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      Comparison of gene mutation spectrum of thalassemia in different regions of China and Southeast Asia

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          Abstract

          Background

          Thalassemia is a common genetic disorder. High prevalence of thalassemia is found in South China, Southeast Asia, India, the Middle East, and the Mediterranean regions. Thalassemia was thought to exist only in southern China, but an increasing number of cases from northern China have been recently reported.

          Methods

          During 2012 to 2017, suspected thalassemia people were detected for common α‐ and β‐thalassemia mutations by gap‐Polymerase Chain Reaction (PCR) and reverse dot blot (RDB) analysis in Peking Union Medical College Hospital. One thousand and fifty‐nine people with thalassemia mutations were analyzed retrospectively. We picked mutated individuals who originally came from northern areas, and conducted telephone follow‐up survey in order to collect their ancestral information. Besides, we used “thalassemia”, “mutation”, and “Southeast Asian countries” as keywords to search the relevant studies in PubMed and Embase databases.

          Results

          All carriers included in our study were resided in northern China. Among them, 17.3% were native northerners and 82.7% were immigrants from southern China. Although substantial difference was found in α‐ and β‐thalassemia ratio and detailed spectrum of α‐ and β‐globin mutation spectrum between our data and data obtained from a previous meta‐analysis literature focused on southern China, the most common gene mutations were the same. Similar β‐thalassemia mutation spectrum was found among Thai, Malaysian Chinese, and Guangdong people, however, no other similarities in gene profile were found between Chinese and other ethnic groups in Southeast Asia.

          Conclusion

          Chinese people in different areas had similar gene mutation, whereas they had significantly different mutation spectrums from other ethnic groups in Southeast Asia.

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          Most cited references28

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          Molecular epidemiological survey of haemoglobinopathies in the Guangxi Zhuang Autonomous Region of southern China.

          Accurate and up-to-date data on the frequency of haemoglobinopathies among the populations of Guangxi Zhuang Autonomous Region, where haemoglobinopathies are most endemic in China, are required. In our study, a total of 5789 samples obtained from members of the Han, Zhang, and Yao ethnic groups in six geographical areas of Guangxi Province were analysed systematically in terms of both haematological and molecular parameters. The results presented that the total heterozygote frequency of thalassaemias and other haemoglobinopathies was 24.51%, of which 17.55% was due to alpha-thalassaemia, 6.43% to beta-thalassaemia, 0.38% to structural haemoglobin variants, and 0.16% to delta-thalassaemia. The mutational spectrum among the local population for each type of disorder was described, including the first report on the true prevalence of three silent alpha thalassemia defects, -alpha(3.7)/(4.78%), -alpha(4.2)/(1.61%) and Hb Westmead (alpha(WS)alpha/) (1.57%) and of delta-thalassemia resulting from five novel and two rare mutations never before identified in Chinese individuals. Comparison of the frequencies of alpha-globin mutations among the ethnic groups showed that there was a statistically significant difference between the Han (15.71%) and Zhuang (20.12%), and between the Han (15.71%) and Yao (20.84%) ethnic groups. In addition, we have performed the first extensive study of haematological parameters of the Hb Westmead mutation using a group of Chinese subjects with compound heterozygosity for this variant and an alpha-thalassaemia deletion. The knowledge gained in this study will enable us to estimate the health burden in this high-risk population and to elucidate the various genetic alterations that underlie haemoglobinopathies.
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            The prevalence of thalassemia in mainland China: evidence from epidemiological surveys

            Comprehensive data regarding the epidemiology and prevalence of thalassemia in mainland China are lacking. To assess the prevalence of thalassemia, we performed a meta-analysis including 16 articles published from 1981 to 2015. The overall prevalence of α-thalassemia, β-thalassemia and α + β-thalassemia was 7.88%, 2.21% and 0.48%, respectively. Trends in thalassemia prevalence in mainland China were not steady; a prevalence map based on a geographic information system (GIS) showed that the geographic distribution of thalassemia was highest in the south of China and decreased from south to north. Additionally, the most common α- and β-globin gene mutation was --SEA and CD41/42, respectively. The current study provides valuable information regarding epidemiology and intervention and supports the planning, implementation and management of prevention programmes for public health.
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              The Prevalence and Molecular Spectrum of α- and β-Globin Gene Mutations in 14,332 Families of Guangdong Province, China

              Objective To reveal the familial prevalence and molecular variation of α- and β-globin gene mutations in Guangdong Province. Methods A total of 40,808 blood samples from 14,332 families were obtained and analyzed for both hematological and molecular parameters. Results A high prevalence of α- and β-globin gene mutations was found. Overall, 17.70% of pregnant women, 15.94% of their husbands, 16.03% of neonates, and 16.83% of couples (pregnant women and their husbands) were heterozygous carriers of α- or β-thalassemia. The regions with the highest prevalence were the mountainous and western regions, followed by the Pearl River Delta; the region with the lowest prevalence was Chaoshan. The total familial carrier rate (both spouses were α- or β-thalassemia carriers) was 1.87%, and the individual carrier rates of α- and β-thalassemia were 1.68% and 0.20%, respectively. The total rate of moderate-to-severe fetal thalassemia was 12.78% among couples in which both parents were carriers. Conclusions There was a high prevalence of α- and β-thalassemia in Guangdong Province. This study will contribute to the development of thalassemia prevention and control strategies in Guangdong Province.
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                Author and article information

                Contributors
                hanbing_li@sina.com
                Journal
                Mol Genet Genomic Med
                Mol Genet Genomic Med
                10.1002/(ISSN)2324-9269
                MGG3
                Molecular Genetics & Genomic Medicine
                John Wiley and Sons Inc. (Hoboken )
                2324-9269
                09 April 2019
                June 2019
                : 7
                : 6 ( doiID: 10.1002/mgg3.2019.7.issue-6 )
                : e680
                Affiliations
                [ 1 ] Department of Clinical Laboratory Peking Union Medical College, Chinese Academe of Medical Science Beijing China
                [ 2 ] Department of Hematology Peking Union Medical College, Chinese Academe of Medical Science Beijing China
                Author notes
                [*] [* ] Correspondence

                Bing Han, Department of Hematology, Peking Union Medical College, Chinese Academe of Medical Science, Beijing, China.

                Email: hanbing_li@ 123456sina.com

                [†]

                These authors contributed equally to this paper.

                Author information
                https://orcid.org/0000-0002-3191-4003
                https://orcid.org/0000-0001-9970-0733
                Article
                MGG3680
                10.1002/mgg3.680
                6565565
                30968607
                5e9cefc1-7e08-4ce5-9252-518b2eb9e5c7
                © 2019 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 June 2018
                : 09 January 2019
                : 06 March 2019
                Page count
                Figures: 1, Tables: 4, Pages: 9, Words: 6643
                Funding
                Funded by: Chinese Academy of Medical Sciences innovation fund for medical sciences
                Award ID: 2016-I2M-3-004
                Funded by: MANDARIN study from Novartis
                Award ID: CICL670AAU05
                Funded by: National Natural Science Foundation of China
                Award ID: 81401725
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                mgg3680
                June 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:13.06.2019

                china,comparison,gene mutation,southeast asia,thalassemia
                china, comparison, gene mutation, southeast asia, thalassemia

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