Comprehensive Analysis of ABO Blood Group Phenotypic and Genotypic Frequency Among A Cohort of Egyptian Blood Donors

Comprehensive Analysis of ABO Blood Group Phenotypic and Genotypic Frequency Among A Cohort of Egyptian Blood Donors | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comprehensive Analysis of ABO Blood Group Phenotypic and Genotypic Frequency Among A Cohort of Egyptian Blood Donors Faiza Essawy, Manal Zahran, Sara Abdelaty, Fawzy Roshdy, Rady Eid El-Araby, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7115350/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Background Given that ABO blood group antigens vary among different ethnic groups and populations, a precise understanding of ABO phenotypes and genotypes is crucial for managing blood bank inventory and ensuring high-quality blood transfusion services. This is implemented to avert lethal incompatibilities following organ transplantation or blood transfusion. This study seeks to identify the prevalent ABO phenotypes and genotypes among a cohort of Egyptian random blood donors and to compare these findings with previously published data from various populations and ethnic groups. Results The distribution of ABO phenotypes in the investigated subjects was 37% for A (35% for A 1 & 2% for A 2 ), 30% for O, 22% for B, and 11% for AB (10% for A 1 B & 1% for A 2 B). however, the allelic distribution of the ABO blood group system revealed frequencies of A allele (29%), B allele (20%), and O allele (51%). In regards to the sub-allelic frequencies of ABO genotypes the results were as follows: A 1 A 1 (6%), A 1 A 2 (3.3%), A 1 O del (26%), A 1 O non − del (0.0%), A 2 A 2 (1.7%), A 2 O del (0.0%), A 2 O non − del (0.0%), BB (8%), BO del (14%), BO non−del (0.0%), O del O del (30%), O del O non−del (0.0%), O non−del O non−del (0.0%), AB (9.3%), and A 2 B (1.7%) in the Egyptian sample population, respectively. Conclusion This work provides a thorough profiling of the ABO blood group phenotypic, allelic, and genotypic distributions in an Egyptian blood donor cohort. The most common phenotype was A (37%), (A1 > A2), followed by O (30%), B (22%), and AB (11%) showing a distribution pattern that was largely in line with that of other Middle Eastern populations. The O allele predominance was confirmed at the allelic level, where the O allele was most prevalent, followed by A and B. Odel/Odel was the most prevalent genotype suggesting that Odel variations may be more prevalent in the Egyptian population. These results emphasize the critical importance of sub-allelic profiling in understanding blood group diversity within a given population which might have implications in population genetics, genetic association research, genetic diseases and blood transfusion compatibility. ABO blood groups ABO genotypes Egyptian donors Introduction The body requires blood to transport oxygen, nutrients, waste products, and hormones. The ABO blood group system, despite the existence of approximately 100 blood group systems and 500 antigens, is the most clinically significant in organ transplantation and blood transfusion programs (Jahanpour et al., 2017). Karl Landsteiner was awarded the Nobel Prize in 1930 for his discovery made in 1900 (Garratty et al., 2000). In 1902, Adriano Sturli and Alfred von Decastello discovered the fourth blood group, designating it as blood group AB (Decastello et al., 1902). ABO antigens on the surface of red blood cells exhibit diverse phenotypes and genetically determined glycoconjugate structures that significantly influence the physiology and pathology of the cells. (Abdulganiyu 2016). The ABO gene comprises seven coding exons, spanning approximately 18 kb of genomic DNA, with exon sizes ranging from 28 to 688 bp. The gene is situated in the 9q34.1–q34.2 region of chromosome 9. Significant polymorphisms exist in its upstream and downstream untranslated regions, along with its exons and introns. These mutations alter the specificity of the gene product (glycosyltransferase) and signify the presence of A or B antigens. (Storryjrolsson et al., 2009). More than 100 ABO alleles could be characterized by various SNPs involving coding and non-coding regions; the most prevalent ABO alleles are ABO*A1.01, ABO*B.01, and ABO*0.01. (Yip, 2002). This study aimed to determine the commonality of ABO phenotypes and genotypes among a cohort of Egyptian random blood donors and compared the results with earlier published data of diverse populations and ethnic groups. Methods The current study received approval from the institutional review board and ethical committee of the Theodor Bilharz Research Institute (TBRI). All procedures were executed in compliance with the Declaration of Helsinki. The ABO genotype and phenotype of 300 healthy Egyptian blood donors were evaluated and compared with diverse populations and ethnic groups. The inclusion criteria comprised Egyptians who were healthy individuals (volunteers, medical students, blood donors, paramedical personnel, and health workers) with no history of benign or malignant diseases and those who tested negative for HBsAg and HCV antibodies via enzyme-linked immunosorbent assay (ELISA). Exclusion criteria encompassed individuals with a history of benign or malignant diseases, diabetes mellitus, and those testing positive for hepatitis B surface antigen (HBsAg) or hepatitis C virus antibodies (HCV Abs). The study conducted HBsAg and HCV Ab screening using the ELISA technique (DIALAB ELISA kits, Austria, Cat. Nos. Z00360 and Z01370, respectively). All participants provided informed consent. After taking informed consent, they were subjected to a detailed questionnaire regarding residence, habits (smoking and alcohol), weight, height, and family history of liver cancer (defined as liver cancer in any of the first-degree relatives). We then collected blood samples under aseptic conditions using a clean venipuncture and a disposable vacuum collection system. 5 mL of blood was withdrawn and divided into the following three portions: A- We delivered 1 ml of blood into a vacutainer containing potassium ethylenediaminetetraacetic acid (EDTA) for forward ABO blood grouping. B- We delivered 2 ml of blood into a plain Vacutainer and allowed it to clot at room temperature. The serum was separated by centrifugation at 2000 rpm for 10 min, and it was used to perform ABO reverse blood grouping and to screen for viral hepatitis markers (HBsAg & HCV Abs). C- 2 ml of blood were delivered into a vacutainer containing potassium EDTA; they were stored at -80°C for subsequent DNA extraction and ABO genotyping. The ABO phenotypes were done by using commercially available monoclonal antibodies (Biotech, UK). We used whole blood samples in EDTA. A tube test was performed using equal volumes (50 µl) of monoclonal reagents (anti-A, anti-B, anti-A, B) (Biotech, UK) and 5% RBC suspensions in saline in appropriately labeled tubes. After thorough homogenization of the contents in each tube, the tubes underwent centrifugation for one minute at 1000 rpm. We then manually observed the presence of agglutination in each tube. Anti-A1 lectin was utilized to identify individuals with positive anti-A monoclonal antibody results to validate their A1 status. DNA was collected for ABO genotyping using the HighPure polymerase chain reaction (PCR) Template Preparation Kit. (Roche Diagnostics, Germany, Cat. No. 11796828001). As shown in Table 1 , four separate reactions, each using a unique LightSNip Detection mix, were used to identify the ABO alleles A2, B, O del , and O non−del . By excluding the four variant alleles A2, B, O del , and O non−del from consideration, the existence of the “wild type A1” allele was indirectly inferred. Real-time PCR was used to amplify DNA on a LightCycler 480II instrument. (Roche Diagnostics, Mannheim, Germany). In the PCR reaction, we utilized 10.4 µl of deionized water, 1.6 µl of magnesium chloride, 2 µl of Roche Diagnostics' FastStart DNA master (Cat. No. 05015278001), 5 µl of DNA template, and 1 µl of each LightSNiP detection reagent mix for the designated allele-specific LightSNiP detection reagent mix (TibMolbiol, Berlin, Germany). A thermal cycling protocol was executed, comprising 45 amplification cycles at 95°C for 10 seconds, 60°C for 10 seconds, and 72°C for 15 seconds. The preliminary stage consisted of denaturation at 95°C for 10 minutes. Alleles were identified via melting curve analysis, consisting of one cycle at 95°C for 30 seconds, 40°C for 2 minutes, and 75°C, followed by a 30-second cooling period at 40°C. Table 1 “LightSNip detection mixes” for detection of A 2 , B, O del , and O non−del alleles. Rs number Expected results A 2 alleles B alleles O del O non−del Rs 8176746 C A C C Rs 8176719 G G - G Rs 8176704 T C C C Rs41302905 C C C T nt: nucleotide; C: cytosine; G: guanine; T: thymine; A: adenine; (−): deletion; Rs: reference sequence; SNP: single nucleotide polymorphism. Statistical analysis: “Microsoft Excel 2016 and the social science statistical software IBM (SPSS) Statistics for Windows, version 26” (IBM Corp., Armonk, N.Y., USA) were used for analysis of the data. We considered a p-value of 0.05 or less to be statistically significant for categorical variables, presenting them as frequencies and percentages. Hardy-Weinberg (H-W) equilibrium was applied to each genotype, and the distribution of categorical variables between the observed and expected ABO genotypes was assessed using the χ² test. The Student's t-test for independent samples is employed when the data follows a normal distribution. The Mann-Whitney U test for independent samples was utilized for non-normally distributed data, facilitating comparisons of numerical