Identification of common and new rare types of weak RhD antigen in patients with blood diseases and healthy person

Головкина, Л. Л.; Каландаров, Р. С.; Pshenichnikova, O. S.; Surin, V. L.; Стремоухова, А Г; Пушкина, Т. Д.; Хасигова, Б. Б.

doi:10.17650/1818-8346-2019-14-3-52-59

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…Якщо уявлення про систему АВО залишаються майже незмінними, то знання про систему Резус (Rh), з часу відкриття і по сьогодні, збагачуються все новими даними [3].…”

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Serologically Weak D-phenotype: Review and Interpretation of Blood Group RhD

Pavliuk¹

2020

Ukr. ž. med. bìol. sportu

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The Rhesus system is the second most important erythrocyte system for transfusion after ABO. Accurate determination of the Rhesus status of the donor, recipient, pregnant allows to prevent the development of post-transfusion hemolytic complications of the fetus or newborn associated with incompatibility of the blood of the mother and the fetus by D antigen. Generally, determination of the Rhesus affiliation of a person is performed by serological methods using anti-Rhesus reagents with full or incomplete antibodies. However, the results of serological studies are not always clear. Mutations and other effects of the RH gene locus disrupt the production of the normal D antigen and lead to the emergence of numerous varieties of antigen D. The variant of antigen D was described in 1946 and was designated as Du. The study showed that the differences between Du antigen and normal D were quantitative rather than qualitative. The Du antigen was later designated as Dweak - a weak D-antigen or a weak D-phenotype. In the early 1950s, anti-D antibodies were detected in recipients with a weak D-antigen after transfusion with Rh-positive blood and in pregnant women with the Du phenotype during pregnancy and at the birth of a D+ baby. It was suggested that the D antigen was not homogeneous and consisted of numerous partial variants: D1, D2, D3, etc. A complete set of partial variants corresponds to a complete D-antigen. The absence of any of one or more partial factors leads to the appearance of attenuated forms of the D antigen, denoted as Dpartial. People lacking certain partial antigens can produce anti-D antibodies against them. Differentiation of weak D phenotypes has great clinical importance, because transfusion of Rh-erythrocytes to recipients with Dweak and who are actually Rh-positive, has no scientific justification and leads to unjustified consumption of deficient blood and unnecessary immunoprophylaxis of anti-Rh immunoglobulin to pregnant women. International laboratory practice has no unified policy regarding the diagnosis of weak variants of D antigen and the interpretation of the results. Polymerase chain reaction allows to accurately define the Rh status of an individual and to avoid unreasonable transfusions of Rh-negative blood and unnecessary immunoprophylaxis

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Serologically Weak D-phenotype: Review and Interpretation of Blood Group RhD

Pavliuk¹

2020

Ukr. ž. med. bìol. sportu

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RHD and RHCE genes polymorphism: literature review

Головкина¹,

Каландаров²

2020

Onkogematologiâ

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The article provides a literature review about RHD and RHCE polymorphisms which encode different RhD and RhC antigen variants. The data about genes RHD and RHCE polymorphisms, RhD weak types, RhD partial types and RhC variants in Russians is presented for the first time. The molecular and serological characteristics of rare RhD and RhC antigens are summarized. The role of serological and molecular methods in Rhesus system antigens identifying is shown.

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Molecular methods in identifying the true grouping of erythrocytes in patients with blood system diseases before transplantation of hematopoietic stem cells and their donors

et al. 2022

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Background. when transplantation of hematopoietic stem cells (HSC) is performing, it is necessary to take into account the incompatibility of the donor and recipient in terms of erythrocyte antigens in order to assess the possibility of immunological complications during HSC transfusion and/or graft engraftment (acute hemolysis, delayed hemolysis, etc.). The results of serological research methods do not always allow identifying the true group affiliation due to posttransfusion chimerism in patients and/or the presence of antigen allelic polymorphism.Aim. To establish the frequency of ABO-incompatible allo-HSC transplantations in the National Research Center for Hematology, to determine by molecular methods the group affiliation of patients with a weakened expression of antigens and/or after multiple blood transfusions before HSC transplantation, to clarify the blood type of HSC donors with a weakened expression of antigens.Materials and methods. The blood of 270 HSC donor-recipient couples was examined. The blood group of the ABO, Rhesus, MNS, Kell systems was determined in a plane agglutination test using the corresponding IgM class Tsoliclones and in gel cards. Genotyping was performed by polymerase chain reaction with primers to identify the genes of the ABO, Rhesus, Kell, and MNS systems.Results. In 2018-2020 270 HSC transplantations were performed at the National Research Center for Hematology. In 141 (52.22 %) couples, incompatibility of the donor and recipient according to the ABO system was revealed: major - 23.33 %, minor - 20 %; bidirectional - 8.89 %. problems in assessing of serological results were observed in 97 (36.3 %) patients: in 78 patients with post-transfusion chimerism and 19 patients with weakened antigen expression; in 15 (5.56 %) HSC donors: in 4 due to the lack of information about the blood group of cryopreserved cells, in 10 due to weakened antigen expression, in 1 to search for informative markers for monitoring HSC engraftment. The results of the study demonstrated that the percentage of agglutinated erythrocytes in post-transfusion chimerism cannot be a reliable criterion for establishing the true phenotype of a patient. In donors and patients with weakened expression of antigens, the presence of ABO*O1, -A1, -A2, -B1, RHD weak type 1, RHD weak type 2, RHD weak type 3, RHCE*Cw genes was confirmed. for the first time in Russia gene RHCE*01.38 was found.Conclusion. The prevalence of ABO-incompatible HSC transplants was noted. problems with serological determination of the blood group in a third of patients before HSC transplantation arose due to the presence of post-transfusion chimerism and weakened expression of antigens. Determining of the genotypes of HSC donors is necessary when the expression of antigens is weakened and cryopreserved cells are received. The percentage of agglutinated erythrocytes in post-transfusion chimerism cannot be a reliable criterion for establishing the true phenotype of a patient. Detection of mixed chimerism in the determination of group factors by serological methods is an indication for genotyping, especially in the context of the predominance of incompatible HSC transplantations.

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Identification of common and new rare types of weak RhD antigen in patients with blood diseases and healthy person

Cited by 4 publications

References 21 publications

Serologically Weak D-phenotype: Review and Interpretation of Blood Group RhD

Serologically Weak D-phenotype: Review and Interpretation of Blood Group RhD

RHD and RHCE genes polymorphism: literature review

Molecular methods in identifying the true grouping of erythrocytes in patients with blood system diseases before transplantation of hematopoietic stem cells and their donors

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