Rhesus System Research Articles

Blood groups systems.

International Society of Blood Transfusion has recently recognized 33 blood group systems. Apart from ABO and Rhesus system, many other types of antigens have been noticed on the red cell membranes. Blood grouping and cross-matching is one of the few important tests that the anaesthesiologist orders during perioperative period. Hence, a proper understanding of the blood group system, their clinical significance, typing and cross-matching tests, and current perspective are of paramount importance to prevent transfusion-related complications. Nonetheless, the knowledge on blood group system is necessary to approach blood group-linked diseases which are still at the stage of research. This review addresses all these aspects of the blood groups system.

Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population.

Background:Maternal red blood cell (RBC) alloimmunization may lead to production of harmful antibodies that result in hemolytic disease of fetus and newborn (HDFN). There is insufficient data on the prevalence of HDFN due to RBC alloantibodies in the Malay neonatal population.Aim:The aim of this study was to determine the incidence of HDFN in the Malay neonatal population due to clinically significant RBC alloantibodies.Subjects and Methods:A cross sectional study was conducted in Transfusion Medicine Unit, Hospital Universitiy Sains Malaysia over one year period from January to December 2009. A total of 5163 Malay pregnant women who attended labor room for delivery were collected and analyzed prospectively. The blood samples were subjected to the standard immunohematological procedure for RBC antibody screening and identification using reagents of Diamed-ID Gel microtyping system. All the newborns with RBC alloantibody were investigated for the evidence of HDFN.Results:Thirty (0.58%) women were found to have clinically significant RBC alloantibodies. Most of the alloantibodies belonged to Rhesus (Rh) system (56.7%) where anti-E (33.3%) was the most common followed by anti-D (10.0%). Rh antibodies were the main cause of HDFN in fourteen (0.27%) neonates. Anti-D and anti-c were identified to cause moderate to very severe HDFN.Conclusions:With the low prevalence of clinically significant RBC alloantibodies and HDFN, routine antenatal antibody screening practice may not be advised as a routine practice at present, preferably reserved for those women of RhD negative or with history of HDFN, significantly of those attributed to anti-c.

Lack of correlation between blood group and HER-2 status in adenocarcinomas of the upper gastrointestinal tract

The assessment of the human epidermal growth factor receptor-2 (HER-2) status has become a routine diagnostic procedure for patients with advanced-stage gastroesophageal adenocarcinoma. The aim of this study was to evaluate the possible correlation between the HER-2 status and the ABO blood group. HER-2 status determination and routine ABO typing was performed according to current standards. We evaluated the correlation between the HER-2 status and the ABO and Rhesus (Rh) system in 100 consecutive patients with adenocarcinoma of the upper gastrointestinal tract. There were no significant differences between HER-2 status and ABO and Rh system. Furthermore, no correlation was observed between the HER-2 status and the ABO and Rh type in patients with adenocarcinoma of the upper gastrointestinal tract.

Recherche des anticorps anti-érythrocytaire en milieu hospitalier : à propos de 2027 patients marocains

Summary Purpose of study Research of irregular red cell antibodies is a required and essential biological analysis for the prevention of haemolytic transfusion reactions. The two main methods used are indirect coombs and enzymatic technique. The latter tends to be abandoned because of the high number of false positive reactions. The purpose of this study was to evaluate, using these two methods, the allo-immunization directed against red cells, in Moroccan patients candidate for blood transfusion. Patients and methods This prospective study was conducted over a period of two and a half months. The sample included 2027 sera from patient's candidate for blood transfusion. Screening for irregular red cell antibodies was routinely performed in all patients, followed by identification of antibodies of all positive sera. Screening and identification were performed using indirect coombs and enzymatic method according to a process of filtration column. Results The antibody screening was positive in 9.6% of cases. The identification revealed a positive reaction in 3.1% of cases by indirect coombs, 60.7% by enzyme assay and 36.2% by the two techniques. Antibodies directed against Rhesus system antigens represent 60.4% of all antibodies detected. Conclusion Our study shows that there is an immunological risk for the patients candidate for blood transfusion. The screening of irregular antibodies using the enzymatic technique is still justified since our patients do not receive an iso-rhesus transfusion systematically.

