ABO blood groups  Reacts best at 20-24°C with antigen

 Activates complement at 37°C

 Antibody are naturally occurring  Detectable at age 3-6 months
 Peaks at 5-10 years
 Inheritance (ABO blood groups)

 Intravascular Hemolysis: ABO Abs  follows mendelian genetics

(IgM)>>binds>>donor red cells  A and B gene
>>>activates>>complement (classical pathway)  Autosomal dominant
 Transfusion of an incompatible ABO type may lead  Co-dominant
to Hemolytic transfusion Reactions  O gene
 Forward Grouping  Autosomal recessive
 Reagent: Antibodies  Amorph or silent
 To identify or to detect antigens on the patient’s  Formation of A,B, and h red cell
red cells antigens
 Method for Newborns  Results from interaction of H and Se (C19) and
 Detection of antigens on an individual RBC’s by a ABO (C9) genes which codes for
known antisera (anti-a and anti-b) Glycosyltransferases
Anti-B Anti-A Anti-A,B  Glycosyltransferases adds sugar to precursor
Monoclonal Ab (IgM)
substance (paragloboside/glycan)
Yellow Blue colorless
 Blood group O inherit at least one H gene (HH or
 Lectins
Hh) and two O genes
 Dolichos biflorus
 Blood group A, B and AB inherit at least one H
 Agg.A1 or A1B
gene (HH or Hh) and one A and B or A,B gene
 Bandeiraea simplicifolia
 Agg. B cells  Interaction of Hh and ABO genes
 Ulex europaeus Glycosyltransferases and immunodominant sugar
 Agg. O cells Gen Glycosyltransferase Immunodomina Antige
 (H specificity) e nt sugar n
 Reverse grouping H α - 2-L-fucosyl L-fucose H
 Reagent: Antigens transferase
 Detection of antibodies on individuals serum by A α – 3-N- N-acetyl-D- A
acetylgalactosamin galactosamine
a known reagent RBCs (A1 and B cells)
yl transferase
 Reagent A1 and B cells B α – 3-D- D-galactose B
 Human source galactosyltransfera
 4-5% RBC suspension se
 ABO antibodies
 Naturally occurring
 Mainly IgM, partly IgG and IgA

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  A antigen sites Synthesize on type 2 Synthesize on type 1
 810,000 to 1,170,000 chains (β 1 >> 4 linkage) chains (β 1 >> 3 linkage)
 B antigen sites α- 2-L-fucosyltransferase α- 2-L-fucosyltransferase
 610,000 to 830,000 (produced by H gene) acts (produced by Se gene) acts
primarily on type 2 chains, primarily on type 1 chains,
 AB antigen sites
in RBC membrane in secretory tissues
 600,000 sites for A ag
 720,000 sites for B ag
 Amount of H antigens among the ABO types:  Bombay phenotype notations
 O>A2>B>A2B>A1>A1B Inherited genes Notations
hh,A OhA
hh,B OhB
hh, AB ohAB

 The Bombay Phenotypes (Oh)

 Formation of ABH soluble antigens
 H gene must be inherited to form the ABH Ag on
RBC
 Se gene must be inherited to form the ABH
soluble Ag
 The precursor substance on secretions is Type 1
 Sese (secretor genes) codes for the production
of α- 2-L-fucosyltransferase that modifies the
Type 1 precursor substance to form the H
substances which can then be modified to
express A and B substance in body secretions
 SeSe and Sese are secretors
 sese are non secretors
 Comparison of RBC Ag and soluble substance
RBC antigens Soluble substances
Glycolipids, glycoproteins Glycoproteins
or glycosphingolipids
 General characteristics
 A,B,H nonsecretor (sese genotype)
 Absence of α – 2-L fucosyltransferase
 Presence of A and B enymes in serum
(depending on ABO genotype)
 RBCs will not react with the anti-H lectin
 RBCs of Oh are compatible only with serum
from another Oh individual
 Amount of H antigens among the ABO types:
 O>A2>B>A2B>A1>A1B
 hh genotype (autosomal recessive)
 No H antigens formed; therefore, no A or B
antigens formed
 Phenotypes as blood group O
 Anti-A, anti-B and anti-AB and Anti-H in the
serum
 Can only be transfused with blood from
another Bombay (Oh)
 Para-Bombay phenotypes
 Rare case here H antigens are in small amounts
or completely absent
 Inheritance of mutated H gene
 Low levels fucosyltransferase that is very
weak in activity
 Very low amounts of H antigen
 Very weak forms of A and B antigens
 Detected only by adsorption and elution
tests
 Usually not detected by forward typing
 Very weak forms of A and B antigens
 If the A and/or B genes is/are inherited
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  Detected only by adsorption and elution  Se gene
tests  To attach fucosyl transferase to type I
 Usually not detected by forward typing substances
 Notations
 Ah: paraBombay A (A gene was also
inherited) with every small number of A
antigens on red cells
 Bh: paraBombay B (B gene was also
inherited) with every small number of B
antigens on red cells
 ABh: paraBombay AB (A and B genes
inherited) low levels of A and B antigens on
red cells
 Silenced H gene (FUT1) but active Se gene (FUT2)
 Se gene >> formation of A,B,H substances in
secretion and plasma
 A,B,H substances are adsorbed on the
membrane of RBCs, which now becomes the
A,B,H antigens
 These paraBombays are also secretors
 Side notes
 Type I precursor substances – found in the
plasma; unbound
 Type II precursor substance – found in the
surface of the red cells
 B genes- highest affinity
 O gene
 Silent gene
 No enzyme, sugar so the result is also H
antigen
 Homozygous
 A>>>>AA
 B>>>>BB
 Heterozygous
 A>>>>AO
 B>>>>BO
 Heterozygous codominant
 AB>>>AB
 Homozygous recessive
 O>>>OO
 Bombay phenotype
 No A and B antigen
 (-) Anti H

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