1
|
Yu X, Peng Y, Nie T, Sun W, Zhou Y. Diabetes and two kinds of primary tumors in a patient with thalassemia: a case report and literature review. Front Oncol 2023; 13:1207336. [PMID: 37637036 PMCID: PMC10455928 DOI: 10.3389/fonc.2023.1207336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Background Thalassemia is a group of common genetic hematologic disorders characterized by deficient synthesis of the hemoglobin chain. Due to effective blood transfusion and optimization of chelate therapy, the survival of thalassemia patients and their overall quality of life have improved noticeably in the past few decades. As a consequence, the longer life expectancy has led to the manifestation of several concomitant morbidities, including heart disease, infections, cirrhosis, endocrine abnormalities, various malignancies, and so on. In this context, the probability and updated literature about some malignancy cases in patients with thalassemia build new scenarios for the next few years. We describe the first report of a thalassemic patient developing diabetes and head and neck cancer and try to summarize the possible predisposing factors and mechanisms behind their phenomenon. Case presentation The current case report describes a 50-year-old Asian man who has been diagnosed with thalassemia since childhood. In early 2017, he was also diagnosed with diabetes and started on insulin-hypoglycemic treatment. The patient was then diagnosed with primary non-keratinizing undifferentiated carcinoma of the nasopharynx in late February 2013. A biopsy of the left tongue revealed squamous cell carcinoma (SCC) in late March 2019. Conclusions We report the first case of a thalassemic patient developing diabetes and squamous cell carcinoma of the head and neck and discuss the possibility of a link between the three diseases. This specific case should alert physicians to the possibility of endocrinopathy and malignancy in thalassemic patients.
Collapse
Affiliation(s)
- Xiaoyan Yu
- Department of Radiotherapy, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Peng
- Department of Radiotherapy, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tingting Nie
- Department of Radiotherapy, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenjia Sun
- Department of Pathology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yajuan Zhou
- Department of Radiotherapy, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
2
|
Liang HF, Liang WM, Xie WG, Lin F, Liu LL, Li LJ, Ge YY, Lu M, Liao YW, Zeng GK, Yao JX, Situ JW, Yang LY. The gene spectrum of thalassemia in Yangjiang of western Guangdong Province. Front Genet 2023; 14:1126099. [PMID: 36861132 PMCID: PMC9968962 DOI: 10.3389/fgene.2023.1126099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
Background: Thalassemia presents a higher incidence in southern China. The objective of this study is to analyze the genotype distribution of thalassemia in Yangjiang, a western city of Guangdong Province in China. Methods: The genotypes of suspected cases with thalassemia were tested by PCR and reverse dot blot (RDB). Unidentified rare thalassemia genotypes of the samples were further ascertained by PCR and direct DNA sequencing. Results: Among 22467 suspected cases with thalassemia, 7658 cases were found with thalassemia genotypes using our PCR-RDB kit. Among these 7658 cases, 5313 cases were found with α-thalassemia (α-thal) alone, --SEA/αα was the most common genotype, accounting for 61.75% of α-thal genotypes, and the following mutations were found: α3.7/αα, -α4.2/αα, αCSα/αα, αWSα/αα, and αQSα/αα. A total of 2032 cases were found with β-thalassemia (β-thal) alone. βCD41-42/βN, βIVS-II-654/βN, and β-28/βN accounted for 80.9% of all β-thal genotypes, and the following genotypes were found: βCD17/βN, βCD71-72/βN, and βE/βN. Compound heterozygotes of β-thal and β-thalassemia homozygotes were identified in 11 and five cases, respectively, in this study. α-thal combined with β-thal was identified in 313 cases, showing 57 genotype combinations of the coincidence of both Hb disorders; one extreme patient had a genotype of --SEA/αWSα and βCD41-42/β-28. In addition, four rare α-mutations (--THAI, HKαα, Hb Q-Thailand, and CD31 AGG>AAG) and six rare β-mutations (CD39 CAG>TAG, IVS-Ⅱ-2 (-T), -90(C>T), Chinese Gγ+(Aγδβ)0, CD104 (-G), and CD19 A>G) were also found in this study population. Conclusion: This study provided detailed genotypes of thalassemia in Yangjiang of western Guangdong Province in China and reflected the complexity of genotypes in this high-prevalence region, and this would be valuable for diagnosis and counseling for thalassemia in this area.
Collapse
Affiliation(s)
- Hong-Feng Liang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Wei-Min Liang
- Medical Laboratory, Women and Children Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Wen-Guang Xie
- Medical Laboratory, Women and Children Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Fen Lin
- Precision Medical Lab Center, Chaozhou Central Hospital Affiliated to Southern Medical University, Chaozhou, Guangdong, China
| | - Li-Li Liu
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Lie-Jun Li
- Guangdong Hybribio Limited Corporation, Chaozhou, Guangdong, China
| | - Yi-Yuan Ge
- Guangdong Hybribio Limited Corporation, Chaozhou, Guangdong, China
| | - Min Lu
- Guangdong Hybribio Limited Corporation, Chaozhou, Guangdong, China
| | - Yu-Wei Liao
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Guang-Kuan Zeng
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Jin-Xiu Yao
- Laboratory Medical Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Jing-Wei Situ
- Laboratory Medical Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China
| | - Li-Ye Yang
- Precision Medical Lab Center, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China,*Correspondence: Li-Ye Yang,
| |
Collapse
|
3
|
|
4
|
Ali G, Tariq MA, Shahid K, Ahmad FJ, Akram J. Advances in genome editing: the technology of choice for precise and efficient β-thalassemia treatment. Gene Ther 2020; 28:6-15. [PMID: 32355226 DOI: 10.1038/s41434-020-0153-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/03/2020] [Accepted: 04/16/2020] [Indexed: 11/09/2022]
Abstract
Beta (β)-thalassemia is one of the most significant hemoglobinopathy worldwide. The high prevalence of the β-thalassemia carriers aggravates the disease burden for patients and national economies in the developing world. The survival of β-thalassemia patients solely relies on repeated transfusions, which eventually results into multi-organ damage. The fetal γ-globin genes are ordinarily silenced at birth and replaced by the adult β-globin genes. However, mutations that cause lifelong persistence of fetal γ-globin, ameliorate the debilitating effects of β-globin mutations. Therefore, therapeutically reactivating the fetal γ-globin gene is a prime focus of researchers. CRISPR/Cas9 is the most common approach to correct disease causative mutations or to enhance or disrupt the expression of proteins to mitigate the effects of the disease. CRISPR/cas9 and prime gene editing to correct mutations in hematopoietic stem cells of β-thalassemia patients has been considered a novel therapeutic approach for effective hemoglobin production. However, genome-editing technologies, along with all advantages, have shown some disadvantages due to either random insertions or deletions at the target site of edition or non-specific targeting in genome. Therefore, the focus of this review is to compare pros and cons of these editing technologies and to elaborate the retrospective scope of gene therapy for β-thalassemia patients.
Collapse
Affiliation(s)
- Gibran Ali
- Institute of Regenerative Medicine, Physiology and Cell Biology Department, University of Health Sciences Lahore, Khyaban-e-Jamia Punjab, Lahore, 54600, Pakistan.
| | - Muhammad Akram Tariq
- Institute of Regenerative Medicine, Physiology and Cell Biology Department, University of Health Sciences Lahore, Khyaban-e-Jamia Punjab, Lahore, 54600, Pakistan
| | - Kamran Shahid
- Department of Oncology Medicine, University of Texas Health Science Center at Tyler, 11937 US HWY 271, Tyler, 75708, TX, USA
| | - Fridoon Jawad Ahmad
- Institute of Regenerative Medicine, Physiology and Cell Biology Department, University of Health Sciences Lahore, Khyaban-e-Jamia Punjab, Lahore, 54600, Pakistan.
