Relationship between AHSP gene expression, ß/α globin mRNA ratio, and clinical severity of the ß-thalassemia patients.

BACKGROUND: Alpha hemoglobin stabilizing protein (AHSP) is a chaperone-like molecule specialized for erythroid series which binds to free α-globin chain. According to this characteristic, AHSP can be considered an important factor which reduces beta thalassemia symptoms. MATERIALS AND METHODS: Reticulocytes RNA extraction and a subsequent cDNA synthesis were performed, followed by Relative qRT-PCR for AHSP, alpha, and beta globin chain genes. The beta actin gene was used as an endogenous reference as well. The relationship between AHSP gene expression, disease severity, and the ß/α globin mRNA ratio was studied among different homozygote ß-thalassemia patients (mild, moderate and severe) and compared with minor thalassemia and the normal population. RESULTS: Analysis of the ß-globin/α-globin mRNA ratio has shown that disease severity enhanced with a decrease in this proportion. Evaluation of the correlation between AHSP gene expression and the average of the ß-globin/α-globin expression ratio indicated a significant but indirect relationship in considered groups. Our results demonstrated that the AHSP gene expression increases in accordance with augmentation of clinical symptoms. CONCLUSIONS: Although one of the main reasons for reduced clinical severity in homozygote ß-thalassemia can be the high level of AHSP gene expression as a chaperon molecule, our findings indicated that AHSP gene expression decreased in a mild category as compared to that in severe and moderate groups.

Analysis of ß/α globin ratio by using relative qRT-PCR for diagnosis of beta-thalassemia carriers.

BACKGROUND: Current routine tests for premarital screening of ß-thalassemia carriers are not applicable for diagnosis of rare atypical minor ß-thalassemia cases. A more specialized laboratory evaluation for them is the measurement of ß/α chain synthesis ratio with the assistance of radioactive amino acids. This method is also no longer routinely accessible. Consequently it is required to establish a rapid, trouble-free, and reliable method that encompasses all the cases of ß-thalassemia carriers. Therefore we have determined ß/α-globin mRNA ratio by applying relative qRT-PCR in various ß-thalassemia patients. METHODS: Reticulocytes RNA extraction and subsequent cDNA synthesis were performed, followed by relative qRT-PCR for α- and ß-globin chain genes and ß-actin gene as an endogenous reference. ß/α-Globin gene ratio was then evaluated with the Pfaffl method. RESULTS: The mean of ß/α ratio was 0.99, 0.81, 0.69, and 0.69 for normal population, minor, intermediate, and major ß-thalassemia, respectively. Approximately 6% of cases with minor thalassemia RBC index and normal HbA2 and having a decreased ß/α ratio were located in the minor ß-thalassemia group. The mean of ß/α mRNA ratio in normal individuals and minor ß-thalassemia was significantly different with all other groups (P-value < 0.05). Nevertheless, there was no such association between ß/α mRNA ratio in major and intermediate ß-thalassemia. CONCLUSION: According to the significant differences achieved, no overlapping between minor ß-thalassemia and normal group, capability of diagnosing atypical minor ß-thalassemia, and accessibility of this technique, we can declare that this method could be suggested as a routine premarital screening test for ß-thalassemia carriers.