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Laget L, Izard C, Durieux-Roussel E, Filosa L, Bailly P, Mazières S, Chiaroni J. Frequency and characterization of RHD and RHCE variants in the Noir Marron population from French Guiana. Transfusion 2022; 62:2631-2638. [PMID: 36286083 DOI: 10.1111/trf.17132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The RH system is one of the most polymorphic blood group systems due to the proximity and opposite orientation of RHD and RHCE genes. Numerous alleles are described and can affect Rh protein expression. This complexity is especially evident in populations of African origin. We performed RHD and RHCE genotyping of the Noir Marron population in French Guiana. This population belongs to the Maroon community who are direct descendants of African slaves, who escaped from Dutch plantations, in the current day Suriname, during the 17th century. They represent an original ethnic group with highly blended culture. METHODS AND MATERIALS A total of 89 DNA samples were collected from four different ethnic groups of the Noir Marron population of French Guiana. RHD and RHCE genotyping was performed using DNA microarray and/or sequencing. RESULTS AND DISCUSSION Significant allelic diversity was shown, with 45% of individuals presenting an RHD gene variant (most common: RHD*DAU, RHD*DIVa, and RHD*DIIIa allele) and 9.4% with a partial D phenotype. Likewise, 85% presenting an RHCE gene variant and 9% a partial RH2 antigen. One original allele was identified in two D+ Noir Marron individuals: a hybrid RHD*DIIIa-CE(9)-D allele, encoding probably a partial D antigen and associated with an RHCE*ce(48C,733G,1006T) allele. The African diversity of RHD and RHCE genes is found in this population with preserved genetic but mixed cultural backgrounds. These data allow us to describe the characteristics of the RH system antigen and highlights a significant number of partial antigens with a risk of alloimmunization.
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Affiliation(s)
- Laurine Laget
- EFS PACA Corse, Laboratoire Immuno-Hématologie Receveur, Marseille, France
| | - Caroline Izard
- EFS PACA Corse, Laboratoire Immuno-Hématologie Receveur, Marseille, France
| | | | - Lugdivine Filosa
- EFS PACA Corse, Laboratoire Immuno-Hématologie Receveur, Marseille, France
| | - Pascal Bailly
- EFS PACA Corse, Laboratoire Immuno-Hématologie Receveur, Marseille, France
| | - Stéphane Mazières
- Aix-Marseille-University Anthropologie Droit Ethique Santé-UMR7268, Marseille, France
| | - Jacques Chiaroni
- EFS PACA Corse, Laboratoire Immuno-Hématologie Receveur, Marseille, France
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Five-Years Review of RHCE Alleles Detected after Weak and/or Discrepant C Results in Southern France. Genes (Basel) 2022; 13:genes13061058. [PMID: 35741820 PMCID: PMC9222276 DOI: 10.3390/genes13061058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 02/04/2023] Open
Abstract
Immunohematology laboratories are regularly facing transfusion issues due to serological weaknesses. Altered (partial) RH antigens account for most of them. In some situations, RHCE variant alleles are involved. Herein we present our three-step molecular exploration, with allele frequencies, that has efficiently untangled RH2 phenotype weaknesses and discrepancies in our 2017–2021 cohort. In the last 5 years, the PACA Corse EFS molecular platform received 265 samples from healthy blood donors or patients with C and C/e typing difficulties. The first-intention technique (DNA array and real time PCR for RHCE*CeRN research) detected RHCE variant alleles in 143 cases (54%). The RHCE alleles classically found in African populations were the most frequent, with RHCE*CeRN allele in 40 cases (15%) and (C)ces haplotype type 1 and 2 in 26 cases (10%). A “CE” effect haplotype was suspected in 56 cases, due to the uncommon DCE haplotype that may explain the low C expression. When there were no RHCE*Ce or RHCE*CE alleles, we then searched for RHD polymorphisms by DNA array. We detected the RHD*DAU5 and RHD*DIVa in 18 and 7 cases respectively, suggesting that C ambiguity is related to the presence of these alleles which has never been described with DAU5. If no variant RHCE and RHD alleles were detected, we finally sequenced the 10 exons of both RHCE and RHD genes according to the clinical context and found seven new RHCE alleles. Thus, this molecular strategy would improve the knowledge of RHCE variants’ expression and, thus, optimize the transfusion management.
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Arnoni CP, Vendrame T, Muniz J, Cortez A, Latini F, Castilho L. RHCE diversity among Brazilian patients with sickle cell disease (SCD) and selected groups of blood donors. Transfusion 2021; 61:3473-3482. [PMID: 34590710 DOI: 10.1111/trf.16689] [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: 05/06/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Several centers have selected Black donors to prevent Rh alloimmunization of patients with sickle cell disease (SCD). As the Brazilian population is considered very admixed and race definition by self-declaration is questionable, this study aimed to compare RHCE diversity among patients with SCD and selected groups of Brazilian blood donors to define which group of donors would be the adequate red cell supply for patients with SCD. METHOD We compared RHCE allele frequencies between patients with SCD and four groups of Brazilian blood donors: self-declared Black donors (SDB), donors with predominant African genetic markers (AAM), donors with weak D expression (WDD), and random donors (RDs). Variant RHCE alleles were identified using molecular protocols. RESULTS Among patients with SCD, 47% had at least one variant RHCE, in SDB and WDD this frequency was higher, 53% and 58.6%, respectively. In AAM and in RD the frequencies were 32% and 27.6%, respectively. In patients with SCD and SDB, the most common alleles were RHCE*ce.01, RHCE*ceVS.01, and RHCE*ceVS.02. WDD had a high frequency of RHCE*ceAR and highest frequency of variant RHCE in both alleles, followed by patients with SCD and SDB. CONCLUSION This study showed that even in an admixed population the selection of SDB donors is the best choice of matching for transfusion support in patients with SCD. For specific RHCE alleles, selection of donors with weak D expression could be a good option.
