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Simtong P, Jumnainsong A, Leelayuwat C. Genetic profile of RHCE, Kell, Duffy, Kidd, Diego and MNS hybrid glycophorins blood groups in ethnic northeastern Thais: Alleles, genotypes and risk of alloimmunisation. Transfus Med 2024. [PMID: 38804163 DOI: 10.1111/tme.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/17/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Antibodies against blood group antigens play a key role in the pathophysiology of haemolytic transfusion reactions (HTRs) and haemolytic disease of the fetus and newborn (HDFN). This study aimed to determine the frequencies of alleles, genotypes, and risk of alloimmunisation of clinically significant blood group systems in ethnic northeastern Thais. METHODS In total, 345 unrelated, healthy, ethnic northeastern Thais were tested using the in-house PCR-sequence specific primers (PCR-SSP) method for simultaneously genotyping of RHCE, Kell, Duffy, Kidd, Diego and MNS glycophorin hybrids and results confirmed by Sanger sequencing. RESULTS In this cohort, the alleles RHCE*C (81.0%) and RHCE*e (84.8%) were more prevalent than RHCE*c (19.0%) and RHCE*E (15.2%). The most common predicted haplotype combinations of the RHCE alleles were C+c-E-e+(R1R1) (59.4%) followed by the C+c+E+e+ (R1R2) (20.6%) and C+c+E-e+ (R1r) (11.3%). The KEL*01 allele was not found in this study. The frequencies of FY*01 and FY*02 were 88.3% and 11.7%, respectively. The genotype FY*02/02 was found in four samples (1.2%). The frequencies of JK*01 and JK*02 were 52.5% and 47.5%, respectively. Homozygous JK*02/02 was found in 81 samples (23.5%). The frequencies of DI*01 and DI*02 were 0.6% and 99.4%, respectively. In total, 64 samples (18.6%) were found to carry the MNS glycophorin hybrids. CONCLUSIONS Our results indicated a possible high risk of c, E, Fyb, Jka, Jkb and Mia alloimmunisation in these populations. Moreover, methods established for genotyping clinically significant blood groups in this study can now be utilised in routine clinical application.
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Affiliation(s)
- Piyapong Simtong
- Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Amonrat Jumnainsong
- Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chanvit Leelayuwat
- Department of Clinical Immunology and Transfusion Sciences, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
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Xu H, Su X, Zuo Q, Zhang L, Chu X. The Research of a Large-Scale Analysis Platform for MNS Blood Group Identification Based on Long-Read Sequencing. Transfus Med Rev 2024:150836. [PMID: 38851986 DOI: 10.1016/j.tmrv.2024.150836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/16/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024]
Abstract
The objective of this study was to devise a novel approach for determining MNS blood group utilizing long-read sequencing (LRS) and to identify intricate genome variations associated with this blood group system. In this study, a total of 60 blood samples were collected from randomly selected Chinese Han blood donors. The amplification of the full-length sequences of GYPA exon 2-7 (11 kb) and GYPB exon 2-6 (7 kb) was conducted on the blood samples obtained from these 60 donors. Subsequently, the sequencing of these amplified sequences was performed using the PacBio platform. The obtained sequencing data were then compared with the reference sequence of the human genome (GRCh38) utilizing the pbmm2 software, resulting in the acquisition of the haploid sequences of GYPA and GYPB. The serological typing prediction was conducted using the International Society of Blood Transfusion (ISBT) database, while the analysis of SNVs sites was performed using deepvariant v1.2.0 software and reference sequence alignment. A total of 60 samples yielded unambiguous high-quality haplotypes, which can serve as a standardized reference sequence for molecular biology typing of MNSs in the Chinese population. In a total of 60 serological samples, the LRS method successfully identified the M, N, S, and s blood group antigens by analyzing specific genetic variations (c.59, c.71, c.72 for GYPA, and c.143 for GYPB), which aligned with the results obtained through conventional serological techniques. 4 Mur samples that had been previously validated through serology and molecular biology were successfully confirmed, and complete haploid sequences were obtained. Notably, one of the Mur samples exhibited a novel breakpoint, GYP (B1-136-B ψ 137-212-A213-229-B230-366), thereby representing a newly identified subtype. Single molecule sequencing, which eliminates the necessity for PCR amplification, effectively encompasses GC and high repeat regions, enhancing accuracy in quantifying mutations with low abundance or frequency. By employing LRS analysis of the core region of GYPA and GYPB, diverse genotypes of MNS can be precisely and reliably identified in a single assay. This approach presents a comprehensive, expeditious, and precise novel method for the categorization and investigation of MNS blood group system.
