Mar 15, The incidence of Rh incompatibility in the Rh-negative mother who is also ABO incompatible is reduced dramatically to % and is believed to. PDF | On Dec 1, , Manuel Olivares G and others published Anemia Tardía en Niños con Incompatibilidad Rh y ABO. Download Citation on ResearchGate | Enfermedad hemolítica del recién nacido por incompatibilidad ABO | The hemolytic disease of the newborn due to ABO.
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To determine the frequency and distribution of ABO and Rh D antigens and, additionally, investigate gene diversity and the structure of Mexican populations. Blood groups were tested insubjects from to For the Rh group, Different distributions of blood groups across regions were found; additionally, genetic analysis revealed that the and allele showed an increasing trend from the north to the center, while u and allele tended to increase from the center to the north.
Also, we found more gene diversity in both loci in the north compared with the center, suggesting population structure in Mexico. This work could help health institutions to identify where they can obtain blood products necessary for medical interventions. Moreover, this piece of information contributes to the knowledge of the genetic structure of the Mexican populations which could have significant implications in different fields of biomedicine.
More than a century has passed since the avo of ABO system by Karl Landsteiner in ; this knowledge has contributed to the understanding of some mechanisms basis of heredity, and today it still has a great conceptual and clinical interest [ 1 ]; also, blood antigens had been related to predisposing individuals to some diseases like cancer, diabetes, infectious diseases, and heart illnesses [ 2 — 4 ] or protecting individuals against some diseases such as malaria and diabetes [ 56 ].
Moreover, blood antigens had been used to evaluate ethnic diversity of human populations [ 7 ], for which they have been widely studied in population genetics [ 89 ]. The ABO and Rh blood groups are the most relevant antigens because their incompatibility produces hemolysis [ 10 ] and hemolytic disease of the newborn in the case of the Rh group [ 11 ]. Furthermore, blood antigens play an important role in the success of transfusions and organ transplants [ 12 ]; compatibility of ABO groups between donors and recipients is desirable to avoid immune responses against allograft and reducing the use of immunosuppressive therapies.
The main challenge is to understand how to promote tolerant immune responses against allograft tissues; different factors such as age, viral serology, and gender had been studied to identify their relationship with allograft rejection. Additionally, the role of ethnicity has been poorly studied [ 13 — 17 ].
For the above, molecular biology has taken great importance to identify genetic variants present in several ethnic groups that r play an important role in the success of allograft transplants between donors and recipients [ incompatibiliadd ].
There are few works about population genetics in Mexico [ 19 — 21 ]. The first studies were performed by Lisker and colleagues, in indigenous and mestizo populations by studying several blood antigens [ 922 ]; however, few populations were studied and currently there is lack of information about blood groups distribution in the country, whereby it is essential to get this information to help health institutions for the effective management of their blood banks that facilitate transplant medicine practices.
Here we report the distribution of ABO and D antigens in 17 states of the country. Additionally, we used the ABO and D loci as gh genetic trait to incompatibilidae gene structure of Mexican populations.
The above will provide information which would support national programs for blood and organ transplant in Mexico as well as increase the knowledge of Mexican genetics. A cross-sectional study was conducted in patients who visited the clinics of Salud Digna para Todos in 17 states of Mexico from to The selection of participants was performed using a nonprobabilistic sampling with information on the blood group test.
From each people, clinical history was obtained before screening for their demographic data. Tubes were inverted for 8 to 10 times to mix well with the incompatibiliadd.
Blood Groups Distribution and Gene Diversity of the ABO and Rh (D) Loci in the Mexican Population
Incimpatibilidad were separated for the determination of blood type. Gene diversity was analyzed according to Nei [ 25 ]. The chi-squared test was performed to compare incompxtibilidad between groups and categories. Data were analyzed with the Minitab V17 software Minitab Inc.
The blood types distribution inpeople studied revealed that O was the most frequent Moreover, the Rh D group was found in The pooled ABO and Rh groups had the following distribution: In contrast, B Rh d 0.
The distribution of pooled blood antigens among age and gender was analyzed; it was found that they had similar frequencies in people ranges from 0 to 90 years Table 1. Interestingly, slight differences were observed in some blood types in both gh.
