Blood group

The Sang is a liquid fabric which one can easily take on a healthy individual to transfuse it with a sick individual. However, in spite of an identical composition cellular of this fabric, there exists a variability, or polymorphism of the various elements of blood between the individuals, which makes impossible the transfusion between certain groups of people. One says people who show the same characteristic that they belong to same the blood group . Up to one recent time, these characteristics were highlighted thanks to specific Anticorps of a épitope, antigenic determinant specifically recognized by an antibody. These épitopes, determinant various Phenotype S, are Génétique lies transmitted.

The various blood groups are gathered in systems. Belong to the same system of blood groups the whole of the épitopes or Phénotype S resulting from the action of various the Allèle S of same a Gène or closely dependant genes.

The discovery of the System ABO, the first of these systems, in 1900, by Landsteiner made it possible to include/understand why some blood transfusions were crowned success whereas others finished in tragedies accidents.

Bases of Immunology

The Antigène S are Molécule S which cover the surface of all the cells of the organization and take part in its identity. They are the targets of the antibodies when they are identified like foreign. But the antigens as well relate to substances external at the organization and against which the antibodies react: the Pollen, the Dust, certain food or drugs, or licked hairs of animals.

The Anticorps are molecules produced by the lymphocytes B of the Immune system which react with the antigens not belonging to the organization. They attack it to not-oneself. Certain antibodies are manufactured “with the request”, others exist naturally in the organization.

When an antibody is fixed specifically at an antigen located at the surface of the red globules, it causes the agglutination, sometimes the hémolyse, of the latter. This agglutination can be either immediate, and thus system ABO discovered, or “was helped” by a technique of artificial agglutination, and it is thus, which after work of Coombs, which produced and used a Antiglobuline, a great number of antibody and systems of blood groups were discovered.

Classification

These antigenic differences between the individuals define the various blood groups and can relate as well to the elements illustrated of blood, globules red, white globules, plates, as on circulating proteins, in particular immunoglobulins. The blood group term having been applied to the only groups known before the years 1950, namely with the érythrocytaires groups, and this term being often included/understood and in general used in a restrictive way in this meaning, these is the latter which will be treated in the continuation of this article. Lastly, historically, in fact the transfusions of érythrocytes posed clinical problems of incompatibility, the other elements of blood being only implied little in immediate transfusional accidents of immunological origin.

We will however say a word on each other system of groups, by addressing the reader to the articles treating in way more detailed each one of these questions, or referring there, like simple polymorphism or allotypie.

Leucocytic blood groups

It is while working with antibodies anti-leucocytes, and while trying to identify leucocytic groups, that Jean Dausset discovered the Système HLA. It was acted in fact of the antigens of histocompatibility present on all the cells of the organization.

The leucocytes, also carry specific antigens, either with the various categories of lymphocytes, or with the polynuclear ones. The latter carry various antigens gathered in 5 systems, HNA1, HNA2, HNA3, HNA4 and HNA5 (HNA for Human Neutrophil Alloantigen).

The antibodies directed against the globules white, likely to be contained in a transfused plasma, that it is of anti HLA or anti HNA, can induce a transfusional accident engraves, the TRALI (transfusion related acute lung injury) which consists of a pulmonary œdémateuse attack.

Plate blood groups

They are systems HPA (Human Platelet Antigens), 6: HPA1, HPA2, HPA3, HPA4, HPA5, and HPA15, as defined by the Committee of Nomenclature of the Plates, PNC created in 2003 in partnership with ISBT and the ISTH (International Company of Thrombosis and Hémostase). Most known of these systems being the system HPA1, follow-up of the system HPA5, whose antibodies anti HPA1-a and HPA5-b are implied respectively in 80% and 10% of the cases of incompatibilities plate fœto-nursery school S.

An antibody in one of these systems involves:

In the event of Incompatibility fœto-nursery school, a thrombopénie at the fetus and the newborn. Sometimes causing intracranial hemorrhages which can be serious.
In the adult, an ineffective transfusion in the event of transfusion of incompatible plates. This transfusion can be exceptionally followed of one will purpura post transfusional where are not only destroyed immediately the transfused plates, but also, by a discussed mechanism, proper plates of the patient.

Serum groups

They are the groups Am, Gm, km of the immunoglobulins has, G, and of the light chain Kappa, as well as group ISf (Inhibiting San Francisco, located on the heavy chain of IgG1). These systems, of which first was discovered by Grubb and Laurell, are given thanks to a Antiglobuline, by a technique of inhibition of agglutination. The technique is indicated in the articles: " To discuss: Robin Coombs " , and in the paragraph allotypie in " To discuss: antibody ".

Érythrocytaires groups

They are the first blood groups which were discovered (ABO, Million), and the term blood groups , used in an isolated way, indicates in rule and in a restrictive way the érythrocytaires groups, if not, one uses the term groups plate, leucocytic, or serum.

Blood groups (érythrocytaires)

The blood independent groups are those which define the systems ABO, Rhésus and Kell, but it exists about it much of different. These three systems are most important, in practice. The first, ABO, because it involves an immediate transfusional accident in the event of incompatible transfusion, and of this fact was the first discovered one. The second, Rhesus, because the immunogenicity of two of its antigens (D, and C, especially) very frequently involves immunizations sources of later accidents and incompatibilities fœto-nursery schools. The third system, Kell, because the Kell antigen is very immunogenic, less however than the antigen RH1, D, and gives so but less frequently, the same complications.

The determination of the group in these three systems in ABO (has, B, AB or O), in Rhesus (about), or in Kell (about) is based, as for all the systems, on the characteristics of the antigens present at the surface of the érythrocyte S and, for system ABO, on the antibodies present in blood.

We give here the list of the various systems definite and referred by ISBT in 2004, with in the order their number, their initial or common denomination, their shortened denomination (symbol) official, the nature of the épitope or the element which carries it, the chromosomal localization. Lastly, in each system, a number with 3 digits is allotted to each antigenic specificity. Thus, in the ABO four specificities are referred: A=001, B=002, AB=003, A1=004. In system Million we arrive at number 046, and in RH we exceed number 050…

Table

There exists, not belonging to these 29 systems, other antigens present on the érythrocyrtes. These antigens are classified in two series.

The first, numbered series 700, gather the antigens of weak incidence, met at less than 1% of the individuals.

The second, numbered series 901, gathers the antigens of high incidence, met at more than 90% of the individuals, and very often more than 99% for the majority of them.

The rare antigens, which they belong to a system, like the V^w antigen of system Million, (system 002, antigen 009) or with series 700 like the Peters antigens (700.018) or Rasmussen (700.040)) are called private antigens, and the anti-private antibodies corresponding .

Frequent antigens, that they belong to a system, like antigen RH46, (system 004, antigen 046) or with series 901, like the antigens Vel (901.001) or At^a (901.003) are called public antigens, and anti-public antibodies corresponding .

ABO and RH, models of blood groups érythrocytaires

These two systems are most important, as well in practice medical, as for their historical interest, because they provided the genetic bases, immunological for all the later studies of the other systems.

System ABO

The system Rhesus

Distribution of the groups

Into France, the blood groups are divided in the following way (example A+ prevails with 39%):

With the Canada, into 2006 the blood groups are divided in the following way:

This distribution can present sensitive differences according to the ethnic origins:

among aboriginals of Australia for example, one counts 68% of O and 32% of have
at the Eskimos, 86% of O
at the Asian ones, one counts a stronger proportion of group B.

Examples of distributions:

Of these distributions, we can calculate the genic frequencies in the various populations. This type of calculations is valid for each system of blood group, by application of the law of Castle-Hardy-Weinberg, article where system ABO is taken for example.

Compatibility

Compatibility, between the blood groups of a donor and a receiver, is posed at the time of the blood transfusions. A transfusion will fail so of the antibodies meet cells presenting the corresponding antigens. An immunological reaction (agglutination and Hémolyse) would start then very quickly to destroy these cells. The consequences can go from an ineffective transfusion without clinical sign, with a light reaction clinical (distresses, shiver), serious (state of shock, hémoglobinurie, Impaired renal function), or dramatic (Shock, disseminated intravascular Coagulation) leading to the death.

It is also posed in the event of Grossesse for the women Rh negative carrying a fetus of Rh positive. If it is about a first pregnancy, in general the things occur well if the mother were not immunized before by the antigen D, RH1. If not, owing to the fact that the antibodies can cross the barrier Placenta anger, the red globules of the fetus are destroyed more or less massively: it is the haemolytic Maladie of the newborn, or MHNN. This disease can present all the stages of gravity. Benign and to involve only one simple ictère (jaundice) and a Anemia momentary, more important and to require transfusions, even a Exsanguinotransfusion with the birth, major asking a caused childbirth or a Cesarean with immediate, extremely serious exsanguinotransfusion asking transfusions in-utéro avoiding the death of the child, even death in utéro of the child before any possible intervention. These last cases became very rare since the prevention of the immunization of the women by an injection of anti-D antibody to the childbirth of a child Positive Rh. Remain however other specificities, of which most frequent are the antione (RH4), and the antione, which also causes haemolytic diseases of the newborn.

Presence of the antibodies

In system ABO, one finds in the blood of all the people of the specific antibodies of the antigens which they do not have on their globules. Thus a person of group B will develop anti-HAVe antibodies naturally and a person of the group O will develop anti-HAVe antibodies and anti-B antibodies. These antibodies are known as regular , because present at all the individuals, except the newborn.

These natural antibodieses appear, in system ABO, as of the first months of the life. They are Immunoglobuline S of IgM class, agglutinant and acting cold: they are complete antibodies.

In the system Rhesus, there are no antibodies present naturally. They appear in general only after the one first sensitizing, by pregnancy or transfusion (some such the antiones or the anti-C^w which can however be " naturels"). These antibodies appeared after sensitizing are known as irregular . They are Immunoglobuline S of class IgG, credits with 37 °C, and which is highlighted only by techniques of artificial agglutination - techniques at the Antiglobuline or with the enzymes. These antibodies, not causing spontaneously agglutination - but being able to cause a hémolyse in vivo - are known as incomplete.

Transfusion of red globules

The red globules (or concentrated érythrocytaire) are extracted from blood donations. Indeed, blood seldom is not any more but transfused in its entirety. It generally is treated and separated in its components.

Thus the concentrate érythrocytaire contains only little plasma, therefore little antibody. The problems of incompatibility of the transfusion of plasma (see below) are thus not presented.

At the time of a transfusion of red globules, it is necessary to take care not to transmit to the receiver blood cells on surface of which antigens are presented that the receiver does not have. An enzymatic treatment, published in 2007 and currently in experimentation, makes it possible to eliminate the antigens has and B of the érythrocytes, and them to transform into red blood corpuscles of group O. This possibility will become effective only in a few years, and, at the beginning, for very particular cases, bloods deprived of a public antigen present at more than 99% of the donors, for example.

The two following tables must thus be respected at the time of a transfusion:

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Thus the AB+ are universal recipients, and O are universal donors of red globules.

With regard to the system RH, this rule is always regarded as valid in the event of vital urgency, and in the absence of known group. But as soon as the group of the patient is known, it is desirable to respect the other antigens of this system, in particular the antigen C (RH 4), in order not to immunize the young women in particular.

Transfusion of plasma

The plasma is one of the components of the Sang. It is collected at the time of a gift in Plasmaphérèse and can be used (in France) for direct transfusion, or extracted from a total blood donation and cannot then be used (in France) only to prepare drugs blood derivative, albumin, immunoglobulins, fibrinogen…

As plasma contains antibodies according to its group in system ABO, the red globules of the receiver should not present the corresponding antigens. The plasma of donors of group AB not containing an antibody is appropriate for all the receivers.

