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Contents

   



(Top)
 


1 Hemoglobin structural biology  





2 Classification of hemoglobinopathies  



2.1  A) Qualitative  



2.1.1  Structural abnormalities  





2.1.2  Chemical abnormalities  







2.2  B) Quantitative  



2.2.1  Production abnormalities  









3 Hemoglobin variants  





4 Electrophoretic migration patterns  



4.1  Alkaline electrophoresis  





4.2  Acid electrophoresis  







5 Evolution  





6 Treatments  





7 References  














Hemoglobinopathy






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Hemoglobinopathy
Other namesHemoglobinopathies
Red blood cells from a person with sickle cell trait
SpecialtyHematology Edit this on Wikidata

Hemoglobinopathy is the medical term for a group of inherited blood disorders involving the hemoglobin, the protein of red blood cells.[1] They are single-gene disorders and, in most cases, they are inherited as autosomal co-dominant traits.[2]

There are two main groups: abnormal structural hemoglobin variants caused by mutations in the hemoglobin genes, and the thalassemias, which are caused by an underproduction of otherwise normal hemoglobin molecules. The main structural hemoglobin variants are HbS, HbE and HbC. The main types of thalassemia are alpha-thalassemia and beta thalassemia.[3]

The two conditions may overlap because some conditions which cause abnormalities in hemoglobin proteins also affect their production. Some hemoglobin variants do not cause pathologyoranemia, and thus are often not classed as hemoglobinopathies.[4][5]

Hemoglobin structural biology[edit]

Normal human hemoglobins are tetrameric proteins composed of two pairs of globin chains, each of which contains one α (alpha) chain and one β (beta) chain. Each globin chain is associated with an iron-containing heme moiety. Throughout life, the synthesis of the α and the β chains is balanced so that their ratio is relatively constant and there is no excess of either type.[6]

The specific α and β chains that are incorporated into Hb are highly regulated during development:[citation needed]

Classification of hemoglobinopathies[edit]

A) Qualitative[edit]

Structural abnormalities[edit]

Hb variants: Hb structural variants are qualitative defects that cause a change in the structure (primary, secondary, tertiary, and/or quaternary) of the Hb molecule. The majority of Hb variants do not cause disease and are most commonly discovered either incidentally or through newborn screening. A subset of Hb variants can cause severe disease when inherited in the homozygous or compound heterozygous state in combination with another structural variant or a thalassemia mutation. When clinical consequences occur, they may include anemia due to hemolysisorpolycythemia due to alterations in the oxygen affinity of the abnormal Hb. Common examples of hemoglobin variants associated with hemolysis include sickle Hb (HbS) and HbC. Hb variants can usually be detected by protein-based assay methods; however, DNA-based methods may be required for variants with ambiguous or unusual results from protein analysis.[citation needed]

The major functional consequences of Hb structural variants can be classified as follows:[citation needed]

Chemical abnormalities[edit]

B) Quantitative[edit]

Production abnormalities[edit]

Red blood cells from a person with beta thalassemia

Copy number variation (e.g., deletion, duplication, insertion) is also a common genetic cause of Hb disorders, and complex rearrangements and globin gene fusions can also occur.[citation needed]

Hemoglobin variants[edit]

Haemoglobin variant are not necessarily pathological. For example, haemoglobin Valletta and haemoglobin Marseille are two haemoglobin variants which are non-pathological[citation needed]

Electrophoretic migration patterns[edit]

Hemoglobin variants can be detected by gel electrophoresis.[15]

Alkaline electrophoresis[edit]

In general on alkaline electrophoresis in order of increasing mobility are hemoglobins A2, E=O=C, G=D=S=Lepore, F, A, K, J, Bart's, N, I, and H.[citation needed]

In general a sickling test is performed on abnormal hemoglobins migrating in the S location to see if the hemoglobin precipitates in solution of sodium bisulfite.[citation needed]

Acid electrophoresis[edit]

In general on acid electrophoresis in order of increasing mobility are hemoglobins F, A=D=G=E=O=Lepore, S, and C.[citation needed]

This is how abnormal hemoglobin variants are isolated and identified using these two methods. For example, a Hgb G-Philadelphia would migrate with S on alkaline electrophoresis and would migrate with A on acid electrophoresis, respectively[citation needed]

Evolution[edit]

Some hemoglobinopathies (and also related diseases like glucose-6-phosphate dehydrogenase deficiency) seem to have given an evolutionary benefit, especially to heterozygotes, in areas where malaria is endemic. Malaria parasites live inside red blood cells, but subtly disturb normal cellular function. In patients predisposed for rapid clearance of red blood cells, this may lead to early destruction of cells infected with the parasite and increased chance of survival for the carrier of the trait.[citation needed]

Hemoglobin functions:

Pathology and organic structural abnormalities may lead to any of the following disease processes:[citation needed]

Treatments[edit]

Hematopoietic stem cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood to replicate inside a patient and to produce normal blood cells.[16][17][18][19][20][21] It may be autologous (the patient's own stem cells are used), allogeneic (the stem cells come from a donor) or syngeneic (from an identical twin).[19][20]

References[edit]

