Transferrin Variants Research Articles

Incidental finding of transferrin variant in capillary electrophoresis: does it have any clinical meaning?

Incidental finding of transferrin variant in capillary electrophoresis: does it have any clinical meaning?

Disialo–trisialo bridging of transferrin is due to increased branching and fucosylation of the carbohydrate moiety

BackgroundCarbohydrate deficient transferrin (CDT) is used for detection of alcohol abuse and follow-up. High performance liquid chromatography (HPLC) of transferrin glycoforms is highly specific for identification of alcohol abuse, but unresolved disialo- and trisialotransferrin glycoforms sometimes makes interpretation difficult. The cause of this phenomenon is unknown, cannot be explained by genetic variants of transferrin, but seems to be associated with liver disease. MethodsNineteen serum samples showing di–tri bridging when analyzed by HPLC were collected. Transferrin was purified by affinity chromatography, and N-linked oligosaccharides were released enzymatically. The N-glycans were further analyzed by high performance anion-exchange chromatography with pulsed amperometric detection and MALDI-TOF mass spectrometry. ResultsThe HPLC-analysis showed three different types of glycoform patterns. The N-glycans from fifteen samples showed patterns with increased number of triantennary structures containing one or two fucose residues. One sample contained an increased amount of triantennary glycans without fucose. Three samples showed a glycosylation pattern similar to normal transferrin. ConclusionsThe di–tri bridging phenomenon was associated with alterations in transferrin glycosylation in the majority of cases. Transferrin contained a higher extent of triantennary and often fucosylated N-linked oligosaccharides. These results may be important in future diagnostic approaches to liver diseases.

Four variants in transferrin and HFE genes as potential markers of iron deficiency anaemia risk: an association study in menstruating women.

BackgroundIron deficiency anaemia is a worldwide health problem in which environmental, physiologic and genetic factors play important roles. The associations between iron status biomarkers and single nucleotide polymorphisms (SNPs) known to be related to iron metabolism were studied in menstruating women.MethodsA group of 270 Caucasian menstruating women, a population group at risk of iron deficiency anaemia, participated in the study. Haematological and biochemical parameters were analysed and 10 selected SNPs were genotyped by minisequencing assay. The associations between genetic and biochemical data were analysed by Bayesian Model Averaging (BMA) test and decision trees. Dietary intake of a representative subgroup of these volunteers (n = 141) was assessed, and the relationship between nutrients and iron biomarkers was also determined by linear regression.ResultsFour variants, two in the transferrin gene (rs3811647, rs1799852) and two in the HFE gene (C282Y, H63D), explain 35% of the genetic variation or heritability of serum transferrin in menstruating women. The minor allele of rs3811647 was associated with higher serum transferrin levels and lower transferrin saturation, while the minor alleles of rs1799852 and the C282Y and H63D mutations of HFE were associated with lower serum transferrin levels. No association between nutrient intake and iron biomarkers was found.ConclusionsIn contrast to dietary intake, these four SNPs are strongly associated with serum transferrin. Carriers of the minor allele of rs3811647 present a reduction in iron transport to tissues, which might indicate higher iron deficiency anaemia risk, although the simultaneous presence of the minor allele of rs1799852 and HFE mutations appear to have compensatory effects. Therefore, it is suggested that these genetic variants might potentially be used as markers of iron deficiency anaemia risk.

Genome-wide association study identifies two loci strongly affecting transferrin glycosylation

