| Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder inherited in the X-linked manner. The condition is prevalent in the Mediterranean region, Africa and Southeast Asia. In Hong Kong, the frequency of G6PD deficiency is around 4.5% in males and 0.3% in females. Over 140 specific mutations of the X-linked gene for G6PD have been characterized in various geographic regions. However, the local mutation pattern has not been clearly determined.;Glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects are vulnerable to chemical-induced haemolysis if exposed to oxidative agents. Little is known, however, of the haemolytic effects of Chinese herbal medicine on G6PD-deficient subjects. Only one case study has reported that a G6PD-deficient newborn developed severe haemolysis after ingestion of Rhizoma Coptidis. Besides, recent studies reported that green tea and its constituents exerted pro-oxidative effects on cellular systems in culture.;In this study, we aim (1) to investigate effects of (a) a panel of Chinese Herbal Medicine (CHM), (b) tea and its constituents, on the oxidative status of human G6PD-deficient erythrocytes in vitro ; (2) to characterize the genotype of G6PD-deficiency in the Chinese population and their specific response to oxidative stress; (3) to develop a novel strain of mice as a model for study of chemicals agents on G6PD-deficient red cell in vivo.;Our results showed that six of eighteen CHM significantly reduced GSH levels in the G6PD-deficient erythrocytes (p<0.05, n=10). After exposure to 1 mg/mL of Rhizoma Coptidis, GSH levels in G6PD-deficient erythrocytes was decreased by 48.9 +/- 5.4% (P<0.001, n=10). At 5 mg/mL of Cortex Moutan, Radix Rehmanniae, Radix Bupleuri, Rhizoma Polygoni Cuspidati and Flos Chimonanthi, GSH levels were decreased significantly (P=0.001 to 0.004) by 51.8 +/- 7.6%, 25.9 +/- 6.7%, 21.0 +/- 6.9%, 17.5 ;We also investigated the pro-oxidative effect of tea and its polyphenolic components on G6PD erythrocytes from G6PD-deficient (n=8) and normal adult (n=8) subjects. The tea extracts significantly reduced GSH and increased GSSG levels in G6PD-deficient erythrocytes in a dose-dependent manner (0.5-10 mg/mL), but not in normal erythrocytes. Similar dose-dependent responses to (-)-Epigallocatechin (EGC) and (-)-Epigallocatechin-3gallate (EGCG), but not to the other polyphenols, were observed. In G6PD-deficient cells, GSH was reduced by 43.3% (EGC at 0.05 mg/mL) and 33.3% (EGCG at 0.5 mg/mL), compared with pre-challenged levels. The concentration of methaemoglobin was increased significantly when these cells were challenged with tea extracts, and EGC. Plasma haemoglobin levels were higher in G6PD-deficient samples after exposure to tea extracts, EGCG, EGC and gallic acid, compared with those in normal blood.;Genetic analysis of 14 mutation hotpots was performed on 98 hemi-/homozygous and 17 heterozygous G6PD-deficient human subjects. We developed a novel Multiplex Primer Extension Reaction (MPER) assay and detected seven specific mutations in 97 subjects: c.1376G>T (33.7%), c.1388G>A (29.6%), c.871G>A + c.1311C>T (12.3%), c.95A>G (9.2%), c.392G>T (7.1%), c.1024C>T (6.2%) and c.1360C>T (1.0%). For the genotyping of 15 heterozygous female, all mutations were identified as follows: c.1376G>T/Normal (33.3%), c.1388G>A/Normal (26.7%), c.871G>A/Normal + c.1311C>T/Normal (20.0%), c.95A>G/Normal (13.3%) and c.392G>T./Normal (6.7%). The c.871G>A and 'silent' mutation c.1311 C>T was newly found to coexist in a high proportion of genotype in our population.;For the development of a G6PD-deficient mouse model, we introduced the mutant Gpdxa-m1Neu allele (a severe ENU-induced mutation that results in 13-15% G6PD activities of wild type littermates) into the C57L/J background (a strain that constitutively exhibits low G6PD activity) through a breeding program. Of significance is that 78% of the F2 generation had G6PD activities <2 U/g Hb, levels similar to those of severe G6PD deficiency in human. The efficacy of this model was preliminary verified by the known haemolytic agent, naphthalene, as demonstrated by the decrease of GSH/GSSG ratio by 24.6% (P=0.032) and increase of methaemoglobin by 4.5 fold (P=0.8) when compared with the respective control without treatment.;In conclusion, some Chinese herbal medicine, tea and tea polyphenols significantly altered the oxidative status of G6PD-deficient erythrocytes in vitro. Their in vivo effects on G6PD-deficient individuals would be further investigated by the novel G6PD-dificient mouse model. |