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Affiliation(s)
- Hua Xu
- Shaanxi Blood Center, Xi'an, China.
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3
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Hsu K. Erythroid anion transport, nitric oxide, and blood pressure. Front Physiol 2024; 15:1363987. [PMID: 38660536 PMCID: PMC11039876 DOI: 10.3389/fphys.2024.1363987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Glycophorin A and glycophorin B are structural membrane glycoproteins bound in the band 3 multiprotein complexes on human red blood cells (RBCs). Band 3 is an erythroid-specific anion exchanger (AE1). AE1-mediated HCO3 - transport provides the substrate for the enzyme-catalyzed conversion HCO3 - (aq) ⇌ CO2(g), which takes place inside the RBCs. Bicarbonate transport via AE1 supports intravascular acid-base homeostasis and respiratory excretion of CO2. In the past decade, we conducted several comparative physiology studies on Taiwanese people having the glycophorin variant GPMur RBC type (which accompanies greater AE1 expression). We found that increased anion transport across the erythrocyte membrane not only enhances gas exchange and lung functions but also elevates blood pressure (BP) and reduces nitric oxide (NO)-dependent vasodilation and exhaled NO fraction (FeNO) in healthy individuals with GP.Mur. Notably, in people carrying the GPMur blood type, the BP and NO-dependent, flow-mediated vasodilation (FMD) are both more strongly correlated with individual hemoglobin (Hb) levels. As blood NO and nitrite (NO2 -) are predominantly scavenged by intraerythrocytic Hb, and NO2 - primarily enters RBCs via AE1, could a more monoanion-permeable RBC membrane (i.e., GPMur/increased AE1) enhance NO2 -/NO3 - permeability and Hb scavenging of NO2 - and NO to affect blood pressure? In this perspective, a working model is proposed for the potential role of AE1 in intravascular NO availability, blood pressure, and clinical relevance.
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Affiliation(s)
- Kate Hsu
- The Laboratory of Immunogenetics, Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan
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4
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Wei L, Zhu S, Wen J, Liao Z, Luo G, Ji Y. The study of variant s antigen expression revealing a novel c.160C>T (p.Arg54Cys) variant on GYPB*s allele associated with partial s phenotype. Transfusion 2024; 64:380-387. [PMID: 38158881 DOI: 10.1111/trf.17697] [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: 05/04/2023] [Revised: 10/07/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Little s antigen is mainly defined by a single nucleotide polymorphism at c.143C (p.Thr48) on the GYPB gene. Several variants on GYPB can alter the expression of s antigen. The aim of this study was to investigate the molecular basis of variant s antigen expression in the Chinese population. STUDY DESIGN AND METHODS A total of 4983 whole blood samples were collected to screen the individuals with discrepant s typing results using two different monoclonal anti-s. Then, the sequence of GYPB exon 4 was analyzed by Sanger sequencing. Flow cytometry analysis was performed to quantify s antigen expression on red blood cells (RBCs). In vitro expression study was performed to verify the effect of the GYPB variants identified on the expression of s antigen. RESULTS Four donors were identified to have discrepant s typing results. Sanger sequencing showed that three donors carried the c.173C > G variant (p.Pro58Arg) specific for sD antigen, the other one carried a novel GYPB (c.160C > T, p.Arg54Cys) variant. Flow cytometry identified a partial and weak expression of s antigen on the RBCs of the four donors. Furthermore, in vitro expression study confirmed the effect of the two variants on the s antigen expression. CONCLUSION The results demonstrated that in addition to p.Thr48, the two extra amino acids p.Arg54 and p.Pro58 are also important for full expression of s antigen. Since the individuals with partial s antigen are at risk for the development of alloanti-s, it is important to select at least two different monoclonal anti-s for correct s typing.