| | - Javed Akram
- University of Health Sciences Lahore, Khyaban-e-Jamia Punjab, Lahore, 54600, Pakistan
| |
Collapse
|
5
|
Wu H, Zhu Q, Zhong H, Yu Z, Zhang Q, Huang Q. Analysis of genotype distribution of thalassemia and G6PD deficiency among Hakka population in Meizhou city of Guangdong Province. J Clin Lab Anal 2019; 34:e23140. [PMID: 31793705 PMCID: PMC7171329 DOI: 10.1002/jcla.23140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 10/14/2019] [Accepted: 11/15/2019] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of the study was to explore genotype distribution thalassemia and G6PD deficiency in Meizhou city, China. Methods A total of 16 158 individuals were involved in thalassemia genetic testing. A total of 605 subjects were screened for common Chinese G6PD mutations by gene chip analysis. Genotypes and allele frequencies were analyzed. Results A total of 5463 cases carried thalassemia mutations were identified, including 3585 cases, 1701 cases, and 177 cases with α‐, β‐, and α + β‐thalassemia mutations, respectively. ‐‐SEA (65.12%), ‐α3.7 (19.05%), and ‐α4.2 (8.05%) deletion were the main mutations of α‐thalassemia, while IVS‐II‐654(C → T) (40.39%), CD41‐42(‐TCTT) (32.72%), ‐28(A → G) (10.11%), and CD17(A → T) (9.32%) mutations were the principal mutations of β‐thalassemia in Meizhou. There were significant differences in allele frequencies in some counties. Genetic testing for G6PD deficiency, six mutation sites, and one polymorphism were detected in our study. A total of 198 alleles with the mutation were detected among 805 alleles (24.6%). G6PD Canton (c.1376 G → T) (45.96%), G6PD Kaiping (c.1388 G → A) (39.39%), and G6PD Gaohe (c.95 A → G) (9.09%) account for 94.44% mutations, followed by G6PD Chinese‐5 (c.1024 C → T) (4.04%), G6PD Viangchan (c.871G → A) (1.01%), and G6PD Maewo (c.1360 C → T) (0.51%). There were some differences of the distribution of G6PD mutations among eight counties in Meizhou. Conclusions The ‐‐SEA, ‐α3.7, and ‐α4.2 deletion were the main mutations of α‐thalassemia, while IVS‐II‐654(C → T), CD41‐42(‐TCTT), ‐28(A → G), and CD17(A → T) mutations were the principal mutations of β‐thalassemia in Meizhou. G6PD c.1376 G → T, c.1388 G → A, and c.95 A → G were the main mutations of G6PD deficiency. There were some differences of the distribution of thalassemia and G6PD mutations among eight counties in Meizhou.
Collapse
Affiliation(s)
- Heming Wu
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, Meizhou, China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Qiuyan Zhu
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, Meizhou, China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Hua Zhong
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, Meizhou, China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Zhikang Yu
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, Meizhou, China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Qunji Zhang
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, Meizhou, China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Qingyan Huang
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, Meizhou, China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| |
Collapse
|
6
|
Karponi G, Zogas N. Gene Therapy For Beta-Thalassemia: Updated Perspectives. APPLICATION OF CLINICAL GENETICS 2019; 12:167-180. [PMID: 31576160 PMCID: PMC6765258 DOI: 10.2147/tacg.s178546] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/11/2019] [Indexed: 12/26/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation was until very recently, the only permanent curative option available for patients suffering from transfusion-dependent beta-thalassemia. Gene therapy, by autologous transplantation of genetically modified hematopoietic stem cells, currently represents a novel therapeutic promise, after many years of extensive preclinical research for the optimization of gene transfer protocols. Nowadays, clinical trials being held on a worldwide setting, have demonstrated that, by re-establishing effective hemoglobin production, patients may be rendered transfusion- and chelation-independent and evade the immunological complications that normally accompany allogeneic hematopoietic stem cell transplantation. The present review will offer a retrospective scope of the long way paved towards successful implementation of gene therapy for beta-thalassemia, and will pinpoint the latest strategies employed to increase globin expression that extend beyond the classic transgene addition perspective. A thorough search was performed using Pubmed in order to identify studies that provide a proof of principle on the aforementioned topic at a preclinical and clinical level. Inclusion criteria also regarded gene transfer technologies of the past two decades, as well as publications outlining the pitfalls that precluded earlier successful implementation of gene therapy for beta-thalassemia. Overall, after decades of research, that included both successes and pitfalls, the path towards a permanent, donor-irrespective cure for beta-thalassemia patients is steadily becoming a realistic approach.
Collapse
Affiliation(s)
- Garyfalia Karponi
- Department of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Zogas
- Department of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
7
|
Abstract
Thalassemia is an inherited autosomal recessive disorder with microcytic hypochromic anemia resulting from reduced or absent synthesis of 1 or more of the globin chains of hemoglobin. This study provided the insight into prevalence and molecular characterization of thalassemia in Hakka population. 14,524 unrelated subjects were included in our study from January 2015 to November 2017. All the subjects were detected by hematological analysis, hemoglobin electrophoresis analysis, and molecular diagnosis (gap-polymerase chain reaction and flow-through hybridization technology). Data analysis was used to compare allele frequencies between the Hakka populations. Seven thousand four hundred twenty-two cases of microcytosis were found. The percentage of microcytosis in Meizhou, Ganzhou, and Heyuan was 50.91% (6738/13,236), 51.27% (445/868), and 56.90% (239/420), respectively. A total of 5516 mutant chromosomes were identified, including 3775 α-thalassemia and 1741 β-thalassemia. --/αα was the most common α-thalassemia genotype, followed by -α/αα and -α/αα, accounted for 84.92% of α-thalassemia genotypes. Twelve kinds of mutations and 26 genotypes in β-thalassemia were found. IVS-II-654(C→T), CD41-42(-TCTT), -28(A→G), and CD17(A→T) alleles accounted for 92.65% of these mutations. IVS-II-654/N, CD41-42/N, -28/N, CD17/N genotypes accounted for 91.53% of β-thalassemia genotypes. 27 fetuses with at-risk pregnancies were subjected to prenatal diagnosis. Five fetuses were Bart's hydrops syndrome and 2 fetuses with β-thalassemia major. There were some differences in molecular characterization of thalassemia among Hakka people in different areas of southern China. Our results enriched the related information of thalassemia in the region, which provided valuable references for the prevention and control of thalassemia.
Collapse
Affiliation(s)
- Pingsen Zhao
- Clinical Core Laboratory
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
- Prenatal Diagnosis Center, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, P. R. China
| | - Heming Wu
- Clinical Core Laboratory
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
- Prenatal Diagnosis Center, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, P. R. China
| | - Ruiqiang Weng
- Clinical Core Laboratory
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
- Prenatal Diagnosis Center, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, P. R. China
| |
Collapse
|
8
|
Lechauve C, Butcher JT, Freiwan A, Biwer LA, Keith JM, Good ME, Ackerman H, Tillman HS, Kiger L, Isakson BE, Weiss MJ. Endothelial cell α-globin and its molecular chaperone α-hemoglobin-stabilizing protein regulate arteriolar contractility. J Clin Invest 2018; 128:5073-5082. [PMID: 30295646 DOI: 10.1172/jci99933] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 08/21/2018] [Indexed: 12/18/2022] Open
Abstract
Arteriolar endothelial cell-expressed (EC-expressed) α-globin binds endothelial NOS (eNOS) and degrades its enzymatic product, NO, via dioxygenation, thereby lessening the vasodilatory effects of NO on nearby vascular smooth muscle. Although this reaction potentially affects vascular physiology, the mechanisms that regulate α-globin expression and dioxygenase activity in ECs are unknown. Without β-globin, α-globin is unstable and cytotoxic, particularly in its oxidized form, which is generated by dioxygenation and recycled via endogenous reductases. We show that the molecular chaperone α-hemoglobin-stabilizing protein (AHSP) promotes arteriolar α-globin expression in vivo and facilitates its reduction by eNOS. In Ahsp-/- mice, EC α-globin was decreased by 70%. Ahsp-/- and Hba1-/- mice exhibited similar evidence of increased vascular NO signaling, including arteriolar dilation, blunted α1-adrenergic vasoconstriction, and reduced blood pressure. Purified α-globin bound eNOS or AHSP, but not both together. In ECs in culture, eNOS or AHSP enhanced α-globin expression posttranscriptionally. However, only AHSP prevented oxidized α-globin precipitation in solution. Finally, eNOS reduced AHSP-bound α-globin approximately 6-fold faster than did the major erythrocyte hemoglobin reductases (cytochrome B5 reductase plus cytochrome B5). Our data support a model whereby redox-sensitive shuttling of EC α-globin between AHSP and eNOS regulates EC NO degradation and vascular tone.
