The D^uPhenoype, Serology, and Clinical Relevance

Abstract

In this article, the authors examine the nature of the Du phenomenon through a comprehensive historical review beginning with the initial description of the Du factor in the 1940s. Pertinent developments in serologic testing methods and genetic concepts are described. Evidence of the importance of the Du factor in transfusion and hemolytic disease of the newborn is also presented. Selected articles on the frequency of Du in Caucasian and Negro populations are cited. Finally, the authors review current theoretical concepts concerning the nature of the Du factor, its importance in current transfusion practice and maternal Rh immune globulin administration, and the use of microscopic Du testing as a screening procedure for fetomaternal hemorrhage.

Do we need to be more concerned about weak D antigens?

“…Approximately one‐third of D– Oriental persons are DEL and thus are truly D+. Weak D is more common in individuals with an African background 16 . Detection of the hybrid Rhesus box in African RHD genomes is complex 22,43 .…”

“…In 1992, D u was renamed “weak D” (by the 2003 Nobel laureate Peter Agre and colleagues) 10 . A review of relevant publications 11‐26 will give the readers of this Editorial a feeling for the impact of the problems and/or controversies in these areas. More recently, there have been added complexities because of findings concerning weak or partial D at the DNA level 27‐36 .…”

Production and Characterization of Human‐Human and Human‐Mouse Hybridomas Secreting Rh(D)‐Specific Monoclonal Antibodies

“…D", though originally used to describe a red cell phenotype involving a weakened D antigen expression only detectable by an indirect globulin test, is also used to refer to the group of D mosaic red cells which lack portions of the common Rh(D) antigen [14,17]. D mosaic individuals whose red cells display a variable reactivity with different preparations of anti-Rh(D) are capable of producing anti-Rh(D) on exposure to normal Rh(D) antigen.…”

“…The inability of any of the MoAb to agglutinate red cells from the D" categories DV and DVI is not of major concern in blood-typing, since it is preferable to consider mothers and transfusion recipients of these phenotypes as Rh negative so as to prevent unnecessary exposure to the Rh(D) antigen [14].…”

Μοριακή ανάλυση των φαινοτύπων του αντιγόνου D του αντιγονικού συστήματος Rhesus και μελέτη της πολυμορφίας του

“…Ο κύριος προβληματισμός ήταν αν οι λήπτες μετάγγισης με φαινοτύπους weak D ή οι έγκυες γυναίκες θα ευαισθητοποιηθούν και θα παράγουν anti-D αντισώματα, και αν ερυθροκύτταρα με φαινότυπο weak D μπορούσαν να ευαισθητοποιήσουν έναν RhD αρνητικό λήπτη ή μια έγκυο γυναίκα. Στις περιπτώσεις αυτές, όταν πρόκειται για αιμοδότες με φαινότυπο weak D, αυτοί χαρακτηρίζονται ως RhD θετικά άτομα, ενώ όταν πρόκειται για δέκτες ως RhD αρνητικά [186][187][188][189][190][191][192] .…”