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Haemoglobin is the component in red cells that is responsible for transporting oxygen from the lungs to all parts of the body. Normal haemoglobin comprises two α globin chains and two β globin chains, and each of these protein chains carry an iron-containing haem group which binds to oxygen.
Haemoglobinopathies are a group of inheritable conditions which affect the quantity and/or structure of the haemoglobin. The most common haemoglobinopathy in Singapore and Southeast Asia is thalassaemia.
In each individual, there are four α genes (two inherited from each parent) and two β genes (one inherited from each parent). They signal the production of the α globin chains and β globin chains respectively in haemoglobin.
Persons with thalassaemia mutations of the α globin genes (α thalassaemia) have reduced production of α globin chains and those with thalassaemia mutations of the β globin genes (β thalassaemia) have reduced production of β globin chains, resulting in decreased quantities of haemoglobin.
There are different types of thalassaemia, which are primarily classified into two main categories:
1. Alpha Thalassaemia: This type occurs when there is a mutation or deletion in one or more of the four genes responsible for making alpha-globin, a component of haemoglobin. The severity depends on how many genes are affected:
2. Beta Thalassaemia: This occurs when one or both of the genes responsible for producing beta-globin are mutated. It is categorised as: