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Tang B, Wang J, Qin D, Yao C, Chen K, Liang L, Chai H, Guo H, Du L. Hb Chapel Hill or Alpha2 74(EF3) Asp>Gly, a mildly unstable variant found in a Chinese family. Hematology 2023; 28:2187154. [PMID: 36939273 DOI: 10.1080/16078454.2023.2187154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/28/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Hb Chapel Hill [Alpha2 74(EF3) Asp > Gly] results from an GAC > GGC substitution at codon 74 of the HBA1 or HBA2 genes. Hb Chapel Hill has not been reported since 1986. METHODS A heterozygous mutation, HBA2: c.224A > G, was identified in the proband, her father and sister. We compared the haematological and clinical data of this family with the data reported in the limited number of individuals. RESULTS Having excluded iron deficiency, the Hb Chapel Hill was asymptomatic in heterozygous state. The cases presented here characterize cases in new techniques including capillary electrophoresis (CE). Two aberrant peaks were identified by CE, a major peak migrating in the zone 7 that correspond to Hb Chapel Hill (αChapel Hill 2β2) and a minor peak migrating in the zone 1 that correspond to Hb Chapel Hill2 (αChapel Hill 2δ2). Focusing on the variant expression, the Hb Chapel Hill plus Hb A2 variant were around 18.9-20.6% of total Hb in three members. CONCLUSION This data will be useful for providing up-to-date and high quality information on the Hb Chapel Hill.
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Affiliation(s)
- Bin Tang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Jicheng Wang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Danqinq Qin
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Cuize Yao
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Keyi Chen
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Lihua Liang
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Huiying Chai
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Hao Guo
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Li Du
- Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
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Bootchaingam P, Charoenratana C, Tongsong T, Luewan S. Effectiveness of placental volume measured by virtual organ computer-aided analysis in prediction of fetal hemoglobin Bart's disease in late first trimester. J Clin Ultrasound 2021; 49:533-537. [PMID: 33860959 DOI: 10.1002/jcu.23004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/21/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of placental volume measured by virtual organ computer-aided analysis (VOCAL) at 12 to 14 weeks of gestation in predicting fetal hemoglobin (Hb) Bart's disease among pregnancies at risk. METHODS This study involves 3-dimensional ultrasound (3D-US) volume datasets derived from pregnancies at risk of fetal Hb Bart's disease at 12 to 14 weeks of pregnancy. VOCAL technique was used to measure and calculate placental volume by the authors, who did not know the fetal diagnosis. Placental thickness was also measured. The diagnostic values of placental volume and placental thickness in prediction of fetal Hb Bart's disease were calculated. RESULTS Sixty-five volume datasets, including 22 datasets of the affected fetuses and 43 unaffected fetuses, were included. The mean placental volume (±SD) of the affected cases was significantly higher than that of the unaffected ones, 85.35 ± 20.84 cm3 vs 52.24 ± 19.01 cm3 (Student's t test, P < .001). In predicting Hb Bart's disease, placental volume and placental thickness had sensitivities of 77.3% and 72.7% respectively as well as specificities of 88.37% and 76.7% respectively. CONCLUSION Of fetuses at risk of Hb Bart's disease, 3D-US VOCAL placental volume may be useful in early detection of affected fetuses. Its effectiveness is superior to that of conventional placental thickness measurement.
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Affiliation(s)
- Phenphan Bootchaingam
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Cholaros Charoenratana
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suchaya Luewan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Cardiero G, Musollino G, Friscia MG, Testa R, Virruso L, Di Girgenti C, Caldora M, Colella Bisogno R, Gaudiano C, Manco G, Lacerra G. Effect of Mutations on mRNA and Globin Stability: The Cases of Hb Bernalda/Groene Hart and Hb Southern Italy. Genes (Basel) 2020; 11:genes11080870. [PMID: 32751969 PMCID: PMC7466077 DOI: 10.3390/genes11080870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
We identified two unstable variants in the third exon of α-globin genes: Hb Bernalda/Groene Hart (HBA1:c.358C>T), and Hb Caserta (HBA2:c.79G>A) in cis to Hb Sun Prairie (HBA2:c.391G>C), also named Hb Southern Italy. These mutations occurred in the H helix of the α-globin that is involved in heme contacting, specific recognition of α-hemoglobin-stabilizing protein (AHSP), and α1β1 interactions. The carriers showed α-thalassemia phenotype, but one also jaundice and cholelithiasis. Molecular identification of clusters of families in Southern Italy encouraged molecular characterization of mRNA, globin chain analyses, molecular modeling studies, and comparison with globin variants to understand the mechanisms causing the α-thalassemia phenotype. A normal amount of Hb Bernalda/Groene Hart mRNA were found, and molecular modeling highlighted additional H bonds with AHSP. For Hb Southern Italy, showing an unexpected α/β biosynthetic ratio typical of the β-thalassemia type, two different molecular mechanisms were shown: Reduction of the variant mRNA, likely due to the No-Go Decay for the presence of unused triplet ACG at cod 26, and protein instability due to the impairment of AHSP interaction. The UDP glucuronosyltransferase 1A (UGT1A1) genotyping was conclusive in the case of jaundice and cholelithiasis. Multiple approaches are needed to properly identify the mechanisms leading to unstable variants and the effect of a mutation.
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Affiliation(s)
- Giovanna Cardiero
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, (IGB-ABT, CNR), National Research Council, 80131 Naples, Italy; (G.C.); (G.M.)
| | - Gennaro Musollino
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, (IGB-ABT, CNR), National Research Council, 80131 Naples, Italy; (G.C.); (G.M.)
| | - Maria Grazia Friscia
- Azienda Ospedaliera Ospedali Civili Riuniti, Centro Trasfusionale e di Microcitemia, 92019 Sciacca, Italy;
| | - Rosario Testa
- Azienda Ospedaliero-Universitaria “Policlinico-Vittorio Emanuele”, Servizio di Talassemia ed Emoglobinopatie, 95123 Catania, Italy;
| | - Lucrezia Virruso
- ARNAS P.O. Civico e Di Cristina Benfratelli, U.O.s.d. Lab. Spec. Genetica Molecolare, 90127 Palermo, Italy; (L.V.); (C.D.G.)
| | - Caterina Di Girgenti
- ARNAS P.O. Civico e Di Cristina Benfratelli, U.O.s.d. Lab. Spec. Genetica Molecolare, 90127 Palermo, Italy; (L.V.); (C.D.G.)
| | | | - Rosario Colella Bisogno
- Azienda Ospedaliera Universitaria OO. RR. San Giovanni di Dio e Ruggi D’Aragona, Medicina Trasfusionale, 84131 Salerno, Italy;
| | - Carlo Gaudiano
- P.O. Madonna delle Grazie, Centro per la Lotta Contro le Microcitemie, ASL 4, 75100 Matera, Italy;
| | - Giuseppe Manco
- Institute of Biochemistry and Cell Biology (IBBC, CNR), National Research Council, 80131 Naples, Italy;
| | - Giuseppina Lacerra
- Institute of Genetics and Biophysics “Adriano Buzzati Traverso”, (IGB-ABT, CNR), National Research Council, 80131 Naples, Italy; (G.C.); (G.M.)
- Correspondence:
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Yingjun X, Yuhuan X, Yuchang C, Dongzhi L, Ding W, Bing S, Yi Y, Dian L, Yanting X, Zeyu X, Nengqing L, Diyu C, Xiaofang S. CRISPR/Cas9 gene correction of HbH-CS thalassemia-induced pluripotent stem cells. Ann Hematol 2019; 98:2661-2671. [PMID: 31495903 DOI: 10.1007/s00277-019-03763-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 07/20/2019] [Indexed: 11/25/2022]
Abstract
Haemoglobin (Hb) H-constant spring (CS) alpha thalassaemia (- -/-αCS) is the most common type of nondeletional Hb H disease in southern China. The CRISPR/Cas9-based gene correction of patient-specific induced pluripotent stem cells (iPSCs) and cell transplantation now represent a therapeutic solution for this genetic disease. We designed primers for the target sites using CRISPR/Cas9 to specifically edit the HBA2 gene with an Hb-CS mutation. After applying a correction-specific PCR assay to purify the corrected clones followed by sequencing to confirm the mutation correction, we verified that the purified clones retained full pluripotency and exhibited a normal karyotype. This strategy may be promising in the future, although it is far from representing a solution for the treatment of HbH-CS thalassemia now.
