Fetal Hemoglobin Levels in Sickle Cell Disease and Normal Individuals Are Partially Controlled by an X-Linked Gene Located at Xp22.2

Fetal hemoglobin (Hb F) production in sickle cell (SS) disease and in normal individuals varies over a 20-fold range and is under genetic control. Previous studies suggested that variant Hb F levels might be controlled by genetic loci separate from the beta-globin complex on chromosome 11. Using mic...

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Bibliographic Details
Published in:Blood 1992-08, Vol.80 (3), p.816-824
Main Authors: Dover, G.J., Smith, K.D., Chang, Y.C., Purvis, S., Mays, A., Meyers, D.A., Sheils, C., Serjeant, G.
Format: Article
Language:English
Subjects:
Adult
Anemia, Sickle Cell - blood
Anemia, Sickle Cell - genetics
Anemias. Hemoglobinopathies
Biological and medical sciences
Child
Chromosome Banding
Chromosome Mapping
Cohort Studies
Diseases of red blood cells
Female
Fetal Hemoglobin - genetics
Fetal Hemoglobin - metabolism
Globins - genetics
Hematologic and hematopoietic diseases
Hematology
Humans
Life Sciences & Biomedicine
Male
Medical sciences
Pedigree
Phenotype
Polymorphism, Restriction Fragment Length
Reference Values
Science & Technology
Sex Characteristics
X Chromosome
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Summary:Fetal hemoglobin (Hb F) production in sickle cell (SS) disease and in normal individuals varies over a 20-fold range and is under genetic control. Previous studies suggested that variant Hb F levels might be controlled by genetic loci separate from the beta-globin complex on chromosome 11. Using microscopic radial immunodiffusion and flow cytometric immunofluorescent assays to determine the percentage of F reticulocytes and F cells in SS and nonanemic individuals, we observed that F-cell levels were significantly higher in nonanemic females than males (mean +/- SD, 3.8% +/- 3.2% v 2.7% +/- 2.3%). F-cell production as determined by F reticulocyte levels in SS females was also higher than in SS males (17% +/- 10% v 13% +/- 8%). We tested the hypothesis that F-cell production in both normal and anemic SS individuals was controlled by an X-linked locus with two alleles, high (H) and low (L). Using an algorithm to determine the 99.8% confidence interval of a normal distribution in nonanemic individuals, we estimated that males and females with at least one H allele had greater than 3.3% F cells. Comparisons of male-male or female-female SS sib pairs with discordant F reticulocyte levels distinguished two phenotypes in SS males (L, less than 12%; H, greater than 12%) and three phenotypes in SS females (LL, less than 12%; HL, 12% to 24%, HH greater than 24%). Linkage analysis using polymorphic restriction sites along the X chromosome in eight SS and one AA family localized the F-cell production (FCP) locus to Xp22.2, with a maximum lod score (logarithm of odds of linkage v independent assortment) of 4.6 at a recombination fraction of 0.04.
ISSN:0006-4971
1528-0020
DOI:10.1182/blood.V80.3.816.816