Polysaccharide sidechains attached to proteins play important roles in cell-cell and receptor-ligand interactions. Variation in the carbohydrate component has been extensively studied for the iron transport protein transferrin, because serum levels of the transferrin isoforms asialotransferrin + disialotransferrin (carbohydrate-deficient transferrin, CDT) are used as biomarkers of excessive alcohol intake. We conducted a genome-wide association study to assess whether genetic factors affect CDT concentration in serum. CDT was measured in three population-based studies: one in Switzerland (CoLaus study, n = 5181) and two in Australia (n = 1509, n = 775). The first cohort was used as the discovery panel and the latter ones served as replication. Genome-wide single-nucleotide polymorphism (SNP) typing data were used to identify loci with significant associations with CDT as a percentage of total transferrin (CDT%). The top three SNPs in the discovery panel (rs2749097 near PGM1 on chromosome 1, and missense polymorphisms rs1049296, rs1799899 in TF on chromosome 3) were successfully replicated , yielding genome-wide significant combined association with CDT% (P = 1.9 × 10(-9), 4 × 10(-39), 5.5 × 10(-43), respectively) and explain 5.8% of the variation in CDT%. These allelic effects are postulated to be caused by variation in availability of glucose-1-phosphate as a precursor of the glycan (PGM1), and variation in transferrin (TF) structure.

A novel C2 transferrin variant interfering with the analysis of carbohydrate-deficient transferrin

BackgroundCarbohydrate-deficient transferrin (CDT) is used as a marker for chronic alcohol abuse. The presence of genetic transferrin variants might affect an individual's iron status and can interfere with CDT analysis. We report on the identification of a patient carrying a novel transferrin variant. We describe the performance of the various CDT methods in its detection and the associated iron status. MethodsDNA of the coding region of transferrin was sequenced and CDT levels were analysed using four different methods: high pressure liquid chromatography (HPLC), capillary zone electrophoresis (CZE), immunochemistry and iso-electric focussing (IEF). ResultsA novel transferrin variant, T139M, was found as a heterozygous genotype in the index patient and all of his four living direct family members (c.416C>p.Thr139Met). CDT analysis of the variant by HPLC and CZE was compromised as a result of the coelution of the different isoforms. CDT levels could be quantified by immunochemistry. Similar results were obtained using IEF analysis. The presence of the C2 transferrin variant did not affect iron status in any of the investigated patients. ConclusionsTransferrin T139M, present as a heterozygous genotype, interferes with CDT analysis by HPLC and CZE but not by immunochemistry. Physiologically, it appears to be functionally normal.

Application of capillary isoelectric focusing and peptide mass fingerprinting in carbohydrate‐deficient transferrin detection

Carbohydrate-deficient transferrin (CDT) is a specific biomarker of alcohol abuse and is widely used in clinical diagnosis to detect and follow up excessive alcohol consumption. However, false %CDT results still exist in CDT detection, because of interference from genetic variants and the lack of standardization in CDT analysis. Therefore, it is still very important to find a method with high sensitivity and high accuracy for CDT detection. Here, we compared the detection sensitivity and accuracy of pI values based methods [isoelectric focusing on polyacrylamide gel electrophoresis (IEF-PAGE) and capillary isoelectric focusing (CIEF)] with hydrophobic characteristic based methods [reversed-phase high-performance liquid chromatography (RP-HPLC)] on CDT detection. Moreover, we investigated the potential of peptide mass fingerprinting (PMF), a method based on the mass spectrometry to identify human transferrin (HTf) variants including CDT isoforms and genetic variants, based on their specific peptide masses. Results indicated that PMF can identify HTf variants including CDT isoforms and genetic variants based on their specific peptides, and CIEF showed higher sensitivity detection of HTf variants than RP-HPLC and IEF-PAGE did. Accordingly, we suggest that PMF is suitable for identifying CDT with high accuracy, and CIEF has potential for detection of CDT and genetic variants with high sensitivity; moreover, they are both worth further investigation in clinical diagnosis.

Transferrin mutations at the glycosylation site complicate diagnosis of congenital disorders of glycosylation type I

