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Isley LJ, Chamberlain AK, Callum P, Shamonki J. Comparison of methodologies to detect hemoglobinopathy carriers in a multi-ethnic sperm donor population. J Genet Couns 2021; 30:1399-1406. [PMID: 33788337 DOI: 10.1002/jgc4.1406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 01/22/2021] [Accepted: 02/11/2021] [Indexed: 11/10/2022]
Abstract
An estimated 7% of the world's population are carriers for a hemoglobin disorder. Current guidelines recommend carrier screening by complete blood count, with follow-up hemoglobin electrophoresis or fractionation based on abnormal result or ethnicity. Advances in molecular genetic testing are thought to increase carrier detection. This study compares carrier screening methodologies in a multi-ethnic sperm donor population. A retrospective analysis was conducted using data from a US sperm bank. All men underwent carrier screening for hemoglobin disorders via complete blood count, hemoglobin fractionation, and molecular testing. Results were compared using counts and percentages. McNemar's exact test was used to examine differences in the marginal probabilities of screening methodologies. Of the 438 tested, 25 (5.7%) were identified as carriers of at least one hemoglobin disorder by molecular testing. Seventeen (68%) of those carriers were missed by recommended methods. No identified carriers were detected by recommended methods but missed by molecular testing. The difference between these discordant pairs was significant (p-value < 0.001). The majority (44%) of carriers were mixed ethnicity, followed by 36% White. Results indicate that molecular screening methodologies have a greater ability to detect carriers of hemoglobin disorders compared to currently recommended methods in a multi-ethnic population.
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Zhou JY, Jiang F, Li J, Chen GL, Li DZ. Coinheritance of Hb City of Hope ( HBB: c.208G>A) and β-Thalassemia: Compromising the Molecular Diagnosis of the Codons 71/72 (+A) ( HBB: c.216_217insA) Mutation by Reverse Dot-Blot Hybridization. Hemoglobin 2019; 43:145-147. [PMID: 31268351 DOI: 10.1080/03630269.2019.1626741] [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: 10/26/2022]
Abstract
More than 900 abnormal hemoglobin (Hb) β chain variants have now been characterized. The majority are due to point mutations resulting in a single amino acid substitution within the globin gene involved, with nearly twice as many β chain variants identified compared to α chain variants. Although most of these variants are clinically and hematologically silent, they can interact with different thalassemia mutations, which could sometimes render laboratory diagnostics in a routine setting difficult. In this study, we present a case of coinheritance of Hb City of Hope [β69(E13)Gly→Ser; HBB: c.208G>A] and β-thalassemia (β-thal), that compromises the molecular diagnosis of β-thal trait.
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Affiliation(s)
- Jian-Ying Zhou
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center , Guangzhou Medical University , Guangzhou , Guangdong Province , People's Republic of China
| | - Fan Jiang
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center , Guangzhou Medical University , Guangzhou , Guangdong Province , People's Republic of China
| | - Jian Li
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center , Guangzhou Medical University , Guangzhou , Guangdong Province , People's Republic of China
| | - Gui-Lan Chen
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center , Guangzhou Medical University , Guangzhou , Guangdong Province , People's Republic of China
| | - Dong-Zhi Li
- a Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center , Guangzhou Medical University , Guangzhou , Guangdong Province , People's Republic of China
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Different forms of Hb Le Lamentin. An unexpected finding in Hba1c quantification. Clin Biochem 2015; 49:57-60. [PMID: 26436569 DOI: 10.1016/j.clinbiochem.2015.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/25/2015] [Accepted: 09/29/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Glycated hemoglobin (HbA1c) is accepted as the most trusted marker for monitoring patients with diabetes mellitus. Ion-exchange high-performance liquid chromatography (HPLC) is one of the most widely used methods for HbA1c analysis. The presence of a hemoglobin variant can interfere with HbA1c quantification, requiring other analyses to clarify the results.Herein, we present two cases of Hb Le Lamentin, which, although they were the same variant, were thought to correspond to different hemoglobinopathies because of their percentages. DESIGN AND METHODS Two male patients presented with an anomalous peak between HbA1c and HbA0 during a routine analysis of HbA1c using ion-exchange HPLC (Variant™ II Turbo).The hemoglobin variants were studied using capillary zone electrophoresis with the Sebia system, and the globin chains were analyzed by reverse-phase HPLC. A genetic analysis was performed using automated sequencing of the α2 and β genes. RESULTS In this work, we describe the first case of homozygous Hb Le Lamentin and the first double-heterozygous case of Hb Le Lamentin/Hb City of Hope. CONCLUSIONS Although the presence of these variants does not lead to clinical anomalies, it also does not affect hematologic parameters. The variants have an impact on the determination of glycated hemoglobin levels using ion-exchange HPLC because the retention time interferes with the elution time of HbA1c, resulting in a falsely reduced value. Therefore, it is necessary to either recalculate the result or use another measurement method.
