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Fotzi I, Pegoraro F, Chiocca E, Casini T, Mogni M, Veltroni M, Favre C. Case Report: Clinical and Hematological Characteristics of ε γδβ Thalassemia in an Italian Patient. Front Pediatr 2022; 10:839775. [PMID: 35372167 PMCID: PMC8969019 DOI: 10.3389/fped.2022.839775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/07/2022] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION εγδβ thalassemia is a rare form of β-thalassemia mostly described in children originating from Northern Europe. Only anecdotic cases from the Mediterranean area are reported. The diagnosis is challenging, considering the rarity of the disease and its heterogeneous clinical presentation. Most patients have neonatal microcytic anemia, sometimes requiring in utero and/or neonatal transfusions, and typically improving with age. CASE DESCRIPTION We report on an Italian newborn presenting with severe neonatal anemia that required red blood cell transfusion. After the first months of life, hemoglobin levels improved with residual very low mean corpuscular volume. β and α thalassemia, IRIDA syndrome, and sideroblastic anemia were excluded. Finally, a diagnosis of εγδβ thalassemia was made after microarray analysis of single nucleotide polymorphisms revealed a 26 kb single copy loss of chromosome 11p15.4, including the HBD, HBBP1, HBG1, and HBB genes. CONCLUSIONS Despite its rarity, the diagnosis of εγδβ thalassemia should be considered in newborns with severe neonatal anemia requiring in utero and/or neonatal transfusions, but also in older infants with microcytic anemia, after excluding more prevalent red blood cell disorders.
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Affiliation(s)
- Ilaria Fotzi
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Francesco Pegoraro
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy.,Department of Health Science, University of Florence, Florence, Italy
| | - Elena Chiocca
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Tommaso Casini
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Massimo Mogni
- Human Genetics Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Marinella Veltroni
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
| | - Claudio Favre
- Department of Pediatric Hematology/Oncology and Hematopoietic Stem Cell Transplantation (HSCT), Meyer Children's University Hospital, Florence, Italy
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De Simone G, Quattrocchi A, Mancini B, di Masi A, Nervi C, Ascenzi P. Thalassemias: From gene to therapy. Mol Aspects Med 2021; 84:101028. [PMID: 34649720 DOI: 10.1016/j.mam.2021.101028] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/19/2021] [Indexed: 12/26/2022]
Abstract
Thalassemias (α, β, γ, δ, δβ, and εγδβ) are the most common genetic disorders worldwide and constitute a heterogeneous group of hereditary diseases characterized by the deficient synthesis of one or more hemoglobin (Hb) chain(s). This leads to the accumulation of unstable non-thalassemic Hb chains, which precipitate and cause intramedullary destruction of erythroid precursors and premature lysis of red blood cells (RBC) in the peripheral blood. Non-thalassemic Hbs display high oxygen affinity and no cooperativity. Thalassemias result from many different genetic and molecular defects leading to either severe or clinically silent hematologic phenotypes. Thalassemias α and β are particularly diffused in the regions spanning from the Mediterranean basin through the Middle East, Indian subcontinent, Burma, Southeast Asia, Melanesia, and the Pacific Islands, whereas δβ-thalassemia is prevalent in some Mediterranean regions including Italy, Greece, and Turkey. Although in the world thalassemia and malaria areas overlap apparently, the RBC protection against malaria parasites is openly debated. Here, we provide an overview of the historical, geographic, genetic, structural, and molecular pathophysiological aspects of thalassemias. Moreover, attention has been paid to molecular and epigenetic pathways regulating globin gene expression and globin switching. Challenges of conventional standard treatments, including RBC transfusions and iron chelation therapy, splenectomy and hematopoietic stem cell transplantation from normal donors are reported. Finally, the progress made by rapidly evolving fields of gene therapy and gene editing strategies, already in pre-clinical and clinical evaluation, and future challenges as novel curative treatments for thalassemia are discussed.
