Chen Tai-Di, Chen Ding-Ping, Wang Wei-Ting, Sun Chien-Feng
Department of Anatomic Pathology, Chang Gung Memorial Hospital, Taoyuan County, Taiwan.
Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan County, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan County, Taiwan.
PLoS One. 2014 May 23;9(5):e98166. doi: 10.1371/journal.pone.0098166. eCollection 2014.
Glycophorin variants of the MNSs blood group are important in Taiwan. For more than 20 years, screening for the most frequent irregular antibody, anti-''Mi(a)', has been conducted by using 'Mi(a)'(+) RBCs, with a significant success. However, the sensitivity and the specificity of this screening strategy have never been validated, and the true incidences of different glycophorin variants in Taiwan have been in controversy. Also, the significance of another less frequent and usually separately reported variant, St(a), has never been evaluated.
METHODOLOGY/PRINCIPAL FINDINGS: We ran a population-based screening (from unselected patients in our hospital) for MNSs blood group glycophorin variants by PCR-sequencing method. GP.Mur (Mil.III) was confirmed by sequence from 57 out of 1027 samples (5.6%), and there was no other Miltenberger subtype glycophorin variant found. Glycophorin variant St(a) was found from 35 out of 1027 samples (3.4%). In contrast to anti-'Mi(a)', which is the most frequently identified irregular antibody in Taiwan, the prevalence of anti-St(a) was only 0.13% as determined by serologic method. In addition, two new alleles for St(a) were found and reported.
CONCLUSION/SIGNIFICANCE: We confirm the long-standing assumption that GP.Mur is the only prevalent Miltenberger subtype in Taiwan. The current anti-'Mi(a)' screening method used in Taiwan, although neither sensitive nor specific, is still a suitable practice. Although St(a) antigen has a high prevalence in Taiwan, routine screening for anti-St(a) is not warranted based on current evidence.
MNSs血型系统的血型糖蛋白变体在台湾地区很重要。二十多年来,一直使用“Mi(a)”阳性红细胞对最常见的不规则抗体抗“Mi(a)”进行筛查,并取得了显著成效。然而,这种筛查策略的敏感性和特异性从未得到验证,台湾地区不同血型糖蛋白变体的真实发生率也一直存在争议。此外,另一种较罕见且通常单独报道的变体St(a)的意义从未被评估过。
方法/主要发现:我们通过聚合酶链反应测序法对本院未经过筛选的患者进行了基于人群的MNSs血型系统血型糖蛋白变体筛查。在1027份样本中,有57份(5.6%)通过测序确认存在GP.Mur(Mil.III),未发现其他密尔滕贝格亚型血型糖蛋白变体。在1027份样本中,有35份(3.4%)发现了血型糖蛋白变体St(a)。与台湾地区最常鉴定出的不规则抗体抗“Mi(a)”不同,通过血清学方法测定,抗St(a)的流行率仅为0.13%。此外,还发现并报道了两个新的St(a)等位基因。
结论/意义:我们证实了长期以来的假设,即GP.Mur是台湾地区唯一普遍存在的密尔滕贝格亚型。台湾地区目前使用的抗“Mi(a)”筛查方法虽然既不敏感也不特异,但仍然是一种合适的做法。尽管St(a)抗原在台湾地区的流行率很高,但根据目前的证据,没有必要对抗St(a)进行常规筛查。