Growth potentials of CCR5-tropic/CXCR4-tropic HIV-1mt clones in macaque cells

Growth potentials of CCR5-tropic/CXCR4-tropic HIV-1mt clones in macaque cells

Prevalence of ABO and Rhesus Blood Groups in Northern India

Background: The ABO blood group system was the first human blood group system to be discovered by Landsteiner in 1900. The second type of blood group is the rhesus system. There are only two Rh phenotype such as Rh positive and Rh negative, depending on whether Rh antigen is present on the red cell or not. The frequency of ABO and Rh phenotypes in different populations has been extensively studied. The present study was done to assess the prevalence of blood groups in different categories of Northern India and to compare our results with other studies conducted in India and else where in the world and its multipurpose future utilities for the health planners. Methods: A retrospective study was carried out on 23,320 blood donors during a period of one year from 1st January to 31st December 2011. The Blood samples were obtained by standard procedures of venupuncture and subjected to determination of ABO and Rhesus blood group using antisera by combined slide and test tube method. Each sample of donors was tested for ABO and Rhesus status. Results: The blood group B (34.84%) was the commonest group prevalent in donors followed by group O (29.75%), A (21.50%) and AB (13.91%). AB negative was not seen in female donors. Conclusion: The commonest ABO blood group was group B in Northern India with Rh negativity at only 4.55%.

Is There an Association between Keloids and Blood Groups?

Objective. The aim of the study is to investigate the possible associations between the blood groups ABO and Rhesus systems and the presence of keloids in patients with black skin. Method. This case-control study was conducted between September 2007 and August 2011 comparing dermatologic outpatients with keloids to matched controls recruited in preanesthetic consultation at Tokoin Teaching Hospital of Lomé (Togo). Results. The distribution of different ABO blood groups and Rhesus blood groups in both groups (cases versus controls) was not significantly different. This distribution of different blood groups was superimposed on the general population of blood donors at the National Blood Transfusion Center of Lomé. Univariate analysis between each blood group and the presence of keloid does not yield any statistically significant association between blood groups and presence of keloids in the subjects. Conclusion. The study shows no significant association between blood groups and the presence of keloids in our patients. Further investigation needs to be conducted to elucidate this hypothesis further by conducting multicenter studies of several ethnic groups.

Frequency of RBC Alloantibodies in Chinese Surgical Patients

Background: The aim of this study was to evaluate the frequency of red blood cell (RBC) alloantibodies in surgical patients. Methods: Blood samples of 18,980 Chinese surgical patients were collected and tested between January 2009 and September 2010. For patients with RBC alloantibodies, sequences of antibodies were identified with the DiaMed Asia antibody screening system. Data regarding sex, age, transfusion history, pregnancy history, and alloantibody specificity were collected. Results: 39 alloantibodies were identified from 18,980 samples, yielding a prevalence of 0.21%. The most frequently identified alloantibodies were Rhesus system antibodies (28/39, 71.8%), including anti-E (17/39; 1 anti-E accompanied by anti-Fy^b), anti-c (5/39), anti-cE (2/39), anti-C^w (1/39), anti-D (1/39), and anti-e (1/39). Other antibodies included anti-M (5/39), anti-Le^a (2/39), anti-Le^b (1/39), anti-K+S (1/39), anti-JK^a (1/39), and anti-JS^a (1/39). The frequency of alloantibodies was greater in females than in males (31 vs. 8). Conclusion: The results show a higher prevalence of RBC alloantibodies in females than in males. Anti-E was the most common alloantibody identified in this Chinese surgical population and was also more frequent in females compared to males.