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Affiliation(s)
- Giovanna De Simone
- Dipartimento di Scienze, Università Roma Tre, Viale Guglielmo Marconi 446, 00146, Roma, Italy
| | - Alberto Quattrocchi
- Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, Facoltà di Farmacia e Medicina, "Sapienza" Università di Roma, Corso della Repubblica, 79, 04100, Latina, Italy
| | - Benedetta Mancini
- Dipartimento di Scienze, Università Roma Tre, Viale Guglielmo Marconi 446, 00146, Roma, Italy
| | - Alessandra di Masi
- Dipartimento di Scienze, Università Roma Tre, Viale Guglielmo Marconi 446, 00146, Roma, Italy
| | - Clara Nervi
- Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, Facoltà di Farmacia e Medicina, "Sapienza" Università di Roma, Corso della Repubblica, 79, 04100, Latina, Italy.
| | - Paolo Ascenzi
- Dipartimento di Scienze, Università Roma Tre, Viale Guglielmo Marconi 446, 00146, Roma, Italy; Accademia Nazionale dei Lincei, Via della Lungara 10, 00165, Roma, Italy.
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Makis A, Georgiou I, Traeger-Synodinos J, Storino MR, Giuliano M, Andolfo I, Hatzimichael E, Chaliasos N, Giapros V, Izzo P, Iolascon A, Grosso M. A Novel εγδβ-Thalassemia Deletion Associated with Severe Anemia at Birth and a β-Thalassemia Intermedia Phenotype Later in Life in Three Generations of a Greek Family. Hemoglobin 2019; 45:351-354. [PMID: 31829079 DOI: 10.1080/03630269.2019.1699568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We describe a novel deletion causing heterozygous εγδβ-thalassemia (εγδβ-thal) across three generations of a Greek family. The Greek deletion is about 72 kb in length, spanning from the hypersensitive site 4 (HS4) in the locus control region (LCR) to the 3' end of the β-globin gene, thus encompassing the entire β-globin gene cluster. The deletion caused severe but transient neonatal anemia and a non transfusion-dependent chronic hemolytic anemia state later in life, resembling mild β-thalassemia intermedia (β-TI) rather than β-thalassemia (β-thal) trait, as had been previously reported. Apart from the presentation of clinical and laboratory characteristics, the challenges involving clinical management are also discussed.
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Affiliation(s)
- Alexandros Makis
- Department of Pediatrics, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Ioannis Georgiou
- Genetics and In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Jan Traeger-Synodinos
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Rosaria Storino
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Mariarosaria Giuliano
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Nikolaos Chaliasos
- Department of Pediatrics, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Vasileios Giapros
- Neonatal Intensive Care Unit, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Paola Izzo
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Michela Grosso
- Department of Molecular Medicine and Medical Biotechnology, CEINGE, Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
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4
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Epsilon gamma delta beta talasemia: una causa infrecuente de anemia fetal y neonatal. Med Clin (Barc) 2018; 150:368-369. [DOI: 10.1016/j.medcli.2017.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/28/2017] [Accepted: 10/05/2017] [Indexed: 11/19/2022]
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Hui ASY, Au PKC, Ting YH, Kan ASY, Cheng YKY, Leung AWK, Chan KYK, Li CK, Tang MHY, Leung TY. First Report of a Novel Deletion Due toεγδβ-Thalassemia in a Chinese Family. Hemoglobin 2017; 41:175-179. [PMID: 28950778 DOI: 10.1080/03630269.2017.1366918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Annie S. Y. Hui
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, People’s Republic of China
| | - Patrick K. C. Au
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of China
| | - Yuen-Ha Ting
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, People’s Republic of China
| | - Anita S. Y. Kan
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of China
| | - Yvonne K. Y. Cheng
