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Ying Y, Yu S, Zhang J, He J, Xu X, Hong X, Zhu F. A case of McLeod syndrome caused by a nonsense variation c.942G>A in the XK gene: A case report. Front Genet 2023; 14:1073139. [PMID: 36816020 PMCID: PMC9929429 DOI: 10.3389/fgene.2023.1073139] [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: 10/20/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Abstract
McLeod syndrome is a rare XK gene-related progressive, debilitating disease involving multiple systems. The blood group phenotypes in McLeod syndrome patients usually display the Kx antigen loss and a decrease in the Kell blood group system antigen expression. This paper describes a 41-year-old male Chinese patient with McLeod syndrome. He first attended a hospital in 2015 and developed progressively worsening symptoms 4 years ago. As the disease progressed, the patient exhibited memory loss, unresponsiveness, and chorea and displayed elevated creatine kinase levels. However, McLeod syndrome could not be diagnosed by these signs and laboratory results. The patient was readmitted to the hospital in 2020 and was suspected of having McLeod syndrome. Serological analysis of the Kell blood group system and genotyping for the XK blood group system were performed, revealing the weak expression of the K antigen and the negative K antigen. Sequencing of the coding region of the XK gene showed a hemizygous c.942G>A variation in the XK gene, which resulted in a premature stop codon at position 314 (p.Trp314Ter). Therefore, the patient was diagnosed with McLeod syndrome. In conclusion, this paper presents a case of McLeod syndrome caused by a nonsense variation c.942G>A in the XK gene. The analysis of the XK gene and blood group antigen is helpful for the diagnosis of McLeod syndrome and for distinguishing it from many other diseases.
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Affiliation(s)
- Yanling Ying
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Shifang Yu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jingjing Zhang
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ji He
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xianguo Xu
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiaozhen Hong
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China,*Correspondence: Xiaozhen Hong, ; Faming Zhu,
| | - Faming Zhu
- Blood Center of Zhejiang Province, Hangzhou, Zhejiang, China,Key Laboratory of Blood Safety Research of Zhejiang Province, Hangzhou, Zhejiang, China,*Correspondence: Xiaozhen Hong, ; Faming Zhu,
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Addams J, Hasan RA, Saifee NH. How we approach transfusions in a patient with high risk of alloimmunization from McLeod phenotype. Pediatr Blood Cancer 2023; 70:e30119. [PMID: 36495235 DOI: 10.1002/pbc.30119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/15/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
McLeod phenotype-caused by the missing Xk protein-is a very rare red cell phenotype, one characteristic of McLeod syndrome, and sometimes associated with X-linked chronic granulomatous disease (CGD). Diagnosis of McLeod phenotype is important for appropriate transfusion management, because red blood cells from all healthy donors will have the Xk protein with its Kx antigen and can lead to red cell antibody formation without the ability to find compatible McLeod phenotype blood for transfusion. We offer a review and approach to diagnosis of the McLeod phenotype and special transfusion considerations.
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Affiliation(s)
- Joel Addams
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, Washington, USA.,Bloodworks Northwest, Seattle, Washington, USA
| | - Rida A Hasan
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.,Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA
| | - Nabiha H Saifee
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.,Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, Washington, USA
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Wang Y, Gao S, Zhu K, Ren L, Yuan X. Integration of Trehalose Lipids with Dissociative Trehalose Enables Cryopreservation of Human RBCs. ACS Biomater Sci Eng 2023; 9:498-507. [PMID: 36577138 DOI: 10.1021/acsbiomaterials.2c01154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cryopreservation of red blood cells (RBCs) is imperative for transfusion therapy, while cryoprotectants are essential to protect RBCs from cryoinjury under freezing temperatures. Trehalose has been considered as a biocompatible cryoprotectant that naturally accumulates in organisms to tolerate anhydrobiosis and cryobiosis. Herein, we report a feasible protocol that enables glycerol-free cryopreservation of human RBCs by integration of the synthesized trehalose lipids and dissociative trehalose through ice tuning and membrane stabilization. Typically, in comparison with sucrose monolaurate or trehalose only, trehalose monolaurate was able to protect cell membranes against freeze stress, achieving 96.9 ± 2.0% cryosurvival after incubation and cryopreservation of human RBCs with 0.8 M trehalose. Moreover, there were slight changes in cell morphology and cell functions. It was further confirmed by isothermal titration calorimetry and osmotic fragility tests that the moderate membrane-binding activity of trehalose lipids exerted cell stabilization for high cryosurvival. The aforementioned study is likely to provide an alternative way for glycerol-free cryopreservation of human RBCs and other types of cells.
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Affiliation(s)
- Yan Wang
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin300350, China
| | - Shuhui Gao
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin300350, China
| | - Kongying Zhu
- Analysis and Measurement Center, Tianjin University, Tianjin300072, China
| | - Lixia Ren
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin300350, China
| | - Xiaoyan Yuan
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin300350, China
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Novelo-Garza B, Benítez-Arvizu G. [Obtaining blood components in blood banks]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:S52-S58. [PMID: 36378143 PMCID: PMC10395912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/04/2022] [Indexed: 06/16/2023]
Abstract
After the first successful blood transfusion, different difficulties of a liquid tissue were overcome; this liquid required special conditions to keep its characteristics with minimal alterations and, thus, to be able to be used in patients who needed it. Subsequently, techniques that also made possible to separate this liquid into its different components for its use were discovered, allowing a more specific treatment of the deficiencies of patients when administering cellular or non-cellular elements. With this, a new area arose within the blood banks to obtaining components. This area became the central point of convergence of all the processes involved in obtaining components, which include the biological qualification of each one of the units, as well as their labeling and release for the different distribution in transfusion services. It is important to highlight that the main source of components is obtained from whole blood; its processing for several decades was an artisanal operator-dependent process; however, with the evolution of technology, now it is possible to carry it out in an automated manner; likewise, today it is possible to obtain components directly from the donor's whole blood by separating it in real time by means of apheresis, which allows obtaining the component of interest and returning the remainder to the donor.
