1
|
Bi S, Dai L, Jiang L, Wang L, Teng M, Liu G, Teng RJ. Chronic granulomatous disease associated with Duchenne muscular dystrophy caused by Xp21.1 contiguous gene deletion syndrome: Case report and literature review. Front Genet 2023; 13:970204. [PMID: 36712874 PMCID: PMC9880252 DOI: 10.3389/fgene.2022.970204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
Chronic granulomatous disease (CGD) and Duchenne muscular dystrophy (DMD) are X-linked recessive disorders whose genes are 4.47 Mb apart within Xp21.1. A combination of both diseases is rare with only five cases reported in the literature where it is known as Xp21.1 "contiguous gene deletion syndrome". We describe a male neonate who presented with sepsis at 19 days of age. The diagnosis of CGD with DMD was established through copy number variation sequencing (CNV-seq) with an extensive 7.5 Mb deletion of Xp21.2-Xp11.4 of the proband. One of his elder sisters and his mother are carriers. The deletion includes six known genes: glycerol kinase (GK), dystrophin (DMD), cilia- and flagella-associated protein 47 (CFAP47), gp91 (CYBB), Kell antigen (XK), and retinitis pigmentosa GTPase regulator (RPGR). Laboratory assays revealed an increased creatine kinase (CK) level, decreased gp91 expression, and a positive nitroblue tetrazolium test. Due to the extensive gene deletion and the poor prognosis, the family determined to pursue conservative management without further laboratory workup. The patient passed away from a fulminant infection at the age of three-month at a local medical facility. To the best of our knowledge, this case of Xp21.1 contiguous gene deletion syndrome represents the most extensive deletion of genes in this region ever reported. A literature review of similar cases is presented.
Collapse
Affiliation(s)
- Shaohua Bi
- Division of Neonatology, Anhui Provincial Children’s Hospital, Hefei, Anhui, China
| | - Liying Dai
- Division of Neonatology, Anhui Provincial Children’s Hospital, Hefei, Anhui, China
| | - Liangliang Jiang
- Department of Pediatrics, Anhui Provincial Children’s Hospital, Hefei, Anhui, China,*Correspondence: Liangliang Jiang,
| | - Lili Wang
- First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Mia Teng
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Guanghui Liu
- Division of Neonatology, Anhui Provincial Children’s Hospital, Hefei, Anhui, China
| | - Ru-Jeng Teng
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| |
Collapse
|
2
|
Ristovska E, Bojadjieva ТM, Velkova Е, Dimceva АH, Todorovski B, Tashkovska M, Rastvorceva RG, Bosevski M. Rare Blood Groups in ABO, Rh, Kell Systems - Biological and Clinical Significance. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2022; 43:77-87. [PMID: 35843921 DOI: 10.2478/prilozi-2022-0021] [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] [Indexed: 06/15/2023]
Abstract
Background: The frequency of ABO, Rh and Kell blood group antigens differs among populations of different ethnic ancestry. There are low-frequency antigens (<1%) and high-frequency antigens (>90%). A rare blood group is defined as the absence of a high-frequency antigen in the general population, as well as absence of multiple frequent antigens within a single or multiple blood group systems. Aim: To perform red blood cell typing and to calculate the antigen and phenotype frequencies, in order to identify rare blood group donors within the clinically most important АВО, Rh and Kell systems. Material and Methods: АВО, Rh (D, C, E, c, e) and Kell (K) antigen typing was performed using specific monoclonal sera and microplate technique, while Cellano (k) typing was performed with a monoclonal anti-k, antihuman globulin and column agglutination technique. Weak ABO subgroups were determined using the absorption elution method or molecular genotyping (PCR-SSP). Results: ABO antigen frequency is: A (40.89%), O (34.22%), B (16.97%), AB (7.92%) and weak ABO subgroups (0, 009 %). The established genotypes were AxO1 (0, 0026%) and AxB (0, 001%). Rh antigen frequency is: D (85.79%), C (71.7%), c (76.0%), E (26.0%) and е (97.95%). The most common Rh pheno-type is the DCcee (32.7%) while the rarest phenotype is the DCCEE phenotype (0. 003%). The prevalence of K and k antigen is 7.5% and 99.94%, respectively. The frequency of the rare phenotype K+k- is 0.06%. Conclusion: Large scale phenotyping of blood group antigens enables the identification of blood donors with rare blood groups for patients with rare phenotypes or with antibodies to high-frequency antigens and to frequent antigens within one or more blood group systems.
Collapse
Affiliation(s)
- Elena Ristovska
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | | | - Еmilija Velkova
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Аnita Hristova Dimceva
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Bojan Todorovski
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Marija Tashkovska
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Rada Grubovic Rastvorceva
- Institute for transfusion medicine, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| | - Marijan Bosevski
- Clinic of cardiology, St Cyril and Methodius University, Medical Faculty, Skopje, RN Macedonia
| |
Collapse
|
3
|
Leiva-Torres GA, Lavoie J, Ethier C, Constanzo-Yanez J, Baillargeon N. A novel KEL null allele with c.223+1g>t leads to the absence of the Kp b antigen in a First Nation donor. Transfusion 2021; 61:E65-E66. [PMID: 34310722 DOI: 10.1111/trf.16604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/18/2021] [Accepted: 06/25/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | - Josée Lavoie
- Medical Affairs and Innovation, Hema-Quebec, Quebec City, Quebec, Canada
| | - Carole Ethier
- Transfusion Medecine, Hema-Quebec, Montreal, Quebec, Canada
| | | | | |
Collapse
|
4
|
Virk M, Papakonstantino K, Cai W, Oh D, Andrews J. Blood Donation During Pregnancy Due to Anti-Ku Hemolytic Disease of the Fetus and Newborn. Lab Med 2020; 50:421-425. [PMID: 31089725 DOI: 10.1093/labmed/lmz020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Management of pregnancy in patients with Kell-null phenotype can be challenging. The immune systems of these patients form an antibody that is universally reactive against the Kell Blood Group System and can cause hemolytic disease of the fetus and newborn. METHODS A 29-year-old woman, pregnant for the first time, developed anti-D and anti-Ku. The mother had to have labor induced when her fetus showed signs of severe anemia, but no compatible blood was available for transfusion. The induction was delayed so that a unit of blood could be collected from the mother. RESULTS Due to delayed cord clamping at delivery, the newborn did not have anemia and did not require a transfusion. The remaining blood was frozen for future needs. CONCLUSION Blood donation by a pregnant woman for potential transfusion to a newborn with anemia is safe for the mother and fetus, and is possibly the only option in hemolytic disease of the newborn due to a rare antibody.
