{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:12:02Z","timestamp":1781511122550,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,7,23]],"date-time":"2013-07-23T00:00:00Z","timestamp":1374537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH","award":["5-T32-HL-07439-34"],"award-info":[{"award-number":["5-T32-HL-07439-34"]}]},{"name":"NIH\/NIGMS","award":["T32-GM008638"],"award-info":[{"award-number":["T32-GM008638"]}]},{"name":"NCI NIH","award":["R01 CA105312"],"award-info":[{"award-number":["R01 CA105312"]}]},{"name":"Buck Family Endowed Chair in Hematology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:p>Acquired aplastic anemia (AA) is a rare life\u2010threatening bone marrow failure syndrome, caused by autoimmune destruction of hematopoietic stem and progenitor cells. Epidemiologic studies suggest that environmental exposures and metabolic gene polymorphisms contribute to disease pathogenesis. Several case\u2013control studies linked homozygous deletion of the glutathione S\u2010transferase theta (<jats:italic>GSTT1<\/jats:italic>) gene to AA; however, the role of<jats:italic>GSTT1<\/jats:italic>deletion remains controversial as other studies failed to confirm the association. We asked whether a more precise relationship between the<jats:italic>GSTT1<\/jats:italic>null polymorphism and aplastic anemia could be defined using a meta\u2010analysis of 609 aplastic anemia patients, including an independent cohort of 67 patients from our institution. We searched PubMed, Embase, and the Cochrane Database for studies evaluating the association between<jats:italic>GSTT1<\/jats:italic>null genotype and development of AA. Seven studies, involving a total of 609 patients and 3,914 controls, fulfilled the eligibility criteria. Meta\u2010analysis revealed a significant association of<jats:italic>GSTT1<\/jats:italic>null genotype and AA, with an OR\u2009=\u20091.74 (95% CI 1.31\u20132.31,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). The effect was not driven by any one individual result, nor was there evidence of significant publication bias. The association between AA and<jats:italic>GSTT1<\/jats:italic>deletion suggests a role of glutathione\u2010conjugation in AA, possibly through protecting the hematopoietic compartment from endogenous metabolites or environmental exposures. We propose a model whereby protein adducts generated by reactive metabolites serve as neo\u2010epitopes to trigger autoimmunity in aplastic anemia. Am. J. Hematol. 88:862\u2013867, 2013. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23521","type":"journal-article","created":{"date-parts":[[2013,6,24]],"date-time":"2013-06-24T18:40:38Z","timestamp":1372099238000},"page":"862-867","source":"Crossref","is-referenced-by-count":14,"title":["Common polymorphic deletion of glutathione S\u2010transferase theta predisposes to acquired aplastic anemia: Independent cohort and meta\u2010analysis of 609 patients"],"prefix":"10.1002","volume":"88","author":[{"given":"Daria V.","family":"Babushok","sequence":"first","affiliation":[{"name":"Division of Hematology Department of Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimei","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Oncology Department of Pediatrics Children's Hospital of Philadelphia, University of Pennsylvania Philadelphia 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