About the Blood Grouping types ,their history and origin

1. TAKORADI TECHNICAL UNIVERSITY
DEPARTMENT OF MEDICAL LAB TECH
B-TECH 300L
BLOOD GROUP SYSTEMS
Dr. Isaac Kporha

2. ABO Antibodies:
• Antibodies:
• Are made mostly of protein molecule; produced in response to
immunogenic stimulation, and are capable of specific interaction with
the provoking antigens
• Each antibody has at least two identical antigen binding sites; the
number of antigen binding sites on an antibody is know as the valence,
majority of antibodies are bivalent
• Antibodies are also called immunoglobulins (Igs)

3. ABO Antibodies:

4. ABO Antibodies:
• Antibodies:
• There are five classes of antibodies: IgG, IgM, IgA, IgD and IgE
• They are Y-shaped molecules with four protein chains:
• 2 identical light chains
• 2 identical heavy chains
• Variable Regions: two sections at the end of the Y arms, this contain the
antigen binding sites (Fab)
• Fab region is identical on the same antibody, however, vary from one antibody
to another

5. Antibodies:
Antibody

6. Antibodies:
Antigen binding sites Antigen binding sites
Constant region
Variable region
Fc region
Heavy chain
Light chain
Antigen binding sites Antigen binding sites

7. Antibodies:
• IgG antibodies:
• Monomer in nature, located in the blood, lymph, intestine
• Form about 80% of immunoglobulins in the body; has a half-life of 23
days
• Is able to fix complement, and is able to cross the placental
• It enhances phagocytosis (opsonization), neutralizes toxins and viruses,
protect fetus and newborns

8. Antibodies:
IgG antibodies:

9. Antibodies:
• IgM antibodies:
• It is a pentamer, located in the blood, lymph, B cell surface (monomer)
• Make up of 5 – 10% of immunoglobulins in serum; Has a half-life of 5
days in serum and is able to fix complement
• It can not pass across the placenta
• It is the first antibody produced during an infection; effective against
microbes and agglutinating antigens

10. Antibodies:
• IgG antibodies:

11. Antibodies:
• IgA antibodies:
• It is a dimer, make up about 10 - 15% of immunoglobulins in the serum
• Can be found in secretions such as tears, saliva, intestine, milk; in the
blood and lymph
• Has a half-life of 6 days in serum, not able to fix complement and
cannot cross the placenta
• It offers localized protection of mucosal surfaces, and provides
immunity to infant digestive tract

12. Antibodies:
• IgA antibodies:

13. Antibodies:
• IgD antibodies:
• It is a monomer in structure; is about 0.2% of total immunoglobulins in
serum
• Found on B-cell surface; in blood and lymph; cannot fix complement
• Has a half-life of 3 days in serum, and cannot pass across the placental
• Its function in serum is unknow, meanwhile it initiate immune response
on B-cell surface

14. Antibodies:
• IgD antibodies:

15. Antibodies:
• IgE antibodies:
• It is a monomer in structure; is about 0.002% of total immunoglobulins
in serum; bound to mast cells and basophils throughout the body,
(blood)
• Has a half-life of 2 days in serum; cannot fix complement
• It cannot pass across the placental
• Its function in allergic reactions and lysis worms

16. Antibodies:
• IgE antibodies:

17. ABO Antibodies:
• ABO Antibodies:
• ABO antibodies are the most important antibodies in transfusion
medicine; and produced to antigens not present on the red cells
• Their production is stimulated by naturally occurring substances
resembling A and B antigens in the environment, hence are called Non-
Red Cells Stimulated (NRCS) antibodies
• ABO antibody production begins at age three to six months; which
peaks at five to ten years of age and continues through life

18. ABO Antibodies:
• ABO Antibodies:
• They are primarily IgM in nature, however, some amount of IgG and IgA
may be present;
• They react best at room temperature or below; also react with their
corresponding antigens in saline medium
• Most IgG antibodies react at 37𝑜𝐶, however, ABO IgG antibodies react
by agglutinating RBCs at room temperature
• ABO antibodies occasionally cause haemolysis at room temperature

19. ABO Antibodies:
• ABO antibodies production decreases in:
• Age
• Newborns and young infants
• Elderly
• Immunodeficient individuals
• Congenital conditions
• Congenital hypogammaglobulinemia
• Congenital agammaglobulinaemia