Collapse
Affiliation(s)
- Mrigender Virk
- Department of Pathology, Stanford University, California
| | | | - Wei Cai
- Department of Pathology, Stanford University, California
| | - David Oh
- Stanford Blood Center, Stanford University
| | - Jennifer Andrews
- Department of Pathology, Stanford University, California.,Department of Pediatrics, Stanford University, California
| |
Collapse
|
5
|
Raud L, Ka C, Gourlaouen I, Callebaut I, Férec C, Le Gac G, Fichou Y. Functional analysis of novelRHDvariants: splicing disruption is likely to be a common mechanism of variant D phenotype. Transfusion 2019; 59:1367-1375. [DOI: 10.1111/trf.15210] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/22/2018] [Accepted: 12/06/2018] [Indexed: 02/01/2023]
Affiliation(s)
- Loann Raud
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Chandran Ka
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Isabelle Gourlaouen
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Isabelle Callebaut
- IMPMC, Sorbonne Universités - UMR CNRS 7590, UPMC Univ Paris 06, Muséum d'Histoire Naturelle, IRD UMR 206; Paris France
| | - Claude Férec
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Gérald Le Gac
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Yann Fichou
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| |
Collapse
|
6
|
From genetic variability to phenotypic expression of blood group systems. Transfus Clin Biol 2017; 24:472-475. [DOI: 10.1016/j.tracli.2017.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 01/06/2023]
|
7
|
Mattaloni SM, Arnoni C, Céspedes R, Nonaka C, Trucco Boggione C, Luján Brajovich ME, Trejo A, Zani N, Biondi CS, Castilho L, Cotorruelo CM. Clinical Significance of an Alloantibody against the Kell Blood Group Glycoprotein. Transfus Med Hemother 2016; 44:53-57. [PMID: 28275334 DOI: 10.1159/000448381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/08/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Kell null (K0) individuals can produce anti-Ku, an antibody against many epitopes in the Kell glycoprotein, after transfusion and/or pregnancy. Since sensitized K0 patients are rare, little is known about anti-Ku clinical relevance and in particular about its association to hemolytic disease of the fetus and newborn. CASE REPORT This work describes a case of neonatal hyperbilirubinemia due to immune-mediated erythrocyte destruction by an alloantibody directed against the Kell glycoprotein. Serologic and molecular approaches identified an anti-Ku alloantibody in maternal serum. A homozygous IVS3 + 1g>a point mutation (KEL*02N.06 allele) was found to be responsible for the lack of Kell antigen expression in the mother's red blood cell and subsequent alloimmunization after a previous pregnancy. Even though in most cases Kell antibodies are clinically severe and may cause suppression of erythropoiesis, in our case the newborn had a moderate anemia and hyperbilirubinemia that was successfully treated with phototherapy without requiring exchange transfusion. Serological and molecular studies performed in the proband's family members allowed us to provide them with proper counseling regarding alloimmunization after transfusion and/or pregnancy. CONCLUSIONS This case enlarges the understanding of the clinical significance of alloantibodies against Kell blood group antigens.
Collapse
Affiliation(s)
- Stella Maris Mattaloni
- IDICER-CONICET, Rosario, Argentina; Laboratorio de Inmunohematología - Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Carine Arnoni
- Colsan-Associaçao Beneficente de Coleta de Sangue, Sao Paulo, Brazil
| | - Rosario Céspedes
- Hospital Zonal General de Agudos Dr. Carlos Bocalandro, Buenos Aires, Argentina
| | - Claudia Nonaka
- Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Carolina Trucco Boggione
- IDICER-CONICET, Rosario, Argentina; Laboratorio de Inmunohematología - Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Melina Eliana Luján Brajovich
- IDICER-CONICET, Rosario, Argentina; Laboratorio de Inmunohematología - Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Andrea Trejo
- Hospital Zonal General de Agudos Dr. Carlos Bocalandro, Buenos Aires, Argentina
| | - Néstor Zani
- Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Claudia Silvia Biondi
- Laboratorio de Inmunohematología - Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| | | | - Carlos Miquel Cotorruelo
- IDICER-CONICET, Rosario, Argentina; Laboratorio de Inmunohematología - Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina
| |
Collapse
|
8
|
Affiliation(s)
- Y. L. Ji
- Institute of Clinical Blood Transfusion; Guangzhou Blood Center; Guangzhou China
| | - C. E. van der Schoot
- Sanquin Research and Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| |
Collapse
|
9
|
Boturão-Neto E, Yamamoto M, Chiba AK, Kimura EYS, de Oliveira MDCVC, do Monte Barretto CL, Nunes MMA, Albuquerque SRL, de Deus Santos MD, Bordin JO. Molecular Basis of KELnull Phenotype in Brazilians. Transfus Med Hemother 2014; 42:52-8. [PMID: 25960716 DOI: 10.1159/000370232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 05/27/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND KELnull (K0) persons can produce clinically significant anti-KEL5 antibody after transfusion and/or pregnancy, requiring K0 blood transfusion when indicated. 37 K0 alleles have been reported in studies over different populations, but none in Amerindian-Caucasian descendants from South America. The aim of this study was to identify the molecular basis of K0 phenotype in Brazilians. METHODS We investigated three K0 samples from different Brazilian blood banks (Recife, Manaus, and Vila Velha) in women with anti-KEL5. KEL antigen typing was performed by serologic techniques, and the K0 status was confirmed by flow cytometry. PCR-RFLP and DNA sequencing of the KEL coding and exon-intron regions were also performed. RESULTS RBCs of the 3 patients were phenotyped as KEL:-1,-2,-3,-4,-7. The 3 patients had the same KEL*02/02 genotype and were negative for KEL*02.03 and KEL*02.06 alleles. The Recife K0 patient was homozygous for IVS16 + 1g>a mutation (KEL*02N.31 allele). The flow cytometry with anti-KEL1, anti-KEL2, anti-KEL3, anti-KEL4, and anti-CD238 confirmed the K0 phenotype. In addition, we found the c.10423C>T mutation (KEL*02N.04 allele) in both the Manaus K0 and the Vila Velha K0 patients. CONCLUSION This report represents the first study of K0 molecular basis performed in Amerindian-Caucasian descendants from South America.
