1. 1. J Med Tech Assoc Thailand, Vol. 43 No. 1, April 2015 Review Article The Differences of Nine Blood Groups System in the Three Major Ethnicities of Human Kallaya Kerdkaewngam* and Jintana Tubrod Antiserum and Standard Cells Production Section, National Blood Centre, Thai Red Cross Society, Bangkok, Thailand. Abstract The Homo sapiens is classified into three main ethnicities: Caucasoids, Negroids and Mongoloids.Eachethnicgroupisdifferentingenetictraitsandbloodtypes.Studyofbloodtypes inhumansfromvariousethnicgroupsgivesbenefitinmanyfieldsofscience.TheNationalBlood Centre, Thai Red Cross Society, with its important role in blood banks and transfusion services has seriously studied the differences in blood types in response to availability of various ethnic blood donors. Each ethnic group has specific differences in rare blood types. Some rare blood types exist predominantly in Mongoloids such as variant MNS or Miltenberger subclasses and Dia positive which were found in Thais at about 9.1 and 2.99%, respectively. Rare blood types Fy(a-b-) were found in Negroids at about 67%. Caucasoids also have 15% of Rh negative blood type. The study of rare blood types is absolutely essential for management of rare blood types for transfusion services and reducing the risk of rare blood types shortage. Antiserum and Standard Cells Production Section, National Blood Centre, produces standard cells including screening cells, pool O cells and identification panel cells that require rare blood types as raw materials in production. These products are distributed to blood banks in various hospitals throughout Thailand for red blood cell antibodies screening and identification in blood donors and patients who need blood transfusion. Key words: Ethnicities, Caucasoids, Negroids, Mongoloids, Rare blood types *Corresponding author E-mail address: kallayak@yahoo.com
2. 2. 43 1 2558 * (Caucasoids) (Negroids) (Mongoloids) (rarebloodtypes) variant MNS Miltenberger subclasses 9.1 Dia positive 2.99 Fy(a-b-) 67 Rh negative 15 rarebloodtypes screeningcells, pool O cells identification panel cells rare blood types : *: E-mail address: kallayak@yahoo.com
3. 3. 5129 (blood transfusion) (organ transplant) (human genetics) (human migration) (anthropology) (human evolution) (forensics science) (hemolytic disease of fetus and newborn: HDFN)(1),(2) (Cauca- soids) (Negroids) (Mongoloids) (1), (3-5) (mutation) (species) (4-7) (rare bloodtype) variant MNS 9.1 Dia positive 2.99 Fy(a-b-) 67 Rh negative 15 Rh negative, Fy(a-b+) rarebloodtypes screening cells, pool O cells identification panel cells rare blood types rare blood types ABO 1900 Landsteiner agglutination agglutination A B agglutination C O ABO ABO
4. 4. 5130 ABO O 44 49 43 A 43 27 27 B 9 20 25 AB 4 4 5(2), (6), (8), (9) ABO 3 A, B A1 oligosaccharide ABO 3 9 9q34.1-q34.2 A B glycosyl transferase A transferase B transferase N-acetyl-D-galactosamine A D-galactose B H H precursor ABO(9), (10) A B O glycosyl transferase deletion single nucleotide reading frame shift stop codon groupO nullphenotype ABO(8) group O H A B ABO A2, A3, B3 subgroup A B A transferase B transferase A B serology(8-10) Rh Rh ABO D Rh negative anti-D Rhnegative 15 Rh negative deletion RHD genome D RHCE Cc Ee RHD (crossing over) meiosis I RHCE RHD variant alleles Rh phenotype (9), (11), (12) Rhnull, Rh DEL, Partial D weak D Rhnull Rh RHAG (Rh-associatedglycoprotein) 6 6p11-p21.1 RHAG glycoprotein N-glycan
