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Genetic Variants Within the Erythroid Transcription Factor, KLF1, and Reduction of the Expression of Lutheran and Other Blood Group Antigens: Review of the In(Lu) Phenotype. Transfus Med Rev 2019; 33:111-117. [DOI: 10.1016/j.tmrv.2019.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/22/2019] [Accepted: 01/30/2019] [Indexed: 11/22/2022]
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Fraser NS, Knauth CM, Schoeman EM, Moussa A, Perkins AC, Walsh T, Millard GM, Dean MM, Hyland CA, Flower RL. Investigation of the variable In(Lu) phenotype caused by KLF1 variants. Transfusion 2018; 58:2414-2420. [PMID: 30222867 DOI: 10.1111/trf.14926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 01/31/2023]
Abstract
INTRODUCTION KLF1 is an essential transcriptional activator that drives erythropoiesis. KLF1 variants can result in the Inhibitor of Lutheran, or In(Lu), phenotype where red blood cells (RBCs) have reduced BCAM (LU) and CD44 (IN). Other RBC surface molecules also have changed expression; however, there is controversy in the literature regarding which are truly impacted. We aimed to investigate KLF1 variants in the Australian population. STUDY DESIGN AND METHODS In(Lu) samples were sourced through screening and through the RBC reference laboratory. Blood donor samples (8036) were screened to identify weakened/absent Lub antigen. Samples were genotyped by massively parallel sequencing, while surface carbohydrates and blood group molecules were assessed by flow cytometry. Hemoglobin (Hb) types were analyzed by high-performance liquid chromatography. RESULTS Four of 8036 donors were identified to be In(Lu), and two previously identified In(Lu) samples were provided from the RBC reference laboratory. Five different KLF1 variants were identified; two were novel: c.954G>C/p.Trp318Cys and c.421C>T/p.Arg141*. BCAM and CD44 were reduced in all samples, consistent with previous reports. As a group, In(Lu) RBCs had reduced CD35 (KN), ICAM4 (LW), and CD147 (OK), and demonstrated increased binding of lectins ECA and SNAI. One In(Lu) sample had elevated HbF and another elevated HbA2. CONCLUSION Different KLF1 variants may potentially produce variable phenotypes. A framework for investigating KLF1 variants and their phenotypic impact has been provided. In the future, given available international databases, further testing algorithms (as advocated here) will allow for correlation of phenotype with genotype and therefore accurately document this variability between KLF1 variants.
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Affiliation(s)
- Nicole S Fraser
- Research and Development, Australian Red Cross Blood Service.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Christine M Knauth
- Research and Development, Australian Red Cross Blood Service.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | | | - Assia Moussa
- Research and Development, Australian Red Cross Blood Service.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Andrew C Perkins
- Australian Centre for Blood Diseases, Monash University, Melbourne, Australia
| | - Terry Walsh
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | | | - Melinda M Dean
- Research and Development, Australian Red Cross Blood Service.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Catherine A Hyland
- Research and Development, Australian Red Cross Blood Service.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Robert L Flower
- Research and Development, Australian Red Cross Blood Service.,School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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