APBMT 2016: 28 October - 30 October

1. HLA Typing in the 21st Century:
High Resolution Typing for Everyone
Nezih Cereb, MD
CEO & Co-founder
Histogenetics
21st Annual Congress of APBMT
28-30 October 2016
Singapore

2. Disclosures
I am a co-owner of Histogenetics and a share holder of PacBio

3. Molecular MismatchesAre Clinically Significant

4. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
4
1991

5. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
5
1991 1996
PCR-SSO for Class II

6. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
6
1991 1996
PCR-SSO for Class II
PCR-SSO for Class I

7. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
7
1991 1996
PCR-SSO for Class II
PCR-SSO for Class I

8. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
8
1991 20011996
PCR-SSO for Class II
PCR-SSO for Class I
Low Volume SBT - Sanger
2x

9. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
9
1991 20011996 2006
PCR-SSO for Class II
PCR-SSO for Class I
Low Volume SBT - Sanger
High Volume SBT - Sanger
2x
47x

10. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
10
1991 201320011996 2006
PCR-SSO for Class II
PCR-SSO for Class I
Low Volume SBT - Sanger
High Volume SBT - Sanger
High volume NGS - Illumina
2016
2x
47x
47x
47x

11. Evolution of Molecular Typing Technologies for HLA
Over The Last 25 years at Histogenetics
11
1991 201320011996 2006
PCR-SSO for Class II
PCR-SSO for Class I
Low Volume SBT - Sanger
High Volume SBT - Sanger
High volume NGS - Illumina
High Volume
SMRT Sequencing
2016
2x
47x
47x
47x
7x

12. Over 6 million Samples typed by SBT and New
Alleles Found at Histogenetics
Number of HLA alleles Published (Jan.2016) 14,473
No of Unique Alleles Submitted by Histogenetics 7,077
Alleles Submitted by Histogenetics including Confir
matory Alleles
14,942
http://www.ebi.ac.uk/ipd/imgt/hla/intro.html

13. Current Sequencing Technologies
Sanger Sequencing
3730xl 96 Capillary DNA
Analyzer
ThermoFisher
ThermoFisher
Seq
MiSeq HiSeq
IonPGM IonProton
Illumina PacBio RSII
MinIon Sequencer
Oxford Nanopore
Next Generation
Sequencing
Third Generation
Sequencing

14. In HLA Class-I Exon 2 and 3 encode Antigen Recognition Sites
Exon 1 Intron 1 Exon 2Intron 2 Exon 3 Intron 3
———
———
—
———
———
In HLA Class-II Exon 2 encodes Antigen Recognition Sites

15. Therefore our traditional HLA typing strategy has been focusing on
identifying DNA Sequences that encode Antigen Recognition Site variations
Exon 1 Intron 1 Exon 2Intron 2 Exon 3 Intron 3
———
———
—
———
———

16. The First Step in All DNA Typing Technologies is the
amplification of the Target DNA sequences to necessary
quantities to generate detectable physical and chemical
signals

17. Millions of copies of those exons are made in PCR reactions to generate
the DNA sequencing template
Exon 1 Intron 1 Exon 2 Intron 2 Exon 3 Intron 3
———
———
—
———
———

18. Millions of copies of those exons are made in PCR reactions to generate
the DNA sequencing template
Exon 1 Intron 1 Exon 2 Intron 2 Exon 3 Intron 3
———
———
—
———
———
Copy 1
Copy 2
Copy …n
Copy 3

19. Initially most of the DNA typing technologies were
based on probe hybridization targeting the
presumed polymorphism regions
(Low and Intermediate Level Resolution Typing)

20. Untested Regions
Probe Based Typing
Probed Region
A*02:0101G/02:06:01G/02:99
Probe
Method
in 2016
in 2015
A*02:0101/02:06:01/02:99………
……………./02:167……………………………
……………………………………/02:251……
…………/02:297………………………………
…………………/02:390………………………
………………………………………………………
Probe
Methodin 2002

21. Probe based methods do not give High
Resolution Typing Results
The Insufficiency of probe-based methods
made it necessary to introduce DNA
sequence-based typing to registry samples in
2006

22. Millions of copies of PCR product made in Sanger sequencing reactions
in a pool of varying length & varying bases at the end
Copy 1
Copy 2
Copy …n
Copy 3
T
A
C
G

23. 3730XL DNAAnalyzer –
The first high throughput automated capillary Sanger sequencer

