Interleukin-6 Gene Polymorphisms Influencing in hematological indices from sickle cell Anemia Patients

Authors

  • Monique de Moraes Pinto Luciano
  • Cinthia Cristina Matheus Xerez Albuquerque
  • José Pereira de Moura Neto

DOI:

https://doi.org/10.34117/bjdv9n2-030

Keywords:

sickle cell anemia, molecular markers, interleukin 6, Manaus, Amazonas

Abstract

The homozygous hemoglobin SS is characterized Sickle Cell Anemia (SCA), altering the original structure of erythrocytes to a sickle shape.  The hemoglobinopathies encompass all genetic diseases of hemoglobin and the SCA is the one that presents the greatest clinical manifestations variability and also the most severe ones, causing chronic hemolysis, vaso-occlusive crises and severe anemia in patients. The present study aimed to investigate the role of rs2069832, rs2069835, rs2069840, rs2069845 and rs2069849 polymorphisms in the Interleukin-6 gene in the hematological values of SCA patients treated at Fundação HEMOAM, Manaus, AM. The inclusion of patients was carried out through outpatient care at HEMOAM. Genomic DNA was extracted using the QIAamp DNA Mini Kit (Qiagen) and molecular analyzes by TaqMan® probes on Applied Biosystems QuantStudio 6 Flex Real-Time PCR System. A total of 277 SCA patients were included in this study, having the female gender having a minimally higher frequency (55.3%). The mean age at diagnosis was approximately three years old, with brown race being the most predominant (77.6%). The rs2069832_AA and rs2069845_AA genotypes showed high values for red blood cell, hemoglobin and hematocrit indices, by having an important role as a protective factor for hemolysis in these patients. While the rs2069835_CC genotype showed decreased values for the same hematimetric indices, demonstrating to be a potential risk factor for increased hemolysis. No significant correlation in hematimetric indices was observed for the rs2069840 and rs2069849 genotypes. There are few studies correlating the genetic variants of the IL-6 gene in SCA in the state of Amazonas, however, it is known that IL-6 is involved in cell proliferation and greater response to inflammatory cytokines, and may modulate the clinical response in these patients, such as chronic hemolysis, vaso-occlusion and infections. Our work demonstrated associations of risk and protective IL-6 genotypes for possible hemolysis in patients with sickle cell anemia. We understand that an investigation with a larger number of patients would be recommended to elucidate the roles of the studied polymorphisms in sickle cell anemia. In addition, elucidating the role of Il-6 in sickle cell anemia may lead to the development of new strategies and therapies to prevent the systemic effects of excessive cytokine production and, consequently, reduce the severity of crises in these patients, providing better prognosis, clinical follow-up and welfare.

References

AHMED S, G, The role of infection in the pathogenesis of vaso-occlusive crisis in patients with sickle cell disease, Mediterranean Journal of Hematology and Infectious Diseases, 2011;3(1).

ARCHER N, GALACTEROS F, BRUGNARA C, 2015. Clinical trials update in sickle cell anemia, Am J Hematol, 2015 Oct; 90 (10): 934-50.

CARNEIRO JJ, GONÇALVES MS, ALBUQUERQUE SRL et al. Deletion in Sickle Cell Disease Patients from the Occidental Brazilian Amazon. v. 5, n. 4, p. 123–128, 2016.

STEINBERG, M.H. (2008) Sickle cell disease and associated hemoglobinopathies. In Cecil Medicine. 23rd ed. Goldman, L., Ausiello, D., et al., Eds. Saunders/Elsevier, Philadelphia. pp. 1217–1226.

OLIVEIRA, M.M.S., MOURA M.A.M., NASCIMENTO M.E.B, et al. Consequências da Anemia Falciforme em adolescentes: Uma revisão sistemática da literature. Consequences of Falciform Anemia in adolescents: A systematic literature review. Braz. J. Hea. Rev., Curitiba, v. 3, n. 4, p. 10222-10231. DOI:10.34119/bjhrv3n4-246.

EATON, W.A. AND HOFRICHTER, J. (1990) Sickle cell hemoglobin polymerization. Adv. Protein Chem. 40, 63–280. 25.

FERRONE, F.A., HOFRICHTER, J., AND EATON, W.A. (1985) Kinetics of sickle hemoglobin polymerization. II. A double nucleation mechanism. J. Mol. Biol. 183, 611–631 26.

MOZZARELLI, A., HOFRICHTER, J., AND EATON, W.A. (1987) Delay time of Hb S gelation prevents most cells from sickling in vivo. Science 237, 500–506. 27.

COLETTA, M., HOFRICHTER, J., FERRONE, F.A., AND EATON, W.A. (1982) Kinetics of sickle hemoglobin polymerization in single red cells. Nature 300, 194–197. 28.