Collapse
Affiliation(s)
- Edmir Boturão-Neto
- Universidade Federal de São Paulo, Hematology and Transfusion Medicine Department, São Paulo, SP, Brazil
| | - Mihoko Yamamoto
- Universidade Federal de São Paulo, Hematology and Transfusion Medicine Department, São Paulo, SP, Brazil
| | - Akemi Kuroda Chiba
- Universidade Federal de São Paulo, Hematology and Transfusion Medicine Department, São Paulo, SP, Brazil
| | - Elisa Yuriko Sugano Kimura
- Universidade Federal de São Paulo, Hematology and Transfusion Medicine Department, São Paulo, SP, Brazil
| | | | | | | | | | | | - José Orlando Bordin
- Universidade Federal de São Paulo, Hematology and Transfusion Medicine Department, São Paulo, SP, Brazil
| |
Collapse
|
10
|
Ji Y, Veldhuisen B, Ligthart P, Haer-Wigman L, Jongerius J, Boujnan M, Ait Soussan A, Luo G, Fu Y, van der Schoot CE, de Haas M. Novel alleles at the Kell blood group locus that lead to Kell variant phenotype in the Dutch population. Transfusion 2014; 55:413-21. [PMID: 25156717 DOI: 10.1111/trf.12838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 07/15/2014] [Accepted: 07/23/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alloantibodies directed against antigens of the Kell blood group system are clinically significant. In the Netherlands, the KEL1 antigen is determined in all blood donors. In this study, after phenotyping of KEL:1-positive donors, genotyping analysis was conducted in KEL:1,-2 donors to identify possible KEL*02 variant alleles. STUDY DESIGN AND METHODS A total of 407 donors with the KEL:1,-2 phenotype were genotyped for the KEL*01/02 polymorphism, followed by direct sequencing of the KEL gene if the KEL*02 allele was detected. Two K0 patients were also included. Transcript analysis was conducted in two probands with the KEL*02. M05 allele defined by a synonymous mutation (G573G). Flow cytometry analysis to determine the expression of Kell antigen was performed. RESULTS Thirty KEL:1,-2 individuals (30/407, 7.4%) with discrepant KEL*01/02 genotype were identified. Seven novel alleles were identified: KEL*02(R86Q, R281W)mod, KEL*02(L133P)null, KEL*02(436delG)null, KEL*02(F418S)null, KEL*02(R492X)null, KEL*02(L611R)null, and KEL*02(R700X)null. Nine variant alleles described before were detected: KEL*02N.06, KEL*02N.15, KEL*02N.17, KEL*02N.19, KEL*02N.21, KEL*02M.02, KEL*02M.04, KEL*02M.05, and KEL*02(Q362K)mod. A transcript lacking Exon 16 was identified in two probands with the KEL*02M.05 allele as described before. Finally, flow cytometry analysis showed a decreased total Kell expression and a relatively increased KEL1 expression in individuals with the KEL:1,2null or KEL:1,2mod phenotype, compared to KEL:1,2 controls. CONCLUSION In 7.4% of a group of tested KEL:1,-2 Dutch donors, a KEL*02null or KEL*02mod allele was found. A relatively increased KEL1 antigen expression in KEL:1,2null and KEL:1,2mod individuals suggest that the expression of Kell-XK complexes depends on the availability of the XK protein.
Collapse
Affiliation(s)
- Yanli Ji
- Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Matteocci A, Mancuso T, Moscetti A, Collaretti A, Castagna K, Spaccino C, Hutchinson T, Grammatico P, Pierelli L. Three missense mutations found in the KEL gene lead to K(mod) or K0 red blood cell phenotypes. Transfusion 2014; 54:3216-21. [PMID: 25041236 DOI: 10.1111/trf.12748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The KEL gene is highly polymorphic. It presents two major alleles, KEL1(K) and KEL2(k), but a variety of mutations give rise to weakened (K(mod) phenotype) or lack (K0 phenotype) of Kell antigen expression. Recently, the use of advanced DNA-based techniques has greatly increased our understanding of the Kell blood group system. STUDY DESIGN AND METHODS Three blood samples that had shown discordant results between the serologic and molecular typing for k were investigated by DNA sequencing. Two of these samples were also subjected to studies of adsorption and elution. RESULTS After sequencing the whole KEL gene, we found three new missense mutations: c.455A>G (p.Tyr152Cys) at Exon 5, c.2111A>C (p.Pro704His) at Exon 19, and c.1726G>C (p.Gly576Arg) at Exon 16. So far, no known clinical implications are associated with these mutations. Further investigation by adsorption and elution methods has defined that c.455A>G and c.1726G>C resulted in K0 phenotype, while c.2111A>C encoded a K(mod) phenotype. CONCLUSION Molecular investigation is an important complement to routine serologic analyses of Kell antigens. Discrepancies between genotype and phenotype may reveal the presence of K(mod) or K0 phenotypes. Our description of three new KEL alleles suggests a role for a wider diagnostic approach to typing of the Kell system.