Icnompatibilidad, O Rh D was most prevalent in women Blood groups were studied in 17 states which belong to 6 regions of Mexico; the blood groups O and Rh D were the most frequent in all states analyzed.
However, their frequencies change across the country Figure 2. The blood type O Rh D was more frequent in Puebla Moreover, A Rh D blood type was more frequent in Sinaloa B Rh D was more frequent in Durango O Rh d was incompatjbilidad frequent in Sinaloa 3. The B Rh d blood type was more frequent in Nayarit 0. Similarly, for the D locus in SinaloaSonoraand Durango the highest heterozygosities were observed, while the lowest heterozygosities were observed in PueblaSan Luis Potosiand Estado de Mexico Table 3.
According to these observations, populations were analyzed to know if they were in the Hardy-Weinberg equilibrium HWE. In contrast, we found that the locus D was in HW equilibrium in all populations analyzed Table 3. The allele frequencies of the ABO and D loci were estimated from the phenotypes observed.
It was found that allele was more frequent in SinaloaJaliscoand Sonorawhile in PueblaEstado de Mexicoand Veracruz it was less frequent Table 3. In SinaloaSonoraand Jalisco this allele was less frequent. PC1 and PC2 explain The PC1 differentiates populations with high frequencies of, and alleles; meanwhile, PC2 separates those with high proportions of and alleles; according to this, four groups could be defined Figure 3.
The first group includes the states of Coahuila, Queretaro, and Incomptaibilidad which have moderate frequencies of the and alleles first quadrant. The second comprises Durango, Aguascalientes, Nuevo Leon, and Guanajuato which have higher proportions of the I B and I D alleles and moderate frequencies of allele second quadrant.
Both groups have states with higher frequencies of the B Rh D and B Rh d blood types; in the second group, there are states with moderate proportions of the AB blood type. Abi geographic clustering in these groups was not evident Figure 3. Interestingly, in the third and fourth group, a geographical clustering was observed; the third group includes the states of Puebla, San Luis Potosi, Estado de Mexico, and Ciudad de Mexico third quadrant which have higher frequencies of and alleles and lower frequencies of the and alleles.
These states are located in the east, north-center, and south-center of the country Table 3. The fourth group has higher frequencies of and alleles and includes the states of Sinaloa, Sonora, Baja California, Michoacan, Jalisco, and Nayarit which belong to northwest and west of Mexico Table 3.
In the second; Sinaloa, Sonora, Jalisco, Michoacan, Nayarit, Baja California, and Durango were included which have higher frequencies of the and alleles in the case of Durango. The states of Aguascalientes, Guanajuato, and Nuevo Leon, also, were included in this group, since they have higher frequencies of the allele and are more related to Durango than the other states of this group Figure 4.
To formally measure the genetic differentiationincompwtibilidad cluster all population studied in 4 main regions and performed analysis for each locus and pooled loci. The overall gene diversity was higher at the ABO locus than the D locus ; similarly, the gene diversity within populations was higher in the ABO locus than the Incompwtibilidad locus.
The regional analysis shows that the highest gene diversity and variability within populations for the ABO locus were found in the west ; ; meanwhile the lowest was observed in the east. For the D locus, the highest gene diversity and variability within the population were observed in the north, and the lowest one was found in the eastTable 4.
The highest genetic differentiation for the ABO incompatiilidad was found in the north and in the west for the D locus.
Surprisingly, a negative value for the genetic differentiation parameter in the east was found, suggesting no differentiation in both loci in this region, which is consistent with low heterozygosities observed Table 4.
The study of blood groups is fundamental in the clinical practice due to the inherent relationship in transfusion medicine and organ transplants [ 12 ]. In Mexico, the rate of blood donations in increased from The above is due to the improvement in donor blood programs established in the country; however, in blood banks it is challenging to get enough blood units, especially for the less frequent blood types. For the above, it is necessary to implement effective programs among health institutions to get specific blood types and products according to their geographic distribution.
However, the information about the proportions of the ABO and Rh D blood groups in Mexico is insufficient; to meet this need here we report the distribution of ABO and Rh D blood groups in several areas of the country.
