Diseases and their clinical heterogeneity - Are we ignoring the SNiPers and micRomaNAgers? An illustration using Beta-thalassemia clinical spectrum and fetal hemoglobin levels

Diseases and pathological ailments are known to perplex clinicians and researchers with their varied clinical manifestations. Such variations are mostly attributed to the complex interplays between numerous molecular players and their modifiers. This complexity in turn baffles scientists further to tweak multiple players together when attempting to identify definitive therapeutic interventions. In this pursuit, researchers often tend to ignore one of the commonest known genetic variations - single nucleotide polymorphisms (SNPs) in non-coding genetic regions. In this study, we demonstrate how SNPs in critical genes and their miRNA regulators may play a crucial role in varied clinical manifestations using the beta-thalassemia clinical spectrum and fetal hemoglobin levels (HbF) as an illustration. A methodological approach using freely available bioinformatics tools was able to identify SNPs in pre-miRNA regions, pre-miRNA flanking regions and miRNA binding sites which in turn are expected to alter the translation process and thereby the expression of HbF.