Collapse
Affiliation(s)
- Antonella Matteocci
- Department of Transfusion Medicine, San Camillo Forlanini Hospital, Rome, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Arnoni CP, Gazito D, Muniz JG, de Medeiros Person R, Brandão F, de Araújo Marques MG, Barreto JA, Castilho L, Latini FRM. Two novelKELalleles encoding K0phenotypes in Brazilians. Transfusion 2014; 54:2128-9. [DOI: 10.1111/trf.12564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 11/29/2013] [Accepted: 12/06/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Diana Gazito
- Colsan-Associação Beneficente de Coleta de Sangue; São Paulo SP Brazil
| | | | | | - Frederico Brandão
- Colsan-Associação Beneficente de Coleta de Sangue; São Paulo SP Brazil
| | | | | | | | | |
Collapse
|
13
|
Karamatic Crew V, Poole J, Burton N, Daniels G. Three uncommonKELalleles in one family with unusual Kell phenotypes explain a 35-year old conundrum. Vox Sang 2013; 106:242-7. [DOI: 10.1111/vox.12094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
14
|
Monfort M, Peyrard T, Arnaud L, Helias V, Maggipinto G, Gérard C. [A KEL*02mod allele responsible for an apparent maternity exclusion]. Transfus Clin Biol 2013; 20:490-5. [PMID: 23727116 DOI: 10.1016/j.tracli.2013.03.278] [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: 06/13/2012] [Accepted: 03/19/2013] [Indexed: 11/17/2022]
Abstract
The patient's rare KEL:1,-2 phenotype was highlighted in course of a routine preoperative erythrocyte typing. Unexpectedly, her two daughters presented a KEL:-1,2 phenotype what appeared first as an apparent maternity exclusion. Flow cytometry, genotyping and adsorption-elution analyses were then performed for those three patients. KEL genotyping showed that the patient's genotype was KEL*01/KEL*02 whereas that of her daughters was KEL*02/KEL*02. By using polyclonal anti-KEL2 reagent, weak amount of KEL2 was identified on the patient's erythrocytes, a result which was confirmed by both flow cytometry and adsorption-elution assays, suggesting that patient's phenotype was in fact KEL:1,2w. These results are in favour of a weak expressed KEL*02 allele (KEL*2mod) transmission coding for a KEL2 antigen detected in some technical conditions only. Those results allowed to explain the apparent maternity exclusion based on initial KEL phenotype. This study also seems to confirm the presence of a compensatory mechanism of the KELmod allele deficient expression in heterozygote patients. A KEL phenotype retrospective study of 80,000 subjects showed a local KEL:1,-2 frequency four times lower than that described in literature. Moreover, a significant number of those individuals would in reality be KEL:1,2w, what still would decrease the real frequency of the KEL:1,2 subjects.
Collapse
Affiliation(s)
- M Monfort
- Laboratoire d'immunohématologie, centre hospitalier universitaire de Liège, Liège, Belgique.
| | | | | | | | | | | |
Collapse
|
15
|
Martin-Blanc S, Simon P, Gien D, Kappler-Gratias S, Le Pennec PY, Pham BN. Identification of novel silent KEL alleles causing KEL:-5 (Ko) phenotype or discordance between KEL:1,-2 phenotype/KEL*01/02 genotype. Transfusion 2013; 53:2859-66. [PMID: 23581578 DOI: 10.1111/trf.12206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 02/03/2013] [Accepted: 02/17/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Kell system, encoded by the KEL gene, is one of the most clinically important blood group systems. Molecular defects may lead to the absence of Kell antigen expression. The very rare KEL:5 results from silent KEL genes, also called KELnull alleles. In a few cases, the rare KEL:1,-2 phenotype may be associated with silent KEL*02 alleles. STUDY DESIGN AND METHODS The aim of this study was to perform DNA investigations to identify silent KEL alleles among 10 KEL:-5 patients and 121 individuals presenting the rare KEL:1,-2 phenotype. Serologic investigations were performed on patients' red blood cells and serum. The KEL gene analysis was done by using a BeadChip assay (HEA Version, 1.2, Immucor), real-time polymerase chain reaction, and/or sequencing of all 19 exons of the KEL gene. RESULTS In KEL:-5 patients, two novel KELnull alleles were described: 821G>A being the second described KELnull allele on a KEL*01 backbone and 184Tdel. In the 121 KEL:1,-2 individuals, nine (7.4%) were found to display a discordant KEL:1,-2 phenotype and KEL*01/KEL*02 genotype. Three novel silent KEL*02 alleles were described: 1084C>A, 1708G>A, and IVS11+5g>a. CONCLUSION The number of silent KEL alleles and the notion that KEL null alleles are on a KEL*02 background may evolve in the coming years. Systematic DNA analysis showed that the number of discordant phenotype/genotype results, related to silent KEL*02 alleles was higher than expected in France. These data emphasize that clinical practice based on DNA analysis for blood group antigens requires caution and should improve the performance of the blood group phenotype prediction.
Collapse
Affiliation(s)
- Stéphanie Martin-Blanc
- Institut National de la Transfusion Sanguine, CNRGS-INSERM U665, Paris; CHU Réunion, Site Sud, Saint Pierre, France
| | | | | | | | | | | |
Collapse
|
16
|
Moulds JM, Persa R, Rierson D, Billingsley KL, Noumsi GT, Hue-Roye K, Reid ME. Three novel alleles in the Kell blood group system resulting in the Knullphenotype and the first in a Native American. Transfusion 2013; 53:2867-71. [DOI: 10.1111/trf.12205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 02/07/2013] [Accepted: 02/17/2013] [Indexed: 11/28/2022]
|
17
|
Prohaska R, Sibon OC, Rudnicki DD, Danek A, Hayflick SJ, Verhaag EM, Jan J V, Margolis RL, Walker RH. Brain, blood, and iron: perspectives on the roles of erythrocytes and iron in neurodegeneration. Neurobiol Dis 2012; 46:607-24. [PMID: 22426390 PMCID: PMC3352961 DOI: 10.1016/j.nbd.2012.03.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 01/17/2012] [Accepted: 03/01/2012] [Indexed: 12/20/2022] Open
Abstract
The terms "neuroacanthocytosis" (NA) and "neurodegeneration with brain iron accumulation" (NBIA) both refer to groups of genetically heterogeneous disorders, classified together due to similarities of their phenotypic or pathological findings. Even collectively, the disorders that comprise these sets are exceedingly rare and challenging to study. The NBIA disorders are defined by their appearance on brain magnetic resonance imaging, with iron deposition in the basal ganglia. Clinical features vary, but most include a movement disorder. New causative genes are being rapidly identified; however, the mechanisms by which mutations cause iron accumulation and neurodegeneration are not well understood. NA syndromes are also characterized by a progressive movement disorder, accompanied by cognitive and psychiatric features, resulting from mutations in a number of genes whose roles are also basically unknown. An overlapping feature of the two groups, NBIA and NA, is the occurrence of acanthocytes, spiky red cells with a poorly-understood membrane dysfunction. In this review we summarise recent developments in this field, specifically insights into cellular mechanisms and from animal models. Cell membrane research may shed light upon the significance of the erythrocyte abnormality, and upon possible connections between the two sets of disorders. Shared pathophysiologic mechanisms may lead to progress in the understanding of other types of neurodegeneration.
