Lewis System Flashcards

1
Q

Five characteristics of the Lewis System

A

It is a system, not a blood group antigen
Cord bloods are always Le(a-b-)
Not manufactured by RBC, not integral, adsorbed onto RBC’s
Decreased expression often seen in pregnant women
Leb expression and immunity are affected by phenotype

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2
Q

What chromosome is Le gene located on?

A

Chromosome 19 - short arm
FUT3 gene
FUT1 and FUT2 are closely linked on long arm

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3
Q

What does the Le gene code for?

A

L-fucosyltransferase adds fucose to GlcNAc on type I chains in a 1-4.
Can’t add to type II chains because a1-4 is taken

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4
Q

How is Lea formed?

A

Lea is formed when a fucose is added to type 1 precursor chains
Only Lea is formed when no Se gene present

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5
Q

How is Leb formed?

A

Leb is formed when a fucose is added to Type 1 H chains
Se gene forms H substance
Lea is still present but much less than Leb

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6
Q

How is ALeb and BLeb formed?

A

Se gene forms H substance, A/B genes form A and B substance, Le gene adds fucose > ALeb and BLeb
In group A, most Leb is ALeb

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7
Q

What is Lewis antigen carried on in plasma?

A

Oligosacchride bound to a lipid

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8
Q

What is Lewis antigen carried on in Saliva?

A

Oligosacchride bound to a protein

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9
Q

Frequency of Le(a-b+)

A

72%

80% are secretors

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10
Q

Frequency of Le(a+b-)

A

22%

20% are non-secretors

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11
Q

Frequency of Le(a-b-)

A

30% of blacks lack the Le gene

6% of whites lack Le gene

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12
Q

Frequency of Le(a+b+)

A

16.8% of japenese are Se(w)
also seen in Australian, Chinese, Taiwan, and Polynesians
Se enzyme is ineffective at making H substance to increased Lea antigen

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13
Q

Antigen charactersitics

A

Not expressed on cord cells
Weaken during pregnancy > Esp Group A women
Resistant to most chemicals
Enhanced by enzymes

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14
Q

Leb is a receptor for…

A

H. pylori - bacteria responsible for causing gastritis

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15
Q

What is Le(a-b-) associated with?

A

Increased susceptibility to E. Coli, candida, Cardiovascular disease, and possibly graft failure in renal transplant patients

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16
Q

Group A Secretors

A

May type as Le(a-b-) because all of Leb is ALeb

17
Q

What is Le(abx) antigen?

A

Also called Stage specific embryonic antigen

Carried on fucosylated unbranched type II chains

18
Q

What is Le(abx) antibody?

A

Reacts with all cells except le(a-b-) red cells
Reacts with 90% of cord cells (infants with Le gene)
Reacting with type 2 precursor w/ Le fucose
Common and found with anti-Lea and Leb

19
Q

What are Le(x) and Le(y) antigens?

A
Isomers of Lea and Leb on Type II chains
Not on RBC + Not part of Lewis
Fucose + Type II precursor chain = Lex
Fucose + Type II H chain = Ley
Fucose + H chain + A = ALey
Fucose + H chain + B = BLey
20
Q

Le(c) genetics and antibody

A

lele, sese
Anti-Le(c) is antibody to precursor type 1 chain or Le(a-b-) non-secretors
adsorbed onto RBC

21
Q

Le(d) genetics and antibody

A

lele, Se
Le(d) = Type 1 H chains
Anti-Le(d) only reacts with Le(a-b-) secretors or Type I H chains

22
Q

ALe(b)

A

FUT3 adds fucose to A substance
Anti-ALeb reacts with A positive secretors Le(a-b+)
Can’t be seperated into Anti-A and Anti-Le(b)
Group A secretor plasma will adsorb out regardless of Lewis type

23
Q

BLe(b)

A

FUT3 adds fucose to B substance
Anti-BLeb reacts with B positive secretors Le(a-b+)
Group A secretor plasma will adsorb out regardless of Lewis type

24
Q

Diseases associated with loss of Lewis antigens

A

Infectious mononucleosis
Severe alcoholic cirrhosis
Alcoholic pancreatitis

25
Disease associated with increased Lewis antigens
Fucosidosis
26
Describe Lewis antigen developement
``` At birth infant is Le(a-b-) 2 months type as Le(a+b-) transitional period of Le(a+b+) 2-3 years true typing can be determined 5-6 years Lewis antigen fully developed ```
27
Characteristics of Lewis antibodies
Fragile, weak agglutination Hemolysis rarely seen in vitro (enzyme treated cells increases) IgM reacts at RT Naturally occurring Not clinically significant cause Le antigens can elute off cells Anti-Lea and anti-Leb often occur together
28
Anti-Le(bH)
Reacts with O and A2 cells Le(a-b+)
29
Anti-Le(bL)
True anti-Leb | Reacts with all Le(a-b+) cells