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Variability of hemoglobin F expression in hemoglobin EE disease: hematological and molecular analysis.
[alpha-thalassemia]
Although
the
molecular
basis
of
variability
of
hemoglobin
(
Hb
)
F
has
been
extensively
examined
in
β-thalassemia
and
sickle
cell
diseases
,
less
study
has
been
done
on
Hb
E
disorder
.
To
address
the
variability
of
Hb
F
expression
in
Hb
EE
disease
,
we
have
examined
multiple
single
nucleotide
polymorphisms
(
SNPs
)
in
the
β-globin
gene
cluster
,
BCL
11
A
and
HBS
1
L
-
MYB
genes
and
determined
their
associations
with
Hb
F
levels
in
this
syndrome
.
Study
was
done
on
141
adult
Thai
individuals
with
homozygous
Hb
E
.
Hematological
parameters
were
recorded
and
Hb
F
measured
using
Hb-
HPLC
analyzer
.
It
was
found
in
26
cases
that
co
-inheritance
of
α-thalassemia
could
lead
to
significant
lower
production
of
Hb
F
.
Association
of
Hb
F
expression
with
the
(
G
)
γ-
Xmn
I
polymorphism
and
other
SNPs
including
rs
2297339
,
rs
2838513
,
rs
4895441
and
rs
9399137
in
HBS
1
L
-
MYB
gene
and
rs
4671393
and
rs
11886868
in
BCL
11
A
gene
was
therefore
analyzed
in
the
remaining
115
cases
without
α-thalassemia
.
It
was
found
that
4
of
these
7
SNPs
including
(
G
)
γ-
XmnI
polymorphism
(
rs
7482144
)
,
HBS
1
L
-
MYB
(
rs
4895441
)
and
(
rs
9399137
)
and
BCL
11
A
(
rs
4671393
)
were
significantly
associated
with
higher
proportions
of
subjects
with
high
Hb
F
(
Hb
F
≥
5
%
)
.
The
result
demonstrated
that
multiple
genetic
modifying
factors
including
T
allele
of
(
G
)
γ-
XmnI
polymorphism
(
rs
7482144
)
,
G
allele
of
HBS
1
L
-
MYB
(
rs
489441
)
,
C
allele
of
HBS
1
L
-
MYB
(
rs
9399137
)
and
C
allele
of
BCL
11
A
(
rs
4671393
)
are
associated
with
increased
Hb
F
and
in
combination
could
explain
approximately
80
%
of
the
variation
of
Hb
F
in
Hb
EE
disease
in
Thai
population
.
Other
genetic
factors
regulating
Hb
F
expression
in
this
common
genetic
disorder
remains
to
be
elucidated
.
Diseases
Validation
Diseases presenting
"other genetic factors"
symptom
alpha-thalassemia
hirschsprung disease
omenn syndrome
papillon-lefèvre syndrome
pendred syndrome
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