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巴西亚马孙州玛瑙斯都会区α地中海贫血3.7 Kb常见缺失的检测

Detection of Common Deletional of α-Thalassemia 3.7 Kb from Metropolitan Region of Manaus, Amazonas, Brazil.

作者信息

Anselmo Fernanda Cozendey, Soumanou Abdou Gafar, de Aguiar Ferreira Cleidiane, Sobrinha Flora Maia Viga, Castro Ana Caroline Santos, Brito Rafael Oliveira, da Mota Adolfo José, de Souza Gonçalves Marilda, de Moura Neto José Pereira

机构信息

Universidade do Estado do Amazonas - Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas, Brasil.

Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, Manaus, Amazonas, Brasil.

出版信息

Mediterr J Hematol Infect Dis. 2021 Jan 1;13(1):e2021001. doi: 10.4084/MJHID.2021.001. eCollection 2021.

Abstract

BACKGROUND

Alpha Thalassemia (α-thal) is a heterogeneous group of hereditary alterations caused by deletions that affect alpha regulatory genes, and the 3.7Kb deletion is the most frequent worldwide. The prevalence ranges from 20% and 35% in Brazil, depending mainly on race, predominant in Afro-descendants.

PURPOSE

The aim was to determine α-thal - and - deletions, estimating their frequency in individuals from six regions of Amazonas State.

METHODS

Volunteers age between 18-59 years old of both genders participated in the study. Blood was collected from March 2014 to September 2017 at the health centers of each participant city. α-thal was performed by GAP-PCR, while α-thal by Multiplex-PCR. The total samples collected from each city were: Manaus (capital), 356 (19.7%); Iranduba 232 (12.8%); Manacapuru, 287 (15.9%); Presidente Figueiredo, 370 (20.5%); Itacoatiara, 301 (16.6%); and Coari, 263 (14.5%).

RESULTS

The average age among males was 35.3±14.8, while for females, it was 36.7±14.9 years old. Microcytosis (MCV <80fL) was found in 158 individuals (8,46%) and α-thal diagnosed in 143 individuals (7.9%), and all of these individuals carried the deletion 5.95% in heterozygous and 1.95% in homozygous. α-thal was not found in any volunteer. The association analyses to the α-thal genotypes were statistically significant for all hematological parameters (p<.001), except serum iron and serum ferritin analyses.

CONCLUSION

This study highlights α-thal 3.7kb deletion as an important public health problem, especially in a population not yet characterized about this disease. Thus, epidemiological studies using molecular tools become relevant in regions where the disease is underestimated, contributing to a better understanding of thalassemia incidence and iron deficiency anemias incidence of the participating cities. We reinforce that future molecular studies in North Region from Brazil can be utilized to describe other genetic anemias as structural hemoglobinopathies that have already proven to be highly prevalent in Brazil.

摘要

背景

α地中海贫血(α-thal)是一组由影响α调控基因的缺失引起的遗传性变异的异质性群体,3.7Kb缺失在全球最为常见。在巴西,其患病率在20%至35%之间,主要取决于种族,在非洲后裔中占主导地位。

目的

旨在确定α-thal及相关缺失情况,估计亚马孙州六个地区个体中的发生频率。

方法

年龄在18至59岁的男女志愿者参与了该研究。2014年3月至2017年9月期间,在每个参与城市的健康中心采集血液样本。α-thal通过缺口聚合酶链反应(GAP-PCR)检测,而α-thal通过多重聚合酶链反应检测。从每个城市收集的样本总数分别为:马瑙斯(首府)356份(19.7%);伊兰杜巴232份(12.8%);马纳卡普鲁287份(15.9%);菲格雷多总统城370份(20.5%);伊塔科阿蒂亚拉301份(16.6%);科阿里263份(14.5%)。

结果

男性的平均年龄为35.3±14.8岁,女性为36.7±14.9岁。158名个体(8.46%)出现小红细胞症(平均红细胞体积<80fL),143名个体(7.9%)被诊断为α-thal,所有这些个体中,5.95%为杂合缺失,1.95%为纯合缺失。未在任何志愿者中发现α-thal。除血清铁和血清铁蛋白分析外,所有血液学参数与α-thal基因型的关联分析均具有统计学意义(p<0.001)。

结论

本研究强调α-thal 3.7kb缺失是一个重要的公共卫生问题,尤其是在尚未对该疾病进行特征描述的人群中。因此,在该疾病被低估的地区,使用分子工具进行流行病学研究变得至关重要,有助于更好地了解参与城市的地中海贫血发病率和缺铁性贫血发病率。我们强调,巴西北部地区未来的分子研究可用于描述其他遗传性贫血,如已证实在巴西高度流行的结构性血红蛋白病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b3/7813276/6fc267e8451c/mjhid-13-1-e2021001f1.jpg

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