Human blood group systems
Encyclopedia
The International Society of Blood Transfusion
International Society of Blood Transfusion
The International Society of Blood Transfusion , is a scientific society, founded in 1935, which aims to promote the study of blood transfusion, and to spread the know-how about the manner in which blood transfusion medicine and science best can serve the patient's interests. The society's central...

 (ISBT) currently recognises 30 major blood group
Blood type
A blood type is a classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells . These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system...

 systems
(including the ABO and Rh systems). Thus, in addition to the ABO antigens and Rhesus antigens, many other antigen
Antigen
An antigen is a foreign molecule that, when introduced into the body, triggers the production of an antibody by the immune system. The immune system will then kill or neutralize the antigen that is recognized as a foreign and potentially harmful invader. These invaders can be molecules such as...

s are expressed on the red blood cell
Red blood cell
Red blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen to the body tissues via the blood flow through the circulatory system...

 surface membrane. For example, an individual can be AB RhD positive, and at the same time M and N positive (MNS system
MNS antigen system
The MNS antigen system is a human blood group system based upon two genes on chromosome 4. There are currently 46 antigens in the system, but the five most important are called M, N, S, s, and U....

), K positive (Kell system
Kell antigen system
The Kell antigen system is a group of antigens on the human red blood cell surface which are important determinants of blood type and are targets for autoimmune or alloimmune diseases which destroy red blood cells. Kell can be noted as K, k, or Kp...

), and Lea or Leb positive (Lewis system
Lewis antigen system
The Lewis antigen system is a human blood group system based upon genes on chromosome 19 q13.3, and 19p13.3 , which both have fucosyltransferase activity. There are two main types of Lewis antigens, Lewis a and Lewis b. They are red cell antigens which are not produced by the erythrocyte itself...

). Many of the blood group systems were named after the patients in whom the corresponding antibodies
Antibody
An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...

 were initially encountered.

The ISBT definition of a blood group system is where one or more antigen
Antigen
An antigen is a foreign molecule that, when introduced into the body, triggers the production of an antibody by the immune system. The immune system will then kill or neutralize the antigen that is recognized as a foreign and potentially harmful invader. These invaders can be molecules such as...

s are "controlled at a single gene locus
Locus (genetics)
In the fields of genetics and genetic computation, a locus is the specific location of a gene or DNA sequence on a chromosome. A variant of the DNA sequence at a given locus is called an allele. The ordered list of loci known for a particular genome is called a genetic map...

 or by two or more very closely linked homologous
Homology (biology)
Homology forms the basis of organization for comparative biology. In 1843, Richard Owen defined homology as "the same organ in different animals under every variety of form and function". Organs as different as a bat's wing, a seal's flipper, a cat's paw and a human hand have a common underlying...

 genes with little or no observable recombination
Genetic recombination
Genetic recombination is a process by which a molecule of nucleic acid is broken and then joined to a different one. Recombination can occur between similar molecules of DNA, as in homologous recombination, or dissimilar molecules, as in non-homologous end joining. Recombination is a common method...

 between them".

Blood grouping postulates

Blood is composed of cells suspended in a liquid. The liquid portion is the plasma, from which therapeutic fractions and derivatives are made.

Suspended in the plasma are three types of cells:
  • Red cells carry oxygen
  • White cells fight infection
  • Platelets stop bleeding in injuries


The most common type of grouping is the ABO grouping. The varieties of protein coating on red blood cells divides blood into four groups:
  • A (A oligosaccharide
    Oligosaccharide
    An oligosaccharide is a saccharide polymer containing a small number of component sugars, also known as simple sugars...

     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)
  • z Negative (Z -ve )
  • zk (Zk )

Rare blood types

In the "ABO" system, all blood belongs to one of four major groups: A, B, AB, or O. 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, with maybe a plus or a minus, a smaller number of people express their blood type in an extensive series of letters in addition to their 'ABO' type designation.

Blood group systems

ISBT
International Society of Blood Transfusion
The International Society of Blood Transfusion , is a scientific society, founded in 1935, which aims to promote the study of blood transfusion, and to spread the know-how about the manner in which blood transfusion medicine and science best can serve the patient's interests. The society's central...

