16 Review Article Page 1 of 16 Glycophorins and the MNS blood group system: a narrative review Genghis H. Lopez1,2, Catherine A. Hyland1,3, Robert L. Flower1,3 1Clinical Services and Research Division, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia; 2School of Medical Science, Griffith Health, Griffith University, Gold Coast, Queensland, Australia; 3School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Genghis H. Lopez, PhD. Clinical Services and Research Division, Australian Red Cross Lifeblood, 44 Musk Avenue, Kelvin Grove, Queensland 4059, Australia. Email:
[email protected]. Abstract: The MNS blood group system, International Society of Blood Transfusion (ISBT) 002, is second after the ABO system. GYPA and GYPB genes encode MNS blood group antigens carried on glycophorin A (GPA), glycophorin B (GPB), or on variant glycophorins. A third gene, GYPE, produce glycophorin E (GPE) but is not expressed. MNS antigens arise from several genetic mechanisms. Single nucleotide variants (SNVs) contribute to the diversity of the MNS system. A new antigen SUMI (MNS50), p.Thr31Pro on GPA has been described in the Japanese population. Unequal crossing-over and gene conversion are the mechanisms forming hybrid glycophorins, usually from parent genes GYPA and GYPB. GYPE also contributes to gene recombination previously only described with GYPA. Recently, however, GYPE was shown to recombine with GYPB to form a GYP(B-E-B) hybrid.