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Affiliation(s)
- Ling Wei
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - Siying Zhu
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - Jizhi Wen
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - Zhijian Liao
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - Guangping Luo
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - Yanli Ji
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
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Hassan SN, Mohamad S, Kannan TP, Hassan R, Wei S, Wan Ab Rahman WS. Prevalence of GP. Mur variant phenotype among Malaysian blood donors. Asian J Transfus Sci 2023; 17:169-174. [PMID: 38274953 PMCID: PMC10807541 DOI: 10.4103/ajts.ajts_125_21] [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: 08/31/2021] [Revised: 09/27/2021] [Accepted: 10/10/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVE A number of glycophorin variant phenotypes or hybrid glycophorin variants of the MNS blood group system bear multiple immunogenic antigens such as Mia, Mur, and MUT. In the East and Southeast Asian populations, glycoprotein (GP.) Mur is the most common glycophorin variant phenotype expressing those three immunogens. The aim of this study was to detect MNS system glycophorin variant phenotypes (GP. Mur, GP. Hop, GP. Bun, GP. HF, and GP. Hut) among Malaysian blood donors. MATERIALS AND METHODS In this cross-sectional study, 144 blood donors were selected under stratified random sampling. The deoxyribonucleic acid was extracted from whole blood samples, followed by a polymerase chain reaction assay. Sanger sequencing was used to identify the specific MNS variants and then validated by a serological crossmatch with known anti-Mur and anti-MUT. RESULTS GP. Mur was identified among Malaysian blood donors with a prevalence of 6.94%, and no other variants of the MNS system were found. CONCLUSION The present study substantiates that GP. Mur is the main variant of the MNS system glycophorin (B-A-B) hybrid in Malaysian blood donors. GP. Mur-negative red blood cells must therefore be considered in the current transfusion policy in order to prevent alloimmunization and immune-mediated transfusion reactions, particularly in transfusion-dependent patients.
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Affiliation(s)
| | - Suharni Mohamad
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Thirumulu Ponnuraj Kannan
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Rosline Hassan
- Department of Hematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - ShuangShi Wei
- CAS Key Lab of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
| | - Wan Suriana Wan Ab Rahman
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Hematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Chomean S, Attapong J, Jitsuvantaya S, Poomsaard K, Dongwilai C, Bunnun P, Kaset C. Development of Mi a Phenotyping Using Paper-Based Device. Diagnostics (Basel) 2022; 12:diagnostics12123104. [PMID: 36553111 PMCID: PMC9777619 DOI: 10.3390/diagnostics12123104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
The MNS7 (Mia) blood group antigen is found at a different prevalence among different ethnic groups. Anti-Mia can cause hemolytic disease of the fetus and newborn (HDFN) and both acute- and delayed-type hemolytic transfusion reactions (HTR). Mia typing should be performed in donors to prevent life-threatening hemolytic transfusion reactions. The gel card and standard tube methods still need specialized equipment, centrifugation, and expertise for result interpretation. We used a novel paper-based analytical device (PAD) pre-coated with monoclonal IgM anti-Mia for Mia phenotyping. We measured grey pixel intensity in blood typing results for interpretation processing using OpenCV at the sample (SP) and elution parts (EP); furthermore, we used the SP: EP ratio and F-score as analysis criteria. We typed 214 blood EDTA samples with PAD-Mia and then compared with gel card results for setting an analysis criterion. We observed 100% sensitivity, specificity, and accuracy when we applied the SP: EP ratio and F-score with the optimal criterion (1.07 and 0.17 for SP: EP ratio and F-score, respectively). The validation of PAD-Mia typing for blood donor samples (n = 150) via F-score gave 100% sensitivity and specificity when compared with the gel card method; therefore, we argue that PAD-Mia typing can be used for Mia phenotyping without sero-centrifugation. Moreover, to study the correlation between genotype and phenotype, PCR-SSP was performed to identify GYP(B-A-B) hybrids. The results revealed that all Mia+ blood samples gave a positive with GP. Hut, GP. HF, GP. Mur, GP. Hop, and GP. Bun. Results of the gel card method and PCR-SSP were concordant. Hence, using PAD-Mia typing in blood donors would be helpful for creating a phenotype database of blood donors for reducing alloimmunization risks.