Collapse
Affiliation(s)
- Christophe Lechauve
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Joshua T Butcher
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Abdullah Freiwan
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Lauren A Biwer
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Julia M Keith
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Miranda E Good
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Hans Ackerman
- Laboratory of Malaria and Vector Research, National Institutes of Allergy and Infectious Diseases, Rockville, Maryland, USA
| | - Heather S Tillman
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Brant E Isakson
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Mitchell J Weiss
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
9
|
Byrou S, Makrigiorgos GM, Christofides A, Kallikas I, Papasavva T, Kleanthous M. Fast Temperature-Gradient COLD PCR for the enrichment of the paternally inherited SNPs in cell free fetal DNA; an application to non-invasive prenatal diagnosis of β-thalassaemia. PLoS One 2018; 13:e0200348. [PMID: 30044883 PMCID: PMC6059429 DOI: 10.1371/journal.pone.0200348] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/25/2018] [Indexed: 11/28/2022] Open
Abstract
Objective To develop a sensitive, specific, simple, cost-effective and reproducible platform for the non-invasive prenatal detection of paternally inherited alleles for β-thalassaemia. The development of such an assay is of major significance in order to replace currently-applied invasive methods containing inherent fetal loss risks. Methods We present a fast Temperature-Gradient Co-amplification at Lower Denaturation Temperature Polymerase Chain Reaction (fast TG COLD PCR) methodology for the detection of the paternally-inherited fetal alleles in maternal plasma. Two single-nucleotide polymorphisms (SNPs), rs7480526 (G/T) and rs968857 (G/A) that are located on the β-globin gene cluster and exhibit a high degree of heterozygosity in the Cypriot population were selected for evaluation. Seventeen maternal plasma samples from pregnancies at risk for β-thalassemia were analysed for the selected SNPs using the novel fast TG COLD PCR assay. Results Using fast TG COLD PCR, the paternally inherited allele in cell free fetal DNA was correctly determined for all the 17 maternal plasma samples tested, showing full agreement with the Chorionic Villus Sampling (CVS) analysis. Conclusions Our findings are encouraging and demonstrate the efficiency and sensitivity of fast TG COLD PCR in detecting the minor paternally-inherited fetal alleles in maternal plasma for the development of a NIPD assay for β-thalassaemia.
Collapse
Affiliation(s)
- Stefania Byrou
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - G. Mike Makrigiorgos
- Department of Radiation Oncology, Division of Medical Physics & Biophysics, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | | | - Thessalia Papasavva
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Nicosia, Cyprus
- * E-mail:
| | - Marina Kleanthous
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| |
Collapse
|
10
|
Zhao P, Wu H, Zhong Z, Lan L, Zeng M, Lin H, Wang H, Zheng Z, Su L, Guo W. Molecular prenatal diagnosis of alpha and beta thalassemia in pregnant Hakka women in southern China. J Clin Lab Anal 2018; 32:e22306. [PMID: 28771834 PMCID: PMC6816879 DOI: 10.1002/jcla.22306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/11/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To date, there has been no systematic study of DNA-based prenatal diagnosis of thalassemia in pregnant Hakka women in southern China. METHODS A total of 279 pregnant Hakka women with confirmed cases of thalassemia who had been treated at the Meizhou People's Hospital in China's Guangdong Province from January 2014 to December 2016 were here enrolled. Genomic DNA was extracted from peripheral blood of couples and villus, amniotic fluid, or fetal cord blood. DNA-based diagnosis was performed on the tissues of fetuses whose parents had tested positive for α- and β-globin gene mutations were found using polymerase chain reaction (PCR) and flow-through hybridization technique. Follow-up visits were performed 6 months after the fetuses were born. Prenatal diagnosis was performed on 279 fetuses in at-risk pregnancies. RESULTS Here, 211 α-thalassemia fetuses were confirmed, including 41 (19.43%) that tested positive for Bart's hydrops syndrome and 15 (7.11%) for Hb H disease. There were 103 (48.81%) heterozygotes. β-thalassemia was confirmed in 68 fetuses, including 23 (33.82%) with severe thalassemia and 27 (39.71%) heterozygotes. Another 12 cases were confirmed with α+β-thalassemia, including three cases of severe β-thalassemia. DNA-based testing prenatal diagnosis of thalassemia was found to be highly reliable. CONCLUSIONS Our findings provide key information for clinical genetic counseling of prenatal diagnosis for major thalassemia in pregnant Hakka women in southern China.
Collapse
Affiliation(s)
- Pingsen Zhao
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Heming Wu
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Zhixiong Zhong
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Liubing Lan
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Department of ObstetricsMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Mei Zeng
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Department of ObstetricsMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Hualan Lin
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Department of ObstetricsMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Huaxian Wang
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Zhiyuan Zheng
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Luxian Su
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Wei Guo
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Prenatal Diagnosis CenterMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| |
Collapse
|
11
|
Lew VL, Tiffert T. On the Mechanism of Human Red Blood Cell Longevity: Roles of Calcium, the Sodium Pump, PIEZO1, and Gardos Channels. Front Physiol 2017; 8:977. [PMID: 29311949 PMCID: PMC5732905 DOI: 10.3389/fphys.2017.00977] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 11/15/2017] [Indexed: 11/13/2022] Open
Abstract
In a healthy adult, the transport of O2 and CO2 between lungs and tissues is performed by about 2 · 1013 red blood cells, of which around 1.7 · 1011 are renewed every day, a turnover resulting from an average circulatory lifespan of about 120 days. Cellular lifespan is the result of an evolutionary balance between the energy costs of maintaining cells in a fit functional state versus cell renewal. In this Review we examine how the set of passive and active membrane transporters of the mature red blood cells interact to maximize their circulatory longevity thus minimizing costs on expensive cell turnover. Red blood cell deformability is critical for optimal rheology and gas exchange functionality during capillary flow, best fulfilled when the volume of each human red blood cell is kept at a fraction of about 0.55-0.60 of the maximal spherical volume allowed by its membrane area, the optimal-volume-ratio range. The extent to which red blood cell volumes can be preserved within or near these narrow optimal-volume-ratio margins determines the potential for circulatory longevity. We show that the low cation permeability of red blood cells allows volume stability to be achieved with extraordinary cost-efficiency, favouring cell longevity over cell turnover. We suggest a mechanism by which the interplay of a declining sodium pump and two passive membrane transporters, the mechanosensitive PIEZO1 channel, a candidate mediator of Psickle in sickle cells, and the Ca2+-sensitive, K+-selective Gardos channel, can implement red blood cell volume stability around the optimal-volume-ratio range, as required for extended circulatory longevity.
Collapse
Affiliation(s)
- Virgilio L Lew
- Physiological Laboratory, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Teresa Tiffert
- Physiological Laboratory, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
12
|
de Souza RAV, Carlos AM, de Souza BMB, Rodrigues CV, Pereira GDA, Moraes-Souza H. Α-Thalassemia: Genotypic Profile Associated with Ethnicity and Hematological Differentiation of Iron Deficiency Anemia in the Region of Uberaba, Minas Gerais, Brazil. Hemoglobin 2015; 39:264-9. [PMID: 26182338 DOI: 10.3109/03630269.2015.1037890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
α-Thalassemia (α-thal) is a hereditary hemoglobinopathy characterized by microcytic anemia due to impaired production of α chains of human globin. Brazilian studies show that the most common genotype is an -α(3.7) deletion with the loss of one or two α genes. As the production of α chains is not as accentuated in these cases, the correct diagnosis can only be achieved through molecular analysis that is not usually routinely performed by laboratories. We investigated the occurrence of α-thal babies born between September 2011 to January 2013 at the hospital of the Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Brazil, and blood donors of the Uberaba Regional Blood Center, Hemominas Foundation, Uberaba, Brazil, correlating it with ethnicity and differences between hematological parameters of donors, α-thal and iron deficiency patients. α-Thalassemia was investigated for the most common deleted alleles (-α(3.7), -α(4.2), - -(SEA), - -(FIL), - -(THAI), -(α)(20.5) and - -(MED)). The incidence in newborns was 13.16% with a predominance of heterozygosity for the -α(3.7) genotype (12.35%), followed by the -α(3.7)/-α(3.7) (0.46%) and αα/-α(4.2) genotypes (0.35%). In blood donors, the prevalence of α-thal was 14.89%, with all cases being heterozygous for the -α(3.7) deletion. There was an association of the α-thal genotype with African ancestors for both groups, thereby confirming published data and showing the strong influence of Blacks on the composition of the population of Brazil's southeastern region. Minor changes were found between hematological parameters of blood donors with iron deficiency and α-thal that did not contribute to the differential diagnosis between the two types of anemia.
