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Bingulac-Popović J, Babić I, Đogić V, Kundid R, Simović Medica J, Mišković B, Jukić I. Prenatal RHD genotyping in Croatia: preliminary results. Transfus Clin Biol 2020; 28:38-43. [PMID: 33227453 DOI: 10.1016/j.tracli.2020.10.011] [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: 09/04/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Croatian Institute of Transfusion Medicine (CITM) implemented non-invasive fetal RHD genotyping as a request for targeted antenatal anti-D prophylaxis. The diagnostic performance of in-house RT-PCR method for fetal RHD genotyping and preliminary results are analyzed. MATERIALS AND METHODS Evaluation included results of RHD genotyping for 205 RhD negative pregnant women, 12-36th week of gestation, whose samples were received in period between 2015 and 2020. QIAsymphony SP DSP Virus Midi Kit was used for cffDNA extraction on QIAsymphony SP platform (Qiagen, Germany). Fragments of RHD exons 7 and 10 and later exon 5 were RT-PCR amplified. As internal controls, amplification of SRY gene or RASSF1A fragment and β-actin genes digested with BsTUI were used. RESULTS We identified 70.72% (145/205) positive and 28.78% (59/205) negative fetal RHD genotypes. We had one inconclusive result (0.50%) due to the interference of maternal DNA with variant genotype RHD*09.02.00/01/*01N.01. When compared to newborns RhD phenotypes, no false negative and three false positive results (3/199, 1.50%) were observed. The test yielded 100% sensitivity and 95.08% specificity, while diagnostic accuracy was 98.48%. We were able to determine one case of fetal variant genotype RHD*04.04/*01N.01 inherited from the father. The negative and positive predictive test values were 100% and 97.86%, respectively. CONCLUSION Automated cffDNA extraction and RT-PCR amplification of fetal RHD exons 5,7,10 and fragments of SRY, RASSF1A genes represents highly reliable system for determining fetal RHD status which enables targeted antenatal anti-D prophylaxis. To obtain high specificity of cffDNA extraction, strict and thoroughly cleaning procedures are required.
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Affiliation(s)
- J Bingulac-Popović
- Department of Molecular Diagnostics, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - I Babić
- Department of Molecular Diagnostics, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - V Đogić
- Department of Molecular Diagnostics, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - R Kundid
- Department of Molecular Diagnostics, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - J Simović Medica
- Department of Transfusion Medicine, General Hospital Pula, Santoriova 24a, 52100 Pula, Croatia.
| | - B Mišković
- Department of Obstetrics and Gynecology, Clinical Hospital "Holy Spirit", 64 Holy Spirit, 10000 Zagreb, Croatia.
| | - I Jukić
- Medical Department, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 10/E, 31000 Osijek, Croatia.
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Zednikova I, Pazourkova E, Lassakova S, Vesela B, Korabecna M. Detection of cell-free foetal DNA fraction in female-foetus bearing pregnancies using X-chromosomal insertion/deletion polymorphisms examined by digital droplet PCR. Sci Rep 2020; 10:20036. [PMID: 33208834 PMCID: PMC7676229 DOI: 10.1038/s41598-020-77084-0] [Citation(s) in RCA: 4] [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: 12/31/2019] [Accepted: 10/23/2020] [Indexed: 12/03/2022] Open
Abstract
In families with X-linked recessive diseases, foetal sex is determined prenatally by detection of Y-chromosomal sequences in cell-free foetal DNA (cffDNA) in maternal plasma. The same procedure is used to confirm the cffDNA presence during non-invasive prenatal RhD incompatibility testing but there are no generally accepted markers for the detection of cffDNA fraction in female-foetus bearing pregnancies. We present a methodology allowing the detection of paternal X-chromosomal alleles on maternal background and the confirmation of female sex of the foetus by positive amplification signals. Using digital droplet PCR (ddPCR) we examined X-chromosomal INDEL (insertion/deletion) polymorphisms: rs2307932, rs16397, rs16637, rs3048996, rs16680 in buccal swabs of 50 females to obtain the population data. For all INDELs, we determined the limits of detection for each ddPCR assay. We examined the cffDNA from 63 pregnant women bearing Y-chromosome negative foetuses. The analysis with this set of INDELs led to informative results in 66.67% of examined female-foetus bearing pregnancies. Although the population data predicted higher informativity (74%) we provided the proof of principle of this methodology. We successfully applied this methodology in prenatal diagnostics in a family with Wiscott-Aldrich syndrome and in pregnancies tested for the risk of RhD incompatibility.
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Affiliation(s)
- Iveta Zednikova
- Department of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Albertov 4, 128 00, Prague, Czech Republic
- Department of Biology and Medical Genetics, General University Hospital in Prague, Albertov 4, 128 00, Prague, Czech Republic
| | - Eva Pazourkova
- Department of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Albertov 4, 128 00, Prague, Czech Republic
- Department of Biology and Medical Genetics, General University Hospital in Prague, Albertov 4, 128 00, Prague, Czech Republic
- Department of Nephrology, First Faculty of Medicine, Charles University and General University Hospital in Prague, U nemocnice 2, 128 08, Prague, Czech Republic
| | - Sona Lassakova
- Department of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Albertov 4, 128 00, Prague, Czech Republic
| | - Barbora Vesela
- Department of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Albertov 4, 128 00, Prague, Czech Republic
| | - Marie Korabecna
- Department of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Albertov 4, 128 00, Prague, Czech Republic.
- Department of Biology and Medical Genetics, General University Hospital in Prague, Albertov 4, 128 00, Prague, Czech Republic.
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Eryilmaz M, Müller D, Rink G, Klüter H, Bugert P. Introduction of Noninvasive Prenatal Testing for Blood Group and Platelet Antigens from Cell-Free Plasma DNA Using Digital PCR. Transfus Med Hemother 2019; 47:292-301. [PMID: 32884502 DOI: 10.1159/000504348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background Noninvasive prenatal testing (NIPT) for fetal antigens is a common standard for targeted immune prophylaxis in RhD-mediated hemolytic disease of the fetus and newborn, and is most frequently done by quantitative PCR (qPCR). A similar approach is considered for other blood group and human platelet alloantigens (HPA). Because of a higher sensitivity compared to qPCR for rare molecule detection, we established and validated digital PCR (dPCR) assays for the detection of RHD exons 3, 5 and 7, KEL1, HPA-1a, and HPA-5b from cell-free DNA (cfDNA) in plasma. The dPCR assays for the Y-chromosomal marker amelogenin and autosomal SNPs were implemented as controls for the proof of fetal DNA. Methods Validation was performed on dilution series of mixed plasma samples from volunteer donors with known genotypes. After preamplification of the target loci, two-color (FAM and VIC) TaqMan<sup>TM</sup> probe chemistry and chip-based dPCR were applied. The assays for RHD included GAPDH as an internal control. For the diallelic markers KEL1/2, HPA-1a/b, HPA-5a/b, and AMEL-X/Y and 3 autosomal SNPs, the probes enabled allelic discrimination in the two fluorescence channels. The dPCR protocol for NIPT was applied to plasma samples from pregnant women. Results The RHD exon 5 assay allowed the detection of a 0.05% RHD target in an RhD-negative background, whereas the exon 7 assay required at least a 0.25% target. The exon 3 assay showed the highest background and required at least a 2.5% RHD target for reliable detection. The dPCR assays for the diallelic markers revealed similar sensitivity and enabled the detection of at least a 0.5% target allele. The HPA-1a assay was the most sensitive and allowed target detection in plasma mixtures containing only 0.05% HPA-1a. The plasma samples from 13 pregnant women at different gestational ages showed unambiguous positive and negative results for the analyzed targets. Conclusion Analysis of cfDNA from maternal plasma using dPCR is suitable for the detection of fetal alleles. Because of the high sensitivity of the assays, the NIPT protocol for RhD, KEL1, and HPA can also be applied to earlier stages of pregnancy.
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Affiliation(s)
- Marion Eryilmaz
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Dennis Müller
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Gabi Rink
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
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Clausen FB. Lessons learned from the implementation of non-invasive fetalRHDscreening. Expert Rev Mol Diagn 2018; 18:423-431. [DOI: 10.1080/14737159.2018.1461562] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Frederik Banch Clausen
- Laboratory of Blood Genetics, Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
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Daniels G, Finning K, Lozano M, Hyland CA, Liew YW, Powley T, Castilho L, Bonet Bub C, Kutner JM, Banch Clausen F, Christiansen M, Sulin K, Haimila K, Legler TJ, Lambert M, Ryan H, Ní Loingsigh S, Matteocci A, Pierelli L, Dovc Drnovsek T, Bricl I, Nogués N, Muñiz-Diaz E, Olsson ML, Wikman A, de Haas M, van der Schoot CE, Massey E, Westhoff CM. Vox Sanguinis International Forum on application of fetal blood grouping. Vox Sang 2017; 113:e26-e35. [DOI: 10.1111/vox.12615] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - C. A. Hyland
- Australian Red Cross Blood Service, Research and Development; 44 Musk Avenue, Kelvin Grove Brisbane Qld 4059 Australia
| | - Y.-W. Liew
- Australian Red Cross Blood Service, Research and Development; 44 Musk Avenue, Kelvin Grove Brisbane Qld 4059 Australia
| | - T. Powley
- Australian Red Cross Blood Service, Research and Development; 44 Musk Avenue, Kelvin Grove Brisbane Qld 4059 Australia
| | - L. Castilho
- Departamento de Hemoterapia; Hospital Israelita Albert Einstein; Avenida Albert Einstein, 627-3° andar Bloco E CEP: 05651-901 São Paulo SP Brazil
| | - C. Bonet Bub
- Departamento de Hemoterapia; Hospital Israelita Albert Einstein; Avenida Albert Einstein, 627-3° andar Bloco E CEP: 05651-901 São Paulo SP Brazil
| | - J. M. Kutner
- Departamento de Hemoterapia; Hospital Israelita Albert Einstein; Avenida Albert Einstein, 627-3° andar Bloco E CEP: 05651-901 São Paulo SP Brazil
| | - F. Banch Clausen
- Laboratory of Blood Genetics, Rigshospitalet, Section 2034, Department of Clinical Immunology; Copenhagen University Hospital; Blegdamsvej 9 Copenhagen Denmark
| | - M. Christiansen
- Department of Clinical Immunology; Aarhus University Hospital; Palle Juul-Jensens Boulevard 99 8200 Aarhus N Denmark
| | - K. Sulin
- Blood Group Unit; Finnish Red Cross Blood Service; Kivihaantie 7 FI-00310 Helsinki Finland
| | - K. Haimila
- Blood Group Unit; Finnish Red Cross Blood Service; Kivihaantie 7 FI-00310 Helsinki Finland
| | - T. J. Legler
- Department of Transfusion Medicine; University Medical Center Göttingen; Georg-August-Universität; Robert-Koch-Str. 40 Göttingen 37075 Germany
| | - M. Lambert
- Irish Blood Transfusion Service; Blood Group Genetics; National Blood Centre; James's Street Dublin 8 Ireland
| | - H. Ryan
- Irish Blood Transfusion Service; Blood Group Genetics; National Blood Centre; James's Street Dublin 8 Ireland
| | - S. Ní Loingsigh
- Irish Blood Transfusion Service; Blood Group Genetics; National Blood Centre; James's Street Dublin 8 Ireland
| | - A. Matteocci
- Department of Transfusion Medicine; San Camillo Forlanini Hospital; Circonvallazione Gianicolense 87 00152 Roma Italy
| | - L. Pierelli
- Department of Experimental Medicine; Sapienza University of Rome; Piazzale Aldo Moro 5 00185 Roma Italy
- Department of Transfusion Medicine; San Camillo Forlanini Hospital; Circonvallazione Gianicolense 87 00152 Roma Italy
| | - T. Dovc Drnovsek
- Department of Immunohematology; Blood Transfusion Centre of Slovenia; Slajmerjeva 6 SI-Ljubljana Slovenia
| | - I. Bricl
- Department of Immunohematology; Blood Transfusion Centre of Slovenia; Slajmerjeva 6 SI-Ljubljana Slovenia
| | - N. Nogués
- Immunohematology Department; Banc de Sang i Teixits; Passeig de Taulat 116 08005 Barcelona Spain
| | - E. Muñiz-Diaz
- Immunohematology Department; Banc de Sang i Teixits; Passeig de Taulat 116 08005 Barcelona Spain
| | - M. L. Olsson
- Department of Laboratory Medicine; Lund University; Lund Sweden
- Department of Clinical Immunology and Transfusion Medicine; LabMedicine; Office of Medical Services; Region Skåne Lund Sweden
| | - A. Wikman
- Department of Clinical Immunology and Transfusion Medicine; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
| | - M. de Haas
- Sanquin Diagnostic Services; Department of Immunohematology Diagnostics; Sanquin Research; Plesmanlaan 125 1066 CX Amsterdam The Netherlands
- Center for Clinical Transfusion Research; Leiden The Netherlands
- Department of Immunohematology and Blood Transfusion; Leiden University Medical Center; Leiden The Netherlands
| | - C. E. van der Schoot
- Sanquin Research; Plesmanlaan 125 1066 CX Amsterdam The Netherlands
- Department of Experimental Immunohematology; Sanquin Research; Amsterdam The Netherlands
- Landsteiner Laboratory; Academic Medical Centre; University of Amsterdam; Amsterdam The Netherlands
| | - E. Massey
- Diagnostic and Therapeutic Services; NHS Blood and Transplant; North Bristol Park, Northway Filton Bristol BS34 7QH UK
| | - C. M. Westhoff
- Immunohematology and Genomics; New York Blood Center; 310 E 67th St New York NY 10065 USA
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Wagner FF, Flegel WA, Bittner R, Döscher A. Molecular typing for blood group antigens within 40 min by direct polymerase chain reaction from plasma or serum. Br J Haematol 2016; 176:814-821. [PMID: 27991657 DOI: 10.1111/bjh.14469] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/05/2016] [Indexed: 01/15/2023]
Abstract
Determining blood group antigens by serological methods may be unreliable in certain situations, such as in patients after chronic or massive transfusion. Red cell genotyping offers a complementary approach, but current methods may take much longer than conventional serological typing, limiting their utility in urgent situations. To narrow this gap, we devised a rapid method using direct polymerase chain reaction (PCR) amplification while avoiding the DNA extraction step. DNA was amplified by PCR directly from plasma or serum of blood donors followed by a melting curve analysis in a capillary rapid-cycle PCR assay. We evaluated the single nucleotide polymorphisms underlying the clinically relevant Fya , Fyb , Jka and Jkb antigens, with our analysis being completed within 40 min of receiving a plasma or serum sample. The positive predictive value was 100% and the negative predictive value at least 84%. Direct PCR with melting point analysis allowed faster red cell genotyping to predict blood group antigens than any previous molecular method. Our assay may be used as a screening tool with subsequent confirmatory testing, within the limitations of the false-negative rate. With fast turnaround times, the rapid-cycle PCR assay may eventually be developed and applied to red cell genotyping in the hospital setting.
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Affiliation(s)
- Franz F Wagner
- DRK Blutspendedienst NSTOB, Institute Springe, Springe, Germany
| | - Willy A Flegel
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Rita Bittner
- DRK Blutspendedienst NSTOB, Institute Springe, Springe, Germany
| | - Andrea Döscher
- DRK Blutspendedienst NSTOB, Institute Bremen-Oldenburg, Oldenburg, Germany
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Adamczyk T, Doescher A, Haydock PV, Aldrich R, Petershofen EK, Müller TH. The Glass Slide Extraction System Snap Card Improves Non-Invasive Prenatal Genotyping in Pregnancies with Antibodies. Transfus Med Hemother 2016; 42:379-84. [PMID: 26733769 DOI: 10.1159/000441542] [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: 02/23/2015] [Accepted: 07/26/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Determination of fetal blood groups in maternal plasma samples critically depends on adequate pre-analytical steps for optimal amplification of fetal DNA. We compared the extraction of cell-free DNA by binding on a glass surface (BCSI SNAP™ Card) with an automated system based on bead technology (MagnaPure compact™). METHODS Maternal blood samples from 281 pregnancies (7th-39th week of gestation) with known antibodies were evaluated in this study. Both the SNAP card and the MagnaPure method were applied to isolate DNA in order to directly compare the amplification in a single base extension assay and/or real-time PCR. RESULTS The mean concentration of total DNA obtained by the SNAP card (33.8 ng/µl) exceeded more than twofold that of MagnaPure extraction (15.7 ng/µl). SNAP card-extracted samples allowed to detect 3.7 single nucleotide polymorphisms (SNPs) versus 2.5 SNPs in MagnaPure extracts to control for traces of fetal DNA. This difference is highest for samples from 7th-13th week of gestation. CONCLUSION The SNAP card system improves DNA extraction efficacy for prenatal diagnosis in maternal blood samples and provides an at least eightfold higher total amount of DNA for the ensuing analysis. Its advantage is most evident for samples from early stages of pregnancy and thus especially valuable for pregnancies with antibodies.
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Affiliation(s)
- Thomasz Adamczyk
- Medical Hospital 'Links der Weser', Gesundheit Nord, Department Internal Medicine, Bremen, Germany
| | - Andrea Doescher
- German Red Cross Blood Transfusion Service NSTOB, Institute Oldenburg, Germany
| | | | | | | | - Thomas H Müller
- German Red Cross Blood Transfusion Service NSTOB, Institute Springe, Germany
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Orzińska A, Guz K, Dębska M, Uhrynowska M, Celewicz Z, Wielgo M, Brojer E. 14 Years of Polish Experience in Non-Invasive Prenatal Blood Group Diagnosis. Transfus Med Hemother 2015; 42:361-4. [PMID: 26733766 DOI: 10.1159/000440821] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 04/02/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Blood cell antigens may cause maternal alloimmunization leading to fetal/newborn disorders. Non-invasive prenatal diagnostics (NIPD) of the blood group permits the determination of feto-maternal incompatibility. AIM To evaluate 14 years of blood group NIPD at the Institute of Hematology and Transfusion Medicine (IHTM) in Warsaw. METHODS Plasma DNA from 536 RhD-negative, 24 Rhc-negative, 26 RhE-negative, 43 K-negative, and 42 HPA-1a-negative pregnant women was examined by real-time PCR to detect RHD, RHCE*c, RHCE*E, RHCE*C, KEL*01 and HPA*1A, respectively. We tested for CCR5, SRY or bi-allelic polymorphisms and quantified the total or fetal DNA. RESULTS The results of fetal antigen status prediction by NIPD in all but one case (false-positive result of KEL*01) were correct taking neonate serology as a reference. It was confirmed that all negative results of NIPD contained fetal DNA except for four cases where there was no difference between the parents' polymorphisms. CONCLUSIONS A fetal genotype compatible with the mother was determined in 25% of all pregnancies tested at the IHTM for the fetal blood group. These cases were not at risk of disease, so it was possible to avoid invasive procedures.
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Affiliation(s)
| | - Katarzyna Guz
- Institute of Haematology and Transfusion Medicine, Warsaw, Poland
| | - Marzena Dębska
- 2nd Department of Obstetrics and Gynaecology Medical Centre of Postgraduate Education, Warsaw, Poland
| | | | - Zbigniew Celewicz
- Department of Obstetrics and Gynaecology, Pomeranian Medical University, Szczecin, Poland
| | - Mirosław Wielgo
- 1th Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Brojer
- Institute of Haematology and Transfusion Medicine, Warsaw, Poland
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Picchiassi E, Di Renzo GC, Tarquini F, Bini V, Centra M, Pennacchi L, Galeone F, Micanti M, Coata G. Non-Invasive Prenatal RHD Genotyping Using Cell-Free Fetal DNA from Maternal Plasma: An Italian Experience. Transfus Med Hemother 2014; 42:22-8. [PMID: 25960712 DOI: 10.1159/000370233] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/27/2014] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND This study assessed the diagnostic accuracy of a non-invasive approach to fetal RHD genotyping using cell-free fetal DNA in maternal plasma and a combination of methodological strategies. METHODS Real-time PCR (qPCR) was performed on 216 RhD-negative women between weeks 10+0 and 14+6 of gestation (1st qPCR). qPCR was repeated (2nd qPCR) to increase the amount of each sample for analysis, on 95 plasma aliquots that were available from first trimester blood collection (group 1) and on 13 samples that were collected between weeks 18+0 and 25+6 of gestation (group 2). qPCR was specific for exons 5 and 7 of the RHD gene (RHD5 and RHD7). The results were interpreted according to the number of positive replicates of both exons. RESULTS 1st qPCR: diagnostic accuracy was of 93.3%. Diagnostic accuracy increased from 90.5% (1st qPCR) to 93.7% (2nd qPCR) in group 1 and from 84.6% (1st qPCR) to 92.3% (2nd qPCR) in group 2. These increments were not statistically significant. CONCLUSION Our approach to RHD genotyping in early pregnancy yielded high diagnostic accuracy. Increasing the amount of DNA analyzed in each sample did not improve significantly the diagnostic accuracy of the test.
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Affiliation(s)
- Elena Picchiassi
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Gian Carlo Di Renzo
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Federica Tarquini
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Vittorio Bini
- Department of Internal Medicine, University Hospital of Perugia, Perugia, Italy
| | - Michela Centra
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Luana Pennacchi
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Fabiana Galeone
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Mara Micanti
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Giuliana Coata
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
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Doescher A, Petershofen EK, Hertenstein B, Kraemer D, Casper J, Schmidt JP, Müller TH. Platelet recovery and survival measured in patients by quantitative polymerase chain reaction of mitochondrial DNA. Transfusion 2014; 55:55-63. [PMID: 25056505 DOI: 10.1111/trf.12778] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 05/27/2014] [Accepted: 05/31/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Mitochondrial (mt) DNA markers have been identified as potential targets for the quantification of endogenous and allogeneic platelets (PLTs) in the blood of individuals who received transfusions. Our goal was to develop a routine polymerase chain reaction (PCR) assay for ex vivo monitoring of PLT survival in patients after transfusion. STUDY DESIGN AND METHODS Targets were selected for real-time (RT)-PCR of mt DNA based on the frequency distribution of nucleotide polymorphisms and assay sensitivity in vitro. The assays were then evaluated with ex vivo samples to measure PLT survival and recovery of therapeutic doses of apheresis PLTs in hematooncologic patients with thrombocytopenia. RESULTS Nucleotides in two positions (73/310 hypervariable region [HVR] 2) and three positions (295 HVR 2, 16069/16311 HVR 1) had allele frequencies of approximately 0.5 and 0.85, respectively, in a population of 960 Caucasian PLT donors. They provided targets for sensitive assays detecting at least 1 × 10(3) PLTs per whole blood sample with adequate reproducibility (interassay coefficient of variation <4.0%). Transfusions of single-donor PLT concentrates in patients with thrombocytopenia (n = 30) were monitored with these markers. The mean 24-hour corrected count increment was 8.3 and the mean calculated survival time was 3.3 days. Results for a second marker were available for 13 transfusions. The survival time values derived from both markers for the same transfusion were almost identical (linear regression: r(2) = 0.957, slope = 0.87). CONCLUSION This RT-PCR method detects mt DNA polymorphisms in Caucasians for a highly sensitive and reproducible quantification of endogenous and allogeneic PLT numbers in blood samples from transfused patients with thrombocytopenia.
