Articles

A Large Cohort Study of Genotype and Phenotype Correlations of Beta-Thalassemia in Iranian Population

Abstract

Background: Thalassemia syndromes are the most prevalent single gene disorders in Iran. This study aimed to evaluate the effect of different types of beta-globin gene mutations, co-inheritance of alpha-globin gene mutations and/or Xmn1 SNP on disease phenotype in a large cohort of Iranian patients.
Subjects and Methods: In total, 433 patients were clinically classified into β-thalassemia major (TM) or intermedia (TI). Multiplex PCR, ARMS-PCR, RFLP-PCR and DNA sequencing were performed to identify both α- and β-globin gene mutations and Xmn1 polymorphism as well. All data were compared and analyzed by SPSS software in TM and TI groups consequently.
Results: A total of 39 different β-globin mutations were identified. Among them, the most common were IVS IInt1 (40.33%) followed by IVS Int5 (9.56%), C30 (7.22%) and Fr8-9(7%). All patients were subjected to evaluate common α-globin gene deletions. The patients inherited concomitant mutations of α- and β-globin, showed no clinical modifications compared with those who had only β-globin mutation. The TI patients showed a significant increase in frequency of both heterozygous and homozygous form of the Xmn1 polymorphism. It was also found that β00 genotype patients, inherited the Xmn1 polymorphism required lesser blood transfusion.
Conclusion: No significant differences were observed, on the severity of disease, between patient's inherited defective α- and β-globin genes and ones with just β-globin gene mutation. Taking the results of this research into account, Xmn1 polymorphism can be considered as an important genetic factor modulating the severity of disease.

Rahimi Z. Genetic epidemiology, hematological and clinical features of hemoglobinopathies in iran. Biomed Res Int. 2013; 2013:803487.

Chaisue C, Kitcharoen S, Wilairat P, et al. Alpha/beta-Globin mRNA ratio determination by multiplex quantitative real-time reverse transcription-polymerase chain reaction as an indicator of globin gene function. Clin Biochem. 2007 Dec; 40(18):1373-7.

Weatherall D.J, Clegg J.B. The Thalassemia Syndromes. 4th ed. Oxford: Malden/MA; Blackwell science, 2001:486, 192-247.

Samavat A, Modell B. Iranian national thalassaemia screening programme. BMJ. 2004 Nov 13; 329(7475): 1134-7.

Fallah MS, Samavat A, Zeinali S. Iranian national program for the prevention of thalassemia and prenatal diagnosis: mandatory premarital screening and legal medical abortion. Prenat Diagn. 2009 Dec; 29(13):1285-6.

Abolghasemi H, Amid A, Zeinali S, et al. Thalassemia in Iran: epidemiology, prevention, and management. J Pediatr Hematol Oncol. 2007 Apr; 29(4):233-8.

Hadipour Dehshal M, Tabrizi Namini M, Ahmadvand A, et al. Evaluation of the national prevention program in iran, 2007-2009: the accomplishments and challenges with reflections on the path ahead. Hemoglobin. 2014; 38(3):179-87.

Galehdari H, Salehi B, Pedram M, et al. High prevalence of rare mutations in the Beta globin gene in an ethnic group in iran. Iran Red Crescent Med J. 2011 May; 13(5):356-8.

Mahdavi MR, Kowsarian M, Karami H, et al. Prevalence of hemoglobin alpha-chain gene deletion in neonates in North of Iran. Eur Rev Med Pharmacol Sci. 2010 Oct; 14(10):871-5.

Denic S, Agarwal MM, Al Dabbagh B, et al. Hemoglobin A2 Lowered by Iron Deficiency and alpha-Thalassemia: Should Screening Recommendation for beta-Thalassemia Change? ISRN Hematol. 2013; 2013:858294.

Alkindi SS, Alzadjali S, Daar S, et al. A stepwise alpha-thalassemia screening strategy in high-prevalence areas. Eur J Haematol. 2013 Aug; 91(2):164-9.

Saleh-Gohari N, Khosravi-Mashizi A. Spectrum of alpha-globin gene mutations in the Kerman Province of Iran. Hemoglobin. 2010; 34(5):451-60.

Rahim F. Correlation of beta-thalassemia mutations with alpha-thalassemia: an experience of the southwestern region of Iran. Hematology. 2010 Dec; 15(6):430-3.

Zandian K, Nateghi J, Keikhaie B, et al. Alpha-thalassemia mutations in Khuzestan Province, Southwest Iran. Hemoglobin. 2008;32(6):546-52.