Collapse
Affiliation(s)
- Renata A Volpe de Souza
- Department of Clinical Medicine, Universidade Federal do Triângulo Mineiro (UFTM) , Uberaba, Minas Gerais , Brazil
| | | | | | | | | | | |
Collapse
|
13
|
Li Z, Li L, Yao Y, Li N, Li Y, Zhang Z, Yan F, Qiu H, Wu C, Zhang Z. A novel promoter mutation (HBB: c.-75G>T) was identified as a cause of β(+)-thalassemia. Hemoglobin 2015; 39:115-20. [PMID: 25657036 DOI: 10.3109/03630269.2014.1002844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report a novel β-globin gene promoter mutation in a Chinese family identified using fluorescence resolution melting curve analysis and gene sequencing. The proband, who showed the phenotype of β-thalassemia intermedia (β-TI), was found to be a compound heterozygote for the novel mutation -25 (G>T) (HBB: c.-75G>T) and a codon 17 (HBB: c.52A>T) mutation. Moreover, conservation analysis using phyloP and phastCons indicated that the mutated base in the proband was conserved. This novel point mutation on the β-globin gene is in close proximity to the conserved ATAA sequence located at position -25 relative to the mRNA Cap site. We performed a further comparative analysis of the clinical phenotypes and hematological parameters in this pedigree and found that the father was a carrier of the novel point mutation and showed low levels of hemoglobin (Hb), mean corpuscular volume (MCV) and mean corpuscular Hb (MCH). Thus, the available evidence suggests that this novel mutation, -25, results in β(+)-thalassemia (β(+)-thal).
Collapse
Affiliation(s)
- Zeyong Li
- Biological Experiment Center, the Second People's Hospital of Guangdong Province , Guangzhou, Guangdong Province , People's Republic of China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Role of α-globin H helix in the building of tetrameric human hemoglobin: interaction with α-hemoglobin stabilizing protein (AHSP) and heme molecule. PLoS One 2014; 9:e111395. [PMID: 25369055 PMCID: PMC4219717 DOI: 10.1371/journal.pone.0111395] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/23/2014] [Indexed: 11/25/2022] Open
Abstract
Alpha-Hemoglobin Stabilizing Protein (AHSP) binds to α-hemoglobin (α-Hb) or α-globin and maintains it in a soluble state until its association with the β-Hb chain partner to form Hb tetramers. AHSP specifically recognizes the G and H helices of α-Hb. To investigate the degree of interaction of the various regions of the α-globin H helix with AHSP, this interface was studied by stepwise elimination of regions of the α-globin H helix: five truncated α-Hbs α-Hb1-138, α-Hb1-134, α-Hb1-126, α-Hb1-123, α-Hb1-117 were co-expressed with AHSP as two glutathione-S-transferase (GST) fusion proteins. SDS-PAGE and Western Blot analysis revealed that the level of expression of each truncated α-Hb was similar to that of the wild type α-Hb except the shortest protein α-Hb1-117 which displayed a decreased expression. While truncated GST-α-Hb1-138 and GST-α-Hb1-134 were normally soluble; the shorter globins GST-α-Hb1-126 and GST-α-Hb1-117 were obtained in very low quantities, and the truncated GST-α-Hb1-123 provided the least material. Absorbance and fluorescence studies of complexes showed that the truncated α-Hb1-134 and shorter forms led to modified absorption spectra together with an increased fluorescence emission. This attests that shortening the H helix leads to a lower affinity of the α-globin for the heme. Upon addition of β-Hb, the increase in fluorescence indicates the replacement of AHSP by β-Hb. The CO binding kinetics of different truncated AHSPWT/α-Hb complexes showed that these Hbs were not functionally normal in terms of the allosteric transition. The N-terminal part of the H helix is primordial for interaction with AHSP and C-terminal part for interaction with heme, both features being required for stability of α-globin chain.
Collapse
|
15
|
Mashhadi MA, Sepehri Z, Heidari Z, Shirzaee E, Kiani Z. The prevalence of zinc deficiency in patients with thalassemia in South East of iran, sistan and baluchistan province. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e6243. [PMID: 25389495 PMCID: PMC4222021 DOI: 10.5812/ircmj.6243] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/27/2013] [Accepted: 07/14/2014] [Indexed: 12/02/2022]
Abstract
Background: There are different and controversial reports about zinc deficiency in patients with major thalassemia. Objectives: The aim of this study was to evaluate zinc status in patients with major thalassemia in Sistan and Baluchistan province, southeastern Iran. Patients and Methods: The study was performed in Ali Asghar Hospital, a specialized governmental hospital located in Zahedan, Iran. In this cross-sectional study, 369 patients with a history of major thalassemia for more than 5 years entered the study using convenience sampling method. Thirty-six subjects were excluded from the study based on our exclusion criteria. Zinc level was measured in all patients after 12 hours fasting using atomic absorption spectrometry method in 2012. Results: Of 369 cases, 333 patients were eligible and evaluated. The mean age was 15.63 ± 7.4 years. One hundred ninety two cases were male and others were female (141 cases). About 27% (90) of the cases were 5-10 years-old, 24% (80) were 10-15 years-old and 49% were older than 15 years old. Iron chelator in 65.46% was Desferrioxamine, in 28.2% was Deferasirox and in 19.5% was combination of Desferrioxamine and Deferiprone. All cases had zinc deficiency, and 98.5% had severe zinc deficiency. Others (1.5%) had mild deficiency. Conclusions: Our study on 333 patients with major thalassemia documented severe zinc deficiency in all cases. We had no cases with normal or increased zinc levels. It was different with other reports in the world.
Collapse
Affiliation(s)
- Mohammad Ali Mashhadi
- Department of Hematology and Oncology, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Zahra Sepehri
- Department of Internal Medicine, Amir Al-Momenin Hospital, Zabol University of Medical Sciences, Zabol, IR Iran
- Corresponding Author: Zahra Sepehri, Department of Internal Medicine, Amir Al-Momenin Hospital, Zabol University of Medical Sciences, Zabol, IR Iran. Tel: +98-9126880468, E-mail:
| | - Zahra Heidari
- Department of Internal Medicine, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Eghbal Shirzaee
- Department of Internal Medicine, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Zohre Kiani
- Kerman University of Medical Sciences, Kerman, IR Iran
| |
Collapse
|
16
|
Yin A, Li B, Luo M, Xu L, Wu L, Zhang L, Ma Y, Chen T, Gao S, Liang J, Guo H, Qin D, Wang J, Yuan T, Wang Y, Huang WW, He WF, Zhang Y, Liu C, Xia S, Chen Q, Zhao Q, Zhang X. The prevalence and molecular spectrum of α- and β-globin gene mutations in 14,332 families of Guangdong Province, China. PLoS One 2014; 9:e89855. [PMID: 24587075 PMCID: PMC3937408 DOI: 10.1371/journal.pone.0089855] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 01/27/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To reveal the familial prevalence and molecular variation of α- and β-globin gene mutations in Guangdong Province. METHODS A total of 40,808 blood samples from 14,332 families were obtained and analyzed for both hematological and molecular parameters. RESULTS A high prevalence of α- and β-globin gene mutations was found. Overall, 17.70% of pregnant women, 15.94% of their husbands, 16.03% of neonates, and 16.83% of couples (pregnant women and their husbands) were heterozygous carriers of α- or β-thalassemia. The regions with the highest prevalence were the mountainous and western regions, followed by the Pearl River Delta; the region with the lowest prevalence was Chaoshan. The total familial carrier rate (both spouses were α- or β-thalassemia carriers) was 1.87%, and the individual carrier rates of α- and β-thalassemia were 1.68% and 0.20%, respectively. The total rate of moderate-to-severe fetal thalassemia was 12.78% among couples in which both parents were carriers. CONCLUSIONS There was a high prevalence of α- and β-thalassemia in Guangdong Province. This study will contribute to the development of thalassemia prevention and control strategies in Guangdong Province.
