Mutational analysis of the LDL receptor and APOB genes in Mexican individuals with autosomal dominant hypercholesterolemia.

The goal of this project was to identify families with autosomal dominant hypercholesterolemia (ADH) to facilitate early detection and treatment and to provide genetic counselling as well as to approximate the mutational diversity of ADH in Mexico. Mutational analysis of the LDLR and APOB genes in 62 index cases with a clinical and/or biochemical diagnosis of ADH was performed. Twenty-five mutations (24 LDLR, 1 APOB) were identified in 38 index cases. A total of 162 individuals with ADH were identified using familial segregation analysis performed in 269 relatives of the index cases. In addition, a novel PCSK9 mutation, c.1850 C>A (p.Ala617Asp), was detected. The LDLR mutations showed the following characteristics: (1) four mutations are novel: c.695 -1G>T, c.1034_1035insA, c.1586 G>A, c.2264_2273del; (2) the most common mutations were c.682 G>A (FH-Mexico), c.1055 G>A (FH-Mexico 2), and c.1090 T>C (FH-Mexico 3); (3) five mutations were identified in 3 or more apparently unrelated probands; (4) three mutations were observed in a true homozygous state; and (5) four index cases were compound heterozygous, and one was a carrier of two mutations in the same allele. These results suggest that, in Mexico, ADH exhibits allelic heterogeneity with 5 relatively common LDLR mutations and that mutations in the APOB gene are not a common cause of ADH. This knowledge is important for the genotype-phenotype correlation and for optimising both cholesterol lowering therapies and mutational analysis protocols. In addition, these data contribute to the understanding of the molecular basis of ADH in Mexico.

Analysis of linkage disequilibrium between the 5' and 3' haplotypes of the beta-globin gene cluster in Mexican afromestizos.

Analysis of the 5' and 3' haplotypes (Hps) of the beta-globin gene cluster was performed in 110 beta(A) chromosomes from unrelated Mexican afromestizo individuals in order to determine Hardy-Weinberg equilibrium, allelic frequencies, linkage disequilibrium (LD) and association between the 5' and 3' haplotypes. All sites were found to be in Hardy-Weinberg equilibrium (p>0.05). In the whole beta-cluster, only 12.87% of the pairs of loci exhibited significant LD (22/171) (r(2)>0.33). Within the 5'Hp, three pairs of loci were associated (epsilonHincII/(G)gammaHindIII, epsilonHincII/3'psibetaHincII and (G)gammaHindIII/3'psibetaHincII). In the 3'Hp, 19 pairs of loci showed significant LD and were distributed mostly among the -551, -340, Exon1nt6 and IVS2nt16 polymorphisms. The absence of pairs of loci significantly linked between both 5' and 3' Hps is noteworthy. The allelic combinations of the 40 studied polymorphisms (5 sites in the 5' Hp and 35 sites in the 3' Hp) displayed 69 distinct haplotypes, 22 of them belonging to group A, 27 to B, 18 to C and 2 to D, which denoted the great heterogeneity of our population. Further, 1a7A1, 1a7B1 and 1a1C1 were the most common sequences with 8, 9 and 9 chromosomes each. Association analysis between both 5' and 3' Hps revealed strong coherence with the proposed evolutionary histories for the beta-globin gene polymorphisms. 5'Hp1 (+----), which is considered to be an ancestral haplotype, was the most frequent haplotype found in our population and was linked to 24 different sequences in the 3'Hp, demonstrating great heterogeneity. A similar result was found in the 3' Hps, where older alleles (a17A1 and a7B1) were linked to a higher number of 5'Hps. This is the first time that an analysis of association among the 5' and 3' haplotypes and the LD has been performed with 40 polymorphisms distributed in the beta-globin gene cluster in the Mexican afromestizo population. The poor LD observed between and within the 5' and 3' Hps show that this region is very prone to recombination events.

Types and frequencies of hemoglobin disorders in the pacific coast of four states of Mexico.

