MOLECULAR CHARACTERIZATION OF BETA THALASSEMIA MAJOR IN PUNJAB, PAKISTAN
Keywords:
HBB mutations, β-Thalassemia major in Punjab, Multiplex ARMS-PCR.Abstract
Abstract
Background: β-Thalassemia major is among the most prevalent hereditary blood disorders in Pakistan. A person develops β-Thalassemia major when they inherit two mutated alleles for the HBB gene. This study aimed to identify the profile of mutations that are found in the population of Punjab, Pakistan, to develop a mutation-targeted diagnostic panel for the detection and better control of the disease.
Settings and Method: The study was conducted at the Sundas Foundation. A cross-sectional approach was adopted for this study, and a non-probability consecutive sampling technique was employed to recruit data from 133 patients between January 2023 and December 2024. Blood samples from the patients were collected and tested using Multiplex ARMS-PCR for common and rare HBB mutations in Punjab.
Results: Our findings revealed that homozygosity was found in 70.9 % of the cases and compound heterozygosity in the remaining 20.4%. Among the 13 mutations involved in our study: IVS1-5 (G>C) (33.8%), Fr8-9 (+G) (28.6%), Fr41-42 (-CTTT) (15%), IVS1-1 (G>A) (7.1%). These four mutations were common and accounted for 77.5% of the cases. Less commonly encountered mutations involved Codon5 (-CT), Codon15 (A>T), Codon30 (G>C), Cap+1 (A>C), Del619, Fr16 (-C). Three hemoglobin variants- HbE Cd-26, HbS Cd-6, and HbC Cd-6 were also investigated in this study.
Conclusion: The most frequently found mutation in our study population is IVS1-5 (G>C). Many additional mutations, such as IVS1-1 (G>A), Fr8-9 (+G), and Fr41-42 (-CTTT), contributed significantly to the disease burden
References
. Zhang S, Chen Z, Chen M, Huang H. Current status and trends in thalassemia burden across South, East and Southeast Asia, 1990–2021 a systematic analysis for the global burden of disease study 2021. BMC Public Health. 2024 Dec 18;24(1):34-72.
. Tuo Y, Li Y, Li Y, Ma J, Yang X, Wu S, Jin J, et al. Global, regional, and national burden of thalassemia, 1990–2021: a systematic analysis for the global burden of disease study 2021. EClinicalMedicine. 2024 Jun 1;72.
. Anwar MU, Bozdar M, Syeda SS, Shah SH. Beta Thalassemia Mutation Analysis in Fetal Samples for Optimal Mutation Screening Strategy. Pak Armed Forces Med J. 2023 Oct 31;73(5):1396.
. Khaliq S. Thalassemia in Pakistan. Hemoglobin. 2022 Jan 2;46(1):12-4.
. Brancaleoni V, Di Pierro E, Motta I, Cappellini MD. Laboratory diagnosis of thalassemia. International Journal of laboratory hematology. 2016 May;38:32-40.
. Jalil T, Yousafzai Y M, Rashid I, Ahmed S, Ali A, Fatima S, Ahmed. Mutational Analysis of Beta Thalassaemia by Multiplex ARMS-PCR in Khyber Pakhtunkhwa, Pakistan. J Ayub Med Coll Abbottabad 2019;31(1):98–103..
Hassni MA, Din M, Babar KM, Lehri SA, Hasni MT, Raza MH, et al. Frequency of Different Types of Mutations in β-Thalassemia Major Patients Presenting in Dr. Akber Niazi Teaching Hospital Islamabad. Pak-Euro Journal of Medical and Life Sciences. 2024 Jun 30;7(2):338a-h.
. Baig SM, Azhar A, Hassan H, Baig JM, Kiyani A, Hameed U, et al. Spectrum of beta-thalassemia mutations in various regions of Punjab and Islamabad, Pakistan: establishment of prenatal diagnosis. haematologica. 2006 Jan 1;91(1):13-15.
. Kumar R, Arya V, Agarwal S. Profiling β Thalassemia mutations in consanguinity and nonconsanguinity for prenatal screening and awareness programme. Advances in hematology. 2015;2015(1):625-721.
. Ansari SH, Shamsi TS, Ashraf M, Farzana T, Bohray M, Perveen K, et al. Molecular epidemiology of β-thalassemia in Pakistan: Far reaching implications. Indian journal of human genetics. 2012 May;18(2):193-197.
. Kuppusamy D, Ramachandran A, Nanda N, Kumar CG, Kar R. Characterisation of β-thalassemia mutations in a tertiary care referral hospital in southern India-A descriptive study. Indian Journal of Hematology and Blood Transfusion. 2024 Sep 28:1-7.
. Hassan K, Rasheed M, Asif N, Anwar T, Tahir M. Spectrum of mutations of beta thalassemia. Journal of Islamabad Medical & Dental College. 2017;6(4):196-202.
. Garewal, Gurjeewan & Das, Reena & Awasthi, Anshu & Ahluwalia, Jasmina & Marwaha, et al. The clinical significance of the spectrum of interactions of CAP+1 (A→C), a silent β-globin gene mutation, with other β-thalassemia mutations and globin gene modifiers in north Indians. European journal of haematology. 2007; 79: 417-421.
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