Volume 68 1959 > Volume 68, No. 4 > Blood groups in Tongans (Polynesia), by J. Staveley and R. Douglas, p 348-353
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BLOOD GROUPS IN TONGANS, (POLYNESIA) 1

RESULTS OF TESTING 200 Tongans for various blood groups and abnormal haemoglobins are the subject of this report. A blood group study of this population has been reported by Kooptzoff and Walsh. 2 These workers tested 102 subjects for the A1A2BO, MNS and Rh systems. We have extended the blood group systems tested to include P, Lewis, Kell, Duffy, Kidd, Diego, Wright, Vel, Sutter and the serum Gm groups. Saliva was also examined for secretion of ABH and Lea substances, and a search was made for abnormal haemoglobins.

GEOGRAPHICAL FEATURES 3

The kingdom of Tonga consists of about 200 islands in three major groups, Tongatapu in the south, Vava'u in the north, and the Ha'apai group lying between these. The islands of Vava'u are generally high and mountainous, those of Ha'apai and Tongatapu low-lying and of coral formation. The kingdom lies between 15° and 23° south and 173° and 177° west, and is free from malaria.

Nuku'alofa, the capital, is on the main island of the southern group, Tongatapu, and lies 1,100 miles north-east of Auckland. The population of the kingdom in 1959 4 is given as 58,351, of which 56,669 are Tongans, and 1,682 part Tongans, Europeans and others.

According to tradition, the inhabitants of Tonga came from Samoa somewhere about 950 A.D.

COLLECTION OF SPECIMENS

With the approval of the Government of Tonga, Dr. Sione Tapa, Chief Medical Officer, generously undertook the selection of the subjects and the collection of the specimens. In this work, Dr. Sateki Tupou, Assistant Medical Officer, played a big part. From each selected person, a clotted blood specimen and blood in Alsever's solution with added antibiotics was obtained by venepuncture. The saliva specimen was obtained after the mouth had been rinsed with water, and was heated in a boiling water bath for ten minutes.

The samples from the 200 people concerned in the study were collected in batches of 50; one batch in May 1959, two during July 1959, and one in September 1959. This allowed the collection to take place just prior to the departure of a ship for New Zealand. It also allowed the testing of each batch to be completed during the week after arrival - 349 in Auckland. This was the third week after the collection of the specimens from the subjects. The specimens were refrigerated at about 4° C. continuously from the time of collection.

The subjects selected by our colleagues have no known foreign ancestry. There were 98 males and 102 females, ranging in age from 14 to 43 years. Their distribution according to the island of their birth, is as follows:

Tongatapu 125
Vava'u 33
Ha'apai 26
Eua 8
Ninafo'ou 5
Mu'a 1
Niuatoputapu 2
METHODS 5 AND RESULTS
The ABO System:

The red cells were tested with anti-A, anti-B and anti-H (Ulex Europeus). Those reacting with anti-A were titred against a group B serum showing a marked difference in titre between A1 and A2 cells. The serum from each individual was tested with A1 and B cells independently.

TABLE I
No. Phenotypes per cent       Genes per cent    
tested O A1 B A1B O A1 B
200 43 45.5 8.5 3 1 65.37 28.42 6.21
1   Expected A1B = 3.5 per cent. Chi2 = 0.1082. P = 0.75.

No A2 specimens were found.

The MNS System:

Tests were made with anti-M, anti-N, anti-S, anti-U, anti-Mg and anti-Vw. Specimens positive with anti-S were tested with anti-s.

TABLE IIa
No. Phenotypes per cent     Genes per cent  
tested M MN N M N
200 OBS. 29.5 59.5 2 11.0 59.25 40.75
  EXP. 35.1 48.28 16.62    
2   Chi2 = 0.241. P. = 0.56.
TABLE IIb
No. S Positive Genes per cent   Chromosomes per cent      
tested per cent S s MS Ms NS Ns
200 3.5 2.50 97.50 2.31 56.94 0.19 40.56

All specimens were positive with anti-U and negative with both anti-Mg and anti-Vw.

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The P System:

Specimens were tested with anti-P1 serum and P2 samples were then tested with anti-P + P1.

