Shanghai Institute of Transfusion Medicine, Shanghai Blood Center, and School of Life Science, East China Normal University, Shanghai, China.
Transfusion. 2012 Feb;52(2):241-6. doi: 10.1111/j.1537-2995.2011.03266.x. Epub 2011 Jul 25.
The D variant phenotypes are often categorized into weak D types and partial D types. Although the molecular basis underlying the partial D phenotype has been investigated in several races, data from Chinese populations are rare.
We collected partial D samples from 1,274,540 blood donors, as well as from sporadic patients in the Chinese population, over a 4-year period. Samples with partial D phenotype were determined by commercial monoclonal anti-D panels and molecular methods. Blood samples with discrepant results of serologic and molecular methods were further investigated by polymerase chain reaction (PCR) with sequence-specific primers and nucleotide sequencing of RHD exons. The detection of antibodies was performed.
A total of 44 samples with partial D phenotypes were confirmed. Molecular typing revealed five different known aberrant alleles as well as four new RHD alleles. As described previously, DVI represented the most frequent partial D type in China with a total of 36 samples. However, discrepant results were observed in four DVI samples with serotyping and genotyping (i.e., DVI category identified by D-screen test and grossly intact RHD gene identified by multiplex PCR). We also found four novel alleles, termed DFR-4, DCS-3, DCC, and DLX.
To date, this study presents the most comprehensive report on partial D in China. The distribution of partial D types in China was found to be complicated and polymorphic, whereas RhD genotyping of DVI-variant samples might give inaccurate results due to a relatively high incidence of RHD(1227G>A) in the Chinese population.
D 变异表型通常分为弱 D 型和部分 D 型。尽管部分 D 表型的分子基础已在多个种族中进行了研究,但来自中国人群的数据却很少。
我们在 4 年内收集了来自 1,274,540 名献血者以及中国人群中散发性患者的部分 D 样本。使用商业单克隆抗-D 面板和分子方法确定具有部分 D 表型的样本。对血清学和分子方法结果不一致的血液样本进行进一步研究,采用聚合酶链反应(PCR)与序列特异性引物和 RHD 外显子核苷酸测序。检测抗体。
共确认了 44 例部分 D 表型样本。分子分型显示了五种不同的已知异常等位基因以及四种新的 RHD 等位基因。如前所述,DVI 是中国最常见的部分 D 型,共有 36 例。然而,在 4 例 DVI 样本中观察到血清学分型和基因分型结果不一致(即 D 筛检试验确定的 DVI 类别和多重 PCR 确定的大致完整的 RHD 基因)。我们还发现了四个新的等位基因,称为 DFR-4、DCS-3、DCC 和 DLX。
迄今为止,本研究是中国关于部分 D 最全面的报告。中国部分 D 型的分布复杂且多态性,而由于中国人群中 RHD(1227G>A)的发生率相对较高,DVI 变异样本的 RhD 基因分型可能会得出不准确的结果。