Expression Of Spectrin αi/50 Hereditary Elliptocytosis And Its Association With The α(lely) Allele

Hereditary elliptocytosis (HE) is a group of hemolytic anemias characterized by the presence of elliptical erythrocytes. The underlying alterations lie in the proteins of the membrane skeleton. Defects of the αI domain of spectrin have been defined based on a decrease in the normal 80-kD αI domain and a concomitant increase in one or more lower molecular weight peptides. We have studied three Brazilian kindreds with black ancestry, who presented mild common spαI/50 HE. Our aim was to determine the molecular alteration responsible for the spαI/50 HE observed in these three kindreds and to evaluate the presence and influence of allele α(LELY) in the expression of this type of HE. In order to establish the molecular defect, exons 5, 6 and 11 were amplified and submitted to a nonradioactive single strand conformation polymorphism protocol. An identical band shift in exon 6 was observed in all 3 patients and their affected relatives. Direct sequencing of the amplification products of exon 6 showed the same molecular defect in all patients: a T→C substitution, responsible for the L260P mutation. Allele α(LELY), detected by PCR and restriction enzyme digestion, was present in the heterozygous form in the three propositi and was associated in trans with the elliptocytogenic mutation. Blood smears of the patients with HE and α(LELY) in trans showed pronounced elliptocytosis, poikilocytosis and a few small red cell fragments, whereas the blood smears of their relatives, who had HE without allele α(LELY), showed mild common HE with a predominance of ovalocytes and the absence of poikilocytes. We conclude that allele α(LELY) does not lead to the worsening of clinical conditions when associated in trans with mild HE, but can be easily distinguished by a blood smear analysis. 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