1
|
Võ TC, Lê HG, Kang JM, Nguyễn ĐTD, Nguyễn TH, Yoo WG, Goo YK, Thi Minh Trinh N, Van Khanh C, Hong Quang H, Na BK. Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Gia Lai Province, Vietnam. Parasitol Int 2024; 100:102868. [PMID: 38387679 DOI: 10.1016/j.parint.2024.102868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/27/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD; EC 1.1.1.49) deficiency is one of the most common X-linked hereditary disorders worldwide. G6PD deficiency provides resistance against severe malaria, but paradoxically, G6PD deficiency is also a stumbling block in fighting against malaria. Primaquine (PQ), a drug for the radical cure of Plasmodium vivax, can cause lethal acute hemolytic anemia in malaria patients with inherited G6PD deficiency. In this study, we analyzed the phenotypic and genotypic G6PD deficiency status in 1721 individuals (963 males and 758 females) residing in three malaria-endemic areas within the Gia Lai province, Vietnam. The G6PD activity in individuals ranged from 3.04 to 47.82 U/g Hb, with the adjusted male median (AMM) of 7.89 U/g Hb. Based on the G6PD activity assay results, no phenotypic G6PD deficiency was detected. However, the multiplex polymerase chain reaction to detect G6PD variations in the gene level revealed that 26 individuals (7 males, 19 females) had Viangchan mutations (871 G > A). Sequencing analyses suggested that all the males were hemizygous Viangchan, whereas one was homozygous, and 18 were heterozygous Viangchan in females. These results suggested a relatively low prevalence of G6PD deficiency mutation rate (1.51%) in the minor ethnic populations residing in the Gia Lai province, Vietnam. However, considering these areas are high-risk malaria endemic, concern for proper and safe use of PQ as a radical cure of malaria is needed by combining a G6PD deficiency test before PQ prescription.
Collapse
Affiliation(s)
- Tuấn Cường Võ
- Department of Parasitology and Tropical Medicine, and Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea; Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Hương Giang Lê
- Department of Parasitology and Tropical Medicine, and Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea; Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Jung-Mi Kang
- Department of Parasitology and Tropical Medicine, and Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea; Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea.
| | - Đặng Thùy Dương Nguyễn
- Department of Parasitology and Tropical Medicine, and Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea; Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Thu Hằng Nguyễn
- Department of Parasitology and Tropical Medicine, and Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea; Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Won Gi Yoo
- Department of Parasitology and Tropical Medicine, and Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea; Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Youn-Kyoung Goo
- Department of Parasitology and Tropical Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea.
| | - Nguyen Thi Minh Trinh
- Tropical Diseases Clinical and Treatment Research Department, Institute of Malariology, Parasitology, and Entomology Quy Nhon, Quy Nhon, Viet Nam
| | - Chau Van Khanh
- Tropical Diseases Clinical and Treatment Research Department, Institute of Malariology, Parasitology, and Entomology Quy Nhon, Quy Nhon, Viet Nam
| | - Huynh Hong Quang
- Tropical Diseases Clinical and Treatment Research Department, Institute of Malariology, Parasitology, and Entomology Quy Nhon, Quy Nhon, Viet Nam.
| | - Byoung-Kuk Na
- Department of Parasitology and Tropical Medicine, and Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea; Department of Convergence Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea.
| |
Collapse
|
2
|
Xuan-Rong Koh D, Zailani MAH, Raja Sabudin RZA, Muniandy S, Muhamad Hata NAA, Mohd Noor SNB, Zakaria N, Othman A, Ismail E. Prevalence and molecular heterogeneity of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the Senoi Malaysian Orang Asli population. PLoS One 2023; 18:e0294891. [PMID: 38085718 PMCID: PMC10715666 DOI: 10.1371/journal.pone.0294891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked genetic disorder characterized by reduced G6PD enzyme levels in the blood. This condition is common in populations exposed to malaria; an acute febrile disease caused by Plasmodium parasites. G6PD-deficient individuals may suffer from acute hemolysis following the prescription of Primaquine, an antimalarial treatment. The population at risk for such a condition includes the Senoi group of Orang Asli, a remote indigenous community in Malaysia. This study aimed to elucidate the G6PD molecular heterogeneity in this subethnic group which is important for malaria elimination. A total of 662 blood samples (369 males and 293 females) from the Senoi subethnic group were screened for G6PD deficiency using a quantitative G6PD assay, OSMMR2000-D kit with Hb normalization. After excluding the family members, the overall prevalence of G6PD deficiency in the studied population was 15.2% (95% CI: 11-19%; 56 of 369), with males (30 of 172; 17.4%) outnumbering females (26 of 197; 13.2%). The adjusted male median (AMM), defined as 100% G6PD activity, was 11.8 IU/gHb. A total of 36 participants (9.6%; 26 male and 10 female) were deficient (<30% of AMM) and 20 participants (5.4%; 4 male and 16 female) were G6PD-intermediate (30-70% of AMM). A total of 87 samples were genotyped, of which 18 showed no mutation. Seven mutations were found among 69 genotyped samples; IVS11 T93C (47.1%; n = 41), rs1050757 (3'UTR +357A>G)(39.1%; n = 34), G6PD Viangchan (c.871G>A)(25.3%; n = 22), G6PD Union (c.1360C>T)(21.8%; n = 19), c.1311C>T(20.7%; n = 18), G6PD Kaiping (c.1388G>A)(8.0%; n = 7), and G6PD Coimbra (c.592C>T)(2.3%; n = 2). Our analysis revealed 27 hemizygote males, 18 heterozygote females, 7 homozygote females, and 2 compound heterozygote females. This study confirms the high prevalence of G6PD deficiency among the Senoi Malaysian Orang Asli, with a significant degree of molecular heterogeneity. More emphasis should be placed on screening for G6PD status and proper and safe use of Primaquine in the elimination of malaria among this indigenous population.
Collapse
Affiliation(s)
- Danny Xuan-Rong Koh
- Faculty of Science and Technology, Center of Frontier Sciences, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | | | | | - Sanggari Muniandy
- Faculty of Science and Technology, Center of Frontier Sciences, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Nur Awatif Akmal Muhamad Hata
- Faculty of Medicine, Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Siti Noor Baya Mohd Noor
- Faculty of Medicine, Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Norhazilah Zakaria
- Faculty of Medicine, Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Ainoon Othman
- Faculty of Medicine and Health Sciences, Department of Pathology, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia
| | - Endom Ismail
- Faculty of Science and Technology, Department of Biological Sciences Dan Biotechnology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| |
Collapse
|
3
|
Zailani MAH, Raja Sabudin RZA, Ithnin A, Alauddin H, Sulaiman SA, Ismail E, Othman A. Population screening for glucose-6-phosphate dehydrogenase deficiency using quantitative point-of-care tests: a systematic review. Front Genet 2023; 14:1098828. [PMID: 37388931 PMCID: PMC10301741 DOI: 10.3389/fgene.2023.1098828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked hereditary disorder and a global public health concern that is most prevalent in malaria-endemic regions including Asia, Africa, and the Mediterranean. G6PD-deficient individuals are at high risk of developing acute hemolytic anemia following treatment with antimalarial drugs including Primaquine and Tafenoquine. However, the currently available tests for G6PD screening are complex and often have been misclassifying cases, particularly for females with intermediate G6PD activity. The latest innovation of quantitative point-of-care (POC) tests for G6PD deficiency provides an opportunity to improve population screening and prevent hemolytic disorders when treating malaria. Aim(s): To assess the evidence on the type and performance of quantitative point-of-care (POC) tests for effective G6PD screening and hence, radical elimination of Plasmodium malaria infections. Methods: Relevant studies published in English language confined from two databases, Scopus and ScienceDirect were searched from November 2016 onwards. The search was conducted using keywords including "glucosephosphate dehydrogenase" or "G6PD", "point-of-care", "screening" or "prevalence", "biosensor" and "quantitative". The review was reported following the PRISMA guidelines. Results: Initial search results yielded 120 publications. After thorough screening and examination, a total of 7 studies met the inclusion criteria, and data were extracted in this review. Two types of quantitative POC tests were evaluated, namely, the CareStartTM Biosensor kit and the STANDARD G6PD kit. Both tests showed promising performance with high sensitivity and specificity ranging mostly from 72% to 100% and 92%-100%, respectively. The positive and negative predictive values (PPV and NPV) ranged from 35% to 72% and 89%-100%, with accuracy ranging from 86% to 98%. Conclusion: In areas with a high prevalence of G6PD deficiency that overlap with malaria endemicity, availability and validation of the diagnostic performance of quantitative POC tests are of absolute importance. Carestart™ biosensor and STANDARD G6PD kits showed high reliability and performed well in comparison to the spectrophotometric reference standard.
Collapse
Affiliation(s)
| | | | - Azlin Ithnin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Hafiza Alauddin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Siti Aishah Sulaiman
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Endom Ismail
- Department of Biological Sciences Dan Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Ainoon Othman
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| |
Collapse
|
4
|
Aung TH, Suansomjit C, Tun ZM, Hlaing TM, Kaewkungwal J, Cui L, Sattabongkot J, Roobsoong W. Prevalence of G6PD deficiency and diagnostic accuracy of a G6PD point-of-care test among a population at risk of malaria in Myanmar. Malar J 2023; 22:143. [PMID: 37127600 PMCID: PMC10150473 DOI: 10.1186/s12936-023-04559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/11/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Over the past decade, the incidence of malaria has steadily declined in Myanmar, with Plasmodium vivax becoming predominant. The resilience of P. vivax to malaria control is attributed to the parasite's ability to form hypnozoites in the host's liver, which can cause relapse. Primaquine is used to eliminate hypnozoites but can cause haemolysis in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals. It is thus necessary to estimate the frequency and variant types of G6PD deficiency in areas where primaquine will be widely used for P. vivax elimination. METHODS In this study, a descriptive cross-sectional survey was conducted to determine the prevalence of G6PD deficiency in a population residing in Nay Pyi Taw, Myanmar, using a standard spectrophotometric assay, a rapid diagnostic test (RDT), Biosensor, and by genotyping G6PD variants. RESULTS G6PD enzyme activity was determined from 772 leukocyte-depleted samples, with an adjusted male median G6PD activity value of 6.3 U/g haemoglobin. Using a cut-off value of 30% enzyme activity, the overall prevalence of G6PD deficiency was 10.8%. Genotyping of G6PD variants was performed for 536 samples, of which 131 contained mutations. The Mahidol variant comprised the majority, and males with the Mahidol variant showed lower G6PD enzyme activity. The G6PD Andalus variant, which has not been reported in Myanmar before, was also identified in this study. CONCLUSION This study provides a G6PD enzyme activity reference value for the Myanmar population and further information on the prevalence and variants of G6PD deficiency among the Myanmar population; it also evaluates the feasibility of G6PD deficiency tests.
Collapse
Affiliation(s)
- Than Htike Aung
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Defence Services Medical Academy, Yangon, Myanmar
| | - Chayanut Suansomjit
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Zaw Min Tun
- Defence Services Medical Research Centre, Nay Pyi Taw, Myanmar
| | | | - Jaranit Kaewkungwal
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Liwang Cui
- Division of Infectious Diseases and International Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Florida, USA
| | - Jetsumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wanlapa Roobsoong
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
5
|
Chamchoy K, Sudsumrit S, Thita T, Krudsood S, Patrapuvich R, Boonyuen U. Cytochrome P450 2D6 (CYP2D6) and glucose-6-phosphate dehydrogenase (G6PD) genetic variations in Thai vivax malaria patients: Implications for 8-aminoquinoline radical cure. PLoS Negl Trop Dis 2022; 16:e0010986. [PMID: 36508454 PMCID: PMC9779666 DOI: 10.1371/journal.pntd.0010986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/22/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Primaquine and tafenoquine are the only licensed drugs that effectively kill the hypnozoite stage and are used to prevent Plasmodium vivax malaria relapse. However, both primaquine and tafenoquine can cause acute hemolysis in glucose-6-phosphate dehydrogenase (G6PD)-deficient people with varying degrees of severity depending on G6PD variants. Additionally, primaquine efficacy against malaria parasites was decreased in individuals with impaired cytochrome P450 2D6 (CYP2D6) activity due to genetic polymorphisms. This study aimed to characterize G6PD and CYP2D6 genetic variations in vivax malaria patients from Yala province, a malaria-endemic area along the Thai-Malaysian border, and determine the biochemical properties of identified G6PD variants. METHODOLOGY/PRINCIPLE FINDINGS Multiplexed high-resolution melting assay and DNA sequencing detected five G6PD variants, including G6PD Kaiping, G6PD Vanua Lava, G6PD Coimbra, G6PD Mahidol, and G6PD Kerala-Kalyan. Biochemical and structural characterization revealed that G6PD Coimbra markedly reduced catalytic activity and structural stability, indicating a high susceptibility to drug-induced hemolysis. While Kerala-Kalyan had minor effects, it is possible to develop mild adverse effects when receiving radical treatment. CYP2D6 genotyping was performed using long-range PCR and DNA sequencing, and the phenotypes were predicted using the combination of allelic variants. Decreased and no-function alleles were detected at frequencies of 53.4% and 14.2%, respectively. The most common alleles were CYP2D6*36+*10 (25.6%), *10 (23.9%), and *1 (22.2%). Additionally, 51.1% of the intermediate metabolizers showed CYP2D6*10/*36+*10 as the predominant genotype (15.9%). CONCLUSIONS/SIGNIFICANCE Our findings provide insights about genetic variations of G6PD and CYP2D6 in 88 vivax malaria patients from Yala, which may influence the safety and effectiveness of radical treatment. Optimization of 8-aminoquinoline administration may be required for safe and effective treatment in the studied population, which could be a significant challenge in achieving the goal of eliminating malaria.