Congenital disorders of glycosylation (CDG) form a group of metabolic disorders caused by deficient glycosylation of proteins and/or lipids. Isoelectric focusing (IEF) of serum transferrin is the most common screening method to detect abnormalities of protein N-glycosylation. On the basis of the IEF profile, patients can be grouped into CDG type I or CDG type II. Several protein variants of transferrin are known that result in a shift in isoelectric point (pI). In some cases, these protein variants co-migrate with transferrin glycoforms, which complicates interpretation. In two patients with abnormal serum transferrin IEF profiles, neuraminidase digestion and subsequent IEF showed profiles suggestive of the diagnosis of CDG type I. Mass spectrometry of tryptic peptides of immunopurified transferrin, however, revealed a novel mutation at the N-glycan attachment site. In case 1, a peptide with mutation p.Asn630Thr in the 2nd glycosylation site was identified, resulting in an additional band at disialotransferrin position on IEF. After neuraminidase digestion, a single band was found at the asialotransferrin position, indistinguishable from CDG type I patients. In case 2, a peptide with mutation p.Asn432His was found. These results show the use of mass spectrometry of transferrin peptides in the diagnostic track of CDG type I.

Importance of HPLC confirmation of problematic carbohydrate-deficient transferrin (CDT) results from a multicapillary electrophoresis routine method

Background This study presents results from a routine laboratory setup for carbohydrate-deficient transferrin (CDT) measurement, using initial capillary electrophoresis (CE) analysis and, in problematic cases, further investigation by high-performance liquid chromatography (HPLC). Methods CDT by the Capillarys CDT assay (disialo- and asialotransferrin) was measured on a Capillarys 2 multicapillary CE system (Sebia). In cases of abnormal peak profiles or other interferences in the electropherogram, samples were remeasured following sample cleanup by “Sample treatment” (Sebia). If the problems remained, or otherwise when confirmatory testing was considered important, samples were analysed by an HPLC candidate reference method. Results In about 0.6% of the routine specimens, reanalysis was performed after sample cleanup. Confirmatory HPLC analysis was needed in half of the cases. Quantification problems were observed for genetic transferrin variants and samples showing a variety of abnormal peak profiles. In these cases, HPLC analysis provided accurate quantification, or at least an estimation (positive/negative), of the CDT level. Confirmatory HPLC analysis was also important for evaluation of borderline values, because only part of those cases were indicated to be true positives. Conclusions These results indicated that a routine laboratory setup for CDT measurement, using initial high-throughput multicapillary CE analysis with a confirmatory HPLC analysis option, will combine rapid quantitative and qualitative workflow with enhanced patient safety.

Evaluation of capillary electrophoresis assay for CDT on SEBIA's Capillarys System: Intra and inter laboratory precision, reference interval and cut-off

Background Carbohydrate-deficient transferrin (CDT) measurement on the multicapillary system Capillarys™ is characterized by high throughput and an on-line sample pre-treatment. This study evaluates the linearity and the precision of this technique, the correlation with the candidate reference method and the effect of genetic transferrin variants. Upper reference limit and cut-off values were calculated. Methods The precision study was carried out following CLSI EP5-A protocol. The between laboratory variation was calculated from an eight-site study. The upper reference limit (URL) was conventionally calculated from a reference population of 225 samples and verified by a Bhattacharya analysis in a large (n = 19,129) population. A population of 314 heavy consumers was used for calculation of the cut-off limit. Additionally the measurement uncertainty was calculated according to EDMA (European Diagnostic Manufacturers Association) and IRMM. Results The imprecision found was less than 5%, linearity was excellent for CDT values ranging from 2% to 20%. The between site variation around the cut-off value (CDT ranging from 1.68% to 1.79%) was clinically not significant. The upper reference limit (95th percentile) was calculated at 1.3% by the conventional IFCC method and confirmed by Bhattacharya calculations. The optimum cut-off for this CZE method was 1.6%, taken into account the measurement uncertainty. The regression equation with the candidate reference method was Disialotransferrin(Capillarys2) = Disialotransferrin(HPLC) ∗ 0.968 − 0.248. Genetic variants and abnormal profiles were well recognized. Conclusions These results demonstrate that the Capillarys CDT method is robust and reliable in routine use with a high degree of homogeneity from one system to another and is highly correlated with the candidate HPLC reference method.