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Affiliation(s)
- Xie Yingjun
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Xie Yuhuan
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Chen Yuchang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Li Dongzhi
- Prenatal Diagnostic Centre, Guangzhou Women and Children Medical Centre affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wang Ding
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Song Bing
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Yang Yi
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Lu Dian
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Xue Yanting
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Xiong Zeyu
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Liu Nengqing
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Chen Diyu
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China
| | - Sun Xiaofang
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510080, China.
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Zaidi MH, Fryer D, Barr C, Watson HG. Haemoglobin Titusville: low oxygen saturations but is the patient hypoxaemic? QJM 2018; 111:893-894. [PMID: 30202934 DOI: 10.1093/qjmed/hcy202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- M H Zaidi
- Department of Haematology, Aberdeen Royal Infirmary, Foresterhill Campus, Aberdeen, UK
| | - D Fryer
- Department of Medicine, Gilbert Bain Hospital, Shetland, UK
| | - C Barr
- Department of Anaesthetics, Gilbert Bain Hospital, Shetland, UK
| | - H G Watson
- Department of Haematology, Aberdeen Royal Infirmary, Foresterhill Campus, Aberdeen, UK
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King AJ, Higgs DR. Potential new approaches to the management of the Hb Bart's hydrops fetalis syndrome: the most severe form of α-thalassemia. Hematology Am Soc Hematol Educ Program 2018; 2018:353-360. [PMID: 30504332 PMCID: PMC6246003 DOI: 10.1182/asheducation-2018.1.353] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The α-thalassemia trait, associated with deletions removing both α-globin genes from 1 chromosome (genotype ζ αα/ζ--), is common throughout Southeast Asia. Consequently, many pregnancies in couples of Southeast Asian origin carry a 1 in 4 risk of producing a fetus inheriting no functional α-globin genes (ζ--/ζ--), leading to hemoglobin (Hb) Bart's hydrops fetalis syndrome (BHFS). Expression of the embryonic α-globin genes (ζ-globin) is normally limited to the early stages of primitive erythropoiesis, and so when the ζ-globin genes are silenced, at ∼6 weeks of gestation, there should be no α-like globin chains to pair with the fetal γ-globin chains of Hb, which consequently form nonfunctional tetramers (γ4) known as Hb Bart's. When deletions leave the ζ-globin gene intact, a low level of ζ-globin gene expression continues in definitive erythroid cells, producing small amounts of Hb Portland (ζ2γ2), a functional form of Hb that allows the fetus to survive up to the second or third trimester. Untreated, all affected individuals die at these stages of development. Prevention is therefore of paramount importance. With improvements in early diagnosis, intrauterine transfusion, and advanced perinatal care, there are now a small number of individuals with BHFS who have survived, with variable outcomes. A deeper understanding of the mechanism underlying the switch from ζ- to α-globin expression could enable persistence or reactivation of embryonic globin synthesis in definitive cells, thereby providing new therapeutic options for such patients.
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Affiliation(s)
- Andrew J King
- Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Douglas R Higgs
- Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom
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Brugger S, Santafé-Marti MD, Lakhal M. Low SpO2 With Normal SaO2 During General Anesthesia: A Case Report. A A Case Rep 2017; 9:197-198. [PMID: 28542050 DOI: 10.1213/xaa.0000000000000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 25-year-old Caucasian man with a history of spherocytosis, splenectomy, recurrent blood transfusion, and no cardiopulmonary disease presented for an emergent laparoscopic cholecystectomy with a baseline pulse oximetric saturation (SpO2) of 88% while breathing room air. The SpO2 increased to only 89% during preoxygenation with an FIO2 1.0. Multiple arterial blood samples revealed SaO2 as high as 100% with PaO2 averaging 390 mm Hg. He was subsequently diagnosed with a dyshemoglobin, hemoglobin Köln. The simultaneous presentation of a stable patient from a cardiopulmonary perspective with normal arterial oxygen tension and saturation in the blood gas analyses despite a low SpO2 measurement outlines the importance of integrating the history of present illness and both the importance and the limitation of the pulse oximetry.
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Affiliation(s)
- Stefan Brugger
- From the University Heart Center Freiburg, Freiburg, Germany
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Ling L, Chen H, Liu C, Chen S, Jin Y, Zhou J. Capillarys 2 Flex Piercing Detected a Rare Case of Hb Broomhill. Ann Clin Lab Sci 2017; 47:625-627. [PMID: 29066493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report a case of an extremely rare hemoglobin (Hb) variant-Hb Broomhill, which has been only reported once in the literature. Hemoglobin fractions were determined by capillary electrophoresis (Sebia Capillarys 2 Flex piercing) and high performance liquid chromatography (HPLC) (Bio-Rad Variant™ II Hemoglobin Testing System), respectively. Complete blood count and DNA sequencing were also performed. The capillary electrophoregram revealed a tiny shoulder peak before the HbA peak and a subtle abnormal HbA2 peak (slightly wider and lower), even though the percentage of each hemoglobin fraction was within the reference range (HbA, 97.4%; HbA2, 2.6%). On HPLC, not only the percentage but also the peak shape of each hemoglobin fraction was normal (HbA 88.2%, HbA2 2.5%, HbF 0.6%). Eventually, sequencing analysis of α genes confirmed a missense mutation (CCC>GCC at codon 114 in alpha1 gene) which caused Hb Broomhill variant. Our report suggest that capillary electrophoresis may be an accurate tool for screening and diagnosis of Hb disorders.
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Affiliation(s)
- Liqin Ling
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Hao Chen
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Chaonan Liu
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Si Chen
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu, P.R. China
| | - YaXiong Jin
- Department of Laboratory medicine, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Jing Zhou
- Department of Laboratory medicine, West China Hospital, Sichuan University, Chengdu, P.R. China
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Abstract
Congenital erythrocytosis (CE) is a rare and heterogeneous disease. The high oxygen affinity hemoglobin (Hb) variants are the most common cause of CE. Herein, we report a Korean patient with isolated erythrocytosis. A 25-year-old man was referred to our hospital for evaluation of high Hb level (Hb 20.4 g/dL, hematocrit 58%, reticulocyte count 2.90%, white blood cell count 6.83×10⁹/L, and platelet count 195×10⁹/L). Bone marrow biopsy revealed normocellular marrow without myeloproliferative features. JAK2 (V617F, exon 12), CALR (exon 9), and MPL W515K/L mutations were not detected. P₅₀ (partial pressure at which Hb is half saturated with oxygen), which is an indicator of left-shift of oxygen dissociation curve (high oxygen affinity state), was 14.3 mm Hg (reference value 22.6-29.4 mm Hg). He was suspected to have CE. Mutation analysis of the HBB gene revealed the known Hb variant, Hb Heathrow [β103(G5)Phe→Leu]. This is the first report of Hb Heathrow in Asian.
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Affiliation(s)
- Sang Yong Shin
- Department of Laboratory Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Hyun Young Kim
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jin Kim
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Hoon Gu Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
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Alauddin H, Langa M, Mohd Yusoff M, Raja Sabudin RZA, Ithnin A, Abdul Razak NF, Sardi NH, Hussin NH. Detection of α-thalassaemia in neonates on cord blood and dried blood spot samples by capillary electrophoresis. Malays J Pathol 2017; 39:17-23. [PMID: 28413201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Haemoglobin Bart's (Hb Bart's) level is associated with α-thalassaemia traits in neonates, enabling early diagnosis of α-thalassaemia. The study aimed to detect and quantify the Hb Bart's using Cord Blood (CB) and CE Neonat Fast Hb (NF) progammes on fresh and dried blood spot (DBS) specimen respectively by capillary electrophoresis (CE). METHODS Capillarys Hemoglobin (E) Kit (for CB) and Capillarys Neonat Hb Kit (for NF) were used to detect and quantify Hb Bart's by CE in fresh cord blood and dried blood spot (DBS) specimens respectively. High performance liquid chromatography (HPLC) using the β-Thal Short Programme was also performed concurrently with CE analysis. Confirmation was obtained by multiplex ARMS Gap PCR. RESULTS This study was performed on 600 neonates. 32/600 (5.3%) samples showed presence of Hb Bart's peak using the NF programme while 33/600 (5.5%) were positive with CB programme and HPLC methods. The range of Hb Bart's using NF programme and CB programme were (0.5-4.1%) and (0.5-7.1%), respectively. Molecular analysis confirmed all positive samples possessed α-thalassaemia genetic mutations, with 23/33 cases being αα/--SEA, four -α3.7/-α3.7, two αα/-α3.7 and three αα/ααCS. Fifty Hb Bart's negative samples were randomly tested for α-genotypes, three were also found to be positive for α-globin gene mutations. Thus, resulting in sensitivity of 91.7% and 88.9% and specificity of 100% for the Capillarys Cord Blood programme and Capillarys Neonat Fast programme respectively. CONCLUSION Both CE programmes using fresh or dried cord blood were useful as a screening tool for α-thalassaemia in newborns. All methods show the same specificity (100%) with variable, but acceptable sensitivities in the detection of Hb Bart.