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Vinciguerra M, Passarello C, Leto F, Cassarà F, Cannata M, Maggio A, Giambona A. Co-inheritance of the rare β hemoglobin variants Hb Yaounde, Hb Görwihl and Hb City of Hope with other alterations in globin genes: impact in genetic counseling. Eur J Haematol 2014; 94:322-9. [DOI: 10.1111/ejh.12431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Margherita Vinciguerra
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Cristina Passarello
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Filippo Leto
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Filippo Cassarà
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Monica Cannata
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Aurelio Maggio
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
| | - Antonino Giambona
- Department of Hematology for rare diseases of blood and blood-forming organs; Regional Reference Laboratory for screening and prenatal diagnosis of hemoglobinopathies; Villa Sofia-Cervello Hospital; Palermo Italy
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Nasouhipur H, Banihashemi A, Youssefi Kamangar R, Akhavan-Niaki H. Hb Knossos: HBB:c.82G>T Associated with HBB:c.315+1G>A Beta Zero Mutation Causes Thalassemia Intermedia. Indian J Hematol Blood Transfus 2014; 30:243-5. [PMID: 25332589 DOI: 10.1007/s12288-014-0343-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 01/15/2014] [Indexed: 10/25/2022] Open
Abstract
β-thalassemia is the most common single gene disorder worldwide and in Iran. In the present study we report for the first time a rare variant of hemoglobin HBB:c.82G>T; Codon 27 GCC→TCC (Ala→Ser), Hb Knossos, using sequencing and reverse dot blot hybridization, in members of a family from North Iran. The family has a 16 years-old compound heterozygous thalassemia intermedia male child presenting this variant together with HBB:c.315+1G>A (IVSII-I) mutation. The father, heterozygous for Hb Knossos, showed borderline hematological indices. To our knowledge, this is the first report of Hb Knossos in trans with the β(O) IVSII-I allele leading to thalassemia intermedia. Our data also highlight the necessity of deep molecular characterization of subjects presenting normal HbA2 level associated with abnormal or borderline red cell indices.
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Affiliation(s)
- Hengameh Nasouhipur
- Cellular and Molecular Biology Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Ali Banihashemi
- Genetic Laboratory of Amirkola Children Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Reza Youssefi Kamangar
- Genetic Laboratory of Amirkola Children Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Haleh Akhavan-Niaki
- Cellular and Molecular Biology Research Center, Babol University of Medical Sciences, Babol, Iran ; Genetic Laboratory of Amirkola Children Hospital, Babol University of Medical Sciences, Babol, Iran
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De Angioletti M, Maglione G, Ferranti P, de Bonis C, Lacerra G, Scarallo A, Pagano L, Fioretti G, Cutolo R, Malorni A. HB City of Hope [β69(E13)GLY→SER] in Italy: Association of the Gene with Haplotype IX. Hemoglobin 2009; 16:27-34. [PMID: 1353069 DOI: 10.3109/03630269209005673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hb City of Hope [beta 69(E13)Gly----Ser] was detected by reversed phase high performance liquid chromatography in an asymptomatic carrier from Naples, Southern Italy. The amino acid substitution, identified by fast atom bombardment mass spectrometry, was due to a TGG----TGA substitution as assessed by DNA sequencing. Analysis of the chromosomal background indicates that the globin gene cluster containing the mutant gene has most probably been rearranged by a recombination event, since the mutation was associated with restriction fragment length polymorphism haplotype IX, instead of haplotype I, as previously reported.
