A comprehensive analysis of DEL types:: partial DEL individuals are prone to anti-D alloimmunization
A comprehensive analysis of DEL types:: partial DEL individuals are prone to anti-D alloimmunization
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DOI：
10.1111/j.1537-2995.2005.00584.x
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发表时间：
2005-10-01
期刊：
影响因子：
2.9
通讯作者：
Legler, TJ
中科院分区：
文献类型：
--
作者：
Körmöczi, GF;Gassner, C;Legler, TJ
背景资料：多态性Rh血型系统的D抗原对于输血和妊娠诱导的同种异体免疫具有特别的临床重要性。具有特定临床意义的不同RhD变体已被表征。最少表达的D变种统称为DEL是血清学检测只能通过吸附洗脱技术，到目前为止只有不明确的抗原properties.Study设计和方法：一个全面的免疫血液学分析的六个目前已知的DEL基因型进行。与RHD相关的DEL表型（M2951），RHD（IVS3+1g > a）、RHD（K409K）、RHD（X418L）或RHD（IVS 5 - 38 del 4）等位基因的检测采用扩展血清学和流式细胞术。吸附-洗脱表位作图显示RHD中D表位丢失显著（IVS 3 +1g > a）相关的DEL表型，而在其他四种DEL类型中，未检测到D抗原定性改变的迹象。在两例RHD（IVS 3 +1g > a）中观察到的同种抗D证实了这种DEL表型的部分性质。RHD（M2951）表型表现出最高的D抗原表达在所有调查的DEL类型，确定通过半定量吸附洗脱方法和流式细胞术。结论：总之，证据提供了不同的DEL基因型编码部分或完整的D抗原表达，这一发现是临床相关的。
Background: The D antigen of the polymorphic Rh blood group system is of particular clinical importance regarding transfusion- and pregnancy-induced alloimmunization. Different RhD variants with specific clinical implications have been characterized. The least expressed D variants collectively called DEL are serologically detectable only by adsorption-elution techniques, with so far only poorly defined antigenic properties.Study Design and Methods: A comprehensive immunohematologic analysis of five of the six currently known DEL genotypes was performed. DEL phenotypes associated with the RHD(M2951), RHD(IVS3+1g > a), RHD(K409K), RHD(X418L), or RHD(IVS5-38del4) allele were characterized with extended serology and flow cytometry.Results: Epitope mapping with adsorption-elution revealed a prominent D epitope loss in the RHD(IVS3+1g > a)-associated DEL phenotype, whereas in the other four DEL types no signs of qualitative D antigen alteration were detected. The observation of alloanti-D in two RHD(IVS3+1g > a) cases confirmed the partial nature of this DEL phenotype. The RHD(M2951) phenotype exhibited the highest D antigen expression among all investigated DEL types, as determined by a semiquantitative adsorption-elution approach and flow cytometry.Conclusion: In conclusion, evidence is provided that different DEL genotypes code either for partial or complete D antigen expression and that this finding is clinically relevant.