目的对1例血型血清学检测为RHD变异型的样本进行基因分型,并进行家系调查分析。方法运用血型血清学检测方法对先证者及其家系样本进行RHD确认及RH血型抗原表位检测,用序列特异性引物PCR(sequence specific primer PCR,PCR-SSP)法分析RH...目的对1例血型血清学检测为RHD变异型的样本进行基因分型,并进行家系调查分析。方法运用血型血清学检测方法对先证者及其家系样本进行RHD确认及RH血型抗原表位检测,用序列特异性引物PCR(sequence specific primer PCR,PCR-SSP)法分析RHD基因外显子的表达,运用Sanger和SMRT(single molecule real-timesequencing)测序法对先证者及其家系样本进行RHD基因的1~10外显子测序分析。通过AlphaFold模拟构建蛋白质三级结构,将突变前后的蛋白质结构进行叠合以观察结构内分子间相互作用力的改变。结果先证者为RHD弱表型,其他抗原为Ccee,直接抗人球蛋白试验、抗体筛查、抗体鉴定试验均为阴性,PCR-SSP初步分型为RHD阳性。其父母血型血清学及PCR-SSP结果均为RHD阳性。SMRT测序结果显示先证者母亲为RHD^(+)/RHD^(-)杂合子。Sanger测序结果显示,先证者父亲携带弱D型54等位基因。AlphaFold建模预测揭示,p.Ser122Leu突变不能与146位GLU形成氢键相互作用。结论该样本为弱D型54,p.Ser122Leu突变导致氨基酸内部分子间作用力发生改变,从而引起突变后蛋白质结构和功能的部分改变。展开更多
Background Rh blood group system is the most complex and immunogenetic blood group system. Prevalent RHD alleles varied in different populations. The purpose of this study is to determine the molecular basis of weak D...Background Rh blood group system is the most complex and immunogenetic blood group system. Prevalent RHD alleles varied in different populations. The purpose of this study is to determine the molecular basis of weak D and DEL phenotype in Anhui Chinese Han population. Methods The D antigen was determined with IgM monoclonal anti-D conformed to the guidelines for donor testing in China. Weak D samples were identified by an indirect antiglobulin test. DEL phenotype was determined by adsorption and elution test. All the RHD 10 exons were screened by PCR with sequence-specific priming or sequenced for the first-time donors who typed weak D, DEL or D negative by serologic test. Results Of all the 30 799 blood donors, 155 blood samples were found D negative with IgM anti-D; 34 blood samples were found D positive by indirect antiglobulin test or absorption elution test. RHD alleles were identified by nucleotide sequencing. Total 4 RHD alleles were found including two new. One hundred and twenty of 155 （77.4%） of the serologically D negative samples lacked the RHD gene. One D negative was RHD（615de12）. Thirty-two of 155 （20.6%） carried RHD（K409K） among them one carrying 1227G〉A and 845G〉A. Two of 155 （1.3%） was weak D type 15. Conclusions In this study at the molecular level, all DEL phenotype is RHD（K409K）; weak D type 15 is the prevalent weak D allele in Anhui Chinese Han population. Additionally, an improved more efficient method was adopted to amplify all the RHD exons in one PCR program. Our study added to the understanding of molecular mechanisms underlying D antigen expression in Anhui Han population and provided useful information for adopting suitable genotyping strategies in routine use.展开更多
文摘目的对1例血型血清学检测为RHD变异型的样本进行基因分型,并进行家系调查分析。方法运用血型血清学检测方法对先证者及其家系样本进行RHD确认及RH血型抗原表位检测,用序列特异性引物PCR(sequence specific primer PCR,PCR-SSP)法分析RHD基因外显子的表达,运用Sanger和SMRT(single molecule real-timesequencing)测序法对先证者及其家系样本进行RHD基因的1~10外显子测序分析。通过AlphaFold模拟构建蛋白质三级结构,将突变前后的蛋白质结构进行叠合以观察结构内分子间相互作用力的改变。结果先证者为RHD弱表型,其他抗原为Ccee,直接抗人球蛋白试验、抗体筛查、抗体鉴定试验均为阴性,PCR-SSP初步分型为RHD阳性。其父母血型血清学及PCR-SSP结果均为RHD阳性。SMRT测序结果显示先证者母亲为RHD^(+)/RHD^(-)杂合子。Sanger测序结果显示,先证者父亲携带弱D型54等位基因。AlphaFold建模预测揭示,p.Ser122Leu突变不能与146位GLU形成氢键相互作用。结论该样本为弱D型54,p.Ser122Leu突变导致氨基酸内部分子间作用力发生改变,从而引起突变后蛋白质结构和功能的部分改变。
文摘Background Rh blood group system is the most complex and immunogenetic blood group system. Prevalent RHD alleles varied in different populations. The purpose of this study is to determine the molecular basis of weak D and DEL phenotype in Anhui Chinese Han population. Methods The D antigen was determined with IgM monoclonal anti-D conformed to the guidelines for donor testing in China. Weak D samples were identified by an indirect antiglobulin test. DEL phenotype was determined by adsorption and elution test. All the RHD 10 exons were screened by PCR with sequence-specific priming or sequenced for the first-time donors who typed weak D, DEL or D negative by serologic test. Results Of all the 30 799 blood donors, 155 blood samples were found D negative with IgM anti-D; 34 blood samples were found D positive by indirect antiglobulin test or absorption elution test. RHD alleles were identified by nucleotide sequencing. Total 4 RHD alleles were found including two new. One hundred and twenty of 155 （77.4%） of the serologically D negative samples lacked the RHD gene. One D negative was RHD（615de12）. Thirty-two of 155 （20.6%） carried RHD（K409K） among them one carrying 1227G〉A and 845G〉A. Two of 155 （1.3%） was weak D type 15. Conclusions In this study at the molecular level, all DEL phenotype is RHD（K409K）; weak D type 15 is the prevalent weak D allele in Anhui Chinese Han population. Additionally, an improved more efficient method was adopted to amplify all the RHD exons in one PCR program. Our study added to the understanding of molecular mechanisms underlying D antigen expression in Anhui Han population and provided useful information for adopting suitable genotyping strategies in routine use.