Collapse
Affiliation(s)
- Kamonwan Chamchoy
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Sirapapha Sudsumrit
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thanyapit Thita
- Drug Research Unit for Malaria (DRUM), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Srivicha Krudsood
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rapatbhorn Patrapuvich
- Drug Research Unit for Malaria (DRUM), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Usa Boonyuen
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- * E-mail: ,
| |
Collapse
|
6
|
Nuinoon M, Krithong R, Pramtong S, Sasuk P, Ngeaiad C, Chaimusik S, Kanboonma J, Sarakul O. Prevalence of G6PD deficiency and G6PD variants amongst the southern Thai population. PeerJ 2022; 10:e14208. [PMID: 36248708 PMCID: PMC9559062 DOI: 10.7717/peerj.14208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/19/2022] [Indexed: 01/24/2023] Open
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme essential for NADPH production and protecting cells, especially red blood cells, from free radicals. The oxidative stress from drugs, chemicals, and infections can induce red blood cell hemolysis in G6PD deficiency patients, causing a genetic disorder. Objectives This study aims to provide more information on G6PD deficiency prevalence and the G6PD variants in the southern Thai population. Methods Five hundred and twenty healthy subjects in 14 provinces in the southern part of Thailand participated in the study. EDTA-blood samples were collected for a hematological parameters study, G6PD deficiency screening, and a molecular study for G6PD mutation. G6PD deficiency screening was tested using a fluorescent spot test. The types of G6PD mutation were identified by the allele-specific PCR method. Results The prevalence of G6PD deficiency in southern Thailand was 6.1% (14/228) in males and 9.6% (28/292) in females. Two homozygous and 26 heterozygous G6PD deficiencies were found in females. G6PD Viangchan (871G>A) was the most common variant with 43%, followed by G6PD Mahidol (487G>A), 24% with an allele frequency of 0.025 and 0.012, respectively. Uncharacterized mutations existed in three samples. The study volunteers had anemia in 36.6% (107/292) females and 7.5% (17/228) males. Among G6PD deficiency subjects, only ten partial G6PD deficiency females had mild anemia. Conclusions This study suggests that the prevalence of G6PD deficiency in southern Thailand aligns with that of other parts of Thailand. Newborn screening for G6PD deficiency is recommended for personal information and medical reference to prevent acute hemolysis from oxidative stressors.
Collapse
Affiliation(s)
- Manit Nuinoon
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand,Hematology and Transfusion Science Research Center (HTSRC), Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Rungnapha Krithong
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Suputcha Pramtong
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Piyawit Sasuk
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Chompunuch Ngeaiad
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Sathanan Chaimusik
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Jiraporn Kanboonma
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Orawan Sarakul
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat, Thailand,Hematology and Transfusion Science Research Center (HTSRC), Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| |
Collapse
|
7
|
Hamali HA. Glucose-6-Phosphate Dehydrogenase Deficiency: An Overview of the Prevalence and Genetic Variants in Saudi Arabia. Hemoglobin 2022; 45:287-295. [DOI: 10.1080/03630269.2022.2034644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hassan A. Hamali
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| |
Collapse
|
8
|
Khammanee T, Sawangjaroen N, Buncherd H, Tun AW, Thanapongpichat S. Prevalence of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency among Malaria Patients in Southern Thailand: 8 Years Retrospective Study. THE KOREAN JOURNAL OF PARASITOLOGY 2022; 60:15-23. [PMID: 35247950 PMCID: PMC8898650 DOI: 10.3347/kjp.2022.60.1.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022]
Abstract
Erythrocytes deficient in glucose-6-phosphate dehydrogenase (G6PD) is more susceptible to oxidative damage from free radical derived compounds. The hemolysis triggered by oxidative agents such as primaquine (PQ) is used for the radical treatment of hypnozoites of P. vivax. Testing of G6PD screening before malaria treatment is not a common practice in Thailand, which poses patients at risk of hemolysis. This retrospective study aimed to investigate the prevalence of G6PD in malaria patients who live in Southern Thailand. Eight hundred eighty-one malaria patients were collected for 8-year from 2012 to 2019, including 785 (89.1%) of P. vivax, 61 (6.9%) of P. falciparum, 27 (3.1%) of P. knowlesi, and 8 (0.9%) of mixed infections. The DiaPlexC genotyping kit (Asian type) and PCR-RFLP were employed to determine the G6PD variants. The result showed that 5 different types of G6PD variants were identified in 26 cases (2.9%); 12/26 (46.2%) had Mahidol (487G>A) and 11/26 (42.3%) had Viangchan (871G>A) variants, while the rest had Kaiping (1388G>A), Union (1360C>T), and Mediterranean (563C>T) variants. G6PD Songklanagarind (196T>A) variant was not found in the study. Our result did not show a significant difference in the malaria parasite densities in patients between G6PD-deficient and G6PD-normal groups. According to our findings, testing G6PD deficiency and monitoring the potential PQ toxicity in patients who receive PQ are highly recommended.
Collapse
Affiliation(s)
- Thunchanok Khammanee
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Nongyao Sawangjaroen
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Hansuk Buncherd
- Faculty of Medical Technology, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Aung Win Tun
- Faculty of Graduate Studies, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
| | - Supinya Thanapongpichat
- Faculty of Medical Technology, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| |
Collapse
|
9
|
Wei H, Wang C, Huang W, He L, Liu Y, Huang H, Chen W, Zheng Y, Xu G, Lin L, Wei W, Chen W, Chen L, Wang J, Lin M. Simultaneous detection of G6PD mutations using SNPscan in a multiethnic minority area of Southwestern China. Front Genet 2022; 13:1000290. [PMID: 36704359 PMCID: PMC9871378 DOI: 10.3389/fgene.2022.1000290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Objectives: Baise, a multiethnic inhabited area of southwestern China, is a historical malaria-endemic area with a high prevalence of G6PD deficiency. However, few studies of G6PD deficiency have been conducted in this region. Therefore, we performed a genetic analysis of G6PD deficiency in the Baise population from January 2020 to June 2021. Methods: A SNPscan assay was developed to simultaneously detect 33 common Chinese G6PD mutations. 30 G6PD-deficient samples were used for the method's validation. Then, a total of 709 suspected G6PD-deficient samples collated from the Baise population were evaluated for G6PD status, type of mutation and effect of mutations. Results: The SNPscan test had a sensitivity of 100% [95% confidence interval (CI): 94.87%-100%] and a specificity of 100% (95% CI: 87.66%-100%) for identifying G6PD mutations. A total of fifteen mutations were identified from 76.72% (544/709) of the samples. The most common mutation was discovered to be G6PD Kaiping (24.12%), followed by G6PD Canton (17.91%), and G6PD Gaohe (11.28%). We compared the G6PD mutation spectrum among Zhuang, Han and other Southeast Asian populations, and the Zhuang population's mutation distribution was quite similar to that in the Han population. Conclusion: This study provided a detailed G6PD mutation spectrum in Baise of southwestern China and will be valuable for the diagnosis and research of G6PD deficiency in this area. Furthermore, the SNPscan assay could be used to quickly diagnose these G6PD mutations accurately.
Collapse
Affiliation(s)
- Huagui Wei
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Chunfang Wang
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Weiyi Huang
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Liqiao He
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Yaqun Liu
- School of Biotechnology and Food Engineering, Hanshan Normal University, Chaozhou, China
| | - Huiying Huang
- School of Biotechnology and Food Engineering, Hanshan Normal University, Chaozhou, China
| | - Wencheng Chen
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Yuzhong Zheng
- School of Biotechnology and Food Engineering, Hanshan Normal University, Chaozhou, China
| | - Guidan Xu
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Liyun Lin
- School of Biotechnology and Food Engineering, Hanshan Normal University, Chaozhou, China
| | - Wujun Wei
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Weizhong Chen
- Department of Medical Laboratory, Chaozhou People’s Hospital Affiliated to Shantou University Medical College, Chaozhou, China
| | - Liying Chen
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Junli Wang
- School of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, China
| | - Min Lin
- Center for Clinical Laboratory Diagnosis and Research, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
- School of Biotechnology and Food Engineering, Hanshan Normal University, Chaozhou, China
- School of Laboratory Medicine, Youjiang Medical University for Nationalities, Baise, China
| |
Collapse
|
10
|
Gopagondanahalli KR, Mittal RA, Abdul Haium AA, Quek BH, Agarwal P, Daniel LM, Chua MC, Rajadurai VS. Risk Factors Predicting the Need for Phototherapy in Glucose 6 Phosphate Dehydrogenase-Deficient Infants in a Large Retrospective Cohort Study. Neonatology 2022; 119:494-500. [PMID: 35700699 DOI: 10.1159/000524966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/25/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Glucose 6-phosphate dehydrogenase (G6PD) deficiency increases the risk of severe neonatal hyperbilirubinemia. This study evaluates the risk factors predicting the need for phototherapy in G6PD-deficient neonates after 72 h of age and assesses the safety of early discharge. METHODS A retrospective cohort study of 681 full-term G6PD-deficient infants with a birth weight ≥2,500 g over 4 years was conducted. We compared the baseline characteristics, bilirubin level on day 4 (after 72 h of life), day of peak bilirubin, G6PD levels, and concomitant ABO incompatibility between the group that required phototherapy (Group A) and those who did not (Group B). RESULTS 396 infants (58%), predominantly males, required phototherapy in the first week of life. The infants who required phototherapy had a lower median gestational age (38.3 vs. 38.7 weeks, p < 0.01) and had lower G6PD levels (2.3 ± 2.5 vs. 3 ± 3.4 IU, p < 0.05) compared to the controls. The mean day-four total serum bilirubin (TSB) levels were higher (213 ± 32 vs. 151 ± 37 µmol/L, p < 0.01), with bilirubin level peaking earlier (3 vs. 4 days of life, p < 0.01) in group A. Regression analysis identified TSB levels on day 4, Chinese race, lower gestation, and concomitant ABO incompatibility as the significant predictors for the need for phototherapy in the study population. In particular, coexisting ABO blood group incompatibility increased the risk of jaundice requiring phototherapy (OR 4.27, 95% CI: 1.98-121, p < 0.01). Day four TSB values above 180 µmol/L predicted the need for phototherapy with 86% sensitivity and 80% specificity. The findings were similar across both male and female infants with G6PD deficiency. CONCLUSION G6PD-deficient infants with day four TSB levels of >180 µmol/L (10.5 mg/dL) and associated ABO blood group incompatibility have a higher risk of requiring phototherapy in the first week of life and should be closely monitored.
Collapse
Affiliation(s)
- Krishna Revanna Gopagondanahalli
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore
| | - Rashmi Arun Mittal
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Abdul Alim Abdul Haium
- Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Head Special Care Service, Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Bin Huey Quek
- Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Senior Consultant and Head Neonatal Intensive Care Unit, Department of Neonatology, KK Womens' and Children's Hospital, Singapore, Singapore
| | - Pratibha Agarwal
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Child Development Unit, KK Women's and Children's Hospital, Singapore, Singapore
| | - Lourdes Mary Daniel
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Department of Child Development Unit, KK Women's and Children's Hospital, Singapore, Singapore
| | - Mei Chien Chua
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Victor Samuel Rajadurai
- Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| |
Collapse
|
11
|
Tantular IS, Kawamoto F. Distribution of G6PD deficiency genotypes among Southeast Asian populations. Trop Med Health 2021; 49:97. [PMID: 34930507 PMCID: PMC8686385 DOI: 10.1186/s41182-021-00387-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 12/05/2021] [Indexed: 11/10/2022] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a group of X-linked, hereditary genetic disorders caused by mutations in the G6PD gene and results in functional variants of about 400 biochemical and clinical phenotypes. Among them, more than 215 genotypes have been identified so far. In this review, specific features of the genotype distribution in different communities and countries are discussed based on multiple reports and our molecular epidemiological studies of Southeast Asian countries. Particularly, in Indonesia, the frequency distribution of G6PD deficiency variants was distinct between western and eastern Indonesian populations, suggesting two different gene flows during Indonesian expansions.