Collapse
Affiliation(s)
- Aihua Yin
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Bing Li
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Department of Healthcare, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China
| | - Mingyong Luo
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Longchang Xu
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Department of Healthcare, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China
| | - Li Wu
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Department of Healthcare, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China
| | - Liang Zhang
- BioChain (Beijing) Science and Technology Inc., Beijing, China
| | - Yuanzhu Ma
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Department of Healthcare, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China
| | - Tingting Chen
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Department of Healthcare, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China
| | - Shuang Gao
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Department of Healthcare, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China
| | - Juqing Liang
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Hao Guo
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Danqing Qin
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Jicheng Wang
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Tenglong Yuan
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Yixia Wang
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Wei-wei Huang
- BioChain (Beijing) Science and Technology Inc., Beijing, China
| | - Wen-Fei He
- BioChain (Beijing) Science and Technology Inc., Beijing, China
| | - Yanxia Zhang
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Chang Liu
- Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
| | - Sujian Xia
- Department of Epidemiology, Medical College, Jinan University, Guangzhou, Guangdong, China
| | - Qingshan Chen
- Department of Health Statistics, Medical College, Jinan University, Guangzhou, Guangdong, China
| | - Qingguo Zhao
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- Department of Healthcare, Guangdong Women And Children Hospital, Guangzhou, Guangdong, China
| | - Xiaozhuang Zhang
- Thalassemia Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, Guangdong, China
- * E-mail:
| |
Collapse
|
17
|
Kiger L, Vasseur C, Domingues-Hamdi E, Truan G, Marden MC, Baudin-Creuza V. Dynamics of α-Hb chain binding to its chaperone AHSP depends on heme coordination and redox state. Biochim Biophys Acta Gen Subj 2014; 1840:277-87. [DOI: 10.1016/j.bbagen.2013.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 09/06/2013] [Accepted: 09/09/2013] [Indexed: 11/27/2022]
|
18
|
GUO ZHIBIN, CHI FENG, SONG YAN, WANG CHANGSHAN, YU RUOXING, WEI TIANLI, GUI JINGANG, ZHU XIKE. Transcriptome analysis of murine thymic epithelial cells reveals age-associated changes in microRNA expression. Int J Mol Med 2013; 32:835-42. [DOI: 10.3892/ijmm.2013.1471] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/19/2013] [Indexed: 11/05/2022] Open
|
19
|
Papasavva TE, Lederer CW, Traeger-Synodinos J, Mavrou A, Kanavakis E, Ioannou C, Makariou C, Kleanthous M. A Minimal Set of SNPs for the Noninvasive Prenatal Diagnosis ofβ-Thalassaemia. Ann Hum Genet 2013; 77:115-24. [DOI: 10.1111/ahg.12004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Accepted: 10/08/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Thessalia E. Papasavva
- Molecular Genetics Thalassaemia Department; The Cyprus Institute of Neurology and Genetics; Nicosia; Cyprus
| | - Carsten W. Lederer
- Molecular Genetics Thalassaemia Department; The Cyprus Institute of Neurology and Genetics; Nicosia; Cyprus
| | - Jan Traeger-Synodinos
- Laboratory of Medical Genetics; University of Athens; St. Sophia's Children's Hospital; Athens; Greece
| | - Ariadne Mavrou
- Laboratory of Medical Genetics; University of Athens; St. Sophia's Children's Hospital; Athens; Greece
| | - Emmanuel Kanavakis
- Laboratory of Medical Genetics; University of Athens; St. Sophia's Children's Hospital; Athens; Greece
| | | | | | - Marina Kleanthous
- Molecular Genetics Thalassaemia Department; The Cyprus Institute of Neurology and Genetics; Nicosia; Cyprus
| |
Collapse
|
20
|
Abstract
A current challenge in the era of genome-wide studies is to determine the responsible genes and mechanisms underlying newly identified loci. Screening of the plasma proteome by high-throughput mass spectrometry (MALDI-TOF MS) is considered a promising approach for identification of metabolic and disease processes. Therefore, plasma proteome screening might be particularly useful for identifying responsible genes when combined with analysis of variation in the genome. Here, we describe a proteomic quantitative trait locus (pQTL) study of plasma proteome screens in an F(2) intercross of 455 mice mapped with 177 genetic markers across the genome. A total of 69 of 176 peptides revealed significant LOD scores (≥5.35) demonstrating strong genetic regulation of distinct components of the plasma proteome. Analyses were confirmed by mechanistic studies and MALDI-TOF/TOF, liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses of the two strongest pQTLs: A pQTL for mass-to-charge ratio (m/z) 3494 (LOD 24.9, D11Mit151) was identified as the N-terminal 35 amino acids of hemoglobin subunit A (Hba) and caused by genetic variation in Hba. Another pQTL for m/z 8713 (LOD 36.4; D1Mit111) was caused by variation in apolipoprotein A2 (Apoa2) and cosegregated with HDL cholesterol. Taken together, we show that genome-wide plasma proteome profiling in combination with genome-wide genetic screening aids in the identification of causal genetic variants affecting abundance of plasma proteins.
Collapse
|
21
|
Genetic approaches to a better understanding of bipolar disorder. Pharmacol Ther 2011; 133:133-41. [PMID: 22004838 DOI: 10.1016/j.pharmthera.2011.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 09/13/2011] [Indexed: 12/24/2022]
Abstract
Bipolar disorder is a disease which causes major disability. The disease has both a manic and depressive component. Current standard of care consists of atypical antipsychotics for the treatment of mania, antidepressants for the treatment of depression, and mood stabilizers for the maintenance of euthymia. The molecular mechanisms which cause the disease are not well understood. Genome wide association studies have provided a set of genes which are linked to the disease. These genes show linkage to physiological and neuroanatomical alterations which are also seen in bipolar disorder.
Collapse
|
22
|
Sankaran VG, Nathan DG. Thalassemia: an overview of 50 years of clinical research. Hematol Oncol Clin North Am 2011; 24:1005-20. [PMID: 21075277 DOI: 10.1016/j.hoc.2010.08.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The thalassemias are attributable to the defective production of the α- and β-globin polypeptides of hemoglobin. Significant discoveries have illuminated the pathophysiology and enhanced the prevention and treatment of the thalassemias, and this article reviews many of the advances that have occurred in the past 50 years. However, the application of new approaches to the treatment of these disorders has been slow, particularly in the developing world where the diseases are common, but there is definite progress. This article emphasizes how the increasing knowledge of cellular and molecular biology are facilitating the development of more effective therapies for these patients.
Collapse
|
23
|
Chiu RWK, Lo YMD. Non-invasive prenatal diagnosis by fetal nucleic acid analysis in maternal plasma: the coming of age. Semin Fetal Neonatal Med 2011; 16:88-93. [PMID: 21075065 DOI: 10.1016/j.siny.2010.10.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Prenatal diagnosis is an important part of obstetrics care. In the current prenatal programmes, definitive diagnosis of fetal genetic or chromosomal conditions is conducted through fetal sampling by amniocentesis or chorionic villus sampling. To obviate the risks of fetal miscarriage that are associated with the invasive sampling procedures, we have been developing non-invasive prenatal diagnostic tests based on cell-free fetal DNA analysis from maternal plasma. To date, fetal sex and rhesus D status determination by circulating fetal DNA analysis is performed clinically in many centres. Strategies for the non-invasive diagnosis of monogenic diseases have been developed. Accurate detection of fetal trisomy 21 by next-generation sequencing has been achieved. Many of the non-invasive prenatal tests could be introduced to the clinics as soon as cost-effective and high throughput protocols are developed.
Collapse
Affiliation(s)
- Rossa W K Chiu
- Centre for Research into Circulating Fetal Nucleic Acids, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | |
Collapse
|
24
|
Alpha-hemoglobin-stabilizing protein: an erythroid molecular chaperone. Biochem Res Int 2011; 2011:373859. [PMID: 21490703 PMCID: PMC3070166 DOI: 10.1155/2011/373859] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 12/19/2010] [Indexed: 12/14/2022] Open
Abstract
Alpha-hemoglobin-stabilizing protein (AHSP) is an erythroid-specific protein that acts as a molecular chaperone for the free α chains of hemoglobin. Evidence strongly suggests that AHSP participates in hemoglobin synthesis and may act to neutralize the cytotoxic effects of excess free alpha-globin subunits that accumulate both in normal and beta-thalassemic erythroid precursor cells. As such, AHSP seems to be essential for normal erythropoiesis, and impaired upregulation of AHSP may lead to premature erythroid cell death, resulting in ineffective erythropoiesis. Reduced AHSP mRNA expression has been associated with clinical variability in some cases of β-thalassemia. It has been shown that αHb variants may also impair AHSP-αHb interactions, leading to pathological conditions that resemble α-thalassemia syndromes. The aim of this paper is to summarize current information concerning the structure and function of AHSP, focusing on its role in normal erythropoiesis and its relevance in health and disease.
