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Background  Nucleotide mutations in the  ABO  gene may reduce the activity of glycosyltransferase, resulting in lower levels of A or B antigen expression in red blood cells. Six known splice sites have been identified according to the database of red cell immunogenetics and the blood group terminology of the International Society of Blood Transfusion. Here, we describe six distinct splice site variants in individuals with ABO subtypes.    Methods  The ABO phenotype was examined using a conventional serological method. A polymerase chain reaction sequence-based typing method was used to examine the whole coding sequence of the  ABO  gene. The  ABO  gene haplotypes were studied using allele-specific primer amplification or cloning technology. In silico analytic tools were used to assess the functional effect of splice site variations.    Results  Six distinct variants in the  ABO  gene splice sites were identified in nine individuals with ABO subtypes, including c.28 + 1_2delGT, c.28 + 5G > A, c.28 + 5G > C, c.155 + 5G > A, c.204-1G > A and c.374 + 5G > A. c.28 + 1_2delGT was detected in an A w  individual, while c.28 + 5G > A, c.28 + 5G > C, and c.204-1G > A were detected in B el  individuals. c.155 + 5G > A was detected in one B 3  and two AB 3  individuals, whereas c.374 + 5G > A was identified in two A el  individuals. Three novel splice site variants (c.28 + 1_2delGT, c.28 + 5G > A and c.28 + 5G > C) in the  ABO  gene were discovered, all of which resulted in low antigen expression. In silico analysis revealed that all variants had the potential to alter splice transcripts.    Conclusions  Three novel splice site variations in the  ABO  gene were identified in Chinese individuals, resulting in decreased A or B antigen expression and the formation of ABO subtypes.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12967-021-03141-5.

Six splice site variations, three of them novel, in the ABO gene occurring in nine individuals with ABO subtypes