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Affiliation(s)
- Carine Prisco Arnoni
- Scientific Technical Department, Colsan - Associação Beneficente de Coleta de Sangue, São Paulo, Brazil
| | | | - Janaína Muniz
- Scientific Technical Department, Colsan - Associação Beneficente de Coleta de Sangue, São Paulo, Brazil
| | - Afonso Cortez
- Scientific Technical Department, Colsan - Associação Beneficente de Coleta de Sangue, São Paulo, Brazil
| | - Flavia Latini
- Scientific Technical Department, Colsan - Associação Beneficente de Coleta de Sangue, São Paulo, Brazil
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A novel algorithm comprehensively characterizes human RH genes using whole-genome sequencing data. Blood Adv 2021; 4:4347-4357. [PMID: 32915977 DOI: 10.1182/bloodadvances.2020002148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/10/2020] [Indexed: 11/20/2022] Open
Abstract
RHD and RHCE genes encode Rh blood group antigens and exhibit extensive single-nucleotide polymorphisms and chromosome structural changes in patients with sickle cell disease (SCD). RH variation can drive loss of antigen epitopes or expression of new epitopes, predisposing patients with SCD to Rh alloimmunization. Serologic antigen typing is limited to common Rh antigens, necessitating a genetic approach to detect variant antigen expression. We developed a novel algorithm termed RHtyper for RH genotyping from existing whole-genome sequencing (WGS) data. RHtyper determined RH genotypes in an average of 3.4 and 3.3 minutes per sample for RHD and RHCE, respectively. In a validation cohort consisting of 57 patients with SCD, RHtyper achieved 100% accuracy for RHD and 98.2% accuracy for RHCE, when compared with genotypes obtained by RH BeadChip and targeted molecular assays and after verification by Sanger sequencing and independent next-generation sequencing assays. RHtyper was next applied to WGS data from an additional 827 patients with SCD. In the total cohort of 884 patients, RHtyper identified 38 RHD and 28 RHCE distinct alleles, including a novel RHD DAU allele, RHD* 602G, 733C, 744T 1136T. RHtyper provides comprehensive and high-throughput RH genotyping from WGS data, facilitating deconvolution of the extensive RH genetic variation among patients with SCD. We have implemented RHtyper as a cloud-based public access application in DNAnexus (https://platform.dnanexus.com/app/RHtyper), enabling clinicians and researchers to perform RH genotyping with next-generation sequencing data.
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Flesch BK, Scherer V, Just B, Opitz A, Ochmann O, Janson A, Steitz M, Zeiler T. Molecular Blood Group Screening in Donors from Arabian Countries and Iran Using High-Throughput MALDI-TOF Mass Spectrometry and PCR-SSP. Transfus Med Hemother 2020; 47:396-408. [PMID: 33173458 DOI: 10.1159/000505495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/14/2019] [Indexed: 12/11/2022] Open
Abstract
Background and Aims Only little is known about blood groups other than ABO blood groups and Rhesus factors in Arabian countries and Iran. During the last years, increased migration to Central Europe has put a focus on the question how to guarantee blood supply for patients from these countries, particularly because hemoglobinopathies with the need of regular blood support are more frequent in patients from that region. Therefore, blood group allele frequencies should be determined in individuals from Arabian countries and Iran by molecular typing and compared to a German rare donor panel. Methods 1,111 samples including 800 individuals from Syria, 147 from Iran, 123 from the Arabian Peninsula, and 41 from Northern African countries were included in a MALDI-TOF MS assay to detect polymorphisms coding for Kk, Fy(a/b), Fy<sub>null</sub>, C<sub>w</sub>, Jk(a/b), Jo(a+/a-), Lu(a/b), Lu(8/14), Ss, Do(a/b), Co(a/b), In(a/b), Js(a/b), Kp(a/b), and variant alleles RHCE*c.697C>G and RHCE *c.733C>G. Yt(a/b), S-s-U-, Vel<sub>null</sub>, Co<sub>null</sub>, and RHCE *c.667G>T were tested by PCR-SSP. Results Of the Arabian donors, 2% were homozygous for the FY *02.01N allele (Fy<sub>null</sub>), and 15.7% carried the heterozygous mutation. However, 0.8% of the German donors also carried 1 copy of the allele. 3.6% of all and 29.3% of Northern African donors were heterozygous for the RHCE *c.733C>G substitution, 0.4% of the Syrian probands were heterozygous for DO *01/DO *01.-05, a genotype that was lacking in German donors. Whereas the KEL *02.06 allele coding for the Js(a) phenotype was missing in Germans; 0.8% of the Syrian donors carried 1 copy of this allele. 1.8% of the Syrian but only 0.3% of the German donors were negative for YT *01. One donor from Northern Africa homo-zygously carried the GYPB *270+5g>t mutation, inducing the S-s-U+<sup>w</sup> phenotype, and in 2 German donors a GYPB *c.161G>A exchange, which induces the Mit+ phenotype, caused a GYPB *03 allele dropout in the MALDI assay. The overall failure rate of the Arabian panel was 0.4%. Conclusions Some blood group alleles that are largely lacking in Europeans but had been described in African individuals are present in Arabian populations at a somewhat lower frequency. In single cases, it could be challenging to provide immunized Arabian patients with compatible blood.
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Affiliation(s)
- Brigitte Katharina Flesch
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany.,German Red Cross Blood Service West, Hagen, Germany
| | - Vanessa Scherer
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | | | - Andreas Opitz
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | - Oswin Ochmann
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | - Anne Janson
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | - Monika Steitz
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
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de Brevern AG, Floch A, Barrault A, Martret J, Bodivit G, Djoudi R, Pirenne F, Tournamille C. Alloimmunization risk associated with amino acid 223 substitution in the RhD protein: analysis in the light of molecular modeling. Transfusion 2018; 58:2683-2692. [DOI: 10.1111/trf.14809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 04/09/2018] [Accepted: 04/21/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Alexandre G. de Brevern
- INSERM UMR_S 1134; Univ. Paris Diderot, Sorbonne Paris Cité, Univ. de la Réunion, Univ. Antilles; Paris
- Laboratory of Excellence GR-Ex; Paris
- Institut National de la Transfusion Sanguine (INTS); Paris
| | - Aline Floch
- Laboratory of Excellence GR-Ex; Paris
- Etablissement Français du Sang Ile de France; Créteil France
- IMRB-INSERM U955 Team 2 “Transfusion et Maladies du Globule Rouge”; Créteil France
- UPEC; Université Paris Est-Créteil; Créteil France
| | | | | | - Gwellaouen Bodivit
- Laboratory of Excellence GR-Ex; Paris
- Etablissement Français du Sang Ile de France; Créteil France
- IMRB-INSERM U955 Team 2 “Transfusion et Maladies du Globule Rouge”; Créteil France
| | - Rachid Djoudi
- Etablissement Français du Sang Ile de France; Créteil France
| | - France Pirenne
- Laboratory of Excellence GR-Ex; Paris
- Etablissement Français du Sang Ile de France; Créteil France
- IMRB-INSERM U955 Team 2 “Transfusion et Maladies du Globule Rouge”; Créteil France
- UPEC; Université Paris Est-Créteil; Créteil France
| | - Christophe Tournamille
- Laboratory of Excellence GR-Ex; Paris
- Etablissement Français du Sang Ile de France; Créteil France
- IMRB-INSERM U955 Team 2 “Transfusion et Maladies du Globule Rouge”; Créteil France
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Allali S, Peyrard T, Amiranoff D, Cohen JF, Chalumeau M, Brousse V, de Montalembert M. Prevalence and risk factors for red blood cell alloimmunization in 175 children with sickle cell disease in a French university hospital reference centre. Br J Haematol 2017; 177:641-647. [PMID: 28402005 DOI: 10.1111/bjh.14609] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 12/27/2016] [Indexed: 12/27/2022]
Abstract
Patients with sickle cell disease (SCD) show a high prevalence of red blood cell (RBC) alloimmunization, but few studies have focused on children. We aimed to study the prevalence and risk factors of RBC alloimmunization in SCD children. We retrospectively analysed the medical and transfusion files for 245 SCD children hospitalized in our centre in 2014 and included 175 patients who had received at least one RBC unit in their lifetime. The main clinical and immuno-haematological characteristics of alloimmunized and non-alloimmunized patients were compared. The prevalence of alloimmunization was 13·7% [95% confidence interval (CI) (8·6-18·6)], and 7·4% [95% CI (3·5-11·3)] after excluding the probable irregular natural antibodies (anti-M, anti-Lea , anti-Leb , anti-Lex ). Main risk factors for alloimmunization were increased number of RBC units received (median of 65 vs. 10 units per patient; P = 0·01) and the presence of one or more red cell autoantibodies (46·2% vs. 4·7%; P < 0·0001). The alloimmunization rate was higher for episodically transfused than chronically transfused patients (1·43 vs. 0·24/100 units received; P < 0·001). The presence of red cell autoantibodies appears to be a major risk factor for alloimmunization in SCD children and could justify specific transfusion guidelines.