24. DNA is ready to be sequenced

25. Each capillary gets millions of copies
of sequencing reactions
Capilary

26. Sanger Sequencing For HLA

27. Sanger
07:02:01G/3
5:01:01G
07:26/35:08:
01
07:18:01/35:
01:42
07:02:34/35:
01:19
07:56:02/35:
124
21 possible ambiguous combination
MiSeq
07:02:01G/35:01:01G
No Ambiguity
07:02:01G
35:01:01G
Sanger
MiSeq
With Sanger sequencing we can get many ambiguous results

28. The Shortcomings of Sanger Sequencing methods
(inability to phase heterzygous sequences and limits
in scalibility) and advances in Next Generation
Sequencing technologies made it necessary to
introduce Single Molecule DNA sequence-based
typing to registry samples in 2013

29. Exon Targeted Amplicon Based Sequencing on MiSeq Platform
Exon 1 Intron 1 Exon 2 Intron 2 Exon 3 Intron 3
———
———
—
———
———
Copy 1
Copy 2
Copy …n
Copy 3

30. I7I5
5’3’
Gene Specific Sequence
Adapter
Target Unknown Sequence
5’ 3’
5’ 3’
I5 I7
First PCR
Second PCR
Flow Cell
Clean Up Second PCR
and place on flow cell
E2 E3 E4
I1 I2 I3
E1
E2 E3 E4
I1 I2 I3
E1 E5
E2 E3 E4
I1 I2 I3
E1 E5 E6 E7
HLA-A
HLA-B
HLA-C
Exon Targeted Amplicon Based Sequencing on MiSeq Pla
tform
E2 E3
I1 I2 I3Class II

31. In Sanger Sequencing
Each capillary gets millions of copies
of sequencing reactions
Single Molecule Sequencing

32. Illumina and Ion Torrent can sequence
short DNA fragments <600 bp
Single Molecule Sequencing
All Next Generation Sequencing Technologies
Sequences one molecule at a time
PacBio can sequence long DNA fragments:
~ 20000 bp

33. Whole Gene for Class I and long range for Class II typing on PacBio SMRT® sequencing Platform
does not have the phasing problem due to its long read capabilities (~20kb and more)
Exon 1 Intron 1 Exon 2 Intron 2 Exon 3 Intron 3
———
———
—
———
———

34. Whole Gene typing for Class I on PacBio SMRT® sequencing
Platform

35. Long Range Gene typing for Class II
on PacBio SMRT® sequencing Platform

37. Based on the length of the DNA to be sequenced
the Movie Time is adjusted
For Whole gene Class I and Long Range Class II
Sequencing we perform 4 hours Movie for each run

38. An Overview of SMRT Sequencing

39. Smart Cell ZMW

40. Smart Cell ZMW

41. Large Scale Whole Gene and Long Range
Sequencing of HLA Class I and Class II
-Histogenetics Experience-
• Beginning of 2016 we have introduced Large Scale Whole Gene and Long
Range Sequencing of HLA Class I and Class II as a routine testing method on
PacBio SMRT® platform.
• We started with few hundreds of samples a week with gradual increases in
volume thereafter. As of today we typed over 80,000 NMDP registry samples
using this approach.
• In parallel we performed class I (A,B exon1-4, C exon2-4 and 7) and
class II (Exon2,3) exon-based amplicon sequencing for those sample on
Illumina MiSeq platform.
• We analyzed the data using our in-house program based on IMGT Allele
database ver.3.24.0

42. Whole Gene typing for Class I on PacBio
SMRT® sequencing Platform

43. I7I5
5’3’
Gene Specific Sequence
Adapter
Target Unknown Sequence
5’ 3’
5’ 3’
I5 I7
First PCR
Second PCR
Flow Cell
Clean Up Second PCR
and place on flow cell
E2 E3 E4I1 I2 I3
E1
E2 E3 E4I1 I2 I3
E1 E5
E2 E3 E4I1 I2 I3
E1 E5 E6 E7
HLA-A
HLA-B
HLA-C
Exon-Targeted Amplicon-Based Sequencing on MiSeq Platform
E2 E3I1 I2 I3
Class II

44. Number of Alleles-Intronic variations
Observed in 60,000 Samples Typed for
Whole Gene (Class I)
A B C
Observed 862 933 865
With Novel variation 511 467 570
Intronic novel
variations
390 361 422
Occurred Once 490 482 516

