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Floch A, Galochkina T, Pirenne F, Tournamille C, de Brevern AG. Molecular dynamics of the human RhD and RhAG blood group proteins. Front Chem 2024; 12:1360392. [PMID: 38566898 PMCID: PMC10985258 DOI: 10.3389/fchem.2024.1360392] [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: 12/22/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction: Blood group antigens of the RH system (formerly known as "Rhesus") play an important role in transfusion medicine because of the severe haemolytic consequences of antibodies to these antigens. No crystal structure is available for RhD proteins with its partner RhAG, and the precise stoichiometry of the trimer complex remains unknown. Methods: To analyse their structural properties, the trimers formed by RhD and/or RhAG subunits were generated by protein modelling and molecular dynamics simulations were performed. Results: No major differences in structural behaviour were found between trimers of different compositions. The conformation of the subunits is relatively constant during molecular dynamics simulations, except for three large disordered loops. Discussion: This work makes it possible to propose a reasonable stoichiometry and demonstrates the potential of studying the structural behaviour of these proteins to investigate the hundreds of genetic variants relevant to transfusion medicine.
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Affiliation(s)
- Aline Floch
- University Paris Est Créteil, INSERM U955 Equipe Transfusion et Maladies du Globule Rouge, IMRB, Créteil, France
- Laboratoire de Biologie Médicale de Référence en Immuno-Hématologie Moléculaire, Etablissement Français du Sang Ile-de-France, Créteil, France
| | - Tatiana Galochkina
- Université Paris Cité and Université des Antilles and Université de la Réunion, Biologie Intégrée du Globule Rouge, UMR_S1134, BIGR, INSERM, DSIMB Bioinformatics team, Paris, France
| | - France Pirenne
- University Paris Est Créteil, INSERM U955 Equipe Transfusion et Maladies du Globule Rouge, IMRB, Créteil, France
- Laboratoire de Biologie Médicale de Référence en Immuno-Hématologie Moléculaire, Etablissement Français du Sang Ile-de-France, Créteil, France
| | - Christophe Tournamille
- University Paris Est Créteil, INSERM U955 Equipe Transfusion et Maladies du Globule Rouge, IMRB, Créteil, France
- Laboratoire de Biologie Médicale de Référence en Immuno-Hématologie Moléculaire, Etablissement Français du Sang Ile-de-France, Créteil, France
| | - Alexandre G. de Brevern
- Université Paris Cité and Université des Antilles and Université de la Réunion, Biologie Intégrée du Globule Rouge, UMR_S1134, BIGR, INSERM, DSIMB Bioinformatics team, Paris, France
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2
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Matzhold EM, Bemelmans M, Polin H, Körmöczi GF, Schönbacher M, Wagner T. Characterization of Novel RHD Allele Variants and Their Implications for Routine Blood Group Diagnostics. Biomedicines 2024; 12:456. [PMID: 38398058 PMCID: PMC10886452 DOI: 10.3390/biomedicines12020456] [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: 01/26/2024] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
The Rh system, including the highly immunogenic D antigen, is one of the clinically most important blood group systems in transfusion medicine. Numerous alleles of the RHD gene are associated with variant RhD phenotypes. In case of Rh incompatibility, some of them can induce hemolytic transfusion reactions and hemolytic disease of the fetus and newborn. Thus, accurate blood group diagnostics are critical for safe transfusion therapy. We characterized phenotypes of four individuals revealing weakened D expression during routine pre-transfusion testing. Standard gel card matrix techniques with monoclonal and polyclonal anti-D antibodies were used for serological typing, complemented using D epitope and antigen density analysis. Genotyping employing PCR with sequence-specific primers, genomic and allele-specific Sanger sequencing and in silico protein analysis were performed. Four novel RHD alleles associated with weak D or partial D phenotypes were identified. One of the mutations is predicted to disrupt the terminal stop codon and result in an elongated translation of the mutant D protein that phenotypically exhibits a loss of D epitopes. Furthermore, a hybrid gene formed with the homologue RHCE gene is described. The presented data enhances the understanding of the Rh system and may contribute to continued advances in blood group diagnostics.
