1HBB GENE:BETA THALASSEMIA Introduction Beta thalassemia is the disease where the production of the haemoglobin gets reduced, thus leading to a decrease in the flow of oxygen in the body. It is the autosomal disorder of the blood which results in severe microcytic hypochromic anaemia, low level of haemoglobin A and abnormal blood smear. The disorder is caused by a genetic mutation in the HBB gene, which plays significant role in sending the signal for the production of a protein known as beta-globin (Vucak et al., 2018).The protein beta-globin is a subunit of haemoglobin which has the function of carrying oxygen in the blood. Thus, the mutation in the HBB gene, prevent the transcription and translation process of the gene and protein is not produced in the body. Absence of beta- globin leads to a reduced amount of functional haemoglobin and cause Beta-thalassemia. In the research of the HBB gene has led to a better understanding of the disease process. It is observed in the study ofThanhet al. (2018) that HBB gene helps to determine and regulate the structure of two types of the polypeptide chain of haemoglobin Hb A. Identification of the pathogenic variant in the molecular genetic testing of HBB gene has been useful in the diagnosis of the disease. The hematologic finding of microcytic hypochromic anaemia has stated that the mutation in the gene sequence of the HBB has cause single protein change which is located in chromosome number 11. In the research ofTraivareeet al. (2018), it is revealed that due to the interaction of Hb E and Hb Yala and frameshift mutation of the beta-globin gene result in Beta- Thalassemia. The author has done DNA analysis which suggested that due to mutation truncated B globin chain is terminated at codon 60, leading to null thalassemia. Thus, this finding can be helpful in the diagnosis of the disorder. However, it also requires to investigate the sequence of the HBB gene to evaluate the prognosis of the disease.
2HBB GENE:BETA THALASSEMIA In the research ofEkwattanakit, Riolueang and Viprakasit(2018) analysis of HBB has also revealed that it has a highly homologous gene sequence and pseudogene known as HBBP1. It has given new insight into the prognosis of the disease. Due to the change in single gene base of the HBB disrupt the protein which makes up Hb A. The X-ray crystallography has suggested the distorted structure of the beta-globin protein, which has caused low production of the haemoglobin. In the study ofMahdieh and Rabbani(2016), there has been researching on the variation of HBB gene by evaluating 1000 genomes database with the objective to describe the frequency of mutation of a diverse population with reference to HG19 genome. The author has observed that there is a high frequency of mutated gene; however, 90% of the case does not lead to beta thalassemia because they are located in the non-coding region of HBB gene. Author has made a concluding remark that out of 10000 people in world, 14 peoples are at the risk of developing beta thalassemia in the next generation. Considering the high prevalence of the disease, research has been conducted to find the effective mean of treatment. This has also given new insight into the treatment. The researched has given the theory that by improving the sequence of HBB gene, Beta thalassemia can be treated or cured. However, research has failed to correct the gene sequence of HBB (Saetung et al., 2017). Hence, this requires extensive research to search for exact mean of treatment of beta- thalassemia. Concerning to the diagnosis, prognosis and treatment of the beta-thalassemia,Cai et al. (2018) have conducted a universal approach to correct the gene mutation of HBB gene of human stem cell for gene therapy. The author has explored the CRISPR/Cas9 approach to perform HBB gene editing by the use of humanized SpCas9 protein. While other researchers are working in developing genome editing in the postnatal CD34+, which is known to depress the expression
3HBB GENE:BETA THALASSEMIA level of HBG in RBC (Bai et al., 2017), it has the competence to substitute the missed HBB in the region of B-thal and help to produce HBB protein and increase the level of haemoglobin in blood. Both recent findings are still in further investigation to determine the effectiveness at the commercial level. Lastly, from the above discussion, it can be concluded that numerous studies have been conducted in the HBB gene and its mutation leading to beta-thalassemia. However, there have been the various limitation in the current understanding of the HBB gene. No relevant study has been conducted to find the mechanism of action that leads to the mutation of the HBB gene. Therefore, research must be explored to evaluate the classification and detail description of the disease.
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4HBB GENE:BETA THALASSEMIA Reference Bai, H., Cai, L., Machairaki, V., Gao, Y., Ye, Z., & Cheng, L. (2017). A Universal Approach to Correct Various HBB Gene Mutations in Human Stem Cells for Gene Therapy of Beta- Thalassemia and Sickle Cell Disease. Cai, L., Bai, H., Mahairaki, V., Gao, Y., He, C., Wen, Y., ... & Ye, Z. (2018). A universal approach to correct various HBB gene mutations in human stem cells for gene therapy of beta‐thalassemia and sickle cell disease.Stem cells translational medicine,7(1), 87-97. Ekwattanakit, S., Riolueang, S., & Viprakasit, V. (2018). Interaction between Hb E and Hb Yala (HBB:c.129delT);anovelframeshiftbetaglobingenemutation,resultingin Hemoglobin E/β0 thalassemia.Hematology,23(2), 117-121. Kim, S. J., Song, J., Phillips, J. D., Reading, N. S., Min, C., Lautersztain, J., ... & Prchal, J. T. (2017). A Study of Novel Beta Globin Mutation Associated with Dominant Beta- Thalassemia,AberrantErythroidMaturationandDifferentiationCompoundedwith Hereditary Pyropoikilocytosis. Mahdieh, N., & Rabbani, B. (2016). Beta thalassemia in 31,734 cases with HBB gene mutations: pathogenic and structural analysis of the common mutations; Iran as the crossroads of the Middle East.Blood reviews,30(6), 493-508. Saetung, R., Ongchai, S., Charoenkwan, P., & Sanguansermsri, T. (2017). GENOTYPING OF BETATHALASSEMIATRAITBYHIGH-RESOLUTIONDNAMELTING ANALYSIS.Southeast Asian Journal of Tropical Medicine and Public Health,48(6), 1338-1339.
5HBB GENE:BETA THALASSEMIA Thanh, H. L. T., Thanh, H. L. T., Luong, L. H., Tran, T. H., Liu, S. C., Truong, H. N., ... & Tran, V. K. (2018). Prenatal diagnosis of a case with SEA-HPFH deletion thalassemia with whole HBB gene deletion.Taiwanese Journal of Obstetrics and Gynecology,57(3), 435- 441. Traivaree, C., Monsereenusorn, C., Rujkijyanont, P., Prasertsin, W., & Boonyawat, B. (2018). Genotype–phenotypecorrelationamongbeta-thalassemiaandbeta-thalassemia/HbE disease in Thai children: predictable clinical spectrum using genotypic analysis.Journal of blood medicine,9, 35. Vucak, J., Turudic, D., Milosevic, D., Bilic, M., Salek, Z., Rincic, M., & Bilic, E. (2018). Genotype-phenotype Correlation of β-Thalassemia in Croatian Patients: A Specific HBB Gene Mutations.Journal of pediatric hematology/oncology,40(2), e77-e82.