45. HLA-A OVERVIEW of 862 Variants
Exon1
Exon 2
Intron1
Intron 2 Exon 3 Intron 3 Exon 4
Intron4
Exon5
Intron 5
Exon6
Introcn6
Exon7
Intron7
Exon8

46. HLA-B OVERVIEW of 933 Variants
Exon1
Exon 2
Intron1
Intron 2 Exon 3 Intron 3 Exon 4
Intron4
Exon5
Intron 5
Exon6
Exon7

47. HLA-C OVERVIEW of 865 Variants
Exon1
Exon 2
Intron1
Intron 2 Exon 3 Intron 3 Exon 4
Intron4
Exon5
Intron 5
Exon6
Introcn6
Exon7
Intron7
Exon8

48. B
C
A
Inter-Class I loci Pattern Comparison

49. 5,470 Samples with Novel Variants detected in 60,000 Whole Gene typed
Samples for Class I on PacBio SMRT® Sequencing Platform
** Samples containing Novel allele in 2 loci : 176 samples
Samples containing Novel allele in 3 loci : 2 samples
Samples Containing Novel Allele(%)
A B C Total
# of Samples containing
Novel variations (Whole gene) 1,906 2,174 1,570 5,470**
# of Samples containing
Novel alleles (ARS) 24 21 32 77
% (Whole gene) 3.3 3.8 2.7 9.5
% (ARS) 0.042 0.036 0.056 0.134
Total # of samples 60,000

50. Novel Variations Observed in Class I
Among 60,000 samples typed
ARS Non ARS Exons
Exon-based Intron-based
Total
SYN NON-SYN SYN NON-SYN
A 5 17 74 185 281 1606 1887
B 6 14 48 62 130 2033 2163
C 9 20 58 164 251 1315 1566
TOTAL 20 51 180 411 662 4954 5616

51. Allele Mutation Description of Mutation Frequency
C*04:09N Deletion Exon 7, 1095delA, in codon 341, causes frameshift and loss of stop codon in exon 8, resulting in the peptide containing an additional 32 amino acids 75
A*24:02:01:02L Point Intron 2, g708G>A, causes a mutation in the splice site prior to exon 3 53
A*24:11N Insertion Exon 4, 627-628insC, in codon 186, causes frameshift and premature stop at codon 196 11
C*05:07N Deletion Exon 3, 352-353delAC, in codon 94, causes frameshift and premature stop at codon 113 11
A*23:19N Point Exon 3, 619G>A, in codon 183, mutation occurs at exon boundary, potentially affecting the splice site. Allele shown to be non-expressed. 5
A*01:16N Insertion Exon 3, 532-533insG, in codon 154, causes frameshift and premature stop at codon 196 4
A*24:09N Point Exon 4, 742-744CAG>TAG, causes Q224X, a premature stop at codon 224 3
A*02:01:14Q Point Exon 4, 703-705GCG>GCA, causing an aberrant dominant splice site, which may affect expression 2
A*02:53N Point Exon 2, 322-324TAC>TAG, causes Y84X, a premature stop at codon 84 2
A*24:90:01N Point Exon 3, 418-420GAC>TAG, causes Y116X, a premature stop at codon 116 2
B*51:11N Insertion Exon 4, 627-628insC, in codon 186 causes frameshift and premature stop at codon 196 2
C*07:264N Point Exon 3, 535-537CAG>TAG, causes Q155X, a premature stop at codon 155 2
A*02:83N Point Exon 4, 829-831GAG>TAG, causes Q253X, a premature stop at codon 253 1
A*30:78N Deletion Exon2, 188delA, in codon 39, causes a frame shift and premature stop codon at codon 54 1
B*40:155:02N Insertion Exon 3, 593-594insCAGAA, in codon 174, causes frameshift and premature stop at codon 191 1
C*03:121N Point Exon 3, 511-513TGG>TGA, causes W147X, premature stop at codon 147 1
C*06:79N Point Exon 3, 538-540TGG>TGA, causes R156X, a premature stop at codon 156 1
C*07:104N Point Exon 3, 424-426TAC>TAA, causes Y118X, a premature stop at codon 118 1
C*07:33N Deletion Exon 2, 92delA, in codon 7, causes frameshift and premature stop at codon 76 1
179 Samples had Null and Alternatively Expressed Class I Alleles
in 60,000 Samples Analyzed

