Splice-site and Frameshift Mutations of β-Globin Gene Found in Thalassemia Carrier Screening in Yogyakarta Special Region, Indonesia

Niken Satuti Nur Handayani, Nailil Husna, Gunawan Rahmil, Riris Anindya Ghifari, Lily Widyawati, Indra Lesmana

Abstract


BACKGROUND: β-thalassemia is an inherited blood disorder that relatively common in Southeast Asian countries. In Indonesia, it is estimated that 200,000 infants with thalassemia carrier born each year. Mutation causing β-thalassemia is highly varied and relatively specific in a population. This study aimed to identify the mutations responsible for β-thalassemia from Thalassemia Carrier Screening conducted in Yogyakarta Special Region. This information is beneficial for developing a strategic prevention program to control thalassemia in the region.

METHODS: Twenty-eight blood samples of haematologically suspected β-thalassemia from participant of thalassemia screening program in Yogyakarta Special Region were investigated for β-globin gene mutation by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), amplification refractory mutation system (ARMS) and DNA sequencing.

RESULTS: Our samples showed average HbA2 value of 5±0.81% and HbF value of 2±2.29%. It showed eight abnormal erythrocyte morphologies dominated by hypochromia (96.4%), cigar cell (85.7%), and microcytosis (78.6%). Our molecular investigation identified three splice-site mutations namely InterVening Sequence (IVS)-1-5 (G>C) (71.4%), IVS-1-2 (T>C) (7.1%), and IVS-1-1 (G>T) (3.6%), two frameshift mutations that are CD35 (-C) (10.7%) and CD8/9 (+G) (3.6%), and a missense mutation of CD6 (GAG>GTG) (3.6%).

CONCLUSION: Our study concluded on a high prevalence of IVS-1-5 (G>C) mutation in Yogyakarta Special Region. This mutation information is significant for developing a strategic prevention program to control thalassemia in the region, for example for developing a rapid molecular test for future screening program.

KEYWORDS: β-Globin gene, thalassemia, screening, carrier, mutation, Yogyakarta


Full Text:

PDF

References


Forget BG, Franklin Bunn H. Classification of the disorders of hemoglobin. Cold Spring Harb Perspect Med. 2013; 3: a011684, CrossRef.

Fucharoen S, Winichagoon P. Haemoglobinopathies in Southeast Asia. Indian J Med Res. 2011; 134: 498-506, PMID.

Surilena. Peranan Relasi keluarga pada psikopatologi remaja penderita talasemia. Damianus J Med. 2014; 13: 137-47, article.

Galanello R, Origa R. Beta-thalassemia. Orphanet J Rare Dis. 2010; 5: 11, CrossRef.

Noor FA, Sultana N, Bhuyan GS, Islam MDT, Hossain M, Sarker SK, et al. Nationwide carrier detection and molecular characterization of β-thalassemia and hemoglobin e variants in Bangladeshi population. Orphanet J Rare Dis. 2020; 15: 1-12, CrossRef.

Haghpanah S, Nasirabadi S, Rahimi N, Faramarzi H, Karimi M. Sociocultural challenges of beta-thalassaemia major birth in carriers of beta-thalassaemia in Iran. J Med Screen. 2012; 19: 109-11, CrossRef.

Dewanto JB, Tansah H, Dewi SP, Napitu H, Panigoro R, Sahiratmadja E. Increased knowledge of thalassemia promotes early carrier status examination among medical students. Universa Med. 2016; 34: 220, CrossRef.

Maskoen AM, Rahayu NS, Reniarti L, Susanah S, Laksono B, Fauziah PN, et al. Mutation spectrum of β-globin gene in thalassemia patients at Hasan Sadikin Hospital - West Java Indonesia. Cell Mol Biol. 2017; 63: 22-4, CrossRef.

Susanto ZA, Siswandari W, Rujito L. Cd60 (GTG > GAG)/Hb Cagliari mutation was found in scanning of β-thalassemia alleles from patients of East Kalimantan, Indonesia. Mol Genet Metab Reports. 2020; 22: 100550, CrossRef.

Husna N, Al Arif A, Putri C, Leonard E, Handayani NSN. Prevalence and distribution of thalassemia trait screening. J Med Sci. 2017; 49: 106-13, CrossRef.

Old J, Traeger-Synodinos J, Galanello R, Petrou M, Angastiniotis M. Prevention of Thalassaemias and other Haemoglobin Disorders. 2nd Edition. Nicosia: Thalassaemia International Federation; 2013, NLMID.

Pramoonjago P, Harahap A, Taufani RA, Setianingsih I, Marzuki S. Rapid screening for the most common β thalassaemia mutations in south east Asia by PCR based restriction fragment length polymorphism analysis (PCR-RFLP). J Med Genet. 1999; 36: 937-8, PMID.

Al Arif A, An-Nizamiya AD, Putri C, Nashrurrokhman M, Husna N, Mulyati, et al. Comparison between three molecular diagnostics for the identification of heterozygous hemoglobin E. Pakistan J Biol Sci. 2020; 23: 17-26, CrossRef.

Danjou F, Anni F, Galanello R. Beta-thalassemia: From genotype to phenotype. Haematologica. 2011; 96(11): 1573-5, CrossRef.

Surjawan Y, Tan HL, Setiabudy RD, Rositawati W. Early screening of hemoglobinopathy in Indonesia using erythrocyte indices. Indones Biomed J. 2017; 9: 99-105, CrossRef.

Hafiza A, Malisa MY, Khirotdin RDAT, Azlin I, Azma Z, Thong MCK, et al. HbA2 levels in normal, β-thalassaemia and haemoglobin E carriers by capillary electrophoresis. Malays J Pathol. 2012; 34: 161-4, PMID.

Körber C, Wölfler A, Neubauer M, Robier C. Red blood cell morphology in patients with β-thalassemia minor. J Lab Med. 2017; 41: 49-52, CrossRef.

Thein SL. Molecular basis of β thalassemia and potential therapeutic targets. Blood Cells Mol Dis. 2018; 70: 54-65, CrossRef.

Peixeiro I, Silva AL, Romão L. Control of human β-globin mRNA stability and its impact on beta-thalassemia phenotype. Haematologica. 2011; 96: 905-13, CrossRef.

Handayani NSN, Purwanto R. CD35 (DEL C) frameshift mutation in exon 2 of β-globin gene on β-thalassemia carriers. Biomed Eng (NY). 2015; 1: 19-23, article.

Maskoen AM, Reniarti L, Sahiratmadja E, Sisca J, Effendi SH. Shine & Lal index as a predictor for early detection of β-thalassemia carriers in a limited resource area in Bandung, Indonesia. BMC Med Genet. 2019; 20: 1-6, CrossRef.

Kho SL, Chua KH, George E, Tan JAMA. High throughput molecular confirmation of β-thalassemia mutations using novel TaqMan probes. Sensors (Switzerland). 2013; 13: 2506-14, CrossRef.




DOI: https://doi.org/10.18585/inabj.v13i1.1406

Copyright (c) 2021 The Prodia Education and Research Institute

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

Indexed by:

                  

               

                

 

 

The Prodia Education and Research Institute