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Nagaharu K, Izumi T, Maruyama M, Sugimoto Y, Ohishi K, Tawara I, Usui E, Tamaki S. Clinical Utility of Flow Cytometry for Detection of Anti-Jk b IgM in Acute Haemolytic Transfusion Reaction. Intern Med 2024; 63:1273-1275. [PMID: 37779057 PMCID: PMC11116007 DOI: 10.2169/internalmedicine.2639-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/20/2023] [Indexed: 10/03/2023] Open
Abstract
Acute hemolytic transfusion reaction (AHTR) is a rare but life-threatening complication of transfusion. We herein report a case of anti-Jkb IgM-related AHTR. Two hours after an 80-year-old man with myelodysplastic syndrome received a packed red blood cell (RBC) A+/Rh-/Jkb+/c- transfusion, he developed acute respiratory failure and a fever. Although he had tested negative in routine screening tests, the 37°C normal saline test was weakly positive for Jkb. We confirmed the presence of anti-Jkb IgM in the patient's serum by flow cytometry. This case demonstrates the potential utility of flow cytometry for IgM detection.
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Affiliation(s)
- Keiki Nagaharu
- Department of Hematology, Mie University Hospital, Japan
- Department of Hematology, Yokkaichi Municipal Hospital, Japan
- Department of Hematology, Japanese Red Cross Ise Hospital, Japan
| | - Takuya Izumi
- Department of Hematology, Japanese Red Cross Ise Hospital, Japan
| | - Mitsuko Maruyama
- Transfusion Medicine and Cell Therapy, Mie University Hospital, Japan
| | - Yuka Sugimoto
- Department of Hematology, Mie University Hospital, Japan
| | - Kohshi Ohishi
- Transfusion Medicine and Cell Therapy, Mie University Hospital, Japan
| | - Isao Tawara
- Department of Hematology, Mie University Hospital, Japan
| | - Eiji Usui
- Department of Hematology, Japanese Red Cross Ise Hospital, Japan
| | - Shigehisa Tamaki
- Department of Hematology, Japanese Red Cross Ise Hospital, Japan
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2
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Butler DD, Hundley DA, Lin HY, Villani V, Bynon JS, Bai Y, Pivalizza EG. Blood Management in a Liver Transplant Recipient with Kidd (Jka) and Rhesus (D) Antibodies: A Case Report. A A Pract 2024; 18:e01769. [PMID: 38557444 DOI: 10.1213/xaa.0000000000001769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
A 67-year-old man presented for urgent liver transplantation (LT). Screening revealed the rare combination of antiRhesus (D) and antiKidd Jk(a) antibodies, requiring antigen-negative red blood cells (RBC) for both phenotypes. This combination has not been reported during LT. Compatible RBCs were initially limited, requiring continued communication between the blood bank/blood supplier to obtain more, including frozen, units. Additional strategies included the use of cell salvage and intentional management of coagulopathy to limit bleeding and RBC requirement. This case highlights blood management during LT when D and Jk(a) antibodies may limit RBC supply and emphasizes the need for effective communication with the blood bank.
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Affiliation(s)
| | | | - Ha Y Lin
- From the Departments of Anesthesiology
| | | | | | - Yu Bai
- Pathology, McGovern Medical School at UTHealth-Houston, Houston, Texas
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3
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Yang J, Ni L, Li A, Li M, Ruan S, Xiang D, Zhu Z, Ye L. A novel homozygous splice-site mutation of JK gene leads to Jk(a-b-) phenotype. Transfus Med 2024; 34:39-45. [PMID: 37950522 DOI: 10.1111/tme.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/28/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES This study aimed to investigate the molecular mechanism of the Jk(a-b-) phenotype in a Chinese transfusion patient. BACKGROUND Many different mutation types relating to Jk(a-b-) phenotype have been reported. However, the splice-site mutation is relatively rare and the related functional verification is lacking. MATERIALS AND METHODS In this study, the blood sample was collected from a transfusion patient with the Jk(a-b-) phenotype. Serotyping was performed using routine serological methods. The exons sequences and coding regions of the JK gene were amplified using polymerase chain reaction and directly sequenced. To perform a minigene splicing assay, the intronic mutation sequences were cloned into a pSPL3 splice reporting vector. The splicing reporter minigene assay was performed in HEK 293T cells. RESULTS The Jk(a-b-) phenotype of the blood sample was identified through serological testing. Sequencing results revealed that the sample had a novel homozygous splice-site mutation JK*02N (NM_015865.7: c.663+3A>C). Further analysis, including cDNA sequencing and minigene splicing assay, confirmed that the novel splice-site mutation resulted in exon skipping. Interestingly, different numbers of exons being skipped were obtained by the two methods. CONCLUSION This study revealed a novel homozygous splicing-site mutation associated with the Jk(a-b-) phenotype in Chinese population. Our results emphasise the importance of the in vitro functional method minigene splicing assay, while also acknowledging its potential limitations when compared to cDNA sequencing.
