Other Blood Group Systems Flashcards
Lewis antigens build off of which precursor substance?
Type 1
Which gene codes for a-4-L-fucosyl transferase, which adds a fucose to the subterminal GALNAC of the precursor substance?
Lewis gene
Which gene codes for an enzyme that adds a fucose to the terminal galactose on the Type 1 precursor substance, making it an H antigen?
Se gene
Which gene is more effective at changing the Type 1 precursor substance: Lewis or Secretor?
Se gene
Lewis antigens adsorb to what type of molecule on RBCs?
glycolipids
Lewis antigens adsorb to what type of molecule in body fluids?
lipoproteins
What type of exchange occurs with Lewis antigens between RBCs, plasma, and body fluids?
free exchange
A type O individual who inherited Le/le and Se/Se will produce which antigens?
H, Le a, Le b
A type O individual who inherits Le/le and se/se will produce which antigens?
Le a
A type A individual who inherits le/le and Se/se will produce which antigens?
A and H
A type A individual who inherits Le/Le and Se/se will produce which antigens?
A, H, Le a, Le b
A type B individual who inherits le/Le and se/se will produce which antigens?
B, Le a
A type B individual who inherits le/le and se/se will produce which antigens?
B, but only on RBC surface, not in secretions
TRUE OR FALSE: Lewis antigens are integral parts of the RBC membrane.
FALSE
Where are Lewis antigens mostly formed?
tissue cells
Are Lewis antigens well developed at birth?
No
TRUE OR FALSE: Lewis antigen levels can decline during pregnancy.
TRUE
TRUE OR FALSE: A normally negative woman can acquire Lewis antigens during pregnancy.
TRUE, but she will remit back to her normal phenotype after birth
Which loci possess the genes needed to determine an individuals Lewis phenotype?
Lele locus, Hh locus, and the Sese locus
Which lewis phenotype is rare in adults?
Le a+, Le b+
When will lewis anitigens begin to be expressed?
12-18 months of age
What is the phenotype of an individual who inherited the following genes? Le sese H
Le a+, Le b-
What is the phenotype of an individual who inherited the following genes? Le Se H
Le a-, Le b+
What is the phenotype of an individual who inherited the following genes? lele, Se, H
Le a-, Le b-
The lewis gene locus is belied to be found on which chromosome and is linked to which complement locus?
Chromosome 19 and linked to C3
Which antigens will be found on RBCs and in secretions if the following genes are inherited: Le Se H
On RBCs: Le b
In secretions: Le a and Le b
Which antigens will be found on RBCs and in secretions if the following genes are inherited: Le Se hh
Le a on RBCs and in secretions
Which lewis phenotype has the highest frequency?
Le a-, Le b+
What provides antigen specificity?
immunodominant sugars
What differentiates Type 1 and Type 2 precursor substances?
Type 1 has a B-1,3 linkage between the terminal galactose and subterminal GALNAC.
Type 2 has a B-1,4 linkage between the terminal galactose and subterminal GALNAC.
Which immunodominant sugar is responsible for H antigen specificity?
Fucose added to the terminal galactose of the precursor substance.
Which immunodominant sugar is responsible for Lewis antigen specificity?
Fucose added to the subterminal GALNAC of the Type 1 precursor chain.
What must occur in order for Lewis b antigens to form?
The individual must have Se and H to first convert the Type 1 precursor to an H antigen and then it can be converted to Lewis b antigen.
Which antigens is a type 2 isomer of Le a?
Le x
Which antigen is a type 2 isomer of Le b?
Le y
Which lewis antigen is evident in Le(a-,b-) individuals who are nonsecretors?
Le c
Which lewis antigen is evident in Le(a-,b-) individuals who are secretors?
Le d
If an individual has inherited A and/or B antigens along with Le, Se, and H, can compound antigens be made?
Yes.
How is an ALe(b) antigen formed?
A fucose is added to the terminal galactose of the precursor substance along with a GALNAC (for A specificity). A fucose is also added to the subterminal GALNAC of the precursor chain.
