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Rao E, Kumar Chandraker S, Misha Singh M, Kumar R. Global distribution of β-thalassemia mutations: An update. Gene 2024; 896:148022. [PMID: 38007159 DOI: 10.1016/j.gene.2023.148022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/29/2023] [Accepted: 11/21/2023] [Indexed: 11/27/2023]
Abstract
One excellent illustration of how a single gene abnormality may result in a spectrum of disease incidence is the incredible phenotypic variety of β-thalassemia, which spans from severe anemia and transfusion needs to an utterly asymptomatic sickness. However, genetic causes of β-thalassemia and how the anemia's severity might be altered at various stages in its pathophysiology have been well investigated. There are currently known to be more than 350 mutations that cause genetic disease. However only 20 β thalassemia mutations account for more than 80% of the β thalassemia mutation across the globe due to phenomenon of geographical clustering where each population has a few common mutations together with a varying number of rare ones. Due to migration of the population, the spectrum of thalassemia mutation in changing from time to time. In this review, efforts are made to collate β globin gene mutations in different countries and populations.
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Affiliation(s)
- Ekta Rao
- ICMR-National Institute of Research in Tribal Health, Jabalpur, M.P, India
| | | | - Mable Misha Singh
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Ravindra Kumar
- ICMR-National Institute of Research in Tribal Health, Jabalpur, M.P, India.
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Yasin NM, Abdul Hamid FS, Hassan S, Mat Yusoff Y, Mohd Sahid EN, Esa E. Characterization of New Alpha Zero (α 0) Thalassaemia Deletion (-- GB) among Malays in Malaysian Population. Diagnostics (Basel) 2023; 13:3286. [PMID: 37892108 PMCID: PMC10606806 DOI: 10.3390/diagnostics13203286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/03/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023] Open
Abstract
Malaysia is a multicultural and multiethnic country comprising numerous ethnic groups. From the total population of 32.7 million, Malays form the bulk of the Bumiputera in Malaysia comprise about 69.9%, followed by Chinese 22.8%, Indian 6.6%, and others 0.7%. The heterogeneous population and increasing numbers of non-citizens in this country affects the heterogeneity of genetic diseases, diversity, and heterogeneity of thalassaemia mutations. Alpha (α)-thalassaemia is an inherited haemoglobin disorder characterized by hypochromic microcytic anaemia caused by a quantitative reduction in the α-globin chain. A majority of the α-thalassaemia are caused by deletions in the α-globin gene cluster. Among Malays, the most common deletional alpha thalassaemia is -α3.7 deletion followed by --SEA deletion. We described the molecular characterization of a new --GB deletion in our population, involving both alpha genes in cis. Interestingly, we found that this mutation is unique among Malay ethnicities. It is important to diagnose this deletion because of the 25% risk of Hb Bart's with hydrops fetalis in the offspring when in combination with another α0- thalassaemia allele. MLPA is a suitable method to detect unknown and uncommon deletions and to characterize those cases which remain unresolved after a standard diagnostic approach.
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Affiliation(s)
- Norafiza Mohd Yasin
- Haematology Unit, Cancer Research Center, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Selangor, Malaysia (S.H.); (Y.M.Y.); (E.E.)
