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Bugert P, Rink G, Klüter H. Evaluation of Single Nucleotide Variants in Intron 1 of the ABO Gene as Diagnostic Markers for the A 1 Blood Group. Transfus Med Hemother 2023; 50:263-269. [PMID: 37767281 PMCID: PMC10521232 DOI: 10.1159/000528683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/12/2022] [Indexed: 09/29/2023] Open
Abstract
Introduction The molecular diagnosis of the A1 blood group is based on the exclusion of ABO gene variants causing blood groups A2, B, or O. A specific genetic marker for the A1 blood group is still missing. Recently, long-read ABO sequencing revealed four sequence variations in intron 1 as promising markers for the ABO*A1 allele. Here, we evaluated the diagnostic values of the 4 variants in blood donors with regular and weak A phenotypes and genotypes. Methods ABO phenotype data (A, B, AB, or O) were taken from the blood donor files. The ABO genotypes (low resolution) were known from a previous study and included the variants c.261delG, c.802G>A, c.803G>C, and c.1061delC. ABO variant alleles (ABO*AW.06,*AW.08,*AW.09,*AW.13, *AW.30, and *A3.02) were identified in weak A donors by sequencing the ABO exons before. For genotyping of the ABO intron 1 variants rs532436, rs1554760445, rs507666, and rs2519093, we applied TaqMan assays with endpoint fluorescence detection according to a standard protocol. Genotypes of the variants were compared with the ABO phenotype and genotype. Evaluation of diagnostic performance included sensitivity, specificity, positive (PPV), and negative predictive value (NPV). Results In 1,330 blood donors with regular ABO phenotypes and genotypes, the intron 1 variants were significantly associated with the proposed A1 blood group. In 15 donors, we found discrepancies to the genotype of at least one of the 4 variants. For the diagnosis of the ABO*A1 allele, the variants showed 98.79-99.48% sensitivity, 99.66-99.81% specificity, 98.80-99.31% PPV, and 99.66-99.86% NPV. Regarding the A phenotype, the diagnostic values were 99.02-99.41% sensitivity, 99.63-99.76% specificity, 99.41-99.61% PPV, and 99.39-99.63% NPV. The *A1 marker allele of all intron 1 variants was also associated with the *AW.06, *AW.13, and *AW.30 variants. Samples with *AW.08, *AW.09, and *A3.02 variants lacked this association. Conclusion The ABO intron 1 variants revealed significant association with the ABO*A1 allele and the A phenotype. However, the intron 1 genotype does not exclude variant alleles causing weak A phenotypes. With the introduction of reliable tag, single nucleotide variants for the A1, A2, B, and O blood groups and the genotyping instead of phenotyping of the ABO blood group are getting more feasible on a routine basis.
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Affiliation(s)
- Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg − Hessen, Mannheim, Germany
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2
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Probabilistic mathematical modelling to predict the red cell phenotyped donor panel size. PLoS One 2022; 17:e0276780. [PMID: 36367895 PMCID: PMC9651592 DOI: 10.1371/journal.pone.0276780] [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: 06/27/2021] [Accepted: 10/13/2022] [Indexed: 11/13/2022] Open
Abstract
In the last decade, Australia has experienced an overall decline in red cell demand, but there has been an increased need for phenotyped matched red cells. Lifeblood and mathematicians from Queensland universities have developed a probabilistic model to determine the percentage of the donor panel that would need extended antigen typing to meet this increasing demand, and an estimated timeline to achieve the optimum required phenotyped (genotyped) panel. Mathematical modelling, based on Multinomial distributions, was used to provide guidance on the percentage of typed donor panel needed, based on recent historical blood request data and the current donor panel size. Only antigen combinations determined to be uncommon, but not rare, were considered. Simulations were run to attain at least 95% success percentage. Modelling predicted a target of 38% of the donor panel, or 205,000 donors, would need to be genotyped to meet the current demand. If 5% of weekly returning donors were genotyped, this target would be reached within 12 years. For phenotyping, 35% or 188,000 donors would need to be phenotyped to meet Lifeblood’s demand. With the current level of testing, this would take eight years but could be performed within three years if testing was increased to 9% of weekly returning donors. An additional 26,140 returning donors need to be phenotyped annually to maintain this panel. This mathematical model will inform business decisions and assist Lifeblood in determining the level of investment required to meet the desired timeline to achieve the optimum donor panel size.