Collapse
Affiliation(s)
- Indah S Tantular
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Department of Parasitology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Fumihiko Kawamoto
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia. .,Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.
| |
Collapse
|
12
|
Tang ASO, Soo XY, Yeo ST, Mansor NA, Chew LP, Chua HH. The mystery of 'saturation gap' and falsely normal G6PD: a case of primaquine-induced haemolysis in Plasmodium vivax malaria infection. J R Coll Physicians Edinb 2021; 51:146-148. [PMID: 34131671 DOI: 10.4997/jrcpe.2021.210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Eradication therapy in Plasmodium vivax in variants of glucose-6-phosphate dehydrogenase (G6PD) deficiency individuals remains a clinical challenge. We present a case of primaquine-induced methaemoglobinaemia and haemolytic anaemia in a patient with falsely normal qualitative G6PD result during initial presentation, which was complicated with clinical sequelae of thrombosis. Further investigations showed moderate degree of G6PD deficiency. Our patient responded well to vitamin C and a modified weekly regimen of primaquine with no evidence of malaria relapse.
Collapse
Affiliation(s)
- Andy Sing Ong Tang
- Department of Internal Medicine, Miri Hospital, Jalan Cahaya, 98000 Miri, Sarawak, Malaysia,
| | - Xin Yin Soo
- Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
| | - Siaw Tze Yeo
- Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
| | - Nor Ainiza Mansor
- Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
| | - Lee Ping Chew
- Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
| | - Hock Hin Chua
- Infectious Disease Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Malaysia
| |
Collapse
|
13
|
Genotype-Phenotype Correlation of G6PD Mutations among Central Thai Children with G6PD Deficiency. Anemia 2021; 2021:6680925. [PMID: 33628497 PMCID: PMC7886513 DOI: 10.1155/2021/6680925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common X-linked inherited erythroenzymopathy in Thailand. The clinical and hematological manifestations of G6PD deficiency are variable. Objective This study aimed to characterize the genotype-phenotype correlation of G6PD mutations in Thai pediatric patients who were followed-up in Phramongkutklao Hospital, a tertiary center in central Thailand. Material and Method. A total of 102 children including 73 males (71.6%) and 29 females (28.4%) were included in our study. Mutation analysis was performed by direct DNA sequencing of all coding exons of the G6PD gene. Ninety-one patients (89.2%) were presented with neonatal hyperbilirubinemia and 11 patients (10.8%) were presented with acute hemolytic anemia beyond the neonatal period. Results Molecular analysis of the G6PD gene in 102 G6PD-deficient Thai children identified 12 different mutations. G6PD Viangchan (871G > A) and G6PD Canton (1376G > T) were the first (46.2%) and the second (15.4%) most common identified mutations among both male and female G6PD-deficient individuals, respectively. All affected males were hemizygous for G6PD mutations and had an average G6PD level of 16.7 ± 11.5 (3–76) IU/ml.RBC. Majority of female patients (27 in 29, 93.1%) were heterozygous for G6PD mutations and had an average G6PD level of 133.6 ± 43.4 (9–195) IU/ml.RBC. Two female patients (6.9%) were either homozygous or compound heterozygous for the mutations and had G6PD level in the affected male range (35 and 10 IU/ml.RBC). Only 1 in 27 heterozygous females (3.7%) had G6PD level in the affected male range (9 IU/ml.RBC) which is possibly explained by nonrandom X-chromosome inactivation. The correlation of genotypes, G6PD levels, and clinical phenotypes was not demonstrated in our study in which all of the included G6PD-deficient patients were presented with neonatal hyperbilirubinemia and acute hemolytic anemia, since the genotype-phenotype correlation is normally demonstrated in chronic nonspherocytic hemolytic anemia (CNSHA) G6PD-deficient individuals. Conclusion This study characterizes the molecular heterogeneity of G6PD variants causing G6PD deficiency in Thai children. Our study demonstrated the efficiency of direct DNA sequencing which can identify 12 missense mutations in Thai children.
Collapse
|
14
|
Boo NY, Sin S, Chee SC, Mohamed M, Ahluwalia AK, Ling MMM, Ong HK. Genetic Factors and Delayed TSB Monitoring and Treatment as Risk Factors Associated with Severe Hyperbilirubinemia in Term Neonates Admitted for Phototherapy. J Trop Pediatr 2020; 66:569-582. [PMID: 32577754 DOI: 10.1093/tropej/fmaa016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES This study aimed to determine whether maternal-fetal blood group isoimmunization, breastfeeding, birth trauma, age when first total serum bilirubin (TSB) was measured, age of admission, and genetic predispositions to hemolysis [due to genetic variants of glucose-6-phosphate dehydrogenase (G6PD) enzyme], and reduced hepatic uptake and/or conjugation of serum bilirubin [due to genetic variants of solute carrier organic anion transporter protein family member 1B1 (SLCO1B1) and uridine diphosphate glucuronosyltransferase family 1 member A1 (UGT1A1)] were significant risk factors associated with severe neonatal hyperbilirubinemia (SNH, TSB ≥ 342µmol/l) in jaundiced term neonates admitted for phototherapy. METHODS The inclusion criteria were normal term neonates (gestation ≥ 37 weeks). Parents/care-givers were interviewed to obtain data on demography, clinical problems, feeding practice and age when first TSB was measured. Polymerase chain reaction-restriction fragment length polymorphism method was used to detect common G6PD, UGT1A1 and SLCO1B1 variants on each neonate's dry blood specimens. RESULTS Of 1121 jaundiced neonates recruited, 232 had SNH. Logistic regression analysis showed that age (in days) when first TSB was measured [adjusted odds ratio (aOR) = 1.395; 95% confidence interval (CI) 1.094-1.779], age (in days) of admission (aOR = 1.127; 95% CI 1.007-1.260) and genetic mutant UGT1A1 promoter A(TA)7TAA (aOR = 4.900; 95% CI 3.103-7.739), UGT1A1 c.686C>A (aOR = 6.095; 95% CI 1.549-23.985), SLCO1B1 c.388G>A (aOR = 1.807; 95% CI 1.242-2.629) and G6PD variants and/or abnormal G6PD screening test (aOR = 2.077; 95% CI 1.025-4.209) were significantly associated with SNH. CONCLUSION Genetic predisposition, and delayed measuring first TSB and commencing phototherapy increased risk of SNH.
Collapse
Affiliation(s)
- Nem-Yun Boo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - Shwe Sin
- Department of Pre-Clinical Science, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - Seok-Chiong Chee
- Department of Pediatrics, Selayang Hospital, Selayang, Selangor, Malaysia
| | - Maslina Mohamed
- Department of Pediatrics, Selayang Hospital, Selayang, Selangor, Malaysia
| | | | | | - Han-Kiat Ong
- Department of Pre-Clinical Science, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| |
Collapse
|
15
|
Devendra R, Gupta V, Shanmugam R, Singh MPSS, Patel P, Valecha N, Mishra N, Ahmed N, Hoti SL, Hegde HV, Warang P, Chiddarwar A, Kedar P, Mayekar P, Mukherjee MB. Prevalence and spectrum of mutations causing G6PD deficiency in Indian populations. INFECTION GENETICS AND EVOLUTION 2020; 86:104597. [PMID: 33069889 DOI: 10.1016/j.meegid.2020.104597] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the most common human erythroenzymopathy affecting around 10% of the world population. India is endemic for malaria and antimalarial drugs are known to induce haemolysis in G6PD deficient individuals. Here we report the prevalence as well as the molecular diversity of G6PD deficiency in geographical regions of India. METHODS AND RESULTS A total of 20,896 individuals (11,838 males and 9058 females) were screened by DPIP dye decolorisation method followed by quantitation of G6PD enzyme activity on the suspected samples. Molecular analysis was undertaken in a total of 350 G6PD deficient individuals by PCR-RFLP and DNA sequencing. A structural characteristic of the novel variant was deduced by using DynaMut web-server. The prevalence rate of G6PD deficiency varied between 0.8 and 6.3% with an overall prevalence of 1.9%. A total of twelve mutations were identified. Of the total deleterious alleles detected G6PD Orissa (56.5%) was found to be the most predominant variant followed by G6PD Mediterranean (23.6%). G6PD Mediterranean, G6PD Kaiping and G6PD Mahidol were found to be severely deficient variant and 14.1% of them showed undetectable activity. A novel mutation c.544C➔G (R182G) in exon 6 was identified in one tribal male where substitution of arginine by glycine, likely causes the alteration in the alpha helix leading to disruption of secondary structure of the protein. CONCLUSION There are large differences in the distribution of G6PD causal variants between Indian states, and this may have implications for the treatment in the malaria endemic areas.
Collapse
Affiliation(s)
- Rati Devendra
- ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012. India
| | - Vinodkumar Gupta
- ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012. India
| | - Rajasubramaniam Shanmugam
- ICMR-National Institute for Research in Tribal Health (NIRTH), Department of Health Research, Ministry of Health & Family Welfare, NIRTH Complex, Nagpur Road, P.O.- Garha, Jabalpur, Madhya Pradesh 482003, India
| | - M P S S Singh
- ICMR-National Institute for Research in Tribal Health (NIRTH), Department of Health Research, Ministry of Health & Family Welfare, NIRTH Complex, Nagpur Road, P.O.- Garha, Jabalpur, Madhya Pradesh 482003, India
| | - Purushottam Patel
- ICMR-National Institute for Research in Tribal Health (NIRTH), Department of Health Research, Ministry of Health & Family Welfare, NIRTH Complex, Nagpur Road, P.O.- Garha, Jabalpur, Madhya Pradesh 482003, India
| | - Neena Valecha
- ICMR-National Institute of Malaria Research (NIMR), Sector 8 Dwarka, Dwarka, New Delhi, Delhi 110077, India
| | - Neelima Mishra
- ICMR-National Institute of Malaria Research (NIMR), Sector 8 Dwarka, Dwarka, New Delhi, Delhi 110077, India
| | - Naseem Ahmed
- ICMR-National Institute of Malaria Research (NIMR), Sector 8 Dwarka, Dwarka, New Delhi, Delhi 110077, India
| | - S L Hoti
- ICMR-National Institute of Traditional Medicine (NITM), Nehru Nagar, Belgavi, Karnataka 590010, India
| | - Harsha V Hegde
- ICMR-National Institute of Traditional Medicine (NITM), Nehru Nagar, Belgavi, Karnataka 590010, India
| | - Prashant Warang
- ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012. India
| | - Ashish Chiddarwar
- ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012. India
| | - Prabhakar Kedar
- ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012. India
| | - Pramod Mayekar
- ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012. India
| | - Malay B Mukherjee
- ICMR-National Institute of Immunohaematology (NIIH), 13th Floor, K.E.M Hospital campus, Parel, Mumbai 400012. India.
| |
Collapse
|
16
|
Vengidasan L, Yunus MA, Yusoff NM, Yahaya BH, Ismail IS. Production and differential activity of recombinant human wild-type G6PD and G6PD Viangchan. ASIAN BIOMED 2020; 14:159-167. [PMID: 37551388 PMCID: PMC10373393 DOI: 10.1515/abm-2020-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Background Glucose-6-phosphate dehydrogenase (G6PD) is essential to produce reduced nicotinamide adenine dinucleotide phosphate, which is required to protect cells against oxidative stress. G6PD deficiency is a genetic variation that may lead to hemolysis with potential consequences, such as kidney failure, and patients often experience low quality of life. Objectives To establish a simple, efficient, and optimized method to produce a G6PDViangchan variant and characterize the phenotypes of recombinant human wild-type G6PD and G6PDViangchan. Methods G6PD was amplified by polymerase chain reaction (PCR) from a human cDNA plasmid, and the gene for G6PDViangchan was amplified by initiating a mutation at location 871 (G>A) through site-directed mutagenesis. Protein expression and western blotting were conducted after successful cloning. The enzymatic activity of both proteins was assessed spectrophotometrically after purification. Results Both amplicons were successfully cloned into a pET26b(+) expression vector and transformed into Escherichia coli BL21 (DE3) cells for overexpression as C-terminally histidine-tagged recombinant proteins. Western blotting confirmed that both proteins were successfully produced at similar levels. The enzymes were purified by immobilized metal (Co) affinity chromatography. Postpurification assay of enzyme activity revealed about 2-fold differences in the levels of specific activity between the wild-type G6PD (155.88 U/mg) and G6PDViangchan (81.85 U/mg), which is consistent with earlier reports. Analysis in silico showed that the coding change in G6PDViangchan has a substantial effect on protein folding structure. Conclusions We successfully cloned, expressed, and purified both wild-type G6PD and G6PDViangchan proteins. Such a protocol may be useful for creating a model system to study G6PD deficiency disease.
