THE ANTI-C CLONE MS-273 USED TO DETECT THE C ANTIGEN FROM RH BLOOD GROUP SEROLOGICALLY BEHAVES LIKE ANTI-CE (RH7), RATHER THAN A CONVENTIONAL ANTI-C (RH2)
- 1Hospital Central de las Fuerzas Armadas, Uruguay
Abstract
Introduction: The Rh blood group is one of the most important in transfusion medicine. All of its five major antigens, D, C, c, E and e, can provoke strong immune responses, and its alloantibodies are the most frequently found in laboratories across the world. Besides D phenotyping, which is mandatory in blood donor's routines, we also add C, c, E and e phenotype to all blood donors. This massive phenotype program is key for several reasons, and one of them is to have easy and reliable access to compatible blood for alloimmunized patients. All the major Rh antigens have shown antigen variability, with many reports of weak or partial antigens in literature. Several clones of monoclonal antibodies have been developed. For anti-C, we used three clones: MS-24, MS-273 and P3X25513G8 (in conjunction with MS-24), considering them generally interchangeable and only depending on stock availability. After several clear discrepancies between the MS-24 and MS-273 clones, and the suspicion that the serologic behaviour of the MS-273 clone could be that of anti-Ce, we developed a series of serologic analysis to profile the pattern of these discrepancies. Ce+ (RH7) is a compound antigen defined as one carrying C and e as the product of a Ce allele, and both antigens must be present in the same RhCE protein. Serologically, the Ce+/Ce- status can be determined on all persons, except the C+ c+ E+ e+ (13,6% of our population), which need a molecular profile to define it. Objectives: To describe the serologic analysis needed to assess the anti-C clone MS-273 behaviour as an anti-Ce. Material and methods: 1200 samples (1000 D+ and 200 D-) were phenotyped in tube and microplate validated platforms. All donors were analyzed for C, c, E and e; for C two clones were used: MS-24 (either from REDIAR, Argentina, or from DIAGAST, France) and MS-273 (from NovaClone, Immucor, US). Positive weak reactions were not considered a discrepancy, due to possible variant C antigens. Only a clear positive/negative discrepancies were considered. Complete Rh phenotype was recorded and the profile of discrepancies was analyzed. Results: All 200 D- samples were in agreement between the two anti-C clones. Among the D-, no phenotype from a forced CE+ (RH22) allele (C+ e- or c- E+) was detected serologically. The only 3 D- C+ samples were also e+, therefore Ce+. Of the 1000 D+ samples, 16 (1,6%) showed a discrepancy: positive 4+ with MS-24 and negative with MS-273. Of these 16 samples, 10 were C+ c+ E+ e+ and 6 were C+ c+ E+ e- (Ce- CE+). Most importantly, no forced Ce+ (n = 654) showed discrepancies, and all Ce- CE+ (n = 6) were negative with MS-273. 188 samples were C+ c+ E+ e+, with the 10 (5,31%) already mentioned showing a discrepancy. A two-sided Fischer exact test showed a highly significant association between Ce status and MS-273 reactivity (p = 6,52*10E-11). We must consider that some, if not all of the C+ c+ E+ e+ discrepancies are from samples that could be CE/ce, instead of the common Ce/cE, but a molecular confirmation is required for these samples. Discussion: There are two aspects to this study: if a molecular confirmation is added to complete the serological anti-Ce behaviour of the clone MS-273, we would have developed a serological screening method to distinguish between Ce and CE alleles. The second involves the provision of phenotyped blood: a patient with an evanescent alloanti-C could potentially receive C+ if a real C+ Ce- is tested with this clone.