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Affiliation(s)
- Sirinart Chomean
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand
| | - Jirapat Attapong
- Thammasat University Research Unit in Medical Technology and Precision Medicine Innovation, Pathumthani 12120, Thailand
| | - Sumittra Jitsuvantaya
- Thammasat University Research Unit in Medical Technology and Precision Medicine Innovation, Pathumthani 12120, Thailand
| | - Komin Poomsaard
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand
| | - Chadchadaporn Dongwilai
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand
| | - Pished Bunnun
- Industrial IoT and Automation Research Group (IIARG), National Electronics and Computer Technology Center (NECTEC), 112 Phaholyothin Road, Khlong Luang District, Pathumthani 12120, Thailand
| | - Chollanot Kaset
- Department of Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand
- Thammasat University Research Unit in Medical Technology and Precision Medicine Innovation, Pathumthani 12120, Thailand
- Correspondence:
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7
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Li Q, Duan S, Sun A, Liao Y, Wu Y, Wang H, Lin H, Huang X, Zhan Z. Study on the antigens and antibodies of Mur and Mia blood groups in southern China. Transfus Apher Sci 2022; 61:103378. [DOI: 10.1016/j.transci.2022.103378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/14/2022] [Accepted: 01/29/2022] [Indexed: 11/26/2022]
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8
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Wei L, Sun A, Wen J, Wang Z, Li Q, Liao Y, Luo G, Ji Y. Molecular genetic analysis of Mi a -positive hybrid glycophorins revealed two novel alleles of GP.Vw and multiple variant transcripts of GYPB existing in both the homozygous GP.Mur and wild-type GPB individuals. Transfusion 2021; 61:2477-2486. [PMID: 34117642 DOI: 10.1111/trf.16450] [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: 10/18/2020] [Revised: 03/16/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The hybrid glycophorins of MNS blood group system express a series of low incidence antigens including Mia , which are commonly found in Southeast Asian populations. In this study, the molecular basis of Mia -positive hybrid glycophorins was firstly clarified in the Chinese Southern Han population. RNA transcripts of GYPB gene in the homozygous GP.Mur individuals were also analyzed. STUDY DESIGN AND METHODS DNAs were extracted from the whole blood samples of 111 Mia -positive donors. Then, high-resolution melting (HRM) analysis for GYP(B-A-B) was used to analyze the genotypes. Sequencing of GYPB pseudoexon 3 was conducted in the samples with variant melting curves. TA-cloning and subsequent sequencing of GYPA exons 2-4 were performed in the Mia -positive samples with normal GYPB/GYPB genotype by HRM. The transcript analysis of GYPB was conducted in homozygous GP.Mur and wild-type glycophorin B (GPB) individuals using RNA extracted from the cultured erythroblast. RESULTS The heterozygous GYP*Mur/GYPB (n = 101), homozygous GYP*Mur/GYP*Mur (n = 7) including one novel GYP*Mur allele with an extra GYPA/GYPE specific nucleotide substitution (c.229+110A>T), heterozygous GYP*Bun/GYPB (n = 1) and GYP*Vw/GYPA (n = 2) with two novel GYP*Vw alleles were identified. RNA transcript analysis revealed multiple transcripts of GYPB existing in both homozygous GP.Mur and normal GPB individuals. CONCLUSION The results showed the genetic diversity of hybrid glycophorins in the Chinese population. Besides, the successful analysis of GYPB transcripts indicates that the cultured erythroblast is a good source for RNA transcript analysis for the protein only expressed on the red blood cells.