variables between the study groups and other ethnic populations. The chi-square (χ²) test was employed to compare categorical data. Results The distribution of ABO phenotypes among the subjects studied was as follows: 37% A (35% A1 and 2% A2), 30% O, 22% B, and 11% AB (10% A1B and 1% A2B). The predominant phenotype was A1, while the least prevalent was A2B. (Table 2 ) Table 2 The frequency of ABO blood group phenotype in the studied Egyptian sample Phenotype number Frequency (%) A 1 106 (35%) A 2 5 (2%) O 90 (30%) B 66 (22%) A 1 B 29 (10%) A 2 B 4 (1%) The major ABO allelic frequencies were 25.7% for A1, 4.5% for A2, 49.7% for O del , 0.0% for O non−del , and 20.5% for B alleles in the study sample of healthy Egyptians. O del had the highest allele frequency, and we were unable to detect any O non−del in the population we were studying. (Table 3 ). Table 3 A 1 , A 2 , B, and O Allele Frequencies in the studied Egyptian sample Allele Number Allele Frequency A 1 154 25.7% A 2 27 4.5% O del 296 49.3% O Non−del 0 0% B 123 20.5% Total 600 100% In terms of ABO genotypes, OO (30%) and AO (26%) were the most common genotypes, followed by BO (14%), while BB was the least common (8%) (Table 4 ). The frequencies of ABO genotypes were as follows: A 1 A 1 (6%), A 1 A 2 (3.3%), A 1 O del (26%), A 1 O non − del (0.0%), A 2 A 2 (1.7%), A 2 O del (0.0%), A 2 O non − del (0.0%), BB (8%), BO del (14%), BO non−del (0.0%), O del O del (30%), O del O non−del (0.0%), O non−del O non−del (0.0%), AB (9.3%), and A 2 B (1.7%) in the Egyptian sample population, respectively. O del O del was the most prevalent gene, followed by A 1 O del and BO del (Table 4 ) Table 4 ABO Genotype frequencies and percentages in the studied Egyptian population Phenotype ABO Genotypes Frequency Percent A 1 A 1 A 1 18 6.0% A 1 A 2 10 3.3% A 1 O del 78 26.0% A 1 O Non − del 0 0.0% A 2 A 2 A 2 5 1.7% A 2 O del 0 0.0% A 2 O Non − del . 0 0.0% B BB 24 8.0% BO del 42 14.0% BO Non−del 0 0.0% O O del O del 90 30.0% O del O Non−del 0 0.0% O Non−del O Non−del 0 0.0% AB A 1 B 28 9.3% A 2 B 5 1.7% Total 300 100.0% No statistically significant variances were revealed between the frequencies of observed and expected genotypes. The results demonstrated that the ABO genotypes of the arbitrarily collected samples existed in H-W equilibrium data. A concordance rate of 100% was spotted between the existent genotype and the “serologically based” expected genotype (Table 5 ). Table 5 Hardy-Weinberg (H-W) equilibrium for comparison between Observed and Expected Major ABO Genotypes Major ABO Genotypes Number Observed results % (Current Study) Expected results (H-W equilibrium) P. value AA 33 11 0.09 0.5 AB 33 11 0.12 0.6 AO 78 26 0.30 0.4 BB 24 8 0.04 0.2 BO 42 14 0.21 0.1 OO 90 30 0.25 0.4 Total 300 100 1.0 H-W equilibrium: Hardy-Weinberg equilibrium. Table 6 Evaluation of the major ABO allelic frequencies in the Egyptian Population versus Other Populations Population A B O References Allele frequency % p. value Allele frequency % p. value Allele frequency % p. value Egyptian 29 - 20 - 51 - (Current Study) Sudanese 19 0.8 14 0.06 66 0.001** (Khalil et al., 1989) German 29 0. 4 10 0.001** 61 0.02* (Lang et al., 2016) White European 21 0.8 12 0.02* 65 0.001** (Yip, 2000) Palestinian 24 0.4 16 0.2 60 0.03* (Saqer and Sharif, 2013) Chinese 28 0.06 30 0.03* 41 0.001** (Zhang et al., 2015) Kuwaitis 13 0.04* 16 0.3 70 0.001** (El-Zawahri & Luqmani, 2008) Jordan 27 0.1 13 0.03* 60 0.03* (Irshaid et al., 2002) Saudi Arabia 21 0.9 15 0.2 63 0.001** (Mohamed et al., 2016) Iranian 23 0.4 18 0.5 58 0.08 (Nojavan et al., 2012) Bahraini 14 0.07 16 0.2 70 0.001** (Al-Arrayed et al., 2001) Lebanese 33 0.01* 9 0.001** 57 0.1 (Kfoury et al., 2001) Iraqi 21 0.8 18 0.5 66 0.02* (Tills et al., 1983) A p-value ≤ 0.05 is significant; a p-value ≤ 0.01 is highly significant.**. Discussion Ever since Landsteiner's identification of the ABO blood groups in 1900, blood group testing has established itself as the conventional technique for ascertaining the antigenic characteristics of red blood cells (RBCs), which vary among different populations and ethnicities. The fundamental measure for averting potentially lethal mismatches in blood transfusions or organ transplants is now the assessment of "ABO phenotype, genotype, and their allelic distributions." (Zaid & Mostafa 2020). A recent comprehensive genomic analysis by Rophina et al. (2025) highlighted the extensive ABO allelic diversity across the Middle East. Drawing from large-scale public datasets—including the Greater Middle East Variome, Iranome, and the Qatar Genome Project—the study identified over 18,000 variants of blood group genes, with 2,443 exonic variants, many of which were novel and clinically significant. Several of these were located within the ABO gene locus, emphasizing the region’s genetic complexity. The presence of Egyptian-linked genomes in these datasets supports the idea that the ABO sub-allele patterns observed in our study reflect broader Middle Eastern genetic variation The distribution of the primary ABO blood group phenotypes among the subjects of this study indicated that A1 was the most prevalent phenotype (35%), whereas A 2 B was the least prevalent (1%). A 2018 study by Swelem et al., supported by a large dataset from Fayoum University (n = 10,662) on the Egyptian population, showed that blood group A was the most common at 39.4%, while blood group AB was the least common at 10.6%, which matched our findings. A study by Zaid and Mustafa (2020) examining the distribution of ABO blood group antigens in the Middle East and North Africa (MENA) region revealed that blood group O was the most prevalent in Iraq (37%), Qatar (45%), Saudi Arabia (55%), Sudan (66.8%), and the United Arab Emirates (48.4%); however, blood group AB was the least common across all reviewed countries (7.6%, 6.5%, 4%, and 0%). Notably, blood group A was the predominant type in Turkey (42.2%), aligning with our findings. Additionally, the genotypic frequencies of the predominant ABO genotypes in the Egyptian sample population were ascertained for this study, revealing that the O del O del genotype exhibited the highest frequency (30%), the BB genotype demonstrated a lower frequency (8%), while A2A2 & A2B showed the least frequent alleles (1.7%). This aligns with findings by Essawy et al. (2020), who reported that the OO genotype was the most common (31.3%), while the BB genotype was among the least prevalent, observed in only 8.1% of individuals. This study represented the first investigation into the distribution of ABO alleles and sub-alleles in an Egyptian cohort, where the allelic distribution of the ABO blood group system revealed frequencies of A allele (29%), B allele (20%), and O allele (51%) within the sampled Egyptian population. These findings are broadly consistent with previous large-scale investigations conducted among Egyptian cohorts. For example, Abdelmonem et al. (2019) studied more than 40,000 blood donors nationwide and reported allele frequencies of A: 25.4%, B: 18.1%, and O: 56.5% using standard phenotypic inference models. Similarly, a more recent university hospital-based cohort study (2022) estimated frequencies of A: 27.9%, B: 19.5%, and O: 52.6%. These closely parallel our observed data, particularly for the B and O alleles, affirming the robustness and representativeness of our findings within the broader Egyptian context. The slight elevation in the A allele frequency observed in our study “A (29%)” compared to previous reports “A (25–28%)” may reflect either regional or sampling variation. The greater resolution provided by genotyping methods applied in this investigation could also explain this difference. Similarly, the B and O allele frequencies are consistent with those reported for the Egyptian population and corroborate numerous independent datasets. Furthermore, our study provides a comparative evaluation of ABO allele frequencies between the Egyptian population and several other populations from Africa, the Middle East, Europe, and Asia. The frequencies observed in our study—A: 29%, B: 20%, O: 51%—demonstrate notable patterns when compared to these populations (Khalil et al., 1989), (Lang et al., 2016), (Yip, 2000), (Saqer and Sharif, 2013), (Zhang et al., 2015), (El-Zawahri & Luqmani, 2008), (Irshaid et al., 2002), (Mohamed et al., 2016), (Nojavan et al., 2012), (Al-Arrayed et al., 2001), (Kfoury et al., 2001), (Tills et al., 1983). The A allele frequency (29%) in the Egyptian cohort is comparable to that in Germans (29%) and Chinese (28%), with no statistically significant difference (p > 0.05) in most comparisons except for Kuwaitis (13%, p = 0.04 ) and Lebanese (33%, p = 0.01 ), indicating some level of regional and ethnic variability. Interestingly, despite genetic proximity, significant differences exist even within the Middle East, as shown by the lower A allele frequencies in Bahraini (14%) and Kuwaiti (13%) populations. The B allele frequency (20%) in the Egyptian cohort is largely consistent with values reported in Palestinians (16%), Jordanians (13%), and Iranians (18%), with most p-values above the 0.05 threshold, indicating no significant difference. However, significant differences were noted when compared to German (10%, p = 0.001 *) and Lebanese (9%, p = 0.001 *) populations, in which they showed markedly lower B allele frequencies. The O allele, typically the most common globally, showed a notably lower frequency in Egyptians (51%) compared to nearly all other populations analyzed. Highly significant differences ( p < 0.01 ) were reported when compared with Sudanese (66%), White Europeans (65%), Kuwaitis (70%), and others, with only Iranians (58%) and Lebanese (57%) showing non-significant differences (p = 0.08 and 0.1, respectively). These findings support the conclusion that while Egypt shares allelic affinity with certain Middle Eastern and European populations, it also demonstrates distinct patterns, particularly in its reduced O allele frequency, which may be influenced by population structure, historical admixture, or genetic drift. Notably, populations such as the Sudanese, Kuwaitis, and Bahrainis showed significantly higher O allele frequencies (66–70%, p < 0.001 *), indicating clear regional divergence. Comparative studies across the Middle East also support the general pattern seen in our data. In Saudi Arabia, for example, Mohamed et al. (2016) reported ABO allele frequencies of A: 24.8%, B: 21.3%, and O: 53.9%, with similar distributions having been observed in Kuwait, Sudan, and the United Arab Emirates, where the O allele consistently dominates. These parallels suggest a shared genetic background and ancestral link among populations in the MENA region, especially concerning the high prevalence of the O allele. In addition, Rophina et al. 