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Affiliation(s)
- Jiaxuan Yang
- Immunohematology Lab, Shanghai Institute of Blood Transfusion, Shanghai Blood Center, Shanghai, China
| | - Lina Ni
- Department of Blood Transfusion, Weihai Central Hospital, Weihai, China
| | - Aijing Li
- Immunohematology Lab, Shanghai Institute of Blood Transfusion, Shanghai Blood Center, Shanghai, China
| | - Minghao Li
- Immunohematology Lab, Shanghai Institute of Blood Transfusion, Shanghai Blood Center, Shanghai, China
| | - Shulin Ruan
- Immunohematology Lab, Shanghai Institute of Blood Transfusion, Shanghai Blood Center, Shanghai, China
| | - Dong Xiang
- Immunohematology Lab, Shanghai Institute of Blood Transfusion, Shanghai Blood Center, Shanghai, China
| | - Ziyan Zhu
- Immunohematology Lab, Shanghai Institute of Blood Transfusion, Shanghai Blood Center, Shanghai, China
| | - Luyi Ye
- Immunohematology Lab, Shanghai Institute of Blood Transfusion, Shanghai Blood Center, Shanghai, China
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4
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Soleimani R, Cabo J, Frelik A, Debry C, Mbende C, Delcourt J, Debortoli N, Renguet E, Devey A, Mullier F, Degosserie J, Moreno Y Banuls L. SLC14A1 gene sequencing shows the JK*01W.06 allele in a JK1 patient with an anti-JK1. Hematol Transfus Cell Ther 2023:S2531-1379(23)02591-9. [PMID: 38177058 DOI: 10.1016/j.htct.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 06/27/2023] [Accepted: 10/17/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
- Reza Soleimani
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium; Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium; Hematology-Hemostasis Laboratory/Laboratory of Clinical Biology, CHU UCL Namur, Yvoir, Belgium.
| | - Julien Cabo
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium; Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium; Hematology-Hemostasis Laboratory/Laboratory of Clinical Biology, CHU UCL Namur, Yvoir, Belgium
| | - Alex Frelik
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium; Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
| | - Cécile Debry
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium; Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
| | - Catherine Mbende
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium
| | - Jacques Delcourt
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium; Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
| | - Nicolas Debortoli
- Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium; Namur Molecular Tech, CHU UCL Namur, Yvoir, Belgium
| | - Edith Renguet
- Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium; Namur Molecular Tech, CHU UCL Namur, Yvoir, Belgium
| | - Anaïs Devey
- Hospital Blood Transfusion Service, CHU de Liège, Liège, Belgium
| | - François Mullier
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium; Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium; Hematology-Hemostasis Laboratory/Laboratory of Clinical Biology, CHU UCL Namur, Yvoir, Belgium; Namur Thrombosis and Hemostasis Center (NTHC), CHU UCL Namur and UNamur Yvoir, Belgium; Namur Research Institute for Life Sciences (NARILIS), Univeristy of Namur, Namur, Belgium
| | - Jonathan Degosserie
- Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium; Namur Molecular Tech, CHU UCL Namur, Yvoir, Belgium; Namur Research Institute for Life Sciences (NARILIS), Univeristy of Namur, Namur, Belgium
| | - Laetitia Moreno Y Banuls
- Hospital Blood Transfusion Service and Donor Blood Center, CHU UCL Namur, Yvoir, Belgium; Department of Laboratory Medicine, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
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5
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Christensen RD, Bahr TM, Ilstrup SJ, Dizon-Townson DS. Alloimmune hemolytic disease of the fetus and newborn: genetics, structure, and function of the commonly involved erythrocyte antigens. J Perinatol 2023; 43:1459-1467. [PMID: 37848604 DOI: 10.1038/s41372-023-01785-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023]
Abstract
Hemolytic disease of the fetus and newborn (HDFN) can occur when a pregnant woman has antibody directed against an erythrocyte surface antigen expressed by her fetus. This alloimmune disorder is restricted to situations where transplacental transfer of maternal antibody to the fetus occurs, and binds to fetal erythrocytes, and significantly shortens the red cell lifespan. The pathogenesis of HDFN involves maternal sensitization to erythrocyte "non-self" antigens (those she does not express). Exposure of a woman to a non-self-erythrocyte antigen principally occurs through either a blood transfusion or a pregnancy where paternally derived erythrocyte antigens, expressed by her fetus, enter her circulation, and are immunologically recognized as foreign. This review focuses on the genetics, structure, and function of the erythrocyte antigens that are most frequently involved in the pathogenesis of alloimmune HDFN. By providing this information we aim to convey useful insights to clinicians caring for patients with this condition.
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Affiliation(s)
- Robert D Christensen
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA.
- Obstetric and Neonatal Operations, Intermountain Health, Salt Lake City, UT, USA.
| | - Timothy M Bahr
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA
- Obstetric and Neonatal Operations, Intermountain Health, Salt Lake City, UT, USA
| | - Sarah J Ilstrup
- Intermountain Health Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, UT, USA
| | - Donna S Dizon-Townson
- Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, and Intermountain Health, Salt Lake City, UT, USA
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6
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Chi G, Dietz L, Tang H, Snee M, Scacioc A, Wang D, Mckinley G, Mukhopadhyay SM, Pike AC, Chalk R, Burgess-Brown NA, Timmermans JP, van Putte W, Robinson CV, Dürr KL. Structural characterization of human urea transporters UT-A and UT-B and their inhibition. SCIENCE ADVANCES 2023; 9:eadg8229. [PMID: 37774028 PMCID: PMC10541013 DOI: 10.1126/sciadv.adg8229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/30/2023] [Indexed: 10/01/2023]
Abstract
In this study, we present the structures of human urea transporters UT-A and UT-B to characterize them at molecular level and to detail the mechanism of UT-B inhibition by its selective inhibitor, UTBinh-14. High-resolution structures of both transporters establish the structural basis for the inhibitor's selectivity to UT-B, and the identification of multiple binding sites for the inhibitor will aid with the development of drug lead molecules targeting both transporters. Our study also discovers phospholipids associating with the urea transporters by combining structural observations, native MS, and lipidomics analysis. These insights improve our understanding of urea transporter function at a molecular level and provide a blueprint for a structure-guided design of therapeutics targeting these transporters.