 №
System name System symbol Epitope
Epitope
An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by the immune system, specifically by antibodies, B cells, or T cells. The part of an antibody that recognizes the epitope is called a paratope...

 or carrier, notes
Chromosome
Chromosome
A chromosome is an organized structure of DNA and protein found in cells. It is a single piece of coiled DNA containing many genes, regulatory elements and other nucleotide sequences. Chromosomes also contain DNA-bound proteins, which serve to package the DNA and control its functions.Chromosomes...

001 ABO
ABO blood group system
The ABO blood group system is the most important blood type system in human blood transfusion. The associated anti-A antibodies and anti-B antibodies are usually IgM antibodies, which are usually produced in the first years of life by sensitization to environmental substances such as food,...

ABO Carbohydrate (N-Acetylgalactosamine
N-Acetylgalactosamine
N-Acetylgalactosamine , is an amino sugar derivative of galactose.-Function:In humans it is the terminal carbohydrate forming the antigen of blood group A....

, galactose
Galactose
Galactose , sometimes abbreviated Gal, is a type of sugar that is less sweet than glucose. It is a C-4 epimer of glucose....

). A, B and H antigens mainly elicit IgM
IGM
IGM as an acronym or abbreviation can refer to:* Immunoglobulin M , the primary antibody against A and B antigens on red blood cells* International Grandmaster, a chess ranking* intergalactic medium* Intragroup medium - see: Intracluster medium...

 antibody reactions, although anti-H is very rare, see the Hh antigen system
Hh antigen system
hh is a rare blood group also called Bombay Blood group. Individuals with the rare Bombay phenotype do not express H antigen...

 (Bombay phenotype, ISBT #18).
9
002 MNS
MNS antigen system
The MNS antigen system is a human blood group system based upon two genes on chromosome 4. There are currently 46 antigens in the system, but the five most important are called M, N, S, s, and U....

MNS GPA / GPB (glycophorin
Glycophorin
A Glycophorin is a sialoglycoprotein of the membrane of a red blood cell. It is a membrane-spanning protein and carries sugar molecules. It is heavily glycosylated . Glycophorins are rich in sialic acid, which gives the red cells a very hydrophilic-charged coat...

s A and B). Main antigens M, N, S, s.
4
003 P
P antigen system
P antigen system is a human blood group system based upon genes on chromosome 22. The P antigens are carbohydrate antigens that include P1, P, and Pk. The P antigen is a receptor for the human pathogen Parvovirus B19 and is the target of auto-anti-P IgG antibodies in paroxysmal cold...

P1 Glycolipid
Glycolipid
Glycolipids are lipids with a carbohydrate attached. Their role is to provide energy and also serve as markers for cellular recognition.-Metabolism:...

. Antigen P1.
22
004 Rh
Rh blood group system
The Rh blood group system is one of thirty current human blood group systems. Clinically, it is the most important blood group system after ABO. At Present, the Rh blood group system consists of 50 defined blood-group antigens, among which the 5 antigens D, C, c, E, and e are the most important...

RH Protein. C, c, D, E, e antigens (there is no "d" antigen; lowercase "d" indicates the absence of D). 1
005 Lutheran
Lutheran antigen system
Lutheran antigen system is a human blood group system based upon genes on chromosome 19.This system is a single locus system, with antigens Lua and Lub. The Lu negative phenotype is very rare. Antibodies to Lutheran antigens are IgG...

LU Protein (member of the immunoglobulin superfamily
Immunoglobulin superfamily
The immunoglobulin superfamily is a large group of cell surface and soluble proteins that are involved in the recognition, binding, or adhesion processes of cells. Molecules are categorized as members of this superfamily based on shared structural features with immunoglobulins ; they all possess a...

). Set of 21 antigens.
19
006 Kell
Kell antigen system
The Kell antigen system is a group of antigens on the human red blood cell surface which are important determinants of blood type and are targets for autoimmune or alloimmune diseases which destroy red blood cells. Kell can be noted as K, k, or Kp...

KEL Glycoprotein. K1 can cause hemolytic disease of the newborn (anti-Kell)
Hemolytic disease of the newborn (anti-Kell)
Hemolytic disease of the newborn is the second most common cause of severe hemolytic diseases of newborns after Rh disease. Anti-Kell1 is becoming relatively more important as prevention of Rh disease is also becoming more effective....

