RhD 음성 한국인에서의 염기서열특이-중합효소 연쇄반응법을 이용한 RHD 유전자검사법

초록

Background :In Caucacians, almost all RhD-negatives have deletion in RHD gene and the RHD genotyping by PCR-SSP is a valuable tool. The aim of this study is to investigate the frequency of RHD gene deletion in RhD-negative Korean donors and evaluate the clinical usefulness of various RHD genotyping methods in Korean. Method :Two hundred fifty RhD-positive blood obtained from Blood Transfusion Research Institute and 119 RhD-negative blood samples were obtained from Korea Red Cross Dong Bu Blood Center. Phenotyping of RhD, RhC/c, and RhE/e antigen was performed using polyclonal and monoclonal antibodies (Dade AG, Switzerland). PCR-SSP was performed by primer sets, specific for exon 3, exon 4, exon 5, exon 6, exon 7, exon 9, and exon 10 of RHD gene and for exon 2, intron 4, and intron 4-exon 5 common to RHD and RHCE genes. Result :The phenotypes of 250 RhD-positives consisted of 106 (42.4%) CCee, 93 (37.2%) CcEe, 26 (10.4%) ccEE, 21 (8.4%) Ccee, 3 (1.2%) ccEe, and 1 (0.4%) ccee. In RhD-negative donors, 62 (52.1%) were ccee, 37 (31.1%) Ccee, 10 (8.4%) ccEE, 6 (5.0%) CcEe, 2 (1.7%) ccEE, and 2 (1.7%) CCee. Twenty-two out of 101 RhD-negatives showed no deletion in all used methods. Deletion frequency of RhD negatives varied according to the methods: 76 (75.3%) in intron 4-exon 5 boundary; 74 (73.3%) in intron 4; 72 (71.3%) in exon 4; 67 (66.3%) in exon 7; 63 (62.4%) in exon 10; 9 (8.9%) in exon 5; no deletion in exon 3, exon 6, and exon 9. Different RhD phenotypes also showed different RHD gene deletion frequency: 80-90% deletion in ccee; 70% in ccEe; 40-50% in Ccee and CcEe; no deletion in CCee phenotypes. Conclusion :RHD gene deletion frequency varied according to the methods applied and individual’s own RhD phenotypes. Therefore, RHD genotyping is not appropriate for a routine test in Blood Bank and individual variation should be considered in prenatal care of RhD-negative women.

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