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Wilson B, Davison CL, Lopez GH, Millard GM, Liew YW, Powley T, Campbell T, Jadhao SS, Nagaraj SH, Perry M, Roulis EV, Toombs M, Irving DO, Flower RL, Hyland CA. A cold case of hemolytic disease of the fetus and newborn resolved by genomic sequencing and population studies to define a new antigen in the Rh system. Transfusion 2024; 64:1171-1176. [PMID: 38686705 DOI: 10.1111/trf.17205] [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: 06/27/2022] [Revised: 10/25/2022] [Accepted: 11/06/2022] [Indexed: 05/02/2024]
Abstract
BACKGROUND We report an obstetric case involving an RhD-positive woman who had developed a red blood cell (RBC) antibody that was not detected until after delivery of a newborn, who presented with a positive direct antiglobulin test result. Immunohematology studies suggested that the maternal antibody was directed against a low-prevalence antigen on the paternal and newborn RBCs. RESULTS Comprehensive blood group profiling by targeted exome sequencing revealed a novel nonsynonymous single nucleotide variant (SNV) RHCE c.486C>G (GenBank MZ326705) on the RHCE*Ce allele, for both the father and newborn. A subsequent genomic-based study to profile blood groups in an Indigenous Australian population revealed the same SNV in 2 of 247 individuals. Serology testing showed that the maternal antibody reacted specifically with RBCs from these two individuals. DISCUSSION The maternal antibody was directed against a novel antigen in the Rh blood group system arising from an RHCE c.486C>G variant on the RHCE*Ce allele linked to RHD*01. The variant predicts a p.Asn162Lys change on the RhCE protein and has been registered as the 56th antigen in the Rh system, ISBT RH 004063. CONCLUSION This antibody was of clinical significance, resulting in a mild to moderate hemolytic disease of the fetus and newborn (HDFN). In the past, the cause of such HDFN cases may have remained unresolved. Genomic sequencing combined with population studies now assists in resolving such cases. Further population studies have potential to inform the need to design population-specific red cell antibody typing panels for antibody screening in the Australian population.
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Affiliation(s)
- Brett Wilson
- Red Cell Reference Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Candice L Davison
- Research and Development Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Genghis H Lopez
- Research and Development Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Glenda M Millard
- Red Cell Reference Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- Research and Development Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Yew-Wah Liew
- Red Cell Reference Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Tanya Powley
- Red Cell Reference Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | | | - Sudhir S Jadhao
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Australia
| | - Shivashankar H Nagaraj
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Australia
| | - Maree Perry
- Research and Development Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Eileen V Roulis
- Research and Development Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Maree Toombs
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - David O Irving
- Research and Development, Clinical Services and Research, Australian Red Cross Lifeblood, Sydney, New South Wales, Australia
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Robert L Flower
- Research and Development Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Catherine A Hyland
- Research and Development Laboratory, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Jadhao S, Davison CL, Roulis EV, Schoeman EM, Divate M, Haring M, Williams C, Shankar AJ, Lee S, Pecheniuk NM, Irving DO, Hyland CA, Flower RL, Nagaraj SH. RBCeq: A robust and scalable algorithm for accurate genetic blood typing. EBioMedicine 2022; 76:103759. [PMID: 35033986 PMCID: PMC8763639 DOI: 10.1016/j.ebiom.2021.103759] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 12/20/2022] Open
Abstract
Background While blood transfusion is an essential cornerstone of hematological care, patients requiring repetitive transfusion remain at persistent risk of alloimmunization due to the diversity of human blood group polymorphisms. Despite the promise, user friendly methods to accurately identify blood types from next-generation sequencing data are currently lacking. To address this unmet need, we have developed RBCeq, a novel genetic blood typing algorithm to accurately identify 36 blood group systems. Methods RBCeq can predict complex blood groups such as RH, and ABO that require identification of small indels and copy number variants. RBCeq also reports clinically significant, rare, and novel variants with potential clinical relevance that may lead to the identification of novel blood group alleles. Findings The RBCeq algorithm demonstrated 99·07% concordance when validated on 402 samples which included 29 antigens with serology and 9 antigens with SNP-array validation in 14 blood group systems and 59 antigens validation on manual predicted phenotype from variant call files. We have also developed a user-friendly web server that generates detailed blood typing reports with advanced visualization (https://www.rbceq.org/). Interpretation RBCeq will assist blood banks and immunohematology laboratories by overcoming existing methodological limitations like scalability, reproducibility, and accuracy when genotyping and phenotyping in multi-ethnic populations. This Amazon Web Services (AWS) cloud based platform has the potential to reduce pre-transfusion testing time and to increase sample processing throughput, ultimately improving quality of patient care. Funding This work was supported in part by Advance Queensland Research Fellowship, MRFF Genomics Health Futures Mission (76,757), and the Australian Red Cross LifeBlood. The Australian governments fund the Australian Red Cross Lifeblood for the provision of blood, blood products and services to the Australian community.
