title: Influence of Rh phenotype on the antigen density of C, c, and D: flow cytometric study using a frozen standard red cell.
abstract: BACKGROUND
  Flow cytometry is increasingly being used for the comparison of antigen density. Indirect immune fluorescence is more sensitive than direct immune fluorescence and thus allows the study of red cells (RBCs) with a weak D antigen.
  
  
  METHODS
  In indirect immune fluorescence, when the fluorescence is standardized by the use of aliquoted frozen standard RBCs, the coefficient of variation in fluorescence intensity was less than 5 percent, which allows accurate determination of minor variations of Rh antigen density.
  
  
  RESULTS
  For D antigen, the well-known suppressive effect of C, and the low antigen density of the weak D phenotype, was demonstrated. Use of epitope-specific monoclonal antibodies yielded similar results and allowed the identification of a D category IV heterozygote; the relative antigen density measured with a monoclonal antibody that reacted with D(IV) was twice that measured with a monoclonal antibody that did not react with D(IV). RBCs from C and c homozygotes had significantly more antigen than those from heterozygotes. There was significant variation in antigen density, depending on Rh phenotype: for example, D+ RBCs had less C antigen than D- RBCs, and Rh:1,2,-3,4,5 (CcDee) RBCs had more c antigen than Rh:1,2,3,4,5 (CcDEe) RBCs. There was no difference in D, C, and c antigen density in neonatal and adult RBCs.
  
  
  CONCLUSIONS
  Flow cytometry is an excellent tool for the demonstration of minor differences in antigen density.
authors.affiliation: Department of Transfusion Medicine, University of Ulm, Germany.
authors.forename: F F
authors.initials: FF
authors.lastname: Wagner
mesh_terms: D000328:Adult; D004912:Erythrocytes / Q000276:immunology; D005434:Flow Cytometry; D006801:Humans; D007231:Infant, Newborn; D007519:Isoantigens / Q000235:genetics / Q000276:immunology*; D010641:Phenotype; D012015:Reference Standards; D015203:Reproducibility of Results; D012204:Rh-Hr Blood-Group System / Q000235:genetics / Q000276:immunology*; D013997:Time Factors
chemical_list: D007519:Isoantigens; D012204:Rh-Hr Blood-Group System