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Affiliation(s)
- Bárbara Novelo-Garza
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Gamaliel Benítez-Arvizu
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Unidad Complementaria Banco de Sangre. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
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Gao S, Niu Q, Wang Y, Ren L, Chong J, Zhu K, Yuan X. A Dynamic Membrane-Active Glycopeptide for Enhanced Protection of Human Red Blood Cells against Freeze-Stress. Adv Healthc Mater 2022; 12:e2202516. [PMID: 36548128 DOI: 10.1002/adhm.202202516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Intracellular delivery of freezing-tolerant trehalose is crucial for cryopreservation of red blood cells (RBCs) and previous strategies based on membrane-disruptive activity usually generate severe hemolysis. Herein, a dynamic membrane-active glycopeptide is developed by grafting with 25% maltotriose and 50% p-benzyl alcohol for the first time to effectively facilitate entry of membrane-impermeable trehalose in human RBCs with low hemolysis. Results of the mechanism acting on cell membranes suggest that reversible adsorption of such benzyl alcohol-grafted glycopeptide on cell surfaces upon weak perturbation with phospholipids and dynamic transition toward membrane stabilization are essential for keeping cellular biofunctions. Furthermore, the functionalized glycopeptide is indicative of typical α-helical/β-sheet structure-driven regulations of ice crystals during freeze-thaw, thereby strongly promoting efficient cryopreservation. Such all-in-one glycopeptide enables achieving both high cell recovery post-thaw >85% and exceptional cryosurvival >95% in direct freezing protocols. The rationally designed benzyl alcohol-modified glycopeptide permits the development of a competent platform with high generality for protection of blood cells against freeze-stress.
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Affiliation(s)
- Shuhui Gao
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, P. R. China
| | - Qingjing Niu
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, P. R. China
| | - Yan Wang
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, P. R. China
| | - Lixia Ren
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, P. R. China
| | | | - Kongying Zhu
- Analysis and Measurement Center, Tianjin University, Tianjin, 300072, P. R. China
| | - Xiaoyan Yuan
- School of Materials Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, P. R. China
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Helander L, McKinney C, Kelly K, Mack S, Sanders M, Gurley J, Dumont LJ, Annen K. Chronic granulomatous disease and McLeod syndrome: Stem cell transplant and transfusion support in a 2-year-old patient—a case report. Front Immunol 2022; 13:994321. [PMID: 36081507 PMCID: PMC9445126 DOI: 10.3389/fimmu.2022.994321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/02/2022] [Indexed: 11/21/2022] Open
Abstract
Chronic granulomatous disease (CGD) with McLeod neuroacanthocytosis syndrome (MLS) is a contiguous gene deletion disorder characterized by defective phagocytic function and decreased Kell antigen expression. CGD cure is achieved through hematopoietic stem cell transplant (HSCT) usually in the peri-pubescent years. The presence of MLS makes peri-transfusion support complex, however. Herein, we present the youngest known case of HSCT for CGD in the setting of MLS. A 2-year-old male patient was diagnosed with CGD plus MLS. Due to the severity of the child’s systemic fungal infection at diagnosis, HSCT was deemed the best treatment option despite his small size and age. A related, matched donor was available, and a unique red blood cell support plan had been implemented. Reduced-intensity conditioning was used to reduce the transplant-related mortality risk associated with myeloablative protocols. The transplant course was uneventful; autologous red blood cell (RBC) transfusion support was successful and allowed for the avoidance of possible antibody formation if allogeneic units had been used. The patient achieved 1-year relapse-free survival. The developed protocols provide a viable path to transplant in the very young, and early transplant to cure could reduce disease-related morbidity.
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Affiliation(s)
- Louise Helander
- ClinImmune Cell and Gene Therapy, Department of Medicine, University of Colorado Anschutz School of Medicine, Denver, CO, United States
- Transfusion Medicine and Apheresis, Department of Pathology, Children’s Hospital Colorado, Denver, CO, United States
- *Correspondence: Louise Helander,
| | - Chris McKinney
- Blood and Marrow Transplant Therapy Program, Children’s Hospital Colorado, Denver, CO, United States
| | - Kathleen Kelly
- Vitalant Research Institute, Vitalant, Denver, CO, United States
| | - Samantha Mack
- Vitalant Research Institute, Vitalant, Denver, CO, United States
- Department of Pathology, University of Colorado Anschutz School of Medicine, Denver, CO, United States
| | - Mary Sanders
- Transfusion Medicine and Apheresis, Department of Pathology, Children’s Hospital Colorado, Denver, CO, United States
| | - Janice Gurley
- Transfusion Medicine and Apheresis, Department of Pathology, Children’s Hospital Colorado, Denver, CO, United States
| | - Larry J. Dumont
- Vitalant Research Institute, Vitalant, Denver, CO, United States
- Department of Pathology, University of Colorado Anschutz School of Medicine, Denver, CO, United States
| | - Kyle Annen
- Transfusion Medicine and Apheresis, Department of Pathology, Children’s Hospital Colorado, Denver, CO, United States
- Department of Pathology, University of Colorado Anschutz School of Medicine, Denver, CO, United States
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