20. ABO Antibodies:
• ABO antibodies production decreases in:
• Immunosuppressed patients
• Immunosuppressive therapy
• Chronic lymphocytic leukemia
• Bone marrow transplant
• Multiple myeloma

21. ABO Antibodies:
• Like maternal antibody of IgG isotype, ABO antibodies cause
Haemolytic Disease of the Fetus and Newborn (HDFN) and
Haemolytic Transfusion Reactions (HTR) cause by maternal;
mostly with blood group O mothers and a group A baby
• Unlike Rh HDFN which occurred mostly after the first
pregnancy; ABO haemolytic disease may affect the first
pregnancy

22. ABO antibodies :
• Anti- A
• Arises in the serum of blood group B individuals exposure to
environmental agents similar to antigen A
• Anti-A antibodies are mostly IgM, however, small amount of IgG and IgA
may be present
• Anti-A is able to agglutinate RBCs suspended in saline and can activate
complement; it may cause rapid intravascular destruction of RBCs
carrying the A antigen

23. ABO antibodies :
• Anti- B
• Arise in the serum of individuals with group A antigens; they are mostly
IgM antibodies, with some small amount being IgG and IgA.
• Readily agglutinates cells suspended in saline, activates complement, and
rapidly cause intravascular haemolysis of RBCs
• Immune anti-B antibodies reacts similarly as anti-A

24. ABO antibodies :
• Anti-AB:
• Found in the serum of group O individuals, together with some
amount of Anti-A and anti-B; it may react with both A, B and AB cells
• Anti-AB is not a mixture of anti-A and anti-B
• Anti-AB have higher titer and avidity than Anti-A or anti-B
• Therefore, they are use to confirm group O donors, testing of
newborn blood samples and in the identification of weak subgroups
of A and B

25. ABO antibodies :
• Anti-A/B:
• The anti-AB IgG antibodies are more likely to occur in the serum of
group O individual sensitized by A or B antigen
• Group O mothers are more likely to have IgG anti-AB in their serum
when carrying a group A or B fetus; this immune IgG anti-AB is more
likely to cause haemolytic disease of the newborn or the fetus

26. ABO Antibodies:
• Antigens and Antibodies in ABO blood groups:

27. The Rhesus (Rh) Blood Group System:
• The Rh blood group system is the second most-known blood
group system; it is highly polymorphic with about 50 known
antigens
• It is the most antigenic (immunogenic) blood group system,
and the primary cause of Haemolytic Disease of the Fetus
and Newborn (HDFN)

28. • Rh Antigen:
• The Rh antigens are known as C, c, D, E, and e however the D
antigen is the most clinically important Rh antigen
• Karl Landsteiner and Alexander Weiner discovered the D antigen in
1940
• The presence or absence of the D antigen is use to refer to an
individual as being Rh positive or Rh negative respectively
The Rhesus (Rh) Blood Group System:

29. • Rh Antigen:
• Unlike ABO system the Rh antigens are found solely on red cells and
not on tissue cells or in body fluids in soluble form; the Rh antigen is
protein in nature
• RhD and RhCE genes are responsible for encoding the Rh proteins
reside on chromosome 1; the RHD gene encodes the D antigen,
while the RhCE gene encodes the C and E antigens in several
arrangements such as: ce, cE, Ce, or CE
The Rhesus (Rh) Blood Group System:

30. • Rh Antigen:
• Rh D antigens do not have a “d” form, therefor , there is a total
absence or deletion of the D gene location, corresponding to the
absence of the D antigen (Rh D negative)
• A large number of amino acid difference exists between RhD and
RhCE proteins, which explains the strong antigenic property of the
RhD antigen when encountered by the immune system of an
individual
The Rhesus (Rh) Blood Group System:

31. • Fisher-Race Theory:
• According to Fisher-Race, Rh antigens are controlled by 3 closely linked
loci (D/d, C/c, E/e)
• Each gene expresses an antigen given the same letter as the italicized
letter of the gene name (e.g., the C gene produces the C antigen)
• Absence of the D antigen is written as “d”
• The genes ordinarily arrange as DCE, however, sometimes can be
arranged alphabetically as CDE
The Rhesus (Rh) Blood Group System:

