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ABO and Rh Blood

group systems

History.

serum

1900 Austria Karl


Landsteiner
Cell and serum
reactions
groups A, B and O.
Antibody to lacking
antigen
1902 von Decastello and
Strli - AB

cells
1

Landsteiner K. ber agglutinationserscheinungen normalen menschichen blutes. Wien Klin


Wochenschr 1901; 14: 1132-1134.

Antigens and antibodies


ABO

Antigens on

Antibody in

phenotype
A
B
AB
O

RBCs
A
B
AB
none

serum
Anti-B
Anti-A
None
Anti-A,B

Antigens are terminal sugars on oligosaccharides


attached to membrane glycolipid and glycoprotein

A Antigen
-1,2

-1,3

Red Cell Surface

-1,4

D-galactose

-1,3

N-acetylglucosamine

-1,3

N-acetyl-D-galactosamine
L-fucose

A gene produces an
enzyme which adds the
A specific sugar NAcGal

B Antigen
-1,2

-1,3

Red Cell Surface

-1,4

D-galactose

-1,3

N-acetylglucosamine

-1,3

N-acetyl-D-galactosamine

L-fucose

B gene produces an
enzyme which adds the
B specific sugar D-Gal

Genotypes and Phenotypes


ABO genes on chromosome 7
one gene from each parent
A and B co-dominant; O amorphic
AA
AO
BB
BO

A
B

AB

AB

OO

Inheritance.
A
A O

A B
AB

A O
A

B
B O

B O
B

Phenotype
Genotype

O O
O

Genotype
Phenotype

Normal ABO Groups


Group

Anti-A

Anti-B

A1
Red Cells

A2
Red Cells

B
Red Cells

O
Red Cells

AB

Antibodies
Naturally occurring
Predominantly complement binding IgM.
Low levels of IgG
Can cause:
Immediate and severe Haemolytic
Transfusion Reactions;
Mild to moderate Haemolytic Disease of
the Newborn

Transfusion practice
Identical ABO phenotype blood is best match but
where not available, use ABO-compatible blood
group O cells are universal donors
group AB - universal recipients
Recipient
phenotype
A
B
AB
O

Donor product to be transfused


Whole blood
RBCs
Plasma
A
A,O
A, AB
B
B, O
B, AB
AB
AB, A, B, O
AB
O
O
O, A, B, AB

Most DEATHS from blood transfusion caused


by ABO incompatibility due to avoidable
clerical ERRORS!!!!

?Rh Bloodgroup system


HISTORY
1939 Levine and Stetson
HDNB mother transfused with and
reacted to fathers blood
1940 Landsteiner and Weiner
Immunised rabbits and guinea pigs
with Rhesus monkey cells

History
1939 Levine and Stetson
Severely anaemic mother

Hydropic
newborn

Severe

HTR

Husband ABO
compatible

Antibody in serum reacted with 85% of NY donors

History

1940 Landsteiner and Weiner

RBCs

Macaco rhesus macaca mulatta

Antibody reacted with 85% of NY donors


both antibodies named anti-Rhesus in error
Antigen detected by anti-rhesus monkey
later re-named LW!!

Genetics

chromosome1
2 genes RHD and RHCE codominant
protein antigens
4 alleles can occupy RHCE locus
RHce, RHcE, RHCE, RHCe
Inheritance of RHD = RhD positive
D ve individuals inherit only RHCE
there is no d antigen

inheritance.
R1r

DCeDcE
DCcEe
R1R2

R2r

DCce
DCedce

DcEe
DcEdce

DCedce
DCe

dceDcE
DcEe

R1R1

R2r

Phenotype
Genotype

dce dce
ce
rr

Genotype
Phenotype

The D Antigen.

Antibodies
Predominantly IgG occasional IgM anti-E
Delayed Haemolytic Transfusion Reactions
Extravascular haemolysis
Haemolytic Disease of the foetus and
newborn
Warm Auto immune Haemolytic anaemia

The plasma membrane

Lipid molecules are amphipathic.


have both polar (charged) and
nonpolar (uncharged) parts
75% are phospholipids

Plasma Membrane
fluid mosaic model describes
sea of lipids in which proteins float like
icebergs
50 % lipid & 50 % protein
held together by hydrogen bonds
lipid is barrier to entry or exit of polar
substances
proteins -gatekeepers -- regulate traffic
50 lipid molecules for each protein molecule

The Lipid Bilayer


Basic framework of the plasma membrane
Lipid: phospholipids, cholesterol, glycolipids

Membrane Lipid Bilayer

Phospholipids, cholesterol, glycolipids

Membrane Fluidity
Membranes are fluid structures, most
of the lipids and many of the
proteins easily move in the bilayer.
Membrane lipids and proteins are
mobile in their own half of bilayer.
Cholesterol serves to stabilize
membrane and reduce fluidity.

Membrane Proteins

Integral versus Peripheral Proteins

Integral Proteins
many are glycoproteins.
combined glycoproteins and glycolipids
form the glycocalyx
cell recognition
Adherence
protection from digestion by enzymes
in extracellular fluid.

Functions of Membrane
Proteins

Formation of Channel
passageway to allow specific substance to
pass through
Transporter Proteins
bind a specific substance, change their
shape & move it across membrane
Receptor Proteins
cellular recognition sitebind to substance
Enzymes

Functions of Membrane
Proteins
Cell Identity Marker
allow cell to recognize
other similar cells
Linker
anchor proteins in cell
membrane or to other cells
allow cell movement
cell shape & structure

Functions of Membrane Proteins

Chimkupete

Blood
Definition
Properties
Composition
Plasma
Cells

Circulation
arteries, veins

Functions

Haemopoiesis - Stages, role of growth


factors

Pluripotent stem cell

Myeloid stem cell

Lymphoid stem cell

CFU-E
CFU-Meg
Proerythroblast Megakaryoblast

Reticulocyte

CFU-GM
Eosinophilic
& Basophilic
myeloblastMyeloblast

Monoblast

megakaryocyte

Eosinophil
Erythrocyte

T lymphoblast & B lymhoblast

Platelets

Basophil

Neutrophil Monocyte

Macrophage

T lymphocyte
Plasma cell

B lymhocyte

Blood cells
Numbers
Morphology
Formation
Maturation
Functions

Lymphocytes &
monocytes
Morphology
Maturation
Functions