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A new high-prevalence LW antigen detected by an antibody in an Indigenous Australian homozygous for LWA c.309C>A variant
Journal article   Peer reviewed

A new high-prevalence LW antigen detected by an antibody in an Indigenous Australian homozygous for LWA c.309C>A variant

Genghis H Lopez, Brett Wilson, Glenda M Millard, Tanya L Cawthorne, Dianne E Grey, Elizabeth A Fong, Robert L Flower, Catherine A Hyland and Yew-Wah Liew
Vox Sanguinis, Vol.117(7), pp.958-965
2022
DOI: https://doi.org/10.1111/vox.13276
PMID: 35412682
url
https://doi.org/10.1111/vox.13276View
Published Version

Abstract

LWEM Indigenous Australian LW high-prevalence antigen LW8 GenBank MN412704 LW blood group system LW*A c.309C>A polymorphism UniSC Diversity Area - Aboriginal and Torres Strait Islander Engagement
Background and objectives: The LW gene encodes the LW glycoprotein that carries the antigens of the LW blood group system. LW antigens are distinct from D antigen, however, they are phenotypically related and anti-LW antibodies are often mistaken as anti-D. An antibody was detected in an Australian patient of Aboriginal descent who consistently typed as LW(a+b-). This study aimed to describe the antibody recognizing a high-prevalence antigen on the LW glycoprotein. Study design and methods: Samples from the patient and her four siblings were investigated. DNA was genotyped by single nucleotide polymorphism (SNP)-microarray and massively parallel sequencing (MPS) platforms. Red blood cells (RBCs) were phenotyped using standard haemagglutination techniques. Antibody investigations were performed using a panel of phenotyped RBCs from adults and cord blood cells. Results: SNP-microarray and MPS genotyped all family members as LW*A/A, (c.299A), predicting LW(a+b-). In addition, a novel LW*A c.309C>A single nucleotide variant was detected in all family members. The patient and one of her siblings (M4) were LW c.309C>A homozygous. Antibody from the patient reacted positive to all reagent panel RBCs and cord blood cells but negative with RBCs from LW(a-b-), Rhnull and sibling M4. Antibody failed to react with RBCs treated with dithiothreitol. Conclusion: Antibody detected in the patient recognized a novel high-prevalence antigen, LWEM, in the LW blood group system. LWEM-negative patients who developed anti-LWEM can be safely transfused with D+ RBCs, however, D- is preferred. Accurate antibody identification can help better manage allocation of blood products especially when D- RBCs are in short supply.

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