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Simtong P, Jumnainsong A, Leelayuwat C. Genetic profile of RHCE, Kell, Duffy, Kidd, Diego and MNS hybrid glycophorins blood groups in ethnic northeastern Thais: Alleles, genotypes and risk of alloimmunisation. Transfus Med 2024; 34:287-297. [PMID: 38804163 DOI: 10.1111/tme.13055] [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: 01/02/2024] [Revised: 04/17/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Antibodies against blood group antigens play a key role in the pathophysiology of haemolytic transfusion reactions (HTRs) and haemolytic disease of the fetus and newborn (HDFN). This study aimed to determine the frequencies of alleles, genotypes, and risk of alloimmunisation of clinically significant blood group systems in ethnic northeastern Thais. METHODS In total, 345 unrelated, healthy, ethnic northeastern Thais were tested using the in-house PCR-sequence specific primers (PCR-SSP) method for simultaneously genotyping of RHCE, Kell, Duffy, Kidd, Diego and MNS glycophorin hybrids and results confirmed by Sanger sequencing. RESULTS In this cohort, the alleles RHCE*C (81.0%) and RHCE*e (84.8%) were more prevalent than RHCE*c (19.0%) and RHCE*E (15.2%). The most common predicted haplotype combinations of the RHCE alleles were C+c-E-e+(R1R1) (59.4%) followed by the C+c+E+e+ (R1R2) (20.6%) and C+c+E-e+ (R1r) (11.3%). The KEL*01 allele was not found in this study. The frequencies of FY*01 and FY*02 were 88.3% and 11.7%, respectively. The genotype FY*02/02 was found in four samples (1.2%). The frequencies of JK*01 and JK*02 were 52.5% and 47.5%, respectively. Homozygous JK*02/02 was found in 81 samples (23.5%). The frequencies of DI*01 and DI*02 were 0.6% and 99.4%, respectively. In total, 64 samples (18.6%) were found to carry the MNS glycophorin hybrids. CONCLUSIONS Our results indicated a possible high risk of c, E, Fyb, Jka, Jkb and Mia alloimmunisation in these populations. Moreover, methods established for genotyping clinically significant blood groups in this study can now be utilised in routine clinical application.
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Affiliation(s)
- Piyapong Simtong
- Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Amonrat Jumnainsong
- Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chanvit Leelayuwat
- Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
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Sonker A, Dubey A, Mohan Y. Molecular typing of Kell, Kidd, and Duffy antigens in direct antiglobulin test-positive autoimmune hemolytic anemia patients. Asian J Transfus Sci 2024; 18:56-61. [PMID: 39036688 PMCID: PMC11259340 DOI: 10.4103/ajts.ajts_174_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/26/2023] [Accepted: 10/18/2023] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND In autoimmune hemolytic anemia (AIHA) patients, conventional pretransfusion testing is difficult to interpret due to the presence of autoantibodies which may show panreactivity. Molecular phenotyping of red cell antigens could potentially be used to precisely match blood units, thereby reducing the need to perform intensive serologic laboratory testing, hence time delay in providing transfusion to such patients. The aim of this study is to perform the molecular typing for Kell, Kidd, and Duffy blood group antigens in direct antiglobulin test (DAT)-positive red blood cells of AIHA patients and provide corresponding antigen-matched blood for transfusion therapy. MATERIALS AND METHODS Blood samples from 50 normal blood donors and 30 DAT-positive AIHA patients were tested using standard serological techniques and polymerase chain reaction-based methods for Kell (K/k), Kidd (Jka/Jkb), and Duffy (Fya/Fyb) blood group systems. Five patients requiring blood transfusion were given donor blood units identical for Kell, Kidd, and Duffy antigens and followed up. RESULTS Genotyping and phenotyping results were 100% concordant for normal blood donors. Serological phenotyping of minor red cell antigens showed varied degree of agglutination for AIHA patients. The molecular typing was able to detect the antigen frequency accurately in all samples. The results of genotyping were used to provide Kell-, Kidd-, and Duffy-matched blood for transfusion therapy to AIHA patients with no adverse reaction. CONCLUSION Molecular blood group typing has proved immensely useful in the determination of actual antigen profile and hence in providing appropriate transfusion support in patients with AIHA reduced risk of transfusion reactions and alloimmunization.
