Blood. 2012 Sep 10. [Epub ahead of print]
Heme oxygenase-1 gene promoter polymorphism is associated with reduced incidence of acute chest syndrome among children with sickle cell disease.
Bean CJ, Boulet SL, Ellingsen D, Pyle ME, Barron-Casella EA, Casella JF, Payne AB, Driggers J, Trau HA, Yang G, Jones K, Ofori-Acquah SF, Hooper WC, Debaun MR.
SourceClinical and Molecular Hemostasis Laboratory Branch, Division of Blood Disorders, National Ctr on Birth Defects & Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, United States;
AbstractSickle cell disease (SCD) is a common hemolytic disorder with a broad range of complications, including vaso-occlusive episodes, acute chest syndrome (ACS), pain, and stroke. Heme oxygenase-1 (gene HMOX1; protein HO-1) is the inducible, rate-limiting enzyme in the catabolism of heme and might attenuate the severity of outcomes from vaso-occlusive and hemolytic crises. A (GT)(n) dinucleotide repeat located in the promoter region of the HMOX1 gene is highly polymorphic, with long repeat lengths linked to decreased activity and inducibility. We examined this polymorphism to test the hypothesis that short alleles are associated with a decreased risk of adverse outcomes (hospitalization for pain or ACS) among a cohort of 942 children with SCD. Allele lengths varied from 13 to 45 repeats and showed a trimodal distribution. Compared with children with longer allele lengths, children with two shorter alleles (4%; ≤25 repeats) had lower rates of hospitalization for ACS (incidence rate ratio 0.28, 95% confidence interval: 0.10-0.81), after adjusting for sex, age, asthma, percentage of fetal hemoglobin and α-globin gene deletion. No relationship was identified between allele lengths and pain rate. We provide evidence that genetic variation in HMOX1 is associated with decreased rates of hospitalization for ACS, but not pain. This study is registered at www.ClinicalTrails.gov (NCT00072761).
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