INTRODUCTION: Hemoglobin disorders are classified into three main groups: structural variants, thalassemias (thal) and hereditary persistence of fetal hemoglobin (HPFH). OBJECTIVE. This study describes the types and frequencies of hemoglobinopathies from four states of the Pacific coast of Mexico (Jalisco, Colima, Nayarit and Michoacan). MATERIAL AND METHODS. We studied 1513 Mexican individuals by hematological and biochemical analysis following the conventional methods, DNA analysis was carried out in abnormal samples. RESULTS. The frequency of hemoglobinopathies was 1.258%. Structural variants were the most common type (0.726%), with seven carriers (0.462%) and one homozygote (0.066%) for Hb S, and three heterozygotes of the following hemoglobins: C (beta6 Glu-->Lys), Fannin-Lubbock I (beta119 Gly-->Asp) and Colima (beta49 Ser-->Cys), with a frequency of 0.066% each. We observed a frequency of 0.466% for the thalassemia group, with one homozygote for the alpha3.7 (-thal) allele (0.066%), and 6 heterozygotes for beta-thal (0.40%), with the allele IVS1:110 G-->A in three subjects, and the alleles Cd 39, IVS1:5 G-->A and -28 A-->C in the three other. HPFH was detected in one subject (0.066%). Jalisco and Colima had the highest frequencies of hemoglobinopathies, 3.015% and 1.331% respectively, and the latter showed the most diversity of hemoglobin disorders. CONCLUSIONS: The observed heterogeneity of types and frequencies of hemoglobinopathies in the regions studied illustrate the importance of further investigation of these abnormalities in Mexico.

Genetic relationship of a Mexican Afromestizo population through the analysis of the 3' haplotype of the beta globin gene in betaA chromosomes.

We analyzed 112 beta(A) chromosomes from the Costa Chica region, with the aim of determining the 3' haplotype (3'Hp) in Afromestizo individuals and its relationship with the reported populations. Thirty polymorphic sites were identified by sequencing and two by restriction fragment length polymorphisms. Genetic variability, genetic distances and neutrality tests were performed with the computer program Arlequin 3.0. Three groups were constructed, which we named 3 kb-Hp, 330 bp-Hp and 2.67 kb-Hp with 32, 15 and 17 polymorphic sites respectively. In 3 kb-Hp, 34 different 3' haplotypes (14 of them new) were found; the three most common were 7B1 (17.8%), 7A1 (17.0%) and 1C1 (14.3%). 330 bp-Hp revealed 18 different allelic sequences; the most frequent were the 1 (AT(9)T(5), 22.3%), 2 (AT(8)T(5), 20.5%) and 3 (AT(7)T(7), 20.5%). 2.67 kb-Hp displayed 14 distinct haplotypes, with B1 (30.3%), A1 (28.6%) and C1 (21.4%) having the highest frequencies. The gene diversity of the Costa Chica population was only significantly different to Gambia. In the genetic distances, the p values were not significant for Vanuatu, Sumatra and Central African Republic. The neutrality tests showed that the patterns of diversity in the Costa Chica population deviate significantly from the expectations of the standard neutral model. This is the first work performed in Mexico in which the extended 3'Hp was analyzed in beta(A) chromosomes. The study showed clearly the presence of African and Asian genes in the Costa Chica population.

Molecular characterization of the--SEA alpha thalassemia allele in Mexican patients with HbH disease.

