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      New mutations of locus control region in Saudi sickle patients

      research-article
      *
      Saudi Journal of Biological Sciences
      Elsevier

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          Abstract

          Sickle cell anemia (SCA) is a common hematological disease affecting humans. Detection of a single base pair mutation in β-globin gene is an important diagnostic tool for SCA. The aim was to study the molecular survey of locus control regions (LCR) in Saudi patients with sickle cell anemia, and to identify the genetic variables and their clinical manifestations.

          Methodology

          Blood samples from 69 unrelated sickle cell disease patients were obtained from the KKUH, Riyadh between 2017–2019. In this study, the DNA was extracted and PCR was performed. Additional PCR amplifications reactions covering the LCR were performed by using another different set of primers. Seven specific primer pairs were used to amplify seven regions in the locus control region (LCR) of β globin family. The generated fragments were sequenced to identify the possible alterations in this region.

          Results

          The results gained from sequencing experiments revealed a wide range of genomic alterations.

           A total of 69 gene alterations have been recognized in the locus control region;-

           The first fragment LCR-HS1 shows 20 alterations;

           The second fragment LCR-HS2 revealed six changes;

           The third fragment LCR-HS3 shows many changes;

           The fifth LCR-HS5 region revealed four changes;

           The sixth fragment LCR-HS6 revealed eight changes;

           The seventh LCR-HS7 fragment demonstrates ten changes.

          Conclusion

          It clear that this study has successfully identified LCR mutations for random Saudi patients with SCD. The above results should be taken further to set up management strategies to improve outcomes.

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          Most cited references16

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          Epidemiology of sickle cell disease in Saudi Arabia

          Sickle cell disease (SCD) is an autosomal recessive disorder characterized by production of abnormal hemoglobin S and is associated with high morbidity and mortality. Information about the prevalence of SCD in Saudi Arabia is patchy and probably underestimated, but studies have reported that SCD is a relatively common genetic disorder in this part of the world. The prevalence of SCD in Saudi Arabia varies significantly in different parts of the country, with the highest prevalence is in the Eastern province, followed by the southwestern provinces. The reported prevalence for sickle-cell trait ranges from 2% to 27%, and up to 2.6% will have SCD in some areas. Clinical and hematological variability exists in SCD in Saudi Arabia with two major phenotypes: a mild phenotype and a severe phenotype. Further studies on the prevalence, molecular and clinical epidemiology of SCD may help predict disease severity and risk stratification of patients to determine whether to receive early intensive care or continued symptomatic care.
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            Hemoglobin research and the origins of molecular medicine.

            Much of our understanding of human physiology, and of many aspects of pathology, has its antecedents in laboratory and clinical studies of hemoglobin. Over the last century, knowledge of the genetics, functions, and diseases of the hemoglobin proteins has been refined to the molecular level by analyses of their crystallographic structures and by cloning and sequencing of their genes and surrounding DNA. In the last few decades, research has opened up new paradigms for hemoglobin related to processes such as its role in the transport of nitric oxide and the complex developmental control of the alpha-like and beta-like globin gene clusters. It is noteworthy that this recent work has had implications for understanding and treating the prevalent diseases of hemoglobin, especially the use of hydroxyurea to elevate fetal hemoglobin in sickle cell disease. It is likely that current research will also have significant clinical implications, as well as lessons for other aspects of molecular medicine, the origin of which can be largely traced to this research tradition.
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              Sickle hemoglobin (HbS) allele and sickle cell disease: a HuGE review.

              Sickle cell disease is caused by a variant of the beta-globin gene called sickle hemoglobin (Hb S). Inherited autosomal recessively, either two copies of Hb S or one copy of Hb S plus another beta-globin variant (such as Hb C) are required for disease expression. Hb S carriers are protected from malaria infection, and this protection probably led to the high frequency of Hb S in individuals of African and Mediterranean ancestry. Despite this advantage, individuals with sickle cell disease exhibit significant morbidity and mortality. Symptoms include chronic anemia, acute chest syndrome, stroke, splenic and renal dysfunction, pain crises, and susceptibility to bacterial infections. Pediatric mortality is primarily due to bacterial infection and stroke. In adults, specific causes of mortality are more varied, but individuals with more symptomatic disease may exhibit early mortality. Disease expression is variable and is modified by several factors, the most influential being genotype. Other factors include beta-globin cluster haplotypes, alpha-globin gene number, and fetal hemoglobin expression. In recent years, newborn screening, better medical care, parent education, and penicillin prophylaxis have successfully reduced morbidity and mortality due to Hb S.
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                Author and article information

                Contributors
                Journal
                Saudi J Biol Sci
                Saudi J Biol Sci
                Saudi Journal of Biological Sciences
                Elsevier
                1319-562X
                2213-7106
                31 January 2020
                May 2020
                31 January 2020
                : 27
                : 5
                : 1265-1270
                Affiliations
                College of Appl.Med.Sci, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
                Author notes
                [* ]Address: Professor of Immunology, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University (PSAU), Saudi Arabia. f.alenzi@ 123456psau.edu.sa
                Article
                S1319-562X(20)30040-1
                10.1016/j.sjbs.2020.01.028
                7182994
                32346334
                a7b09640-b586-4ca8-954e-2cf1ac575ed8
                © 2020 Published by Elsevier B.V. on behalf of King Saud University.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 9 December 2019
                : 16 January 2020
                : 22 January 2020
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