoing such treatments. Overall, this study provides essential information on the hemoglobinopathy mutation spectrum in Bangladesh and highlights the need for nationwide screening programs and an integrated policy for diagnosing and managing individuals with hemoglobinopathies.
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Affiliation(s)
- Tamanna Kabir
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Saeed Anwar
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Jarin Taslem Mourosi
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Shanjida Akter
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mohammad Jakir Hosen
- Department of Genetic Engineering and Biotechnology, School of Life Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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Belmokhtar I, Lhousni S, Elidrissi Errahhali M, Ghanam A, Elidrissi Errahhali M, Sidqi Z, Ouarzane M, Charif M, Bellaoui M, Boulouiz R, Benajiba N. Molecular heterogeneity of β-thalassemia variants in the Eastern region of Morocco. Mol Genet Genomic Med 2022; 10:e1970. [PMID: 35615994 PMCID: PMC9356555 DOI: 10.1002/mgg3.1970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/22/2022] [Accepted: 05/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background β‐thalassemia syndromes are the most common hereditary blood disorders in the world and are recognized as a major health problem in Morocco. They are characterized by the reduction or the absence of β‐globin chain synthesis. The severity of the disease depends on the nature of the variants affecting the β‐globin gene (HBB), and each ethnic group has its own mutation spectrum. Hereby, we present, for the first time, the molecular profile of β‐thalassemia in the Eastern region of Morocco. Methods This study concerns 39 cases from 33 families who were enrolled in the BRO Biobank. Nineteen were diagnosed with β‐thalassemia major and 20 with β‐thalassemia minor. To detect mutations of the β‐globin gene, we have used RFLP‐PCR and Sanger sequencing. Results Nine known β‐thalassemia variants have been identified. Among these, we reported, for the first time in the Moroccan population, the Czechoslovakian variant C38/39(‐C) at homozygous state. The C39(C > T) was the most frequent variant (72.54%), followed by FSC5(‐CT) (5.88%), FSC6(−A), IVS‐1‐110(G > A), −29(A > G), C38/39(‐C) (3.92% each), and finally by IVS‐I‐1(G > A), IVS‐II‐1(G > A), and −56(G > C) (1.96%). Of particular interest this mutational spectrum of β‐thalassemia is very different from that found in previous studies in Morocco or in other North African countries. Conclusion This study is the first contribution to the description of the molecular profile of β‐thalassemia in the Eastern region of Morocco. It shows the high molecular heterogeneity of β‐thalassemia in our country. Therefore, these results can be valuable for the implementation of carrier screening, genetic counseling, and prenatal diagnosis programs.
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Affiliation(s)
- Ihab Belmokhtar
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | - Saida Lhousni
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | - Mounia Elidrissi Errahhali
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | - Ayad Ghanam
- Department of PediatricsMohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Mohammed PremierOujdaMorocco
| | - Manal Elidrissi Errahhali
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | | | - Meryem Ouarzane
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | - Majida Charif
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | - Mohammed Bellaoui
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | - Redouane Boulouiz
- Genetics Unit, Medical Sciences Research Laboratory, Faculty of Medicine and PharmacyUniversity Mohammed PremierOujdaMorocco
| | - Noufissa Benajiba
- Department of PediatricsMohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Mohammed PremierOujdaMorocco
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Antonello G, Lo Monaco C, Napoli P, Solimando D, Curcio C, Barberio G, Maoggi S, Ivaldi G, Nigra M. Two co-inherited hemoglobin variants revealed by capillary electrophoresis during quantification of glycated hemoglobin. Clin Chem Lab Med 2022; 60:886-890. [PMID: 35218178 DOI: 10.1515/cclm-2021-1242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/14/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The observation of numerous new structural defects in hemoglobin (Hb) has often been linked to the evolution and development of device technologies used for the separation and quantification of hemoglobin components. However, the increased use of preventive tests for hemoglobinopathies and separative methods to quantify glycated hemoglobin (HbA1c) also contributed to these observations, as demonstrated by the case described here. Our aim is to emphasize that different separative method can provide more useful information in patient management. METHODS A 64-year-old diabetic woman of Moroccan descent was examined in the context of HbA1c monitoring. The test was performed using high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) systems. Molecular characterization was performed by direct sequencing of the β and α globin genes. RESULTS The two methods used showed the presence of an anomalous fraction identified as HbS, already observed previously, but only through CE it was possible to observe the presence of another variant and its hybrid components. Direct sequencing of β and α globin genes confirmed heterozygous HbS [β6 (A3) Glu→Val; HBB: c.20A>T] and allowed to identify a mutation on the α 2, [α114 (GH2) Pro→Leu gene; HBA2: c.344C>T] corresponding to the rare Hb Nouakchott variant. CONCLUSIONS The two Hb variants highlighted by the EC and the molecular characterization therefore allowed adequate advice, the correct assessment of HbA1c and metabolic status and therefore better clinical management of the patient. The availability of different instruments in the same laboratory, confirming situations of diagnostic uncertainty, represents a valuable opportunity that should be encouraged.
