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Genetic Variant Detection in the CALR gene using High Resolution Melting Analysis
Published on: August 26, 2020
RhD variants in Caucasians: consequences for checking clinically relevant alleles
Hélène Ansart-Pirenne1, Marianne Asso-Bonnet, Pierre-Yves Le Pennec
1National Blood Group Reference Center and the French Establishment of Transfusion of Ile de France, Hôpital Henri Mondor, Créteil, France.
Insights
This study identified five new weak D variants, improving understanding of D antigen variations. Genotyping weak D Type 1 and 2 can optimize blood transfusions for carriers.
Area of Science:
- Hematology
- Immunogenetics
- Blood group serology
Background:
- Weak D type carriers have limited immunization risk unless antigen density is below 400 antigens per red blood cell (RBC).
- Partial D carriers, however, can produce anti-D antibodies.
Purpose of the Study:
- To characterize new variants of the D antigen.
- To investigate the molecular basis of weak D expression and anti-D production.
Main Methods:
- Serologic and molecular analyses were performed on 168 blood samples from Caucasian individuals.
- Focus on samples exhibiting weak D expression and/or anti-D production.
Main Results:
- Identified 70 partial D and 62 weak D cases.
- Characterized five novel weak D alleles (399G>T, 680T>C, 833G>A, 851C>T, 1015G>A).
- Weak D Type 1 and 2 alleles showed antigen density up to 500, while new variants and most other weak D variants had densities below 400 antigens/RBC.
Conclusions:
- Provided molecular characterization of five new D variants.
- Recommended routine genotyping for weak D Type 1 and 2 in laboratories for serologically weak D antigens.
- Genotyping can prevent wastage of D- RBC units by enabling safe transfusion of D+ units to carriers.
Background:
Weak D type carriers cannot be immunized against D except when antigen density is below 400 antigens per RBC, whereas partial D carriers can produce anti-D.
Study Design And Methods:
A total of 168 blood samples from Caucasian individuals were studied because of weak D expression and/or anti-D production. Serologic analysis and molecular analysis were performed.
Results:
In total, 70 partial D and 62 weak D were identified. Among weak D samples, 30 weak D Type 1 and 21 weak D Type 2 alleles were found. Five new alleles were characterized carrying 399G > T, 680T > C, 833G > A, 851C > T, and 1015G > A, respectively. According to previous studies, antigen density was up to 500 for weak D Type 1 and 2, except when there was a dCe haplotype in trans. Antigen density was below 400 antigens per red blood cell for the new variants and most other weak D variants.
Conclusion:
These results provide molecular characterization of five new D variants. They also suggest that it would be advantageous to develop in routine laboratories weak D Type 1 and 2 genotyping for serologically depressed D antigen. It will help to avoid wasting of D- red blood cell units because carriers may safely receive D+ units.
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