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Affiliation(s)
- Eva M. Matzhold
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Maria Bemelmans
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Helene Polin
- Austrian Red Cross, Blood Transfusion Service of Upper Austria, 4020 Linz, Austria;
| | - Günther F. Körmöczi
- Department of Transfusion Medicine and Cell Therapy, Medical University of Vienna, 1090 Vienna, Austria; (G.F.K.); (M.S.)
| | - Marlies Schönbacher
- Department of Transfusion Medicine and Cell Therapy, Medical University of Vienna, 1090 Vienna, Austria; (G.F.K.); (M.S.)
| | - Thomas Wagner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria;
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3
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Pazourkova E, Zednikova I, Korabecna M, Kralova J, Pisacka M, Novotna M, Calda P, Horinek A. Optimization of diagnostic strategy for non-invasive cell-free foetal RHD determination from maternal plasma. Vox Sang 2021; 116:1012-1019. [PMID: 33761162 DOI: 10.1111/vox.13099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 11/20/2020] [Accepted: 03/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of the study was to optimize routine non-invasive prenatal detection of fetal RHD gene from plasma of RhD-negative pregnant women (the median of gestational age was 25 weeks, range 10-38) to detect RhD materno-fetal incompatibility and to avoid the redundant immunoprophylaxis. MATERIALS AND METHODS Initially only one exon of RHD gene (exon 10) was investigated in 281 plasma samples (144 verified after delivery), in the second phase three RHD exons (5, 7, 10) were analyzed in 246 samples of plasma and maternal genomic DNA (204 verified) by real-time PCR method. Detection of Y-chromosomal sequence DYS-14 and five X-chromosomal insertion/deletion polymorphisms was used to confirm the fetal cfDNA detectability in plasma. Specific polymorphisms in RHD gene were detected by sequence-specific primer PCR in nine samples. RESULTS When only the RHD exon 10 was tested, 2·8% of verified samples were false positive and 3·5% false negative. With three RHD exons (5, 7, 10) and maternal genomic DNA testing, only one case was false negative (0·5%). Nine samples were inconclusive due to RHD-positive results in maternal genomic DNA. These samples were analyzed for specific mutations in RHD gene. Combination of both methods for fetal cfDNA verification succeeded in 75% of tested group. CONCLUSION Implementation of analysis of three RHD exons and maternal genomic DNA to routine practice lowers dramatically the ratio of false positive and negative results. This method enables more accurate determination of fetal RHD status with the reduction of unnecessary medical care and RhD immunoprophylaxis.
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Affiliation(s)
- Eva Pazourkova
- Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic.,Department of Nephrology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
| | - Iveta Zednikova
- Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
| | - Marie Korabecna
- Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
| | - Jana Kralova
- Department of Immunohematology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Martin Pisacka
- Department of Immunohematology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Michaela Novotna
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
| | - Pavel Calda
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
| | - Ales Horinek
- Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic.,3rd Department of Medicine, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
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4
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Floch A, Pirenne F, Barrault A, Chami B, Toly-Ndour C, Tournamille C, de Brevern AG. Insights into anti-D formation in carriers of RhD variants through studies of 3D intraprotein interactions. Transfusion 2021; 61:1286-1301. [PMID: 33586199 DOI: 10.1111/trf.16301] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 11/04/2020] [Accepted: 01/13/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Many RhD variants associated with anti-D formation (partial D) in carriers exposed to the conventional D antigen carry mutations affecting extracellular loop residues. Surprisingly, some carry mutations affecting transmembrane or intracellular domains, positions not thought likely to have a major impact on D epitopes. STUDY DESIGN AND METHODS A wild-type Rh trimer (RhD1 RhAG2 ) was modeled by comparative modeling with the human RhCG structure. Taking trimer conformation, residue accessibility, and position relative to the lipid bilayer into account, we redefine the domains of the RhD protein. We generated models for RhD variants carrying one or two amino acid substitutions associated with anti-D formation in published articles (25 variants) or abstracts (12 variants) and for RHD*weak D type 38. We determined the extracellular substitutions and compared the interactions of the variants with those of the standard RhD. RESULTS The findings of the three-dimensional (3D) analysis were correlated with anti-D formation for 76% of RhD variants: 15 substitutions associated with anti-D formation concerned extracellular residues, and structural differences in intraprotein interactions relative to standard RhD were observed in the others. We discuss the mechanisms by which D epitopes may be modified in variants in which the extracellular residues are identical to those of standard RhD and provide arguments for the benignity of p.T379M (RHD*DAU0) and p.G278D (RHD*weak D type 38) in transfusion medicine. CONCLUSION The study of RhD intraprotein interactions and the precise redefinition of residue accessibility provide insight into the mechanisms through which RhD point mutations may lead to anti-D formation in carriers.
