Risk Estimation of HNA-3 Incompatibility and Alloimmunization in Thai Populations

Abstract

Severe transfusion-related acute lung injury (TRALI) is often due to antibodies in blood components directed against human neutrophil antigen (HNA)-3a. This study aimed to report the genotype frequencies of the HNA-3 system and to estimate the potential risk of HNA-3 incompatibility and alloimmunization in two Thai populations. Eight hundred DNA samples obtained from 500 unrelated healthy blood donors at the National Blood Centre, Thai Red Cross Society, Bangkok and 300 samples from the Blood Bank, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand were included. HNA-3 genotyping was performed using an in-house polymerase chain reaction with sequence-specific primer (PCR-SSP) technique. The observed frequencies of the HNA-3a/3a, HNA-3a/3b, and HNA-3b/3b genotypes were 0.528, 0.380, and 0.092 in central Thais and 0.600, 0.350, and 0.050 in northern Thais, respectively. The frequencies were used to estimate HNA-3 incompatibility and risk of HNA-3a alloimmunization. The HNA-3 incompatibility in central Thais (33.28%) was higher than northern Thais (28.75%), corresponding to a significantly higher probability of HNA-3a alloimmunization (P<0.05) similar to Japanese and Chinese populations. This study showed the high risk of HNA-3 incompatibility and alloimmunization, especially in central Thai blood donors. A molecular-based identification of the HNA-3 genotype of female donors is suggested to reduce the risk of TRALI following plasma and whole blood allogeneic transfusion.

A study of human neutrophil antigen genotype frequencies in Hong Kong

“…Comparing the allele frequencies with other studies, the allele distribution of Han Chinese in Hong Kong is similar to that in Han populations in Guangzhou (Xia et al, ) and in Zhejiang, an Eastern coastal province in China (He et al, ). Furthermore, we also demonstrate frequencies of the HNA‐3a allele broadly similar to those found in Yi, Han (Nanjing) and Tibetan populations (0·58, 0·66 and 0·69, respectively) (Chen et al, ), which are also similar to the frequency of HNA‐3a/3a, HNA‐3a/3b and HNA‐3b/3b genotypes of 0·528, 0·380 and 0·092 in populations from central Thailand and 0·600, 0·350 and 0·050 in Northern Thailand, respectively (Nathalang et al, ).…”

Assessment of HNA alloimmunisation risk in Northeastern Thais, Burmese and Karen

“…The probabilities of the incompatibility of different HNA systems after random transfusions were estimated based on the HNA allele frequencies of each population using the following formula: mismatch probability = a 2 (1 − a 2 ) + b 2 (1 − b 2 ) = 2 ab (1 − ab ), where a and b are the frequencies of the HNA allele (Xu et al ., ). The potential risk for alloimmunisation against HNA systems was calculated using the following formula: risk for a phenotypes = bb ( ab + aa ) and for b phenotypes = aa ( ab + bb ), where aa, ab and bb are the genotype frequencies (Nathalang et al ., ).…”

Genotype frequency of human neutrophil antigen‐3 polymorphisms in the Yi, Han, and Tibetan populations of China

“…The SLC44A2*2 allele frequencies vary among populations and range in the Han population from 38.2% (Nanning) to 26.2% (Guangzhou) . Although TRALI is much less frequently reported in China than in the United States, the susceptible allele SLC44A2*2 is more prevalent in any East Asian population compared to 17% in Caucasians and 7% in African Americans …”