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Izard C, Laget L, Beley S, Bichel N, De Boisgrollier L, Picard C, Chiaroni J, Di Cristofaro J. Resolution of RHCE Haplotype Ambiguities in Transfusion Settings. Int J Mol Sci 2024; 25:5868. [PMID: 38892055 PMCID: PMC11172784 DOI: 10.3390/ijms25115868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
Red blood cell (RBC) transfusion, limited by patient alloimmunization, demands accurate blood group typing. The Rh system requires specific attention due to the limitations of serological phenotyping methods. Although these have been compensated for by molecular biology solutions, some RhCE ambiguities remain unresolved. The RHCE mRNA length is compatible with full-length analysis and haplotype discrimination, but the RHCE mRNA analyses reported so far are based on reticulocyte isolation and molecular biology protocols that are fastidious to implement in a routine context. We aim to present the most efficient reticulocyte isolation method, combined with an RT-PCR sequencing protocol that embraces the phasing of all haplotype configurations and identification of any allele. Two protocols were tested for reticulocyte isolation based either on their size/density properties or on their specific antigenicity. We show that the reticulocyte sorting method by antigen specificity from EDTA blood samples collected up to 48 h before processing is the most efficient and that the combination of an RHCE-specific RT-PCR followed by RHCE allele-specific sequencing enables analysis of cDNA RHCE haplotypes. All samples analyzed show full concordance between RHCE phenotype and haplotype sequencing. Two samples from the immunohematology laboratory with ambiguous results were successfully analyzed and resolved, one of them displaying a novel RHCE allele (RHCE*03 c.340C>T).
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Affiliation(s)
- Caroline Izard
- Etablissement Français du Sang PACA Corse, 13005 Marseille, France
- Aix Marseille University CNRS EFS ADES UMR7268, 13015 Marseille, France
| | - Laurine Laget
- Etablissement Français du Sang PACA Corse, 13005 Marseille, France
- Aix Marseille University CNRS EFS ADES UMR7268, 13015 Marseille, France
| | - Sophie Beley
- Etablissement Français du Sang PACA Corse, 13005 Marseille, France
| | - Nelly Bichel
- Etablissement Français du Sang PACA Corse, 13005 Marseille, France
| | | | - Christophe Picard
- Etablissement Français du Sang PACA Corse, 13005 Marseille, France
- Aix Marseille University CNRS EFS ADES UMR7268, 13015 Marseille, France
| | - Jacques Chiaroni
- Etablissement Français du Sang PACA Corse, 13005 Marseille, France
- Aix Marseille University CNRS EFS ADES UMR7268, 13015 Marseille, France
| | - Julie Di Cristofaro
- Etablissement Français du Sang PACA Corse, 13005 Marseille, France
- Aix Marseille University CNRS EFS ADES UMR7268, 13015 Marseille, France
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2
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Hutchison CJ, Srivastava K, Polin H, Bueno MU, Flegel WA. Rh flow cytometry: An updated methodology for D antigen density applied to weak D types 164 and 165. Transfusion 2023; 63:2141-2151. [PMID: 37792462 PMCID: PMC10680490 DOI: 10.1111/trf.17543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND An original methodology for determining the D antigen density on red cells was published in 2000 and has been applied in many publications since. This flow cytometry-based assay remained largely unrevised utilizing monoclonal anti-Ds that are not readily available anymore. We updated the methodology to quantify erythrocyte D antigen sites using microspheres and monoclonal anti-Ds that are commercially available today. METHODS The absolute D antigen density of a frozen standard CcDEe cell, drawn in 2003, a fresh blood donation from the same individual, drawn in 2022, and an internal control CcDEe cell, was quantified by flow cytometry using fluorescence-labeled microspheres. The internal control CcDEe cell was used in conjunction with 9 commercial anti-Ds to determine D antigen densities of 7 normal D, 4 partial D, and 11 weak D type samples, including 2 novel alleles. RESULTS The reproducibility of the updated assay was evaluated with red cells of published D antigen densities. The current results matched the known ones closely. The new weak D types 164 and 165 carried 4500 and 1505 D antigens/red cell, respectively. The absolute D antigen density decreased from 27,231 to 26,037 in an individual over 19 years. DISCUSSION The updated assay gave highly reproducible results for the D antigen densities of Rh phenotypes. Readily available anti-Ds allowed for the determination of the D antigen densities of 7 weak D types. The assay is suitable to evaluate the effects of distinct amino acid substitutions on the RhD phenotype.
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Affiliation(s)
- Chloe Jayne Hutchison
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Kshitij Srivastava
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Helene Polin
- Department of Immunogenetics, Red Cross Transfusion Service for Upper Austria, Linz, Austria
| | - Marina Ursula Bueno
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Willy Albert Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
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3
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Yin Q. DEL variants: review of molecular mechanisms, clinical consequences and molecular testing strategy. Funct Integr Genomics 2023; 23:318. [PMID: 37840046 DOI: 10.1007/s10142-023-01249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023]
Abstract
Patients with DEL phenotype, a D variant with a low number of D antigens per red blood cell, are routinely typed as RhD-negative in serology testing and are detectable only by adsorption and elution techniques or molecular methods. DEL is of clinical importance worldwide, as indicated by its genotype-phenotype discrepancies among different populations and its potential to cause anti-D alloimmunization when DEL phenotype individuals are inadvertently managed as RhD-negative. This narrative review summarized the DEL alleles causing DEL phenotype and the underlying mechanisms. The clinical consequences and current molecular testing approach were discussed to manage the transfusion needs of patients and donors with DEL phenotype.
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Affiliation(s)
- Qinan Yin
- Henan Engineering Research Center of Digital Pathology and Artificial Intelligence Diagnosis, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.
- Precision Medicine Laboratory, School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China.
