Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Sci Rep. 2017 Aug 29;7(1):9822. doi: 10.1038/s41598-017-10045-2.
Glucose-6-phosphate dehydrogenase (G6PD) activity is essential for redox equilibrium of red blood cells (RBCs) and, when compromised, the RBCs are more susceptible to haemolysis. 8-aminoquinolines (primaquine and tafenoquine) are used for the radical curative treatment of Plasmodium vivax malaria and can cause haemolysis in G6PD deficient subjects. Haemolytic risk is dependent on treatment dose and patient G6PD status but ultimately it correlates with the number of G6PD deficient RBCs. The G6PD spectrophotometric assay reliably identifies deficient subjects but is less reliable in heterozygous females, especially when other blood conditions are present. In this work we analysed samples with a range of G6PD phenotypes and haematologic conditions from 243 healthy volunteers of Asian or African-American heritage using both the spectrophotomeric assay and the G6PD flow-cytometric assay. Overall 18.5% of subjects (29.3% of Asian females) presented with anaemia, associated with decreased RBCs volume (MCV) and reticulocytosis; the flow-cytometric assay showed good correlation with the spectrophotometric assay (Pearson's r 0.918-0.957) and was less influenced by haemoglobin concentration, number of RBCs and number of reticulocytes. This resulted in more precise quantification of the number of G6PD deficient RBCs and presumably higher predictive power of drug induced haemolytic risk.
葡萄糖-6-磷酸脱氢酶（G6PD）活性对于红细胞（RBC）的氧化还原平衡至关重要，当该酶活性受到损害时，RBC 更容易发生溶血。8-氨基喹啉（伯氨喹啉和他非诺喹）用于根治间日疟原虫疟疾，在 G6PD 缺乏的个体中可引起溶血。溶血风险取决于治疗剂量和患者的 G6PD 状态，但最终与 G6PD 缺乏的 RBC 数量相关。分光光度法 G6PD 测定可可靠地识别缺乏的个体，但在杂合女性中不太可靠，尤其是在存在其他血液状况时。在这项工作中，我们使用分光光度法和 G6PD 流式细胞术分析了来自 243 名亚洲或非裔美国健康志愿者的具有不同 G6PD 表型和血液学状况的样本。总体而言，18.5%的受试者（29.3%的亚洲女性）患有贫血症，伴有 RBC 体积（MCV）和网织红细胞减少；流式细胞术与分光光度法具有良好的相关性（Pearson's r 0.918-0.957），受血红蛋白浓度、RBC 数量和网织红细胞数量的影响较小。这导致更精确地量化 G6PD 缺乏的 RBC 数量，并可能提高药物诱导的溶血风险的预测能力。