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Affiliation(s)
- H Alauddin
- UKM Medical Center, Faculty of Medicine, Department of Pathology, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia.
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Diamantis P, Unke OT, Meuwly M. Migration of small ligands in globins: Xe diffusion in truncated hemoglobin N. PLoS Comput Biol 2017; 13:e1005450. [PMID: 28358830 PMCID: PMC5391117 DOI: 10.1371/journal.pcbi.1005450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 04/13/2017] [Accepted: 03/13/2017] [Indexed: 11/18/2022] Open
Abstract
In heme proteins, the efficient transport of ligands such as NO or O2 to the binding site is achieved via ligand migration networks. A quantitative assessment of ligand diffusion in these networks is thus essential for a better understanding of the function of these proteins. For this, Xe migration in truncated hemoglobin N (trHbN) of Mycobacterium Tuberculosis was studied using molecular dynamics simulations. Transitions between pockets of the migration network and intra-pocket relaxation occur on similar time scales (10 ps and 20 ps), consistent with low free energy barriers (1-2 kcal/mol). Depending on the pocket from where Xe enters a particular transition, the conformation of the side chains lining the transition region differs which highlights the coupling between ligand and protein degrees of freedom. Furthermore, comparison of transition probabilities shows that Xe migration in trHbN is a non-Markovian process. Memory effects arise due to protein rearrangements and coupled dynamics as Xe moves through it. Binding and transport of ligands in proteins is essential, in particular in globular proteins which often exhibit internal cavities. In truncated Hemoglobin N (trHbN) these cavities are arranged as a network with particular connectivities. The present work supports the notion that ligand diffusion in trHbN is an active process and coupled to the protein dynamics. Furthermore, transition probabilities between neighboring pockets depend on the location from where the ligand entered the transition, which is typical for non-Markovian processes. Hence, ligand migration in trHbN exhibits memory effects due to dynamical coupling between the protein and ligand motion.
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Affiliation(s)
| | - Oliver T. Unke
- Department of Chemistry, University of Basel, Basel, Switzerland
| | - Markus Meuwly
- Department of Chemistry, University of Basel, Basel, Switzerland
- * E-mail:
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Manning LR, Popowicz AM, Padovan JC, Chait BT, Manning JM. Gel filtration of dilute human embryonic hemoglobins reveals basis for their increased oxygen binding. Anal Biochem 2017; 519:38-41. [PMID: 27965062 PMCID: PMC5237603 DOI: 10.1016/j.ab.2016.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/08/2016] [Accepted: 12/09/2016] [Indexed: 02/05/2023]
Abstract
This report establishes a correlation between two known properties of the human embryonic hemoglobins-- their weak subunit assemblies as demonstrated here by gel filtration at very dilute protein concentrations and their high oxygen affinities and reduced cooperativities reported previously by others but without a mechanistic basis. We demonstrate here that their high oxygen affinities are a consequence of their weak assemblies. Weak vs strong hemoglobin tetramers represent a regulatory mechanism to modulate oxygen binding capacity by altering the equilibrium between the various steps in the assembly process that can be described as an inverse allosteric effect.
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Affiliation(s)
- Lois R Manning
- Department of Biology, Northeastern University, Boston, MA 02115, USA
| | - Anthony M Popowicz
- Information Technology, The Rockefeller University, New York, NY 10065, USA
| | - Julio C Padovan
- Laboratory for Mass Spectrometry and Gaseous Ion Chemistry, The Rockefeller University, New York, NY 10065, USA
| | - Brian T Chait
- Laboratory for Mass Spectrometry and Gaseous Ion Chemistry, The Rockefeller University, New York, NY 10065, USA
| | - James M Manning
- Department of Biology, Northeastern University, Boston, MA 02115, USA.
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Ambelil M, Nguyen N, Dasgupta A, Risin S, Wahed A. Hemoglobin Wayne Trait with Incidental Polycythemia. Ann Clin Lab Sci 2017; 47:96-98. [PMID: 28249925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Hemoglobinopathies, caused by mutations in the globin genes, are one of the most common inherited disorders. Many of the hemoglobin variants can be identified by hemoglobin analysis using conventional electrophoresis and high performance liquid chromatography; however hemoglobin DNA analysis may be necessary in other cases for confirmation. Here, we report a case of a rare alpha chain hemoglobin variant, hemoglobin Wayne, in a 47-year-old man who presented with secondary polycythemia. Capillary zone electrophoresis and high performance liquid chromatography revealed a significant amount of a hemoglobin variant, which was further confirmed by hemoglobin DNA sequencing as hemoglobin Wayne. Since the patient was not homozygous for hemoglobin Wayne, which is associated with secondary polycythemia, the laboratory diagnosis in this case was critical in ruling out hemoglobinopathy as the etiology of his polycythemia.
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Affiliation(s)
- Manju Ambelil
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, TX, USA
| | - Nghia Nguyen
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, TX, USA
| | - Amitava Dasgupta
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, TX, USA
| | - Semyon Risin
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, TX, USA
| | - Amer Wahed
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, TX, USA
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Martínez-López R, Ropero P, Ballesteros Gallar C, Romero Román C, de la Fuente-Gonzalo F, M Nieto J, Navarro Casado L, González FA. Hemoglobin Le Lamentin in the province of Albacete, Spain: Discovery of 32 cases. Clin Biochem 2016; 50:217-222. [PMID: 27823958 DOI: 10.1016/j.clinbiochem.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Hemoglobin Le Lamentin (α20(B1)His→Gln) is a ubiquitous variant that has been previously described in a small number of isolated patients. We report the incidental observation of Hb Le Lamentin in a large population from the province of Albacete, in southeastern Spain. Our study investigates possible reasons for the elevated number of carriers of this variant and its implications for the management of diabetes in our region. DESIGN & METHODS The subjects are 32 diabetic patients whose hemoglobin displayed an unusual peak while they were being tested for glycated hemoglobin at the laboratory of the University General Hospital of Albacete over a 3-year period. Measurements were made by high performance liquid chromatography using a Variant™ II Turbo Kit-2.0, and subsequently the samples of the 32 patients with anomalous peaks were sent to the Hospital Clínico San Carlos (Madrid, Spain) for molecular characterization of any Hb variants. RESULTS Molecular studies revealed 31 out of 32 patients heterozygous for Le Lamentin, and in one of them, Hb City of Hope was associated with Hb Le Lamentin. The remaining patient was homozygous for the Le Lamentin mutation. Additionally, most patients were native to the northeastern half of the province of Albacete and were unrelated. CONCLUSIONS Our study describes the largest finding to date of hemoglobin Le Lamentin in a sample of patients. The fact that our region has been perpetually depopulated, with a population that has remained stable in small localities over the centuries, may have favored the survival of the mutation. Since the presence of this variant underestimates the true value of glycated hemoglobin measured by HPLC, it is necessary to systematically review chromatograms.