Collapse
Affiliation(s)
- Lelamekala Vengidasan
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Malaysia, Bertam13200, Penang, Malaysia
| | - Muhammad Amir Yunus
- Infectomics Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam13200, Penang, Malaysia
| | - Narazah Mohd Yusoff
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Malaysia, Bertam13200, Penang, Malaysia
| | - Badrul Hisham Yahaya
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Malaysia, Bertam13200, Penang, Malaysia
| | - Ida Shazrina Ismail
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Malaysia, Bertam13200, Penang, Malaysia
| |
Collapse
|
17
|
Leong A, Lim VJY, Wang C, Chai JF, Dorajoo R, Heng CK, van Dam RM, Koh WP, Yuan JM, Jonas JB, Wang YX, Wei WB, Liu J, Reilly DF, Wong TY, Cheng CY, Sim X. Association of G6PD variants with hemoglobin A1c and impact on diabetes diagnosis in East Asian individuals. BMJ Open Diabetes Res Care 2020; 8:8/1/e001091. [PMID: 32209585 PMCID: PMC7103857 DOI: 10.1136/bmjdrc-2019-001091] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/20/2020] [Accepted: 02/14/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Hemoglobin A1c (HbA1c) accuracy is important for diabetes diagnosis and estimation of overall glycemia. The G6PD-Asahi variant which causes glucose-6-phosphate dehydrogenase (G6PD) deficiency has been shown to lower HbA1c independently of glycemia in African ancestry populations. As different G6PD variants occur in Asian ancestry, we sought to identify Asian-specific G6PD variants associated with HbA1c. RESEARCH DESIGN AND METHODS In eight Asian population-based cohorts, we performed imputation on the X chromosome using the 1000 Genomes reference panel and tested for association with HbA1c (10 005 East Asians and 2051 South Asians). Results were meta-analyzed across studies. We compared the proportion of individuals classified as having diabetes/pre-diabetes by fasting glucose ≥100 mg/dL or HbA1c ≥5.7% units among carriers and non-carriers of HbA1c-associated variants. RESULTS The strongest association was a missense variant (G6PD-Canton, rs72554665, minor allele frequency=2.2%, effect in men=-0.76% unit, 95% CI -0.88 to -0.64, p=1.25×10-27, n=2844). Conditional analyses identified a secondary distinct signal, missense variant (G6PD-Kaiping, rs72554664, minor allele frequency=1.6%, effect in men=-1.12 % unit, 95% CI -1.32 to -0.92, p=3.12×10-15, pconditional_Canton=7.57×10-11). Adjusting for glucose did not attenuate their effects. The proportion of individuals with fasting glucose ≥100 mg/dL did not differ by carrier status of G6PD-Canton (p=0.21). Whereas the proportion of individuals with HbA1c ≥5.7% units was lower in carriers (5%) compared with non-carriers of G6PD-Canton (30%, p=0.03). CONCLUSIONS We identified two G6PD variants in East Asian men associated with non-glycemic lowering of HbA1c. Carriers of these variants are more likely to be underdiagnosed for diabetes or pre-diabetes than non-carriers if screened by HbA1c without confirmation by direct glucose measurements.
Collapse
Affiliation(s)
- Aaron Leong
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Victor Jun Yu Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Chaolong Wang
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Jin-Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke NUS Medical School, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany
- Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ya Xing Wang
- Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen-Bin Wei
- Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Dermot F Reilly
- Genetics, Merck Sharp and Dohme IA, Kenilworth, New Jersey, USA
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| |
Collapse
|
18
|
Alina MF, Azma RZ, Norunaluwar J, Azlin I, Darnina AJ, Cheah FC, Noor-Farisah AR, Siti-Hawa AA, Danny XRK, Zulkifli NF, Ainoon O. Genotyping of Malaysian G6PD-deficient neonates by reverse dot blot flow-through hybridisation. J Hum Genet 2019; 65:263-270. [PMID: 31863082 DOI: 10.1038/s10038-019-0700-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 10/13/2019] [Accepted: 11/23/2019] [Indexed: 11/09/2022]
Abstract
G6PD deficiency is the commonest enzyme deficiency found in humans. Current diagnostic methods lack sensitivity to detect all cases of G6PD deficiency. We evaluated the reverse dot blot flow-through hybridisation assay designed to detect simultaneously multiple known G6PD mutations in a group of Malaysian neonates. Archival DNA samples from 141 G6PD-deficient neonates were subjected to reverse dot blot flow-through hybridisation assay using the GenoArray Diagnostic Kit (Hybribio Limited, Hong Kong) and DNA sequencing. The method involved PCR amplification of 5 G6PD exons using biotinylated primers, hybridisation of amplicons to a membrane containing oligoprobes designed for G6PD mutations known to occur in the Malaysian population and colour detection by enzyme immunoassay. The assay detected 13 of the 14 G6PD mutations and genotyped 133 (94.3%) out of 141 (102 males, 39 females) cases. Among the 39 female G6PD-deficient neonates, there were 7 homozygous and 6 compound heterozygous cases. The commonest alleles were G6PD Viangchan 871G > A (21%) and G6PD Mahidol 487G > A(20%) followed by G6PD Mediterranean 563C > T, (14%), G6PD Vanua Lava 383T > C (12%), G6PD Canton 1376G > T (10%), G6PD Orissa 131C > G (6.3%) G6PD Coimbra 592C > T (5.6%) plus 6 other mutations. DNA sequencing of remaining cases revealed 6 cases of intron 11 nt 93C > T not previously reported in Malaysia and two novel mutations, one case each of nt 1361G > T and nt 1030G > A. We found the reverse dot blot assay easy to perform, rapid, accurate and reproducible, potentially becoming an improved diagnostic test for G6PD deficiency.
Collapse
Affiliation(s)
- M F Alina
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.,Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - R Z Azma
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia.
| | - J Norunaluwar
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia.,Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - I Azlin
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - A J Darnina
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - F C Cheah
- Department of Paediatrics, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - A R Noor-Farisah
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - A A Siti-Hawa
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - X R K Danny
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Noor-Fadzilah Zulkifli
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - O Ainoon
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.
| |
Collapse
|
19
|
Li Y, Wu T, Chen L, Zhu Y. Associations between G6PD, OATP1B1 and BLVRA variants and susceptibility to neonatal hyperbilirubinaemia in a Chinese Han population. J Paediatr Child Health 2019; 55:1077-1083. [PMID: 30636082 DOI: 10.1111/jpc.14346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 11/01/2018] [Accepted: 11/18/2018] [Indexed: 12/30/2022]
Abstract
AIM Hyperbilirubinaemia is a common disorder in newborns. The aim of this study was to investigate the associations between G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 variants and the risk of neonatal hyperbilirubinaemia in a Chinese neonate population. METHODS A total of 447 Chinese neonates with hyperbilirubinaemia were selected as the study group and 544 healthy subjects were recruited as the control group matched by baseline sex, age, feeding pattern and delivery mode. About 2 mL of peripheral venous blood was taken from all subjects. The single nucleotide polymorphisms (SNPs) of G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 loci were examined by the polymerase chain reaction and Sanger sequencing technique in the peripheral blood of all subjects. RESULTS For the G6PD 1388 G>A SNP, individuals carrying the A-allele were associated with a significantly increased risk of neonatal hyperbilirubinaemia (adjusted odds ratio (OR) = 1.49, P < 0.001, 95% confidence interval (CI): 1.31-1.67). This risk increased significantly in the CC genotype carriers at the rs4149056 locus of the SLCO1B1 gene (OR = 2.17, 95% CI: 1.87-2.33), whereas it decreased significantly in individuals carrying the G-allele at the rs699512 locus of the BLVRA gene (adjusted OR = 0.84, P = 0.01, 95% CI: 0.75-0.95). The G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512 SNPs had a significant impact on serum total bilirubin levels. Moreover, individuals carrying the A-allele of G6PD 1388 G>A and BLVRA rs699512 had a significantly increased risk of developing neonatal hyperbilirubinaemia (OR = 5.01, P < 0.001, 95% CI: 3.42-7.85). CONCLUSION Genetic variants of bilirubin metabolism genes, including G6PD 1388 G>A, SLCO1B1 rs4149056 and BLVRA rs699512, are associated with the risk of neonatal hyperbilirubinaemia, and are potential markers for predicting the disorder.
Collapse
Affiliation(s)
- Yongpei Li
- Department of Child Health Care, Hangzhou Women's Hospital, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| | - Ting Wu
- Department of Child Health Care, Hangzhou Women's Hospital, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| | - Ling Chen
- Department of Child Health Care, Hangzhou Women's Hospital, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| | - Yunxia Zhu
- Department of Child Health Care, Hangzhou Women's Hospital, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| |
Collapse
|
20
|
Chiu YH, Chen HJ, Chang YC, Liu YN, Kao SM, Liu MY, Weng YY, Hsiao KJ, Liu TT. Applying a multiplexed primer extension method on dried blood spots increased the detection of carriers at risk of glucose-6-phosphate dehydrogenase deficiency in newborn screening program. Clin Chim Acta 2019; 495:271-277. [PMID: 31022393 DOI: 10.1016/j.cca.2019.04.074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/15/2019] [Accepted: 04/19/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Patients with glucose-6-phosphate dehydrogenase deficiency might develop acute hemolytic anemia, chronic hemolytic anemia, and neonatal hyperbilirubinemia when exposed to high levels of oxidative stress. Severe hemolysis may occur in not only patients but also female carriers under certain conditions. However, 80%-85% of female carriers were undetected in an existing newborn screening program because of their wide-ranging levels of enzyme activity. METHODS We developed a cost- and time-efficient multiplex SNaPshot assay using dried blood spots. RESULTS By detecting 21 common mutations in Taiwan and Southeast Asia, the assay could determine 98.2% of the mutant alleles in our cohort of Taiwanese newborns. The 9 undetermined mutant alleles were consequently detected by Sanger sequencing, of which 5 unpublished variations-c.187G > A (Pingtung), c.585G > C (Tainan), c.586A > T (Changhua), c.743G > A (Chiayi), and c.1330G > A (Tainan-2)-were detected. Furthermore, 13% of mild mutations were missed in male infants whose enzyme levels at 6.1-7.0 U/gHb in the newborn screening program when set the cutoff value at 6.0 U/gHb. We therefore suggest increasing the cutoff value and applying the multiplex SNaPshot assay as the second tier for neonatal screening. CONCLUSIONS Our approach could significantly increase the detection rate of male patients and female carriers with a reasonable cost and a reasonable number of clinic referrals.
Collapse
Affiliation(s)
- Yen-Hui Chiu
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Department of Biotechnology and Pharmaceutical Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Hsiao-Jan Chen
- Neonatal Screening Center, The Chinese Foundation of Health, Taipei, Taiwan
| | - Ying-Chen Chang
- Cancer Progression Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Ning Liu
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Shu-Min Kao
- Neonatal Screening Center, The Chinese Foundation of Health, Taipei, Taiwan
| | - Mei-Ying Liu
- Neonatal Screening Center, The Chinese Foundation of Health, Taipei, Taiwan
| | - Ying-Yen Weng
- Cancer Progression Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Kwang-Jen Hsiao
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Preventive Medicine Foundation, Taipei, Taiwan.
| | - Tze-Tze Liu
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Cancer Progression Research Center, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
21
|
Zhong Z, Wu H, Li B, Li C, Liu Z, Yang M, Zhang Q, Zhong W, Zhao P. Analysis of Glucose-6-Phosphate Dehydrogenase Genetic Polymorphism in the Hakka Population in Southern China. Med Sci Monit 2018; 24:7316-7321. [PMID: 30315739 PMCID: PMC6196584 DOI: 10.12659/msm.908402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background In southern China, glucose-6-phosphate dehydrogenase (G6PD) deficiency is a significant health problem. The aim of this study was to investigate the molecular epidemiological characteristic of the G6PD gene among Chinese Hakka in southern Guangdong province. Material/Methods We screened 611 unrelated subjects for G6PD genetic polymorphism analyzed by a gene chip analysis for common Chinese G6PD mutations. G-6-PD enzyme activity was determined by use of the G-6-PD quantitative detection kit. Results Seven mutation sites were detected from subjects in our study. G6PD Canton (c.1376 G→T)(33.06%), G6PD Kaiping (c.1388 G→A)(30.67%), and polymorphism (c.1311 C→T)(25.89%) account for 89.62% of mutations, followed by G6PD Gaohe (c.95 A→G)(5.97%), G6PD Chinese-5 (c.1024 C→T)(3.58%), G6PD Maewo (c.1360 C→T)(0.39%), and G6PD Viangchan (c.871G→A)(0.39%). Conclusions We studied the genetic polymorphisms and frequencies of G6PD gene in the Hakka population of Meizhou. Our results coincide with the results among the Chinese Jiangxi Hakka population. It was consistent with previous research reports on Chinese people. There were differences in the results of reports from some other Asian populations. Our results could be useful for future prevention and control of G6PD deficiency aimed at the Chinese Hakka population.