Which immunodominant sugar is responsible for A specificity?
GALNAC
Which immunodominant sugar is responsible for B specificity?
galactose
Which lewis antibody is commonly naturally occurring?
anti-Le(a)
Which phenotype will commonly produce anti-Le(a)?
Le(a-,b-)
Anti-Le(a) is what type of immunoglobulin?
IgM (binds complement)
Anti-Le(b) is what type of immunoglobulin?
IgM
Why does anti-Le(bH) react best with Le(b+) RBCs that are type O or A2?
There are more H antigens exposed to react with.
Which lewis antibody reacts with nonsecretors who lack Le gene?
anti-Le(c)
Which lewis antibody reacts with secretors who lack Le gene?
anti-Le(d)
Which reacts with all individuals with the Le gene?
Anti-Le(x)
Lewis antigens mostly react at what temperature?
room temperature
When are lewis antigens considered significant?
When they demonstrate in vitro hemolysis or react in AHG phase
Which lewis antigen has receptors for Helicobacter pylori?
Le(b)
Which lewis antigens are associated with GI, colorectal, and lung cancers?
Le(x) and Le(y)
Which lewis antibody is associated with renal failure?
anti-Le(a)
What substance can be used to neutralize lewis antibodies?
soluble lewis antigens
What is the order of Rh antigen frequency from highest to lowest?
e>c>D>C>E
Which has the highest and lowest frequency: Kell and Cillano
Kell (K) - lowest
Cillano (k) - highest
Lu(b) has high or low frequency?
High
Which immunoglobulin class is responsible for anti-M,-N,-P,-I, and -Lu(a)?
IgM
Which immunoglobulin class is responsible for anti-Ss,-Kell,-Duffy,-Kidd, and -Lu(b)?
IgG
Which Rh antigens have the highest frequency?
e and c … followed by D
Which antigens have the highest frequency? M or N
roughly the same (~75%)
Which antigens are more frequent? S or s
s
Which lewis antigen has the highest frequency?
Le(b)
TRUE OR FALSE: P antigens occur in high frequency
TRUE
Which Colton antigen is expressed most frequently?
Co(a)
Which Kell antigens have the highest frequencies?
k, Kp(b), and Js(b)
Which Lutheran antigen occurs most frequently?
Lu(b)
Which Diego antigen occurs more frequently?
Di(b)
Which Cartwright antigen occurs most frequently?
Yt(a)
If you lack the U antigen, then you will also lack…
Ss
Is the MNSsU blood group well developed at birth?
yes
M antigen is found on which glycoprotein?
glycophorin A
N antigen is found on which glycoprotein?
glycophorin B
Which amino acids are switched that define M and N?
M: position 1- SER position 5-GLY
N: position 1 - LEU position 5-GLU
S and s are found on which glycoprotein?
glycophorin B
What amino acid difference defines S from s?
At position 29 or GPB:
S has MET and s has THR
anti-M and anti-N are of which class of immunoglobulin?
IgM, but can have IgG component
Which antibody can be seen in renal patients on dialysis due to the formaldehyde altering antigens?
anti-N
Which MN antibody can be naturally occurring?
anti-M
Which MN antibody is common with bacterial infections?
anti-M
Which class on immunoglobulin are anti-S and anti-s?
IgG ( can react at colder temperatures)
Anti-S,s tend to be more significant than anti-M,N because…
Anti-S,s are IgG and are implicated in HDFN and HTR
Which MNSs antibodies are implicated in HDFN and HTR with hemoglobinuria?
anti-S and anti-s
A combination antibody of anti-P,-P1, and -Pk is called…
anti-Tj(a)
Which P phonotype has the highest frequency?
P1
Which blood group system is related to ABO, Le, and I blood groups?
P
Roughly how long does is take for P antigens to reach full mature expression?
7 years
What happens to P1 upon storage?
degrades
Are MNSs destroyed or enhanced by enzymes?
destroyed (they extend far off the RBC surface
Are P antigens destroyed, enhanced, or unaffected by enzymes?
unaffected
