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The Associations of SEA-α Thalassemia 1, XmnI-Gγ Polymorphism and β-Globin Gene Mutations with the Clinical Severity of β-thalassemia Syndrome in Northern Thailand

Thanusak Tatu PhD*,***, Waratip Sritong MS*, Torpong Sa-nguansermsri MD**

Affiliation : * Division of Clinical Microscopy, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand ** Thalassemia Research Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand *** Biomedical Technology Research Center, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand

Background : At least three genetic factors including β-thalassemia mutations, α-thalassemia, and XmnI-Gγ polymorphism were shown to modify clinical symptoms in β-thalassemia disease.
Objective : To determine associations of β-thalassemia mutations, SEA-α thalassemia 1, and XmnI-Gγ polymorphism, and clinical severity of β-thalassemia in northern Thailand. Material and Method: Thirty-two β-thalassemia major and 28 β-thalassemia intermedia attending the Thalassemia Clinic at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand were recruited. The β-globin gene mutations and SEA-α thalassemia 1 were determined by MS-PCR and Gap-PCR, respectively. The XmnI-Gγ polymorphism was identified by RFLP analysis. Odds ratio was calculated to evaluate the associations of these three genetic factors and clinical symptoms.
Results : Eight β-globin gene mutations (both βO and β+) were found. Twenty-nine point one percent of the patients had at least one XmnI-Gγ site (XmnI-Gγ: +) and 4.1% of the patients were heterozygote for the SEA-α thalassemia 1. The β-globin gene mutations showed maximal impact and the XmnI-Gγ polymorphism had minimal influence on clinical severity in this cohort. The SEA-α thalassemia 1 had the least effect on the clinical severity due to its low prevalence in these patients.
Conclusion : Although these three genetic factors play roles in modifying clinical symptoms of β-thalassemia, the β-thalassemia mutations should be considered first, followed respectively by the XmnI-Gγ polymorphism and the SEA-α thalassemia 1, in management and prenatal diagnosis of β-thalassemia in northern Thailand.

Keywords : β-thalassemia, HbE/β-thalassemia, β-thalassemia mutations, SEA-α thalassemia 1, XmnI-Gγ polymorphism, HbE


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