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Affiliation(s)
| | - Paloma Ropero
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Carlos Romero Román
- Servicio de Análisis Clínicos, Hospital General Universitario de Albacete, Albacete, Spain
| | | | - Jorge M Nieto
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
| | - Laura Navarro Casado
- Servicio de Análisis Clínicos, Hospital General Universitario de Albacete, Albacete, Spain
| | - Fernando A González
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
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Koga M, Inada S, Miyazaki A. Identification of the Presence of Variant Hemoglobin Using a Measurement of the Labile HbA1c (#C) Fraction. Ann Clin Lab Sci 2016; 46:387-392. [PMID: 27466298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Labile HbA1c migrates in the #C fraction together with modified hemoglobin (such as carbamylated hemoglobin, acetaldehyde hemoglobin, and acetylated hemoglobin) when HbA1c is measured by Arkray's high-performance liquid chromatography (HPLC). It is assumed that most of the labile glycation products of variant hemoglobin do not migrate in #C fraction; in addition, a part of the stable glycation products of variant hemoglobin migrates in #C fraction. We hypothesized that subjects with variant hemoglobin are likely to show abnormally low or high values of #C fraction. In this study, we investigated this hypothesis. Twenty-one non-diabetic subjects with nine types of variant hemoglobin, and 103 non-diabetic subjects without variant hemoglobin were used. HbA1c and #C fraction were measured by Arkray's HPLC (HA-8180) using standard mode. The values of #C fraction in the control group were 1.75 ± 0.15% (range: 1.5-2.1%). The variant hemoglobin group reported #C fraction values of ≤1.3% in twelve subjects, ≥2.3% in five subjects, and within the reference range (1.4-2.2%) in three subjects. When the cutoff values of #C fraction were set at ≤1.3% and ≥2.3%, sensitivity and specificity were 86% and 100%, respectively. Most non-diabetic subjects with variant hemoglobin showed abnormal values of #C fraction. Measurement of #C fraction is a useful screening test for variant hemoglobin in non-diabetic subjects.
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Affiliation(s)
- Masafumi Koga
- Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Japan
| | - Shinya Inada
- Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Japan
| | - Ayako Miyazaki
- Department of Clinical Laboratory Medicine, Hyogo Medical College, Nishinomiya, Japan
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Son R, Higuchi T, Mizuno A, Koyamada R, Okada S, Yamashiro Y. A Newly Characterized Hemoglobin Variant with a High Oxygen Affinity, Hb Fuchu-II, Presenting with Acute Myocardial Infarction. Intern Med 2016; 55:285-7. [PMID: 26831025 DOI: 10.2169/internalmedicine.55.5311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 65-year-old Japanese man presented with acute myocardial infarction (AMI) and polycythemia. Biochemical studies of the patient's hemoglobin (Hb) and the sequencing of his globin genes revealed that the polycythemia was secondary to a high oxygen affinity Hb variant, Hb Fuchu-II. Hb variants with high oxygen affinity can be an additional thrombotic risk factor in older patients and/or those with other risk factors. The patient was diagnosed with hemoglobinopathy after the development of AMI and exemplifies the importance of recognizing such conditions and of taking appropriate prophylactic interventions.
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Affiliation(s)
- Raku Son
- Internal Medicine, St. Luke's International Hospital, Japan
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Brenan CJH. The Genie Is Out of the Bottle. IEEE Pulse 2015; 6:3. [PMID: 26394455 DOI: 10.1109/mpul.2015.2432991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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18
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Benítez IC, Lameiro PC, Ropero P, De la Osa JJL, Fernández FG, Ortiz AM. Hemoglobin Valme HBB:c.124T>G: a new hemoglobin variant with diminished oxygen affinity causes interference in hemoglobin A1c measurement in an automated ion-exchange HPLC method. Clin Chem Lab Med 2015; 53:e211-3. [PMID: 25781690 DOI: 10.1515/cclm-2014-1028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 02/19/2015] [Indexed: 11/15/2022]
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Singha K, Fucharoen G, Fucharoen S. Interaction of Hb Grey Lynn (Vientiane) [α91(FG3)Leu>Phe (α1)] with Hb E [β26(B8) Glu>Lys] and α(+)-thalassemia: Molecular and Hematological Analysis. Clin Lab 2015; 61:631-5. [PMID: 26118199 DOI: 10.7754/clin.lab.2014.141112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hemoglobin (Hb) Grey Lynn is a Hb variant caused by a mutation at codon 91 of α1-globin gene whereas Hb E is a common β-globin chain variant among Southeast Asian population. We report two hitherto undescribed conditions of Hb Grey Lynn found in Thai individuals. METHODS The study was done on two unrelated Thai subjects. Hematological parameters were recorded and Hb analysis was carried out using automated Hb analyzers. Mutations were identified by DNA analysis. Hematological features of the patients were compared with those of various forms of Hb Grey Lynn documented previously. RESULTS Hb and DNA analyses identified a heterozygous Hb Grey Lynn in one patient and a double heterozygous Hb Grey Lynn and Hb E with α(+)-thalassemia in another. Interaction of α(Grey Lynn) with β(E) chains leads to the formation of a new Hb variant, namely the Hb Grey Lynn E (α(GL)2β(E)2), detectable by liquid chromatography (10.3%) but masked by Hb E on capillary electrophoresis. CONCLUSIONS Interaction of these multiple globin gene defects could lead to complex hemoglobinopathies requiring combined analysis with multiple Hb analyzers followed by DNA testing to provide accurate diagnosis of the cases.
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Touhami I, Le Gallais D, Perrey S, Bibi A, Koubaa D, Mankai R, Bartagi Z, Messaoud T, Fattoum S. Impaired oxygen uptake kinetics in the first high-level athlete with Hb Hope: a case study. J Sports Med Phys Fitness 2015; 55:544-548. [PMID: 24947919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Hemoglobin (Hb) Hope is a beta-globin chain variant with reduced oxygen (O₂) affinity, known to induce anemia. This usually leads to limitations in O₂uptake (VO₂) and exercise tolerance. We studied the case of a high-level female athlete with Hb Hope. She had been selected for cross-country races from 13 yrs onward, then was a national junior champion in 400-m race, and finally failed to win any cross-country races as an adult. Hematological analysis revealed normal red blood cell indices and Hb level (12.3 g.dL⁻¹). Incremental exercise showed peak work rate (WR), VO(2max) and gas exchange threshold (GET) within normal ranges for healthy females. Constant WR testing at 90% of GET showed that kinetics of pulmonary VO₂included the presence of a slow component. This was in disagreement with the data on VO₂kinetics response to exercise intensities below GET. Phase 2 parameters, time constant (τ2, 31 s), time delay (TD2, 39 s), amplitude (A2, 780 ml.min⁻¹), and gain in VO₂(ΔVO₂ .ΔWR-1, 9.2 ml.min-1.W⁻¹) were within normal ranges. Phase 3 showed a slow component similar to that reported in severe exercise. The absence of anemia and the normality of phase 2 suggested normal O₂delivery and oxidative metabolism in exercising muscles. In contrast, phase 3 suggested poor aerobic capacity and limited exercise tolerance. However, the lack of symptoms during testing also suggested that the slow component was due to the specific recruitment of fast-twitch fibers in this former champion athlete with Hb Hope in races requiring mainly anaerobic metabolism.
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Affiliation(s)
- I Touhami
- EA 2992 Dynamics of Cardiovascular Incoherencies, Montpellier 1 University, Montpellier, France -
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Duvelleroy MA, Martin JL, Teisseire B, Gauduel Y, Duruble M. Abnormal hemoglobin oxygen affinity and the coronary circulation. Bibl Haematol 2015:70-7. [PMID: 7378040 DOI: 10.1159/000430549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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23
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Bisconte MG, Caldora M, Musollino G, Cardiero G, Flagiello A, La Porta G, Lagona L, Prezioso R, Qualtieri G, Gaudiano C, Medulla E, Merlino A, Pucci P, Lacerra G. α-Thalassemia associated with hb instability: a tale of two features. the case of Hb Rogliano or α1 Cod 108(G15)Thr→Asn and Hb Policoro or α2 Cod 124(H7)Ser→Pro. PLoS One 2015; 10:e0115738. [PMID: 25730315 PMCID: PMC4346585 DOI: 10.1371/journal.pone.0115738] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 12/01/2014] [Indexed: 11/28/2022] Open
Abstract
We identified two new variants in the third exon of the α-globin gene in families from southern Italy: the Hb Rogliano, α1 cod108 ACC>AAC or α1[α108(G15)Thr→Asn] and the Hb Policoro, α2 cod124 TCC>CCC or α2[α124(H7)Ser→Pro]. The carriers showed mild α-thalassemia phenotype and abnormal hemoglobin stability features. These mutations occurred in the G and H helices of the α-globin both involved in the specific recognition of AHSP and β1 chain. Molecular characterization of mRNA, globin chain analyses and molecular modelling studies were carried out to highlight the mechanisms causing the α-thalassemia phenotype. The results demonstrated that the α-thalassemia defect associated with the two Hb variants originated by different defects. Hb Rogliano showed an intrinsic instability of the tetramer due to anomalous intra- and inter-chain interactions suggesting that the variant chain is normally synthesized and complexed with AHSP but rapidly degraded because it is unable to form the α1β1 dimers. On the contrary in the case of Hb Policoro two different molecular mechanisms were shown: the reduction of the variant mRNA level by an unclear mechanism and the protein instability due to impairment of AHSP interaction. These data highlighted that multiple approaches, including mRNA quantification, are needed to properly identify the mechanisms leading to the α-thalassemia defect. Elucidation of the specific mechanism leads to the definition of a given phenotype providing important guidance for the diagnosis of unstable variants.
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Affiliation(s)
- Maria Grazia Bisconte
- U.O.S. Microcitemia e patologia del globulo rosso, O.O.C. Ematologia A.O. Cosenza, Italy
| | - Mercedes Caldora
- Laboratorio Specialistico di Ematologia, P.O. San Giovanni Bosco A.S.L. NA1, Napoli, Italy
| | - Gennaro Musollino
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
| | - Giovanna Cardiero
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
| | - Angela Flagiello
- Dipartimento di Scienze Chimiche and Ceinge Biotecnologie Avanzate, Università degli Studi “Federico II”, Napoli, Italy
| | - Gaetana La Porta
- U.O.S. Microcitemia e patologia del globulo rosso, O.O.C. Ematologia A.O. Cosenza, Italy
| | - Laura Lagona
- U.O.D. di Thalassemia, ARNAS “Garibaldi”, Catania, Italy
| | - Romeo Prezioso
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
| | - Gabriele Qualtieri
- U.O.S. Microcitemia e patologia del globulo rosso, O.O.C. Ematologia A.O. Cosenza, Italy
| | - Carlo Gaudiano
- Ospedale Civile, Centro per la lotta contro le Microcitemie, Matera, Italy
| | - Emilia Medulla
- U.O.D. di Thalassemia, ARNAS “Garibaldi”, Catania, Italy
| | - Antonello Merlino
- Dipartimento di Scienze Chimiche, Università degli Studi “Federico II” and Istituto di Biostrutture e Bioimmagini, CNR Napoli, Italy
| | - Piero Pucci
- Dipartimento di Scienze Chimiche and Ceinge Biotecnologie Avanzate, Università degli Studi “Federico II”, Napoli, Italy
| | - Giuseppina Lacerra
- Istituto di Genetica e Biofisica “Adriano Buzzati-Traverso”- Consiglio Nazionale delle Ricerche (CNR), Napoli, Italy
- * E-mail:
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Shemer OS, Tamary H. Think about hemoglobinopathies. Isr Med Assoc J 2014; 16:785-786. [PMID: 25630210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Fujiwara T, Okamoto K, Niikuni R, Takahashi K, Okitsu Y, Fukuhara N, Onishi Y, Ishizawa K, Ichinohasama R, Nakamura Y, Nakajima M, Tanaka T, Harigae H. Effect of 5-aminolevulinic acid on erythropoiesis: a preclinical in vitro characterization for the treatment of congenital sideroblastic anemia. Biochem Biophys Res Commun 2014; 454:102-8. [PMID: 25450364 DOI: 10.1016/j.bbrc.2014.10.050] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 10/10/2014] [Indexed: 01/19/2023]
Abstract
Congenital sideroblastic anemia (CSA) is a hereditary disorder characterized by microcytic anemia and bone marrow sideroblasts. The most common form of CSA is attributed to mutations in the X-linked gene 5-aminolevulinic acid synthase 2 (ALAS2). ALAS2 is a mitochondrial enzyme, which utilizes glycine and succinyl-CoA to form 5-aminolevulinic acid (ALA), a crucial precursor in heme synthesis. Therefore, ALA supplementation could be an effective therapeutic strategy to restore heme synthesis in CSA caused by ALAS2 defects. In a preclinical study, we examined the effects of ALA in human erythroid cells, including K562 cells and human induced pluripotent stem cell-derived erythroid progenitor (HiDEP) cells. ALA treatment resulted in significant dose-dependent accumulation of heme in the K562 cell line. Concomitantly, the treatment substantially induced erythroid differentiation as assessed using benzidine staining. Quantitative reverse transcription polymerase chain reaction (RT-PCR) analysis confirmed significant upregulation of heme-regulated genes, such as the globin genes [hemoglobin alpha (HBA) and hemoglobin gamma (HBG)] and the heme oxygenase 1 (HMOX1) gene, in K562 cells. Next, to investigate the mechanism by which ALA is transported into erythroid cells, quantitative RT-PCR analysis was performed on previously identified ALA transporters, including solute carrier family 15 (oligopeptide transporter), member (SLC15A) 1, SLC15A2, solute carrier family 36 (proton/amino acid symporter), member (SLC36A1), and solute carrier family 6 (neurotransmitter transporter), member 13 (SLC6A13). Our analysis revealed that SLC36A1 was abundantly expressed in erythroid cells. Thus, gamma-aminobutyric acid (GABA) was added to K562 cells to competitively inhibit SLC36A1-mediated transport. GABA treatment significantly impeded the ALA-mediated increase in the number of hemoglobinized cells as well as the induction of HBG, HBA, and HMOX1. Finally, small-interfering RNA-mediated knockdown of ALAS2 in HiDEP cells considerably decreased the expression of HBA, HBG, and HMOX1, and these expression levels were rescued with ALA treatment. In summary, ALA appears to be transported into erythroid cells mainly by SLC36A1 and is utilized to generate heme. ALA may represent a novel therapeutic option for CSA treatment, particularly for cases harboring ALAS2 mutations.
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Affiliation(s)
- Tohru Fujiwara
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan; Department of Molecular Hematology/Oncology, Tohoku University Graduate School, Sendai, Japan
| | - Koji Okamoto
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Ryoyu Niikuni
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | | | - Yoko Okitsu
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Yasushi Onishi
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan
| | - Kenichi Ishizawa
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan; Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | - Ryo Ichinohasama
- Department of Hematopathology, Tohoku University Graduate School, Sendai, Japan
| | - Yukio Nakamura
- Cell Engineering Division, RIKEN BioResource Center, Tsukuba, Ibaraki, Japan
| | | | | | - Hideo Harigae
- Department of Hematology and Rheumatology, Tohoku University Graduate School, Sendai, Japan; Department of Molecular Hematology/Oncology, Tohoku University Graduate School, Sendai, Japan.
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Basak J, Bhattacharyya DM, Mukhopadhyay A. Fannin-Lubbock-I [α₂β₂¹¹⁹(GLY>ASP)], a rare mutation in the beta-globin gene, has been detected for the first time in a Hindu Brahmin family in West Bengal, India. Cell Mol Biol Lett 2014; 19:277-83. [PMID: 24802353 PMCID: PMC6275635 DOI: 10.2478/s11658-014-0192-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 04/04/2014] [Indexed: 11/25/2022] Open
Abstract
This study aims to describe the hemoglobin Fannin-Lubbock-I, which has a rare mutation substituting the amino acid glycine with aspartic acid at codon 119 of the β-globin chain. A Bengalee Hindu Brahmin family from Kolkata in West Bengal was the focus of this study. Molecular analysis using ARMS-PCR and direct DNA sequencing revealed the presence of a GGC > GAC mutation in codon 119 of the β-globin gene in a heterozygote state in three women of the same family. This is the first report of the hemoglobin Fannin-Lubbock-I from India. Our results will help to identify this mutation, which is relatively infrequent in our population.