SILVA TT, GONÇALVES RS, ARAUJO MMS et al. Qualidade de vida de pacientes com anemia falciforme: revisão bibliográfica / Quality of life of patients with falciform anemia: bibliographic review. Braz. J. Hea. Rev., Curitiba, v. 3, n. 3, p. 5024-5029. DOI:10.34119/bjhrv3n3-084

FERRONE F.A. AND NAGEL R.L. (2001) Polymer structure and polymerization of deoxyhemoglobin S. In Disorders of Hemoglobin: Genetics, Pathophysiology, and Clinical Management. Steinberg, M.H., Forget, B.G., Higgs, D.R., and Nagel, R.L., Eds. Cambridge University Press, Cambridge. pp. 577–610.

FRENETTE, P. S., & ATWEH, G. F. (2007). Sickle cell disease: old discoveries, new concepts, and future promise. The Journal of clinical investigation, 117(4), 850–858. https://doi.org/10.1172/JCI30920.

CHALACHEVA, P., KHALEEL, M., SUNWOO, J., SHAH, P., DETTERICH, J. A., KATO, R. M., THUPTIMDANG, W., MEISELMAN, H. J., SPOSTO, R., TSAO, J., WOOD, J. C., ZELTZER, L., COATES, T. D., & KHOO, M. (2017). Biophysical markers of the peripheral vasoconstriction response to pain in sickle cell disease. PloS one, 12(5), e0178353. https://doi.org/10.1371/journal.pone.0178353.

POPKO, K., GORSKA, E., & DEMKOW, U. (2010). Influence of interleukin-6 and G174C polymorphism in IL-6 gene on obesity and energy balance. European journal of medical research, 15 Suppl 2(Suppl 2), 123–127. https://doi.org/10.1186/2047-783x-15-s2-123.

HIBBERT, J. M., HSU, L. L., BHATHENA, S. J., IRUNE, I., SARFO, B., CREARY, M. S., GEE, B. E., MOHAMED, A. I., BUCHANAN, I. D., AL-MAHMOUD, A., & STILES, J. K. (2005). Proinflammatory cytokines and the hypermetabolism of children with sickle cell disease. Experimental biology and medicine (Maywood, N.J.), 230(1), 68–74. https://doi.org/10.1177/153537020523000109.

PATEL, N., GONSALVES, C. S., MALIK, P., & KALRA, V. K. (2008). Placenta growth factor augments endothelin-1 and endothelin-B receptor expression via hypoxia-inducible factor-1 alpha. Blood, 112(3), 856–865. https://doi.org/10.1182/blood-2007-12-130567.

LANARO, C., FRANCO-PENTEADO, C. F., ALBUQUEQUE, D. M., SAAD, S. T., CONRAN, N., & COSTA, F. F. (2009). Altered levels of cytokines and inflammatory mediators in plasma and leukocytes of sickle cell anemia patients and effects of hydroxyurea therapy. Journal of leukocyte biology, 85(2), 235–242. https://doi.org/10.1189/jlb.0708445.

STEINBERG M. H. (2009). Genetic etiologies for phenotypic diversity in sickle cell anemia. TheScientificWorldJournal, 9, 46–67. https://doi.org/10.1100/tsw.2009.10.

LETTRE G. (2012). The search for genetic modifiers of disease severity in the β-hemoglobinopathies. Cold Spring Harbor perspectives in medicine, 2(10), a015032. https://doi.org/10.1101/cshperspect.a015032.

VICARI, P., ADEGOKE, S. A., MAZZOTTI, D. R., CANÇADO, R. D., NOGUTTI, M. A., & FIGUEIREDO, M. S. (2015). Interleukin-1β and interleukin-6 gene polymorphisms are associated with manifestations of sickle cell anemia. Blood cells, molecules & diseases, 54(3), 244–249. https://doi.org/10.1016/j.bcmd.2014.12.004.

ZIDI, S., STAYOUSSEF, M., ALSALEH, B. L., GAZOUANI, E., MEZLINI, A., EBRAHIM, B. H., YACOUBI-LOUESLATI, B., & ALMAWI, W. Y. (2017). Relationships between Common and Novel Interleukin-6 Gene Polymorphisms and Risk of Cervical Cancer: a Case-Control Study. Pathology oncology research: POR, 23(2), 385–392. https://doi.org/10.1007/s12253-016-0127-9.

HAN, L., LEE, C. K., PANG, H., CHAN, H. T., LO, I. L., LAM, S. K., CHEONG, T. H., & HO, J. C. (2017). Genetic predisposition to lung adenocarcinoma among never-smoking Chinese with different epidermal growth factor receptor mutation status. Lung cancer (Amsterdam, Netherlands), 114, 79–89. https://doi.org/10.1016/j.lungcan.2017.10.012.

KAANANE, H., SENHAJI, N., BERRADI, H., BENCHAKROUN, N., BENIDER, A., KARKOURI, M., & NADIFI, S. (2019). Association of variants in IL6-related genes with lung cancer risk in Moroccan population. Lung, 197(5), 601-608

TAHERI, M., NOROOZI, R., RAKHSHAN, A., GHANBARI, M., OMRANI, M. D., & GHAFOURI-FARD, S. (2019). IL-6 Genomic Variants and Risk of Prostate Cancer. Urology journal, 16(5), 463–468. https://doi.org/10.22037/uj.v0i0.4543.

