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Ankathil R, Eva F, Bakar ZA, Yunus NM, Nawi NA, Annuar A, Ting CY, Sulong S. A Dual Gender Rare Case with 47,XY, + 18/46,XX Karyotype: Chimera or Mosaic? JOURNAL OF CHILD SCIENCE 2021. [DOI: 10.1055/s-0040-1722275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Our objective is to report one rare case of dual gender chimerism involving abnormal male trisomy 18 and normal female karyotype. The baby was born full term with birth weight of 1.8 kg, not vigorous with light meconium stained liquor and Apgar score of 51, 85 and 910. Parents are 40 years old and mother is G6P5 + 1. The baby had clinical features of Edwards syndrome, and a blood sample was sent to Human Genome Centre, Universiti Sains Malaysia, Malaysia for cytogenetic analysis. Conventional cytogenetic analysis results showed two distinct sex discordant genetic cell lines XY and XX in 90:10 ratio. The male genetic cell line XY also showed trisomy 18 (47,XY, + 18) consistent with clinical diagnosis of male Edwards syndrome, whereas the second genetic cell line showed normal 46,XX female. The present case was reported as dual gender chimera with chi 47,XY, + 18/46,XX karyotype pattern. To the best of available knowledge, dual gender chimerism with abnormal male trisomy 18 and normal female karyotype has not been reported so far, and this case is reported for its rarity and as the first report.
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Affiliation(s)
- Ravindran Ankathil
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Foong Eva
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Zulaikha Abu Bakar
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nazihah Mohd Yunus
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nurul Alia Nawi
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Aziati Annuar
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Cheng Yi Ting
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Sarina Sulong
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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McKnight TFP, Strain JE, Vege S, Lam C, Hubbard EM, Kopko PM, Westhoff CM, Allen ES. ABO maternal-child discordance: Evidence of variable allelic expression and considerations for investigation. Transfusion 2021; 61:979-985. [PMID: 33475168 DOI: 10.1111/trf.16263] [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: 04/08/2020] [Revised: 10/28/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND We report a case of apparent mother-child ABO group noninheritance. A Caucasian mother initially typed as group O and her infant group AB. Investigation ruled out preanalytical causes such as mislabeled samples and in vitro fertilization. MATERIALS AND METHODS Red blood cells were characterized by routine serologic testing. Genomic data were analyzed by targeted polymerase chain reaction-restriction fragment length polymorphism and Sanger sequencing. Transferase structures were modeled using PyMOL molecular visualization software. RESULTS Serologic testing initially demonstrated the mother was group O, father group AB, and infant group AB. Further testing of the maternal sample with anti-A,B demonstrated weak A expression. Molecular testing revealed the maternal sample had an ABO*O.01.01 allele in trans to an A allele, ABO*AW.29 (c.311T>A, p.Ile104Asn), determined by gene sequencing. The sample from the infant carried the same ABO*AW.29 allele in trans to a B allele, ABO*B.01. CONCLUSION ABO genotyping revealed an A transferase encoded by ABO*AW.29, with apparent variable activity. Although A antigen expression is well known to be weak in newborns, it was robust on the red blood cells (RBCs) of the AB infant and undetectable with anti-A on the mother. Variable expression of weak subgroups may reflect competition or enhancement by a codominant allele, as well as glycan chain maturation on red cells. Previous examples in group AB mothers with Aweak infants suggested that the decreased expression is primarily due to glycan immaturity. To our knowledge, this is the first reported case of the ABO*AW.29 allele presenting with weak A expression in a group Aweak mother and robust A expression in a group AB infant, suggesting the in trans allele is an important factor in determining transferase activity and may override age-related effects.
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Affiliation(s)
- Tristan F P McKnight
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | | | | | - Christina Lam
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, California, USA
| | - Eustratia M Hubbard
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Patricia M Kopko
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | | | - Elizabeth S Allen
- Department of Pathology, University of California San Diego, La Jolla, California, USA
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Natural human chimeras: A review. Eur J Med Genet 2020; 63:103971. [PMID: 32565253 DOI: 10.1016/j.ejmg.2020.103971] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/06/2020] [Accepted: 06/01/2020] [Indexed: 12/24/2022]
Abstract
The term chimera has been borrowed from Greek mythology and has a long history of use in biology and genetics. A chimera is an organism whose cells are derived from two or more zygotes. Recipients of tissue and organ transplants are artificial chimeras. This review concerns natural human chimeras. The first human chimera was reported in 1953. Natural chimeras can arise in various ways. Fetal and maternal cells can cross the placental barrier so that both mother and child may become microchimeras. Two zygotes can fuse together during an early embryonic stage to form a fusion chimera. Most chimeras remain undetected, especially if both zygotes are of the same genetic sex. Many are discovered accidently, for example, during a routine blood group test. Even sex-discordant chimeras can have a normal male or female phenotype. Only 28 of the 50 individuals with a 46,XX/46,XY karyotype were either true hermaphrodites or had ambiguous genitalia. Blood chimeras are formed by blood transfusion between dizygotic twins via the shared placenta and are more common than was once assumed. In marmoset monkey twins the exchange via the placenta is not limited to blood but can involve other tissues, including germ cells. To date there are no examples in humans of twin chimeras involving germ cells. If human chimeras are more common than hitherto thought there could be many medical, social, forensic, and legal implications. More multidisciplinary research is required for a better understanding of this fascinating subject.
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Yang JJ, Hwang SH, Ko DH, Seo EJ, Oh HB. Tri-allelic expression of HLA gene in 46,XX/46,XY chimerism. Transpl Immunol 2018; 53:38-42. [PMID: 30579837 DOI: 10.1016/j.trim.2018.12.004] [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: 11/19/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Chimerism is defined as coexistence of different cell lines in an individual. 46,XX/46,XY chimerism is very rare and exhibits broad range of clinical phenotypes. Most cases are detected at infancy or younger age due to disorders of sex development, while phenotypically normal cases are incidentally discovered through abnormal blood grouping results or multiple genotypes in HLA. OBJECTIVE Aim was to determine the genetic expression of numerous HLA alleles detected in phenotypically normal 46,XX/46,XY chimerism. MATERIALS AND METHODS A patient was admitted for lung transplantation due to end-stage pulmonary disease. Pre-transplantation work-up included blood group typing and HLA DNA typing analyses. Peripheral blood and hair follicle specimens were used to confirm unusual tri-allelic results by high-resolution PCR-SBT. Cytogenetic analyses of karyotyping, FISH and chromosomal microarray were done. Flowcytometry crossmatch analysis was conducted using lymphocytes and anti-HLA sera defined by Luminex panel reactive antibody test (One Lambda, Inc., Canoga Park, CA), to determine antigen expression of HLA alleles. RESULTS 46,XX/46,XY chimerism was confirmed through series of cytogenetic analyses. HLA typing of the patient revealed three alleles from HLA-A, -B and -DRB1 loci. Antigen expression of all 3 HLA alleles was confirmed by flow cytometry crossmatch. DISCUSSION A case of normal phenotype 46,XX/46,XY chimerism was detected for the first time in Korean patient admitted for lung transplantation. Cytogenetic results were confirmatory for chimerism and HLA typing using PCR-SBT method was able to detect the presence of 3 HLA alleles. Flowcytometry crossmatch was proven sensitive for detecting antigen expression of different cell lines of small proportions.
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Affiliation(s)
- John Jeongseok Yang
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Sang-Hyun Hwang
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Dae-Hyun Ko
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Eul-Ju Seo
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea
| | - Heung-Bum Oh
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
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Choi EJ, Kim SR, Kim YJ, Kang SM, Kim GY, Kim JH, Lee YJ. Clinical and Genetic Analysis of an Infertile Male with 46,XX/46,XY Chimerism. Andrologia 2018; 51:e13215. [PMID: 30536450 DOI: 10.1111/and.13215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/25/2018] [Accepted: 11/09/2018] [Indexed: 11/28/2022] Open
Abstract
The sex chromosome-discordant chimerism 46,XX/46,XY is rarely found in humans with a phenotypically normal appearance, and this lack of phenotypic changes and the rarity of chimerism make it difficult to identify its exact incidence. Here, we report a case of this sex chromosome-discordant chimerism diagnosed by cytogenic and molecular analyses of peripheral blood in a phenotypically normal male who was referred to our facility for infertility. Based on the karyotype, fluorescence in situ hybridisation (FISH) and short tandem repeat (STR) analyses, the type of this chimerism was determined to be tetragametic presenting four alleles at two loci on chromosomes 16 and 21.
