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The ABO BloodGroup System
Illood group: The type or specilication ot'anindividual'sbloodaccording to the presence or absence of specificagglutinogens on tlie red cells. Blood transfusion: The introductionof blclod trom one person (the donor) into the circulation(veins)of anotherperson(the recipient). A blood transfusion r.r,hen is perfbrmecl therecipienthassuffered considerable blood loss.perhapsas a result of seriousinjury or as a resultol sur-eery. It is importantthat the blood of therecipienthas compatible blood groups with the blood of the donor. Incompatibility': When the aggiutinogens on the red cells in the donor bloodreactwith the agglutinins in the recipient's blood.If this happens (clumptogether). thenthered cellsin the transfusion will agglutinate This problems mav cause serious or deathil'the clumpedcellsblockcoronarv vessels to the heart musclc (causinghcart attack or cardiacarrest)or if theyblock theglomeruliof the kidnevs(causing kidney failure). or if they (causins vessels blockcerebral stroke anddeathof certain braintissues). The clumped redcellsalsoswellanclrupture, releasing haemoglobin into theblood:this is called'haemolysis'.

81' studving this Factsheetvou should gain a knor.vledge of: o the nature of the ABO blood group s.vstem and its importance: o the pattern of inheritanceof'the ABO blood group s.vstem: o a brief historical perspective on ABO groups and transfusion. Definitions Antigen: Anv substance that when introcluced into. or presentin. the tissuesor hlooclcituses the lbrmation of antibodiesand onlv reacts with its specif)cantiboclies. Antibodl': A protein proclucecl b1,certaincells of thc bod1,' in the presence of a specif ic antigen. The antibodl,'combines with thatantigen to inhibit. neutralise or destroyit. Agglutinogen: An antigen locatedon thesurf'ace plasmamembrane of red bloodcells(erytluocytes)which determines the blooclgroup of the individual.Agglutinogens aregeneticalll, determined. Agglutinin: A spccitic antibodvin bloodplasmacapabie of causins the clumpingof red bloodcells or bacteria or particlessuchasviruses. They arc sometimes called 'isoantibodies' to clistinguish them lrom 'immune which appearalter un immune response. antibodies' The a-s-qlutinins appearsoonafterbirth and arepresentin plasmathroughout lil-e. Agglutination:The clurnping together ol bloodcellsor microorgurisms. usualll'dueto an antigen-antibody reaction.

The ABO blood group system This is based on two agglutinogens ref-erred to asA and B. Lidividuals whose erythrocytes developonly agglutino-een A are said to liave blood type A. Those whose erythrocytes develop onl1,' auulutinogenB are said to have bloodgroupB. Someindividuals. who haveervtluocyres whichdevelop both a-eglutinogen A and B. are said to have blood sroup AB. Thoseindividuals who manuf-acture neitheragglutinogen aresaicl to haveblood group O. Thble l. The ABO blood group system Blood group A Agglutinogenon red blurd ell Type A

The blood sroup agglutinins.a and b. are presentin the plasmaof the individuals.Blood group A plasmacontainsagglutinin b. blood group B plasmacontainsagglutinina, blood group AB does not contain either agglutininand blood group O containsboth agglutininsa and b. Table i illustrates the ABO blood group system.

Type B B AB

Type AB
neither

TypeO

Agglutinin in plasma

neither

a+b

a_s-slutinin b will clump the B agglutinogen .'. people from group A can'treceive blood from B o r A B b u l c a nr e c e i v e blood lrom A or O

agglutinina will clump the doesnot contain a or b A a-q-slutinogen .'. people agglutinin .'. canreceive from uroupB can'treceive blood from A. B, AB and blood fiom A or AB but o canreceive blood lrom B orO

agglutinina andb will clump the A and B a-eglutinogen .'. people fiom -eroup O can't receiveblood fiom A. AB and B but can only receiveblood liom O

TheABO BloodGroupSystem

Bio Factsbeet

Exam Hint:- Depending on which specification is being followed, examiners may ask questions testing recall knowledgeabout the ABO blood group system or they may set data interpretation questions relating to the ABO system. lt is not unknown for data interpretation questionsto be set on other blood group systems,such as the Rhesus system and the MNO system. To answer these, the student should remember that the biological principles governing the ABO system and other blood group systems are similar. Some specifications require candidates to develop historical perspectives of the subject, but these will prabably only be relevant in essay type answers.

Peoplewho havet-,,"pe AB blood liave neitheragglutininand so havebecn called 'universalrecipients'sincethey'can receivebloocltrom any of the ABO groups. The term'universal'means'in all possible circumstances' anclso these termshavetallen into disusebecause thel' takeno accountof otherblood groups.such as the rhesusgroups.which must be consiclered betbre translusion. ho\^ incompatible red cells anclplasmaagglutinins Fig I illustrates clump tosether.

