title: Genotyping of RHD by multiplex polymerase chain reaction analysis of six RHD-specific exons.
abstract: BACKGROUND
  Qualitative RHD variants are the result of the replacement of RHD exons by their RHCE counterparts or of point mutations in RHD causing amino acid substitutions. For RHD typing, the use of at least two RHD typing polymerase chain reaction (PCR) assays directed at different regions of RHD is advised to prevent discrepancies between phenotyping and genotyping results, but even then discrepancies occur. A multiplex RHD PCR based on amplification of six RHD-specific exons in one reaction mixture is described.
  
  
  METHODS
  Six RHD-specific primer sets were designed to amplify RHD exons 3, 4, 5, 6, 7, and 9. DNA from 119 donors (87 D+, 14 D- and 18 with known D variants; whites and nonwhites) with known Rh phenotypes was analyzed.
  
  
  RESULTS
  All six RHD-specific exons from 85 D+ individuals were amplified, whereas none of the RHD exons from 13 D- individuals were amplified. Multiplex PCR analysis showed that the genotypes of two donors typed as D+ were DIVa and DVa. Red cell typing confirmed these findings. From all D variants tested (DIIIc, DIVa, DIVb, DVa, DVI, DDFR, DDBT) and from RoHar, RHD-specific exons were amplified as expected from the proposed genotypes.
  
  
  CONCLUSIONS
  The multiplex PCR assay is reliable in determining genotypes in people who have the D+ and partial D phenotypes as well as in discovering people with new D variants. Because the multiplex PCR is directed at six regions of RHD, the chance of discrepancies is markedly reduced. The entire analysis can be performed in one reaction mixture, which results in higher speed, higher accuracy, and the need for smaller samples. This technique might be of great value in prenatal RHD genotyping.
authors.affiliation: Transfusion Service Laboratory, Bloodbank Rotterdam, The Netherlands.
authors.forename: P A
authors.initials: PA
authors.lastname: Maaskant-van Wijk
authors.forename: B H
authors.initials: BH
authors.lastname: Faas
authors.forename: J A
authors.initials: JA
authors.lastname: de Ruijter
authors.forename: M A
authors.initials: MA
authors.lastname: Overbeeke
authors.forename: A E
authors.initials: AE
authors.lastname: von dem Borne
authors.forename: D J
authors.initials: DJ
authors.lastname: van Rhenen
authors.forename: C E
authors.initials: CE
authors.lastname: van der Schoot
mesh_terms: D000483:Alleles; D001483:Base Sequence; D004247:DNA / Q000032:analysis; D017931:DNA Primers / Q000235:genetics; D005091:Exons / Q000235:genetics; D005838:Genotype; D006801:Humans; D021141:Nucleic Acid Amplification Techniques; D017354:Point Mutation; D016133:Polymerase Chain Reaction / Q000379:methods*; D012204:Rh-Hr Blood-Group System / Q000235:genetics*; D012680:Sensitivity and Specificity
chemical_list: D017931:DNA Primers; D012204:Rh-Hr Blood-Group System; D004247:DNA