Transcript 20 Blood types

BLOOD TYPES
Blood types
 Blood types is the common
of normal antigens signs,
which are combined on
immunologic and genetic
bases
There are
 erythrocytes
 leukocytes and
 serum blood types
Model of erythrocyte membranes with
embedded molecules of different blood
group systems. Such systems currently
known 25 (AB0, Rh, Cromer, Diego,
Duffy, MNS, Lewis, etc.), and they
include more than 300 different antigens
History of the discovery of blood groups
 In 1900, the Austrian
physician Karl Landsteiner
published the results of
studies, which showed that all
people have three blood types.
Prague, Jan Jansky doctor
found that people are not 3,
and 4 blood groups and gave
them refer to Roman
numerals: I, II, III, IV.
Agglutination
 Agglutination ( Latin agglutinatio adhesive) - this process is irreversible
agglutination of red blood cells under
the influence of antibodies. It is usually
accompanied by hemolysis . The same
happens in the bloodstream transfusion
of incompatible blood .
Agglutination of red blood cells is the
result of antigen-antibody reaction . In
the erythrocyte membrane are
complexes with antigenic properties.
These antigenic complexes called
agglutinogens . They interact with
specific antibodies dissolved in plasma agglutinins . Normally, blood is no
agglutinins in their own erythrocytes.
Attention!
 The blood of every
human individual
contains a set of specific
erythrocyte
agglutinogens.
Everyone has only her
characteristic set of
antigens.
In practice, now we take
into account basically
two antigenic systems a AB0 and CDE.
 Under this system, human erythrocytes are divided
according to the antigenic structure into four groups:
without antigen (now known that this antigen H)
antigens A, B, AB.
Plasma under natural antibodies are conventionally
denoted: αβ; β; α and missing.
Thus, people are distinguished combination of
antigens and antibodies in the system AB0:
 0(І)αβ ;
 А(ІІ)β ;
 В(ІІІ)α;
 АВ(ІV).
ABO Blood Groups
Plasma
Plasma
Plasma
Plasma
Average Percents
 Type O—46%
 Type A—40%
 Type B—10%
 Type AB—4%
Determination of blood in the system AB0 by
standard serum
 On clean white plane after their
entries for glass, apply a standard
serum first, second and third blood
group two series. In each of drops of
standard serum angle net of glass,
make ten times smaller amount of
blood, and after 2-3 minutes add one
drop of saline. With the advent of
agglutination observed within 5
minutes. Install blood type. In the
case of four blood groups, conduct
additional determination of standard
serum group.
В(ІІІ)α
Determination of blood in the system AB0
by monoclonal antibodies
 Pure white plane for glass
divided into 4 sections: anti-A,
anti-B, anti-D and control. Put
in the relevant sector 1 drop of
monoclonal antibodies anti-A,
anti-B, anti-D and the control
saline NaCl. Angle of glass
make ten times smaller amount
of blood in two drops of
monoclonal antibodies.
Observation of the reaction on
the plate shaking for 2.5
minutes.
В(ІІІ)α,
Rh+
System СDЕ (rhesus)
At present, there are 6 major Rh antigens . For its designation in
Europe adopted the nomenclature of Fisher-Race. According
to him, the antigens are indicated by letters :
 D, C, E, d, c, e.
Sometimes used Wiener nomenclature under which antigens are
indicated: Rh0; rh '; rh "; Hr0; hr'; hr".
Often the two nomenclatures used simultaneously. Thus the
symbols of the signs are in brackets:
 Rh0 (D); rh '( C ); rh "( E ); Hr0 (d); hr' (c); hr" (e).
Antigen Rh0 (D) - the main antigen of the Rh-system. It is found
in red blood cells 85 % of people.
 Based on the presence of erythrocyte antigen Rh0 (D) isolated
Rh- positive blood. Human blood, red blood cells are devoid
of this antigen relate to Rh-positive group.
System СDЕ (rhesus)
 Antigen Rh0 (D) are unevenly distributed among the various races.
In European populations, people with Rh-negative blood type make
up 15%, Mongoloid race - about 0.5%.
 The main six of Rh antigens may often occur in combination : CDE 15,85%; Cde- 53, 2 %: cDE- 14 , 58 %, cde - 12,36%.
 Natural antibodies to the Rh blood group system is not there. They
can only be acquired , immune .
 They are formed under special pregnancy when there is ingestion of
Rh negative women through the vessels of the placenta of Rh
positive fetal red blood cells .
Mechanism of Rh-conflict in pregnancy
 They can only be acquired , immune (during pregnancy
when there is ingestion of Rh (-) women through the
vessels of the placenta Rh (+) erythrocytes of the fetus).
Mechanism of Rh conflict in pregnancy: immune
antibodies formed in the body of Rh -negative women
pregnant Rh-positive fetus, have the ability to cross the
placenta into the body of the fetus, its cause hemolysis of
erythrocytes. During labor in the blood of a newborn baby
comes many antibodies and developed hemolytic disease.
Antibodies can get newborn and mother's milk .
Rhesus conflict Pregnancy
Leukocytes blood types
 1. Common antigens
of leukocytes (HLA
system)
 2. Antigens of
granulocytes.
 3. Antigens of
lymphocytes.
Leukocytes blood types
 First data for leukocyte group received the French explorer
Dausset in 1954 of open leukocyte antigen entered the
science called «Mac».
 Now there are more than 40 antigens of leukocytes, which
are divided into three antigenic systems:
 1. Total leukocyte antigens.
 2. Antigens granulocytes.
 3. Antigens lymphocytes.
Common leukocyte antigens (system HLAhuman leucocyte antigene).
 According to WHO recommendations using letter- numeric designation for
antigens, whose existence is confirmed by a number of laboratories in parallel
investigated antigens.
 Genetically HLA- antigens are 4 subtypes (A , B, C, D), each of which combines
allelic antigens. The most studied is A and B. For example HLA-A1, HLA-A2,
HLA-A3, HLA-A5, HLA-A7, HLA-A8.
 For the first subspecies amount of antigen is 19 , the second-20.
 HLA antigens are also found in addition to leukocytes in the cells of various
organs and tissues ( skin, liver, kidney , spleen , etc.).
 Mismatch of donor and recipient antigens after these reactions accompanied by the
development of tissue incompatibility. Therefore, the installation of these antigens
are used for tissue typing when choosing a transplant donor HLA- like phenotype.
Antigens granulocytes
 This system antigens characteristic only for
cells of myeloid series, as in the bone
marrow and blood .
 3 known granulocyte antigens : NA- 1 , NA2 ; NB- 1, that can be divided into 3 blood
group antigen in this system.
 Established that antibodies against
granulocyte antigens cause short-term
reduction in the number of neutrophils in the
newborn.
 If you do not take into account the total
leukocyte antigens and antigens of
granulocytes , you can post transfusion
reactions due to the fact that in the plasma of
the recipient will be antibodies against
antigens and as a result of their interaction
allocated pyrogenic substances .
Lymphocyte antigens
 Lymphocyte antigens unique to
cells of lymphoid tissue.
 Known until one antigen of the
group, which is designated LYD1. It
occurs in people with a frequency of
about 36%. The value of this group
antigens in transfusiology and
transplantology is not fully
understood.
Serum group
 The highest value among most whey proteins have genetic heterogeneity of
immunoglobulins.
 We know of two immunoglobulin Gm i Inv. The system has more than 20 Gm
antigen levels , like 20 blood group Gm ( 1) and Gm ( 2 ), etc. , and the system has
a 3 Inv antigens, ie 3 blood types : Inv ( 1 ), Inv ( 2 ), Inv (3).
 Alpha -1 globulin . In the area of ​alpha -1- globulin polymorphism observed large .
Among them, 17 were found phenotypes of the system.
 Alpha -2- globulins . In this section distinguish polymorphisms , including
ceruloplasmin .
 There are 4 types of ceruloplasmin (Cp): Cp A; Cp AB; Cp B i Cp BC. Most
commonly found group Cp B. In this group of Europeans found 99 %, and negroid
- in 94 % of cases.
 Beta globulins . These include transferrin (Tf). It easily enters the compound of
iron. The specified property provides the performance of important physiological
functions - transport of iron to the bone marrow , where it is used for blood .
 There are the following groups : TfC, TfD.
Transfusion of blood
 We must transfused only
blood of one groop with
recipient!!!
 Before the transfusion we must
do the test on individual blood
compatibility
 in AB0 system
 in DCE system
 Biological test
The test of the compatibility AB0 system
 The test of the compatibility AB0 system aimed at the detection of
antibodies in the blood of the recipient to the donor's red blood cells .
 Sterile syringes collected from the vein of the recipient 1-3 ml of
blood and carry it in a test tube containing a solution of citric acid sodium. The tube is centrifuged . After, pipette the serum of the
recipient and shall put 2 drops on a plate. These drops of serum
added to 10 times less of donor‘s blood. Shaking the plate 5 min. ,
And then add 1-2 drops of 0.9 % solution of NaCl. The appearance
of agglutination indicate that this blood can not be transfused .
 Blood donor and recipient are not compatible in the system AB0.
 Test of Rh compatibility
aimed at detecting antierythrocyte Rh antibodies.
 In a petri dish put the serum
of the recipient. Add 10
times less of donor‘s blood.
The mixture was stirred and
heated in a water bath
(temperature 45 ° C) for 10
min. The presence of
agglutination indicating that
blood incompatibility Rh
factor.
The biological sample
 Recipient pour 10-15 ml of
blood, then stop the infusion
and monitor its condition. If no
violations of life, then after 3-5
minutes pour 10-15 ml of blood
and re-infusion is stopped.
Watch 5 minutes. Such
manipulation is carried out for
the third time. If the health of
the recipient is not observed
any violations of health, the
blood can be transfused.
Otherwise, stop the
transfusion
Physiological effects of transfused blood
 1.Stimulating - stimulates the functions of various
body systems and metabolic processes.
 2. Hematopoietic - enhances blood.
 3. Immunologic - strengthens the body's defenses
by introducing antibodies.
 4. Nutrients effect - with blood enters nutrients.
Groups substitutes are:
 1. Hemodynamic - to normalize
hemodynamic.
 2. Detoxification- for the
treatment of poisoning.
 3. Preparations for parenteral
nutrition:
 • protein hydrolysates;
 • solutions of amino acids;
 • drugs fat emulsion.
Groups substitutes are:
 4. Regulators of water and
salt, and acid-base balance:
 • saline;
 • osmo diuretic.
 5. Blood substitutes with
the function of carrying
oxygen.
 6. Blood substitutes
complex action.