Nitric oxide (NO) is highly reactive, produced in endothelial cells by endothelial NO synthase (eNOS) and has been implicated in sickle cell pathophysiology. We evaluated the distribution of functionally significant eNOS variants (the T786C variant in the promoter region, the Glu298Asp variant in exon 7, and the variable number of tandem repeats (VNTR) in intron 4) in Africans, African Americans and Caucasians. The C-786 variant was more common in Caucasians than in Africans and African Americans. Consistent with other findings, the Asp-298 variant had the highest frequency in Caucasians followed by African Americans, but was completely absent in Africans. The very rare intron 4 allele, eNOS 4c, was found in some Africans and African Americans, but not in Caucasians. eNOS 4d allele was present in 2 Africans. These findings suggest a consistent and widespread genomic diversity in the distribution of eNOS variants in Africans, comparative to African Americans and Caucasians.

Sickle cell disease shows marked variability in severity and pathophysiology among individuals, probably linked to differential expression of various adhesion molecules. In this study, we investigated the differential distribution, genomic diversity and haplotype frequency of endothelial nitric oxide synthase (eNOS) and endothelin-1 (ET-1) polymorphisms, recently implicated as important in modification of disease severity. One hundred and forty five sickle cell disease patients (HbSS) and 244 adult and pediatric controls, without sickle cell disease (HbAA), were recruited from Mali. Genotypic analysis of the functionally significant eNOS variants (T786C, G894T and intron 4) and endothelin-1 (G5665T) was carried out with a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Our results show that the wild type alleles are the most frequent for all eNOS variants between cases and controls. Allelic and genotypic frequencies of eNOS polymorphic groups are not significantly different between cases and controls (P > 0.05). In addition, there is no association between eNOS variants and sickle cell disease, contrary to published reports. On the other hand, we report that endothelin-1 (G5665T) mutant variant had the lowest allelic frequency, and is significantly associated with sickle cell disease in Africa (P < 0.05). Similarly, haplotype frequencies were the same between cases and controls, except for the haplotype combining all mutant variants (T, C, 4a; P = 0.01). eNOS polymorphic variants are less frequent, with no significance with sickle cell disease in Africa. On the other hand, endothelin-1 is associated with sickle cell disease, and has the capacity to redefine pathophysiology and possibly serve as modulator of disease phenotype.

We examined malaria infection in asymptomatic blood donors from Mali, analyzing allelic diversity of Plasmodium falciparum (Pf) merozoite surface proteins (msp) -1 and -2 as well as the distribution of sulphadoxine-pyrimethamine (SP) resistance genes. A total of 140 genomic DNA samples were screened. Allele-specific nested polymerase chain reaction (PCR) analysis of Pfmsp-1 and Pfmsp-2 was performed, plus fragment analysis of the polymorphic regions to identify allelic diversity of the parasite population. We found parasite positivity due to Pf alone in 20.7% of these donors. Diverse allelic polymorphism of Pfmsp-1 and Pfmsp-2 was identified, with a high rate of multiplicity of infection (1.84 and 1.82 for Pfmsp-1 and Pfmsp-2, respectively). In addition, we found a high degree of SP resistance, with mutations at several dhfr and dhps codons. We conclude that there is an extensive diversity of Pfmsp-1 and Pfmsp-2 allelic types and SP drug resistance in Pf-infected donors from Mali.

Sickle cell disease (SCD) shows marked variability in severity among individuals; this variability probably linked to differential expression of adhesion molecules. Polymorphisms of the endothelial nitric oxide synthase (eNOS) have been implicated in disease severity, potentially delineating vascular complications. There is paucity of information on endothelin-1 (ET-1) diversity and disease severity or ethnic stratification. We examined genomic diversity and estimated haplotype frequency of eNOS and ET-1 polymorphisms in children with SCD. Thirteen SCD children (HbSS) and 176 adult and pediatric controls (HbAA) from Mali were recruited. Genotypic analysis of eNOS variants (T786C, Glu298Asp and intron 4) and ET-1 (G5665T) was carried out with a PCR-RFLP assay. Our results show the frequency distribution and allelic diversity of eNOS and ET-1 variants. Endothelin-1 (G5665T) mutant form was the most frequent, and probably most significant among children with SCD, though the distribution is out of Hardy-Weinberg equilibrium (P=0.0008). eNOS variants showed no difference between SCD and controls. We show that eNOS variants are less frequent, and may have no functional significance in SCD. Additionally, eNOS allele and genotype frequencies are not significantly different in cases and controls. Association between ET-1 and eNOS variants in African versus African American SCD children will be explored and the reason(s) for the HWE deviation will be investigated.