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Affiliation(s)
- Jayasri Basak
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute (NCRI), 16A Park Lane, Kolkata, 700016 India
| | - Deboshree M. Bhattacharyya
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute (NCRI), 16A Park Lane, Kolkata, 700016 India
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Kotila TR. Beta thalassaemia in Nigeria: myth or fact? Afr J Med Med Sci 2013; 42:355-358. [PMID: 24839740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The high prevalence of sickle cell disorders and the mild deletional alpha-thalassaemia among Nigerians is well known, but beta-thalassaemia is believed to be almost nonexistent. Beta thalassaemia trait (BTT) was screened for in patients with unexplained recurrent haemolytic anaemia and healthy individuals. METHODS beta-thalassaemia trait (BTT) was screened for using MCH and HbA2 of 27 pg and 3.5% respectively as cut off in 151 Nigerians which included 29 patients and 122 apparently healthy individuals. The subjects were categorized into four, Group I (high HbA2, low MCH), Group II (low HbA2 and MCH), Group III (high HbA2 and high/normal MCH) and Group IV (normal HbA2 and MCH). RESULTS Group I are possible carriers of BTT while group IV are least likely to carry either alpha or beta thalassaemia genes. There were 36 (26%), 39 (28%), 27 (19%) and 38 (27%) in groups I-IV respectively. The mean MCH, MCV, haematocrit and HbA2 for the study population were 26 +/-2.8, 81 +/- 7.9, 37.5 +/- 6.8 and 3.4 +/- 1.7 respectively. The mean MCV and haematocrit were significantly lower for group I compared to group IV (76.9 Vs 86.6, p = 0.00) and (36.5Vs39.7, p = 0.03) respectively. Group II had significantly lower MCV and haematocrit than group IV (75.4 (p = 0.00) and 36.4 (p = 0.01) respectively. There was a positive correlation between the MCH and MCV with the haematocrit (p = 0.004, p = 0.001 respectively) but HbA2 showed a stronger negative correlation with the haematocrit (p < 0.0001). CONCLUSION This does not only show the presence of BTT, but a higher prevalence than previously thought, mutations responsible for it should therefore be characterized.
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Taliercio RM, Ashton RW, Horwitz L, Swanson KC, Wendt PC, Hoyer JD, Oliveira JL. Hb Grove City [β38(C4)Thr→Ser, ACC>AGC;HBB: c.116C>G]: A New Low Oxygen Affinity β Chain Variant. Hemoglobin 2013; 37:396-403. [PMID: 23651408 DOI: 10.3109/03630269.2013.789794] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Liao C, Li DZ. A protocol for screening of aneuploidy in pregnancies at risk for α-thalassemia. J Matern Fetal Neonatal Med 2013; 26:731-2. [PMID: 23311911 DOI: 10.3109/14767058.2013.765853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Piehler AP, Grimholt RM, Bjerner J, Urdal P, Buchmann M. Discrepancy between HbA1c and fasting glucose results due to HbD. Scand J Clin Lab Invest 2012. [PMID: 23198773 DOI: 10.3109/00365513.2012.744089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Grispo MT, Natarajan C, Projecto-Garcia J, Moriyama H, Weber RE, Storz JF. Gene duplication and the evolution of hemoglobin isoform differentiation in birds. J Biol Chem 2012; 287:37647-58. [PMID: 22962007 PMCID: PMC3488042 DOI: 10.1074/jbc.m112.375600] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 09/06/2012] [Indexed: 11/06/2022] Open
Abstract
The majority of bird species co-express two functionally distinct hemoglobin (Hb) isoforms in definitive erythrocytes as follows: HbA (the major adult Hb isoform, with α-chain subunits encoded by the α(A)-globin gene) and HbD (the minor adult Hb isoform, with α-chain subunits encoded by the α(D)-globin gene). The α(D)-globin gene originated via tandem duplication of an embryonic α-like globin gene in the stem lineage of tetrapod vertebrates, which suggests the possibility that functional differentiation between the HbA and HbD isoforms may be attributable to a retained ancestral character state in HbD that harkens back to a primordial, embryonic function. To investigate this possibility, we conducted a combined analysis of protein biochemistry and sequence evolution to characterize the structural and functional basis of Hb isoform differentiation in birds. Functional experiments involving purified HbA and HbD isoforms from 11 different bird species revealed that HbD is characterized by a consistently higher O(2) affinity in the presence of allosteric effectors such as organic phosphates and Cl(-) ions. In the case of both HbA and HbD, analyses of oxygenation properties under the two-state Monod-Wyman-Changeux allosteric model revealed that the pH dependence of Hb-O(2) affinity stems primarily from changes in the O(2) association constant of deoxy (T-state)-Hb. Ancestral sequence reconstructions revealed that the amino acid substitutions that distinguish the adult-expressed Hb isoforms are not attributable to the retention of an ancestral (pre-duplication) character state in the α(D)-globin gene that is shared with the embryonic α-like globin gene.
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MESH Headings
- Algorithms
- Amino Acid Sequence
- Animals
- Binding Sites/genetics
- Binding, Competitive
- Birds/blood
- Birds/classification
- Birds/genetics
- Cloning, Molecular
- Evolution, Molecular
- Gene Duplication
- Genetic Variation
- Hemoglobin A/chemistry
- Hemoglobin A/genetics
- Hemoglobin A/metabolism
- Hemoglobins/chemistry
- Hemoglobins/genetics
- Hemoglobins/metabolism
- Hemoglobins, Abnormal/chemistry
- Hemoglobins, Abnormal/genetics
- Hemoglobins, Abnormal/metabolism
- Kinetics
- Models, Molecular
- Molecular Sequence Data
- Oxygen/chemistry
- Oxygen/metabolism
- Protein Binding
- Protein Isoforms/chemistry
- Protein Isoforms/genetics
- Protein Isoforms/metabolism
- Protein Structure, Tertiary
- Sequence Analysis, DNA
- Sequence Homology, Amino Acid
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Affiliation(s)
- Michael T. Grispo
- From the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska 68588 and
| | | | - Joana Projecto-Garcia
- From the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska 68588 and
| | - Hideaki Moriyama
- From the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska 68588 and
| | - Roy E. Weber
- Zoophysiology, Institute for Bioscience, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Jay F. Storz
- From the School of Biological Sciences, University of Nebraska, Lincoln, Nebraska 68588 and
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Azma RZ, Othman A, Azman N, Alauddin H, Ithnin A, Yusof N, Razak NF, Sardi NH, Hussin NH. Co-inheritance of compound heterozygous Hb Constant Spring and a single -alpha(3.7) gene deletion with heterozygous deltabeta thalassaemia: a diagnostic challenge. Malays J Pathol 2012; 34:57-62. [PMID: 22870600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Haemoglobin Constant Spring (Hb CS) mutation and single gene deletions are common underlying genetic abnormalities for alpha thalassaemias. Co-inheritance of deletional and non-deletional alpha (alpha) thalassaemias may result in various thalassaemia syndromes. Concomitant co-inheritance with beta (beta) and delta (delta) gene abnormalities would result in improved clinical phenotype. We report here a 33-year-old male patient who was admitted with dengue haemorrhagic fever, with a background history of Grave's disease, incidentally noted to have mild hypochromic microcytic red cell indices. Physical examination revealed no thalassaemic features or hepatosplenomegaly. His full blood picture showed hypochromic microcytic red cells with normal haemoglobin (Hb) level. Quantitation of Hb using high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) revealed raised Hb F, normal Hb A2 and Hb A levels. There was also small peak of Hb CS noted in CE. H inclusions was negative. Kleihauer test was positive with heterocellular distribution of Hb F among the red cells. DNA analysis for alpha globin gene mutations showed a single -alpha(-3.7) deletion and Hb CS mutation. These findings were suggestive of compound heterozygosity of Hb CS and a single -alpha(-3.7) deletion with a concomitant heterozygous deltabeta thalassaemia. Co-inheritance of Hb CS and a single -alpha(-3.7) deletion is expected to result at the very least in a clinical phenotype similar to that of two alpha genes deletion. However we demonstrate here a phenotypic modification of alpha thalassemia presumptively as a result of co-inheritance with deltabeta chain abnormality as suggested by the high Hb F level.
