Fourth lecture.

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Presentation transcript:

Fourth lecture

Blood groups The surface f RBCs contain many antigens called agglutinogens. Two groups of antigens, the ABO & Rh antigens are important clinically. 1-ABO system: There are 4 main blood types, distinguished by their carbohydrate antigens: a- Type A has agglutinogen A on RBCs surface. b- Type B has agglutinogen B on RBCs surface. C- Type AB has both agglutinogens A & B. d- Type O has neither agglutinogen A nor B.

Blood groups Blood plasma contains antibodies against these agglutinogens called agglutinins. There are 2 types of agglutinins: Anti A (α) which attacks A agglutinogens. Anti B (β) which attacks B agglutinogens. The blood of any person does not contain one agglutinogen and its corresponding agglutinin.

Blood groups Universal donor: Type O blood can be transfused to all blood groups, because it doesn’t contain any agglutinogen. So, type O is therefore a universal donor. Universal recipient: Persons with type AB blood don’t contain anti A and anti B agglutinins in their plasma. Persons of this type can receive blood from donors off all types. So, type AB is therefore a universal recipient.

A O B AB Blood Types B Antigen A & B Antigens Neither A nor B Antigens Antibodies bind with antigens to cause clumping of blood cells (agglutination) so people with type A blood have circulating antibodies for type B = β. People with blood type AB have neither α nor β antibodies. People with blood type O circulate both α and β A Antigen

Agglutination Reaction

Rhesus system Rh system is so named because it was first discovered in the blood of the Rhesus monkey. Rn system is important on blood transfusion like ABO system. There are 6 common types of Rh antigens (agglutinogens) C, D, E, c, d, e. The type D antigen is widely prevalent in the population.

Rhesus system A person which has the D antigen is said to be Rh positive. Whereas, a person who does not have the D antigen is said to be Rh negative. Normally, there is no anti Rh agglutinin in the plasma, but it can be formed in the following conditions:-

A-Blood transfusion If an Rh –ve person receives Rh +ve blood the body starts to make anti Rh agglutununs that will remain in the blood. These agglutinins develop slowly and reach maximum after 2-4 months. If a second transfusion of an Rh +ve is given later, the previously formed anti Rh agglutinins will react with the transfused Rh +ve RBCs & transfusion reaction occur.

B-In pregnancy If an Rh –ve mother becomes pregnant from an Rh +ve husband, the fetus will most probably be Rh positive like his father. This stimulates the production of anti Rh agglutinin against the Rh +ve. The anti Rh agglutinin rises slowly over a period of 2-4 months. So the 1st baby passes unaffected.

B-In pregnancy With subsequent pregnancies with Rh +ve babies, the level of the anti Rh agglutinins rises progressively. Anti Rh agglutinins can pass to the fetal blood causing agglutination of RBCs of the fetus. At birth the newly born infant shows jaundice and severe anemia, a condition known as hemolytic disease of the newborn. Administration of anti Rh gamma globulin to the Rh –ve mother immediately after delivery or abortion prevents the production of anti Rh agglutinin by the mother.