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
Which antibody is associated with tapeworms?
anti-P1
Which P antibody is commonly naturally occurring and IgM?
anti-P1,-P
Which antigen is the receptor for the pyrovirus?
P antigen
Which P antibody is a potent naturally occurring hemolysin?
anti-Tj(a)
Which antibody has been associated with spontaneous chronic abortions and transplant rejection?
anti-Tj(a)
Which antibody is naturally occurring in P(k) individuals?
alloanti-P
Which antibody is associated with paroxysmal cold hemoglobinuria and other cold agglutinin disorders?
autoanti-P
Which antigen expression is required in order for Luke antigens to be expressed?
P antigens
Which Luke phenotype is most frequent?
Luke +
Which antibody is associated with Hodgkin’s Lymphoma?
anti-Luke
What is the difference between i and I?
I has more extensive branching than i
I antigen content is strong most frequently in…
adults
Ii are enhanced, destroyed, or unaffected by enzymes?
enhanced
Ii is defined by a series of what chains rather than a gene?
carbohydrates
I Cord phenotype is most common in…
infants
Most anti-Ii are of what immunoglobulin class?
IgM
What is the biggest danger of anti-Ii?
masking other potentially significant antibodies
Which antibody is possibly associated with Mycoplasma pneumoniae?
Anti-I
Which antibody can be associated with viral disorders such as Ebstein Barr?
anti-i
Which antibody may be seen in alcoholic cirrhosis and myelogenous leukemia?
anti-i
Which Ii antibody can cause HDFN, rarely?
anti-i
Does ficin or papain denature Kell antigens?
yes
Which antigen is 2nd in immunogenicity after D?
Kell (K)
Which Kell antigens have high frequency?
k, Js(b), Kp(b)
K(0) is a silent Kell allele that is associated with which disorders?
muscle and nerve disorders
Which Kell antigen suppresses other Kell antigens in cis position?
Kp(a)
What is the probable biochemical nature of Kell antigens?
Carried on glycoproteins of RBC membrane
Anti-K is of what immunoglobulin class?
IgG and reactive in the AHG phase
How is anti-K stimulated to form?
exposure to RBC or pregnancy
Which enhancement media can be used to enhance anti-K?
PEG and Albumin
What media may decrease anti-K activity?
Low ionic strength media (LISS)
Is anti-K associated with HTR and HDFN?
yes
Why are antibodies to Kp(a) and Js(a) rare?
Because they are low frequency antigens so there are few exposures to stimulate the formation of those antibodies.
Why are antibodies to k, Kp(b), and Js(b) rare?
They are high frequency antigens and since so few people lack the antigen, few people will form antibodies against them.
Which antibodies parallel anti-K, but only cause mild cases of HDFN?
anti-k, -Kp(b), -Js(a)
Are the Duffy antigens well developed at birth?
yes
Why don’t Duffy antigens store well?
They tend to elute RBC surface
Are Duffy antigens enhanced, destroyed, or unaffected by enzyme treatment?
destroyed
What antigens are needed in order for malaria to infect cells?
Duffy
What is the most common Duffy phenotype for Caucasians?
Fy(a+, b+)
What is the most common Duffy phenotype for Afro-Americans?
Fy(a-, b-)
What Duffy phenotype is protective against malaria?
Fy(a-, b-)
Which antigen is a result of Duffy and Rh gene interaction, common in Caucasians, and is unaffected by enzymes?
Fy5
Which antigen is similar to Fy(a), affected by enzymes, and defines the receptor for Plasmodium vivax to enter RBCs?
Fy6
Antibodies to duffy antigens are almost always stimulated by…
RBCs or pregnancy.
Duffy antibodies tend to be of which immunoglobulin class?
IgG
Which antibodies are notorious for delayed HTR?
anti-Fy
TRUE OR FALSE: Anti-Fy(b) is more frequent than anti-Fy(a)
FALSE
Anti-Duffys react well with which enhancement media?
LISS
What is the result of either amorph Jk or result of InJk that prevents Jk expression?
Kidd(null)
Kidd(null) is frequent in which population?