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Yasin NM, Abdul Hamid FS, Hassan S, Sudin A, Yassim H, Mohd Sahid EN, Mat Yusoff Y, Esa E, Saleem M. Molecular and hematological studies in a cohort of beta zero South East Asia deletion (β°-thal SEA) from Malaysian perspective. Front Pediatr 2022; 10:974496. [PMID: 36533237 PMCID: PMC9748471 DOI: 10.3389/fped.2022.974496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/26/2022] [Indexed: 12/03/2022] Open
Abstract
ABSTRACT We report the haematological parameters and molecular characterization of beta zero (β°) South East Asia (SEA) deletion in the HBB gene cluster with unusually high levels of Hb F compared to a classical heterozygous beta zero (β°)-thalassaemia. METHODS Retrospective study on 17 cases of (β°) South East Asia (SEA) deletion from 2016 to 2019 referred to Institute for Medical Research were conducted. The clinical information and haematological profiles were evaluated. The mutation was analyzed, and the results were compared with other β°-thalassaemia groups. For HBB gene genotyping, all the cases were subjected for multiplex gap-PCR, 5 cases were subjected for HBB gene sequencing for exclusion of compound heterozygous with other beta variants. Co-inheritance of α-thalassaemia were determined using multiplex gap-PCR and multiplex ARMS-PCR. RESULTS Seventeen cases were positive for β°-thal SEA deletion. Fifteen cases were heterozygous and two were compound heterozygous for β°-thal SEA deletion. The results were compared with 182 cases of various heterozygous β° deletions and mutations. The mean Hb for heterozygous β°-thal SEA deletion (13.44 ± 1.45 g/dl) was normal and significantly higher than heterozygous IVS 1-1 and Codon 41/42 (post hoc test, p < 0.05). The medians for the MCV and MCH of β°-thal SEA deletion were significantly higher than for all heterozygote β°-thalassaemia traits (Mann Whitney test, p < 0.05). Patients with β°-thal SEA deletion had elevated levels of Hb A2 consistent with β-thalassaemia traits, with Hb F levels consistent with HPFH or δβ-thalassaemia carriers. The median for Hb A2 was 4.00 + 1.00%, similar to that observed in other β°-thalassaemia groups except for IVS 1-1 mutation (median 5.30 + 0.45%) and β°-Filipino (∼45 kb deletion) deletion (median 6.00 + 0.58). Interestingly, we found that Hb F levels for β°-thal SEA deletion were statistically higher than other β°-thalassaemia mutations (median 19.00 + 5.50%, p < 0.05), except for the β°-thal 3.5 kb deletion group. CONCLUSION We conclude that β°-thal SEA deletion has a unique haematological parameters of beta zero thalassaemia trait. We affirm to classifying this deletion as SEA-HPFH based on previous studies considering the phenotype features rather than the molecular defect of β°-thal SEA deletion, as this will make it easier to offer genetic counselling to affected individuals.
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Affiliation(s)
- Norafiza Mohd Yasin
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
| | - Faidatul Syazlin Abdul Hamid
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
| | - Syahzuwan Hassan
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
| | - Aziee Sudin
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
| | - Haiyuni Yassim
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
| | - Ermi Neiza Mohd Sahid
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
| | - Yuslina Mat Yusoff
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
| | - Ezalia Esa
- Hematology Unit, Cancer Research Centre, Institute for Medical Research, Ministry of Health (Malaysia), Kuala Lumpur, Malaysia
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Saha J, Panja A, Nayek K. The Prevalence of HBB Mutations among the Transfusion-Dependent and Non Transfusion-Dependent Hb E/β-Thalassemia Children in a Tertiary Center of West Bengal, India. Hemoglobin 2021; 45:157-162. [PMID: 34060430 DOI: 10.1080/03630269.2021.1933023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Hb E (HBB: c.79G>A)/β-thalassemia (Hb E/β-thal) is responsible for nearly half of all the different kinds of severe β-thal. This disorder is characterized by a wide range of clinical variability ranging from mild, asymptomatic non transfusion-dependent thalassemia (NTDT) to severe transfusion-dependent thalassemia (TDT). The aim of the present study was to determine the prevalence of different β-globin gene (HBB) mutations in Hb E/β-thal subjects and their potential role in transfusion dependence. One hundred and ten consecutive children with Hb E/β-thal attending the Pediatric Department of Burdwan Medical College, Burdwan, West Bengal, India were enrolled. Based on hemoglobin (Hb) electrophoresis or high-performance liquid chromatography (HPLC), patients were recruited and later β-globin gene sequencing was done to find out the prevalence of different HBB mutations. Transfusion-dependent thalassemia was seen in 42 children (38.2%), while NTDT was seen in 68 children (61.8%). A total of 10 different β-globin mutant alleles were characterized. The most frequent mutation on the β-globin gene was IVS-I-5 (G>C) (HBB: c0.92+5G>C) in both groups. The β-globin gene mutations alone cannot determine transfusion dependence among the Hb E/β-thal patients.