Collapse
Affiliation(s)
- Rainer Prohaska
- Max F. Perutz Laboratories, Medical University of Vienna, Vienna, Austria
| | - Ody C.M. Sibon
- Section of Radiation & Stress Cell Biology, Department of Cell Biology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Dobrila D. Rudnicki
- Department of Psychiatry, Division of Neurobiology, Laboratory of Genetic Neurobiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
| | - Susan J. Hayflick
- Departments of Molecular & Medical Genetics, Pediatrics and Neurology, Oregon Health & Science University, Portland OR USA
| | - Esther M. Verhaag
- Section of Radiation & Stress Cell Biology, Department of Cell Biology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Vonk Jan J
- Section of Radiation & Stress Cell Biology, Department of Cell Biology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Russell L. Margolis
- Department of Psychiatry, Division of Neurobiology, Laboratory of Genetic Neurobiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology and Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ruth H. Walker
- Departments of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA and Mount Sinai School of Medicine, New York, NY USA
| |
Collapse
|
18
|
Yang MH, Li L, Kuo YF, Hung YS, Yu LC, Hung CS, Tsai SJL, Lin KS, Chu DC. Genetic and functional analyses describe a novel 730delG mutation in the KEL gene causing K0 phenotype in a Taiwanese blood donor. Transfus Med 2011; 21:318-24. [DOI: 10.1111/j.1365-3148.2011.01084.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
19
|
Wester ES, Steffensen R, Ligthart PC, Vad J, de Haas M, Storry JR, Olsson ML. KEL*02 alleles with alterations in and around exon 8 in individuals with apparent KEL:1,-2 phenotypes. Vox Sang 2010; 99:150-7. [PMID: 20384970 DOI: 10.1111/j.1423-0410.2010.01334.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Antibodies to antigens in the Kell blood group system, especially anti-KEL1, are involved in both haemolytic disease of the newborn and foetus and haemolytic transfusion reactions. Correct typing results are important and discrepancies between serologic and genetic typing must be resolved. Here, we describe the investigation of three healthy individuals who were initially phenotyped as KEL:1,-2. MATERIALS AND METHODS Antigen typing was performed by standard serological techniques and by flow cytometric analysis. The KEL*01/02 polymorphism was tested by an allele-discrimination TaqMan assay as well as by PCR with allele-specific primers and PCR-RFLP. DNA sequencing of the KEL coding region was also performed. RESULTS Two KEL*02N alleles with mutated splice sites around exon 8 were identified: intron 7 -1g>c (novel) and intron 8 +1g>t (previously reported in one case of K(0)). In the third sample, a missense mutation in exon 8, 787G>A (novel) predicting Gly263Arg, was detected on a KEL*02 allele and associated with dramatically weakened KEL2 antigen expression. CONCLUSION Resolution of discrepant phenotype/genotype results identified silencing mutations in or around exon 8. A combination of molecular and serologic methods has the potential to improve the quality of test results and was required to ensure both the accurate KEL2 antigen status and KEL*01 zygosity of these individuals.
Collapse
Affiliation(s)
- E S Wester
- Department of Clinical Immunology and Transfusion Medicine, University and Regional Laboratories, Region Skåne, Lund, Sweden
| | | | | | | | | | | | | |
Collapse
|
20
|
Yang Y, Wang L, Wang C, Chen H, Guo Z, Zhang Y, Zhu Z. Two novel null alleles of theKELgene detected in two Chinese women with the Knullphenotype. Transfus Med 2009; 19:235-44. [DOI: 10.1111/j.1365-3148.2009.00962.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Kang MG, Lim YA, Lee KM. [A hemolytic transfusion reaction due to Anti-Ku antibody in a patient with Knull phenotype: the first case in Korea]. Ann Lab Med 2009; 29:238-42. [PMID: 19571622 DOI: 10.3343/kjlm.2009.29.3.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Knull phenotype completely lacks all Kell system antigens. Anti-Ku antibody is seen in immunized persons with Knull phenotype by transfusion or pregnancy. It can cause a fatal hemolytic transfusion reaction. A 66-yr-old male patient with liver cirrhosis visited emergency center due to acute bleeding. The patient was at hypovolemic shock status: his blood pressure was 80/50 mmHg, pulse rate was 110/min and hemoglobin level was 4.4 g/dL. Because of the presence of antibody against high incidence antigen, we could not find any compatible blood for the patient. Nevertheless, 4 units of packed RBCs had to be transfused. Moderate hemolytic transfusion reaction was developed after transfusion. At endoscopic examination, blood was spurting from gastric cardiac varix. Endoscopic histoacryl injection was tried, and bleeding was successfully controlled. After bleeding stopped, he was managed for anemia using steroid and other medical therapy instead of transfusion. His hemoglobin level was improved to 7.7 g/dL at the time of discharge. Later he has been proved to have a Knull phenotype, which is very rare, and anti-Ku antibody. This report is the first case of anti-Ku in a Knull phenotype person in Korea, who experienced a moderate hemolytic transfusion reaction.
Collapse
Affiliation(s)
- Min Gu Kang
- Department of Laboratory Medicine, Ajou University School of Medicine, Yeongtong-Gu, Suwon, Korea
| | | | | |
Collapse
|
22
|
Abstract
The X-linked McLeod syndrome is defined by absent Kx red blood cell antigen and weak expression of Kell antigens, and this constellation may be accidentally detected in routine screening of apparently healthy blood donors. Most carriers of this McLeod blood group phenotype have acanthocytosis and elevated serum creatine kinase levels and are prone to develop a severe neurological disorder resembling Huntington's disease. Onset of neurological symptoms ranges between 25 and 60 years, and the penetrance of the disorder appears to be high. Additional symptoms of the McLeod neuroacanthocytosis syndrome that warrant therapeutic and diagnostic considerations include generalized seizures, neuromuscular symptoms leading to weakness and atrophy, and cardiopathy mainly manifesting with atrial fibrillation, malignant arrhythmias and dilated cardiomyopathy. Therefore, asymptomatic carriers of the McLeod blood group phenotype should have a careful genetic counseling, neurological examination and a cardiologic evaluation for the presence of a treatable cardiomyopathy.
