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

J Clin Lab Anal. 2013 Jul;27(4):267-71. doi: 10.1002/jcla.21594.

Abstract

Background: Current routine tests for premarital screening of β-thalassemia carriers are not applicable for diagnosis of rare atypical minor β-thalassemia cases. A more specialized laboratory evaluation for them is the measurement of β/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 β-thalassemia carriers. Therefore we have determined β/α-globin mRNA ratio by applying relative qRT-PCR in various β-thalassemia patients.

Methods: Reticulocytes RNA extraction and subsequent cDNA synthesis were performed, followed by relative qRT-PCR for α- and β-globin chain genes and β-actin gene as an endogenous reference. β/α-Globin gene ratio was then evaluated with the Pfaffl method.

Results: The mean of β/α ratio was 0.99, 0.81, 0.69, and 0.69 for normal population, minor, intermediate, and major β-thalassemia, respectively. Approximately 6% of cases with minor thalassemia RBC index and normal HbA2 and having a decreased β/α ratio were located in the minor β-thalassemia group. The mean of β/α mRNA ratio in normal individuals and minor β-thalassemia was significantly different with all other groups (P-value < 0.05). Nevertheless, there was no such association between β/α mRNA ratio in major and intermediate β-thalassemia.

Conclusion: According to the significant differences achieved, no overlapping between minor β-thalassemia and normal group, capability of diagnosing atypical minor β-thalassemia, and accessibility of this technique, we can declare that this method could be suggested as a routine premarital screening test for β-thalassemia carriers.

Keywords: premarital screening; relative qRT-PCR; thalassemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Genetic Carrier Screening / methods*
  • Genetic Testing / methods
  • Humans
  • Infant
  • Premarital Examinations / methods
  • RNA, Messenger / metabolism
  • Real-Time Polymerase Chain Reaction
  • alpha-Globins / genetics*
  • beta-Globins / genetics*
  • beta-Thalassemia / diagnosis*
  • beta-Thalassemia / genetics

Substances

  • RNA, Messenger
  • alpha-Globins
  • beta-Globins