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Affiliation(s)
- Raja Zahratul Azma
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
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33
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Chen Q, Fabry ME, Rybicki AC, Suzuka SM, Balazs TC, Etzion Z, de Jong K, Akoto EK, Canterino JE, Kaul DK, Kuypers FA, Lefer D, Bouhassira EE, Hirsch RE. A transgenic mouse model expressing exclusively human hemoglobin E: indications of a mild oxidative stress. Blood Cells Mol Dis 2012; 48:91-101. [PMID: 22260787 DOI: 10.1016/j.bcmd.2011.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 11/04/2011] [Accepted: 11/22/2011] [Indexed: 11/19/2022]
Abstract
Hemoglobin (Hb) E (β26 Glu→Lys) is the most common abnormal hemoglobin (Hb) variant in the world. Homozygotes for HbE are mildly thalassemic as a result of the alternate splice mutation and present with a benign clinical picture (microcytic and mildly anemic) with rare clinical symptoms. Given that the human red blood cell (RBC) contains both HbE and excess α-chains along with minor hemoglobins, the consequence of HbE alone on RBC pathophysiology has not been elucidated. This becomes critical for the highly morbid β(E)-thalassemia disease. We have generated transgenic mice exclusively expressing human HbE (HbEKO) that exhibit the known aberrant splicing of β(E) globin mRNA, but are essentially non-thalassemic as demonstrated by RBC α/β (human) globin chain synthesis. These mice exhibit hematological characteristics similar to presentations in human EE individuals: microcytic RBC with low MCV and MCH but normal MCHC; target RBC; mild anemia with low Hb, HCT and mildly elevated reticulocyte levels and decreased osmotic fragility, indicating altered RBC surface area to volume ratio. These alterations are correlated with a mild RBC oxidative stress indicated by enhanced membrane lipid peroxidation, elevated zinc protoporphyrin levels, and by small but significant changes in cardiac function. The C57 (background) mouse and full KO mouse models expressing HbE with the presence of HbS or HbA are used as controls. In select cases, the HbA full KO mouse model is compared but found to be limited due to its RBC thalassemic characteristics. Since the HbEKO mouse RBC lacks an abundance of excess α-chains that would approximate a mouse thalassemia (or a human thalassemia), the results indicate that the observed in vivo RBC mild oxidative stress arises, at least in part, from the molecular consequences of the HbE mutation.
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Affiliation(s)
- Qiuying Chen
- Department of Medicine/Hematology, Albert Einstein College of Medicine, Bronx, NY, USA
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Kwan WY, So CH, Chan WP, Leung WC, Chow KM. Re-emergence of late presentations of fetal haemoglobin Bart's disease in Hong Kong. Hong Kong Med J 2011; 17:434-440. [PMID: 22147311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES To compare early and late presentations of fetal haemoglobin Bart's disease in the Kowloon West Cluster in Hong Kong, and to find reasons for the re-emergence of late presentations. DESIGN Case series with internal comparisons. SETTING Two tertiary obstetric units in Hong Kong. PATIENTS All cases with confirmed diagnosis of fetal haemoglobin Bart's disease from 1 January 2000 to 31 December 2009. PRIMARY OUTCOME antenatal care in the current pregnancy. SECONDARY OUTCOMES clinical presentations, ultrasound features, and pregnancy outcomes. RESULTS A total of 59 cases (46 early presentations and 13 late presentations) of fetal haemoglobin Bart's disease were identified during the study period. All the late presentations were identified from year 2003 onwards. Late presentations were significantly associated with non-eligible obstetric patients (69% vs 11%; P<0.001), non-booked status at our antenatal service (62% vs 0%; P<0.001), and unavailability of partner's mean corpuscular volume status (23% vs 0%; P=0.009). Mothers presenting late were more likely to have symptoms or signs (85% vs 0%; P<0.001) and to suffer from gestational hypertensive disorder (54% vs 0%; P<0.001). Ultrasound features of these pregnancies included cardiomegaly (94%), placentomegaly (98%), and hydrops fetalis (77%). All pregnancies presenting early were either legally terminated or miscarried. The perinatal mortality in late presentations was 85%. CONCLUSION The re-emergence of late presentations of fetal haemoglobin Bart's disease after 2003 was related to influx of non-eligible obstetric patients without proper antenatal screening and diagnosis of thalassaemia. Maternal low mean corpuscular volume and characteristic prenatal ultrasound features such as cardiomegaly, placentomegaly, and hydrops fetalis are useful for detecting affected pregnancies in this group of patients. Better education of both patients and doctors is necessary to explain the importance of early diagnosis of the disease and the seriousness of complications due to late presentations, so as to reduce undesirable maternal and perinatal outcomes.
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Affiliation(s)
- W Y Kwan
- Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Laichikok, Hong Kong.
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35
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Leung TN. Fetal haemoglobin Bart's disease in Hong Kong: why early diagnosis could not be made. Hong Kong Med J 2011; 17:432-433. [PMID: 22147310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
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36
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Edison ES, Shaji RV, Chandy M, Srivastava A. Interaction of hemoglobin E with other abnormal hemoglobins. Acta Haematol 2011; 126:246-8. [PMID: 21986214 DOI: 10.1159/000329904] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 06/07/2011] [Indexed: 11/19/2022]
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Sugawara Y, Hayashi Y, Shigemasa Y, Abe Y, Ohgushi I, Ueno E, Shimamoto F. Molecular biosensing mechanisms in the spleen for the removal of aged and damaged red cells from the blood circulation. Sensors (Basel) 2010; 10:7099-121. [PMID: 22163593 PMCID: PMC3231191 DOI: 10.3390/s100807099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Revised: 06/25/2010] [Accepted: 07/10/2010] [Indexed: 12/01/2022]
Abstract
Heinz bodies are intraerythrocytic inclusions of hemichrome formed as a result of hemoglobin (Hb) oxidation. They typically develop in aged red cells. Based on the hypothesis that hemichrome formation is an innate characteristic of physiologically normal Hb molecules, we present an overview of our previous findings regarding the molecular instability of Hb and the formation of hemichrome, as well as recent findings on Heinz body formation within normal human erythrocytes. Human adult Hb (HbO2 A) prepared from healthy donors showed a tendency to produce hemichrome, even at close to physiological temperature and pH. Recent studies found that the number of Heinz bodies formed in red cells increased with increasing temperature when freshly drawn venous blood from healthy donors was subjected to mild heating above 37 °C. These findings suggest that Hb molecules control the removal of non-functional erythrocytes from the circulation via hemichrome formation and subsequent Heinz body clustering. In this review, we discuss the molecular biosensing mechanisms in the spleen, where hemichrome formation and subsequent Heinz body clustering within erythrocytes play a key role in the removal of aged and damaged red cells from the blood circulation.
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Affiliation(s)
- Yoshiaki Sugawara
- Department of Health Science, Prefectural University of Hiroshima, Hiroshima 734-8558, Japan.
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38
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Oniankitan O, Fianyo E, Houzou P, Tagbor KC, Mijiyawa M. [Semiological profile of gout in patients with AA, AS and AC hemoglobins]. Tunis Med 2010; 88:30-32. [PMID: 20415210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM To search a possible difference in gout and in the risk factors for gout expression according to the of hemoglobin in patients seen at the lomé teaching hospital rheumatology clinic (Togo). PATIENTS AND METHODS Medical records of patients seen during 17 years were studied. The patients affected by the gout and answering New York criteria have been included. All patients object of the comparison, benefitted from a hemoglobin electrophoresis and the search of possible risk factors for gout. RESULTS Among the 14902 patients seen over a 17 year period, 214 had gout (210 males, 4 famales). These 214 patients were carriers of an AA hemoglobin (147 cases), of an AS hemoglobin (41 cases), or of an AC hemoglobin (26 cases). The alcoholism, the obesity, and the arterial hypertension were the main risk factors associated with gout in 207 patients (97%). Semiological and risk factors comparison according to the type of hemoglobin didn't show statistically significant difference. CONCLUSION it results from this study that the AS hemoglobin and AC hemoglobin don't exercise any influence on the gout semiological expression. Thus, the presence of one of these hemoglobins in gout patient must exercise no influence in the diagnostic gait and in the etiological investigation.
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Abstract
It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Currently, among these glycated proteins, glycated hemoglobin (HbA(1C)) is used as the gold standard index of glycemic control in clinical practice for diabetes treatment. However, HbA(1C) does not accurately reflect the actual status of glycemic control in some conditions where plasma glucose changes during short term, and in patients who have diseases such as anemia and variant hemoglobin. In comparison, another index of glycemic control, glycated albumin (GA), more accurately reflects changes in plasma glucose during short term and also postprandial plasma glucose. Although GA is not influenced by disorders of hemoglobin metabolism, it is affected by disorders of albumin metabolism. This review summarizes diseases and pathological conditions where GA measurement is useful. These include the status of glycemic control changes during short term, diseases which cause postprandial hyperglycemia, iron deficiency anemia, pregnancy, chronic liver disease (liver cirrhosis), chronic renal failure (diabetic nephropathy), and variant hemoglobin.
