Acute chest syndrome is associated with single nucleotide polymorphism-defined beta globin cluster haplotype in children with sickle cell anaemia

Br J Haematol. 2013 Oct;163(2):268-76. doi: 10.1111/bjh.12507. Epub 2013 Aug 16.

Abstract

Genetic diversity at the human β-globin locus has been implicated as a modifier of sickle cell anaemia (SCA) severity. However, haplotypes defined by restriction fragment length polymorphism sites across the β-globin locus have not been consistently associated with clinical phenotypes. To define the genetic structure at the β-globin locus more thoroughly, we performed high-density single nucleotide polymorphism (SNP) mapping in 820 children who were homozygous for the sickle cell mutation (HbSS). Genotyping results revealed very high linkage disequilibrium across a large region spanning the locus control region and the HBB (β-globin gene) cluster. We identified three predominant haplotypes accounting for 96% of the β(S) -carrying chromosomes in this population that could be distinguished using a minimal set of common SNPs. Consistent with previous studies, fetal haemoglobin level was significantly associated with β(S) -haplotypes. After controlling for covariates, an association was detected between haplotype and rate of hospitalization for acute chest syndrome (ACS) (incidence rate ratio 0·51, 95% confidence interval 0·29-0·89) but not incidence rate of vaso-occlusive pain or presence of silent cerebral infarct (SCI). Our results suggest that these SNP-defined β(S) -haplotypes may be associated with ACS, but not pain or SCI in a study population of children with SCA.

Keywords: acute chest syndrome; genetic analysis; haplotype; sickle cell anaemia; β-globin.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Chest Syndrome / etiology*
  • Adolescent
  • Alleles
  • Anemia, Sickle Cell / complications*
  • Anemia, Sickle Cell / genetics*
  • Child
  • Child, Preschool
  • Female
  • Fetal Hemoglobin / genetics
  • Haplotypes*
  • Humans
  • Linkage Disequilibrium
  • Male
  • Multigene Family
  • Patient Admission / statistics & numerical data
  • Polymorphism, Single Nucleotide*
  • beta-Globins / genetics*

Substances

  • beta-Globins
  • Fetal Hemoglobin