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Dezan MR, Oliveira VB, Conrado MCAV, da Rocha MC, Luz F, Gallucci A, Pereira AC, Krieger JE, Rocha V, Mendrone-Junior A, Dinardo CL. Variant genotypes associated with reduced expression of RhCE antigens among Brazilian blood donors. Transfusion 2021; 61:1923-1931. [PMID: 33687082 DOI: 10.1111/trf.16355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The genetic diversity of the RHCE gene locus has been explored in diverse populations of different racial backgrounds. Data referring to the diversity of RHCE encoding weakened expression of C, c, E, and e in multiethnic populations is still incomplete. METHODS Samples from Brazilian blood donors presenting reduced expression of C, c, E, or e on gel method were selected for the study. All exons and flanking introns of RHCE were genotyped though direct Sanger sequencing for the included donors. RESULTS Sixty-six donors were included: 23 with weak C, 22 with weak c, 6 with weak E, 14 with weak e, and 1 with weak c and E. Among the samples with weak C, the following altered RH*C were encountered: RHCE*CeMA (n = 3), RHCE*Ce941C (n = 1), and RHCE*CeVA (n = 1). RHD*D-CE(4-7)-D was detected in six cases, RHCE*CE was presumably present in five cases, and seven cases were unexplained. Two altered alleles underlay the weak c phenotype: RHCE*ceJAL (n = 20) and RHCE*ce340T (n = 2), and two altered RHCE justified weak e: RHCE*ceMO (n = 6) and RHCE*ceJAL (n = 8). Three variant RHCE were associated with weak E: RHCE*cEJU (n = 4), RHCE*cE382C (n = 1), and RHCE*cEIV (n = 1). The RHCE*cE905A justified one case of weak c and E. CONCLUSION We describe the distribution of RHCE variants found in association with weak expression of C, c, E, and e in blood donors of multiethnic origin, which differs in comparison to that previously reported for people of African or Caucasian descent.
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Affiliation(s)
| | | | | | | | - Fabio Luz
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | | | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo, São Paulo, Brazil
| | - José E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of São Paulo, São Paulo, Brazil
| | - Vanderson Rocha
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Department of Hematology, Churchill Hospital, NHS BT, Oxford University, Oxford, UK.,Discipline of Hematology, University of São Paulo School of Medicine, São Paulo, Brazil
| | | | - Carla Luana Dinardo
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Floch A, Tournamille C, Chami B, Pirenne F. Genotyping in Sickle Cell Disease Patients: The French Strategy. Transfus Med Hemother 2018; 45:264-270. [PMID: 30283276 DOI: 10.1159/000490858] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/11/2018] [Indexed: 01/13/2023] Open
Abstract
This review presents the French strategy for blood group genotyping in high-responder and newly diagnosed sickle cell disease (SCD) patients. In addition to FY, JK, and MNS genotyping, the RH blood group system is now explored in SCD patients in France. Molecular typing has been used for the deduction of partial RH2 (C) antigens since 2010, and the gradual implementation of systematic RHD and RHCE genotyping nationwide was initiated in late 2014. In our laboratory, 962 RH:2 (C-positive) SCD patients have been tested since 2010, and 1,148 SCD patients of all RH phenotypes have been genotyped for clinically relevant alleles of RHD and RHCE since late 2014.