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Affiliation(s)
- Atul Sonker
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Anju Dubey
- Department of Transfusion Medicine, Kalyan Singh Super Speciality Cancer Institute, Lucknow, Uttar Pradesh, India
| | - Yatendra Mohan
- Department of Transfusion Medicine, S.N. Medical College, Agra, Uttar Pradesh, India
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Jadoon SA, Salamat N, Khan SA, Yazdani MS, Khatak N, Naeem MA. Genotyping for Dombrock blood group alleles in Northern Pakistani blood donors. Immunohematology 2021; 37:113-117. [PMID: 34591376 DOI: 10.21307/immunohematology-2021-016] [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
Genotyping can be used to identify rare blood group antigens and to solve suspected blood group discrepancies, particularly when serologic methods are limited. Unfortunately, only a few such studies have been performed in Pakistan. The present study was conducted to determine the frequency of Dombrock blood group alleles by genotyping samples from blood donors from the north of Pakistan. Blood samples were taken with consent from 300 blood donors; DNA was extracted and tested for DO*01 and DO*02 alleles by sequence-specific primer polymerase chain reaction (PCR-SSP), followed by gel electrophoresis. Allele frequencies were calculated. The observed and expected genotype frequencies were compared using the χ2 test. The allele frequencies for DO*01 and DO*02 were 0.40 and 0.60, respectively. Genotype frequencies were in Hardy-Weinberg equilibrium. This study in Pakistani blood donors provides Dombrock blood group allele frequencies by PCR-SSP. This approach is efficient and economical and can be applied in developing countries. The findings can contribute to the development of in-house red blood cell panels, identification of rare blood types, and establishment of a national rare blood donor program. Genotyping can be used to identify rare blood group antigens and to solve suspected blood group discrepancies, particularly when serologic methods are limited. Unfortunately, only a few such studies have been performed in Pakistan. The present study was conducted to determine the frequency of Dombrock blood group alleles by genotyping samples from blood donors from the north of Pakistan. Blood samples were taken with consent from 300 blood donors; DNA was extracted and tested for DO*01 and DO*02 alleles by sequence-specific primer polymerase chain reaction (PCR-SSP), followed by gel electrophoresis. Allele frequencies were calculated. The observed and expected genotype frequencies were compared using the χ2 test. The allele frequencies for DO*01 and DO*02 were 0.40 and 0.60, respectively. Genotype frequencies were in Hardy-Weinberg equilibrium. This study in Pakistani blood donors provides Dombrock blood group allele frequencies by PCR-SSP. This approach is efficient and economical and can be applied in developing countries. The findings can contribute to the development of in-house red blood cell panels, identification of rare blood types, and establishment of a national rare blood donor program.