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Affiliation(s)
- Sudhir Jadhao
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | - Candice L Davison
- Australian Red Cross Lifeblood Research and Development, Brisbane, Queensland, Australia
| | - Eileen V Roulis
- Australian Red Cross Lifeblood Research and Development, Brisbane, Queensland, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Elizna M Schoeman
- Australian Red Cross Lifeblood Research and Development, Brisbane, Queensland, Australia
| | - Mayur Divate
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | - Mitchel Haring
- Office of eResearch, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | - Chris Williams
- Office of eResearch, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | - Arvind Jaya Shankar
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | - Simon Lee
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland 4059, Australia
| | - Natalie M Pecheniuk
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - David O Irving
- Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia
| | - Catherine A Hyland
- Australian Red Cross Lifeblood Research and Development, Brisbane, Queensland, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Robert L Flower
- Australian Red Cross Lifeblood Research and Development, Brisbane, Queensland, Australia; Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shivashankar H Nagaraj
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland 4059, Australia; Translational Research Institute, Brisbane, Australia.
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Hyland CA, O'Brien H, Flower RL, Gardener GJ. Non-invasive prenatal testing for management of haemolytic disease of the fetus and newborn induced by maternal alloimmunisation. Transfus Apher Sci 2020; 59:102947. [PMID: 33115620 DOI: 10.1016/j.transci.2020.102947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Anti-D immunoglobulin prophylaxis reduces the risk of RhD negative women becoming alloimmunised to the RhD antigen and is a major preventative strategy in reducing the burden of haemolytic disease of the fetus and newborn (HDFN). HDFN also arises from other maternal red cell antibodies, with the most clinically significant, after anti-D, being anti-K, anti-c and anti-E. Among the 39 human blood group systems advanced genomic technologies are still revealing novel or rare antigens involved in maternal alloimmunisation. Where clinically significant maternal antibodies are detected in pregnancy, non-invasive prenatal testing (NIPT) of cell-free fetal DNA provides a safe way to assess the fetal blood group antigen status. This provides information as to the risk for HDFN and thus guides management strategies. In many countries, NIPT fetal RHD genotyping as a diagnostic test using real-time PCR has already been integrated into routine clinical care for the management of women with allo-anti-D to assess the risk for HDFN. In addition, screening programs have been established to provide antenatal assessment of the fetal RHD genotype in non-alloimmunised RhD negative pregnant women to target anti-D prophylaxis to those predicted to be carrying an RhD positive baby. Both diagnostic and screening assays exhibit high accuracy (over 99 %). NIPT fetal genotyping for atypical (other than RhD) blood group antigens presents more challenges as most arise from a single nucleotide variant. Recent studies show potential for genomic and digital technologies to provide a personalised medicine approach with NIPT to assess fetal blood group status for women with other (non-D) red cell antibodies to manage the risk for HDFN.