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Affiliation(s)
- Gamma Chi
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Larissa Dietz
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - Haiping Tang
- Department of Chemistry, University of Oxford, Oxford OX1 3TA, UK
- Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford OX1 3QU, UK
| | - Matthew Snee
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
| | - Andreea Scacioc
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Dong Wang
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Gavin Mckinley
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Shubhashish M. M. Mukhopadhyay
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Ashley C. W. Pike
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Rod Chalk
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Nicola A. Burgess-Brown
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
| | - Jean-Pierre Timmermans
- Laboratory of Cell Biology and Histology (CBH) at Antwerp Centre for Advanced Microscopy (ACAM), Department of Veterinary Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Wouter van Putte
- Laboratory of Cell Biology and Histology (CBH) at Antwerp Centre for Advanced Microscopy (ACAM), Department of Veterinary Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
- PUXANO, Ottergemsesteenweg Zuid 713, 9000 Gent, Belgium
| | - Carol V. Robinson
- Department of Chemistry, University of Oxford, Oxford OX1 3TA, UK
- Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford OX1 3QU, UK
| | - Katharina L. Dürr
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Nuffield Department of Medicine Research Building, Oxford OX3 7FZ, UK
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7
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Bae CO, Kwon SS, Kim S. Investigation of blood group genotype prevalence in Korean population using large genomic databases. Sci Rep 2023; 13:15326. [PMID: 37714914 PMCID: PMC10504236 DOI: 10.1038/s41598-023-42473-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/11/2023] [Indexed: 09/17/2023] Open
Abstract
Blood group antigens, which are prominently expressed in red blood cells, are important in transfusion medicine. The advent of high-throughput genome sequencing technology has facilitated the prediction of blood group antigen phenotypes based on genomic data. In this study, we analyzed data from a large Korean population to provide an updated prevalence of blood group antigen phenotypes, including rare ones. A robust dataset comprising 72,291 single nucleotide polymorphism arrays, 5318 whole-exome sequences, and 4793 whole-genome sequences was extracted from the Korean Genome and Epidemiology Study, Genome Aggregation Database, and Korean Variant Archive and then analyzed. The phenotype prevalence of clinically significant blood group antigens, including MNSs, RHCE, Kidd, Duffy, and Diego, was predicted through genotype analysis and corroborated the existing literature. We identified individuals with rare phenotypes, including 369 (0.51%) with Fy(a-b+), 188 (0.26%) with Di(a+b-), and 16 (0.02%) with Jr(a-). Furthermore, we calculated the frequencies of individuals with extremely rare phenotypes, such as p (0.000004%), Kell-null (0.000310%), and Jk(a-b-) (0.000438%), based on allele frequency predictions. These findings offer valuable insights into the distribution of blood group antigens in the Korean population and have significant implications for enhancing the safety and efficiency of blood transfusion.
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Affiliation(s)
- Cheol O Bae
- Department of Laboratory Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, 03722, South Korea
| | - Soon Sung Kwon
- Department of Laboratory Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, 03722, South Korea.
| | - Sinyoung Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, 03722, South Korea
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8
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O’Brien S, Lea RA, Jadhao S, Lee S, Sukhadia S, Arunachalam V, Roulis E, Flower RL, Griffiths L, Nagaraj SH. Genetic Characterization of Blood Group Antigens for Polynesian Heritage Norfolk Island Residents. Genes (Basel) 2023; 14:1740. [PMID: 37761880 PMCID: PMC10530796 DOI: 10.3390/genes14091740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Improvements in blood group genotyping methods have allowed large scale population-based blood group genetics studies, facilitating the discovery of rare blood group antigens. Norfolk Island, an external and isolated territory of Australia, is one example of an underrepresented segment of the broader Australian population. Our study utilized whole genome sequencing data to characterize 43 blood group systems in 108 Norfolk Island residents. Blood group genotypes and phenotypes across the 43 systems were predicted using RBCeq. Predicted frequencies were compared to data available from the 1000G project. Additional copy number variation analysis was performed, investigating deletions outside of RHCE, RHD, and MNS systems. Examination of the ABO blood group system predicted a higher distribution of group A1 (45.37%) compared to group O (35.19%) in residents of the Norfolk Island group, similar to the distribution within European populations (42.94% and 38.97%, respectively). Examination of the Kidd blood group system demonstrated an increased prevalence of variants encoding the weakened Kidd phenotype at a combined prevalence of 12.04%, which is higher than that of the European population (5.96%) but lower than other populations in 1000G. Copy number variation analysis showed deletions within the Chido/Rodgers and ABO blood group systems. This study is the first step towards understanding blood group genotype and antigen distribution on Norfolk Island.