, which can be severe.
7
007 Lewis
Lewis antigen system
The Lewis antigen system is a human blood group system based upon genes on chromosome 19 q13.3, and 19p13.3 , which both have fucosyltransferase activity. There are two main types of Lewis antigens, Lewis a and Lewis b. They are red cell antigens which are not produced by the erythrocyte itself...

LE Carbohydrate (fucose
Fucose
Fucose is a hexose deoxy sugar with the chemical formula C6H12O5. It is found on N-linked glycans on the mammalian, insect and plant cell surface, and is the fundamental sub-unit of the fucoidan polysaccharide...

 residue). Main antigens Lea and Leb - associated with tissue ABH antigen secretion.
19
008 Duffy
Duffy antigen
Duffy antigen/chemokine receptor also known as Fy glycoprotein or CD234 is a protein that in humans is encoded by the DARC gene....

FY Protein (chemokine receptor
Chemokine receptor
Chemokine receptors are cytokine receptors found on the surface of certain cells, which interact with a type of cytokine called a chemokine. There have been 19 distinct chemokine receptors described in mammals...

). Main antigens Fya and Fyb. Individuals lacking Duffy antigens altogether are immune to malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

 caused by Plasmodium vivax
Plasmodium vivax
Plasmodium vivax is a protozoal parasite and a human pathogen. The most frequent and widely distributed cause of recurring malaria, P. vivax is one of the four species of malarial parasite that commonly infect humans. It is less virulent than Plasmodium falciparum, which is the deadliest of the...

and Plasmodium knowlesi
Plasmodium knowlesi
Plasmodium knowlesi is a primate malaria parasite commonly found in Southeast Asia. It causes malaria in long-tailed macaques , but it may also infect humans, either naturally or artificially....

.
1
009 Kidd
Kidd antigen system
The Kidd antigen system is present on the membranes of red blood cells and the kidney and helps determine a person's blood type. The Jk antigen is found on a protein responsible for urea transport in the red blood cells and the kidney. The gene encoding this protein is found on chromosome 18....

dbMHC Protein (urea transporter). Main antigens Jka and Jkb. 18
010 Diego
Diego antigen system
The Diego Antigen System comprises 21 rare blood factors, any of which is carried on the band 3 protein, coded for by the gene SLC4A1 , located on human chromosome 17. The band 3 protein functions in the transport of chlorine ions and carbonate...

DI Glycoprotein (band 3
Band 3
Anion Exchanger 1 or Band 3 is a phylogenetically preserved transport protein responsible for mediating the exchange of chloride for bicarbonate across a plasma membrane. Functionally similar members of the AE clade are AE2 and AE3.It is ubiquitous throughout the vertebrates...

, AE 1, or anion exchange). Positive blood is found only among East Asia
East Asia
East Asia or Eastern Asia is a subregion of Asia that can be defined in either geographical or cultural terms...

ns and Native Americans
Indigenous peoples of the Americas
The indigenous peoples of the Americas are the pre-Columbian inhabitants of North and South America, their descendants and other ethnic groups who are identified with those peoples. Indigenous peoples are known in Canada as Aboriginal peoples, and in the United States as Native Americans...

.
17
011 Yt or Cartwright
Yt antigen system
The Yt antigen system is present on the membrane of red blood cells and helps determine a person's blood type. The antigens are found on the protein acetylcholinesterase, an enzyme which helps break down acetylcholine. The Yt system features two alleles, Yt and Yt...

YT Protein (AChE, acetylcholinesterase
Acetylcholinesterase
"Acetylcholinesterase, also known as AChE or acetylcholine acetylhydrolase, is an enzyme that degrades the neurotransmitter acetylcholine, producing choline and an acetate group. It is mainly found at neuromuscular junctions and cholinergic nervous system, where its activity serves to terminate...

).
7
012 XG
Xg antigen system
The XG antigen is a red blood cell surface antigen discovered in 1962.The PBDX gene that encodes the antigen is located on the short arm of the X chromosome. Since males normally have one X chromosome they are considered hemizygotes...

XG Glycoprotein. X
X chromosome
The X chromosome is one of the two sex-determining chromosomes in many animal species, including mammals and is common in both males and females. It is a part of the XY sex-determination system and X0 sex-determination system...