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Affiliation(s)
- Slimane Allali
- Department of Paediatrics, Necker Hospital for Sick Children, Paris Descartes University, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Thierry Peyrard
- Laboratory of Excellence GR-Ex, Paris, France.,Département Centre National de Référence pour les Groupes Sanguins (CNRGS), Institut National de la Transfusion Sanguine (INTS), Paris, France.,Inserm UMR_S1134, Paris Diderot University, Paris, France
| | - Denise Amiranoff
- Etablissement Français du Sang (EFS), Necker Hospital for Sick Children, Paris, France
| | - Jérémie F Cohen
- Department of Paediatrics, Necker Hospital for Sick Children, Paris Descartes University, Paris, France.,Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), Inserm UMR1153, Paris, France
| | - Martin Chalumeau
- Department of Paediatrics, Necker Hospital for Sick Children, Paris Descartes University, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France.,Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), Inserm UMR1153, Paris, France
| | - Valentine Brousse
- Department of Paediatrics, Necker Hospital for Sick Children, Paris Descartes University, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Mariane de Montalembert
- Department of Paediatrics, Necker Hospital for Sick Children, Paris Descartes University, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
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Granier T, Chiaroni J, Bailly P, Silvy M. First description of a D-CE-D hybrid gene on a weak D Type 2 molecular background. Transfusion 2017; 57:1248-1253. [PMID: 28164316 DOI: 10.1111/trf.14023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/12/2016] [Accepted: 12/16/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND RhD phenotypes that express a significantly reduced amount of RhD antigen per red blood cell may be mistyped as RhD-negative by standard serologic methods. The molecular identification of weak D Type 1, 2, or 3 carriers allows managing them as RhD-positive and, thus, rationalizes the use of RhD-negative stock units and the administration of Rh-immunoglobulin prophylaxis, avoiding unnecessary costs and possible side effects. STUDY DESIGN AND METHODS One sample was investigated for confirming a D-C-E+c+e- phenotype. Rh phenotyping was performed with the microplate direct hemagglutination test. DNA array analysis was performed using the BeadChip wRhD kit, and the RHD gene was explored by sequencing to determine the molecular background associated with RhD-negative phenotype. RESULTS Molecular investigations showed a lack of amplification of Exons 3 through 7 and c.1154G>T transversion in Exon 9, suggesting an RHD-CE-D composite on a weak D Type 2 background. We attempted to precisely identify the two recombination sites generating this hybrid allele. The 5' and 3' breakpoints were located in Introns 2 and 7, which showed concentration of mobile Alu sequences most likely involved in the RHD-cE(3-7)-weak D Type 2 allele. CONCLUSION Altogether, we identified the first example of an RHD-CE-D large hybrid allele on a weak D Type 2 background associated with an RhD-negative phenotype. By investigating the RHCE-D breakpoint zones, we suggest a mobile element-mediated recombination.
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Affiliation(s)
- Thomas Granier
- Etablissement Français du Sang Alpes Méditerranée.,Aix Marseille Univ, CNRS, EFS, ADES, "Biologie des Groupes Sanguin,", Marseille, France
| | - Jacques Chiaroni
- Etablissement Français du Sang Alpes Méditerranée.,Aix Marseille Univ, CNRS, EFS, ADES, "Biologie des Groupes Sanguin,", Marseille, France
| | - Pascal Bailly
- Etablissement Français du Sang Alpes Méditerranée.,Aix Marseille Univ, CNRS, EFS, ADES, "Biologie des Groupes Sanguin,", Marseille, France
| | - Monique Silvy
- Etablissement Français du Sang Alpes Méditerranée.,Aix Marseille Univ, CNRS, EFS, ADES, "Biologie des Groupes Sanguin,", Marseille, France
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Ba A, Bagayoko S, Chiaroni J, Baiily P, Silvy M. Genotyping of 28 blood group alleles in blood donors from Mali: Prediction of rare phenotypes. Transfus Apher Sci 2016; 54:289-95. [DOI: 10.1016/j.transci.2015.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 11/28/2022]
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Ouchari M, Romdhane H, Chakroun T, Abdelkefi S, Jarrey I, Houissa B, Jemni Yacoub S. The Duffy blood group system in the Tunisian population. Transfus Clin Biol 2015; 22:76-9. [PMID: 25936942 DOI: 10.1016/j.tracli.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 03/20/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tunisia was described to as genetically heterogenous. Besides the 1% native Berber, the genetically influence of the Europeans seems much larger than that of sub-Saharan populations. Due to their ethnic variability, blood group variants have the potential to support population analyses. The aim of this study was to estimate the Duffy blood group system in this mixed population with enhanced characterization of samples with aberrant expression. MATERIALS AND METHODS Standard serological testing for the Duffy antigen was done for 105 Tunisian blood donors. Samples with altered Fy expression underwent DNA sequencing of the DARC, RHD and RHCE genes. RESULTS The Fy(a-b+) was the most common phenotype identified in the Tunisian population (38.1%). Five samples with Fy(a-b-) phenotype were determined as FY*02N.01/FY*02N.01 by a homozygous occurrence of the FY*B-67C>T alteration. Another three individuals exhibited a Fy(b+(w))Fy(x) expression, confirmed by a FY*A/FY*02M.01 (n = 1) and a FY*02M.01/FY*02M.01 (n = 2) genotype. RHD and RHCE sequencing (n= 8) revealed altered alleles observed in black populations in 5 samples. One individual with FY*02M.01/FY*02M.01 have the silent 165C>T nucleotide substitution each in the RHD and RHCE gene. DISCUSSION The composition of blood group variants determined in this study confirms the genetically proximity of Tunisia to Europe. The small sub-Saharan genetic influence was approved by a limited number of variant samples associated with the black population.