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Wen J, Jia S, Wang Z, Chen J, Liang Q, Wei L, Richard G, Fichou Y, Luo G, Ji Y. Molecular and serological analysis of the D variant in the Chinese population and identification of seven novel RHD alleles. Transfusion 2023; 63:402-414. [PMID: 36382965 DOI: 10.1111/trf.17186] [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: 08/09/2022] [Revised: 09/30/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The molecular basis of the D variant phenotype in the Chinese differs greatly from that of the Caucasian. Adapting a specific D typing strategy to the spectrum of prevalent RHD variant alleles is necessary. STUDY DESIGN AND METHODS Blood samples with ambiguous D phenotypes were collected in the Southern Chinese population. A special three-step typing strategy was applied. First, the common DVI type 3 was identified from epitope profiles of D antigen. Then, another common weak D type 15 (RHD*845A) was identified by epitope profiles of D antigen and Sanger sequencing of RHD exon 6. Finally, the remaining D variants were genotyped mainly by Sanger sequencing. For the novel RHD alleles in the coding region and exon-intron junction, in vitro transfection and minigene splicing assays were performed, respectively. The anti-D investigation was performed. RESULTS DVI type 3 (65/253, 25.7%) and weak D type 15 (62/253, 24.5%) were common Chinese D variants, and RHD*960A, DFR, RHD*weak D type 25, 72, and 136 were frequent variant RHD alleles. Besides, twenty-two sporadic and seven novel RHD alleles (RHD*188A; RHD*688C; RHD*782 T; RHD*1181C; RHD*165 T, 993A; RHD*148 + 3G > T and RHD*1227 + 5G > C) were identified. The deleterious effect of the novel RHD alleles on D antigen or mRNA expression was confirmed. Anti-D was detected in two DVI type 3 pregnant women. DISCUSSION The three-step typing strategy provides an effective approach for Chinese D variant typing. It can be anticipated that commercially available RHD genotyping kits have limitations for testing Chinese D variants, as some of the frequent variants are not interrogated.
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Affiliation(s)
- Jizhi Wen
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China.,The Key Medical Laboratory of Guangzhou, Guangzhou, People's Republic of China
| | - Shuangshuang Jia
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China.,The Key Medical Laboratory of Guangzhou, Guangzhou, People's Republic of China
| | - Zhen Wang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China.,The Key Medical Laboratory of Guangzhou, Guangzhou, People's Republic of China
| | - Jingwang Chen
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China.,The Key Medical Laboratory of Guangzhou, Guangzhou, People's Republic of China
| | - Qianni Liang
- Department of Blood Transfusion, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Ling Wei
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China.,The Key Medical Laboratory of Guangzhou, Guangzhou, People's Republic of China
| | | | - Yann Fichou
- Univ Brest, Inserm, EFS, UMR 1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Guangping Luo
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China.,The Key Medical Laboratory of Guangzhou, Guangzhou, People's Republic of China
| | - Yanli Ji
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China.,The Key Medical Laboratory of Guangzhou, Guangzhou, People's Republic of China
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Raud L, Le Tertre M, Vigneron L, Ka C, Richard G, Callebaut I, Chen JM, Férec C, Le Gac G, Fichou Y. Missense RHD single nucleotide variants induce weakened D antigen expression by altering splicing and/or protein expression. Transfusion 2021; 61:2468-2476. [PMID: 34110623 DOI: 10.1111/trf.16538] [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: 10/26/2020] [Revised: 04/09/2021] [Accepted: 04/28/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Although D variant phenotype is known to be due to genetic defects, including rare missense single nucleotide variants (SNVs), within the RHD gene, few studies have addressed the molecular and cellular mechanisms driving this altered expression. We and others showed previously that splicing is commonly disrupted by SNVs in constitutive splice sites and their vicinity. We thus sought to investigate whether rare missense SNVs located in "deep" exonic regions could also impair this mechanism. STUDY DESIGN AND METHODS Forty-six missense SNVs reported within exons 6 and 7 were first selected from the Human RhesusBase. Their respective effect on splicing was assessed by using an in vitro assay. An RhD-negative cell model was further generated by using the CRISPR-Cas9 approach. RhD-mutated proteins were overexpressed in the newly created model, and cell membrane expression of the D antigen was measured by flow cytometry. RESULTS Minigene splicing assay showed that 14 of 46 (30.4%) missense SNVs alter splicing. Very interestingly, further investigation of two missense SNVs, which both affect codon 338 and confer a weak D phenotype, showed various mechanisms: c.1012C>G (p.Leu338Val) disrupts splicing only, while c.1013T>C (p.Leu338Pro) alters only the protein structure, in agreement with in silico prediction tools and 3D protein structure visualization. CONCLUSION Our functional data set suggests that missense SNVs damage quantitatively D antigen expression by, at least, two different mechanisms (splicing alteration and protein destabilization) that may act independently. These data thereby contribute to extend the current knowledge of the molecular mechanisms governing weakened D expression.
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Affiliation(s)
- Loann Raud
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Marlène Le Tertre
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France.,Service de Génétique Médicale, CHRU Brest, Brest, France
| | | | - Chandran Ka
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France.,Service de Génétique Médicale, CHRU Brest, Brest, France
| | - Gaëlle Richard
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Isabelle Callebaut
- Sorbonne Université, Muséum National d'Histoire Naturelle, UMR CNRS 7590, Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie (IMPMC), Paris, France
| | - Jian-Min Chen
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Claude Férec
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France.,Service de Génétique Médicale, CHRU Brest, Brest, France
| | - Gérald Le Gac
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France.,Service de Génétique Médicale, CHRU Brest, Brest, France
| | - Yann Fichou
- Univ Brest, Inserm, EFS, UMR1078, GGB, Brest, France.,Laboratory of Excellence GR-Ex, Paris, France
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Yanasik M, Oguz FS, Besisik SK, Huslu M, Ozturk G, Temurhan S, Aydin F. Frequency of RHD variants in serologically weak D Turkish blood donors. Transfus Apher Sci 2020; 60:103024. [PMID: 33308979 DOI: 10.1016/j.transci.2020.103024] [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: 05/30/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND RhD typing has remained of primary importance, as being the leading cause of hemolytic disease of the newborn. Among Rh system's 55 blood group antigens, RhD is the most immunogenic. We aimed with this study to determine weak D/partial D variant frequency in blood donors who were admitted to our blood center and have serologically designated blood group weak D. MATERIALS AND METHODS We screened blood donors who admitted between 2011 and 2017 to our blood center. Sixty-seven serologically weak D phenotyped donors have participated in the study. These donors' samples were studied further by Polymerase Chain Reaction Sequence- Specific Primers (PCR-SSP) for determining D variants. RESULTS Weak D phenotype was detected in 228(0.12 %) out of 177,554 donors. Sixty-seven of them agreed to take part in the study. The frequency of weak D and partial D was 68.7 % (n = 46), and 22.4 % (n = 15), in order. The most encountered weak D and partial D variant was type 15 and DFR type, respectively. CONCLUSIONS The prevalence of serologically weak D phenotypes varies by race and ethnicity. Turkey is a country covering a mixture of European and Asian DNA with different ethnic groups. Thus, our research as giving the overall distribution of RHD variants from the largest city of Turkey, which may reflect the general ethnic background of the country, would help to the establishment of a databank for blood banking. This paper is the first molecular study on RHD variants in Turkey. New molecular research would be more reliable and precise.
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Affiliation(s)
- Melek Yanasik
- Istanbul Medical Faculty Hospital Blood Center, Istanbul University, Istanbul, Turkey
| | - Fatma Savran Oguz
- Istanbul Medical Faculty, Department of Medical Biology, Istanbul University, Istanbul, Turkey.
| | | | - Mukadder Huslu
- Istanbul Medical Faculty Hospital Blood Center, Istanbul University, Istanbul, Turkey
| | - Gulyuz Ozturk
- Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, School of Medicine, Altunizade Hospital, Acıbadem University, Istanbul, Turkey
| | - Sonay Temurhan
- Istanbul Medical Faculty, Department of Medical Biology, Istanbul University, Istanbul, Turkey
| | - Filiz Aydin
- Istanbul Science University, Department of Medical Biology, Istanbul, Turkey
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7
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Zhang X, Li G, Zhou Z, Shao C, Huang X, Li L, Li X, Liu Y, Fan H, Li J. Molecular and computational analysis of 45 samples with a serologic weak D phenotype detected among 132,479 blood donors in northeast China. J Transl Med 2019; 17:393. [PMID: 31775789 PMCID: PMC6880393 DOI: 10.1186/s12967-019-02134-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 11/09/2019] [Indexed: 02/07/2023] Open
Abstract
Background RH1 is one of the most clinically important blood group antigens in the field of transfusion and in the prevention of fetal incompatibility. The molecular analysis and characterization of serologic weak D phenotypes is essential to ensuring transfusion safety. Methods Blood samples from a northeastern Chinese population were randomly screened for a serologic weak D phenotype. The nucleotide sequences of all 10 exons, adjacent flanking intronic regions, and partial 5′ and 3′ untranslated regions (UTRs) were detected for RHD genes. Predicted deleterious structural changes in missense mutations of serologicl weak D phenotypes were analyzed using SIFT, PROVEAN and PolyPhen2 software. The protein structure of serologic weak D phenotypes was predicted using Swiss-PdbViewer 4.0.1. Results A serologic weak D phenotype was found in 45 individuals (0.03%) among 132,479 blood donors. Seventeen distinct RHD mutation alleles were detected, with 11 weak D, four partial D and two DEL alleles. Further analyses resulted in the identification of two novel alleles (RHD weak D 1102A and 399C). The prediction of a three-dimensional structure showed that the protein conformation was disrupted in 16 serologic weak D phenotypes. Conclusions Two novel and 15 rare RHD alleles were identified. Weak D type 15, DVI Type 3, and RHD1227A were the most prevalent D variant alleles in a northeastern Chinese population. Although the frequencies of the D variant alleles presented herein were low, their phenotypic and genotypic descriptions add to the repertoire of reported RHD alleles. Bioinformatics analysis on RhD protein can give us more interpretation of missense variants of RHD gene.
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Affiliation(s)
- Xu Zhang
- Institute of Transfusion Medicine, Liaoning Blood Center, Shenyang, Liaoning, China.,Key Laboratory of Blood Safety Research of Liaoning Province, Shenyang, Liaoning, China
| | - Guiji Li
- Department of Hematology, The Forth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhuren Zhou
- Institute of Transfusion Medicine, Liaoning Blood Center, Shenyang, Liaoning, China.,Key Laboratory of Blood Safety Research of Liaoning Province, Shenyang, Liaoning, China
| | - Chaopeng Shao
- Department of Transfusion, the Second People's Hospital of Shenzhen, Shenzhen, China
| | - Xuying Huang
- Institute of Transfusion Medicine, Liaoning Blood Center, Shenyang, Liaoning, China.,Key Laboratory of Blood Safety Research of Liaoning Province, Shenyang, Liaoning, China
| | - Lichun Li
- Institute of Transfusion Medicine, Liaoning Blood Center, Shenyang, Liaoning, China.,Key Laboratory of Blood Safety Research of Liaoning Province, Shenyang, Liaoning, China
| | - Xiaofeng Li
- Institute of Transfusion Medicine, Liaoning Blood Center, Shenyang, Liaoning, China.,Key Laboratory of Blood Safety Research of Liaoning Province, Shenyang, Liaoning, China
| | - Ying Liu
- Institute of Transfusion Medicine, Harbin Blood Center, Harbin, Heilongjiang, China
| | - Hua Fan
- Department of Hematology, The Forth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Jianping Li
- Institute of Transfusion Medicine, Liaoning Blood Center, Shenyang, Liaoning, China. .,Key Laboratory of Blood Safety Research of Liaoning Province, Shenyang, Liaoning, China. .,Institute of Transfusion Medicine, Harbin Blood Center, Harbin, Heilongjiang, China. .,Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning, China.
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8
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Shi J, Luo Y. Effects of RHD gene polymorphisms on distinguishing weak D or DEL from RhD- in blood donation in a Chinese population. Mol Genet Genomic Med 2019; 7:e00681. [PMID: 30950221 PMCID: PMC6565595 DOI: 10.1002/mgg3.681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Weak D or DEL red blood cell units may be mistyped as RhD- by current serology assays, which can lead to incompatible transfusion to RhD- recipients and further cause anti-D immunization. Molecular RHD blood group typing is a very effective method for overcoming current technical limits. The purpose of this study was to identify RHD single-nucleotide polymorphisms (SNPs) and compare the genotype prevalence among confirmed RhD- individuals in a Chinese population as well as explore effective biomarkers for current weak D or DEL detection before blood transfusion. METHODS In the present study, 125 weak D (1, 2, 3, and 4.1) or DEL and 185 RhD- blood samples from donors detected by current standard serology were collected. Genotyping system was used to analyze the SNPs of RHD in each sample. RESULTS Seven SNPs (rs592372, rs11485789, rs6669352, rs3118454, rs1053359, rs590787, and rs3927482) were detected in the RHD region. Rs3118454, rs1053359, rs590787, and rs3927482 showed significant differences between the weak D (1, 2, 3 and 4.1) or DEL and RhD- groups. Further combined analysis of the allelic distribution of these four SNPs revealed their higher frequencies in the RhD- group. CONCLUSION The SNPs rs3118454, rs1053359, rs590787, and rs3927482 in RHD showed a significantly higher frequency among an RhD- Chinese population and are potential biomarkers.
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Affiliation(s)
- Jie Shi
- Nanjing Red Cross Blood Center, Nanjing, Jiangsu, P. R. China
| | - Ying Luo
- Nanjing Red Cross Blood Center, Nanjing, Jiangsu, P. R. China.,Division of Nephrology and Rheumatology, Center for Nephrology and Metabolomics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, P. R. China
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9
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Thongbut J, Raud L, Férec C, Promwong C, Nuchnoi P, Fichou Y. Comprehensive Molecular Analysis of Serologically D-Negative and Weak/Partial D Phenotype in Thai Blood Donors. Transfus Med Hemother 2019; 47:54-60. [PMID: 32110194 DOI: 10.1159/000499087] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background Molecular genetics of the Rh system has been extensively studied in Caucasians, Black Africans, East Asians, and Indians more recently. In this work, we sought to investigate the molecular basis of variant D expression in the Thai population, which remains unknown. Materials and Methods Blood samples from 450 Thai donors showing the variant D phenotype were collected. The RHD gene was analyzed by quantitative multiplex polymerase chain reaction of short fluorescent fragments and/or Sanger sequencing. Results The most frequent alleles in 200 D-negative and 121 DEL samples were the whole RHD gene deletion and the Asian DEL alleles, respectively. In 129 weak/partial D samples, 36 variant alleles were identified, including eight novel alleles. RHD*06.03, which is common in variant D samples from South China, is the most prevalent variant allele, followed by the recently reported Indian RHD*01W.150 allele. Discussion For the first time, a comprehensive overview of the nature and distribution of variant RHD alleles in Thailand is reported. It is a milestone to pave the way towards improvement of the current screening strategy to identify DEL donors accurately. The next step will be the design and implementation of a simple molecular test for screening the most frequent alleles, specifically in this population.
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Affiliation(s)
- Jairak Thongbut
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.,National Blood Centre, Thai Red Cross Society, Bangkok, Thailand
| | - Loann Raud
- Univ Brest, INSERM, EFS, UMR 1078, GGB, Brest, France.,Laboratoire de Génétique Moléculaire et d'Histocompatibilité, CHU Morvan, Brest, France
| | - Claude Férec
- Univ Brest, INSERM, EFS, UMR 1078, GGB, Brest, France.,Laboratoire de Génétique Moléculaire et d'Histocompatibilité, CHU Morvan, Brest, France.,Laboratory of Excellence GR-Ex, Brest, France
| | | | - Pornlada Nuchnoi
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.,Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Yann Fichou
- Univ Brest, INSERM, EFS, UMR 1078, GGB, Brest, France.,Laboratoire de Génétique Moléculaire et d'Histocompatibilité, CHU Morvan, Brest, France
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10
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Raud L, Ka C, Gourlaouen I, Callebaut I, Férec C, Le Gac G, Fichou Y. Functional analysis of novelRHDvariants: splicing disruption is likely to be a common mechanism of variant D phenotype. Transfusion 2019; 59:1367-1375. [DOI: 10.1111/trf.15210] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/22/2018] [Accepted: 12/06/2018] [Indexed: 02/01/2023]
Affiliation(s)
- Loann Raud
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Chandran Ka
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Isabelle Gourlaouen
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Isabelle Callebaut
- IMPMC, Sorbonne Universités - UMR CNRS 7590, UPMC Univ Paris 06, Muséum d'Histoire Naturelle, IRD UMR 206; Paris France
| | - Claude Férec
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Gérald Le Gac
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
| | - Yann Fichou
- UMR1078 "Génétique, Génomique Fonctionnelle et Biotechnologies"; INSERM, EFS, Université de Brest, IBSAM, CHU de Brest; Brest France
- Laboratory of Excellence GR-Ex; Paris France
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11
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Chen DP, Wen YH, Lu JJ, Tseng CP, Wang WT. Rapid rare ABO blood typing using a single PCR based on a multiplex SNaPshot reaction. J Formos Med Assoc 2018; 118:395-400. [PMID: 29970336 DOI: 10.1016/j.jfma.2018.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/06/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND ABO subgroups would be considered when discrepancies in ABO grouping occur. Serological methods including adsorption-elution test, salivary ABH inhibition test, and anti-A1 (lectin) saline method could be used. However, these serological methods are laboring and obscure. Therefore, reliable and affordable method to assess the ABO subgroups is of particular interest. METHODS To solve this problem, the multiplex SNaPshot-based assays were designed to determine rare A and B subgroups. Primers used as probes for determination of rare ABO blood groups known in Taiwanese population were designed. Many ABO subtype samples were used to validate the accuracy and reproducibility of our SNaPshot panel. RESULTS A panel of primer probes were successfully designed in determining 8 SNP sites (261, 539, 838, 820, 745, 664, IVS6 +5, and 829 in exon 6 and 7) for A phenotype and 6 SNP sites (261, 796, IVS3 +5, 247, 523, and 502 in exon 2, 6 and 7 and intron 3) for B phenotype. SNaPshot analysis for defining blood group A alleles (A1, A2, A3, Am and Ael) and blood group B alleles (B1, B3, Bw and Bel) was therefore available. CONCLUSION SNaPshot analysis could be used in reference laboratories for typing known rare subgroups of A and B without DNA cloning and traditional sequencing. Moreover, this method would help to construct databases of genotyped blood donors, and it potentially plays a role in determining fetal-maternal ABO incompatibility.
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Affiliation(s)
- Ding-Ping Chen
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Ying-Hao Wen
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jang-Jih Lu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Ping Tseng
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Ting Wang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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12
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Srivastava K, Stiles DA, Wagner FF, Flegel WA. Two large deletions extending beyond either end of the RHD gene and their red cell phenotypes. J Hum Genet 2018; 63:27-35. [PMID: 29215093 PMCID: PMC5764804 DOI: 10.1038/s10038-017-0345-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/12/2017] [Accepted: 08/14/2017] [Indexed: 01/22/2023]
Abstract
Only two partial deletions longer than 655 nucleotides had been reported for the RHD gene, constrained within the gene and causing DEL phenotypes. Using a combination of quantitative PCR and long-range PCR, we examined three distinct deletions affecting parts of the RHD gene in three blood donors. Their RHD nucleotide sequences and exact boundaries of the breakpoint regions were determined. DEL phenotypes were caused by a novel 18.4 kb deletion and a previously published 5.4 kb deletion of the RHD gene; a D-negative phenotype was caused by a novel 7.6 kb deletion. Examination of the deletion-flanking regions suggested microhomology-mediated end-joining, replication slippage, and non-homologous end-joining, respectively, as the most likely mechanisms for the three distinct deletions. We described two new deletions affecting parts of the RHD gene, much longer than any previously reported partial deletion: one was the first deletion observed at the 5' end of the RHD gene extending into the intergenic region, and the other the second deletion observed at its 3' end. Large deletions present at either end are a mechanism for a much reduced RhD protein expression or its complete loss. Exact molecular characterization of such deletions is instrumental for accurate RHD genotyping.