52. 149 Samples Had Null and Alternatively Expressed Class I Alleles
Reported within common “G” groups
A*02:01:01G
A*24:02:01G
B*51:01:01G
C*04:01:01G
G Codes For Reporting
of Ambiguous Allele Typings
Null and Alternatively Expressed
Class I Alleles Found using Whole genome sequencing
E2 E3
Int1
E1 E2 E3 E4 E5 E6 E7 E8
Int1 Int2 Int3 Int4 Int5 Int6 Int75’ UTR 3’UTR
http://hla.alleles.org/alleles/g_groups.html
A*02:01:14Q
Exon 4, 703-705GCG>GCA, causing an aberrant dominant splice site, which may aff
ect expression
2
A*02:83N Exon 4, 829-831GAG>TAG, causes Q253X, a premature stop at codon 253 1
A*24:02:01:02L Intron 2, g708G>A, causes a mutation in the splice site prior to exon 3 55
A*24:09N Exon 4, 742-744CAG>TAG, causes Q224X, a premature stop at codon 224 3
A*24:11N
Exon 4, 627-628insC, in codon 186, causes frameshift and premature stop at codon 1
96
11
B*51:11N
Exon 4, 627-628insC, in codon 186 causes frameshift and premature stop at codon 19
6
2
C*04:09N
Exon 7, 1095delA, in codon 341, causes frameshift and loss of stop codon in exon 8,
resulting in the peptide containing an additional 32 amino acids
75

53. Among 60,000 Analyzed
17 Samples Had Null and Alternatively Expressed
11 Novel Variations
Allele Mutation Description of Mutation F
A*24:02:01:XX Substitution Intron 2, g474G>T, causes incorrect splicing (further study required) 1
A*31:01:02:XX Substitution Intron7, g2730G>A, causes incorrect splicing (further study required) 2
A*33:NULL Insertion Exon 4, 627-628insC, in codon 186, causes frameshift and premature stop codon at 196 1
B*07:NULL Deletion Exon3, 610-619DelGAGCGCGCTG, in cod 180-184. > frameshift and premature stop codon at 186 1
B*44:NULL
Insertion Exon 4, 626-627insC, in codon 185, causes frameshift and premature stop codon at 196 2
B*53:Null Substitution Exon3, 424-426TAC>TAA, causes Y118X, a premature stop at codon 118 1
DPB1*01:Null Substitution Exon2, 166-168AGA>TGA, causes R27X, a premature stop at codon 27 1
DPB1*02:Null Substitution Exon3, 490-492GAG>TAG, causes E135X, a premature stop at codon 135 4
DPB1*04:Null Substitution Exon3, 490-492TGC>TGA, causes R128X, a premature stop at codon 128 2
DPB1*04:Null Substitution Exon3, ,580-582CAG>TAG, causes Q165X, a premature stop at codon 165 1
DQB1*03:Null Substitution Exon3, 445-447TGC>TGA, causes C117X, a premature stop at codon 117 1

54. Class II

55. Long Range Gene typing for Class II
on PacBio SMRT® sequencing Platform

56. Class II PacBio SMRT® sequenced samples
Target Length samples processed
DRB1
Exon 2 to Exon 3 3kb 60,000
Exon 2 to Exon 6 5.1kb 828
DQB1
Exon 2 to Exon 3 4kb
60,000
Exon 2 to Exon 6 5.7kb 828
DPB1
Exon 2 to Exon 3 4.6kb 60,000
Exon 2 to Exon 5 6.5kb 828

57. Number of Allele- Intronic Variants
Observed in 60,000
Samples Typed for Long Range (Class II)
DRB1 DQB1 DPB1
Observed 1036 714 1457
With Novel variation 316 402 482
Intronic novel
variations
310 392 465
Exon 3 Sequence unavail
able in the database but
revealed in this work
107 43 84

58. Exon-Based Novel Variations in Class II
ARS Non ARS-Exon 3 Total
S Del NS S NS Del Ins
IE Ju.
Mut.
DPB1 6 10 0 42 95 0 1 3 157
DQB1 5 6 2 24 49 9 0 1 96
DRB1 1 6 0 17 40 5 0 0 69
TOTAL
12 22 2 83 184 14 1 4 322

59. E2
G-T-A-G-A-C
E2
C-A-G-C-T-T
E3
130.2
A
E3
G
DQB1*06:03:01, DQB1*06:04:01
or
DQB1*06:39, DQB1*06:41
Resolving Phase (cis-trans) Ambiguities
E2
C-A-G-C-T-T
E2
G-T-A-G-A-C
E3
A
E3
G
06:03:01
06:04:01
Phasing resolves ambiguity
06:04:01G
06:04:01
06:34
06:36
06:38
06:39
06:52
06:86
06:03:01G,
06:03:01
06:110
06:41
06:44

