Romana M, Keclard L, Guillemin G, Lavocat E, Saint-Martin C, Berchel C, Mérault G
Unité de Recherche sur la Drépanocytose, INSERM U 359, Pointe-à-Pitre, Guadeloupe.
Am J Hematol. 1996 Dec;53(4):228-33. doi: 10.1002/(SICI)1096-8652(199612)53:4<228::AID-AJH3>3.0.CO;2-#.
In order to perform genetic counselling and prenatal diagnosis of Hb-S-beta-thalassemia disease and beta-thalassemia, we have delineated the spectrum of beta-thalassemia alleles in the Guadeloupean population. A sample of 63 unrelated families was analyzed including 70 beta-thalassemia carriers, 52 Hb-S-beta-thalassemia, and 8 patients with different beta-thalassemic hemoglobinopathies. Among the eleven mutations identified, four of them [-29 (A --> G), IVS-I-5 (G --> A), IVS-II-1 (G --> A), and IVS-I-5 (G --> C)] account for 77.6% of the beta-thalassemia chromosomes present in the studied families. The seven other variants, CD 24 (T --> A), IVS-I-2 (T --> C), Poly A (T --> C), -88 (C --> T), IVS- 11-849 (A --> G), Hb E, and Hb Lepore are less frequent. As a result, Hb S-beta+-thalassemia type 1 (low Hb A values: 5-15%) together with Hb S-beta(omicron)-thalassemia phenotypes are as frequent as Hb S-beta+-thalassemia type 2 (high Hb A values: 20-30%) in the Guadeloupean population. Patients with Hb S-beta+-thalassemia type 2 have milder hematological manifestations of the disease compared to patients with Hb S-beta(omicron)-thalassemia and Hb S-beta+-thalassemia type 1. This first report on the type and nature of beta-thalassemia mutations in Guadeloupe shows that prenatal diagnosis of Hb S-beta-thalassemia and beta-thalassemia should be feasible by direct detection of point mutation in most cases.
为了对血红蛋白S-β地中海贫血病和β地中海贫血进行遗传咨询和产前诊断,我们已经描绘出瓜德罗普人群中β地中海贫血等位基因的图谱。分析了63个无亲缘关系的家庭样本,包括70名β地中海贫血携带者、52名血红蛋白S-β地中海贫血患者以及8名患有不同β地中海贫血血红蛋白病的患者。在所鉴定出的11种突变中,其中4种[-29(A→G)、IVS-Ⅰ-5(G→A)、IVS-Ⅱ-1(G→A)和IVS-Ⅰ-5(G→C)]占研究家庭中β地中海贫血染色体的77.6%。其他7种变异,即密码子24(T→A)、IVS-Ⅰ-2(T→C)、多聚腺苷酸(T→C)、-88(C→T)、IVS-Ⅱ-849(A→G)、血红蛋白E和血红蛋白Lepore则较为少见。因此,在瓜德罗普人群中,1型血红蛋白S-β+地中海贫血(低血红蛋白A值:5%-15%)以及血红蛋白S-β0地中海贫血表型与2型血红蛋白S-β+地中海贫血(高血红蛋白A值:20%-30%)的出现频率相同。与血红蛋白S-β0地中海贫血和1型血红蛋白S-β+地中海贫血患者相比,2型血红蛋白S-β+地中海贫血患者的疾病血液学表现较轻。这份关于瓜德罗普β地中海贫血突变类型和性质的首次报告表明,在大多数情况下,通过直接检测点突变对血红蛋白S-β地中海贫血和β地中海贫血进行产前诊断应该是可行的。