Alpha-Thalassemia is one of the most prevalent hemoglobin disorders in the world, in South-East Asians, the --SEA allele is widely found in the HbH disease patients. The purpose of this work is to describe the molecular characteristics of Hemoglobin H disease in three patients from two Mexican families, as well to analyze the DNA sequence of the --SEA allele to determine the precise site of the crossover. The -alpha 3.7 and --SEA alleles were identified using an established long-PCR method modified in our laboratory. The crossover site of --SEA mutation was analyzed by DNA sequencing. The three HbH subjects showed the same genotype -alpha3.7/--SEA. The -alpha3.7 allele has been observed in almost every racial studied group, whereas the --SEA allele is predominant in South-East Asian countries. DNA analysis through the breakpoint sites of the SEA allele in both families showed the 5' breakpoint at the third base of codon 28 in the psi alpha 2 gene and the 3' breakpoint within an Alu-Jo sequence, 1,328 nucleotides upstream of the 3'HVR. Therefore the size of the deletion is 19,303 nucleotides. This is the first report in which the flanking deletion sites of the --SEA mutation have been analyzed in Mexican patients, the 5' and 3' ends of the deletion is well determined.

Molecular characterization of the - -SEA alpha thalassemia allele in Mexican patients with HbH disease / Caracterización molecular del alelo - -SEA de talasemia alfa en pacientes mexicanos con enfermedad por HbH

α-Thalassemia is one of the most prevalent hemoglobin disorders in the world, in South-East Asians, the--SEA allele is widely found in the HbH disease patients. The purpose of this work is to describe the molecular characteristics of Hemoglobin H disease in three patients from two Mexican families, as well to analyze the DNA sequence of the --SEA allele to determine the precise site of the crossover. The -α3.7 and --SEA alleles were identified using an established long-PCR method modified in our laboratory. The crossover site of --SEA mutation was analyzed by DNA sequencing. The three HbH subjects showed the same genotype -α3.7/--SEA. The -α3.7 allele has been observed in almost every racial studied group, whereas the --SEA allele is predominant in South-East Asian countries. DNA analysis through the breakpoint sites of the --SEA allele in both families showed the 5' breakpoint at the third base of codon 28 in the ψα2 gene and the 3' breakpoint within an Alu-Jo sequence, 1,328 nucleotides upstream of the 3'HVR. Therefore the size of the deletion is 19,303 nucleotides. This is the first report in which the flanking deletion sites of the--SEA mutation have been analyzed in Mexican patients, the 5' and 3' ends of the deletion is well determined.

La Talasemia-α es uno de los desórdenes de la hemoglobina más prevalences en el mundo. En el sureste de Asia, --SEA es el alelo más frecuente en pacientes con enfermedad por HbH (EHbH). En el presente trabajo se describen las características moleculares de tres pacientes con EHbH de dos familias mexicanas, y se analiza la secuencia de DNA del alelo --SEA, para determinar los sitios de ruptura. Los alelos -α3.7y --SEA se identificaron por un método de PCR modificado en nuestro laboratorio y los sitios de ruptura por secuenciación de DNA. Los tres pacientes con EHbH mostraron el genotipo -a3.7/--SEA. El alelo -α3.7 está ampliamente distribuido en el mundo, mientras que el alelo--SEA predomina en los países del sureste de Asia. El análisis de DNA del alelo--SEA mostró en 5' el sitio de ruptura en el codón 28 del pseudogén ψα2 y en 3', dentro de la secuencia Alu-Jo, localizada a 1,328 nucleótidos de la región HVR3', lo que da un segmento delecionado de 19,303 nucleótidos. Éste es el primer reporte en el que se analizan los sitios que flanquean la deleción del alelo --SEA en pacientes mexicanos y se definen con precisión los extremos 5' y 3' de la deleción.

Prevalence of -alpha(3.7) and alpha alpha alpha(anti3.7) alleles in sickle cell trait and beta-thalassemia patients in Mexico.