Polynesian
Kidd antigens are enhanced, destroyed, or unaffected by enzyme treatment?
destroyed
Which Kidd phenotype is most common in Afro-Americans?
Jk(a+, b-)
Which Kidd phenotype is most common in Caucasians?
Jk(a+, b-)
Which Kidd phenotype is rare?
Jk(a-,b-)
Antibodies against Kidd antigens are of which immunoglobulin class?
IgG, but sometimes IgM
Which antibodies are notorious for showing dosage?
anti-Kidd
Which antibody is unstable because it disappears rapidly from circulation so fresh serum is needed for detection?
Anti-Kidd
Kidd antibodies are enhanced by which media?
PEG and LISS
Which antibodies can have titers that drop below detectable levels and are notorious for goin undetected in the lab?
Anti-Kidd
Lu(a) is poorly developed at birth and takes how many years to fully develop?
15 years
Which Lutheran antigen is also present when Lu(a) or Lu(b) are present?
Lu3
Are Lu4, Lu5, Lu7, Lu11, Lu16, Lu17 high or low frequency antigens?
high frequency
In the Lutheran system, high incidence antigens are probably what while the low frequency antigens are probably…
High incidence antigens are the originals
Low incidence antigens are mutations of the originals
Which Lutheran phenotype if the most frequent and which one is the most rare?
Most Frequent: Lu(a-,b+)
Rare: Lu(a-,b-)
Regulator genes and Synthesis genes are needed in order to express which antigens?
Lutheran antigens
Synthesis genes influence which blood systems?
Lu, P, I
Syn-1B is also known as…
InLu
Syn-1B is an (inhibitor or activator) or Lu, P, and I systems and is (dominant or recessive)?
inhibitor
dominant
Syn-1A is an (inhibitor or activator) or Lu, P, and I systems and is (dominant or recessive)?
inhibitor
recessive
Anti-Lu(a) is of what immunoglobulin class?
IgM (can be naturally occurring)
Which antibody can be IgG, IgA, or IgM?
anti-Lu(b)
Which antigen is of interest in genetic studies, but has not been implicated in HDFN or HTR?
Xg(a)
What percentage of males and females are Xg(a) positive?
Males: 66%
Females: 88%
Which Diego antigens are high incidence?
Di(b) and Wr(b)
Diego antigens are associated with which glycoprotein?
glycophorin A
Di(a) is rare except in which populations?
Asians and Afro-American
Diego antibodies are severe with (HDFN or HTR), but not with (HDFN or HTR).
severe with HTR, but not with HDFN
Which Diego antibody has been seen as a naturally occurring IgM and as immune IgG?
Anti-Wr(a)
Which Diego antibody can be seen as an autoantibody in patients with AIIHA?
Anti-Wr(b)
Which Cartwright antigen is of high incidence?
Yt(a)
Where are cartwright antigens located?
On RBC acetylcholine esterase (an enzyme involved in neurotransmission)
Which cartwright antigen is well developed at birth and which one is not well developed at birth?
Yt(a) is not well developed at birth
Yt(b) is well developed at birth, but is a weak immunogen
Which Scianna antigens are high incidence?
Sc1 and Sc3
Sc3 is present on cells with…
Sc1 and/or Sc2
Anti-Di(a) and anti-Di(b) typically react in which phase?
AHG
Anti-Wr(a) and anti-Wr(b) typically react in which phase?
IS
Cartwright antibodies typically react in which phase?
AHG
Scianna antibodies typically react in which phase?
AHG
Colton antibodies typically react in which phase?
AHG
Which Colton antigens are high incidence?
Co(a) and Co3
Where are Colton antigens located?
on CHIP (channel-forming integral protein)
Which antigens are responsible for RBC water permeability?
Colton
Which protein and antigens are present in tissues of proximal and decending tubules and collecting ducts of the kidneys and are responsible for 80% water reabsorption?
CHIP and Colton antigens
Which chromosome are Colton genes located?
Chromosome 7
Which Colton phenotype is linked to monosomy-7 and a rare form of dyserythropoietic anemia?
