Rattanawiriyachai Pichsinee, Khumsuk Piyathida, Intharanut Kamphon, Khantisitthiporn Onruedee, Sasikarn Wiradee, Nathalang Oytip
Graduate Program in Medical Technology, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani, Thailand.
Blood Bank, Sirinthorn Hospital, Bangkok, Thailand.
Transfus Med Hemother. 2025 Apr 14:1-6. doi: 10.1159/000545810.
The MNS7 (Mi) is a low-prevalence antigen associated with GP.Mur hybrid glycophorin, which is high in Thai populations. Consequently, anti-Mi, particularly anti-Mur caused by alloimmunisation is involved in transfusion medicine. In Thailand, before the first transfusion of transfusion-dependent patients with thalassemia, typing of Mi and Rh antigens is minimally required to provide phenotype-matched donors. A patient with Mi-positive phenotype encoded by homozygote (do not express GPB, JENU-negative) receiving either Mi-negative or Mi-positive phenotype can produce anti-JENU, leading to difficulty in locating compatible donors. Genotyping for hybrid alleles to predict the JENU-negative phenotype is alternatively implemented. This study aimed to predict the JENU-negative phenotype in multitransfused Thai patients using PCR-based coupled DNA sequencing.
Blood samples from 861 multitransfused Thai patients were included. Mi antigen testing was performed using serology and PCR-sequence-specific primer. () hybrid alleles were analyzed using Sanger DNA sequencing. Only 5 of 68 patients receiving more than 40 red cell units developed alloantibodies. The sequence analysis revealed that 60 of 68 patients carried the allele, including / heterozygotes (86.76%) and the / homozygote (1.47%). The remaining 8 patients were / heterozygotes (10.29%) and / heterozygotes (1.47%). The , , and alleles were not observed. One female patient with JENU-negative phenotype received 24 red cell transfusions within 1 year without alloantibody production, which might be due to the number of red blood cell (RBC) units or her disease status.
Concerning this study, multiple transfusions can induce alloantibody production. Therefore, phenotype-match transfusions are beneficial among patients with long-term transfusion therapy, and further investigation of the JENU-negative phenotype is suggested.
MNS7（Mi）是一种与GP.Mur杂合血型糖蛋白相关的低频率抗原，在泰国人群中其频率较高。因此，同种免疫引起的抗-Mi，尤其是抗-Mur，在输血医学中具有重要意义。在泰国，对于依赖输血的地中海贫血患者，在首次输血前，最少需要进行Mi和Rh抗原分型，以提供表型匹配的供者。具有纯合子编码的Mi阳性表型（不表达GPB，JENU阴性）的患者接受Mi阴性或Mi阳性表型的血液时，可能会产生抗-JENU，导致难以找到相容的供者。另外也可通过对杂合等位基因进行基因分型来预测JENU阴性表型。本研究旨在利用基于聚合酶链反应（PCR）的双链DNA测序法预测多次输血的泰国患者的JENU阴性表型。
纳入861例多次输血的泰国患者的血样。采用血清学方法和PCR序列特异性引物进行Mi抗原检测。使用桑格DNA测序法分析（）杂合等位基因。在接受超过40个红细胞单位输血的68例患者中，只有5例产生了同种抗体。序列分析显示，68例患者中有60例携带等位基因，包括/杂合子（86.76%）和/纯合子（1.47%）。其余8例患者为/杂合子（10.29%）和/杂合子（1.47%）。未观察到、、和等位基因。一名具有JENU阴性表型的女性患者在1年内接受了24次红细胞输血，未产生同种抗体，这可能与红细胞单位数量或其疾病状态有关。
关于本研究，多次输血可诱导同种抗体产生。因此，对于长期接受输血治疗的患者，进行表型匹配输血是有益的，建议对JENU阴性表型进行进一步研究。