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Affiliation(s)
- Catherine A Hyland
- Clinical Services and Research, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Helen O'Brien
- Clinical Services and Research, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Robert L Flower
- Clinical Services and Research, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Ito S, Kaito S, Miyazaki T, Kikuchi G, Isa K, Tsuneyama H, Kurita R, Ogasawara K, Uchikawa M, Satake M. A new antigen SUMI carried on glycophorin A encoded by the GYPA*M with c.91A>C (p.Thr31Pro) belongs to the MNS blood group system. Transfusion 2020; 60:1287-1293. [PMID: 32358867 DOI: 10.1111/trf.15828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND MNS is one of the highly polymorphic blood groups comprising many antigens generated by genomic recombination among the GYPA, GYPB, and GYPE genes as well as by single-nucleotide changes. We report a patient with red blood cell (RBC) antibody against an unknown low-frequency antigen, tentatively named SUMI, and investigated its carrier molecule and causal gene. STUDY DESIGN AND METHODS Standard serologic tests, including enzyme tests, were performed. Monoclonal anti-SUMI-producing cells (HIRO-305) were established by transformation and hybridization methods using lymphocytes from a donor having anti-SUMI. SUMI+ RBCs were examined by immunocomplex capture fluorescence analysis (ICFA) using HIRO-305 and murine monoclonal antibodies against RBC membrane proteins carrying blood group antigens. Genomic DNA was extracted from whole blood, and the GYPA gene was analyzed by polymerase chain reactions and Sanger sequencing. RESULTS Serologic screening revealed that 23 of the 541,522 individuals (0.0042%) were SUMI+, whereas 1351 of the 10,392 individuals (13.0%) had alloanti-SUMI. SUMI antigen was sensitive to ficin, trypsin, pronase, and neuraminidase, but resistant to α-chymotrypsin and sulfydryl-reducing agents. ICFA revealed that the SUMI antigen was carried on glycophorin A (GPA). According to Sanger sequencing and cloning, the SUMI+ individuals had a GYPA*M allele with c.91A>C (p.Thr31Pro), which may abolish the O-glycan attachment site. CONCLUSIONS The new low-frequency antigen SUMI is carried on GPA encoded by the GYPA*M allele with c.91A>C (p.Thr31Pro). Neuraminidase sensitivity suggests that glycophorin around Pro31 are involved in the SUMI determinant.
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Affiliation(s)
- Shoichi Ito
- Japanese Red Cross Tohoku Block Blood Center, Miyagi, Japan
| | - Sayaka Kaito
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Toru Miyazaki
- Japanese Red Cross Hokkaido Block Blood Center, Sapporo, Japan
| | - Go Kikuchi
- Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | - Kazumi Isa
- Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | - Hatsue Tsuneyama
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan.,Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | - Ryo Kurita
- Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | | | - Makoto Uchikawa
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
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Hyland CA, Roulis EV, Schoeman EM. Developments beyond blood group serology in the genomics era. Br J Haematol 2019; 184:897-911. [PMID: 30706459 DOI: 10.1111/bjh.15747] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Blood group serology and single nucleotide polymorphism-based genotyping platforms are accurate but do not provide a comprehensive cover for all 36 blood group systems and do not cover the antigen diversity observed among population groups. This review examines the extent to which genomics is shaping blood group serology. Resources for genomics include the Human Reference Genome Sequence assembly; curated blood group tables listing variants; public databases providing information on genetic variants from world-wide studies; and massively parallel sequencing technologies. Blood group genomic studies span the spectrum, from bioinformatic data mining of huge data sets containing whole genome and whole exome information to laboratory investigations utilising targeted sequencing approaches. Blood group predictions based on genome sequencing and genomic studies are proving accurate, and have shown utility in both research and reference settings. Overall, studies confirm the potential for blood group genomics to reshape donor and patient transfusion management strategies to provide more compatible blood transfusions.