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Affiliation(s)
- Jinia Saha
- Department of Paediatric Medicine, Burdwan Medical College and Hospital, Burdwan, India
| | - Amrita Panja
- Molecular Biology and Human Genetics Laboratory, Department of Zoology, The University of Burdwan, Burdwan, India
| | - Kaustav Nayek
- Department of Paediatric Medicine, Burdwan Medical College and Hospital, Burdwan, India
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Lim LN, Teh LK, Yu KS, Chua SM, George E, Lai MI, Wong L. Genetic variants of HBS1L-MYB with Hb subtypes level among Filipino β°-deletion carriers co-inherited with −α3.7 deletion thalassaemia. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Mohd Ibrahim H, Muda Z, Othman IS, Mohamed Unni MN, Teh KH, Thevarajah A, Gunasagaran K, Ong GB, Yeoh SL, Muhammad Rivai A, Che Mohd Razali CH, Din ND, Abdul Latiff Z, Jamal R, Mohamad N, Mohd Ariffin H, Alias H. Observational study on the current status of thalassaemia in Malaysia: a report from the Malaysian Thalassaemia Registry. BMJ Open 2020; 10:e037974. [PMID: 32601117 PMCID: PMC7328811 DOI: 10.1136/bmjopen-2020-037974] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Thalassaemia is the most common inherited blood disorder in Malaysia. This study aims to report the current status of thalassaemia in Malaysia and provide a comprehensive understanding of the disease through data obtained from the Malaysian Thalassaemia Registry. DESIGN Data were extracted from the Malaysian Thalassaemia Registry, a web-based system accessible to enrolled users through www.mytalasemia.net.my. SETTING The Malaysian Thalassaemia Registry data was recorded from reports obtained from 110 participating government and university hospitals in Malaysia. PARTICIPANTS The patients were those attending the 110 participating hospitals for thalassaemia treatment. INTERVENTION Data were collected from the Malaysian Thalassaemia Registry from 2007 until the fourth quarter of 2018. PRIMARY OUTCOME MEASURE 7984 out of 8681 patients with thalassaemia registered in the Malaysian Thalassaemia Registry were reported alive. RESULTS Majority of the patients were reported in the state of Sabah (22.72%); the largest age group affected was 5.0-24.9 years old (64.45%); the largest ethnic group involved was Malay (63.95%); and the major diagnosis was haemoglobin E/β-thalassaemia (34.37%). From the 7984 patients, 56.73% were on regular blood transfusions and 61.72% were on chelation therapy. A small fraction (14.23%) has undergone splenectomy, while the percentage of patients with severe iron overload (serum ferritin ≥5000 µg/L) reduced over time. However, cardiac complications are still the main cause of death in patients with thalassaemia. CONCLUSION Data gathered into the registry can be used to understand the progression of the disorder, to monitor iron overload management and to improve the outcomes of treatment, to enhance preventive strategies, reduce healthcare burden and improve the quality of life. Sustainability of the Malaysian Thalassaemia Registry is important for surveillance of thalassaemia management in the country and help the national health authorities to develop more effective policies.
