In Focus
Commentary
Members of the Working Party for Red Cell Immunogenetics and Blood Group Terminology (RCI&BGT) have contributed to this October edition of Transfusion Today.
The articles provide a progressive picture, reflecting past history, recent and present developments and moving toward research activities designed to meet future needs of the transfusion community.
The first article is by Frederik Clausen who heads the Working Party subgroup for Cell-free (cf) DNA. Transfusion Medicine played a significant role in the history of cfDNA by showing that non-invasive prenatal testing of the cfDNA provides a safe and accurate maternal blood test to assess the fetal RhD blood group status for RhD negative women. Frederik provides further background, explaining the ongoing vision and role of this sub-group.
The Rh blood group is just one of 47 recognised blood group systems and an article by Vanja Karamatic Crew tracks the discovery of blood group systems and antigens with advances in technologies. These discoveries are of clinical importance in Transfusion and Maternal-Fetal Medicine. They also contribute to understanding how red cells develop (the process called erythropoiesis) and understanding the biological role of proteins in the red cell membrane.
Vanja and Peter Ligthart have recently accepted the roles of joint Educational Officers for the Working Party. An article by Peter focuses on two of the newer blood groups, namely CD36 and CTL2. These are carried on proteins that are present on the red cell membrane as well as platelets and/or neutrophils, respectively. Peter discusses the laboratory significance of these findings and highlights a meeting of three working parties, RCI&BGT, Platelet Immunobiology and Granulocyte Immunobiology at the Barcelona Congress to consider these shared findings.
An article by the RCI&BGT young professional representatives, Nysa McGowan and Gloria Wu, mentored by the Past Chair, Jill Storry, looks beyond the coding region of the blood group gene to explain blood group diversity arising due to changes in the non-coding regions of the gene. This includes changes in regulatory elements preventing or decreasing the expression of the antigen. The importance of reference sequences is explained, and the need for population-specific reference sequences was highlighted.
An article by Bill Flegel describes the challenges involved in collecting samples in Ethiopia for blood group studies, which are being performed in collaboration with the NIH. This is a heartwarming account of the enthusiasm and resilience of teams working together to overcome all challenges.
A further article by Bill gives an overview of the ‘dynamic nature of human DNA sequences’. Bill defines the specific DNA ‘breakpoints’ in the RH gene for a Pacific Islander. Such breakpoints may have different phenotypic impacts, for example, associated with either the D-negative or DEL phenotype, and heralds the need for further studies in this area. In summary, new blood groups, antigens and alleles are still being discovered. Over 1800 allelic variants are now registered by the WP. All alleles are associated with clinically significant antigens. A key role for the WP experts is to name and curate such alleles in Tables. Along with a list of Blood Group Systems and Antigens, these Allele Tables will soon be available on a new electronic blood group allelic database intended for use by the Transfusion Community.
Thank you to the members who contributed to this edition of Transfusion Today and to all our members for your hard work and ongoing support.
