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This is the most common human hemoglobin tetramer, accounting for over 97% of the total red blood cell hemoglobin in normal adults. [55] hemoglobin A2, (HbA2) is a second form of adult hemoglobin and is composed of two alpha and two delta chains. This hemoglobin typically makes up 1-3% of hemoglobin in adults. [55]
Normal levels range from 2.1-3.2%, but in the beta-thalassemia disorder, the levels increase to 3.5-6.0%. Additionally, individuals with beta-thalassemia exhibit a high red cell count and low hemoglobin levels. [3] Individuals that express lower levels of hemoglobin A2, have the a 0-thalassemia trait or homozygous gene for a +-thalassemia. [2]
The physiological effects of these variants can range from minor to severe. [3] Mutations can caused impaired production of hemoglobin (thalassemia) or produce structurally altered hemoglobins. Some hemoglobin variants, such as HbS which causes sickle-cell anemia, are responsible for severe diseases and are considered hemoglobinopathies.
Whereas normal adults have less than 1% of hemoglobin F, patients with only one disease gene have 5-30%. Patients with two disease copies can have hemoglobin F in up to 100% of red blood cells. [31] As other diseases such as sickle cell disease could also cause a higher level of hemoglobin F to be present, it can sometimes be misdiagnosed. [32]
Hemoglobin A (HbA), also known as adult hemoglobin, hemoglobin A1 or α 2 β 2, is the most common human hemoglobin tetramer, accounting for over 97% of the total red blood cell hemoglobin. [1] Hemoglobin is an oxygen-binding protein, found in erythrocytes , which transports oxygen from the lungs to the tissues. [ 2 ]
Normal levels of hemoglobin vary according to sex and age in the range 9.5 to 17.2 grams of hemoglobin in every deciliter of blood. [6] Hemoglobin also transports other gases. It carries off some of the body's respiratory carbon dioxide (about 20–25% of the total) [7] as carbaminohemoglobin, in which CO 2 binds to the heme protein.
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