Abstract
This chapter discusses the molecular basis of antigenic specificity in the ABO, H, and Lewis blood-group systems. The classical ABO blood group system provided the first examples of single human polymorphic characters that were not associated with inherited diseases, and the understanding of the serological relationships in this system laid the basis for the safe transfusion of blood from one individual to another. The antigenic structures classified within the ABO blood-group system are known to arise through the expression of genes encoding glycosyltransferase enzymes responsible for the terminal glycosylation of carbohydrate chains in glycoproteins, glycolipids and free oligosaccharides. The ABO classification is based on the presence or absence of two antigens, A and B, on the erythrocyte surface and two antibodies anti-A and anti-B which always occur in the plasma when the corresponding antigen is missing. It is the presence of these naturally occurring antibodies that makes knowledge of the ABO groups of crucial importance in blood transfusion.
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