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Affiliation(s)
- Giovanni Antonello
- Laboratorio Analisi, Ospedale Martini, ASL Città di Torino, Torino, Italy
| | - Carlo Lo Monaco
- Laboratorio Analisi, Ospedale Martini, ASL Città di Torino, Torino, Italy
| | - Patrizia Napoli
- Laboratorio Analisi, Ospedale Martini, ASL Città di Torino, Torino, Italy
| | - Daniela Solimando
- Laboratorio Analisi, Ospedale Martini, ASL Città di Torino, Torino, Italy
| | - Cristina Curcio
- Laboratorio Genetica, Fondazione Ca'Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppina Barberio
- U.O.C. Medicina di Laboratorio, Ospedale di Treviso, ULSS2 "Marca trevigiana", Treviso, Italy
| | | | - Giovanni Ivaldi
- Laboratorio Genetica Umana, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Giannina Gaslini, Genova, Italy
| | - Marco Nigra
- Laboratorio Analisi, Ospedale Martini, ASL Città di Torino, Torino, Italy
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Genc A, Tastemir Korkmaz D, Bayram S, Rencuzogullari E. The Effect of Five Single Nucleotide Polymorphisms on Hb F Variation of β-Thalassemia Traits and Hematologically Normal Individuals in Southeast Turkey. Hemoglobin 2020; 44:231-239. [PMID: 32674697 DOI: 10.1080/03630269.2020.1787178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
β-Thalassemia (β-thal) is caused by deficiency of β-globin chain synthesis and leads to the accumulation of unstable globin chain production. This results in a higher Hb F level in order to neutralize the excess α chains. In addition, γ-globin gene expression, due to genetic factors after birth, leads to increased Hb F levels in adulthood [hereditary persistence of fetal hemoglobin (Hb) (HPFH)]. In this study, the relationship between β-thal trait and individuals with suspected HPFH and a control group was investigated in Adıyaman, Turkey. Single nucleotide polymorphism (SNP) analyses were performed in five different polymorphic regions using real-time polymerase chain reaction (qPCR) methods [rs4671393 (G>A), rs766432 (A>C), rs9402686 (G>A), rs28384513 (T>G), rs1609812 (A>G)]. No significant difference was found between the control and β-thal group in the codominant inheritance model in the rs1609812 (A>G) polymorphism region only, while all the other polymorphic regions were found to be statistically significant. It was found that different genotype models increased Hb F levels between 1.6- and 3.06-fold in four studied polymorphic regions [rs4671393 (G>A), rs766432 (A>C), rs9402686 (G>A), rs28384513 (T>G)]. All of the polymorphic regions increased the Hb F levels from 1.86- to 24.76-fold, except rs9402686 (G>A) and rs28384513 (T>G) over dominant and rs1609812 (A>G) codominant inheritance models. The AC and AA genotypes increased Hb F levels in the B-cell CLL/lymphoma 11 A haplotype studies. It was determined that both haplotypes 2 and 4 increased Hb F levels. As a result, SNPs strongly affect the Hb F levels in both healthy individuals and β-thal trait.
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Affiliation(s)
- Ahmet Genc
- Vocational School of Health Services, Adıyaman University, Adıyaman, Turkey
| | | | - Suleyman Bayram
- Department of Nursing, School of Health, Adıyaman University, Adıyaman, Turkey
| | - Eyyup Rencuzogullari
- Department of Biology, Faculty of Science and Letters, Adıyaman University, Adıyaman, Turkey
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Alaoui-Ismaili FZ, Laghmich A, Ghailani-Nourouti N, Barakat A, Bennani-Mechita M. XmnI Polymorphism in Sickle Cell Disease in North Morocco. Hemoglobin 2020; 44:190-194. [PMID: 32508152 DOI: 10.1080/03630269.2020.1772284] [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: 10/24/2022]
Abstract
Sickle cell disease is one of the most common severe monogenic disorders in the world. The -158 XmnI polymorphism (C>T) of the Gγ-globin gene promoter is known to be associated with increased expression of the Gγ-globin gene, thus, higher production of Hb F and lesser clinical severity. This study aims to determine the frequency of the XmnI polymorphism and its association with Hb F levels as a modulating factor of sickle cell disease severity in north Moroccan patients. Three hundred and eight subjects carrying the sickle cell mutation and 160 healthy individuals were recruited at the regional hospital of Larache, Morocco. The complete blood count and the Hb F levels were analyzed. The XmnI polymorphism was determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique and statistical analysis were done using the Statistical Package for Social Sciences software version 20. Our results estimated the allelic frequency of the XmnI polymorphism in our population at 15.8%. Out of 468 samples, 7.6% were homozygous [+/+] and 16.4% were heterozygous [+/-] for the XmnI polymorphism. This polymorphism was revealed at 20.6% in SS patients, 24.2% in AS carriers, 28.6% in Hb S (HBB: c.20A>T)/β-thalassemia (β-thal) patients and 22.5% in AA subjects. The north Moroccan sickle cell disease patients have shown a low frequency of the XmnI polymorphism. This was later found to be associated with high Hb F levels and mild clinical severity.
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Affiliation(s)
- Fatima-Zahra Alaoui-Ismaili
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaadi, Tangier, Morocco
| | - Achraf Laghmich
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaadi, Tangier, Morocco
| | - Naima Ghailani-Nourouti
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaadi, Tangier, Morocco
| | - Amina Barakat
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaadi, Tangier, Morocco
| | - Mohcine Bennani-Mechita
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaadi, Tangier, Morocco
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Facile spectroscopy and atomic force microscopy for the discrimination of α and β thalassemia traits and diseases: A photodiagnosis approach. Photodiagnosis Photodyn Ther 2019; 27:149-155. [DOI: 10.1016/j.pdpdt.2019.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 12/21/2022]
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Romdhane L, Mezzi N, Hamdi Y, El-Kamah G, Barakat A, Abdelhak S. Consanguinity and Inbreeding in Health and Disease in North African Populations. Annu Rev Genomics Hum Genet 2019; 20:155-179. [PMID: 31039041 DOI: 10.1146/annurev-genom-083118-014954] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
North Africa is defined as the geographical region separated from the rest of the continent by the Sahara and from Europe by the Mediterranean Sea. The main demographic features of North African populations are their familial structure and high rates of familial and geographic endogamy, which have a proven impact on health, particularly the occurrence of genetic diseases, with a greater effect on the frequency and spectrum of the rarest forms of autosomal recessive genetic diseases. More than 500 different genetic diseases have been reported in this region, most of which are autosomal recessive. During the last few decades, there has been great interest in the molecular investigation of large consanguineous North African families. The development of local capacities has brought a substantial improvement in the molecular characterization of these diseases, but the genetic bases of half of them remain unknown. Diseases of known molecular etiology are characterized by their genetic and mutational heterogeneity, although some founder mutations are encountered relatively frequently. Some founder mutations are specific to a single country or a specific ethnic or geographic group, and others are shared by all North African countries or worldwide. The impact of consanguinity on common multifactorial diseases is less evident.
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Affiliation(s)
- Lilia Romdhane
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 1002 Tunis Belvédère, Tunisia; .,Department of Biology, Faculty of Sciences of Bizerte, Université Tunis Carthage, 7021 Jarzouna, Tunisia
| | - Nessrine Mezzi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 1002 Tunis Belvédère, Tunisia;
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 1002 Tunis Belvédère, Tunisia;
| | - Ghada El-Kamah
- Department of Clinical Genetics, Human Genetics and Genome Research Division, National Research Centre, Cairo 12622, Egypt
| | - Abdelhamid Barakat
- Laboratoire de Génétique Humaine et Biologie Moléculaire, Département de Recherche Scientifique, Institut Pasteur du Maroc, 20100 Casablanca, Morocco
| | - Sonia Abdelhak
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 1002 Tunis Belvédère, Tunisia;
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Alpha-Thalassemia in North Morocco: Prevalence and Molecular Spectrum. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2080352. [PMID: 31001551 PMCID: PMC6436373 DOI: 10.1155/2019/2080352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/09/2019] [Accepted: 02/24/2019] [Indexed: 12/31/2022]
Abstract
Unlike the other hemoglobinopathies, few researches have been published concerning α-thalassemia in Morocco. The epidemiological features and the mutation spectrum of this disease are still unknown. This regional newborn screening is the first to study α-thalassemia in the north of Morocco. During the period from January 2015 to December 2016, 1658 newborns umbilical blood samples were investigated. Suspected newborns were screened for α-globin defects using Gap-PCR and Multiplex Ligation-dependent Probe Amplification technique. The prevalence of α-thalassemia, its mutation spectrum, and its allelic frequencies were described for the first time in Morocco. Six different α-globin genetic disorders were detected in 16 neonates. This screening valued the prevalence of α-thalassemia in the studied population at 0.96% and showed the wide mutation spectrum and the heterogeneous geographical distribution of the disease. A high rate of carriers was observed in Laouamra, a rural commune in Larache province. Heterogeneity of α-globin alleles in Morocco explains the high variability of α-thalassemia severity. This diversity reflects the anthropological history of the country. These results would contribute to the prevention of thalassemia in Morocco directing the design of a nationwide screening strategy and awareness campaign.
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Murad H, Moassas F, Ghoury I, Mukhalalaty Y. Haplotype Analysis of Three Common β-Thalassemia Mutations in Syrian Patients. Hemoglobin 2019; 42:302-305. [PMID: 30669902 DOI: 10.1080/03630269.2018.1553789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
β-Globin haplotypes were used to investigate the origin of three common β-globin mutations, IVS-I-110 (G>A); HBB: c.93-21G>A, IVS-I-1 (G>A); HBB: c.92 + 1G>A and codon 39 (C>T); HBB: c.118C > T in Syrian patients. Haplotype analysis was done for 49 unrelated patients with β-thalassemia (β-thal) and 20 unrelated healthy subjects by polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) for the β-globin gene cluster of the following polymorphic restriction sites: HincII 5' to ε, HindIII 5' to Gγ, HindIII 5' to Aγ, HincII in ψβ, HincII 3' to ψβ, AvaII in β, and HinfI 3' to β. The IVS-I-110 mutation was associated with three haplotypes: I [+ - - - - + +] (79.4%), V [+ - - - - + -] (5.9%) and VII [+ - - - - - +] (14.7%), while, the two mutations IVS-I-1 and codon 39 were be linked to a single haplotype V (100.0%) and II [- + + - + + +] (100.0%), respectively. The normal chromosomes (βA/βA) were associated with four haplotypes, I (50.0%), II (7.5%), V (32.5%) and VII (10.0%). In the Syrian population, the IVS-I-110 mutation was associated with multi haplotypes, whereas the IVS-I-1 and codon 39 mutations have a single origin. More studies for the other mutations will be very useful for genetic epidemiological studies in Syria.
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Affiliation(s)
- Hossam Murad
- a Department of Molecular Biology and Biotechnology , Atomic Energy Commission of Syria , Damascus , Syria
| | - Faten Moassas
- a Department of Molecular Biology and Biotechnology , Atomic Energy Commission of Syria , Damascus , Syria
| | - Ifad Ghoury
- b Department of Radiation Medicine , Atomic Energy Commission of Syria , Damascus , Syria
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Bouyarmane W, Uwingabiye J, Biaz A, Rachid A, Mechal Y, Dami A, Bouhsain S, Ouzzif Z, El Machtani Idrissi S. Unexpected discovery of hemoglobinopathy C/β° thalassemia. Clin Case Rep 2018; 6:2117-2120. [PMID: 30455903 PMCID: PMC6230608 DOI: 10.1002/ccr3.1815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/03/2018] [Accepted: 08/19/2018] [Indexed: 12/03/2022] Open
Abstract
High performance liquid chromatography (HPLC) is the current method of choice for the detection of hemoglobinopathies and the quantification of A2 and fetal hemoglobin. We are describing a case where a double heterozygosity C/beta-thalassemia was fortuitously identified, during assaying HBA1c, by HPLC.
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Affiliation(s)
- Wafaa Bouyarmane
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Jean Uwingabiye
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Asmaa Biaz
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Achraf Rachid
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Youness Mechal
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Abdellah Dami
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Sanae Bouhsain
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Zhor Ouzzif
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
| | - Samira El Machtani Idrissi
- Department of Clinical Biochemistry and ToxicologyMohammed V Military Teaching HospitalFaculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
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Elloumi-Zghal H, Chaabouni Bouhamed H. Genetics and genomic medicine in Tunisia. Mol Genet Genomic Med 2018; 6:134-159. [PMID: 29663716 PMCID: PMC5902400 DOI: 10.1002/mgg3.392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 03/07/2018] [Indexed: 01/19/2023] Open
Abstract
Genetics and genomic medicine in Tunisia.