's (2025) study on the pan-Middle East region provided genomic insights toward the molecular foundations of such distributions. Using the Greater Middle East Variome, Qatar Genome, and Iranome projects, which include over 2,800 whole-genome and exome sequences, they uncovered significant ABO allelic diversity, notably with the O allele variants, especially O del , being highly prevalent across many regional genomes. The inclusion of the Egyptian genome in these datasets strengthens the argument in support of the assumption that the ABO allele distributions in our study are representative not just of Egypt but also of a larger proportion of the Middle East populations. The consistency of A and B frequencies across the Palestinian, Jordanian, Iranian, and Saudi Arabian populations suggests a degree of shared ancestry or gene flow across the Levant and Arabian Peninsula. Conversely, the significant differences in allele distributions between Egyptians and populations such as Germans and White Europeans emphasize the importance of ethnic and regional specificity in blood group genetics, which has implications for transfusion practices, population genetics, and disease association studies. Notably, the absence of similar sub-allelic data in recent publications highlights the novelty and importance of our study. Conclusion Our study presents the first comprehensive data on the prevalence of ABO alleles and suballeles in the Egyptian population. The observed allele distribution demonstrates a close genetic resemblance to Middle Eastern populations and certain European groups, including the English, Swedish, and German. These findings have important implications for the design and implementation of national blood transfusion services. By understanding the genetic makeup of the population, healthcare providers in Egypt can optimize strategies for recruiting blood donors, improve blood inventory management, and enhance the safety and efficiency of transfusion practices. Furthermore, our results contribute valuable information to the field of population genetics by shedding light on the ancestral and evolutionary relationships between the Egyptian population and other global populations. This genetic insight may help refine models of human migration and population history in the region. In addition, accurate knowledge of ABO and RhD group frequencies is crucial for forensic science, including the resolution of disputed paternity and identity cases. Finally, the study's findings can support ongoing efforts to investigate associations between specific blood groups and susceptibility to certain diseases. A recent allelic study conducted in Egypt by Elsayed et al. (2025) investigated the association between ABO gene polymorphisms and von Willebrand factor (vWF) levels in pediatric patients with acute lymphoblastic leukemia (ALL). The study identified a significant correlation between the rs2519093 C allele and an increased risk of ALL among Egyptian children. Notably, the incidence of ALL was found to be higher among individuals with O, A, and B blood group phenotypes compared to individuals with the AB phenotype. As research continues to uncover links between blood group antigens and various health conditions—including infectious diseases, cardiovascular disorders, and cancer—these data may guide public health planning and the development of targeted disease prevention strategies tailored to the Egyptian population. Abbreviations del deletion DNA Deoxyribonucleic acid ELISA enzyme-linked immunosorbent assay HBsAg hepatitis B surface antigen HCV Abs hepatitis C virus antibody EDTA Ethylenediaminetetraacetic acid PCR polymerase chain reaction nt nucleotide C cytosine G guanine T thymine A adenine (−) deletion Rs reference sequence SNP single nucleotide polymorphism SPSS Social Science Statistical Software IBM H-W Hardy-Weinberg RBCs red blood cells VWF Von Willibrand Factor ALL Acute Lymphoblastic Leukemia Declarations Ethics approval: This study was approved by the ethical committees of Theodor Bilharz Research Institute, Giza-Egypt and informed consent was obtained from all participants. All authors confirm that the paper represents honest work and verify that all the reported results are valid. Consent for publication from participant: Not applicable Duplicate publication: The manuscript has not been submitted to any other journal, nor has a substantially similar form (in print or electronically, including on a website) been accepted for publication elsewhere, and it is not under consideration by another publication Availability of data and material: All data generated or analyzed during this study are included in this published article. A consent to participate declaration: All participants provided informed consent. A declaration of any potential competing interests All Authors of this manuscript declare no conflict of interest. Funding information: This work took place at the Theodor Bilharz Research Institute, Cairo University and it was funded by the institute. Authors’ contribution: Dr. Faiza Essawy, MD, is a professor of hematology at Theodor Bilharz Research Institute; she is the principal investigator (PI) of the study. Dr. Manal Zahran, MD, is a professor of hematology at Theodor Bilharz Research Institute and the co-PI. Dr. Sara Abdelaty, MD, lecturer of clinical pathology and hematology at Theodor Bilharz Research Institute, was responsible for writing and reviewing the manuscript. Dr. Fawzy Roshdy, Ph.D., at the Central Lab of Theodor Bilharz Research Institute, was tasked with sample collection and securing informed consent from the patients. Dr. Rady Eid EL-Araby , Ph.D., at the Division of Oral Biology, Dept. of Periodontology, Tufts University, School of Medicine, Boston, MA. USA was responsible for the statistical analysis. Dr. Alaa Gad serves as an assistant professor in the Hematology department at the Faculty of Medicine, Cairo University; she authored and submitted the manuscript of the paper. Finally, Dr. Rabab Foad, M.D., serves as an assistant professor of hematology at Theodor Bilharz Research Institute. She engaged in case selection, patient sample collection, and manuscript composition. All authors contributed to the analysis and interpretation of results. Acknowledgement: We would like to express our gratitude to Theodor Bilharz Research Institute for giving us the chance to accomplish this piece of work with the help of its competent technicians and the updated equipment and instrumentation. References Jahanpour O, Pyuza JJ, Ntiyakunze EO, Mremi A, Shao ER. ABO and rhesus blood group distribution and frequency among blood donors at Kilimanjaro Christian Medical Center, Moshi, Tanzania. BMC Res Notes. 2017;10(1):738. Garratty G, Dzik W, Issitt PD, Lublin DM, Reid ME, Zelinski T. Terminology for blood group antigens and genes: historical origins and guidelines in the new millennium. Transfusion. 2000;40:477–89. Von Decastello A, Sturli A. Ueber die Iso agglutinin in serum gesunder and Kranaker Menschen. Mfiner Med WSchr. 1902;49:1090–5. Abdulganiyu. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7115350","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":493264359,"identity":"c2529b62-a2e6-4036-8277-91889a457eb5","order_by":0,"name":"Faiza Essawy","email":"","orcid":"","institution":"Theodor Bilharz Research Institute","correspondingAuthor":false,"prefix":"","firstName":"Faiza","middleName":"","lastName":"Essawy","suffix":""},{"id":493264360,"identity":"3ac36db5-6c47-40c8-acb2-31a51c1e0e64","order_by":1,"name":"Manal Zahran","email":"","orcid":"","institution":"Theodor Bilharz Research Institute","correspondingAuthor":false,"prefix":"","firstName":"Manal","middleName":"","lastName":"Zahran","suffix":""},{"id":493264362,"identity":"eeae9918-5f70-4a2a-b329-42e774e6db65","order_by":2,"name":"Sara Abdelaty","email":"","orcid":"","institution":"Theodor Bilharz Research Institute","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"","lastName":"Abdelaty","suffix":""},{"id":493264363,"identity":"9a4b0c0e-122f-4603-b834-657f0afa0a2d","order_by":3,"name":"Fawzy Roshdy","email":"","orcid":"","institution":"Theodor Bilharz Research Institute","correspondingAuthor":false,"prefix":"","firstName":"Fawzy","middleName":"","lastName":"Roshdy","suffix":""},{"id":493264364,"identity":"66beb689-e947-4062-8ddb-d2af7b47b030","order_by":4,"name":"Rady Eid El-Araby","email":"","orcid":"","institution":"Tufts University","correspondingAuthor":false,"prefix":"","firstName":"Rady","middleName":"Eid","lastName":"El-Araby","suffix":""},{"id":493264365,"identity":"a08c2892-e625-405c-a072-4884f6ab1642","order_by":5,"name":"Alaa Gad","email":"data:image/png;base64,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","orcid":"","institution":"Cairo University","correspondingAuthor":true,"prefix":"","firstName":"Alaa","middleName":"","lastName":"Gad","suffix":""},{"id":493264366,"identity":"7c98ce4f-b0eb-4435-ab23-2d0d1f56a0fd","order_by":6,"name":"Rabab Fouad","email":"","orcid":"","institution":"Theodor Bilharz Research Institute","correspondingAuthor":false,"prefix":"","firstName":"Rabab","middleName":"","lastName":"Fouad","suffix":""}],"badges":[],"createdAt":"2025-07-13 20:38:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7115350/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7115350/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87996674,"identity":"895f7627-d339-4366-b7f7-744914e94865","added_by":"auto","created_at":"2025-07-31 09:34:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":904319,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7115350/v1/8edb2a8b-ee6f-4d35-9905-e428a0f9b6ea.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comprehensive Analysis of ABO Blood Group Phenotypic and Genotypic Frequency Among A Cohort of Egyptian Blood Donors","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe body requires blood to transport oxygen, nutrients, waste products, and hormones. The ABO blood group system, despite the existence of approximately 100 blood group systems and 500 antigens, is the most clinically significant in organ transplantation and blood transfusion programs (Jahanpour et al., 2017). Karl Landsteiner was awarded the Nobel Prize in 1930 for his discovery made in 1900 (Garratty et al., 2000). In 1902, Adriano Sturli and Alfred von Decastello discovered the fourth blood group, designating it as blood group AB (Decastello et al., 1902).\u003c/p\u003e\u003cp\u003eABO antigens on the surface of red blood cells exhibit diverse phenotypes and genetically determined glycoconjugate structures that significantly influence the physiology and pathology of the cells. (Abdulganiyu 2016).\u003c/p\u003e\u003cp\u003eThe ABO gene comprises seven coding exons, spanning approximately 18 kb of genomic DNA, with exon sizes ranging from 28 to 688 bp. The gene is situated in the 9q34.1–q34.2 region of chromosome 9. Significant polymorphisms exist in its upstream and downstream untranslated regions, along with its exons and introns. These mutations alter the specificity of the gene product (glycosyltransferase) and signify the presence of A or B antigens. (Storryjrolsson et al., 2009). More than 100 ABO alleles could be characterized by various SNPs involving coding and non-coding regions; the most prevalent ABO alleles are ABO*A1.01, ABO*B.01, and ABO*0.01. (Yip, 2002).\u003c/p\u003e\u003cp\u003eThis study aimed to determine the commonality of ABO phenotypes and genotypes among a cohort of Egyptian random blood donors and compared the results with earlier published data of diverse populations and ethnic groups.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e The current study received approval from the institutional review board and ethical committee of the Theodor Bilharz Research Institute (TBRI). All procedures were executed in compliance with the Declaration of Helsinki.\u003c/p\u003e\u003cp\u003eThe ABO genotype and phenotype of 300 healthy Egyptian blood donors were evaluated and compared with diverse populations and ethnic groups. The inclusion criteria comprised Egyptians who were healthy individuals (volunteers, medical students, blood donors, paramedical personnel, and health workers) with no history of benign or malignant diseases and those who tested negative for HBsAg and HCV antibodies via enzyme-linked immunosorbent assay (ELISA). Exclusion criteria encompassed individuals with a history of benign or malignant diseases, diabetes mellitus, and those testing positive for hepatitis B surface antigen (HBsAg) or hepatitis C virus antibodies (HCV Abs). The study conducted HBsAg and HCV Ab screening using the ELISA technique (DIALAB ELISA kits, Austria, Cat. Nos. Z00360 and Z01370, respectively). All participants provided informed consent.\u003c/p\u003e\u003cp\u003eAfter taking informed consent, they were subjected to a detailed questionnaire regarding residence, habits (smoking and alcohol), weight, height, and family history of liver cancer (defined as liver cancer in any of the first-degree relatives). We then collected blood samples under aseptic conditions using a clean venipuncture and a disposable vacuum collection system. 5 mL of blood was withdrawn and divided into the following three portions:\u003c/p\u003e\u003cp\u003eA- We delivered 1 ml of blood into a vacutainer containing potassium ethylenediaminetetraacetic acid (EDTA) for forward ABO blood grouping.\u003c/p\u003e\u003cp\u003eB- We delivered 2 ml of blood into a plain Vacutainer and allowed it to clot at room temperature. The serum was separated by centrifugation at 2000 rpm for 10 min, and it was used to perform ABO reverse blood grouping and to screen for viral hepatitis markers (HBsAg \u0026amp; HCV Abs).\u003c/p\u003e\u003cp\u003eC- 2 ml of blood were delivered into a vacutainer containing potassium EDTA; they were stored at -80°C for subsequent DNA extraction and ABO genotyping.\u003c/p\u003e\u003cp\u003eThe ABO phenotypes were done by using commercially available monoclonal antibodies (Biotech, UK). We used whole blood samples in EDTA. A tube test was performed using equal volumes (50 µl) of monoclonal reagents (anti-A, anti-B, anti-A, B) (Biotech, UK) and 5% RBC suspensions in saline in appropriately labeled tubes. After thorough homogenization of the contents in each tube, the tubes underwent centrifugation for one minute at 1000 rpm. We then manually observed the presence of agglutination in each tube. Anti-A1 lectin was utilized to identify individuals with positive anti-A monoclonal antibody results to validate their A1 status.\u003c/p\u003e\u003cp\u003eDNA was collected for ABO genotyping using the HighPure polymerase chain reaction (PCR) Template Preparation Kit. (Roche Diagnostics, Germany, Cat. No. 11796828001). As shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, four separate reactions, each using a unique LightSNip Detection mix, were used to identify the ABO alleles A2, B, O\u003csup\u003edel\u003c/sup\u003e, and O\u003csup\u003enon−del\u003c/sup\u003e. By excluding the four variant alleles A2, B, O\u003csup\u003edel\u003c/sup\u003e, and O\u003csup\u003enon−del\u003c/sup\u003e from consideration, the existence of the “wild type A1” allele was indirectly inferred.\u003c/p\u003e\u003cp\u003eReal-time PCR was used to amplify DNA on a LightCycler 480II instrument. (Roche Diagnostics, Mannheim, Germany). In the PCR reaction, we utilized 10.4 µl of deionized water, 1.6 µl of magnesium chloride, 2 µl of Roche Diagnostics' FastStart DNA master (Cat. No. 05015278001), 5 µl of DNA template, and 1 µl of each LightSNiP detection reagent mix for the designated allele-specific LightSNiP detection reagent mix (TibMolbiol, Berlin, Germany). A thermal cycling protocol was executed, comprising 45 amplification cycles at 95°C for 10 seconds, 60°C for 10 seconds, and 72°C for 15 seconds. The preliminary stage consisted of denaturation at 95°C for 10 minutes. Alleles were identified via melting curve analysis, consisting of one cycle at 95°C for 30 seconds, 40°C for 2 minutes, and 75°C, followed by a 30-second cooling period at 40°C.\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e“LightSNip detection mixes” for detection of A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e, B, O\u003csup\u003edel\u003c/sup\u003e, and O\u003csup\u003enon−del\u003c/sup\u003e alleles.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRs number\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExpected results\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e alleles\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eB alleles\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eO\u003csup\u003edel\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eO \u003csup\u003enon−del\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRs 8176746\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eA\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRs 8176719\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e-\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eG\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRs 8176704\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eT\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRs41302905\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eT\u003c/span\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003ent: nucleotide; C: cytosine; G: guanine; T: thymine; A: adenine; (−): deletion; Rs: reference sequence; SNP: single nucleotide polymorphism.\u003c/p\u003e\u003ch2\u003eStatistical analysis:\u003c/h2\u003e\u003cp\u003e“Microsoft Excel 2016 and the social science statistical software IBM (SPSS) Statistics for Windows, version 26” (IBM Corp., Armonk, N.Y., USA) were used for analysis of the data. We considered a p-value of 0.05 or less to be statistically significant for categorical variables, presenting them as frequencies and percentages. Hardy-Weinberg (H-W) equilibrium was applied to each genotype, and the distribution of categorical variables between the observed and expected ABO genotypes was assessed using the χ² test.\u003c/p\u003e\u003cp\u003eThe Student's t-test for independent samples is employed when the data follows a normal distribution. The Mann-Whitney U test for independent samples was utilized for non-normally distributed data, facilitating comparisons of numerical variables between the study groups and other ethnic populations. The chi-square (χ²) test was employed to compare categorical data.