32. • Fisher-Race Theory:
• An individual inherits a set of Rh genes from each parent (i.e., a D or d,
C or c and E or e)
• The combination of the genes inherited form one parent is called a
haplotype (DCE, DCe, DcE, Dce, CE, Ce, cE, or ce); the pairing of
maternal and paternal haplotypes results in the genotype of the
offspring
The Rhesus (Rh) Blood Group System:

33. • Fisher-Race Theory:
The Rhesus (Rh) Blood Group System:
D C E c e Designation
+ + - - + DCe
- + - - + Ce
+ - + + - DEc
- - + + - Ec
+ + + - - DCE
- + + - - CE
+ - - + + Dce
- - - + + ce

34. • Wiener Theory:
• According to Wiener Rh antigens are controlled by alleles at one gene
locus, with 8 alleles occupying the Rh gene locus
• Wiener nomenclature assigned a letter and symbol to the Rh antigen
based on the factors present
• R denotes the presence of D antigen, r indicates the absence of D antigen
• C antigen is represented by 1, C in the absence of D antigen is indicated by
a single prime (‘), c antigen is indicated by neither 1 nor (‘)
The Rhesus (Rh) Blood Group System:

35. • Wiener Theory:
• E antigen is represented by 2, E in the absence of D antigen is indicated by
a double prime (“), e antigen is indicated by neither 2 nor (“)
• The presence of C and E antigens together with D antigen is indicated by z,
while the presence of C and E in the absence of D antigen is indicated by y
The Rhesus (Rh) Blood Group System:

36. designation D C E c e
𝑅1 + + - - +
𝑟′
- + - - +
𝑅2 + - + + -
𝑟" - - + + -
𝑅𝑧
+ + + - -
𝑟𝑦
- + + - -
𝑅𝑜 + - - + +
r - - - + +
The Rhesus (Rh) Blood Group System:
Wiener’s nomenclature:

37. Wiener
terminology
D C E c e Fisher-Rece
terminology
𝑅1 + + - - + DCe
𝑟′
- + - - + Ce
𝑅2 + - + + - DcE
𝑟" - - + + - cE
𝑅𝑧
+ + + - - DCE
𝑟𝑦
- + + - - CE
𝑅𝑜 + - - + + Dce
r - - - + + ce
The Rhesus (Rh) Blood Group System:
Wiener and Fisher-Race terminologies:

38. • The D Antigen:
• It is the most important Rh antigen, and most important blood group
antigen after ABO antigens
• Individuals who inherited either one or two D genes, have the D antigen
on their red cell surface and are tagged Rh positive; while who did not
inherit the D genes from any of their parents will not have the D antigen
on their red cell surface, and said to be Rh negative
The Rhesus (Rh) Blood Group System:

39. • The D Antigen:
• The D antigen is highly antigenic; Rh negative (D negative) persons will
develop anti-D antibody when transfused with Rh positive (D positive)
blood; the amount of D antigen present on the red blood cells varies
with an individual’s genotype
• There is significant variation in the amino acid sequence of the D
protein, which cause the expression of various D antigens including
weak D, partial D and Del
The Rhesus (Rh) Blood Group System:

40. • The weak D or 𝐷𝑢
:
• Some persons have RBCs that possess variations in the quantity of D
antigen or the specificity of the D antigen epitopes; the weak D antigen
is produced by multiple genetic mechanisms through genetic mutations
• Weak D antigen results when the C antigen is inherited trans to the D
antigen on different chromosomes (Dce/dCe); however do not results
when the D gene is inherited cis to the C gene (Dce/dce)
The Rhesus (Rh) Blood Group System:

41. • The weak D or 𝐷𝑢
:
The Rhesus (Rh) Blood Group System:

42. • The weak D or 𝐷𝑢
:
• Individuals with weak D initially test negative with anti-D serologically,
however, test positive when further tested using Indirect Antiglobulin
Test (IAT), weak D donors are tagged as Rh positive
• However, weak D recipients are tagged as Rh negative, because
individuals with weak D antigen may produce anti-D due to missing
epitopes of the D antigen
The Rhesus (Rh) Blood Group System: