Genotyping-based prediction of Diego blood group phenotypes: Implications for Thai blood donors
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Abstract
Background: The Dia and Dib antigens of the Diego (DI) blood group system can cause alloimmunization following transfusion or pregnancy. Although the Di(a-b+) phenotype predominates, the Di(a+) antigen is relatively common in Asian populations. Due to serological limitations, particularly the lack of anti-Dib, genotyping is increasingly used to predict DI phenotypes and facilitate identifying antigen-negative blood donors for patients with anti-Dia or anti-Dib.
Objectives: The study aimed to determine the frequencies of DI*A and D*B alleles to predict DI phenotypes and establish an inventory of Thai blood donors with the rare Di(a+b-) phenotype.
Materials and methods: A total of 3,500 blood samples from unrelated healthy Thai blood donors were included. All samples were tested with anti-Dia using the conventional tube technique and genotyped for DI*A and DI*B alleles by in-house polymerase chain reaction with sequence-specific primer technique. The DI allele frequencies were calculated to estimate the risk of alloimmunization.
Results: The DI genotyping and phenotyping results showed 100% concordance. Among 3,500 Central Thai blood donors, predicted phenotypes were ranked as Di(a-b+), 3,407 (97.34%), followed by Di(a+b+), 92 (2.63%), and Di(a+b-), 1 (0.03%). The DI*A and DI*B allele frequencies were 0.013 and 0.987. The DI*A and DI*B frequencies are consistent with those observed in Central and Northern Thai populations and in other Southeast Asian populations, but differ significantly from those observed in Southern Thai, Japanese, Chinese, and Korean populations (p<0.001). Notably, one donor with the rare Di(a+b-) phenotype was observed in this study; this likely reflects the greater likelihood of detecting rare phenotypes when screening a much larger sample size than in related Thai studies.
Conclusion: The implementation of the PCR-SSP technique plays a crucial role in identifying DI blood group antigens, particularly in situations where specific antisera are unavailable. This approach also contributes to establishing an inventory of donors with rare blood phenotypes, thereby enhancing transfusion safety.
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
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