(clumped)red cells Students sometirnes ask the question'r.','h1' do somepeopleciur)' naturarl Fig l. Agglutinated person's antiboclies reclcell antisens'l' against another The answerlies in the tact that the antigenicsubstances A and B are not conlined to human cellsbut occurin man-v otherorsanisms. includinggut-dwelling bacteria and agglutinogen on otherbacteria Peoplearethuscontinually thatthebody encounters. exposed rcd cell surfhce to theseantigensdurine everl,daylil-eanclso developantibodies against bindswith them wl-ren they are firreignto the bod1,'. or do not producethe antibodies specilic when they'are not tbreign.For instance . peoplewho containthe A antigen aggiutinin 'a' will not produce antibodywhenthel'come intt'r on their cell membranes in plasma 'b' with bacteriai will however. contact A antigen. The1, develop antigen if with bacterial theycomeinto contact B antigen. sinccthis isrecognised aslbrei-en.
Blood transfusion Blood translusion hasbeenattempted many times durins history,either as experimental transtusions between mammals of thesame or dillerentspecies. in an attemptto savelif-e. or betrn'een humans SamuelPepys( 1633- 1703). in his lamousdiary,. describedsevcraltranslusions tliat he had witnessed. were riskv and usuallv resultedin the death ol the Such transfusions recipient. ( 1875 La.ndois thatwhenthered cells of an animal. lbr example. ) discovered a lamb. were mixed with the serumof anotheranirnal.lor example.a dog. and incubated at 37"Cthev were haemolvsed within 2 minutes. The ABO blood group systemwas the llrst systemto be discovered. bv the GermanimmunologistDr Carl Landsteiner in l90l . Hc was lortunatc because his laboratory staff expressed all fbur blood sroups.so that when he mixed red cells lrom eachof his statf with serumtiom eachot his statf he was ableto determine all tbur groups. Remember:-Seruntis tlrc.fluidleft after bloocllrusclorted. It is tlrc sante as plasntubut u'ithouttlrc clottirtg1:r'oteitts. sucltasJibrittogetr

red blood cells bound together

groupsareknown. Belorebloodis transfused . evenil'donorandrecipicnt it must be testedasainstthe recipient'sblood to ensure that no unloreseen A drop of the recipient'sserumcan be factorsare causingagglutination. placedon a slide andmixed u'ith a drop of the donorblood - if it remains 'qranular' If it becomes clearthenthereis no agglutination. thenthe cells havebeenacclutinated. Exam Hint :- Studentsfrequentlybecome confusedand write that'the agglutinins in the donated blood plasma will agglutinate the recipient's red cells'. This does not happen because these agglutininsbecome greatly diluted when the donated blood is transfused into the much larqer blood volume of the recipient.

'typed'by Samples ot blood canbe testingthem.b1'' mixin-e singledropsof whether blood with drops of known antisera on glassslidesto establish occursor not. A knowledgeof blood typescan be important agglutination in linking suspects to crimes. in disprovine paternitl' and as part of anthropological studies to establish a relationship races. between Inheritanceof the ABO blood groups (antigens) Tlie ag-elutinins arean integrnlpartof thered cell membrane and of all cells of the body'.The multiple allele gene of plasmamentbranes regulatingthe developmentof theseantisenspossesses three alleles, Io. IB and Io. IA and IB are co-dominantand both causethe designated development of their antigen1,A or B ). The alleleIo doesnot produceanv reco-enisable etfectand can be considered to be recessive. Any individual will contain two of these alleles on corresponding loci or.ra pair of (bothalleles The individualmay be homozygous homologous chromosomes. (hasdissimilar or heterozygous alleles). Therearethussix possible thesame) genotypes which sovern the development of the fbur ABO blood types. Theseare shown in Table 2. Table 2. The inheritance of ABO blood groups. Blood group Possiblegenot.r'pes 7o Frequencl'' in British nopulation
IAIA. I^IO
A') --

Once Landsteiner had discoveredthe ABO systemit was possibletcr perfbrmbloodtransfusion with a greater degree of success. but transtusions had to be direct tiom personto person.During the First World War (1914 -1918)theuseof bloodanticoa-sulants wasdiscovered. suchascitratc This meant that bloods could then be storedwithout clotting. and so resular possible. indirecttranslusion became When transfusion is perlbrmed it is important that the recipientplasma agglutinins do not clump and haemolyse the red cellsin the donation.The compatibletranslusions are: 'b' agglutinin . type A blood contains and so can receiveonly types A and O blood. . type B blood contains'a' ag-elutinin and so can receiveonly types B and O blood. . typeAB blooddoesnot contain'a' or 'b' agglutininandso can receive typesA. B, AB and O blood. . type O blood containsboth agglutinins 'a' and 'b' and so can only receiveO blood. Note that type O bloodcontainsneitherA or B cells andso canbe transtused peoplewho are -qroup into any person. For this reason, O havebeencalled 'universaldonors'.