The effects of Alzheimer's disease associated transferrin variants on APP metabolism

The effects of Alzheimer's disease associated transferrin variants on APP metabolism

Ice-age endurance: the effects of cryopreservation on proteins of sperm of common carp, Cyprinus carpio L

Damage to spermatozoa during cryopreservation is regarded as a major obstacle to the expansion of sperm storage technology. The authors used two-dimensional polyacrylamide gel electrophoresis and matrix-associated laser desorption/ionization time-of-flight mass spectrometry to explore whether the protein profile of common carp ( Cyprinus carpio) spermatozoa is affected by cryopreservation. Fourteen protein spots were significantly altered following cryopreservation. Eleven of these were identified: three as specific membrane proteins (N-ethylmaleimide-sensitive fusion protein attachment protein alpha, cofilin 2, and annexin A4) involved in membrane trafficking, organization, and cell movement; six as cytoplasmic enzymes (S-Adenosylhomocysteine hydrolase, Si:dkey-180p18.9 protein, lactate dehydrogenase B, phosphoglycerate kinase 1, transaldolase 1, and esterase D/formylglutathione hydrolase) involved in cell metabolism, oxidoreductase activity, and signal transduction; and two as transferrin variant C and F. Based on these findings, the authors hypothesize that transferrin in cryopreserved sperm may protect spermatozoa against oxidative damage during the freeze-thaw process. Cryopreservation caused changes in spermatozoa protein profiles that may lead to decreased spermatozoa velocity, motility, and fertilization success, and to subsequent ova hatching rate.

Iron and Parenteral Nutrition

There is ample evidence that iron is an essential trace element, but assessment of iron status and decisions on the amounts needed and the means of delivery in patients on parenteral nutrition (PN) have been unclear. Although iron requirements may diminish during acute illness, the frequent concurrence of blood loss and iron deficiency argue strongly for maintenance of levels of delivery in line with basal requirements. Maintenance of iron delivery has not been thought likely to present risk, but new data are questioning this. The needs of menstruating, pregnant, and lactating women are greater than those of adult men. The evidence favors an intravenous dose of around 1 mg of elemental iron per day in adult men and postmenopausal women. Doses of 1.5 mg/d [DOSAGE ERROR CORRECTED] in menstruating women and 2.0 mg/d [DOSAGE ERROR CORRECTED] for those in the later stages of pregnancy or lactating can be supported. A calibrated response is required in the growing child. Continued monitoring of iron status is recommended. Iron is an essential component for most PN regimens. The quantity of iron to be included should take account of predicted requirements.

Potential diagnostic biomarkers in serum of idiopathic pulmonary arterial hypertension

The pathogenesis of idiopathic pulmonary arterial hypertension (IPAH) is unknown, and the syndrome of IPAH remains a diagnostic and therapeutic challenge. The present study investigated the disease-specific proteins that aid in the diagnosis of IPAH and thus to study their role in the disease process. A comparative proteomic analysis was used for clinical screening of serum proteins in 10 patients with IPAH and compared with 10 normal subjects. Furthermore, enzyme linked immunosorbent assay (ELISA) was performed for comparison with serum proteins between individual IPAH patients and controls. Nine proteins and their isoforms, including leucine-rich alpha-2-glycoprotein (LRG), haptoglobin precursor, albumin isoform 2, transferrin variant, C3 complement, hydroxypyruvate reductase isoform 1, RAF1, fibrinogen isoformgamma-A and fibrinogen isoformgamma-B showed significant changes in serum of IPAH patients compared with controls by proteomic analysis. And significant higher serum levels of LRG in IPAH patients compared with controls were found by ELISA. Correlation analysis disclosed a significant association between serum LRG concentrations and New York Heart Association (NYHA) functional class (r=0.71, P<0.01) and cardiac output (CO) (r=-0.65, P<0.01). These results indicate that there are significant differences in the expression of proteins in the serum of patients with IPAH and normal subjects. And the measurement of LRG, RAF1 and C3 complement levels in the serum may be helpful for the diagnosis of IPAH. In particular, LRG may be a specific prognostical biomarker of IPAH.