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Affiliation(s)
- Hishamshah Mohd Ibrahim
- Division for Research and Technical Support, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Zulaiha Muda
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Ida Shahnaz Othman
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Mohamed Najib Mohamed Unni
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Kok Hoi Teh
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Asohan Thevarajah
- Department of Paediatrics, Sabah Women & Children Hospital, Likas, Kota Kinabalu, Sabah, Malaysia
| | - Kogilavani Gunasagaran
- Department of Paediatrics, Sabah Women & Children Hospital, Likas, Kota Kinabalu, Sabah, Malaysia
| | - Gek Bee Ong
- Department of Paediatrics, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
| | - Seoh Leng Yeoh
- Department of Paediatrics, Hospital Pulau Pinang, Georgetown, Pulau Pinang, Malaysia
| | | | | | - Nazzlin Dizana Din
- Department of Paediatrics, Hospital Sultanah Nur Zahirah Kuala Terengganu, Kuala Terengganu, Terengganu, Malaysia
| | - Zarina Abdul Latiff
- Department of Paediatrics, UKM Medical Centre, The National University of Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia
| | - Norsarwany Mohamad
- Department of Paediatrics, Hospital Universiti Sains Malaysia, Kota Bahru, Kelantan, Malaysia
| | - Hany Mohd Ariffin
- Department of Paediatrics, University of Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Hamidah Alias
- Department of Paediatrics, UKM Medical Centre, The National University of Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia
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Delatycki MB, Alkuraya F, Archibald A, Castellani C, Cornel M, Grody WW, Henneman L, Ioannides AS, Kirk E, Laing N, Lucassen A, Massie J, Schuurmans J, Thong M, Langen I, Zlotogora J. International perspectives on the implementation of reproductive carrier screening. Prenat Diagn 2019; 40:301-310. [DOI: 10.1002/pd.5611] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/22/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Martin B. Delatycki
- Victorian Clinical Genetics Services Parkville Victoria Australia
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
| | - Fowzan Alkuraya
- Department of GeneticsKing Faisal Specialist Hospital and Research Centre Riyadh Saudi Arabia
- Saudi Human Genome ProgramKing Abdulaziz City for Science and Technology Riyadh Saudi Arabia
- College of MedicineAlfaisal University Riyadh Saudi Arabia
| | - Alison Archibald
- Victorian Clinical Genetics Services Parkville Victoria Australia
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
| | - Carlo Castellani
- Cystic Fibrosis CentreIRCCS Istituto Giannina Gaslini Genoa Italy
| | - Martina Cornel
- Department of Clinical GeneticsAmsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Amsterdam Reproduction and Development Research Institute Amsterdam The Netherlands
| | - Wayne W. Grody
- Divisions of Medical Genetics and Molecular Diagnostics, Departments of Pathology and Laboratory Medicine, Pediatrics, and Human GeneticsUCLA School of Medicine Los Angeles California USA
- UCLA Institute for Society and Genetics, Molecular Diagnostic Laboratories and Clinical Genomics CenterUCLA Medical Center Los Angeles California USA
| | - Lidewij Henneman
- Department of Clinical GeneticsAmsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Amsterdam Reproduction and Development Research Institute Amsterdam The Netherlands
| | | | - Edwin Kirk
- Sydney Children's Hospital Randwick New South Wales Australia
- New South Wales Health Pathology Randwick New South Wales Australia
- School of Women's and Children's HealthUniversity of New South Wales Randwick New South Wales Australia
| | - Nigel Laing
- University of Western Australia Centre for Medical Research and Harry Perkins Institute of Medical ResearchQEII Medical Centre Nedlands Western Australia Australia
- Neurogenetic Unit, Department of Diagnostic Genomics, PathWest Laboratory MedicineQEII Medical Centre Nedlands Western Australia Australia
| | - Anneke Lucassen
- Faculty of Medicine, Southampton Medical SchoolUniversity of Southampton Southampton UK
| | - John Massie
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of PaediatricsUniversity of Melbourne Parkville Victoria Australia
- Department of Respiratory MedicineRoyal Children's Hospital Parkville Victoria Australia
| | - Juliette Schuurmans
- Faculty of Medicine, Southampton Medical SchoolUniversity of Southampton Southampton UK
- Department of Genetics, University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Meow‐Keong Thong
- Genetics and Metabolism Unit, Department of Paediatrics, Faculty of MedicineUniversity of Malaya Kuala Lumpur Malaysia