To our knowledge, this is the first multicenter study of the ABO and Rh D blood groups in Mexico, in which the overall distribution in both genders, in a wide age range, and in different states of the country has been analyzed.
A total ofindividuals from 17 states of Mexico were studied between abk years and We found that the ABO groups distribution was O Our observations were similar to eh reports in which the O group was the most frequent, followed by the A, B, and AB groups [ 29 — 35 ]. Interestingly, the Rh Incompatibildiad antigen was more frequent in Mexico The frequency observed was slightly similar to those found in indigenous populations [ 37 — 39 ], reflecting the complex processes of the admixture giving rise to Mexican mestizo populations [ 9 ].
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The above could be explained by the sampling method used, which would result in the overrepresentation of females in the sample. Previous studies have been conducted in Mexico to determine the local distribution of the ABO and Rh D blood groups; a few of those works were performed in indigenous people [ 3740 — 42 ] and the majority in mestizos [ 29 — 35 ].
For this study, samples were obtained from metropolitan cities, most incompatibipidad which are composed of mestizo individuals; variability in proportions of blood antigens was found in different areas of the country. The frequencies observed in Coahuila, Nuevo Leon, Jalisco, and Ciudad de Abbo were similar to that previously reported [ 30 — 34 ]; however, for Durango, Puebla, and Guanajuato, proportions of blood antigens were different compared with our results [ 29313435 ].
Moreover, the allele frequencies for both loci in previous works were different from those reported here. Additionally, populations studied in those reports were not in Hardy-Weinberg genetic equilibrium HWE in both loci [ 30 — 323435 ] except in Puebla [ 29 ] and Coahuila [ 31 ]. The above could result from nonrandom sampling or internal migrations that happens in this states by their socioeconomic development because the sample size is big and other disturbance events have not been reported in these populations i.
Interestingly, we found that the Rh D locus was in HWE; however, more studies are needed to corroborate our observations. The above is important because if populations are in HWE this means that the observed frequencies incompatibioidad blood groups will be similar in each generation. This information will allow health institutions to obtain enough blood units since the site where it is more frequent to get a specific blood type with incompatibiildad confidence that these frequencies will be rrh constant is known, and it will be not necessary to investigate the distribution of blood groups in these populations again as soon.
Additionally, geographical cline of the ABO and D loci with remarkably high frequencies in the north and the center for the andrespectively, was identified; more studies are needed to explain the possible causes underlying these cline distributions in the country.
Different factors like migrations, nonrandom mating, and infectious diseases among others would confer evolutionary constraints over this genetic trait [ 44344 ]; it would be possible that both loci have some selection pressure resulting in their current distribution in Mexico; however, this remains unexplored yet. In this report, we evidenced regional differences of the blood groups distribution; we suspect that these differences could be a result of differentiation between regions; according to this, we studied the genetic structure of the population by using the ABO and D loci as genetic markers.
Differentiation in Mexican populations was found among regions analyzed; also a higher heterozygosity and gene diversity were observed in the north and west; meanwhile, in the east and south-center incompayibilidad found low heterozygosity and gene diversity.
It is interesting to note that in the east there was no genetic differentiation for both loci which was evident by the negative value of the genetic differentiation estimator [ 45 ]. The above would be possible by the lowest heterozygosity found in Puebla in which the highest frequencies of the and alleles were observed. It would be interesting to investigate the reason for the reduction in heterozygosity of both loci in Puebla.
Rh Incompatibility During Pregnancy (for Parents)
Additionally, it is necessary to sample other populations of the east to corroborate our observations and extend this study to other regions of Mexico to know the countrywide distribution of the ABO and Rh D blood groups. There are a few works about gene diversity in Mexico; our results with the ABO and D loci as a genetic trait are consistent with them in which the genetic structure of indigenous and mestizo populations was explored with SNPs as genetic markers [ 1920 ].
Similar to ours, these works reported that populations in the north have higher heterozygosities with respect to those located in the center and the south of the country [ 20 ]. Additionally, they found genetic stratification in indigenous communities [ 1920 ]. Interestingly, this Native-American population substructure is recapitulated in the genomes of Mexican mestizos [ 19 ] which is consistent with our observations of genetic differentiation in Mexican populations across several regions of the country.