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Affiliation(s)
- Andrea Doescher
- DRK-Blutspendedienst NSTOB, Institut Bremen-Oldenburg, Oldenburg, Germany
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Paternal RHD zygosity determination in Tunisians: evaluation of three molecular tests. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2014; 13:59-65. [PMID: 24960665 DOI: 10.2450/2014.0308-13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 02/11/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND The choice of a molecular test for first intention determination of paternal RHD zygosity, before entering into invasive diagnostics, is important for the management of pregnancies at risk of haemolytic disease of the foetus and newborn related to anti-RhD. MATERIALS AND METHODS RHD zygosity was evaluated in 370 RH:1 Tunisian donors by polymerase chain reaction - sequence-specific polymorphism (PCR-SSP) analysis and polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) amplification of hybrid Rhesus box and by real time quantitative polymerase chain reaction (RQ-PCR) specific for RHD exon 5. To evaluate the accuracy of molecular tests in the cases of discordant results, the ten exons of RHD and Rhesus boxes were amplified by PCR and sequenced. RESULTS Molecular investigations revealed that our 370 donors comprise 193 dizygous and 145 hemizygous individuals and 32 subjects whose zygosity remains unknown. Positive predictive values were higher than 99% for all the methods, reaching 100% for RQ-PCR. Negative predictive values were 83.24%, 87.27% and 98% for PCR-SSP, PCR-RFLP and RQ-PCR respectively. This study also revealed 19 novel Rhesus box polymorphisms and three novel RHD alleles: RHD(Trp185Stop), RHD(Ala176Thr) and RHD(Ile342Ile). DISCUSSION RQ-PCR is the most convenient method for first intention determination of paternal RHD zygosity in Tunisians. However, taking into account positive and negative predictive values, PCR-RFLP could be an alternative despite the heterogeneity of Rhesus boxes and the complexity of RHD.
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Clausen FB. Integration of noninvasive prenatal prediction of fetal blood group into clinical prenatal care. Prenat Diagn 2014; 34:409-15. [PMID: 24431264 DOI: 10.1002/pd.4326] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 12/21/2022]
Abstract
Incompatibility of red blood cell blood group antigens between a pregnant woman and her fetus can cause maternal immunization and, consequently, hemolytic disease of the fetus and newborn. Noninvasive prenatal testing of cell-free fetal DNA can be used to assess the risk of hemolytic disease of the fetus and newborn to fetuses of immunized women. Prediction of the fetal RhD type has been very successful and is now integrated into clinical practice to assist in the management of the pregnancies of RhD immunized women. In addition, noninvasive prediction of the fetal RhD type can be applied to guide targeted prenatal prophylaxis, thus avoiding unnecessary exposure to anti-D in pregnant women. The analytical aspect of noninvasive fetal RHD typing is very robust and accurate, and its routine utilization has demonstrated high sensitivities for fetal RHD detection. A high compliance with administering anti-D is essential for obtaining a clinical effect. Noninvasive fetal typing of RHC/c, RHE/e, and KEL may become more widely used in the future.
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Affiliation(s)
- Frederik Banch Clausen
- Laboratory of Blood Genetics, Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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van der Schoot CE, Thurik FF, Veldhuisen B, de Haas M. Noninvasive prenatal blood group and HPA-1a genotyping: the current European experience. Transfusion 2013; 53:2834-6. [DOI: 10.1111/trf.12411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 12/13/2022]
Affiliation(s)
- C. Ellen van der Schoot
- Department of Experimental Immunohematology; Sanquin Research; Landsteiner Laboratory; Academic Medical Center; University of Amsterdam; Amsterdam; the Netherlands
| | - Florentine F. Thurik
- Department of Experimental Immunohematology; Sanquin Research; Landsteiner Laboratory; Academic Medical Center; University of Amsterdam; Amsterdam; the Netherlands
| | | | - Masja de Haas
- Department of Diagnostic Immunohematology; Sanquin Diagnostic Services; Amsterdam; the Netherlands
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