| | - Irene Langen
- Department of Genetics, University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Joël Zlotogora
- Hadassah‐Hebrew University Medical School Jerusalem Israel
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Ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries: protocol for a systematic review. Syst Rev 2017; 6:140. [PMID: 28697779 PMCID: PMC5505010 DOI: 10.1186/s13643-017-0535-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 06/28/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There has been little focus in the literature on how to build genetic testing and counseling services in low- and middle-income countries in a responsible, ethical, and culturally appropriate manner. It is unclear to what extent this area is being explored and what form further research should take. The proposed knowledge synthesis aims to fill this gap in knowledge and mine the existing data to determine the breadth of work in this area and identify ethical, social, and cultural issues that have emerged. METHODS/DESIGN An integrated knowledge translation approach will be undertaken by engaging knowledge users throughout the review to ensure relevance to their practice. Electronic databases encompassing various disciplines, such as healthcare, social sciences, and public health, will be searched. Studies that address clinical genetic testing and/or counseling and ethical, social, and/or cultural issues of these genetic services, and are performed in low- and middle-income countries as defined by World Bank will be considered for inclusion. Two independent reviewers will be involved in a two-stage literature screening process, data extraction, and quality appraisal. Studies included in the review will be analyzed by thematic analysis. A narrative synthesis guided by the social ecological model will be used to summarize findings. DISCUSSION This systematic review will provide a foundation of evidence regarding ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries. Using the social ecological model as a conceptual framework will facilitate the understanding of broader influences of the sociocultural context on an individual's experience with clinical genetic testing and counseling, thereby informing interdisciplinary sectors in future recommendations for practice and policy. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016042894.
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Shah PS, Shah ND, Ray HSP, Khatri NB, Vaghasia KK, Raval RJ, Shah SC, Rao MV. Mutation analysis of β-thalassemia in East-Western Indian population: a recent molecular approach. APPLICATION OF CLINICAL GENETICS 2017; 10:27-35. [PMID: 28546763 PMCID: PMC5436775 DOI: 10.2147/tacg.s127531] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background β-Thalassemia is the most prevalent genetic disorder in India. Its traits and coinheritance vary from mild to severe conditions, resulting in thalassemia minor, intermediate, and major, depending upon many factors. Purpose The objective of this study was to identify the incidence of β-thalassemia traits, their coinheritance, and mutations, as well as to support the patients already diagnosed with β-thalassemia in East-Western Indian population for better management. Patients and methods Seventy-five referral cases for β-thalassemia were analyzed for various β-thalassemia traits, heterozygosity, and homozygosity conditions. Blood phenotypic parameters using cell counter and capillary electrophoresis were investigated. Analyses of eight common mutations of thalassemia in India were carried out using polymerase chain reaction-amplification refractory mutation system, end point polymerase chain reaction, and DNA sequencing methods. Results Of these (75) referral cases from East-Western Indian region, 68 were positive for β-thalassemia (90.67%). The majority of case types were of β-thalassemia minor (49, 65.33%), followed by HbE traits (6, 8.0%) and β-thalassemia major, including heterozygous and homozygous (5, 6.66%; 4, 5.33%) types and then HbE homozygous (2, 2.66%), as well as one each of the HbE/β-thalassemia and HbD/β-thalassemia (1, 1.34%) combination. Mutation analysis also revealed that the highest frequency of mutation was c.92+5G>C (41, 60.29%) followed by deletion 619bp (9, 13.23%) and c.79G>A (8, 11.76%) in our study group. Five cases (nos. 24, 27, 33, 58, and 71) exhibited coinheritance between β0/β+ (2), β0/β D (1), and c.124_127delTTCT/β+ or β0(2) affecting the Rajasthani and Gujarati populations in our study of the Western region of India. Conclusion We strongly recommend these Western populations for genetic screening before adopting reproductive technologies and interracial marital relations.