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Affiliation(s)
- Masafumi Koga
- Department of Internal Medicine, Kinki Central Hospital, Itami, Japan.
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40
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Gaudreau PO, Weng X, Cournoyer G, Robin L, Gagnon C, Soulières D. Treatment with hydroxyurea in a patient compound heterozygote for a high oxygen affinity hemoglobin and beta-thalassemia minor. Am J Hematol 2009; 84:766-8. [PMID: 19787797 DOI: 10.1002/ajh.21526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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41
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Ingle J, Adewoye A, Dewan R, Okoli M, Rollins L, Eung SH, Luo HY, Chui DHK, Steinberg MH. Hb Hope [β136(H14)Gly→Asp (GGT→GAT)]: Interactions with Hb S [β6(A3)Glu→Val (GAG→GTG)], Other Variant Hemoglobins and Thalassemia. Hemoglobin 2009; 28:277-85. [PMID: 15658184 DOI: 10.1081/hem-200037801] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hb Hope [beta136(H14)Gly-->Asp (GGT-->GAT)] was first described in an African-American family in 1965. Since then, it has been found in combination with several different globin gene mutations in many other families of divergent ethnic backgrounds. The basis for its relatively frequent occurrences remains unexplained. This variant hemoglobin (Hb) is mildly unstable and has reduced oxygen affinity, but is generally innocuous clinically. This variant Hb can present as a confounding factor in arriving at a correct diagnosis by either electrophoresis or high performance liquid chromatography (HPLC), particularly during the neonatal period. DNA-based diagnostics can help solve this potential problem.
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Affiliation(s)
- John Ingle
- Department of Medicine and Pathology, Division of Hematology/Oncology, Boston University School of Medicine, Boston, Massachusetts, USA
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Wong WS, Chan AYY, Yip SF, Ma ESK. Thalassemia Intermedia Due to Co‐inheritance of β0/β+‐Thalassemia and (– –SEA)α‐Thalassemia/Hb Westmead [α122(H5)His > Gln (α2)] in a Chinese Family. Hemoglobin 2009; 28:151-6. [PMID: 15182058 DOI: 10.1081/hem-120035917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Two brothers from a Chinese family with beta-thalassemia intermedia who harbor both alpha- and beta-globin gene defects are described. They are both compound heterozygous for codons 41/42 (-CTTT) beta0-thalassemia and nt - 28 (A > G) beta(+)-thalassemia mutations together with concurrent (- -SEA) alpha-thalassemia (SEA) deletion. One sibling also harbors Hb Westmead, giving an unusual genotype of beta0/beta(+)-thalassemia and (- -SEA) alpha-thalassemia/Hb Westmead. With respect to the age at presentation and transfusion requirement, this subject shows a milder clinical phenotype than his brother, most probably explainable by the presence of Hb Westmead in addition to the SEA deletion, which causes a further amelioration of the alpha-chain excess and hence a less severe disease. For areas with high prevalence of both alpha- and beta-thalassemia mutations, their interactions should always be considered in genotype phenotype correlation. Moreover, routine laboratory diagnostic strategy for non-deletional alpha-globin gene mutations in the Chinese may need to include Hb Westmead, as it is a common alpha-globin gene mutation in our population apart from Hb Constant Spring and Hb Quong Sze.
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Affiliation(s)
- Wai-Shan Wong
- Division of Hematology, Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, PR China
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Galanello R, Perseu L, Barella S, Satta S, Fais A, Era B, Corda M. Hb Belfast [β15(A12)Trp→Arg]: Definition of the Clinical and Hematological Phenotype. Hemoglobin 2009; 28:217-22. [PMID: 15481889 DOI: 10.1081/hem-120040219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We report the sixth occurrence of Hb Belfast [beta15(A12)Trp-->Arg], a mild, unstable beta chain variant, in a large family wherein nine subjects were affected. DNA analysis showed a TUG-->AGG mutation at codon 15 of the beta-globin gene, confirming a Trp-->Arg amino acid substitution. The oxygen affinity of the isolated variant was increased. The clinical phenotype is silent or very mild, the only clinical finding being an intermittent moderate jaundice.
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Affiliation(s)
- Renzo Galanello
- Dipartimento di Scienze Biomediche e Biotecnologie, Università degli Studi di Cagliari, Cagliari, Italia.
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Feliu-Torres A, Eberle SE, Roldán A, González S, Sciuccati G. Hb Johnstown [β109(G11)Val→Leu]: a High Oxygen Affinity Variant Associated with β0‐Thalassemia. Hemoglobin 2009; 28:335-8. [PMID: 15658189 DOI: 10.1081/hem-200037799] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hb Johnstown [beta109(G11)Val-->Leu], a high oxygen affinity hemoglobin (Hb) variant associated with beta0-thalassemia (thal) [IVS-I-1 (G-->A)], was identified in an 8-year-old girl referred to our laboratory because of erythrocytosis and a left-shifted oxygen dissociation curve (ODC). The phylogenetic tree showed that the mother was heterozygous for the Hb variant and the father was a beta0-thal carrier. This Hb variant, with normal electrophoresis, was characterized at the DNA level by beta gene sequencing. The amino acid substitution potentially disrupts alpha1beta1 contacts i n the deoxyHb conformation, thus shifting the equilibrium towards the high affinity oxyHb conformation. The erythrocytosis and low values for actual P50 due to Hb Johnstown were more marked due to the co-inheritance of the beta0-thal.
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Affiliation(s)
- Aurora Feliu-Torres
- Servicio de Hematología-Oncología, Hospital de Pediatría Professor Dr Juan P Garrahan, Buenos Aires, Argentina.
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Hedlund B, Paine S, Smith CM, Raines J, Morrison WT, Adams J. Hemoglobin Minneapolis-Laos [β-118 (GH1) Phe→Tyr] A New Hemoglobin Variant with Normal Functional Properties. Hemoglobin 2009; 8:75-8. [PMID: 6547119 DOI: 10.3109/03630268408996962] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
High oxygen affinity haemoglobins result in polycythaemia and cardiovascular adaptation to maintain tissue oxygenation. The polycythaemia can cause symptoms of hyperviscosity and vaso-occlusive disease. We report a kindred with a high affinity haemoglobin (Haemoglobin Yakima) one of whose members gave birth to two infants with intra-uterine growth retardation and who suffered with symptoms of hyperviscosity which settled on reduction of the PCV by venesection.
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Affiliation(s)
- R J Grace
- Department of Haematology, St. Thomas' Hospital, London, UK
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49
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Petrides PE, Beykirch MK, Kohne E. The high oxygen-affinity Hemoglobin Johnstown [(beta 109(G11) Val-->Leu] in a German kindred with an elevated erythrocyte hemoglobin content: potential interaction with HFE mutations. Blood Cells Mol Dis 2007; 40:180-2. [PMID: 17950634 DOI: 10.1016/j.bcmd.2007.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2007] [Revised: 08/20/2007] [Accepted: 08/20/2007] [Indexed: 11/19/2022]
Abstract
A 23-year-old man with an elevated blood hemoglobin was found to have hemoglobin (Hb) Johnstown, a high oxygen-affinity hemoglobin and an elevated red cell hemoglobin content. The hemoglobin mutation was present in all family members who consented to molecular investigation. No elevation of the erythropoietin level was found in the carriers. A high ferritin level was observed in one family member. When carriers of the hemoglobin mutation were analyzed for mutations in the HFE-genes (C282Y, H63D and S65C), only the individual with the high ferritin level was a compound heterozygous for the H63D/S65C genotype. This genotype normally does not confer the hemochromatosis phenotype but may contribute to iron overload when present in an individual with increased hemoglobin synthesis. The original report of this hemoglobin variant was in the United States. Additional descriptions followed from Spain and Argentina. The family in this report is the first described in Central Europe carrying the beta109 (Val-->Leu) mutation.
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Affiliation(s)
- Petro E Petrides
- Hematology Oncology Center, 80331 Munich, Zweibrückenstr.2, Germany.
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50
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Waitumbi JN, Kifude CM, Withers MR, Polhemus ME, Heppner DG, Ogutu BR. Hb G-Philadelphia or Stanleyville II? When the phenotype and genotype do not agree. Eur J Haematol 2007; 79:177-8. [PMID: 17608715 DOI: 10.1111/j.1600-0609.2007.00879.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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