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Vinciguerra M, Cannata M, Cassarà F, Passarello C, Leto F, Calvaruso G, Renda D, Maggio A, Giambona A. HBB: c.316-125A>G and HBB: c.316-42delC: Phenotypic Evaluations of Two Rare Changes in the Second Intron of the HBB Gene. Hemoglobin 2017; 41:234-238. [DOI: 10.1080/03630269.2017.1397014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Margherita Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Monica Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Cristina Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Leto
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Giuseppina Calvaruso
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Disma Renda
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Aurelio Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Antonino Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-Forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
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Role of nonsense-mediated decay and nonsense-associated altered splicing in the mRNA pattern of two new α-thalassemia mutants. Int J Biochem Cell Biol 2017; 91:212-222. [DOI: 10.1016/j.biocel.2017.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/15/2017] [Accepted: 07/18/2017] [Indexed: 11/22/2022]
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15
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Vinciguerra M, Cassarà F, Cannata M, Renda D, Calvaruso G, Leto F, Passarello C, Maggio A, Giambona A. Phenotypic evaluations of HBB:c.93-23T>C, a nucleotide substitution in the IVS I nt 108 of β-globin gene. J Clin Pathol 2017; 71:jclinpath-2017-204651. [PMID: 28794124 DOI: 10.1136/jclinpath-2017-204651] [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: 06/30/2017] [Revised: 07/14/2017] [Accepted: 07/19/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Thalassaemia and variant haemoglobin are the most common severe monogenic disorders worldwide. AIMS To develop prenatal diagnosis programmes for the prevention of the most important haemoglobin disorders and identify healthy carriers of thalassaemia. METHODS Sequencing analysis was used to obtain complete data on gene structure and to correlate specific phenotypic expression with mutations, especially for new or very rare mutations in globin genes. RESULTS A rare single nucleotide variation, HBB:c.93-23T>C, located in nucleotide 108 of the first intervening sequence of the HBB gene, was identified. This variation was previously reported but its clinical significance was not known. Six heterozygous patients had this nucleotide variation and eight further cases co-inherited it together with other defects in the globin genes. Heterozygous subjects for this substitution showed normal haematological and electrophoretic features, whereas subjects who were compound heterozygotes for this mutation and another defect in globin genes showed the classic phenotype of a healthy carrier. CONCLUSION This nucleotide can be considered a single nucleotide polymorphism and not a thalassaemic mutation that reduces the production of haemoglobin. This is another example of a very rare nucleotide variation. Knowledge of this is important so that appropriate genetic counselling can be carried out of a couple potentially at risk, where one of the partners is a carrier of β-thalassaemia and the other is carrier of a nucleotide variation.
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Affiliation(s)
- Margherita Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Monica Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Disma Renda
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Giuseppina Calvaruso
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Filippo Leto
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Cristina Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Aurelio Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Antonino Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Diagnosis of Rare Diseases, Villa Sofia-Cervello Hospital, Palermo, Italy
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β-Thalassemia Distribution in the Old World: an Ancient Disease Seen from a Historical Standpoint. Mediterr J Hematol Infect Dis 2017; 9:e2017018. [PMID: 28293406 PMCID: PMC5333734 DOI: 10.4084/mjhid.2017.018] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 02/05/2017] [Indexed: 11/12/2022] Open
Abstract
Background Haemoglobinopathies constitute the commonest recessive monogenic disorders worldwide, and the treatment of affected individuals presents a substantial global disease burden. β-thalassaemia is characterised by the reduced synthesis (β+) or absence (βo) of the β-globin chains in the HbA molecule, resulting in accumulation of excess unbound α-globin chains that precipitate in erythroid precursors in the bone marrow and in the mature erythrocytes, leading to ineffective erythropoiesis and peripheral haemolysis. Approximately 1.5% of the global population are heterozygotes (carriers) of the β-thalassemias; there is a high incidence in populations from the Mediterranean basin, throughout the Middle East, the Indian subcontinent, Southeast Asia, and Melanesia to the Pacific Islands. Aim The principal aim of this paper is to review, from a historical standpoint, our knowledge about an ancient disease, the β-thalassemias, and in particular, when, how and in what way β-thalassemia spread worldwide to reach such high incidences in certain populations. Results Mutations involving the β-globin gene are the most common cause of genetic disorders in humans. To date, more than 350 β-thalassaemia mutations have been reported. Considering the current distribution of β- thalassemia, the wide diversity of mutations and the small number of specific mutations in individual populations, it seems unlikely that β-thalassemia originated in a single place and time. Conclusions Various processes are known to determine the frequency of genetic disease in human populations. However, it is almost impossible to decide to what extent each process is responsible for the presence of a particular genetic disease. The wide spectrum of β-thalassemia mutations could well be explained by looking at their geographical distribution, the history of malaria, wars, invasions, mass migrations, consanguinity, and settlements. An analysis of the distribution of the molecular spectrum of haemoglobinopathies allows for the development and improvement of diagnostic tests and management of these disorders.
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Li CK. New trend in the epidemiology of thalassaemia. Best Pract Res Clin Obstet Gynaecol 2017; 39:16-26. [DOI: 10.1016/j.bpobgyn.2016.10.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 08/21/2016] [Accepted: 10/14/2016] [Indexed: 01/19/2023]
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Giambona A, Damiani G, Vinciguerra M, Jakil C, Cannata M, Cassarà F, Picciotto F, Schillaci G, Cigna V, Renda D, Leto F, Passarello C, Maggio A. Incidence of haemoglobinopathies in Sicily: the impact of screening and prenatal diagnosis. Int J Clin Pract 2015; 69:1129-38. [PMID: 25727926 DOI: 10.1111/ijcp.12628] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Haemoglobinopathies are a major public health problem in Sicily: it was estimated a frequency of 1/245 couples are at risk of haemoglobinopathies. This paper reviews legislative actions, prevention activities, carrier screening, genetic counselling, foetal sampling and laboratory methodology analysis evolution reporting the results of 30 years of prevention actions to assess the efficiency of our preventative programme in the control of haemoglobinopathies in Sicily. METHODS This programme consisted principally of five phases: legislative actions, public awareness campaign, carrier screening, genetic counselling and prenatal diagnosis. RESULTS These programmes have been very effective, which we can see from a greater public awareness of thalassaemia and its prevention in the target population furthermore by a marked decline in the incidence of thalassaemia major and sickle cell anaemia from 1 in 245 live births in the absence of prevention to 1 in 2000, with a reduction in about 85%. The residual cases were because of a conscious choice by expecting parents in relation to improved life expectancy as well as improved quality of life of the affected patients. CONCLUSION The study suggests that public health authorities should act and invest in a similar programme for prevention of thalassaemia, as well as in relation to the increased survival of patients and the consequent organ complications.