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Affiliation(s)
- Ling Wei
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China
| | - Ainong Sun
- Department of Laboratory Medicine, Zhongshan Blood Center, Zhongshan, People's Republic of China
| | - Jizhi Wen
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China
| | - Zhen Wang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China
| | - Qiao Li
- Department of Laboratory Medicine, Zhongshan Blood Center, Zhongshan, People's Republic of China
| | - Yanting Liao
- Department of Laboratory Medicine, Zhongshan Blood Center, Zhongshan, People's Republic of China
| | - Guangping Luo
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China
| | - Yanli Ji
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, People's Republic of China
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Universal Detection of Mi a Antigen and Frequencies of Glycophorin Hybrids among Blood Donors in Taiwan by Human Monoclonal Antibodies against Mi a (MNS7), Mur (MNS10), and MUT (MNS35) Antigens. Diagnostics (Basel) 2021; 11:diagnostics11050806. [PMID: 33946749 PMCID: PMC8146793 DOI: 10.3390/diagnostics11050806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 02/02/2023] Open
Abstract
Glycophorin hybrids such as GP.Mur are common in Southeast Asians. In Taiwan, clinically significant alloantibodies to the GP.Mur phenotype are the most important issue in blood banks. A large-scale screening of glycophorin hybrids in the Taiwanese population is urgently needed to ensure transfusion safety. Four clones of human hybridomas that secrete anti-Mia, anti-MUT, and anti-Mur were established by fusing human B-lymphocytes and myeloma cells (JMS-3). The specificity of each monoclonal antibody (MoAb) was characterized. Three MoAbs were applied on an Automated Pretransfusion Blood Testing Analyzer (PK7300/PK7400) for donor screening. Genotyping was performed to determine the detailed subgrouping of glycophorin hybrids. Four MoAbs are IgM antibodies. Anti-Mia (377T) binds to 46DXHKRDTYA54, 48HKRDTYAAHT57 peptides, and anti-Mia (367T) binds to 43QTNDXHKRD51 peptides (X indicates T, M, or K). Anti-Mur is reactive with 49KRDTYPAHTA58 peptides. Anti-MUT is reactive with 47KHKRDTYA54. A total of 78,327 donors were screened using three MoAbs, and 3690 (4.71%) were GP.Mur, 20 (0.025%) were GP.Hut, and 18 (0.022%) were GP.Vw. When the Mia antigen was introduced as routine screening, the frequency of Mi(a+) among blood donors in Taiwan was 4.66% (67,348/1,444,541). Mia antigen was implemented as a routine blood testing, and the results were labeled on all red blood cell (RBC) units.
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10
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Successful prenatal management of two foetuses affected by antibodies against GP.Mur with prenatal genotyping analysis and a literature review. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 19:135-143. [PMID: 33085590 DOI: 10.2450/2020.0058-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/30/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND GP.Mur belongs to the GP(B-A-B) hybrid glycophorin family, which is the most common hybrid glycophorin in Southeast Asia. Antibodies against GP.Mur may cause a clinically significant haemolytic disease of the foetus and newborn (HDFN) although, so far, not many cases have been reported in mainland China. MATERIALS AND METHODS Two Chinese women with a history of severe hydrops foetalis were seen in our centre. Alloantibody identification and GYP.Mur genotyping analysis were used for prenatal evaluation. Intrauterine transfusion was performed in two pregnancies in case 1. The features of these two women are described and literature-reported cases of HDFN related to antibodies against GP.Mur are summarised. RESULTS The phenotype of both mothers was Mia- Mur-, while the fathers' was Mia+ Mur+ with a heterozygous GYP.Mur hybrid gene as determined by a high-resolution melting method of genotyping. In case 1, the antibodies against GP.Mur were detected in the mother's serum and the cord blood of two foetuses. Fortunately, the latest foetus was successfully saved after intrauterine transfusion. In case 2, hydrops foetalis occurred in the first two pregnancies, but the risk of HDFN was excluded for the third foetus because of the GP.Mur negative phenotype. The literature review showed that 68.8% (11/16) of the reported cases of HDFN related to antibodies against GP.Mur occurred in the Chinese population, and that 37.5% (6/16) of them were cases of severe HDFN. DISCUSSION More cases of severe HDFN caused by antibodies against GP.Mur are presumably undetected as GP.Mur cells are not included in the panel of obligatory screening tests in most Southeast Asian countries including mainland China. The high-resolution melting method for GYP.Mur genotyping and zygosity detection is helpful in prenatal management.