Intérêt de l'immunosoustraction des immunoglobulines et de la transferrine dans le dosage de la transferrine désialylée en électrophorèse capillaire

CDT (Carbohydrate Deficient Transferrin) is considered as the most efficient biomarker of alcohol abuse available for routine use. Among the various methods developed for its measurement, capillary zone electrophoresis (CZE) on the multicapillary analyzer Capillarys2 provides high quality results at high throughput. However, the non CDT specific measurement of protein absorbance at 200 nm may bring abnormal profiles in samples from patients with high polyclonal immunoglobulin level or monoclonal component. We evaluated the automated immunosubtraction procedure developed by the manufacturer in 48 samples with abnormal electrophoretic profiles that potentially could interfere with CZE measurement of CDT. Elimination of the serum immunoglobulins raised the number of interpretable profiles from 19 (40%) to 37 (77%). The immunosubtraction procedure failed in samples with a monoclonal component present at a concentration > 60 g/L and in some samples harbouring a partially degraded C3 fraction. Six samples identified as genetic BC transferrin variants were also included in the study and submitted to an automated transferrin subtraction procedure to ascertain whether the additional peak were actually transferrin glycoforms. After treatment, two samples were classified as homozygote C for transferrin due to the persistence of one of the supposed transferrin peak. In conclusion, immunoglobulin and transferrin subtraction allow a better CDT measurement in most samples with interfering monoclonal components and avoid misclassification of suspected transferrin BC or CD variants.

Population studies in northern Sweden. VII. Serum transferrin variants as markers of Finnish admixture.

Population studies in northern Sweden. VII. Serum transferrin variants as markers of Finnish admixture.

Transferrin C subtypes in different ethnic groups.

The frequencies of transferrin C subtypes were studied in a number of different ethnic groups. The transferrin gene C2 was found to be polymorphic in all populations studied with the possible exception of Polynesians. The highest frequency of the C2 gene was found in Japanese (26 %) and the lowest in Africans (5–6 %). In European populations the C2 frequency varied from 9 to 19 %. Central Sweden and Finland had lower C2 frequencies than the rest of Europe. Swedish Lapps had a C2 frequency similar to that in Northern Sweden and Northern Europe. Placental extracts were found to be suitable for the study of transferrin variants. The Tf phenotype observed in placental extracts corresponded to that of the mother.

Geographical variation of transferrin allele frequencies in three deer species from Scandinavia.

Blood samples from 871 moose (Alces alces L.), 91 red deer (Cervus elaphus L.), and 33 roe deer (Capreolus capreolus L.) from Scandinavia were analysed for serum transferrin variability by agarose electrophoresis. The patterns of variability suggest two alleles in the moose, three in the red deer, but only one in the roe deer. Spatial heterogeneity of allele frequencies was found in both variable species. Differences in the level of transferrin variation among closely related species of Cervidae may be related to the social structure of each species and its effects on the transmission of disease organisms.

Variants in TF and HFE Explain ∼40% of Genetic Variation in Serum-Transferrin Levels

Only a small proportion of genetic variation in complex traits has been explained by SNPs from genome-wide association studies (GWASs). We report the results from two GWASs for serum markers of iron status (serum iron, serum transferrin, transferrin saturation with iron, and serum ferritin), which are important in iron overload (e.g., hemochromatosis) and deficiency (e.g., anemia) conditions. We performed two GWASs on samples of Australians of European descent. In the first GWAS, 411 adolescent twins and their siblings were genotyped with 100K SNPs. rs1830084, 10.8 kb 3' of TF, was significantly associated with serum transferrin (p total association test = 1.0 x 10(-9); p within-family test = 2.2 x 10(-5)). In the second GWAS on an independent sample of 459 female monozygotic (MZ) twin pairs genotyped with 300K SNPs, we found rs3811647 (within intron 11 of TF, HapMap CEU r(2) with rs1830084 = 0.86) was significantly associated with serum transferrin (p = 3.0 x 10(-15)). In the second GWAS, we found two additional and independent SNPs on TF (rs1799852 and rs2280673) and confirmed the known C282Y mutation in HFE to be independently associated with serum transferrin. The three variants in TF (rs3811647, rs1799852 and rs2280673) plus the HFE C282Y mutation explained approximately 40% of genetic variation in serum transferrin (p = 7.8 x 10(-25)). These findings are potentially important for our understanding of iron metabolism and of regulation of hepatic protein secretion, and also strongly support the hypothesis that the genetic architecture of some endophenotypes may be simpler than that of disease.