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Affiliation(s)
- Stacie O’Brien
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Rodney A. Lea
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Sudhir Jadhao
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD 4059, Australia; (E.R.); (R.L.F.)
| | - Simon Lee
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Shrey Sukhadia
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Vignesh Arunachalam
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Eileen Roulis
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD 4059, Australia; (E.R.); (R.L.F.)
| | - Robert L. Flower
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD 4059, Australia; (E.R.); (R.L.F.)
| | - Lyn Griffiths
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Shivashankar H. Nagaraj
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
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9
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Halawani AJ, Saboor M, Abu-Tawil HI, Alhazmy AY, Mashlawi WQ, Bantun F, Mansor AS. The frequencies of Kidd blood group antigens and phenotypes among Saudi blood donors in Southwestern Saudi Arabia. Saudi J Biol Sci 2022; 29:251-254. [PMID: 35002415 PMCID: PMC8716892 DOI: 10.1016/j.sjbs.2021.08.081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The patients who require transfusion are prevalent in the Jazan Province, Saudi Arabia. Therefore, it is essential to know the frequency of blood group antigens in such a population. The Kidd blood group system (JK) has two antithetical antigens, Jka and Jkb. Antibodies to these antigens may result in delayed hemolytic transfusion reactions. The present study investigated the frequencies of Jka and Jkb and the phenotypes among Saudi blood donors living in the Jazan Province. METHODS One hundred and forty-three samples from anonymous Saudi volunteer blood donors in the Jazan Province were serotype to detect Jka and Jkb using gel card technology and determine the phenotypes of the JK blood group system. RESULTS The prevalence of Jka and Jkb antigens were 90.64% (n = 126) and 69.40% (n = 93), respectively. The JK phenotypes were 34.96% Jk(a + b - ) (n = 51), 12.59% Jk(a - b + ) (n = 18), 52.45% Jk(a + b + ) (n = 75), and 0% Jk(a - b - ). The frequencies of the JK phenotypes in the Jazan population were significantly different from those in the Asian population (P < 0.05). CONCLUSIONS We reported the frequencies of the Jka and Jkb antigens and the distribution of the JK phenotypes in a group of Saudi blood donors in the Jazan Province, Saudi Arabia. The phenotype Jk(a + b + ) was the most common among the study population. Furthermore, this study emphasizes the significance of identifying the frequency of JK antigens and phenotypes in the provinces of Saudi Arabia.
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Affiliation(s)
- Amr J. Halawani
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- SMIRES for Consultation in Specialized Medical Laboratories, Jazan University, Jazan, Saudi Arabia
| | - Muhammad Saboor
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
- Medical Research Center (MRC), Jazan University, Jazan, Saudi Arabia
| | - Hisham I. Abu-Tawil
- Department of Laboratory and Blood Bank, Prince Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia
- Department of Laboratory and Blood Bank, King Faisal Medical City for Southern Regions, Ministry of Health, Abha, Saudi Arabia
| | - Ali Y. Alhazmy
- Department of Laboratory and Blood Bank, Prince Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Waleed Q. Mashlawi
- Department of Laboratory and Blood Bank, Prince Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Farkad Bantun
- SMIRES for Consultation in Specialized Medical Laboratories, Jazan University, Jazan, Saudi Arabia
- Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah S. Mansor
- SMIRES for Consultation in Specialized Medical Laboratories, Jazan University, Jazan, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
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10
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Manrai PA, Siddon AJ, Hager KM, Hendrickson JE, Keller MA, Tormey CA. Development of anti-Jk3 associated with silenced Kidd antigen expression and a novel single nucleotide variant of the JK gene. Immunohematology 2021; 37:109-112. [PMID: 34591379 DOI: 10.21307/immunohematology-2021-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Anti-Jk3 is a rare alloantibody to a high-prevalence antigen primarily seen in individuals of Polynesian descent and is associated with a handful of well-established variants of the SLC14A1 gene. We report a case of the Jknull phenotype, associated with formation of anti-Jk3, in a patient of non-Polynesian descent. This patient, a 51-year-old woman self-described as of Jamaican and Scottish ancestry, presented to our hospital for oncologic care. The patient's blood sample typed as blood group A, D+. All screening and panel reagent red blood cells showed reactivity, ranging from 2 to 4+; autocontrol and direct antiglobulin test were both negative. Antigen phenotyping revealed Jk(a-b-), leading to suspicion for anti-Jk3, which was subsequently confirmed by our immunohematology reference laboratory. Given her reported familial background, testing of the SLC14A1 gene was performed, revealing that the patient was heterozygous for the single nucleotide variant (SNV) at c.838G>A in exon 8 and therefore carries both JK*01 and JK*02 alleles that encode Jka and Jkb, respectively. However, the patient was found to be heterozygous for several additional SNVs: c.28G>A in exon 3; c.191G>A, c.226G>A, and c.303G>A in exon 4; and c.757T>C in exon 7. The patient's Jk(b-) phenotype can be explained by coinheritance of c.838A with c.191G>A, which defines null allele JK*02N.09. Coinheritance of SNVs c.28G>A and c.838G with rare SNV c.757C that is predicted to cause a non-conservative amino acid change (p.S253P) likely accounts for the complete serologic absence of Jka and the ability to form anti-Jk3 in this case. This finding would represent a new JK*01 null allele. This evaluation illustrates the importance of genetic analysis in identifying the factors preventing a high-prevalence antigen from being expressed, particularly when discovered outside of an expected racial or ethnic group. Anti-Jk3 is a rare alloantibody to a high-prevalence antigen primarily seen in individuals of Polynesian descent and is associated with a handful of well-established variants of the SLC14A1 gene. We report a case of the Jknull phenotype, associated with formation of anti-Jk3, in a patient of non-Polynesian descent. This patient, a 51-year-old woman self-described as of Jamaican and Scottish ancestry, presented to our hospital for oncologic care. The patient’s blood sample typed as blood group A, D+. All screening and panel reagent red blood cells showed reactivity, ranging from 2 to 4+; autocontrol and direct antiglobulin test were both negative. Antigen phenotyping revealed Jk(a–b–), leading to suspicion for anti-Jk3, which was subsequently confirmed by our immunohematology reference laboratory. Given her reported familial background, testing of the SLC14A1 gene was performed, revealing that the patient was heterozygous for the single nucleotide variant (SNV) at c.838G>A in exon 8 and therefore carries both JK*01 and JK*02 alleles that encode Jka and Jkb, respectively. However, the patient was found to be heterozygous for several additional SNVs: c.28G>A in exon 3; c.191G>A, c.226G>A, and c.303G>A in exon 4; and c.757T>C in exon 7. The patient’s Jk(b–) phenotype can be explained by coinheritance of c.838A with c.191G>A, which defines null allele JK*02N.09. Coinheritance of SNVs c.28G>A and c.838G with rare SNV c.757C that is predicted to cause a non-conservative amino acid change (p.S253P) likely accounts for the complete serologic absence of Jka and the ability to form anti-Jk3 in this case. This finding would represent a new JK*01 null allele. This evaluation illustrates the importance of genetic analysis in identifying the factors preventing a high-prevalence antigen from being expressed, particularly when discovered outside of an expected racial or ethnic group.