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Affiliation(s)
- A Giambona
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Damiani
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Vinciguerra
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Jakil
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - M Cannata
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Cassarà
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Picciotto
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - G Schillaci
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - V Cigna
- U.O.C. of Gynecology and Obstetrics, U.O.S. Prenatal Diagnosis, A.O.R. Villa Sofia-Cervello Hospital, Palermo, Italy
| | - D Renda
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - F Leto
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - C Passarello
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
| | - A Maggio
- Department of Hematology for Rare Diseases of Blood and Blood-forming Organs, Laboratory for Molecular Prenatal of Hemoglobinipathies, Villa Sofia-Cervello Hospital, Palermo, Italy
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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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Romdhane L, Messaoud O, Bouyacoub Y, Kerkeni E, Naouali C, Cherif Ben Abdallah L, Tiar A, Charfeddine C, Monastiri K, Chabchoub I, Hachicha M, Tadmouri GO, Romeo G, Abdelhak S. Comorbidity in the Tunisian population. Clin Genet 2015; 89:312-9. [PMID: 26010040 DOI: 10.1111/cge.12616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 05/19/2015] [Accepted: 05/17/2015] [Indexed: 12/18/2022]
Abstract
Genetic diseases in the Tunisian population represent a real problem of public health as their spectrum encompasses more than 400 disorders. Their frequency and distribution in the country have been influenced by demographic, economic and social features especially consanguinity. In this article, we report on genetic disease association referred to as comorbidity and discuss factors influencing their expressivity. Seventy-five disease associations have been reported among Tunisian families. This comorbidity could be individual or familial. In 39 comorbid associations, consanguinity was noted. Twenty-one founder and 11 private mutations are the cause of 34 primary diseases and 13 of associated diseases. As the information dealing with this phenomenon is fragmented, we proposed to centralize it in this report in order to draw both clinicians' and researcher's attention on the occurrence of such disease associations in inbred populations as it makes genetic counseling and prenatal diagnosis challenging even when mutations are known.
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Affiliation(s)
- L Romdhane
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia.,Department of Biology, Faculty of Science of Bizerte, Université Tunis Carthage, Zarzouna, Tunisia
| | - O Messaoud
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Y Bouyacoub
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - E Kerkeni
- Laboratoire de Pharmacologie, Faculté de Médecine de Monastir, Université de Monastir, Monastir, Tunisia
| | - C Naouali
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - L Cherif Ben Abdallah
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - A Tiar
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - C Charfeddine
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - K Monastiri
- EPS Fattouma Bourguiba, Centre de Maternité & de Néonatologie de Monastir, Service de Réanimation et de Médecine Néonatale, Monastir, Tunisia
| | - I Chabchoub
- Service de Pédiatrie, CHU Hédi Chaker, Sfax, Tunisia
| | - M Hachicha
- Service de Pédiatrie, CHU Hédi Chaker, Sfax, Tunisia
| | - G O Tadmouri
- Faculty of Public Health, Jinan University, Tripoli, Lebanon
| | - G Romeo
- Dipartimento di Scienze Mediche e Chirurgiche Policlinico Sant'Orsola-Malpighi, Unità Operativa di Genetica Medica, Bologna, Italy
| | - S Abdelhak
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
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Anwar WA, Khyatti M, Hemminki K. Consanguinity and genetic diseases in North Africa and immigrants to Europe. Eur J Public Health 2015; 24 Suppl 1:57-63. [PMID: 25107999 DOI: 10.1093/eurpub/cku104] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Endemic diseases are caused by environmental and genetic factors. While in this special issue several chapters deal with environmental factors, including infections, the present focus is on genetic causes of disease clustering due to inbreeding and recessive disease mechanisms. Consanguinity is implying sharing of genetic heritage because of marriage between close relatives originating from a common ancestor. With limited natural selection, recessive genes may become more frequent in an inbred compared with an outbred population. Consanguinity is common in North Africa (NA), and the estimates range from 40 to 49% of all marriages in Tunisia and 29-33% in Morocco. As a consequence, recessive disorders are common in the NA region, and we give some examples. Thalassaemia and sickle cell disease/anaemia constitute the most common inherited recessive disorders globally and they are common in NA, but with immigration they have spread to Europe and to other parts of the world. Another example is familial Mediterranean fever, which is common in the Eastern Mediterranean area. With immigrantion from that area to Sweden, it has become the most common hereditary autoinflammatory disease in that country, and there is no evidence that any native Swede would have been diagnosed with this disease. The examples discussed in this chapter show that the historic movement of populations and current immigration are influencing the concept of 'endemic' disease.
