Human anion exchanger1 mutations and distal renal tubular acidosis.

The human anion exchanger 1 (AE1 or SLC4A1) gene encodes anion exchanger 1 (or band 3) protein in erythrocytes and in alpha-intercalated cells of the kidney. Thus, AE1 mutations show pleiotrophic effects resulting in two distinct and seemingly unrelated defects, an erythrocyte abnormality and distal renal tubular acidosis (dRTA). Southeast Asian ovalocytosis (SAO), a well-known red blood cell (RBC) defect, which is widespread in Southeast Asian regions, is caused by AE1 mutation due to a deletion of 27 base pairs in codons 400-408 (delta400-408) leading to an in-frame 9 amino-acid loss in the protein. Co-existence of SAO and dRTA is usually not seen in the same individual. However, the two conditions can co-exist as the result of compound heterozygosities between delta400-408 and other mutations. The reported genotypes include delta400-408/G701D, delta400-408/R602H, delta400-408/deltaV850, and delta400-408/A858D. The presence of dRTA, with or without RBC abnormalities, may occur from homozygous or compound heterozygous conditions of recessive AE1 mutations (eg G701D/G701D, V488M/V488M, deltaV850/deltaV850, deltaV850/A858D, G701D/S773P) or heterozygous dominant AE1 mutations (eg R598H, R589C, R589S, S613F, R901X). Codon 589 of this gene seems to be a 'mutational hot-spot' since repeated mutations at this codon occurring in different ethnic groups and at least two de novo (R589H and R589C) mutations have been observed. Therefore, AE1 mutations can result in both recessive and dominant dRTA, possibly depending on the position of the amino acid change in the protein. As several mutant AE1 proteins still maintain a significant anion transport function but are defective in targeting to the cell surface, impaired intracellular trafficking of the mutant AE1 is an important molecular mechanism involved in the pathogenesis of dRTA associated with AE1 mutations.

Malaria species and Southeast Asian ovalocytosis defined by a 27-bp deletion in the erythrocyte band 3 gene.

To evaluate the resistance of SAO against species specific malaria infection, relationships between parasite species and the 27-bp deletion in the band 3 gene were studied in malaria endemic Sumba Island, eastern Indonesia. Thick blood films were prepared from patients with malaria symptoms (n=129) and healthy controls (n=231). Species of Plasmodium was identified by microscopic observation. The 27-bp deletion was screened by the PCR method. Among 231 healthy controls, 29 (12.6%) had the 27-bp deletion, whereas 14 (10.9%) among 129 patients confirmed with malaria infection harbored the 27-bp deletion. No significant difference was observed in the prevalence of the 27-bp deletion between controls and patients (p>0.8). There was no significant difference in the frequency of the 27-bp deletion between P. vivax and P. falciparum infected subjects at 5% level by Fisher's exact test. The present result showing no correlation between the presence of the 27-bp deletion and infected parasite species is consistent with the post-invasion resistance hypothesis that may involve not a single malaria species.

Estudio clinico y bioquimico de 9 pacientes con eliptocitosis hereditaria / Clinical and biochemical study of 9 patients with hereditary elliptocytosis

Se estudiaron nueve pacientes (cuatro familias) con eliptocitosis herediataria (EH). Desde el punto de vista clínico, se identificaron dos tipos de presentación: siete pacientes fueron formas compensadas y dos (de 7 y 63 años) pertenecientes a distintas familias mostraron anemia, esplenomegalia, reticulocitosis y fragmentación globular. En una familia se comprobó una disminución del stock total de la proteína 4.1 en la electroforesis de proteína de membrana en gel de poliacrilamida con SDS (SDS-PAGE). Uno de sus miembros se comprobó como forma descompensada. El estudio de dímeros y tetrámeros y la digestión tríptica de espectrina fue normal en todos los casos. En la determinación de la deformabilidad en función de la osmoralidad con el ectacitómetro se halló una buena correlación entre el índice de deformabilidad (ID) y el grado de anemia. De acuerdo a los resultados de este estudio pudimos confirmar la gran heterogeneidad clínica de la EH aún en miembros de una misma familia

Eliptocitosis herediataria no hemolítica en una familia mexicana / Herditary non-haemolytic elliptocytosis in a Mexican family

Se informa de hallazgos realizados en forma accidental en uno de los miembros de una familia mexicana con eliptocitosis hereditaria no hemolítica. De los 25 familiares estudiados, 15 presentaron la alteración. Esta enfermedad se diagnostica al observar en el frotis de sangre periférica más de 25% de eritrocitos con forma "eliptica". El diagnóstico se confirma cuando varios miembros de la familia están afectados

Ovalocytosis in Papua New Guinea -- dominantly inherited resistance to malaria.

Analysis of ovalocytosis in families has demonstrated dominant inheritance. This conclusion is based on finding ovalocytic children of ovalocytic Melanesian mothers and normocytic Caucasian fathers. Inheritance of resistance to thermal deformation and to crenation upon storage correlated with inheritance of ovalocytic erythrocyte morphology. The latter was associated with in vitro resistance to invasion by P. falciparum.