Collapse
Affiliation(s)
- Zhixiong Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Heming Wu
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Bin Li
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Cunren Li
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Zhidong Liu
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Min Yang
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Qifeng Zhang
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Wei Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| | - Pingsen Zhao
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland)
| |
Collapse
|
22
|
Goh KL. Lessons learnt from the epidemiology of Helicobacter pylori infection in Malaysia: JGHF Marshall and Warren Lecture 2017. J Gastroenterol Hepatol 2018; 33:1177-1184. [PMID: 29498759 DOI: 10.1111/jgh.14131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 02/16/2018] [Accepted: 02/19/2018] [Indexed: 12/12/2022]
Abstract
The study of Helicobacter pylori in Malaysia has given several important insights into the epidemiology of the infection and pathogenesis of disease. Malaysia has a multiracial Asian population with three major Asian races living together-Malay, Chinese, and Indian. Races remain fairly distinct because of a paucity of interracial marriages. The "Racial Cohort Hypothesis" proposes that the infection occurs within racial groups rather than between. As such, the high prevalence among Indians (> 50%) and Chinese (40-50%) reflects the high prevalence in their countries of origin even though migration had taken place more than two generations before. The Malays have a comparatively low prevalence of about 10-20%. Despite the high prevalence of H. pylori, the Indians have a low gastric cancer incidence of less than 10 per 100 000 per year. This is in contrast to the Chinese who has an incidence in excess of 20 per 100 000 per year. We have called this the "Indian Enigma." The reason for this enigma is unclear and is the result of interaction between bacterial virulence factors, host susceptibility, and environmental factors. Phylogenetically, Chinese bacterial strains are distinct from Indians and Malays and are predominantly hpEastAsia/hsp EAsia. CagA EPIYA motifs among Chinese belong predominantly to the more virulent ABD motif. There is no clear distinguishing profile among host genetic factors. Environmental factors particularly diet may play an important role. Indians consume chilies and curries, which may be gastro protective, whereas Chinese consume more preserved and salted foods, which are thought to be carcinogenic.
Collapse
Affiliation(s)
- Khean-Lee Goh
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
23
|
Powers JL, Best DH, Grenache DG. Genotype-Phenotype Correlations of Glucose-6-Phosphate-Deficient Variants Throughout an Activity Distribution. J Appl Lab Med 2018; 2:841-850. [PMID: 33636823 DOI: 10.1373/jalm.2017.024935] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 11/08/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder that may manifest as neonatal jaundice or acute hemolytic anemia. Quantitative assessment of G6PD activity in erythrocytes is required to definitively diagnose a deficiency. Most males and homozygous females have low enzyme activities, whereas heterozygous females may have a range of activities. We sought to examine G6PD genotype-phenotype associations to identify an activity cutoff above which G6PD deficiency is unlikely. METHODS Ninety-five residual samples were randomly selected to represent the various regions of a G6PD activity distribution. DNA was isolated from the leukocyte fraction and sequenced using the Sanger method. ROC curves were used to establish cutoffs. RESULTS Thirteen variant alleles were identified, including 1 not previously reported. In the very deficient activity range, we found males and homozygous females of both class II and III variants. In the deficient category, we found predominantly class III males and heterozygous females. The presumed deficient category contained class III and IV variants and nonvariants. An activity cutoff of <7.85 U/g hemoglobin (Hb) was 100% sensitive and 94% specific for identifying a G6PD-deficient male, and a cutoff of <8.95 U/g Hb was 90% sensitive and 82% specific for a deficient female. CONCLUSIONS The observed activity groupings were not because of a particular variant class. Cutoffs to identify the presence of a deficiency variant for males and females may be useful when trying to decide whether to recommend genetic analysis.
Collapse
Affiliation(s)
- Jennifer L Powers
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| | - D Hunter Best
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| | - David G Grenache
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT
| |
Collapse
|
24
|
Banyatsuppasin W, Jindadamrongwech S, Limrungsikul A, Butthep P. Prevalence of Thalassemia and Glucose-6-Phosphate Dehydrogenase Deficiency in Newborns and Adults at the Ramathibodi Hospital, Bangkok, Thailand. Hemoglobin 2017; 41:260-266. [PMID: 29251006 DOI: 10.1080/03630269.2017.1402026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Thalassemias and glucose-6-phosphate dehydrogenase (G6PD) deficiency are the most common inherited blood disorders. They are distributed among populations living in malaria endemic regions resulting in survival advantage from severe malaria disease. The aims of this study were to analyze the prevalence of thalassemias and G6PD deficiency at the Ramathibodi Hospital, Bangkok, Thailand. A total of 616 adult and 174 cord blood samples were collected and analyzed for red blood cell (RBC) parameters, hemoglobin (Hb) typing and DNA analysis for G6PD mutations and α-thalassemia (α-thal). The two most prominent types of thalassemia were heterozygous Hb E (HBB: c.79G>A), (19.5% in newborns and 35.6% in adults) followed by heterozygous α-thal-2 [-α3.7 (rightward) deletion] at 18.7% in newborns and 19.5% in adults. After performing G6PD genotyping using multiplex amplification refractory mutation system-polymerase chain reaction (multiplex ARMS-PCR) for 10 G6PD mutations, the prevalence of G6PD mutation was found in 12.0% of newborns and 11.7% of adults. The G6PD Viangchan [871 (G>A)] is the most common G6PD mutation in newborns (42.9%) and adults (52.8%). In addition, coinheritance of various types of thalassemia with G6PD deficiency were found. The results indicated that heterozygous Hb E and G6PD Viangchan are predominant both in newborns and adults in this study.
Collapse
Affiliation(s)
- Wansa Banyatsuppasin
- a Department of Pathology, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Sumalee Jindadamrongwech
- a Department of Pathology, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Anchalee Limrungsikul
- b Department of Medicine, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Punnee Butthep
- a Department of Pathology, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| |
Collapse
|
25
|
Boonyuen U, Chamchoy K, Swangsri T, Junkree T, Day NPJ, White NJ, Imwong M. A trade off between catalytic activity and protein stability determines the clinical manifestations of glucose-6-phosphate dehydrogenase (G6PD) deficiency. Int J Biol Macromol 2017; 104:145-156. [PMID: 28583873 PMCID: PMC5625996 DOI: 10.1016/j.ijbiomac.2017.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 01/08/2023]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common polymorphism and enzymopathy in humans, affecting approximately 400 million people worldwide. It is responsible for various clinical manifestations, including favism, hemolytic anemia, chronic non-spherocytic hemolytic anemia, spontaneous abortion, and neonatal hyperbilirubinemia. Understanding the molecular mechanisms underlying the severity of G6PD deficiency is of great importance but that of many G6PD variants are still unknown. In this study, we report the construction, expression, purification, and biochemical characterization in terms of kinetic properties and stability of five clinical G6PD variants-G6PD Bangkok, G6PD Bangkok noi, G6PD Songklanagarind, G6PD Canton+Bangkok noi, and G6PD Union+Viangchan. G6PD Bangkok and G6PD Canton+Bangkok noi showed a complete loss of catalytic activity and moderate reduction in thermal stability when compared with the native G6PD. G6PD Bangkok noi and G6PD Union+Viangchan showed a significant reduction in catalytic efficiency, whereas G6PD Songklanagarind showed a catalytic activity comparable to the wild-type enzyme. The Union+Viangchan mutation showed a remarkable effect on the global stability of the enzyme. In addition, our results indicate that the location of mutations in G6PD variants affects their catalytic activity, stability, and structure. Hence, our results provide a molecular explanation for clinical manifestations observed in individuals with G6PD deficiency.
Collapse
Affiliation(s)
- Usa Boonyuen
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
| | - Kamonwan Chamchoy
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
| | - Thitiluck Swangsri
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
| | - Thanyaphorn Junkree
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Nicholas J White
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Mallika Imwong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
| |
Collapse
|
26
|
Chaowanathikhom M, Nuchnoi P, Palasuwan D. Significance of 3′UTR and Pathogenic Haplotype in Glucose-6-Phosphate Deficiency. Lab Med 2017; 48:73-88. [DOI: 10.1093/labmed/lmw065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
|
27
|
Jalil N, Azma RZ, Mohamed E, Ithnin A, Alauddin H, Baya SN, Othman A. Evaluation of Glucose-6-Phosphate Dehydrogenase stability in stored blood samples. EXCLI JOURNAL 2016; 15:155-62. [PMID: 27103895 PMCID: PMC4834747 DOI: 10.17179/excli2015-604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/02/2016] [Indexed: 12/05/2022]
Abstract
Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is the commonest cause of neonatal jaundice in Malaysia. Recently, OSMMR2000-D G6PD Assay Kit has been introduced to quantitate the level of G6PD activity in newborns delivered in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). As duration of sample storage prior to analysis is one of the matters of concern, this study was conducted to identify the stability of G6PD enzyme during storage. A total of 188 cord blood samples from normal term newborns delivered at UKMMC were selected for this study. The cord bloods samples were collected in ethylene-diamine-tetra-acetic acid (EDTA) tubes and refrigerated at 2-8 °C. In addition, 32 out of 188 cord blood samples were spotted on chromatography paper, air-dried and stored at room temperature. G6PD enzyme activities were measured daily for 7 days using the OSMMR2000-D G6PD Assay Kit on both the EDTA blood and dried blood samples. The mean value for G6PD activity was compared between days of analysis using Student Paired T-Test. In this study, 172 out of 188 cord blood samples showed normal enzyme levels while 16 had levels corresponding to severe enzyme deficiency. The daily mean G6PD activity for EDTA blood samples of newborns with normal G6PD activity showed a significant drop on the fourth day of storage (p < 0.005) while for samples with severely deficient G6PD activity, significant drop was seen on third day of storage (p = 0.002). Analysis of dried cord blood showed a significant reduction in enzyme activity as early as the second day of storage (p = 0.001). It was also noted that mean G6PD activity for spotted blood samples were lower compared to those in EDTA tubes for all days (p = 0.001). Thus, EDTA blood samples stored at 2-8 °C appeared to have better stability in terms of their G6PD enzyme level as compared to dried blood samples on filter paper, giving a storage time of up to 3 days.
Collapse
Affiliation(s)
- Norunaluwar Jalil
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur; Department of Medical Laboratory Technology, Universiti Teknologi MARA, Puncak Alam, Selangor
| | - Raja Zahratul Azma
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Emida Mohamed
- Department of Medical Laboratory Technology, Universiti Teknologi MARA, Puncak Alam, Selangor
| | - Azlin Ithnin
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Hafiza Alauddin
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Siti Noor Baya
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Ainoon Othman
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur
| |
Collapse
|
28
|
Jamornthanyawat N, Awab GR, Tanomsing N, Pukrittayakamee S, Yamin F, Dondorp AM, Day NPJ, White NJ, Woodrow CJ, Imwong M. A population survey of the glucose-6-phosphate dehydrogenase (G6PD) 563C>T (Mediterranean) mutation in Afghanistan. PLoS One 2014; 9:e88605. [PMID: 24586352 PMCID: PMC3931629 DOI: 10.1371/journal.pone.0088605] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 01/12/2014] [Indexed: 11/19/2022] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common inherited enzyme defect and an important problem in areas with Plasmodium vivax infection because of the risk of haemolysis following administration of primaquine to treat the liver forms of the parasite. We undertook a genotypic survey of 713 male individuals across nine provinces of Afghanistan in which malaria is found, four in the north and five in the east. RFLP typing at nucleotide position 563 detected 40 individuals with the Mediterranean mutation 563C>T, an overall prevalence of 5.6%. This varied according to self-reported ethnicity, with prevalence in the Pashtun/Pashai group of 33/369 (8.9%) compared to 7/344 individuals in the rest of the population (2.0%; p<0.001, Chi-squared test). Multivariate analysis of ethnicity and geographical location indicated an adjusted odds ratio of 3.50 (95% CI 1.36-9.02) for the Pashtun/Pashai group, while location showed only a trend towards higher prevalence in eastern provinces (adjusted odds ratio = 1.73, 0.73-4.13). Testing of known polymorphic markers (1311C>T in exon 11, and C93T in intron XI) in a subset of 82 individuals wild-type at C563 revealed a mixture of 3 haplotypes in the background population and was consistent with data from the 1000 Genomes Project and published studies. By comparison individuals with G6PD deficiency showed a highly skewed haplotype distribution, with 95% showing the CT haplotype, a finding consistent with relatively recent appearance and positive selection of the Mediterranean variant in Afghanistan. Overall, the data confirm that the Mediterranean variant of G6PD is common in many ethnic groups in Afghanistan, indicating that screening for G6PD deficiency is required in all individuals before radical treatment of P. vivax with primaquine.