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Affiliation(s)
- Kshitij Srivastava
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, MSC 1184, 10 Center Drive, Bethesda, 20892, MD, USA
| | - David Alan Stiles
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, MSC 1184, 10 Center Drive, Bethesda, 20892, MD, USA
| | - Franz Friedrich Wagner
- Red Cross Blood Service NSTOB, Institute Springe, Eldagsener Strasse 38, 31830, Springe, Germany
| | - Willy Albert Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, MSC 1184, 10 Center Drive, Bethesda, 20892, MD, USA.
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13
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Chun S, Yun JW, Park G, Cho D. The synonymous nucleotide substitution RHD 1056C>G alters mRNA splicing associated with serologically weak D phenotype. J Clin Lab Anal 2017; 32:e22330. [PMID: 28926139 DOI: 10.1002/jcla.22330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 08/30/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND D antigen is one of the most clinically significant blood group antigens. Variation of the RHD gene can cause weak D or partial D phenotypes. While most variations are missense substitutions with amino acid changes, those without are called "silent" or "synonymous" substitutions. Synonymous substitutions often have little effect on the protein, not altering the phenotype. However, effect on splicing can affect end-product protein. We report a new synonymous variation, RHD 1056C>G, that resulted in weak D phenotype, and predicted its effect with various in silico methods. METHODS Serologic testing of the D antigen with full sequencing of the RHD gene was done. Human Splice Finder was used to predict the effect of this variation, and validation of this method was done with all known RHD variations reported in the literature. RESULTS RHD 1056C>G was predicted to cause the formation of an exonic splicing silencer (ESS) site. The creation of new ESS site potentially inhibits the splicing event, resulting alteration of splicing. This is similar to remodeling of splice acceptor or donor site, as this kind of deep exonic variation could affect the D antigen's quality or quantity. This is in concordance with serologic results, which showed only delayed weak agglutination to anti-D reagents. CONCLUSIONS The analytic methods we applied showed good correlation with the actual phenotype, along with concordant results when analyzing other known variants reported in the literature. We conclude that RHD 1056C>G results in serologic weak D phenotype.
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Affiliation(s)
- Sejong Chun
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Won Yun
- Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Geon Park
- Department of Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Duck Cho
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Seoul, Korea
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14
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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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15
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Filosa L, Beley S, Chiaroni J, Bailly P, Silvy M. New silent and weak D alleles: molecular characterization and associated antigen density. Transfusion 2016; 56:2154-5. [PMID: 27189905 DOI: 10.1111/trf.13655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/30/2016] [Accepted: 04/04/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Lugdivine Filosa
- Laboratoire d'Hématologie Moléculaire: Biologie des Groupes Sanguins, Établissement Français du Sang Alpes Méditerranée, Marseille, France
| | - Sophie Beley
- Laboratoire d'Hématologie Moléculaire: Biologie des Groupes Sanguins, Établissement Français du Sang Alpes Méditerranée, Marseille, France.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Jacques Chiaroni
- Laboratoire d'Hématologie Moléculaire: Biologie des Groupes Sanguins, Établissement Français du Sang Alpes Méditerranée, Marseille, France.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Pascal Bailly
- Laboratoire d'Hématologie Moléculaire: Biologie des Groupes Sanguins, Établissement Français du Sang Alpes Méditerranée, Marseille, France.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
| | - Monique Silvy
- Laboratoire d'Hématologie Moléculaire: Biologie des Groupes Sanguins, Établissement Français du Sang Alpes Méditerranée, Marseille, France.,UMR 7268 ADÉS, Aix-Marseille Université-EFS-CNRS, Marseille, France
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16
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Papasavva T, Martin P, Legler TJ, Liasides M, Anastasiou G, Christofides A, Christodoulou T, Demetriou S, Kerimis P, Kontos C, Leontiades G, Papapetrou D, Patroclos T, Phylaktou M, Zottis N, Karitzie E, Pavlou E, Kountouris P, Veldhuisen B, van der Schoot E, Kleanthous M. Prevalence of RhD status and clinical application of non-invasive prenatal determination of fetal RHD in maternal plasma: a 5 year experience in Cyprus. BMC Res Notes 2016; 9:198. [PMID: 27036548 PMCID: PMC4818414 DOI: 10.1186/s13104-016-2002-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND After the discovery that cell-free fetal DNA (cffDNA) is circulating in the maternal plasma of pregnant women, non-invasive prenatal diagnosis for fetal RhD in maternal plasma in RhD negative women at risk for haemolytic disease of the newborn (HDN) was clinically established and used by many laboratories. The objectives of this study are: (a) to assess the feasibility and report our experiences of the routine implementation of fetal RHD genotyping by analysis of cffDNA extracted from maternal plasma of RhD negative women at risk of HDN, and (b) to estimate the RhD phenotype frequencies, the RHD genotype frequencies and the RhD zygosity in the Cypriot population. METHODS cffDNA was extracted from maternal plasma of 73 RhD negative pregnant women. Real-Time Multiplex-PCR was used to amplify regions of RHD gene in exons 4, 5 and 10. RhD phenotypes were determined on 445 random samples using conventional agglutination slide test. RESULTS The fetus was predicted to be positive in 53 cases and negative in 18 cases. Two of cases were identified as D-variants, weak D type-1 and 11. The frequency of RhD negative homozygosity in the Cypriot population was estimated to be 7.2%, while the frequencies of RHD hemizygosity and RhD positive homozygosity was calculated to be 39.2 and 53.6%, respectively. CONCLUSION Fetal RHD genotyping can be accurately determined using cffDNA from maternal plasma. The implementation of the test has eliminated all use of unnecessary anti-D and reduced the total use of anti-D by 25.3% while achieving appropriate management of the RhD negative pregnancies.
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Affiliation(s)
- Thessalia Papasavva
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, 6 Internanional Airport Ave, Agios Dometios, 1683, Nicosia, Cyprus.
| | - Pete Martin
- International Blood Group Reference Laboratory, Bristol Institute for Transfusion Sciences, NHS Blood and Transport, North Bristol Park, Filton, Bristol, BS34 7QG, UK
| | - Tobias J Legler
- Department of Transfusion Medicine, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Marios Liasides
- Zoodochou Pigis Clinic, 9 Antisthenous, Kapsalos, 3086, Limassol, Cyprus
| | - George Anastasiou
- Mother and Child Medical Center, 9-11 Penelopis Delta Str., 1076, Nicosia, Cyprus
| | | | - Tasos Christodoulou
- Apollonion Private Hospital, Lefkotheou 20, Strovolos, 2054, Nicosia, Cyprus
| | - Sotos Demetriou
- European Woman's Clinic, Vyzantiou 26, Strovolos, 2064, Nicosia, Cyprus
| | - Prokopis Kerimis
- Ygia Polyclinic Private Hospital, 21, Nafpliou str., 3305, Limassol, Cyprus
| | - Charis Kontos
- Iasis Hospital, 8 Voriou Ipirou str., 8069, Paphos, Cyprus
| | | | - Demetris Papapetrou
- Mother and Child Medical Center, 9-11 Penelopis Delta Str., 1076, Nicosia, Cyprus
| | | | - Marios Phylaktou
- Apollonion Private Hospital, Lefkotheou 20, Strovolos, 2054, Nicosia, Cyprus
| | - Nikos Zottis
- Ledra Obstetrics Gynecology Clinic, 19 Pindarou, Ayios Antonios, 1060, Nicosia, Cyprus
| | - Eleni Karitzie
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, 6 Internanional Airport Ave, Agios Dometios, 1683, Nicosia, Cyprus
| | - Eleni Pavlou
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, 6 Internanional Airport Ave, Agios Dometios, 1683, Nicosia, Cyprus
| | - Petros Kountouris
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, 6 Internanional Airport Ave, Agios Dometios, 1683, Nicosia, Cyprus
| | | | | | - Marina Kleanthous
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, 6 Internanional Airport Ave, Agios Dometios, 1683, Nicosia, Cyprus
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17
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Fichou Y, Férec C. Molecular RHD-RHCE Analysis by Multiplex PCR of Short Fluorescent Fragments. Methods Mol Biol 2016; 1310:97-104. [PMID: 26024628 DOI: 10.1007/978-1-4939-2690-9_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several hundred variant alleles have been reported within the homologous RHD and RHCE genes that encode the antigens involved in the human Rh blood group system, which is of the main interest in the field of both transfusion and obstetrical medicine. Although these variants can be mostly characterized at the molecular level by sequence-specific primer polymerase chain reaction (SSP-PCR) and/or direct sequencing, some allelic combinations remain unresolved by conventional methods. Typically exon deletion or hybrid genes may be difficult to assess in a heterozygous context. Here we describe a qualitative and quantitative method to resolve copy number variations in the RH gene exons by quantitative multiplex polymerase chain reaction (PCR) of short fluorescent fragments (QMPSF).
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Affiliation(s)
- Yann Fichou
- Etablissement Français du Sang (EFS) - Bretagne, 46 rue Félix Le Dantec, 29218, Brest, France,
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18
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Wang M, Wang BL, Xu W, Fan DD, Peng ML, Pan J, Yao P, Jiang GM, Wan XJ. Anti-D alloimmunisation in pregnant women with DEL phenotype in China. Transfus Med 2015; 25:163-9. [PMID: 26033335 DOI: 10.1111/tme.12211] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 04/02/2015] [Accepted: 05/03/2015] [Indexed: 01/28/2023]
Affiliation(s)
- M. Wang
- The Department of Blood Transfusion; Affiliated Provincial Hospital of Anhui Medical University; Hefei Anhui China
- The Department of Laboratory Medicine; Affiliated Provincial Hospital of Anhui Medical University; Hefei Anhui China
| | - B. L. Wang
- The Department of Laboratory Medicine; Affiliated Provincial Hospital of Anhui Medical University; Hefei Anhui China
| | - W. Xu
- The Department of Blood Transfusion; The First Affiliated Hospital of Anhui Medical University; Hefei Anhui China
| | - D. D. Fan
- The Department of Epidemiology & Biostatistics, School of Public Health; Anhui Medical University; Hefei Anhui China
| | - M. L. Peng
- The Department of Epidemiology & Biostatistics, School of Public Health; Anhui Medical University; Hefei Anhui China
| | - J. Pan
- The Department of Blood Transfusion; Affiliated Provincial Hospital of Anhui Medical University; Hefei Anhui China
| | - P. Yao
- The Department of Laboratory Medicine; Affiliated Provincial Hospital of Anhui Medical University; Hefei Anhui China
| | - G. M. Jiang
- The Department of Blood Transfusion; Affiliated Provincial Hospital of Anhui Medical University; Hefei Anhui China
| | - X. J. Wan
- The Department of Blood Transfusion; Affiliated Provincial Hospital of Anhui Medical University; Hefei Anhui China
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19
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Fichou Y, Gehannin P, Corre M, Le Guern A, Le Maréchal C, Le Gac G, Férec C. Extensive functional analyses ofRHDsplice site variants: Insights into the potential role of splicing in the physiology of Rh. Transfusion 2015; 55:1432-43. [DOI: 10.1111/trf.13083] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/08/2015] [Accepted: 02/10/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Yann Fichou
- Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078
- Etablissement Français du Sang (EFS)-Région Bretagne
| | - Pierre Gehannin
- Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078
- Etablissement Français du Sang (EFS)-Région Bretagne
| | - Manon Corre
- Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078
- Etablissement Français du Sang (EFS)-Région Bretagne
| | - Alice Le Guern
- Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078
- Etablissement Français du Sang (EFS)-Région Bretagne
| | - Cédric Le Maréchal
- Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078
- Etablissement Français du Sang (EFS)-Région Bretagne
- Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan
- Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale; Brest France
| | - Gérald Le Gac
- Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078
- Etablissement Français du Sang (EFS)-Région Bretagne
- Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan
- Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale; Brest France
| | - Claude Férec
- Institut National de la Santé et de la Recherche Médicale (Inserm), UMR1078
- Etablissement Français du Sang (EFS)-Région Bretagne
- Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Centre Hospitalier Régional Universitaire (CHRU), Hôpital Morvan
- Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale; Brest France
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20
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Xu W, Zhu M, Wang BL, Su H, Wang M. Prospective Evaluation of a Transfusion Policy of RhD-Positive Red Blood Cells into DEL Patients in China. Transfus Med Hemother 2014; 42:15-21. [PMID: 25960711 DOI: 10.1159/000370217] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 05/14/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The D antigen is highly immunogenic, requiring only a small quantity of transfused red blood cells (RBCs) to cause alloimmunization in D- immunocompetent recipients. DEL was reported arousing alloimmunization to true Rh- patients. Molecular studies of the RHD gene have revealed that DEL individuals retain a grossly intact RHD gene or have a portion of RHD in their genomes. Avoiding immunization with clinically important antibodies is a primary objective in transfusion medicine. METHODS In order to determine whether pregnant DEL women carrying an RhD+ fetus are at risk of anti-D alloimmunization, 808 Rh- pregnant women with a history of gestations or parturitions who regularly visited hospitals for their prenatal anti-D screening and postpartum care from January 2011 to December 2012 were investigated. Samples were analyzed for DEL by PCR with specific primers, PCR-sequence-specific primers (PCR-SSP), reverse transcription-PCR (RT-PCR), PCRrestriction fragment length polymorphism (PCR-RFLP), and by gene sequencing to characterize different alleles. RESULTS Among the 808 Rh- pregnant women of our sample, 178 (22.0%) were typed as DEL; 168 DEL samples were confirmed to have the RHD (1,227 G>A) allele, 8 DEL samples were characterized by one base mutation of the RHD (3G >A) allele, and the remaining two DEL samples were determined to carry RHD-CE(4-9)-D or RHD-CE(2-5)-D. The observation of allo-anti-D in two prominent D epitope loss cases confirmed the partial nature of these DEL phenotypes. CONCLUSIONS In conclusion, evidence is provided that different DEL genotypes code either for partial or complete D antigen expression. It is suggested that the use of RhD+ RBCs in complete D antigen DEL patients does not induce adverse reaction.