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Affiliation(s)
- M De Angioletti
- Istituto Internazionale di Genetica e Biofisica, CNR, Napoli, Italia
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Keser I, Manguoglu E, Kayisli O, Yesilipek A, Luleci G. Combination of Hb Knossos [Cod 27 (G-T)] and IVSII-745 (C-G) in a Turkish patient with beta-thalassemia major. GENETIC TESTING 2007; 11:228-230. [PMID: 17949282 DOI: 10.1089/gte.2006.0521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Beta-thalassemia is the most common disease among hemoglobinopathies in Antalya, Turkey, as well as world-wide. Mutations found in Turkish beta-thalassemia patients constitute a heterogeneous group, consisting mostly of point mutations. Only in very rare cases did deletions or insertions cause affected or carrier phenotypes. Hb Knossos [beta 27 (B9) Ala-Ser] is a rare variant with a normal HbA2 level. In this study, we aimed to investigate the effect of compound heterozygosity for Hb Knossos [Cod 27 (G-T)] and IVSII-745 (C-G). To our knowledge, this is the first report of such a combination related with beta-thalassemia major phenotype in a Turkish family, where reverse dot blot hybridization (RDBH) and DNA sequencing analysis were used. Heterozygous inheritance of the mutation results in mild beta-thalassemia phenotype, whereas homozygous inheritance leads to intermediate beta-thalassemia. As a result, the compound heterozygosity of Hb Knossos with IVSII-745 appears as the cause of the beta-thalassemia major phenotype in our case. The combination of these mutations [Hb Knossos, Cod 27 (G-T), and IVSII-745, C-G] causes the beta-thalassemia major phenotype, and this is important for genetic counseling.
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Affiliation(s)
- Ibrahim Keser
- Department of Medical Biology and Genetics, Medical School, Akdeniz University, 07070, Antalya, Turkey.
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Efremov GD. Forty-four years (1955-1999) devoted to hemoglobin research: Titus H. J. Huisman (1923-1999). Hemoglobin 2001; 25:125-68. [PMID: 11480778 DOI: 10.1081/hem-100104025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- G D Efremov
- Macedonian Academy of Sciences and Arts, Research Center for Genetic Engineering and Biotechnology, Skopje, Republic of Macedonia.
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Tadmouri GO, Başak AN. Beta-thalassemia in Turkey: a review of the clinical, epidemiological, molecular, and evolutionary aspects. Hemoglobin 2001; 25:227-39. [PMID: 11480784 DOI: 10.1081/hem-100104031] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- G O Tadmouri
- Bogaziçi University, Department of Molecular Biology and Genetics, Bebek-Istanbul, Turkey
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Abstract
Thalassemia intermedia encompasses a number of clinical conditions ranging in severity from beta-thalassemia carrier state to transfusion-dependent thalassemia major. The molecular bases of thalassemia intermedia, only partially defined, are very heterogeneous, but in general any factor able to reduce the globin-chain imbalance results in a milder form of thalassemia. These factors are the presence of a silent or mild beta-thalassemia allele, associated with a high residual beta-globin production, and the coinheritance of alpha-thalassemia or of genetic determinants that increase the gamma-chain production. Less frequent mechanisms are double heterozygosity for beta-thalassemia and triplicated alpha genes, and the presence of a hyperunstable hemoglobin variant. However, for a consistent number of beta zero-thalassemia homozygotes with a thalassemia intermedia phenotype the modifying factor has not been defined yet. In contrast, there are simple beta-thalassemia carriers who, for unknown reasons, have an unusually severe clinical phenotype.