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Affiliation(s)
- P A Manrai
- Department of Laboratory Medicine, Yale School of Medicine , 333 Cedar Street, New Haven, CT 06520
| | - A J Siddon
- Department of Laboratory Medicine, Yale School of Medicine , New Haven, CT
| | - K M Hager
- Department of Laboratory Medicine, Yale School of Medicine , New Haven, CT
| | - J E Hendrickson
- Department of Laboratory Medicine, Yale School of Medicine , New Haven, CT
| | - M A Keller
- National Molecular Laboratory, American Red Cross , Philadelphia, PA
| | - C A Tormey
- Department of Laboratory Medicine, Yale School of Medicine , New Haven, CT
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11
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Lin M, Liu M, Zhang S, Chen C, Wang J. Different Types of Minor Blood Group Incompatibility Causing Haemolytic Disease of Neonates in one of the National Children's Medical Centre in China. J Blood Med 2021; 12:497-504. [PMID: 34211305 PMCID: PMC8240843 DOI: 10.2147/jbm.s303633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/20/2021] [Indexed: 01/27/2023] Open
Abstract
Purpose To review the neonatal cases with different types of minor blood group incompatible haemolytic diseases in China, and to improve the clinical understanding and management. Materials and Methods Seven cases from January, 1st, 2013 to December 31st, 2019 were searched out and reviewed retrospectively. All clinical data and laboratory findings were collected. Results There were totally seven cases enrolled including three cases of MNS, three of Diego, and one of Kidd combined with Rh, anti-RhE incompatibility. Among the seven cases, two had intrauterine transfusion, two underwent exchange transfusion, five received intravenous immune globulin, five cases developed anaemia, and three of them had transfusion. But among them, only four were found to have positive antibody screening and three were confirmed HDN with antibody types antenatally. Conclusion The clinical presentation is diverse. Antibody screening followed by the technique of peak systolic velocity in the fetal middle cerebral artery (MCA-PSV) helps to filter out the severe cases.
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Affiliation(s)
- Mingchun Lin
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China.,Neonatal Fellowship Training at Children's Hospital of Fudan University, Yueqing Maternal and Child Health Hospital, Wenzhou, Zhejiang Province, People's Republic of China
| | - Meixiu Liu
- Blood Bank, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Shulian Zhang
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Chao Chen
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Jin Wang
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
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12
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Cabo J, Brochier A, Saussoy P, van Dievoet MA, Capirchio L, Delire B, Deneys V. Positive direct antiglobulin test in COVID-19 patients: Decision-making process. Transfus Clin Biol 2021; 28:414-419. [PMID: 34111506 PMCID: PMC8183097 DOI: 10.1016/j.tracli.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 01/04/2023]
Abstract
In this unprecedented crisis of severe acute respiratory syndrome coronavirus 2 and its associated coronavirus disease 2019 (COVID-19), polymerase chain reaction and then serological testing platforms have been massively developed to face the important screening demand. Polymerase chain reaction and serological testing platforms are not the only actors impacted by the crisis, transfusion services are facing important difficulties. A positive direct antiglobulin test is frequently observed for patients encountering COVID-19. Patients with severe symptoms may develop anaemia and become good candidates for blood transfusions. The interpretation of a positive direct antiglobulin test for patients recently transfused and suffering from COVID-19 is complex. The differentiation between COVID-19 induced antibodies and possible associated transfusion alloantibodies is therefore crucial. In this context, the elution technique incorporated in an appropriate decision-making process plays its full role. This intricate topic is presented through a case report followed by literature review and finally decision-making process for COVID-19 patients necessitating red blood cells administration.
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Affiliation(s)
- J Cabo
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - A Brochier
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - P Saussoy
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - M-A van Dievoet
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - L Capirchio
- Gastroenterology department, Cliniques Universitaires St Luc, Université catholique de Louvain, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - B Delire
- Gastroenterology department, Cliniques Universitaires St Luc, Université catholique de Louvain, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - V Deneys
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
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13
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Antigen density dictates RBC clearance, but not antigen modulation, following incompatible RBC transfusion in mice. Blood Adv 2021; 5:527-538. [PMID: 33496748 DOI: 10.1182/bloodadvances.2020002695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/17/2020] [Indexed: 12/17/2022] Open
Abstract
Incompatible red blood cell (RBC) transfusion can result in life-threatening transfusion complications that can be challenging to manage in patients with transfusion-dependent anemia. However, not all incompatible RBC transfusions result in significant RBC removal. One factor that may regulate the outcome of incompatible RBC transfusion is the density of the incompatible antigen. Despite the potential influence of target antigen levels during incompatible RBC transfusion, a model system capable of defining the role of antigen density in this process has not been developed. In this study, we describe a novel model system of incompatible transfusion using donor mice that express different levels of the KEL antigen and recipients with varying anti-KEL antibody concentrations. Transfusion of KEL+ RBCs that express high or moderate KEL antigen levels results in rapid antibody-mediated RBC clearance. In contrast, relatively little RBC clearance was observed following the transfusion of KEL RBCs that express low KEL antigen levels. Intriguingly, unlike RBC clearance, loss of the KEL antigen from the transfused RBCs occurred at a similar rate regardless of the KEL antigen density following an incompatible transfusion. In addition to antigen density, anti-KEL antibody levels also regulated RBC removal and KEL antigen loss, suggesting that antigen density and antibody levels dictate incompatible RBC transfusion outcomes. These results demonstrate that antibody-induced antigen loss and RBC clearance can occur at distinct antigen density thresholds, providing important insight into factors that may dictate the outcome of an incompatible RBC transfusion.