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Affiliation(s)
- Wei Xu
- Department of Laboratory Medicine, Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, China ; Department of Blood Transfusion, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Mei Zhu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Bao-Long Wang
- Department of Laboratory Medicine, Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Hong Su
- Department of Epidemiology & Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Min Wang
- Department of Laboratory Medicine, Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, China
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21
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Silvy M, Filosa L, Chiaroni J, Bailly P. [Contribution of red blood group genotyping for recipients in immune-hematology through three years of activity at the EFS Alpes-Méditerranée]. Transfus Clin Biol 2014; 21:289-95. [PMID: 25443328 DOI: 10.1016/j.tracli.2014.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 06/12/2014] [Indexed: 11/18/2022]
Abstract
AIM OF THE STUDY Current knowledge of the molecular basis of most blood groups enables genetic testing for blood groups to overcome the limitations of agglutination. A retrospective review was carried out on genotyping assays performed between 2011 and 2013. METHODS AND PATIENTS The Molecular Hematology Laboratory of the EFS Alpes-Méditerranée implements commercially available tools (BioArray, Gen-Probe) and other techniques (TaqMan, tetra-primer ARMS-PCR, sequencing). It provides a high-level of expertise in molecular biology, complying with regulatory requirements and standards. RESULTS A total of 2382 genotyping assays was performed including 764 extended typings and 115 large extended typings essentially in cases involving multiple transfusion and suspected rare blood type. Phenotype discrepancies linked to the RH system accounted for 1501 genotypings. Discrepancies linked to the D and E were mainly related to an allele coding for weak antigen (weak D type 1, 2, 3 and EIV) while those linked to C, c and e antigens were related to an allele coding for a partial antigen (RN, ces(340), ceMo). A high prevalence of (C)ces haplotype in trans of a DAR allele was observed in Afro-Caribbean (54/62). CONCLUSION In transfusion medicine, red-cell genotyping can overcome the limitations of hemagglutination. It must be used only in situations where it provides a benefit either for the patient or resource management. For implementation of appropriate transfusional practices, this technique requires a sound knowledge of the genetic characteristics of blood groups and clinically relevant variants. It also requires competency with molecular biology tools and continuously updated scientific data.
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Affiliation(s)
- M Silvy
- Laboratoire d'hématologie moléculaire, Établissement français du sang (EFS) Alpes-Méditerranée, 207, boulevard Sainte-Marguerite, 13009 Marseille, France; UMR 7268 ADÉS Aix-Marseille université - EFS - CNRS, 13009 Marseille, France
| | - L Filosa
- Laboratoire d'hématologie moléculaire, Établissement français du sang (EFS) Alpes-Méditerranée, 207, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - J Chiaroni
- Laboratoire d'hématologie moléculaire, Établissement français du sang (EFS) Alpes-Méditerranée, 207, boulevard Sainte-Marguerite, 13009 Marseille, France; UMR 7268 ADÉS Aix-Marseille université - EFS - CNRS, 13009 Marseille, France
| | - P Bailly
- Laboratoire d'hématologie moléculaire, Établissement français du sang (EFS) Alpes-Méditerranée, 207, boulevard Sainte-Marguerite, 13009 Marseille, France; UMR 7268 ADÉS Aix-Marseille université - EFS - CNRS, 13009 Marseille, France.
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22
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Van Sandt VS, Gassner C, Emonds MP, Legler TJ, Mahieu S, Körmöczi GF. RHDvariants in Flanders, Belgium. Transfusion 2014; 55:1411-7. [DOI: 10.1111/trf.12947] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 09/22/2014] [Accepted: 10/10/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Vicky S.T. Van Sandt
- Histocompatibility and Immunogenetic Laboratory; Red Cross Flanders; Mechelen Belgium
| | - Christoph Gassner
- Blood Transfusion Service Zürich; Swiss Red Cross; Schlieren Switzerland
| | - Marie-Paule Emonds
- Histocompatibility and Immunogenetic Laboratory; Red Cross Flanders; Mechelen Belgium
| | - Tobias J. Legler
- Department of Transfusion Medicine; University of Göttingen; Göttingen Germany
| | - Sarah Mahieu
- Histocompatibility and Immunogenetic Laboratory; Red Cross Flanders; Mechelen Belgium
- ZNA Stuivenberg; Antwerp Belgium
| | - Günther F. Körmöczi
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
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23
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Orzińska A, Guz K, Polin H, Pelc-Kłopotowska M, Bednarz J, Gieleżyńska A, Sliwa B, Kowalewska M, Pawłowska E, Włodarczyk B, Malaga Alicja Żmudzin M, Krzemienowska M, Srivastava K, Michalewska B, Gabriel C, Flegel WA, Brojer E. RHD variants in Polish blood donors routinely typed as D-. Transfusion 2013; 53:2945-53. [PMID: 23634715 PMCID: PMC5497842 DOI: 10.1111/trf.12230] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 01/10/2013] [Accepted: 02/10/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Blood donors exhibiting a weak D or DEL phenotypical expression may be mistyped D- by standard serology hence permitting incompatible transfusion to D- recipients. Molecular methods may overcome these technical limits. Our aim was to estimate the frequency of RHD alleles among the apparently D- Polish donor population and to characterize its molecular background. STUDY DESIGN AND METHODS Plasma pools collected from 31,200 consecutive Polish donors typed as D- were tested by real-time polymerase chain reaction (PCR) for the presence of RHD-specific markers located in Intron 4 and Exons 7 and 10. RHD+ individuals were characterized by PCR or cDNA sequencing and serology. RESULTS Plasma cross-pool strategy revealed 63 RHD+ donors harboring RHD*01N.03 (n = 17), RHD*15 (n = 12), RHD*11 (n = 7), RHD*DEL8 (n = 3), RHD*01W.2 (n = 3), RHD-CE(10) (n = 3), RHD*01W.3, RHD*01W.9, RHD*01N.05, RHD*01N.07, RHD*01N.23, and RHD(IVS1-29G>C) and two novel alleles, RHD*(767C>G) (n = 3) and RHD*(1029C>A). Among 47 cases available for serology, 27 were shown to express the D antigen CONCLUSION 1) Plasma cross-pool strategy is a reliable and cost-effective tool for RHD screening. 2) Only 0.2% of D- Polish donors carry some fragments of the RHD gene; all of them were C or E+. 3) Almost 60% of the detected RHD alleles may be potentially immunogenic when transfused to a D- recipient.
