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ABO BLOOD GROUP HistoryLandsteiners discovered the ABO Blood Group System in 1901He and five co-workers began mixing each others red blood cells and serum together and accidentally performed the ABO groupings.Main Phenotypes (A, B, AB, O)ABO gene located on long arm of chromosome 9

Karl Landsteiner discovered that blood clumping was an immunological reaction which occurs when the receiver of a blood transfusion has antibodies against the donor blood cells. Karl Landsteiner's work made it possible to determine blood types and thus paved the way for blood transfusions to be carried out safely. For this discovery he was awarded the Nobel Prize in Physiology or Medicine in 1930.History of Blood Groups and Blood Transfusions (Cont.)

*Inheritance of ABO Groups

Blood TransfusionsA blood transfusion is a procedure in which blood is given to a patient through an intravenous (IV) line in one of the blood vessels. Blood transfusions are done to replace blood lost during surgery or a serious injury. A transfusion also may be done if a persons body can't make blood properly because of an illness.

Rh + Can receive + or - Rh - Can only receive -

*Significance of ABO GroupABO mismatched transfusions:RareMay be life threateningCan be caused by technical or clerical errorIntravascular haemolysisMore severe in group O patients

*The Rh(D) AntigenRH is the most complex system, with over 45 antigens Discovered in 1940 after work on Rhesus monkeysSubsequently discovered to be unrelated to monkeysRH gene located on short arm of chromosome 1

Rh antigens are transmembrane proteins with loops exposed at the surface of red blood cells.

They appear to be used for the transport of carbon dioxide and/or ammonia across the plasma membrane.

RBCs that are "Rh positive" express the antigen designated D.

*Simple Genetics of Rh(D)86% of caucasians are Rh(D) posThe antithetical antigen d has not been foundThe d gene is recessive:Dd, dD, DD, persons are Rh(D) posOnly dd persons are Rh(D) neg

*Distribution of Rh(D) Types

PopulationRh(D) posRh(D) negCaucasian86%14%African-American95%5%Oriental>99%

*Significance of Rh(D)80% of Rh(D) neg persons exposed to Rh(D) pos blood will develop anti-DAnti-D can also be stimulated by pregnancy with an Rh(D) positive babySensitisation can be prevented by the use of anti-D immunoglobulin, antenatally and post natallyRh(D) neg females of childbearing potential should never be given Rh(D) positive blood products

*Inheritance of ABO and Rh(D)MotherGroup A AORh(D) pos DdFatherGroup B BORh(D) pos DdGroup A AORh(D) pos DdGroup B BORh(D) pos DdGroup O OORh(D) neg dd

A person with Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies.

A person with Rh+ blood can receive blood from a person with Rh- blood without any problems.

Why is an Rh incompatibility so dangerous during pregnancy?

Most anti-A or anti-B antibodies are of the IgM class (large molecules) and these do not cross the placenta.

In fact, an Rh/type O mother carrying an Rh+/type A, B, or AB foetus is resistant to sensitisation to the Rh antigen.

Her anti-A and anti-B antibodies destroy any foetal cells that enter her blood before they can elicit anti-Rh antibodies in her.

This phenomenon has led to an effective preventive measure to avoid Rh sensitisation. Shortly after each birth of an Rh+ baby, the mother is given an injection of anti-Rh antibodies (or Rhogam).

These passively acquired antibodies destroy any foetal cells that got into her circulation before they can elicit an active immune response in her. Rh incompatibility during pregnancy (cont.)

ABO antibodiesgroup A serum contains anti-Bgroup B serum contains anti-Agroup AB serum contains no antibodiesgroup O serum contains anti-A, anti-B, and anti-A,B

Anti-A1Group O and B individuals contain anti-A in their serumHowever, the anti-A can be separated into different components: anti-A and anti-A1Anti-A1 only agglutinates the A1 antigen, not the A2 antigenThere is no anti-A2.

Anti-A,BFound in the serum of group O individualsReacts with A, B, and AB cellsPredominately IgG, with small portions being IgMAnti-A,B is one antibody, it is not a mixture of anti-A and anti-B antibodies

ABO antibodiesIgM is the predominant antibody in Group A and Group B individualsAnti-AAnti-BIgG (with some IgM) is the predominant antibody in Group O individualsAnti-A,B (with some anti-A and anti-B)

ABO AntibodiesUsually present within the first 3-6 months of lifeStable by ages 5-6 yearsDecline in older ageNewborns may passively acquire maternal antibodies (IgG crosses placenta)

Laboratory Testing:ABO typing

ABO Blood Groups

ABO GroupAntigen PresentAntigen MissingAntibody PresentAABanti-BBBAanti-AONoneA and Banti-A, anti-B, anti-A,B ABA and BNoneNone

The ABO Blood Group System

Laboratory Determination of the ABO System

Serology: This is a direct detection of the ABO antigens. It is the main method used in blood transfusion centres and hospital blood banks.

Thisform of testing involves two components: a) Antibodies that are specific at detecting a particular ABO antigen on RBCs. b) Cells that are of a known ABO group that are agglutinated by the naturally occurring antibodies in the person'sserum.

Illustration of the forward and reverse grouping reaction patterns of the ABO groups using a blood group tile

http://www.bh.rmit.edu.au/mls/subjects/abo/resources/genetics1.htm

ReferencesAldahr MHS. ABO Blood Group. Faculty of Applied Medical Sciences Blood Bank Medical Tecnology. download 2011Giacobbe. ABO & Rh(D) Blood Groups. Anatomy & Physiology. Unit 9 Circulatory System.download 2011Musani MI. Blood groups and Rhesus factor. Download 2011 Trimpe T. Blood Basics. Forensic Science.2006Wilkins RN. ABO Blood Group System. University of Mississippi Medical Center. Download 2011.

*Remember: most ABO antibodies are IgM, but some are IgG. Mothers can pass those IgG antibodies through placenta to fetus*