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14
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Allhoff W, Weidner L, Lindlbauer N, Grüner L, Libisch M, Schistal E, Jungbauer C. Jk null alleles in two patients with anti-Jk3. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2021; 19:237-243. [PMID: 33539287 PMCID: PMC8092040 DOI: 10.2450/2021.0349-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/23/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND As of publication, a total of 41 null alleles have been acknowledged by the International Society of Blood Transfusion (ISBT) to cause the rare Jknull phenotype, but none have been discovered in Austria thus far. MATERIALS AND METHODS Two patients with anti-Jk3 were serologically identified by a positive antibody screening and typed as Jk(a-b-). The initial genotyping using an SSP-PCR method for the common 838A/G polymorphism indicated a JK*02/02, or JK*01/02 genotype, respectively. To find the disruptive mutations, Sanger sequencing was performed and results were compared to the reference sequence. The patient's antibodies were characterized with a monocyte monolayer assay (MMA) for their potential clinical significance. RESULTS Three novel null-mutations of the SLC14A1 gene were found in two patients. Patient 1 was homozygous for a 10bp deletion in exon 4 (c.157_166del on JK*02). Testing of her family members revealed Mendelian inheritance of the deletional allele. The other patient was compound heterozygous for two mutations: one allele carrying a single base deletion in exon 4 (c.267delC on JK*01) and the other a splice site mutation in intron 3 (c.152-1g>a on JK*02). The MMA results suggest high clinical significance of the anti-Jk3 in both patients. DISCUSSION The detected mutations led to Jknull phenotypes and are the first description of JKnull alleles in the Austrian population.
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Affiliation(s)
- Wolfgang Allhoff
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Vienna, Austria
| | - Lisa Weidner
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Vienna, Austria
| | - Nadja Lindlbauer
- Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria
| | - Lydia Grüner
- Department of Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria
| | - Manuel Libisch
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Vienna, Austria
| | - Elisabeth Schistal
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Vienna, Austria
| | - Christof Jungbauer
- Austrian Red Cross, Blood Service for Vienna, Lower Austria and Burgenland, Vienna, Austria
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15
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Kim GL, Kim Y, Chang YP, Seo JH, Lee MJ. Successful Treatment of Severe Hemolytic Disease of the Newborn Caused by Anti-Jk b. CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2021. [DOI: 10.15264/cpho.2021.28.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Goo Lyeon Kim
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Yoonsoo Kim
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
| | - Young Pyo Chang
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
- Dankook University College of Medicine, Cheonan, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
- Dankook University College of Medicine, Cheonan, Korea
| | - Mee Jeong Lee
- Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
- Dankook University College of Medicine, Cheonan, Korea
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16
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Yu L, Liu T, Fu S, Li L, Meng X, Su X, Xie Z, Ren J, Meng Y, Lv X, Du Y. Physiological functions of urea transporter B. Pflugers Arch 2019; 471:1359-1368. [PMID: 31734718 PMCID: PMC6882768 DOI: 10.1007/s00424-019-02323-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 11/04/2022]
Abstract
Urea transporters (UTs) are membrane proteins in the urea transporter protein A (UT-A) and urea transporter protein B (UT-B) families. UT-B is mainly expressed in endothelial cell membrane of the renal medulla and in other tissues, including the brain, heart, pancreas, colon, bladder, bone marrow, and cochlea. UT-B is responsible for the maintenance of urea concentration, male reproductive function, blood pressure, bone metabolism, and brain astrocyte and cardiac functions. Its deficiency and dysfunction contribute to the pathogenesis of many diseases. Actually, UT-B deficiency increases the sensitivity of bladder epithelial cells to apoptosis triggers in mice and UT-B-null mice develop II-III atrioventricular block and depression. The expression of UT-B in the rumen of cow and sheep may participate in digestive function. However, there is no systemic review to discuss the UT-B functions. Here, we update research approaches to understanding the functions of UT-B.
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Affiliation(s)
- Lanying Yu
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Tiantian Liu
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Shuang Fu
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Li Li
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Xiaoping Meng
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Xin Su
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Zhanfeng Xie
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Jiayan Ren
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China
| | - Yan Meng
- Department of Pathophysiology, College of Basic Medicine, Jilin University, Changchun, 130021, Jilin, People's Republic of China.
| | - Xuejiao Lv
- Department of Respiratory Medicine, the Second Affiliated Hospital of Jilin University, Changchun, 130041, Jilin, People's Republic of China.
| | - Yanwei Du
- Changchun University of Chinese Medicine, Changchun, 130117, People's Republic of China.