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Affiliation(s)
- Aline Floch
- Univ Paris Est Creteil, INSERM U955, Transfusion et Maladies du Globule Rouge, IMRB, Creteil, France.,Etablissement francais du sang Ile-de-France, Creteil, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - France Pirenne
- Univ Paris Est Creteil, INSERM U955, Transfusion et Maladies du Globule Rouge, IMRB, Creteil, France.,Etablissement francais du sang Ile-de-France, Creteil, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Aurélie Barrault
- Univ Paris Est Creteil, INSERM U955, Transfusion et Maladies du Globule Rouge, IMRB, Creteil, France.,Etablissement francais du sang Ile-de-France, Creteil, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Btissam Chami
- Etablissement francais du sang Ile-de-France, Creteil, France
| | - Cécile Toly-Ndour
- Unité Fonctionnelle d'expertise en Immuno-Hémobiologie Périnatale, Centre National de Référence en Hémobiologie Périnatale (CNRHP), Service de Médecine Fœtale, Pôle Périnatalité, Hôpital Trousseau, GH HUEP, APHP, Paris, France
| | - Christophe Tournamille
- Univ Paris Est Creteil, INSERM U955, Transfusion et Maladies du Globule Rouge, IMRB, Creteil, France.,Etablissement francais du sang Ile-de-France, Creteil, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Alexandre G de Brevern
- Laboratoire d'Excellence GR-Ex, Paris, France.,Université de Paris, Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, Université de la Réunion, Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine (INTS), Paris, France
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5
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Choi S, Yu H, Cho D. First Korean Case of Partial D DBS-1. Ann Lab Med 2020; 40:337-340. [PMID: 32067436 PMCID: PMC7054695 DOI: 10.3343/alm.2020.40.4.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/18/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sooin Choi
- Department of Laboratory Medicine, Soonchunhyang University Hospital Cheonan, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - HongBi Yu
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Duck Cho
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.,Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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6
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Guzijan G, Milosavić M, Radojković-Sredić D, Lilić M, Jukić B. Molecular typing of RhD-negative blood donors with C and/or E antigen. SCRIPTA MEDICA 2019. [DOI: 10.5937/scriptamed50-22635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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7
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Floch A, Gien D, Tournamille C, Chami B, Habibi A, Galactéros F, Bierling P, Djoudi R, Pondarré C, Peyrard T, Pirenne F. High immunogenicity of red blood cell antigens restricted to the population of African descent in a cohort of sickle cell disease patients. Transfusion 2018; 58:1527-1535. [PMID: 29707783 DOI: 10.1111/trf.14633] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/12/2018] [Accepted: 01/29/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) patients undergo multiple red blood cell (RBC) transfusions and are regularly exposed to low-prevalence (LP) antigens specific to individuals of African descent. This study evaluated the prevalence of antibodies against LP antigens in SCD patients and the need to identify these antibodies in everyday practice. STUDY DESIGN AND METHODS Plasma from 211 SCD patients was tested with RBCs expressing the following LP antigens: RH10 (V), RH20 (VS), RH23 (DW ), RH30 (Goa ), KEL6 (Jsa ), and MNS6 (He). RESULTS Nine LP antibodies were found in eight patients (3.8%): five anti-RH23, two anti-RH30, and two anti-MNS6. The exposure risk, calculated for each LP antigen, was below 3% per RBC unit, for all antigens tested. Thus, in this cohort of transfused SCD patients, the prevalence of LP antibodies was similar to that of antibodies against antigens of the FY, JK, and MNS blood group systems. These findings also reveal the occurrence of anti-RH23 in SCD patients. No anti-RH20 or anti-KEL6 were found, despite the high frequency of mismatch situations. CONCLUSION These results highlight the immunogenicity of these LP antigens, and the evanescence of antibodies against LP antigens. They also highlight the importance of appropriate pretransfusion testing for patients frequently transfused, who are likely to be exposed to multiple types of blood group antigens.