Plasmas containing an antibody, generally natural in another system (anti-P1, anti-Lewis, anti-MR.…), except system Rhesus, are not used in France. With regard to the system Rhesus, plasmas containing anti-D (thus resulting immunized women) are reserved, in France, for the manufacture of anti-D immunoglobulins, or other drugs blood derivative. These plasmas are thus not perfusés directly with patients. It is clear that in countries where plasmas would be used containing anti-D, the receiver could be only one subject Rh negative, just like the concentrate érythrocytaire resulting from donneuse having anti-D can be transfused only with one patient negative Rh.

With regard to their antigenicity, frozen fresh plasmas, not having undergone a viral inactivation S.D. (solvent-detergent), nor a filtration, but being made safe by forty, can contain some likely red blood corpuscles, if not to cause a detectable primary immunization, at least to induce it or start again a secondary immunization. From where the preference of certain doctors to comply with for these plasmas a rule of compatibility Rhesus identical to that of the red globules, without the benefit of this attitude being really documented.

The plasmas viro-attenuated by method S.D. (solvent-detergent), having been filtered, do not contain any more globular stromas and cannot be immunogenic. For these plasmas, we do not take account of the Rhésus group.

The donor and the receiver must thus respect the following tables:

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Thus whereas the people of group AB are universal recipients of red globules in system ABO, they are universal donors of plasma.

Transfusional dead ends

Certain patients pose enormous transfusional problems. They are subjects deprived of a public antigen, prone Vel negative, RH-46 or KEL-2, for example. These people can be transfused once if they do not have an antibody, but cannot any more the being as soon as they are immunized, except by the extremely rare bloods deprived of these antigens. In the same way certain people having several antibodies can receive only bloods of a compatible phenotype in the various systems concerned, from where their scarcity. These patients must thus take part in a protocol of car-transfusion, programs transfusion autologist differed in the event of programmed surgical operation, and make gifts of blood which will be preserved frozen at the National Bank of Rare Bloods of Phenotype - BNSPR-, either for them-even, or for other patients having the same phenotype.

Genetics of the blood groups

The blood groups érythrocytaires are defined thanks to the differences observed between the individuals on the surface of the érythrocyte S. It is thus about allotypic characters, i.e. different from one individual to another inside the same species.

These differences relate to the presence, the absence or the space fitting on the surface of the érythrocytes of Sucre S or oses (systems ABO, P…), or of Protein S (systems Rh, Kell…). As many differences which can constitute an antigenic épitope for somebody who does not have it.

These characters are genetically transmitted according to the Lois of Mendel.

Genetics of systems ABO and Rhesus

System ABO

Characterized by two possible sugars on the surface of the érythrocyte, either a galactose (antigen B) or N-acétyl-galactosamine (antigen A). These sugars are fixed on a basic substance, called substance H, itself osidic. The presence of each one of these sugars is due to a specific enzyme coded by a gene itself specific, gene has for the antigen has, gene B for the antigen B. the presence of an inactive gene to locus ABO does not allow the addition of a sugar this basic substance H which thus remains in the state. This inactive gene is called gene O .

Thus system ABO is thus characterized by three genes has , B , and O .

These genes are carried by a autosome (in opposition to the sexual chromosomes X or Y). Any individual thus has two genes, one coming from his father and the other of his mother, with same a locus, i.e. with a site defined on the chromosome. In fact, for system ABO, on chromosome 9.

When the subject has at the same time the gene has and the gene B , two sugars are then on the érythrocyte and the subject is of group AB. When it has only 2 genes O , it will be of group O, if it has one or two genes has and not the gene B , it will be has, if it has one or two genes B and not the gene has , it will be B.

Thus, a couple of parents, whose mother is genetically has / O , therefore of group has, and the father B / O , therefore of group B will be able to have children of four different groups. If each parent transmits his gene O , the child will be genetically O / O , therefore of group O . If the father transmits the gene O and the mother the gene has , the child will be has / O , therefore of group A. If the father transmits the gene B and the mother the gene O , the child will be B / O , therefore of group B. If the mother transmits the gene has and the father the gene B , the child will be then has / B , therefore of group AB.

