Abstract
Alloantibodies to the Diego (DI) blood group system, anti-Dia and anti-Dib are clinically significant in causing hemolytic transfusion reactions (HTRs) and hemolytic disease of the fetus and newborn (HDFN), especially in Asian populations with Mongolian ancestry. This study aimed to report the frequency of the DI*A and DI*B alleles in a Central Thai population and to compare them with those of other populations previously published. Altogether, 1,011 blood samples from unrelated healthy blood donors at the National Blood Centre, Thai Red Cross Society, Bangkok were included. Only 391 samples were tested with anti-Dia by conventional tube technique. All samples were genotyped for DI*A and DI*B alleles using an in-house polymerase chain reaction with sequence-specific primer (PCR-SSP) technique. The DI phenotyping and genotyping results were in 100% concordance. The DI*A and DI*B allele frequencies among 1,011 Central Thais were 0.0183 (37/2,022) and 0.9817 (1,985/2,022), respectively. Allele frequencies were compared between Central Thai and other populations. Our data shows that DI*A and DI*B allele frequencies are similar to Southeast Asian, Brazilian, Southern Brazilian and American Native populations; whereas, these frequencies significantly differ from those reported in East Asian, Italian, Alaska Native/Aleut, Hawaiian/Pacific Islander and Filipino populations (P<0.05), corresponding to the results of a matrix of geometric genetic distances. This study confirms that the prevalence of DI*A and DI*B alleles among Central Thais is similar to Southeast Asians and different to others populations of the world. A PCR-based identification of DI genotyping should overcome some of the serological limitations in transfusion medicine and provides a complementary tool for further population-genetic studies.
Highlights
The Diego (DI) blood group system (The International Society of Blood Transfusion, ISBT) 010 was first reported in 1955 by Layrisse et al, when anti-Dia was found in the case of fatal hemolytic disease of the fetus and newborn (HDFN) [1]
1,011 DNA samples included 391 known Dia antigen phenotype samples and an additional 620 samples were genotyped for DIÃA and DIÃB alleles by in-house polymerase chain reaction with sequence-specific primer (PCR-SSP)
According to the interpretation of polymerase chain reaction (PCR)-SSP, homozygous DIÃA/DIÃA and DIÃB/DIÃB samples were positive with only the set of DI-AB-F and DI-A-R primers and the set of DI-AB-F and DI-B-R primers, respectively
Summary
The Diego (DI) blood group system (The International Society of Blood Transfusion, ISBT) 010 was first reported in 1955 by Layrisse et al, when anti-Dia was found in the case of fatal hemolytic disease of the fetus and newborn (HDFN) [1]. Thereafter, the Diego antibodies (anti-Dia and anti-Dib) became involved in mild and severe cases of HDFN and hemolytic transfusion reactions (HTRs) [2,3,4,5,6,7,8,9]. Antithecal antigens (Dia and Dib) are the products of DIÃA and DIÃB alleles caused by a single nucleotide polymorphism, SNP (c.2561C>T) in the human erythrocyte membrane anion-transport protein gene (SLC4A1). This gene encodes a substance called band 3 protein, which is expressed on the surface of red blood cells (RBCs) and plays a central role in mediating the transport of carbon dioxide in the blood. A single amino acid substitution in position 854 results in a leucine corresponding to Dia antigen and proline to the Dib antigen [11,12,13]
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