013 Scianna SC Glycoprotein. 1
014 Dombrock DO Glycoprotein (fixed to cell membrane by GPI, or glycosyl-phosphatidyl-inositol). 12
015 Colton
Colton antigen system
The Colton antigen system is present on the membranes of red blood cells and in the tubules of the kidney and helps determine a person's blood type. The Co antigen is found on a protein called aquaporin-1 which is responsible for water homeostasis and urine concentration.The Co antigen is...

CO Aquaporin 1
Aquaporin 1
AQP1 is a widely expressed water channel, whose physiological function has been most thoroughly characterized in the kidney.It is found in the basolateral and apical plasma membranes of the proximal tubules, the descending limb of the loop of Henle, and in the descending portion of the vasa...

. Main antigens Co(a) and Co(b).
7
016 Landsteiner-Wiener LW Protein (member of the immunoglobulin superfamily
Immunoglobulin superfamily
The immunoglobulin superfamily is a large group of cell surface and soluble proteins that are involved in the recognition, binding, or adhesion processes of cells. Molecules are categorized as members of this superfamily based on shared structural features with immunoglobulins ; they all possess a...

).
19
017 Chido/Rodgers CH/RG C4A C4B (complement fractions). 6
018 Hh/Bombay
Hh antigen system
hh is a rare blood group also called Bombay Blood group. Individuals with the rare Bombay phenotype do not express H antigen...

H Carbohydrate (fucose
Fucose
Fucose is a hexose deoxy sugar with the chemical formula C6H12O5. It is found on N-linked glycans on the mammalian, insect and plant cell surface, and is the fundamental sub-unit of the fucoidan polysaccharide...

 residue).
19
019 Kx
XK (protein)
XK is a protein found on human red blood cells and other tissues which is responsible for the Kx antigen which helps determine a person's blood type.-Clinical significance:...

XK Glycoprotein. X
X chromosome
The X chromosome is one of the two sex-determining chromosomes in many animal species, including mammals and is common in both males and females. It is a part of the XY sex-determination system and X0 sex-determination system...

020 Gerbich GE GPC / GPD (Glycophorin
Glycophorin
A Glycophorin is a sialoglycoprotein of the membrane of a red blood cell. It is a membrane-spanning protein and carries sugar molecules. It is heavily glycosylated . Glycophorins are rich in sialic acid, which gives the red cells a very hydrophilic-charged coat...

s C and D).
2
021 Cromer CROM Glycoprotein (DAF or CD55, regulates complement fractions C3 and C5, attached to the membrane by GPI). 1
022 Knops KN Glycoprotein (CR1 or CD35, immune complex receptor). 1
023 Indian IN Glycoprotein (CD44
CD44
The CD44 antigen is a cell-surface glycoprotein involved in cell–cell interactions, cell adhesion and migration. In humans, the CD44 antigen is encoded by the CD44 gene.- Tissue distribution and isoforms :...

 adhesion function?).
11
024 Ok OK Glycoprotein (CD147). 19
025 Raph MER2 Transmembrane glycoprotein. 11
026 JMH JMH Protein (fixed to cell membrane by GPI). 6
027 Ii
Ii antigen system
Ii antigen system is a human blood group system based upon genes on chromosome 6.-External links:* at BGMUT Blood Group Antigen Gene Mutation Database at NCBI, NIH...

I Branched (I) / unbranched (i) polysaccharide
Polysaccharide
Polysaccharides are long carbohydrate molecules, of repeated monomer units joined together by glycosidic bonds. They range in structure from linear to highly branched. Polysaccharides are often quite heterogeneous, containing slight modifications of the repeating unit. Depending on the structure,...

.
6
028 Globoside GLOB Glycolipid. Antigen P. 3
029 GIL GIL Aquaporin 3
Aquaporin 3
Aquaporin 3 is found in the basolateral cell membrane of principal collecting duct cells and provide a pathway for water to exit these cells. In kidney, AQP3 gene expression is not regulated by vasopressin . This protein is also a determinant for the GIL blood group system.-External links:* at...

.
9
030 Rh-associated glycoprotein
RHAG
Rh-associated glycoprotein is an ammonia transporter protein that in humans is encoded by the RHAG gene. RHAG has also recently been designated CD241 . Mutations in the RHAG gene can cause stomatocytosis....

RHAG Rh-associated glycoprotein. 6

External links

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