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3
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Luken JS, Ritsema SP, Van der Wal MM, van der Schoot CE, Rouwette EAJA, de Haas M, Janssen MP. Mapping anticipated advantages and disadvantages of implementation of extensive donor genotyping: A focus group approach. Transfus Med 2022; 32:366-374. [PMID: 35668008 DOI: 10.1111/tme.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/11/2022] [Accepted: 04/24/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Current genotyping techniques allow typing of all relevant red cell, human leukocyte and platelet antigens in a single analysis. Even genetic markers related to donor health can be added. Implementation of this technology will affect various stakeholders within the transfusion chain. This study aims to systematically map the anticipated advantages and disadvantages of a national rollout of blood group genotyping of donors, which will affect the availability of rare donors and the implementation of an extensively typed blood transfusion policy. MATERIALS AND METHODS Two focus-group sessions were held with a wide representation of stakeholders, including representatives of donor and patient organisations. A dedicated software tool was used to collect the reflections of participants on genotyping for blood group antigens and extensive matching. Additionally, stakeholders and experts discussed various prepared propositions. All information collected was categorised. RESULTS From 162 statements collected, 59 statements (36%) were labelled as 'hopes' and 77 (48%) as 'fears'. Twenty-six (16%) statements remained unlabelled. The statements were divided in 18 categories under seven main themes: patient health, genotyping, privacy issues and ethical aspects, donor management, inventory management and logistics, hospital and transfusion laboratory and general aspects. The discussion on the propositions was analysed and summarised. CONCLUSION Stakeholders believe that a genotyped donor pool can result in a reduction of alloimmunization and higher availability of typed blood products. There are concerns regarding logistics, costs, consent for extended typing, data sharing, privacy issues and donor management. These concerns need to be carefully addressed before further implementation.
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Affiliation(s)
- Jessie S Luken
- Department of Immunohaematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | - Sebastien P Ritsema
- Transfusion Technology Assessment Group, Donor Medicine Research Department, Sanquin Research, Amsterdam, The Netherlands
| | - Merel M Van der Wal
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - C Ellen van der Schoot
- Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands
| | | | - Masja de Haas
- Department of Immunohaematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, The Netherlands.,Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mart P Janssen
- Transfusion Technology Assessment Group, Donor Medicine Research Department, Sanquin Research, Amsterdam, The Netherlands
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Powell Z, Jiang N, Shrestha R, Jackson DE. Would a National Antibody Register contribute to improving patient outcomes? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2022; 20:132-142. [PMID: 35244534 PMCID: PMC8971016 DOI: 10.2451/2021.0421-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/01/2021] [Indexed: 06/14/2023]
Abstract
Despite stringent testing protocols, there always remains a chance of a delayed haemolytic transfusion reaction (DHTR) occurring as a result of an undetected or unknown antibody. In this systemic review and meta-analysis, we aimed to investigate improvements to patient outcomes that could be achieved through the implementation of a national antibody registry. A series of searches through PubMed and SCOPUS identified a collection of articles with relevant information, restricted to full text, English language articles available through the RMIT Library service. 25 articles were considered for the review, four of these found to have relevant, extractable data for use in the meta-analysis. Alloantibody evanescence rates were analysed for the potential for reducing DHTRs associated with transfusion services, returning significant results indicating antibody evanescence rates of up to 68.4% in one study, with p-values less than 0.001. Due to the small number of included studies however, the interference values were quite high for these analyses at greater than 90% for each. Additional, beneficial side-effects of such a system were also considered, along with reductions in DHTRs. In conclusion it was determined that a National antibody registry would contribute to improving patient outcomes, however further studies could be performed to determine a stronger correlation, and exact levels of improvement that could be achieved.