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Affiliation(s)
- Aline Floch
- Etablissement Français du Sang (EFS)-Ile de France, Créteil.,INSERM U955, Equipe 2 "Transfusion et maladies du globule rouge", Créteil.,Laboratory of Excellence GR-Ex, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil
| | - Dominique Gien
- Laboratory of Excellence GR-Ex, Créteil, France.,Département Centre National de Référence pour les Groupes Sanguins, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - Christophe Tournamille
- Etablissement Français du Sang (EFS)-Ile de France, Créteil.,INSERM U955, Equipe 2 "Transfusion et maladies du globule rouge", Créteil.,Laboratory of Excellence GR-Ex, Créteil, France
| | - Btissam Chami
- Etablissement Français du Sang (EFS)-Ile de France, Créteil
| | - Anoosha Habibi
- INSERM U955, Equipe 2 "Transfusion et maladies du globule rouge", Créteil.,Centre de Référence de la Drépanocytose, Unité des Maladies du Globule Rouge, Hôpitaux Universitaires Henri Mondor, Créteil
| | - Frédéric Galactéros
- INSERM U955, Equipe 2 "Transfusion et maladies du globule rouge", Créteil.,Centre de Référence de la Drépanocytose, Unité des Maladies du Globule Rouge, Hôpitaux Universitaires Henri Mondor, Créteil
| | - Philippe Bierling
- Etablissement Français du Sang (EFS)-Ile de France, Créteil.,INSERM U955, Equipe 2 "Transfusion et maladies du globule rouge", Créteil.,Laboratory of Excellence GR-Ex, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil.,Service de Pédiatrie et Drépanocytose, Centre Intercommunal de Créteil, Créteil, France
| | - Rachid Djoudi
- Etablissement Français du Sang (EFS)-Ile de France, Créteil
| | - Corinne Pondarré
- INSERM U955, Equipe 2 "Transfusion et maladies du globule rouge", Créteil.,Service de Pédiatrie et Drépanocytose, Centre Intercommunal de Créteil, Créteil, France
| | - Thierry Peyrard
- Laboratory of Excellence GR-Ex, Créteil, France.,Département Centre National de Référence pour les Groupes Sanguins, Institut National de la Transfusion Sanguine (INTS), Paris, France
| | - France Pirenne
- Etablissement Français du Sang (EFS)-Ile de France, Créteil.,INSERM U955, Equipe 2 "Transfusion et maladies du globule rouge", Créteil.,Laboratory of Excellence GR-Ex, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil
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8
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Srivastava K, Polin H, Sheldon SL, Wagner FF, Grabmer C, Gabriel C, Denomme GA, Flegel WA. The DAU cluster: a comparative analysis of 18 RHD alleles, some forming partial D antigens. Transfusion 2016; 56:2520-2531. [PMID: 27480171 PMCID: PMC5499517 DOI: 10.1111/trf.13739] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND The Rh system is the most complex and polymorphic blood group system in humans with more than 460 alleles known for the RHD gene. The DAU cluster of RHD alleles is characterized by the single-nucleotide change producing the p.Thr379Met amino acid substitution. It is called the DAU-0 allele and has been postulated to be the primordial allele, from which all other alleles of the DAU cluster have eventually evolved. STUDY DESIGN AND METHODS For two novel DAU alleles, the nucleotide sequences of all 10 exons as well as adjacent intronic regions, including the 5' and 3' untranslated regions (UTR), were determined for the RHD and RHCE genes. A phylogenetic tree for all DAU alleles was established using the neighbor-joining method with Pan troglodytes as root. Standard hemagglutination and flow cytometry tests were performed. RESULTS We characterized two DAU alleles, DAU-11 and DAU-5.1, closely related to DAU-3 and DAU-5, respectively. A phylogenetic analysis of the 18 known DAU alleles indicated point mutations and interallelic recombination contributing to diversification of the DAU cluster. CONCLUSIONS The DAU alleles encode a group of RhD protein variants, some forming partial D antigens known to permit anti-D in carriers; all are expected to cause anti-D alloimmunization in recipients of red blood cell transfusions. The DAU alleles evolved through genomic point mutations and recombination. These results suggest that the cluster of DAU alleles represent a clade, which is concordant with our previous postulate that they derived from the primordial DAU-0 allele.
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Affiliation(s)
- Kshitij Srivastava
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Helene Polin
- Red Cross Transfusion Service of Upper Austria, Linz, Austria
| | - Sherry Lynne Sheldon
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | | | - Christoph Grabmer
- Department of Blood Group Serology and Transfusion Medicine, SALK-Paracelsus Medical University, Salzburg, Austria
| | - Christian Gabriel
- Red Cross Transfusion Service of Upper Austria, Linz, Austria
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | | | - Willy Albert Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland.
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9
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Srivastava K, Lee E, Owens E, Rujirojindakul P, Flegel WA. Full-length nucleotide sequence of ERMAP alleles encoding Scianna (SC) antigens. Transfusion 2016; 56:3047-3054. [PMID: 27612015 DOI: 10.1111/trf.13801] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Scianna (SC) blood group system comprises two antithetical antigens, Sc1 and Sc2, and five additional antigens. The antigens reside on a glycoprotein encoded by the erythroblast membrane-associated protein (ERMAP) gene. For the common ERMAP alleles, we determined the full-length nucleotide sequence that encodes the Scianna glycoprotein. STUDY DESIGN AND METHODS Blood donor samples from five populations were analyzed including 20 African Americans, 10 Caucasians, 10 Thai, five Asians, and five Hispanics for a total of 100 chromosomes. An assay was devised to determine the genomic sequence of the ERMAP gene in one amplicon, spanning 21.4 kb and covering Exons 2 to 12 and the intervening sequence (IVS). All alleles (confirmed haplotypes) were resolved without ambiguity. RESULTS Among 50 blood donors, we found 80 single-nucleotide polymorphisms (SNPs), including six novel SNPs, in 21,308 nucleotides covering the coding sequence of the ERMAP gene and including the introns. The noncoding sequences harbored 75 SNPs (68 in the introns and seven in the 3'-UTR). No SNP indicative of a nonfunctional allele was detected. The nucleotide sequences for 48 ERMAP alleles (confirmed haplotypes) were determined by allele-specific polymerase chain reaction and sequencing in 100 chromosomes. CONCLUSIONS We documented 48 ERMAP alleles of 21,308 nucleotides each. The two nucleotide sequences available in GenBank for ERMAP alleles of similar length have not been found in our 100 chromosomes. Alleles determined without ambiguity can be used as templates to analyze next generation sequencing data, which will enhance the reliability in clinical diagnostics.