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Affiliation(s)
- Eun Jung Choi
- iDream Research Center, Mizmedi Hospital, Seoul, Korea
| | | | - Young Joo Kim
- iDream Research Center, Mizmedi Hospital, Seoul, Korea
| | - Soo Man Kang
- iDream Research Center, Mizmedi Hospital, Seoul, Korea
| | - Gi Young Kim
- Department of Urology, Mizmedi Hospital, Seoul, Korea
| | - Jong Hyun Kim
- Department of Urology, Mizmedi Hospital, Seoul, Korea
| | - Young Jin Lee
- iDream Research Center, Mizmedi Hospital, Seoul, Korea
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Laursen RJ, Alsbjerg B, Vogel I, Gravholt CH, Elbaek H, Lildballe DL, Humaidan P, Vestergaard EM. Case of successful IVF treatment of an oligospermic male with 46,XX/46,XY chimerism. J Assist Reprod Genet 2018; 35:1325-1328. [PMID: 29713857 DOI: 10.1007/s10815-018-1194-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/18/2018] [Indexed: 10/17/2022] Open
Abstract
INTRODUCTION We present a case of an infertile male with 46,XX/46,XYchimerism fathering a child after ICSI procedure. METHODS Conventional cytogenetic analysis on chromosomes, derived from lymphocytes, using standard Q-banding procedures with a 450-550-band resolution and short-tandem-repeat analysis of 14 loci. RESULTS Analysis of 20 metaphases from lymphocytes indicated that the proband was a karyotypic mosaic with an almost equal distribution between male and female cell lines. In total, 12 of 20 (60%) metaphases exhibited a normal female karyotype 46,XX, while 8 of 20 (40%) metaphases demonstrated a normal male karyotype 46,XY. No structural chromosomal abnormalities were present. Out of 14 STR loci, two loci (D18S51 and D21S11) showed four different alleles in peripheral blood, buccal mucosal cells, conjunctival mucosal cells, and seminal fluid. In three loci (D2S1338, D7S820, and vWA), three alleles were detected with quantitative differences that indicated presence of four alleles. In DNA extracted from washed semen, four alleles were detected in one locus, and three alleles were detected in three loci. This pattern is consistent with tetragametic chimerism. There were no quantitative significant differences in peak heights between maternal and paternal alleles. STR-analysis on DNA from the son confirmed paternity. CONCLUSION We report a unique case with 46,XX/46,XY chimerism confirmed to be tetragametic, demonstrated in several tissues, with male phenotype and no genital ambiguity with oligospermia fathering a healthy child after IVF with ICSI procedure.
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Affiliation(s)
- R J Laursen
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark.
| | - B Alsbjerg
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark.,Health, Aarhus University, Aarhus, Denmark
| | - I Vogel
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - C H Gravholt
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Molecular Medicine (MOMA), Aarhus University Hospital, Aarhus, Denmark
| | - H Elbaek
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark
| | - D L Lildballe
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - P Humaidan
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark.,Health, Aarhus University, Aarhus, Denmark
| | - E M Vestergaard
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
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Reddy OL, Ward DC, McGonigle AM. Blood Typing Discrepancies. CHIMERISM 2018. [DOI: 10.1007/978-3-319-89866-7_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Klimczewska K, Kasperczuk A, Suwińska A. The Regulative Nature of Mammalian Embryos. Curr Top Dev Biol 2018; 128:105-149. [DOI: 10.1016/bs.ctdb.2017.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Fertilization and Early Embryonic Errors. CHIMERISM 2018. [DOI: 10.1007/978-3-319-89866-7_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Grubic Z, Stingl Jankovic K, Kelecic J, Batinic D, Dubravcic K, Zunec R. A case of maternal-foetal chimerism identified during routine histocompatibility testing for hematopoietic stem cell transplantation. Int J Immunogenet 2015; 43:1-7. [PMID: 26663895 DOI: 10.1111/iji.12241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/20/2015] [Accepted: 10/25/2015] [Indexed: 11/29/2022]
Abstract
This report describes a case of maternal-foetal chimerism identified in a boy diagnosed with SCID, who underwent HLA testing in preparation for HSCT. The first analysis was carried out on DNA from peripheral blood and included HLA-A, HLA-B, HLA-DRB1 typing using PCR-SSO. The patient's HLA-B typing results were noninterpretable. All samples were re-typed for HLA-B using PCR-SSP, again resulting in noninterpretable typing of patient's HLA-B. In both cases, several weak positive probes/reactions interfered with the interpretation when using commercial software. Next round of HLA typing, using PCR-SSP and PCR-SSO methods, included the patient's bone marrow sample and HLA-C locus, but interpretation was again not possible. The PCR-STR analysis performed on both peripheral blood and bone marrow samples revealed seven STRs for which two maternal and one paternal allele were detected. Retrospective manual interpretation of HLA-B and HLA-C typing revealed that weak positive reactions were indeed owed to paternal HLA-B and HLA-C alleles and that the patient had both maternal and one paternal allele. Retyping of HLA-B and HLA-C loci and STR analysis on the patient's buccal cells sample revealed the expected one maternal/one paternal allele pattern. In summary, the combination of several different typing methods and manual interpretation were necessary to obtain the patient's HLA typing results.
