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Jacko G, Thorpe R, Daly J. Equity in blood transfusion precision services. Int J Equity Health 2024; 23:77. [PMID: 38637779 PMCID: PMC11027542 DOI: 10.1186/s12939-024-02170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/03/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Blood collection agencies are integrating precision medicine techniques to improve and individualise blood donor and recipient outcomes. These organisations have a role to play in ensuring equitable application of precision medicine technologies for both donors and transfusion recipients. BODY: Precision medicine techniques, including molecular genetic testing and next generation sequencing, have been integrated in transfusion services to improve blood typing and matching with the aim to reduce a variety of known transfusion complications. Internationally, priorities in transfusion research have aimed to optimise services through the use of precision medicine technologies and consider alternative uses of genomic information to personalise transfusion experiences for both recipients and donors. This has included focusing on the use of genomics when matching blood products for transfusion recipients, to personalise a blood donor's donation type or frequency, and longitudinal donor research utilising blood donor biobanks. CONCLUSION Equity in precision services and research must be of highest importance for blood collection agencies to maintain public trust, especially when these organisations rely on volunteer donors to provide transfusion services. The investment in implementing equitable precision medicine services, including development of blood donor biobanks, has the potential to optimise and personalise services for both blood donors and transfusion recipients.
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Affiliation(s)
- Georgina Jacko
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, Brisbane, QLD, Australia.
| | - Rachel Thorpe
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - James Daly
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, Brisbane, QLD, Australia
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Rophina M, Sinha A, Biswas D, Basu D, Datta SS, Scaria V. Molecular basis of DEL phenotype in the Indian population: Insights from next-generation sequencing analysis of two cases. Transfus Apher Sci 2024; 63:103872. [PMID: 38272782 DOI: 10.1016/j.transci.2024.103872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/27/2024]
Abstract
The DEL phenotype represents an intriguing and challenging aspect of blood group serology. This condition is characterized by an extremely weak expression of the D antigen on red blood cells, to the extent that it often eludes detection through routine serological methods. Identifying the DEL phenotype necessitates more specialized techniques, such as adsorption and elution tests, to reveal the presence of the D antigen. This distinctive phenotype underscores the complexity and subtlety of blood group genetics and highlights the importance of using advanced methods to accurately classify individuals with this condition, as their ability to form anti-D antibodies can have clinical implications during transfusion and pregnancy scenarios. There is a paucity of data for the DEL phenotype in the Indian population, and the molecular basis has not been elucidated yet. Our investigation delves into the genetic underpinnings of two distinct DEL phenotype cases that pose challenges for resolution through conventional serological techniques. We employ next-generation amplicon sequencing to unravel the intricate genetic landscape underlying these cases. In the D-negative donor, the DEL phenotype was first identified serologically, which was subsequently confirmed by molecular analysis. In the second case, it was associated with an anti-D antibody in a D-positive patient. Initial data analysis unveiled a substantial reduction in coverage across the exonic segments of the RHD gene in both samples, suggesting the potential presence of RHD exon deletions. On both occasions, we identified a homozygous intronic RHD polymorphism that is well established to be linked to the RHD* 01EL.32/RHD*DEL32 variant.
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Affiliation(s)
- Mercy Rophina
- CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, Delhi 110025, India; Academy of Scientific and Innovative Research (AcSIR), CSIR-HRDC Campus, Sector 19, Kamla Nehru Nagar, Ghaziabad, Uttar Pradesh 201002, India
| | - Ayesha Sinha
- Department of Transfusion Medicine, Tata Medical Center, Newtown, Rajarhat, 700160, Kolkata, India
| | - Durba Biswas
- Department of Transfusion Medicine, Tata Medical Center, Newtown, Rajarhat, 700160, Kolkata, India
| | - Debapriya Basu
- Department of Transfusion Medicine, Tata Medical Center, Newtown, Rajarhat, 700160, Kolkata, India
| | - Suvro Sankha Datta
- Department of Transfusion Medicine, Tata Medical Center, Newtown, Rajarhat, 700160, Kolkata, India.
