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Blood, Vol. 95 No. 4 (February 15), 2000:
pp. 1487-1492
RED CELLS
From the Department of Nursing and Health Sciences, the Hong Kong
Polytechnic University, Hong Kong SAR, China.
The ABO blood group is clinically the most important blood group
system. Elucidation of the molecular basis of the ABO polymorphism allows genotype determination without family studies. Described here is
a new method based on the simultaneous amplification by polymerase
chain reaction (PCR) of 3 fragments from exon 6, and 5' and
3' ends of exon 7 of the ABO gene, followed by single-strand conformation polymorphism (SSCP) analysis. This multiplex PCR-SSCP protocol allows the well-established base changes at 9 nucleotide positions 261, 297, 467, 526, 646, 657, 681, 1059, and 1096 to be
assayed simultaneously so that 7 common alleles (A1,
A1v, A2, B, O1,
O1v, and O2) can be distinguished in a
single-tube single-lane format. Each allele was characterized by a set
of 3 haplotype-specific SSCP patterns. Chinese (n = 125) and white
European (n = 98) samples were analyzed, and their
genotypes were found consistent with the serologic phenotypes or could
be deduced unambiguously. Fifteen samples (2 Chinese and 13 white
European) were each found carrying at least 1 rare allele. Most
of these alleles were new and some might be generated by intragenic
recombination. This technique is the simplest, quickest, and most
informative method reported to date and also readily identifies new alleles.
(Blood. 2000;95:1487-1492)
The ABO blood group system was discovered by Karl
Landsteiner at the beginning of the 20th century. However, it was only
in 1990 that the nucleotide (nt) sequence of the ABO gene was
determined,1,2 and in 1995 that its genomic organization
was elucidated.3 The ABO locus spans over 18 kilobases (kb)
and consists of 7 exons, which range in size from 26 to 688 base pairs
(bp), with most of the coding sequence lying in exon 7.3
The 2 major alleles, A and B, differ in 8 positions at nt 297, 526, 657, 703, 796, 803, 930, and 1096 (Table 1), and 4 of these base substitutions (nt 526, 703, 796, and 803) result in amino
acid substitutions (residues 176, 235, 266, and 268).2,4 The amino acid substitutions at the last 2 positions are critical in
determining the specificity of theglycosytransferase.5
There are 2 A1 alleles, A1 and A1
variant (or A1v); they differ at nt 467 with the resulting
substitution of leucine in A1v for proline in
A1.2 Both are common, though with greatly different frequencies, in the few populations so far
studied.6-9 The A2 allele is characterized by a
single-base substitution at nt 467 (as in the A1v allele)
and a single-base deletion at nt 1059.10 This deletion generates a frameshift and results in an additional domain at the
carboxyl terminal of the mature protein, and is thought to be critical
in determining the activity and substrate specificity of the
transferase.
There are 3 common O alleles. The O1 allele differs from
the A1 allele by a single-base deletion at nt 261 (Table
1), which shifts the reading frame of the coding sequence and leads to
the translation an enzymatically inactive protein.2 The O1 variant (or O1v) allele has not only the
single-base deletion at nt 261 but also another 9 single-base
substitutions when compared with the A1 allele.2,11 The O2 allele does not possess the
nt 261 deletion found in O1 and O1v alleles,
and differs from the A1 allele in 4 nt substitutions, 297, 526, 802, and 1096, resulting in 2 amino acid
substitutions.4,12 These 2 amino acid substitutions were
found to abolish the activity of the transferase expressed in vitro.
Both O1 and O1v are very
common6-9,11,13-15, whereas O2 is
less common.4,5,13,14,16-19
The molecular basis of many other rare alleles has also been
delineated and was reviewed recently.20 This indicates the presence of extensive polymorphism in the coding sequence of the ABO
locus. This is further substantiated by the identification of many more
new rare alleles by single-strand conformation polymorphism (SSCP)
analysis of 4 fragments separately amplified using polymerase chain
reaction (PCR) from the last 2 exons of the gene, which account for
78% of the coding sequences.8,21,22 SSCP analysis detects
single nucleotide polymorphisms (SNPs) and small insertions/deletions on the basis of the differential electrophoretic mobility of
single-stranded DNA fragments with different sequences.23
This report describes the development and use of an ABO genotyping
method based on multiplex PCR-SSCP analysis that can discriminate the
above-mentioned 7 common ABO alleles (A1, A1v,
A2, B, O1, O1v, and O2)
in a single-tube single-lane format. This technique is the simplest,
quickest, most cost-effective, and informative ABO genotyping method
reported to date. Another advantage is its capability of
identifying new alleles very easily.
Samples
PCR amplification
SSCP analysis
Direct sequencing of PCR products For samples to be sequenced, a 2051-bp fragment spanning exon 6, intron 6, and exon 7 was amplified using the primer pair ABOe6F1/ABOi7R4 (Table 2) as described previously with the following modifications: 0.5 µmol/L of each primer, and amplification carried out for 35 cycles of 95°C/1 min and 68°C/3 min. The PCR products were electrophoresed in agarose gel and purified using QIAquick Gel Extraction Kit (QIAGEN GmbH, Hilden, Germany) according to the manufacturer's instructions. The purified PCR products were sequenced using ABI PRISM BigDye Terminator Cycle Sequencing Ready Reaction Kit and the sequenced samples electrophoresed using ABI PRISM 310 Genetic Analyzer (both from Perkin Elmer) according to the manufacturer's protocol with the following modifications. The cycle sequencing was instead carried out for 30 cycles of 96°C/30 s and 60°C/4 minutes 15 seconds in a final reaction volume of 10 µL (half the recommended volume). Three primers were used to sequence to exons 6 and 7: ABOi6R1, ABO-5S (see Samples) and ABOi7R5 (5' TGC AGG CAG CCC TCC CAG AG 3').
