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Gunes AK, Gozden HE. The Spectrum of Beta-Thalassemia Mutations in Syrian Refugees and Turkish Citizens. Cureus 2021; 13:e15434. [PMID: 34258108 PMCID: PMC8254855 DOI: 10.7759/cureus.15434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction and objectives Neighboring the border between Turkey and Syria, Sanliurfa is one of the Turkish provinces with the highest number of Syrian refugees in our country. We aimed to find out the spectrum of beta-globin gene mutations in adult Turkish citizens and Syrian refugees with beta-thalassemia major. Results Of the participants, 35 patients (70%) were Turkish citizens and 15 patients (30%) were Syrian. The most common mutation in Turkish patients was found to be IVS-I-110 (G>A) with a frequency of 28.8%, followed by IVS-I-6 (T>C) with a frequency of 15.5%. Other common mutations were IVS-I-1 (G>A) and codon 39 (C>T) with frequencies of 11.1%. These four mutations accounted for 65.5% of all mutations in the Turkish cohort. The most common mutations in Syrian refugee patients were IVS-I-1 (G>A), IVS-II-1 (G>A), IVS-I-5 (G>C), and codon 5 (-CT), all with a frequency of 15.7%, accounting for 62.8% of all mutations in the Syrian patients. In the analysis, codon 5 (-CT) mutation (15.7% vs 0%, p=0.023) was found significantly higher in Syrian refugees compared to Turkish citizens. Discussion and conclusions A wide spectrum of mutations was detected in beta-thalassemia major patients living in the Sanliurfa region. Mutational profiles in Turkish and Syrian patients were found to be significantly different from each other. Because marriages between Syrian refugees and Turkish citizens are increasing in our region, the genetic findings and the mutational profiles in Turkish and Syrian patients obtained in this study are thought to become useful for future prenatal molecular diagnostic tests.
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Affiliation(s)
- Ahmet Kursad Gunes
- Department of Hematology, Ankara City Hospital, Ankara, TUR.,Department of Hematology, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, TUR
| | - Hilmi Erdem Gozden
- Department of Hematology, Abdulhamid Han Education and Research Hospital, Istanbul, TUR.,Department of Hematology, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, TUR
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Oudat RI, Abualruz HS, Al-Shiek NKA, Al-Mashaqba EA, Al-Hiari RA, Alsoukhni HA, Hammad MAA. Sickle Cell Disease in Jordan: The Experience of a Major Referral Center. Med Arch 2021; 75:27-30. [PMID: 34012195 PMCID: PMC8116085 DOI: 10.5455/medarh.2021.75.27-30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction Sickle cell disorders are the most frequently encountered hemoglobin variants in Jordan. Both alpha and beta thalassemias are also prevalent in this population. However, studies on the interaction between these hemoglobin disorders are lacking. Aim To determine the genotypes responsible for Sickle cell disease in Jordan, by retrospectively reviewing the data from a major referral center in the country's capital. Methods A total 29,712 peripheral blood samples referred and investigated for hemoglobinopathies over a 10-year period at Princess Iman Center at Amman, Jordan were retrospectively reviewed. In addition to full blood counts, high performance liquid chromatography, those who were identified with sickle cell hemoglobin were studied using polymerase chain reaction and reverse hybridization to determine the various sickle cell disease genotypes. Results Out of the (29,712) blood samples, 450 were sickle cell trait, while 216 had sickle cell disease. Of the latter: 120 were found to be cases of Sickle cell anemia (Hb SS), 66 were compound heterozygous for Sickle cell and a beta thalassemia mutation (Sickle/β-thalassemia), while 30 had concomitant alpha thalassemia (HbSS/alpha thalassemia). The most frequent genotype associated with sickle/β-thalassemia was HbS/ IVS-110 (G>A), followed by Hb S/IVS-I-6 (T>C), HbS/IVS-II-745 (C>G) and HbS/ IVS-II-1 (G>A). While the most frequent alpha genotype detected in HbSS/α-thalassemia samples was (-α3.7/αα) followed by (-α3.7/-α3.7). Hb SS patients had the severest hematological phenotype compared to those with sickle/β-thalassemia and sickle/ α-thalassemia. Furthermore, within the sickle/β-thalassemia subgroup the least severe hematological phenotype was encountered in HbS/IVS-1-6 (T>C), while the most severe in HbS/IVS-II-1 (G>A) genotype. Conclusion The most frequent Sickle cell disease genotype in Jordanians is Sickle cell anemia (HbSS), followed by Sickle/β-thalassemia and least frequent is HbSS/alpha thalassemia. The concomitant identified thalassemia mutations were consistent with their spectrum among the Jordanian population.