DOSSUS, L., KAAKS, R., CANZIAN, F., ALBANES, D., BERNDT, S. I., BOEING, H., ... & COX, D. G. (2010). PTGS2 and IL6 genetic variation and risk of breast and prostate cancer: results from the Breast and Prostate Cancer Cohort Consortium (BPC3). Carcinogenesis, 31(3), 455-461.

GHOLAMI, M., SHARIFI, F., SHAHRIARI, S., KHOSHNEVISAN, K., LARIJANI, B., & AMOLI, M. M. (2019). Association of interleukin-6 polymorphisms with obesity: A systematic review and meta-analysis. Cytokine, 123, 154769. https://doi.org/10.1016/j.cyto.2019.154769.

STRAFELLA, C., CAPUTO, V., TERMINE, A., BARATI, S., CALTAGIRONE, C., GIARDINA, E., & CASCELLA, R. (2020). Investigação de variações genéticas de IL6 e IL6R como potenciais biomarcadores de prognóstico e farmacogenética: implicações para COVID-19 e distúrbios neuroinflamatórios. Life (Basileia, Suíça), 10 (12), 351. https://doi.org/10.3390/life10120351.

SOUSA, A. L., FAVA, V. M., SAMPAIO, L. H., MARTELLI, C. M., COSTA, M. B., MIRA, M. T., & STEFANI, M. M. (2012). Genetic and immunological evidence implicates interleukin 6 as a susceptibility gene for leprosy type 2 reaction. The Journal of infectious diseases, 205(9), 1417–1424. https://doi.org/10.1093/infdis/jis208.

SALES-MARQUES, C., CARDOSO, CC, ALVARADO-ARNEZ, LE, ILLARAMENDI, X., SALES, AM, HACKER, MA, BARBOSA, MGM, NERY, JADC, PINHEIRO, RO, SARNO, EN, PACHECO, AG, & MORAES, MO (2017). Polimorfismos genéticos dos genes IL6 e NOD2 são fatores de risco para reações inflamatórias na hanseníase. https://doi.org/10.1371/journal.pntd.0005754.

TAYLOR SC, SHACKS SJ, MITCHELL RA, BANKS A. Serum interleukin-6 levels in the steady state of sickle cell disease. J Interferon Cytokine Res. 1995 Dec;15(12):1061-4. doi: 10.1089/jir.1995.15.1061. PMID: 8746787.

ELAMMARY, Y., SEWELAM, N., AL-WAKEEL, H. ET AL. Interleukin-1β and interleukin-6 gene polymorphisms in Egyptian sickle cell disease patients. Egypt Pediatric Association Gaz 68, 14 (2020). https://doi.org/10.1186/s43054-020-00025-z.

PIERROT-GALLO, BRUNA SPINELLA et al. Haptoglobin gene polymorphisms and interleukin-6 and -8 levels in patients with sickle cell anemia. Revista Brasileira de Hematologia e Hemoterapia [online]. 2015, v. 37, n. 5 [Accessed 13 December 2022], pp. 329-335. Available from: <https://doi.org/10.1016/j.bjhh.2015.07.006>. ISSN 1806-0870.

COSTA, MANUELA FREIRE HAZIN ET al. Interleukin-6 in pregnancy with sickle cell disease. Hematology, Transfusion and Cell Therapy [online]. 2019, v. 41, n. 4 [Accessed 13 December 2022], pp. 298-302. Available from: <https://doi.org/10.1016/j.htct.2019.02.001>. Epub 25 Nov 2019. ISSN 2531-1387.

RINCÓN-LÓPEZ, E.M., NAVARRO GÓMEZ, M.L., HERNÁNDEZ-SAMPELAYO MATOS, T. et al. Interleukin 6 as a marker of severe bacterial infection in children with sickle cell disease and fever: a case–control study. BMC Infect Dis 21, 741 (2021). https://doi.org/10.1186/s12879-021-06470-4.

SARRAY S, SALEH LR, LISA SALDANHA F, AL-HABBOUBI HH, MAHDI N, ALMAWI WY. Serum IL-6, IL-10, and TNFα levels in pediatric sickle cell disease patients during vasoocclusive crisis and steady state condition. Cytokine. 2015 Mar;72(1):43-7. doi: 10.1016/j.cyto.2014.11.030. Epub 2015 Jan 5.

DOMINGOS IF, PEREIRA-MARTINS DA, SOBREIRA MJVC, et al. High levels of proinflammatory cytokines IL-6 and IL-8 are associated with a poor clinical outcome in sickle cell anemia. Ann Hematol. 2020 May;99(5):947-953. doi: 10.1007/s00277-020-03978-8. Epub 2020 Mar 5.

Downloads

Published

2023-02-06

How to Cite

Luciano, M. de M. P., Albuquerque, C. C. M. X., & de Moura Neto, J. P. (2023). Interleukin-6 Gene Polymorphisms Influencing in hematological indices from sickle cell Anemia Patients. Brazilian Journal of Development, 9(2), 6581–6594. https://doi.org/10.34117/bjdv9n2-030

Issue

Section

Original Papers