System Rhesus

It is a protein system. Two genes are located at locus very close one to the other on the chromosome n°1, and are thus transmitted together one generation to the following one. These two genes result from a duplication of an original gene, and synthesize two very close proteins having the same structure and the same function; if one is absent, the other replaces it, which can thus explain the great quantity of proteins D at the subjects having a délétion with locus EC (of phenotype D--, that is to say RH: 1, - 2, - 3, - 4, - 5 in international nomenclature), or reactivities different from red blood corpuscles according to the number of each épitopes present, at the time of a search for irregular Antibodies. With the first locus, locus D, is the allele D, which synthesizes the protein Rhésus D defined by the presence of the antigen D or RH1, that is to say an empty site called D, which does not synthesize anything. With the second locus, locus EC, is a gene which synthesizes one second protein which does not carry épitope D. But this second protein presents two others épitopes principal. One as of these épitopes defines the antigens C or C, the second the antigens E or E. The same protein can thus have four possible combinations of épitopes: this, This, this, EC.

Thus, by combining the whole as of these possibilities, we obtain 8 possible fittings, or haplotypes, on the same chromosome. Four as of these fittings comprise the gene D which will define a subject standard Rh positive. They are the haplotypes Dce , DCe , DcE , DCE . Four as of these fittings do not comprise gene D. It acts of the haplotypes dce , dCe , dcE , dCE .

The same reasoning as for genes of system ABO applies to the haplotypes Rhésus system. Thus two parents Rh positive of genotype D / D , therefore hétérozygotes with the locus D, will be able to have a child Rh negative of genotype D / D .

Genetics of the other systems

The whole of the other systems of blood groups follows the same genetic laws. However characteristics specific to each system exist. Lewis system for example, the synthesis of its antigens depending on two genetic systems (Lewis, with its alleles It, the and system H with its alleles H, H ), or the systems Xg or Kx whose genes are located on X chromosome, and not on a chromosome autosomal

Apparent anomalies and filiation

In each system of blood group we can be confronted with apparent anomalies of transmission.

Thus, in system ABO, we know that the antigen has results from a sugar (ose) fixed by an enzyme on a basic substance, also osidic, said substance H. This same substance H results from the action of a gene H , that very rare subjects do not have. These subjects are of genotype H / H , having in double dose the inactive allele H of H . These subjects are known as of group “Bombay”, of the name of the locality where this characteristic was described. These subjects thus do not have substance H on their red globules, and have an anti-H antibody in their plasma, which prohibits or makes dangerous any transfusion nonof the same blood group (not " Bombay"). Not having this substance H, even if these subjects " Bombay" have the gene has or the gene B , the substances has or B could not be manufactured, and these subjects will be seemingly of group O. Their children inheriting this relative of a gene H and of a gene has or B , and other relative of a normal gene H (in the Hh system) and of a gene O for example (in system ABO) will be able to again express the gene has or B which was transmitted to them by the first relative and will be of group has or B normal.

The same difficulty can arise in any other system where there exists an amorphous allele, a délétion, a change or an inhibiting system. There exists thus extremely rare a haplotype rh_null in the system Rhésus. This haplotype, which synthesizes any of the two proteins RH, neither RHD, nor RHCE, is noted RH: --- . Let us suppose a father determined like D+, C+, E, C, e+, i.e. having the antigens D, C, and E, and not having the antigens C and E. We let us deduce the probable genotype from it from this father as being DCe / DCe , or DCe / dCe . However, this father, plain with a woman of genotype dce / dce , will be able to have a child D, C, E, c+, e+, i.e. not having the antigen awaited C. This child will be regarded wrongly as genotype dce / dce . We then note an apparent exclusion of paternity, the child being supposed to have received a haplotype dce which does not exist in his/her father. However this can be perfectly explained by the genotype DCe / --- of this father, who transmitted his haplotype " ---" with his/her child whose real genotype is dce / --- .

In conclusion, an anomaly connects transmission of a blood group does not allow in any way it of only concluding with an exclusion of paternity or maternity. Such a conclusion must be based on several systems, and maintaining on molecular biology (analyzes direct on the level of the chromosomes).