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Affiliation(s)
- Wagida A Anwar
- 1 Community Medicine Department, Ain Shams University, Cairo, Egypt
| | | | - Kari Hemminki
- 3 Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany4 Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden
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Kumar R, Sagar C, Sharma D, Kishor P. β-Globin Genes: Mutation Hot-Spots in the Global Thalassemia Belt. Hemoglobin 2014; 39:1-8. [DOI: 10.3109/03630269.2014.985831] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bouzid K, Ahmed HB, Kalai E, Blibeche S, Couque N, Khiari K, Bahlous A, Abdelmoula J. Prevalence of hemoglobin variants in a diabetic population at high risk of hemoglobinopathies and optimization of HbA1c monitoring by incorporating HPLC in the laboratory workup. Libyan J Med 2014; 9:25768. [PMID: 25361891 PMCID: PMC4216394 DOI: 10.3402/ljm.v9.25768] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 09/29/2014] [Accepted: 10/06/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In Tunisia, diabetes mellitus and hemoglobinopathies are major public health problems. Glycated hemoglobin (HbA1c) is recommended for long-term monitoring of diabetes mellitus, but the presence of hemoglobin variants may interfere with HbA1c measurement. The aim was to determine the prevalence of hemoglobin variants in Tunisian diabetics and optimize the monitoring of diabetics using HbA1c. METHODS The study enrolled 9,792 Tunisian diabetic patients. HbA1c was measured by cation-exchange high-pressure liquid chromatography (HPLC). All the chromatograms were analyzed for the presence of Hb variants. RESULTS We identified 228 cases (2.33%) of Hb variants with D-10 HPLC (Bio-Rad): 191 with HbA/S trait, 27 with HbA/C trait, and 10 hemoglobin variants with the mention 'Variant-Window' on the chromatograms and subsequently identified as HbA/S on Variant I HPLC (Bio-Rad). Thus, the prevalence of HbS was 2.05%. We did not find any homozygous variant. All HbA1c results were reported to the treating physician. CONCLUSIONS To evaluate glycated hemoglobin in populations with a high prevalence of hemoglobinopathies, we should use the HPLC method, which is easy, economical, and reliable. Based on an algorithm, hemoglobin variants visualized on HPLC should be reported to the physician to improve the management of patients.
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Affiliation(s)
- Kahena Bouzid
- Laboratory of Clinical Biochemistry, Charles Nicolle Hospital, Tunis, Tunisia; Faculty of Medicine University El Manar-Tunis, El Manar, Tunisia; Laboratory of Engineering of Proteins and Bioactive Molecules: LR 11EES24:LIP-MB, Tunis, Tunisia;
| | - Habib B Ahmed
- Department of Cardiology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Eya Kalai
- Laboratory of Clinical Biochemistry, Charles Nicolle Hospital, Tunis, Tunisia
| | - Salma Blibeche
- Laboratory of Clinical Biochemistry, Charles Nicolle Hospital, Tunis, Tunisia
| | - Nathalie Couque
- Department of Molecular Genetics and Biochemistry, Robert Debré Hospital, Paris, France
| | - Karima Khiari
- Department of Endocrinology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Afef Bahlous
- Laboratory of Clinical Biochemistry, Charles Nicolle Hospital, Tunis, Tunisia
| | - Jaouida Abdelmoula
- Laboratory of Clinical Biochemistry, Charles Nicolle Hospital, Tunis, Tunisia
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Natural Remedies for the Treatment of Beta-Thalassemia and Sickle Cell Anemia-Current Status and Perspectives in Fetal Hemoglobin Reactivation. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:123257. [PMID: 27350962 PMCID: PMC4897541 DOI: 10.1155/2014/123257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 07/21/2014] [Accepted: 07/25/2014] [Indexed: 11/18/2022]
Abstract
For the treatment of β-thalassemia and sickle cell disease (SCD), pharmacological induction of fetal hemoglobin (HbF) production may be a promising approach. To date, numerous studies have been done on identifying the novel HbF-inducing agents and understanding the underlying mechanism for stimulating the HbF production. In this review, we have summarized the identified HbF-inducing agents by far. By examining the action mechanisms of the HbF-inducing agents, various studies have suggested that despite the ability of stimulating HbF production, the chemotherapeutic agents could not be practically applied for treating β-hemoglobinopathies, especially β-thalassemia, due to the their cytotoxicity and growth-inhibitory effect. Owing to this therapeutic obstacle, much effort has been put on identifying new HbF-inducing agents from the natural world with the combination of efficacy, safety, and ease of use. Therefore, this review aims to (i) reveal the novel screening platforms for identifying potential inducers with high efficiency and accuracy and to (ii) summarize the new identified natural remedies for stimulating HbF production. Hopefully, this review can provide a new insight into the current status and future perspectives in fetal hemoglobin reactivation for treating β-thalassaemia and SCD.
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Damiani G, Vinciguerra M, Jakil C, Cannata M, Cassarà F, Picciotto F, Schillaci G, Cigna V, Renda D, Volpes A, Sammartano F, Milone S, Allegra A, Passarello C, Leto F, Giambona A. Prenatal Diagnosis of Hemoglobinopathies: From Fetoscopy to Coelocentesis. THALASSEMIA REPORTS 2014. [DOI: 10.4081/thal.2014.2200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Prenatal diagnosis of hemoglobinopathies involves the study of fetal material from blood, amniocytes, trophoblast coelomatic cells and fetal DNA in maternal circulation. Its first application dates back to the 70s and it involves globin chain synthesis analysis on fetal blood. In the 1980s molecular analysis was introduced as well as amniocentesis and chorionic villi sampling under high-resolution ultrasound imaging. The application of direct sequencing and polymerase chain reactionbased methodologies improved the DNA analysis procedures and reduced the sampling age for invasive prenatal diagnosis from 18 to 16–11 weeks allowing fetal genotyping within the first trimester of pregnancy. In the last years, fetal material obtained at 7–8 weeks of gestation by coelocentesis and isolation of fetal cells has provided new platforms on which to develop diagnostic capabilities while non-invasive technologies using fetal DNA in maternal circulation are starting to develop.