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Affiliation(s)
- Zachary Powell
- Laboratory Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Nan Jiang
- Laboratory Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Rajeshwori Shrestha
- Laboratory Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Denise E Jackson
- Laboratory Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
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5
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Jovanovic Srzentic S, Lilic M, Vavic N, Radovic I, Djilas I. Genotyping of Eight Human Platelet Antigen Systems in Serbian Blood Donors: Foundation for Platelet Apheresis Registry. Transfus Med Hemother 2021; 48:228-233. [PMID: 34539316 DOI: 10.1159/000514487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/11/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction The aim of this study was to investigate the allele and genotype frequencies of 8 human platelet antigen (HPA) systems among blood donors from the Blood Transfusion Institute of Serbia and to compare them with published studies. These data would be useful to establish the basis for a platelet apheresis donor registry. Material and Methods Seventy-two unrelated male platelet apheresis/blood donors from Serbia were typed for 8 HPA systems (HPA-1 to HPA-6, HPA-9, and HPA-15) via the FluoGene method, based on polymerase chain reaction-sequence-specific amplification (PCR-SSP; PCR using sequence-specific primers) with fluorometric signal detection. Allele and genotype frequencies were estimated by direct counting and compared to the expected genotype frequencies according to the Hardy-Weinberg principle. The transfusion mismatch probability was calculated for every HPA specificity. Results The allele frequencies were: HPA-1a, 0.868; HPA-1b, 0.132; HPA-2a, 0.917; HPA-2b, 0.083; HPA-3a, 0.611; HPA-3b, 0.389; HPA-5a, 0.903; HPA-5b, 0.097; HPA-9a, 0.993; HPA-9b, 0.007; HPA-15a, 0.472; and HPA-15b, 0.528. For HPA-4 and HPA-6 only allele a was detected. Discussion The HPA allele frequencies of European populations showed no significant differences in comparison with our results. Statistically significant differences were revealed in comparison with some populations of non-European origin. In the tested donors no HPA-2 bb genotype was detected, but we found 1 donor with the rare HPA-9b allele. The biggest transfusion mismatch probability in the Serbian population is for systems HPA-15 (37.4%) and HPA-3 (36.2%), which means that more than a third of random transfusions could cause mismatch in these systems. This study was enabled by the introduction of molecular HPA typing, and it provides initial results of the HPA allele and genotype frequencies in the population of blood donors in Serbia. They will be used to provide a compatible blood supply on demand for treating patients with alloimmune thrombocytopenic disorders. The successful implementation of PCR-SSP with fluorometric signal detection could be further complemented in the future by the introduction of high-throughput methods, which will largely depend on the available financial resources.
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Affiliation(s)
- Snezana Jovanovic Srzentic
- Department of Prenatal Molecular Testing and Blood Group Typing, Blood Transfusion Institute of Serbia, Belgrade, Serbia
| | - Marko Lilic
- Department of Biology, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Natasa Vavic
- Department of Donor Apheresis, Blood Transfusion Institute of Serbia, Belgrade, Serbia
| | - Ivana Radovic
- Department of Prenatal Molecular Testing and Blood Group Typing, Blood Transfusion Institute of Serbia, Belgrade, Serbia
| | - Iva Djilas
- Department of Blood Donor Testing, Blood Transfusion Institute of Serbia, Belgrade, Serbia
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6
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Nagervadze M, Tsintsadze I, Akhvlediani L, Koiava T, Tskvitinidze S, Khukhunaishvili R, Koridze M. ABO system combination with Rh, Kell and MN group in Georgian blood donors. AMERICAN JOURNAL OF BLOOD RESEARCH 2021; 11:132-139. [PMID: 34079626 PMCID: PMC8165715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/14/2021] [Indexed: 06/12/2023]
Abstract
UNLABELLED There are numerous scientific data about the study of the prevalence of blood group antigens in the different donor population. Several studies showed that the profile of major blood group antigens is not similar in blood donors from different local areas. RESEARCH OBJECTIVE Our scientific goal was to study of the prevalence blood group antigens in the Georgian blood donor population. In the current study, we analyzed the 48 phenotypically combinations based on four major (ABO, Rh, Kell, and MN) blood groups. RESEARCH METHODS The blood of 1009 donors has been studied on RBC antigens. The sample were collected from the diagnostic laboratory of Medina Ltd Health Centre of Batumi. Blood typing of the sample has been carried out on the basis of the immunogenetics laboratory of Batumi Shota Rustaveli State University. The universal monoclone antibodies was used for identify minor blood group antigens. We used as forward as reverse grouping methods. For identification erythrocytes, blood group antigens also were used ID cards, such as ABO/D + Reverse Grouping. RESULT 12 phenotypic combinations have been identified in each O, A, B, AB group of ABO system. Out of 48 theoretically possible phenotypic combinations, we can actually find 1,9 times less phenotypes and the real amount is 25 phenotypes. The remaining 23 phenotypic combinations have not been observed in the studied donors. These are: 1. O, Rh-K+ MM; 2. O, Rh-K- MN; 3. O, Rh-K- NN; 4. A, Rh-K+ MN; 5. A, Rh-K+ MM; 6. A, Rh-K+ NN; 7. A, Rh-K- MM; 8. A, Rh-K- NN; 9. B, Rh+K+ NN; 10. B, Rh-K+ MN; 11. B, Rh-K+ MM; 12. B, Rh-K+ NN; 13. B, Rh-K- MN; 14. B, Rh-K- MM; 15. B, Rh-K- NN; 16. AB, Rh+K+ MN; 17. AB, Rh+K+ NN; 18. AB, Rh+K- NN; 19. AB, Rh+K- MM; 20. AB, Rh-K+ MN; 21. AB, Rh-K+ MM; 22. AB, Rh-K+ NN; 23. B, Rh-K- NN. The value of χ2 in the case is equal to 3221,16. The P-Value is < .00001. The result is significant at P < .05. Out of 1009 studied donors 349 are carriers of phenotypic group A (II), while 19 donors carry AB (IV) group specification. This means that 36.23% of the studied donors have A antigen on the surface of erythrocyte membrane. The majority of them A1 subgroup. CONCLUSION As our research showed there is a quit high polymorphism of blood group phenotype combinations in Georgian blood donors in the example of one clinic. This kind of data is very important for the clinics' rational preparation of whole blood or blood components.
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Affiliation(s)
- Marina Nagervadze
- Biology Department, Batumi Shota Rustaveli State UniversityBatumi, Georgia
- Medical Faculty, Bau International UniversityBatumi, Georgia
| | - Irine Tsintsadze
- Biology Department, Batumi Shota Rustaveli State UniversityBatumi, Georgia
- Medical Faculty, Bau International UniversityBatumi, Georgia
| | - Leila Akhvlediani
- Biology Department, Batumi Shota Rustaveli State UniversityBatumi, Georgia
- Medical Faculty, Bau International UniversityBatumi, Georgia
| | - Tea Koiava
- Departament of Clinical Medicine, Batumi Shota Rustaveli State UniversityBatumi, Georgia
| | - Sophiko Tskvitinidze
- Medical Faculty, Bau International UniversityBatumi, Georgia
- Departament of Clinical Medicine, Batumi Shota Rustaveli State UniversityBatumi, Georgia
| | | | - Marina Koridze
- Biology Department, Batumi Shota Rustaveli State UniversityBatumi, Georgia
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7
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Flesch BK, Reil A, Nogués N, Canals C, Bugert P, Schulze TJ, Huiskes E, Porcelijn L, Höglund P, Ratcliffe P, Schönbacher M, Kerchrom H, Kellershohn J, Bayat B. Multicenter Study on Differential Human Neutrophil Antigen 2 Expression and Underlying Molecular Mechanisms. Transfus Med Hemother 2020; 47:385-395. [PMID: 33173457 DOI: 10.1159/000505523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/18/2019] [Indexed: 12/29/2022] Open
Abstract
