El-Gharbawi Nesrine, Shaheen Iman, Hamdy Mona, Elgawhary Somaya, Samir Mohamed, Hanna Baher Matta, Ali Eman Yousief, Youssef Eman Ahmed
Clinical Pathology Department, Cairo University, Cairo, Egypt.
Pediatric Hematology, Department of pediatrics, Cairo University, Cairo, Egypt.
Indian J Hematol Blood Transfus. 2023 Apr;39(2):258-265. doi: 10.1007/s12288-022-01580-8. Epub 2022 Nov 1.
Iron overload remains a major cause of morbidity and mortality among β-thalassemia major (β-TM) patients. Iron regulatory proteins and their genetic variants together with changes in hepcidin levels in thalassemic patients could affect the disease manifestations. This work aimed to study genetic variations of ferroportin-1 (FPN1-8CG), Transmembrane Serine Protease 6 (TMPRSS6 rs855791) and hemojuvelin (HJV I222N and G320V) genes within a cohort of 97 β-TM Egyptian patients by Polymerase chain reaction Restriction Fragment Length Polymorphism (PCR-RFLP) in comparison to fifty normal control subjects. Among β-TM patients; the CG variant of FPN1 was significantly higher, while the TT and TC variants of TMPRSS6 were significantly lower in comparison to controls. Liver Iron Concentration (LIC) was significantly higher among β-TM patients harboring the FPN1 (GG) genotype and we found that FPN1gene mutation acts as independent predictor of MRI LIC (p = 0.011), Pulmonary artery pressure (PAP) was significantly higher in patients harboring the mutant FPN1 (GG and CG) genotypes (p value 0.04). β-TM patients having the HJV I222N (AA) genotype were having significantly higher cardiac iron overload (p value = 0.026). The studied genetic variants of iron regulatory proteins could alter the manifestations of iron overload thus resulting in different clinical phenotypes of thalassemic patients, these findings need to be confirmed by larger cohorts of patients with longer follow-up periods.
The online version contains supplementary material available at 10.1007/s12288-022-01580-8.
铁过载仍是重型β地中海贫血(β-TM)患者发病和死亡的主要原因。铁调节蛋白及其基因变异以及地中海贫血患者中血色病抑制素水平的变化可能会影响疾病表现。本研究旨在通过聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,对97例埃及β-TM患者和50例正常对照者进行研究,分析铁转运蛋白1(FPN1-8CG)、跨膜丝氨酸蛋白酶6(TMPRSS6 rs855791)和血色素沉着蛋白(HJV I222N和G320V)基因的遗传变异情况。在β-TM患者中,与对照组相比,FPN1的CG变异显著更高,而TMPRSS6的TT和TC变异显著更低。携带FPN1(GG)基因型的β-TM患者肝脏铁浓度(LIC)显著更高,我们发现FPN1基因突变是MRI LIC的独立预测因子(p = 0.011),携带突变FPN1(GG和CG)基因型的患者肺动脉压(PAP)显著更高(p值0.04)。具有HJV I222N(AA)基因型的β-TM患者心脏铁过载显著更高(p值 = 0.026)。所研究的铁调节蛋白基因变异可能会改变铁过载的表现,从而导致地中海贫血患者出现不同的临床表型,这些发现需要在更大规模、随访期更长的患者队列中得到证实。
在线版本包含可在10.1007/s12288-022-01580-8获取的补充材料。