The aim of this study was to determine the frequency of alpha-globin gene mutations in three groups of Mexican unrelated individuals. The first two groups were normal and sickle cell trait individuals from the Costa Chica region, a place with a 12.8% frequency of HbS carriers, and the third group comprised of Mexican mestizo patients with beta-thalassemia. We searched for -alpha(3.7) and -alpha(4.2) alpha(+)-thalassemia deletion alleles, as well as the alpha alpha alpha(anti3.7) triplication through long-gap PCR. The alleles -alpha(3.7) and alpha alpha alpha(anti3.7) were found in the heterozygote state only; 19% of the normal subjects had the -alpha(3.7) allele, and 2% showed the alpha alpha alpha(anti3.7) allele. In individuals with the sickle cell trait, 17% had the -alpha(3.7) deletion, and the alpha alpha alpha(anti3.7) triplication was observed in 3% of these individuals. We revealed that 16% of the subjects with beta-thalassemia showed the -alpha(3.7) deletion and 28% the alpha alpha alpha(anti3.7) triplication. The -alpha(4.2) deletion was not detected in any individual. The frequency of the -alpha(3.7) allele was roughly the same in the three groups studied; this can be explained by the fact that the three groups have common genes from Africa and the Mediterranean, where a high prevalence of alpha(+)-thalassemia has been observed. To our knowledge, the frequency of alpha alpha alpha(anti3.7) triplication observed in the Mexican beta-thalassemia patients is the highest reported. As the -alpha(3.7) and alpha alpha alpha(anti3.7) alleles are very common in our selected populations, we believe that there is a need to investigate systematically the alpha-globin gene mutations in all hemoglobinopathies in the Mexican population.

3' haplotypes of the beta-globin gene in beta(S)-chromosomes of Mexican individuals.

The beta-globin gene cluster has shown high polymorphic diversity organized in 5' and 3' haplotypes (Hps). beta(S)-Chromosomes are in linkage disequilibrium with the 5' Hps Bantu, Benin, Senegal, Cameroon, and Arab-Indian. In Mexican mestizos with African west coast origins, we observed the following 5' Hps in beta(S)-chromosomes: Bantu, 78.8%; Benin, 18.2%; and atypical Hp 9, 3.0%. With the purpose of establishing the 3' Hps, we analyzed 35 polymorphic sites--6 by RFLP analysis and 29 by DNA sequencing--in 33 unrelated beta(S)-chromosomes. The polymorphic sites were structured according to Harding et al. [R.M. Harding, S.M. Fullerton, R.C. Griffiths, J.B. Clegg, Archaic African and Asian lineages in the genetic ancestry of modern humans, Am. J. Hum. Genet. 60 (1997) 772-789] and Lapoumeroulie et al. [C. Lapoumeroulie, O. Dunda, R. Ducrocq, G. Trabuchet, M. Mony-Lobe, J.M. Bodo, P. Carnevale, D. Labie, J. Elion, R. Krishnamoorthy, A novel sickle cell mutation of yet another origin in Africa: the Cameroon type, Hum. Genet. 89 (1992) 333-337]. All Bantu beta(S)-chromosomes showed the 12A1 3' Hp with (AT)6T9 repeats (84.9%), a novel 3' Hp. The Benin Hp was 2B2, with (AT)8T4 (12.1%), and the atypical Hp 9 4B1, (AT)8T5 (3.0%). Because of the high linkage disequilibrium observed for the Bantu and 12A1 Hps, we expect that, if there is a single origin of the Bantu beta(S) mutation, all must show the 12A1 polymorphic DNA sequence in the 3' Hp. A correlation between the 5' and 3' Hps could be observed with the other beta(S) mutations. The atypical Hp 9 was also atypical at the 3' Hp, with the same repeats as observed with the Cameroon beta(S) mutation; however, it differed in one position from the typical Lapoumeroulie Cameroon Hp, indicating that these beta(S)-chromosomes arose by different genetic mechanisms or by a novel beta(S) mutation. We stress the importance of the study of DNA polymorphisms at 3' Hp to allow understanding of the genetic diversity of beta(S)-chromosomes, as well as their implications in beta(S) gene expression and the possible effects on the clinical phenotype.

Molecular spectrum of beta-thalassemia in the Mexican population.