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Affiliation(s)
- S A Jadoon
- Army Medical College , Rawalpindi, Pakistan, Jadoon House H#107/8, S#11, Habibullah Colony, Abbottabad, Khyber Pakhtunkhwa , Pakistan
| | - N Salamat
- P-First Solutions , Islamabad , Pakistan
| | - S A Khan
- National University of Medical Sciences , Rawalpindi , Pakistan
| | - M S Yazdani
- Combined Military Hospital , Abbottabad , Pakistan
| | - N Khatak
- Combined Military Hospital Medical College , Lahore , Pakistan
| | - M A Naeem
- Armed Forces Institute of Transfusion , Rawalpindi , Pakistan
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Sarihi R, Oodi A, Dadkhah Tehrani R, Jalali SF, Mardani F, Azarkeivan A, Gudarzi S, Amirizadeh N. Blood group genotyping in alloimmunized multi-transfused thalassemia patients from Iran. Mol Genet Genomic Med 2021; 9:e1701. [PMID: 33963817 PMCID: PMC8372074 DOI: 10.1002/mgg3.1701] [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: 02/03/2021] [Revised: 03/02/2021] [Accepted: 04/13/2021] [Indexed: 01/19/2023] Open
Abstract
Objectives Serological methods may not be reliable for RBC antigen typing, especially in multi‐transfused patients. The blood group systems provoking the most severe transfusion reactions are mainly Rh, Kell, Kidd, and Duffy. We intended to determine the genotype of these blood group system antigens among Iranian alloimmunized thalassemia patients using molecular methods and compare the results with serological phenotyping. Methods Two hundred patients participated in this study. Blood group phenotype and genotype were determined using the serological method and PCR‐SSP, respectively. The genotypes of patients with incompatibility between phenotype and genotype were re‐evaluated by RFLP‐PCR and confirmed by DNA sequencing. Results Discrepancies between phenotype and genotype results were found in 132 alleles and 83 (41.5%) patients; however, there was complete accordance between the three genotyping methods. Most discrepancies were detected in Rh and Duffy systems with 47 and 45 cases, respectively, and the main discrepancy was in the FY*B/FY*B allele when serologically showed Fy(a+b+). All 39 undetermined phenotypes, due to mixed‐field reactions, were resolved by molecular genotyping. Conclusion Molecular genotyping is more reliable compared with the serological method, especially in multi‐transfused patients. Therefore, the addition of blood group genotyping to serological assays can lead to an antigen‐matched transfusion in these patients.
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Affiliation(s)
- Reyhaneh Sarihi
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Arezoo Oodi
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Raziyeh Dadkhah Tehrani
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Seyedeh Farzaneh Jalali
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Fahimeh Mardani
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Azita Azarkeivan
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Samira Gudarzi
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Naser Amirizadeh
- Blood transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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Gholamrezazade A, Amirizadeh N, Oodi A. Genotyping analysis of the MNS blood group system of thalassemia patients with alloantibodies in Iran. Transfus Apher Sci 2020; 60:103006. [PMID: 33229298 DOI: 10.1016/j.transci.2020.103006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Serological methods are unreliable for accurate determination of blood group antigens in multi-transfused thalassemia patients. The MNS blood group system has five high-frequency antigens. Many studies demonstrated that some antibodies including anti-S, anti-s, and anti-U may cause acute and delayed transfusion reactions and hemolytic disease of the fetus and newborn. This study aimed to determine the genotype of the MNS blood group in thalassemia patients with alloantibodies by molecular methods. MATERIAL AND METHODS In this study, 104 blood samples from thalassemia patients were collected. The blood group phenotype for M, N, S and s antigens was determined by the tube hemagglutination method. MNS blood group genotyping was performed using PCR-SSP and DNA Sequencing methods. RESULTS All patients were genotyped with a total of 6 pairs of primers. Discrepancies between genotype and phenotype were observed in 22 patients with S/s alleles and 2 patients with M/N alleles, however, there was full accordance between the results of SSP-PCR and DNA sequencing. The frequency of MNS blood group alleles was determined as follows: 25 % MNSs, 23 % MNss, 21 % MMSs, 9% MMSS, 9% MMss, 8% NNss, 2%MNSS, and NNSS, NNSs, MM genotypes at 1% each. CONCLUSION In conclusion, molecular genotyping is more reliable than serological methods in multiple transfusion patients and can lead to a more compatible blood unit for transfusion in these patients.