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Affiliation(s)
- Raida I Oudat
- Department of Hematopathology, Princess Iman Research and Laboratory Sciences Center, Amman, Jordan
| | - Heba S Abualruz
- Department of Hematopathology, Princess Iman Research and Laboratory Sciences Center, Amman, Jordan
| | - Nazih Kh Abu Al-Shiek
- Department of Hematopathology, Princess Iman Research and Laboratory Sciences Center, Amman, Jordan
| | - Eman A Al-Mashaqba
- Department of Hematopathology, Princess Iman Research and Laboratory Sciences Center, Amman, Jordan
| | - Rawan A Al-Hiari
- Department of Hematopathology, Princess Iman Research and Laboratory Sciences Center, Amman, Jordan
| | - Hala A Alsoukhni
- Department of Mathematics, Al-Zaytoonah University of Jordan, Amman, Jordan
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Faraon R, Daraghmah M, Samarah F, Srour MA. Molecular characterization of β-thalassemia intermedia in the West Bank, Palestine. BMC HEMATOLOGY 2019; 19:4. [PMID: 30820323 PMCID: PMC6380065 DOI: 10.1186/s12878-019-0135-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 02/07/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND We aimed to investigate the molecular basis of β-Thalassemia intermedia (TI) in the West Bank region and its management practices. METHODS This was a case series multi-center study and included 51 cases of TI. DNA sequencing was used to analyze β-globin gene mutations. Common α-globin gene mutations were screened by Gap-PCR (-α3.7, -α4.2, --MED, αααanti3.7) or DNA sequencing (α2-IVS II 5 nt del). XmnI -158 C > T polymorphisms of Gγ-globin gene was determined by RFLP-PCR. RESULTS Seven β-globin gene mutations were observed, namely IVS-I -6 C > T, IVS-I-110 G > A, IVS-II-1 G > A, IVS-I-1 G > A, Codon 37 Trp > Stop, beta - 101 and IVS-II-848 C > A. Ten genotypes were observed. Homozygosity for IVS-I-6 accounted for the majority of TI cases with a frequency of 74.5%. The second common β-globin gene genotype was homozygote IVS-I-110 G > A (5.8%) and homozygote IVS-II-1 G > A (5.8%). The remaining seven genotypes were each detected in about 2% of patients. α-Thalassemia mutations were seen in five patients (9.8%), and included (-α3.7, αααanti3.7 and α2-IVSII-5 nt del). XmnI polymorphism was observed in four patients (7.8%), three homozygotes and one heterozygote. CONCLUSIONS Homozygosity for the mild β-globin gene IVS-I-6 allele was the major contributing factor for the TI phenotype among the study subjects. The role of XmnI SNP and α-thalassemia mutations in ameliorating the TI phenotype was observed in few patients for each factor. The beta - 101 C > T mutation was diagnosed in one patient in homozygote state for the first time in Palestine.
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Affiliation(s)
- Rashail Faraon
- Department of Medical Laboratory Sciences, Al-Quds University, East Jerusalem, Palestine
| | - Mahmoud Daraghmah
- Palestine Thalassemia Patients’ Friends Society, Al-Bireh, Palestine
| | - Fekri Samarah
- Department of Medical Laboratory Sciences, Arab-American University, Jenin, Palestine
| | - Mahmoud A. Srour
- Department of Medical Laboratory Sciences, Al-Quds University, East Jerusalem, Palestine
- Department of Biology & Biochemistry, Birzeit University, P.O. Box 14, Birzeit, Palestine
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Hassan TH, Salam MMA, Zakaria M, Shehab M, Sarhan DT, Zidan ESH, El Gerby KM. Impact of Genotype of Beta Globin Gene on Hepatic and Myocardial Iron Content in Egyptian Patients with Beta Thalassemia. Indian J Hematol Blood Transfus 2018; 35:284-291. [PMID: 30988565 DOI: 10.1007/s12288-018-1034-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/24/2018] [Indexed: 01/19/2023] Open
Abstract
Iron overload causes most of the mortality and morbidity associated with thalassemia. Excess iron deposits primarily in the liver, but once a threshold level is reached, iron loading may occur in other tissues such as the heart. Magnetic resonance imaging is a well established technique to noninvasively quantify myocardial and liver iron content. More than 300 disease-causing mutations have been identified. We aimed to determine the impact of genotype on liver iron content in patients with beta thalassemia. Cross sectional study was carried on 73 patients with beta thalassemia. MRI liver and heart was performed to determine hepatic and myocardial iron overload. Genotyping was determined by DNA sequencing technique. The mean liver iron content was 17.4 mg/g dw and mean cardiac T2* was 25.5 ms in our patients. Patients with β0β0 were associated with significantly higher liver and myocardial iron content compared to those with β0β+ and β+β+ genotypes. There was a clear association between genotype and both hepatic and myocardial iron overload. Patients with β0β0 had significantly higher liver and heart iron content compared to those with β0β+ and β+β+ genotypes. Liver iron content was strongly correlated to serum ferritin levels and myocardial iron overload.