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe distribution of ABO phenotypes among the subjects studied was as follows: 37% A (35% A1 and 2% A2), 30% O, 22% B, and 11% AB (10% A1B and 1% A2B). The predominant phenotype was A1, while the least prevalent was A2B. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe frequency of ABO blood group phenotype in the studied Egyptian sample\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhenotype\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003enumber\u003c/p\u003e\u003cp\u003eFrequency (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csub\u003e\u003cb\u003e1\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e106 (35%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csub\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eO\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e90 (30%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e66 (22%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csub\u003e\u003cb\u003e1\u003c/b\u003e\u003c/sub\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29 (10%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csub\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sub\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4 (1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe major ABO allelic frequencies were 25.7% for A1, 4.5% for A2, 49.7% for O\u003csup\u003edel\u003c/sup\u003e, 0.0% for O\u003csup\u003enon\u0026minus;del\u003c/sup\u003e, and 20.5% for B alleles in the study sample of healthy Egyptians. O\u003csup\u003edel\u003c/sup\u003e had the highest allele frequency, and we were unable to detect any O\u003csup\u003enon\u0026minus;del\u003c/sup\u003e in the population we were studying. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e, A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e, B, and O Allele Frequencies in the studied Egyptian sample\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAllele\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAllele Frequency\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e154\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eO\u003c/b\u003e \u003csup\u003e\u003cb\u003edel\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e296\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eO\u003c/b\u003e\u003csup\u003e\u003cb\u003eNon\u0026minus;del\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e600\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn terms of ABO genotypes, OO (30%) and AO (26%) were the most common genotypes, followed by BO (14%), while BB was the least common (8%) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe frequencies of ABO genotypes were as follows: A\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e (6%), A\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e (3.3%), A\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e (26%), A\u003csup\u003e1\u003c/sup\u003eO\u003csup\u003enon\u0026thinsp;\u0026minus;\u0026thinsp;del\u003c/sup\u003e (0.0%), A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e (1.7%), A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e (0.0%), A\u003csup\u003e2\u003c/sup\u003eO\u003csup\u003enon\u0026thinsp;\u0026minus;\u0026thinsp;del\u003c/sup\u003e (0.0%), BB (8%), BO\u003csup\u003edel\u003c/sup\u003e (14%), BO\u003csup\u003enon\u0026minus;del\u003c/sup\u003e (0.0%), O\u003csup\u003edel\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e (30%), O\u003csup\u003edel\u003c/sup\u003eO\u003csup\u003enon\u0026minus;del\u003c/sup\u003e (0.0%), O\u003csup\u003enon\u0026minus;del\u003c/sup\u003eO\u003csup\u003enon\u0026minus;del\u003c/sup\u003e (0.0%), AB (9.3%), and A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eB (1.7%) in the Egyptian sample population, respectively. O\u003csup\u003edel\u003c/sup\u003e O\u003csup\u003edel\u003c/sup\u003e was the most prevalent gene, followed by A\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e and BO\u003csup\u003edel\u003c/sup\u003e (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eABO Genotype frequencies and percentages in the studied Egyptian population\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhenotype\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eABO Genotypes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csub\u003e\u003cb\u003e1\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e1\u003c/sup\u003eO\u003csup\u003eNon\u0026thinsp;\u0026minus;\u0026thinsp;del\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eA\u003c/b\u003e\u003csub\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sub\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e2\u003c/sup\u003eO\u003csup\u003eNon\u0026thinsp;\u0026minus;\u0026thinsp;del\u003c/sup\u003e.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBB\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBO\u003csup\u003edel\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBO\u003csup\u003eNon\u0026minus;del\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eO\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eO\u003csup\u003edel\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eO\u003csup\u003edel\u003c/sup\u003eO\u003csup\u003eNon\u0026minus;del\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eO\u003csup\u003eNon\u0026minus;del\u003c/sup\u003eO\u003csup\u003eNon\u0026minus;del\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eAB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eB\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eB\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eNo statistically significant variances were revealed between the frequencies of observed and expected genotypes. The results demonstrated that the \u003cem\u003eABO\u003c/em\u003e genotypes of the arbitrarily collected samples existed in H-W equilibrium data. A concordance rate of 100% was spotted between the existent genotype and the \u0026ldquo;serologically based\u0026rdquo; expected genotype (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eHardy-Weinberg (H-W) equilibrium for comparison between Observed and Expected Major \u003cem\u003eABO\u003c/em\u003e Genotypes\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMajor ABO Genotypes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eObserved results %\u003c/p\u003e\u003cp\u003e(Current Study)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eExpected results\u003c/p\u003e\u003cp\u003e(H-W equilibrium)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP. value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAO\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBO\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOO\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eH-W equilibrium: Hardy-Weinberg equilibrium.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEvaluation of the major \u003cem\u003eABO\u003c/em\u003e allelic frequencies in the Egyptian Population versus Other Populations\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePopulation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u003cem\u003eA\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003e\u003cem\u003eO\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eReferences\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAllele frequency %\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep. value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAllele frequency %\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep. value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAllele frequency %\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep. value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEgyptian\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e(Current Study)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSudanese\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Khalil et al., 1989)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGerman\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0. 4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.02*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Lang et al., 2016)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWhite European\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.02*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Yip, 2000)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePalestinian\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.03*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Saqer and Sharif, 2013)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eChinese\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.03*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Zhang et al., 2015)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eKuwaitis\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.04*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(El-Zawahri \u0026amp; Luqmani, 2008)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eJordan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.03*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.03*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Irshaid et al., 2002)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSaudi Arabia\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Mohamed et al., 2016)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIranian\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Nojavan et al., 2012)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBahraini\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Al-Arrayed et al., 2001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLebanese\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.001**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Kfoury et al., 2001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIraqi\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.02*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(Tills et al., 1983)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eA p-value\u0026thinsp;\u0026le;\u0026thinsp;0.05 is significant; a p-value\u0026thinsp;\u0026le;\u0026thinsp;0.01 is highly significant.