Rh First Part Flashcards
Hemolytic Disease of the Fetus and Newborn (HDFN) linked to Rh BGS by (4) in ____
1940
Levine and Stetson
• Rh Antigens
From ‘______
Not necessarily the Rhesus monkey that has discovered Rh blood groups possible.
• It came from a woman who gave birth to a stillborn baby (dead upon birth), her second child
Rhesus monkey cells’
Demonstrated by_______
They injected Rhesus monkey red cells to (2)
Landsteiner and Weiner
guinea pigs and rabbits.
Current Rh Genetic Theory
2 genes linked in Chromosome 1
RHD and RHCE genes
According to the ______ theory, there are two genes responsible for the production of Rh antigens
They are located in the same chromosome but in different loci in very close proximity
Considered to be haplotype?
current genetic theory
- Chromosome 6; Coexpressor
RHAG
Not an
antigen, but rather
a
glycoprotein - related to the Rh
glycorprotein itself.
RHAG
The absence of RHAG gene can affect the expression of…
RHD and RHCE antigens.
• RH glycoprotein is made up of__\ amino acids that traverses to the plasma membrane____ times.
416
12
Individuals who are Rh null most likely don’t have the Rh glycoprotein - will suffer a particular RBC morphology abnormality -____.
STOMATOCYTOSIS
In 103rd AA
If SERINE →
If PROLINE →
Capital C
small c
In 226th AA
If PROLINE →
If ALANINE →
Capital E
Small e
One of the two major Rh nomenclatures
Three different genes on three different loci in CLOSE PROXIMITY on the same chromosome → STILL IN CHROMOSOME 1
Fisher-Race genetic theory
One gene codes for three combinations
Weiner Genetic Theory
R°, R1, R2, Rz, r, r’, r”, ry
Weiner Genetic Theory
Dce, dce, DcE, DCe, dCe, dcE, DCE, dCE
Fisher race
DCEce
12345
Rosenfield Numeric Technology
Six digit number for every authenticated blood group specificity
FIRST THREE NUMBERS: BLOOD GROUP SYSTEM (004)
REMAINING THREE: Antigenic specificity
ISBT Numeric Terminology
ISBT
Rh°
rh’
hr”
004001
004002
004005
Antigens:
Most to least
WELL DEVELOPED EARLY IN FETAL LIFE
Exposure to at least 1 mL of Rh positive cells would stimulate antibody production of Rh negative persons
D> c>E>C>e
It is one of the two major Rh nomenclature systems (the other being Wiener).
Fisher-Race system
This theory proposes that three separate but closely linked genes on Chromosome 1 determine Rh antigen expression.
• Each gene controls the production of one of three pairs of Rh antigens:
• D or d
• C or c
• E or e
Fisher race
A person with dce/dce genotype would be_____ because they lack the D antigen.
Rh-negative
No Rh antigens are present at all
Rh-null
Absent (D) Present (CE)
Other Rh antigens still present
Rh-negative (Rh-)
individuals lack all Rh antigens, causing serious red blood cell membrane instability.
Rh-null
is a modified form of Rh expression, where D, C, and e antigens are present but weakly expressed.
Rhmod
The _____proposes that one gene is responsible for producing three closely associated antigenic factors:
• D (Rho factor)
• C (hr’ factor)
• E (hr” factor)
Weiner Genetic Theory
• In____, three separate genes on Chromosome 1 code for the Rh antigens (D, C/c, and E/e).
• In_____, a single gene codes for a single structure (agglutinogen) that expresses three antigenic factors.
Fisher-Race
Weiner’s Theory
The term_____\ is synonymous with antigen, meaning it stimulates antibody production.
agglutinogen
refers to the antibody produced against a specific antigen
Agglutinin
refer to the different antigenic subcomponents detected through serological reactions.
Blood factors
If a person inherits R° (Ro) → They express
D, c, e antigens.
If a person inherits R’ (R1) → They express
D, C, e antigens.
If a person inherits R² (R2) → They express
D, c, E antigens.
If a person inherits Rz (Rz) → They express
D, C, E antigens.
No Rh antigens present (complete absence of Rh system antigens)
Rh-null
rr (equivalent to Rh-null)
Weakened Rh expression Rh antigens are weakly expressed due to RHAG mutation
Rhmod
If a person has D+, C+, E-, c+, e+, their Rh designation in Rosenfield notation would be:
Rh:
1, 2, -3, 4, 5
Rosenfield notation
If another person has D-, C-, E+, c+, e+, their Rh designation would be:
Rh: -1, -2, 3, 4, 5
assigns six-digit codes to each blood group antigen for standardized identification.
International Society of Blood Transfusion (ISBT)
If a blood sample contains
D+, C-, E+, c+, e-
the ISBT notation would be:
004001, 004003, 004004
Comparison Across Nomenclatures:
• _____→ One gene produces multiple antigenic factors.
• ____→ Three closely linked genes code for D, C/c, E/e.
• ____→ Antigens are numbered in a set order (D, C, E, c, e).
• ____→ A globally standardized six-digit system for antigen classification.
Weiner
Fisher-Race
Rosenfield
ISBT
Rank (From Strongest to Weakest)
D
c
E
C
e
Rh antigens are present on red blood cells (RBCs) as early as the___\ of fetal development.
first trimester
IgG class
are the most clinically significant because they can cause Hemolytic Disease of the Newborn (HDN) and Hemolytic Transfusion Reactions (HTR).
IgG1 and IgG3
If Rh-negative individuals receive Rh-positive blood, they can develop..
anti-D antibodies.
The immune response to Rh antigens follows this sequence:
• _____is the first antibody produced (which does NOT cross the placenta).
• IgM later switches to____, which can cross the placenta and attack fetal red cells
IgM
IgG
• Caused by mutations in the RHD gene → Leads to fewer D antigens on the RBC surface.
• Common in African-Americans.
• Detected using Indirect Antiglobulin Test (IAT) or Indirect Coombs Test.
Genetic Weak D
• Some parts of the D antigen are missing → The individual may form anti-D antibodies against the missing parts if exposed to normal Rh-positive blood.
Partial D (Mosaic D)
