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Título: | Genetic modulators of fetal hemoglobin expression and ischemic stroke occurrence in African descendant children with sickle cell anemia |
Autor: | Nicolau, Marta Vargas, Sofia Silva, Marisa Coelho, Andreia Ferreira, Emanuel Mendonça, Joana Vieira, Luís Kjöllerström, Paula Maia, Raquel Silva, Rita Dias, Alexandra Ferreira, Teresa Morais, Anabela Soares, Isabel Mota Lavinha, João Faustino, Paula |
Palavras-chave: | Sickle cell anemia Fetal hemoglobin Cerebrovascular disease KLF1 gene Genetic risk factors |
Data: | 2019 |
Editora: | Springer |
Citação: | Ann Hematol (2019) |
Resumo: | Sickle cell anemia (SCA) is an autosomal recessive monogenic disease with significant clinical variability. Cerebrovascular disease, particularly ischemic stroke, is one of the most severe complications of SCA in children. This study aimed to investigate the influence of genetic variants on the levels of fetal hemoglobin (Hb F) and biochemical parameters related with chronic hemolysis, as well as on ischemic stroke risk, in ninety-one unrelated SCA patients, children of sub-Saharan progenitors. Our results show that a higher Hb F level has an inverse relationship with the occurrence of stroke, since the group of patients who suffered stroke presents a significantly lower mean Hb F level (5.34 ± 4.57% versus 9.36 ± 6.48%; p = 0.024). Furthermore, the co-inheritance of alpha-thalassemia improves the chronic hemolytic pattern, evidenced by a decreased reticulocyte count (8.61 ± 3.58% versus 12.85 ± 4.71%; p < 0.001). In addition, our findings have confirmed the importance of HBG2 and BCL11A loci in the regulation of Hb F expression in sub-Saharan African SCA patients, as rs7482144_A, rs11886868_C, and rs4671393_A alleles are significantly associated with a considerable increase in Hb F levels (p = 0.019, p = 0.026, and p = 0.028, respectively). Concerning KLF1, twelve different variants were identified, two of them novel. Seventy-three patients (80.2%) presented at least one variant in this gene. However, no correlation was observed between the presence of these variants and Hb F level, severity of hemolysis, or stroke occurrence, which is consistent with their in silico-predicted minor functional consequences. Thus, we conclude that the prevalence of functional KLF1 variants in a sub-Saharan African background does not seem to be relevant to SCA clinical modulation. |
Descrição: | © Springer-Verlag GmbH Germany, part of Springer Nature 2019 |
Peer review: | yes |
URI: | http://hdl.handle.net/10451/39426 |
DOI: | 10.1007/s00277-019-03783-y |
ISSN: | 0939-5555 |
Versão do Editor: | https://link.springer.com/journal/277 |
Aparece nas colecções: | FM-ISAMB-Artigos em Revistas Internacionais |
Ficheiros deste registo:
Ficheiro | Descrição | Tamanho | Formato | |
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Genetic_modulators.pdf | 394,69 kB | Adobe PDF | Ver/Abrir Acesso Restrito. Solicitar cópia ao autor! |
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