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Affiliation(s)
- Catherine A Hyland
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Eileen V Roulis
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Elizna M Schoeman
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
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Schoeman EM, Roulis EV, Liew YW, Martin JR, Powley T, Wilson B, Millard GM, McGowan EC, Lopez GH, O'Brien H, Condon JA, Flower RL, Hyland CA. Targeted exome sequencing defines novel and rare variants in complex blood group serology cases for a red blood cell reference laboratory setting. Transfusion 2017; 58:284-293. [PMID: 29119571 DOI: 10.1111/trf.14393] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 08/21/2017] [Accepted: 09/05/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND We previously demonstrated that targeted exome sequencing accurately defined blood group genotypes for reference panel samples characterized by serology and single-nucleotide polymorphism (SNP) genotyping. Here we investigate the application of this approach to resolve problematic serology and SNP-typing cases. STUDY DESIGN AND METHODS The TruSight One sequencing panel and MiSeq platform was used for sequencing. CLC Genomics Workbench software was used for data analysis of the blood group genes implicated in the serology and SNP-typing problem. Sequence variants were compared to public databases listing blood group alleles. The effect of predicted amino acid changes on protein function for novel alleles was assessed using SIFT and PolyPhen-2. RESULTS Among 29 unresolved samples, sequencing defined SNPs in blood group genes consistent with serologic observation: 22 samples exhibited SNPs associated with varied but known blood group alleles and one sample exhibited a chimeric RH genotype. Three samples showed novel variants in the CROM, LAN, and RH systems, respectively, predicting respective amino acid changes with possible deleterious impact. Two samples harbored rare variants in the RH and FY systems, respectively, not previously associated with a blood group allele or phenotype. A final sample comprised a rare variant within the KLF1 transcription factor gene that may modulate DNA-binding activity. CONCLUSION Targeted exome sequencing resolved complex serology problems and defined both novel blood group alleles (CD55:c.203G>A, ABCB6:c.1118_1124delCGGATCG, ABCB6:c.1656-1G>A, and RHD:c.452G>A) and rare variants on blood group alleles associated with altered phenotypes. This study illustrates the utility of exome sequencing, in conjunction with serology, as an alternative approach to resolve complex cases.
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Affiliation(s)
- Elizna M Schoeman
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Eileen V Roulis
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Yew-Wah Liew
- Red Cell Reference Laboratory, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Jacqueline R Martin
- Red Cell Reference Laboratory, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Tanya Powley
- Red Cell Reference Laboratory, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Brett Wilson
- Red Cell Reference Laboratory, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Glenda M Millard
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Eunike C McGowan
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Genghis H Lopez
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Helen O'Brien
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Jennifer A Condon
- Red Cell Reference Laboratory, Australian Red Cross Blood Service, Melbourne, Victoria, Australia
| | - Robert L Flower
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Catherine A Hyland
- Clinical Services and Research, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
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Venkataraman R, Yusuf K. Intravenous immunoglobulin in the management of a rare cause of hemolytic disease of the newborn: Anti-SARA antibodies. J Neonatal Perinatal Med 2017; 10:329-332. [PMID: 28854515 DOI: 10.3233/npm-16131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hemolytic disease of newborn (HDN) is a condition that develops in a fetus, when the IgG molecules produced by the mother pass through the placenta and attack the fetal red blood cells. HDN can occur due to Rh and ABO incompatibilities between the mother and the fetus as well as due to other allo-immune antibodies belonging to Kell (K and k), Duffy (Fya), Kidd (Jka and Jkb), and MNS (M, N, S, and s) systems. Role of intravenous immunoglobulin in management of HDN is not clear.SARA red blood cell antigen, first discovered in 1990 is a low frequency antigen. We report, a multiparous female whose pregnancy was complicated by HDN due to anti-SARA antibodies requiring both exchange transfusion and intravenous immunoglobulin. The response was sustained after intravenous immunoglobulin (IVIG) rather than after exchange transfusion.
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Affiliation(s)
| | - Kamran Yusuf
- Section of Neonatology, University of Calgary, Calgary, AB, Canada
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Storry JR, Castilho L, Chen Q, Daniels G, Denomme G, Flegel WA, Gassner C, de Haas M, Hyland C, Keller M, Lomas-Francis C, Moulds JM, Nogues N, Olsson ML, Peyrard T, van der Schoot CE, Tani Y, Thornton N, Wagner F, Wendel S, Westhoff C, Yahalom V. International society of blood transfusion working party on red cell immunogenetics and terminology: report of the Seoul and London meetings. ACTA ACUST UNITED AC 2016; 11:118-122. [PMID: 29093749 DOI: 10.1111/voxs.12280] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Working Party has met twice since the last report: in Seoul, South Korea 2014, and in London, UK 2015, both in association with the International Society of Blood Transfusion (ISBT) Congress. As in previous meetings, matters pertaining to blood group antigen nomenclature were discussed. Eleven new blood group antigens were added to seven blood group systems. This brings the current total of blood group antigens recognized by the ISBT to 346, of which 308 are clustered within 36 blood groups systems. The remaining 38 antigens are currently unassigned to a known blood group system.