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Affiliation(s)
- Parth S Shah
- Department of Medicine, Lahey Hospital and Medical Center, Boston, MA
| | - Nidhi D Shah
- Department of Pediatrics, Nassau University Medical Centre, New York, NY, USA
| | | | | | | | | | - Sandip C Shah
- Supratech Micropath Laboratory and Research Institute
| | - Mandava V Rao
- School of Sciences, Gujarat University, Ahmedabad, Gujarat, India
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Genetic Counseling Services and Development of Training Programs in Malaysia. J Genet Couns 2013; 22:911-6. [DOI: 10.1007/s10897-013-9589-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 03/27/2013] [Indexed: 10/26/2022]
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Moatter T, Kausar T, Aban M, Ghani S, Pal JA. Prenatal screening for β-thalassemia major reveals new and rare mutations in the Pakistani population. Int J Hematol 2012; 95:394-8. [PMID: 22392582 DOI: 10.1007/s12185-012-1036-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 02/20/2012] [Accepted: 02/23/2012] [Indexed: 11/24/2022]
Abstract
β-Thalassemia is the most common genetic disorder in Pakistan, where more than 6000 affected children are born annually, and the carrier population is around 10 million. The objective was to study β-globin gene mutations in chorionic villous biopsy samples. Prenatal screening of 383 pregnant women between 2003 and 2010 was carried out using a panel of 13 mutation primers and amplification refractory mutations system (ARMS)-PCR. In addition, DNA sequencing was used to confirm uncharacterized mutations and in some cases fetal disease status was confirmed by linkage analysis. Families enrolled in this study represented major ethnic groups in Pakistan. Of the 13 mutations tested, three mutations accounted 71% of the total, including IVS1-5(G-C)[HBB:c.92+5G>C], codon 8/9(+G) [HBB:c.27_28insG] and del 619[NG_000007.3:g71609-72227del619]. Mutations in four uncharacterized samples were later confirmed by DNA sequencing as -88(C-T)[HBB:c.-138C>G], -90(C-T)[HBB:c.-140C>T] and codon 59(+T)[HBB:c.178_179insT]. To our knowledge, this is the first report of these mutations in Pakistan. Moreover, 19.2% fetal samples were normal and 52.3% heterozygous, whereas 26.4% were affected with thalassemia major. IVS1-5:IVS1-5 was the most common genotype in fetal samples. Prenatal diagnosis of β-thalassemia using ARMS PCR is an efficient approach for reducing the burden of this disease in Pakistan. In addition, rare mutations reported in this study should be incorporated in the diagnostic strategy.
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Affiliation(s)
- Tariq Moatter
- Department of Pathology and Microbiology, Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
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Sivalingam M, Looi ML, Zakaria SZS, Hamidah NH, Alias H, Latiff ZA, Ibrahim H, Jamal R. Molecular study and genotype/phenotype correlation of β Thalassemia in Malaysia. Int J Lab Hematol 2012; 34:377-82. [PMID: 22335963 DOI: 10.1111/j.1751-553x.2012.01405.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION To study the ß-gene mutations spectrum, the genotype/phenotype correlation, the modulatory effect of co-inherited factors such as α-gene mutations and of Xmn1 polymorphism in a large cohort of Malaysian patients. METHODS A total of 264 cases clinically diagnosed as Thalassemia major (TM) (111), Thalassemia intermedia (21), HbE-β Thalassemia (131), and 1 HbE homozygous were studied. The detection of α and ß gene mutations and characterization of Xmn1 polymorphism were performed by multiplex PCR, amplification refractory mutation system (ARMS), DNA sequencing, and restriction fragment length polymorphism (RFLP)-PCR. RESULTS A total of 19 ß Thalassemia mutations were characterized. CD26 and CD41/42 were the most common found in the Malay and Chinese population, respectively. The sensitivity of the clinical diagnosis for β TM, thalassemia intermedia, and HbE/β thalassemia was 94.0%, 15.2%, and 89.2%, respectively. Patients with Xmn1 heterozygosity [+/-] required less frequent transfusion compared with those without the polymorphism. Co-inheritance of α-thalassemia alleviates the severity of HbE-β thalassemia in our cohort. CONCLUSION Molecular analysis should be used for a better diagnosis and management of β thalassemia.
