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Truncated glycosyltransferase coding regions in novel ABO alleles give rise to weak A or B blood group expression and discrepant typing results

Ricci Hagman, Jennifer LU ; Hult, Annika LU ; Hellberg, Åsa LU and Olsson, Martin L LU orcid (2023) In Transfusion 63(10). p.1951-1961
Abstract
Background
Correct ABO blood-group matching between donor and patient is crucial for safe transfusions. We investigated the underlying reason causing inconclusive ABO serology in samples referred to our laboratory.
Study Design and Methods
Flow cytometric analysis, ABO genotyping, and sequencing were used to characterize ABO-discrepant blood samples (n = 13). ABO gene variants were inserted in a GFP-containing bicistronic vector to assess A/B expression following overexpression in HeLa cells.
Results
Seven novel alleles with nonsense mutations predicted to truncate the encoded ABO glycosyltransferases were identified. While these variants could represent O alleles, serology showed signs of ABO glycosyltransferase... (More)
Background
Correct ABO blood-group matching between donor and patient is crucial for safe transfusions. We investigated the underlying reason causing inconclusive ABO serology in samples referred to our laboratory.
Study Design and Methods
Flow cytometric analysis, ABO genotyping, and sequencing were used to characterize ABO-discrepant blood samples (n = 13). ABO gene variants were inserted in a GFP-containing bicistronic vector to assess A/B expression following overexpression in HeLa cells.
Results
Seven novel alleles with nonsense mutations predicted to truncate the encoded ABO glycosyltransferases were identified. While these variants could represent O alleles, serology showed signs of ABO glycosyltransferase activity. ABO*A1.01-related alleles displayed remarkably characteristic percentages of A-positive cells for samples with the same variant: c.42C>A (p.Cys14*; 10%), c.102C>A (p.Tyr34*; 31%–32%, n = 2), c.106dup (p.Val36Glyfs*21; 16%–17%, n = 3) or c.181_182ins (p.Leu61Argfs*21; 12%–13%, n = 2). Transfection studies confirmed significantly decreased A expression compared to wild type. The remaining variants were found on ABO*B.01 background: c.1_5dup (pGly3Trpfs*20), c.15dup (p.Arg6Alafs*51) or c.496del (p.Thr166Profs*26). Although the absence of plasma anti-B was noted overall, B antigen expression was barely detected on erythrocytes. Overexpression confirmed decreased B in two variants compared to wildtype while c.1_5dup only showed a non-significant downward trend.
Conclusion
Samples displaying aberrant ABO serology revealed seven principally interesting alleles. Despite the presence of truncating mutations, normally resulting in null alleles, low levels of ABO antigens were detectable where alterations affected ABO exons 1–4 but not exon 7. This is compatible with the previously proposed concept that alternative start codons in early exons can be used to initiate the translation of functional ABO glycosyltransferase.
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Transfusion
volume
63
issue
10
pages
1951 - 1961
publisher
Wiley-Blackwell
external identifiers
  • pmid:37694916
  • scopus:85170569276
ISSN
1537-2995
DOI
10.1111/trf.17534
language
English
LU publication?
yes
id
c4bb7209-f33f-46f1-a475-57970e719732
date added to LUP
2023-10-19 13:33:47
date last changed
2023-10-20 04:00:38
@article{c4bb7209-f33f-46f1-a475-57970e719732,
  abstract     = {{Background<br/>Correct ABO blood-group matching between donor and patient is crucial for safe transfusions. We investigated the underlying reason causing inconclusive ABO serology in samples referred to our laboratory.<br/>Study Design and Methods<br/>Flow cytometric analysis, ABO genotyping, and sequencing were used to characterize ABO-discrepant blood samples (n = 13). ABO gene variants were inserted in a GFP-containing bicistronic vector to assess A/B expression following overexpression in HeLa cells.<br/>Results<br/>Seven novel alleles with nonsense mutations predicted to truncate the encoded ABO glycosyltransferases were identified. While these variants could represent O alleles, serology showed signs of ABO glycosyltransferase activity. ABO*A1.01-related alleles displayed remarkably characteristic percentages of A-positive cells for samples with the same variant: c.42C&gt;A (p.Cys14*; 10%), c.102C&gt;A (p.Tyr34*; 31%–32%, n = 2), c.106dup (p.Val36Glyfs*21; 16%–17%, n = 3) or c.181_182ins (p.Leu61Argfs*21; 12%–13%, n = 2). Transfection studies confirmed significantly decreased A expression compared to wild type. The remaining variants were found on ABO*B.01 background: c.1_5dup (pGly3Trpfs*20), c.15dup (p.Arg6Alafs*51) or c.496del (p.Thr166Profs*26). Although the absence of plasma anti-B was noted overall, B antigen expression was barely detected on erythrocytes. Overexpression confirmed decreased B in two variants compared to wildtype while c.1_5dup only showed a non-significant downward trend.<br/>Conclusion<br/>Samples displaying aberrant ABO serology revealed seven principally interesting alleles. Despite the presence of truncating mutations, normally resulting in null alleles, low levels of ABO antigens were detectable where alterations affected ABO exons 1–4 but not exon 7. This is compatible with the previously proposed concept that alternative start codons in early exons can be used to initiate the translation of functional ABO glycosyltransferase.<br/>}},
  author       = {{Ricci Hagman, Jennifer and Hult, Annika and Hellberg, Åsa and Olsson, Martin L}},
  issn         = {{1537-2995}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1951--1961}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Transfusion}},
  title        = {{Truncated glycosyltransferase coding regions in novel ABO alleles give rise to weak A or B blood group expression and discrepant typing results}},
  url          = {{http://dx.doi.org/10.1111/trf.17534}},
  doi          = {{10.1111/trf.17534}},
  volume       = {{63}},
  year         = {{2023}},
}