Abstract
Background
Patients' inflammatory history is an important factor underlying red blood cell (RBC)
alloimmunization, which is a frequent transfusion complication among individuals with
sickle cell disease (SCD). HLA-G has been associated with different inflammatory and
auto - immune diseases. Our goal was to verify whether the HLA-G + 3142 C>G and 14-bp
Ins/Del variations are associated with RBC antibody development among SCD patients.
Methods
This was a single-center case-control study. SCD patients were randomly selected for
the study and divided into two groups: ‘Alloimmunized’ and ‘Nonalloimmunized’ depending
on the presence of irregular antibodies. The ‘Alloimmunized’group was further divided
into two subgroups according to the presence of only antibodies against the Rh and
Kell blood group systems or the existence of antibodies to antigens of the other blood
group systems.
Results
A total of 213 patients were included in the study (110 alloimmunized and 103 non-alloimmunized).
The ‘Alloimmunized’ and ‘Non-alloimmunized’ groups did not differ statistically regarding
the HLA-G + 14 bp Ins/Del ( p = 0.494) and + 3142 C>G ( p = 0.334). Individuals who
had only antibodies against the Rh and Kell antigens had a frequency of HLA-G + 3142GG
genotype almost twice as high compared to the groupwith antibodies against less immunogenic
antigens ( p = 0.043).
Conclusions
The genotype frequency of HLA-G + 3142 C>G differs among alloimmunized SCD patients,
depending on the presence of antibodies against low immunogenic RBC antigens. This
highlights a possible role played by the HLA-G molecule in the RBC alloimmunization
process.
Keywords
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Article info
Publication history
Published online: April 26, 2022
Accepted:
April 7,
2022
Received in revised form:
April 1,
2022
Received:
January 6,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.