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Affiliation(s)
- J R Storry
- Department of Clinical Immunology and Transfusion Medicine, Office for Medical Services, Lund, Sweden
| | - L Castilho
- University of Campinas/Hemocentro, Campinas, Brazil
| | - Q Chen
- Jiangsu Province Blood Center, Nanjing, China
| | - G Daniels
- Bristol Institute for Transfusion Sciences, NHS Blood and Transplant, Bristol, UK
| | - G Denomme
- Blood Center of Wisconsin, Milwaukee, WI, USA
| | - W A Flegel
- Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, USA
| | - C Gassner
- Blutspende Zurich, Zurich, Switzerland
| | - M de Haas
- Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
| | - C Hyland
- Australian Red Cross Blood Services, Brisbane, Qld, Australia
| | - M Keller
- American Red Cross Blood Services, Philadelphia, PA, USA
| | | | | | - N Nogues
- Banc de Sang i Teixits, Barcelona, Spain
| | - M L Olsson
- Department of Laboratory Medicine, Division of Hematology and Transfusion Medicine, Lund University, Lund, Sweden
| | - T Peyrard
- Institut National de la Transfusion Sanguine, Département Centre National de Référence pour les Groupes Sanguins, Inserm UMR_S1134, Paris, France
| | | | - Y Tani
- Osaka Red Cross Blood Center, Osaka, Japan
| | - N Thornton
- International Blood Group Reference Laboratory, NHS Blood and Transplant, Bristol, UK
| | - F Wagner
- Red Cross Blood Service NSTOB, Springe, Germany
| | - S Wendel
- Blood Bank, Hospital Sirio-Libanes, São Paulo, Brazil
| | - C Westhoff
- New York Blood Center, New York, NY, USA
| | - V Yahalom
- NBGRL Magen David Adom, Ramat Gan, Israel
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McBean R, Liew YW, Wilson B, Kupatawintu P, Emthip M, Hyland C, Flower R. Genotyping confirms inheritance of the rare At(a-) type in a case of haemolytic disease of the newborn. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2015; 2:53-5. [PMID: 27499913 PMCID: PMC4858124 DOI: 10.1002/cjp2.33] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 11/02/2015] [Indexed: 11/10/2022]
Abstract
The At(a) blood group antigen (now AUG2 in the Augustine system) is a high-frequency antigen with negative phenotype At(a-) found only in individuals of African ancestry. In a twin pregnancy, the fifth pregnancy in a woman of African origin, serological investigations confirmed that the mother was At(a-) and anti-At(a) was detected. DNA samples were exome sequenced and alignment was performed to allow variant calling. It was confirmed that the single nucleotide polymorphism, rs45458701, within the SLC29A1 gene encoding the ENT1 protein, recently reported to be a basis of the At(a-) phenotype was also the basis of the phenotype in this family. The reagents for serological analysis required to identify the rare blood type present in this mother are held in only a few reference laboratories worldwide. This case highlights the utility of genetic methods in resolving complex investigations involving blood grouping and demonstrates that genotyping of variants associated with blood types present in specific ethnic groups may be the fastest method available for identification of the basis of fetomaternal incompatibilities.
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Affiliation(s)
- Rhiannon McBean
- Research and Development, Australian Red Cross Blood Service QLD Australia
| | - Yew-Wah Liew
- Red Cell Reference Laboratory, Australian Red Cross Blood Service QLD Australia
| | - Brett Wilson
- Red Cell Reference Laboratory, Australian Red Cross Blood Service QLD Australia
| | | | - Morakot Emthip
- National Blood Centre, Thai Red Cross Society Bangkok Thailand
| | - Catherine Hyland
- Research and Development, Australian Red Cross Blood Service QLD Australia
| | - Robert Flower
- Research and Development, Australian Red Cross Blood Service QLD Australia
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