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Affiliation(s)
- Aline Floch
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France.,INSERM U955, Equipe 2 'Transfusion et maladies du globule rouge', Créteil, France.,Laboratory of Excellence GR-Ex, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France
| | - Christophe Tournamille
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France.,INSERM U955, Equipe 2 'Transfusion et maladies du globule rouge', Créteil, France.,Laboratory of Excellence GR-Ex, Créteil, France
| | - Btissam Chami
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France
| | - France Pirenne
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France.,INSERM U955, Equipe 2 'Transfusion et maladies du globule rouge', Créteil, France.,Laboratory of Excellence GR-Ex, Créteil, France.,Institut Mondor de Recherche Biomédicale (IMRB), Université Paris Est-Créteil (UPEC), Faculté de Médecine, Créteil, France
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Westhoff CM, Vege S, Halter Hipsky C, Hue-Roye K, Copeland T, Velliquette RW, Horn T, Lomas-Francis C, Reid ME. RHCE*ceTI encodes partial c and partial e and is often in cis to RHD*DIVa. Transfusion 2013; 53:741-6. [PMID: 22804620 PMCID: PMC3477252 DOI: 10.1111/j.1537-2995.2012.03800.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the Rh blood group system, variant RhD and RhCE express several partial antigens. We investigated RH in samples with partial DIVa that demonstrated weak and variable reactivity with anti-C. STUDY DESIGN AND METHODS Standard hemagglutination techniques, polymerase chain reaction-based assays, and RH sequencing were used. RESULTS DNA analysis showed that six red blood cell (RBC) samples with weak and inconsistent reactivity with anti-C lacked RHCE*C, but all had RHD*DIVa, which encodes partial D and Go(a) . We then tested RBCs from 19 Go(a+) cryopreserved samples (confirmed to have RHD*DIVa) with four anti-C and observed weak variable reactions. RHCE genotyping found all but one of the samples with RHD*DIVa also had RHCE nt 48G>C and 1025C>T, named RHCE*ceTI. Lookback of samples referred for workup and found to have either allele revealed 47 of 55 had both RHD*DIVa and RHCE*ceTI, four had RHD*DIVa without RHCE*ceTI, and four had RHCE*ceTI without RHD*DIVa. Alloanti-c was found in a patient with c+ RBCs and RHCE*ceTI in trans to RHCE*Ce, and alloanti-e was found in a patient with e+ RBC and RHCE*ceTI in trans to RHCE*cE. RHD*DIVa in trans to RHD erroneously tested as RHD hemizygous. CONCLUSIONS RHD*DIVa and RHCE*ceTI almost always, but not invariably, travel together. This haplotype is found in people of African ancestry and the RBCs can demonstrate aberrant reactivity with anti-C. RHCE*ceTI encodes partial c and e antigens. We confirm that RHD zygosity assays are unreliable in samples with RHD*DIVa.
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Affiliation(s)
- Connie M Westhoff
- Laboratory of Immunohematology and Genomics, New York Blood Center, Long Island City, New York 10065, USA.
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Silvy M, Di Cristofaro J, Beley S, Papa K, Rits M, Richard P, Chiaroni J, Bailly P. Identification of RHCE and KEL alleles in large cohorts of Afro-Caribbean and Comorian donors by multiplex SNaPshot and fragment assays: a transfusion support for sickle cell disease patients. Br J Haematol 2011; 154:260-70. [PMID: 21623766 DOI: 10.1111/j.1365-2141.2011.08691.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To lower the alloimmunization risk following transfusion in blacks, we developed two genotyping assays for large-scale screening of Comorian and Afro-Caribbean donors. One was a multiplex SNaPshot assay designed to identify ce(s) (340), ceMO/AR/EK/BI/SM, ce(s) , ce(s) (1006) and KEL*6/*7 alleles. The other was a multiplex fragment assay designed to detect RHD, RHDψ and RHCE*C and 455A>C transversion consistent with (C)ce(s) Type 1 and DIII Type5 ce(s) . Variant RHCE*ce alleles or RH haplotypes were detected in 58·69% of Comorians and 41·23% of Afro-Caribbeans. The ce(s) allele, (C)ce(s) Type 1, and DIII Type 5 ce(s) haplotypes were identified respectively in 39·13%, 14·67% and 4·88% of Comorians and 32·23%, 5·28% and 1·76% of Afro-Caribbeans. Genotypes consistent with partial D, C, c and/or e antigen expression were observed in 26·08% of Comorians and 14·69% of Afro-Caribbeans. No homozygous genotype corresponding to the RH:-18, -34, and -46 phenotypes were found. However, over 50% of genotypes produced low-prevalence antigens at risk for negative recipients, i.e., V, VS, JAL, and/or KEL6. One new variant RHCE*ce(s) (712) allele was identified. This is the first determination of variant RHCE and KEL allele frequencies. Results indicate the most suitable targets for molecular assay screening to optimize use of compatible blood units and lower immunization risk.
