The Dombrock (014) System

By
Alfred Cudjoe
The Dombrock blood group system

Background

• Has the symbol DO and number 014, designated by the ISBT

• Name after Mrs. Dombrock (recipient), found in 1965.

• Prevalence in whites 18%-Do(a+b–), 49%-Do(a+b+), 33%-

Do(a–b+)
Dombrock blood group Antigens

• Originally comprised two antithetical antigens, Do a (1965) and Dob

(1973)

• Later - antigens Jo a (Joseph), Hy (Holley), and Gy a (Gregory) 

• DOYA and DOMR, were recently added to the system

• The antigens are destroyed by the enzymes pronase, trypsin and

chymotrypsin, and by treatment with reducing agents.
 Dombrock blood group Antigens
Early Antigens Recent Antigens

• DOa • DOYA,
• DOb • DOMR
• DOLG
• Gya,
• Hy, Main Phynotypes
• JOa Do(a+b–)
Do(a+b+)
Do(a–b+)
The Dombrock blood group system
Reactivity with anti- Occurrence (%)

RBC DOa DOb Gya Hy JOa Whites Blacks

phenotype
Do(a+b–) + 0 + + + 18 11
Do(a+b+) + + + + + 49 44
Do(a–b+) 0 + + + + 33 45
Gy(a–) 0 0 0 0 0 Rare Rare
Hy– 0 wk wk 0 0/wk Not found Rare
Jo(a–) wk 0/Wk+ + wk 0 Not found Rare
The Dombrock blood group

• The Dombrock antigens are located on a

glycosylphosphatidylinositol (GPI)-anchored protein that is
encoded by the gene ART4 (ADP-ribosyltransferase 4)

• The gene (DO, ART4) encoding the Do glycoprotein, located on

the short arm of chromosome 12,

• The GPI is embedded in the membrane of Dombrock-expressing

cells,
The Dombrock blood group

• DOa has antithetical relationship with DOb

• The DOb antigen is distinguished from the DOa antigen

• DOb contains an amino acid sequence known as an arginine-

glycine-aspartic acid (RGD)

• (RGD) play a role in cell-to-cell interactions.

The Dombrock blood group

• DOa antigen high in Europeans – about 65 percent

• DOb antigen has an increased incidence in Africans and Asians.

• In all populations studied, the Gya, Hy, and JOa antigens have
been estimated to occur in more than 99 percent of individuals
The Dombrock blood group

• The DOa antigen can also be found on lymphocytes and lymph

nodes, in bone marrow, and in the tissues of the spleen, ovaries,
testes, intestines, and fetal heart

• The expression of Dombrock antigens is highest in the fetal liver.

• In very rare cases, none of the five Dombrock antigens are

expressed on red blood cells, resulting in a Dombrock-null
phenotype (Gy(a–)
The Dombrock blood group

• The absence of Dombrock antigens can occur as a result of the

loss of GPI-anchored proteins from the surface of red blood
cells.

• The loss of these proteins underlies a rare condition known as

paroxysmal nocturnal hemoglobinuria, in which red blood cells
undergo premature destruction by immune cells.
Antibodies

• Anti-Doa and anti-Dob are rarely found

• But they have been implicated in causing hemolytic transfusion

reactions.
• Antibodies in the Dombrock blood group system can be difficult
to identi
• React optimally by column agglutination technology or by the
IAT using
• papain- or ficin-treated RBCs.
Clinical significances

• Rarely does it cause transfusion reactions

• But transfusion reactions have been reported

Reference

• Warke N, Poole J, Mayer B, et al. New antigen in the Dombrock

blood group system: DOYA (abstract). Transfusion 2008;48
(Suppl.):209A.

• Costa FP, Hue-Roye K, Sausais L, et al. Absence of DOMR, a

new antigen in the Dombrock blood group system that weakens
expression of Do, Gy, Hy, Jo, and DOYA antigens. Transfusion
2010 (in press)
Thank you