Collapse
|
25
|
Vasseur C, Pissard S, Domingues‐Hamdi E, Marden MC, Galactéros F, Baudin‐Creuza V. Evaluation of the free α-hemoglobin pool in red blood cells: a new test providing a scale of β-thalassemia severity. Am J Hematol 2011; 86:199-202. [PMID: 21264907 DOI: 10.1002/ajh.21918] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
β-Thalassemias are characterized by an imbalance of globin chains with an excess of α-chains which precipitates in erythroid precursors and red blood cells (RBCs) leading to inefficient erythropoiesis. The severity of the disease correlates with the amount of unpaired α-chains.Our goal was to develop a simple test for evaluation of the free α-hemoglobin pool present in RBC lysates. Alpha-Hemoglobin Stabilizing Protein (AHSP), the chaperone of α-Hb, was used to trap excess a-Hb. A recombinant GST-AHSP fusion protein was bound to an affinity micro-column and then incubated with hemolysates of patients. After washing, the α-Hb was quantified by spectrophotometry in the elution fraction. This assay was applied to 54 patients: 28 without apparent Hb disorder, 20 β-thalassemic and 6 α-thalassemic. The average value of free α-Hb pool was 93 ± 21 ppm (ng of free α-Hb per mg of Hb subunits)in patients without Hb disorder, while it varies from 119 to 1,756 ppm, in β-thalassemic patients and correlated with genotype. In contrast,the value of the free α-Hb pool was decreased in α-thalassemic patients (65 ± 26 ppm). This assay may help to characterize β-thalassemia phenotypes and to follow the evolution of the globin chain imbalance(α/β+γ ratio) in response to treatment.
Collapse
Affiliation(s)
- Corinne Vasseur
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
| | - Serge Pissard
- Assistance Publique Hôpitaux de Paris (APHP), Laboratoire de biochimie et de génétique, Hôpital Henri Mondor, Université Paris Est (UPE), Créteil, France
- INSERM U955 équipe 11, IMRB, Créteil France
| | - Elisa Domingues‐Hamdi
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
| | - Michael C. Marden
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
| | - Frédéric Galactéros
- Assistance Publique Hôpitaux de Paris (APHP), Unité des Maladies Génétiques du Globule Rouge (UMGGR), Hôpital Henri Mondor, UPE, Créteil, France
| | - Véronique Baudin‐Creuza
- Institut National de la Santé et de la Recherche Médicale (INSERM) U779, Université Paris XI, Le Kremlin‐Bicêtre, France
| |
Collapse
|
26
|
Cappellini MD, Musallam KM, Taher AT. Insight onto the pathophysiology and clinical complications of thalassemia intermedia. Hemoglobin 2010; 33 Suppl 1:S145-59. [PMID: 20001620 DOI: 10.3109/03630260903351528] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Our understanding of the molecular and pathophysiological mechanisms underlying the disease process in patients with thalassemia intermedia (TI) has substantially increased over the past decade. TI encompasses a wide clinical spectrum of beta-thalassemia phenotypes. Some TI patients are asymptomatic until adult life, whereas others are symptomatic from as young as 2 years. A number of clinical complications commonly associated with TI are rarely seen in thalassemia major, including extramedullary hematopoiesis, leg ulcers, gallstones, thrombosis, and pulmonary hypertension. There are a number of options currently available for managing patients with TI, including transfusion therapy, iron chelation therapy, modulation of fetal hemoglobin production, and hematopoietic stem cell transplantation. However, at present, there are no clear guidelines for an orchestrated optimal treatment plan.
Collapse
|
27
|
Thalassaemia intermedia: an update. Mediterr J Hematol Infect Dis 2009; 1:e2009004. [PMID: 21415986 PMCID: PMC3033165 DOI: 10.4084/mjhid.2009.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 08/19/2009] [Indexed: 01/29/2023] Open
Abstract
Our understanding of the molecular and pathophysiological mechanisms underlying the disease process in patients with thalassaemia intermedia (TI) has substantially increased over the past decade. TI encompasses a wide clinical spectrum of beta-thalassaemia phenotypes. Some TI patients are asymptomatic until adult life, whereas others are symptomatic from as young as 2 years of age. A number of clinical complications commonly associated with TI are rarely seen in thalassaemia major, including extramedullary hematopoiesis, leg ulcers, gallstones, thrombosis and pulmonary hypertension. There are a number of options currently available for managing patients with TI, including transfusion therapy, iron chelation therapy, modulation of foetal haemoglobin production and haematopoietic stem cell transplantation. However, at present, there are no clear guidelines for an orchestrated optimal treatment plan.
Collapse
|
28
|
Vasseur C, Domingues-Hamdi E, Brillet T, Marden MC, Baudin-Creuza V. The alpha-hemoglobin stabilizing protein and expression of unstable alpha-Hb variants. Clin Biochem 2009; 42:1818-23. [PMID: 19482015 DOI: 10.1016/j.clinbiochem.2009.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 05/13/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine the role of the alpha-hemoglobin stabilizing protein (AHSP) in the clinical expression of alpha-hemoglobin (alpha-Hb) variants described as unstable, ten alpha chain variants have been studied with their chaperone. AHSP specifically binds free alpha-Hb to form a soluble heterodimer until it is replaced by the beta-Hb partner. In this way, AHSP prevents the precipitation of free alpha chains which might damage the membrane of erythrocyte. AHSP specifically recognizes the G and H helices of alpha-Hb that are also involved in the alpha1beta1 dimer interface. AHSP may act as a modifier in alpha-thalassemias and lead to the thalassemic phenotypes observed in certain unstable alpha-Hb variants previously considered unstable. The different abnormalities of the alpha chain were located either in the G helix: Hb Bronovo alpha103(G10)His-->Leu, Hb Sallanches alpha104(G11)Cys-->Tyr, Hb Oegstgeest alpha104(G11)Cys-->Ser, Hb Bleuland alpha108(G15)Thr-->Asn, Hb Suan Dok alpha109(G16)Leu-->Arg and as yet undescribed alpha109(G16)Leu-->Gln, in the GH corner: Hb Foggia alpha117(GH5)Phe-->Ser, or in the H helix: Hb Groene Hart alpha119(H2)Pro-->Ser, Hb Diamant alpha119(H2)Pro-->Leu, Hb Utrecht alpha129(H12)Leu-->Pro. DESIGN AND METHODS These different mutated alpha-Hb were co-expressed with their chaperone AHSP as a fusion protein with glutathione S-transferase (GST) and analyzed by SDS-PAGE. RESULTS In all cases the proteins were normally synthesized in bacteria as shown by an expression level of mutated GST-alpha-Hbs similar to that observed for normal GST-alpha-Hb. In contrast, the recovered quantities of purified mutated GST-alpha-Hbs associated with AHSP are highly variable. An extreme case is GST-alpha-Hb(Utrecht) which was only found at trace levels. CONCLUSION One can assume that different mechanisms may be responsible for the amount of abnormal Hb recovered, such as a highly unstable alpha chain or an impaired formation of the complex AHSP/alpha-Hb or a modification of the alphabeta dimer formation.