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Affiliation(s)
- Kshitij Srivastava
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Eunah Lee
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Eric Owens
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Pairaya Rujirojindakul
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Willy A Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
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10
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Sandler SG, Flegel WA, Westhoff CM, Denomme GA, Delaney M, Keller MA, Johnson ST, Katz L, Queenan JT, Vassallo RR, Simon CD. It's time to phase in RHD genotyping for patients with a serologic weak D phenotype. College of American Pathologists Transfusion Medicine Resource Committee Work Group. Transfusion 2015; 55:680-9. [PMID: 25438646 PMCID: PMC4357540 DOI: 10.1111/trf.12941] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/07/2014] [Accepted: 10/07/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S Gerald Sandler
- Department of Pathology and Laboratory Medicine, MedStar Georgetown University Hospital, Washington, DC
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11
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Srivastava K, Almarry NS, Flegel WA. Genetic variation of the whole ICAM4 gene in Caucasians and African Americans. Transfusion 2014; 54:2315-24. [PMID: 24673173 DOI: 10.1111/trf.12615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 01/19/2014] [Accepted: 01/20/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND Landsteiner-Wiener (LW) is the human blood group system Number 16, which comprises two antithetical antigens, LW(a) and LW(b) and the high-prevalence antigen LW(ab) . LW is encoded by the intracellular adhesion molecule 4 (ICAM4) gene. The ICAM4 protein is part of the Rhesus complex in the red cell membrane and is involved in cell-cell adhesion. STUDY DESIGN AND METHODS We developed a method to sequence the whole 1.9-kb ICAM4 gene from genomic DNA in one amplicon. We determined the nucleotide sequence of Exons 1 to 3, the two introns, and 402-bp 5'-untranslated region (UTR) and 347-bp 3'-UTR in 97 Caucasian and 91 African American individuals. RESULTS Seven variant ICAM4 alleles were found, distinct from the wild-type ICAM4 allele (GenBank KF712272), known as LW*05 and encoding LW(a) . An effect of the LW(a) /LW(b) amino acid substitution on the protein structure was predicted by two of the three computational modeling programs used. CONCLUSIONS We describe a practical approach for sequencing and determining the ICAM4 alleles using genomic DNA. LW*05 is the ancestral allele, which had also been observed in a Neanderthal sample. All seven variant alleles are immediate derivatives of the prevalent LW*05 and caused by one single-nucleotide polymorphism (SNP) in each allele. Our data were consistent with the NHLBI GO Exome Sequencing Project (ESP) and the dbSNP databases, as all SNPs had been observed previously. Our study has the advantage over the other databases in that it adds haplotype (allele) information for the ICAM4 gene, clinically relevant in the field of transfusion medicine.
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Affiliation(s)
- Kshitij Srivastava
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
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12
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von Zabern I, Wagner FF, Moulds JM, Moulds JJ, Flegel WA. D category IV: a group of clinically relevant and phylogenetically diverse partial D. Transfusion 2013; 53:2960-73. [PMID: 23461862 DOI: 10.1111/trf.12145] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 01/06/2013] [Accepted: 01/10/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The D typing strategies in several European countries protect carriers of D category VI (DVI) from anti-D immunization but not carriers of other partial D. Besides DVI, one of the clinically most important partial D is D category IV (DIV). A detailed description and direct comparison of the different DIV types was missing. STUDY DESIGN AND METHODS RHD nucleotide sequences were determined from genomic DNA. D epitope patterns were established with commercial monoclonal anti-D panels. RESULTS DIV comprises several variants of the D antigen with distinct serology, molecular structures, evolutionary origins, and ethnic prevalences. The DIV phenotype is determined by 350H shared by all, but not limited to, DIV variants which are further divided into DIVa and DIVb. The DIVa phenotype is expressed by DIV Type 1.0 harboring 350H and the dispersed amino acids 62F, 137V, and 152T. The DIVb phenotype is expressed by DIV Type 3 to Type 5 representing RHD-CE-D hybrids. Four of the six postulated DIV variants were encountered among 23 DIV samples analyzed. Of 12 DIV carriers with anti-D, 10 were female and seven likely immunized by pregnancy. Two DIV-related alleles are newly described: DWN, which differs from DIV Type 4 by 350D and epitope pattern. DNT carries 152T, known to cause a large D antigen density. CONCLUSION DIV alleles arose from at least two independent evolutionary events. DIV Type 1.0 with DIVa phenotype belongs to the oldest extant human RHD alleles. DIV Type 2 to Type 5 with DIVb phenotype arose from more recent gene conversions. Anti-D immunization, especially dreaded in pregnancies, will be avoided not only in carriers of DVI but also in carriers of other D variants like DIV, if our proposed D typing strategy is adopted.