Collapse
Affiliation(s)
- H H Jung
- Department of Neurology, University Hospital Zürich, Frauenklinikstrasse 26, 8091 Zürich, Switzerland.
| | | | | |
Collapse
|
23
|
Körmöczi GF, Wagner T, Jungbauer C, Vadon M, Ahrens N, Moll W, Mühlbacher A, Ozgül-Gülce S, Kleinrath T, Kilga-Nogler S, Schönitzer D, Gassner C. Genetic diversity of KELnull and KELel: a nationwide Austrian survey. Transfusion 2007; 47:703-14. [PMID: 17381630 DOI: 10.1111/j.1537-2995.2007.01174.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Besides ABO and RH, the KEL blood group system, including the two antithetical antigens KEL1 and KEL2, is the most important owing to the frequent appearance of anti-KEL alloantibodies and their considerable clinical significance. So far, only limited information was available on KEL variant alleles determining the rare silent KELnull and KELel phenotypes with absent or diminished KEL antigen expression detected only by adsorption-elution techniques, respectively. STUDY DESIGN AND METHODS For a systematic investigation of the KELnull and KELel phenotypes, 401 KEL:1,-2 samples (representing 2.6% of all Austrian KEL:1,-2 samples) and 811 KEL:1,2 samples were genotyped for the KEL*1/KEL*2-specific single-nucleotide polymorphism. All heterozygous KEL*1/KEL*2 and 4 additional KELnull samples were subjected to detailed immunohematologic examination and allele-specific sequencing. RESULTS In 14 KEL:1,-2 samples, discrepant KEL*1/KEL*2 heterozygosity was observed, indicating the presence of silent or barely expressed KEL*2 alleles, whereas all KEL:1,2 individuals were homozygous for KEL*2. In the course of further molecular analysis, 8 novel KEL*2null and 2 KEL*2el alleles were discovered, representing 67 and 33 percent of previously known KEL*2null- and KEL*2el-encoding alleles, respectively. In addition, two different known KEL*2null and KEL*2el alleles each were confirmed. The immunohematologic properties of KEL variant red blood cells were defined by extended KEL phenotyping and flow cytometric KEL1, KEL2, KEL4, and KEL7 antigen as well as total Kell protein quantification. CONCLUSION For the first time, exact KELnull and KELel population frequencies could be established in this population.
Collapse
Affiliation(s)
- Günther F Körmöczi
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Affiliation(s)
- Soohee Lee
- New York Blood Center, New York, New York 10021, USA.
| |
Collapse
|
25
|
Abstract
Landsteiner and his colleagues demonstrated that human beings could be classified into four groups depending on the presence of one (A) or another (B) or both (AB) or none (O) of the antigens on their red cells. The number of the blood group antigens up to 1984 was 410. In the next 20 years, there were 16 systems with 144 antigens and quite a collection of antigens waiting to be assigned to systems, pending the discovery of new information about their relationship to the established systems. The importance of most blood group antigens had been recognized by immunological complications of blood transfusion or pregnancies; their molecular structure and function however remained undefined for many decades. Recent advances in molecular genetics and cellular biochemistry resulted in an abundance of new information in this field of research. In this review, we try to give some examples of advances made in the field of 'structure and function of the red cell surface molecules.'
Collapse
Affiliation(s)
- Abbasali Pourazar
- Department of Immunology, School of Medicine Medical Science, University of Isfahan, Iran
| |
Collapse
|
26
|
Lydaki E, Nikoloudi I, Kaminopetros P, Bolonaki I, Sifakis S, Kikidi K, Koumantakis E, Foundouli K. Serial blood donations for intrauterine transfusions of severe hemolytic disease of the newborn with the use of recombinant erythropoietin in a pregnant woman alloimmunized with anti-Ku. Transfusion 2005; 45:1791-5. [PMID: 16271105 DOI: 10.1111/j.1537-2995.2005.00604.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The management of a pregnant woman with the rare Ko phenotype and anti-Ku is a special challenge, because matched blood is extremely rare and the possibility of severe hemolytic disease of the newborn is high. CASE REPORT A 30-year-old woman with rare Ko (Knull) phenotype presented at 18 weeks of gestation with positive indirect agglutination test results. She had anti-Ku due to previous blood transfusion, one pregnancy, and two abortions. STUDY DESIGN AND METHODS During this pregnancy, anti-Ku titers ranged from 1024 to 4096. At the 26th week of gestation ultrasound showed a hydropic fetus and urgent intrauterine exchange transfusion was performed with the maternal red blood cells (RBCs). Recombinant human erythropoietin (rHu-EPO) and intravenous (IV) iron were administered to the mother to ensure an adequate supply of matched RBCs for intrauterine transfusions and possible perinatal hemorrhage. RESULTS Intrauterine transfusions were repeated every 1 to 3 weeks. By 35 weeks 2 days of gestation, the mother had donated 4 units of blood, and four intrauterine transfusions had been performed. Cesarean section was then decided and a healthy male newborn was born. He was treated with phototherapy but without exchange transfusions. By the 15th day of life rHu-EPO was administrated to the newborn because of anemia. The maternal RBCs completely disappeared from the child's blood by Day 100. CONCLUSIONS As shown in this case, treatment with rHu-EPO and IV Fe has effectively increased the mother's capacity to donate RBCs for autologous use and intrauterine transfusions, with no adverse effects to the mother or the child.