Collapse
Affiliation(s)
- Corinne Vasseur
- INSERM U779, University of Paris XI, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France
| | | | | | | | | |
Collapse
|
29
|
Tosto F, Salvatore M, Falbo V, Floridia G, Censi F, Bombieri C, Rosatelli MC, Taruscio D. The Italian Scheme of External Quality Assessment for β-Thalassemia: Genotyping and Reporting Results and Testing Strategies in a 5-Year Survey. Genet Test Mol Biomarkers 2009; 13:31-6. [DOI: 10.1089/gtmb.2008.0072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Fabrizio Tosto
- Department of Cell Biology and Neuroscience, National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Salvatore
- Department of Cell Biology and Neuroscience, National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Vincenzo Falbo
- Department of Cell Biology and Neuroscience, National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanna Floridia
- Department of Cell Biology and Neuroscience, National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Federica Censi
- Department of Cell Biology and Neuroscience, National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Cristina Bombieri
- Section of Biology and Genetics, Department of Mother and Child and Biology, University of Verona, Verona, Italy
| | | | - Domenica Taruscio
- Department of Cell Biology and Neuroscience, National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| |
Collapse
|
30
|
Noninvasive prenatal diagnosis of monogenic diseases by digital size selection and relative mutation dosage on DNA in maternal plasma. Proc Natl Acad Sci U S A 2008; 105:19920-5. [PMID: 19060211 DOI: 10.1073/pnas.0810373105] [Citation(s) in RCA: 234] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Prenatal diagnosis of monogenic diseases, such as cystic fibrosis and beta-thalassemia, is currently offered as part of public health programs. However, current methods based on chorionic villus sampling and amniocentesis for obtaining fetal genetic material pose a risk to the fetus. Since the discovery of cell-free fetal DNA in maternal plasma, the noninvasive prenatal assessment of paternally inherited traits or mutations has been achieved. Due to the presence of background maternal DNA, which interferes with the analysis of fetal DNA in maternal plasma, noninvasive prenatal diagnosis of maternally inherited mutations has not been possible. Here we describe a digital relative mutation dosage (RMD) approach that determines if the dosages of the mutant and wild-type alleles of a disease-causing gene are balanced or unbalanced in maternal plasma. When applied to the testing of women heterozygous for the CD41/42 (-CTTT) and hemoglobin E mutations on HBB, digital RMD allows the fetal genotype to be deduced. The diagnostic performance of digital RMD is dependent on interplay between the fractional fetal DNA concentration and number of DNA molecules in maternal plasma. To achieve fetal genotype diagnosis at lower volumes of maternal plasma, fetal DNA enrichment is desired. We thus developed a digital nucleic acid size selection (NASS) strategy that effectively enriches the fetal DNA without additional plasma sampling or experimental time. We show that digital NASS can work in concert with digital RMD to increase the proportion of cases with classifiable fetal genotypes and to bring noninvasive prenatal diagnosis of monogenic diseases closer to reality.
Collapse
|
31
|
Pawlowski PH, Burzyńska B, Zielenkiewicz P. Theoretical model of thalassemic erythrocyte shape transformation. J Theor Biol 2008; 254:575-9. [PMID: 18652835 DOI: 10.1016/j.jtbi.2008.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 06/24/2008] [Accepted: 06/24/2008] [Indexed: 10/21/2022]
Abstract
Our earlier model of reticulocyte shape transformation [Pawlowski, P.H., Burzynska, B., Zielenkiewicz, P., 2006. Theoretical model of reticulocyte to erythrocyte shape transformation. J. Theor. Biol. 243, 24-38] was applied to explain the morphological properties of thalassemic erythrocytes. Modification of the standard set of parameters of the model, describing minimal cell volume, membrane bending rigidity, and membrane tension, allowed for simulation of development of alpha- and beta-thalassemic cells from splenectomized and nonsplenectomized individuals. This resulted in observation of thin rim discocytes, tailed erythrocytes and oval forms, as well as in differentiation of time of the cell shape metamorphosis. A comparative analysis of the susceptibility of thalassemic and normal erythrocytes to undergo deformation as well of their stability was performed.
Collapse
Affiliation(s)
- Piotr H Pawlowski
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warszawa, Poland.
| | | | | |
Collapse
|
32
|
Pan HF, Long GF, Li Q, Feng YN, Lei ZY, Wei HW, Huang YY, Huang JH, Lin N, Xu QQ, Ling SY, Chen XJ, Huang T. Current status of thalassemia in minority populations in Guangxi, China. Clin Genet 2007; 71:419-26. [PMID: 17489847 DOI: 10.1111/j.1399-0004.2007.00791.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thalassemia is one of the most common monogenic disorders in the world. In order to develop a community-based prevention program, we screened 12,900 individuals for alpha- and beta-thalassemia in Baise City, Guangxi, China, with hematological methods and molecular assays. We found that the frequency of carriers in this area for alpha-thalassemia is 15%. Beta-thalassemia carriers comprise 4.8% of the populations. Five mutations account for 98% of alpha-thalassemia [--SEA 46.7%; -alpha/4.2, 23.9%; -alpha/3.7, 21.7%; hemoglobin (Hb) Constant Spring, 6.5%; Hb Quong Sze, 1.1%]. Seven mutations in the beta-globin gene account for 99% of the mutations [codon (CD) 41/42 (-TCTT) (39.4%), CD 17(A-->T) (32%), CD 71/72 (+A) (7.4%), -28 (A-->G) (5.8%), IVS-2-654 (C-->T) (5.8%), CD26 (Hb E) (4%), IVS-1 (G-->A) (3.7%), and CD 43(G-->T) (1.9%)]. Most individuals with alpha-thalassemia major die in the uterus or shortly after birth. Among 106 patients with beta-thalassemia major followed by our clinic, the majority died before 5 years of age. Knowledge surveys about thalassemia were conducted. Our results show a severe lack of knowledge about thalassemia in both medical professionals and in the general populations. This study shows that thalassemia is a very severe public health issue in minority populations in Baise City, China. Identification of the common mutations will allow us to design cost-effective molecular tests. There is an urgent need to educate the general population and the medical community for a successful community-based prevention program.
Collapse
Affiliation(s)
- H F Pan
- Division of Human Genetics, Department of Pediatrics, University of California, Irvine, CA 92697, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Papassotiriou I, Stamoulakatou A, Wajcman H, Kister J, Dimisianos G, Lazaropoulou C, Kanavaki I, Vavourakis E, Kattamis A, Kanavakis E, Traeger-Synodinos J. Observation of a rare hemoglobin variant [Hb Lulu island, beta107(G9)Gly-->Asp, GGC-->GAC] co-inherited with a beta+-thalassemia mutation [IVS-I-110 (G-->A)] or in the heterozygous state in a Greek-Albanian family. Hemoglobin 2006; 30:409-18. [PMID: 16987796 DOI: 10.1080/03630260600867842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report clinical, hematological, biochemical, functional and molecular studies carried out on two first cousins from a Greek-Albanian family who have clinical and hematological findings consistent with the diagnosis of thalassemia intermedia. DNA studies determined that they had co-inherited a common Mediterranean beta-thalassemia (thal) mutation, IVS-I-110 (G-->A), in trans to a beta-globin gene mutation at codon 107 (GGC-->GAC), predicted to give rise to a rare unstable beta chain variant Hb Lulu Island or beta107(G9)Gly-->Asp.
Collapse
Affiliation(s)
- Ioannis Papassotiriou
- Department of Clinical Biochemistry, Aghia Sophia Children's Hospital, Athens, Greece.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Di Bella C, Salpietro C, La Rosa M, Cuppari C, Piraino B, Cutri MR, Rigoli L. Identification of α-thalassemia mutations in subjects from Eastern Sicily (Italy) with abnormal hematological indices and normal Hb A2. Ann Hematol 2006; 85:829-31. [PMID: 16951927 DOI: 10.1007/s00277-006-0165-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Accepted: 06/23/2006] [Indexed: 12/01/2022]
Abstract
We analyzed the prevalence of alpha-thalassemia mutations in 298 subjects from Eastern Sicily (Italy) with reduced mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), normal HbA2 and HbF, and normal serum iron. In 131 subjects (43.9%) we found six different genotypes of alpha-thalassemia: -alpha3.7/alphaalpha (36.6%), -alpha3.7/-alpha3.7 (27.5%), -(MED)/alphaalpha (10.0%), -alpha20.5/alphaalpha (9.1%), alphaHphIalpha/alphaalpha (8.4%), alphaHphIalpha/alphaHphIalpha (6.1%), and -alpha3.7/alphaHphIalpha (2.3%). Our data underline that in Eastern Sicily populations, the molecular screening of alpha-thalassemia mutations and/or deletions may be useful to better characterize the clinically asymptomatic subjects with a slightly reduced MCV and MCH and normal iron status.
Collapse
Affiliation(s)
- Chiara Di Bella
- Unità Operativa di Genetica, Dipartimento di Scienze Pediatriche Mediche e Chirurgiche, pad NI, Policlinico Universitario, Messina, Italy
| | | | | | | | | | | | | |
Collapse
|
35
|
Li Y, Holzgreve W, DI Naro E, Vitucci A, Hahn S. Cell-Free DNA in Maternal Plasma: Is It All a Question of Size? Ann N Y Acad Sci 2006; 1075:81-7. [PMID: 17108195 DOI: 10.1196/annals.1368.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Fetal cell-free DNA (cf-DNA) represents only a small fraction of the total cf-DNA in maternal plasma. This feature has rendered it difficult to reliably distinguish fetal alleles which are not very disparate from maternal ones, such as those involving point mutations, by conventional polymerase chain reaction (PCR)-based approaches. It has recently been shown that cell-free fetal DNA molecules have a smaller size than comparable cf-DNA molecules of maternal origin, and that this feature can be exploited for the selective enrichment of fetal DNA sequences, thereby permitting the detection of otherwise masked fetal genetic traits. By the use of this approach, we have shown that it is possible to detect fetal genetic loci for microsatellite markers, as well as point mutations involved in disorders such as achondroplasia and beta-thalassemia.