Background The human neutrophil antigen 2 (HNA-2), which is expressed on CD177, is undetectable in 3-5% of the normal population. Exposure of these HNA-2<sub>null</sub> individuals to HNA-2-positive cells can cause immunization and pro-duction of HNA-2 antibodies, which can induce immune neutropenia and transfusion-related acute lung injury. In HNA-2-positive individuals, neutrophils are divided into a CD177<sup>pos.</sup> and a CD177<sup>neg.</sup> subpopulation. The molecular background of HNA-2 deficiency and the bimodal expression pattern, however, are not completely decoded. Study Design An international collaboration was conducted on the genetic analysis of HNA-2-phenotyped blood samples, including HNA-2-deficient individuals, mothers, and the respective children with neonatal immune neutropenia and regular blood donors. Results From a total of 54 HNA-2<sub>null</sub> individuals, 43 were homozygous for the CD177 *787A>T substitution. Six carried the CD177 *c.1291G>A single nucleotide polymorphism. All HNA-2-positive samples with >40% CD177<sup>pos.</sup> neutrophils carried the *787A wild-type allele, whereas a lower rate of CD177<sup>pos.</sup> neutrophils was preferentially associated with *c.787AT heterozygosity. Interestingly, only the *c.787A allele sequence was detected in complementary DNA (cDNA) sequence analysis carried out on all *c.787AT heterozygous individuals. However, cDNA analysis after sorting of CD177<sup>pos.</sup> and CD177<sup>neg.</sup> neutrophil subsets from HNA-2-positive individuals showed identical sequences, which makes regulatory elements within the promoter unlikely to affect CD177 gene transcription in different CD177 neutrophil subsets. Conclusion This comprehensive study clearly demonstrates the impact of single nucleotide polymorphisms on the expression of HNA-2 on the neutrophil surface but challenges the hypothesis of regulatory epigenetic effects being implicated in the bimodal CD177 expression pattern.
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Affiliation(s)
- Brigitte K Flesch
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany.,German Red Cross Blood Service West, Hagen, Germany
| | | | - Núria Nogués
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Carme Canals
- Immunohematology Laboratory, Blood and Tissue Bank, Barcelona, Spain
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service of Baden-Württemberg, Hessen gGmbH, Mannheim, Germany
| | - Torsten J Schulze
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service of Baden-Württemberg, Hessen gGmbH, Mannheim, Germany.,Institute Springe, German Red Cross Blood Service NSTOB, Springe, Germany
| | - Elly Huiskes
- Department of Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands
| | - Leendert Porcelijn
- Department of Immunohematology Diagnostics, Sanquin, Amsterdam, The Netherlands
| | - Petter Höglund
- Center for Hematology and Regenerative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Ratcliffe
- Center for Hematology and Regenerative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marlies Schönbacher
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Hans Kerchrom
- Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Josina Kellershohn
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
| | - Behnaz Bayat
- Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig University, Giessen, Germany
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8
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Flesch BK, Scherer V, Just B, Opitz A, Ochmann O, Janson A, Steitz M, Zeiler T. Molecular Blood Group Screening in Donors from Arabian Countries and Iran Using High-Throughput MALDI-TOF Mass Spectrometry and PCR-SSP. Transfus Med Hemother 2020; 47:396-408. [PMID: 33173458 DOI: 10.1159/000505495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/14/2019] [Indexed: 12/11/2022] Open
Abstract
Background and Aims Only little is known about blood groups other than ABO blood groups and Rhesus factors in Arabian countries and Iran. During the last years, increased migration to Central Europe has put a focus on the question how to guarantee blood supply for patients from these countries, particularly because hemoglobinopathies with the need of regular blood support are more frequent in patients from that region. Therefore, blood group allele frequencies should be determined in individuals from Arabian countries and Iran by molecular typing and compared to a German rare donor panel. Methods 1,111 samples including 800 individuals from Syria, 147 from Iran, 123 from the Arabian Peninsula, and 41 from Northern African countries were included in a MALDI-TOF MS assay to detect polymorphisms coding for Kk, Fy(a/b), Fy<sub>null</sub>, C<sub>w</sub>, Jk(a/b), Jo(a+/a-), Lu(a/b), Lu(8/14), Ss, Do(a/b), Co(a/b), In(a/b), Js(a/b), Kp(a/b), and variant alleles RHCE*c.697C>G and RHCE *c.733C>G. Yt(a/b), S-s-U-, Vel<sub>null</sub>, Co<sub>null</sub>, and RHCE *c.667G>T were tested by PCR-SSP. Results Of the Arabian donors, 2% were homozygous for the FY *02.01N allele (Fy<sub>null</sub>), and 15.7% carried the heterozygous mutation. However, 0.8% of the German donors also carried 1 copy of the allele. 