Frequencies of ABO Gene and Rh Blood Groups in Hamadan, Iran

Background: Determining of gene frequencies of A, Band 0 genes from ABO blood group system and D and d genes from Rhesus system are objectives of the present study. Methods: The study was a cross sectional descriptive study. All the voluntary blood donors, 7361 people, attending to the Hamadan, Iran, Blood Bank during 1996 were studied. Primary information from the sex of blood donors and their results of ABO & Rh blood types were obtained from the official records of Hamadan Blood Bank. Then the frequencies of genes A, B, 0 of ABO system and D and d genes of Rhesus system were calculated. The final results were compared with each other according to their sex. Results: In ABO system, the most frequent blood types were 0, A, Band AB, respectively. Conclusion: The frequent alleles were 0, A, B, respectively. The frequency of AB type in women was about twice than the men. About 92% of subjects were Rh positive.

The Dagestan gene pool: Polymorphism of immunogenetic and biochemical markers in Kumyks

This study is a part of long-term investigations devoted to the analysis of the gene pool of Dagestan ethnic groups. The phenotype (in %), gene, and haplotype frequencies in Kumyk ethnic group are reported. A total of 39 alleles and six haplotypes of 14 loci (AB0, Rhesus, P, Levis, Kell, HP, GC, C'3, TF, 6PGD, GLO1, ESD, ACP, and PGM1) of immunobiochemical genetic marker systems were examined. Rare haplotypes of the Rhesus system were identified, including CDE in the Karabudakhkent population with the frequency of 0.030, and Cde and cdE in the Dorgeli population with the frequencies of 0.034 and 0.38, respectively. Similarly to the other ethnic populations of Dagestan examined, Kukyk populations carried rare, albeit typically "Caucasoid" gene ACP1(c) of the AcP1 locus. The frequency of this allele in the two populations was similar, constituting 0.031 for Karabudakhkent and 0.032 for Dorgeli. In Kumyks, allele frequencies of the AB0, Rhesus, P, Lewis, Kell, HP, GC, C'3, TF, 6PGD, GLO1, ESD, ACP, but not PGM1, systems were similar to the mean allele frequencies at these loci observed in the other ethnic groups from the Dagestan, Caucasus, and the whole European historical ethnographic province. At the same time, the allele frequency values obtained were different from those for the populations of Kazakhstan, Central Asia, Siberia, and the Ruswsian Far East. Thus, the results obtained for classical genetic markers indicate that Kumyks are genetically closer to the indigenous populations of Dagestan than to Turkic-speaking populations. Analysis of the fit of the observed phenotype frequencies to the Hardy-Weinberg expectations showed that compared to other indigenous populations of Dagestan examined, in Kumyks the genetic state of the population upon random allele association was close to equilibrium. Probably, this state was determined by practical absence of the consanguineous marriages upon preservation of intra-aul endogamy.

Gene pool of Daghestan ethnic groups: Polymorphism of classical gene markers in the Darghin ethnic group

The work is part of a study of the gene pool for Daghestan ethnic groups. In total, 38 alleles and eight genotypes were studied at 14 loci (AB0, Rhesus, P, Lewis, Kell, HP, GC, C'3, TF, 6-PGD, GLO1, ESD, ACP, and PGM1) of immunogenetic and biochemical polymorphic gene systems. A high frequency of allele d of the Rhesus system was observed in all populations examined (0.399-0.474). Among the rare haplotypes of the Rhesus system, we observed CDE in the Degva population, Cde in the Sergokala and Degva populations, and cdE in the Sergokala and Vanashimakhi populations. The typical Caucasian ACP1c allele of the ACP1 locus, which is rather uncommon, was observed at a relatively high frequency in three (Segokala, Vanashimakhi, and Gubden) of the four local populations under study. In the Lewis system, a high frequency of the Le(a+b+) phenotype, which is characteristic of early childhood, was detected in the adult populations of Sergokala and Degva. The rare PGM1v allele of the phosphoglucomutase 1 system (PGM 1) was additionally observed in the Sergokala population. Statistical analysis identified 19 cases where the observed phenotype frequencies significantly differed from the frequencies expected from the Hardy--Weinberg equilibrium.