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17
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When might transferrin, hemopexin or haptoglobin administration be of benefit following the transfusion of red blood cells? Curr Opin Hematol 2019; 25:452-458. [PMID: 30281034 DOI: 10.1097/moh.0000000000000458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW After transfusion, a percentage of red blood cells undergo hemolysis within macrophages. Intravascular exposures to hemin and hemoglobin (Hb) can occur after storage bag hemolysis, some transfusion reactions, during use of medical assist devices and in response to bacterial hemolysins. Proteins that regulate iron, hemin and Hb either become saturated after iron excess (transferrin, Tf) or depleted after hemin (hemopexin, Hpx) and Hb (haptoglobin, Hp) excess. Protein saturation or stoichiometric imbalance created by transfusion increases exposure to non-Tf bound iron, hemin and Hb. Tf, Hpx and Hp are being developed for hematological disorders where iron, hemin and Hb contribute to pathophysiology. However, complexed to their ligands, each represents a potential iron source for pathogens, which may complicate the use of these proteins. RECENT FINDINGS Erythrophagocytosis by macrophages and processes of cell death that lead to reactive iron exposure are increasingly described. In addition, the effects of transfusion introduced circulatory hemin and Hb are described in the literature, particularly following large volume transfusion, infection and during concomitant medical device use. SUMMARY Supplementation with Tf, Hpx and Hp suggests therapeutic potential in conditions of extravascular/intravascular hemolysis. However, their administration following transfusion may require careful assessment of concomitant disease.
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18
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Inhaled nitric oxide prevents systemic and pulmonary vasoconstriction due to hemoglobin-based oxygen carrier infusion: A case report. J Crit Care 2019; 51:213-216. [PMID: 30709560 PMCID: PMC10150649 DOI: 10.1016/j.jcrc.2018.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/02/2018] [Accepted: 04/12/2018] [Indexed: 11/24/2022]
Abstract
Hemoglobin-based oxygen carriers (HBOCs) are used in extreme circumstances to increase hemoglobin concentration and improve oxygen delivery when allogenic red blood cell transfusions are contraindicated or not immediately available. However, HBOC-induced severe pulmonary and systemic vasoconstriction due to peripheral nitric oxide (NO) scavenging has stalled its implementation in clinical practice. We present a case of an 87 year-old patient with acute life-threatening anemia who received HBOC while breathing NO gas. This case shows that inhaled NO allows for the safe use of HBOC infusion by preventing HBOC-induced pulmonary and systemic vasoconstriction.
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19
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Wu PC, Chyan T, Feng S, Chen M, Pai S. Genotyping and serotyping profiles showed weak Jk
a
presentation for previously typed as Jk
null
donors. Vox Sang 2019; 114:268-274. [DOI: 10.1111/vox.12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/08/2019] [Accepted: 01/20/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Ping Chun Wu
- Taipei Blood Center Taiwan Blood Services Foundation Taipei Taiwan
| | - Tsui‐Wei Chyan
- Taipei Blood Center Taiwan Blood Services Foundation Taipei Taiwan
| | - Shu‐Hui Feng
- Taipei Blood Center Taiwan Blood Services Foundation Taipei Taiwan
| | - Ming‐Hung Chen
- Taipei Blood Center Taiwan Blood Services Foundation Taipei Taiwan
| | - Shun‐Chung Pai
- Taipei Blood Center Taiwan Blood Services Foundation Taipei Taiwan
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20
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Boateng LA, Campbell AD, Davenport RD, Osei-Akoto A, Hugan S, Asamoah A, Schonewille H. Red blood cell alloimmunization and minor red blood cell antigen phenotypes in transfused Ghanaian patients with sickle cell disease. Transfusion 2019; 59:2016-2022. [DOI: 10.1111/trf.15197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Lilian A. Boateng
- Medical Laboratory Technology; Kwame Nkrumah University of Science and Technology; Kumasi Ghana
- International Public Health; Liverpool School of Tropical Medicine; Liverpool United Kingdom
| | - Andrew D. Campbell
- Paediatrics; George Washington School of Medicine and Health Sciences; Washington District of Columbia
| | - Robertson D. Davenport
- Blood Bank and Transfusion Services; University of Michigan Health Systems; Ann Arbor Michigan
| | - Alex Osei-Akoto
- Child Health, School of Medical Sciences; Kwame Nkrumah University of Science and Technology; Kumasi Ghana
| | - Sheri Hugan
- Blood Bank and Transfusion Services; University of Michigan Health Systems; Ann Arbor Michigan
| | - Akwasi Asamoah
- Medical Laboratory Technology; Kwame Nkrumah University of Science and Technology; Kumasi Ghana
| | - Henk Schonewille
- Department of Experimental Immunohematology; Sanquin; Amsterdam Netherlands
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21
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Shah SB, Bhargava AK, Chawla R, Pathak A. Robotic hysterectomy in Trendelenburg position in a severely anaemic JKa alloimmunised patient with impending high-output cardiac failure: An anaesthetic challenge. Indian J Anaesth 2018; 62:385-388. [PMID: 29910498 PMCID: PMC5971629 DOI: 10.4103/ija.ija_5_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Kidd blood group alloimmunisation, though extremely rare, may produce considerable morbidity, and even mortality. Severe anaemia and impending high-output cardiac failure requiring blood transfusion should be weighed against the risk of severe transfusion reactions even with fully cross-matched blood. Kidd antibodies are a common cause of delayed haemolytic transfusion reaction (DHTR) since they have a tendency remain undetectable in plasma. A low -grade DHTR (second hit) was grossly amplified by a second DHTR (third hit) superimposed on it in our patient leading to severe haemolysis with serum bilirubin reaching 68 mg%. Indirect antiglobulin test (indirect Coombs reaction) should ideally be performed in all patients (scheduled for major surgery requiring blood transfusion) who have experienced a previous pregnancy or blood transfusion. Non-invasive continuous haemoglobin monitoring and non-invasive cardiac output monitoring can prove invaluable tools in management.