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Affiliation(s)
- R Galanello
- Istituto di Clinica e Biologia dell'Età Evolutiva, Ospedale Regionale, Cagliari, Italy.
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Affiliation(s)
- T H Huisman
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta 30912-2100
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Abstract
DNA data have been collected for 41 patients with beta-thalassemia intermedia without transfusion dependency. They belonged to 33 families, and 45 of their parents were included in the study. Eight patients were homozygous for the frameshift at codon 8 (-AA), and nine were homozygous for the IVS-2 nt 1 (G----A) mutation; haplotypes IV and III, respectively, were associated with these mutations. Three patients had a G gamma A gamma(delta beta)0-thalassemia homozygosity, characterized by a deletion of 13 kb. Of the remaining subjects, ten had a homozygosity for the IVS-1 nt 6 (T----C) mutation, and five were compound heterozygotes for one mild and one severe thalassemia determinant. Combinations with Hb Knossos, the T----A mutation at nt -30, the C----T mutation at nt -101, the G----A and G----C mutations at IVS-1 nt 5, and the G----A mutation at IVS-1 nt 110 were the other thalassemia determinants resulting in beta-thalassemia intermedia in the six remaining patients. Haplotypes IV and IX were associated with the latter three mutations. The C----T mutation at nt -158 5' to the G gamma gene was characteristic for haplotypes III, IV, and IX. Genotype and phenotype correlation indicated significant differences in some of the hematological parameters among patients with the frameshift at codon 8 (-AA) or with the IVS-2 nt 1 (G----A) mutation, with both the frameshift at codon 8 and the T----C mutation at IVS-1 nt 6, and with both the IVS-2 nt 1 (G----A) and IVS-1 nt 6 (T----C) mutations. Statistically significant differences were found in the mean values for hemoglobin (Hb) A2 in heterozygotes with the frameshift at codon 8 (-AA) and the IVS-1 nt 5 (G----A) mutation. Variations in the number of alpha-globin genes resulted in modifications of the phenotypical expression of the beta-thalassemia intermedia determinants.
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Affiliation(s)
- C Altay
- Institute of Child Health, Hacettepe University, Ankara, Turkey
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Oner R, Altay C, Gurgey A, Aksoy M, Kilinç Y, Stoming TA, Reese AL, Kutlar A, Kutlar F, Huisman TH. Beta-thalassemia in Turkey. Hemoglobin 1990; 14:1-13. [PMID: 2200760 DOI: 10.3109/03630269009002250] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A review is presented of the various beta-thalassemia alleles observed in nearly 191 patients with beta-thalassemia major and their 182 heterozygous relatives. Determination was by gene amplification and dot-blot hybridization with synthetic probes, specific for 27 different mutations. Eighteen mutations have been observed; six of these account for nearly 83% of all thalassemia abnormalities. A new mutation, i.e. a G----C mutation at the acceptor splice site of IVS-I, was found in one teenager who was homozygous for this disease. The high consanguinity among the families was considered the main reason for the high number of patients with a homozygosity for the IVS-I-110 (G----A) mutation. Combinations of different mutations were present in many patients; some were mildly affected because of the specific mutation present on one chromosome. Combinations of classical beta-thalassemia and an abnormal hemoglobin mainly concerned Hb S. Hbs Knossos and Lepore were rare occurrences. A comparison of hematological data for adults with heterozygosities for some of the common alleles confirmed the low Hb A2 values in IVS-I-6 (T----C) heterozygotes and the high Hb F values for codon 8 (-AA), IVS-II-1 (G----A), and IVS-I-1 (G----A) heterozygotes.
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Affiliation(s)
- R Oner
- Children's Center, Hacettepe University, Ankara, Turkey
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