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Affiliation(s)
- M Sivalingam
- UKM Medical Molecular Biology Institute (UMBI), Kuala Lumpur, Cheras, Malaysia
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Multiplexed genotyping of beta globin mutations with MALDI-TOF mass spectrometry. Clin Chim Acta 2011; 412:999-1002. [DOI: 10.1016/j.cca.2011.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 02/04/2011] [Indexed: 11/20/2022]
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Colah R, Gorakshakar A, Nadkarni A. Global burden, distribution and prevention of β-thalassemias and hemoglobin E disorders. Expert Rev Hematol 2011; 3:103-17. [PMID: 21082937 DOI: 10.1586/ehm.09.74] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The β-thalassemias, including the hemoglobin E disorders, are not only common in the Mediterranean region, South-East Asia, the Indian subcontinent and the Middle East but have now become a global problem, spreading to much of Europe, the Americas and Australia owing to migration of people from these regions. Approximately 1.5% of the global population are heterozygotes or carriers of the β-thalassemias. While the overall frequencies of carriers of these disorders are known in most countries, there have been few attempts at micromapping and wherever this has been done, significant variations are seen even within small geographic regions. Thus, the figures for the estimated numbers of births each year of homozygous β-thalassemia and the severe compound states involving other hemoglobin disorders may be an underestimate. Screening strategies have varied from premarital to antenatal in different countries depending on socio-cultural and religious customs in different populations. Prenatal diagnosis programs are ongoing in many countries and the knowledge of the distribution of mutations has facilitated the establishment of successful control programs. Many of these were through North-South partnerships and networking. Yet, there are many countries in Asia where they are lacking, and South-South partnerships are now being developed in South-East Asia and the Indian subcontinent to link centers with expertise to centers where expertise needs to be developed. Although the carrier frequencies will remain unaltered, this will eventually help to bring down the burden of the birth of affected children with β-thalassemias and hemoglobin E disorders in Asia.
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Affiliation(s)
- Roshan Colah
- National Institute of Immunohaematology, Indian Council of Medical Research ,KEM Hospital Campus, Parel, Mumbai, India.
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Madan N, Sharma S, Sood SK, Colah R, Bhatia LHM. Frequency of β-thalassemia trait and other hemoglobinopathies in northern and western India. INDIAN JOURNAL OF HUMAN GENETICS 2010; 16:16-25. [PMID: 20838487 PMCID: PMC2927789 DOI: 10.4103/0971-6866.64941] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION India is an ethnically diverse country with an approximate population of 1.2 billion. The frequency of beta-thalassemia trait (βTT) has variously been reported from <1% to 17% and an average of 3.3%. Most of these studies have been carried out on small population groups and some have been based on hospital-based patients. There is also a variation in the prevalence of hemoglobinopathies in different regions and population groups in the country. A high frequency of Hb D has been reported from the North in the Punjabi population, Hb E in the eastern region of India and Hb S is mainly reported from populations of tribal origin from different parts of the country. OBJECTIVES To study the gene frequency of βTT and other hemoglobinopathies in three regions East (Kolkata), West (Mumbai) and North (Delhi) in larghe population group (schoolchildren) for a more accurate assessment of gene frequency for planning of control programmes for haemoglobinopathies. MATERIALS AND METHODS This study included 5408 children from 11 schools in Delhi, 5682 from 75 schools in Mumbai and 957 schoolchildren from Kolkata who were screened for βTT and haemoglobinopathies. These included 5684 children from 75 schools in Mumbai and 5408 children from 11 schools in Delhi. Children were 11-18 years of age of both sexes. The final report is, however, only on 11090 schoolchildren from Mumbai and Delhi as data from Kolkata was restricted both in numbers and objectives and could not be included for comparison. RESULTS The overall gene frequency of βTT in Mumbai and Delhi was 