Molecular heterogeneity of glucose-6-phosphate dehydrogenase (G6PD) variants in the south of Thailand and identification of a novel variant (G6PD Songklanagarind)

Abstract

Two hundred and twenty-five G6PD-deficient subjects in Songklanagarind Hospital in the south of Thailand comprising 210 males and 15 females were studied. Neonatal jaundice was detected in 85% of these patients. Acute hemolysis related to infection was detected in 17.3% of the G6PD-deficient subjects. Drug-induced acute hemolysis was detected in 1.8% and favism was observed in 3.6% of G6PD-deficient patients. The molecular analysis was performed on 134 G6PD-deficient individuals by a combination of PCR-RFLP, multiplex polymerase chain reaction by multiple tandem forward primers and a common reverse primer assay (MPTP) and DNA sequencing to characterize the mutations of the samples with abnormal MPTP bands. We found 10 different missense G6PD mutations and the three most common variants were G6PD Viangchan 871,G→A (31.3%), G6PD Kaiping 1388,G→A (20.1%) and G6PD Mahidol 487,G→A (17.2%) followed by G6PD Canton 1376,G→T (9.7%), G6PD Union 1360,C→T (2.2%), G6PD Gaohe 95,A→G (1.5%), G6PD Quing Yuan 392,G→T (0.7%), G6PD Mediterranean 563,C→T (0.7%), G6PD Songklanagarind 196,T→A (0.7%), silent mutation 1311,C→T (6.7%), and uncharacterized variant (9%). A novel missense mutation at codon 196, T TC→ A TC in exon 4 of the G6PD gene predicting a single amino acid substitution, Phe66Ile was identified and we designated this novel class II variant as G6PD Songklanagarind. The G6PD variants among the Thais in the southern part are heterogeneous and G6PD Viangchan, Kaiping, Mahidol, and Canton variants account for about 78% of the cases. Our findings provide some evidence that G6PD Viangchan and Mahidol are common Southeast Asian variants and support the theory of genetic drifts throughout Southeast Asia.