Human blood group systems
346 red blood cell antigens and 33 platelet antigens have been serologically defined. The genetic basis for most of these antigens lie in 45 red blood cell or six platelet genes. Thirty-five major human blood group systems (including the ABO and Rh- systems) were recognised by the International Society of Blood Transfusion (ISBT) in October 2012. In addition to the ABO antigens and Rh (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".
Blood grouping postulates
Blood is composed of cells suspended in a liquid-like substance called plasma. Suspended in the plasma are three types of cells:
- A (A oligosaccharide is present)
- B (B oligosaccharide is present)
- AB (A and B oligosaccharides are present)
- O (neither A nor B, only their precursor H oligosaccharide present)
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:
- A1 Negative (A1 −ve)
- A1 Positive (A1 +ve)
- A1B Negative (A1B −ve)
- A1B Positive (A1B +ve)
- A2 Negative (A2 −ve)
- A2 Positive (A2 +ve)
- A2B Negative (A2B −ve)
- A2B Positive (A2B +ve)
- B Negative (B −ve)
- B Positive (B +ve)
- B1 Positive (B1 +ve)
- O Negative (O −ve)
- O Positive (O+ve)
Rare blood types
In the "ABO" system, (and Rhesus D system) all blood belongs to one of four major groups: A+/−, B+/−, AB+/−, or O+/−. The presence (+) or absence (−) of the RhD (Rhesus D) antigen is indicated by the plus or minus following the ABO type. 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, which may be a plus or a minus, a smaller number of people express their blood type in an extensive series of letters in addition to their 'AB-' type designation. The h/h blood group, also known as Oh or the Bombay blood group, is a rare blood type. This blood phenotype was first discovered in Bombay, now known as Mumbai, in India, by Dr. Y. M. Bhende in 1952.
Blood group systems
|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).||9q34.2|
|002||MNS||MNS||GPA / GPB (glycophorins A and B). Main antigens M, N, S, s.||4q31.21|
|003||P||P||Glycolipid. Three antigens: P1, P, and Pk||22q13.2|
|004||Rh||RH||Protein. C, c, D, E, e antigens (there is no "d" antigen; lowercase "d" indicates the absence of D).||1p36.11|
|005||Lutheran||LU||Protein (member of the immunoglobulin superfamily). Set of 21 antigens.||19q13.32|
|006||Kell||KEL||Glycoprotein. K1 can cause hemolytic disease of the newborn (anti-Kell), which can be severe.||7q34|
|007||Lewis||LE||Carbohydrate (fucose residue). Main antigens Lea and Leb — associated with tissue ABH antigen secretion.||19p13.3|
|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.||1q23.2|
|009||Kidd||JK||Protein (urea transporter). Main antigens Jka and Jkb.||18q12.3|
|010||Diego||DI||Glycoprotein (band 3, AE 1, or anion exchange). Positive blood is found only among East Asians and Native Americans.||17q21.31|
|011||Yt||YT||Protein (AChE, acetylcholinesterase).||7q22.1|
|014||Dombrock||DO||Glycoprotein (fixed to cell membrane by GPI, or glycosyl-phosphatidyl-inositol).||12p12.3|
|015||Colton||CO||Aquaporin 1. Main antigens Co(a) and Co(b).||7p14.3|
|016||Landsteiner-Wiener||LW||Protein (member of the immunoglobulin superfamily).||19p13.2|
|017||Chido||CH||C4A C4B (complement fractions).||6p21.3|
|018||Hh||H||Carbohydrate (fucose residue).||19q13.33|
|020||Gerbich||GE||GPC / GPD (Glycophorins C and D).||2q14.3|
|021||Cromer||CROM||Glycoprotein (DAF or CD55, regulates complement fractions C3 and C5, attached to the membrane by GPI).||1q32.2|
|022||Knops||KN||Glycoprotein (CR1 or CD35, immune complex receptor).||1q32.2|
|023||Indian||IN||Glycoprotein (CD44 adhesion function?).||11p13|
|026||JMH||JMH||Protein (fixed to cell membrane by GPI). Also known as Semaphorin 7A or CD108.||15q24.1|
|027||Ii||I||Branched (I) / unbranched (i) polysaccharide.||6p24.2|
|028||Globoside||GLOB||Glycolipid. Antigen P.||3q26.1|
|030||Rh-associated glycoprotein||RHAg||Rh-associated glycoprotein.||6p21-qter|
|031||Forssman||FORS||Globoside alpha-1,3-N-acetylgalactosaminyltransferase 1 (GBGT1)||9q34.13|
|032||Langereis||LAN||ABCB6. Porphyrin transporter||2q36|
|033||Junior||JR||ABCG2. Multi-drug transporter protein||4q22|
|034||Vel||Vel||Human red cell antigens||1p36.32|
- Lane WJ, Westhoff CM, Uy JM, Aguad M, Smeland-Wagman R, Kaufman RM, Rehm HL, Green RC, Silberstein LE; MedSeq Project (2015) Comprehensive red blood cell and platelet antigen prediction from whole genome sequencing: proof of principle. Transfusion doi: 10.1111/trf.13416.
- "Table of blood group systems v3.0" (PDF). International Society of Blood Transfusion. October 28, 2012. Retrieved May 11, 2013.
- ISBT Committee on Terminology for Red Cell Surface Antigens. "Terminology Home Page". Retrieved 2009-02-13.
- Information Courtesy: Indian Red Cross Society, Tamil Nadu Branch.
- Virginie Helias; Carole Saison; Bryan A Ballif; Thierry Peyrard; Junko Takahashi; Hideo Takahashi; Mitsunobu Tanaka; Jean-Charles Deybach; Hervé Puy; Maude Le Gall; Camille Sureau; Bach-Nga Pham; Pierre-Yves Le Pennec; Yoshihiko Tani; Jean-Pierre Cartron; Lionel Arnaud (15 January 2012), "ABCB6 is dispensable for erythropoiesis and specifies the new blood group system Langereis", Nature Genetics 44 (2): 170–173, doi:10.1038/ng.1069, PMC 3664204, PMID 22246506
- ISBT Table of blood group antigens within systems Updated August 2008.
- BGMUT Blood Group Antigen Gene Mutation Database at NCBI, NIH.
- Blood Groups and Red Cell Antigens National Center for Biotechnology Information (NCBI).
- Distribution of Blood Types, Behavioral Sciences Department, Palomar College.
- Blood group antigen proteins