5. 5. 5131 D, C E RHAG RhAG RhD RhCE Rhnull phenotype Rh (stomato-spherocytosis) (12) Rhnull Rhnull Rh DEL DEL phenotype D D D anti- globulin test Absorption-elution Okubo 1984(13) Rh DEL Rh negative Anti-D RhDEL Rh DEL Rh negative Rh DEL Rh negative Rhnegative phenotype Rh rr(D-C-E-c+e+) Rh DEL phenotype rr(D-C+E-c+e+), rr (D-C-E+c+e+) rr(D-C+E+c+e+) phenotype Rh rr (D-C-E-c+e+) phenotype Rh Anti-D(12) partial D weak D phenotype RHD D D epitope epitope partialD RHD hybrid RHCE D anti-D epitope D D agglutina- tion monoclonal anti-D weak D D 70 5,200 D Rhpositive D 15,000 (R1r) 33,000 (R2R2) (12) Rh 12 MNS MNS M, N, S s M N glycophorins A S s glycophorins B variant alleles Rh GYPA GYPB 4 4q28.2-q13.1 GYPA 6 exons 60Kbp GYPB 5exons 1 exon pseudoexon
6. 6. 5132 58 kbp(8), (9) GYPA glycophorinsA GYPB glycophorinsB meiosis I (generearrangement) (hybrid) glycophorins A glycophorins B variant alleles Miltenberger series Mia variant MNS Verweyst (Vw), Miltenberger (Mia), Murrell (Mur), Hill (Hil), Hut, Hop, Nob, DANE, MUT, TSEN MINY(14), (15) GYPA GYPB single crossing over, double crossing over gene conversion single crossing over GYPA GYPB meiosis I GYP (B-A) hybrid GYPA GYPB double crossing over GYPA GYPB GYP(A-B-A) GYP (B-A-B) gene conversion hybrid alleles glycophorins phenotype MNS phenotype En (a-) glycophorins A phenotype S-s-U- deletion GYPB phenotype MkMk glycophorins A glycophorins B GYPA GYPB deletion phenotype (8) variantMNS 11classes class MiIII(16) (14) hybrid glycosphorins A glycosphorins B 10 (17), (18) P GLOB Collection P 5 P, P1, Pk, LKE (Luke) p P1 Landsteiner Levine 1927 Pk Sanger 1955 Matson P 1965 Tippett LKE (Luke) 1990 International Society of Blood Transfusion (ISBT) P P1 P, Pk LKE (Luke) unnamed collection 1991 collection globoside(GLOBO) 1996 GLOB P GLOBCollection P, P1 Pk
7. 7. 5133 precursor glucosylation ceramide beta-galactose lactosylce- ramide (Laccer) precursor globoside paragloboside P Pk globoside P1 paraglobo- side(19) P1, P2, p, P1 k P2 k phenotype nullphenotype P GLOB Collection p phenotype Pk,P P1 rare phenotype P2 k phenotype P P1 P1 k phenotype P pphenotype 5.8 Vsterbotten p phenotype 141 p phenotype Amish p phenotype anti-Tja anti-P1PPk HDFN anti-P1PPk IgM potent hemolysis P1, P Pk (hemolytic transfusion reaction: HTR) p phenotype hemolysis pphenotype pphenotype Ume p phenotype Anti- P1PPk (19), (20) B3GALNT1 P 3 5 exons 3--N-acetylgalactosaminyltransferase globoside4 P type II transmembrane glycoprotein ( 3GalNAc-T1, EC 2.4.1.79) 331 N-gly- cosylation sites A4GALT Pk 22 2 3 exons type II transmembrane glycoprotein 353 A4GALT 4 548T>A (M183K), 560G>A (G187D), 752C>T(P251L) 783G>A (W261X) p phenotype P1 LKE P1 A4GALT Pk 22q11.3 22q13.2 LKE (20) Lewis Lewis glycolipids