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Jongruamklang P, Grimsley S, Thornton N, Robb J, Olsson ML, Storry JR. Characterization of
GYP*Mur
and novel
GYP*Bun
‐like hybrids in Thai blood donors reveals a qualitatively altered s antigen. Vox Sang 2020; 115:472-477. [DOI: 10.1111/vox.12909] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/11/2020] [Accepted: 02/19/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Philaiphon Jongruamklang
- Division of Hematology and Transfusion Medicine Department of Laboratory Medicine Lund University Lund Sweden
- Department of Medical Technology School of Allied Health Sciences University of Phayao Phayao Thailand
| | - Shane Grimsley
- International Blood Group Reference Laboratory NHSBT Bristol UK
| | - Nicole Thornton
- International Blood Group Reference Laboratory NHSBT Bristol UK
| | | | - Martin L. Olsson
- Division of Hematology and Transfusion Medicine Department of Laboratory Medicine Lund University Lund Sweden
- Clinical Immunology and Transfusion Medicine Office for Medical Services Lund Sweden
| | - Jill R. Storry
- Division of Hematology and Transfusion Medicine Department of Laboratory Medicine Lund University Lund Sweden
- Clinical Immunology and Transfusion Medicine Office for Medical Services Lund Sweden
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Lin X, Rubio G, Patel J, Banerjee S, Frame T, Billups N, Yang J. Hybrid glycophorin and red blood cell antigen genotyping in Asian American type O blood donors with Mi a phenotype. Transfusion 2019; 59:3767-3775. [PMID: 31697429 DOI: 10.1111/trf.15584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The GP.Mur glycophorin with Mia phenotype is relatively common and clinically significant in the Southeast Asian populations. The aim of this study is to genotype Mia -positive Asian American type O blood donors. Red blood cell (RBC) minor antigens were also determined in the same cohort. STUDY DESIGN AND METHODS Asian American blood donors of the Gulf Coast Regional Blood Center (Houston, TX) were screened using a typing reagent (NOVACLONE Anti-Mia Monoclonal IgG Typing Reagent, Dominion Biologicals Ltd) from March 2016 to July 2018. Aliquots of Mia -positive blood from type O donors were subjected to serologic confirmation using Mia - and/or Mur-specific GAMA210 and 64D6 monoclonal antibodies, and two human antisera. Extracted genomic DNA was amplified by polymerase chain reaction (PCR) using GYP hybrid gene/allele-specific primers followed by bidirectional Sanger sequencing. Zygosity for GYP*Mur and GYP*Bun was determined using TaqMan real-time PCR assay. Phenotypes of 35 RBC antigens and three phenotypic variants were determined with use of an in vitro diagnostic test, PreciseType HEA Molecular BeadChip Test (Immucor). RESULTS By screening 4600 blood donations in the Houston metropolitan area, 209 samples from 103 unique donors were identified to be Mia -positive. By PCR and sequencing analysis, 97 of the 103 Mia -positive donors carried hybrid genes GYP*Mur (89.7% including two homozygotes), GYP*Bun (6.2%), GYP*Vw (3.1%) and GYP*Hut (1.0%). Concordance between serology and DNA analysis was 98%, 99%, and 100% for the GAMA210, 64D6, and human antisera, respectively. Genotyping of RBC antigens showed that the Mia -positive donors were predominantly associated M+ N- S- s+ (48.5%) and M+ N+ S- s+ (38.1%) phenotypes. CONCLUSIONS The GP.Mur glycophorin is most prevalent in the Mia -positive Asian American type O blood donors.