Anomalies, curiosities and pathologies

Weak antigens

In all the systems we can see weak antigens, often announced by an asterisk, or a F - weak in index, or W - weak- in index, on the results of the laboratory, such A*, B*, E* or FY1* or JK1_w. It is even sometimes impossible to highlight these antigens by the usual techniques of grouping. Techniques of Fixing-elution are then used, even of molecular biology if need be.

It is thus antigens has weak or B weak (A3, Ax, Am… B3, Bx…) for which it is the weakness or the absence of anti-HAVe antibody or anti-B the proof Simonin-Michon which draws the attention, and prevents that these groups are not, wrongly, labelled O. This antigen has, or B, is however present on the érythrocytes, but is not put, or badly not highlighted at the time of the globular test of Beth-Vincent.

In the system RH, the weak antigens D are still called D^u.

All the other antigens of blood group can be weakened, for various reasons, change of gene, miss substrate, inhibiting gene… Ainsi, as for Rh_null, exist a Lu_null phenotype, therefore Lu (has, B), which had either with the presence of an amorphous gene in double dose, case where no antigen LU can be highlighted, or, generally, with the action of an inhibiting gene. It is often about a gene autosomic IN (Lu) active in simple amount, case where a very small quantity of antigen can be highlighted on the érythrocytes. This gene IN (Lu) causes a strong depression of the Lutheran antigens, para-Lutheran and AnWj (Anton), and a weakening of the antigens of some other systems of blood groups, P1, I, Indian, Knops. Also exist, in some families, a second gene inhibiting Luthéran named XS2 , dependant on X chromosome, the normal gene being named XS1 , from which the action is slightly different from In (Lu) on the other antigens of blood group.

Certain antigens of group are known to give, to the laboratory, of the very variable reactions from one individual to another, the such P1 antigen in the adult, or give weaker reactions at the subject hétérozygote than at the homozygote (effect of amount, antigens M, NR, S, Jka…), or are not developed with the birth and appear gradually in the space of two or five years, like the antigens Lewis or P1.

Lewis system

Certain women It (has, b+) or It (a+, B), for thirty percent of them, lose during their pregnancy the Lewis antigen which they have. They thus appear as It (has, B) and develop a natural antibodies anti-Lewis, anti-Lea, anti-Leb and/or anti-Lex. One month with more after the childbirth, this antibody disappeared and these women found their normal Lewis phenotype. This loss of antigen is without consequence for érythrocyte, because substance Lewis is substance (glycosphingolipide) which does not belong to the membrane of the érythrocyte, but is a soluble substance (which one finds in plasma, saliva, the tears, milk, sperm…) adsorbed passively on the érythrocyte.

The Lewis substance is not detected on the érythrocyte a fetus nor newborn which is thus It (has, B) with the birth. It appears It (a+, B) at approximately the one month age, then It (a+, b+) before becoming It (has, b+) towards the two years age if such must be its final phenotype, when it is genetically It (gene the ) and Secreting (gene ), at least at the Caucasians. This explains, inter alia reasons, why the anti-Lewis developed in the mother do not have any consequence for the fetus.

Hematopoietic dreams

When the placentas of two twins dizygotes amalgamate and allow a circulation crossed between the fetuses, each one of them then has its own original cells like those of its twin or his binocular. There is Clerc's Office, tolerance immunizing and the two cellular lines cohabit at the same individual. In each system we can observe a double cellular population due to the difference in group according to the origin of the cells. Some érythrocytes actually belonging to the individual will be, for example, has, Rh+, K, others, coming from its twin could be B, Rh, K+. Sometimes, in the event of early death of the second embryo, the chimerism is a fortuitous discovery for the surviving individual. These is a case which can pose problem in the affiliations, to even simulate an exclusion of maternity, the genetic inheritance of the circulating cells not being the same one as that of the somatic or germinal cells. Sometimes even there is early fusion between two eggs and it results one individual from it, which does not pose a problem if the eggs are same sex. It results from it a single individual who thus has two types of cells, and not only the hematopoietic cells, each cellular line having its own genetic inheritance.

