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地中海贫血症的先进分子方法以及资源有限环境下分子水平诊断测试的选择

Advanced molecular approaches to thalassemia disorder and the selection of molecular-level diagnostic testing in resource-limited settings.

作者信息

Meenakumari Balaiah, K Chandramouleeswari, Dhanasekar Sariga

机构信息

Institute of Child health and hospital for children, Rina mandal road, Egmore, Chennai, Tamil Nadu, India.

Institute of Child health and hospital for children, Rina mandal road, Egmore, Chennai, Tamil Nadu, India.

出版信息

Hematol Transfus Cell Ther. 2025 Jun 14;47(3):103860. doi: 10.1016/j.htct.2025.103860.

DOI:10.1016/j.htct.2025.103860
PMID:40523316
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12206028/
Abstract

Beta-thalassemia is a genetic disorder that significantly burdens healthcare systems globally. This inherited blood disorder, categorized into beta-thalassemia and alpha-thalassemia, results in insufficient globin production, leading to anemia and iron overload from frequent transfusions. Severe cases, known as thalassemia major, require regular blood transfusions. Beyond clinical suspicion and biochemical tests, molecular techniques are essential for confirming the diagnosis and guiding treatment. Advanced molecular profiling methods such as Polymerase Chain Reaction (PCR), Multiplex Ligation-dependent Probe Amplification (MLPA), Next-Generation Sequencing (NGS), Third-Generation Sequencing (TGS), and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) are effective in detecting mutations. Epigenetic factors also play a crucial role, driving the development of epidrugs for targeted therapy. This review covers various molecular techniques, established gene-editing methods, epigenetic mechanisms, and the impact of artificial intelligence on thalassemia management. It highlights the importance of selecting precise and sensitive molecular tools for detecting thalassemia gene mutations and stresses the need to make these testing methods accessible in resource-limited clinical settings.

摘要

β地中海贫血是一种遗传性疾病,给全球医疗系统带来了沉重负担。这种遗传性血液疾病分为β地中海贫血和α地中海贫血,会导致珠蛋白生成不足,进而引发贫血以及因频繁输血导致的铁过载。严重的病例,即重型地中海贫血,需要定期输血。除了临床怀疑和生化检测外,分子技术对于确诊和指导治疗至关重要。先进的分子分析方法,如聚合酶链反应(PCR)、多重连接依赖探针扩增(MLPA)、下一代测序(NGS)、第三代测序(TGS)和成簇规律间隔短回文重复序列(CRISPR),在检测突变方面很有效。表观遗传因素也起着关键作用,推动了用于靶向治疗的表观遗传药物的开发。这篇综述涵盖了各种分子技术、既定的基因编辑方法、表观遗传机制以及人工智能对地中海贫血管理的影响。它强调了选择精确且灵敏的分子工具来检测地中海贫血基因突变的重要性,并强调了在资源有限的临床环境中使这些检测方法可及的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1574/12206028/6cea1aab239e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1574/12206028/6cea1aab239e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1574/12206028/6cea1aab239e/gr1.jpg

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本文引用的文献

1
miR-214 aggravates oxidative stress in thalassemic erythroid cells by targeting ATF4.miR-214 通过靶向 ATF4 加重地中海贫血症红系细胞的氧化应激。
PLoS One. 2024 Apr 16;19(4):e0300958. doi: 10.1371/journal.pone.0300958. eCollection 2024.
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Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-Thalassemia.社论:CRISPR-Cas9 治疗性基因编辑治疗镰状细胞病和输血依赖型β-地中海贫血的首次监管批准。
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Long Non-Coding RNA H19 Leads to Upregulation of γ-Globin Gene Expression during Erythroid Differentiation.
长非编码 RNA H19 在红细胞分化过程中导致 γ-珠蛋白基因表达上调。
Hemoglobin. 2024 Jan;48(1):4-14. doi: 10.1080/03630269.2023.2284950. Epub 2024 Feb 29.
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Third-generation sequencing identified two rare α-chain variants leading to hemoglobin variants in Chinese population.第三代测序技术鉴定了两种导致中国人血红蛋白变异的罕见α-链变异。
Mol Genet Genomic Med. 2024 Jan;12(1):e2365. doi: 10.1002/mgg3.2365.
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Clinical, laboratory, and molecular characteristics of a cohort of children with hemoglobinopathy S/beta-thalassemia.一组血红蛋白病S/β地中海贫血患儿的临床、实验室及分子特征
Hematol Transfus Cell Ther. 2024 Apr-Jun;46(2):167-175. doi: 10.1016/j.htct.2023.11.002. Epub 2023 Dec 19.
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Scalable noninvasive amplicon-based precision sequencing (SNAPseq) for genetic diagnosis and screening of β-thalassemia and sickle cell disease using a next-generation sequencing platform.使用下一代测序平台的可扩展无创扩增子精准测序(SNAPseq)用于β地中海贫血和镰状细胞病的基因诊断与筛查
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7
Case report: Identification of a novel triplication of alpha-globin gene by the third-generation sequencing: pedigree analysis and genetic diagnosis.病例报告:第三代测序技术鉴定新型α-珠蛋白基因三重复:家系分析与遗传诊断。
Hematology. 2023 Dec;28(1):2277571. doi: 10.1080/16078454.2023.2277571. Epub 2023 Dec 7.
8
Predicting Thalassemia Using Feature Selection Techniques: A Comparative Analysis.使用特征选择技术预测地中海贫血:一项比较分析。
Diagnostics (Basel). 2023 Nov 14;13(22):3441. doi: 10.3390/diagnostics13223441.
9
Current Status of β-Thalassemic Burden in India.印度β-地中海贫血负担的现状。
Hemoglobin. 2023 Sep;47(5):181-190. doi: 10.1080/03630269.2023.2269837. Epub 2023 Dec 7.
10
Identification of double heterozygous -α/-α using third-generation sequencing.使用第三代测序技术鉴定双重杂合子 -α/-α。
Hematology. 2023 Dec;28(1):2250646. doi: 10.1080/16078454.2023.2250646.