AB血型个体ABO抗原减弱的原因与探讨*

doi:10.3969/j.issn.1671-2587.2025.01.011

临床输血与检验 ›› 2025, Vol. 27 ›› Issue (1): 76-82.DOI: 10.3969/j.issn.1671-2587.2025.01.011

AB血型个体ABO抗原减弱的原因与探讨^*

赵亚玲, 张媛媛, 邵伟, 王子夜, 马斯禹, 王艳侠, 江欣, 甘佳

中国医学科学院北京协和医院输血科,北京 100730

收稿日期:2024-08-16 发布日期:2025-02-25
通讯作者: 甘佳,主要从事输血医学相关研究,（E-mail）ganjia@pumch.cn。
作者简介:赵亚玲,主要从事临床输血和分子免疫血液学研究,（E-mail）zhaoyaling@pumch.cn。
基金资助:
*本课题受中央高水平临床科研专项项目（No.2022-PUMCH-B-057）资助

Exploration and Analysis of the Causes of ABO Antigen Weakening in AB Blood Group Individuals

ZHAO Yaling, ZHANG Yuanyuan, SHAO Wei, WANG Ziye, MA Siyu, WANG Yanxia, JIANG Xin, GAN Jia

Blood Transfusion Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730

Received:2024-08-16 Published:2025-02-25

摘要/Abstract

摘要： 目的探讨AB血型个体A抗原和/或B抗原减弱的可能原因,为AB血型的准确鉴定提供帮助。方法使用血清学试验与分子生物学相结合的方法鉴定10例ABO抗原减弱的AB型个体,为进一步探究ABO抗原减弱可能的原因,对比分析A型、B型、AB型及ABO抗原减弱型个体的血浆转移酶活性及抗原表达,探究AB型个体抗原减弱可能的原因。结果 10例ABO抗原减弱的AB型个体中,亚型5例,怀疑为白血病相关患者1例,4例抗原减弱原因不明,对比正常的A型和B型,AB型个体血浆糖基转移酶活性无明显差异（P>0.05）,但A抗原和B抗原表达明显减弱;而4例原因不明的血清学B抗原减弱的AB型个体,3例GTA活性无变化但GTB活性略低;1例GTA及GTB活性均有降低;血型亚型个体对应血浆糖基转移酶活性有明显降低。结论 AB型个体ABO抗原表达可能受年龄、疾病、基因多态性、表观遗传修饰及糖基转移酶的竞争作用等多种因素影响,鉴定时应将既往史、病历分析、血清学技术、基因分型技术和糖基转移酶活性分析、甚至表观遗传分析等结合,寻找ABO抗原减弱的原因。

关键词: AB血型, ABO抗原减弱, 糖基转移酶, 竞争作用

Abstract: Objective To investigate the possible reasons for the weakened A and/or B antigens in individuals with AB blood type, aiming to facilitate accurate identification of AB blood type. Methods A combined approach of serological testing and molecular biology was employed to identify ten AB-type individuals with weakened ABO antigens. To further explore the potential causes of ABO antigen weakening, the plasma glycosyltransferase activity and antigen expression were compared among individuals with A, B, AB blood types, and those with weakened ABO antigens, aiming to elucidate the underlying reasons for antigen weakening in all AB-type individuals. Results Among the ten AB-type individuals with weakened ABO antigens, five were identified as subtypes, 1 was suspected of leukemia, and the causes of weakening remained unclear in four cases. When compared with normal A and B types, normal AB-type individuals exhibited no significant difference in plasma glycosyltransferase activity (P>0.05), but their A and B antigen expressions were notably weaker. Among the 4 AB-type individuals with unexplained serological B antigen weakening, three showed no change in GTA activity but slightly lower GTB activity, while one exhibited decreased activities of both GTA and GTB. In contrast, individuals with blood type subtypes displayed significantly reduced plasma glycosyltransferase activities. Conclusion The ABO antigen expression in AB-type individuals may be influenced by multiple factors, including age, disease, genetic polymorphisms, epigenetic modifications, and the competitive effects of glycosyltransferases. Therefore, a comprehensive approach that integrates past medical history, case analysis, serological techniques, genotyping, glycosyltransferase activity analysis, and even epigenetic analysis should be adopted during identification to unravel the reasons for ABO antigen weakening.

Key words: AB blood type, ABO antigen weakening, Glycosyltransferase, Competitive effect

中图分类号:

R457.1⁺1

赵亚玲, 张媛媛, 邵伟, 王子夜, 马斯禹, 王艳侠, 江欣, 甘佳. AB血型个体ABO抗原减弱的原因与探讨^*[J]. 临床输血与检验, 2025, 27(1): 76-82.

ZHAO Yaling, ZHANG Yuanyuan, SHAO Wei, WANG Ziye, MA Siyu, WANG Yanxia, JIANG Xin, GAN Jia. Exploration and Analysis of the Causes of ABO Antigen Weakening in AB Blood Group Individuals[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2025, 27(1): 76-82.

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AB血型个体ABO抗原减弱的原因与探讨^*

Exploration and Analysis of the Causes of ABO Antigen Weakening in AB Blood Group Individuals

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