Get access

The RHCE allele ceRT: D epitope 6 expression does not require D-specific amino acids

Authors

  • Franz F. Wagner,

    Corresponding author
    1. From the Department of Transfusion Medicine, University of Ulm, Ulm; the Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, Ulm; the Red Cross Blood Service, Baden-Württemberg-Hessen, Institute Ulm, Ulm; and Biotest AG, Dreieich, Germany.
      Address reprint requests to: Willy A. Flegel, MD, Institut für Klinische Transfusionsmedizin und Immungenetik Ulm, Helmholtzstrasse 10, D-89081 Ulm, Germany; e-mail: waf@ucsd.edu.
    Search for more papers by this author
  • Birgit Ladewig,

    1. From the Department of Transfusion Medicine, University of Ulm, Ulm; the Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, Ulm; the Red Cross Blood Service, Baden-Württemberg-Hessen, Institute Ulm, Ulm; and Biotest AG, Dreieich, Germany.
    Search for more papers by this author
  • Willy A. Flegel

    1. From the Department of Transfusion Medicine, University of Ulm, Ulm; the Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, Ulm; the Red Cross Blood Service, Baden-Württemberg-Hessen, Institute Ulm, Ulm; and Biotest AG, Dreieich, Germany.
    Search for more papers by this author

  • Supported by the DRK-Blutspendedienst Baden-Württemberg-Hessen, Mannheim; by the University of Ulm (Forschungsförderungsprojekt P. 531); and by the Deutsche Gesellschaft für Transfusionsmedizin und Immunhämatologie (Project DGTI/fle/00-01).

  • TRANSFUSION 2003;43:1248-1253.

Address reprint requests to: Willy A. Flegel, MD, Institut für Klinische Transfusionsmedizin und Immungenetik Ulm, Helmholtzstrasse 10, D-89081 Ulm, Germany; e-mail: waf@ucsd.edu.

Abstract

BACKGROUND:  False-positive D typing in patients may lead to anti-D immunization caused by D+ transfusions or by omission of anti-D prophylaxis. Known causes of such errors are RhCE variants carrying RhD-specific amino acids and cold agglutinin activity of some frequently used monoclonal anti-D.

STUDY DESIGN AND METHODS:  The molecular basis of eight samples referred because of “false-positive” reactions with some commercial monoclonal anti-D was investigated by PCR and nucleotide sequencing from genomic DNA. PCR with sequence-specific priming was developed to specifically detect the underlying aberrant RHCE allele. The D epitope profile of the allele was determined by serology.

RESULTS:  The aberrant reactivity of the samples was caused by the RHCE allele RHCE(R154T) that occurred in a cde haplotype. The phenotype dubbed ceRT expressed the important D epitope 6, which is the target epitope of most monoclonal anti-D used in routine typing.

DISCUSSION:  The characterization of ceRT demonstrated a previously unknown mechanism of antigen D expression that does not require any D-specific amino acid. At least for some D epitopes, D-like structures may be mimicked by RhCE proteins carrying amino acid substitutions not representative for RhD.

Get access to the full text of this article

Ancillary