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Affiliation(s)
- Tamer H Hassan
- 1Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, 44111 Egypt
| | - Mohamed M Abdel Salam
- 1Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, 44111 Egypt
| | - Marwa Zakaria
- 1Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, 44111 Egypt
| | - Mohamed Shehab
- 1Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, 44111 Egypt
| | - Dina T Sarhan
- 1Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, 44111 Egypt
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Elhawary NA, Jiffri EH, Jambi S, Mufti AH, Dannoun A, Kordi H, Khogeer A, Jiffri OH, Elhawary AN, Tayeb MT. Molecular characterization of exonic rearrangements and frame shifts in the dystrophin gene in Duchenne muscular dystrophy patients in a Saudi community. Hum Genomics 2018; 12:18. [PMID: 29631625 PMCID: PMC5891934 DOI: 10.1186/s40246-018-0152-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 04/02/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In individuals with Duchenne muscular dystrophy (DMD), exon skipping treatment to restore a wild-type phenotype or correct the frame shift of the mRNA transcript of the dystrophin (DMD) gene are mutation-specific. To explore the molecular characterization of DMD rearrangements and predict the reading frame, we simultaneously screened all 79 DMD gene exons of 45 unrelated male DMD patients using a multiplex ligation-dependent probe amplification (MLPA) assay for deletion/duplication patterns. Multiplex PCR was used to confirm single deletions detected by the MLPA. RESULTS There was an obvious diagnostic delay, with an extremely statistically significant difference between the age at initial symptoms and the age of clinical evaluation of DMD cases (t value, 10.3; 95% confidence interval 5.95-8.80, P < 0.0001); the mean difference between the two groups was 7.4 years. Overall, we identified 147 intragenic rearrangements: 46.3% deletions and 53.7% duplications. Most of the deletions (92.5%) were between exons 44 and 56, with exon 50 being the most frequently involved (19.1%). Eight new rearrangements, including a mixed deletion/duplication and double duplications, were linked to seven cases with DMD. Of all the cases, 17.8% had duplications with no hot spots. In addition, confirmation of the reading frame hypothesis helped account for new DMD rearrangements in this study. We found that 81% of our Saudi patients would potentially benefit from exon skipping, of which 42.9% had a mutation amenable to skipping of exon 51. CONCLUSIONS Our study could generate considerable data on mutational rearrangements that may promote future experimental therapies in Saudi Arabia.
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Affiliation(s)
- Nasser A Elhawary
- Department of Medical Genetics, Medicine College, Umm Al-Qura University, P.O. Box 57543, Mecca, 21955, Saudi Arabia.
- Department of Molecular Genetics, Faculty of Medicine, Ain Shams University, Cairo, 11566, Egypt.
| | - Essam H Jiffri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Samira Jambi
- Department of Pediatrics, Al Hada Military Hospital, Al Hada, Saudi Arabia
| | - Ahmad H Mufti
- Department of Medical Genetics, Medicine College, Umm Al-Qura University, P.O. Box 57543, Mecca, 21955, Saudi Arabia
| | - Anas Dannoun
- Department of Medical Genetics, Medicine College, Umm Al-Qura University, P.O. Box 57543, Mecca, 21955, Saudi Arabia
| | - Hassan Kordi
- Department of Medical Genetics, Medicine College, Umm Al-Qura University, P.O. Box 57543, Mecca, 21955, Saudi Arabia
| | - Asim Khogeer
- Department of Plan and Research, General Directorate of Health Affairs, Mecca Region, Ministry of Health, Mecca, Saudi Arabia
| | - Osama H Jiffri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | | | - Mohammed T Tayeb
- Department of Medical Genetics, Medicine College, Umm Al-Qura University, P.O. Box 57543, Mecca, 21955, Saudi Arabia
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Molecular characterization of exonic rearrangements and frame shifts in the dystrophin gene in Duchenne muscular dystrophy patients in a Saudi community. Hum Genomics 2018. [PMID: 29631625 DOI: 10.1186/s40246-018-0152-8]] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In individuals with Duchenne muscular dystrophy (DMD), exon skipping treatment to restore a wild-type phenotype or correct the frame shift of the mRNA transcript of the dystrophin (DMD) gene are mutation-specific. To explore the molecular characterization of DMD rearrangements and predict the reading frame, we simultaneously screened all 79 DMD gene exons of 45 unrelated male DMD patients using a multiplex ligation-dependent probe amplification (MLPA) assay for deletion/duplication patterns. Multiplex PCR was used to confirm single deletions detected by the MLPA. RESULTS There was an obvious diagnostic delay, with an extremely statistically significant difference between the age at initial symptoms and the age of clinical evaluation of DMD cases (t value, 10.3; 95% confidence interval 5.95-8.80, P < 0.0001); the mean difference between the two groups was 7.4 years. Overall, we identified 147 intragenic rearrangements: 46.3% deletions and 53.7% duplications. Most of the deletions (92.5%) were between exons 44 and 56, with exon 50 being the most frequently involved (19.1%). Eight new rearrangements, including a mixed deletion/duplication and double duplications, were linked to seven cases with DMD. Of all the cases, 17.8% had duplications with no hot spots. In addition, confirmation of the reading frame hypothesis helped account for new DMD rearrangements in this study. We found that 81% of our Saudi patients would potentially benefit from exon skipping, of which 42.9% had a mutation amenable to skipping of exon 51. CONCLUSIONS Our study could generate considerable data on mutational rearrangements that may promote future experimental therapies in Saudi Arabia.