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Affiliation(s)
- M Ouchari
- Centre régional de transfusion sanguine, hôpital Farhat Hached, Sousse, Tunisia
| | - H Romdhane
- Centre régional de transfusion sanguine, hôpital Farhat Hached, Sousse, Tunisia
| | - T Chakroun
- Centre régional de transfusion sanguine, hôpital Farhat Hached, Sousse, Tunisia
| | - S Abdelkefi
- Centre régional de transfusion sanguine, hôpital Farhat Hached, Sousse, Tunisia
| | - I Jarrey
- Centre régional de transfusion sanguine, hôpital Farhat Hached, Sousse, Tunisia
| | - B Houissa
- Centre régional de transfusion sanguine, hôpital Farhat Hached, Sousse, Tunisia
| | - S Jemni Yacoub
- Centre régional de transfusion sanguine, hôpital Farhat Hached, Sousse, Tunisia.
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11
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Ba A, Beley S, Chiaroni J, Bailly P, Silvy M. RH diversity in Mali: characterization of a new haplotype RHD*DIVa/RHCE*ceTI(D2). Transfusion 2015; 55:1423-31. [PMID: 25857637 DOI: 10.1111/trf.13109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 03/03/2015] [Accepted: 03/09/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Knowledge of RH variants in African populations is critical to improving transfusion safety in countries with populations of African ancestry and to providing valuable information and direction for future development of transfusion in Africa. The purpose of this report is to describe RH diversity in individuals from Mali. STUDY DESIGN AND METHODS Blood samples collected from 147 individuals self-identified as Dogon and Fulani were analyzed for Rh antigens and alleles. RESULTS The most common RHD allele variant was RHD*DAU0. Five predicted partial-D phenotypes were attributed to RHD*DAU3 or RHD*DIVa. Neither RHD*DAR nor RHD*DIIIa was found. Investigation of RHCE revealed three predicted partial-e antigens encoded by RHCE*ce(254G) in trans to RHCE*cE. Regarding C antigen, 28 Fulani typed as C+ and 16 of 28 harbored at least one RHCE*Ce-D(4)-ce, two being homozygous and predicted to show a rare RH:32,-46 phenotype. A new RHCE*ceTI with replacement of Exon 2 by RHD (RHCE*ceTI(D2)) was identified in Dogon and was identified by inheritance study to be in cis to RHD*DIVa. These samples typed C- with anti-C polyclonal antibody and monoclonal antibodies (MoAbs) MS24, P3X2551368+MS24, and MS273, but positive with anti-RhCe MoAb-BS58. The same pattern was observed in sample with RHD*DIVa/RHCE*ceTI. CONCLUSION Our survey indicated an uneven distribution of RH variant alleles between Dogon and Fulani, suggesting that study in well-documented cohorts is warranted. A high incidence of predicted partial-C phenotype encoded by RHCE*Ce-D(4)-ce was found in Fulani. Further study will also be needed to clarify the clinical significance of the new DIVa/ceTI(D2) haplotype encoding partial D and variant ce antigens.
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Affiliation(s)
- Alhassane Ba
- Centre National de Transfusion Sanguine (CNTS), Bamako, Mali.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Sophie Beley
- Etablissement Français du Sang Alpes Méditerranée.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Jacques Chiaroni
- Etablissement Français du Sang Alpes Méditerranée.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Pascal Bailly
- Etablissement Français du Sang Alpes Méditerranée.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Monique Silvy
- Etablissement Français du Sang Alpes Méditerranée.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
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Moulds JM, Noumsi GT, Billingsley KL. A comparison of methods for the detection of the r'(s) haplotype. Transfusion 2014; 55:1418-22. [PMID: 25496603 DOI: 10.1111/trf.12956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/16/2014] [Accepted: 10/21/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The r'(s) haplotype is found in 5% to 15% of individuals of African descent. Persons with this haplotype have a partial C antigen and weakened e and can produce anti-C or other "e-like" alloantibodies. Thus, for these chronically transfused patients, accurate detection of the r'(s) haplotype is important for selection of matched units. STUDY DESIGN AND METHODS African-American donors were genotyped using the human erythrocyte antigen (HEA) microarray. Samples (n = 125) identified as "possible r'(s) " were then tested by IDCORE XT and RHD and RHCE microarrays. DNA sequencing was used to resolve discordant samples. The genotyping results were compared to serologic testing using a monoclonal anti-C reagent (Clone MS24). RESULTS Of the 125 possible r'(s) samples identified by HEA, only 94 (75%) were confirmed by both RHD and RHCE microarrays. The IDCORE XT accurately detected 93 of 94 (99%) of the confirmed r'(s) and had no false positives. DNA sequencing of the one discordant sample revealed the presence of a compound heterozygote with RHD* DIII.4/RHCE*ceVS.02 as one haplotype and r'(s) Type 2 as the other. The 31 unconfirmed r'(s) samples carried RHCE*ceVS.03 not linked to the hybrid RHD-CE-D. This occurred most often with RHD*DIIIa (55%) or RHD*01 (19%) and rarely with DIII.4, DIII.6, DAU3, and weak D Type 14. Serologic testing with anti-C gave 100% concordance with the r'(s) samples. CONCLUSIONS The predominant type of r'(s) in African-Americans is Type 1, which can be detected either by a reagent anti-C containing Clone MS24 or by IDCORE XT. However, serology cannot differentiate between a normal C allele and the hybrid.