SSCP banding patterns Fragment 1 (F1) was amplified from exon 6 and its immediate flanking regions, fragment 2 (F2) from the 5' end of exon 7, and fragment 3 (F3) from the 3' end of exon 7 and the 3' untranslated region (Table 1). Thus, this strategy assayed the known SNPs at nt 261 and 297; at nt 467, 526, 646, 657, and 681; and at nt 1059 to 1061 and 1096, respectively. The numbers of standard SSCP banding patterns were 4 for F1 (1a to 1d corresponding to alleles O1, O1v, A1/A1v/A2, and B/O2), 5 for F2 (2a to 2e corresponding to A1v/A2, A1/O1, O2, B, and O1v), and 3 for F3 (3a to 3c corresponding to B/O2, A1/A1v/O1/O1v, and A2) (Figure 1A and B, and Table 1). In other words, the observed haplotypes of the known SNPs within every amplified fragment each produced a distinctive SSCP pattern.
ABO genotyping of Chinese and white European samples The distribution of ABO genotypes determined by the multiplex PCR-SSCP analysis is shown in Table 3 and the allele frequencies calculated by the method of gene counting are shown in Table 4. The genotypes of the Chinese samples could be determined unambiguously and were consistent with the serologic phenotypes. These genotypes also correlated with those determined by the DGGE method,24 except for 2 cases, given the following differences between the 2 methods. The DGGE method analyzed PCR products (250 bp) amplified from exon 6 and its immediate flanking regions, and thus could not distinguish between alleles A1 and A1v, which differ at nt 467 (exon 7, Table 1). The DGGE method was also unable to differentiate between alleles B and O2, which have the same sequence in exon 6 (Table 1), though allele O2 was not found in the Chinese samples in this study. Incidentally, the O1v allele was found to be identical to the "O2" allele defined by DGGE. Two group O samples, genotyped as O1O1v by the DGGE method, were each found to be heterozygous for O1v and a different rare O allele (Ov1 and Ov4 as shown in Table 5); the genotypes are written as O1vOv in Table 3. These 2 rare O alleles could indeed be typed as the O1 allele when only the F1 fragment was considered (pattern 1a), but they did not have the expected pattern 2b for F2 (see below). Note that Ov is being used here as a generic notation for any "new" O allele other than O1, O1v, and O2.
Description of new alleles New alleles were identified by subtracting the SSCP patterns of the common allele, if present, from those observed in the heterozygotes. This study identified a total of 15 samples (2 Chinese and 13 white European) carrying at least 1 "new" allele (Table 3). Although the white European samples were not typed serologically, the new alleles could still be identified as being A or O alleles. These 15 samples were sequenced for exons 6 and 7. (The nucleotide sequences for new alleles identified in this study have been submitted to GenBank [accession numbers: AF182745 to AF182756].) The SSCP banding patterns for each distinct new allele are shown in Figure 1C, and the corresponding base changes underlying these alleles in Table 5.
Molecular cloning of the ABO gene and elucidation of the molecular basis of its various alleles allow the direct determination of the ABO genotypes without family studies. One group of methods relied on the restriction analysis of SNPs in PCR-amplified products, with or without multiplexing the PCRs.2,4,16,26-30 This approach culminated in the development of a single-tube single-lane genotyping method based on restriction analysis of duplex PCR products and claimed to discriminate 5 alleles (A1, A2, B, O1, and O2).4 However, this particular method and another30 solely relied on the SNP at nt 467 to differentiate A1 and A2, and thus could not distinguish between A1v and A2 (Table 1).
I would like to thank Drs C. Gassner (Central Institute for Blood Transfusion and Immunological Department, General Hospital and University Clinics, Innsbruck, Austria), M. J. Hessner (The Blood Center of Southeastern Wisconsin, Milwaukee, WI), R. L. Sparrow (Red Cross, Blood Bank Victoria, Southbank, Victoria, Australia), and R. Steffensen (Regional Centre for Blood Transfusion and Clinical Immunology, Aalborg Hospital, Aalborg, Denmark) for their provision of DNA samples carrying O2 or A2 alleles. Thanks also go to Dr David Whitehouse (MRC Human Biochemical Genetics Unit, Galton Laboratory, University College, London, UK) for his white European DNA samples. Last but not least, I would also like to thank Dr M. C. Chow (Department of Applied Biology and Chemical Technology, Hong Kong Polytechnic University, HK) for allowing me to use the ABI PRISM 310 Genetic Analyzer.
Submitted February 24, 1999; accepted October 19, 1999.
This study was supported by a departmental research grant (G-S062), Department of Nursing and Health Sciences, Hong Kong Polytechnic University.
Reprints: S. P. Yip, Department of Nursing and Health Sciences, the Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; e-mail: hsspyip{at}polyu.edu.hk.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
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