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Abstract
Available and flexible choice of methods for screening and detecting β-thalassemia (β-thal) can promote control of thalassemia in developing countries. In this study, two methods, the amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and reverse dot-blot hybridization assays were developed to detect common β-thal mutations in 244 thalassemia patients and 152 healthy people in North Vietnam. The most common mutation was codon 26 (G>A), also known as Hb E (HBB: c.79G>A), accounting for 26.4% of the total studied chromosomes, followed by codons 41/42 (-TCTT) (HBB: c.126_129delCTTT) and codon 17 (A>T) (HBB: c.c.52A>T), accounting for 19.4 and 16.4%, respectively. In addition, codon 95 (+A) (HBB: c.c.287_288insA) that is known as the Vietnamese mutation, accounted for 0.6%. Moreover, the heterozygous state of the four mutations was also found in healthy people, of which Hb E was again the most common mutation with a frequency 3.0%. The results of this study provide available methods and indicative data for preventive and control strategies concerning the genetic diagnosis of thalassemia.
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Affiliation(s)
- Lan Thi Thuong Vo
- a Faculty of Biology , Vietnam National University, University of Science , Thanh Xuan , Hanoi , Vietnam
| | - Trang Thu Nguyen
- a Faculty of Biology , Vietnam National University, University of Science , Thanh Xuan , Hanoi , Vietnam
| | - Hai Xuan Le
- b National Institute of Hematology and Blood Transfusion , Cau Giay , Hanoi , Vietnam
| | - Ha Thi Thu Le
- a Faculty of Biology , Vietnam National University, University of Science , Thanh Xuan , Hanoi , Vietnam
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Sousos N, Adamidou D, Klonizakis P, Agapidou A, Theodoridou S, Spanos G, Psarras K, Vetsiou E, Vyzantiadis TA, Vlachaki E. Presence of the IVS-I-6-Mutated Allele in Beta-Thalassemia Major Patients Correlates with Extramedullary Hematopoiesis Incidence. Acta Haematol 2017; 137:175-182. [PMID: 28399542 DOI: 10.1159/000463919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/14/2016] [Indexed: 01/03/2023]
Abstract
Extramedullary hematopoiesis (EMH) results from the extension of hematopoietic tissue beyond the confines of the bones. Since the initiation of regular transfusion programs from an early age for all thalassemia major (ΤΜ) patients, EMH has not been considered a clinical issue anymore. The present study aims to record the prevalence of EMH in chronically transfused ΤΜ patients followed at our institution and to investigate possible risk factors associated with its occurrence. The project was designed as a retrospective, nonexperimental, descriptive, exploratory study. In total, the study enrolled 104 patients. EMH was revealed in 15/104 (14%) patients. The presence of intravening sequence (IVS)-I-6 was significantly related with the development of EMH (p < 0.05). No other demographic or biological factor studied was found to be related with the presence of EMH. The study stresses a profound incidence of asymptomatic EMH in a solid group of well-transfused ΤΜ patients. Given the high incidence of the IVS-I-6 allele in the Mediterranean and Middle Eastern region, high-quality, prospective, multicenter studies could confirm the association of EMH occurrence with the presence of the IVS-I-6 mutation and further evaluate the exact role of this mutation in the EMH process.