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Affiliation(s)
- Inge von Zabern
- Department of Transfusion Medicine, University Hospital, Ulm, Germany; Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany; DRK (German Red Cross) Blood Donor Service Baden-Württemberg-Hessen, Institute, Ulm, Germany; DRK Blood Donor Service NSTOB, Institute, Springe, Germany; Scientific Support Services, LifeShare Blood Centers, Shreveport, Louisiana; Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
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13
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Abstract
Rhesus is the clinically most important protein-based blood group system. It represents the largest number of antigens and the most complex genetics of the 30 known blood group systems. The RHD and RHCE genes are strongly homologous. Some genetic complexity is explained by their close chromosomal proximity and unusual orientation, with their tail ends facing each other. The antigens are expressed by the RhD and the RhCE proteins. Rhesus exemplifies the correlation of genotype and phenotype, facilitating the understanding of general genetic mechanisms. For clinical purposes, genetic diagnostics of Rhesus antigens will improve the cost-effective development of transfusion medicine.
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Affiliation(s)
- Willy A Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, MD 20892, United States.
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14
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Bugert P, Scharberg EA, Geisen C, von Zabern I, Flegel WA. RhCE protein variants in Southwestern Germany detected by serologic routine testing. Transfusion 2009; 49:1793-802. [PMID: 19453980 DOI: 10.1111/j.1537-2995.2009.02220.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Variant RHCE alleles with diminished expression of C, c, E, and e antigens have been described and indicate the genetic diversity of this gene locus in several populations. In this study the molecular background of variant RhCE antigens identified by standard serologic routine testing in German blood donors and patients was determined. STUDY DESIGN AND METHODS Samples from blood donors and patients were routinely analyzed for RhCE phenotype using the PK7200 analyzer with two sets of monoclonal anti-C, -c, -E, and -e reagents. Samples with confirmed variant RhCE antigens were analyzed by nucleotide sequencing of the 10 RHCE exons. A multiplex polymerase chain reaction with sequence-specific priming (PCR-SSP) method was established for rapid typing of the rare RHCE alleles. RESULTS We identified 43 samples with serologic RhCE variants. Molecular analysis revealed variant RHCE alleles in 34 samples. Altogether 22 RHCE alleles were detected; 10 have not been published before. Twenty alleles harbored distinct single-nucleotide substitutions, 18 of which encoded amino acid changes and 2 of which occurred in noncoding regions. Two samples represented RHCE-D-CE hybrid alleles involving different segments of the RHCE Exon 5. A multiplex PCR-SSP screening for 17 RHCE alleles was negative in 1344 samples of the DNA bank GerBS. The cumulative phenotype frequency was estimated between 1 in 488 (0.20%) and 1 in 8449 (0.012%). CONCLUSION Single-amino-acid substitutions were the molecular basis for variant RhCE antigen expression in most samples. Nucleotide substitutions in RHCE exons were excluded as possible mechanism of diminished RhCE antigen expression in one-fifth of the serologically identified samples.
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Affiliation(s)
- Peter Bugert
- German Red Cross Blood Donor Service, Baden-Württemberg-Hessen, Germany
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