  1. ^ CDC (2019-02-08). "Hemoglobinopathies Research". Centers for Disease Control and Prevention. Retrieved 2019-05-05.
  • ^ Weatherall, D. J.; Clegg, J. B. (2001). "Inherited haemoglobin disorders: An increasing global health problem". Bulletin of the World Health Organization. 79 (8): 704–712. PMC 2566499. PMID 11545326.
  • ^ "Hemoglobinopathies and Thalassemia". medicalassistantonlineprograms.org/. Archived from the original on 2015-01-09. Retrieved 2013-11-07.
  • ^ "Hemoglobin Variants". Lab Tests Online. American Association for Clinical Chemistry. 2007-11-10. Retrieved 2008-10-12.
  • ^ Huisman THJ (1996). "A Syllabus of Human Hemoglobin Variants". Globin Gene Server. Pennsylvania State University. Retrieved 2008-10-12.
  • ^ Weatherall DJ. The New Genetics and Clinical Practice, Oxford University Press, Oxford 1991.
  • ^ Huisman TH. The structure and function of normal and abnormal haemoglobins. In: Baillière's Clinical Haematology, Higgs DR, Weatherall DJ (Eds), W.B. Saunders, London 1993. p.1.
  • ^ Natarajan K, Townes TM, Kutlar A. Disorders of hemoglobin structure: sickle cell anemia and related abnormalities. In: Williams Hematology, 8th ed, Kaushansky K, Lichtman MA, Beutler E, et al. (Eds), McGraw-Hill, 2010. p.ch.48.
  • ^ Eaton, William A.; Hofrichter, James (1990). "Sickle Cell Hemoglobin Polymerization". Advances in Protein Chemistry. 40: 63–279. doi:10.1016/S0065-3233(08)60287-9. ISBN 9780120342402. PMID 2195851.
  • ^ Srivastava, P.; Kaeda, J. S.; Roper, D.; Vulliamy, T. J.; Buckley, M.; Luzzatto, L. (1995). "Severe hemolytic anemia associated with the homozygous state for an unstable hemoglobin variant (Hb Bushwick)". Blood. 86 (5): 1977–1982. doi:10.1182/blood.V86.5.1977.bloodjournal8651977. PMID 7655024.
  • ^ a b Percy, M. J.; Butt, N. N.; Crotty, G. M.; Drummond, M. W.; Harrison, C.; Jones, G. L.; Turner, M.; Wallis, J.; McMullin, M. F. (2009). "Identification of high oxygen affinity hemoglobin variants in the investigation of patients with erythrocytosis". Haematologica. 94 (9): 1321–1322. doi:10.3324/haematol.2009.008037. PMC 2738729. PMID 19734427.
  • ^ Wilcox I, Boettger K, Greene L, Malek A, Davis L, Steinberg MH, Luo HY, Chui DH (January 2009). "Hemoglobin Kenya composed of alpha- and ((A)gammabeta)-fusion-globin chains, associated with hereditary persistence of fetal hemoglobin". American Journal of Hematology. 84 (1): 55–8. doi:10.1002/ajh.21308. PMID 19006227. S2CID 29114149.
  • ^ Joseph Bonavetura and Austin Riggs, March 1968, "Hemoglobin Kansas, A Human Hemoglobin with a Neutral Amino Acid Substitution and an Abnormal Oxygen Equilibrium", The Journal of Biological Chemistry, Vol. 243, No. 5, Issue of March 10, pages 980–991.
  • ^ "rs33948057". dbSNP. National Center for Biotechnology Information. Retrieved 7 February 2014.
  • ^ Greene DN, Vaughn CP, Crews BO, Agarwal AM (January 2015). "Advances in detection of hemoglobinopathies". Clinica Chimica Acta; International Journal of Clinical Chemistry. 439: 50–7. doi:10.1016/j.cca.2014.10.006. PMID 25314938.
  • ^ Monga I, Kaur K, Dhanda S (March 2022). "Revisiting hematopoiesis: applications of the bulk and single-cell transcriptomics dissecting transcriptional heterogeneity in hematopoietic stem cells". Briefings in Functional Genomics. 21 (3): 159–176. doi:10.1093/bfgp/elac002. PMID 35265979.
  • ^ Nabarrete, J. M.; Pereira, A. Z.; Garófolo, A.; Seber, A.; Venancio, A. M.; Grecco, C. E.; Bonfim, C. M.; Nakamura, C. H.; Fernandes, D.; Campos, D. J.; Oliveira, F. L.; Cousseiro, F. K.; Rossi, F. F.; Gurmini, J.; Viani, K. H.; Guterres, L. F.; Mantovani, L. F.; Darrigo Lg, Junior; Albuquerque, M. I.; Brumatti, M.; Neves, M. A.; Duran, N.; Villela, N. C.; Zecchin, V. G.; Fernandes, J. F. (2021). "Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Children and adolescents". Einstein. 19: eAE5254. doi:10.31744/einstein_journal/2021AE5254. PMC 8664291. PMID 34909973.
  • ^ Forman SJ, Negrin RS, Antin JH, Appelbaum FR. Thomas' hematopoietic cell transplantation: stem cell transplantation. 5th ed. Vol. 2. New Jersey: Wiley-Blackwell; 2016. p.1416.
  • ^ a b Felfly H, Haddad GG (2014). "Hematopoietic stem cells: potential new applications for translational medicine". Journal of Stem Cells. 9 (3): 163–197. PMID 25157450.
  • ^ a b Park B, Yoo KH, Kim C (December 2015). "Hematopoietic stem cell expansion and generation: the ways to make a breakthrough". Blood Research. 50 (4): 194–203. doi:10.5045/br.2015.50.4.194. PMC 4705045. PMID 26770947.
  • ^ Mahla RS (2016). "Stem Cells Applications in Regenerative Medicine and Disease Therapeutics". International Journal of Cell Biology. 2016 (7): 6940283. doi:10.1155/2016/6940283. PMC 4969512. PMID 27516776.

  • Category:Hereditary hemolytic anemias Category:Disorders of globin and globulin proteins


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