Xiong Yuqi, Zou Shuying, Zou Xin, Ma Sifei, Yang Hongmei
Changzhou Blood Center, Changzhou Key Specialized Laboratory of Clinical Blood Transfusion, Changzhou, China.
Changzhou Blood Center, Changzhou Key Specialized Laboratory of Clinical Blood Transfusion, Changzhou, China.
Transfus Apher Sci. 2025 Jun;64(3):104157. doi: 10.1016/j.transci.2025.104157. Epub 2025 May 14.
Red cell antibodies of a certain specificity are produced following the immunization of a corresponding antigen-negative individual through pregnancy or transfusion, such as RhCcEe allogeneic infusion. The transfusion incompatibility of RhC/c and RhE/e can be estimated based on the proportion of the RhCcEe phenotype. DEL has been positively correlated with RhC and RhE phenotypes. Elucidating the RhCcEe phenotype may facilitate the identification and screening of DEL variants.
The risk of alloimmunization due to RhC/c and RhE/e incompatibility were estimated by analyzing the frequency of RhCcEe phenotypes in 783 RhD negative blood donors and more than 458,000 RhD positive individuals. DEL screening was performed on RhC+ and/or RhE+ samples from RhD negative population. A total of 106 RhC+ and(or) RhE+ RhD negative blood donors were selected for DEL screening using an absorption and elution test, fluorescent probe-based quantitative PCR, and RHD sequencing.
Significant differences in RhCcEe phenotype distribution were observed between RhD positive and RhD negative Chinese individuals. Among RhD-positive Chinese individuals, the transfusion incompatibility rates for E/e and C/c were notably high at 31.09 % and 34.04 %, respectively. The highest alloimmunization risks were observed for anti-c (24.889 %), followed by anti-E (24.731 %). The RhD negative population had the highest alloimmunization risk of anti-C(24.257 %). Among the 106 RhC+ and(or) RhE+ D-negative samples, thirty-four DELs were observed, with a proportion of 16.27 %. Thirty-two DELs were confirmed to have the RHD 1227G>A allele. Two DEL cases have RHD-CE-D hybrid alleles, including one RHD-CE(3-9)-D and one RHD-CE(3-6)-D.
We have determined the prevalence of RhCcEe phenotypes in Chinese and derived the incompatibility of E/e and C/c in the same population, enabling the estimation of their potential alloimmunization risk. The RhC+ phenotype, in conjunction with the anti-D adsorption-elution test and the RHD 1227A allele PCR technique, can effectively differentiate true RhD-negative individuals from those with the DEL phenotype.
特定特异性的红细胞抗体是在相应抗原阴性个体通过妊娠或输血（如RhCcEe同种异体输注）免疫后产生的。RhC/c和RhE/e的输血不相容性可根据RhCcEe表型的比例来估计。DEL与RhC和RhE表型呈正相关。阐明RhCcEe表型可能有助于DEL变异体的鉴定和筛查。
通过分析783名RhD阴性献血者和超过45.8万名RhD阳性个体的RhCcEe表型频率，估计RhC/c和RhE/e不相容性导致的同种免疫风险。对RhD阴性人群中RhC+和/或RhE+样本进行DEL筛查。使用吸收和洗脱试验、基于荧光探针的定量PCR和RHD测序，对106名RhC+和（或）RhE+ RhD阴性献血者进行DEL筛查。
在RhD阳性和RhD阴性中国人中观察到RhCcEe表型分布存在显著差异。在RhD阳性中国人中，E/e和C/c的输血不相容率分别高达31.09%和34.04%。观察到抗-c（24.889%）的同种免疫风险最高，其次是抗-E（24.731%）。RhD阴性人群中抗-C的同种免疫风险最高（24.257%）。在106份RhC+和（或）RhE+ D阴性样本中，观察到34例DEL，比例为16.27%。32例DEL被证实具有RHD 1227G>A等位基因。2例DEL病例具有RHD-CE-D杂交等位基因，包括1例RHD-CE(3-9)-D和1例RHD-CE(3-6)-D。
我们确定了中国人中RhCcEe表型的流行情况，并得出了同一人群中E/e和C/c的不相容性，从而能够估计其潜在的同种免疫风险。RhC+表型结合抗-D吸收洗脱试验和RHD 1227A等位基因PCR技术，可以有效地将真正的RhD阴性个体与具有DEL表型的个体区分开来。