Manual Chronic Partial Exchange In Children and Adolescents with Sickle Cell Disease: Impact on Clinical Outcome and Iron Overload

AbstractAbstract 4821 Background:Red cell exchange transfusion is frequently used in the management of patients with sickle cell disease either electively or therapeutically to maintain an hemoglobin S (Hb S) level < 30–50%. This target is often difficult to maintain. In order to assess the effects of chronic partial exchange transfusion (CPET) a) on level of Hb and Hb S, b) on iron overload c) the need for chelation, d) on risk of long term adverse events and e) clinical outcome, we analyzed the data of sickle cell disease patients treated by long term CPET in our center. Methods/subjects:In the cohort of 163 SCD patients followed at University Children's Hospital at Brussels (Belgium), 10 benefit from CPET. Main reasons for CPET were neurologic disease (4), frequent ACS (3), previous severe hepatic cholestasis (2), leg ulcer (1) and pulmonary hypertension (1). The median age at start of treatment was 13 years (range 4 –19). These patients (6 males and 4 females) account for 248 exchanges during a median follow-up of 20 months (range 6– 36). These exchanges are until now performed manually and the volume exchanged is calculated taking into account the Hb level and the last HbS percentage. It is usually between 30 and 40 ml/kg BW. Except if severe anemia occurs, the goal of these exchanges is to keep a constant hematocrit level. All patients had a full red cell phenotype performed and received blood matched for ABO, Rhesus, Kell and Duffy antigens systems. The estimation of iron balance (iron intake- iron removed) was calculated yearly. Results:The pre-exchange Hb value was 9.5 g/dl (median; range: 7.7–10.9 g/dl) and the mean post value was 9.4/dl (range: 8.4– 11.1 g/dl). These values are not statistically different (p> 0.05). The majority of patients (9/10) are reached an HbS < 50% when measured 3–5 weeks after PET (just before the next procedure) with a median HbS value of 40% (range: 30–54). At start of CPET program, the median ferritin level was 439 ng/ml (range: 80 – 1704). Five patients had already a ferritin > 500 ng/mL due to numerous previous transfusions. At last evaluation, the median ferritin did not change significantly and was 531 ng/ml (range 84– 3840). The two patients with ferritin higher than 1000 ng/ml start chelation with good result for one. One The mean annual net RBC load were 1.72 ml RBC/kg/yr provided approximately 1.85 mg of iron/kg/yr. Individual data are given in table 1. CPET-treated patients exchanged showed clinical improvement with disappearance of SCD crisis and related complications. The procedure was well tolerated by most patients, and adverse effects were limited to mild hypotension (3/10). No autoimmune hemolysis or allo-immunisation was documented in this cohort. All children remained negative for HIV and hepatitis C virus infections. Conclusion: Manual CPET seems to be safe to prevent middle-term iron overload and the need of elation therapy in most of patients. CPET can therefore be recommended for SCD patients who required decreased in Hb S levels either prophylactically or therapeutically. Manual are safe, effective and easy to use when mechanized exchanges are not possible for technical reasons. Disclosures:No relevant conflicts of interest to declare.

