New York Blood Center, New York, NY 10021, USA.
Hematology Am Soc Hematol Educ Program. 2009:171-7. doi: 10.1182/asheducation-2009.1.171.
DNA-based tests are increasingly being used to predict a blood group phenotype to improve transfusion medicine. This is possible because genes encoding 29 of the 30 blood group systems have been cloned and sequenced, and the molecular bases associated with most antigens have been determined. RBCs carrying a particular antigen, if introduced into the circulation of an individual who lacks that antigen (through transfusion or pregnancy), can elicit an immune response. It is the antibody from such an immune response that causes problems in clinical practice and the reason why antigen-negative blood is required for safe transfusion. The classical method of testing for blood group antigens and antibodies is hemagglutination; however, it has certain limitations, some of which can be overcome by testing DNA. Such testing allows conservation of antibodies for confirmation by hemagglutination of predicted antigen-negativity. High-throughput platforms provide a means to test relatively large numbers of donors, thereby opening the door to change the way antigen-negative blood is provided to patients and to prevent immunization. This review summarizes how molecular approaches, in conjunction with conventional hemagglutination, can be applied in transfusion medicine.
基于 DNA 的检测方法越来越多地被用于预测血型表型，以改善输血医学。之所以如此，是因为已经克隆和测序了编码 30 个血型系统中的 29 个的基因，并且确定了与大多数抗原相关的分子基础。将携带特定抗原的 RBC 引入缺乏该抗原的个体（通过输血或妊娠）的循环中，会引发免疫反应。正是这种免疫反应产生的抗体在临床实践中造成了问题，这也是为什么需要抗原阴性的血液进行安全输血的原因。检测血型抗原和抗体的经典方法是血凝法；然而，它存在某些局限性，其中一些局限性可以通过检测 DNA 来克服。这种检测可以保存抗体，以备通过预测的抗原阴性的血凝法进行确认。高通量平台提供了一种方法来测试相对大量的供体，从而为改变向患者提供抗原阴性血液的方式并预防免疫提供了可能。本综述总结了分子方法如何与传统的血凝法结合应用于输血医学。
