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[一个罕见的88 C>G()β地中海贫血突变与α地中海贫血共遗传家族的分子遗传学特征及文献复习]

[Molecular genetic characteristics of a family which coinheritance of rare-88 C>G () β-thalassemia mutation with α-thalassemia and review of the literature].

作者信息

Li W, Chen L T, Yu Y, Wang J, Li C Y, Cai T E, Lu C J, Li D X, Tian X J

机构信息

Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Feb 6;57(2):253-258. doi: 10.3760/cma.j.cn112150-20220818-00823.

Abstract

The molecular genetic characteristics of a family with rare -88 C>G ( c.-138 C>G) β-thalassemia gene mutation were studied using cohort study. The cohort study was conducted from June to August 2022 by Prenatal Diagnosis Center of Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center. The phenotype and genotype were analyzed by hematological cytoanalyzer, automatic electrophoretic analysis system, and next-generation sequencing (NGS). And then, Sanger sequencing was used to verify the rare gene results. The results showed that the proband, her father, her uncle and her younger male cousin had discrete microcytosis (MCV 70.1 fl, 71.9 fl, 73.1 fl and 76.6 fl, respectively) and hypochromia (MCH 21.5 pg,22.0 pg,22.6 pg and 23.5 pg, respectively), elevated hemoglobin A2 level (5.3%, 5.4%, 5.4% and 5.5%, respectively), slightly elevated or normal fetal hemoglobin (Hb F), but no anemia. The proband was identified to have co-inherited ɑ-thalassemia (Hb Westmead gene heterozygous mutation, ɑɑ/ɑɑ) and β-thalassemia with a rare -88 C>G (: c.-138 C>G) heterozygous mutation (β/β). Her mother had the same α-thalassemia as the proband. Her father, her uncle and her younger male cousin had the same rare -88 C>G heterozygous mutations as the proband. While her grandmother and younger brother were not carrier of thalassemia. In conclusion, 4 cases of rare -88 C>G() heterozygous mutation had been detected in a Chinese family. Carriers of this beta-thalassemia are clinically asymptomatic. This study enriches the knowledge of the thalassemia mutation spectrum in Chinese people and provides valuable information for genetic counseling, prenatal diagnosis, and prevention of thalassemia, providing a scientific basis for improving the quality of birth population and preventing birth defects.

摘要

采用队列研究方法,对一个携带罕见的 -88 C>G(c.-138 C>G)β地中海贫血基因突变的家系进行分子遗传学特征研究。该队列研究由上海儿童医学中心管理的三亚市妇女儿童医院产前诊断中心于2022年6月至8月开展。通过血液学细胞分析仪、自动电泳分析系统和二代测序(NGS)对表型和基因型进行分析。然后,采用桑格测序法验证罕见基因结果。结果显示,先证者、其父亲、其叔叔和其年幼的男性表弟均有离散性小红细胞症(平均红细胞体积分别为70.1 fl、71.9 fl、73.1 fl和76.6 fl)和低色素血症(平均血红蛋白含量分别为21.5 pg、22.0 pg、22.6 pg和23.5 pg),血红蛋白A2水平升高(分别为5.3%、5.4%、5.4%和5.5%),胎儿血红蛋白(Hb F)轻度升高或正常,但无贫血。先证者被鉴定为共遗传了α地中海贫血(Hb Westmead基因杂合突变,αα/α - )和β地中海贫血,伴有罕见的 -88 C>G(: c.-138 C>G)杂合突变(β/β)。其母亲与先证者具有相同的α地中海贫血。其父亲、其叔叔和其年幼的男性表弟与先证者具有相同的罕见 -88 C>G杂合突变。而其祖母和弟弟不是地中海贫血携带者。综上所述,在中国一个家系中检测到4例罕见的 -88 C>G()杂合突变。这种β地中海贫血的携带者临床上无症状。本研究丰富了中国人地中海贫血突变谱的知识,为地中海贫血的遗传咨询、产前诊断和预防提供了有价值的信息,为提高出生人口素质和预防出生缺陷提供了科学依据。

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