在医院的献血服务中,从血清D阴性向分子RHD阴性转换一个多民族的献血池
Willy A Flegel1, Kshitij Srivastava2, Lorraine G Caruccio2
1Laboratory Services Section, Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA. waf@nih.gov.
Journal of translational medicine
|June 19, 2025
概括
分子RHD查发现1.9%的D阴性献血者对RHD基因呈阳性,表明存在Del等位基因. 这种方法对于预防输血接受者的合免疫非常重要.
科学领域:
- 血液学 血液学 血液学
- 遗传学 遗传学 是一个
- 免疫学 免疫学 免疫学
背景情况:
- 德尔表型的特征是D-抗原表达非常低,导致RhD蛋白阳性红细胞被错误地标记为D-阴性.
- 分子类型识别,特别是检测RHD基因,与传统的血清学方法相比,为识别Del个体提供了更高的灵敏度.
- 目前的RHD基因查实践往往涉及将捐赠者样本组合在一起,这可能不适用于所有人群.
研究的目的:
- 开发和实施一种敏感的分子检测方法,用于在D阴性献血者中对个人RHD基因进行查.
- 准确识别具有DEL等位基因的个体,这些个体在表型上是D负的,但在基因型上是RHD阳性的.
- 评估多民族献血者群体中Del等位基因的流行率.
主要方法:
- 一种模块化的实时聚合酶链反应 (PCR) 试验被设计为针对RHD基因的特定区域 (intron 4,exon 5和exon 7).
- 该试验用于对所有血液供献者进行个别检测,这些血液供献者使用常规血清学方法始终输入D阴性.
- RHD基因查的灵敏度能够检测到每次反应只能检测到5个RHD阳性基因组DNA拷贝.
主要成果:
- 在15年的时间里,2254名D阴性捐赠者被单独测试,显示42名捐赠者 (1.9%) 对RHD基因呈阳性.
- 在RHD阳性捐赠者中,大多数 (34个人,80.9%) 携带了共同的RHDΨ等位基因,而其他人则携带已知的RHD变异或新的RHD删除.
- 该研究还确定了2名携带DVI变异的捐赠者,确定其在美国的种群频率约为731分之一.
结论:
- 模块化RHD查方法对于个体供体检测是有效的,特别是当样本组合对多民族人口来说不切实际时.
- 自2009年以来,在NIH临床中心成功地将D阴性捐赠者转换为分子RHD阴性状态.
- 血清D阴性捐赠者的分子RHD查是识别D基的个体的重要策略,从而防止与输血相关的异免疫.
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