Collapse
Affiliation(s)
- Ying Li
- Laboratory for Prenatal Medicine, Department of Research, University Women's Hospital, Spitalstrasse 21, CH 4031 Basel, Switzerland
| | | | | | | | | |
Collapse
|
36
|
Weiss MJ, Zhou S, Feng L, Gell DA, Mackay JP, Shi Y, Gow AJ. Role of alpha-hemoglobin-stabilizing protein in normal erythropoiesis and beta-thalassemia. Ann N Y Acad Sci 2006; 1054:103-17. [PMID: 16339656 DOI: 10.1196/annals.1345.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Hemoglobin (Hb) synthesis is coordinated by homeostatic mechanisms to limit the accumulation of free alpha or beta subunits, which are cytotoxic. Alpha hemoglobin-stabilizing protein (AHSP) is an abundant erythroid protein that specifically binds free alphaHb, stabilizes its structure, and limits its ability to participate in chemical reactions that generate reactive oxygen species. Gene ablation studies in mice demonstrate that AHSP is required for normal erythropoiesis. AHSP-null erythrocytes are short-lived, contain Hb precipitates, and exhibit signs of oxidative damage. Loss of AHSP exacerbates beta-thalassemia in mice, indicating that altered AHSP expression or function could modify thalassemia phenotypes in humans, a topic that is beginning to be explored in clinical studies. We used biochemical, spectroscopic, and crystallographic methods to examine how AHSP stabilizes alphaHb. AHSP binds the G and H helices of alphaHb on a surface that largely overlaps with the alpha1-beta1 interface of HbA. This result explains previous findings that betaHb can competitively displace AHSP from alphaHb to form HbA tetramer. Remarkably, binding of AHSP to oxygenated alphaHb induces dramatic conformational changes and converts the heme-bound iron to an oxidized hemichrome state in which all six coordinate positions are occupied. This structure limits the reactivity of heme iron, providing a mechanism by which AHSP stabilizes alphaHb. These findings suggest a biochemical pathway through which AHSP might participate in normal Hb synthesis and modulate the severity of thalassemias. Moreover, understanding how AHSP stabilizes alphaHb provides a theoretical basis for new strategies to inhibit the damaging effects of free alphaHb that accumulates in beta-thalassemia.
Collapse
Affiliation(s)
- Mitchell J Weiss
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | | | | | | | | | | | | |
Collapse
|
37
|
Traeger-Synodinos J. Real-time PCR for prenatal and preimplantation genetic diagnosis of monogenic diseases. Mol Aspects Med 2006; 27:176-91. [PMID: 16430951 DOI: 10.1016/j.mam.2005.12.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The provision of prenatal diagnosis requires the highest standards in laboratory practice to ensure an accurate result. In preimplantation genetic diagnosis protocols additionally have to address the need to achieve an accurate result from 1 to 2 cells within a limited time. Emerging protocols of "non-invasive" prenatal diagnosis, which are based on analysis of free fetal DNA in the circulation of the pregnant mother, also have to achieve a result from a limited quantity of fetal DNA against a high background of maternal free DNA. Real-time PCR uses fluorescent probes or dyes and dedicated instruments to monitor the accumulation of amplicons produced throughout the progress of a PCR reaction. Real-time PCR can be used for quantitative or qualitative evaluation of PCR products and is ideally suited for analysis of nucleotide sequence variations (point mutations) and gene dosage changes (locus deletions or insertions/duplications) that cause human monogenic diseases. Real-time PCR offers a means for more rapid and potentially higher throughput assays, without compromising accuracy and has several advantages over end-point PCR analysis, including the elimination of post-PCR processing steps and a wide dynamic range of detection with a high degree of sensitivity. This review will focus on real-time PCR protocols that are suitable for genotyping monogenic diseases with particular emphasis on applications to prenatal diagnosis, non-invasive prenatal diagnosis and preimplantation genetic diagnosis.
Collapse
Affiliation(s)
- Joanne Traeger-Synodinos
- Department of Medical Genetics, National and Kapodistrian University of Athens, St. Sophia's Children's Hospital, Athens 11527, Greece.
| |
Collapse
|
38
|
NIENHUIS ARTHURW. Eighth Cooley's Anemia Symposium: Summation and Perspective. Ann N Y Acad Sci 2005. [DOI: 10.1196/annals.1345.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
39
|
Jones R, Pembrey M, Golding J, Herrick D. The search for genenotype/phenotype associations and the phenome scan. Paediatr Perinat Epidemiol 2005; 19:264-75. [PMID: 15958149 DOI: 10.1111/j.1365-3016.2005.00664.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
All the approaches to the search for genotype/phenotype associations have their share of problems. Comparing the genome scan and candidate gene approaches, the former makes fewer assumptions at the genetic level or about mechanism but has greater statistical difficulties while the latter partially solves the statistical problem but makes more assumptions at both genetic and mechanistic levels. Among current difficulties is a lack of information about the nature of gene variant/phenotype associations: the frequency with which different classes of gene or sequence are involved; the type of genetic variation most commonly involved; the appropriate genetic models to apply to analysis. The overarching problem is that of multiple testing, one solution to which is to integrate genetic information to create a smaller number of compound variables. At the other end of the scale, decisions about the level of complexity at which to pitch the identification of phenotypes also affect the multiple testing problem: whether to pitch them at the level of disease outcomes, or at any of the multiple levels of intermediate phenotypes or traits. The third issue is how best to deal with gene/gene or gene/environment interactions, or whether to ignore them. Only as more genotype/phenotype associations emerge, by whatever means, will the numbers of results allow these questions to be answered. We describe here a new approach to genotype/phenotype association studies, the phenome scan, in which dense phenotypic information in human cohorts is scanned for associations with individual genetic variants. We believe that this approach can generate data that will be useful in answering generic questions about genotype/phenotype associations as well as in discovering novel ones.
Collapse
Affiliation(s)
- Richard Jones
- ALSPAC, Department of Community-Based Medicine, University of Bristol, Bristol, UK.
| | | | | | | |
Collapse
|
40
|
|
41
|
Tiffert T, Lew VL, Ginsburg H, Krugliak M, Croisille L, Mohandas N. The hydration state of human red blood cells and their susceptibility to invasion by Plasmodium falciparum. Blood 2005; 105:4853-60. [PMID: 15728121 PMCID: PMC1894996 DOI: 10.1182/blood-2004-12-4948] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2004] [Accepted: 02/17/2005] [Indexed: 11/20/2022] Open
Abstract
In most inherited red blood cell (RBC) disorders with high gene frequencies in malaria-endemic regions, the distribution of RBC hydration states is much wider than normal. The relationship between the hydration state of circulating RBCs and protection against severe falciparum malaria remains unexplored. The present investigation was prompted by a casual observation suggesting that falciparum merozoites were unable to invade isotonically dehydrated normal RBCs. We designed an experimental model to induce uniform and stable isotonic volume changes in RBC populations from healthy donors by increasing or decreasing their KCl contents through a reversible K(+) permeabilization pulse. Swollen and mildly dehydrated RBCs were able to sustain Plasmodium falciparum cultures with similar efficiency to untreated RBCs. However, parasite invasion and growth were progressively reduced in dehydrated RBCs. In a parallel study, P falciparum invasion was investigated in density-fractionated RBCs from healthy subjects and from individuals with inherited RBC abnormalities affecting primarily hemoglobin (Hb) or the RBC membrane (thalassemias, hereditary ovalocytosis, xerocytosis, Hb CC, and Hb CS). Invasion was invariably reduced in the dense cell fractions in all conditions. These results suggest that the presence of dense RBCs is a protective factor, additional to any other protection mechanism prevailing in each of the different pathologies.
Collapse
Affiliation(s)
- Teresa Tiffert
- Physiological Laboratory, University of Cambridge, Cambridge, United Kingdom.
| | | | | | | | | | | |
Collapse
|