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Affiliation(s)
| | | | - Rajiv Chawla
- Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Amardeep Pathak
- Department of Transfusion Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
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22
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Lawicki S, Coberly EA, Lee LA, Johnson M, Eichbaum Q. Jk3 alloantibodies during pregnancy-blood bank management and hemolytic disease of the fetus and newborn risk. Transfusion 2018; 58:1157-1162. [PMID: 29479723 DOI: 10.1111/trf.14548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 01/04/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Kidd-null phenotype, Jk(a-b-), occurs in individuals who do not express the JK glycoprotein. Jk(a-b-) individuals can make an antibody against the Jk3 antigen, a high-incidence antigen present in more than 99.9% of most populations. This presents many challenges to the blood bank including identification of the antibody, masking of other antibodies, and how to provide transfusion support given the rarity of Jk3-negative blood products. Kidd antibodies may cause acute and delayed hemolytic reactions as well as hemolytic disease of the fetus and newborn (HDFN). In this article, we present a series of four practical cases of pregnant women with the anti-Jk3 alloantibody that demonstrate a range of clinical presentations of Kidd-related HDFN. STUDY DESIGN AND METHODS We retrospectively reviewed the clinical and blood bank records for four patients and their newborns encountered at institutions in Tennessee, Missouri, Hawaii, and Guam with an anti-Jk3 identified during pregnancy. RESULTS Two cases showed no significant evidence for HDFN, while two cases were of mild-to-moderate severity requiring early delivery due to elevated middle cerebral artery (MCA) flow velocities but requiring only phototherapy for hyperbilirubinemia. No intrauterine or neonatal transfusions were necessary. Anti-Jk3 alloantibody titers ranged from 2 to 128. CONCLUSION Clinical manifestations of anti-Jk3 HDFN are generally mild to moderate. Anti-Jk3 titers were not found to correlate directly with HDFN severity. We suggest a titer of 16 to 32 as a cutoff for implementing enhanced monitoring of fetal MCA flow velocities, as such titers may be indicative of elevated HDFN risk.
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Affiliation(s)
- Shaun Lawicki
- Department of Pathology, University of Hawaii, Honolulu, Hawaii
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Emily A Coberly
- Department of Pathology and Anatomical Sciences, University of Missouri Health System, Columbia, Missouri
| | - Laura A Lee
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mary Johnson
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Quentin Eichbaum
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
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23
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Jakobsen MA, Dellgren C, Sheppard C, Yazer M, Sprogøe U. The use of next-generation sequencing for the determination of rare blood group genotypes. Transfus Med 2017; 29:162-168. [PMID: 29265667 DOI: 10.1111/tme.12496] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 11/13/2017] [Accepted: 11/26/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Next-generation sequencing (NGS) for the determination of rare blood group genotypes was tested in 72 individuals from different ethnicities. BACKGROUND Traditional serological-based antigen detection methods, as well as genotyping based on specific single nucleotide polymorphisms (SNPs) or single nucleotide variants (SNVs), are limited to detecting only a limited number of known antigens or alleles. NGS methods do not have this limitation. METHODS NGS using Ion torrent Personal Genome Machine (PGM) was performed with a customised Ampliseq panel targeting 15 different blood group systems on 72 blood donors of various ethnicities (Caucasian, Hispanic, Asian, Middle Eastern and Black). RESULTS Blood group genotypes for 70 of 72 samples could be obtained for 15 blood group systems in one step using the NGS assay and, for common SNPs, are consistent with previously determined genotypes using commercial SNP assays. However, particularly for the Kidd, Duffy and Lutheran blood group systems, several SNVs were detected by the NGS assay that revealed additional coding information compared to other methods. Furthermore, the NGS assay allowed for the detection of genotypes related to VEL, Knops, Gerbich, Globoside, P1PK and Landsteiner-Wiener blood group systems. CONCLUSIONS The NGS assay enables a comprehensive genotype analysis of many blood group systems and is capable of detecting common and rare alleles, including alleles not currently detected by commercial assays.
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Affiliation(s)
- M A Jakobsen
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark
| | - C Dellgren
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - C Sheppard
- Virginia Blood Services, Richmond, Virginia, USA
| | - M Yazer
- University of Southern Denmark, Odense, Denmark.,Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - U Sprogøe
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
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24
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Dias T, Patabendige M, Kajendran J, Kularathna M. Jk3 antibodies complicated with severe fetal anaemia requiring intrauterine transfusion: a case report. Transfus Med 2017; 29:214-216. [PMID: 29178628 DOI: 10.1111/tme.12490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/29/2017] [Accepted: 10/30/2017] [Indexed: 12/01/2022]
Affiliation(s)
- T Dias
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - M Patabendige
- University Unit of Obstetrics and Gynaecology, North Colombo Teaching Hospital (NCTH), Ragama, Sri Lanka
| | - J Kajendran
- University Unit of Obstetrics and Gynaecology, North Colombo Teaching Hospital (NCTH), Ragama, Sri Lanka
| | - M Kularathna
- Blood Bank, North Colombo Teaching Hospital (NCTH), Ragama, Sri Lanka
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