Blood Groups Flashcards
Residual HLA class1 glycoprotein molecules on RBCs
BG antigens
Weak on cord cells
Chromosome 6. Band p21. I
BG antigens are sensitive to (2 chemicals)
CDP and EGA
Ch/Rg sensitive to?
Enzymes: Ficin/papain
Pronase, Trypsin, Chymotrypsin
Also, can be neutralized
Ch/Rg (017)
RESISTANT to…
DTT, CDP and EGA
9 antigens in Kn system (022)
Kna, Knb, McCa, McCb, Sla, Yka, Vil, SI3, KCAM
JMH resistant to (2 chemicals)
Acquired loss of CD108
EGA and CDP
Proteolytic enzymes
Ficin
Papain
Disulfide bond reducing agents
DTT
AET
PP1Pk are glycoLIPIDS, not glycoPROTEINS
True
Alternate form of a gene
Allele
Fixed position on a chromosome
Locus
Group of alleles inherited together
Haplotyoe
Eg. RHD and RHCE
Duffy gene
FY; ACKR1 (atypical chemokine receptor 1)
Chr: 1
5 antigens
Receptor for plasmodium vivax and knowlesi
CCI = (PLT increment)x(body surface area - m^2) / number PLTs transfused x10^11
PPR percent platelet recovery
(PLT increment) x (weight inKg x 75ml) / (PLT count of product)x(PLT volume in mL)
Gene for MNS system (002)
GYPA (M,N)
GYPB (S, s)
Chr: 4
4 common antigen: M N S s
49 total antigens
Gene for Lewis system
(LE/007)
FUT3
Chr: 19
6 antigens
Gene for Kell system
(006)
KEL
Chr: 7
6 common antigens (KEL1-6)
36 total antigens
Gene for Kidd system
(JK/009)
SLC14A1 (solute carrier/transport protein)
Chr: 18
UT-B urea transport protein
3 common antigens
Jka, Jkb, Jk3
Jk(a-b-) seen in Polynesian and Chinese
Silencing gene results in SINGLE dose expression of antithetical antigen
Weaker than double dose expression
Eg. Fyb silenced = SINGLE dose Fya in Fy(a+b-) in AA donors
Blood groups characterized in 4 ways:
- Serologically
- Genetically
- Functionally
- Structurally
Gene for P1PK system (003)
P1PK; A4GALT
Chr: 22
3 antigens P1, Pk, NOR
Gene for H (018)
H; FUT1 (a-fucosyltransferase enzyme)
Chr: 19
A1 lectin
Dolichos biflorus
Anti-H lectin
Ulex europaeus
Secretor gene name
FUT2 (Se or secretor)
Chr: 19
Bombay phenotype
Inheritance of non-functional FUT1(H) and FUT2(Se) gene
Para-Bombay
Inherited NON-functional FUT1(H) gene with FUNCTIONAL FUT2/Se gene
GLOB (Globoside) 028
2 antigens: P, Px2
Chr 3
Anti PP1Pk
IgM or IgM/IgG
Clinically significant
Naturally occurring in ‘p’ phenotype
Seen in: spontaneous abortion
Anti-P
Naturally occurring in P1k and P2k phenotypes
-recurrent spontaneous abortions and PCH
RH blood group gene (004)
RHD, RHCE (codominant)
Chr: 1
5 common antigens
Rh ‘combo’ antigens:
ce(f) RH6
Ce RH7 (rhi)
CE (Rh 22)
cE (Rh 27)
RH null caused by…
RHAG Rh-associated glycoprotein gene ABSENT or mutated (Chr 6)
-produces stomatocytes (bite cells)
Ena- (high) caused by loss of this
Lack of Glycophorin A
Lack of GPB results in…
No S or s expression; lack U antigen (high)
2% blacks
Mk gene
No GPA or GPB production;
Lacks all MNS antigens
Ko- Kell null
Lack all KEL system antigens
Produce: anti-Ku
McLeod cells
- Diminished amounts of KEL antigens
- lack Kx and Km
- X-linked
- acanthocytosis
- CGD
Fy(a-b-) resistant to which malaria parasite
Plasmodium vivax
(ACKR1) Chemokine receptor is receptor for P. Vivax and P. knowlesi
Gene for Lutheran blood group
LU; BCAM
Chr: 19
25 antigens
IgM, IgA or IgG
Increases red cell adhesion
Gene for LW antigen (016)
ICAM
Chr: 19
3 antigens - LWb (low), LWa (high), LWab (high)
More LW antigen on Dpos rbcs
???
MHC Genes on Chr 6 are responsible for which (group) antigens?
HLA antigens
HLA class1 produces which antigen groups?