8. 8. 5134 (15) Lewis IgM phenotype Le(a-b-) phenotype Le(a+b-) phenotype Le(a-b+) anti-Lewis HTR HDFN renal transplant rejection anti-Lea 1946 Mourant agglutina- tion 37 HDFN natural occurring antibody agglutination 25 Andresen anti-Leb agglutination O A2 Le(a-b+) Brendemoen anti-Leb agglutination A B O anti-Leb anti-LebH anti-LebL Lewis IgM Lewis phenotype FUT2 secretor (SE) gene FUT3 Lewis (LE) gene 6 Lea Leb Leab LebH A Leb B Leb Lewis ABH ABO Lewis secretor (SE) phenotypeLe(a+b-) non-secretor FUT2 phenotypeLe(a-b+) secretor phenotypeLe(a-b-) secretor non-secretor phenotype Le(a+b+) secretor (20), (22) phenotype Le(a-b-) 30(21) Lewis anti-Lea+b phenotype Le(a-b-)(22) Kidd Kidd 1951 anti-Jka Mrs. Kidd anti-K HDFN anti-Jkb HTR anti-Fya Kidd Kidd immunogen Kidd delayed HTR Kidd Jka Jkb phenotype 3 Jk(a+b-) Jk(a-b+) Jk(a+b+) phenotype Jk(a-b-) single amino acid (Ser291Pro) Jkb Kidd
9. 9. 5135 phenotype Jk(a+b-) 26.3 51.1 23.2 phenotype Jk(a-b+) 23.4 8.1 26.8 phenotypeJk(a+b+) 50.3 40.8 49.1 phenotypeJk(a-b-) 0.9 Kidd polymorphism null phenotype Jk(a-b-) homozygous silent allele silentallele splicesite exon 6 exon 7 genomicdeletions exon 4 5 nonsense exon 7 stop codon dominantinhibitor In(Jk) linked Jk (HUT11)(23) Duffy Duffy 1950 anti-Fya HTR hemophilia ORhnegative 3unit indirect antiglobulin test anti-Duffy (anti-Fya) Ikin anti-Fyb HDFN Duffy FYA FYB 1 1q22 q23 phenotype Fy(a+b-), Fy(a-b+), Fy(a+b+) Fy(a-b-)(24) Fy(a-b-) phenotype 67(24) Duffy phenotype Fy(a-b-) Fyb Fyb phenotypeFy(a-b-) Duffy phenotype Fy(a-b-) GATA promoter region FY allele Duffy glycoprotein phenotype Fy(a-b-) point mutation allele FYA FYB stop codon Duffy glycoprotein phenotype Fy(a-b-) Duffy anti-Fya anti-Fy3 anti-Fyb Fyb (24) Kell Kx Kell 1946 antiglobulin test HDFN antiglobulin test DAT positive
10. 10. 5136 9 Kell Kelleher K (synonyms: Kell, K1) k (synonyms:Cellano,K2) highincidence antigen 1957 Kpa, Kpb K0 (Kellnull) phenotype 24 high-incidence antigen k, Kpb, Jsb, K11 K14 low-incidenceantigen K,Kpa,Kpc,Jsa,K17 K24 Kell Kell glycoprotein 3,500 17,000 null phenotype Kell K0 Kell Kmod phenotype Kell Kellglycoprotein XK Kell X McLeod syndrome Kell K1 9 HDFN Kell (high immunogenic) K1 negative K1 negative(23) anti-K1 Kell K1 KK 0.07 Kk 1.78(18) Kell K1 Kell KEL gene 7 q33 19 exons 21.5 kb Kell (K0) KEL nucleotide deletion, defective splicing, premature stop codons amino acid substitutions XK XK gene X Xp21 3 exons major deletions, minor deletions, point mutations, splice site frameshiftmutations XK McLeod syndrome XK X-linkedgene carrier23 Diego Diego 1955 Mrs. Diego HDFN Dia low-incidence antigen 1967 Dib high-incidenceantigen 1995 Wra/Wrb Wra low-incidence antigen 1953 Dia
11. 11. 5137 Wra Diego 1955 Diego 19 Dia marker Dia phenotype Di(a+b-) anti-Dib Dia 0.47 13 15 17 Dia Diego anti-Dia anti-Dib anti-Wra anti- Wrb HTR HDFN anti-Dia rare antibody anti-Wra naturallyoccurringantibody autoimmunehemolyticanemia anti-Dib anti-Wrb Dib negative Wrbnegative Dib positive Wrb positive Dib negative 700 (25) Dib negative O1 rare cells rare blood types Table 1 rarebloodtypes rare blood types rarebloodtypes American Rare Donor Program (ARDP) (Japanese Red Cross) rare blood types (26) rare blood types monoclonal antibodies phenotyping rare antibodies
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