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Affiliation(s)
- Z Grubic
- Tissue Typing Center, Clinical Department for Transfusion Medicine ad Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - K Stingl Jankovic
- Tissue Typing Center, Clinical Department for Transfusion Medicine ad Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Kelecic
- Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - D Batinic
- Clinical Unit for Cellular Immunodiagnostics, Clinical Department of Laboratory Diagnosis, University Hospital Centre Zagreb, Zagreb, Croatia
| | - K Dubravcic
- Clinical Unit for Cellular Immunodiagnostics, Clinical Department of Laboratory Diagnosis, University Hospital Centre Zagreb, Zagreb, Croatia
| | - R Zunec
- Tissue Typing Center, Clinical Department for Transfusion Medicine ad Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
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James PA, Rose K, Francis D, Norris F. High-level 46XX/46XY chimerism without clinical effect in a healthy multiparous female. Am J Med Genet A 2011; 155A:2484-8. [DOI: 10.1002/ajmg.a.34123] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 04/24/2011] [Indexed: 11/06/2022]
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Winberg J, Gustavsson P, Lagerstedt-Robinson K, Blennow E, Lundin J, Iwarsson E, Nordenström A, Anderlid BM, Bondeson ML, Nordenskjöld A, Nordgren A. Chimerism resulting from parthenogenetic activation and dispermic fertilization. Am J Med Genet A 2010; 152A:2277-86. [DOI: 10.1002/ajmg.a.33594] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Reddy KS, Schwartz GE, Jamedhor M. A fertile XY/XX chimeric male with chronic myeloid leukemia in a minor 46,XX cell line and a history of polycythemia vera and trisomy 9 in the major 46,XY cell line. Leuk Lymphoma 2009; 50:1375-80. [PMID: 19562617 DOI: 10.1080/10428190903047761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Scientific and forensic standards for homologous blood transfusion anti-doping analyses. Forensic Sci Int 2008; 179:23-33. [DOI: 10.1016/j.forsciint.2008.04.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Revised: 01/07/2008] [Accepted: 04/12/2008] [Indexed: 11/18/2022]
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Draper NL, Conley C, Smith C, Benson K. Dispermic chimerism identified during HLA typing for stem cell transplantation. Transfusion 2008; 48:1398-402. [DOI: 10.1111/j.1537-2995.2008.01711.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yunis EJ, Zuniga J, Romero V, Yunis EJ. Chimerism and tetragametic chimerism in humans: implications in autoimmunity, allorecognition and tolerance. Immunol Res 2007; 38:213-36. [DOI: 10.1007/s12026-007-0013-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 10/23/2022]
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Abstract
The finding of a mixture of 46,XX and 46,XY cells in an individual has been rarely reported in literature. It usually results in individuals with ambiguous genitalia. Approximately 10% of true human hermaphrodites show this type of karyotype. However, the underlying mechanisms are poorly understood. It may be the result of mosaicism or chimerism. By definition, a chimera is produced by the fusion of two different zygotes in a single embryo, while a mosaic contains genetically different cells issued from a single zygote. Several mechanisms are involved in the production of chimera. Stricto sensu, chimerism occurs from the post-zygotic fusion of two distinct embryos leading to a tetragametic chimera. In addition, there are other entities, which are also referred to as chimera: parthenogenetic chimera and chimera resulting from fertilization of the second polar body. Furthermore, a particular type of chimera called 'androgenetic chimera' recently described in fetuses with placental mesenchymal dysplasia and in rare patients with Beckwith-Wiedemann syndrome is discussed. Strategies to study mechanisms leading to the production of chimera and mosaics are also proposed.
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Affiliation(s)
- V Malan
- Service de Cytogénétique, Hôpital Necker - Enfants Malades, APHP, Paris, René Descartes-Paris 5 University, Paris, France.
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Mosebach M, Parkner A, Jakubiczka S, Wieacker P, Heim MU. Dispermic chimerism identified during blood group determination and HLA typing. Transfusion 2006; 46:1978-81. [PMID: 17076853 DOI: 10.1111/j.1537-2995.2006.01005.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chimerism is the presence of two or more genetically distinct cell populations in one organism. STUDY DESIGN AND METHODS We report the identification of dispermic chimerism in a 19-year-old female volunteer blood donor. During routine ABO blood grouping strong reactions of the blood donors red blood cells (RBCs) with anti-A reagents and mixed-field reactions with anti-B reagents were observed, while serum-testing showed the absence of anti-A and anti-B antibodies. AB0 blood group genotyping, HLA-typing and microsatellite analysis were performed using blood-samples, buccal mucosa and fibroblasts of the blood-donor and blood-samples of her parents. RESULTS AB0 blood group genotyping showed three ABO blood group alleles (0(1), A(2) and B) in the DNA-samples of the blood-donor. The evidence of chimerism was supported by the detection of three alleles for the HLA-A and HLA-DRB1 loci. Microsatellite analysis with ten markers revealed three alleles for loci D7S821 and D19S412. All studies carried out, the third allele was always of paternal origin. CONCLISION: The results suggested a case of a human dispermic chimerism. Our proposed explanation for the development of chimerism in the reported case is the fertilization of an oocyte and the corresponding second polar body by two different sperms.
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Affiliation(s)
- Mira Mosebach
- Institute of Transfusion Medicine and Immunohematology and the Institute of Human Genetics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
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Bourthoumieu S, Esclaire F, Yardin C. Chimerism in twins: Caution is needed in interpretation of karyotypes. Am J Med Genet A 2006; 140:533-5. [PMID: 16470796 DOI: 10.1002/ajmg.a.31111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Yu N, Kruskall MS, Yunis JJ, Knoll JHM, Uhl L, Alosco S, Ohashi M, Clavijo O, Husain Z, Yunis EJ, Yunis JJ, Yunis EJ. Disputed maternity leading to identification of tetragametic chimerism. N Engl J Med 2002; 346:1545-52. [PMID: 12015394 DOI: 10.1056/nejmoa013452] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Neng Yu
- American Red Cross Blood Services, New England Region, Dedham, Mass, USA
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Abstract
Analysis on five common classes of human natural chimeras (cytomictical, whole body, fetal-maternal, germ cell, and tumor chimeras) reveals that (1) they initiate only during pregnancy, (2) the most common class are chimeras which contain maternal cells, and (3) the primary mechanisms that are involved in their formation and establishment are still elusive. These classes of natural chimerism, are involved only with maladaptive phenomena such as malignancy and autoimmune diseases and without any documented benefit. A recent review has challenged the accepted dogma that the evolution of immunity is pathogen-directed and asserted that preserving individuality from littering the soma and the germline by conspecific alien cells might have been the original function of the innate immunity. Following this tenet, I propose here that human natural chimerism is a by-product of the new role evolved from primitive components of immunity to "educate" the developing embryo with the armamentarium of effector mechanisms, dedicated to purge the individual from pervasive somatic and germline variants, and is not a vestige of evolution.
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Affiliation(s)
- B Rinkevich
- Minerva Center for Marine Invertebrates Immunology and Developmental Biology, National Institute of Oceanography, Haifa, Israel.
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Morgan WT, Watkins WM. Unravelling the biochemical basis of blood group ABO and Lewis antigenic specificity. Glycoconj J 2000; 17:501-30. [PMID: 11421345 DOI: 10.1023/a:1011014307683] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The ABO blood-group polymorphism is still the most clinically important system in blood transfusion practice. The groups were discovered in 1900 and the genes at the ABO locus were cloned nearly a century later in 1990. To enable this goal to be reached intensive studies were carried out in the intervening years on the serology, genetics, inheritance and biochemistry of the antigens belonging to this system. This article describes biochemical genetic investigations on ABO and the related Lewis antigens starting from the time in the 1940s when serological and classical genetical studies had established the immunological basis and mode of inheritance of the antigens but practically nothing was known about their chemical structure. Essential steps were the definition of H as the product of a genetic system Hh independent of ABO, and the establishment of the precursor-product relationship of H to A and B antigens. Indirect methods gave first indications that the specificity of antigens resided in carbohydrate and revealed the immunodominant sugars in the antigenic structures. Subsequently chemical fragmentation procedures enabled the complete determinant structures to be established. Degradation experiments with glycosidases revealed how loss of one specificity by the removal of a single sugar unit exposed a new specificity and suggested that biosynthesis proceeded by a reversal of this process whereby the oligosaccharide structures were built up by the sequential addition of sugar units. Hence, the primary blood-group gene products were predicted to be glycosyltransferase enzymes that added the last sugar to complete the determinant structures. Identification of these enzymes gave new genetic markers and eventually purification of the blood-group A-gene encoded N-acetylgalactosaminyltransferase gave a probe for cloning the ABO locus. Blood-group ABO genotyping by DNA methods has now become a practical possibility.
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Affiliation(s)
- W T Morgan
- Department of Haematology, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom
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23
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Affiliation(s)
- J D West
- Department of Obstetrics and Gynaecology, University of Edinburgh, United Kingdom
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24
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Strain L, Dean JC, Hamilton MP, Bonthron DT. A true hermaphrodite chimera resulting from embryo amalgamation after in vitro fertilization. N Engl J Med 1998; 338:166-9. [PMID: 9428825 DOI: 10.1056/nejm199801153380305] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- L Strain
- Human Genetics Unit, University of Edinburgh, Western General Hospital, United Kingdom
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25
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Falik-Borenstein TC, Korenberg JR, Schreck RR. Confined placental chimerism: prenatal and postnatal cytogenetic and molecular analysis, and pregnancy outcome. AMERICAN JOURNAL OF MEDICAL GENETICS 1994; 50:51-6. [PMID: 8160753 DOI: 10.1002/ajmg.1320500112] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The presence of two cell lines in chorionic villi sampling (CVS) represents a significant complication in CVS analysis, interpretation, and counseling. We report on the cytogenetic and molecular analysis of a pregnancy that was conceived on clomiphene citrate. Two cell lines (46,XX and 47,XY,+9) were discovered in CVS analysis done for maternal age; 94% of the cells in the culture were 46,XX and 6% were 47,XY, +9 (the direct preparation was 46,XX). As neither line could have derived from the other, chimerism and not mosaicism was suspected, with the 47,XY,+9 cells deriving from a co-twin whose demise was the result of the autosomal trisomy. At a subsequent amniocentesis, only normal female cells were observed and a normal female infant was delivered at term. Cytogenetic analysis done on the infant's peripheral blood and on a sample of an umbilical vessel showed only 46,XX cells, while amnion and a fibrotic area of the placenta contained 2 cell lines, 46,XX and 47,XY,+9. Molecular analysis of 3 different tissues was done by the polymerase chain reaction (PCR) and Southern blotting, using Y specific primers and probes, respectively. The presence of Y specific DNA was detected in the placenta and amnion, but not in the umbilical blood vessel. These data excluded true chimerism in the fetal tissues at the level of about 1 in 10(5) cells and have defined for the first time probable confined placental chimerism (CPC), the result most likely of a "vanishing twin." Whenever two cell lines are found in CVS, especially in the setting of pharmacologically stimulated ovulation, the possibility of CPC should be considered. The effects of CPC on placental function and fetal outcome merit further study.
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Affiliation(s)
- T C Falik-Borenstein
- Simon Winter Institute for Human Genetics, Bnai-Zion Medical Center, Technion, Faculty of Medicine, Haifa, Israel
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26
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Kominato Y, Fujikura T, Shimada I, Takizawa H, Hayashi K, Mori T, Matsuda T. Monoclonal antibody to blood group glycosyltransferases, produced by hybrids constructed with Epstein-Barr-virus-transformed B lymphocytes from a patient with ABO-incompatible bone marrow transplant and mouse myeloma cells. Vox Sang 1990; 59:116-8. [PMID: 2173279 DOI: 10.1111/j.1423-0410.1990.tb05022.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A patient with chronic myeloid leukemia secreted an antibody to blood group glycosyltransferases after ABO-incompatible bone marrow transplantation (B recipient/O donor). Peripheral B lymphocytes from the recipient were transformed with Epstein-Barr virus, and then fused by polyethylene glycol with mouse myeloma cell line P3-X63/Ag8.653. After the cloning of the hybridoma cells, a cell line which produced human IgM antibody to blood group glycosyltransferases was established. The antibody completely neutralized B transferase activity at low concentration, while a larger amount of immunoglobulins was required to neutralize A transferase activity.