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Wang YJ, Liu JR, Liu Y. Safety issues related to the electronic cross-matching of blood in mainland China: A prospective cohort study involving cross-matching of 40,228 blood samples. Medicine (Baltimore) 2019; 98:e16703. [PMID: 31464901 PMCID: PMC6736444 DOI: 10.1097/md.0000000000016703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Although the electronic cross-matching of blood has been widely applied in some developed countries and regions, concern over the risk of undetected red blood cell (RBC) antibodies has limited its application in mainland China.This study was performed to explore the missed detection rate of RBC antibodies in a Chinese population from 2011 to 2016. If the results of 2 consecutive tests of ABO/RhD blood group identification were consistent and antibody screening results were negative, electronic cross-matching of the blood was performed. In addition, traditional serological cross-matching of blood (polybrene method) and a parallel experiment for electronic cross-matching of blood were performed to analyze the missed detection of unexpected RBC antibodies in blood donors and recipients.Using the polybrene method, 40,228 blood samples were tested by parallel traditional serological cross-matching of blood; among these samples, blood compatibility was found in 40,222 cases, primary incompatibility (incompatibility of the donor's erythrocytes with the recipient's serum) was found in 6 cases, and no secondary incompatibility was found. Identification of antibody specificity was performed using panel cells, and all unexpected RBC antibodies were confirmed as anti-Mur alloantibodies in the MNS system.Further improvements in the erythrocyte antigenic spectrum, especially the Mur antigen in Asian populations, are expected to ensure the safety of implementing electronic cross-matching in China.
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Affiliation(s)
- Yuan-Jie Wang
- Blood Transfusion Department, Suining Central Hospital, An Affiliated Hospital of Chongqing University
| | - Jia-Rui Liu
- Clinical Laboratory, Suining Central Hospital, An Affiliated Hospital of Chongqing University
| | - Yong Liu
- Intensive Care Unit, Suining Central Hospital, An Affiliated Hospital of Chongqing University, Suining, Sichuan, China
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Hassan SN, Thirumulu Ponnuraj K, Mohamad S, Hassan R, Wan Ab Rahman WS. Molecular Detection of Glycophorins A and B Variant Phenotypes and their Clinical Relevance. Transfus Med Rev 2019; 33:118-124. [PMID: 30910255 DOI: 10.1016/j.tmrv.2019.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/14/2019] [Accepted: 02/04/2019] [Indexed: 01/25/2023]
Abstract
Crossover or conversion between the homologous regions of glycophorin A (GYPA) and glycophorin B (GYPB) gives rise to several different hybrid glycophorin genes encoding a number of different glycophorin variant phenotypes which bear low prevalence antigens in the MNS blood group system. GP.Mur is the main glycophorin variant phenotype which causes hemolytic transfusion reaction (HTR) and hemolytic disease of the fetus and newborn (HDFN) in East and Southeast Asians. The detection of glycophorin variant phenotypes using serological methods is limited to phenotyping reagents that are not commercially available. Moreover, the red blood cells used for antibody identification are usually of the GP.Mur phenotype. The current Polymerase Chain Reaction (PCR)-based methods and loop-mediated isothermal amplification (LAMP) are available alternatives to phenotyping that allow for the specific detection of glycophorin variant phenotypes. This review highlights the molecular detection method for glycophorins A and B variant phenotypes and their clinical relevance.