HLA-A, HLA-B, HLA-C antigens
Expressed on all nucleated cells
HLA class II responsible for/produces
HLA-DP, HLA-DQ, HLA-DR
Expressed on antigen presenting cells (B lymphs, macrophages)
HLA class III responsible for/produces
Non-HLA, complement proteins and tumor necrosis factor
HLA plays a role in platelet refractoriness
HLA class I antigens present on platelets
HPA-1a (most common; 80%)
HPA antibodies seen in the following conditions:
- FNAIT - maternal IgG destroys fetal platelets
- Post-tx purpura- 5-10 days after transfusion
- Platelet refractoriness
HNA (human neutrophil antigens) related conditions (2)
9 HNAs; related to:
- NAN - maternal IgG destroys fetal neutrophils (anti-HNA-1a, 1b, HNA-2)
- TRALI - respiratory distress within 6hrs of transfusion
Ch/Rg - located on C4 protein
Proteins Adsorb onto rbc membrane
C4A - binds to protein (Rg)
C4B - binds to carBohydrates (Ch)
Knops system antigens
Complement receptor 1 (CD35)
Chr 1
Receptor for plasmodium falciparum
Knops null
Helgeson cell - unable to detect all antigens in system due to low copy numbers
YT system (011) CAN be clinically significant
AChE protein
Chr 7
MMA is needed
Anti-Yta
Chromosome 7 abnormalities
Myelodysplasias
Some SLE
PNH
Dombrock system (014)
Chr 12
Potentially clinically significant
8 antigens - Doa, Dob, Gya(null), Hy, Jo, DOYA, DoMR, DoLG
Requires DNA to predict expression
P1 gene
Chr 22
Stronger antigen expression in AA
???
Type 1 chains
Proteins in plasma and secretions
- Beta 1-3 linkage
- N-acetylgalactosamine
Type 2 chains
Found on lipids on RbcS
- Beta 1-4 linkage
- Glucose
M antigen amino acids
GPA 20-24
Ser-Ser-Thr-Thr-Glycine
N antigen
L-S-T-T-Glutamic acid
S antigen
GPB
L-S-T-T-Glutamic (‘N’) +
Methionine (S)
Threonine
Blood groups:
Chromosome 1
(D R Kn Sc)
Duffy
Rh
Knops
Scianna
Cromer
Vel
Blood groups:
Chromosome 2
Gerbich
Lan
Blood groups:
Chromosome 3
Globoside
Blood groups:
Chromosome 4
MNS
JR
Blood groups:
Chromosome 6
[Rich-6]
(R)HAG
(I)
(C)hido/Rogers
(H)LA
Blood groups:
Chromosome 7
Kell
Yt/Cartwright
Colton
Blood groups:
Chromosome 9 **
ABO
FORS
Gill
Blood groups:
Chromosome 11
Indian/In
Raph
CD59
Blood groups:
Chromosome 12
Dombrock
Do (dozen = 12)
Blood groups:
Chromosome 15
JMH
Blood groups:
Chromosome 18
Kidd (JK)
You’re only a “Kidd” until you’re 18
Blood groups:
Chromosome 19 **
H (FUT1 gene)
Lewis (FUT 3 gene)
Lutheran
LW
Blood groups:
Chromosome 22
P1Pk
D’el found in which population?
Very low copy numbers of D antigen; only detectable by adsorption/elution
East Asians (25-30%) of D-
High resolution genotyping methods
cDNA
Sanger sequencing
Next Gen sequencing
Low resolution genotyping
Gel-based
HEA array
RFLP-PCR
SSP-PCR
In(Lu) is depressed copy numbers - don’t make anti-Lu3. (Not a true Lu null)
- has 1 normal + 1 mutated KLF1 gene
- Detectible by ads/elu
- Also depressed: AnWj, Co, P1, Indian, Sc, Di
TRALI symptoms
- HYPOtension,
-HLA or NEUTROPHIL antibodies - respiratory distress,
-within 6 hrs of transfusion
TACO Symptoms
- HYPERtension
- cardiogenic edema
- Fluid overload
- vascular confestikn
Variant D types/alleles
Weak D (145 alleles)
D’el (46 alleles)
Partial D (130 alleles)
Over expressed Lu antigens in SCD
Causes binding of increased quantities of laminin (LN 511/521)
Inflamed endothelial adhesion causing blockages
Potentially clinically significant antibodies
Anti-Yta
Anti-Dob
Duffy glycoprotein is erythrocyte receptor for which interleukin?
Interleukin 8
??What low incidence antigen is associated with D••
Evans (Rh37)
?? What low incidence antigen is associated with D-IVa
Go(a+)
What cell morphology is associated with Rh null
Stomatocytes
What cell morphology is associated with McLeod/CGD
Acanthocytes
??? Lewis:
Glyco-LIPIDS (plasma)
Glyco-PROTEINS (secretions)
Need to verify