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Affiliation(s)
- Y Kominato
- Department of Legal Medicine, Toyama Medical and Pharmaceutical University, Japan
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27
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Lage JM, Vanmarter LJ, Mikhail E. Vascular anastomoses in fused, dichorionic twin placentas resulting in twin transfusion syndrome. Placenta 1989; 10:55-9. [PMID: 2717545 DOI: 10.1016/0143-4004(89)90006-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We have provided pathologic documentation of vascular anastomoses across fused, dichorionic placentas. These placental anastomoses resulted in the twin transfusion syndrome.
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Affiliation(s)
- J M Lage
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115
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Schoenle E, Schmid W, Schinzel A, Mahler M, Ritter M, Schenker T, Metaxas M, Froesch P, Froesch ER. 46,XX/46,XY chimerism in a phenotypically normal man. Hum Genet 1983; 64:86-9. [PMID: 6575956 DOI: 10.1007/bf00289485] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Some twenty cases of dispermic chimeras with the karyotype 46,XX/46,XY, discovered because of gonadal dysplasias or a true hermaphroditism, have been reported. This is a report of a phenotypically normal man with 46,XX/46,XY chimerism in whom a prepubertal finding of positive X-chromatin was interpreted as Klinefelter syndrome. The diagnosis was revised 11 years later when the family doctor, who doubted the earlier diagnosis because of the patient's normal-sized testes, sent him to an outpatient clinic. The young man was 23 years old, athletic (74kg, 180cm), with normal body proportions, normal sexual hair distribution, normal libido and potency, normal endocrine parameters, and a normal spermiogram. The karyotype revealed an XX/XY mosaic in a proportion of 1:2. An identical set of maternal markers (Q- and C-banding) was present in male and female cells. Differences were found with respect to two paternal markers. Furthermore, blood, serum, and red cell enzyme groups in five systems showed two phenotypes, again with duality of paternal origin. It is concluded that a positive X-chromatin in prepuperty, especially in the absence of supporting clinical features, must be followed by a karyotype study.
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Abstract
More than 70 spontaneous chimeric propositi in man are known. This review attempts to summarize the information given by 32 twin chimeras, 32 dispermic chimeras and 11 chimeras of unestablished type.
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Bird GW, Wingham J, Nicholson GS, Battey DA, Koster HG, Webb T. Another example of haemopoietic (twin) chimaerism in a subject unaware of being a twin. JOURNAL OF IMMUNOGENETICS 1982; 9:317-22. [PMID: 6816856 DOI: 10.1111/j.1744-313x.1982.tb00988.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A fourth human blood group chimaera studies in Birmingham is an example of haemopoietic (twin) chimaerism in which the subject was unaware of being a twin. Chimaerism was discovered during routine antenatal serological investigation in which it was shown that the proposita has two red cell populations, one of the rhesus genotype rr, and the other R1r. Further studies showed that she has two populations of lymphocytes, one with the female karyotype, 46XX, and the other with the male karyotype, 46XY. Skin fibroblasts were all 46XX.
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Badet J, Lopez M, Habibi B, Cartron JP, Noel A, Salmon D, Seger J, Salmon C. Atypical transmission of ABO blood groups in a French family. JOURNAL OF IMMUNOGENETICS 1982; 9:169-77. [PMID: 6809837 DOI: 10.1111/j.1744-313x.1982.tb00788.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A group AB mother (Mrs P.D.) gave birth to a group O female baby (C.D.). Extensive study of the blood group genetic markers in both the parents and the child, carried out on several occasions, showed nothing unusual outside the ABO system. Mrs P.D. then, gave birth to a second female baby who was also group O. Mrs P.D. had normal amounts of A, B, H and Lewis antigens in her saliva. The H, A and B agglutinability of her red cells was in the range of normal A2B group. This A2B blood group was characterized by very low A gene-specified glycosyltransferase activity in serum. Moreover this activity was undetectable in red blood cell membranes. These results are discussed in the light of various hypotheses in order to explain this unusual transmission of ABO blood group.
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