Flow cytometric studies of the D antigen of various Rh phenotypes with particular reference to D<sup>u</sup> and D<sub>el</sub>

Rhesus is the clinically most important protein-based blood group system. It represents the largest number of antigens and the most complex genetics of the 30 known blood group systems. The RHD and RHCE genes are strongly homologous. Some genetic complexity is explained by their close chromosomal proximity and unusual orientation, with their tail ends facing each other. The antigens are expressed by the RhD and the RhCE proteins. Rhesus exemplifies the correlation of genotype and phenotype, facilitating the understanding of general genetic mechanisms. For clinical purposes, genetic diagnostics of Rhesus antigens will improve the cost-effective development of transfusion medicine.

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“…Thus, the D antigen detection is by el ution only (D EL ). Typically, RBCs with DEL express 200 or fewer copies of the D antigen per RBC 40.…”

Section: Molecular Classification Of Rh Phenotypesmentioning

confidence: 99%

Molecular genetics and clinical applications for RH

Flegel

2011

Transfusion and Apheresis Science

148

182

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“…63 The Del phenotype has been detected in approximately 30% of East Asians (Hong Kong, Taiwan, and mainland China). 64 In the current era of frequent migrations, the Del phenotype is of global interest because of an increasing number of reports that it has caused Rh alloimmunization when Del red blood cells were transfused as Rh negative or by pregnancy.…”

Section: Commentmentioning

confidence: 99%

Policies and Procedures Related to Testing for Weak D Phenotypes and Administration of Rh Immune Globulin: Results and Recommendations Related to Supplemental Questions in the Comprehensive Transfusion Medicine Survey of the College of American Pathologists

Sandler

Roseff

Domen

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Advances in RHD genotyping offer an opportunity to update policies and practices for testing weak D phenotypes and administration of Rh immune globulin to postpartum women. Objectives.—To repeat questions from a 1999 College of American Pathologists proficiency test survey, to evaluate current practices for testing for weak D and administration of Rh immune globulin, and to determine whether there is an opportunity to begin integrating RHD genotyping in laboratory practice. Design.—The College of American Pathologists Transfusion Medicine Resource Committee sent questions from the 1999 survey to laboratories that participated in the 2012 proficiency test survey. The results of the 2012 survey were compared with those from 1999. Results from published RHD genotyping studies were analyzed to determine if RHD genotyping could improve current policies and practices for serological Rh typing. Results.—More than 3100 survey participants responded to the 2012 questions. The most significant finding was a decrease in the number of transfusion services performing a serological weak D test on patients as a strategy to manage those with a weak D as Rh negative (from 58.2% to 19.8%, P < .001). Data from RHD genotyping studies indicate that approximately 95% of women with a serological weak D could be managed safely and more logically as Rh positive. Conclusions.—Selective integration of RHD genotyping policies and practices could improve the accuracy of Rh typing results, reduce unnecessary administration of Rh immune globulin in women with a weak D, and decrease transfusion of Rh-negative red blood cells in most recipients with a serological weak D phenotype.

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“…Hasekura et al . have suggested that some DELs were caused by a trans effect of C on a haplotype containing a weak D allele [18]. Whether the D VI -like DEL has a similar mechanism, that the DEL was resulted from the influence of C in trans on a haplotype with a partial D allele, needs to be further analysed.…”

Section: Discussionmentioning

confidence: 99%

Molecular basis of DEL phenotype in the Chinese population

Wang

Shao

et al. 2014

BMC Med Genet

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BackgroundRh blood group system is the most complex and immunogenetic blood group system. Prevalent RHD alleles vary in different populations. We conducted the present study to examine the genotype of DEL individuals and to elucidate whether novel alleles exist in the Chinese population.MethodsDEL phenotype was identified by a serologic adsorption-elution method. The nucleotide sequences of ten RHD exons and exon-intron boundary regions were evaluated by RHD gene-specific PCR-SSP and sequencing.ResultsOf 42306 samples from individual donors and patients, 165 samples were typed as D-negative. Among these D-negative samples, 41 DEL individuals were observed. Thirty-seven DELs were confirmed to have the RHD1227A allele. Two DELs seemed to have RHD-CE-D hybrid alleles, including one RHD-CE (4–7)-D and one RHD-CE (2–5)-D. Two novel RHD alleles were found among the rest of the DEL samples, including one RHD93T > A and one RHD838G > A.ConclusionIn this study, about 24.85% (41/165) of the apparent D-negative Chinese individuals were DEL. RHD1227G > A is the most frequent allele in Chinese DEL phenotypes, accounting for 90.24% (37/41). The RHD-CE-D hybrid allele might be the second most frequent DEL allele in the Chinese population. Our study would contribute to the understanding of the molecular mechanism underlying D antigen expression of DEL individuals and provide useful information for designing suitable genotyping strategies in RhD-negative individuals in Asia.

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Flow cytometric studies of the D antigen of various Rh phenotypes with particular reference to D^u and D_el

Cited by 26 publications

References 9 publications

Molecular genetics and clinical applications for RH

Molecular genetics and clinical applications for RH

Policies and Procedures Related to Testing for Weak D Phenotypes and Administration of Rh Immune Globulin: Results and Recommendations Related to Supplemental Questions in the Comprehensive Transfusion Medicine Survey of the College of American Pathologists

Molecular basis of DEL phenotype in the Chinese population

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Flow cytometric studies of the D antigen of various Rh phenotypes with particular reference to Du and Del

Cited by 26 publications

References 9 publications

Molecular genetics and clinical applications for RH

Molecular genetics and clinical applications for RH

Policies and Procedures Related to Testing for Weak D Phenotypes and Administration of Rh Immune Globulin: Results and Recommendations Related to Supplemental Questions in the Comprehensive Transfusion Medicine Survey of the College of American Pathologists

Molecular basis of DEL phenotype in the Chinese population

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Flow cytometric studies of the D antigen of various Rh phenotypes with particular reference to D^u and D_el