Bashyam Murali D, Chaudhary Ajay K, Bhat Vijay
Laboratory of Molecular Oncology, Centre for DNA Fingerprinting and Diagnostics, Nampally, Hyderabad 500001, India.
Hemoglobin. 2012;36(5):497-503. doi: 10.3109/03630269.2012.700532.
β-Thalassemia (β-thal) is a common single gene autosomal recessive disorder resulting in severe anemia due to reduced or absent β-globin polypeptide synthesis. The disease is caused by mutations in the β-globin gene; eight common mutations are proposed to cause the majority of β-thal in India. However, the occurrence of a region-specific mutation spectrum in India has also been suggested. We had earlier carried out analyses of the β-globin gene mutation spectrum from southern Indian states of Andhra Pradesh and Karnataka. In the current study, we have analyzed three of 73 transfusion-dependent patients visiting a referral hospital in Karnataka State, South India, who did not carry any of the 22 common β-globin gene mutations as determined by reverse dot-blot analysis. The IVS-II-837 (T>G) (β(+)) (HBB:c.316-14TG) mutation was detected in two of the three patients analyzed suggesting a higher occurrence of the mutation in β-thal patients in Karnataka when compared to other regions of India. The rare polyadenylation (poly A) site (T>C) (AATAAA>AACAAA; β(+)) mutation was detected in the third patient. The IVS-II-837 mutation was also identified in asymptomatic carrier parents during routine high performance liquid chromatography (HPLC)-based Hb A(1c) screening in suspected diabetes patients. This is the first report of the identification of β-thal trait through HPLC-based diabetes screening in India, revealing the importance of linking diabetes screening with screening for thalassemia.
β地中海贫血(β-thal)是一种常见的单基因常染色体隐性疾病,由于β-珠蛋白多肽合成减少或缺乏导致严重贫血。该疾病由β-珠蛋白基因突变引起;在印度,八种常见突变被认为导致了大多数β地中海贫血病例。然而,也有人提出印度存在区域特异性突变谱。我们之前对印度南部安得拉邦和卡纳塔克邦的β-珠蛋白基因突变谱进行了分析。在本研究中,我们分析了印度南部卡纳塔克邦一家转诊医院的73名依赖输血的患者中的3名,通过反向点杂交分析确定他们没有携带22种常见β-珠蛋白基因突变中的任何一种。在分析的3名患者中的2名检测到IVS-II-837(T>G)(β(+))(HBB:c.316-14TG)突变,这表明与印度其他地区相比,卡纳塔克邦β地中海贫血患者中该突变的发生率更高。在第三名患者中检测到罕见的聚腺苷酸化(poly A)位点(T>C)(AATAAA>AACAAA;β(+))突变。在疑似糖尿病患者的常规基于高效液相色谱(HPLC)的Hb A(1c)筛查中,也在无症状携带者父母中鉴定出IVS-II-837突变。这是印度首次通过基于HPLC的糖尿病筛查鉴定β地中海贫血特征的报告,揭示了将糖尿病筛查与地中海贫血筛查联系起来的重要性。