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, People’s Republic of China
| | - Alex W. K. Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Kelvin Y. K. Chan
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of China
| | - Chi-Kong Li
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Mary H. Y. Tang
- Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of China
| | - Tak-Yeung Leung
- Department of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, People’s Republic of China
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Vasseur C, Domingues-Hamdi E, Ledudal K, Le Corvoisier P, Barau C, Ghaleh B, Rialland A, Pissard S, Galactéros F, Baudin-Creuza V. Red blood cells free α-haemoglobin pool: a biomarker to monitor the β-thalassemia intermedia variability. The ALPHAPOOL study. Br J Haematol 2017. [DOI: 10.1111/bjh.14800] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Corinne Vasseur
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
| | - Elisa Domingues-Hamdi
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
| | - Katia Ledudal
- Inserm; Centre d'Investigation Clinique 1430; Hôpital Universitaire Henri Mondor Assistance Publique Hôpitaux de Paris (AP-HP); Créteil France
| | - Philippe Le Corvoisier
- Inserm; Centre d'Investigation Clinique 1430; Hôpital Universitaire Henri Mondor Assistance Publique Hôpitaux de Paris (AP-HP); Créteil France
| | - Caroline Barau
- Plateforme de Ressources Biologiques; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Bijan Ghaleh
- Plateforme de Ressources Biologiques; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Amandine Rialland
- Unité de Recherche Clinique; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Serge Pissard
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
- Laboratoire de Génétique; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Frédéric Galactéros
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
- Unité des Maladies Génétiques du Globule Rouge; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Véronique Baudin-Creuza
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
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7
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Cardiero G, Prezioso R, Dembech S, Del Vecchio Blanco F, Scarano C, Lacerra G. Identification and molecular characterization of a novel 163 kb deletion: The Italian (ϵγδβ)(0)-thalassemia. ACTA ACUST UNITED AC 2016; 21:317-24. [PMID: 27077761 DOI: 10.1080/10245332.2015.1133007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE AND IMPORTANCE To verify the presence of β-thalassemia in subjects showing hematologic phenotype of α-thalassemia, conduct normal molecular sequence analysis of the α-globin genes, and detect the absence of the most frequent α-thalassemia deletions. CLINICAL PRESENTATION A patient from Apulia (Southern Italy) was referred to our institution for the occasional founding of hypochromic polyglobulia and microcytic red blood cells associated with normal levels of Hb A2 and Hb F and normal iron parameters. INTERVENTION AND TECHNIQUE The patient has been investigated using Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA), quantitative real-time PCR, restriction analysis, and gap-PCR. A novel deletion, the Italian (ϵγδβ)(0)-thalassemia, has been identified. The 5' breakpoint was within a LINE element of 80 kb 3' of the ε-globin gene, and the 3' breakpoint was within a 160-bp palindrome of about 30 kb 5' of the β-globin gene. The breakpoint region was characterized by the presence of a microhomology (5'-TCT-3') and of an insertion of 43 bp owing to the duplication of the 160-bp palindrome. Comparison of the Hb and Hb A2 values of (ϵγδβ)(0)-thalassemia from the literature with those of (molecularly known) thalassemia carriers indicated a higher level of Hb A2 with respect to α-thalassemia and a lower level of Hb with respect to β(0)-thalassemia carriers. CONCLUSION In this study, we report the first (ϵγδβ)(0)-thalassemia case identified in Italy. To avoid misdiagnosis of β-thalassemia, we suggest verifying the presence of large deletions of the β-globin gene cluster in subjects showing a higher border line level of Hb A2 and a lower level of Hb.
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Affiliation(s)
- Giovanna Cardiero
- a Istituto di Genetica e Biofisica "Adriano Buzzati-Traverso" - CNR , Napoli , Italy
| | - Romeo Prezioso
- a Istituto di Genetica e Biofisica "Adriano Buzzati-Traverso" - CNR , Napoli , Italy
| | - Sabrina Dembech
- b Azienda Ospedaliero-Universitaria , Ospedali Riuniti, Foggia , Italy
| | - Francesca Del Vecchio Blanco
- c Dipartimento di Biochimica, Biofisica e Patologia Generale , Seconda Università degli Studi di Napoli , Napoli , Italy
| | - Clelia Scarano
- b Azienda Ospedaliero-Universitaria , Ospedali Riuniti, Foggia , Italy
| | - Giuseppina Lacerra
- a Istituto di Genetica e Biofisica "Adriano Buzzati-Traverso" - CNR , Napoli , Italy
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Von Kanel T, Röthlisberger B, Schanz U, Dutly F, Huber AR, Saller E. A Swiss (εγδβ)⁰-thalassemia patient with a novel 3-Mb deletion associated with mild mental impairment. Am J Hematol 2013; 88:158-9. [PMID: 23255297 DOI: 10.1002/ajh.23364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 10/30/2012] [Accepted: 11/07/2012] [Indexed: 11/05/2022]
Affiliation(s)
- Thomas Von Kanel
- Centre of Laboratory Medicine; Kantonsspital Aarau; Tellstrasse; Aarau; Switzerland
| | - Benno Röthlisberger
- Centre of Laboratory Medicine; Kantonsspital Aarau; Tellstrasse; Aarau; Switzerland
| | - Urs Schanz
- Division of Hematology; University Hospital Zürich; Raemistrasse Zürich; Switzerland
| | - Fabrizio Dutly
- Institut für medizinische & molekulare Diagnostik AG; Rautistrasse Zürich; Switzerland
| | - Andreas R. Huber
- Centre of Laboratory Medicine; Kantonsspital Aarau; Tellstrasse; Aarau; Switzerland
| | - Elisabeth Saller
- Institut für medizinische & molekulare Diagnostik AG; Rautistrasse Zürich; Switzerland
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Shalev H, Landau D, Pissard S, Krasnov T, Kapelushnik J, Gilad O, Broides A, Dgany O, Tamary H. A novel epsilon gamma delta beta thalassemia presenting with pregnancy complications and severe neonatal anemia. Eur J Haematol 2013. [DOI: 10.1111/ejh.12047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hanna Shalev
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Daniela Landau
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Serge Pissard
- Laboratory of Biochemistry and Genetics, Henri Mondor and UPEC; Creteil; France
| | - Tanya Krasnov
- Pediatric Hematology Laboratory, Felsenstein Medical Research Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University; Tel Aviv; Israel
| | - Joseph Kapelushnik
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Oded Gilad
- Department of Pediatrics B; Schneider Children's Medical Center of Israel, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University; Tel Aviv; Israel
| | - Arnon Broides
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Orly Dgany
- Laboratory of Biochemistry and Genetics, Henri Mondor and UPEC; Creteil; France
| | - Hannah Tamary
- Department of Hematology-Oncology; Schneider Children's Medical Center of Israel; Petach Tikva and Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv; Israel
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10
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Rooks H, Clark B, Best S, Rushton P, Oakley M, Thein OS, Cuthbert AC, Britland A, Ruf A, Thein SL. A novel 506kb deletion causing εγδβ thalassemia. Blood Cells Mol Dis 2012; 49:121-7. [PMID: 22677107 DOI: 10.1016/j.bcmd.2012.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 05/04/2012] [Indexed: 01/01/2023]
Abstract
We describe a novel deletion causing εγδβ thalassemia in a Pakistani family. The Pakistani deletion is 506kb in length, and the second largest εγδβ thalassemia deletion reported to date. It removes the entire β globin gene (HBB) cluster, extending from 431kb upstream to 75kb downstream of the ε globin gene (HBE). The breakpoint junction occurred within a 160bp palindrome embedded in LINE/LTR repeats, and contained a short (9bp) region of direct homology which may have contributed to the recombination event. Characterization of the deletion breakpoints has been particularly challenging due to the complexity of DNA deletion, insertion and inversion, involving a multitude of methodologies, mirroring the changing DNA analysis technologies.