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Affiliation(s)
- Nikolaos Sousos
- Adult Thalassemia Unit, Second Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
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Combined Genetic Biomarkers Confer Susceptibility to Risk of Urothelial Bladder Carcinoma in a Saudi Population. DISEASE MARKERS 2017. [PMID: 28348449 DOI: 10.1155/2017/1474560]] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We evaluated the associations between seven single nucleotide polymorphisms and susceptibility to urothelial bladder carcinoma (UBC) in a Saudi population. Genomic DNA was taken from buccal cells of 52 patients with UBC and 104 controls for genotyping of GSTT1, GSTM1, rs4646903, rs1048943, TP53 rs1042522, rs1801133, and rs1801394 using PCR and TaqMan® assays. The rs1801133 and rs1801394 variants showed strong associations with UBC (OR = 2.3, P = 0.0002; OR = 2.6, P = 0.0001, resp.). Homozygosity of Pro72 conferred a significant double risk in cases compared with controls (30.8% versus 15.4%), but the homozygote Arg/Arg had no effect on risk. Genotypic combinations of GSTM1/GSTT1, rs4646903/rs1048943, and rs1801133/rs1801394 exhibited significant linkage with the disease (χ2 = 10.3, P = 0.006; χ2 = 13.9, P = 0.003; and χ2 = 20.4, P = 0.0004, resp.). The GSTM1 and rs1042522Arg and rs1801394G variant alleles were more frequent in current smokers with UBC (52.4%, 52.5%, and 64.3%, resp.) than were the corresponding wild-types. Despite some variants having only a slight effect on UBC risk, the interaction effect of combined genetic biomarkers-or even the presence of one copy of a variant allele-is potentially much greater. Perhaps more studies regarding next-generation genetic sequencing and its utility can add to the risk of UBC.
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Elhawary NA, Nassir A, Saada H, Dannoun A, Qoqandi O, Alsharif A, Tayeb MT. Combined Genetic Biomarkers Confer Susceptibility to Risk of Urothelial Bladder Carcinoma in a Saudi Population. DISEASE MARKERS 2017; 2017:1474560. [PMID: 28348449 PMCID: PMC5350417 DOI: 10.1155/2017/1474560] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/21/2017] [Accepted: 02/05/2017] [Indexed: 02/07/2023]
Abstract
We evaluated the associations between seven single nucleotide polymorphisms and susceptibility to urothelial bladder carcinoma (UBC) in a Saudi population. Genomic DNA was taken from buccal cells of 52 patients with UBC and 104 controls for genotyping of GSTT1, GSTM1, rs4646903, rs1048943, TP53 rs1042522, rs1801133, and rs1801394 using PCR and TaqMan® assays. The rs1801133 and rs1801394 variants showed strong associations with UBC (OR = 2.3, P = 0.0002; OR = 2.6, P = 0.0001, resp.). Homozygosity of Pro72 conferred a significant double risk in cases compared with controls (30.8% versus 15.4%), but the homozygote Arg/Arg had no effect on risk. Genotypic combinations of GSTM1/GSTT1, rs4646903/rs1048943, and rs1801133/rs1801394 exhibited significant linkage with the disease (χ2 = 10.3, P = 0.006; χ2 = 13.9, P = 0.003; and χ2 = 20.4, P = 0.0004, resp.). The GSTM1 and rs1042522Arg and rs1801394G variant alleles were more frequent in current smokers with UBC (52.4%, 52.5%, and 64.3%, resp.) than were the corresponding wild-types. Despite some variants having only a slight effect on UBC risk, the interaction effect of combined genetic biomarkers-or even the presence of one copy of a variant allele-is potentially much greater. Perhaps more studies regarding next-generation genetic sequencing and its utility can add to the risk of UBC.