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BibTeX
@article{lopez2026antic,
title = {{THE ANTI-C CLONE MS-273 USED TO DETECT THE C ANTIGEN FROM RH BLOOD GROUP SEROLOGICALLY BEHAVES LIKE ANTI-CE (RH7), RATHER THAN A CONVENTIONAL ANTI-C (RH2)}},
author = {Yuro LÓPEZ and Macarena CAVALLERI and Lorena GUIGOU and Johana GÓNGORA and Rosario GÓMEZ REARDEN},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.107013},
url = {https://doi.org/10.1016/j.htct.2026.107013},
note = {CC BY},
}
RIS
TY - JOUR
TI - THE ANTI-C CLONE MS-273 USED TO DETECT THE C ANTIGEN FROM RH BLOOD GROUP SEROLOGICALLY BEHAVES LIKE ANTI-CE (RH7), RATHER THAN A CONVENTIONAL ANTI-C (RH2)
AU - Yuro LÓPEZ
AU - Macarena CAVALLERI
AU - Lorena GUIGOU
AU - Johana GÓNGORA
AU - Rosario GÓMEZ REARDEN
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.107013
UR - https://doi.org/10.1016/j.htct.2026.107013
AB - Introduction: The Rh blood group is one of the most important in transfusion medicine. All of its five major antigens, D, C, c, E and e, can provoke strong immune responses, and its alloantibodies are the most frequently found in laboratories across the world. Besides D phenotyping, which is mandatory in blood donor's routines, we also add C, c, E and e phenotype to all blood donors. This massive phenotype program is key for several reasons, and one of them is to have easy and reliable access to compatible blood for alloimmunized patients. All the major Rh antigens have shown antigen variability, with many reports of weak or partial antigens in literature. Several clones of monoclonal antibodies have been developed. For anti-C, we used three clones: MS-24, MS-273 and P3X25513G8 (in conjunction with MS-24), considering them generally interchangeable and only depending on stock availability. After several clear discrepancies between the MS-24 and MS-273 clones, and the suspicion that the serologic behaviour of the MS-273 clone could be that of anti-Ce, we developed a series of serologic analysis to profile the pattern of these discrepancies. Ce+ (RH7) is a compound antigen defined as one carrying C and e as the product of a Ce allele, and both antigens must be present in the same RhCE protein. Serologically, the Ce+/Ce- status can be determined on all persons, except the C+ c+ E+ e+ (13,6% of our population), which need a molecular profile to define it. Objectives: To describe the serologic analysis needed to assess the anti-C clone MS-273 behaviour as an anti-Ce. Material and methods: 1200 samples (1000 D+ and 200 D-) were phenotyped in tube and microplate validated platforms. All donors were analyzed for C, c, E and e; for C two clones were used: MS-24 (either from REDIAR, Argentina, or from DIAGAST, France) and MS-273 (from NovaClone, Immucor, US). Positive weak reactions were not considered a discrepancy, due to possible variant C antigens. Only a clear positive/negative discrepancies were considered. Complete Rh phenotype was recorded and the profile of discrepancies was analyzed. Results: All 200 D- samples were in agreement between the two anti-C clones. Among the D-, no phenotype from a forced CE+ (RH22) allele (C+ e- or c- E+) was detected serologically. The only 3 D- C+ samples were also e+, therefore Ce+. Of the 1000 D+ samples, 16 (1,6%) showed a discrepancy: positive 4+ with MS-24 and negative with MS-273. Of these 16 samples, 10 were C+ c+ E+ e+ and 6 were C+ c+ E+ e- (Ce- CE+). Most importantly, no forced Ce+ (n = 654) showed discrepancies, and all Ce- CE+ (n = 6) were negative with MS-273. 188 samples were C+ c+ E+ e+, with the 10 (5,31%) already mentioned showing a discrepancy. A two-sided Fischer exact test showed a highly significant association between Ce status and MS-273 reactivity (p = 6,52*10E-11). We must consider that some, if not all of the C+ c+ E+ e+ discrepancies are from samples that could be CE/ce, instead of the common Ce/cE, but a molecular confirmation is required for these samples. Discussion: There are two aspects to this study: if a molecular confirmation is added to complete the serological anti-Ce behaviour of the clone MS-273, we would have developed a serological screening method to distinguish between Ce and CE alleles. The second involves the provision of phenotyped blood: a patient with an evanescent alloanti-C could potentially receive C+ if a real C+ Ce- is tested with this clone.
SN - 2531-1379
SN - 2531-1387
ER -