3.6% of all and 29.3% of Northern African donors were heterozygous for the RHCE *c.733C>G substitution, 0.4% of the Syrian probands were heterozygous for DO *01/DO *01.-05, a genotype that was lacking in German donors. Whereas the KEL *02.06 allele coding for the Js(a) phenotype was missing in Germans; 0.8% of the Syrian donors carried 1 copy of this allele. 1.8% of the Syrian but only 0.3% of the German donors were negative for YT *01. One donor from Northern Africa homo-zygously carried the GYPB *270+5g>t mutation, inducing the S-s-U+<sup>w</sup> phenotype, and in 2 German donors a GYPB *c.161G>A exchange, which induces the Mit+ phenotype, caused a GYPB *03 allele dropout in the MALDI assay. The overall failure rate of the Arabian panel was 0.4%. Conclusions Some blood group alleles that are largely lacking in Europeans but had been described in African individuals are present in Arabian populations at a somewhat lower frequency. In single cases, it could be challenging to provide immunized Arabian patients with compatible blood.
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Affiliation(s)
- Brigitte Katharina Flesch
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany.,German Red Cross Blood Service West, Hagen, Germany
| | - Vanessa Scherer
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | | | - Andreas Opitz
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | - Oswin Ochmann
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | - Anne Janson
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
| | - Monika Steitz
- German Red Cross Blood Service Rhineland-Palatinate and Saarland, Bad Kreuznach, Germany
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Muniz AA, da Silva AR, Ferraz IA, Martins ML, Godin MM, Schmidt LC, Dusse LMSA, da Silva Malta MCF. The screening of rare blood donors in a highly admixed population: A new approach for Holley and Diego genotyping and impact of genomic and self-reported ancestry. Transfus Med 2019; 30:148-156. [PMID: 31820508 DOI: 10.1111/tme.12653] [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: 07/25/2019] [Revised: 10/21/2019] [Accepted: 11/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The present study aimed to develop strategies for genotyping DO*HY (Dombrock system) and DI*A/DI*B (Diego system) alleles and to evaluate the impact of genomic and self-declared ancestry on rare donor screening in admixed populations. BACKGROUND The antigens Hy and Dib demonstrate clinical importance. The lack of antisera for the serological evaluation of these antigens makes it necessary to develop molecular methods. In addition, considering that some rare red blood cell phenotypes present differences in frequency between ethnic groups, it is important to assess the applicability of self-declared ancestry in the search for rare donors in admixed populations. METHODS DO*HY and DI*A/DI*B genotyping based on real-time polymerase chain reaction (PCR) was standardised. A total of 457 blood donors clustered by self-defined skin colour/race categories were genotyped. Furthermore, individual genomic ancestry was used in the analyses. RESULTS The assays developed are reproducible and provide satisfactory results even at low concentrations of DNA, which make them useful in situations where the DNA is scarce, such as dried blood spots on filter paper, or when screening for pooled samples. No significant difference was observed in the frequencies of the DI*A, DI*B and DO*HY, comparing the self-declared White (branco) donors with those who are Black (preto) and Brown (pardo). CONCLUSION Real-time PCR, especially using pooled samples, is a promising strategy to screen rare blood donors. Although both self-reported race/colour and some blood group phenotypes are associated with ancestry, the results point to a greater complexity in the application of self-declared race/colour in the screening of rare donors in admixed populations.