TABLE III
No. Phenotypes per cent   Genes per cent  
tested P1+ P1 P1 P2
200 35.5 64.5 19.69 80.31

All specimens negative with anti-P1 were positive with anti-P + P1.

The Lewis and Secretor Systems:

Anti-Lea and anti-Lea + Leb sera were used with the red cells. Saliva specimens were tested in titration for secretion of AB & H substances and for secretion of Lea substance. Saliva from group O individuals was tested with anti-H, from group A & AB with anti-A, and from group B people with anti-B.

Twenty-three of the saliva specimens were not included as they were unsatisfactory, mostly due to an accident during the heating when water got into the jars. The Lewis types of the corresponding blood specimens have also been omitted from the results in Table IV.

TABLE IV
No. Phenotypes per cent     Phenotypes per cent   Genes per cent  
tested Lea+ Lea-b+ Lea-b— Se se Se se
177 23.7 61.02 15.25 69.49 30.51 44.76 55.24

Note: Lea substance was found in the saliva of those whose red cells were Lea+ or Lea-b+. Half those of the type Lea-b— were found to secrete AB or H.

The Rh System:

The sera used for testing in this system were:

  • 4 anti-C sera (of which 2 were ‘pure’ anti-C)
  • 1 anti-Cw serum
  • 1 anti-c serum
  • 2 anti-E sera
  • 1 anti-D serum (saline agglutinating)
  • 1 anti-D serum (incomplete—used with ficin treated cells)
  • 1 anti-V serum
  • 1 anti-e serum (with samples positive with anti-E)
  • 1 anti-f serum for the confirmation of Ro and Rz)
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TABLE V 6
No.   Phenotypes per cent        
tested CCDee CcDEe ccDEE CcDeef ccDEef CcDEEF
200 OBS. 46.5 36.5 4.0 8.5 4.0 0.5
  EXP. 47.61 33.46 5.88 8.62 3.04 0.02
Chromosomes per cent      
CDe cDE cDe CDE
69.00 24.25 6.25 0.50

No samples positive with anti-V were encountered.

The Duffy System:

An anti-Fya serum was used with all specimens and those giving negative reactions were tested with anti-Fyb to recognise Fya-b—, but this type was not found.

TABLE VI
No. Phenotypes per cent   Genes per cent  
tested Fya+ Fya-b+ Fya Fyb
200 98.5 1.5 98.78 1.22
The Kell System:

All specimens were tested with anti-K, anti-k, anti-Kpa and anti-Kpb.

TABLE VII 7
No. Phenotypes per cent   ‘Genes’ per cent  
tested KKpbk Kpbk Kb kb
200 0.5 99.5 0.025 99.75

All specimens were negative with anti-Kpa.

The Kidd System:

Only anti-Jka was available.

TABLE VIII
No. Phenotypes per cent   Genes per cent  
tested Jka+ Jka- Jka Jkb
200 72.5 27.5 47.56 52.44
Tests in other Systems:

The specimens were tested with the other available antisera; results are shown in Table IX.

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TABLE IX
Antiserum Number Tested No. of Positive Reactions
Anti-Dia 200 0
Anti-Wra 200 0
Anti-Jsa 200 0
Anti-Vel 3 86 86
3   Used with group 0 specimens only.
The Gm Groups:

The method used was that described by Moullec et al., 8 with the modification that tubes showing inhibition of the agglutination of the sensitised cells by the rheumatoid serum were centrifuged before the results were accepted as Gma positive.

202 white blood donors in Auckland were tested as a control series.

TABLE X
    Phenotypes per cent   Genes per cent  
  No. Tested Gma+ Gma- Gma Gm
Tongans 200 100 0 100 0
Blood Donors 200 58.00 42.00 35.19 64.81
Abnormal Haemoglobins:

In all the 200 specimens the search for abnormal haemoglobins was made with the following tests:

  • (1) Sickling Test (using the Sodium Metabisulphite method).
  • (2) Films stained for 18 hours with 1% cresyl blue in citratesaline were examined for the so-called haemoglobin-H ‘inclusion bodies’. 9
  • (3) Films, stained with Leishman stain, were searched for erythroblastaemia and hypochromic macrocytic red cells.
  • (4) The alkali denaturation method described by Singer et al. 10
  • (5) Paper electrophoresis with barbitone buffer at pH 8.6.

