RH BLOOD GROUP SYSTEM (MID1) PART 1

004

RH BLOOD GROUP SYSTEM

• 2nd most important blood group system

• A significant cause of HTR and primary cause of HDFN

• ISBT no. ___

Levine, Stetson

RH BLOOD GROUP SYSTEM

• Discovered in 1939 by ________ and __________ in serum of obstetrical patient who received blood transfusion from her husband after delivering a dead body

• the MOTHER is pregnant, and she received blood from her HUSBAND

• They isolated an antibody from the mother's serum, when they tested it on the red cell of the husband, the antibody was able to bind both in room temperature and at 37C.

• The fetus and the father possess a common factor that the mother lacks.

Landsteiner, Wiener

RH BLOOD GROUP SYSTEM

• Named in 1940 AS Rh by _____________ and _____________ after discovering that the antibody isolated in 1939 can agglutinate Rhesus macaque monkey red cells.

IgG

RH BLOOD GROUP SYSTEM

• The antibodies produced by RH antigens are ____ type, they can cross the placenta.

Rabbit, Guinea pig, Rhesus macaca or Macaca mulata

RH BLOOD GROUP SYSTEM

• The test animal is _______ and _________. They try to inject red cells of the rhesus monkey (______________ or _____________) ←scientific name

85%, Landsteiner-Wiener antibody

RH BLOOD GROUP SYSTEM

• The test animal produces an antibody that can agglutinate ___ of human RBC

• The antibody isolated for the humans retained the name RH.

• The antibody produces by the test animals named as _____________________(L-W)

Rh positive

RH ANTIGENS

• There is D antigen in RBC

Rh negative

RH ANTIGENS

• There is no D antigen in RBC

D>c>E>C>e

RH ANTIGENS

• Over 50 Antigens

d

RH ANTIGENS

• ___= indicates the absence of D antigen

Big D

RH ANTIGENS

• Under the Rh blood group system, we have more than 50 antigens. This >50 antigens have been classified according to their significance.

• There is only 5 significant antibodies (D>c>E>C>e)

• The _____ is the most immunogenic among all antigens

Immunogenic

RH ANTIGENS

• _________________- has a abilily to mount, to activate the immune system to produce antibody.

Immunogenicity

RH ANTIGENS

• _________________- pertains to the ability of a foreign substance such as antigen to provoke the immune response in the body.

Chromosome no.1

Nomenclatures of the Rh System

• The alleles for the Rh blood group system are actually found in or chromosome. The _________________

Fischer-Race (DCE)

Nomenclatures of the Rh System

• Based on the theory that the antigen of the systems were produced by the three closely linked set of alleles, each gene was responsible for producing a product (or an antigen) on the red cell membrane.

• It has genetic basis

Nomenclatures of the Rh System

• Postulated that the gene responsible for defining Rh are actually produced an agglutinogen that contains a series of blood factors, in which each factor is an antigen recognized by an antibody.

• It has genetic basis

Rosenfield (Alpha Numeric)

Nomenclatures of the Rh System

• Number is assigned to each antigen of the Rh system in order of its discovery.

• We just assigned numbers

ISBT nomenclature

Nomenclatures of the Rh System

• uses 6 number designation.

• We just assigned numbers

Rh0

ISBT: 004001

Fisher-Race: D

• Give the Wiener

rh’

ISBT: 004002

Fisher-Race: C

• Give the Wiener

rh’’

ISBT: 004003

Fisher-Race: E

• Give the Wiener

hr’

ISBT: 004004

Fisher-Race: c

• Give the Wiener

hr’’

ISBT: 004005

Fisher-Race: e

• Give the Wiener

DCE nomenclature

Fisher Race Terminology

• Also called as ___________________________

• According to Fisher Race, each Rh genes are inherited from each parent as a set of 3 closely linked set of alleles.

  • Example: DCe/DcE

Codominant

Fisher Race Terminology

• Rh genes are expressed as _______________ (All of the product will be expressed)

• An individual’s Rh phenotype is reported as DCE rather than CDE (Because according to Fisher, he postulated that the locus of C lies between D and E)

Fisher-Race (DCE)

• Inherit 3 genes

• Each genes codes for Ag

E

GENE FREQUENCY

• The least predominant

• 30%

• very low in frequency, it is exposed with other individuals, it can produce anti-big _.

e

GENE FREQUENCY

• It is a most predominant. H is a Public Antigen.

• Almost all individuals have this antigen. There's only few individuals have anti-small ___, because small __ is almost present in all of the individuals.

• 98%

Rh-Hr nomenclature

WIENER TERMINOLOGY

• Also known as _____________________

• According to Wiener, each Rh gene that we inherit from our parents encodes for an agglutinogen that contain a series of 3 blood factors/antigens.

• Fisher-Race can be converted to Wiener terminology and vice versa.

D

RULES

• R and 0 refers to

d

RULES

• r refers to ___

C, c

RULES

• 1 and ‘ refers to __ and _

E, e

RULES

• 2 and ‘‘ refers to __ and __

C, E

RULES

• If r precedes h, it refers to __ or __

c, e

RULES

• If h precedes r, it refers __ or __

Numbers

RULES

• ________ are used with R

Symbols

RULES

• ________ ‘ and ‘‘ are used with r

Z, y

RULES

• __ and __ are used to refer when both C and E are present

C/E

RULES

• rh= ___

Ce

RULES

• rh’= ____

Z, z, R

RULES

• CE= ___, __ is also used for big __

y

RULES

• Ce= __

Alpha-Numeric Nomenclature

Rosenfield & Coworkers Terminology

• Also known as ________________________

Numeric Nomenclature

ISBT Terminology

• Also known as __________________

• Uses 6 digit number to refer to red cell antigens.

Chromosome no.1

GENETICS OF RH SYSTEM

• RHD and RHCE genes: located on __________________

Chromosome no.6

GENETICS OF RH SYSTEM

• RHAG/X1r gene: located on _________________ (co-expressor of DCE genes)

Rh associated glycoprotein

GENETICS OF RH SYSTEM

• _____________________→ not part of Rh Blood Group System. Separate Blood Group System whose ISBT number is 030

X0r

GENETICS OF RH SYSTEM

ABNORMAL GENES

• ____: regulator type of Rh null

XQr

GENETICS OF RH SYSTEM

ABNORMAL GENES

• _______: Rhmod phenotype (partial suppression of Rh antigen expression)

r

GENETICS OF RH SYSTEM

ABNORMAL GENES

• ___: little r double bar: silent type of Rh null/Amorph type

Silent type

RH NULL PHENOTYPE

• _____________: due to inheritance of r: little r double bar

Regulator type

RH NULL PHENOTYPE

• ___________________: due to inheritance of XorXor

Hemoglobin, Hematocrit, Haptoglobin

RH NULL PHENOTYPE

• What are the DECREASED in signs and symptoms?

Bilirubin, Hemoglobin F

RH NULL PHENOTYPE

• What are the INCREASED in signs and symptoms?