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Zorai A, Moumni I, Mosbahi I, Douzi K, Chaouachi D, Guemira F, Abbes S. Rare hemoglobin variants in Tunisian population. Int J Lab Hematol 2014; 37:148-54. [DOI: 10.1111/ijlh.12259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/15/2014] [Indexed: 11/28/2022]
Affiliation(s)
- A. Zorai
- Laboratoire d'Hématologie Moléculaire et Cellulaire; Institut Pasteur; Tunis Tunisia
| | - I. Moumni
- Laboratoire d'Hématologie Moléculaire et Cellulaire; Institut Pasteur; Tunis Tunisia
| | - I. Mosbahi
- Laboratoire d'Hématologie Moléculaire et Cellulaire; Institut Pasteur; Tunis Tunisia
| | - K. Douzi
- Laboratoire d'Hématologie Moléculaire et Cellulaire; Institut Pasteur; Tunis Tunisia
| | - D. Chaouachi
- Laboratoire d'Hématologie Moléculaire et Cellulaire; Institut Pasteur; Tunis Tunisia
| | - F. Guemira
- Laboratoire de biologie clinique; Institut Saleh Azaiez; Tunis Tunisia
| | - S. Abbes
- Laboratoire d'Hématologie Moléculaire et Cellulaire; Institut Pasteur; Tunis Tunisia
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Aloni MN, Kumumangi JM, Malemba-Ilunga JJ, Usungo FU, Nzuka SKN, Lapu BS, Ekila MB, Kittel F. [Current level of information about sickle cell disease among medical students at Brussels, Belgium]. Rev Epidemiol Sante Publique 2013; 62:27-32. [PMID: 24388739 DOI: 10.1016/j.respe.2013.09.003] [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: 03/28/2012] [Revised: 08/11/2013] [Accepted: 09/25/2013] [Indexed: 11/19/2022] Open
Abstract
AIM The increasing prevalence of sickle cell disease (SCD) is an important issue in Belgium due to migrations from high prevalence areas. It has become the most common genetic disease in Belgium. The impact is important in terms of health service delivery, especially since Belgian physicians have little experience with the disease. This study was designed to determine the current level of knowledge about SCD among medical students at the Louvain's Catholic University, Brussels. METHOD This study was part of a larger cross-sectional and descriptive study carried out at the Louvain's Catholic University in December 2010. Data were collected from medical students using self-administered structured questionnaires. RESULTS In this study, 152 students were enrolled. All respondents had heard about SCD, the majority during their medical school curriculum. All students (100%) thought SCD is an African disease. A majority recognized that SCD is a serious illness and that it is linked with malaria. Anemia was the most frequently cited symptoms (98.0%) followed by splenomegaly (77.5%). Only 51% reported pain as a symptom. A majority knew they would have patients with the disease in their future career but only 2.3% of students considered specializing in the field of SCD. Using criteria for scoring information delivery, awareness about SCD was among the lowest in Belgium. CONCLUSION For Belgian medical students, SCD is an exotic disease. Too little information about SCD is delivered. Continuing medical education about SCD can be recommended for medical students in Belgium.
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Affiliation(s)
- M N Aloni
- Division of Hemato-oncology and Nephrology, University Hospital of Kinshasa, School of Medicine, University of Kinshasa, Kinshasa, République Démocratique du Congo; École de santé publique, université Catholique de Louvain, 1200 Bruxelles, Belgique.
| | - J M Kumumangi
- École de santé publique, université Catholique de Louvain, 1200 Bruxelles, Belgique
| | | | - F U Usungo
- École de santé publique, université Catholique de Louvain, 1200 Bruxelles, Belgique
| | - S K N Nzuka
- École de santé publique, université Catholique de Louvain, 1200 Bruxelles, Belgique
| | - B S Lapu
- École de santé publique, université Catholique de Louvain, 1200 Bruxelles, Belgique
| | - M B Ekila
- Département de médecine interne, cliniques universitaires de Kinshasa, université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - F Kittel
- École de Santé publique, université libre de Bruxelles, 1070 Bruxelles, Belgique
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Jouini L, Sahli CA, Laaouini N, Ouali F, Youssef IB, Dakhlaoui B, Othmeni R, Ouennich F, Fredj SH, Siala H, Becher M, Toumi NE, Fattoum S, Hafsia R, Bibi A, Messaoud T. Association between clinical expression and molecular heterogeneity in β-thalassemia Tunisian patients. Mol Biol Rep 2013; 40:6205-12. [DOI: 10.1007/s11033-013-2732-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 09/14/2013] [Indexed: 10/26/2022]
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Hamamy HA, Al-Allawi NAS. Epidemiological profile of common haemoglobinopathies in Arab countries. J Community Genet 2012; 4:147-67. [PMID: 23224852 DOI: 10.1007/s12687-012-0127-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 11/18/2012] [Indexed: 02/07/2023] Open
Abstract
Haemoglobinopathies including the thalassemias and sickle cell disease are known to be prevalent inherited disorders in most Arab countries with varying prevalence rates and molecular characterisation. β-thalassemia is encountered in polymorphic frequencies in almost all Arab countries with carrier rates of 1-11 % and a varying number of mutations. The most widespread mutation in Lebanon, Egypt, Syria, Jordan, Tunisia and Algeria is the IVS-I-110 (G>A). In the Eastern Arabian Peninsula, the Asian Indian mutations (IVS-I-5 (G>C), codons 8/9 (+G) and IVS-I (-25 bp del)) are more common. The α-thalassemias are encountered in the majority of Arab countries in frequencies ranging from 1 to 58 % with the highest frequencies reported from Gulf countries. The (-α(3.7)) mutation is the most frequent followed by the non-deletional α2 polyadenylation signal mutation (AATAAA>AATAAG) and the α2 IVS1 5-bp deletion. The rates of sickle cell trait in Arab countries range from 0.3 to 30 %, with the Benin, the Arab-Indian and the Bantu haplotypes constituting the bulk of the haplotypes, leading to two major phenotypes; a mild one associated with the Arab-Indian and a severe one with the Benin and Bantu haplotypes. Public health approaches targeting prevention of haemoglobinopathies in Arab countries include newborn screening for sickle cell disease, and premarital screening for carriers of β-thalassemia and sickle cell disease. These services are still patchy and inadequate in many Arab countries recommending the upgrade of these services with strengthening of the education and training of health care providers and raising public awareness on the feasibility of prevention and care for haemoglobinopathies.