It was not expected that haemoglobin-H would be separated on paper electrophoresis as the haemoglobin solutions were prepared by freezing the washed red cells from the Alsever's solution. However, none of the films stained with cresyl bllue showed the inclusion bodies.

No haemoglobin other than A was found, and the Leishman films showed no red cell abnormalities.

SUMMARY AND ACKNOWLEDGEMENTS

Results of testing 200 Tongans for various blood group systems and for haemoglobin variants are reported. The systems investigated were A1A2BO, MNS, P, Lewis, Secretor, Rh, Duffy, Kidd, Kell, Diego, Vel, Wright, Sutter and Gm. No haemoglobin variants were found.

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Without the approval of the Tongan Government and the meticulous manner in which Dr. S. Tapa and his staff at Vaiola Hospital carried out the collection of specimens, the study could not have been initiated, nor would the specimens have been received in Auckland in excellent order for testing, as they were. The authors acknowledge with gratitude this co-operation. Credit is also due to the ship's officers of the Union Steamship Company, who attended to the refrigeration of the specimens during transit. We are also indebted to many colleagues for gifts of sera which broadened the scope of the study enormously. Dr. A. E. Mourant provided strong anti-M and anti-N sera; Dr. R. E. Rosenfield anti-S and anti-f; Dr. Philip Levine anti-k, anti-e and anti-Fya; Dr. Eloise Giblett anti-s, anti-V and anti-Jsa; Dr. F. H. Allen anti-Mg, anti-Vw, anti-Kpa, anti-Wra and anti-Kpb; Dr. M. Layrisse anti-Dia; Dr. Leon Sussman anti-Vel; Dr. Bruce Chown anti-Fyb; Dr. R. Race anti-P+P1; and Dr. T. Greenwalt anti-U.

We also gratefully acknowledge the technical assistance given by Miss Juliet Jacobs.

REFERENCES
  • ALLEN, F. H., LEWIS, S. J., FUDENBERG, H., 1958. “Studies on Anti-Kpb, a New Antibody in the Kell Blood Group System.” Vox Sanguinis, 3:1-13.
  • KOOPTZOFF, Olga, and WALSH, R. J., 1957. “The Blood Groups of Some Native Inhabitants of the Tongan Islands.” Oceania, 27:214-219.
  • MOULLEC, J., KHERUMIAN, R., SUTTON, E., and ESPAGNON, P., 1956. “Contribution à L'étude du facteur de Groupe Gma du plasma humain.” Revue d'Hématologie, 2:512-518.
  • MOURANT, A. E., 1954. The Distribution of the Human Blood Groups. Oxford, Blackwell Scientific Publications.
  • PACIFIC ISLANDS YEAR BOOK, 1956. Seventh Edition. Sydney, Pacific Publications Pty. Ltd.
  • —— 1959. Eighth Edition. Sydney, Pacific Publications Pty. Ltd.
  • SINGER, K., CHERNOFF, A. L., and SINGER, L., 1951. “Studies on Abnormal Haemoglobins, I Alkali Denaturation.” Blood, 6:413.
  • STAVELEY, J. M. and DOUGLAS, R., 1958. “Blood Groups in Maoris.” Journal of the Polynesian Society, 67:239-247.
1   This work was carried out under a grant from the Auckland Medical Research Foundation.
2   Kooptzoff & Walsh, 1957.
3   Pacific Islands Year Book, 1956:109.
4   Pacific Islands Year Book, 1959:111.
5   Testing methods used were those detailed by Staveley and Douglas, 1958.
6   Calculations following Mourant, 1954.
7   Following the notation suggested by Chown and Lewis quoted by Allen, Lewis & Fudenberg 1958.
8   Moullec, Kherumian, Sutton & Espagnon, 1956.
9   A preparation showing these inclusion bodies was kindly sent to us by Dr. J. A. M. Ager, St. Thomas' Hospital, London.
10   Singer Chernoff and Singer, 1951.