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Affiliation(s)
- Nasser Attia Elhawary
- 1Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, P.O. Box 57543, Mecca 21955, Saudi Arabia
- 2Department of Molecular Genetics, Medical Genetics Center, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
- *Nasser Attia Elhawary:
| | - Anmar Nassir
- 3Department of Surgery, Faculty of Medicine, Umm Al-Qura University, Mecca 21955, Saudi Arabia
- 4Department of Urology, King Abdullah Medical City Specialist Hospital, Mecca 21955, Saudi Arabia
| | - Hesham Saada
- 4Department of Urology, King Abdullah Medical City Specialist Hospital, Mecca 21955, Saudi Arabia
| | - Anas Dannoun
- 1Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, P.O. Box 57543, Mecca 21955, Saudi Arabia
| | - Omar Qoqandi
- 1Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, P.O. Box 57543, Mecca 21955, Saudi Arabia
| | - Ammar Alsharif
- 5Division of Internal Medicine, Al-Noor Specialist Hospital, Mecca 21955, Saudi Arabia
| | - Mohammed Taher Tayeb
- 1Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, P.O. Box 57543, Mecca 21955, Saudi Arabia
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Al-Akhras A, Badr M, El-Safy U, Kohne E, Hassan T, Abdelrahman H, Mourad M, Brintrup J, Zakaria M. Impact of genotype on endocrinal complications in β-thalassemia patients. Biomed Rep 2016; 4:728-736. [PMID: 27284414 DOI: 10.3892/br.2016.646] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/18/2016] [Indexed: 01/27/2023] Open
Abstract
In β-thalassemia, certain mutations cause a complete absence of β-globin chain synthesis, termed β0-thalassemia, while others may allow certain β-globin production and are termed β+- or β++-thalassemia. The homozygous state results in severe anemia, which requires regular blood transfusion. By contrast, frequent blood transfusion can in turn lead to iron overload, which may result in several endocrinal complications. The present study aimed to investigate the impact of genotype on the development of endocrine complications in β-thalassemia patients. A cross-sectional study was conducted on 100 thalassemia patients >10 years. A data abstraction form was designed to capture the appropriate information from the individual medical records, including full clinical, laboratory, transfusion and chelation data. The genotype of the patients was identified by the DNA sequencing technique. Growth retardation and hypogonadism were the most prominent endocrinal complications (70 and 67%, respectively) followed by hypothyroidism, diabetes mellitus and hypoparathyrodism (8, 8 and 7%, respectively). The most common mutations identified were IVS-1-110, IVS-1-1 and IVS-1-6 (63, 47 and 41%, respectively). Patients with the β0β0 genotype had a significantly higher prevalence of growth retardation, hypogonadism, hypothyroidism and hypoparathyrodism compared to those with the β0β+ and β+β+ genotypes (P<0.001, P<0.001, P<0.001 and P=0.037, respectively). Patients with the homozygous IVS-11-745 mutation had a significantly higher prevalence of diabetes (P=0.001). The underlying genetic defect in thalassemia patients is a contributing factor for the development of endocrinal complications, as patients with the more severe defects have a greater rate of iron loading through higher red cell consumption.
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Affiliation(s)
- Ahmed Al-Akhras
- Department of Pediatrics, Zagazig University, Zagazig 44111, Egypt
| | - Mohamed Badr
- Department of Pediatrics, Zagazig University, Zagazig 44111, Egypt
| | - Usama El-Safy
- Department of Pediatrics, Zagazig University, Zagazig 44111, Egypt
| | - Elisabeth Kohne
- Department of Pediatrics and Adolescents, Laboratory of Hemoglobinopathy, University of Ulm, D-89069 Ulm, Germany
| | - Tamer Hassan
- Department of Pediatrics, Zagazig University, Zagazig 44111, Egypt
| | | | - Mohamed Mourad
- Department of Clinical Pathology, Zagazig University, Zagazig 44111, Egypt
| | - Joaquin Brintrup
- Department of Pediatrics and Adolescents, Laboratory of Hemoglobinopathy, University of Ulm, D-89069 Ulm, Germany
| | - Marwa Zakaria
- Department of Pediatrics, Zagazig University, Zagazig 44111, Egypt
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El-Fadaly N, Abd-Elhameed A, Abd-Elbar E, El-Shanshory M. Accuracy of Reverse Dot-Blot PCR in Detection of Different β-Globin Gene Mutations. Indian J Hematol Blood Transfus 2015; 32:239-43. [PMID: 27065589 DOI: 10.1007/s12288-015-0553-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 05/09/2015] [Indexed: 12/21/2022] Open
Abstract
Prevention programs for β-thalassemia based on molecular diagnosis of heterozygous carriers and/or patients require the use of reliable mutation screening methods. The aim of this study was to compare between direct DNA sequencing, and reverse dot-blot PCR in detection of different β-globin gene mutations in Egyptian children with β-thalassemia. Forty children with β-thalassemia were subjected to mutation analysis, performed by both direct DNA sequencing and β-globin Strip Assay MED™ (based on reverse dot-blot PCR). The most frequent mutant alleles detected by reverse dot-blot PCR were; IVSI-110 G>A (31.25 %), IVS I-6 T > C (21.25 %), and IVS I-1 G>A (20 %). Relatively less frequent mutant alleles detected by reverse dot-blot PCR were "IVSII-1 G>A (5 %), IVSII-745 C>G (5 %), IVSII-848 C>A (2.5 %), IVSI-5 G>C (2.5 %), -87 C>G(2.5 %), and cd39 C>T (2.5 %)", While the genotypes of three patients (6 alleles 7.5 %) were not detected by reverse dot-blot PCR. Mutant alleles detected by direct DNA sequencing were the same as reverse dot-blot PCR method except it revealed the genotypes of 3 undetected patients (one patient was homozygous IVSI-110 G>A, and two patients were homozygous IVS I-1 G>A. Sensitivity of the reverse dot-blot PCR was 92.5 % when compared to direct DNA sequencing for detecting β-thalassemia mutations. Our results therefore suggest that, direct DNA sequencing may be preferred over reverse dot-blot PCR in critical diagnostic situations like genetic counseling for prenatal diagnosis.