Collapse
Affiliation(s)
- Natsuda Jamornthanyawat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ghulam R. Awab
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Ministry of Public Health, Islamic Republic of Afghanistan, Kabul, Afghanistan
| | - Naowarat Tanomsing
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sasithon Pukrittayakamee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Fazel Yamin
- Ministry of Public Health, Islamic Republic of Afghanistan, Kabul, Afghanistan
| | - Arjen M. Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Nicholas P. J. Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Nicholas J. White
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Charles J. Woodrow
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Mallika Imwong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| |
Collapse
|
29
|
Wong F, Boo N, Othman A. Risk factors associated with unconjugated neonatal hyperbilirubinemia in Malaysian neonates. J Trop Pediatr 2013; 59:280-5. [PMID: 23640907 DOI: 10.1093/tropej/fmt023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the risk factors associated with neonatal hyperbilirubinemia in Malaysian neonates. METHODS A prospective study was conducted to investigate the effects of glucose-6-phosphate dehydrogenase (G6PD) mutation, variant uridine diphosphate glucuronosyltransferase UGT1A1 gene and hepatic organic anion transporter protein (OATP2) gene on a group of neonates. Hyperbilirubinemia was defined as a total serum bilirubin level of ≥250 µmol/l. RESULTS Of 318 neonates, 52 (16.4%) had hyperbilirubinemia. The incidence of G6PD mutation was 5.4% (15/280) among these infants. The incidence of G6PD mutation was significantly higher in the male neonates with hyperbilirubinemia (7.8%) when compared with the normal male neonates without hyperbilirubinemia (1.8%; p = 0.03). Logistic regression analysis showed that the significant risk factors for neonatal hyperbilirubinemia were Malay ethnicity [adjusted odds ratio (OR), 2.77; 95% confidence interval (CI): 1.31-5.86; p = 0.007] and G6PD mutation (adjusted OR, 3.29; 95% CI: 1.06-10.1820; p = 0.039). The gender, birth weight and gestation age of neonates, variant c.211G > A and variant of OATP2 gene were not significant. CONCLUSIONS Neonates with Malay ethnicity and G6PD mutation were at risk for hyperbilirubinemia.
Collapse
Affiliation(s)
- Feiliang Wong
- Unit NICU, Department of Pediatrics, UKMMC, 56000, Kuala Lumpur, Malaysia.
| | | | | |
Collapse
|
30
|
Ezz El-Deen ZM, Hussin NF, Abdel Hamid TA, Abdel Migeed OR, Samy RM. G6PD Deficiency and G6PD (Mediterranean and Silent) Polymorphisms in Egyptian Infants with Neonatal Hyperbilirubinemia. Lab Med 2013. [DOI: 10.1309/lmqosc1ry6ectdu2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
31
|
|
32
|
Abstract
Background There is a strong correlation between glucose-6-phosphate dehydrogenase (G6PD) deficiency and neonatal hyperbilirubinemia with a rare but potential threat of devastating acute bilirubin encephalopathy. G6PD deficiency was observed in 4–14% of hospitalized icteric neonates in Pakistan. G6PD c.563C > T is the most frequently reported variant in this population. The present study was aimed at evaluating the time to onset of hyperbilirubinemia and the postnatal bilirubin trajectory in infants having G6PD c.563C > T. Methods This was a case–control study conducted at The Aga Khan University, Pakistan during the year 2008. We studied 216 icteric male neonates who were re-admitted for phototherapy during the study period. No selection was exercised. Medical records showed that 32 were G6PD deficient while 184 were G6PD normal. Each infant was studied for birth weight, gestational age, age at the time of presentation, presence of cephalhematoma, sepsis and neurological signs, peak bilirubin level, age at peak bilirubin level, days of hospitalization, whether phototherapy or exchange blood transfusion was initiated, and the outcome. During hospital stay, each baby was tested for complete blood count, reticulocyte count, ABO and Rh blood type, direct antiglobulin test and quantitative G6PD estimation [by kinetic determination of G6PDH]. G6PDgenotype was analyzed in 32 deficient infants through PCR-RFLP analysis and gene sequencing. Results G6PD variants c.563C > T and c.131 C > G were observed in 21 (65%) and three (9%) of the 32 G6PD deficient infants, respectively. DNA of eight (25%) newborns remained uncharacterized. In contrast to G6PD normal neonates, infants with c.563C > T variant had significantly lower enzyme activity (mean ± 1SD; 0.3 ± 0.2 U/gHb vs. 14.0 ± 4.5 U/gHb, p < 0.001) experienced higher peak levels of total serum bilirubin (mean ± 1SD; 16.8 ± 5.4 mg/dl vs. 13.8 ± 4.6 mg/dl, p = 0.008) which peaked earlier after birth (mean ± 1SD 2.9 ± 1.6 vs. 4.3 ± 2.3 days, p = 0.007). No statistically significant difference was observed in mean weight, age at presentation, hemoglobin, reticulocyte count, TSH level, hospital stay or in the frequency of initiation of phototherapy or blood exchange between the two groups. Conclusions We concluded that infants with G6PD c.563C > T variant developed jaundice earlier than infants with normal G6PD enzyme levels. Compared to G6PD normal infants, G6PD c.563C > T carrying infants had significantly low G6PD activity.
Collapse
|
33
|
Sirdah M, Reading NS, Perkins SL, Shubair M, Aboud L, Prchal JT. Hemolysis and Mediterranean G6PD mutation (c.563 C>T) and c.1311 C>T polymorphism among Palestinians at Gaza Strip. Blood Cells Mol Dis 2012; 48:203-8. [DOI: 10.1016/j.bcmd.2012.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 01/26/2012] [Indexed: 01/08/2023]
|
34
|
Al-Musawi BM, Al-Allawi N, Abdul-Majeed BA, Eissa AA, Jubrael JM, Hamamy H. Molecular characterization of glucose-6-phosphate dehydrogenase deficient variants in Baghdad city - Iraq. BMC BLOOD DISORDERS 2012; 12:4. [PMID: 22452742 PMCID: PMC3323424 DOI: 10.1186/1471-2326-12-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 03/27/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although G6PD deficiency is the most common genetically determined blood disorder among Iraqis, its molecular basis has only recently been studied among the Kurds in North Iraq, while studies focusing on Arabs in other parts of Iraq are still absent. METHODS A total of 1810 apparently healthy adult male blood donors were randomly recruited from the national blood transfusion center in Baghdad. They were classified into G6PD deficient and non-deficient individuals based on the results of methemoglobin reduction test (MHRT), with confirmation of deficiency by subsequent enzyme assays. DNA from deficient individuals was studied using a polymerase chain reaction-Restriction fragment length polymorphism (PCR-RFLP) for four deficient molecular variants, namely G6PD Mediterranean (563 C→T), Chatham (1003 G→A), A- (202 G→A) and Aures (143 T→C). A subset of those with the Mediterranean variant, were further investigated for the 1311 (C→T) silent mutation. RESULTS G6PD deficiency was detected in 109 of the 1810 screened male individuals (6.0%). Among 101 G6PD deficient males molecularly studied, the Mediterranean mutation was detected in 75 cases (74.3%), G6PD Chatham in 5 cases (5.0%), G6PD A- in two cases (2.0%), and G6PD Aures in none. The 1311 silent mutation was detected in 48 out of the 51 G6PD deficient males with the Mediterranean variant studied (94.1%). CONCLUSIONS Three polymorphic variants namely: the Mediterranean, Chatham and A-, constituted more than 80% of G6PD deficient variants among males in Baghdad. Iraq. This observation is to some extent comparable to other Asian Arab countries, neighboring Turkey and Iran.
Collapse
Affiliation(s)
- Bassam Ms Al-Musawi
- Department of Pathology, College of Medicine, University of Dohuk, Azadi Hospital road, 1014 AM Dohuk, Iraq.
| | | | | | | | | | | |
Collapse
|
35
|
Amini F, Ismail E, Zilfalil BA. Prevalence and molecular study of G6PD deficiency in Malaysian Orang Asli. Intern Med J 2012; 41:351-3. [PMID: 21507164 DOI: 10.1111/j.1445-5994.2011.02456.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study aims to define the prevalence and the molecular basis of G6PD deficiency in the Negrito tribe of the Malaysian Orang Asli. Four hundred and eighty seven consenting Negrito volunteers were screened for G6PD deficiency through the use of a fluorescent spot test. DNA from deficient individuals underwent PCR-RFLP analysis using thirteen recognized G6PD mutations. In the instances when the mutation could not be identified by PCR-RFLP, the entire coding region of the G6PD gene was subjected to DNA sequencing. In total, 9% (44/486) of the sample were found to be G6PD-deficient. However, only 25 samples were subjected to PCR-RFLP and DNA sequencing. Of these, three were found to carry Viangchan, one Coimbra and 16, a combination of C1311T in exon 11 and IVS11 T93C. Mutation(s) for the five remaining samples are unknown. The mean G6PD enzyme activity ranged 5.7 IU/gHb in deficient individuals. Our results demonstrate that the frequency of G6PD deficiency is higher among the Negrito Orang Asli than other Malaysian races. The dual presence of C1311T and IVS11 T93C in 64% of the deficient individuals (16/44) could well be a result of genetic drift within this isolated group.
Collapse
Affiliation(s)
- F Amini
- School of Bioscience and Biotechnology, Faculty of Science and Technology, PERMATApintar UKM, The University of Kebangsaan Malaysia, Selangor Human Genome Centre, The University of Sains Malaysia, Kelantan, Malaysia
| | | | | |
Collapse
|
36
|
Kim S, Nguon C, Guillard B, Duong S, Chy S, Sum S, Nhem S, Bouchier C, Tichit M, Christophel E, Taylor WRJ, Baird JK, Menard D. Performance of the CareStart™ G6PD deficiency screening test, a point-of-care diagnostic for primaquine therapy screening. PLoS One 2011; 6:e28357. [PMID: 22164279 PMCID: PMC3229584 DOI: 10.1371/journal.pone.0028357] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 11/07/2011] [Indexed: 11/19/2022] Open
Abstract
Development of reliable, easy-to-use, rapid diagnostic tests (RDTs) to detect glucose-6-phosphate dehydrogenase (G6PD) deficiency at point of care is essential to deploying primaquine therapies as part of malaria elimination strategies. We assessed a kit under research and development called CareStart™ G6PD deficiency screening test (Access Bio, New Jersey, USA) by comparing its performance to quantitative G6PD enzyme activity using a standardized spectrophotometric method ('gold standard'). Blood samples (n = 903) were collected from Cambodian adults living in Pailin province, western Cambodia. G6PD enzyme activities ranged from 0 to 20.5 U/g Hb (median 12.0 U/g Hg). Based on a normal haemoglobin concentration and wild-type G6PD gene, the normal values of G6PD enzymatic activity for this population was 3.6 to 20.5 U/g Hg (95(th) percentiles from 5.5 to 17.2 U/g Hg). Ninety-seven subjects (10.7%) had <3.6 U/g Hg and were classified as G6PD deficient. Prevalence of deficiency was 15.0% (64/425) among men and 6.9% (33/478) among women. Genotype was analyzed in 66 G6PD-deficient subjects and 63 of these exhibited findings consistent with Viangchang genotype. The sensitivity and specificity of the CareStart™ G6PD deficiency screening test was 0.68 and 1.0, respectively. Its detection threshold was <2.7 U/g Hg, well within the range of moderate and severe enzyme deficiencies. Thirteen subjects (1.4%, 12 males and 1 female) with G6PD enzyme activities <2 U/g Hg were falsely classified as "normal" by RDT. This experimental RDT test here evaluated outside of the laboratory for the first time shows real promise, but safe application of it will require lower rates of falsely "normal" results.
