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Association between BCL11A, HSB1L-MYB, and XmnI γG-158 (C/T) gene polymorphism and hemoglobin F level in Egyptian sickle cell disease patients

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Abstract

Sickle cell disease (SCD) is a monogenic disease characterized by multisystem morbidity and highly variable clinical course. Inter-individual variability in hemoglobin F (HbF) levels is one of the main modifiers that account for the clinical heterogeneity in SCD. HbF levels are affected by, among other factors, single nucleotide polymorphisms (SNPs) at the BCL11A gene and the HBS1L-MYB intergenic region and Xmn1 gene. Our aim was to investigate HbF-enhancer haplotypes at these loci to obtain a first overview of the genetic situation of SCD patients in Egypt and its impact on the severity of the disease. The study included 100 SCD patients and 100 matched controls. Genotyping of BCL11A (rs1886868 C/T), HBS1L-MYB (rs9389268 A/G) and Xmn1 γG158 (rs7842144 C/T) SNPs showed no statistically significant difference between SCD patients and controls except for the hetero-mutant genotypes of BCL11A which was significantly higher in SCD patients compared with controls. Baseline HbF levels were significantly higher in those with co-inheritance of polymorphic genotypes of BCL11A + HSB1L-MYB and BCL11A + Xmn1. Steady-state HbF levels, used as an indicator of disease severity, were significantly higher in SCD-Sβ patients having the polymorphic genotypes of HSB1L-MYB. Fold change of HbF in both patient groups did not differ between those harboring the wild and the polymorphic genotypes of the studied SNPs. In conclusion, BCL11A, HSB1L, and Xmn1 genetic polymorphisms had no positive impact on baseline HbF levels solely but had if coexisted. Discovery of the molecular mechanisms controlling HbF production could provide a more effective strategy for HbF induction.

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Authors and Affiliations

  1. Pediatric Department, Pediatric Hematology & BMT Unit, Kasr Al-Ainy School of Medicine, Cairo University, Kasr Al-Ainy St, Cairo, 11562, Egypt

    Mona El-Ghamrawy

  2. Clinical and Chemical Pathology Department, KasrAl-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

    Marianne E. Yassa & Mervat Mamdooh Khorshied

  3. Pediatric Department, KasrAl-Ainy Faculty of Medicine, Cairo University, Kasr Al-Ainy St, Cairo, 11562, Egypt

    Angie M. S. Tousson & Marwa Abd El-hady

  4. Pediatric and Neonatology, Ministry of Health, Cairo, Egypt

    Erini Mikhaeil

  5. Misr University for Science and Technology, 6th of October City, Egypt

    Nada B. Mohamed

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  1. Mona El-Ghamrawy
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All authors were involved in choosing the topic, study design, following the practical part of the paper, revision of the statistical analysis and formulating the results, writing and editing the manuscript.

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Correspondence to Mervat Mamdooh Khorshied.

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El-Ghamrawy, M., Yassa, M.E., Tousson, A.M.S. et al. Association between BCL11A, HSB1L-MYB, and XmnI γG-158 (C/T) gene polymorphism and hemoglobin F level in Egyptian sickle cell disease patients. Ann Hematol 99, 2279–2288 (2020). https://doi.org/10.1007/s00277-020-04187-z

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