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Affiliation(s)
- Agnieszka Orzińska
- Department of Immunohematology and Immunology of Transfusion Medicine, Institute of Haematology and Blood Transfusion, Warsaw, Poland; Regional Blood Transfusion Centers in Warsaw, Kraków, Gdańsk, Racibórz, Kalisz, Kielce, Radom, Poland; Red Cross Transfusion Centre of Upper Austria, Linz, Austria; Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
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24
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A new strategy to identify rare blood donors: single polymerase chain reaction multiplex SNaPshot reaction for detection of 16 blood group alleles. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12 Suppl 1:s256-63. [PMID: 23736910 DOI: 10.2450/2013.0242-12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 12/11/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND As an alternative to phenotyping, large-scale DNA-based assays, which are feasible for high-throughput donor red blood cell typing, were developed for determination of blood group polymorphisms. However, high-throughput genotyping platforms based on these technologies are still expensive and the inclusion of single nucleotide polymorphisms and analysis of the alleles depend on the manufacturer's determination. To overcome this limitation and in order to develop an assay to enable the screening of rare donors, we developed a SNaPshot assay for analysis of nine single nucleotide polymorphisms related to antigens that are difficult to assess using conventional serology. MATERIALS AND METHODS The single polymerase chain reaction multiplex SNaPshot reaction was optimized to identify nine single nucleotide polymorphisms determining 16 alleles: KEL*3/KEL*4, KEL*6/KEL*7, DI*1/DI*2, DI*3/DI*4, YT*1/YT*2, CO*1/CO*2, DO*1/DO*2, DO*4, DO*5. We designed a single multiplex PCR with primers encompassing the blood group single nucleotide polymorphisms and performed an internal reaction with probe primers able to discriminate the alleles after fragment analysis. The SNaPshot assay was validated with 140 known alleles previously determined by PCR restriction fragment length polymorphism. RESULTS We were able to simultaneous detect nine single nucleotide polymorphisms defining 16 blood group alleles on an assay based on a multiplex PCR combined with a single base extension using genomic DNA. DISCUSSION This study demonstrates a robust genotyping strategy for conducting rare donor screening which can be applied in blood centers and could be an important tool for identifying antigen-negative donors and, therefore, for providing rare blood.
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25
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Fichou Y, Le Maréchal C, Jamet D, Bryckaert L, Ka C, Audrézet MP, Le Gac G, Dupont I, Chen JM, Férec C. Establishment of a medium-throughput approach for the genotyping ofRHDvariants and report of nine novel rare alleles. Transfusion 2012; 53:1821-8. [DOI: 10.1111/trf.12009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 09/24/2012] [Accepted: 10/01/2012] [Indexed: 01/22/2023]
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26
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Chen JM, Fichou Y, Jamet D, Dupont I, Cooper DN, Le Maréchal C, Férec C. Small deletions within theRHDcoding sequence: a report of two novel mutational events and a survey of the underlying pathophysiologic mechanisms. Transfusion 2012; 53:206-10. [DOI: 10.1111/j.1537-2995.2012.03713.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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27
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Fichou Y, Chen JM, Le Maréchal C, Jamet D, Dupont I, Chuteau C, Durousseau C, Loirat MJ, Bailly P, Férec C. Weak D caused by a founder deletion in the RHD gene. Transfusion 2012; 52:2348-55. [PMID: 22420867 DOI: 10.1111/j.1537-2995.2012.03606.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The RhD blood group system exemplifies a genotype-phenotype correlation by virtue of its highly polymorphic and immunogenic nature. Weak D phenotypes are generally thought to result from missense mutations leading to quantitative change of the D antigen in the red blood cell membrane or intracellularly. STUDY DESIGN AND METHODS Different sets of polymerase chain reaction primers were designed to map and clone a deletion involving RHD Exon 10, which was found in approximately 3% of approximately 2000 RHD hemizygous subjects with D phenotype ambiguity. D antigen density was measured by flow cytometry. Transcript analysis was carried out by 3'-rapid amplification of complementary DNA ends. Haplotype analysis was performed by microsatellite genotyping. RESULTS A 5405-bp deletion that removed nearly two-thirds of Intron 9 and almost all of Exon 10 of the RHD gene was characterized. It is predicted to result in the replacement of the last eight amino acids of the wild-type RhD protein by another four amino acids. The mean RhD antigen density from two deletion carriers was determined to be only 30. A consensus haplotype could be deduced from the deletion carriers based on the microsatellite genotyping data. CONCLUSION The currently reported deletion was derived from a common founder. This deletion appears to represent not only the first large deletion associated with weak D but also the weakest of weak D alleles so far reported. This highly unusual genotype-phenotype relationship may be attributable to the additive effect of three distinct mechanisms that affect mRNA formation, mRNA stability, and RhD/ankyrin-R interaction, respectively.
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Affiliation(s)
- Yann Fichou
- Etablissement Français du Sang (EFS)-Bretagne, France
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28
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Silvy M, Chapel-Fernandes S, Callebaut I, Beley S, Durousseau C, Simon S, Lauroua P, Dubosc-Marchenay N, Babault C, Mouchet C, Ferrera V, Chiaroni J, Bailly P. Characterization of novel RHD alleles: relationship between phenotype, genotype, and trimeric architecture. Transfusion 2012; 52:2020-9. [DOI: 10.1111/j.1537-2995.2011.03544.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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29
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Fichou Y, Le Maréchal C, Bryckaert L, Guerry C, Bénech C, Dupont I, Jamet D, Férec C, Chen JM. Variant screening of the RHD gene in a large cohort of subjects with D phenotype ambiguity: report of 17 novel rare alleles. Transfusion 2011; 52:759-64. [DOI: 10.1111/j.1537-2995.2011.03350.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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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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