**.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eEver since Landsteiner's identification of the ABO blood groups in 1900, blood group testing has established itself as the conventional technique for ascertaining the antigenic characteristics of red blood cells (RBCs), which vary among different populations and ethnicities. The fundamental measure for averting potentially lethal mismatches in blood transfusions or organ transplants is now the assessment of \"ABO phenotype, genotype, and their allelic distributions.\" (Zaid \u0026amp; Mostafa 2020).\u003c/p\u003e\u003cp\u003eA recent comprehensive genomic analysis by Rophina et al. (2025) highlighted the extensive ABO allelic diversity across the Middle East. Drawing from large-scale public datasets\u0026mdash;including the Greater Middle East Variome, Iranome, and the Qatar Genome Project\u0026mdash;the study identified over 18,000 variants of blood group genes, with 2,443 exonic variants, many of which were novel and clinically significant. Several of these were located within the ABO gene locus, emphasizing the region\u0026rsquo;s genetic complexity. The presence of Egyptian-linked genomes in these datasets supports the idea that the ABO sub-allele patterns observed in our study reflect broader Middle Eastern genetic variation\u003c/p\u003e\u003cp\u003eThe distribution of the primary ABO blood group phenotypes among the subjects of this study indicated that A1 was the most prevalent phenotype (35%), whereas A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eB was the least prevalent (1%). A 2018 study by Swelem et al., supported by a large dataset from Fayoum University\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;10,662) on the Egyptian population, showed that blood group A was the most common at 39.4%, while blood group AB was the least common at 10.6%, which matched our findings.\u003c/p\u003e\u003cp\u003eA study by Zaid and Mustafa (2020) examining the distribution of ABO blood group antigens in the Middle East and North Africa (MENA) region revealed that blood group O was the most prevalent in Iraq (37%), Qatar (45%), Saudi Arabia (55%), Sudan (66.8%), and the United Arab Emirates (48.4%); however, blood group AB was the least common across all reviewed countries (7.6%, 6.5%, 4%, and 0%). Notably, blood group A was the predominant type in Turkey (42.2%), aligning with our findings.\u003c/p\u003e\u003cp\u003eAdditionally, the genotypic frequencies of the predominant ABO genotypes in the Egyptian sample population were ascertained for this study, revealing that the O\u003csup\u003edel\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e genotype exhibited the highest frequency (30%), the BB genotype demonstrated a lower frequency (8%), while A2A2 \u0026amp; A2B showed the least frequent alleles (1.7%). This aligns with findings by Essawy et al. (2020), who reported that the OO genotype was the most common (31.3%), while the BB genotype was among the least prevalent, observed in only 8.1% of individuals.\u003c/p\u003e\u003cp\u003eThis study represented the first investigation into the distribution of ABO alleles and sub-alleles in an Egyptian cohort, where the allelic distribution of the ABO blood group system revealed frequencies of A allele (29%), B allele (20%), and O allele (51%) within the sampled Egyptian population. These findings are broadly consistent with previous large-scale investigations conducted among Egyptian cohorts. For example, Abdelmonem et al. (2019) studied more than 40,000 blood donors nationwide and reported allele frequencies of A: 25.4%, B: 18.1%, and O: 56.5% using standard phenotypic inference models. Similarly, a more recent university hospital-based cohort study (2022) estimated frequencies of A: 27.9%, B: 19.5%, and O: 52.6%. These closely parallel our observed data, particularly for the B and O alleles, affirming the robustness and representativeness of our findings within the broader Egyptian context.\u003c/p\u003e\u003cp\u003e The slight elevation in the A allele frequency observed in our study \u0026ldquo;A (29%)\u0026rdquo; compared to previous reports \u0026ldquo;A (25\u0026ndash;28%)\u0026rdquo; may reflect either regional or sampling variation. The greater resolution provided by genotyping methods applied in this investigation could also explain this difference. Similarly, the B and O allele frequencies are consistent with those reported for the Egyptian population and corroborate numerous independent datasets.\u003c/p\u003e\u003cp\u003eFurthermore, our study provides a comparative evaluation of ABO allele frequencies between the Egyptian population and several other populations from Africa, the Middle East, Europe, and Asia. The frequencies observed in our study\u0026mdash;A: 29%, B: 20%, O: 51%\u0026mdash;demonstrate notable patterns when compared to these populations (Khalil et al., 1989), (Lang et al., 2016), (Yip, 2000), (Saqer and Sharif, 2013), (Zhang et al., 2015), (El-Zawahri \u0026amp; Luqmani, 2008), (Irshaid et al., 2002), (Mohamed et al., 2016), (Nojavan et al., 2012), (Al-Arrayed et al., 2001), (Kfoury et al., 2001), (Tills et al., 1983).\u003c/p\u003e\u003cp\u003eThe A allele frequency (29%) in the Egyptian cohort is comparable to that in Germans (29%) and Chinese (28%), with no statistically significant difference (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) in most comparisons except for Kuwaitis (13%, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.04\u003c/em\u003e) and Lebanese (33%, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.01\u003c/em\u003e), indicating some level of regional and ethnic variability. Interestingly, despite genetic proximity, significant differences exist even\u003c/p\u003e\u003cp\u003ewithin the Middle East, as shown by the lower A allele frequencies in Bahraini (14%) and Kuwaiti (13%) populations.\u003c/p\u003e\u003cp\u003eThe B allele frequency (20%) in the Egyptian cohort is largely consistent with values reported in Palestinians (16%), Jordanians (13%), and Iranians (18%), with most p-values above the 0.05 threshold, indicating no significant difference. However, significant differences were noted when compared to German (10%, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/em\u003e*) and Lebanese (9%, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/em\u003e*) populations, in which they showed markedly lower B allele frequencies.\u003c/p\u003e\u003cp\u003eThe O allele, typically the most common globally, showed a notably lower frequency in Egyptians (51%) compared to nearly all other populations analyzed. Highly significant differences (\u003cem\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/em\u003e) were reported when compared with Sudanese (66%), White Europeans (65%), Kuwaitis (70%), and others, with only Iranians (58%) and Lebanese (57%) showing non-significant differences (p\u0026thinsp;=\u0026thinsp;0.08 and 0.1, respectively).\u003c/p\u003e\u003cp\u003eThese findings support the conclusion that while Egypt shares allelic affinity with certain Middle Eastern and European populations, it also demonstrates distinct patterns, particularly in its reduced O allele frequency, which may be influenced by population structure, historical admixture, or genetic drift. Notably, populations such as the Sudanese, Kuwaitis, and Bahrainis showed significantly higher O allele frequencies (66\u0026ndash;70%, \u003cem\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e*), indicating clear regional divergence.\u003c/p\u003e\u003cp\u003eComparative studies across the Middle East also support the general pattern seen in our data. In Saudi Arabia, for example, Mohamed et al. (2016) reported ABO allele frequencies of A: 24.8%, B: 21.3%, and O: 53.9%, with similar distributions having been observed in Kuwait, Sudan, and the United Arab Emirates, where the O allele consistently dominates. These parallels suggest a shared genetic background and ancestral link among populations in the MENA region, especially concerning the high prevalence of the O allele.\u003c/p\u003e\u003cp\u003eIn addition, Rophina et al. 's (2025) study on the pan-Middle East region provided genomic insights toward the molecular foundations of such distributions. Using the Greater Middle East Variome, Qatar Genome, and Iranome projects, which include over 2,800 whole-genome and exome sequences, they uncovered significant ABO allelic diversity, notably with the O allele variants, especially O\u003csup\u003edel\u003c/sup\u003e, being highly prevalent across many regional genomes. The inclusion of the Egyptian genome in these datasets strengthens the argument in support of the assumption that the ABO allele distributions in our study are representative not just of Egypt but also of a larger proportion of the Middle East populations.