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Affiliation(s)
- N El-Fadaly
- Clinical Pathology, Tanta University, Tanta, Egypt
| | | | - E Abd-Elbar
- Clinical Pathology, Tanta University, Tanta, Egypt
| | - M El-Shanshory
- Pediatric Departments, Tanta University, Tanta, Egypt ; Faculty of Medicine, Tanta University, Tanta, Gharbia Egypt
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Molecular Characterization of β-Thalassemia in Nineveh Province Illustrates the Relative Heterogeneity of Mutation Distributions in Northern Iraq. Indian J Hematol Blood Transfus 2015; 31:213-7. [PMID: 25825560 DOI: 10.1007/s12288-014-0369-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 03/06/2014] [Indexed: 10/25/2022] Open
Abstract
Beta thalassemia is an important health problem in Nineveh province, a large province in Northwestern Iraq. No previous study of significance had focused on the spectrum of β-thalassemia mutations in this part of the country. A total of 94 unrelated β-thalassemia minor subjects from the latter province were recruited. Their carrier status was confirmed by full blood count, Hb A2 and F estimation. Thereafter their DNA was subjected to multiplex polymerase chain reaction and reverse hybridization to detect 20 β-thalassemia mutations. A total of eleven different β-thalassemia mutations were documented. The most frequent mutation was IVS-I-110 (G>A) documented in 34 %, followed by IVS-I-6 (T>C) in 9.6 %, IVS-I-5(G>C) in 8.5 %, codon 39 (C>T) and codon 44 (-C) in 7.4 % each, while IVS-I-1(G>A) and IVS-II-1(G>A) were encountered in 6.4 % each. Other mutations were less frequent including codon 8 (-AA), IVS-I-130 (G>C), codon 5 (-CT) and IVS-II-745(C>G). The current study revealed notable differences in the relative frequencies of several β-thalassemia mutations in Nineveh province as compared to other parts of Northern Iraq. Such an observation may be reflective of different ethnic backgrounds and varying historical population interactions. It is believed that these findings complement those of earlier studies on β-thalassemia mutations from the country, and are quite essential in the setting of a proposed national preventive program.
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Elmezayen AD, Kotb SM, Sadek NA, Abdalla EM. β-Globin Mutations in Egyptian Patients With β-Thalassemia. Lab Med 2015; 46:8-13. [DOI: 10.1309/lm1aykg6ve8mlphg] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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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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16
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Spectrum of Beta Globin Gene Mutations in Egyptian Children with β-Thalassemia. Mediterr J Hematol Infect Dis 2014; 6:e2014071. [PMID: 25408857 PMCID: PMC4235483 DOI: 10.4084/mjhid.2014.071] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 09/26/2014] [Indexed: 12/25/2022] Open
Abstract
Background The molecular defects resulting in a β-thalassemia phenotype, in the Egyptian population, show a clear heterogenic mutations pattern. PCR-based techniques, including direct DNA sequencing are effective on the molecular detection and characterization of these mutations. The molecular characterization of β-thalassemia is necessary for carrier screening, genetic counseling, and to offer prenatal diagnosis. The aim of the work was to evaluate the different β-globin gene mutations in two hundred β-thalassemic Egyptian children. Subjects and Methods This study was carried out on two hundred β-thalassemic Egyptian children covering most Egyptian Governorates including 158 (79%) children with thalassemia major (TM) and 42 (21%) children with thalassemia intermedia(TI). All patients were subjected to meticulous history taking, clinical examination, complete blood count, hemoglobin electrophoresis, serum ferritin and direct fluorescent DNA sequencing of the β-globin gene to detect the frequency of different mutations. Results The most common mutations among patients were IVS I-110(G>A) 48%, IVS I-6(T>C) 40%, IVS I-1(G>A) 24%, IVS I-5(G>C)10%, IVS II-848 (C>A) 9%, IVS II-745(C>G) 8%, IVS II-1(G>A) 7%, codon “Cd”39(C> T) 4%, −87(C>G) 3% and the rare mutations were: Cd37 (G>A), Cd8 (−AA), Cd29(−G), Cd5 (−CT), Cd6(−A), Cd8/9(+G), Cd 106/107(+G), Cd27(C>T), IVS II-16(G> C), Cd 28 (−C), Cap+1(A>C), −88(C>A), all of these rare mutations were present in 1%. There was a considerable variation in phenotypic severity among patients resulting from the interaction of different β∘ and β+mutations. Furthermore, no genotype-phenotype association was found both among the cases with thalassemia major and the cases with thalassemia intermedia. Conclusion Direct DNA sequencing provides insights for the frequency of different mutations in patients with β-thalassemia including rare and/or unknown ones. The most common mutations in Egyptian children with beta thalassemia were IVS I-110(G>A) 48%, IVS I-6(T>C) 40%, IVS I-1(G>A)24%, IVS I-5(G>C)10%, IVS II-848 (C>A) 9%, IVS II-745(C>G) 8%, IVS II-1(G>A) 7%.