Collapse
Affiliation(s)
- Saorin Kim
- Malaria Molecular Epidemiology Unit, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
| | - Chea Nguon
- National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia
| | - Bertrand Guillard
- Medical Laboratory, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
| | - Socheat Duong
- National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia
| | - Sophy Chy
- Malaria Molecular Epidemiology Unit, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
| | - Sarorn Sum
- Malaria Molecular Epidemiology Unit, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
| | - Sina Nhem
- Malaria Molecular Epidemiology Unit, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
| | | | | | - Eva Christophel
- WHO Regional Office for the Western Pacific, Manilla, Philippines
| | - Walter R. J. Taylor
- Service de Médecine Internationale et Humanitaire, Hopitaux Universitaires de Genève, Geneva, Switzerland
| | - John Kevin Baird
- Eijkman Oxford Clinical Research Unit, Jakarta, Indonesia
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Didier Menard
- Malaria Molecular Epidemiology Unit, Pasteur Institute of Cambodia, Phnom Penh, Cambodia
- * E-mail:
| |
Collapse
|
37
|
Breurec S, Guillard B, Hem S, Brisse S, Dieye FB, Huerre M, Oung C, Raymond J, Tan TS, Thiberge JM, Vong S, Monchy D, Linz B. Evolutionary history of Helicobacter pylori sequences reflect past human migrations in Southeast Asia. PLoS One 2011; 6:e22058. [PMID: 21818291 PMCID: PMC3139604 DOI: 10.1371/journal.pone.0022058] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 06/14/2011] [Indexed: 12/16/2022] Open
Abstract
The human population history in Southeast Asia was shaped by numerous migrations and population expansions. Their reconstruction based on archaeological, linguistic or human genetic data is often hampered by the limited number of informative polymorphisms in classical human genetic markers, such as the hypervariable regions of the mitochondrial DNA. Here, we analyse housekeeping gene sequences of the human stomach bacterium Helicobacter pylori from various countries in Southeast Asia and we provide evidence that H. pylori accompanied at least three ancient human migrations into this area: i) a migration from India introducing hpEurope bacteria into Thailand, Cambodia and Malaysia; ii) a migration of the ancestors of Austro-Asiatic speaking people into Vietnam and Cambodia carrying hspEAsia bacteria; and iii) a migration of the ancestors of the Thai people from Southern China into Thailand carrying H. pylori of population hpAsia2. Moreover, the H. pylori sequences reflect iv) the migrations of Chinese to Thailand and Malaysia within the last 200 years spreading hspEasia strains, and v) migrations of Indians to Malaysia within the last 200 years distributing both hpAsia2 and hpEurope bacteria. The distribution of the bacterial populations seems to strongly influence the incidence of gastric cancer as countries with predominantly hspEAsia isolates exhibit a high incidence of gastric cancer while the incidence is low in countries with a high proportion of hpAsia2 or hpEurope strains. In the future, the host range expansion of hpEurope strains among Asian populations, combined with human motility, may have a significant impact on gastric cancer incidence in Asia.
Collapse
Affiliation(s)
- Sebastien Breurec
- Unité de Biologie Médicale et Environnementale, Institut Pasteur, Dakar, Senegal.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Nadarajan V, Shanmugam H, Sthaneshwar P, Jayaranee S, Sultan KS, Ang C, Arumugam S. Modification to reporting of qualitative fluorescent spot test results improves detection of glucose-6-phosphate dehydrogenase (G6PD)-deficient heterozygote female newborns. Int J Lab Hematol 2011; 33:463-70. [PMID: 21501392 DOI: 10.1111/j.1751-553x.2011.01309.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The glucose-6-phosphate dehydrogenase (G6PD) fluorescent spot test (FST) is a useful screening test for G6PD deficiency, but is unable to detect heterozygote G6PD-deficient females. We sought to identify whether reporting intermediate fluorescence in addition to absent and bright fluorescence on FST would improve identification of mildly deficient female heterozygotes. METHODS A total of 1266 cord blood samples (705 male, 561 female) were screened for G6PD deficiency using FST (in-house method) and a quantitative enzyme assay. Fluorescence intensity of the FST was graded as either absent, intermediate or normal. Samples identified as showing absent or intermediate fluorescence on FST were analysed for the presence of G6PD mutations using TaqMan@SNP genotyping assays and direct nucleotide sequencing. RESULTS Of the 1266 samples, 87 samples were found to be intermediate or deficient by FST (49 deficient, 38 intermediate). Of the 49 deficient samples, 48 had G6PD enzyme activity of ≤ 9.5 U/g Hb and one sample had normal enzyme activity. All 38 intermediate samples were from females. Of these, 21 had G6PD activity of between 20% and 60%, and 17 samples showed normal G6PD activity. Twenty-seven of the 38 samples were available for mutation analysis of which 13 had normal G6PD activity. Eleven of the 13 samples with normal G6PD activity had identifiable G6PD mutations. CONCLUSION Glucose-6-phosphate dehydrogenase heterozygote females cannot be identified by FST if fluorescence is reported as absent or present. Distinguishing samples with intermediate fluorescence from absent and bright fluorescence improves detection of heterozygote females with mild G6PD deficiency. Mutational studies confirmed that 85% of intermediate samples with normal enzyme activity had identifiable G6PD mutations.
Collapse
Affiliation(s)
- V Nadarajan
- Department of Pathology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia Division of Laboratory Medicine, Department of Pathology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | | | | | | | | | | |
Collapse
|
39
|
Minucci A, De Luca D, Torti E, Concolino P, Maurizi P, Giardina B, Zuppi C, Capoluongo E. Acute haemolytic crisis due to concomitant presence of infection and possible altered acetaminophen catabolism in a Philipino child carrying the G6PD-Vanua Lava mutation. Ann Clin Biochem 2011; 48:282-5. [PMID: 21441392 DOI: 10.1258/acb.2010.010163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD), an X-linked hereditary deficiency, is the most common of all clinically significant enzyme defects. While many drugs are responsible for haemolytic anaemia in G6PD-deficient patients, acetaminophen's imputability is still under debate, although an overdose of this drug can provoke acute haemolytic events. We report a case of a Philipino child carrying the G6PD-Vanua Lava mutation with acute haemolytic crisis related to infection in progress and acetaminophen's administration. Fever and concomitant infection, through an increment of erythrocyte glutathione depletion, sensitized the infant to the haemolytic event. In this condition, acetaminophen (or paracetamol [PCM]) was capable of inducing a haemolytic crisis in our G6PD-deficient patient although administered under standard conditions. PCM seems to have induced the haemolytic event, probably by the alteration of its catabolism due to dehydration and fever. The enzymatic G6PD instability associated to the presence of the G6PD-Vanua Lava mutation could have led to an increment of red blood cells' sensitivity to lysis; hence, it is possible that PCM toxicity may also be due to the presence of this particular mutation. Finally, we propose a new biochemical classification of this G6PD variant.
Collapse
Affiliation(s)
- Angelo Minucci
- Laboratory of Clinical Diagnostic Molecular Biology, Institute of Biochemistry & Clinical Biochemistry, Teaching Hospital A.Gemelli, Heart, Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Sarkar S, Biswas NK, Dey B, Mukhopadhyay D, Majumder PP. A large, systematic molecular-genetic study of G6PD in Indian populations identifies a new non-synonymous variant and supports recent positive selection. INFECTION GENETICS AND EVOLUTION 2010; 10:1228-36. [PMID: 20713184 DOI: 10.1016/j.meegid.2010.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 08/07/2010] [Accepted: 08/09/2010] [Indexed: 10/19/2022]
Abstract
Malaria has been endemic in India. G6PD deficiency is known to confer resistance to malaria. Many G6PD deficiency variants, some of which are India-specific, are known to occur in high frequencies in India. This is the first systematic molecular-genetic study in multiple populations from India drawn from diverse ethnic, socio-cultural and geographical backgrounds. Resequencing of the G6PD gene was carried out in 80 males and then the polymorphic variants were genotyped in 400 individuals of both genders, drawn from 10 ethnic groups of India. Our study has identified one new exonic variant (M159I; exon-5), occurring in multiple populations, that is predicted to result in G6PD deficiency. A strong geographical sub-structuring of known G6PD variants has also been established. We have compared all available data from public-domain resources with those generated in this study to identify the nature and extent of natural selection. Our results (a) provide indication of weak negative selection, and (b) reveal signals of recent positive selection for the G6PD Orissa and G6PD Coimbra mutation bearing haplotypes. These inferences have been interpreted in the light of malarial protection to the populations that have been long exposed to plasmodium infection.
Collapse
Affiliation(s)
- Somosree Sarkar
- Human Genetics Unit, Indian Statistical Institute, Kolkata, India
| | | | | | | | | |
Collapse
|
41
|
Prevalence and molecular characterization of Glucose-6-Phosphate dehydrogenase deficient variants among the Kurdish population of Northern Iraq. BMC HEMATOLOGY 2010; 10:6. [PMID: 20602793 PMCID: PMC2913952 DOI: 10.1186/1471-2326-10-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Accepted: 07/05/2010] [Indexed: 11/10/2022]
Abstract
Background Glucose-6-Phosphate dehydrogenase (G6PD) is a key enzyme of the pentose monophosphate pathway, and its deficiency is the most common inherited enzymopathy worldwide. G6PD deficiency is common among Iraqis, including those of the Kurdish ethnic group, however no study of significance has ever addressed the molecular basis of this disorder in this population. The aim of this study is to determine the prevalence of this enzymopathy and its molecular basis among Iraqi Kurds. Methods A total of 580 healthy male Kurdish Iraqis randomly selected from a main regional premarital screening center in Northern Iraq were screened for G6PD deficiency using methemoglobin reduction test. The results were confirmed by quantitative enzyme assay for the cases that showed G6PD deficiency. DNA analysis was performed on 115 G6PD deficient subjects, 50 from the premarital screening group and 65 unrelated Kurdish male patients with documented acute hemolytic episodes due to G6PD deficiency. Analysis was performed using polymerase chain reaction/restriction fragment length polymorphism for five deficient molecular variants, namely G6PD Mediterranean (563 C→T), G6PD Chatham (1003 G→A), G6PD A- (202 G→A), G6PD Aures (143 T→C) and G6PD Cosenza (1376 G→C), as well as the silent 1311 (C→T) mutation. Results Among 580 random Iraqi male Kurds, 63 (10.9%) had documented G6PD deficiency. Molecular studies performed on a total of 115 G6PD deficient males revealed that 101 (87.8%) had the G6PD Mediterranean variant and 10 (8.7%) had the G6PD Chatham variant. No cases of G6PD A-, G6PD Aures or G6PD Cosenza were identified, leaving 4 cases (3.5%) uncharacterized. Further molecular screening revealed that the silent mutation 1311 was present in 93/95 of the Mediterranean and 1/10 of the Chatham cases. Conclusions The current study revealed a high prevalence of G6PD deficiency among Iraqi Kurdish population of Northern Iraq with most cases being due to the G6PD Mediterranean and Chatham variants. These results are similar to those reported from neighboring Iran and Turkey and to lesser extent other Mediterranean countries.
Collapse
|
42
|
Molecular heterogeneity of glucose-6-phosphate dehydrogenase deficiency among the tribals in Western India. Blood Cells Mol Dis 2009; 43:156-7. [DOI: 10.1016/j.bcmd.2009.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 05/13/2009] [Indexed: 11/21/2022]
|
43
|
Hue NT, Charlieu JP, Chau TTH, Day N, Farrar JJ, Hien TT, Dunstan SJ. Glucose-6-phosphate dehydrogenase (G6PD) mutations and haemoglobinuria syndrome in the Vietnamese population. Malar J 2009; 8:152. [PMID: 19589177 PMCID: PMC2717975 DOI: 10.1186/1475-2875-8-152] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Accepted: 07/10/2009] [Indexed: 11/15/2022] Open
Abstract
Background In Vietnam the blackwater fever syndrome (BWF) has been associated with malaria infection, quinine ingestion and G6PD deficiency. The G6PD variants within the Vietnamese Kinh contributing to the disease risk in this population, and more generally to haemoglobinuria, are currently unknown. Method Eighty-two haemoglobinuria patients and 524 healthy controls were screened for G6PD deficiency using either the methylene blue reduction test, the G-6-PDH kit or the micro-methaemoglobin reduction test. The G6PD gene variants were screened using SSCP combined with DNA sequencing in 82 patients with haemoglobinuria, and in 59 healthy controls found to be G6PD deficient. Results This study confirmed that G6PD deficiency is strongly associated with haemoglobinuria (OR = 15, 95% CI [7.7 to 28.9], P < 0.0001). Six G6PD variants were identified in the Vietnamese population, of which two are novel (Vietnam1 [Glu3Lys] and Vietnam2 [Phe66Cys]). G6PD Viangchan [Val291Met], common throughout south-east Asia, accounted for 77% of the variants detected and was significantly associated with haemoglobinuria within G6PD-deficient ethnic Kinh Vietnamese (OR = 5.8 95% CI [114-55.4], P = 0.022). Conclusion The primary frequency of several G6PD mutations, including novel mutations, in the Vietnamese Kinh population are reported and the contribution of G6PD mutations to the development of haemoglobinuria are investigated.
