CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(04): 583-589
DOI: 10.1055/s-0043-1770068
Original Article

Prevalence and Impact of HMOX1 Polymorphism (rs2071746: A > T) in Indian Sickle Cell Disease Patients

Hareram Pandey
1   Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Kanwaljeet Singh
2   Lab Sciences & Molecular Medicine, Army Hospital Research and Referral, Delhi Cantt, Delhi, India
1   Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Jasmita Dass
1   Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Seema Tyagi
1   Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Tulika Seth
1   Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Renu Saxena
1   Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Manoranjan Mahapatra
1   Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
› Author Affiliations
Funding Authors would like to acknowledge the financial support given by Indian Council of Medical Research (ICMR)-56/1/2019-HAE/BMS-), New Delhi, India, for the present study.


Introduction Fetal hemoglobin (HbF) levels play significant role in lowering down the morbidity and mortality in sickle cell disease (SCD) patients. Coinheritance of heme oxygenase-1 (HMOX1) rs2071746:A > T polymorphism may contribute to variable HbF levels in Indian SCD patients.

Objective This study was aimed to evaluate the role of HMOX1 polymorphism and its impact on HbF level in Indian SCD patients.

Materials and Methods One-hundred twenty confirmed cases of SCD and 50 healthy controls were recruited. Their mean age was 11.5 ± 8.6 years (range: 3–23 years). Quantification of Hb, HbA2, HbF, and HbS was done by capillary zone electrophoresis. Allele-specific polymerase chain reaction was used to genotype HMOX1 (rs2071746:A > T) gene polymorphism.

Results Out of the 120 cases of SCD, 65 were hemoglobin sickle-shaped (HbSS) and 55 were sickle-beta thalassemia (Sβ). Out of 65 HbSS patients, 29 (44.6%) were heterozygous (AT), 20 (30.76%) were homozygous (TT), and 16 (24.61%) were found wild-type (AA) genotype. Out of 55 Sβ, 22 (40%) were heterozygous, 18 (32%) were homozygous and 15 (28%) were wild-type. Patients carrying HMOX1 (rs2071746:A > T), AT, and TT genotypes had less anemia, painful crisis, splenomegaly, hepatomegaly, jaundice, and blood transfusion. HbF level was found higher in TT genotype (in HbSS the HbF levels was 25.1 ± 4.4; in sickle-beta thalassemia the HbF levels was 36.1 ± 4.7) than wild-type(AA) and was statistically significant (p-value <0.001).

Conclusion The TT genotype of the rs2071746:A > T polymorphism was associated with increased levels of Hb F (p < 0.001). It can serve as a HbF modifier in Indian sickle cell diseases patients.

Authors' Contributions

H.R.P. designed the study, performed experimental studies, and drafted the manuscript. K.S. compiled the data and contributed to writing. R.R. and J.D. performed analysis and helped in drafting the manuscript. S.T. reviewed the manuscript and helped in shaping the manuscript. T.S., R.S., and M.M. provided valuable suggestions and clinical outputs. All authors read and approved the final the manuscript.

Statement of Informed Consent

All persons gave their informed consent prior to their inclusion in the study.

Publication History

Received: 27 June 2022

Accepted: 17 April 2023

Article published online:
19 June 2023

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