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Affiliation(s)
- Joann M Moulds
- John J. Moulds Scientific Support Services, LifeShare Blood Centers, Shreveport, Louisiana
| | - Ghislain T Noumsi
- John J. Moulds Scientific Support Services, LifeShare Blood Centers, Shreveport, Louisiana
| | - Katrina L Billingsley
- John J. Moulds Scientific Support Services, LifeShare Blood Centers, Shreveport, Louisiana
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RHD positive among C/E+ and D-negative blood donors in Tunisia. Transfus Clin Biol 2014; 21:320-3. [PMID: 25458985 DOI: 10.1016/j.tracli.2014.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 10/03/2014] [Indexed: 11/23/2022]
Abstract
PURPOSE OF THE STUDY The aim of this study was to investigate RHD alleles among Tunisian blood donors with D-negative phenotype and positive for C and/or E antigen. PATIENTS AND METHODS A total of 100 D-negative and C/E+ samples were analyzed by RHD genotyping using an initial test for RHD exon 10. In case of a positive reaction, further molecular investigations including real time quantitative PCR, allele specific PCR and nucleotide sequencing were done to elucidate the RHD involved mechanisms. RESULTS Seventy-five percent of the studied samples lacked the RHD gene. Twenty-three percent carried the hybrid RHD-CE-D alleles (16 RHD-CE(3-7)-D, 5 RHD-CE(4-7)-D, 1 RHD-CE(4-8)-D, 1 RHD-CE(3-8)-D) and 2% were weak D (1 weak D type 1 and 1 weak D type 5). CONCLUSION Our study proved the high frequency of RHD gene among serologically D-negative samples, positive for C and/or E antigen. Thus achieving systematically RHCE phenotyping in all transfusion centers on the Tunisian territory and considering blood donated from D-negative C/E+ persons as D-positive will be recommended to reduce anti-D allo-immunization.
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Trucco Boggione C, Luján Brajovich ME, Tarragó M, Mattaloni SM, Biondi CS, Muñiz-Díaz E, Nogués N, Cotorruelo CM. Molecular structures identified in serologically D- samples of an admixed population. Transfusion 2014; 54:2456-62. [DOI: 10.1111/trf.12691] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 01/30/2014] [Accepted: 02/10/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Carolina Trucco Boggione
- Laboratorio de Inmunohematología e Inmunogenética, Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
| | - Melina E. Luján Brajovich
- Laboratorio de Inmunohematología e Inmunogenética, Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
| | - Marcel Tarragó
- Laboratorio de Inmunohematología; Banc de Sang i Teixits; Barcelona Spain
| | - Stella M. Mattaloni
- Laboratorio de Inmunohematología e Inmunogenética, Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
| | - Claudia S. Biondi
- Laboratorio de Inmunohematología e Inmunogenética, Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
| | - Eduardo Muñiz-Díaz
- Laboratorio de Inmunohematología; Banc de Sang i Teixits; Barcelona Spain
| | - Núria Nogués
- Laboratorio de Inmunohematología; Banc de Sang i Teixits; Barcelona Spain
| | - Carlos M. Cotorruelo
- Laboratorio de Inmunohematología e Inmunogenética, Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
- CONICET; Buenos Aires Argentina
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15
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Gowland P, Gassner C, Hustinx H, Stolz M, Gottschalk J, Tissot JD, Thierbach J, Maier A, Sigurdardottir S, Still F, Fontana S, Frey BM, Niederhauser C. Molecular RHD screening of RhD negative donors can replace standard serological testing for RhD negative donors. Transfus Apher Sci 2014; 50:163-8. [DOI: 10.1016/j.transci.2014.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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(C)ce(s) haplotype screening in Tunisian blood donors. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12:405-9. [PMID: 24333089 DOI: 10.2450/2013.0153-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 08/28/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND The (C)ce(s) haplotype, mainly found in black individuals, contains two altered genes: a hybrid RHD-CE-D(s) gene segregated with a ce(s) allele of RHCE with two single nucleotide polymorphisms, c. 733C>G (p.Leu245Val) in exon 5 and c. 1006G>T (Gly336Cys) in exon 7. This haplotype could be responsible for false positive genotyping results in RhD-negative individuals and at a homozygous level lead to the loss of a high incidence antigen RH34. The aim of this study was to screen for the (C)ce(s) haplotype in Tunisian blood donors, given its clinico-biological importance. MATERIAL AND METHODS Blood samples were randomly collected from blood donors in the blood transfusion centre of Sousse (Tunisia). A total of 356 RhD-positive and 44 RhD-negative samples were tested for the (C)ce(s) haplotype using two allele-specific primer polymerase chain reactions that detect c. 733C>G (p.Leu245Val) and c. 1006G>T (p. Gly336Cys) substitutions in exon 5 and 7 of the RHCE gene. In addition, the presence of the D-CE hybrid exon 3 was evaluated using a sequence-specific primer polymerase chain reaction. RESULTS Among the 400 individuals only five exhibited the (C)ce(s) haplotype in heterozygosity, for a frequency of 0.625%. On the basis of the allele-specific primer polymerase chain reaction results, the difference in (C)ce(s) haplotype frequency was not statistically significant between RhD-positive and RhD-negative blood donors. DISCUSSION These data showed the presence of the (C)ce(s) haplotype at a low frequency (0.625%) compared to that among Africans in whom it is common. Nevertheless, the presence of RHD-CE-D(s) in Tunisians, even at a lower frequency, should be considered in the development of a molecular genotyping strategy for Rh genes, to ensure better management of the prevention of alloimmunisation.
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Two molecular polymorphisms to detect the (C)ce(s) type 1 haplotype. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12:136-7. [PMID: 24333080 DOI: 10.2450/2013.0149-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 07/12/2013] [Indexed: 11/21/2022]
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18
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Abstract
Blood group genotyping is gaining widespread adoption in blood centres and transfusion services. The current interest for a blood centre is its use as a screening tool to accurately predict donor phenotypes. However, not only is blood group genotyping used to screen for uncommon and rare types on a mass-scale, it can be used to optimize the inventory of multiple antigen-negative screened units. In addition, blood group genotyping provides blood types when antisera are not available, it can predict weak and variant antigens, and can aid in the resolution of ABO discrepancies. There are quality improvement benefits in blood group genotyping because it can screen for RHD alleles in Rh-negative blood donors and can be used to confirm that donors are suitable for reagent red cell production. It is possible that blood group genotyping information may be used as a donor recruitment tool. Given that genotyping can convey much more information about the expression of some complex antigens, e.g. hrB, Uvar, and Duffy, clinical trials are probably needed to show that genotyped or 'dry matched' transfusions are superior to phenotyped blood.