812 Automated Eco-Genetic System Prognosis of Bronchial Asthma in Georgian Population

Background: According to the actual direction of nowadays allergology more attention is paid to the prevention in early age period significantly decreases morbidity of allergic diseases and improve quality of life. Hereditary predisposition plays the most important role in the developing of disease, but it is not everything recognizable, it may be not demonstrated clinical symptoms in parents and other close relatives of affected individual. Aim: To elaborate the new automated assessment cost-effective system which would allow early diagnostic and prevention BA by using “formalized cards”. This system is based on the primary and secondary prognosis of BA. Methods: HLA- markers (Terrasaki microlymphocytotoxic tests) typing was performed with 2nd class (DR, DQ) and 1st class (A, B, C) antigens locus's; Erythrocyte markers: ABO, Rhesus and MNS systems, Clinical-genealogic method (Falconer D., 1965): study of genealogical tree of investigated families; Genetic - statistic analysis “ Informative Criteria” of different signs: ontogeny, phenotypic, environmental factors (by Kulback, Goubler E.B, 1990). Method of multi-dimensional phenotyping: agglomerative- hierarchical cluster analyse of chosen systems of signs. Analyse was performed in the interactive order. Results: Multi-dimensional phenotyping shoves phenotype classes: Classes of basic predisposition, including up to 80% of individuals with manifested asthma; Classes of relative predisposition, including less then 80% of individuals with manifested asthma; Phenotype classes including a few patients; Phenotype classes not predisposed to BA, basically including healthy persons. Conclusion: Elaborated computing table is enough simple and opportune for comprehensive use. It is proposed, for primary prognostic of BA. This method gives.

Fréquence de l’allo-immunisation érythrocytaire chez les malades polytransfusés au centre hospitalo-universitaire du Point G, Bamako, Mali

This prospective study conducted within 9 months period aimed to determine the frequency of red cell alloimmunization among polytransfused patients of the medical Hematology and oncology ward, and the unit of hemodialysis of the Nephrology ward at the Point-G hospital. Irregular red blood cell antibody screening and identification were performed by gel-filtration method using indirect antiglobulin test and enzymatic treated cells. We did not use saline medium. A total of 78 patients were included in this study. The mean age of the patients was 36.78 ± 14.73 years (range: 11 and 77 years). The sex ratio was of 1.11 in favour of the women. The mean blood units transfused were 12.21 ± 9.99 units (range: 4 and 45 units). The Rhesus phenotypes Dccee, DccEe and DCcee were most predominant, with the respective frequencies of 67.9, 15.4 and 10.3%. Kell antigen was found at a frequency of 1.28%. The total rate of red cell alloimmunization was 10.3%. There was no significant difference between the two wards. All the screened agglutinins were warm antibodies belonging to the Rhesus system: anti-E (7.7%), anti-C (1.3%) and anti-D (1.3%). Only Anti-E was present among hematologic patients. We did not find a significant link between the sex, the age, the number of blood units transfused and the positivity of the antibody screening. We conclude that the frequency of post-transfusional alloimmunization is high among polytransfused patients in Mali. A systematic antibody screening among these patients and the selection of red cells with known Rhesus/Kell phenotypes would allow an optimal blood transfusion safety.

Spectral dependence of resolving power of optical method of detection of ultrasonically enhanced agglutination of human blood erythrocytes

The spectral dependence of the resolving power of an acoustooptic method of monitoring agglutination of human blood erythrocytes is studied theoretically and experimentally. It is shown that, in principle, the resolving power of this method can be increased by several dozen times. The results of the work can be used to create instruments for determining the human blood type in the AB0 system and in the Rhesus system.

The importance of rhesus status

The history of haemolytic disease of the newborn, caused by incompatibility between the fetus and mother for the rhesus D (RhD) antigen, has been called one of the most brilliant successes achieved in medicine.1 Preventive treatment is so effective that it has decreased the number of intrauterine fetal deaths by more than 100 fold and the incidence of maternal alloimmunisation by more than 50 fold.2 The first dated case report of haemolytic disease of the newborn was in a set of twins born in the 1600s.3 However, it was not until 1940 that the link with the RhD antigen was made by Landsteiner and Weiner. They discovered an antibody that led to the agglutination of human erythrocytes after experiments in which rabbits were immunised with rhesus monkey erythrocytes.4 In 1969, a campaign of anti-D immunoglobulin prophylaxis was introduced. Deaths attributed to RhD alloimmunisation were reduced from 46 in 100 000 births to 1.6 in 100 000 births during the first 20 years of the campaign. However, haemolytic disease of the newborn and neonatal death continued to occur, and still do—owing in part to covert sensitising events during pregnancy, and in part to a lack of knowledge and compliance with guidelines.5 Erythrocytes carry many antigens on their surface. The most important are those belonging to the ABO system and to the rhesus system. The rhesus system comprises antigens c, C, D, e, and E. Of these, the D antigen is the most important. It is inherited on one gene, located on chromosome 1. It has two alleles: the dominant RhD positive, where the individual expresses the D antigen, and the recessive RhD negative, where there is no expression.6 The incidence of the rhesus D antigen varies between different ethnic groups.6 It is estimated that the prevalence …