Collapse
Affiliation(s)
- Nguyen Thi Hue
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Vietnam.
| | | | | | | | | | | | | |
Collapse
|
44
|
Tay CY, Mitchell H, Dong Q, Goh KL, Dawes IW, Lan R. Population structure of Helicobacter pylori among ethnic groups in Malaysia: recent acquisition of the bacterium by the Malay population. BMC Microbiol 2009; 9:126. [PMID: 19538757 PMCID: PMC2708179 DOI: 10.1186/1471-2180-9-126] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 06/19/2009] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Helicobacter pylori is a major gastric bacterial pathogen. This pathogen has been shown to follow the routes of human migration by their geographical origin and currently the global H. pylori population has been divided into six ancestral populations, three from Africa, two from Asia and one from Europe. Malaysia is made up of three major ethnic populations, Malay, Chinese and Indian, providing a good population for studying recent H. pylori migration and admixture. RESULTS Seventy eight H. pylori isolates, including 27 Chinese, 35 Indian and 16 Malay isolates from Malaysia were analysed by multilocus sequence typing (MLST) of seven housekeeping genes and compared with the global MLST data. STRUCTURE analysis assigned the isolates to previously identified H. pylori ancestral populations, hpEastAsia, hpAsia2 and hpEurope, and revealed a new subpopulation, hspIndia, within hpAsia2. Statistical analysis allowed us to identify population segregation sites that divide the H. pylori populations and the subpopulations. The majority of Malay isolates were found to be grouped together with Indian isolates. CONCLUSION The majority of the Malay and Indian H. pylori isolates share the same origin while the Malaysian Chinese H. pylori is distinctive. The Malay population, known to have a low infection rate of H. pylori, was likely to be initially H. pylori free and gained the pathogen only recently from cross infection from other populations.
Collapse
Affiliation(s)
- Chin Yen Tay
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Hazel Mitchell
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Quanjiang Dong
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Khean-Lee Goh
- Department of Medicine, Faculty of Medicine, University of Malaysia, Kuala Lumpar, Malaysia
| | - Ian W Dawes
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Ruiting Lan
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| |
Collapse
|
45
|
Nkhoma ET, Poole C, Vannappagari V, Hall SA, Beutler E. The global prevalence of glucose-6-phosphate dehydrogenase deficiency: A systematic review and meta-analysis. Blood Cells Mol Dis 2009; 42:267-78. [DOI: 10.1016/j.bcmd.2008.12.005] [Citation(s) in RCA: 440] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 12/19/2008] [Indexed: 11/15/2022]
|
46
|
Nuchprayoon I, Louicharoen C, Charoenvej W. Glucose-6-phosphate dehydrogenase mutations in Mon and Burmese of southern Myanmar. J Hum Genet 2007; 53:48-54. [PMID: 18046504 DOI: 10.1007/s10038-007-0217-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 10/19/2007] [Indexed: 11/29/2022]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is highly prevalent in Southeast Asians. G6PD mutations are associated with specific ethnic groups in Southeast Asia. Mon is a minority ethnic group in Myanmar, which speaks Monic, a distinct language of Mon-Khmer classification. We studied G6PD mutations in Mon and Burmese males of southern Myanmar who migrated to Thailand in Samutsakhon province. G6PD deficiency was identified in 19 (12%) of 162 Mon males and 17 (10%) of 178 Burmese males, and then assayed for G6PD mutations. Among 19 G6PD-deficient Mons, 12 were G6PD Mahidol; one case each was G6PD Jammu (871G > A; nt 1311C), G6PD Kaiping (1388G > A), G6PD Mediterranean (563C > T), a novel mutation 94(C > G); and three remain unidentified. Among 17 G6PD-deficient Burmese, 12 were G6PD Mahidol; one each was G6PD Coimbra (592C > T), G6PD Kerala-Kalyan (949G > A), and G6PD Valladolid (406C > T); and two remain unidentified. G6PD Mahidol (487G > A) is the most common mutation among Mons and Burmese. All G6PD deficient Mon and Burmese, except for a person with G6PD Valladolid, shared the same haplotype nt93T, nt1311C. Despite a similar language root with Cambodian's Khmer language, our study suggests that Mon people share a common ancestry with Burmese rather than Cambodians.
Collapse
Affiliation(s)
- Issarang Nuchprayoon
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd, Bangkok, 10330, Thailand. .,Chula Medical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Chalisa Louicharoen
- Chula Medical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Warisa Charoenvej
- Department of Clinical Pathology, Samutsakhon Hospital, Samutsakhon, Thailand
| |
Collapse
|
47
|
Chalvam R, Kedar PS, Colah RB, Ghosh K, Mukherjee MB. A novel R198H mutation in the glucose-6-phosphate dehydrogenase gene in the tribal groups of the Nilgiris in Southern India. J Hum Genet 2007; 53:181-184. [DOI: 10.1007/s10038-007-0225-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Accepted: 11/06/2007] [Indexed: 10/22/2022]
|
48
|
Yang Y, Zhu Y, Li D, Li Z, Lü H, Wu J, Tang J, Tong S. Characterization of glucose-6-phosphate dehydrogenase deficiency and identification of a novel haplotype 487G>A/IVS5-612(G>C) in the Achang population of Southwestern China. ACTA ACUST UNITED AC 2007; 50:479-85. [PMID: 17653668 DOI: 10.1007/s11427-007-0072-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Accepted: 06/01/2007] [Indexed: 12/17/2022]
Abstract
The prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency and its gene mutations were studied in the Achang population from Lianghe County in Southwestern China. We found that 7.31% (19 of 260) males and 4.35% (10 of 230) females had G6PD deficiency. The molecular analysis of G6PD gene exons 2-13 was performed by a PCR-DHPLC-Sequencing or PCR-Sequencing. Sixteen independent subjects with G6PD Mahidol (487G>A) and the new polymorphism IVS5-612 (G>C), which combined into a novel haplotype, were identified accounting for 84.2% (16/19). And 100% Achang G6PD Mahidol were linked to the IVS5-612 C. The percentage of G6PD Mahidol in the Achang group is close to that in the Myanmar population (91.3% 73/80), which implies that there are some gene flows between Achang and Myanmar populations. Interestingly, G6PD Canton (1376G>T) and G6PD Kaiping (1388G>A), which were the most common G6PD variants from other ethnic groups in China, were not found in this Achang group, suggesting that there are different G6PD mutation profiles in the Achang group and other ethnic groups in China. Our findings appear to be the first documented report on the G6PD genetics of the AChang people, which will provide important clues to the Achang ethnic group origin and will help prevention and treatment of malaria in this area.
Collapse
Affiliation(s)
- YinFeng Yang
- Department of Biochemistry, Faculty of Basic Medicine, Kunming University of Medical Sciences, Kunming 650031, China
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Kawamoto F, Matsuoka H, Kanbe T, Tantular IS, Pusarawati S, Kerong HI, Damianus W, Mere D, Dachlan YP. Further investigations of glucose-6-phosphate dehydrogenase variants in Flores Island, eastern Indonesia. J Hum Genet 2006; 51:952-957. [PMID: 16927025 DOI: 10.1007/s10038-006-0044-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2006] [Accepted: 07/26/2006] [Indexed: 10/24/2022]
Abstract
We conducted field surveys for malaria and glucose-6-phosphate dehydrogenase (G6PD) deficiency in the eastern part of Flores Island, East Nusa Tenggara Province, Indonesia. A total of 1,108 volunteers (642 males and 466 females) belonging to three ethnic groups (Sikka, Ende and Bajo) were examined, and 55 G6PD-deficient individuals (38 males and 17 females) were detected. Among them, 50 samples were analyzed molecularly, in addition to three deficient cases in a Bajo family. In the Sikka population, G6PD Kaiping (1388G>A), one of the two common variants in the Chinese population, was unexpectedly found as the most dominant variant (11/22, 50.0%), followed by G6PD Chatham (1003G>A, 36.4%), G6PD Coimbra (592C>T, 9.1%) and G6PD Vanua Lava (383T>C, 4.5%). Frequency of G6PD Kaiping in the Sikka might be the highest among non-Chinese populations reported so far. In the Ende population, G6PD Vanua Lava (9/14, 64.3%) was the highest, followed by G6PD Kaiping (14.3%), G6PD Chinese-5 (1024C>T, 14.3%) and G6PD Chatham (7.1%). In the Bajo population, a total of 18 deficient cases were analyzed, and a novel mutation (844G>T) in exon 8 with a predicted amino acid change of 282 Asp>Tyr was found in a 7-year-old boy at a Bajo village near Maumere. This new Class II (mild type) variant was also confirmed in his mother and sister, and designated as G6PD Bajo Maumere. The missense mutation at the same nucleotide 844 has been known as G6PD Seattle/Lodi/Modena/Ferrara II, but this mutation is caused by a G>C substitution (282 Asp>His). In the Bajo population, G6PD Viangchan (871G>A, IVS 11 nt93 T>C, 1311C>T), the most common variant in continental Southeast Asian populations, was found to be the dominant (11/18, 61.1%), followed by G6PD Vanua Lava and the new variant (each 16.7%), and G6PD Coimbra (5.6%). These results strongly suggest that the Bajo peoples may have different ancestors from those for Sikka and Ende, and may be much closer to continental Southeast Asian populations. It is interesting that G6PD Canton (1376G>T), another common variant in Chinese, was not seen in the Flores population.
Collapse
Affiliation(s)
- Fumihiko Kawamoto
- Institute of Scientific Research, Faculty of Medicine, Oita University, Yufu, Japan.
| | - Hiroyuki Matsuoka
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Shimotsuke, Japan
| | - Toshio Kanbe
- Department of Advanced Medical Science, Nagoya University Graduate School of Medicine, Showa, Nagoya, Japan
| | - Indah S Tantular
- Tropical Disease Center, Airlangga University, Surabaya, Indonesia
| | | | - Henyo I Kerong
- Health Department, Maumere, Sikka District, East Nusa Tenggala Province, Indonesia
| | - Wera Damianus
- Health Department, Maumere, Sikka District, East Nusa Tenggala Province, Indonesia
| | - Dominikus Mere
- Health Department, Ende, Ende District, East Nusa Tenggala Province, Indonesia
| | - Yoes P Dachlan
- Tropical Disease Center, Airlangga University, Surabaya, Indonesia
| |
Collapse
|
50
|
Laosombat V, Sattayasevana B, Chotsampancharoen T, Wongchanchailert M. Glucose-6-phosphate dehydrogenase variants associated with favism in Thai children. Int J Hematol 2006; 83:139-43. [PMID: 16513531 DOI: 10.1532/ijh97.a20513] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In a study conducted at Songklanagarind Hospital in the south of Thailand, the subjects were 225 patients (210 boys and 15 girls) with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Favism was found in 3.6% of the G6PD-deficient children. Approximately one half of the G6PD-deficient patients with favism were younger than 2 years. Sudden onset of anemia was found within 1 to 3 days after ingestion of dried fava beans. The classic features of favism, which are pallor, hemoglobinuria, and jaundice, were detected in all cases. To characterize the known G6PD mutations in Thai children, molecular analysis was performed for 8 G6PD-deficient children with favism by a combination of polymerase chain reaction-restriction fragment length polymorphism analysis and amplification refractory mutation system analysis. The G6PD variants in these children were G6PD Kaiping 1388,G-->A; G6PD Mahidol 487,G-->A; G6PD Viangchan 871,G-->A; and uncharacterized mutation with silent mutation 1311,C-->T.
Collapse
Affiliation(s)
- Vichai Laosombat
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand.
| | | | | | | |
Collapse
|