title: RHCE alleles detected after weak and/or discrepant results in automated Rh blood grouping of blood donors in Northern Germany.
abstract: BACKGROUND
  More than 170 weak or partial RHD alleles are currently known. A similar heterogeneity of RHCE alleles may be anticipated, but a large-scale systematic analysis of the molecular bases of altered C, c, E, and e antigenicity in European blood donors was lacking.
  
  
  METHODS
  Between November 2004 and October 2006, samples collected from 567,105 blood donors in the northwest of Germany were surveyed for weakened and/or discrepant serologic reaction patterns of the C, c, E, or e antigens in automated testing. Samples from 187 donors with systematic typing problems were further investigated by manual typing and in 122 donors by DNA typing. The polymorphisms determining C, c, E, and e, as well as three repeatedly found substitutions, M167K, G96S, and L115R, were tested by PCR-SSP. Further analysis consisted of sequencing of the exons of RHCE. In addition, 13 referred samples were analyzed.
  
  
  RESULTS
  RHcE(M167K) known as E variant I was the most frequent allele, found in 70 of 122 analyzed donors. Among 13 referred samples, C typing problems predominated. Overall, 34 different underlying alleles were detected, 23 of which were new. Molecular causes included single-amino-acid substitutions, gene conversions, multiple dispersed amino acid substitutions, protein extensions, and in-frame amino acid deletions.
  
  
  CONCLUSIONS
  In addition to RHcE(M167K), a large number of different alleles are underlying CcEe typing problems. Molecular mechanisms parallel those found in RHD. Elucidation of the molecular bases of variant antigens is important to improve serologic and molecular typing methods.
authors.affiliation: DRK Blutspendedienst NSTOB, Institut Bremen-Oldenburg, Oldenburg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Döscher
authors.forename: Claudia
authors.initials: C
authors.lastname: Vogt
authors.forename: Rita
authors.initials: R
authors.lastname: Bittner
authors.forename: Ingrid
authors.initials: I
authors.lastname: Gerdes
authors.forename: Eduard K
authors.initials: EK
authors.lastname: Petershofen
authors.forename: Franz F
authors.initials: FF
authors.lastname: Wagner
mesh_terms: D000483:Alleles; D001782:Blood Donors / Q000706:statistics & numerical data*; D001788:Blood Grouping and Crossmatching / Q000379:methods*; D005858:Germany; D006801:Humans; D009154:Mutation; D016133:Polymerase Chain Reaction; D012204:Rh-Hr Blood-Group System / Q000235:genetics*
chemical_list: C066468:RHCE protein, human; D012204:Rh-Hr Blood-Group System