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Affiliation(s)
- Atefe Gholamrezazade
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - Naser Amirizadeh
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - Arezoo Oodi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
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Vasco M, Costa D, Scognamiglio M, Signoriello G, Alfano R, Magnussen K, Napoli C. Evidences on overweight of regular blood donors in a center of Southern Italy. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kidd Blood Group Genotyping for Thalassemia Patient in Iran. Indian J Hematol Blood Transfus 2020; 36:550-555. [PMID: 32647431 DOI: 10.1007/s12288-020-01283-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 04/18/2020] [Indexed: 01/26/2023] Open
Abstract
We aimed to determine the JK genotype in thalassemia patients from Iran using different molecular methods to compare with phenotyping results. We also aimed to standardize for the first time, the Tetra-Primer ARMS PCR method for JK genotyping. The serology method cannot correctly determine the phenotype of blood group antigens in patients with multiple blood transfusions. Peripheral blood samples were taken from two hundred alloimmunized thalassemic patients in Tehran Adult Thalassemic Clinic. The samples were tested phenotypically by routine serological methods. After DNA Extraction, SSP-PCR was performed. DNA sequencing and PCR-RFLP were used to confirm the SSP-PCR results. Discrepancies were found between the phenotype and genotype in 32 out of 200 cases. In 16 cases phenotype was determined as Jk (a + b +) but genotype was JK*A/JK*A, in 14 cases phenotype was Jk (a + b +) while the genotype showed JK*B/JK*B, 1 case had been phenotyped as Jk (a + b -) but it was genotyped as JK*A/JK*B and 1 case had been phenotyped as Jk (a - b +) but it was genotyped as JK*A/JK*B. Serological results for a few samples could not be confirmed because of mix-field agglutination. The genotyping however verified the presence of Kidd alleles. Molecular methods are a valuable tool to predict blood group phenotypes in multi-transfused patients in order to select RBC units for a perfect matching improving blood transfusion and preventing alloimmunization. Also Tetra-Primer ARMS PCR is simple and cost effective methods that could be alternative by conventional Molecular methods.
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Belsito A, Costa D, Signoriello S, Fiorito C, Tartaglione I, Casale M, Perrotta S, Magnussen K, Napoli C. Clinical outcome of transfusions with extended red blood cell matching in β-thalassemia patients: A single-center experience. Transfus Apher Sci 2018; 58:65-71. [PMID: 30591410 DOI: 10.1016/j.transci.2018.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/31/2018] [Accepted: 11/26/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND The development of alloantibodies may complicate the management of patients with β-thalassemia. An extended antigenic matching may reduce the risk of alloimmunization. Our previous study showed that the introduction of molecular red blood cell (RBC) typing allows finding suitable blood units for multi-transfused patients. The aim of this study was to evaluate the benefit of RBC transfusion with extended antigenic match. MATERIALS AND METHODS At the University of Campania "L. Vanvitelli", we selected β-thalassemia major patients (age ≤23 years), without preformed alloantibodies. Data of patients receiving transfusion of leukoreduced RBC units for a period of one year with partial better match (PBM) including ABO, RhD, C/c, E/e, K/k antigens and consecutive one year with extended match (EM) including ABO, RhD, C/c, E/e, K/k, Fya/Fyb, Jka/Jkb, M/N, S/s antigens, were compared. RESULTS Eighteen patients, 8 males and 10 females with a mean age of 15.4 years (6.4 SD) received a mean number of 41.2 (6.0 SD) RBC units transfused with PBM and 41.8 (6.2 SD) with EM protocols. After two years of RBC transfusions with both antigen matching protocols, no new alloantibodies were developed in patients. No significant differences in Hb concentration and volume of RBC transfused were found between PBM and EM protocols. CONCLUSIONS Thalassemia patients may benefit from receiving RBC transfusions based on extended antigen matching as demonstrated by the lack of new alloantibodies. However, our data show a high concordance between PBM and EM protocols considering pre-transfusion Hb, increment of Hb and volume of RBC transfused.
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Affiliation(s)
- A Belsito
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), University of Campania "L. Vanvitelli", Naples, Italy.
