Cited by 1Hemoglobinopathies and Related DisordersRNA Research and SplicingIron Metabolism and Disorders

Importance of the 3′UTR region in globin synthesis: identification of two novel HBA1 mutations causing α-Thalassemia

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Benito, Sara Ferrer, Abío, Mariola, Bardón-Cancho, Eduardo J., Nieto, Jorge M., Ortega, Belén, González, F. A., Villegas, Ana, Benavente, Celina +1 more·2025·Annals of Hematology

Abstract

Alpha-thalassemia is primarily caused by large deletions in the HBA1 and HBA2 genes, but a minority of cases result from non-deletional mutations, including variants in untranslated regions (UTRs) that affect mRNA regulation. The 3'UTR is crucial for post-transcriptional control, influencing mRNA stability, localization, and translation via binding elements for RNA-binding proteins and microRNAs. We describe two patients with persistent microcytosis and normal iron levels. Standard hematological analyses were complemented by high-performance liquid chromatography (HPLC) and capillary electrophoresis to rule out common hemoglobinopathies. Molecular analysis was performed using multiplex PCR and direct sequencing of the HBA1 3'UTR. Patient 1, a 3-year-old Nigerian boy, carried a novel insertion mutation (HBA1:c.*119_120insT) five nucleotides downstream of the transcription termination signal. Patient 2, a 31-year-old Moroccan woman, exhibited a missense variant (HBA1:c.*150C > A) located 40 nucleotides downstream of the TTS. Both variants are located within regulatory regions of the HBA1 3'UTR. In silico analyses suggest disruption of RNA secondary structure, impaired interactions with HuR and AUF1 proteins, altered microRNA binding (e.g., miR-16-5p), and potential interference with polyadenylation signals, resulting in mRNA instability and reduced alpha-globin synthesis. These two novel mutations in the 3'UTR of HBA1 expand the spectrum of non-deletional alpha-thalassemia variants and highlight the importance of regulatory regions in globin gene expression. Their inclusion in routine molecular screening may enhance diagnostic accuracy in cases of unresolved microcytic anemia.

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  1. Matoulkova E, Michalova K, Vojtesek B, Hrstka R (2012) The role of the 3′UTR in post-transcriptional regulation of protein expression in mammalian cells. J Proteom 75(4):1015–1026

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Authors
Benito, S. F., Abío, M., Bardón-Cancho, E. J., Nieto, J. M., Ortega, B., González, F. A., Villegas, A., Benavente, C., & Ropero, P.
Affiliations
  • Universidad Complutense de Madrid (ES)
  • Hospital Clínico San Carlos (ES)
Corresponding author
Ropero, Paloma
Venue
Annals of Hematology
Published
2025-12-13
Volume
104
Issue
12
Pages
6169-6174
ISSN
  • 0939-5555 (ISSN-L)
  • 1432-0584
OpenAlex
W4417290102
Cited by
1
References
16
Citations by year
2026: 1
FWCI
0.90
Type
journal article
Language
en
Open access
Locations
  • Annals of Hematology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Research and Splicing
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
Keywords
alpha-thalassemia, HbA1, 3' untranslated region, insertion mutation, missense mutations, mRNA stability, post-transcriptional regulation, HuR, AUF1, microRNA binding, miR-16-5p, polyadenylation, microcytic anemia, globin gene regulation
MeSH terms
Adult, Child, Preschool, Female, Glycated Hemoglobin, Humans, Male, Mutation, alpha-Thalassemia, Mutation, Missense, 3' Untranslated Regions, alpha-Globins

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