The CYB5R3c.350C>G and G6PD A alleles modify severity of anemia in malaria and sickle cell disease

dc.contributor.authorGordeuk, Victor R.
dc.contributor.authorShah, Binal N.
dc.contributor.authorZhang, Xu
dc.contributor.authorThuma, Philip E.
dc.contributor.authorZulu, Stenford
dc.contributor.authorMoono, Rodgers
dc.contributor.authorReading, N. Scott
dc.contributor.authorSong, Jihyun
dc.contributor.authorZhang, Yingze
dc.contributor.authorNouraie, Mehdi
dc.contributor.authorCampbell, Andrew
dc.contributor.authorMinniti, Caterina P.
dc.contributor.authorRana, Sohail R.
dc.contributor.authorDarbari, Deepika S.
dc.contributor.authorKato, Gregory J.
dc.contributor.authorNiu, Mei
dc.contributor.authorCastro, Oswaldo L.
dc.contributor.authorMachado, Roberto
dc.contributor.authorGladwin, Mark T.
dc.contributor.authorPrchal, Josef T.
dc.contributor.departmentMedicine, School of Medicineen_US
dc.date.accessioned2022-10-27T17:15:26Z
dc.date.available2022-10-27T17:15:26Z
dc.date.issued2020-11
dc.description.abstractGenetic modifiers of anemia in Plasmodium falciparum infection and sickle cell disease (SCD) are not fully known. Both conditions are associated with oxidative stress, hemolysis and anemia. The CYB5R3 gene encodes cytochrome b5 reductase 3, which converts methemoglobin to hemoglobin through oxidation of NADH. CYB5R3c.350C > G encoding CYB5R3T117S , the most frequent recognized African-specific polymorphism, does not have known functional significance, but its high allele frequency (23% in African Americans) suggests a selection advantage. Glucose-6-phosphate dehydrogenase (G6PD) is essential for protection from oxidants; its African-polymorphic X-linked A+ and A- alleles, and other variants with reduced activity, coincide with endemic malaria distribution, suggesting protection from lethal infection. We examined the association of CYB5R3c.350C > G with severe anemia (hemoglobin <5 g/dL) in the context of G6PD A+ and A- status among 165 Zambian children with malaria. CYB5R3c.350C > G offered protection against severe malarial anemia in children without G6PD deficiency (G6PD wild type or A+/A- heterozygotes) (odds ratio 0.29, P = .022) but not in G6PD A+ or A- hemizygotes/homozygotes. We also examined the relationship of CYB5R3c.350C > G with hemoglobin concentration among 267 children and 321 adults and adolescents with SCD in the US and UK and found higher hemoglobin in SCD patients without G6PD deficiency (β = 0.29, P = .022 children; β = 0.33, P = .004 adults). Functional studies in SCD erythrocytes revealed mildly lower activity of native CYB5R3T117S compared to wildtype CYB5R3 and higher NADH/NAD+ ratios. In conclusion, CYB5R3c.350C > G appears to ameliorate anemia severity in malaria and SCD patients without G6PD deficiency, possibly accounting for CYB5R3c.350C > G selection and its high prevalence.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationGordeuk VR, Shah BN, Zhang X, et al. The CYB5R3c.350C>G and G6PD A alleles modify severity of anemia in malaria and sickle cell disease. Am J Hematol. 2020;95(11):1269-1279. doi:10.1002/ajh.25941en_US
dc.identifier.urihttps://hdl.handle.net/1805/30429
dc.language.isoen_USen_US
dc.publisherWileyen_US
dc.relation.isversionof10.1002/ajh.25941en_US
dc.relation.journalAmerican Journal of Hematologyen_US
dc.rightsPublisher Policyen_US
dc.sourcePMCen_US
dc.subjectSickle Cell Anemiaen_US
dc.subjectGlucosephosphate dehydrogenaseen_US
dc.subjectPlasmodium falciparumen_US
dc.titleThe CYB5R3c.350C>G and G6PD A alleles modify severity of anemia in malaria and sickle cell diseaseen_US
dc.typeArticleen_US
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