60. Resolved typing by phasing E2 and E3
DQB1*06:02:01G, DQB1*06:04:01G DQB1*06:02:01, DQB1*06:04:01
DQB1*06:02:01G, DQB1*06:09:01G DQB1*06:02:01, DQB1*06:09:01
DQB1*06:03:01G, DQB1*06:04:01G DQB1*06:03:01, DQB1*06:04:01
DQB1*06:03:01G, DQB1*06:09:01G DQB1*06:03:01, DQB1*06:09:01
DPB1*01:01:02G, DPB1*02:01:02G DPB1*01:01:02, DPB1*02:01:02
DPB1*01:01:02G, DPB1*04:01:01G DPB1*01:01:02, DPB1*04:01:01:01/DPB1*04:01:01:02
DPB1*01:01:02G, DPB1*17:01:01G DPB1*01:01:02, DPB1*17:01
DPB1*02:01:02G, DPB1*04:02:01G DPB1*02:01:02, DPB1*04:02:01:01
DPB1*02:01:02G, DPB1*03:01:01G DPB1*02:01:02, DPB1*03:01:01
DPB1*13:01:01G, DPB1*02:01:02G DPB1*13:01:01, DPB1*02:01:02
DPB1*02:01:02G, DPB1*19:01:01G DPB1*02:01:02, DPB1*19:01
11 Examples of DQB1 (4 Patterns) and DPB1 (20 Patterns) Exon 2
and 3 phase ambiguity with Exon targeted Amplicon-based
Illumina MiSeq platform that is resolved on PacBio Platform

61. New Definitions of High
Resolution HLA Typing:
From Precious Metals (Sil
ver, Gold, Platinum)
To Pixel Defintions (1x…8
x…1000x…)

62. Levels of HLA High Resolution Typing Under NGS Microscope
1X Resolution
Class I: Antigen Recognition Site (ARS) Typing for exon 2 and 3 in phase
Class II: ARS Typing for exon 2

63. Levels of HLA High Resolution Typing Under NGS Microscope
2X Resolution
Class I: Exon 2, 3 and 4 typing
Class II: Exon 2 and 3 typing

64. Levels of HLA High Resolution Typing Under NGS Microscope
3X Resolution
Class I: Exon 2, 3 and 4 typing, and ruling out CWD null alleles
Class II: Exon 2 and 3 typing

65. Levels of HLA High Resolution Typing Under NGS Microscope
4X Resolution
Class I: Exons 1-8 typing
Class II: Exons 2-6 typing

66. Levels of HLA High Resolution Typing Under NGS Microscope
8X Resolution
Class I: All exons and introns typing
Class II: Exons 2-6 and introns 2-5 typing

67. High Resolution State-of-The-Art
HLA Typing to Anyone, Everywhere!

68. Selecting the Best Sequencing Technology for
HLA Typing
Each of the sequencing technologies may deliver high quality DNA se
quence information, but each has its own limitations.
When they are used to complement each other they can
provide fast, affordable, and high quality HLA typing results.
At Histogenetics we combine all three sequencing
Technologies to deliver the required results at required time window.

69. Modern Courier Services Allow Global Access to Histogenetics Services
Argentina 2
Armenia 1
Australia 1
Austria 2
Belgium 9
Canada 8
China 1
Colombia 3
Cyprus 1
Czech Republic 2
Denmark 4
Finland 1
France 4
Germany 6
Greece 3
Hong Kong 1
Hungary 1
India 116
Indonesia 1
Israel 3
Italy 3
Kenya 1
Korea 1
Kuwait 2
Lithuania 1
Malaysia 2
Nepal 1
Netherlands 2
New Zealand 1
Nigeria 6
Norway 1
Pakistan 3
Poland 3
Portugal 1
Puerto Rico 1
Saudi Arabia 4
Singapore 6
Slovakia 2
South Korea 2
Sri Lanka 1
Srilanka 4
Sweden 2
Switzerland 4
Taiwan 1
Thailand 3
The Netherlands 1
Trinidad and Tobago 1
Turkey 7
Uganda 3
United Kingdom 8
United States 127
Venezuela 1
Vietnam 1