| | - Vinod Scaria
- CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), Mathura Road, Delhi 110025, India; Academy of Scientific and Innovative Research (AcSIR), CSIR-HRDC Campus, Sector 19, Kamla Nehru Nagar, Ghaziabad, Uttar Pradesh 201002, India; Vishwanath Cancer Care Foundation, B 702, Neelkanth Business Park Kirol Village, Mumbai, 400 086, India
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O’Brien S, Lea RA, Jadhao S, Lee S, Sukhadia S, Arunachalam V, Roulis E, Flower RL, Griffiths L, Nagaraj SH. Genetic Characterization of Blood Group Antigens for Polynesian Heritage Norfolk Island Residents. Genes (Basel) 2023; 14:1740. [PMID: 37761880 PMCID: PMC10530796 DOI: 10.3390/genes14091740] [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: 06/23/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Improvements in blood group genotyping methods have allowed large scale population-based blood group genetics studies, facilitating the discovery of rare blood group antigens. Norfolk Island, an external and isolated territory of Australia, is one example of an underrepresented segment of the broader Australian population. Our study utilized whole genome sequencing data to characterize 43 blood group systems in 108 Norfolk Island residents. Blood group genotypes and phenotypes across the 43 systems were predicted using RBCeq. Predicted frequencies were compared to data available from the 1000G project. Additional copy number variation analysis was performed, investigating deletions outside of RHCE, RHD, and MNS systems. Examination of the ABO blood group system predicted a higher distribution of group A1 (45.37%) compared to group O (35.19%) in residents of the Norfolk Island group, similar to the distribution within European populations (42.94% and 38.97%, respectively). Examination of the Kidd blood group system demonstrated an increased prevalence of variants encoding the weakened Kidd phenotype at a combined prevalence of 12.04%, which is higher than that of the European population (5.96%) but lower than other populations in 1000G. Copy number variation analysis showed deletions within the Chido/Rodgers and ABO blood group systems. This study is the first step towards understanding blood group genotype and antigen distribution on Norfolk Island.
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Affiliation(s)
- Stacie O’Brien
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Rodney A. Lea
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Sudhir Jadhao
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD 4059, Australia; (E.R.); (R.L.F.)
| | - Simon Lee
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Shrey Sukhadia
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Vignesh Arunachalam
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Eileen Roulis
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD 4059, Australia; (E.R.); (R.L.F.)
| | - Robert L. Flower
- Clinical Services and Research, Australian Red Cross Lifeblood, Brisbane, QLD 4059, Australia; (E.R.); (R.L.F.)
| | - Lyn Griffiths
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
| | - Shivashankar H. Nagaraj
- Centre for Genomics and Personalized Health, Queensland University of Technology, Brisbane, QLD 4059, Australia; (S.O.); (R.A.L.); (S.J.); (S.L.); (S.S.); (V.A.); (L.G.)
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Liu HL, Li QL. Matched Queues with Flexible and Impatient Customers. Methodol Comput Appl Probab 2023. [DOI: 10.1007/s11009-023-09980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Using Whole Genome Sequencing to Characterize Clinically Significant Blood Groups Among Healthy Older Australians. Blood Adv 2022; 6:4593-4604. [PMID: 35420653 PMCID: PMC9636324 DOI: 10.1182/bloodadvances.2022007505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
There have been no comprehensive studies of a full range of blood group polymorphisms within the Australian population. This problem is compounded by the absence of any databases carrying genomic information on chronically transfused patients and low frequency blood group antigens in Australia. Here, we use RBCeq, a web server–based blood group genotyping software, to identify unique blood group variants among Australians and compare the variation detected vs global data. Whole-genome sequencing data were analyzed for 2796 healthy older Australians from the Medical Genome Reference Bank and compared with data from 1000 Genomes phase 3 (1KGP3) databases comprising 661 African, 347 American, 503 European, 504 East Asian, and 489 South Asian participants. There were 661 rare variants detected in this Australian sample population, including 9 variants that had clinical associations. Notably, we identified 80 variants that were computationally predicted to be novel and deleterious. No clinically significant rare or novel variants were found associated with the genetically complex ABO blood group system. For the Rh blood group system, 2 novel and 15 rare variants were found. Our detailed blood group profiling results provide a starting point for the creation of an Australian blood group variant database.
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Jadhao S, Hoy W, Lee S, Patel HR, McMorran BJ, Flower RL, Nagaraj SH. The genomic landscape of blood groups in Indigenous Australians in remote communities. Transfusion 2022; 62:1110-1120. [PMID: 35403234 PMCID: PMC9544628 DOI: 10.1111/trf.16873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 02/02/2022] [Accepted: 02/11/2022] [Indexed: 11/28/2022]
Abstract
Background Methods and materials Results Conclusion
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Affiliation(s)
- Sudhir Jadhao
- Centre for Genomics and Personalised Health Queensland University of Technology Brisbane Queensland Australia
- Translational Research Institute Brisbane Queensland Australia
| | - Wendy Hoy
- Faculty of Medicine University of Queensland Brisbane Queensland Australia
| | - Simon Lee
- Centre for Genomics and Personalised Health Queensland University of Technology Brisbane Queensland Australia
- Translational Research Institute Brisbane Queensland Australia
| | - Hardip R. Patel
- National Centre for Indigenous Genomics Australian National University Canberra Australian Capital Territory Australia
| | - Brendan J. McMorran
- Department of Immunology and Infectious Disease, The John Curtin School of Medical Research, College of Health and Medicine The Australian National University Canberra Australian Capital Territory Australia
| | - Robert L. Flower
- Research and Development Australian Red Cross Lifeblood Red Cell Reference Laboratory Brisbane Queensland Australia
| | - Shivashankar H. Nagaraj
- Centre for Genomics and Personalised Health Queensland University of Technology Brisbane Queensland Australia
- Translational Research Institute Brisbane Queensland Australia
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