| | - D Costa
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), University of Campania "L. Vanvitelli", Naples, Italy
| | - S Signoriello
- Department of Medicine and Public Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - C Fiorito
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), University of Campania "L. Vanvitelli", Naples, Italy
| | - I Tartaglione
- Department of Women, Child and General and Specialistic Surgery, University of Campania "L. Vanvitelli", Naples, Italy
| | - M Casale
- Department of Women, Child and General and Specialistic Surgery, University of Campania "L. Vanvitelli", Naples, Italy
| | - S Perrotta
- Department of Women, Child and General and Specialistic Surgery, University of Campania "L. Vanvitelli", Naples, Italy
| | - K Magnussen
- Department of Blood Centre and Laboratory Medicine, Innlandet Hospital Trust, Lillehammer, Norway
| | - C Napoli
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), University of Campania "L. Vanvitelli", Naples, Italy; Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania "L. Vanvitelli", Naples, Italy
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DI*A and DI*B Allele Frequencies Among Southern Thai Blood Donors. Indian J Hematol Blood Transfus 2018; 34:506-509. [PMID: 30127562 DOI: 10.1007/s12288-017-0886-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022] Open
Abstract
Diego (DI) blood group genotyping is clinically important in Asian populations. Data of Diego blood type among southern Thais is still unknown. This study aimed to report DI*A and DI*B allele frequencies in southern Thai blood donors and to estimate potential risk of Dia incompatibility and alloimmunization in Thai populations. DNA samples obtained from 427 southern Thai blood donors were genotyped for DI*A and DI*B alleles by polymerase chain reaction with sequence-specific primer. DI*A and DI*B allele frequencies among southern Thais were 0.0047 and 0.9953. Their frequencies were similar to those among American Native, Italian, Filipino, Alaska Native/Aleut and Hawaiian/Pacific Islander populations; while, the frequencies significantly differed from central and northern Thai, Southeast Asian, Brazilian, Southern Brazilian, Brazilian Japanese descendants, Japanese, Han Chinese, Chinese, and Korean populations (P < 0.05). The Dia incompatibility among southern Thais (0.93%) was lower than among central Thais (3.49%), corresponding to a significantly lower probability of Dia alloimmunization (P < 0.05). This is the first report of DI*A and DI*B allele frequencies among southern Thais, which is beneficial for not only creating information for estimating risk of alloimmunization, but also providing antigen-negative red cell donors to prevent both alloimmunization and adverse transfusion reactions.
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Predicted S and s phenotypes from genotyping results among Thai populations to prevent transfusion-induced alloimmunization risks. Transfus Apher Sci 2018; 57:582-586. [PMID: 30078741 DOI: 10.1016/j.transci.2018.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND S and s antigens of the MNS system are of clinical importance because alloanti-S and -s have usually caused delayed hemolytic transfusion reactions and hemolytic disease of the fetus and newborn. Various red cell genotyping has been established to predict the phenotypes to solve serological test limitations. OBJECTIVES AND METHODS This study aimed to determine S and s genotype frequencies and to estimate the alloimmunization risks among central, northern and southern Thai populations. Altogether, 1237 blood samples from Thai blood donors were included. Only 150 samples were tested with anti-S and anti-s by indirect antiglobulin test. All samples were genotyped for GYPB*S and GYPB*s alleles using inhouse PCR with sequence-specific primer. Additionally, the allele frequencies were used to estimate alloimmunization risks and compare with other populations. RESULTS The phenotyping and genotyping results in 150 samples were in 100% concordance. The allele frequencies of GYPB*S in central, northern and southern Thais were 0.061, 0.040 and 0.097, and GYPB*s were 0.939, 0.960 and 0.903, respectively. The frequencies among central Thais were similar to those among northern Thai and Korean populations (P > 0.05) but significantly differed from those of Asian, Caucasian African American and Hispanic populations (P < 0.05). In addition, the risk of S alloimmunization among southern Thais (0.1566) was higher than those among central (0.1038) and northern Thais (0.0736). CONCLUSION This was the first study to report S and s predicted phenotypes and estimate alloimmunization risks among Thais, which is beneficial to prevent transfusion-induced alloimmunization among donors and patients.