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Affiliation(s)
- Monique Silvy
- Laboratoire d'Hématologie Moléculaire, Établissement Français du Sang Alpes Méditerranée, UMR 6578, Université de Méditerranée, Marseille, France
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Abstract
BACKGROUND The low-prevalence Rh antigen, JAL, was named after the index case, Mr. J. Allen. Based on reactivity of seven multi-specific sera with his RBCs, it was apparent that they express at least one additional low-prevalence antigen. The purpose of this study was to investigate the other low-prevalence antigen(s) on J. Allen's RBCs. METHODS Blood samples and reagents were from our collections. Hemagglutination and DNA analyses were performed by standard methods. RESULTS Our DNA analyses confirmed the presence of RHCE*ceS(340T) in J. Allen and revealed the presence of RHCE*ceBI (ce 48C, 712G, 818T, 1132G) and RHD*DOL (509T, 667T). RBCs from J. Allen were agglutinated by anti-JAL, anti-STEM, and anti-DAK. Two of the reactive multi-specific sera reported in the original paper reacted with RBCs from J. Allen, and with RBCs from four other people with RHCE*ceBI, including the original STEM+ index case (P. Stemper) but not with RBCs with the DIIIa, DAK+ phenotype. We conclude that they contain anti-STEM. CONCLUSION J.Allen's RBCs express the low-prevalence Rh antigens, JAL, V/VS (extremely weakly), STEM, and DAK. The presence of JAL on the variant Rhce, RhceJAL (16Cys, 114Trp, 245Val), STEM on the variant Rhce, RhceBI (16Cys, 238Val, 273Val, 378Val), and DAK on the variant RhD (170Thr, 223Val), encoded by RHD*DOL in trans to RHCE*ceBI is consistent with expression of these antigens. When J. Allen RBCs are used to detect and identify an anti-JAL, it is important to remember that they also express STEM and DAK.
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Affiliation(s)
- K Hue-Roye
- Laboratory of Immunochemistry, New York Blood Center, New York, NY, USA
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Hipsky CH, Lomas-Francis C, Fuchisawa A, Reid ME, Moulds M, Christensen J, Nickle P, Vege S, Westhoff C. RHCE*ceCF encodes partial c and partial e but not CELO, an antigen antithetical to Crawford. Transfusion 2011; 51:25-31. [PMID: 20609196 DOI: 10.1111/j.1537-2995.2010.02764.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND RH43 (Crawford) is encoded by RHCE*ce with nucleotide changes 48G>C, 697C>G, and 733C>G (RHCE*ceCF). We investigated the Rh antigen expression and antibody specificities in four patients with this allele. STUDY DESIGN AND METHODS Hemagglutination tests, DNA extraction, polymerase chain reaction (PCR)-restriction fragment length polymorphism, allele-specific PCR, reticulocyte RNA isolation, reverse transcription-PCR cDNA analyses, cloning, and sequencing were performed by standard procedures. RESULTS Red blood cells (RBCs) from two patients typed D+C-E-c+e+/-, hrS-/+W, hrB- and their serum was reactive (3+) with all RBC samples of common Rh phenotype tested, but nonreactive with Rhnull or D-- RBCs (apparent alloanti-Rh17). At the RHCE locus, Patient 1 was homozygous for RHCE*ceCF, and Patient 2 inherited RHCE*ceCF in trans to a silenced RHCE*cE. Cross-testing of serum and RBCs from these two samples showed mutual compatibility, indicating that both antibodies define the same novel high-prevalence antigen on Rhce. Two additional patients, one whose serum contained alloanti-c but the RBCs typed C+c+ and one whose serum contained anti-e but the RBCs typed E+e+, also had RHCE*ceCF. RHCE*Ce was present in trans in the former and RHCE*cE in the latter patient. CONCLUSION We report that amino acid changes on RhceCF (Trp16Cys, Gln233Glu, and Leu245Val) alter the protein to the extent that c and e antigens are partial, and a high-prevalence antigen, we have named CELO (provisional ISBT Number 004058; RH58) is not expressed. CELO is antithetical to RH43 (Crawford).
