The International Society of Blood Transfusion (ISBT) currently recognises 30 major blood group systems (including the ABO and Rh systems).[1] Thus, in addition to the ABO antigens and Rhesus antigens, many other antigens are expressed on the red blood cell surface membrane. For example, an individual can be AB RhD positive, and at the same time M and N positive (MNS system), K positive (Kell system), and Lea or Leb positive (Lewis system). Many of the blood group systems were named after the patients in whom the corresponding antibodies were initially encountered.
The ISBT definition of a blood group system is where one or more antigens are "controlled at a single gene locus or by two or more very closely linked homologous genes with little or no observable recombination between them".[2]
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Blood is composed of cells suspended in a liquid. The liquid portion is the plasma, from which therapeutic fractions and derivatives are made.
Suspended in the plasma are three types of cells:
The most common type of grouping is the ABO grouping. The varieties of protein coating on red blood cells divides blood into four groups:
There are subtypes under this grouping (listed as A1, A2, A1B or A2B…) some of which are quite rare. Apart from this there is a protein which plays an important part in the grouping of blood. This is called the Rh factor. If this is present, the particular blood type is called positive. If it is absent, it is called negative. Thus we have the following broad categories:[3]
In the "ABO" system, all blood belongs to one of four major groups: A, B, AB, or O. But there are more than two hundred minor blood groups that can complicate blood transfusions. These are known as rare blood types. Whereas common blood types are expressed in a letter or two, with maybe a plus or a minus, a smaller number of people express their blood type in an extensive series of letters in addition to their 'ABO' type designation.
ISBT № | System name | System symbol | Epitope or carrier, notes | Chromosome |
---|---|---|---|---|
001 | ABO | ABO | Carbohydrate (N-Acetylgalactosamine, galactose). A, B and H antigens mainly elicit IgM antibody reactions, although anti-H is very rare, see the Hh antigen system (Bombay phenotype, ISBT #18). | 9 |
002 | MNS | MNS | GPA / GPB (glycophorins A and B). Main antigens M, N, S, s. | 4 |
003 | P | P1 | Glycolipid. Antigen P1. | 22 |
004 | Rh | RH | Protein. C, c, D, E, e antigens (there is no "d" antigen; lowercase "d" indicates the absence of D). | 1 |
005 | Lutheran | LU | Protein (member of the immunoglobulin superfamily). Set of 21 antigens. | 19 |
006 | Kell | KEL | Glycoprotein. K1 can cause hemolytic disease of the newborn (anti-Kell), which can be severe. | 7 |
007 | Lewis | LE | Carbohydrate (fucose residue). Main antigens Lea and Leb - associated with tissue ABH antigen secretion. | 19 |
008 | Duffy | FY | Protein (chemokine receptor). Main antigens Fya and Fyb. Individuals lacking Duffy antigens altogether are immune to malaria caused by Plasmodium vivax and Plasmodium knowlesi. | 1 |
009 | Kidd | dbMHC | Protein (urea transporter). Main antigens Jka and Jkb. | 18 |
010 | Diego | DI | Glycoprotein (band 3, AE 1, or anion exchange). Positive blood is found only among East Asians and Native Americans. | 17 |
011 | Yt or Cartwright | YT | Protein (AChE, acetylcholinesterase). | 7 |
012 | XG | XG | Glycoprotein. | X |
013 | Scianna | SC | Glycoprotein. | 1 |
014 | Dombrock | DO | Glycoprotein (fixed to cell membrane by GPI, or glycosyl-phosphatidyl-inositol). | 12 |
015 | Colton | CO | Aquaporin 1. Main antigens Co(a) and Co(b). | 7 |
016 | Landsteiner-Wiener | LW | Protein (member of the immunoglobulin superfamily). | 19 |
017 | Chido/Rodgers | CH/RG | C4A C4B (complement fractions). | 6 |
018 | Hh/Bombay | H | Carbohydrate (fucose residue). | 19 |
019 | Kx | XK | Glycoprotein. | X |
020 | Gerbich | GE | GPC / GPD (Glycophorins C and D). | 2 |
021 | Cromer | CROM | Glycoprotein (DAF or CD55, regulates complement fractions C3 and C5, attached to the membrane by GPI). | 1 |
022 | Knops | KN | Glycoprotein (CR1 or CD35, immune complex receptor). | 1 |
023 | Indian | IN | Glycoprotein (CD44 adhesion function?). | 11 |
024 | Ok | OK | Glycoprotein (CD147). | 19 |
025 | Raph | MER2 | Transmembrane glycoprotein. | 11 |
026 | JMH | JMH | Protein (fixed to cell membrane by GPI). | 6 |
027 | Ii | I | Branched (I) / unbranched (i) polysaccharide. | 6 |
028 | Globoside | GLOB | Glycolipid. Antigen P. | 3 |
029 | GIL | GIL | Aquaporin 3. | 9 |
030 | Rh-associated glycoprotein | RHAG | Rh-associated glycoprotein. | 6 |
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