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Affiliation(s)
- Helen Rooks
- King's College London, Molecular Haematology, James Black Centre, London SE5 9NU, UK
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Joly P, Lacan P, Garcia C, Meley R, Pondarré C, Francina A. A Novel Deletion/Insertion Caused by a Replication Error in the β-Globin Gene Locus Control Region. Hemoglobin 2011; 35:316-22. [DOI: 10.3109/03630269.2011.571331] [Citation(s) in RCA: 7] [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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12
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Vasseur C, Pissard S, Domingues‐Hamdi E, Marden MC, Galactéros F, Baudin‐Creuza V. Evaluation of the free α-hemoglobin pool in red blood cells: a new test providing a scale of β-thalassemia severity. Am J Hematol 2011; 86:199-202. [PMID: 21264907 DOI: 10.1002/ajh.21918] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
β-Thalassemias are characterized by an imbalance of globin chains with an excess of α-chains which precipitates in erythroid precursors and red blood cells (RBCs) leading to inefficient erythropoiesis. The severity of the disease correlates with the amount of unpaired α-chains.Our goal was to develop a simple test for evaluation of the free α-hemoglobin pool present in RBC lysates. Alpha-Hemoglobin Stabilizing Protein (AHSP), the chaperone of α-Hb, was used to trap excess a-Hb. A recombinant GST-AHSP fusion protein was bound to an affinity micro-column and then incubated with hemolysates of patients. After washing, the α-Hb was quantified by spectrophotometry in the elution fraction. This assay was applied to 54 patients: 28 without apparent Hb disorder, 20 β-thalassemic and 6 α-thalassemic. The average value of free α-Hb pool was 93 ± 21 ppm (ng of free α-Hb per mg of Hb subunits)in patients without Hb disorder, while it varies from 119 to 1,756 ppm, in β-thalassemic patients and correlated with genotype. In contrast,the value of the free α-Hb pool was decreased in α-thalassemic patients (65 ± 26 ppm). This assay may help to characterize β-thalassemia phenotypes and to follow the evolution of the globin chain imbalance(α/β+γ ratio) in response to treatment.
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Affiliation(s)
- Corinne Vasseur
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
| | - Serge Pissard
- Assistance Publique Hôpitaux de Paris (APHP), Laboratoire de biochimie et de génétique, Hôpital Henri Mondor, Université Paris Est (UPE), Créteil, France
- INSERM U955 équipe 11, IMRB, Créteil France
| | - Elisa Domingues‐Hamdi
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
| | - Michael C. Marden
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
| | - Frédéric Galactéros
- Assistance Publique Hôpitaux de Paris (APHP), Unité des Maladies Génétiques du Globule Rouge (UMGGR), Hôpital Henri Mondor, UPE, Créteil, France
| | - Véronique Baudin‐Creuza
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
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13
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Mikula M, Buller-Burckle A, Gallivan M, Sun W, Franklin CR, Strom CM. The importance of β globin deletion analysis in the evaluation of patients with β thalassemia. Int J Lab Hematol 2011; 33:310-7. [PMID: 21219590 DOI: 10.1111/j.1751-553x.2010.01287.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Beta globin deletion/duplication analysis may serve as a useful adjunct to sequence analysis. Our purpose was to develop a robust assay for beta globin deletion/duplication analysis and determine its role in evaluating patients with beta thalassemia. METHODS A single tube semi-quantitative fluorescent PCR assay capable of detecting deletions and duplications in the beta globin cluster and the associated locus control region (LCR) was developed and validated. RESULTS Six hundred seventy one de-identified samples submitted for beta globin sequence analysis were tested for deletions and duplications of the beta globin cluster. Twenty-two deletions were detected (3%, 22/671). Seventeen of the 22 (82%) deletion samples were negative for mutations in the whole gene sequencing assay. For 5 of the samples, homozygous point mutations were inferred by beta globin sequencing. Among the deletions detected, 11 (50%) involved only the beta globin gene (5 covering the entire gene, 2 spanning the 5' end of the gene and 4 encompassing the 3' end of the gene). Ten samples (45%) were heterozygous delta-beta deletions spanning both the delta globin and beta globin genes. One patient with a single deletion had Hb Lepore. CONCLUSION Beta globin deletion/duplication analysis is necessary to correctly identify the genotype in some patients being evaluated for beta thalassemia.
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Affiliation(s)
- M Mikula
- Department of Molecular Genetics, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA 96690, USA.
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Prenatal diagnosis of hemoglobin disorders: Present and future strategies. Clin Biochem 2009; 42:1767-79. [DOI: 10.1016/j.clinbiochem.2009.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 06/24/2009] [Accepted: 07/02/2009] [Indexed: 12/14/2022]
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