P Sebastiani1, J J Farrell2, A Alsultan3, S Wang4, H L Edward2, H Shappell4, H Bae5, J N Milton4, C T Baldwin2, A M Al-Rubaish6, Z Naserullah7, F Al-Muhanna6, A Alsuliman8, P K Patra9, L A Farrer2, D Ngo2, V Vathipadiekal2, D H K Chui2, A K Al-Ali10, M H Steinberg2. 1. Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States. Electronic address: sebas@bu.edu. 2. Department of Medicine, Boston University School of Medicine, Boston, MA, United States. 3. Sickle Cell Disease Research Center and Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 4. Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States. 5. College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States. 6. Department of Internal Medicine, College of Medicine, University of Dammam, Dammam, Saudi Arabia. 7. Department of Pediatrics, Maternity & Child Hospital, Dammam, Saudi Arabia. 8. Department of Hematology, King Fahd Hospital, Hafof, Al-Ahsa, Saudi Arabia. 9. Deptartment of Biochemistry, Pt. J.N.M. Medical College, Raipur, Chattisgarh, India. 10. Prince Mohammed Center for Research & Consultation Studies, University of Dammam, Dammam, Saudi Arabia.
Abstract
BACKGROUND: Fetal hemoglobin (HbF) levels in sickle cell anemia patients vary. We genotyped polymorphisms in the erythroid-specific enhancer of BCL11A to see if they might account for the very high HbF associated with the Arab-Indian (AI) haplotype and Benin haplotype of sickle cell anemia. METHODS AND RESULTS: Six BCL112A enhancer SNPs and their haplotypes were studied in Saudi Arabs from the Eastern Province and Indian patients with AI haplotype (HbF ~20%), African Americans (HbF ~7%), and Saudi Arabs from the Southwestern Province (HbF ~12%). Four SNPs (rs1427407, rs6706648, rs6738440, and rs7606173) and their haplotypes were consistently associated with HbF levels. The distributions of haplotypes differ in the 3 cohorts but not their genetic effects: the haplotype TCAG was associated with the lowest HbF level and the haplotype GTAC was associated with the highest HbF level and differences in HbF levels between carriers of these haplotypes in all cohorts were approximately 6%. CONCLUSIONS: Common HbF BCL11A enhancer haplotypes in patients with African origin and AI sickle cell anemia have similar effects on HbF but they do not explain their differences in HbF.
BACKGROUND: Fetal hemoglobin (HbF) levels in sickle cell anemiapatients vary. We genotyped polymorphisms in the erythroid-specific enhancer of BCL11A to see if they might account for the very high HbF associated with the Arab-Indian (AI) haplotype and Benin haplotype of sickle cell anemia. METHODS AND RESULTS: Six BCL112A enhancer SNPs and their haplotypes were studied in Saudi Arabs from the Eastern Province and Indian patients with AI haplotype (HbF ~20%), African Americans (HbF ~7%), and Saudi Arabs from the Southwestern Province (HbF ~12%). Four SNPs (rs1427407, rs6706648, rs6738440, and rs7606173) and their haplotypes were consistently associated with HbF levels. The distributions of haplotypes differ in the 3 cohorts but not their genetic effects: the haplotype TCAG was associated with the lowest HbF level and the haplotype GTAC was associated with the highest HbF level and differences in HbF levels between carriers of these haplotypes in all cohorts were approximately 6%. CONCLUSIONS: Common HbF BCL11A enhancer haplotypes in patients with African origin and AI sickle cell anemia have similar effects on HbF but they do not explain their differences in HbF.
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