Tvne A Tvne B Tvpe AB

IBJB. IBIo
IAIB

9 3
46

T1'peO

IO IO

TheABO BloodGroupSystem

Bio Factsbeet

The liequencies o1'ABO groupsvar\ in clitfbrentpopulations aroundthe world. tbr reasons that are not clear.Group B has a high lrequencyin the populations indigenous of CentralAsiabut hasa lower trequencl,in Europe. Exam Hint:- use the accepted symbolsfor the three alleles, theseare IA, IB and lc. lf asked to show a genetic cross, then label the parents, gametes and offspilng clearly.

l.

A husband, rvho is blood sroup A. suspects that his wit'e's third child has beenfathered by'anotherman. His own llrst two children possess blood qroupsO and AB. The third. suspect child. is blood rroup B. justilied'? Are the husband's suspicions Explain)-ouranswer. 4

Answers l.

The followins senetic cross sl-rou's thc possibleresuitsof crossingit heterozvqous groupA individualu,itha heterozygous group B person: Parents Group A
IAIO

Blood Possiblealleles available group


CTOSS

Parent I I^. I' I \ IB


I \.IB

Parent 2
I\. IO
IB.IO IO

Impossible phenotypesin offspring blood groups

Groul JB Jc)

AxA

B.AB:

Gametes

(r ' )
IBJc)

ABxB ABxO

o:
AB,O:
noncimpossible:

Offspring

JAlcr

I{lB group A B

JoJo group O

AxB OxO

I*.O
In

I B. I o Jo

group A

group B

A .B. AB:

There is a I in 4 chance o1aparticular blood appearing in theotfspring. -croup PracticeQuestions l. Themultiple allele inheritance svstem o1theABOblood system sroup
contains thecodominant alleles IAandIBancltherecessivc alleleIo. The tablebelow showspossible crosses betweenpeopleof certainABO groups.the allelesthey can contribute and the phenotvpes of offsprin-e which could not be produced as a resultof this cross. Completethe table by' writing in the allelesand blood group phenotl'pes in the empty boxes. Illood group
CTOSS

)
?. (a) Genotvpe MM NN MN Agglutinogen M N M + N Blood group/phenotype M: N: MN:
f

-'t

Possiblealleles available Parent I Parent 2

Impossible phenotypes in offspring blood groups

( b ) ( i ) therewould be ncladverse efl-ect/no agglutination: because thereare no relatedantibodies in the nlasma:

AxA

ABxB ABxO
AxB

( i i ) the immune systemof the body may have becomesensitised to theforeignred (M or N) cells: thus.with the secondtranstusion. aeslutination could occur: 2 3. both parents must containan Io allele because they have a child with group O/genotype OO: oneparent mustcontainan Io alleleandoneparenta IBallelesincethey have a child with group AB/genotypeAB: tather is blood group A and so must have genotypeIAIO: mothermusthave genotype ItsIo and so could beara child of -eroup B/ genotypeIuIo, the IB allelecomin-e irom the mother and the Io allelefrom the father: thus the father'ssuspicions are not iustiflecl(no mark) max4

OxO

-)
2. In the MN blood group svstemthe two codominantallelesare called M andN. M regulates theproduction o1agglutinogen M andN regulates the productionof agslutinogenN. Theseare on the red cell surfaces. No relatedantibodies occur in the plasmain this blood sroup system. (a) Complete the lbllowing tableto showthe genotypes. agglutinogens and phenotypes of the threepossibleMN blood sroups. Genotype Agglutino-een Blood group/phenotype

(b) (i) If blood of one of these-qroups was transfused into a person with another o1thesegroups, what, if anythingwould happen'l Explain your answer. 2 (ii) If the sametransfusion wasrepeated a f-ew monthslater,what. if anythingwould happen'l Explain your answer. 2

Acknowledgements: Tlis FuctsJtcet h'us rescurchedurtd v'rincn by Murrin Gri/J'in Cuniculunt Press,Unil3058,The Big Peg, 120 VyseStreet,Birmingham. BI8 6i\,lF Bio Factsheets ntuy be copitd./ree oJ'clturge br tcuclting stuJJ'rtr students. provided lltut tlteir scfutttl is u registerad subsc'ribet'. Ntt lturt oJ'tltescFuc'tslrcets nruv bc reprttdutetl ttr trurrsnritted. , slttred in u rctrievtLi.sr'.sloii, in uny olher J l t r n t o r b v u r t t ' t t l l t e r n t e u n s .u ' i t h o u t t h a p r i r t r p e r n t i s s i o no J t l t c p u l t l i s h e r .

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