4.05% being 2.68% and 5.47% in children of the two cities respectively. In Mumbai, the gene frequency was evenly distributed. Majority of the children with βTT from Mumbai were from Marathi (38.9%) and Gujarati (25%) speaking groups. Gene frequency was >5% in Bhatias, Khatris, Lohanas and Schedule Castes. In Delhi, a higher incidence was observed in schoolchildren of North and West Delhi (5.8-9.2%). The schoolchildren of North and West Delhi comprised predominantly of Punjabi origin compared to children in the South of the city (2.2%, 2.3%). When analyzed state-wise, the highest incidence was observed in children of Punjabi origin (7.6%) and was >4% from several other states. Majority of the traits from Mumbai were anemic (95.1% male and 85.6% in female). The prevalence of anemia was lower (62.7% male and 58.4% female) children with βTT from Delhi. This was a reflection of the higher prevalence of anemia in children without hemoglobinopathy in Mumbai than in Delhi. Nutritional deficiency was probably more severe and rampant in children Mumbai. Gene frequency of Hb D was greater in schoolchildren from Delhi (1.1%) than in Mumbai (0.7%). Hb S trait (0.2%) was observed exclusively in children from Mumbai. A low incidence of Hb E trait (0.04%) was seen in children in Mumbai. A higher incidence is reported from the East. The number of cases studied from the eastern region was small as the data from the East (Kolkata) could not be included in the analysis. CONCLUSION This study comprises a larger number of children studied for the gene frequency of βTT and other hemoglobinopathies from India. Population groups with higher gene frequencies require screening programmes and facilities for antenatal diagnosis as well as increased awareness and educational programmes to control the birth of thalassemic homozygotes. The overall carrier frequency of βTT was 4.05% and reinforces the differential frequency of β-thalassemia trait in schoolchildren from Delhi and Mumbai and the higher incidence of hemoglobin D in Punjabis as reported previously. The birth incidence calculated thereof for homozygous thalassemics would be 11,316 per year which are added each year to the existing load of homozygous thalassemics. This is much higher than the previously reported number of births annually. Hence suitable control measures need to be undertaken urgently in India.
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Affiliation(s)
- Nishi Madan
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110 095, India
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Mirasena S, Shimbhu D, Sanguansermsri M, Sanguansermsri T. Detection of beta-thalassemia mutations using a multiplex amplification refractory mutation system assay. Hemoglobin 2008; 32:403-9. [PMID: 18654891 DOI: 10.1080/03630260701798391] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We developed two sets of a multiplex amplification refractory mutation system (M-ARMS) assay to identify specific beta-thalassemia (beta-thal) mutations that are common in Thailand. The first one was for the detection of mutants with codon 17 (A>T), IV S-I-1 (G >T)), codons 41/42 (-TCT T) and codons 71/72 (+A), while the second one was for the -87 (C>A), -28 (A>G) and IVS-II-654 (C>T). Application of the proposed assay to 282 persons with beta-thal trait revealed a positive result in 276 cases (97.8%). There were 258 cases (91.5%) positive for the set 1 M-ARMS assay and 18 cases (6.4%) were positive for set 2. Six cases (2.2%) were negative for both sets 1 and 2, and were further characterized by DNA sequencing. The mutations detected by the set 1 M-ARMS assay were 113 cases (40.1%) of codons 41/42, 95 (33.7%) of codon 17, 41 (14.5%) of IVS-I-1 and nine cases (3.2%) of codons 71/72, while by set 2 there were 12 cases (4.2%) of -28, four cases(1.4%) of -87 and two cases (0.7%) of IVS-II-654. Mutations undetectable by M-ARMS assay were two cases of codons 27/28 (+C), one case of codon 35 (C>A), one of codon 43 (G>T), one of -31 (A>G) and one of IVS-I-5 (C>G). The M-ARMS assay proved to be a valuable tool for the analysis of beta-thal mutations. The method is robust, accurate, simple, speedy and cost-effective. The application of this assay will facilitate genetic counseling and prenatal diagnosis for severe thalassemia in high-risk pregnancies.
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Affiliation(s)
- Saisiri Mirasena
- Department of Biochemistry, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand.
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