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Affiliation(s)
- Christine Halter Hipsky
- Laboratories of Immunohematology and Immunochemistry, New York Blood Center, New York, New York 10065, USA
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Hue-Roye K, Hipsky CH, Velliquette RW, Fuchisawa A, Lomas-Francis C, Hoppe C, Reid ME. A novel RHCE*ce 48C, 733G allele with Nucleotide 941C in Exon 7 encodes an altered red blood cell e antigen. Transfusion 2011; 51:32-5. [PMID: 20576012 DOI: 10.1111/j.1537-2995.2010.02765.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several RHCE*ce alleles have in common a 733C>G (Leu245Val) change. Some encode an altered expression of e on red blood cells (RBCs) and individuals with such RBCs can make e-like alloantibodies. The identification of an apparent anti-hr(B) in the serum of an E-e+ African American patient prompted us to analyze her DNA, which revealed a novel RHCE*ce allele. We also screened blood samples from African Americans to determine the frequency of the novel allele. STUDY DESIGN AND METHODS Hemagglutination tests and molecular analyses were performed by standard procedures. RESULTS Analysis of the proband's DNA revealed RHCE*ce 48C/C, 733G/G, 941T/C, and 1006G/T. Of 272 samples from African Americans, 257 were RHCE*941T/T (wild type), and 15 (6%) were RHCE*941T/C. Of these 15, 14 were RHCE*ce/ce, 10 with 733C/G and four with 733G/G, and one was RHCE*ce/cE, 733C/G. Cloning experiments confirmed the Nucleotide 941 change and showed that 48C, 733G, 941C, and 1006T were carried on the same allele. RBCs from the 15 samples carrying the RHCE*941C variant typed V/VS+ and hrB+W. CONCLUSION This study identifies a novel allele, RHCE*ce 48C, 733G, 941C, 1006T which is predicted to encode 16Cys, 245Val, 314Ala, and 336CyS and was shown to encode c, V/VS, and an altered expression of e and hrB antigens. The clinical significance of the antibody found in the proband is not established because E+e- RBC components were transfused to the patient. The novel RHCE*ce 48C, 733G, 941C, 1006T allele was present in 5.5% of samples from African Americans and thus, in this small cohort, it had a frequency of 0.028.
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Affiliation(s)
- Kim Hue-Roye
- Laboratory of Immunochemistry, New York Blood Center, New York, New York 10065, USA
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Pham BN, Peyrard T, Juszczak G, Beolet M, Deram G, Martin-Blanc S, Dubeaux I, Roussel M, Kappler-Gratias S, Gien D, Poupel S, Rouger P, Le Pennec PY. Analysis of RhCE variants among 806 individuals in France: considerations for transfusion safety, with emphasis on patients with sickle cell disease. Transfusion 2010; 51:1249-60. [DOI: 10.1111/j.1537-2995.2010.02970.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wiwanitkit V. Mutation in Rh48: Assessment for possible mutation prone point. Indian J Hematol Blood Transfus 2010; 26:6-7. [DOI: 10.1007/s12288-010-0003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 06/25/2009] [Indexed: 10/19/2022] Open
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Westhoff CM, Vege S, Wylie D, Nickle P, Lomas-Francis C, Hue-Roye K, Reid ME. The JAL antigen (RH48) is the result of a change in RHCE that encodes Arg114Trp. Transfusion 2008; 49:725-32. [PMID: 19170983 DOI: 10.1111/j.1537-2995.2008.02034.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The JAL antigen (Rh48) was discovered more than 30 years ago when it caused hemolytic disease of the fetus and newborn in an African American family. A decade later it was found to cause hemolytic disease of the fetus and newborn in a Caucasian family. The presence of the same low-prevalence antigen in two different ethnic groups is rare, but additional JAL+ in both groups was subsequently identified. This study was undertaken to investigate the RH gene(s) responsible for expression of JAL and to determine the structural relationship between JAL and other Rh antigens. STUDY DESIGN AND METHODS Samples from 17 JAL+ people were included: 2 Caucasian, 6 African American, 7 African Brazilian, 1 Caribbean, and 1 Puerto Rican. RHCE and RHD were investigated at the genomic level, and Rh cDNAs were cloned and sequenced for some samples. RESULTS Caucasian JAL+ probands had RHCE*Ce, while JAL+ probands with African ancestry had RHCE*ce, but all had a nucleotide 340C>T change in Exon 3 of RHCE predicted to encode Arg114Trp. The JAL-encoding RHCE*ce also had 733C>G (Leu245Val) and was linked to conventional RHD or to RHD*DAU0. CONCLUSIONS JAL+ results from a nucleotide 340C>T (Arg114Trp) on either a Ce or ce background. Homology modeling of the JAL+ RhCE protein suggests that the Arg-->Trp change eliminates a critical loop-stabilizing H-bond between the side chain of Arg114 and the e-specific amino acid Ala226. Additionally, accommodation of the bulky tryptophan would disrupt the conformation of the extracellular loops containing C/c- and e-specific amino acids, providing a structural hypothesis for the simultaneous altered expression of C/c, e, and V/VS antigens.
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Affiliation(s)
- Connie M Westhoff
- Molecular Blood Group and Platelet Testing Laboratory, American Red Cross, Penn-Jersey Region, Philadelphia, PA 19130, USA.
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