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Affiliation(s)
- Amanda A Muniz
- Fundação Hemominas, Belo Horizonte, Brazil.,Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adão R da Silva
- Fundação Hemominas, Belo Horizonte, Brazil.,Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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10
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Eryilmaz M, Müller D, Rink G, Klüter H, Bugert P. Introduction of Noninvasive Prenatal Testing for Blood Group and Platelet Antigens from Cell-Free Plasma DNA Using Digital PCR. Transfus Med Hemother 2019; 47:292-301. [PMID: 32884502 DOI: 10.1159/000504348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background Noninvasive prenatal testing (NIPT) for fetal antigens is a common standard for targeted immune prophylaxis in RhD-mediated hemolytic disease of the fetus and newborn, and is most frequently done by quantitative PCR (qPCR). A similar approach is considered for other blood group and human platelet alloantigens (HPA). Because of a higher sensitivity compared to qPCR for rare molecule detection, we established and validated digital PCR (dPCR) assays for the detection of RHD exons 3, 5 and 7, KEL1, HPA-1a, and HPA-5b from cell-free DNA (cfDNA) in plasma. The dPCR assays for the Y-chromosomal marker amelogenin and autosomal SNPs were implemented as controls for the proof of fetal DNA. Methods Validation was performed on dilution series of mixed plasma samples from volunteer donors with known genotypes. After preamplification of the target loci, two-color (FAM and VIC) TaqMan<sup>TM</sup> probe chemistry and chip-based dPCR were applied. The assays for RHD included GAPDH as an internal control. For the diallelic markers KEL1/2, HPA-1a/b, HPA-5a/b, and AMEL-X/Y and 3 autosomal SNPs, the probes enabled allelic discrimination in the two fluorescence channels. The dPCR protocol for NIPT was applied to plasma samples from pregnant women. Results The RHD exon 5 assay allowed the detection of a 0.05% RHD target in an RhD-negative background, whereas the exon 7 assay required at least a 0.25% target. The exon 3 assay showed the highest background and required at least a 2.5% RHD target for reliable detection. The dPCR assays for the diallelic markers revealed similar sensitivity and enabled the detection of at least a 0.5% target allele. The HPA-1a assay was the most sensitive and allowed target detection in plasma mixtures containing only 0.05% HPA-1a. The plasma samples from 13 pregnant women at different gestational ages showed unambiguous positive and negative results for the analyzed targets. Conclusion Analysis of cfDNA from maternal plasma using dPCR is suitable for the detection of fetal alleles. Because of the high sensitivity of the assays, the NIPT protocol for RhD, KEL1, and HPA can also be applied to earlier stages of pregnancy.
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Affiliation(s)
- Marion Eryilmaz
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Dennis Müller
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Gabi Rink
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Peter Bugert
- Institute of Transfusion Medicine and Immunology, Heidelberg University, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
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Krog GR, Rieneck K, Clausen FB, Steffensen R, Dziegiel MH. Blood group genotyping of blood donors: validation of a highly accurate routine method. Transfusion 2019; 59:3264-3274. [DOI: 10.1111/trf.15474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/08/2019] [Accepted: 07/19/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Grethe Risum Krog
- Laboratory of Blood Genetics, Blood Bank, Department of Clinical ImmunologyCopenhagen University Hospital, (Rigshospitalet) Copenhagen Denmark
| | - Klaus Rieneck
- Laboratory of Blood Genetics, Blood Bank, Department of Clinical ImmunologyCopenhagen University Hospital, (Rigshospitalet) Copenhagen Denmark
| | - Frederik Banch Clausen
- Laboratory of Blood Genetics, Blood Bank, Department of Clinical ImmunologyCopenhagen University Hospital, (Rigshospitalet) Copenhagen Denmark
| | - Rudi Steffensen
- Department of Clinical ImmunologyAalborg University Hospital Aalborg Denmark
| | - Morten Hanefeld Dziegiel
- Laboratory of Blood Genetics, Blood Bank, Department of Clinical ImmunologyCopenhagen University Hospital, (Rigshospitalet) Copenhagen Denmark
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12
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Schulze TJ, Bugert P. Granulocytes: From Basic Research to Clinical Use. Transfus Med Hemother 2018; 45:288-289. [PMID: 30498406 PMCID: PMC6257150 DOI: 10.1159/000494035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Affiliation(s)
- Torsten J. Schulze
- Institute Springe, German Red Cross Blood Donor Services NSTOB, Springe, Germany; Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
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