\u003c/p\u003e\u003cp\u003eThe consistency of A and B frequencies across the Palestinian, Jordanian, Iranian, and Saudi Arabian populations suggests a degree of shared ancestry or gene flow across the Levant and Arabian Peninsula. Conversely, the significant differences in allele distributions between Egyptians and populations such as Germans and White Europeans emphasize the importance of ethnic and regional specificity in blood group genetics, which has implications for transfusion practices, population genetics, and disease association studies. Notably, the absence of similar sub-allelic data in recent publications highlights the novelty and importance of our study.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur study presents the first comprehensive data on the prevalence of ABO alleles and suballeles in the Egyptian population. The observed allele distribution demonstrates a close genetic resemblance to Middle Eastern populations and certain European groups, including the English, Swedish, and German. These findings have important implications for the design and implementation of national blood transfusion services. By understanding the genetic makeup of the population, healthcare providers in Egypt can optimize strategies for recruiting blood donors, improve blood inventory management, and enhance the safety and efficiency of transfusion practices.\u003c/p\u003e\u003cp\u003eFurthermore, our results contribute valuable information to the field of population genetics by shedding light on the ancestral and evolutionary relationships between the Egyptian population and other global populations. This genetic insight may help refine models of human migration and population history in the region. In addition, accurate knowledge of ABO and RhD group frequencies is crucial for forensic science, including the resolution of disputed paternity and identity cases.\u003c/p\u003e\u003cp\u003eFinally, the study's findings can support ongoing efforts to investigate associations between specific blood groups and susceptibility to certain diseases. A recent allelic study conducted in Egypt by Elsayed et al. (2025) investigated the association between ABO gene polymorphisms and von Willebrand factor (vWF) levels in pediatric patients with acute lymphoblastic leukemia (ALL). The study identified a significant correlation between the rs2519093 C allele and an increased risk of ALL among Egyptian children. Notably, the incidence of ALL was found to be higher among individuals with O, A, and B blood group phenotypes compared to individuals with the AB phenotype. As research continues to uncover links between blood group antigens and various health conditions\u0026mdash;including infectious diseases, cardiovascular disorders, and cancer\u0026mdash;these data may guide public health planning and the development of targeted disease prevention strategies tailored to the Egyptian population.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003edel\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003edeletion\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDNA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eDeoxyribonucleic acid\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eELISA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eenzyme-linked immunosorbent assay\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eHBsAg\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ehepatitis B surface antigen\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eHCV Abs\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ehepatitis C virus antibody\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEDTA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEthylenediaminetetraacetic acid\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePCR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003epolymerase chain reaction\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ent\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003enucleotide\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eC\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ecytosine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eG\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eguanine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ethymine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eadenine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e(\u0026minus;)\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003edeletion\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eRs\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ereference sequence\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSNP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003esingle nucleotide polymorphism\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSocial Science Statistical Software IBM\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eH-W\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eHardy-Weinberg\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eRBCs\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ered blood cells\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eVWF\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eVon Willibrand Factor\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eALL\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAcute Lymphoblastic Leukemia\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the ethical committees of Theodor Bilharz Research Institute, Giza-Egypt and informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003eAll authors confirm that the paper represents honest work and verify that all the reported results are valid.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication from participant:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDuplicate publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe manuscript has not been submitted to any other journal, nor has a substantially similar form (in print or electronically, including on a website) been accepted for publication elsewhere, and it is not under consideration by another publication\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA consent to participate declaration:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants provided informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA declaration of any potential competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll Authors of this manuscript declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding information:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work took place at the Theodor Bilharz Research Institute, Cairo University and it was funded by the institute.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contribution:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDr. Faiza Essawy, MD, is a professor of hematology at Theodor Bilharz Research Institute; she is the principal investigator (PI) of the study. Dr. Manal Zahran, MD, is a professor of hematology at Theodor Bilharz Research Institute and the co-PI. \u0026nbsp; Dr. Sara Abdelaty, MD, lecturer of clinical pathology and hematology at Theodor Bilharz Research Institute, was responsible for writing and reviewing the manuscript. Dr. Fawzy Roshdy, Ph.D., at the Central Lab of Theodor Bilharz Research Institute, was tasked with sample collection and securing informed consent from the patients. Dr. Rady Eid EL-Araby\u003csup\u003e,\u003c/sup\u003e Ph.D., at the Division of Oral Biology, Dept. of Periodontology, Tufts University, School of Medicine, \u0026nbsp;Boston, MA. USA was responsible for the statistical analysis. Dr. Alaa Gad serves as an assistant professor in the Hematology department at the Faculty of Medicine, Cairo University; she authored and submitted the manuscript of the paper. Finally, Dr. Rabab Foad, M.D., serves as an assistant professor of hematology at Theodor Bilharz Research Institute. She engaged in case selection, patient sample collection, and manuscript composition. All authors contributed to the analysis and interpretation of results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our gratitude to Theodor Bilharz Research Institute for giving us the chance to accomplish this piece of work with the help of its competent technicians and the updated equipment and instrumentation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJahanpour O, Pyuza JJ, Ntiyakunze EO, Mremi A, Shao ER. ABO and rhesus blood group distribution and frequency among blood donors at Kilimanjaro Christian Medical Center, Moshi, Tanzania. BMC Res Notes. 2017;10(1):738.\u003c/li\u003e\n\u003cli\u003eGarratty G, Dzik W, Issitt PD, Lublin DM, Reid ME, Zelinski T. Terminology for blood group antigens and genes: historical origins and guidelines in the new millennium. Transfusion. 2000;40:477\u0026ndash;89.\u003c/li\u003e\n\u003cli\u003eVon Decastello A, Sturli A. Ueber die Iso agglutinin in serum gesunder and Kranaker Menschen. Mfiner Med WSchr. 1902;49:1090\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eAbdulganiyu. Distribution of ABO and Rh (D) blood groups and associated traits: a study of the College of Nursing and Midwifery [MSc thesis]. Obangede: Kogi State; 2016.\u003c/li\u003e\n\u003cli\u003eStorry JR, Olsson ML. The ABO blood group system revisited: a review and update. Immunohematology. 2009;25(2):48\u0026ndash;59.\u003c/li\u003e\n\u003cli\u003eYip SP. Sequence variation at the human ABO locus. Ann Hum Genet. 2002;66(1):1\u0026ndash;27.\u003c/li\u003e\n\u003cli\u003eKhalil IA, Phrykian S, Farri AD. Blood group distribution in Sudan. Gene Geogr. 1989;3(1):7\u0026ndash;10.\u003c/li\u003e\n\u003cli\u003eLang K, Wagner I, Sch\u0026ouml;ne B, Sch\u0026ouml;fl G, Birkner K, Hofmann JA, et al. ABO allele-level frequency estimation based on population-scale genotyping by next generation sequencing. BMC Genomics. 2016;17:1\u0026ndash;11.