Beta-thalassemia (beta-thal) is present in 59% and 75% of patients with abnormal hemoglobin disorders in northwestern and central Mexico, respectively. In our Research Center, up until 1997, we reported the presence of 13 beta-thal alleles in 26 unrelated chromosomes (-28A>C; -87C>T; MET1VAL; IVS1, G>A, +1; IVS1, G>A, +5; IVS1, G>C, +5; IVS1, G>A, +110; IVS2, C>G, +745; GLU6FS; VAL11FS; GLN39TER; HBD/HBB 104 kb del; and HBD87/HBB116 fusion). Since then, 57 more beta-thal chromosomes have been identified by the amplification-refractory mutation system (ARMS) and DNA sequencing from 54 individuals with beta-thalassemia (seven compound heterozygotes, three with two beta-thal alleles, three with beta-thal and HbS, and one with beta-thal and HbD; and 47 beta-thal heterozygotes). Nine of the previously observed alleles were found, together with three new alleles: IVS2, G>A, +1; LYS17TER; and 4-bp del, 41/42CTTT. Moreover, a novel mutation was observed, HIS77FS, bringing to a total of 17 beta-thal alleles identified in our population. Six alleles constitute 78.3% of the observed alleles: five Mediterranean alleles (GLN39TER; IVS1, G>A, +1; IVS1, G>A, +110; HBD/HBB 104 kb del; and IVS1, G>A, +5) and one common in the Kurdish population (-28A>C). We note especially the presence in these families of -28A>C and VAL11FS, both of which have previously been considered private alleles. The observed spectrum of mutations is characteristic of populations with low frequencies of thalassemias. Because thalassemia is not a rare disease in Mexico, we emphasize its necessary consideration in the differential diagnosis of microcytic hypochromic anemia.

Red cell membrane protein deficiencies in Mexican patients with hereditary spherocytosis.

Twenty-seven families and four individual patients with hereditary spherocytosis (HS) from the northwestern region of Mexico were studied. An autosomal dominant inheritance pattern was identified in 59% of 22 families. Densitometric analysis of erythrocyte membrane proteins revealed individual protein deficiencies in 39% of the patients studied, in whom the principal altered proteins were the alpha spectrins (13%), band 3 protein (10%), ankyrin (6%), 4.2 protein (6%), and the beta spectrins (3%). A predominant deficiency of spectrins has also been observed in other Latin American and Mediterranean countries. However, it is well known that deficiencies in these proteins are heterogeneous across different ethnic groups. A combined protein deficiency was observed in 52% of patients, most frequently involving the spectrins, band 3 protein, 4.2 protein, and 4.1 protein. In three subjects, no abnormalities were detected (10%). We conclude that, despite the observed heterogeneity, the principal affected proteins are essentially similar to those observed in other ethnic groups.

Analysis of betaS and betaA genes in a Mexican population with African roots.

To investigate the origin of the beta(A) and beta(S) genes in a Mexican population with African roots and a high frequency of hemoglobin S, we analyzed 467 individuals (288 unrelated) from different towns in the states of Guerrero and Oaxaca in the Costa Chica region. The frequency of the sickle-cell trait was 12.8%, which may represent a public health problem. The frequencies of the beta-haplotypes were determined from 350 nonrelated chromosomes (313 beta(A) and 37 beta(S)). We observed 15 different beta(A) haplotypes, the most common of which were haplotypes 1 (48.9%), 2 (13.4%), and 3 (13.4%). The calculation of pairwise distributions and Nei's genetic distance analysis using 32 worldwide populations showed that the beta(A) genes are more closely related to those of Mexican Mestizos and North Africans. Bantu and Benin haplotypes and haplotype 9 were related to the beta(S) genes, with frequencies of 78.8, 18.2, and 3.0%, respectively. Comparison of these haplotypes with 17 other populations revealed a high similitude with the population of the Central African Republic. These data suggest distinct origins for the beta(A) and beta(S) genes in Mexican individuals from the Costa Chica region.