Co(a-, b-)
Gregory (Gy), Holley (Hy), and Joseph (Jo) are high incidence antigens that belong to which blood system?
Dombrock
TRUE OR FALSE: Dombrock antigens are poorly developed on cord cells
TRUE
Dombrock antibodies will typically react at which phase?
AHG
CH1, CH2, CH3, RG1, and RG2 are high frequency antigens that are part of which blood group system?
Chido/Rodgers
Are Chido/Rodger antigens sensitive to enzymes?
yes
TRUE OR FALSE: Chido/Rodgers antigens are greatly expressed on cord cells
FALSE. They are poorly expressed
What chromosome carried the Chido/Rodgers genes?
Chromosome 6
Which miscellaneous blood group system is related to the HLA system?
Chido/Rodgers
C4A refers to …..
C4B refers to…
C4A = Rodgers
C4B = Chido
Chido/Rodgers antigens are RBC antigens but are also found on
C4d fragments of C4A (Rodgers) and C4B (Chido) glycoprotein of C4
Null Chido/Rodgers is associated with
autoimmune diseases
Although Chido/Rodgers RBCs have not been implicated in HTR or HDFN, large amounts of what have resulted in severe anaphylactic reactions?
large amounts of plasma products
What is a problem Chido/Rodgers antibodies have of testing and how can it be resolved
May obscure other antibodies due to their weak and variable reactions.
Neutralize or inhibit antibodies by using Ag + plasma
Neutralizing CH/RG antibodies may also remove which other antibodies?
anti-Le
Which Gerbich antigens are high incidence?
Ge2, Ge3, Ge4
Gerbich gene can be found on which chromosome?
Chromosome 2
Where are Gerbich antigens located?
On glycophorin C and D in the RBC membrane
Which antigens are associated with membrane band 4.1 and implicated in maintaining RBC shape?
Gerbich (Ge)
Gerbich antibodies are of which immunoglobulin class?
IgG
Which gerbich antibodies can be naturally occurring IgM?
anti-Ge2 and anti-Ge3
anti-Wb and anti-Ls(a)
Which antigens can be found in serum, plasma, urine, platelets, WBCs, and placental tissue?
Cromer
TRUE OR FALSE: Cromer antigens can be depressed during pregnancy
TRUE
Which antigens are carried by DAF (decay accelerating factor)?
Cromer
INAB is a Cromer Null type where an individual lacks…
all Comer antigens and DAF
Which blood group system has antibodies that are predominantly IgG1?
Cromer
Concentrated urine, serum, plasma that is Ag+ can be used to neutralize which antibody?
anti-Cromer
All KNOPS antigens are high incidence except:
Kn(b)
KNOPS antigens are depressed in patients with Lu(a-, b-) phenotype due to…
the In(Lu) gene
Which antigens are located on complement receptor 1?
KNOPS
Why do autoimmune diseases, SLE, and chronic cold agglutinin disease depress KNOPS antigens?
Because of the loss of CR1
Which Indian Blood group antigen is high incidence?
In(b)
Indian blood group antigens are inherited on which chromosome?
chromosome 11
Anti-In(b) can cause (HTR or HDFN).
HTR
Bgs are antigens part of which HLA class?
Class 1
How are HLAs (Bgs) found on platelet and RBCs?
RBCs and platelets are nucleated during develop and during maturation they can carry residual Bg antigens
Which antibodies cause a nuisance in blood bank?
Bg antibodies
Which antibodies may increase in infectious mono, polycythemia, and hemolytic anemia?
anti-Bgs
Anti-Bgs are of which immunoglobulin class?
IgG
Bg(a) corresponds to HLA-?
Bg(b) corresponds to HLA-?
Bg(c) corresponds to HLA-?
Bg(a) corresponds to HLA-B7
Bg(b) corresponds to HLA-B17
Bg(c) corresponds to HLA-A28
Which antigens are enhanced by enzymes?
ABO, Rh, Kidd, Lewis, I, P
Which antigens are destroyed by enzymes?
Duffy, MNSs
Which antigen is unaffected by enzymes?
Kell