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Saleh RM, Zefarina Z, Che Mat NF, Chambers GK, Edinur HA. Transfusion Medicine and Molecular Genetic Methods. Int J Prev Med 2018; 9:45. [PMID: 29899883 PMCID: PMC5981227 DOI: 10.4103/ijpvm.ijpvm_232_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 08/05/2017] [Indexed: 02/07/2023] Open
Abstract
Transfusion procedures are always complicated by potential genetic mismatching between donor and recipient. Compatibility is determined by several major antigens, such as the ABO and Rhesus blood groups. Matching for other blood groups (Kell, Kidd, Duffy, and MNS), human platelet antigens, and human leukocyte antigens (HLAs) also contributes toward the successful transfusion outcomes, especially in multitransfused or highly immunized patients. All these antigens of tissue identity are highly polymorphic and thus present great challenges for finding suitable donors for transfusion patients. The ABO blood group and HLA markers are also the determinants of transplant compatibility, and mismatched antigens will cause graft rejection or graft-versus-host disease. Thus, a single and comprehensive registry covering all of the significant transfusion and transplantation antigens is expected to become an important tool in providing an efficient service capable of delivering safe blood and quickly locating matching organs/stem cells. This review article is intended as an accessible guide for physicians who care for transfusion-dependent patients. In particular, it serves to introduce the new molecular screening methods together with the biology of these systems, which underlies the tests.
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Affiliation(s)
| | - Zulkafli Zefarina
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nor Fazila Che Mat
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Hisham Atan Edinur
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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Frequency of red blood cell genotypes in multi-transfused patients and blood donors from Minas Gerais, Southeast Brazil. Transfus Apher Sci 2017; 57:71-75. [PMID: 29330014 DOI: 10.1016/j.transci.2017.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/30/2017] [Accepted: 12/11/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The frequency of red blood cell (RBC) antigens in Brazil varies due to differences in the ethnic groups in different regions; however, these studies have not been performed in Minas Gerais, where African admixture is more prevalent in comparison with other states. Due to these facts, this study aimed to determine the frequency of RBC genotypes on Rh, Kell, Duffy and Kidd systems in blood donors and multi-transfused patients from Minas Gerais, Southeast Brazil. METHODS Blood samples were collected from 170 donors and 117 patients with different diagnosis and at least three RBC transfusions. DNA was extracted from leukocytes and genotyped by PCR-SSP, Multiplex or RFLP to alleles of the referred systems. The results were compared by the Chi-Square test, with a significance level of 5%. RESULTS The most frequent genotypes were: RHD+, RHCE*ce/RHCE*ce, KEL*2/KEL*2, FY*B-67T/FY*B-67T and JK*A/JK*B. FY*B-67C/FY*B-67C, RHD*Ψ and JK*A/JK*A genotypes were more prevalent in sickle cell disease (SCD) patients than in donors. Many differences in RBC genotype frequencies were observed in comparison with studies from other states and countries. CONCLUSION The results reinforce the importance of determining RBC genotypes of blood donors and patients in different regions of Brazil and the world, improving the transfusion safety of individuals requiring chronic RBC transfusions, especially those with SCD, due to ethnic differences in relation to donors.
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The role of molecular typing and perfect match transfusion in sickle cell disease and thalassaemia: An innovative transfusion strategy. Transfus Apher Sci 2017; 56:234-237. [PMID: 28185828 DOI: 10.1016/j.transci.2017.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/12/2017] [Accepted: 01/16/2017] [Indexed: 11/23/2022]
Abstract
Chronic red blood cell transfusions remain an essential part of supportive treatment in patients with thalassaemia and sickle cell disease (SCD). Red blood cell (RBC) transfusions expose patients to the risk of developing antibodies: RBC alloimmunization occurs when the immune system meets foreign antigens. We created a register of extensively genotyped donors to achieve a better matched transfusion in order to reduce transfusion alloimmunization. Extended RBC antigen typing was determined and confirmed by molecular biology techniques using Human Erythrocyte Antigen (HEA) BeadChip (BioArray Solutions Ltd., Warren, NJ) in periodic blood donors and in patients with thalassaemia and SCD. During 3 years, we typed extensively 1220 periodic blood donors, 898 male and 322 female. We also studied 10 hematologic patients affected by thalassaemia and sickle cell disease referred to our institution as candidate to periodic transfusions. Our patients (8 females and 2 males with a median age of 48 years, range 24-76 years), extensively typed using molecular techniques and screened for RBC alloantibodies, were transfused with a median of 33.5 RBC units. After three years of molecular typing, the "perfect match" transfusion strategy avoided new alloantibodies development in all studied patients.