\u003c/li\u003e\n\u003cli\u003eSaqer L, Sharif F. Allele and genotype frequencies of the ABO blood group system in a Palestinian population. Asian J Pharm Nurs Med Sci. 2013;1:98\u0026ndash;103.\u003c/li\u003e\n\u003cli\u003eZhang C, Zhu J, Yang J, Wan Y, Ma T, Cui Y. Determination of ABO blood group genotypes using the real-time loop-mediated isothermal amplification method. Mol Med Rep. 2015;12(4):5963\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eEl-Zawahri MM, Luqmani YA. Molecular genotyping and frequencies of A1, A2, B, O1, and O2 alleles of the ABO blood group system in a Kuwaiti population. Int J Hematol. 2008;87:303\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eIrshaid NM, Ramadan S, Wester ES, Olausson P, Hellberg \u0026Aring;, Merza JY, et al. Phenotype prediction by DNA‐based typing of clinically significant blood group systems in Jordanian blood donors. Vox Sang. 2002;83(1):55\u0026ndash;62.\u003c/li\u003e\n\u003cli\u003eMohamed A, Hindawi S, Al-Harthi S, Alam Q, Alam M, Haque A, et al. Allelic variance among ABO blood group genotypes in a population from the western region of Saudi Arabia. Blood Res. 2016;51(4):274\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eNojavan M, Shamsasenjan K, Movassaghpour A, Akbarzadehlaleh P, Torabi S, Ghojazadeh M. Allelic prevalence of ABO blood group genes in the Iranian Azari population. Bioimpacts. 2012;2(4):207\u0026ndash;12.\u003c/li\u003e\n\u003cli\u003eAl-Arrayed S, Shome D, Hafadh N, Amin S, Al Mukhareq H, Al Mulla M, et al. ABO blood group and RhD phenotypes in Bahrain: results of screening school children and blood donors. Bahrain Med Bull. 2001;23(3):112\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eKfoury E, Mahfouz R, Tabarani R, Ayoub T, Zaatari G. Lebanese population: prevalence of the erythrocyte phenotypes. Leban Med J. 2001;49:140\u0026ndash;2.\u003c/li\u003e\n\u003cli\u003eTills D, Kopec A, Tills R. The distribution of the human blood groups and other polymorphisms. Supplement 1. Oxford: Oxford University Press; 1983.\u003c/li\u003e\n\u003cli\u003eRoan Z, Mustafa I. The distribution of the ABO and RH blood groups among different populations in the MENA region: A review. Highlights BioSci. 2020;3.\u003c/li\u003e\n\u003cli\u003eRophina M, Pandhare K, Scaria V. A comprehensive characterization of blood group antigen variants in the Middle Eastern population genomes: insights into genetic epidemiology [Preprint]. medRxiv. 2023 Nov 20. doi:10.1101/2023.11.20.23298777.\u003c/li\u003e\n\u003cli\u003eSwelem O, Goubran F, Younis S, Kamel N. ABO, RH phenotypes, and Kell blood group frequencies in an Egyptian population. Hematol Transfus Int J. 2018;6. doi:10.15406/htij.2018.06.00156.\u003c/li\u003e\n\u003cli\u003eEssawy F, Sadek H, Abdelaty S, Zahran M, Madkour B, Mashhour A, et al. The study examines the relationship between ABO blood group genotypes and the risk of developing hepatocellular carcinoma in a cohort of Egyptian patients. Gene Rep. 2020;21:100760.\u003c/li\u003e\n\u003cli\u003eAbdelmonem M, Elsayad Z, El-Attar L. Distribution of ABO and Rh blood groups among Egyptian blood donors. Indian Internet J Forensic Med Toxicol. 2019;17(3):112\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eUniversity Hospital ABO Gene Frequency Study. Indian Internet J Forensic Med Toxicol. 2022;19(1):85\u0026ndash;90.\u003c/li\u003e\n\u003cli\u003eMohamed EA, Gad A, Alshamrani H, Alghamdi S. ABO and Rh blood group distribution in Saudi Arabia: a population-based study. Saudi Med J. 2016;37(8):964\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eElsayed EIS, Shaaban AN, Seleem AK, Attia ZI, et al. Impact of ABO gene polymorphism and von Willebrand factor on genetic susceptibility to acute lymphoblastic leukemia in Egyptian pediatric patients. Egypt J Med Hum Genet. 2025;26(1):1\u0026ndash;12. doi:10.1186/s43042-024-00633.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-genomic-data","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"gtic","sideBox":"Learn more about [BMC Genomic Data](http://bmcgenet.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/gtic/default.aspx","title":"BMC Genomic Data","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"ABO blood groups, ABO genotypes, Egyptian donors","lastPublishedDoi":"10.21203/rs.3.rs-7115350/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7115350/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eGiven that ABO blood group antigens vary among different ethnic groups and populations, a precise understanding of ABO phenotypes and genotypes is crucial for managing blood bank inventory and ensuring high-quality blood transfusion services. This is implemented to avert lethal incompatibilities following organ transplantation or blood transfusion. This study seeks to identify the prevalent ABO phenotypes and genotypes among a cohort of Egyptian random blood donors and to compare these findings with previously published data from various populations and ethnic groups.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe distribution of ABO phenotypes in the investigated subjects was 37% for A (35% for A\u003csub\u003e1\u003c/sub\u003e \u0026amp; 2% for A\u003csub\u003e2\u003c/sub\u003e), 30% for O, 22% for B, and 11% for AB (10% for A\u003csub\u003e1\u003c/sub\u003eB \u0026amp; 1% for A\u003csub\u003e2\u003c/sub\u003eB). however, the allelic distribution of the ABO blood group system revealed frequencies of A allele (29%), B allele (20%), and O allele (51%). In regards to the sub-allelic frequencies of ABO genotypes the results were as follows: A\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e (6%), A\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e (3.3%), A\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e (26%), A\u003csup\u003e1\u003c/sup\u003eO\u003csup\u003enon\u0026thinsp;\u0026minus;\u0026thinsp;del\u003c/sup\u003e (0.0%), A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eA\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e (1.7%), A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e (0.0%), A\u003csup\u003e2\u003c/sup\u003eO\u003csup\u003enon\u0026thinsp;\u0026minus;\u0026thinsp;del\u003c/sup\u003e (0.0%), BB (8%), BO\u003csup\u003edel\u003c/sup\u003e (14%), BO\u003csup\u003enon\u0026minus;del\u003c/sup\u003e (0.0%), O\u003csup\u003edel\u003c/sup\u003eO\u003csup\u003edel\u003c/sup\u003e (30%), O\u003csup\u003edel\u003c/sup\u003eO\u003csup\u003enon\u0026minus;del\u003c/sup\u003e (0.0%), O\u003csup\u003enon\u0026minus;del\u003c/sup\u003eO\u003csup\u003enon\u0026minus;del\u003c/sup\u003e (0.0%), AB (9.3%), and A\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003eB (1.7%) in the Egyptian sample population, respectively.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis work provides a thorough profiling of the ABO blood group phenotypic, allelic, and genotypic distributions in an Egyptian blood donor cohort. The most common phenotype was A (37%), (A1\u0026thinsp;\u0026gt;\u0026thinsp;A2), followed by O (30%), B (22%), and AB (11%) showing a distribution pattern that was largely in line with that of other Middle Eastern populations. The O allele predominance was confirmed at the allelic level, where the O allele was most prevalent, followed by A and B. Odel/Odel was the most prevalent genotype suggesting that Odel variations may be more prevalent in the Egyptian population. These results emphasize the critical importance of sub-allelic profiling in understanding blood group diversity within a given population which might have implications in population genetics, genetic association research, genetic diseases and blood transfusion compatibility.\u003c/p\u003e","manuscriptTitle":"Comprehensive Analysis of ABO Blood Group Phenotypic and Genotypic Frequency Among A Cohort of Egyptian Blood Donors","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-31 09:18:07","doi":"10.21203/rs.3.rs-7115350/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-11T10:32:32+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-08T15:13:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-04T12:42:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"166723693509798131316402234168712929342","date":"2026-01-29T02:00:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"2561015363132330851603039376384993698","date":"2026-01-26T09:07:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"208750539082290025180391970933159118378","date":"2026-01-23T00:41:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-13T10:29:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"298969543436480631611075942058696450704","date":"2025-07-29T10:44:53+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-28T10:06:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-28T09:40:07+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-28T07:45:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-27T11:06:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Genomic Data","date":"2025-07-27T08:29:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-genomic-data","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"gtic","sideBox":"Learn more about [BMC Genomic Data](http://bmcgenet.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/gtic/default.aspx","title":"BMC Genomic Data","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8f85da89-a549-486f-89e7-d9e47e2a645b","owner":[],"postedDate":"July 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-20T09:38:21+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-31 09:18:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7115350","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7115350","identity":"rs-7115350","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}