The same images of double population are seen regularly at the laboratory after transfusion, and in the case of Clerc's Office S of therapeutic marrow. This double population is visible before total catch of the Clerc's Office, and reappears in the event of rejection.

Loss of an antigen of blood group

In certain preleucemic affections, refractory anemias in particular, certain lines of érythrocytes can lose, or rather not synthesize more, certain antigens of blood groups. For example, a known subject of group AB, can have three types of globules in circulation, namely of globules AB, has, and O, the first line not being reached, the second having lost an enzyme, and the third while having lost two. We have business then so that we name double populations érythrocytaires. This report is sometimes an element etiologic of anemia, well before the other clinical elements.

This antigen loss of blood groups can be accompanied by a loss of other enzymes érythrocytaires (adélinate kinase), without speaking about the possible chromosomal attacks of the other lines myéloïdes.

B acquired

At the time of infections of tract digestive, at the time of cancers colics in particular, certain germs release enzyme, désacétylase, which transforms N-acétyl-galactosamine, which constitutes the substance has group ABO, into galactosamine. Certain anti-B reagents, recognizing normally only galactose, reacted then as if the group had the substance B. the now marketed reagents are controlled and do not present any more, in theory, this crossed reaction, which could cause error between inexperienced hands, making determine like AB a subject of group A. As of the end of the infection, the anomaly disappears gradually.

Other pathologies

Kell Protein not expressed at the subject of McLeod phenotype whose gene XK, located in Xp21.1, is genetically related in a narrow way to genes of pigmentary retinite (RP), the chronic granulomatose (CGD) and the myopathy of Duchenne (DMD), according to sequence Xpter-DMD-XK-CGD-RP-Xcent. A délétion at this place explaining the possible one occurred of these affections at the subjects of McLeod phenotype, which in addition present an important acanthocytose and a haemolytic anemia compensated often well.
chronic RH_null and hémolyse.
System FY and resistance to the Paludism.
Agammaglobulinémie and problem of determination of blood group ABO - discordance enters the globular and serum tests.
the rates of vWF and F VIII (factors of coagulation von Willebrand and antihemophilic A) are weaker at the subjects of blood group O. the results of a proportioning must thus be interpreted according to the blood group.

Genetics of the populations

The genic frequencies of the alleles of the blood groups, calculated thanks to the Law of Castle-Hardy-Weinberg, allowed to the rise of the Génétique populations. Thanks to it, we can follow the migrations and filiations of the various populations of the sphere.

Notes and references of the article

See too

1) " Human blood groups" , Geoff Daniels, Blackwell Ltd Science, 1995

2) " Molecular bases of the antigens of the sanguins" groups; , Jean-Pierre Cartron and Philippe Rouger, Masson, 1998

3) " The blood group antigen", Marion E. Reid and Christine Lomas-Francis, Facts Book, Elsevier Academic Close, 2° edition, 2004.

External bonds and documents

International Society for Blood Transfusion (ISBT)
National Center for Biotechnology Information (NCBI)
Platelet Nomenclature Commitee (PNC)
plate Antigens, nomenclature, Vox Sanguinis 2003
Systems HNA
Systems HNA (pdf)
Systems érythrocytaires
Distribution of the blood groups according to the ethnos groups
a calculator which indicates the blood group of the children from that of the parents

Random links:

Blood group

Bases of Immunology

Classification

Leucocytic blood groups

Plate blood groups

Serum groups

Érythrocytaires groups

Blood groups (érythrocytaires)

Table

ABO and RH, models of blood groups érythrocytaires

System ABO

The system Rhesus

Distribution of the groups

Compatibility

Presence of the antibodies

Transfusion of red globules

Transfusion of plasma

Transfusional dead ends

Genetics of the blood groups

Genetics of systems ABO and Rhesus

System ABO

System Rhesus

Genetics of the other systems

Apparent anomalies and filiation

Anomalies, curiosities and pathologies

Weak antigens

Lewis system

Hematopoietic dreams

Loss of an antigen of blood group

B acquired

Other pathologies

Genetics of the populations

Notes and references of the article

See too

Related articles

External bonds and documents