Collapse
Affiliation(s)
- Evaggelia Lydaki
- Department of Transfusion Medicine, University Hospital of Heraklion, Crete, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Wester ES, Storry JR, Schneider K, Nilsson Sojka B, Poole J, Olsson ML. Genetic basis of the K0phenotype in the Swedish population. Transfusion 2005; 45:545-9. [PMID: 15819675 DOI: 10.1111/j.0041-1132.2005.04283.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The absence of all Kell blood group antigens (K(0) phenotype) is very rare. K(0) persons, however, can produce clinically significant anti-Ku (K5) after transfusion and/or pregnancy and require K(0) blood for transfusion. Ten alleles giving rise to the K(0) phenotype have been reported: different populations were studied although none from Scandinavia. STUDY DESIGN AND METHODS Three K(0) samples were identified by blood banks in Sweden (Uppsala, Umeå, and Linköping) during a 20-year period. Kell antigen typing was performed with standard serologic techniques by the respective blood banks and K(0) status was confirmed by the International Blood Group Reference Laboratory in Bristol, England. Polymerase chain reaction and DNA sequencing of the KEL coding region (exons 1-19) was performed on genomic DNA. RESULTS The Uppsala K(0) was homozygous for a 1540C>T substitution in exon 13, leading to an immediate stop codon. The Umeå K(0) was homozygous for 1023delG in exon 8 that results in a frameshift and a premature stop codon in exon 9. In the Linköping K(0), a previously reported mutation g>a at +1 of intron 3 was found. CONCLUSION Two novel and one previously reported null alleles at the KEL locus are described. The identified nonsense mutations abolish expression of the Kell glycoprotein and are thus responsible for the K(0) phenotype in these Swedish families.
Collapse
|
28
|
Lee S, Russo DCW, Reid ME, Redman CM. Mutations that diminish expression of Kell surface protein and lead to the Kmod RBC phenotype. Transfusion 2003; 43:1121-5. [PMID: 12869119 DOI: 10.1046/j.1537-2995.2003.00472.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Kmod is an inherited rare RBC phenotype characterized by weak but detectable expression of high-incidence Kell antigens. STUDY DESIGN AND METHODS The 19 exons and the intron-exon regions of the KEL gene from four unrelated Kmod individuals were sequenced and compared to wild-type KEL. To study the mechanisms by which the mutations result in depression of Kell antigens, mutant and wild-type Kell proteins were expressed in 293T cells and the amounts of protein present on the cell surface were determined. RESULTS The following point mutations were identified: Kmod-1, homozygous 1208G>A, S363N; Kmod-2, heterozygous, 1208G>A, S363N and 2150 A>G, Y677C; Kmod-3 (previously classified as KEL:-13), heterozygous 1106T>C, L329P and 1716G>A, W532Stop; Kmod-4, heterozygous, 2227G>A, G703R and a silent 1839C>T mutation. In transfected 293T cells, fewer G703R and L329P mutant Kell proteins were transported to the cell surface compared with wild-type Kell protein, and there was no detectable Y677C mutant Kell protein. Previously, it was shown that that S363N Kell protein was not detected on the cell surface. CONCLUSION Different point mutations, causing amino acid substitutions and presumably altering protein conformation, inhibit transport of the mutant Kell proteins to the cell surface. The different mutations leading to the Kmod phenotype explain why anti-Ku made by persons with the Kmod phenotype are not mutually compatible.
Collapse
Affiliation(s)
- Soohee Lee
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York 10021, USA.
| | | | | | | |
Collapse
|
29
|
Koda Y, Soejima M, Tsuneoka M, Yasumoto K, Higashitani T, Sagawa K, Kimura H. Heterozygosity for two novel null alleles of the KEL gene causes the Kell-null phenotype in a Japanese woman. Br J Haematol 2002; 117:220-5. [PMID: 11918559 DOI: 10.1046/j.1365-2141.2002.03368.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Kell-null (Ko) phenotype is rare and it does not express the Kell antigens on erythrocyte membranes. Recently, several distinct missense and nonsense base substitutions in the coding region and the donor splice site of intron 3 were identified in the KEL gene in individuals with the Ko phenotype. We analysed both genomic DNA and cDNA sequences of the KEL gene in a Japanese woman with the Ko phenotype. She was found to be heterozygous for two novel null KEL alleles. One allele contained an A to G substitution in intron 5 that changes the 3'-splice site of intron 5 from AAG to AGG, resulting in a reading frameshift by a single guanine insertion in KEL mRNA, and the other allele contained a single G to A substitution in exon 12 (codon 459) creating a termination codon. Neither mutation was found in 114 randomly selected Japanese individuals. The results suggested that the Ko blood group phenotype might be owing to several distinct non-functional alleles without any prevalent allele.
Collapse
Affiliation(s)
- Yoshiro Koda
- Department of Forensic Medicine and Human Genetics, Kurume University School of Medicine, Yasumoto Hospital, Mizuma, Japan
| | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
Kell is one of the major human red blood cell groups and comprises 22 antigens. These antigens are produced by alleles located on chromosome 7, including sets of antithetical antigens such as Kell (K, K1) and cellano (k, K2), which differ in a single amino acid change (T193M). It consists of a 93-Kd transmembrane glycoprotein that is surface-exposed and shares sequence and structural homology with zinc endopeptidases, which are involved in regulating bioactive peptides. Anti-Kell antibodies have been shown to suppress fetal erythropoiesis. Recently published data indicate a similar effect on myeolopoiesis and megakaryopoiesis. Substantial thrombocytopenia in fetuses affected with HDN due to anti-K antibodies led to the discovery of the inhibitory effect of Kell-related antibodies on CFU-MK growth. In addition to its inhibitory effect on BFU-E growth, anti-Kell antibodies significantly reduced CFU-GM colony formation from haematologically normal individuals. Moreover, anti-cellano and anti-Kp(b) antibodies also inhibited the growth of CFU-GM from antigen positive MNC. These data indicate that Kell is not restricted to erythroid blood cells, but is expressed on a broader spectrum of haematopoietic cells than previously believed.