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Affiliation(s)
| | - Kannan Thirumulu Ponnuraj
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Suharni Mohamad
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Rosline Hassan
- Department of Hematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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15
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Wei L, Lopez GH, Zhang Y, Wen J, Wang Z, Fu Y, Hyland CA, Flower RL, Luo G, Ji Y. Genotyping analysis of MNS blood group GP(B‐A‐B) hybrid glycophorins in the Chinese Southern Han population using a high‐resolution melting assay. Transfusion 2018; 58:1763-1771. [DOI: 10.1111/trf.14641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/30/2018] [Accepted: 02/11/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Ling Wei
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Genghis H. Lopez
- Clinical Services and Research, Australian Red Cross Blood ServiceQueensland Australia
| | - Yang Zhang
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Jizhi Wen
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Zhen Wang
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Yongshui Fu
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Catherine A. Hyland
- Clinical Services and Research, Australian Red Cross Blood ServiceQueensland Australia
| | - Robert L. Flower
- Clinical Services and Research, Australian Red Cross Blood ServiceQueensland Australia
| | - Guangping Luo
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
| | - Yanli Ji
- Institute of Clinical Blood Transfusion, Guangzhou Blood CenterGuangzhou P.R. China
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Nadarajan VS. The prevalence, immunogenicity, and evanescence of alloantibodies to MUT and Mur antigens of GP.Mur red blood cells in a Southeast Asian patient cohort. Transfusion 2018; 58:1189-1198. [PMID: 29441590 DOI: 10.1111/trf.14538] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Antibodies to Mia , MUT, and Mur are among the most frequently identified alloantibodies in Southeast Asia. Understanding the characteristics of these antibodies in terms of induction and evanescence would aid in optimizing methods for their detection. STUDY DESIGN AND METHODS Antibody testing results between the years 2013 and 2015 with relevant patient demographic data and red blood cell (RBC) transfusion history were retrieved. Cumulative alloimmunization incidence and evanescence to MUT and Mur were estimated by Kaplan-Meier analysis in relation to the number of RBC units transfused and time. RESULTS Of 70,543 selected patients, 6186 nonalloimmunized subjects with available antibody testing results posttransfusion were identified. Cumulative alloimmunization incidence for MUT increased from 0.12% (95% confidence interval [CI], 0.03-0.21) to 0.63% (95% CI, 0.25-1.01), while for Mur it increased from 0.04% (95% CI, 0-0.09) to 0.42% (95% CI, 0.05-0.79) when a patient was transfused 2 RBC units as compared to 12. Both antibodies had high evanescence rates and at 1 year, anti-MUT and -Mur will be detected in only 45% (95% CI, 35%-57%) and 27% (95% CI, 17%-43%), respectively, of previously positive patients. MUT and Mur immunogenicity was estimated to be 1.7 and 1.2 times higher than E when their rate of evanescence was taken into account. CONCLUSION Antibodies to MUT and Mur develop following multiple RBC exposures. Immunogenicity of MUT/Mur and evanescence rates of the corresponding antibodies is higher compared to anti-E. Appropriate selection of antibody screening cells is needed in view of the high prevalence, immunogenicity, and evanescence of the antibodies.
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Affiliation(s)
- Veera Sekaran Nadarajan
- Department of Pathology, Faculty of Medicine, University Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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Genotyping for Glycophorin GYP(B-A-B) Hybrid Genes Using a Single Nucleotide Polymorphism-Based Algorithm by Matrix-Assisted Laser Desorption/Ionisation, Time-of-Flight Mass Spectrometry. Mol Biotechnol 2017; 58:665-671. [PMID: 27435823 DOI: 10.1007/s12033-016-9966-6] [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] [Indexed: 01/01/2023]
Abstract
The genetic basis for five GP(B-A-B) MNS system hybrid glycophorin blood group antigens results from rearrangement between the homologous GYPA and GYPB genes. Each hybrid glycophorin displays a characteristic profile of antigens. Currently, no commercial serological reagents are currently available to serologically type for these antigens. The aim of this study was to develop a single nucleotide polymorphism (SNP) mapping genotyping technique to allow characterisation of various GYP(B-A-B) hybrid alleles. Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry (MS) assays were designed to genotype five GYP(B-A-B) hybrid alleles. Eight nucleotide positions were targeted and incorporated into the SNP mapping protocol. The allelic frequencies were calculated using peak areas. Sanger sequencing was performed to resolve a GYP*Hop 3' breakpoint. Observed allelic peak area ratios either coincided with the expected ratio or were skewed (above or below) from the expected ratio with switching occurring at and after the expected break point to generate characteristic mass spectral plots for each hybrid. Sequencing showed that the GYP*Hop crossover in the intron 3 region, for this example, was identical to that for GYP*Bun reference sequence. An analytical algorithm using MALDI-TOF MS genotyping platform defined GYPA inserts for five GYP(B-A-B) hybrids. The SNP mapping technique described here demonstrates proof of concept that this technology is viable for genotyping hybrid glycophorins, GYP(A-B-A), GYP(A-B) and GYP(B-A), and addresses the gap in current typing technologies.
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