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Affiliation(s)
- Hanan A Hamamy
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland,
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Romdhane L, Kefi R, Azaiez H, Ben Halim N, Dellagi K, Abdelhak S. Founder mutations in Tunisia: implications for diagnosis in North Africa and Middle East. Orphanet J Rare Dis 2012; 7:52. [PMID: 22908982 PMCID: PMC3495028 DOI: 10.1186/1750-1172-7-52] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 08/02/2012] [Indexed: 01/17/2023] Open
Abstract
Background Tunisia is a North African country of 10 million inhabitants. The native background population is Berber. However, throughout its history, Tunisia has been the site of invasions and migratory waves of allogenic populations and ethnic groups such as Phoenicians, Romans, Vandals, Arabs, Ottomans and French. Like neighbouring and Middle Eastern countries, the Tunisian population shows a relatively high rate of consanguinity and endogamy that favor expression of recessive genetic disorders at relatively high rates. Many factors could contribute to the recurrence of monogenic morbid trait expression. Among them, founder mutations that arise in one ancestral individual and diffuse through generations in isolated communities. Method We report here on founder mutations in the Tunisian population by a systematic review of all available data from PubMed, other sources of the scientific literature as well as unpublished data from our research laboratory. Results We identified two different classes of founder mutations. The first includes founder mutations so far reported only among Tunisians that are responsible for 30 genetic diseases. The second group represents founder haplotypes described in 51 inherited conditions that occur among Tunisians and are also shared with other North African and Middle Eastern countries. Several heavily disabilitating diseases are caused by recessive founder mutations. They include, among others, neuromuscular diseases such as congenital muscular dystrophy and spastic paraglegia and also severe genodermatoses such as dystrophic epidermolysis bullosa and xeroderma pigmentosa. Conclusion This report provides informations on founder mutations for 73 genetic diseases either specific to Tunisians or shared by other populations. Taking into account the relatively high number and frequency of genetic diseases in the region and the limited resources, screening for these founder mutations should provide a rapid and cost effective tool for molecular diagnosis. Indeed, our report should help designing appropriate measures for carrier screening, better evaluation of diseases burden and setting up of preventive measures at the regional level.
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Affiliation(s)
- Lilia Romdhane
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, BP 74, 13 Place Pasteur, Tunis 1002, Tunisia
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Abstract
The sickle cell (HbS) gene occurs at a variable frequency in the Middle Eastern Arab countries, with characteristic distribution patterns and representing an overall picture of blood genetic disorders in the region. The origin of the gene has been debated, but studies using β-globin gene haplotypes have ascertained that there were multiple origins for HbS. In some regions the HbS gene is common and exhibits polymorphism, while the reverse is true in others. A common causative factor for the high prevalence and maintenance of HbS and thalassaemia genes is malaria endemicity. The HbS gene also co-exists with other haemoglobin variants and thalassaemia genes and the resulting clinical state is referred to as sickle cell disease (SCD). In the Middle Eastern Arab countries, the clinical picture of SCD expresses two distinct forms, the benign and the severe forms, which are related to two distinct β-globin gene haplotypes. These are referred to as the Saudi-Indian and the Benin haplotypes, respectively. In a majority of the Middle Eastern Arab countries the HbS is linked to the Saudi-Indian haplotype, while in others it is linked to the Benin haplotype. This review outlines the frequency, distribution, clinical feature, management and prevention as well as gene interactions of the HbS genes with other haemoglobin disorders in the Middle Eastern Arab countries.
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Veten FM, Abdelhamid IO, Meiloud GM, Ghaber SM, Salem ML, Abbes S, Houmeida AO. Hb S [β6(A3)Glu→Val, GAG>GTG] and β-Globin Gene Cluster Haplotype Distribution in Mauritania. Hemoglobin 2012; 36:311-5. [DOI: 10.3109/03630269.2012.688782] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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López-Escribano H, Parera MM, Guix P, Serra JM, Gutierrez A, Balsells D, Oliva-Berini E, Castro JA, Ramon MM, Picornell A. Balearic archipelago: three islands, three beta-thalassemia population patterns. Clin Genet 2012; 83:175-80. [DOI: 10.1111/j.1399-0004.2012.01864.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Liu K, Xing H, Zhang S, Liu SM, Fung MC. Cucurbitacin D induces fetal hemoglobin synthesis in K562 cells and human hematopoietic progenitors through activation of p38 pathway and stabilization of the γ-globin mRNA. Blood Cells Mol Dis 2010; 45:269-75. [PMID: 20926322 DOI: 10.1016/j.bcmd.2010.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 09/13/2010] [Accepted: 09/13/2010] [Indexed: 02/08/2023]
Abstract
The search for novel therapeutic candidates targeting fetal hemoglobin (HbF) activation to reduce the imbalance of globin genes is regarded as a promising approach for the clinical management of sickle cell disease and β-thalassemia. For the first time, we identified cucurbitacin D (CuD), an oxygenated tetracyclic triterpenoid, as a molecular entity inducing γ-globin gene expression and HbF synthesis in K562 cells and human hematopoietic progenitors from a β-thalassemia patient. CuD demonstrated a higher potency in HbF induction when compared with hydroxyurea, which was revealed by the evidence that CuD results in a higher fetal cell percentage and greater HbF content in K562 cells, in addition, to being less cytotoxic. Moreover, CuD also promotes higher HbF expression in primary erythroid cells. In the study to elucidate the molecular mechanisms of CuD's action, our data indicated that CuD-stimulated HbF synthesis was mediated by p38 pathway activation. At the post-transcriptional level, CuD treatment led to a significant elongation of the γ-globin mRNA half-life in K562 cells. Taken together, the results suggest that CuD may be a potential therapeutic agent for β-hemoglobinopathies, including sickle cell anemia and β-thalassemia.
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Affiliation(s)
- Kan Liu
- Department of Biology, the Chinese University of Hong Kong, Shatin, Hong Kong
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