Collapse
Affiliation(s)
- T Wagner
- Department of Blood Group Serology and Transfusion Medicine, University Hospital Graz, Austria.
| | | | | |
Collapse
|
31
|
Lee S, Reid ME, Redman CM. Point mutations in KEL exon 8 determine a high-incidence (RAZ) and a low-incidence (KEL25, VLAN) antigen of the Kell blood group system. Vox Sang 2001; 81:259-63. [PMID: 11904003 DOI: 10.1046/j.1423-0410.2001.00119.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES The molecular basis of two Kell blood group antigens, RAZ (provisionally KEL27) and VLAN (KEL25), were determined. MATERIALS AND METHODS The DNA sequences of the open reading frames and the flanking intron regions of the 19 KEL exons from RAZ and VLAN probands were compared with that of common KEL. Genotyping assays were designed to confirm and detect RAZ and VLAN phenotypes. RESULTS A homozygous G865A mutation, encoding lysine instead of glutamic acid at amino acid position 249 of Kell protein, defines the RAZ phenotype, while a heterozygous G863A mutation in KEL, encoding an arginine to glutamine substitution at amino acid 248, characterizes the VLAN phenotype. CONCLUSION Point mutations G865A and G863A, in adjacent codons of KEL exon 8, which cause amino acid substitutions, characterize the RAZ and VLAN Kell blood group phenotypes.
Collapse
Affiliation(s)
- S Lee
- Lindsley F. Kimball Research Institute of the New York Blood Center, 310 East 67th Street, New York, NY 10021, USA.
| | | | | |
Collapse
|
32
|
Abstract
Biochemical and molecular genetic studies have revealed that blood group antigens are present on cell surface molecules of wide structural diversity, including carbohydrate epitopes on glycoproteins and/or glycolipids, and peptide antigens on proteins inserted within the membrane via single or multi-pass transmembrane domains, or via glycosylphosphatidylinositol linkages. These studies have also shown that some blood group antigens are carried by complexes consisting of several membrane components which may be lacking or severely deficient in rare blood group 'null' phenotypes. In addition, although all blood group antigens are serologically detectable on red blood cells (RBCs), most of them are also expressed in non-erythroid tissues, raising further questions on their physiological function under normal and pathological conditions. In addition to their structural diversity, blood group antigens also possess wide functional diversity, and can be schematically subdivided into five classes: i) transporters and channels; ii) receptors for ligands, viruses, bacteria and parasites; iii) adhesion molecules; iv) enzymes; and v) structural proteins. The purpose of this review is to summarize recent findings on these molecules, and in particular to illustrate the existing structure-function relationships.
Collapse
MESH Headings
- Animals
- Anion Exchange Protein 1, Erythrocyte/chemistry
- Anion Exchange Protein 1, Erythrocyte/physiology
- Antigens, Protozoan
- Blood Group Antigens/chemistry
- Blood Group Antigens/classification
- Blood Group Antigens/genetics
- Blood Group Antigens/immunology
- Blood Group Antigens/physiology
- Blood Proteins/chemistry
- Blood Proteins/genetics
- Blood Proteins/immunology
- Blood Proteins/physiology
- Carrier Proteins/chemistry
- Carrier Proteins/genetics
- Carrier Proteins/immunology
- Carrier Proteins/physiology
- Cell Adhesion Molecules/chemistry
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/immunology
- Cell Adhesion Molecules/physiology
- Chromosomes, Human/genetics
- Enzymes/chemistry
- Enzymes/genetics
- Enzymes/immunology
- Enzymes/physiology
- Erythrocyte Membrane/chemistry
- Erythrocyte Membrane/immunology
- Erythrocytes/enzymology
- Erythrocytes/microbiology
- Erythrocytes/parasitology
- Erythrocytes/virology
- Genes
- Humans
- Integrins/chemistry
- Integrins/genetics
- Integrins/immunology
- Integrins/physiology
- Ion Channels/chemistry
- Ion Channels/genetics
- Ion Channels/immunology
- Ion Channels/physiology
- Models, Molecular
- Organ Specificity
- Protein Conformation
- Protozoan Proteins
- Receptors, Cell Surface/chemistry
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/immunology
- Receptors, Cell Surface/physiology
- Receptors, HIV/physiology
- Rh-Hr Blood-Group System/chemistry
- Rh-Hr Blood-Group System/genetics
- Rh-Hr Blood-Group System/immunology
- Rh-Hr Blood-Group System/physiology
- Species Specificity
- Structure-Activity Relationship
Collapse
|
33
|
Lee S, Russo DC, Reiner AP, Lee JH, Sy MY, Telen MJ, Judd WJ, Simon P, Rodrigues MJ, Chabert T, Poole J, Jovanovic-Srzentic S, Levene C, Yahalom V, Redman CM. Molecular defects underlying the Kell null phenotype. J Biol Chem 2001; 276:27281-9. [PMID: 11375401 DOI: 10.1074/jbc.m103433200] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Expression of the Kell blood group system is dependent on two proteins, Kell and XK, that are linked by a single disulfide bond. Kell, a type II membrane glycoprotein, is a zinc endopeptidase, while XK, which has 10 transmembrane domains, is a putative membrane transporter. A rare phenotype termed Kell null (Ko) is characterized by the absence of Kell protein and Kell antigens from the red cell membrane and diminished amounts of XK protein. We determined the molecular basis of eight unrelated persons with Ko phenotypes by sequencing the coding and the intron-exon splice regions of KEL and, in some cases, analysis of mRNA transcripts and expression of mutants on the cell surface of transfected cells. Six subjects were homozygous: four with premature stop codons, one with a 5' splice site mutation, G to A, in intron 3, and one with an amino acid substitution (S676N) in exon 18. Two Ko persons with premature stop codons had identical mutations in exon 4 (R128Stop), another had a different mutation in exon 4 (C83Stop), and the fourth had a stop codon in exon 9 (Q348Stop). Two Ko persons were heterozygous for two mutations. One had a 5' splice site mutation (G to A) in intron 3 of one allele that caused aberrant splicing and exon skipping, and the other allele had an amino acid substitution in exon 10 (S363N). The other heterozygote had the same amino acid substitution in exon 10 (S363N) in one allele and a premature stop codon in exon 6 (R192Stop) in the other allele. The S363N and S676N mutants, expressed in 293T cells, were retained in a pre-Golgi compartment and were not transported to the cell surface, indicating that these mutations inhibit trafficking. We conclude that several different molecular defects cause the Kell null phenotype.
Collapse
Affiliation(s)
- S Lee
- Lindsley F. Kimball Research Institute of the New York Blood Center, New York, New York 10021, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|