70. Misleading claims about performing High Resolution
HLA Typing by Simple Sanger Sequencing
Locus HLA-A HLA-B HLA-C HLA-DRB1 HLA-DQB1
1 11:01:01 35:03:01 04:01:01 13:01:01 06:01:01
2 31:01:02 52:01:01 12:02:01 15:01:01 06:03:01
Remarks : Typing by SBT method from Applied Biosystems by Life Technologies, U.S.A
Version 3.20.0 2015 April 17

71. HLA LABS that claim they perform High Resolution
HLA TypingLocus HLA-A HLA-B HLA-C HLA-DRB1 HLA-DQB1
1 11:01:01 35:03:01 04:01:01 13:01:01 06:01:01
2 31:01:02 52:01:01 12:02:01 15:01:01 06:03:01
Locus Allele
Reported
Alleles
Included Alleles Rare Alleles
A
1 11:01:01 - -
2 31:01:02
31:01:13,
31:71/31:72/31:81
31:23/31:46/31:48/
31:55/31:56/31:59
B
1 35:03:01 35:03:13, 35:06
35:13/35:70/35:10
9/35:167
2 52:01:01 52:01:08/52:01:27,52:36,51:07:02
52:07/52:11/52:12,
/52:10:01
C
1 04:01:01 04:01:30/04:01:54 -
2 12:02:01 12:02:02/12:02:09/12:02:10 -
DRB1
1 13:01:01 13:01:08 -
2 15:01:01
15:01:17,15:02:01/15:02:09/15:85/15:86/15:110/15:11
3N
15:19/15:69/15:74
DQB1
1 06:01:01 06:01:05 -
2 06:03:01
06:03:11/06:03:12/06:03:15/06:03:17/06:03:18/06:03:1
9,06:07:01,06:30/06:32/06:60/06:61/06:62/06:92/06:1 -

72. HLA-A: 3 ambiguous
combinations:
HLA-C: 10 ambiguous
combinations
11:01:01G, 31:01:02G 04:01:01G, 12:02:01G
11:116, 31:06 04:29, 12:41
11:181, 31:41 04:15:01, 12:10:01
HLA-B: 7 ambiguous combinations 04:33, 12:132
35:03:01G, 52:01:01G 04:01:55, 12:02:03
35:06, 52:12 04:01:30, 12:02:09
35:109, 52:11 04:15:03, 12:10:02
35:167, 52:10:01 04:114, 12:72
35:13, 51:07:02 04:94:01, 12:85
53:04, 78:05 04:172, 12:146
53:33, 78:06
Actualresults

73. HLA-DRB1: 6 ambiguous
combinations
HLA-DQB1: 2 ambiguous combin
ations
13:01:01G, 15:01:01G 06:01:01G, 06:03:01G
13:01:05, 15:01:04 06:01:12, 06:03:14
13:01:06, 15:01:24
13:09, 15:10
13:52, 15:32
13:69, 15:62
Actual results (Continued)

74. Phasing could be an issue with Exon Targeted Amplicon Based Sequencing on MiSeq Platform
Allele I
Allele II
Correct Phase Incorrect Phase
Allele 1
Allele 2
Allele 3
Allele 4
Exon 2 Exon 3
Exon 2 Exon 3 Exon 2 Exon 3
Intron 2
Intron 2 Intron 2
C*04:29
C*:12:41
C*04:01:01G
C*12:02:01G

75. Easy Access and Interpretation of HLA
data Anywhere

93. • It is time to think and establish New Definitions of HLA Typing:
• To move away from low and Intermediate Resolution towards exclusively High Resolution
HLA typing;
• To move away from precious metal (Silver, Gold, Platinum) definitions of High resolution Typing;
• Towards Pixel Defintions (1x, 2x, 3x, 4x, 8x…1000x…) High resolution: That is based on Regions
covered and Sequenced in Phase
• Whole gene and long range sequencing of class I and Class II genes is essential in determining the
structural integrity and expressivity of the genes that could not be determined solely based on
ARS and enabling us to resolve phase ambiguities.
• Whole gene sequencing will be the routine HLA Typing approach in the near future
• These technologies and services are available now to anyone, anywhere in the world!
Conclusions

94. Acknowledgments
HwaRan Kim
Jaejun Ryu
Eunsil Kim
Seho Choi
Jangyoung Kwan
JeongOk Jeon
HyeonJin Park
Vijayraghavan Seshadri
Soo Young Yang
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