The dagestan gene pool: Analysis of the frequencies of classical genetic markers in Avars

This study is part of long-term research in the gene pool of Dagestan ethnic groups. The phenotype (in percent), gene, and haplotype frequencies in three Avar populations are reported. A total of 37 alleles of 13 loci of immune and biochemical genetic marker systems (ABO, Rhesus, P, Lewis, HP, GC, C'3, TF, 6PGD, GLO1, ESD, ACP, and PGM1) have been studied. Rare haplotypes of the Rhesus system (CDE, Cde, and cdE) have been found in the populations studied. In two out of three local populations (Khunzakh and Kharakhi), a typically "Caucasoid" rare gene ACP1c of the AcP1 locus has proved to be relatively frequent (0.030 and 0.023, respectively). The frequencies of the allele variants P2, le, and Hp1 of loci of the P, Lewis, and HP systems, respectively, have been found to be lower than in other Caucasian ethnic groups and the total northern Eurasian population. The mean allele frequencies for the GC, C'3, TF, 6PGD, GLO1, and ESD systems in the populations studied are comparable wit those for both Caucasian ethnic groups and the total population of the European historical ethnographic province. Statistical analysis of the results has shown 11 cases of significant deviations of the observed phenotype frequencies from the Hardy-Weinberg equilibrium.

Rare gems: null phenotypes of blood groups.

Rare gems: null phenotypes of blood groups.

The Study of Rhesus System among the Rajputs and Varlis of Dadra and Nagar Haveli

The Study of Rhesus System among the Rajputs and Varlis of Dadra and Nagar Haveli

Identification of a direct hemolytic effect dependent on the catalytic activity induced by phospholipase‐D (dermonecrotic toxin) from brown spider venom

Brown spiders have world-wide distribution and are the cause of health problems known as loxoscelism. Necrotic cutaneous lesions surrounding the bites and less intense systemic signs like renal failure, DIC, and hemolysis were observed. We studied molecular mechanism by which recombinant toxin, biochemically characterized as phospholipase-D, causes direct hemolysis (complement independent). Human erythrocytes treated with toxin showed direct hemolysis in a dose-dependent and time-dependent manner, as well as morphological changes in cell size and shape. Erythrocytes from human, rabbit, and sheep were more susceptible than those from horse. Hemolysis was not dependent on ABO group or Rhesus system. Confocal and FACS analyses using antibodies or GFP-phospholipase-D protein showed direct toxin binding to erythrocytes membrane. Moreover, toxin-treated erythrocytes reacted with annexin-V and showed alterations in their lipid raft profile. Divalent ion chelators significantly inhibited hemolysis evoked by phospholipase-D, which has magnesium at the catalytic domain. Chelators were more effective than PMSF (serine-protease inhibitor) that had no effect on hemolysis. By site-directed mutation at catalytic domain (histidine 12 by alanine), hemolysis and morphologic changes of erythrocytes (but not the toxin's ability of membrane binding) were inhibited, supporting that catalytic activity is involved in hemolysis and cellular alterations but not toxin cell binding. The results provide evidence that L. intermedia venom phospholipase-D triggers direct human blood cell hemolysis in a catalytic-dependent manner.