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Affiliation(s)
- Gregory A Denomme
- Diagnostic Laboratories, BloodCenter of Wisconsin, Milwaukee, WI, USA
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19
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Ouchari M, Polin H, Romdhane H, Abdelkefi S, Houissa B, Chakroun T, Gabriel C, Hmida S, Jemni Yacoub S. RHD*weak partial 4.0 is associated with an altered RHCE*ce(48C, 105T, 733G, 744C, 1025T) allele in the Tunisian population. Transfus Med 2013; 23:245-9. [PMID: 23742316 DOI: 10.1111/tme.12037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 03/02/2013] [Accepted: 03/12/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES D is the most immunogenic blood group antigen. About 1% of whites carry an altered RHD allele leading to quantitative or qualitative changes in the antigen D expression. T201R and F223V encoded by 602C>G and 667T>G are specific amino acid substitutions of the weak D type 4 cluster of African origin, comprising the alleles RHD*09.01, RHD*09.02, RHD*09.03, RHD*09.04 and RHD*09.05. The purpose of this study was to estimate the presence of these RHD genotypes in the Tunisian population. MATERIALS AND METHODS Ethylenediaminetetraacetate blood samples from 907 D+ and 93 D- blood donors were tested for markers 602G and 667G by allele-specific primer-polymerase chain reaction (PCR-ASP). Samples with positive reactions were re-evaluated by DNA sequencing for RHD and RHCE exons 1-10 and adjacent intronic sequences. RESULTS Among 907 D+ samples, 19 individuals were identified to harbour the RHD*weak partial 4.0 allele. RHCE sequencing post-haplotype-specific extraction (HSE) revealed an altered RHCE*ce(48C, 105T, 733G, 744C, 1025T) in those samples. The linkage of the RHCE polymorphisms to one haplotype was proven by DNA sequencing post-HSE. CONCLUSION The RHD*weak partial 4.0 allele syn. RHD*09.03 was estimated to occur 1 in 47 among D+ Tunisians. There was no evidence for other RHD alleles included in the weak D type 4 cluster.
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Affiliation(s)
- M Ouchari
- Unité de recherche "UR06SP05" Centre Régional de Transfusion Sanguine, Sousse, Tunisia
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20
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Fichou Y, Le Maréchal C, Bryckaert L, Dupont I, Jamet D, Chen JM, Férec C. A convenient qualitative and quantitative method to investigate RHD-RHCE hybrid genes. Transfusion 2013; 53:2974-82. [PMID: 23550903 DOI: 10.1111/trf.12179] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/24/2013] [Accepted: 02/10/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Molecular biology techniques, such as single specific-primer polymerase chain reaction (PCR), denaturing-high performance liquid chromatography, direct sequencing, next-generation sequencing, and microarray platforms, contribute to the efficient genotyping of the human blood group RHD gene. However, some alleles remain undetermined in rare cases in DNA samples carrying two copies of the RHD gene, which challenge the identification of D-CE hybrid genes. STUDY DESIGN AND METHODS We set up, in a single-tube format, a qualitative and quantitative assay based on multiplex PCR of short fluorescent fragments (QMPSF) to simultaneously amplify all 10 RHD exons on the one hand and all 10 RHCE exons on the other hand. RESULTS The test proved to be useful to rapidly identify hybrid genes in hemizygous RHD samples carrying a hybrid D-CE gene and to resolve unknown genotypes by quantifying individual exons in compound heterozygous samples, but also unexpectedly helped to redefine the RHDΨ haplotype. While validating the test, two novel single-point variants, c.648G>C (p.L216F) and c.1048G>C (p.D350H), were found. CONCLUSION For the first time, a QMPSF-based method is reliable to individually quantify the exons of both RH genes, including hybrid D-CE genes in compound heterozygous samples and may help to investigate samples with unknown RHD and/or RHCE status.
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Affiliation(s)
- Yann Fichou
- Etablissement Français du Sang (EFS)-Bretagne, Brest, France; Institut National de la Santé et de la Recherche Médicale (INSERM), U1078, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan, Brest, France
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21
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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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22
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Affiliation(s)
- Geoff Daniels
- International Blood Group Reference Laboratory; NHS Blood and Transplant; Bristol UK
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23
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Silvy M, Granier T, Beley S, Chiaroni J, Bailly P. Identification of novel polymorphism restricted to the(C)cestype 1haplotype avoids risk of transfusion deadlock in SCD patients. Br J Haematol 2012; 160:863-7. [PMID: 23278863 DOI: 10.1111/bjh.12179] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Monique Silvy
- Etablissement Français du Sang Alpes Méditerranée; Marseille France
- ADÉS UMR 7268; EFS; Aix Marseille Université; Marseille France
| | - Thomas Granier
- Etablissement Français du Sang Alpes Méditerranée; Marseille France
- ADÉS UMR 7268; EFS; Aix Marseille Université; Marseille France
| | - Sophie Beley
- Etablissement Français du Sang Alpes Méditerranée; Marseille France
- ADÉS UMR 7268; EFS; Aix Marseille Université; Marseille France
| | - Jacques Chiaroni
- Etablissement Français du Sang Alpes Méditerranée; Marseille France
- ADÉS UMR 7268; EFS; Aix Marseille Université; Marseille France
| | - Pascal Bailly
- Etablissement Français du Sang Alpes Méditerranée; Marseille France
- ADÉS UMR 7268; EFS; Aix Marseille Université; Marseille France
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24
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Roussel M, Poupel S, Nataf J, Juszczak G, Woimant G, Mailloux A, Menanteau C, Pham BN, Rouger P, Le Pennec PY, Peyrard T. RHD*DOL1andRHD*DOL2encode a partial D antigen and are in cis with the rareRHCE*ceBIallele in people of African descent. Transfusion 2012; 53:363-72. [DOI: 10.1111/j.1537-2995.2012.03743.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Moussa H, Tsochandaridis M, Chakroun T, Jridi S, Abdelneji B, Hmida S, Silvy M, Bailly P, Gabert J, Levy-Mozziconacci A, Jemni-Yacoub S. Molecular background of D-negative phenotype in the Tunisian population. Transfus Med 2012; 22:192-8. [PMID: 22420413 DOI: 10.1111/j.1365-3148.2012.01142.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Most studies of the molecular basis of Rhesus D-negative phenotype have been conducted in Caucasian and African populations. A comprehensive survey of RHD alleles was lacking in people from North Africa (Tunisians, Moroccans and Algerians) which could be very efficient for managing donors and patients carrying an RHD molecular variant. We analyse the molecular background of D-negative population in Tunisia in the present study. MATERIALS AND METHODS Blood samples were collected from native Tunisians. A total of 448 D-negative donors from different regions of Tunisia were analysed by RHD genotyping according to an adopted strategy using real-time PCR, ASP-PCR and sequencing. RESULTS Among the 448 D-negative samples, 443 were phenotyped unequivocally as true D-negative including three molecular backgrounds which were RHD gene deletion (n = 437), RHDψ pseudogene (n = 2) and RHD-CE-D hybrid gene (n = 4) with the respective frequencies of 0·9900, 0·0023 and 0·0046. The remaining five samples, in discordance with the serological results, were identified as two weak D type 11, one weak D type 29, one weak D type 4·0 and one DBT-1 partial D. CONCLUSION This study showed that the Tunisian population gets closer to Caucasians, given that the RHD gene deletion is the most prevalent cause of D-negative phenotype, but it is slightly different by the presence of the RHDψ pseudogene which was found with a very low frequency compared with that described in the African population. Nevertheless, the relative occurrence of weak D variants among studied serologically D-negative samples make necessary the adaptation of RHD genotyping strategy to the spectrum of prevalent alleles.