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Jarjour RA, Murad H, Moasses F, Al-Achkar W. Molecular update of β-thalassemia mutations in the Syrian population: identification of rare β-thalassemia mutations. Hemoglobin 2014; 38:272-6. [PMID: 24828949 DOI: 10.3109/03630269.2014.912661] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
β-Thalassemia (β-thal) is an autosomal recessive disorder characterized by variable degrees of anemia, bone marrow hyperplasia, splenomegaly, and complications related to the severity of the anemic state. The β-thalassemias result from mutations in and around the β-globin gene (HBB) located as a cluster on the short arm of chromosome 11. In Syria, β-thal is highly prevalent. The main aim of this study was to identify the frequency of HBB mutations in 189 Syrian β-thal patients and carriers of β-thal. Out of the 189 patients and carriers recruited in this study, 181 patients had at least one HBB mutation and eight patients did not show any mutation. The 10 most frequent ones constituted 77.5% of all HBB mutations. These mutations in order of frequency were: IVS-I-110 (G > A) (17.0%), IVS-I-1 (G > A) (14.7%), codon 39 (C > T) (14.4%), IVS-II-1 (G > A) (9.8%), codon 8 (-AA) (6.2%), IVS-I-6 (T > C) (5.2%), IVS-I-5 (G > C) (4.9%), codon 5 (-C) (3.2%), IVS-I-5 (G > A) (3.2%) and codon 37 (G > A) (2.2%). Another 21 mutations were less frequent or sporadic. These results provide important tools for adapting a prenatal molecular diagnostic test for the Syrian population.
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Affiliation(s)
- Rami A Jarjour
- Human Genetics Division, Molecular Biology and Biotechnology Department, Atomic Energy Commission of Syria (AECS) , Damascus , Syria
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Al-Allawi NA, Al-Mousawi BM, Badi AI, Jalal SD. The Spectrum of β-Thalassemia Mutations in Baghdad, Central Iraq. Hemoglobin 2013; 37:444-53. [DOI: 10.3109/03630269.2013.810641] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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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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El-Beshlawy A, El-Shekha A, Momtaz M, Said F, Hamdy M, Osman O, Meshaal S, Gafaar T, Petrou M. Prenatal diagnosis for thalassaemia in Egypt: what changed parents' attitude? Prenat Diagn 2012; 32:777-82. [PMID: 22693141 DOI: 10.1002/pd.3901] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To present the current status of the prenatal diagnosis services and results from the largest thalassaemia center in Egypt treating 3000 patients. Traditionally, prenatal diagnosis has not been successful in reducing the births of affected children in Egypt, because the majority of women undergoing prenatal diagnosis continued to have affected pregnancies. METHODS Seventy-one pregnant mothers at risk for β-thalassaemia underwent prenatal diagnosis by chorionic villus sampling (n=57) or amniocentesis (n=14) between 11 to 14 weeks of gestation. Molecular characterization of fetal DNA by reverse dot blot hybridization and polymerase chain reaction-amplification refractory mutation system techniques was conducted in all cases. RESULTS Twenty-four women (33.8%) were found to have affected fetuses; 100% of these women opted to terminate the pregnancy. The change in attitude towards termination of pregnancy was related to in-depth counseling of the religious aspects towards prenatal diagnosis and termination of pregnancy. Forty-eight women (66.2%) with normal or carrier fetuses for β-thal requested human leukocyte antigen typing of the fetal material to determine if the fetus was a human leukocyte antigen match for their existing thalassaemic siblings. CONCLUSION This study demonstrates that prenatal diagnosis is feasible and acceptable in Egypt, a Muslim country, provided an in-depth discussion, which also addresses the religious considerations of prevention, is held with the couples.
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Affiliation(s)
- A El-Beshlawy
- Pediatric Hematology Department, Cairo University, Cairo, Egypt.
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