Evidence for two transferrin loci in the Salmo trutta genome

To determine the organization of transferrin (TF) locus in the Salmo trutta genome, partial DNA and cDNA sequencing, fluorescent in situ hybridization (FISH) and Salmo salar BAC analysis were performed. TF expression levels and copy number prediction were assessed using real-time PCR. In addition to two previously reported DNA TF variant sequences of S. trutta and Salmo marmoratus (TF1), two novel variant sequences (TF2) were revealed in both species. Variant-specific sequence tags, characterizing two variants for each TF type (TF1 and TF2), were identified in genomic clones from each of the F1 hybrids between S. trutta and S. marmoratus. These clearly documented double heterozygote status at the TF loci. The real-time PCR data showed that each of the two TF types (TF1 and TF2) existed in one copy only and that the transcription of TF2 was considerably lower compared with TF1. Using FISH, hybridization signals were observed on two medium-sized acrocentric chromosomes of S. trutta karyotype. A TF type-specific PCR followed by a restriction analysis revealed the presence of two TF loci in the majority of analysed BAC clones. It was concluded that the TF gene is duplicated in the genome of S. trutta, and that the two TF loci are located adjacent to one another on the same chromosome. The differing transcription levels of TF1 and TF2 appear to depend on the corresponding promoter activity, which at least for TF2 seems to vary between different Salmo congeners.

“Metal Detector” Gene May Influence Lead Absorption: Variants Predict Higher Blood Lead Levels in Children

An estimated 310,000 U.S. children between ages 1 and 5 have elevated blood lead levels despite efforts to reduce lead in the environment. Research in the past decade has begun to focus on factors that could make some children more susceptible to lead poisoning even at low levels of exposure. A new study explores one such possible factor—gene variants that influence lead absorption—linking variants in two iron metabolism genes to higher blood lead levels in children [EHP 116:1261–1266; Hopkins et al.]. When researchers analyzed umbilical cord blood from 422 children in Mexico, they found that the presence of two variants of the hemochromatosis (HFE ) gene—HFE C282Y and HFE H63D—predicted blood lead levels 11% higher than those in children not carrying the variants. Moreover, the presence of either HFE variant combined with a variant form of the transferrin (TF ) receptor gene—TF-P570S—predicted blood lead levels 50% higher than in children with none of the variants. Although the HFE and TF genes normally regulate iron metabolism, they may also influence blood lead levels because lead—like iron—is a divalent metal. Thus, the two metals can be “mistaken” for each other during metabolic processes. The HFE gene regulates iron-binding proteins, including TF, and variant forms of this gene sometimes induce hemochromatosis, a disease characterized by increased intestinal absorption of iron that contributes to abnormally high iron stores in adulthood. The authors hypothesized that the HFE variants might similarly increase absorption of lead, a hypothesis supported by the results of this study. TF interacts with HFE to form a complex that down-regulates iron absorption. However, TF-P570S may interact with the HFE variants in ways that heighten metal absorption rates. Study results showed the TF and HFE variants produced higher lead levels than those predicted by either HFE variant alone. Previously published research by these investigators has shown that having the HFE variants predicted lower blood lead levels in elderly men compared with men without the variants. The contrasting findings, the authors speculate, may reflect age-specific differences in body iron stores and in the variants’ effect on lead metabolism. Among children with low iron body stores and high iron needs, the variants predicted higher blood lead levels. But as iron stores accumulate with age, the variants down-regulated iron and lead absorption, leading to progressive declines in blood lead levels. The study’s key implications are twofold: first, that children with variant iron-metabolizing genes may be especially susceptible to the effects of lead at low exposure levels, and second, that genetic variants may increase risk at one life stage and decrease it at others.