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Belsito A, Magnussen K, Napoli C. Emerging strategies of blood group genotyping for patients with hemoglobinopathies. Transfus Apher Sci 2016; 56:206-213. [PMID: 28040400 DOI: 10.1016/j.transci.2016.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 02/06/2023]
Abstract
Red cell alloimmunization is a serious problem in chronically transfused patients. A number of high-throughput DNA assays have been developed to extend or replace traditional serologic antigen typing. DNA-based typing methods may be easily automated and multiplexed, and provide reliable information on a patient. Molecular genotyping promises to become cheaper, being not dependent on serologic immunoglobulin reagents. Patients with hemoglobinopathies could benefit from receiving extended genomic typing. This could limit post transfusional complications depending on subtle antigenic differences between donors and patients. Patient/donor compatibility extended beyond the phenotype Rh/Kell may allows improved survival of transfused units of red blood cells (RBC) and lead to reduced need for blood transfusion and leading to less iron overload and reduced risk of alloimmunization. Here we discuss the advantages and limitations of current techniques, that detect only predefined genetic variants. In contrast, target enrichment next-generation sequencing (NGS) has been used to detect both known and de novo genetic polymorphisms, including single-nucleotide polymorphisms, indels (insertions/deletions), and structural variations. NGS approaches can be used to develop an extended blood group genotyping assay system.
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Affiliation(s)
- A Belsito
- Department of Internal Medicine and Specialistic Units Clinical Immunoematology Immunohematology U.O.C. Immunohematology, Transfusion Medicine and Organ Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine and Specialist Units, Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Naples, Italy.
| | - K Magnussen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - C Napoli
- Department of Internal Medicine and Specialistic Units Clinical Immunoematology Immunohematology U.O.C. Immunohematology, Transfusion Medicine and Organ Transplant Immunology (SIMT), Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine and Specialist Units, Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Naples, Italy
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15
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Distribution of DI*A and DI*B Allele Frequencies and Comparisons among Central Thai and Other Populations. PLoS One 2016; 11:e0165134. [PMID: 27764238 PMCID: PMC5072727 DOI: 10.1371/journal.pone.0165134] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/06/2016] [Indexed: 12/29/2022] Open
Abstract
Alloantibodies to the Diego (DI) blood group system, anti-Dia and anti-Dib are clinically significant in causing hemolytic transfusion reactions (HTRs) and hemolytic disease of the fetus and newborn (HDFN), especially in Asian populations with Mongolian ancestry. This study aimed to report the frequency of the DI*A and DI*B alleles in a Central Thai population and to compare them with those of other populations previously published. Altogether, 1,011 blood samples from unrelated healthy blood donors at the National Blood Centre, Thai Red Cross Society, Bangkok were included. Only 391 samples were tested with anti-Dia by conventional tube technique. All samples were genotyped for DI*A and DI*B alleles using an in-house polymerase chain reaction with sequence-specific primer (PCR-SSP) technique. The DI phenotyping and genotyping results were in 100% concordance. The DI*A and DI*B allele frequencies among 1,011 Central Thais were 0.0183 (37/2,022) and 0.9817 (1,985/2,022), respectively. Allele frequencies were compared between Central Thai and other populations. Our data shows that DI*A and DI*B allele frequencies are similar to Southeast Asian, Brazilian, Southern Brazilian and American Native populations; whereas, these frequencies significantly differ from those reported in East Asian, Italian, Alaska Native/Aleut, Hawaiian/Pacific Islander and Filipino populations (P<0.05), corresponding to the results of a matrix of geometric genetic distances. This study confirms that the prevalence of DI*A and DI*B alleles among Central Thais is similar to Southeast Asians and different to others populations of the world. A PCR-based identification of DI genotyping should overcome some of the serological limitations in transfusion medicine and provides a complementary tool for further population-genetic studies.