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Affiliation(s)
- H Moussa
- Unité de Recherche UR06SP05 Centre Régional de Transfusion Sanguine, Sousse, Tunisia
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26
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Silvy M, Di Cristofaro J, Beley S, Papa K, Rits M, Richard P, Chiaroni J, Bailly P. Identification of RHCE and KEL alleles in large cohorts of Afro-Caribbean and Comorian donors by multiplex SNaPshot and fragment assays: a transfusion support for sickle cell disease patients. Br J Haematol 2011; 154:260-70. [PMID: 21623766 DOI: 10.1111/j.1365-2141.2011.08691.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To lower the alloimmunization risk following transfusion in blacks, we developed two genotyping assays for large-scale screening of Comorian and Afro-Caribbean donors. One was a multiplex SNaPshot assay designed to identify ce(s) (340), ceMO/AR/EK/BI/SM, ce(s) , ce(s) (1006) and KEL*6/*7 alleles. The other was a multiplex fragment assay designed to detect RHD, RHDψ and RHCE*C and 455A>C transversion consistent with (C)ce(s) Type 1 and DIII Type5 ce(s) . Variant RHCE*ce alleles or RH haplotypes were detected in 58·69% of Comorians and 41·23% of Afro-Caribbeans. The ce(s) allele, (C)ce(s) Type 1, and DIII Type 5 ce(s) haplotypes were identified respectively in 39·13%, 14·67% and 4·88% of Comorians and 32·23%, 5·28% and 1·76% of Afro-Caribbeans. Genotypes consistent with partial D, C, c and/or e antigen expression were observed in 26·08% of Comorians and 14·69% of Afro-Caribbeans. No homozygous genotype corresponding to the RH:-18, -34, and -46 phenotypes were found. However, over 50% of genotypes produced low-prevalence antigens at risk for negative recipients, i.e., V, VS, JAL, and/or KEL6. One new variant RHCE*ce(s) (712) allele was identified. This is the first determination of variant RHCE and KEL allele frequencies. Results indicate the most suitable targets for molecular assay screening to optimize use of compatible blood units and lower immunization risk.
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Affiliation(s)
- Monique Silvy
- Laboratoire d'Hématologie Moléculaire, Établissement Français du Sang Alpes Méditerranée, UMR 6578, Université de Méditerranée, Marseille, France
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Krog GR, Clausen FB, Berkowicz A, Jørgensen L, Rieneck K, Nielsen LK, Dziegiel MH. Is current serologic RhD typing of blood donors sufficient for avoiding immunization of recipients? Transfusion 2011; 51:2278-85. [PMID: 21569040 DOI: 10.1111/j.1537-2995.2011.03156.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Avoiding immunization with clinically important antibodies is a primary objective in transfusion medicine. Therefore, it is central to identify the extent of D antigens that escape routine RhD typing of blood donors and to improve methodology if necessary. STUDY DESIGN AND METHODS We screened 5058 D- donors for the presence of the RHD gene, targeting Exons 5, 7, and 10 with real-time polymerase chain reaction. Samples that were positive in the screen test were investigated further by adsorption-elution, antibody consumption, flow cytometry, and sequencing of all RHD exons with intron-specific primers. Lookback was performed on all recipients of RBCs from RHD+ donors. RESULTS We found 13 RHD+ samples (0.26%). No variants or chimeras were found. Characterization of DNA revealed a novel DEL type (IVS2-2 A>G). In the lookback of the 136 transfusions with subsequent antibody follow-up, of which 13 were from DEL donors, one recipient developed anti-D. However, in this case, a competing and more likely cause of immunization was the concurrent transfusion of D+ platelets. Eleven recipients were immunized with 13 antibodies different from anti-D, of which five were anti-K. CONCLUSION In our laboratory, serologic RhD typing was safe. We detected all D variants and only missed DEL types. In assessing the immunization risk we included a DEL donor, found previous to this study, that did immunize a recipient with anti-D. We conclude that inadvertent immunization with D antigens in our setting was rare and in the order of 1.4 in 100,000 D- transfusions.
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Affiliation(s)
- Grethe Risum Krog
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.
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Abstract
Although hemagglutination serves the immunohematology reference laboratory well, when used alone, it has limited capability to resolve complex problems. This overview discusses how molecular approaches can be used in the immunohematology reference laboratory. In order to apply molecular approaches to immunohematology, knowledge of genes, DNA-based methods, and the molecular bases of blood groups are required. When applied correctly, DNA-based methods can predict blood groups to resolve ABO/Rh discrepancies, identify variant alleles, and screen donors for antigen-negative units. DNA-based testing in immunohematology is a valuable tool used to resolve blood group incompatibilities and to support patients in their transfusion needs.
