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RBCs of Asian-type DEL do not undergo antibody-mediated phagocytosis by macrophages.

Created on 21 Jul 2026

Authors

Qi Ren, Tong Li, Ziyue Mi, Yudi Xie, Lushu Cao, Yan Xia, Haixia Xu, Honghong He, Li Tian, Zhong Liu

Published in

Blood transfusion = Trasfusione del sangue. Jun 24, 2026. Epub Jun 24, 2026.

Abstract

In the Rhesus (Rh) blood group system, D is the most immunogenic antigen. RhD-negative patients with anti-D must be transfused RhD-negative red blood cells (RBC) to avoid hemolytic transfusion. RBC of Asian-type DEL phenotype are typed as RhD-negative by routine blood group serological methods because they have very weak expression of D antigen. The prevalence of Asian-type DEL phenotypes was 30% in RhD-negative Chinese donors. Therefore, this DEL type can be transfused to RhD-negative patients with anti-D. However, there is a lack of direct evidence regarding the safety of this practice and potential mechanisms in act.
The proportion of Asian-type DEL donors that serologically tested RhD-negative was investigated by using genotyping. Furthermore, a model system for in vivo clearance was established to assess antibody-mediated phagocytosis of Asian-type DEL RBC by macrophages.
We identified six serologically RhD-negative donors, 16 Asiantype DEL donors according to polymerase chain reaction polymerase chain reaction with sequence-specific primers (PCR-SSP), and six PCR-SSP RhD-positive donors across various regions in China. Our study revealed that antibody-mediated RBC clearance was not observed following co-culture of opsonized Asian-type DEL RBC with macrophages.
Incompatible transfusion of Asian-type DEL RBC may not result in significant RBC clearance.

PMID:
42475658
Bibliographic data and abstract were imported from PubMed on 21 Jul 2026.

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