Tamaddoni A, Hadavi V, Nejad NH, et al. Alpha-Thalassemia mutation analyses in Mazandaran province, North Iran. Hemoglobin. 2009; 33(2):115-23.

Hadavi V, Jafroodi M, Hafezi-Nejad N, et al. Alpha-thalassemia mutations in Gilan Province, North Iran. Hemoglobin. 2009; 33(3):235-41.

Mehrabi M, Alibakhshi R, Fathollahi S, et al. The spectrum of beta-thalassemia mutations in Kermanshah Province in West Iran and its association with hematological parameters. Hemoglobin. 2013; 37(6): 544-52.

Rahiminejad MS, Zeinali S, Afrasiabi A, et al. Beta-Thalassemia mutations found during 1 year of prenatal diagnoses in Fars Province, Iran. Hemoglobin. 2011; 35(4):331-7.

Yatim NF, Rahim MA, Menon K, et al. Molecular characterization of alpha- and beta-thalassaemia among Malay patients. Int J Mol Sci. 2014; 15(5):8835-45.

El-Shanshory M, Hagag A, Shebl S, et al. Spectrum of Beta Globin Gene Mutations in Egyptian Children with beta-Thalassemia. Mediterr J Hematol Infect Dis. 2014; 6(1): e2014071.

Nagar R, Sinha S, Raman R. Haemoglobinopathies in eastern Indian states: a demographic evaluation. J Community Genet. 2014 Jul 25.

Dadheech S, Jain S, Madhulatha D, et al. Association of Xmn1 -158 gammaG variant with severity and HbF levels in beta-thalassemia major and sickle cell anaemia. Mol Biol Rep. 2014 May; 41(5):3331-7.

Pandey S, Mishra RM, Saxena R. Modulating Effect of the -158 gamma (C-->T) Xmn1 Polymorphism in Indian Sickle Cell Patients. Mediterr J Hematol Infect Dis. 2012; 4(1):e2012001.

Miller SA, Dykes DD, Polesky HF. A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res. 1988 Feb 11; 16(3):1215.

Chong SS, Boehm CD, Higgs DR, et al. Single-tube multiplex-PCR screen for common deletional determinants of alpha-thalassemia. Blood. 2000 Jan 1; 95(1): 360-2.

Dode C, Krishnamoorthy R, Lamb J, et al. Rapid analysis of -alpha 3.7 thalassaemia and alpha alpha alpha anti 3.7 triplication by enzymatic amplification analysis. Br J Haematol. 1993 Jan; 83(1):105-11.

Sutton M, Bouhassira EE, Nagel RL. Polymerase chain reaction amplification applied to the determination of beta-like globin gene cluster haplotypes. Am J Hematol. 1989 Sep; 32(1):66-9.

Winichagoon P, Fucharoen S, Chen P, et al. Genetic factors affecting clinical severity in beta-thalassemia syndromes. J Pediatr Hematol Oncol. 2000 Nov-Dec; 22(6):573-80.

Sivalingam M, Looi ML, Zakaria SZ, et al. Molecular study and genotype/phenotype correlation of beta Thalassemia in Malaysia. Int J Lab Hematol. 2012 Aug; 34(4):377-82.

Dedoussis GV, Mandilara GD, Boussiu M, et al. HbF production in beta thalassaemia heterozygotes for the IVS-II-1 G-->A beta(0)-globin mutation. Implication of the haplotype and the (G)gamma-158 C-->T mutation on the HbF level. Am J Hematol. 2000 Jul; 64(3):151-5.

Serjeant G. Sickle Cell Disease 3rd edition ed: Oxford University press; 2001.

Nuntakarn L, Fucharoen S, Fucharoen G, et al. Molecular, hematological and clinical aspects of thalassemia major and thalassemia intermedia associated with Hb E-beta-thalassemia in Northeast Thailand. Blood Cells Mol Dis. 2009 Jan-Feb; 42(1):32-5.

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IssueVol 9, No 4 (2015) QRcode
SectionArticles
Keywords
α-thalassemia β-thalassemia major β-thalassemia intermedia Xmn1 polymorphism Iran

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How to Cite
1.
Maryami F, Azarkeivan A, Fallah MS, Zeinali S. A Large Cohort Study of Genotype and Phenotype Correlations of Beta-Thalassemia in Iranian Population. Int J Hematol Oncol Stem Cell Res. 2016;9(4):198-202.