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Affiliation(s)
- Marion E Reid
- New York Blood Center, 310 East 67th Street, New York, NY 10065, Telephone: 212-570-3294 / Fax: 212-737-4935,
| | - Gregory A Denomme
- Blood Center of Wisconsin, 638 18 Street, Milwaukee, WI, 53201-2178, Telephone: 414-937-6440 / Fax: 414-937-6404,
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Transfusion considerations concerning patients with anti-hrB and confounding co-morbid conditions: pregnancy and coagulopathy. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2011; 9:225-9. [PMID: 21251455 DOI: 10.2450/2010.0029-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Indexed: 11/21/2022]
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30
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Pham BN, Peyrard T, Juszczak G, Beolet M, Deram G, Martin-Blanc S, Dubeaux I, Roussel M, Kappler-Gratias S, Gien D, Poupel S, Rouger P, Le Pennec PY. Analysis of RhCE variants among 806 individuals in France: considerations for transfusion safety, with emphasis on patients with sickle cell disease. Transfusion 2010; 51:1249-60. [DOI: 10.1111/j.1537-2995.2010.02970.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Westhoff CM, Vege S, Halter-Hipsky C, Whorley T, Hue-Roye K, Lomas-Francis C, Reid ME. DIIIa and DIII Type 5 are encoded by the same allele and are associated with altered RHCE*ce alleles: clinical implications. Transfusion 2010; 50:1303-11. [PMID: 20088832 PMCID: PMC2908519 DOI: 10.1111/j.1537-2995.2009.02573.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The partial D phenotype DIIIa was originally reported to be associated with 455A>C in Exon 3, 602C>G in Exon 4, and 667T>G in Exon 5. Other alleles with these changes were subsequently identified and designated DIII Types 5, 6, and 7, as they had additional alterations. The observation that DNA samples associated with the DIIIa phenotype had more changes than those originally reported motivated us to reanalyze the DIIIa probands (BP and DJ) from the original study. We also studied additional DIIIa samples to clarify the RHD background and establish the associated RHCE. STUDY DESIGN AND METHODS Hemagglutination testing was performed by standard methods. RHD and RHCE were analyzed by combinations of polymerase chain reaction-restriction fragment length polymorphism, exon-specific sequencing, cloning, or direct sequencing of Rh-cDNAs. RESULTS The RHD alleles from BP, DJ, and 58 additional DIIIa samples had the three reported nucleotide changes as well as 186G>T, 410C>T, and 819G>A. The DIIIa allele was associated with several altered RHCE*ce-alleles, the prominent one being ceS (48C, 733G, 1006T). CONCLUSION The DIIIa phenotype is associated with six RHD changes, five of which encode amino acid changes, and partial DIIIa and DIII Type 5 are encoded by the same RHD allele. In all samples, RHD*DIIIa was inherited with altered RHCE*ce. Patients with partial DIIIa are at risk for production of alloanti-D, but they are also at risk for alloanti-e, -c, or antibodies to high-prevalence Rh antigens if there is no conventional RHCE*ce in trans. Among 39 patients studied, 16 had alloanti-D and 27 had alloanti-e or anti-hrB.
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Affiliation(s)
- Connie M Westhoff
- National Molecular Blood Group and Platelet Testing Laboratory, American Red Cross, Philadelphia, Pennsylvania, USA.
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Daniels G. The molecular genetics of blood group polymorphism. Hum Genet 2009; 126:729-42. [PMID: 19727826 DOI: 10.1007/s00439-009-0738-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Accepted: 08/19/2009] [Indexed: 02/07/2023]
Abstract
Over 300 blood group specificities on red cells have been identified, many of which are polymorphic. The molecular mechanisms responsible for these polymorphisms are diverse, though many simply represent single nucleotide polymorphisms (SNPs). Other mechanisms include the following: gene deletion; single nucleotide deletion and sequence duplication, which introduce reading-frame shifts; nonsense mutation; intergenic recombination between closely linked genes, giving rise to hybrid genes and hybrid proteins; and a SNP in the promoter region of a blood group gene. Examples of these various genetic mechanisms are taken from the ABO, Rh, Kell, and Duffy blood group systems. Null phenotypes, in which no antigens of a blood group system are expressed, are not generally polymorphic, but provide good examples of the effect of inactivating mutations on blood group expression. As natural human 'knock-outs', null phenotypes provide useful clues to the functions of blood group antigens. Knowledge of the molecular backgrounds of blood group polymorphisms provides a means to predict blood group phenotypes from genomic DNA. This has two main applications in transfusion medicine: determination of foetal blood groups to assess whether the foetus is at risk from haemolytic disease and ascertainment of blood group phenotypes in multiply transfused, transfusion-dependent patients, where serological tests are precluded by the presence of donor red cells. Other applications are being developed for the future.
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Affiliation(s)
- Geoff Daniels
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant, Filton, Bristol, UK.
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Pham BN, Peyrard T, Tourret S, Beolet M, Many H, Juszczak G, Roussel M, Kappler-Gratias S, Rouger P, Le Pennec PY. Anti-HrB and anti-hrb revisited. Transfusion 2009; 49:2400-5. [PMID: 19624490 DOI: 10.1111/j.1537-2995.2009.02307.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Since their description in the 1970s, anti-Hr(B) (antibody against a high-prevalence Rh antigen) and anti-hr(B) (anti-e-like antibody) are still a subject of debate about representing two aspects of a global immune response or being two independent antibodies. STUDY DESIGN AND METHODS The aim of this study was to evaluate the immune response against the antigens of Rh system of 30 individuals presenting a hr(B)(RH31)- phenotype. Genomic analysis of RH genes was performed in all individuals. RESULTS Among the 30 individuals, 27 had a Hr(B)(RH34)- phenotype. No immunization against Rh antigens was found in 16 individuals. Three individuals made anti-D only, whereas six individuals made anti-Hr(B) (four with anti-hr(B) and two without anti-hr(B)) and two individuals made anti-hr(B) without anti-Hr(B). Among the 30 individuals, three had a Hr(B)+ phenotype. No immunization against Rh antigens was found in one individual, whereas two individuals made anti-hr(B); the genomic analysis of selected individuals showed the presence of a (C)ce(s) haplotype, either Type 1 or Type 2, and a DIII Type 5 ce(s) haplotype, in the homozygous state, in compound heterozygosity with each other or in heterozygosity with a DcE haplotype. Genomic data were in accordance with serologic data. CONCLUSION Our data provide the evidence that anti-Hr(B) and anti-hr(B) are independent antibodies, defining two different specificities. These antibodies may be produced by individuals expressing variants of RhCE protein. Serologic and molecular data indicate that e antigen encoded by the (C)ce(s) haplotype is a partial antigen. In individuals carrying a (C)ce(s) haplotype, the risk and the type of alloimmunization to Rh antigens are related to the second Rh haplotype.
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Affiliation(s)
- Bach-Nga Pham
- Institut National de la Transfusion Sanguine, CNRGS-INSERM U665, Paris, France.
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Pham BN, Peyrard T, Juszczak G, Auxerre C, Godin S, Bonin P, Rouger P, Le Pennec PY. Alloanti-c (RH4) revealing that the(C)ceshaplotype encodes a partial c antigen. Transfusion 2009; 49:1329-34. [DOI: 10.1111/j.1537-2995.2009.02129.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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