Next-Generation sequencing efforts have revealed a surprisingly high prevalence of mutations in human KLF1. The chance of a KLF1 null child being conceived is approximately 1:24,000 in Southern China. With pre-natal blood transfusions and bone marrow transplant, it is possible to be born without KLF1. Most mutations in KLF1 lead to a recessive loss-of-function phenotype, and mice as the cause of a rare inherited anemia
CDA type IV. Additional family studies and clinical research unveiled the molecular genetics of the HPFH KLF1-related condition and established KLF1 as a novel quantitative trait locus for HbF (HBFQTL6). Permissive nature of the role of KLF1 on expression of several RBC antigens are evidenced by a series of known KLF1 mutations which are named after its modifier gene effect on Lutheral blood group In(Lu) ie "Inhibitor of Lutheran". No homozygouse alive human examples are known, corroborating with the Embryonic lethality of KLF1 homozygous mice. So the In(Lu) mutatants are significantly heteroinsuffient for KLF1 function such that RBC are formed, but there is an apparent dominant negative effect on expression of Lutheran Antigen (Basal cell adhesion Molecule) after which it was named, but also significant but somewhat variable degree of inhibition of expression of Colton (Aquaporin1), Ok (CD147 ie EMMPRIN), Indian(CD44), Duffy (Duffy antigen/chemokine receptor or Fy), Scianna (ERMAP), MN (glycophorin A), Diego(band 3), P1, i, AnWj (CD44) etc. Antigens on RBC membrane, and some of which might overlap with KLF1 mutations causing the fraction of hereditary persistence of fetal hemoglobin with
CDA type IV. == References==