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Fichou Y, Mariez M, Le Maréchal C, Férec C. The experience of extended blood group genotyping by next-generation sequencing (NGS): investigation of patients with sickle-cell disease. Vox Sang 2016; 111:418-424. [PMID: 27442304 DOI: 10.1111/vox.12432] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/04/2016] [Accepted: 06/06/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients suffering from haemoglobinopathies may be treated by red blood cell (RBC) transfusion on a regular basis and then exposed to multiple antigens with a recurrent, potential risk of alloimmunization routinely prevented by extended RBC antigen cross-matching. While time-consuming and labour-intensive serological analyses are the gold standard for RBC typing, genotyping by current high-throughput molecular tools, including next-generation sequencing (NGS), appears to offer a potent alternative. STUDY DESIGN AND METHODS The potential of extended blood group genotyping (EBGG) by NGS of 17 genes involved in 14 blood group systems was evaluated in a cohort of 48 patients with sickle-cell disease. Sample preparation and sequencing were simplified and automated for future routine implementation. RESULTS Sequencing data were obtained for all DNA samples with two different sequencing machines. Prediction of phenotypes could be made in 12 blood group systems and partially in two other blood group systems (Rh and MNS). Importantly, predicted phenotypes in the MNS (S/s), Duffy, Kidd and Kell systems matched well with serological data (98·9%), when available. Unreferenced alleles in the ACHE and ART4 genes, respectively, involved in the Yt and Dombrock blood groups, were identified, then contributing to extend the current knowledge of blood group molecular genetics. CONCLUSIONS Overall, we consider that our strategy for NGS-based EBGG, assisted by a simple method for genotyping exons 1 and 2 of the pairs of homologous genes (i.e. RHD/RHCE and GYPA/GYPB), as well as the future support of potent bioinformatics tools, may be implemented for routine diagnosis in specific populations.
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Affiliation(s)
- Y Fichou
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France
| | - M Mariez
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France
| | - C Le Maréchal
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France.,Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan, Brest, France.,Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale (UBO), Brest, France
| | - C Férec
- Etablissement Français du Sang (EFS) - Région Bretagne, Brest, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078, Brest, France.,Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan, Brest, France.,Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale (UBO), Brest, France
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Costa DC, Schinaider AA, Santos TM, Schörner EJ, Simon D, Maluf SW, de Moraes ACR, Silva MCS. Frequencies of polymorphisms of the Rh, Kell, Kidd, Duffy and Diego systems of Santa Catarina, Southern Brazil. Rev Bras Hematol Hemoter 2016; 38:199-205. [PMID: 27521857 PMCID: PMC4997891 DOI: 10.1016/j.bjhh.2016.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 03/31/2016] [Accepted: 04/11/2016] [Indexed: 11/25/2022] Open
Abstract
Background Red blood cell genes are highly polymorphic with the distribution of alleles varying between different populations and ethnic groups. The objective of this study was to investigate gene polymorphisms of blood groups in the state of Santa Catarina, Southern Brazil. Methods Three hundred and seventy-three unrelated blood donors and 31 transfusion-dependent patients were evaluated to investigate polymorphisms of the Rh, Kell, Duffy, Kidd, and Diego blood group systems in a population from the state of Santa Catarina. The subjects, from seven regions that comprise the blood-banking network of the state, were assessed between August 2011 and March 2014. The genotypes of the Rh, Kell, Duffy, Kidd, and Diego systems were determined using the restriction fragment length polymorphism-polymerase chain reaction and allele-specific polymerase chain reaction techniques. Results The genotype frequencies in this study were significantly different when populations from different regions of Santa Catarina were compared. Furthermore, there were also significant differences in the genetic frequencies compared to other Brazilian states. The genotype frequencies of the Kell and Kidd blood groups are similar to European populations from Naples, Italy and Zurich, Switzerland. Conclusion This article reports for the first time the frequency of polymorphisms of blood group systems in blood donors from Santa Catarina, Southern Brazil.
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Affiliation(s)
| | | | | | | | - Daniel Simon
- Universidade Luterana do Brasil, Canoas, RS, Brazil
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