RESUMEN
BACKGROUND: A weak D type resulted from a quantitative reduction of the RhD antigen, whereas a partial D type resulted from a qualitatively altered RhD protein. Based on different serological properties from a weak D type, a partial D type was suspected in cases with anti-D in their serum or if nonreactive to some reagents. Most Red Cross Blood Centers pay attention to donors in determining RhD typing with a monoclonal anti-D reagent. This study examined the reactivity patterns of 4 different monoclonal anti-D reagents in RhD typing and a weak D test in 14 cases with partial D. MATERIALS AND METHODS: We collected a total of 201, 847 samples from blood donors and screened out 649 samples as Rh-negative in RhD typing with monoclonal anti-D (Bioscot) and bromelin treatment applied to an automatic analyzer between October 2002 and March 2003. Further, we performed RhD typing and weak D test using the tube method with 4 commercially available monoclonal anti-D reagents. In 14 cases with different reactivity patterns, we performed a confirming test for partial D using a `ID-partial RhD-typing' (Diamed, Switzerland) set consisting of 6 monoclonal antibodies. RESULTS: Partial D(DFR) was observed in 92.9% (13/14) and a partial D(indeterminate) was observed in 7.1% (1/14). The red blood cells from 14 cases with partial D were not agglutinated with 4 various commercially available anti-D reagents. However, in subsequently performed weak-D tests, different reactivity to their anti-D reagents were shown, namely irresponsiveness (Dade Behring, 14/14, 100%), trace-to-1+ responsiveness (Ortho-clinical diagnostics, 13/14, 92.9%), trace-to-3+ responsiveness (Bioscot, 14/14, 100%), and 1+-to-3+ responsiveness (GreenCross, Korea, 14/14, 100%). CONCLUSIONS: Considering that the most partial D discovered in the Southwestern area of Korea was partial D(DFR), it is recommended that RhD typing and/or weak D tests in blood donors should be done using more than two anti-D reagents from different clones.
Asunto(s)
Humanos , Anticuerpos Monoclonales , Donantes de Sangre , Bromelaínas , Células Clonales , Eritrocitos , Indicadores y Reactivos , Corea (Geográfico) , Cruz Roja , Donantes de TejidosRESUMEN
Many patients with chronic renal failure (CRF) requiring hemodialysis present with hypertriglyceridemia (HTG). But the exact cause of HTG in CRF is still unknown. Genetic variation of the apo AI-CIII-AIV gene cluster was reported to be associated with primary HTG, atherosclerosis and coronary artery disease. This study was designed to evaluate the association between the restriction fragment length polymorphism (RFLP) of the apo AI-CIII-AIV gene cluster and HTG in patients with CRF undergoing hemodialysis. Genetic variations of the apo AI-CIII-AIV gene cluster were analysed in peripheral leukocyte samples from 59 patients with CRF undergoing hemodialysis: 17 patients with HTG (CRF-HTG) and 42 patients without HTG (CRF-NTG). The RFLP was achieved through the digestion of PCR products by two restriction enzymes, SstI and MspI. The frequency of SstI minor allele (S2) in CRF-HTG was 0.44, which was significantly higher than that in CRF-NTG (0.17). Frequencies of MspI minor allele (M2) in CRF-HTG and CRF-NTG were not significantly different (0.5 vs 0.32) (p=0.07). Frequencies of S2-M2 genotype were 0.65 in CRF-HTG, and 0.27 in CRF-NTG (p>0.005). These data indicate that genetic variation of the apo AI-CIII-AIV gene cluster may serve as one of the causes of HTG in CRF.
Asunto(s)
Femenino , Humanos , Masculino , Apolipoproteína A-I/genética , Apolipoproteínas A/genética , Apolipoproteínas C/genética , Apolipoproteínas C/sangre , Colesterol/sangre , Hipertrigliceridemia/genética , Hipertrigliceridemia/complicaciones , Fallo Renal Crónico/genética , Fallo Renal Crónico/complicaciones , HDL-Colesterol/sangre , Persona de Mediana Edad , Familia de Multigenes , Diálisis Renal , Triglicéridos/sangre , Variación GenéticaRESUMEN
Many patients with chronic renal failure (CRF) requiring hemodialysis present with hypertriglyceridemia (HTG). But the exact cause of HTG in CRF is still unknown. Genetic variation of the apo AI-CIII-AIV gene cluster was reported to be associated with primary HTG, atherosclerosis and coronary artery disease. This study was designed to evaluate the association between the restriction fragment length polymorphism (RFLP) of the apo AI-CIII-AIV gene cluster and HTG in patients with CRF undergoing hemodialysis. Genetic variations of the apo AI-CIII-AIV gene cluster were analysed in peripheral leukocyte samples from 59 patients with CRF undergoing hemodialysis: 17 patients with HTG (CRF-HTG) and 42 patients without HTG (CRF-NTG). The RFLP was achieved through the digestion of PCR products by two restriction enzymes, SstI and MspI. The frequency of SstI minor allele (S2) in CRF-HTG was 0.44, which was significantly higher than that in CRF-NTG (0.17). Frequencies of MspI minor allele (M2) in CRF-HTG and CRF-NTG were not significantly different (0.5 vs 0.32) (p=0.07). Frequencies of S2-M2 genotype were 0.65 in CRF-HTG, and 0.27 in CRF-NTG (p>0.005). These data indicate that genetic variation of the apo AI-CIII-AIV gene cluster may serve as one of the causes of HTG in CRF.
Asunto(s)
Femenino , Humanos , Masculino , Apolipoproteína A-I/genética , Apolipoproteínas A/genética , Apolipoproteínas C/genética , Apolipoproteínas C/sangre , Colesterol/sangre , Hipertrigliceridemia/genética , Hipertrigliceridemia/complicaciones , Fallo Renal Crónico/genética , Fallo Renal Crónico/complicaciones , HDL-Colesterol/sangre , Persona de Mediana Edad , Familia de Multigenes , Diálisis Renal , Triglicéridos/sangre , Variación GenéticaRESUMEN
BACKGROUND: Hypertriglyceridemia (HTG) has been considered a characteristic plasma lipid abnormality in hemodialysis patients with chronic renal failure, but is actually shown in only some of them (30-50%). Also renal dyslipidemia may contribute to atherosclerosis in hemodialysis patients. METHODS: Study population consisted of 34 patients with normotriglyceridemia (NTG), 11 patients with HTG and 47 controls. We measured total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), apolipoprotein (apo) A-I, apoB, apoC-III and apoE. RESULTS: Compared with controls, the NTG patients had significantly decreased levels of TC, HDL-C, and low density lipoprotein-cholesterol (LDL-C). But HTG patients had significantly increased TG, and TC/HDL-C ratio which were considered to represent the atherogenic indicator and had decreased HDL-C and LDL-C (P <0.001), with significant increase of TG and TC/HDL-C ratio compared with those of NTG patients. In the apolipoprotein profiles, all patients showed decreased levels of apoA-I, apoB, and apoA-I/apoC-III ratio and increased levels of apoC-III and apoC-III/apoE ratio compared with those of controls (P <0.001). Especially, HTG patients had significantly increased levels of apoC-III compared with NTG patients. CONCLUSIONS: So these results indicated that abnormalities of those potentially atherogenic lipid and lipoproteins may contribute to the high incidence of cardiovascular diseases and progression of renal disease in the HTG patients than NTG patients on maintenance hemodialysis.